Search results for: hospital service
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5528

Search results for: hospital service

698 Value Clusters of Grade 9 Teachers in the District of Trece Martires City, Division of Cavite: Basis for a Revised Values Education Program (RVEP)"

Authors: Juland D. Salayo

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With numerous innovations introduced in the Philippine educational system, the country’s struggle of materializing its national goal of transforming lives ends with great loss. Many agree that the failure to emerge the integral values of the program, framework and the implementers impedes realization. Employing a descriptive-correlational method, it aimed to determine the value clusters of the Grade 9 teachers as assessed by themselves and by the students, the significant difference of the assessed values and the significant difference on the values based on their profile. Respondents were composed of sixty-nine (69) teachers and three hundred forty (340) students using simple random sampling. Through a survey-questionnaire, the study revealed that the teachers have high regards on their self-reliance, honesty and trustworthiness, obedience, politeness and respect and self-discipline and spirituality. In contrast, they have ranked the following values fairly: justice and fairness, courage, responsibility and punctuality and nationalism and patriotism. Having assessed by the students, they have highly regarded their teachers’ self-reliance, responsibility and punctuality, obedience, politeness and respect and fair play and sportsmanship. On the other hand, the student-respondents made a low assessment on the level of the teachers’ justice and fairness, nationalism and patriotism, honesty and trustworthiness and excellence. Using t-test, it showed that there is a significant difference between the assessments of the respondents. Finally, among the demographic profiles, only civil status and age rejected the hypothesis. The following were recommended: provide educators value-enhancement trainings and conferences, organize value-oriented organizations and activities, and make intensive value-campaigns heightening the low-assessed values. Thus, a Revised Values Education Program (RVEP) was made to further meet the objectives of the program, address the needs of its clienteles, and responding to the demands of both education and society towards excellence in service, social and economic revolution, and constructive national goals which are based from integral values.

Keywords: values, value clusters, values education program, values education, teachers' assessed values

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697 Eco-Design of Construction Industrial Park in China with Selection of Candidate Tenants

Authors: Yang Zhou, Kaijian Li, Guiwen Liu

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Offsite construction is an innovative alternative to conventional site-based construction, with wide-ranging benefits. It requires building components, elements or modules were prefabricated and pre-assembly before installed into their final locations. To improve efficiency and achieve synergies, in recent years, construction companies were clustered into construction industrial parks (CIPs) in China. A CIP is a community of construction manufacturing and service businesses located together on a common property. Companies involved in industrial clusters can obtain environment and economic benefits by sharing resources and information in a given region. Therefore, the concept of industrial symbiosis (IS) can be applied to the traditional CIP to achieve sustainable industrial development or redevelopment through the implementation of eco-industrial parks (EIP). However, before designing a symbiosis network between companies in a CIP, candidate support tenants need to be selected to complement the existing construction companies. In this study, an access indicator system and a linear programming model are established to select candidate tenants in a CIP while satisfying the degree of connectivity among the enterprises in the CIP, minimizing the environmental impact, and maximizing the annualized profit of the CIP. The access indicator system comprises three primary indicators and fifteen secondary indicators, is proposed from the perspective of park-based level. The fifteen indicators are classified as three primary indicators including industrial symbiosis, environment performance and economic benefit, according to the three dimensions of sustainability (environment, economic and social dimensions) and the three R's of the environment (reduce, reuse and recycle). The linear programming model is a method to assess the satisfactoriness of all the indicators and to make an optimal multi-objective selection among candidate tenants. This method provides a practical tool for planners of a CIP in evaluating which among the candidate tenants would best complement existing anchor construction tenants. The reasonability and validity of the indicator system and the method is worth further study in the future.

Keywords: construction industrial park, China, industrial symbiosis, offsite construction, selection of support tenants

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696 Projected Uncertainties in Herbaceous Production Result from Unpredictable Rainfall Pattern and Livestock Grazing in a Humid Tropical Savanna Ecosystem

Authors: Daniel Osieko Okach, Joseph Otieno Ondier, Gerhard Rambold, John Tenhunen, Bernd Huwe, Dennis Otieno

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Increased human activities such as grazing, logging, and agriculture alongside unpredictable rainfall patterns have been detrimental to the ecosystem service delivery, therefore compromising its productivity potential. This study aimed at simulating the impact of drought (50%) and enhanced rainfall (150%) on the future herbaceous CO2 uptake, biomass production and soil C:N dynamics in a humid savanna ecosystem influenced by livestock grazing. Rainfall pattern was predicted using manipulation experiments set up to reduce (50%) and increase (150%) ambient (100%) rainfall amounts in grazed and non-grazed plots. The impact of manipulated rainfall regime on herbaceous CO2 fluxes, biomass production and soil C:N dynamics was measured against volumetric soil water content (VWC) logged every 30 minutes using the 5TE (Decagon Devices Inc., Washington, USA) soil moisture sensors installed (at 20 cm soil depth) in every plots. Herbaceous biomass was estimated using destructive method augmented by standardized photographic imaging. CO2 fluxes were measured using the ecosystem chamber method and the gas analysed using LI-820 gas analyzer (USA). C:N ratio was calculated from the soil carbon and Nitrogen contents (analyzed using EA2400CHNS/O and EA2410 N elemental analyzers respectively) of different plots under study. The patterning of VWC was directly influenced by the rainfall amount with lower VWC observed in the grazed compared to the non-grazed plots. Rainfall variability, grazing and their interaction significantly affected changes in VWC (p < 0.05) and subsequently total biomass and CO2 fluxes. VWC had a strong influence on CO2 fluxes under 50% rainfall reduction in the grazed (r2 = 0.91; p < 0.05) and ambient rainfall in the ungrazed (r2 = 0.77; p < 0.05). The dependence of biomass on VWC across plots was enhanced under grazed (r2 = 0.78 - 0.87; p < 0.05) condition as compared to ungrazed (r2 = 0.44 - 0.85; p < 0.05). The C:N ratio was however not correlated to VWC across plots. This study provides insight on how the predicted trends in humid savanna will respond to changes influenced by rainfall variability and livestock grazing and consequently the sustainable management of such ecosystems.

Keywords: CO2 fluxes, rainfall manipulation, soil properties, sustainability

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695 Internet Health: A Cross-Sectional Survey Exploring Identified Risks and Online Safety Measures in Parent and Children with Neurodevelopmental Disorders

Authors: Abdirahim Mohamed, Sarita Rana Chhetri, Michael Sleath, Nadia Saleem

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Rationale: Internet usage has been very much integrated into our daily lives. Internet usage within a neurodevelopmental disorder population is also on the increase. Nevertheless, there is very little empirical research on how this population virtually protect themselves; along with how their parents can keep them safe online. This topic was an ever-growing concern to the parents within our services and in many cases would add to the stresses and mental health of parents. This ignited an idea within our team to conduct research to explore the perceived online risks within this population and how they keep themselves safe. In conjunction, we also explored how parents and caregivers monitor and safeguard their young people to the potential threats online. Our hypothesis was that the perceived risks will heavily outnumber the safeguarding measures implemented by this population. Method: Within the Coventry and Warwickshire NHS Partnership Trust Child and Adolescent Mental Health Service (CAMHS), we distributed qualitative questionnaires to all the clinical bases (N=80). Questions explored topics such as daily internet usage, safeguarding measures, and perceived threats. The researchers requested for all CAMHS clinicians to identify participants. Participants in this study were accessing CAMHS for neurodevelopmental specific interventions. Results: The data were analysed using both Excel and SPSS. Within SPSS, a MANOVA was conducted and found a significant difference between safeguarding measures and perceived online risks within responses (p ≤ 0.5). This supports our hypothesis that participants in this population are well versed in the safeguarding issues of the internet; however, struggle to implement appropriate preventative measures. Data were also screened using Excel and found that all parents and carers stated they 'monitored their child’s internet use'. Conclusion: Data suggest that parents/carers may require more specific intervention to equip them with preventative measures due to the clear discrepancy between perceived risks and safeguarding measures. More research may also need to be conducted around this area to determine appropriate methodology to explore this topic further.

Keywords: Internet, health , how safe are we , internet health check

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694 Choking among Babies, Toddlers and Children with Special Needs: A Review of Mechanisms, Implications, Incidence, and Recommendations of Professional Prevention Guidelines

Authors: Ella Abaev, Shany Segal, Miri Gabay

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Background: Choking is a blockage of airways that prevents efficient breathing and air flow to the lungs. Choking may be partial or full and is an emergency situation. Complete or prolonged choking leads to apnea, lack of oxygen in the tissues of the body and brain, and can cause death. There are three mechanisms of choking: obstruction of internal respiratory tracts by food or object aspiration, any material that blocks or covers external air passages, external pressure on the neck or trapping between objects. Children's airways are narrower than that of adults and therefore the risk of choking is greater, due to the aspiration of food and other foreign bodies into the lungs. In the Child Development Center at Safra Children’s Hospital, Tel Hashomer in Israel are treated infants, toddlers, and children aged 0-18 years with various developmental disabilities. Due to the increase in reports of ‘almost an event’ of choking in the past year and the serious consequences of choking event, it was decided to give an emphasis to the issue. Incidence and methods: The number of reports of ‘almost an event’ or a choking event was examined at the center during the years 2013-2018 and a thorough research work was conducted on the subject in order to build a prevention program. Findings: Between 2013 and 2018 the center reported about ten cases of ‘almost choking events’. In the middle of 2018 alone three cases of ‘almost an event’ were reported. Objective: Providing knowledge leads to awareness raise, change of perception, change in behavior and prevention. The center employs more than 130 staff members from various sectors so that it is the work of multi-professional teams to promote the quality and safety of the treatment. The familiarity of the staff with risk factors, prevention guidelines, identification of choking signs, and treatment are most important and significant in determining the outcome of a choking event. Conclusions and recommendations: After in-depth research work was carried out in cooperation with the Risk Management Unit on the subject of choking, which include a description of the definitions, mechanisms, risk factors, treatment methods and extensive recommendations for prevention (e.g. using treatment and stimulation accessories with standards association stamps and adjustment of the type of food and the way it is served to match to the child's age and the ability to swallow). The expected stages of development and emphasis on the population of children with special needs were taken into account. The research findings will be published by the staff and parents of the patients, professional publications, and lectures and there is an expectation to decrease the number of choking events in the next years.

Keywords: children with special needs, choking, educational system, prevention guidelines

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693 Chemical Aging of High-Density Polyethylene (HDPE-100) in Interaction with Aggressive Environment

Authors: Berkas Khaoula, Chaoui Kamel

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Polyethylene (PE) pipes are one of the best options for water and gas transmission networks. The main reason for such a choice is its high-quality performance in service conditions over long periods of time. PE pipes are installed in contact with different soils having various chemical compositions with confirmed aggressiveness. As a result, PE pipe surfaces undergo unwanted oxidation reactions. Usually, the polymer mixture is designed to include some additives, such as anti-oxidants, to inhibit or reduce the degradation effects. Some other additives are intended to increase resistance to the ESC phenomenon associated with polymers (ESC: Environmental Stress Cracking). This situation occurs in contact with aggressive external environments following different contaminations of soil, groundwater and transported fluids. In addition, bacterial activity and other physical or chemical media, such as temperature and humidity, can play an enhancing role. These conditions contribute to modifying the PE pipe structure and degrade its properties during exposure. In this work, the effect of distilled water, sodium hypochlorite (bleach), diluted sulfuric acid (H2SO4) and toluene-methanol (TM) mixture are studied when extruded PE samples are exposed to those environments for given periods. The chosen exposure periods are 7, 14 and 28 days at room temperature and in sealed glass containers. Post-exposure observations and ISO impact tests are presented as a function of time and chemical medium. Water effects are observed to be limited in explaining such use in real applications, whereas the changes in TM and acidic media are very significant. For the TM medium, the polymer toughness increased drastically (from 15.95 kJ/m² up to 32.01 kJ/m²), while sulfuric acid showed a steady augmentation over time. This situation may correspond to a hardening phenomenon of PE increasing its brittleness and its ability for structural degradation because of localized oxidation reactions and changes in crystallinity.

Keywords: polyethylene, toluene-methanol mixture, environmental stress cracking, degradation, impact resistance

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692 Development of Family Quality of Life Scale for a Family Which Has a Person with Disability: Results of a Delphi Study

Authors: Thirakorn Maneerat, Darunee Jongudomkarn, Jiraporn Khiewyoo

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Family quality of life of families who have persons with disabilities is a core concern in government services and community health promotion to deal with the multidimensionality of today’s health and societal issues. The number of families who have persons with disabilities in Thailand is gradually increasing. However, facilitation and evaluation of such family quality of life are limited by the lack of feasible tools. As a consequence, service provided for the families is not optimally facilitated and evaluated. This paper is part of a larger project which is aimed to develop a scale for measuring of family quality of life of families who have persons with developmental disabilities in Thailand, presenting the results of a three-round Delphi method involving 11 experts. The study was obtained during December 2013 to May 2014. The first round consisted of open-ended questionnaire and content analysis of the answers. The second round comprised a 5-point Likert scale structured questionnaire based on the first round analysis, with required the experts to identify the most relevant studied tool aspects. Their feedbacks levels of agreements were statistic analysis using the median, interquartile range and quartile deviation. The included criteria for items acceptance were greater than 3.50 of the median, lesser than 1.50 of interquartile range, and 0.65 or less of a quartile deviation. Finally, the proposed questionnaire was structured and validated by the experts in the third round. The results found that across all three rounds, the experts achieved 100% agreement on the five factors regarding to quality of life of a family who have person with disability were considered. These five factors with 38 items were included: 1) 10 items of family interactions; 2) 9 items of child rearing; 3) 7 items of physical and material resources; 4) 5 items of social-emotional status; and 7 items of disability-related services and welfare. Next step of the study was examined the construct validity by using factor analysis methods.

Keywords: tool development, family quality of life scale, person with disability, Delphi study

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691 Women Entrepreneurship in Poland and Its Impact on the Country’s Economic Development

Authors: Sabina Klimek

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In general, entrepreneurs are viewed as agents of change whose goal is to ensure that resources are efficiently utilized. They are very important in the global economy; they create wealth and provide jobs. At the same time, many policymakers say that women entrepreneurs are a ‘special group’ worthy of their own research and policies. The status of Polish women has been changing as well, even though, to a large extent, it is still defined by the double role that women are expected to fill according to the dominant stereotypical model of family life. However, in the past decade, Polish women’s economic activities have experienced rapid growth and today are at a high level. In the article, the author presents the results of a survey conducted among women entrepreneurs in Poland concerning the functioning of their enterprises, motivation in setting up a company, and barriers that hinder them in business. The questionnaire (300 questionnaires were provided) and case studies carried out by the author have proven that female entrepreneurs in Poland are characterized by commonalities. Mostly they run small or micro-enterprises, operate in larger cities, are well-educated, and run service companies. Their main motivation to run their own business is mostly indicated by their need for independence. However, one of their biggest barriers and hesitations is the apprehension of non-payment. Entrepreneurs want to develop their companies, go to foreign markets and implement new solutions. They are not afraid of the future; they are only trying to create it. Detailed hypothesis, which reads as follows. The author additionally conducted a macroeconomic analysis calculating what part of GDP in Poland is produced by female entrepreneurs. The results of the study presented in this article prove that female entrepreneurship in Poland has a stable impact on the economy of the country, and women entrepreneurs produce over 13% of the national GDP. After years of growth in the number of female entrepreneurs in Poland, there has been a period of stabilization. However, there has also been a reduction in the number of self-employed people as well as the number of women in total employment. In the article, the author analyses the reasons for decreasing number of self-employed women and the total employment of women in Poland and provides suggestions for steps and incentives that should be made in order to encourage female entrepreneurship to grow in the country.

Keywords: women entrepreneurship, women in business, women entrepreneurship in Poland, Poland, GDP of Poland

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690 Laparoscopic Resection Shows Comparable Outcomes to Open Thoracotomy for Thoracoabdominal Neuroblastomas: A Meta-Analysis and Systematic Review

Authors: Peter J. Fusco, Dave M. Mathew, Chris Mathew, Kenneth H. Levy, Kathryn S. Varghese, Stephanie Salazar-Restrepo, Serena M. Mathew, Sofia Khaja, Eamon Vega, Mia Polizzi, Alyssa Mullane, Adham Ahmed

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Background: Laparoscopic (LS) removal of neuroblastomas in children has been reported to offer favorable outcomes compared to the conventional open thoracotomy (OT) procedure. Critical perioperative measures such as blood loss, operative time, length of stay, and time to postoperative chemotherapy have all supported laparoscopic use rather than its more invasive counterpart. Herein, a pairwise meta-analysis was performed comparing perioperative outcomes between LS and OT in thoracoabdominal neuroblastoma cases. Methods: A comprehensive literature search was performed on PubMed, Ovid EMBASE, and Scopus databases to identify studies comparing the outcomes of pediatric patients with thoracoabdominal neuroblastomas undergoing resection via OT or LS. After deduplication, 4,227 studies were identified and subjected to initial title screening with exclusion and inclusion criteria to ensure relevance. When studies contained overlapping cohorts, only the larger series were included. Primary outcomes include estimated blood loss (EBL), hospital length of stay (LOS), and mortality, while secondary outcomes were tumor recurrence, post-operative complications, and operation length. The “meta” and “metafor” packages were used in R, version 4.0.2, to pool risk ratios (RR) or standardized mean differences (SMD) in addition to their 95% confidence intervals in the random effects model via the Mantel-Haenszel method. Heterogeneity between studies was assessed using the I² test, while publication bias was assessed via funnel plot. Results: The pooled analysis included 209 patients from 5 studies (141 OT, 68 LS). Of the included studies, 2 originated from the United States, 1 from Toronto, 1 from China, and 1was from a Japanese center. Mean age between study cohorts ranged from 2.4 to 5.3 years old, with female patients occupying between 30.8% to 50% of the study populations. No statistically significant difference was found between the two groups for LOS (SMD -1.02; p=0.083), mortality (RR 0.30; p=0.251), recurrence(RR 0.31; p=0.162), post-operative complications (RR 0.73; p=0.732), or operation length (SMD -0.07; p=0.648). Of note, LS appeared to be protective in the analysis for EBL, although it did not reach statistical significance (SMD -0.4174; p= 0.051). Conclusion: Despite promising literature assessing LS removal of pediatric neuroblastomas, results showed it was non-superior to OT for any explored perioperative outcomes. Given the limited comparative data on the subject, it is evident that randomized trials are necessary to further the efficacy of the conclusions reached.

Keywords: laparoscopy, neuroblastoma, thoracoabdominal, thoracotomy

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689 Designing for Sustainable Public Housing from Property Management and Financial Feasibility Perspectives

Authors: Kung-Jen Tu

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Many public housing properties developed by local governments in Taiwan in the 1980s have deteriorated severely as these rental apartment buildings aged. The lack of building maintainability considerations during project design phase as well as insufficient maintenance funds have made it difficult and costly for local governments to maintain and keep public housing properties in good shape. In order to assist the local governments in achieving and delivering sustainable public housing, this paper intends to present a developed design evaluation method to be used to evaluate the presented design schemes from property management and financial feasibility perspectives during project design phase of public housing projects. The design evaluation results, i.e. the property management and financial implications of presented design schemes that could occur later during the building operation and maintenance phase, will be reported to the client (the government) and design schemes revised consequently. It is proposed that the design evaluation be performed from two main perspectives: (1) Operation and property management perspective: Three criteria such as spatial appropriateness, people and vehicle circulation and control, property management working spaces are used to evaluate the ‘operation and PM effectiveness’ of a design scheme. (2) Financial feasibility perspective: Four types of financial analyses are performed to assess the long term financial feasibility of a presented design scheme, such as operational and rental income analysis, management fund analysis, regular operational and property management service expense analysis, capital expense analysis. The ongoing Chung-Li Public Housing Project developed by the Taoyuan City Government will be used as a case to demonstrate how the presented design evaluation method is implemented. The results of property management assessment as well as the annual operational and capital expenses of a proposed design scheme are presented.

Keywords: design evaluation method, management fund, operational and capital expenses, rental apartment buildings

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688 Positioning of Lesbian and Gay Workers within the Corporate Sector in Sri Lanka: The Case of Residents in the Colombo District

Authors: Pramoda Karunarathna, Hemamalie Gunatilaka

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This study is based on experiences of Sri Lankan lesbian and gay workers’ career in the corporate sector, which include both manufacturing and service sectors. The study has started with the intention of shedding light on a grey area to observe the negative effects on lesbian and gay workers and their experiences while they are employed in the Sri Lankan corporate sector. In order to understand the experiences of lesbian and gay workers while they are at work within the corporate sector, the study seeks to address four questions. First research question is about the challenges faced by lesbian and gay workers while they are at work, and the second research question looks at their career patterns. Third research question seeks to address the behavior at work, and the fourth research question looks at the influence of class, religion, and cultural aspects on the career of lesbian and gay workers. Methodologically, the research was based on semi-structured interviews with nine participants (five gay men and four lesbian women) having work experience in the corporate sector and residing in Colombo, the capital city of Sri Lanka. The research found that the participants have gone through the process of developing sexual identity; gay men possess more feminine characteristics, while lesbian women possess more masculine characteristics. Further, their identity gets revealed in different ways, such as through the curriculum vitae, at the interviews, through the attire and behavior, and with the use of social media. The study also found that lesbian and gay workers experience discrimination due to violation of hierarchical power difference by other employees and marginalization, verbal and nonverbal abuse by other men at work are common experiences. Another finding is that lesbian and gay workers adopt strategies for survival at work, and they prefer the NGO sector to the corporate sector. In contrast, even within the corporate sector, advertising is preferred by lesbian and gay workers. Some of the Sri Lankan corporate sector organizations, especially multinational organizations, have initiated diversity training, and it might lead to making these organisations lesbian and gay-friendly workplaces in the future. It is also found that nearly 44 percent of the participants do not have a religion, and it is due to the rejection of deviant behaviours by most of the religions. In conclusion, lesbian and gay workers experience discrimination at work in the Sri Lankan corporate sector with an exception to the companies relating to advertising and non-governmental organisations is the sector that these workers prefer the most.

Keywords: lesbian workers, gay workers, Sri Lankan corporate sector, discrimination

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687 Supporting International Student’s Acculturation Through Chatbot Technology: A Proposed Study

Authors: Sylvie Studente

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Despite the increase in international students migrating to the UK, the transition from home environment to a host institution abroad can be overwhelming for many students due to acculturative stressors. These stressors are reported to peak within the first six months of transitioning into study abroad which has determinantal impacts for Higher Education Institutions. These impacts include; increased drop-out rates and overall decreases in academic performance. Research suggests that belongingness can negate acculturative stressors through providing opportunities for students to form necessary social connections. In response to this universities have focussed on utilising technology to create learning communities with the most commonly deployed being social media, blogs, and discussion forums. Despite these attempts, the application of technology in supporting international students is still ambiguous. With the reported growing popularity of mobile devices among students and accelerations in learning technology owing to the COVID-19 pandemic, the potential is recognised to address this challenge via the use of chatbot technology. Whilst traditionally, chatbots were deployed as conversational agents in business domains, they have since been applied to the field of education. Within this emerging area of research, a gap exists in addressing the educational value of chatbots over and above the traditional service orientation categorisation. The proposed study seeks to extend upon current understandings by investigating the challenges faced by international students in studying abroad and exploring the potential of chatbots as a solution to assist students’ acculturation. There has been growing interest in the application of chatbot technology to education accelerated by the shift to online learning during the COVID-19 pandemic. Although interest in educational chatbots has surged, there is a lack of consistency in the research area in terms of guidance on the design to support international students in HE. This gap is widened when considering the additional challenge of supporting multicultural international students with diverse. Diversification in education is rising due to increases in migration trends for international study. As global opportunities for education increase, so does the need for multiculturally inclusive learning support.

Keywords: chatbots, education, international students, acculturation

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686 Correlation Between Different Radiological Findings and Histopathological diagnosis of Breast Diseases: Retrospective Review Conducted Over Sixth Years in King Fahad University Hospital in Eastern Province, Saudi Arabia

Authors: Sadeem Aljamaan, Reem Hariri, Rahaf Alghamdi, Batool Alotaibi, Batool Alsenan, Lama Althunayyan, Areej Alnemer

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The aim of this study is to correlate between radiological findings and histopathological results in regard to the breast imaging-reporting and data system scores, size of breast masses, molecular subtypes and suspicious radiological features, as well as to assess the concordance rate in histological grade between core biopsy and surgical excision among breast cancer patients, followed by analyzing the change of concordance rate in relation to neoadjuvant chemotherapy in a Saudi population. A retrospective review was conducted over 6-year period (2017-2022) on all breast core biopsies of women preceded by radiological investigation. Chi-squared test (χ2) was performed on qualitative data, the Mann-Whitney test for quantitative non-parametric variables, and the Kappa test for grade agreement. A total of 641 cases were included. Ultrasound, mammography, and magnetic resonance imaging demonstrated diagnostic accuracies of 85%, 77.9% and 86.9%; respectively. magnetic resonance imaging manifested the highest sensitivity (72.2%), and the lowest was for ultrasound (61%). Concordance in tumor size with final excisions was best in magnetic resonance imaging, while mammography demonstrated a higher tendency of overestimation (41.9%), and ultrasound showed the highest underestimation (67.7%). The association between basal-like molecular subtypes and the breast imaging-reporting and data system score 5 classifications was statistically significant only for magnetic resonance imaging (p=0.04). Luminal subtypes demonstrated a significantly higher percentage of speculation in mammography. Breast imaging-reporting and data system score 4 manifested a substantial number of benign pathologies in all the 3 modalities. A fair concordance rate (k= 0.212 & 0.379) was demonstrated between excision and the preceding core biopsy grading with and without neoadjuvant therapy, respectively. The results demonstrated a down-grading in cases post-neoadjuvant therapy. In cases who did not receive neoadjuvant therapy, underestimation of tumor grade in biopsy was evident. In summary, magnetic resonance imaging had the highest sensitivity, specificity, positive predictive value and accuracy of both diagnosis and estimation of tumor size. Mammography demonstrated better sensitivity than ultrasound and had the highest negative predictive value, but ultrasound had better specificity, positive predictive value and accuracy. Therefore, the combination of different modalities is advantageous. The concordance rate of core biopsy grading with excision was not impacted by neoadjuvant therapy.

Keywords: breast cancer, mammography, MRI, neoadjuvant, pathology, US

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685 Industry 4.0 Platforms as 'Cluster' ecosystems for small and medium enterprises (SMEs)

Authors: Vivek Anand, Rainer Naegele

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Industry 4.0 is a global mega-trend revolutionizing the world of advanced manufacturing, but also bringing up challenges for SMEs. In response, many regional, as well as digital Industry 4.0 Platforms, have been set up to boost the competencies of established enterprises as well as SMEs. The concept of 'Clusters' is a policy tool that aims to be a starting point to establish sustainable and self-supporting structures in industries of a region by identifying competencies and supporting cluster actors with services that match their growth needs. This paper is motivated by the idea that Clusters have the potential to enable firms, particularly SMEs, to accelerate the innovation process and transition to digital technologies. In this research, the efficacy of Industry 4.0 platforms as Cluster ecosystems is evaluated, especially for SMEs. Focusing on the Baden Wurttemberg region in Germany, an action research method is employed to study how SMEs leverage other actors on Industry 4.0 Platforms to further their Industry 4.0 journeys. The aim is to evaluate how such Industry 4.0 platforms stimulate innovation, cooperation and competitiveness. Additionally, the barriers to these platforms fulfilling their promise to serve as capacity building cluster ecosystems for SMEs in a region will also be identified. The findings will be helpful for academicians and policymakers alike, who can leverage a ‘cluster policy’ to enable Industry 4.0 ecosystems in their regions. Furthermore, relevant management and policy implications stem from the analysis. This will also be of interest to the various players in a cluster ecosystem - like SMEs and service providers - who benefit from the cooperation and competition. The paper will improve the understanding of how a dialogue orientation, a bottom-up approach and active integration of all involved cluster actors enhance the potential of Industry 4.0 Platforms. A strong collaborative culture is a key driver of digital transformation and technology adoption across sectors, value chains and supply chains; and will position Industry 4.0 Platforms at the forefront of the industrial renaissance. Motivated by this argument and based on the results of the qualitative research, a roadmap will be proposed to position Industry 4.0 Platforms as effective clusters ecosystems to support Industry 4.0 adoption in a region.

Keywords: cluster policy, digital transformation, industry 4.0, innovation clusters, innovation policy, SMEs and startups

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684 Mechanical Properties and Antibiotic Release Characteristics of Poly(methyl methacrylate)-based Bone Cement Formulated with Mesoporous Silica Nanoparticles

Authors: Kumaran Letchmanan, Shou-Cang Shen, Wai Kiong Ng

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Postoperative implant-associated infections in soft tissues and bones remain a serious complication in orthopaedic surgery, which leads to impaired healing, re-implantation, prolong hospital stay and increase cost. Drug-loaded implants with sustained release of antibiotics at the local site are current research interest to reduce the risk of post-operative infections and osteomyelitis, thus, minimize the need for follow-up care and increase patient comfort. However, the improved drug release of the drug-loaded bone cements is usually accompanied by a loss in mechanical strength, which is critical for weight-bearing bone cement. Recently, more attempts have been undertaken to develop techniques to enhance the antibiotic elution as well as preserve the mechanical properties of the bone cements. The present study investigates the potential influence of addition of mesoporous silica nanoparticles (MSN) on the in vitro drug release kinetics of gentamicin (GTMC), along with the mechanical properties of bone cements. Simplex P was formulated with MSN and loaded with GTMC by direct impregnation. Meanwhile, Simplex P with water soluble poragen (xylitol) and high loading of GTMC as well as commercial bone cement CMW Smartset GHV were used as controls. MSN-formulated bone cements are able to increase the drug release of GTMC by 3-fold with a cumulative release of more than 46% as compared with other control groups. Furthermore, a sustained release could be achieved for two months. The loaded nano-sized MSN with uniform pore channels significantly build up an effective nano-network path in the bone cement facilitates the diffusion and extended release of GTMC. Compared with formulations using xylitol and high GTMC loading, incorporation of MSN shows no detrimental effect on biomechanical properties of the bone cements as no significant changes in the mechanical properties as compared with original bone cement. After drug release for two months, the bending modulus of MSN-formulated bone cements is 4.49 ± 0.75 GPa and the compression strength is 92.7 ± 2.1 MPa (similar to the compression strength of Simplex-P: 93.0 ± 1.2 MPa). The unaffected mechanical properties of MSN-formulated bone cements was due to the unchanged microstructures of bone cement, whereby more than 98% of MSN remains in the matrix and supports the bone cement structures. In contrast, the large portions of extra voids can be observed for the formulations using xylitol and high drug loading after the drug release study, thus caused compressive strength below the ASTM F541 and ISO 5833 minimum of 70 MPa. These results demonstrate the potential applicability of MSN-functionalized poly(methyl methacrylate)-based bone cement as a highly efficient, sustained and local drug delivery system with good mechanical properties.

Keywords: antibiotics, biomechanical properties, bone cement, sustained release

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683 Characters of Developing Commercial Employment Sub-Centres and Employment Density in Ahmedabad City

Authors: Bhaumik Patel, Amit Gotecha

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Commercial centres of different hierarchy and sizes play a vital role in the growth and development of the city. Economic uncertainty and demand for space leads to more urban sprawl and emerging more commercial spaces. The study was focused on the understanding of various indicators affecting the commercial development that can help to solve many issues related to commercial urban development and can guide for future employment growth centre development, Accessibility, Infrastructure, Planning and development regulations and Market forces. The aim of the study was to review characteristics and identifying employment density of Commercial Employment Sub-centres by achieving objectives Understanding various employment sub-centres, Identifying characteristics and deriving behaviour of employment densities and Evaluating and comparing employment sub-centres for the Ahmedabad city. Commercial employment sub-centres one in old city (Kalupur), second in highly developed commercial (C.G.road-Ashram road) and third in the latest developing commercial area (Prahladnagar) were identified by distance from city centre, Land use diversity, Access to Major roads and Public transport, Population density in proximity, Complimentary land uses in proximity and Land price. Commercial activities were categorised into retail, wholesale and service sector and sub categorised into various activities. From the study, Time period of establishment of the unit is a critical parameter for commercial activity, building height, and land-use diversity. Employment diversity is also one parameter for the commercial centre. The old city has retail, wholesale and trading and higher commercial density concerning units and employment both. Prahladnagar area functioned as commercial due to market pressure and developed as more units rather than a requirement. Employment density is higher in the centre of the city, as far as distance increases from city centre employment density and unit density decreases. Characters of influencing employment density and unit density are distance from city centre, development type, establishment time period, building density, unit density, public transport accessibility and road connectivity.

Keywords: commercial employment sub-centres, employment density, employment diversity, unit density

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682 Prevalence of Positive Serology for Celiac Disease in Children With Autism Spectrum Disorder

Authors: A. Venkatakrishnan, M. Juneja, S. Kapoor

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Background: Gastrointestinal dysfunction is an emerging co morbidity seen in autism and may further strengthen the association between autism and celiac disease. This is supported by increased rates (22-70%) of gastrointestinal symptoms like diarrhea, constipation, abdominal discomfort/pain, and gastrointestinal inflammation in children with the etiology of autism is still elusive. In addition to genetic factors, environmental factors such as toxin exposure, intrauterine exposure to certain teratogenic drugs, are being proposed as possible contributing factors in the etiology of Autism Spectrum Disorders (ASD) in cognizance with reports of increased gut permeability and high rates of gastrointestinal symptoms noted in children with ASD, celiac disease has also been proposed as a possible etiological factor. Despite insufficient evidence regarding the benefit of restricted diets in Autism, GFD has been promoted as an alternative treatment for ASD. This study attempts to discern any correlation between ASD and celiac disease. Objective: This cross sectional study aims to determine the proportion of celiac disease in children with ASD. Methods: Study included 155 participants aged 2-12 yrs, diagnosed as ASD as per DSM-5 attending the child development center at a tertiary care hospital in Northern India. Those on gluten free diet or having other autoimmune conditions were excluded. A detailed Performa was filled which included sociodemographic details, history of gastrointestinal symptoms, anthropometry, systemic examination, and pertinent psychological testing was done using was assessed using Developmental Profile-3(DP-3) for Developmental Quotient, Childhood Autism Rating Scale-2 (CARS-2) for severity of ASD, Vineland Adaptive Behavior Scales (VABS) for adaptive behavior, Child Behavior Checklist (CBCL) for behavioral problems and BAMBI (Brief Autism Mealtime Behavior Scales) for feeding problems. Screening for celiac was done by TTG-IgA levels, and total serum IgA levels were measured to exclude IgA deficiency. Those with positive screen were further planned for HLA typing and endoscopic biopsy. Results: A total of 155 cases were included, out of which 5 had low IgA levels and were hence excluded from the study. The rest 150 children had TTG levels below the ULN and normal total serum IgA level. History of Gastrointestinal symptoms was present in 51 (34%) cases abdominal pain was the most frequent complaint (16.6%), followed by constipation (12.6%). Diarrhea was seen in 8 %. Gastrointestinal symptoms were significantly more common in children with ASD above 5 yrs (p-value 0.006) and those who were verbal (p = 0.000). There was no significant association between socio-demographic factors, anthropometric data, or severity of autism with gastrointestinal symptoms. Conclusion: None of the150 patients with ASD had raised TTG levels; hence no association was found between ASD and celiac disease. There is no justification for routine screening for celiac disease in children with ASD. Further studies are warranted to evaluate association of Non Celiac Gluten Sensitivity with ASD and any role of gluten-free diet in such patients.

Keywords: autism, celiac, gastrointestinal, gluten

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681 Radioprotective Efficacy of Costus afer against the Radiation-Induced Hematology and Histopathology Damage in Mice

Authors: Idowu R. Akomolafe, Naven Chetty

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Background: The widespread medical application of ionizing radiation has raised public concern about radiation exposure and, thus, associated cancer risk. The production of reactive oxygen species and free radicals as a result of radiation exposure can cause severe damage to deoxyribonucleic acid (DNA) of cells, thus leading to biological effect. Radiotherapy is an excellent modality in the treatment of cancerous cells, comes with a few challenges. A significant challenge is the exposure of healthy cells surrounding the tumour to radiation. The last few decades have witnessed lots of attention shifted to plants, herbs, and natural product as an alternative to synthetic compound for radioprotection. Thus, the study investigated the radioprotective efficacy of Costus afer against whole-body radiation-induced haematological, histopathological disorder in mice. Materials and Method: Fifty-four mice were randomly divided into nine groups. Animals were pretreated with the extract of Costus afer by oral gavage for six days before irradiation. Control: 6 mice received feed and water only; 6 mice received feed, water, and 3Gy; 6 mice received feed, water, and 6Gy; experimental: 6 mice received 250 mg/kg extract; 6 mice received 500 mg/kg extract; 6 mice received 250 mg/kg extract and 3Gy; 6 mice received 500 mg/kg extract and 3Gy; 6 mice received 250 mg/kg extract and 6Gy; 6 mice received 500 mg/kg extract and 6Gy in addition to feeding and water. The irradiation was done at the Radiotherapy and Oncology Department of Grey's Hospital using linear accelerator (LINAC). Thirty-six mice were sacrificed by cervical dislocation 48 hours after irradiation, and blood was collected for haematology tests. Also, the liver and kidney of the sacrificed mice were surgically removed for histopathology tests. The remaining eighteen (18) mice were used for mortality and survival studies. Data were analysed by one-way ANOVA, followed by Tukey's multiple comparison test. Results: Prior administration of Costus afer extract decreased the symptoms of radiation sickness and caused a significant delay in the mortality as demonstrated in the experimental mice. The first mortality was recorded on day-5 post irradiation, and this happened to the group E- that is, mice that received 6Gy but no extract. There was significant protection in the experimental mice, as demonstrated in the blood counts against hematopoietic and gastrointestinal damage when compared with the control. The protection was seen in the increase in blood counts of experimental animals and the number of survivor. The protection offered by Costus afer may be due to its ability to scavenge free radicals and restore gastrointestinal and bone marrow damage produced by radiation. Conclusions: The study has demonstrated that exposure of mice to radiation could cause modifications in the haematological and histopathological parameters of irradiated mice. However, the changes were relieved by the methanol extract of Costus afer, probably through its free radical scavenging and antioxidant properties.

Keywords: costus afer, hematological, mortality, radioprotection, radiotherapy

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680 [Keynote Talk]: Mental Health Challenges among Women in Dubai, Mental Health Needs Assessment for Dubai (2015), Public Health and Safety Department - Dubai Health Authority (DHA)

Authors: Kadhim Alabady

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Purpose: Mental health problems affect women and men equally, but some are more common among women. To Provide a baseline of the current picture of major mental health challenges among women in Dubai. which can then be used to measure the impact of interventions or service development. Method: We have used mixed methods evaluation approaches. This was used to increase the validity of findings by using a variety of data collection techniques. We have integrated qualitative and quantitative methods in this piece of work. Conducting the two approaches is to explore issues that might not be highlighted enough through one method. Results: The key findings are: The prevalence of people who suffer from different types of mental disorders remains largely unknown, many women are unwilling to seek professional help because of lack of awareness or the stigma attached to it. -It is estimated there were around 2,928–4,392 mothers in Dubai (2014) suffering from postnatal depression of which 858–1,287, early intervention can be effective. -The system for managing health care for women with mental illness is fragmented and contains gaps and duplications. -It is estimated 1,029 girl aged 13–19 years affected with anorexia nervosa and there would be an estimated 1,029 girl aged 13–19 years affected with anorexia nervosa. Recommendations: -Work is required with primary health care in order to identify women with undiagnosed mental illnesses. Further work is undertaken within primary health care to assess disease registries with the aim of helping GP practices to improve their disease registers. -It is important to conduct local psychiatric morbidity surveys in Dubai to obtain data and assess the prevalence of essential mental health symptoms and conditions that are not routinely collected to get a clear sense of what is needed and to assist decision and policy making in getting a complete picture on what services are required. -Emergency Mental Health Care – there is a need for a crisis response team to respond to emergencies in the community. -Continuum of care – a significant gap in the services for women once they diagnosed with mental disorder.

Keywords: mental health, depression, schizophrenia, women

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679 Audit of Intraoperative Ventilation Strategy in Prolonged Abdominal Surgery

Authors: Prabir Patel, Eugene Ming Han Lim

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Introduction: Current literature shows that postoperative pulmonary complications following abdominal surgery may be reduced by using lower than conventional tidal volumes intraoperatively together with moderate levels of positive end expiratory pressure (PEEP). The recent studies demonstrated significant reduction demonstrated significant reduction in major complications in elective abdominal surgery through the use of lower tidal volumes (6-8 ml/kg predicted body weight), PEEP of 5 cmH20 and recruitment manoeuvres compared to higher ‘conventional’ volumes (10-12 mls/kg PBW) without lung recruitment. Our objective was to retrospectively audit current practice for patients undergoing major abdominal surgery in Sir Charles Gairdner Hospital. Methods: Patients over 18 undergoing elective general surgery lasting more than 3 hours and intubated during the duration of procedure were included in this audit. Data was collected over a 6 month period. Patients who had hepatic surgery, procedures necessitating one-lung ventilation, transplant surgery, documented history of pulmonary or intracranial hypertension were excluded. Results: 58 suitable patients were identified and notes were available for 54 patients. Key findings: Average peak airway pressure was 21cmH20 (+4), average peak airway pressure was less than 30 cmH20 in all patients, and less than 25 cmH20 in 80% of the cases. PEEP was used in 81% of the cases. Where PEEP was used, 75% used PEEP more than or equal to 5 cmH20. Average tidal volume per actual body weight was 7.1 ml/kg (+1.6). Average tidal volume per predicted body weight (PBW) was 8.8 ml/kg (+1.5). Average tidal volume was less than 10 ml/kg PBW in 90% of cases; 6-8 ml/kg PBW in 40% of the cases. There was no recorded use of recruitment manoeuvres in any cases. Conclusions: In the vast majority of patients undergoing prolonged abdominal surgery, a lung protective strategy using moderate levels of PEEP, peak airway pressures of less than 30 cmH20 and tidal volumes of less than 10 cmH20/kg PBW was utilised. A recent randomised control trial demonstrated benefit from utilising even lower volumes (6-8 mls/kg) based on findings in critical care patients, but this was compared to volumes of 10-12 ml/kg. Volumes of 6-8 ml/kg PBW were utilised in 40% of cases in this audit. Although theoretically beneficial, clinical benefit of lower volumes than what is currently practiced in this institution remains to be seen. The incidence of pulmonary complications was much lower than in the other cited studies and a larger data set would be required to investigate any benefit from lower tidal volume ventilation. The volumes used are comparable to results from published local and international data but PEEP utilisation was higher in this audit. Strategies that may potentially be implemented to ensure and maintain best practice include pre-operative recording of predicted body weight, adjustment of default ventilator settings and education/updates of current evidence.

Keywords: anaesthesia, intraoperative ventilation, PEEP, tidal volume

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678 Use of Telephone Counselling in Employee Assistance Program

Authors: Andy S.K. Cheng, Samuel Leung, Cindy Kwok, Hector Tsang

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Background: Telephone counselling is one of the essential interventions that can be found in most of the Employee Assistance Programs (EAP). The purposes of this study were to (1) explore the trend of the telephone counselling from 2003-2016 in Hong Kong; (2) explore which EAP issue requires more follow-up; and 3) examine the relationship between the EAP issues and demographic data such as gender and job ranking. Method: Date of EAP services usage was collected from EAP providers in Hong Kong during 2003-2016. EAP issues were categorized into two domains, namely workplace issues and personal issues. Each domain has 12 sub-categories. Two hypotheses were formulated in this study (1) there was a gender difference in EAP issues and the follow-up hours; and (2) there was a significant difference between job ranking, EAP issues and follow-up hours. Results: A total of eight hundred and ninety-three valid cases were identified for analysis. Of them, three hundred and forty-three cases sought for follow-up. The duration of follow-up by hours was calculated for each of the follow-up cases. The results of the study shows that the top three workplace issues that required the longest duration of follow-up were (1) workload, (2) supervisor-subordinate relationship; and (3) team member’s relationship. On the other hand, the top three personal issues that required the longest duration of follow-up were (1) parenting/parent-child relationship, (2) family care, and (3) marital relationship. Two-way ANOVA was performed to compare the total follow-up hours (excluding first intake) between gender and EAP issues. There was no statistical significance for gender (p =.891), but a statistically significant main effect for EAP issues (p <.001) was found. Post-hoc analysis (Tukey’s test) showed that total follow-up hour in personal issues was statistically significant higher than that in handling workplace issues (p <.001). However, there was no statistically significant interaction effect between gender and EAP issues (p=.879) and between job ranking and EAP issues (p=.843). Conclusion: Telephone counselling is a very common intervention in addressing EAP issues arising from workplace and personal level in Hong Kong. It was frequently used to handle interpersonal relationships and the service usage was independent of gender and job ranking.

Keywords: employee assistance program, follow-up time, interpersonal relationships, telephone counselling

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677 Disabled Young People’s Hopes and Dreams in a Rapidly Changing Society: Co-Production Peer Research

Authors: Tillie Curran

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This co-production project aimed for an expansive exploration of disabled young people’s hopes and dreams in the context of unprecedented societal changes. The research questions developed with disabled young people acting as peer researchers, ask ‘what does a good life look like now, and, what are your hopes and dreams for the future?’ Disabled children’s childhood studies and an asset-based approach placed the voice of disabled young people at the centre of the research process and inviting participants to ‘think big’! Over 18 months, academics, members of a Centre for Independent Living and peer researchers, came together to facilitate knowledge cafes with fifty disabled young people aged between 14 and 25 in a college and youth club setting. Methods used included trigger questions, photos voice, video, and cartooning. The peer researchers also investigated how house robots and connected autonomous vehicles might support their future aspirations and sense of freedom in this new era with a trip to the university robotic laboratory. Key themes arising from participants’ hopes and dream were about ‘being responsible’, ‘loving’, ‘freedom and happiness’ and a ‘strong sense of self and togetherness’ and suggest alternative narratives and rich visions of the future possibilities for disabled young people. The five key messages peer researchers produced for the report emphasised freedom to define their futures, desires to make the world a better place, to belong and have the chance of their own family life. Thematic analysis, production of the report and impact activities were all co-produced and as the project progressed peer researchers increasingly demonstrated a role as ‘change makers’ and have formed a young people’s co-production group going on into the future. Discussion of the project highlights the factors that made these processes successful and the ethical dilemmas encountered in the context of normalcy. Finally, we consider the implications for all involved as we rethink ‘the future’, not in terms of normative ideals or trajectories, or seeing service ‘transition’ as an end, but in terms of disabled young people’s contribution, participation, freedoms, and possibilities.

Keywords: co-production, disability, robotic, youth

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676 Informing, Enabling and Inspiring Social Innovation by Geographic Systems Mapping: A Case Study in Workforce Development

Authors: Cassandra A. Skinner, Linda R. Chamberlain

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The nonprofit and public sectors are increasingly turning to Geographic Information Systems for data visualizations which can better inform programmatic and policy decisions. Additionally, the private and nonprofit sectors are turning to systems mapping to better understand the ecosystems within which they operate. This study explores the potential which combining these data visualization methods—a method which is called geographic systems mapping—to create an exhaustive and comprehensive understanding of a social problem’s ecosystem may have in social innovation efforts. Researchers with Grand Valley State University collaborated with Talent 2025 of West Michigan to conduct a mixed-methods research study to paint a comprehensive picture of the workforce development ecosystem in West Michigan. Using semi-structured interviewing, observation, secondary research, and quantitative analysis, data were compiled on workforce development organizations’ locations, programming, metrics for success, partnerships, funding sources, and service language. To best visualize and disseminate the data, a geographic system map was created which identifies programmatic, operational, and geographic gaps in workforce development services of West Michigan. By combining geographic and systems mapping methods, the geographic system map provides insight into the cross-sector relationships, collaboration, and competition which exists among and between workforce development organizations. These insights identify opportunities for and constraints around cross-sectoral social innovation in the West Michigan workforce development ecosystem. This paper will discuss the process utilized to prepare the geographic systems map, explain the results and outcomes, and demonstrate how geographic systems mapping illuminated the needs of the community and opportunities for social innovation. As complicated social problems like unemployment often require cross-sectoral and multi-stakeholder solutions, there is potential for geographic systems mapping to be a tool which informs, enables, and inspires these solutions.

Keywords: cross-sector collaboration, data visualization, geographic systems mapping, social innovation, workforce development

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675 The Moderating Role of Payment Platform Applications’ Relationship with Increasing Purchase Intention Among Customers in Kuwait - Unified Theory of Acceptance and Sustainable Use of Technology Model

Authors: Ahmad Alsaber

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This paper aims to understand the intermediary role of the payment platform applications by analyzing the various factors that can influence the desirability of utilizing said payment services in Kuwait, as well as to determine the effect of the presence of different types of payment platforms on the variables of the “Unified Theory of Acceptance and Use of Technology” (UTAUT) model. The UTAUT model's findings will provide an important understanding of the moderating role of payment platform mobile applications. This study will explore the influence of payment platform mobile applications on customer purchase intentions in Kuwait by employing a quantitative survey of 200 local customers. Questions will cover their usage of payment platforms, purchase intent, and overall satisfaction. The information gathered is then analyzed using descriptive statistics and correlation analysis in order to gain insights. The research hopes to provide greater insight into the effect of mobile payment platforms on customer purchase intentions in Kuwait. This research will provide important implications to marketers and customer service providers, informing their strategies and initiatives, as well as offer recommendations to payment platform providers on how to improve customer satisfaction and security. The study results suggest that the likelihood of a purchase is affected by performance expectancy, effort expectancy, social influence, risk, and trust. The purpose of this research is to understand the advancements in the different variables that Kuwaiti customers consider while dealing with mobile banking applications. With the implementation of stronger security measures, progressively more payment platform applications are being utilized in the Kuwaiti marketplace, making them more desirable with their accessibility and usability. With the development of the Kuwaiti digital economy, it is expected that mobile banking will have a greater impact on banking transactions and services in the future.

Keywords: purchase intention, UTAUT, performance expectancy, social influence, risk, trust

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674 Interprofessional School-Based Mental Health Services for Rural Adolescents in South Australia

Authors: Garreth Kestell, Lukah Dykes, Danielle Zerk, Kyla Trewartha, Rhianon Marshall, Elena Rudnik

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Adolescent mental health is an international priority and the impact of innovative service models must be evaluated. Secondary school-based mental health services (SBMHS) involving private general practitioners and psychologists are a model of care being trialed in South Australia. Measures of depression, anxiety, and stress are routinely collected throughout psychotherapy sessions. This research set out to quantify the impact of psychotherapy for rural adolescents in a school setting and explore the importance of session frequency. Methods: Demographics, session date and DASS21 scores from students (n=65) seen in 2016 by three psychologists working at the SBMHS were recorded. Students were aged 13-18 years (M=15.43, SD= 1.24), mostly female (F=51, M=14), attended between 1 and 23 sessions with a median of 6 sessions (MAD 5.93) in one-year. The treating psychologist collected self-administered DASS21 scores. A mixed model analysis was used with age, sex, treating psychologist, months from first session, and session number as fixed effects, with response variables of DASS depression, anxiety, and stress scores. Results: 71.5% were classified as having extreme or severe anxiety and half had extreme or severe depression and/or stress scores. On average males had a greater increase in DASS scores over time but males attending more sessions benefited most from therapy. Discussion: Psychologists are treating rural adolescents in schools for severe anxiety, depression, and stress. This pilot study indicates that a predictive model combining demographics, session frequency, and DASS scores may help identify who is most likely to benefit from individual psychotherapy. Variations in DAS scores of individuals over time indicate the need for the collection of information such as living situation and exposure to alcohol. A larger sample size and additional data are currently being collected to allow for a more robust analysis.

Keywords: adolescent health, psychotherapy, school based mental health services, DAS21

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673 The Effect of the Contributory Pension Scheme on Employees’ Performance

Authors: Oladipo Jimoh Ayanda, Fashagba Mathew Olasehinde

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Pension is a post retirement benefit paid to employees after retirement to cushion the effects of severance from monthly emoluments. It serves the dual purpose of providing financial succour to retired employees as well as motivating employees currently in service to greater performance on duty. However, the scheme, as operated in Nigeria, is prone to some pitfalls such as delayed and irregular payments, inadequate budgetary provisions, employee sufferings and deaths arising from the rigors of verification exercises, among others. This necessitated the replacement of the old scheme with the contributory pension scheme through an enabling law in 2004. The implementation of the new scheme has its own challenges especially in connection with administration. These challenges pose a fundamental problem of establishing a nexus between pension benefits and work performance which represent the focus of the study. The study objectives were to: determine the effect of contributory pension scheme on employees’ performance. The study population consisted of National Universities Commission recognized public and private universities in the South West Nigeria. Multi-stage sampling method involving stratified sampling and systematic sampling was used in selecting 359 respondents while data were collected through questionnaire administration. The procedure for analyzing the data included descriptive statistic, normal distribution test and cross-tabulation (gamma coefficient). The findings of the study showed that the existence of the scheme positively enhances employees’ performance as indicated by normal distribution test with Z-score (10.169) which is greater than the table value (1.96) at 0.05 level. The study concluded that the scope for enhancing employee current job performance can be quite elastic if future retirement benefits are guaranteed through proper and efficient administration and management of the contributory pension scheme. The study recommended that certain factors such as employers’ commitment which account for different levels of confidence between public and private universities should be looked into in order to improve confidence across board while the provisions of the scheme as they affect the PFAs should be properly monitored to ensure compliance.

Keywords: pension, retirement, performance, employees, benefit

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672 Open Innovation for Crowdsourced Product Development: The Case Study of Quirky.com

Authors: Ana Bilandzic, Marcus Foth, Greg Hearn

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In a narrow sense, innovation is the invention and commercialisation of a new product or service in the marketplace. The literature suggests places that support knowledge exchange and social interaction, e.g. coffee shops, to nurture innovative ideas. With the widespread success of Internet, interpersonal communication and interaction changed. Online platforms complement physical places for idea exchange and innovation – the rise of hybrid, ‘net localities.’ Further, since its introduction in 2003 by Chesbrough, the concept of open innovation received increased attention as a topic in academic research as well as an innovation strategy applied by companies. Open innovation allows companies to seek and release intellectual property and new ideas from outside of their own company. As a consequence, the innovation process is no longer only managed within the company, but it is pursued in a co-creation process with customers, suppliers, and other stakeholders. Quirky.com (Quirky), a company founded by Ben Kaufman in 2009, recognised the opportunity given by the Internet for knowledge exchange and open innovation. Quirky developed an online platform that makes innovation available to everyone. This paper reports on a study that analysed Quirky’s business process in an extended event-driven process chain (eEPC). The aim was to determine how the platform enabled crowdsourced innovation for physical products on the Internet. The analysis reveals that key elements of the business model are based on open innovation. Quirky is an example of how open innovation can support crowdsourced and crowdfunded product ideation, development and selling. The company opened up various stages in the innovation process to its members to contribute in the product development, e.g. product ideation, design, and market research. Throughout the process, members earn influence through participating in the product development. Based on the influence they receive, shares on the product’s turnover. The outcomes of the study’s analysis highlighted certain benefits of open innovation for product development. The paper concludes with recommendations for future research to look into opportunities of open innovation approaches to be adopted by tertiary institutions as a novel way to commercialise research intellectual property.

Keywords: business process, crowdsourced innovation, open innovation, Quirky

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671 Critical Appraisal, Smart City Initiative: China vs. India

Authors: Suneet Jagdev, Siddharth Singhal, Dhrubajyoti Bordoloi, Peesari Vamshidhar Reddy

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There is no universally accepted definition of what constitutes a Smart City. It means different things to different people. The definition varies from place to place depending on the level of development and the willingness of people to change and reform. It tries to improve the quality of resource management and service provisions for the people living in the cities. Smart city is an urban development vision to integrate multiple information and communication technology (ICT) solutions in a secure fashion to manage the assets of a city. But most of these projects are misinterpreted as being technology projects only. Due to urbanization, a lot of informal as well government funded settlements have come up during the last few decades, thus increasing the consumption of the limited resources available. The people of each city have their own definition of Smart City. In the imagination of any city dweller in India is the picture of a Smart City which contains a wish list of infrastructure and services that describe his or her level of aspiration. The research involved a comparative study of the Smart City models in India and in China. Behavioral changes experienced by the people living in the pilot/first ever smart cities have been identified and compared. This paper discussed what is the target of the quality of life for the people in India and in China and how well could that be realized with the facilities being included in these Smart City projects. Logical and comparative analyses of important data have been done, collected from government sources, government papers and research papers by various experts on the topic. Existing cities with historically grown infrastructure and administration systems will require a more moderate step-by-step approach to modernization. The models were compared using many different motivators and the data is collected from past journals, interacting with the people involved, videos and past submissions. In conclusion, we have identified how these projects could be combined with the ongoing small scale initiatives by the local people/ small group of individuals and what might be the outcome if these existing practices were implemented on a bigger scale.

Keywords: behavior change, mission monitoring, pilot smart cities, social capital

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670 Effect of Nigella Sativa Seeds and Ajwa Date on Blood Glucose Level in Saudi Patients with Type 2 Diabetes Mellitus

Authors: Reham Algheshairy, Khaled Tayeb, Christopher Smith, Rebecca Gregg, Haruna Musa

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Background: Diabetes is a medical condition that refers to the pancreas’ inability to secrete sufficient insulin levels, a hormone responsible for controlling glucose levels in the body. Any surplus glucose in the blood stream is excreted through the urinary system. Insulin resistance in blood cells can also cause this condition despite the fact that the pancreas is producing the required amount of insulin A number of researchers claim that the prevalence of diabetes in Saudi Arabia has reached epidemic proportions, although one study did observe one positive in the rise in the awareness of diabetes, possibly indicative of Saudi Arabia’s improving healthcare system. While a number of factors can cause diabetes, the ever-increasing incidence of the disease in Saudi Arabia has been blamed primarily on low levels of physical activity and high levels of obesity. Objectives: The project has two aims. The first aim of the project is to investigate the regulatory effects of consumption of Nigella seeds and Ajwah dates on blood glucose levels in diabetic patients with type 2 diabetes. The second aim of the project is to investigate whether these dietary factors may have potentially beneficial effects in controlling the complications that associated with type 2 diabetes. Methods: This use a random-cross intervention trail of 75 Saudi male and female with type 2 diabetes in Al-Noor hospital in Makkah ( KSA) aged between 18 and 70 years were divided into 3 groups. Group 1 will consume 2g of Nigella Sativa seeds daily along with a modified diet for 12 weeks, group 2 will be given Ajwah dates daily with a modified diet for 12 weeks and group 3 will follow a modified diet for 12 weeks. Anthropometric measurements were taken at baseline, along with bloods for HbA1c, fasting blood sugar and at the end of 12 weeks. Results: This study found significant decrease in blood level (FBG & 2PPBG) and HbA1c in the groups with diet and Nigella seeds) compared to Ajwa date. However, there is no significant change were found in HbA1c, FBG and 2hrpp regarding Ajwa group. Conclusion: This study illustrated a significant improvement in some markers of glycaemia following 2 g of Ns and diet for 12 weeks. The dose of 2g/day of consumed Nigella seeds was found to be more effective in controlling BGL and HbA1c than control and Ajwa groups. This suggests that Nigella seeds and following a diet may have a potential effect (a role in controlling outcomes for type 2 diabetes and controlling the disease). Further research is needed on a large scale to determine the optimum dose and duration of Nigella and Ajwa in order to achieve the desired results.

Keywords: type 2 diabetes, Nigella seeds, Ajwa dates, fasting blood glucose, control

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669 Transit Facility Planning in Fringe Areas of Kolkata Metropolitan Region

Authors: Soumen Mitra, Aparna Saha

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The perceived link between the city and the countryside is evolving rapidly and is getting shifted away from the assumptions of mainstream paradigms to new conceptual networks where rural-urban links are being redefined. In this conceptual field, the fringe interface is still considered as a transitional zone between city and countryside, and is defined as a diffused area rather than a discrete territory. In developing countries fringe areas are said to have both rural and urban characteristics but are devoid of basic municipal facilities. Again, when the urban core areas envelopes the fringe areas along with it the character of fringe changes but services are not well facilitated which in turn results to uneven growth, rapid and haphazard development. One of the major services present in fringe areas is inter-linkages in terms of transit corridors. Planning for the appropriate and sustainable future of fringe areas requires a sheer focus on these corridors pertaining to transit facility, for better accessibility and mobility. Inducing a transit facility plan enhances the various facilities and also increases their proximity for user groups. The study focuses on the western fringe region of Kolkata metropolis which is a major source of industrial hub and housing sector, thus converting the agricultural lands into non-agricultural use. The study emphasizes on providing transit facilities both physical (stops, sheds, terminals, etc.) and operational (ticketing system, route prioritization, integration of transit modes, etc.), to facilitate the region as well as accelerate the growth pattern systematically. Hence, the scope of this work is on the basis of prevailing conditions in fringe areas and attempts for an effective transit facility plan. The strategies and recommendations are in terms of road widening, service coverage, feeder route prioritization, bus stops facilitation, pedestrian facilities, etc, which in turn enhances the region’s growth pattern. Thus, this context of transit facility planning acts as a catalytic agent to avoid the future unplanned growth and accelerates it towards an integrated development.

Keywords: feeder route, fringe, municipal planning, transit facility

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