Search results for: scientific evidence
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5666

Search results for: scientific evidence

986 Online Delivery Approaches of Post Secondary Virtual Inclusive Media Education

Authors: Margot Whitfield, Andrea Ducent, Marie Catherine Rombaut, Katia Iassinovskaia, Deborah Fels

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Learning how to create inclusive media, such as closed captioning (CC) and audio description (AD), in North America is restricted to the private sector, proprietary company-based training. We are delivering (through synchronous and asynchronous online learning) the first Canadian post-secondary, practice-based continuing education course package in inclusive media for broadcast production and processes. Despite the prevalence of CC and AD taught within the field of translation studies in Europe, North America has no comparable field of study. This novel approach to audio visual translation (AVT) education develops evidence-based methodology innovations, stemming from user study research with blind/low vision and Deaf/hard of hearing audiences for television and theatre, undertaken at Ryerson University. Knowledge outcomes from the courses include a) Understanding how CC/AD fit within disability/regulatory frameworks in Canada. b) Knowledge of how CC/AD could be employed in the initial stages of production development within broadcasting. c) Writing and/or speaking techniques designed for media. d) Hands-on practice in captioning re-speaking techniques and open source technologies, or in AD techniques. e) Understanding of audio production technologies and editing techniques. The case study of the curriculum development and deployment, involving first-time online course delivery from academic and practitioner-based instructors in introductory Captioning and Audio Description courses (CDIM 101 and 102), will compare two different instructors' approaches to learning design, including the ratio of synchronous and asynchronous classroom time and technological engagement tools on meeting software platform such as breakout rooms and polling. Student reception of these two different approaches will be analysed using qualitative thematic and quantitative survey analysis. Thus far, anecdotal conversations with students suggests that they prefer synchronous compared with asynchronous learning within our hands-on online course delivery method.

Keywords: inclusive media theory, broadcasting practices, AVT post secondary education, respeaking, audio description, learning design, virtual education

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985 Risk of Fatal and Non-Fatal Coronary Heart Disease and Stroke Events among Adult Patients with Hypertension: Basic Markov Model Inputs for Evaluating Cost-Effectiveness of Hypertension Treatment: Systematic Review of Cohort Studies

Authors: Mende Mensa Sorato, Majid Davari, Abbas Kebriaeezadeh, Nizal Sarrafzadegan, Tamiru Shibru, Behzad Fatemi

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Markov model, like cardiovascular disease (CVD) policy model based simulation, is being used for evaluating the cost-effectiveness of hypertension treatment. Stroke, angina, myocardial infarction (MI), cardiac arrest, and all-cause mortality were included in this model. Hypertension is a risk factor for a number of vascular and cardiac complications and CVD outcomes. Objective: This systematic review was conducted to evaluate the comprehensiveness of this model across different regions globally. Methods: We searched articles written in the English language from PubMed/Medline, Ovid/Medline, Embase, Scopus, Web of Science, and Google scholar with a systematic search query. Results: Thirteen cohort studies involving a total of 2,165,770 (1,666,554 hypertensive adult population and 499,226 adults with treatment-resistant hypertension) were included in this scoping review. Hypertension is clearly associated with coronary heart disease (CHD) and stroke mortality, unstable angina, stable angina, MI, heart failure (HF), sudden cardiac death, transient ischemic attack, ischemic stroke, subarachnoid hemorrhage, intracranial hemorrhage, peripheral arterial disease (PAD), and abdominal aortic aneurism (AAA). Association between HF and hypertension is variable across regions. Treatment resistant hypertension is associated with a higher relative risk of developing major cardiovascular events and all-cause mortality when compared with non-resistant hypertension. However, it is not included in the previous CVD policy model. Conclusion: The CVD policy model used can be used in most regions for the evaluation of the cost-effectiveness of hypertension treatment. However, hypertension is highly associated with HF in Latin America, the Caribbean, Eastern Europe, and Sub-Saharan Africa. Therefore, it is important to consider HF in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment in these regions. We do not suggest the inclusion of PAD and AAA in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment due to a lack of sufficient evidence. Researchers should consider the effect of treatment-resistant hypertension either by including it in the basic model or during setting the model assumptions.

Keywords: cardiovascular disease policy model, cost-effectiveness analysis, hypertension, systematic review, twelve major cardiovascular events

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984 Validation of a Placebo Method with Potential for Blinding in Ultrasound-Guided Dry Needling

Authors: Johnson C. Y. Pang, Bo Peng, Kara K. L. Reeves, Allan C. L. Fud

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Objective: Dry needling (DN) has long been used as a treatment method for various musculoskeletal pain conditions. However, the evidence level of the studies was low due to the limitations of the methodology. Lack of randomization and inappropriate blinding is potentially the main sources of bias. A method that can differentiate clinical results due to the targeted experimental procedure from its placebo effect is needed to enhance the validity of the trial. Therefore, this study aimed to validate the method as a placebo ultrasound(US)-guided DN for patients with knee osteoarthritis (KOA). Design: This is a randomized controlled trial (RCT). Ninety subjects (25 males and 65 females) aged between 51 and 80 (61.26 ± 5.57) with radiological KOA were recruited and randomly assigned into three groups with a computer program. Group 1 (G1) received real US-guided DN, Group 2 (G2) received placebo US-guided DN, and Group 3 (G3) was the control group. Both G1 and G2 subjects received the same procedure of US-guided DN, except the US monitor was turned off in G2, blinding the G2 subjects to the incorporation of faux US guidance. This arrangement created the placebo effect intended to permit comparison of their results to those who received actual US-guided DN. Outcome measures, including the visual analog scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) subscales of pain, symptoms, and quality of life (QOL), were analyzed by repeated measures analysis of covariance (ANCOVA) for time effects and group effects. The data regarding the perception of receiving real US-guided DN or placebo US-guided DN were analyzed by the chi-squared test. The missing data were analyzed with the intention-to-treat (ITT) approach if more than 5% of the data were missing. Results: The placebo US-guided DN (G2) subjects had the same perceptions as the use of real US guidance in the advancement of DN (p<0.128). G1 had significantly higher pain reduction (VAS and KOOS-pain) than G2 and G3 at 8 weeks (both p<0.05) only. There was no significant difference between G2 and G3 at 8 weeks (both p>0.05). Conclusion: The method with the US monitor turned off during the application of DN is credible for blinding the participants and allowing researchers to incorporate faux US guidance. The validated placebo US-guided DN technique can aid in investigations of the effects of US-guided DN with short-term effects of pain reduction for patients with KOA. Acknowledgment: This work was supported by the Caritas Institute of Higher Education [grant number IDG200101].

Keywords: ultrasound-guided dry needling, dry needling, knee osteoarthritis, physiotheraphy

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983 A Holistic Analysis of the Emergency Call: From in Situ Negotiation to Policy Frameworks and Back

Authors: Jo Angouri, Charlotte Kennedy, Shawnea Ting, David Rawlinson, Matthew Booker, Nigel Rees

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Ambulance services need to balance the large volume of emergency (999 in the UK) calls they receive (e.g., West Midlands Ambulance Service reports per day about 4,000 999 calls; about 679,000 calls per year are received in Wales), with dispatching limited resource for on-site intervention to the most critical cases. The process by which Emergency Medical Dispatch (EMD) decisions are made is related to risk assessment and involves the caller and call-taker as well as clinical teams negotiating risk levels on a case-by-case basis. Medical Priority Dispatch System (MPDS – also referred to as Advanced Medical Priority Dispatch System AMPDS) are used in the UK by NHS Trusts (e.,g WAST) to process and prioritise 999 calls. MPDS / AMPDS provide structured protocols for call prioritisation and call management. Protocols/policy frameworks have not been examined before in the way we propose in our project. In more detail, the risk factors that play a role in the EMD negotiation between the caller and call-taker have been analysed in both medical and social science research. Research has focused on the structural, morphological and phonological aspects that could improve, and train, human-to-human interaction or automate risk detection, as well as the medical factors that need to be captured from the caller to inform the dispatch decision. There are two significant gaps in our knowledge that we address in our work: 1. the role of backstage clinical teams in translating the caller/call-taker interaction in their internal risk negotiation and, 2. the role of policy frameworks, protocols and regulations in the framing of institutional priorities and resource allocation. We take a multi method approach and combine the analysis of 999 calls with the analysis of policy documents. We draw on interaction analysis, corpus methodologies and thematic analysis. In this paper, we report on our preliminary findings and focus in particular on the risk factors we have identified and the relationship with the regulations that create the frame within which teams operate. We close the paper with implications of our study for providing evidence-based policy intervention and recommendations for further research.

Keywords: emergency (999) call, interaction analysis, discourse analysis, ambulance dispatch, medical discourse

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982 Modeling the International Economic Relations Development: The Prospects for Regional and Global Economic Integration

Authors: M. G. Shilina

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The interstate economic interaction phenomenon is complex. ‘Economic integration’, as one of its types, can be explored through the prism of international law, the theories of the world economy, politics and international relations. The most objective study of the phenomenon requires a comprehensive multifactoral approach. In new geopolitical realities, the problems of coexistence and possible interconnection of various mechanisms of interstate economic interaction are actively discussed. Currently, the Eurasian continent states support the direction to economic integration. At the same time, the existing international economic law fragmentation in Eurasia is seen as the important problem. The Eurasian space is characterized by a various types of interstate relations: international agreements (multilateral and bilateral), and a large number of cooperation formats (from discussion platforms to organizations aimed at deep integration). For their harmonization, it is necessary to have a clear vision to the phased international economic relations regulation options. In the conditions of rapid development of international economic relations, the modeling (including prognostic) can be optimally used as the main scientific method for presenting the phenomenon. On the basis of this method, it is possible to form the current situation vision and the best options for further action. In order to determine the most objective version of the integration development, the combination of several approaches were used. The normative legal approach- the descriptive method of legal modeling- was taken as the basis for the analysis. A set of legal methods was supplemented by the international relations science prognostic methods. The key elements of the model are the international economic organizations and states' associations existing in the Eurasian space (the Eurasian Economic Union (EAEU), the European Union (EU), the Shanghai Cooperation Organization (SCO), Chinese project ‘One belt-one road’ (OBOR), the Commonwealth of Independent States (CIS), BRICS, etc.). A general term for the elements of the model is proposed - the interstate interaction mechanisms (IIM). The aim of building a model of current and future Eurasian economic integration is to show optimal options for joint economic development of the states and IIMs. The long-term goal of this development is the new economic and political space, so-called the ‘Great Eurasian Community’. The process of achievement this long-term goal consists of successive steps. Modeling the integration architecture and dividing the interaction into stages led us to the following conclusion: the SCO is able to transform Eurasia into a single economic space. Gradual implementation of the complex phased model, in which the SCO+ plays a key role, will allow building an effective economic integration for all its participants, to create an economically strong community. The model can have practical value for politicians, lawyers, economists and other participants involved in the economic integration process. A clear, systematic structure can serve as a basis for further governmental action.

Keywords: economic integration, The Eurasian Economic Union, The European Union, The Shanghai Cooperation Organization, The Silk Road Economic Belt

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981 New Knowledge Co-Creation in Mobile Learning: A Classroom Action Research with Multiple Case Studies Using Mobile Instant Messaging

Authors: Genevieve Lim, Arthur Shelley, Dongcheol Heo

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Abstract—Mobile technologies can enhance the learning process as it enables social engagement around concepts beyond the classroom and the curriculum. Early results in this ongoing research is showing that when learning interventions are designed specifically to generate new insights, mobile devices support regulated learning and encourage learners to collaborate, socialize and co-create new knowledge. As students navigate across the space and time boundaries, the fundamental social nature of learning transforms into mobile computer supported collaborative learning (mCSCL). The metacognitive interaction in mCSCL via mobile applications reflects the regulation of learning among the students. These metacognitive experiences whether self-, co- or shared-regulated are significant to the learning outcomes. Despite some insightful empirical studies, there has not yet been significant research that investigates the actual practice and processes of the new knowledge co-creation. This leads to question as to whether mobile learning provides a new channel to leverage learning? Alternatively, does mobile interaction create new types of learning experiences and how do these experiences co-create new knowledge. The purpose of this research is to explore these questions and seek evidence to support one or the other. This paper addresses these questions from the students’ perspective to understand how students interact when constructing knowledge in mCSCL and how students’ self-regulated learning (SRL) strategies support the co-creation of new knowledge in mCSCL. A pilot study has been conducted among international undergraduates to understand students’ perspective of mobile learning and concurrently develops a definition in an appropriate context. Using classroom action research (CAR) with multiple case studies, this study is being carried out in a private university in Thailand to narrow the research gaps in mCSCL and SRL. The findings will allow teachers to see the importance of social interaction for meaningful student engagement and envisage learning outcomes from a knowledge management perspective and what role mobile devices can play in these. The findings will signify important indicators for academics to rethink what is to be learned and how it should be learned. Ultimately, the study will bring new light into the co-creation of new knowledge in a social interactive learning environment and challenges teachers to embrace the 21st century of learning with mobile technologies to deepen and extend learning opportunities.

Keywords: mobile computer supported collaborative learning, mobile instant messaging, mobile learning, new knowledge co-creation, self-regulated learning

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980 Factors Affecting Cesarean Section among Women in Qatar Using Multiple Indicator Cluster Survey Database

Authors: Sahar Elsaleh, Ghada Farhat, Shaikha Al-Derham, Fasih Alam

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Background: Cesarean section (CS) delivery is one of the major concerns both in developing and developed countries. The rate of CS deliveries are on the rise globally, and especially in Qatar. Many socio-economic, demographic, clinical and institutional factors play an important role for cesarean sections. This study aims to investigate factors affecting the prevalence of CS among women in Qatar using the UNICEF’s Multiple Indicator Cluster Survey (MICS) 2012 database. Methods: The study has focused on the women’s questionnaire of the MICS, which was successfully distributed to 5699 participants. Following study inclusion and exclusion criteria, a final sample of 761 women aged 19- 49 years who had at least one delivery of giving birth in their lifetime before the survey were included. A number of socio-economic, demographic, clinical and institutional factors, identified through literature review and available in the data, were considered for the analyses. Bivariate and multivariate logistic regression models, along with a multi-level modeling to investigate clustering effect, were undertaken to identify the factors that affect CS prevalence in Qatar. Results: From the bivariate analyses the study has shown that, a number of categorical factors are statistically significantly associated with the dependent variable (CS). When identifying the factors from a multivariate logistic regression, the study found that only three categorical factors -‘age of women’, ‘place at delivery’ and ‘baby weight’ appeared to be significantly affecting the CS among women in Qatar. Although the MICS dataset is based on a cluster survey, an exploratory multi-level analysis did not show any clustering effect, i.e. no significant variation in results at higher level (households), suggesting that all analyses at lower level (individual respondent) are valid without any significant bias in results. Conclusion: The study found a statistically significant association between the dependent variable (CS delivery) and age of women, frequency of TV watching, assistance at birth and place of birth. These results need to be interpreted cautiously; however, it can be used as evidence-base for further research on cesarean section delivery in Qatar.

Keywords: cesarean section, factors, multiple indicator cluster survey, MICS database, Qatar

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979 Business Intelligent to a Decision Support Tool for Green Entrepreneurship: Meso and Macro Regions

Authors: Anishur Rahman, Maria Areias, Diogo Simões, Ana Figeuiredo, Filipa Figueiredo, João Nunes

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The circular economy (CE) has gained increased awareness among academics, businesses, and decision-makers as it stimulates resource circularity in the production and consumption systems. A large epistemological study has explored the principles of CE, but scant attention eagerly focused on analysing how CE is evaluated, consented to, and enforced using economic metabolism data and business intelligent framework. Economic metabolism involves the ongoing exchange of materials and energy within and across socio-economic systems and requires the assessment of vast amounts of data to provide quantitative analysis related to effective resource management. Limited concern, the present work has focused on the regional flows pilot region from Portugal. By addressing this gap, this study aims to promote eco-innovation and sustainability in the regions of Intermunicipal Communities Região de Coimbra, Viseu Dão Lafões and Beiras e Serra da Estrela, using this data to find precise synergies in terms of material flows and give companies a competitive advantage in form of valuable waste destinations, access to new resources and new markets, cost reduction and risk sharing benefits. In our work, emphasis on applying artificial intelligence (AI) and, more specifically, on implementing state-of-the-art deep learning algorithms is placed, contributing to construction a business intelligent approach. With the emergence of new approaches generally highlighted under the sub-heading of AI and machine learning (ML), the methods for statistical analysis of complex and uncertain production systems are facing significant changes. Therefore, various definitions of AI and its differences from traditional statistics are presented, and furthermore, ML is introduced to identify its place in data science and the differences in topics such as big data analytics and in production problems that using AI and ML are identified. A lifecycle-based approach is then taken to analyse the use of different methods in each phase to identify the most useful technologies and unifying attributes of AI in manufacturing. Most of macroeconomic metabolisms models are mainly direct to contexts of large metropolis, neglecting rural territories, so within this project, a dynamic decision support model coupled with artificial intelligence tools and information platforms will be developed, focused on the reality of these transition zones between the rural and urban. Thus, a real decision support tool is under development, which will surpass the scientific developments carried out to date and will allow to overcome imitations related to the availability and reliability of data.

Keywords: circular economy, artificial intelligence, economic metabolisms, machine learning

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978 Dragonflies (Odonata) Reflect Climate Warming Driven Changes in High Mountain Invertebrates Populations

Authors: Nikola Góral, Piotr Mikołajczuk, Paweł Buczyński

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Much scientific research in the last 20 years has focused on the influence of global warming on the distribution and phenology of living organisms. Three potential responses to climate change are predicted: individual species may become extinct, adapt to new conditions in their existing range or change their range by migrating to places where climatic conditions are more favourable. It means not only migration to areas in other latitudes, but also different altitudes. In the case of dragonflies (Odonata), monitoring in Western Europe has shown that in response to global warming, dragonflies tend to change their range to a more northern one. The strongest response to global warming is observed in arctic and alpine species, as well as in species capable of migrating over long distances. The aim of the research was to assess whether the fauna of aquatic insects in high-mountain habitats has changed as a result of climate change and, if so, how big and what type these changes are. Dragonflies were chosen as a model organism because of their fast reaction to changes in the environment: they have high migration abilities and short life cycle. The state of the populations of boreal-mountain species and the extent to which lowland species entered high altitudes was assessed. The research was carried out on 20 sites in Western Sudetes, Southern Poland. They were located at an altitude of between 850 and 1250 m. The selected sites were representative of many types of valuable alpine habitats (subalpine raised bog, transitional spring bog, habitats associated with rivers and mountain streams). Several sites of anthropogenic origin were also selected. Thanks to this selection, a wide characterization of the fauna of the Karkonosze was made and it was compared whether the studied processes proceeded differently, depending on whether the habitat is primary or secondary. Both imagines and larvae were examined (by taking hydrobiological samples with a kick-net), and exuviae were also collected. Individual species dragonflies were characterized in terms of their reproductive, territorial and foraging behaviour. During each inspection, the basic physicochemical parameters of the water were measured. The population of the high-mountain dragonfly Somatochlora alpestris turned out to be in a good condition. This species was noted at several sites. Some of those sites were situated relatively low (995 m AMSL), which proves that the thermal conditions at the lower altitudes might be still optimal for this species. The protected by polish law species Somatochlora arctica, Aeshna subarctica and Leucorrhinia albifrons, as well as strongly associated with bogs Leucorrhinia dubia and Aeshna juncea bogs were observed. However, they were more frequent and more numerous in habitats of anthropogenic origin, which may suggest minor changes in the habitat preferences of dragonflies. The subject requires further research and observations over a longer time scale.

Keywords: alpine species, bioindication, global warming, habitat preferences, population dynamics

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977 Forced-Choice Measurement Models of Behavioural, Social, and Emotional Skills: Theory, Research, and Development

Authors: Richard Roberts, Anna Kravtcova

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Introduction: The realisation that personality can change over the course of a lifetime has led to a new companion model to the Big Five, the behavioural, emotional, and social skills approach (BESSA). BESSA hypothesizes that this set of skills represents how the individual is thinking, feeling, and behaving when the situation calls for it, as opposed to traits, which represent how someone tends to think, feel, and behave averaged across situations. The five major skill domains share parallels with the Big Five Factor (BFF) model creativity and innovation (openness), self-management (conscientiousness), social engagement (extraversion), cooperation (agreeableness), and emotional resilience (emotional stability) skills. We point to noteworthy limitations in the current operationalisation of BESSA skills (i.e., via Likert-type items) and offer up a different measurement approach: forced choice. Method: In this forced-choice paradigm, individuals were given three skill items (e.g., managing my time) and asked to select one response they believed they were “worst at” and “best at”. The Thurstonian IRT models allow these to be placed on a normative scale. Two multivariate studies (N = 1178) were conducted with a 22-item forced-choice version of the BESSA, a published measure of the BFF, and various criteria. Findings: Confirmatory factor analysis of the forced-choice assessment showed acceptable model fit (RMSEA<0.06), while reliability estimates were reasonable (around 0.70 for each construct). Convergent validity evidence was as predicted (correlations between 0.40 and 0.60 for corresponding BFF and BESSA constructs). Notable was the extent the forced-choice BESSA assessment improved upon test-criterion relationships over and above the BFF. For example, typical regression models find BFF personality accounting for 25% of the variance in life satisfaction scores; both studies showed incremental gains over the BFF exceeding 6% (i.e., BFF and BESSA together accounted for over 31% of the variance in both studies). Discussion: Forced-choice measurement models offer up the promise of creating equated test forms that may unequivocally measure skill gains and are less prone to fakability and reference bias effects. Implications for practitioners are discussed, especially those interested in selection, succession planning, and training and development. We also discuss how the forced choice method can be applied to other constructs like emotional immunity, cross-cultural competence, and self-estimates of cognitive ability.

Keywords: Big Five, forced-choice method, BFF, methods of measurements

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976 Innovations in the Implementation of Preventive Strategies and Measuring Their Effectiveness Towards the Prevention of Harmful Incidents to People with Mental Disabilities who Receive Home and Community Based Services

Authors: Carlos V. Gonzalez

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Background: Providers of in-home and community based services strive for the elimination of preventable harm to the people under their care as well as to the employees who support them. Traditional models of safety and protection from harm have assumed that the absence of incidents of harm is a good indicator of safe practices. However, this model creates an illusion of safety that is easily shaken by sudden and inadvertent harmful events. As an alternative, we have developed and implemented an evidence-based resilient model of safety known as C.O.P.E. (Caring, Observing, Predicting and Evaluating). Within this model, safety is not defined by the absence of harmful incidents, but by the presence of continuous monitoring, anticipation, learning, and rapid response to events that may lead to harm. Objective: The objective was to evaluate the effectiveness of the C.O.P.E. model for the reduction of harm to individuals with mental disabilities who receive home and community based services. Methods: Over the course of 2 years we counted the number of incidents of harm and near misses. We trained employees on strategies to eliminate incidents before they fully escalated. We trained employees to track different levels of patient status within a scale from 0 to 10. Additionally, we provided direct support professionals and supervisors with customized smart phone applications to track and notify the team of changes in that status every 30 minutes. Finally, the information that we collected was saved in a private computer network that analyzes and graphs the outcome of each incident. Result and conclusions: The use of the COPE model resulted in: A reduction in incidents of harm. A reduction the use of restraints and other physical interventions. An increase in Direct Support Professional’s ability to detect and respond to health problems. Improvement in employee alertness by decreasing sleeping on duty. Improvement in caring and positive interaction between Direct Support Professionals and the person who is supported. Developing a method to globally measure and assess the effectiveness of prevention from harm plans. Future applications of the COPE model for the reduction of harm to people who receive home and community based services are discussed.

Keywords: harm, patients, resilience, safety, mental illness, disability

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975 Prominence of Biopsychosocial Formulation in Health Care Delivery for Aging Population: Empowering Caregiving through Natural Socio-Environmental Approaches

Authors: Kristine Demilou D. Santiago

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An access to a high-quality health care system is what sets apart industrialized nations, such as the United States from other developing countries, which in this case is specifically pertaining to their older population. But what was the underrated factor in the sphere of quality healthcare rendered to elderly people in the Western context? Will this salient factor could push conviction to prorogue the existing gaps between self-denial patient-client and cheek by jowl medications? Are the natural socio-environmental approaches of caregiving the protracted remedy to healthcare disparities for aging population considering their day to day living? The conceptual framework of this model is primarily associated with addressing health and illness of human beings considering the biological, psychological and socio-environmental factors around them. The relevance of biopsychosocial formulation advancing each of the characteristics in the Biopsychosocial (BPS) model in a balance contemplation is the tumult of this study in an attempt to respond to prevailing disparities in caregiving services for old-aged patients on a day to day living. Caregiving services have been the medium path connecting between the patient and its prescribed medications. Moreover, caregivers serve as positive reinforcers in a patient’s environment. Therefore, caregivers play an important role in healthcare delivery to patients. They are considered significant people whom their acts will give an impact to a patient’s view in life. This research study intends to present the supreme importance of biopsychosocial assessment to old-aged patients with mental health illness and conditions. Biopsychosocial assessment will secure the quality of full medication to an old-aged adult suffering from a mental illness. This is because it offers a recognizably wholesome approach to medical healing of old-aged adult patients. The principle of biopsychosocial supersedes the biomedicine being offered to old-aged adults having mental illness, but it does not take away the high relevance of scientific biomedicine in healing patients. The framework presented an overlapping participation of each of its factors in its BPS model that affects in general a person’s health. The correlation between the biological (physiological), psychological (mental) and social (environment) in a person’s health condition requires equal attention according to BPS, and it always coexist with each other. Indisputably said, bio-medicine has been and is being in its unceasing endeavor to provide scientifically proven health care medications for every individual seeking medical treatments. As we grow older and eventually reach the other side of the median population, not only our physiological aspects change, our psychological and socio-environmental changes happen too. Caregiving is a salient responsibility taking place on these inevitable changes.

Keywords: biopsychosocial formulation, caregiving through natural approaches, US health care, BPS in caregiving, caregiving for aging population

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974 Measuring Self-Regulation and Self-Direction in Flipped Classroom Learning

Authors: S. A. N. Danushka, T. A. Weerasinghe

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The diverse necessities of instruction could be addressed effectively with the support of new dimensions of ICT integrated learning such as blended learning –which is a combination of face-to-face and online instruction which ensures greater flexibility in student learning and congruity of course delivery. As blended learning has been the ‘new normality' in education, many experimental and quasi-experimental research studies provide ample of evidence on its successful implementation in many fields of studies, but it is hard to justify whether blended learning could work similarly in the delivery of technology-teacher development programmes (TTDPs). The present study is bound with the particular research uncertainty, and having considered existing research approaches, the study methodology was set to decide the efficient instructional strategies for flipped classroom learning in TTDPs. In a quasi-experimental pre-test and post-test design with a mix-method research approach, the major study objective was tested with two heterogeneous samples (N=135) identified in a virtual learning environment in a Sri Lankan university. Non-randomized informal ‘before-and-after without control group’ design was employed, and two data collection methods, identical pre-test and post-test and Likert-scale questionnaires were used in the study. Selected two instructional strategies, self-directed learning (SDL) and self-regulated learning (SRL), were tested in an appropriate instructional framework with two heterogeneous samples (pre-service and in-service teachers). Data were statistically analyzed, and an efficient instructional strategy was decided via t-test, ANOVA, ANCOVA. The effectiveness of the two instructional strategy implementation models was decided via multiple linear regression analysis. ANOVA (p < 0.05) shows that age, prior-educational qualifications, gender, and work-experiences do not impact on learning achievements of the two diverse groups of learners through the instructional strategy is changed. ANCOVA (p < 0.05) analysis shows that SDL is efficient for two diverse groups of technology-teachers than SRL. Multiple linear regression (p < 0.05) analysis shows that the staged self-directed learning (SSDL) model and four-phased model of motivated self-regulated learning (COPES Model) are efficient in the delivery of course content in flipped classroom learning.

Keywords: COPES model, flipped classroom learning, self-directed learning, self-regulated learning, SSDL model

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973 Influence of the Popularity of Opera during Risorgimento on Foreign Presence in Italy

Authors: Andrew Wee

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As a result of the Italian Independence Wars starting in 1848, Italy began to change through unification. People gradually moved away from some of their traditional practices and values, such as the long-held belief that women were inferior to men, as part of the Risorgimento. Italians began to take interest in opera as a form of emotional release. As opera became more popular and prominent in their culture, it aided in the dissemination of ideas, especially stimulating the spread of imperialism, in the late 19th century, as Italy began extending its presence to other countries. In order to collect the information needed to analyze Italy’s foreign presence, it was necessary to consult texts concerning the culture of the Risorgimento. These texts included primary sources from operatic composers and contemporary recorded accounts. Letters from Giuseppe Verdi, a leader in opera during the Risorgimento, have been scrutinized for indications of popular attitudes of the time. The cultural context of the Risorgimento is essential to understanding the Italian motives and attitudes towards the outside world. On the more political side, research has also entailed the study of historical data of general laws, policies, and their purposes concerning geopolitical boundaries and foreign affairs, such as Edward Said’s thesis on Orientalism. By establishing these two characteristics of Italy, the paper will thoroughly illustrate Italy’s presence in foreign affairs. Texts have been searched with the intent of using information that reveals Italian attitudes toward exotic countries to determine whether their demeanor was positive or condescending. Motives behind sources have been interpreted in context in order to form a complete picture of the Italian sentiment towards foreigners. Additionally, research pertaining to Italian nationalism and imperialism such as song and literature has been used. The primary form of research has been the division of sources that are culturally based and those that are political in nature. Opera had always been developing since its creation in the 17th century, and in the 19th century, the bel canto movement revolutionized opera and its role in Italian society. This paper uses evidence that popular sentiment was influenced by opera to support the belief that the evolution of opera was as a result of the nationalist sentiment, and in turn fueled the cultural movement known as the Risorgimento. In this way, opera proceeded to affect Italian culture by spreading the idea of imperialism.

Keywords: opera, Italian unification, music history, imperialism

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972 Characterization of WNK2 Role on Glioma Cells Vesicular Traffic

Authors: Viviane A. O. Silva, Angela M. Costa, Glaucia N. M. Hajj, Ana Preto, Aline Tansini, Martin Roffé, Peter Jordan, Rui M. Reis

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Autophagy is a recycling and degradative system suggested to be a major cell death pathway in cancer cells. Autophagy pathway is interconnected with the endocytosis pathways sharing the same ultimate lysosomal destination. Lysosomes are crucial regulators of cell homeostasis, responsible to downregulate receptor signalling and turnover. It seems highly likely that derailed endocytosis can make major contributions to several hallmarks of cancer. WNK2, a member of the WNK (with-no-lysine [K]) subfamily of protein kinases, had been found downregulated by its promoter hypermethylation, and has been proposed to act as a specific tumour-suppressor gene in brain tumors. Although some contradictory studies indicated WNK2 as an autophagy modulator, its role in cancer cell death is largely unknown. There is also growing evidence for additional roles of WNK kinases in vesicular traffic. Aim: To evaluate the role of WNK2 in autophagy and endocytosis on glioma context. Methods: Wild-type (wt) A172 cells (WNK2 promoter-methylated), and A172 transfected either with an empty vector (Ev) or with a WNK2 expression vector, were used to assess the cellular basal capacities to promote autophagy, through western blot and flow-cytometry analysis. Additionally, we evaluated the effect of WNK2 on general endocytosis trafficking routes by immunofluorescence. Results: The re-expression of ectopic WNK2 did not interfere with autophagy-related protein light chain 3 (LC3-II) expression levels as well as did not promote mTOR signaling pathway alteration when compared with Ev or wt A172 cells. However, the restoration of WNK2 resulted in a marked increase (8 to 92,4%) of Acidic Vesicular Organelles formation (AVOs). Moreover, our results also suggest that WNK2 cells promotes delay in uptake and internalization rate of cholera toxin B and transferrin ligands. Conclusions: The restoration of WNK2 interferes in vesicular traffic during endocytosis pathway and increase AVOs formation. This results also suggest the role of WNK2 in growth factor receptor turnover related to cell growth and homeostasis and associates one more time, WNK2 silencing contribution in genesis of gliomas.

Keywords: autophagy, endocytosis, glioma, WNK2

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971 2,7-diazaindole as a Potential Photophysical Probe for Excited State Deactivation Processes

Authors: Simran Baweja, Bhavika Kalal, Surajit Maity

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Photoinduced tautomerization reactions have been the centre of attention among scientific community over past several decades because of their significance in various biological systems. 7-azaindole (7AI) is considered as a model system for DNA base pairing and to understand the role of such tautomerization reactions in mutations. To the best of our knowledge, extensive studies have been carried on 7-azaindole and its solvent clusters exhibiting proton/ hydrogen transfer in both solution as well as gas phase. Derivatives of above molecule, like 2,7- and 2,6-diazaindoles are proposed to have even better photophysical properties due to the presence of -aza group on the 2nd position. However, there are a few studies in the solution phase which suggest the relevance of these molecules, but there are no experimental studies reported in the gas phase yet. In our current investigation, we present the first gas phase spectroscopic data of 2,7-diazaindole (2,7-DAI) and its solvent cluster (2,7-DAI-H2O). In this, we have employed state-of-the-art laser spectroscopic methods such as fluorescence excitation (LIF), dispersed fluorescence (DF), resonant two-photon ionization time of flight mass spectrometry (2C-R2PI), photoionization efficiency spectroscopy (PIE), IR-UV double resonance spectroscopy i.e. fluorescence-dip infrared spectroscopy (FDIR) and resonant ion-dip infrared spectroscopy (IDIR) to understand the electronic structure of the molecule. The origin band corresponding to S1 ← S0 transition of the bare 2,7-DAI is found to be positioned at 33910 cm-1 whereas the origin band corresponding to S1 ← S0 transition of the 2,7-DAI-H2O is positioned at 33074 cm-1. The red shifted transition in case of solvent cluster suggests the enhanced feasibility of excited state hydrogen/ proton transfer. The ionization potential for the 2,7-DAI molecule is found to be 8.92 eV, which is significantly higher that the previously reported 7AI (8.11 eV) molecule, making it a comparatively complex molecule to study. The ionization potential is reduced by 0.14 eV in case of 2,7-DAI-H2O (8.78 eV) cluster compared to that of 2,7-DAI. Moreover, on comparison with the available literature values of 7AI, we found the origin band of 2,7-DAI and 2,7-DAI-H2O to be red shifted by -729 and -280 cm-1 respectively. The ground and excited state N-H stretching frequencies of the 27DAI molecule were determined using fluorescence-dip infrared spectra (FDIR) and resonant ion dip infrared spectroscopy (IDIR), obtained at 3523 and 3467 cm-1, respectively. The lower value of vNH in the electronic excited state of 27DAI implies the higher acidity of the group compared to the ground state. Moreover, we have done extensive computational analysis, which suggests that the energy barrier in excited state reduces significantly as we increase the number of catalytic solvent molecules (S= H2O, NH3) as well as the polarity of solvent molecules. We found that the ammonia molecule is a better candidate for hydrogen transfer compared to water because of its higher gas-phase basicity. Further studies are underway to understand the excited state dynamics and photochemistry of such N-rich chromophores.

Keywords: photoinduced tautomerization reactions, gas phse spectroscopy, ), IR-UV double resonance spectroscopy, resonant two-photon ionization time of flight mass spectrometry (2C-R2PI)

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970 Maturity Level of Knowledge Management in Whole Life Costing in the UK Construction Industry: An Empirical Study

Authors: Ndibarefinia Tobin

Abstract:

The UK construction industry has been under pressure for many years to produce economical buildings which offer value for money, not only during the construction phase, but more importantly, during the full life of the building. Whole life costing is considered as an economic analysis tool that takes into account the total investment cost in and ownership, operation and subsequent disposal of a product or system to which the whole life costing method is being applied. In spite of its importance, the practice is still crippled by the lack of tangible evidence, ‘know-how’ skills and knowledge of the practice i.e. the lack of professionals with the knowledge and training on the use of the practice in construction project, this situation is compounded by the absence of available data on whole life costing from relevant projects, lack of data collection mechanisms and so on. The aforementioned problems has forced many construction organisations to adopt project enhancement initiatives to boost their performance on the use of whole life costing techniques so as to produce economical buildings which offer value for money during the construction stage also the whole life of the building/asset. The management of knowledge in whole life costing is considered as one of the many project enhancement initiative and it is becoming imperative in the performance and sustainability of an organisation. Procuring building projects using whole life costing technique is heavily reliant on the knowledge, experience, ideas and skills of workers, which comes from many sources including other individuals, electronic media and documents. Due to the diversity of knowledge, capabilities and skills of employees that vary across an organisation, it is significant that they are directed and coordinated efficiently so as to capture, retrieve and share knowledge in order to improve the performance of the organisation. The implementation of knowledge management concept has different levels in each organisation. Measuring the maturity level of knowledge management in whole life costing practice will paint a comprehensible picture of how knowledge is managed in construction organisations. Purpose: The purpose of this study is to identify knowledge management maturity in UK construction organisations adopting whole life costing in construction project. Design/methodology/approach: This study adopted a survey method and conducted by distributing questionnaires to large construction companies that implement knowledge management activities in whole life costing practice in construction project. Four level of knowledge management maturity was proposed on this study. Findings: From the results obtained in the study shows that 34 contractors at the practiced level, 26 contractors at managed level and 12 contractors at continuously improved level.

Keywords: knowledge management, whole life costing, construction industry, knowledge

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969 Configuring Resilience and Environmental Sustainability to Achieve Superior Performance under Differing Conditions of Transportation Disruptions

Authors: Henry Ataburo, Dominic Essuman, Emmanuel Kwabena Anin

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Recent trends of catastrophic events, such as the Covid-19 pandemic, the Suez Canal blockage, the Russia-Ukraine conflict, the Israel-Hamas conflict, and the climate change crisis, continue to devastate supply chains and the broader society. Prior authors have advocated for a simultaneous pursuit of resilience and sustainability as crucial for navigating these challenges. Nevertheless, the relationship between resilience and sustainability is a rather complex one: resilience and sustainability are considered unrelated, substitutes, or complements. Scholars also suggest that different firms prioritize resilience and sustainability differently for varied strategic reasons. However, we know little about whether, how, and when these choices produce different typologies of firms to explain differences in financial and market performance outcomes. This research draws inferences from the systems configuration approach to organizational fit to contend that a taxonomy of firms may emerge based on how firms configure resilience and environmental sustainability. The study further examines the effects of these taxonomies on financial and market performance in differing transportation disruption conditions. Resilience is operationalized as a firm’s ability to adjust current operations, structure, knowledge, and resources in response to disruptions, whereas environmental sustainability is operationalized as the extent to which a firm deploys resources judiciously and keeps the ecological impact of its operations to the barest minimum. Using primary data from 199 firms in Ghana and cluster analysis as an analytical tool, the study identifies four clusters of firms based on how they prioritize resilience and sustainability: Cluster 1 - "strong, moderate resilience, high sustainability firms," Cluster 2 - "sigh resilience, high sustainability firms," Cluster 3 - "high resilience, strong, moderate sustainability firms," and Cluster 4 - "weak, moderate resilience, strong, moderate sustainability firms". In addition, ANOVA and regression analysis revealed the following findings: Only clusters 1 and 2 were significantly associated with both market and financial performance. Under high transportation disruption conditions, cluster 1 firms excel better in market performance, whereas cluster 2 firms excel better in financial performance. Conversely, under low transportation disruption conditions, cluster 1 firms excel better in financial performance, whereas cluster 2 firms excel better in market performance. The study provides theoretical and empirical evidence of how resilience and environmental sustainability can be configured to achieve specific performance objectives under different disruption conditions.

Keywords: resilience, environmental sustainability, developing economy, transportation disruption

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968 Surge in U. S. Citizens Expatriation: Testing Structual Equation Modeling to Explain the Underlying Policy Rational

Authors: Marco Sewald

Abstract:

Comparing present to past the numbers of Americans expatriating U. S. citizenship have risen. Even though these numbers are small compared to the immigrants, U. S. citizens expatriations have historically been much lower, making the uptick worrisome. In addition, the published lists and numbers from the U.S. government seems incomplete, with many not counted. Different branches of the U. S. government report different numbers and no one seems to know exactly how big the real number is, even though the IRS and the FBI both track and/or publish numbers of Americans who renounce. Since there is no single explanation, anecdotal evidence suggests this uptick is caused by global tax law and increased compliance burdens imposed by the U.S. lawmakers on U.S. citizens abroad. Within a research project the question arose about the reasons why a constant growing number of U.S. citizens are expatriating – the answers are believed helping to explain the underlying governmental policy rational, leading to such activities. While it is impossible to locate former U.S. citizens to conduct a survey on the reasons and the U.S. government is not commenting on the reasons given within the process of expatriation, the chosen methodology is Structural Equation Modeling (SEM), in the first step by re-using current surveys conducted by different researchers within the population of U. S. citizens residing abroad during the last years. Surveys questioning the personal situation in the context of tax, compliance, citizenship and likelihood to repatriate to the U. S. In general SEM allows: (1) Representing, estimating and validating a theoretical model with linear (unidirectional or not) relationships. (2) Modeling causal relationships between multiple predictors (exogenous) and multiple dependent variables (endogenous). (3) Including unobservable latent variables. (4) Modeling measurement error: the degree to which observable variables describe latent variables. Moreover SEM seems very appealing since the results can be represented either by matrix equations or graphically. Results: the observed variables (items) of the construct are caused by various latent variables. The given surveys delivered a high correlation and it is therefore impossible to identify the distinct effect of each indicator on the latent variable – which was one desired result. Since every SEM comprises two parts: (1) measurement model (outer model) and (2) structural model (inner model), it seems necessary to extend the given data by conducting additional research and surveys to validate the outer model to gain the desired results.

Keywords: expatriation of U. S. citizens, SEM, structural equation modeling, validating

Procedia PDF Downloads 216
967 Numerical Board Game for Low-Income Preschoolers

Authors: Gozde Inal Kiziltepe, Ozgun Uyanik

Abstract:

There is growing evidence that socioeconomic (SES)-related differences in mathematical knowledge primarily start in early childhood period. Preschoolers from low-income families are likely to perform substantially worse in mathematical knowledge than their counterparts from middle and higher income families. The differences are seen on a wide range of recognizing written numerals, counting, adding and subtracting, and comparing numerical magnitudes. Early differences in numerical knowledge have a permanent effect childrens’ mathematical knowledge in other grades. In this respect, analyzing the effect of number board game on the number knowledge of 48-60 month-old children from disadvantaged low-income families constitutes the main objective of the study. Participants were the 71 preschoolers from a childcare center which served low-income urban families. Children were randomly assigned to the number board condition or to the color board condition. The number board condition included 35 children and the color board game condition included 36 children. Both board games were 50 cm long and 30 cm high; had ‘The Great Race’ written across the top; and included 11 horizontally arranged, different colored squares of equal sizes with the leftmost square labeled ‘Start’. The numerical board had the numbers 1–10 in the rightmost 10 squares; the color board had different colors in those squares. A rabbit or a bear token were presented to children for selecting, and on each trial spun a spinner to determine whether the token would move one or two spaces. The number condition spinner had a ‘1’ half and a ‘2’ half; the color condition spinner had colors that matched the colors of the squares on the board. Children met one-on-one with an experimenter for four 15- to 20-min sessions within a 2-week period. In the first and fourth sessions, children were administered identical pretest and posttest measures of numerical knowledge. All children were presented three numerical tasks and one subtest presented in the following order: counting, numerical magnitude comparison, numerical identification and Count Objects – Circle Number Probe subtest of Early Numeracy Assessment. In addition, same numerical tasks and subtest were given as a follow-up test four weeks after the post-test administration. Findings obtained from the study; showed that there was a meaningful difference between scores of children who played a color board game in favor of children who played number board game.

Keywords: low income, numerical board game, numerical knowledge, preschool education

Procedia PDF Downloads 349
966 Fostering Ties and Trusts through Social Interaction within Community Gardening

Authors: Shahida Mohd Sharif, Norsidah Ujang

Abstract:

Recent research has shown that many of the urban population in Kuala Lumpur, especially from the lower-income group, suffer from socio-psychological problems. They are reported as experiencing anxiety, depression, and stress, which is made worst by the recent COVID-19 pandemic. Much of the population was forced to observe the Movement Control Order (MCO), which is part of pandemic mitigation measures, pushing them to live in isolation as the new normal. The study finds the need to strategize for a better approach to help these people coping with the socio-psychological condition, especially the population from the lower-income group. In Kuala Lumpur, as part of the Local Agenda 21 programme, the Kuala Lumpur City Hall has introduced Green Initiative: Urban Farming, which among the approaches is the community garden. The local authority promotes the engagement to be capable of improving the social environment of the participants. Research has demonstrated that social interaction within community gardens can help the members improve their socio-psychological conditions. Therefore, the study explores the residents’ experience from low-cost flats participating in the community gardening initiative from a social attachment perspective. The study will utilise semi-structured interviews to collect the participants’ experience with community gardening and how the social interaction exchange between the members' forms and develop their ties and trust. For a context, the low-cost flats are part of the government social housing program (Program Perumahan Rakyat dan Perumahan Awam). Meanwhile, the community gardening initiative (Projek Kebun Kejiranan Bandar LA21 KL) is part of the local authority initiative to address the participants’ social, environmental, and economic issues. The study will conduct thematic analysis on the collected data and use the ATLAS.ti software for data organization and management purposes. The findings could help other researchers and stakeholders understand the social interaction experience within community gardens and its relation to ties and trusts. The findings could shed some light on how the participants could improve their social environment, and its report could provide the local authority with evidence-based documentation.

Keywords: community gardening participation, lower-income population, social attachment, social interaction

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965 The Textual Criticism on the Age of ‘Wan Li’ Shipwreck Porcelain and Its Comparison with ‘Whitte Leeuw’ and Hatcher Shipwreck Porcelain

Authors: Yang Liu, Dongliang Lyu

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After the Wan li shipwreck was discovered 60 miles off the east coast of Tan jong Jara in Malaysia, numerous marvelous ceramic shards have been salvaged from the seabed. Remarkable pieces of Jing dezhen blue-and-white porcelain recovered from the site represent the essential part of the fascinating research. The porcelain cargo of Wan li shipwreck is significant to the studies on exported porcelains and Jing dezhen porcelain manufacture industry of Late-Ming dynasty. Using the ceramic shards categorization and the study of the Chinese and Western historical documents as a research strategy, the paper wants to shed new light on the Wan li shipwreck wares classification with Jingdezhen kiln ceramic as its main focus. The article is also discussing Jing dezhen blue-and-white porcelains from the perspective of domestic versus export markets and further proceeding to the systematization and analyses of Wan li shipwreck porcelain which bears witness to the forms, styles, and types of decoration that were being traded in this period. The porcelain data from two other shipwrecked projects -White Leeuw and Hatcher- were chosen as comparative case studies and Wan li shipwreck Jing dezhen blue-and-white porcelain is being reinterpreted in the context of art history and archeology of the region. The marine archaeologist Sten Sjostrand named the ship ‘Wanli shipwreck’ because its porcelain cargoes are typical of those made during the reign of Emperor Wan li of Ming dynasty. Though some scholars question the appropriateness of the name, the final verdict of the history is still to be made. Based on previous historical argumentation, the article uses a comparative approach to review the Wan li shipwreck blue-and-white porcelains on the grounds of the porcelains unearthed from the tomb or abandoned in the towns and carrying the time-specific reign mark. All these materials provide a very strong evidence which suggests that the porcelain recovered from Wan li ship can be dated to as early as the second year of Tianqi era (1622) and early Chongzhen reign. Lastly, some blue-and-white porcelain intended for the domestic market and some bowls of blue-and-white porcelain from Jing dezhen kilns recovered from the Wan li shipwreck all carry at the bottom the specific residue from the firing process. The author makes the corresponding analysis for these two interesting phenomena.

Keywords: blue-and-white porcelain, Ming dynasty, Jing dezhen kiln, Wan li shipwreck

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964 Placebo Analgesia in Older Age: Evidence from Event-Related Potentials

Authors: Angelika Dierolf, K. Rischer, A. Gonzalez-Roldan, P. Montoya, F. Anton, M. Van der Meulen

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Placebo analgesia is a powerful cognitive endogenous pain modulation mechanism with high relevance in pain treatment. Older people would benefit, especially from non-pharmacologic pain interventions, since this age group is disproportionately affected by acute and chronic pain, while pharmacological treatments are less suitable due to polypharmacy and age-related changes in drug metabolism. Although aging is known to affect neurobiological and physiological aspects of pain perception, as for example, changes in pain threshold and pain tolerance, its effects on cognitive pain modulation strategies, including placebo analgesia, have hardly been investigated so far. In the present study, we are assessing placebo analgesia in 35 older adults (60 years and older) and 35 younger adults (between 18 and 35 years). Acute pain was induced with short transdermal electrical pulses to the inner forearm, using a concentric stimulating electrode. Stimulation intensities were individually adjusted to the participant’s threshold. Next to the stimulation site, we applied sham transcutaneous electrical nerve stimulation (TENS). Participants were informed that sometimes the TENS device would be switched on (placebo condition), and sometimes it would be switched off (control condition). In reality, it was always switched off. Participants received alternating blocks of painful stimuli in the placebo and control condition and were asked to rate the intensity and unpleasantness of each stimulus on a visual analog scale (VAS). Pain-related evoked potentials were recorded with a 64-channel EEG. Preliminary results show a reduced placebo effect in older compared to younger adults in both behavioral and neurophysiological data. Older people experienced less subjective pain reduction under sham TENS treatment compared to younger adults, as evidenced by the VAS ratings. The N1 and P2 event-related potential components were generally reduced in the older group. While younger adults showed a reduced N1 and P2 under sham TENS treatment, this reduction was considerably smaller in older people. This reduced placebo effect in the older group suggests that cognitive pain modulation is altered in aging and may at least partly explain why older adults experience more pain. Our results highlight the need for a better understanding of the efficacy of non-pharmacological pain treatments in older adults and how these can be optimized to meet the specific requirements of this population.

Keywords: placebo analgesia, aging, acute pain, TENS, EEG

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963 Tip-Apex Distance as a Long-Term Risk Factor for Hospital Readmission Following Intramedullary Fixation of Intertrochanteric Fractures

Authors: Brandon Knopp, Matthew Harris

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Purpose: Tip-apex distance (TAD) has long been discussed as a metric for determining risk of failure in the fixation of peritrochanteric fractures. TAD measurements over 25 millimeters (mm) have been associated with higher rates of screw cut out and other complications in the first several months after surgery. However, there is limited evidence for the efficacy of this measurement in predicting the long-term risk of negative outcomes following hip fixation surgery. The purpose of our study was to investigate risk factors including TAD for hospital readmission, loss of pre-injury ambulation and development of complications within 1 year after hip fixation surgery. Methods: A retrospective review of proximal hip fractures treated with single screw intramedullary devices between 2016 and 2020 was performed at a 327-bed regional medical center. Patients included had a postoperative follow-up of at least 12 months or surgery-related complications developing within that time. Results: 44 of the 67 patients in this study met the inclusion criteria with adequate follow-up post-surgery. There was a total of 10 males (22.7%) and 34 females (77.3%) meeting inclusion criteria with a mean age of 82.1 (± 12.3) at the time of surgery. The average TAD in our study population was 19.57mm and the average 1-year readmission rate was 15.9%. 3 out of 6 patients (50%) with a TAD > 25mm were readmitted within one year due to surgery-related complications. In contrast, 3 out of 38 patients (7.9%) with a TAD < 25mm were readmitted within one year due to surgery-related complications (p=0.0254). Individual TAD measurements, averaging 22.05mm in patients readmitted within 1 year of surgery and 19.18mm in patients not readmitted within 1 year of surgery, were not significantly different between the two groups (p=0.2113). Conclusions: Our data indicate a significant improvement in hospital readmission rates up to one year after hip fixation surgery in patients with a TAD < 25mm with a decrease in readmissions of over 40% (50% vs 7.9%). This result builds upon past investigations by extending the follow-up time to 1 year after surgery and utilizing hospital readmissions as a metric for surgical success. With the well-documented physical and financial costs of hospital readmission after hip surgery, our study highlights a reduction of TAD < 25mm as an effective method of improving patient outcomes and reducing financial costs to patients and medical institutions. No relationship was found between TAD measurements and secondary outcomes, including loss of pre-injury ambulation and development of complications.

Keywords: hip fractures, hip reductions, readmission rates, open reduction internal fixation

Procedia PDF Downloads 138
962 The Impact of the Covid-19 Crisis on the Information Behavior in the B2B Buying Process

Authors: Stehr Melanie

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The availability of apposite information is essential for the decision-making process of organizational buyers. Due to the constraints of the Covid-19 crisis, information channels that emphasize face-to-face contact (e.g. sales visits, trade shows) have been unavailable, and usage of digitally-driven information channels (e.g. videoconferencing, platforms) has skyrocketed. This paper explores the question in which areas the pandemic induced shift in the use of information channels could be sustainable and in which areas it is a temporary phenomenon. While information and buying behavior in B2C purchases has been regularly studied in the last decade, the last fundamental model of organizational buying behavior in B2B was introduced by Johnston and Lewin (1996) in times before the advent of the internet. Subsequently, research efforts in B2B marketing shifted from organizational buyers and their decision and information behavior to the business relationships between sellers and buyers. This study builds on the extensive literature on situational factors influencing organizational buying and information behavior and uses the economics of information theory as a theoretical framework. The research focuses on the German woodworking industry, which before the Covid-19 crisis was characterized by a rather low level of digitization of information channels. By focusing on an industry with traditional communication structures, a shift in information behavior induced by an exogenous shock is considered a ripe research setting. The study is exploratory in nature. The primary data source is 40 in-depth interviews based on the repertory-grid method. Thus, 120 typical buying situations in the woodworking industry and the information and channels relevant to them are identified. The results are combined into clusters, each of which shows similar information behavior in the procurement process. In the next step, the clusters are analyzed in terms of the post and pre-Covid-19 crisis’ behavior identifying stable and dynamic information behavior aspects. Initial results show that, for example, clusters representing search goods with low risk and complexity suggest a sustainable rise in the use of digitally-driven information channels. However, in clusters containing trust goods with high significance and novelty, an increased return to face-to-face information channels can be expected after the Covid-19 crisis. The results are interesting from both a scientific and a practical point of view. This study is one of the first to apply the economics of information theory to organizational buyers and their decision and information behavior in the digital information age. Especially the focus on the dynamic aspects of information behavior after an exogenous shock might contribute new impulses to theoretical debates related to the economics of information theory. For practitioners - especially suppliers’ marketing managers and intermediaries such as publishers or trade show organizers from the woodworking industry - the study shows wide-ranging starting points for a future-oriented segmentation of their marketing program by highlighting the dynamic and stable preferences of elaborated clusters in the choice of their information channels.

Keywords: B2B buying process, crisis, economics of information theory, information channel

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961 The Power-Knowledge Relationship in the Italian Education System between the 19th and 20th Century

Authors: G. Iacoviello, A. Lazzini

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This paper focuses on the development of the study of accounting in the Italian education system between the 19th and 20th centuries. It also focuses on the subsequent formation of a scientific and experimental forma mentis that would prepare students for administrative and managerial activities in industry, commerce and public administration. From a political perspective, the period was characterized by two dominant movements - liberalism (1861-1922) and fascism (1922-1945) - that deeply influenced accounting practices and the entire Italian education system. The materials used in the study include both primary and secondary sources. The primary sources used to inform this study are numerous original documents issued from 1890-1935 by the government and maintained in the Historical Archive of the State in Rome. The secondary sources have supported both the development of the theoretical framework and the definition of the historical context. This paper assigns to the educational system the role of cultural producer. Foucauldian analysis identifies the problem confronted by the critical intellectual in finding a way to deploy knowledge through a 'patient labour of investigation' that highlights the contingency and fragility of the circumstances that have shaped current practices and theories. Education can be considered a powerful and political process providing students with values, ideas, and models that they will subsequently use to discipline themselves, remaining as close to them as possible. It is impossible for power to be exercised without knowledge, just as it is impossible for knowledge not to engender power. The power-knowledge relationship can be usefully employed for explaining how power operates within society, how mechanisms of power affect everyday lives. Power is employed at all levels and through many dimensions including government. Schools exercise ‘epistemological power’ – a power to extract a knowledge of individuals from individuals. Because knowledge is a key element in the operation of power, the procedures applied to the formation and accumulation of knowledge cannot be considered neutral instruments for the presentation of the real. Consequently, the same institutions that produce and spread knowledge can be considered part of the ‘power-knowledge’ interrelation. Individuals have become both objects and subject in the development of knowledge. If education plays a fundamental role in shaping all aspects of communities in the same way, the structural changes resulting from economic, social and cultural development affect the educational systems. Analogously, the important changes related to social and economic development required legislative intervention to regulate the functioning of different areas in society. Knowledge can become a means of social control used by the government to manage populations. It can be argued that the evolution of Italy’s education systems is coherent with the idea that power and knowledge do not exist independently but instead are coterminous. This research aims to reduce such a gap by analysing the role of the state in the development of accounting education in Italy.

Keywords: education system, government, knowledge, power

Procedia PDF Downloads 133
960 Estimating Industrial Pollution Load in Phnom Penh by Industrial Pollution Projection System

Authors: Vibol San, Vin Spoann

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Manufacturing plays an important role in job creation around the world. In 2013, it is estimated that there were more than half a billion jobs in manufacturing. In Cambodia in 2015, the primary industry occupies 26.18% of the total economy, while agriculture is contributing 29% and the service sector 39.43%. The number of industrial factories, which are dominated by garment and textiles, has increased since 1994, mainly in Phnom Penh city. Approximately 56% out of total 1302 firms are operated in the Capital city in Cambodia. Industrialization to achieve the economic growth and social development is directly responsible for environmental degradation, threatening the ecosystem and human health issues. About 96% of total firms in Phnom Penh city are the most and moderately polluting firms, which have contributed to environmental concerns. Despite an increasing array of laws, strategies and action plans in Cambodia, the Ministry of Environment has encountered some constraints in conducting the monitoring work, including lack of human and financial resources, lack of research documents, the limited analytical knowledge, and lack of technical references. Therefore, the necessary information on industrial pollution to set strategies, priorities and action plans on environmental protection issues is absent in Cambodia. In the absence of this data, effective environmental protection cannot be implemented. The objective of this study is to estimate industrial pollution load by employing the Industrial Pollution Projection System (IPPS), a rapid environmental management tool for assessment of pollution load, to produce a scientific rational basis for preparing future policy direction to reduce industrial pollution in Phnom Penh city. Due to lack of industrial pollution data in Phnom Penh, industrial emissions to the air, water and land as well as the sum of emissions to all mediums (air, water, land) are estimated using employment economic variable in IPPS. Due to the high number of employees, the total environmental load generated in Phnom Penh city is estimated to be 476.980.93 tons in 2014, which is the highest industrial pollution compared to other locations in Cambodia. The result clearly indicates that Phnom Penh city is the highest emitter of all pollutants in comparison with environmental pollutants released by other provinces. The total emission of industrial pollutants in Phnom Penh shares 55.79% of total industrial pollution load in Cambodia. Phnom Penh city generates 189,121.68 ton of VOC, 165,410.58 ton of toxic chemicals to air, 38,523.33 ton of toxic chemicals to land and 28,967.86 ton of SO2 in 2014. The results of the estimation show that Textile and Apparel sector is the highest generators of toxic chemicals into land and air, and toxic metals into land, air and water, while Basic Metal sector is the highest contributor of toxic chemicals to water. Textile and Apparel sector alone emits 436,015.84 ton of total industrial pollution loads. The results suggest that reduction in industrial pollution could be achieved by focusing on the most polluting sectors.

Keywords: most polluting area, polluting industry, pollution load, pollution intensity

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959 Functional Impairment in South African Children with ADHD: Design, Implementation and Evaluation of a Targeted Intervention

Authors: Mareli Fischer, Kevin G. F. Thomas

Abstract:

Although Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent childhood neurobehavioural disorders, little empirical research has been published on its clinical presentation in Africa, and, globally, few studies evaluate ADHD intervention programs that emphasize parent training. Hence, Stage 1 of this research programme aimed to describe the functional impairment of South African children with ADHD, and also sought to investigate the influence of sociodemographic variables (e.g., sex, age, socioeconomic status, family environment) and clinical variables (e.g., ADHD subtype and comorbidity) on the degree of that impairment. We used the Mini International Neuropsychiatric Interview for Children and Adolescents as a diagnostic tool, and the Child Behavior Checklist, the Strengths and Difficulties Questionnaire, and the Impairment Rating Scale as measures of functional impairment. Results from this stage of the research indicated that South African children and adolescents who meet diagnostic criteria for ADHD experience most functional impairment in the school domain, as well as in the area of social functioning. None of the measured sociodemographic variables had a significant detrimental or protective effect on how ADHD symptoms impacted on functioning. In terms of comorbidity, the presence of Major Depressive Disorder, Conduct Disorder, and Oppositional Defiant Disorder were all associated with significantly impaired overall functioning. Stage 2 of the research programme aimed to design, implement, and evaluate a child-specific intervention that targeted the primary areas of impairment identified in Stage 1. Existing literature suggests that a positive parent-training programme, in the group format, is one of the best options for cost-effective and successful ADHD intervention. Hence, the intervention took that form. Parents were taught basic behaviour analysis concepts within a supportive group context. Evaluation of the intervention’s efficacy used many of the same measures as in Stage 1, but also featured semi-structured interviews with participants and naturalistic observation of parent-child interaction. We will discuss preliminary results of that evaluation. Studying functional impairment and designing intervention plans in this way will pave the way for evidence-based treatment plans for children and adolescents diagnosed with ADHD.

Keywords: attention deficit/hyperactivity disorder, children, intervention, parenting groups

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958 A Systematic Review on Factors/Predictors and Outcomes of Parental Distress in Childhood Acute Lymphoblastic Leukemia

Authors: Ana Ferraz, Martim Santos, M. Graça Pereira

Abstract:

Distress among parents of children with acute lymphoblastic leukemia (ALL) is common during treatment and can persist several years post-diagnosis, impacting the adjustment of children and parents themselves. Current evidence is needed to examine the scope and nature of parental distress in childhood ALL. This review focused on associated variables, predictors, and outcomes of parental distress following their ALL diagnosis of their child. PubMed, Web of Science, and PsycINFO databases were searched for English and Spanish papers published from 1983 to 2021. PRISMA statement was followed, and papers were evaluated through a standardized methodological quality assessment tool (NHLBI). Of the 28 papers included, 16 were evaluated as fair, eight as good, and four as poor. Regarding results, 11 papers reported subgroup differences, and 15 found potential predictors of parental distress, including sociodemographic, psychosocial, psychological, family, health, and ALL-specific variables. Significant correlations were found between parental distress, social support, illness cognitions, and resilience, as well as contradictory results regarding the impact of sociodemographic variables on parental distress. Family cohesion and caregiver burden were associated with distress, and the use of healthy coping strategies was associated with less anxiety. Caregiver strain contributed to distress, and the overall impact of illness positively predicted anxiety in mothers and somatization in fathers. Differences in parental distress were found regarding group risk, time since diagnosis, and treatment phases. Thirteen papers explored the outcomes of parental distress on psychological, family, health, and social/education outcomes. Parental distress was the most important predictor of family strain. Significant correlations were found between parental distress at diagnosis and further psychological adjustment of parents themselves and their children. Most papers reported correlations between parental distress on children’s adjustment and quality of life, although few studies reported no association. Correlations between maternal depression and child participation in education and social life were also found. Longitudinal studies are needed to better understand parental distress and its consequences on health outcomes, in particular. Future interventions should focus mainly on parents on distress reduction and psychological adjustment, both in parents and children over time.

Keywords: childhood acute lymphoblastic leukemia, family, parental distress, psychological adjustment, quality of life

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957 The Effectiveness of Blended Learning in Pre-Registration Nurse Education: A Mixed Methods Systematic Review and Met Analysis

Authors: Albert Amagyei, Julia Carroll, Amanda R. Amorim Adegboye, Laura Strumidlo, Rosie Kneafsey

Abstract:

Introduction: Classroom-based learning has persisted as the mainstream model of pre-registration nurse education. This model is often rigid, teacher-centered, and unable to support active learning and the practical learning needs of nursing students. Health Education England (HEE), a public body of the Department of Health and Social Care, hypothesises that blended learning (BL) programmes may address health system and nursing profession challenges, such as nursing shortages and lack of digital expertise, by exploring opportunities for providing predominantly online, remote-access study which may increase nursing student recruitment, offering alternate pathways to nursing other than the traditional classroom route. This study will provide evidence for blended learning strategies adopted in nursing education as well as examine nursing student learning experiences concerning the challenges and opportunities related to using blended learning within nursing education. Objective: This review will explore the challenges and opportunities of BL within pre-registration nurse education from the student's perspective. Methods: The search was completed within five databases. Eligible studies were appraised independently by four reviewers. The JBI-convergent segregated approach for mixed methods review was used to assess and synthesize the data. The study’s protocol has been registered with the International Register of Systematic Reviews with registration number// PROSPERO (CRD42023423532). Results: Twenty-seven (27) studies (21 quantitative and 6 qualitative) were included in the review. The study confirmed that BL positively impacts nursing students' learning outcomes, as demonstrated by the findings of the meta-analysis and meta-synthesis. Conclusion: The review compared BL to traditional learning, simulation, laboratory, and online learning on nursing students’ learning and programme outcomes as well as learning behaviour and experience. The results show that BL could effectively improve nursing students’ knowledge, academic achievement, critical skills, and clinical performance as well as enhance learner satisfaction and programme retention. The review findings outline that students’ background characteristics, BL design, and format significantly impact the success of the BL nursing programme.

Keywords: nursing student, blended learning, pre-registration nurse education, online learning

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