Search results for: service delivery disparity

Authors: Jo Mitchell, Daniel Johnson

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MindMax is a digital community and learning platform built to maximise the wellbeing and resilience of AFL Players and Australian men. The MindMax application engages men, via their existing connection with sport and video games, in a range of wellbeing ideas, stories and actions, because we believe fit minds, kick goals. MindMax is an AFL Players Association led project, supported by a Movember Foundation grant, to improve the mental health of Australian males aged between 16-35 years. The key engagement and delivery strategy for the project was digital technology, sport (AFL) and video games, underpinned by evidenced based wellbeing science. The project commenced April 2015, and the expected completion date is March 2017. This paper describes the conceptual model underpinning product development, including progress, key learnings and challenges, as well as the research agenda. Evaluation of the MindMax project is a multi-pronged approach of qualitative and quantitative methods, including participatory design workshops, online reference groups, longitudinal survey methods, a naturalistic efficacy trial and evaluation of the social and economic return on investment. MindMax is focused on the wellness pathway and maximising our mind's capacity for fitness by sharing and promoting evidence-based actions that support this. A range of these ideas (from ACT, mindfulness and positive psychology) are already being implemented in AFL programs and services, mostly in face-to-face formats, with strong engagement by players. Player's experience features strongly as part of the product content. Wellbeing science is a discipline of psychology that explores what helps individuals and communities to flourish in life. Rather than ask questions about illness and poor functioning, wellbeing scientists and practitioners ask questions about wellness and optimal functioning. While illness and wellness are related, they operate as separate constructs and as such can be influenced through different pathways. The essential idea was to take the evidence-based wellbeing science around building psychological fitness to the places and spaces that men already frequent, namely sport and video games. There are 800 current senior AFL players, 5000+ past players, and 11 million boys and men that are interested in the lives of AFL Players; what they think and do to be their best both on and off field. AFL Players are also keen video gamers – using games as one way to de-stress, connect and build wellbeing. There are 9.5 million active gamers in Australia with 93% of households having a device for playing games. Video games in MindMax will be used as an engagement and learning tool. Gamers (including AFL players) can also share their personal experience of how games help build their mental fitness. Currently available games (i.e., we are not in the game creation business) will also be used to motivate and connect MindMax participants. The MindMax model is built with replication by other sport codes (e.g., Cricket) in mind. It is intended to not only support our current crop of athletes but also the community that surrounds them, so they can maximise their capacity for health and wellbeing.

Keywords: Australian football league, digital application, positive psychology, wellbeing

Procedia PDF Downloads 239

Authors: Vishwajit Ghatge, David Looper

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Over the last few decades, oilfield service rolling equipment has significantly increased in weight, primarily because of emissions regulations, which require larger/heavier engines, larger cooling systems, and emissions after-treatment systems, in some cases, etc. Larger engines cause more vibration and shock loads, leading to failure of electronics and control systems. If the vibrating frequency of the engine matches the system frequency, high resonance is observed on structural parts and mounts. One such existing automated control equipment system comprising wire rope mounts used for mounting computers was designed approximately 12 years ago. This includes the use of an industrial- grade computer to control the system operation. The original computer had a smaller, lighter enclosure. After a few years, a newer computer version was introduced, which was 10 lbm heavier. Some failures of internal computer parts have been documented for cases in which the old mounts were used. Because of the added weight, there is a possibility of having the two brackets impact each other under off-road conditions, which causes a high shock input to the computer parts. This added failure mode requires validating the existing mount design to suit the new heavy-weight computer. This paper discusses the modal finite element method (FEM) analysis and experimental modal analysis conducted to study the effects of vibration on the wire rope mounts and the computer. The existing mount was modelled in ANSYS software, and resultant mode shapes and frequencies were obtained. The experimental modal analysis was conducted, and actual frequency responses were observed and recorded. Results clearly revealed that at resonance frequency, the brackets were colliding and potentially causing damage to computer parts. To solve this issue, spring mounts of different stiffness were modeled in ANSYS software, and the resonant frequency was determined. Increasing the stiffness of the system increased the resonant frequency zone away from the frequency window at which the engine showed heavy vibrations or resonance. After multiple iterations in ANSYS software, the stiffness of the spring mount was finalized, which was again experimentally validated.

Keywords: experimental modal analysis, FEM Modal Analysis, frequency, modal analysis, resonance, vibration

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Authors: Gevorgianiene Violeta, Sumskiene Egle

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Background. Child removal is a profound and life-altering measure that significantly impacts both children and their mothers. Unfortunately, mothers with intellectual disabilities are disproportionately affected by the removal of their children. This action is often taken due to concerns about the mother's perceived inability to care for the child, instances of abuse and neglect, or struggles with addiction. In many cases, the failure to meet society's standards of a "good mother" is seen as a deviation from conventional norms of femininity and motherhood. From an institutional perspective, separating a child from their mother is sometimes viewed as a step toward restoring justice or doing what is considered "right." In another light, this act of child removal can be seen as the removal of a mother from her child, an attempt to shield society from the complexities and fears associated with motherhood for women with disabilities. This separation can be likened to the Greek legend of the Minotaur, a fearsome beast confined within an impenetrable labyrinth. By reimagining this legend, we can see the social fears surrounding 'mothering with intellectual disability' as deeply sealed within an unreachable place. The Aim of this Presentation. Our goal with this presentation is to draw from our research and the metaphors found in the Greek legend to delve into the profound challenges faced by mothers with intellectual disabilities in raising their children. These challenges often become entangled within an insurmountable labyrinth, including navigating complex institutional bureaucracies, enduring persistent doubts cast upon their maternal competencies, battling unfavorable societal narratives, and struggling to retain custody of their children. Coupled with limited social support networks, these challenges frequently lead to situations resulting in maternal failure and, ultimately, child removal. On a broader scale, this separation of a child from their mother symbolizes society’s collective avoidance of confronting the issue of 'mothering with disability,' which can only be effectively addressed through united efforts. Conclusion. Just as in the labyrinth of the Minotaur legend, the struggles faced by mothers with disabilities in their pursuit of retaining their children reveal the need for a metaphorical 'string of Ariadne.' This string symbolizes the support offered by social service providers, communities, and the loved ones these women often dream of but rarely encounter in their lives.

Keywords: motherhood, disability, child removal, support.

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Authors: Emilio A. Berny-Brandt, Sonia E. Ruiz

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Steel tubular towers serving as support structures for large wind turbines are subject to several hundred million stress cycles arising from the turbulent nature of the wind. This causes high-cycle fatigue which can govern tower design. The practice of maintaining the support structure after wind turbines reach its typical 20-year design life have become common, but without quantifying the changes in the reliability on the tower. There are several studies on this topic, but most of them are based on the S-N curve approach using the Miner’s rule damage summation method, the de-facto standard in the wind industry. However, the qualitative nature of Miner’s method makes desirable the use of fracture mechanics to measure the effects of fatigue in the capacity curve of the structure, which is important in order to evaluate the integrity and reliability of these towers. Temporal and spatially varying wind speed time histories are simulated based on power spectral density and coherence functions. Simulations are then applied to a SAP2000 finite element model and step-by-step analysis is used to obtain the stress time histories for a range of representative wind speeds expected during service conditions of the wind turbine. Rainflow method is then used to obtain cycle and stress range information of each of these time histories and a statistical analysis is performed to obtain the distribution parameters of each variable. Monte Carlo simulation is used here to evaluate crack growth over time in the tower base using the Paris-Erdogan equation. A nonlinear static pushover analysis to assess the capacity curve of the structure after a number of years is performed. The capacity curves are then used to evaluate the changes in reliability of a steel tower located in Oaxaca, Mexico, where wind energy facilities are expected to grow in the near future. Results show that fatigue on the tower base can have significant effects on the structural capacity of the wind turbine, especially after the 20-year design life when the crack growth curve starts behaving exponentially.

Keywords: crack growth, fatigue, Monte Carlo simulation, structural reliability, wind turbines

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Authors: Malika Turganova, Aigul Abduldayeva

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Modern conditions require nursing innovations at the primary ambulatory stage in the health system of Kazakhstan. There is a growing need for nurses involved in before-doctor attendance for preventive interview with a female population about reproductive health. We conducted questionnaire survey of the population of Astana in 2015. Questionnaires were drawn up according to the criteria of sexual health of World Health Organization. 3593 respondents out of 8000 questionnaires agreed to answer the questions anonymously, mM=±2,1. The average age of women comprised 37,4±11,2, Ме=31,7 years of age. Analysis of awareness about marriage hygiene revealed that 72,7% of respondents did not receive information about marriage hygiene and 89,1% respondents consider it more advisable before marriage. 45,9% of respondents specified the internet as a source of information on marriage hygiene issues, 24,5% of respondents pointed out friends, and 21,5% specified doctor. Comparing female age groups under and after 40 years old we see that proportion of cases when parents provide information about marriage hygiene issues comprises 4.3% (χ2 =9.8, p<0.05). The most important factor of preservation of women reproductive health is handling a problem of unwanted pregnancy. The responsibility lies equally in men and women. Data analysis of contraceptive methods by ranking showed three most frequently used methods: contraception sheath – 29.3%, then coitus interruptus – 18.7% and hormonal preparations – 16.9%. The most important factor of women's reproductive health preservation is a solving of the problem of unwanted pregnancy, and in this respect, the responsibility lies equally in men and women. Analyzing obtained data on contraceptive methods by ranking three of the most frequently used methods are condoms – 29,3%, then coitus interruptus – 18,7% and hormonal preparations – 16,9%. Additional oral survey of the population showed a low level of informational support of female population by family physicians, health care professionals of educational organizations (schools, universities, and colleges) about hormonal contraceptive. Females of both age groups used to think that hormonal contraceptives cause collateral damage such as blastoma, cancer, increased body weight, varix dilatation of lower limbs. Satisfaction with the frequency of sexual relations of the respondents comprised 57,6%. At that, women under 40 years of age are the most satisfied women among age groups (χ2 =5,8, p<0,05).

Keywords: nurse, public health service of Kazakhstan, reproductive and sexual health, trust of population

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Authors: Lucia Varra, Marzia Timolo

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The interest of scholars towards corporate sustainability has strengthened in recent years in parallel with the growing need to undertake paths of cultural and organizational change, as a way for greater competitiveness and stakeholders’ satisfaction. In fact, studies on the business sustainability, while on the one hand have integrated the three dimensions of sustainability that existed for some time in the economic approaches (economic, environmental and social dimensions), on the other hand did not give rise to an organic construct that puts together the aspects of strategic management with corporate social responsibility and even less with the organizational issues. Therefore some important questions remain open: Which organizational structure and which operational mechanisms are coherent or propitious to a sustainability strategy? Existing studies appear to be fragmented, although some aspects have shared importance: knowledge management, human resource, management, leadership, innovation, etc. The construction of a model of sustainable organization that supports the sustainability strategy no longer seems to be postponed, as is its connection with the main practices of measuring corporate social responsibility performance. The paper aims to identify the organizational characteristics of a sustainable corporate. To this end, from a theoretical point of view the work examines the main existing literary contributions and, from a practical point of view, it presents a business case referring to a service organization that for years has undertaken the sustainability strategy. This paper is divided into two parts: the first part concerns a review of the main articles on the strategic management topic and the main organizational issues raised by the literature, such as knowledge management, leadership, innovation, etc.; later, a modeling of the main variables examined by scholars and an integration of these with the international measurement standards of CSR is proposed. In the second part, using the methodology of the case study company, the hypotheses and the structure of the proposed model that aims to integrate the strategic issues with the organizational aspects and measurement of sustainability performance, are applied to an Italian company, which has some organizational and human resource management interventions are in place to align strategic decisions with the structure and operating mechanisms of the structure. The case presented supports the hypotheses of the model.

Keywords: CSR, strategic management, sustainable leadership, sustainable human resource management, sustainable organization

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Authors: Mohammad Arabi

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Business Process Reengineering (BPR) is a systematic approach to fundamentally redesign organizational processes to achieve significant improvements in organizational performance. At Fars Regional Electric Company, implementing BPR is deemed essential to increase productivity, reduce costs, and improve service quality. This article examines how BPR can help enhance the performance of Fars Regional Electric Company. The objective of this research is to evaluate and analyze the advancements in process modeling and reengineering at Fars Regional Electric Company and to provide solutions for improving the productivity and efficiency of organizational processes. This study aims to demonstrate how BPR can be used to improve organizational processes and enhance the overall performance of the company. This research employs both qualitative and quantitative research methods and includes interviews with senior managers and experts at Fars Regional Electric Company. The analytical tools include process modeling software such as Bizagi and ARIS, and statistical analysis software such as SPSS and Minitab. Data analysis was conducted using advanced statistical methods. The results indicate that the use of BPR techniques can lead to a significant reduction in process execution time and overall improvement in quality. Implementing BPR at Fars Regional Electric Company has led to increased productivity, reduced costs, and improved overall performance of the company. This study shows that with proper implementation of BPR and the use of modeling tools, the company can achieve significant improvements in its processes. Recommendations: (1) Continuous Training for Staff: Invest in continuous training of staff to enhance their skills and knowledge in BPR. (2) Use of Advanced Technologies: Utilize modeling and analysis software to improve processes. (3) Implementation of Effective Management Systems: Employ knowledge and information management systems to enhance organizational performance. (4) Continuous Monitoring and Review of Processes: Regularly review and revise processes to ensure ongoing improvements. This article highlights the importance of improving organizational processes at Fars Regional Electric Company and recommends that managers and decision-makers at the company seriously consider reengineering processes and utilizing modeling technologies to achieve developmental goals and continuous improvement.

Keywords: business process reengineering, electric company, Fars province, process modeling advancements

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Authors: Kemkanit Sanyanunthana

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The purpose of this research is to study the management system of information technology which supports the education of five private universities in Thailand, according to the case studies which have been developing their qualities and standards of management and education by service provision of information technology to support the excellence performance. The concept to connect information technology with a suitable system has been created by information technology administrators for development, as a system that can be used throughout the organizations to help reach the utmost benefits of using all resources. Hence, the researcher as a person who has been performing these duties within higher education is interested to do this research by selecting the Control Objective for Information and Related Technology 5 (COBIT 5) for the Malcolm Baldrige National Quality Award (MBNQA) of America, or the National Award which applies the concept of Total Quality Management (TQM) to the organization evaluation. Such evaluation is called the Education Criteria for Performance Excellence (EdPEx) focuses on studying and comparing education quality development for excellent performance using COBIT 5 in terms of information technology to study the problems and obstacles of the investigation process for an information technology system, which is considered as an instrument to drive all organizations to reach the excellence performance of the information technology, and to be the model of evaluation and analysis of the process to be in accordance with the strategic plans of the information technology in the universities. This research is conducted in the form of descriptive and survey research according to the case studies. The data collection were carried out by using questionnaires through the administrators working related to the information technology field, and the research documents related to the change management as the main study. The research can be concluded that the performance based on the APO domain process (ALIGN, PLAN AND ORGANISE) of the COBIT 5 standard frame, which emphasizes concordant governance and management of strategic plans for the organizations, could reach only 95%. This might be because of some restrictions such as organizational cultures; therefore, the researcher has studied and analyzed the management of information technology in universities as a whole, under the organizational structures, to reach the performance in accordance with the overall APO domain which would affect the determined strategic plans to be able to develop based on the excellence performance of information technology, and to apply the risk management system at the organizational level into every performance process which would develop the work effectiveness for the resources management of information technology to reach the utmost benefits. 

Keywords: COBIT5, APO, EdPEx Criteria, MBNQA

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Authors: Saidur R. Chowdhury, Mamme K. Addai, Ernest K. Yanful

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The research was performed to assess the potential of nickel smelter slag, an industrial waste, as an adsorbent in the removal of metals from aqueous solution. An investigation was carried out for Arsenic (As), Copper (Cu), lead (Pb) and Cadmium (Cd) adsorption from aqueous solution. Smelter slag was obtain from Ni ore at the Vale Inco Ni smelter in Sudbury, Ontario, Canada. The batch experimental studies were conducted to evaluate the removal efficiencies of smelter slag. The slag was characterized by surface analytical techniques. The slag contained different iron oxides and iron silicate bearing compounds. In this study, the effect of pH, contact time, particle size, competition by other ions, slag dose and distribution coefficient were evaluated to measure the optimum adsorption conditions of the slag as an adsorbent for As, Cu, Pb and Cd. The results showed 95-99% removal of As, Cu, Pb, and almost 50-60% removal of Cd, while batch experimental studies were conducted at 5-10 mg/L of initial concentration of metals, 10 g/L of slag doses, 10 hours of contact time and 170 rpm of shaking speed and 25oC condition. The maximum removal of Arsenic (As), Copper (Cu), lead (Pb) was achieved at pH 5 while the maximum removal of Cd was found after pH 7. The column experiment was also conducted to evaluate adsorption depth and service time for metal removal. This study also determined adsorption capacity, adsorption rate and mass transfer rate. The maximum adsorption capacity was found to be 3.84 mg/g for As, 4 mg/g for Pb, and 3.86 mg/g for Cu. The adsorption capacity of nickel slag for the four test metals were in decreasing order of Pb > Cu > As > Cd. Modelling of experimental data with Visual MINTEQ revealed that saturation indices of < 0 were recorded in all cases suggesting that the metals at this pH were under- saturated and thus in their aqueous forms. This confirms the absence of precipitation in the removal of these metals at the pHs. The experimental results also showed that Fe and Ni leaching from the slag during the adsorption process was found to be very minimal, ranging from 0.01 to 0.022 mg/L indicating the potential adsorbent in the treatment industry. The study also revealed that waste product (Ni smelter slag) can be used about five times more before disposal in a landfill or as a stabilization material. It also highlighted the recycled slags as a potential reactive adsorbent in the field of remediation engineering. It also explored the benefits of using renewable waste products for the water treatment industry.

Keywords: adsorption, industrial waste, recycling, slag, treatment

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Authors: Jose Daniel Giraldo Arias, Camilo Rojas Gomez, David Villegas Delgado, Gullermo Idarraga Alarcon, Juan Meza Meza

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The reverse engineering processes are widely used in the industry with the main goal to determine the materials and the manufacture used to produce a component. There are a lot of characterization techniques and computational tools that are used in order to get this information. A study case of a reverse engineering applied to a secondary sandwich- hybrid type structure used in a helicopter is presented. The methodology used consists of five main steps, which can be applied to any other similar component: Collect information about the service conditions of the part, disassembly and dimensional characterization, functional characterization, material properties characterization and manufacturing processes characterization, allowing to obtain all the supports of the traceability of the materials and processes of the aeronautical products that ensure their airworthiness. A detailed explanation of each step is covered. Criticality and comprehend the functionalities of each part, information of the state of the art and information obtained from interviews with the technical groups of the helicopter’s operators were analyzed,3D optical scanning technique, standard and advanced materials characterization techniques and finite element simulation allow to obtain all the characteristics of the materials used in the manufacture of the component. It was found that most of the materials are quite common in the aeronautical industry, including Kevlar, carbon, and glass fibers, aluminum honeycomb core, epoxy resin and epoxy adhesive. The stacking sequence and volumetric fiber fraction are a critical issue for the mechanical behavior; a digestion acid method was used for this purpose. This also helps in the determination of the manufacture technique which for this case was Vacuum Bagging. Samples of the material were manufactured and submitted to mechanical and environmental tests. These results were compared with those obtained during reverse engineering, which allows concluding that the materials and manufacture were correctly determined. Tooling for the manufacture was designed and manufactured according to the geometry and manufacture process requisites. The part was manufactured and the mechanical, and environmental tests required were also performed. Finally, a geometric characterization and non-destructive techniques allow verifying the quality of the part.

Keywords: reverse engineering, sandwich-structured composite parts, helicopter, mechanical properties, prototype

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Authors: Sandra Cecilia Bautista-Rodríguez, Vladimir Melgarejo

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Climate change, loss of ecosystems, increasing poverty, increasing marginalization of rural communities and declining food security are global issues that require urgent attention. In this regard, a great deal of research has focused on how agroecosystems respond to these challenges as they provide ecosystem services (ES) that lead to higher levels of resilience, adaptation, productivity and self-sufficiency. Hence, the valuing of ecosystem services plays an important role in the decision-making process for the design and management of agroecosystems. This paper aims to define the link between ecosystem service valuation methods and ES value dimensions in agroecosystems from ecological economics and agroecology. The method used to identify valuation methodologies was a literature review in the fields of Agroecology and Ecological Economics, based on a strategy of information search and classification. The conceptual framework of the work is based on the multidimensionality of value, considering the social, ecological, political, technological and economic dimensions. Likewise, the valuation process requires consideration of the ecosystem function associated with ES, such as regulation, habitat, production and information functions. In this way, valuation methods for ES in agroecosystems can integrate more than one value dimension and at least one ecosystem function. The results allow correlating the ecosystem functions with the ecosystem services valued, and the specific tools or models used, the dimensions and valuation methods. The main methodologies identified are multi-criteria valuation (1), deliberative - consultative valuation (2), valuation based on system dynamics modeling (3), valuation through energy or biophysical balances (4), valuation through fuzzy logic modeling (5), valuation based on agent-based modeling (6). Amongst the main conclusions, it is highlighted that the system dynamics modeling approach has a high potential for development in valuation processes, due to its ability to integrate other methods, especially multi-criteria valuation and energy and biophysical balances, to describe through causal cycles the interrelationships between ecosystem services, the dimensions of value in agroecosystems, thus showing the relationships between the value of ecosystem services and the welfare of communities. As for methodological challenges, it is relevant to achieve the integration of tools and models provided by different methods, to incorporate the characteristics of a complex system such as the agroecosystem, which allows reducing the limitations in the processes of valuation of ES.

Keywords: ecological economics, agroecosystems, ecosystem services, valuation of ecosystem services

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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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Authors: A. Gonzalez Aguna, J. M. Santamaria Garcia, J. L. Gomez Gonzalez, R. Barchino Plata, M. Fernandez Batalla, S. Herrero Jaen

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Background: Computer Science is a field that transcends other disciplines of knowledge because it allows to support all kinds of physical and mental tasks. Health centres have a greater number and complexity of technological devices and the population consume and demand services derived from technology. Also, nursing education plans have included competencies related to and, even, courses about new technologies are offered to health professionals. However, nurses still limit their performance to the use and evaluation of products previously built. Objective: Develop a teaching-learning methodology for acquiring skills on designing applications for care. Methodology: Blended learning teaching with a group of graduate nurses through official training within a Master's Degree. The study sample was selected by intentional sampling without exclusion criteria. The study covers from 2015 to 2017. The teaching sessions included a four-hour face-to-face class and between one and three tutorials. The assessment was carried out by written test consisting of the preparation of an IEEE 830 Standard Specification document where the subject chosen by the student had to be a problem in the area of care. Results: The sample is made up of 30 students: 10 men and 20 women. Nine students had a degree in nursing, 20 diploma in nursing and one had a degree in Computer Engineering. Two students had a degree in nursing specialty through residence and two in equivalent recognition by exceptional way. Except for the engineer, no subject had previously received training in this regard. All the sample enrolled in the course received the classroom teaching session, had access to the teaching material through a virtual area and maintained at least one tutoring. The maximum of tutorials were three with an hour in total. Among the material available for consultation was an example of a document drawn up based on the IEEE Standard with an issue not related to care. The test to measure competence was completed by the whole group and evaluated by a multidisciplinary teaching team of two computer engineers and two nurses. Engineers evaluated the correctness of the characteristics of the document and the degree of comprehension in the elaboration of the problem and solution elaborated nurses assessed the relevance of the chosen problem statement, the foundation, originality and correctness of the proposed solution and the validity of the application for clinical practice in care. The results were of an average grade of 8.1 over 10 points, a range between 6 and 10. The selected topic barely coincided among the students. Examples of care areas selected are care plans, family and community health, delivery care, administration and even robotics for care. Conclusion: The applied methodology of learning-teaching for the design of technologies demonstrates the success in the training of nursing professionals. The role of expert is essential to create applications that satisfy the needs of end users. Nursing has the possibility, the competence and the duty to participate in the process of construction of technological tools that are going to impact in care of people, family and community.

Keywords: care, learning, nursing, technology

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Authors: Jin-Hee Kim

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The way that globalization distinguishes itself from the previous changes is scope and intensity of changes, which together affect many parts of a nation’s system. In this way, globalization has its relation with the concept of ‘internationalization’ in that a nation state formulates a set of strategies in many areas of its governance to actively react to it. In short, globalization is a ‘catalyst,’ and internationalization is a ‘response’. In this regard, the field of higher education is one of the representative cases that globalization has several consequences that change the terrain of national policy-making. Started and been dominated mainly by the Western world, it has now been expanded to the ‘late movers,’ such as Asia-Pacific countries. The case of internationalization of Korean higher education is, therefore, located in a unique place in this arena. Yet Korea still is one of the major countries of sending its students to the so-called, ‘first world.’ On the other hand, it has started its effort to recruit international students from the world to its higher education system. After new Millennium, particularly, internationalization of higher education has been launched in its full-scale and gradually been one of the important global policy agenda, striving in both ways by opening its turf to foreign educational service providers and recruiting prospective students from other countries. Particularly the latter, recruiting international students, has been highlighted under the government project named ‘Study Korea,’ launched in 2004. Not only global, but also local issues and motivations were based to launch this nationwide project. Bringing international students means various desirable economic outcomes such as reducing educational deficit as well as utilizing them in Korean industry after the completion of their study, to name a few. In addition, in a similar vein, Korea's higher education institutes have started to have a new comers of adult learners. When it comes to the questions regarding the quality and access of this new learning agency, the answer is quite tricky. This study will investigate the different dimension of education provision and learning process to empower diverse group regardless of nationality, race, class and gender in Korea. Listening to the voices of international students and adult learning as non-traditional participants in a changing Korean higher educational space not only benefit students themselves, but Korean stakeholders who should try to accommodate more comprehensive and fair educational provisions for more and more diversifying groups of learners.

Keywords: education equity, access, globalisation, international students, adult learning, learning support

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Authors: Mohamed S. Selim, Nesreen A. Fatthallah, Shimaa A. Higazy, Hekmat R. Madian, Sherif A. El-Safty, Mohamed A. Shenashen

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After the 2003 prohibition on employing TBT-based antifouling coatings, polysiloxane antifouling nano-coatings have gained in popularity as environmentally friendly and cost-effective replacements. A series of non-toxic polydimethylsiloxane nanocomposites filled with nanosheets of graphene oxide (GO) decorated with magnetite nanospheres (GO-Fe₃O₄ nanospheres) were developed and cured via a catalytic hydrosilation method. Various GO-Fe₃O₄ hybrid concentrations were mixed with the silicone resin via solution casting technique to evaluate the structure–property connection. To generate GO nanosheets, a modified Hummers method was applied. A simple co-precipitation method was used to make spherical magnetite particles under inert nitrogen. Hybrid GO-Fe₃O₄ composite fillers were developed by a simple ultrasonication method. Superhydrophobic PDMS/GO-Fe₃O₄ nanocomposite surface with a micro/nano-roughness, reduced surface-free energy (SFE), high fouling release (FR) efficiency was achieved. The physical, mechanical, and anticorrosive features of the virgin and GO-Fe₃O₄ filled nanocomposites were investigated. The synergistic effects of GO-Fe₃O4 hybrid's well-dispersion on the water-repellency and surface topological roughness of the PDMS/GO-Fe₃O₄ nanopaints were extensively studied. The addition of the GO-Fe₃O₄ hybrid fillers till 1 wt.% could increase the coating's water contact angle (158°±2°), minimize its SFE to 12.06 mN/m, develop outstanding micro/nano-roughness, and improve its bulk mechanical and anticorrosion properties. Several microorganisms were employed for examining the fouling-resistance of the coated specimens for 1 month. Silicone coatings filled with 1 wt.% GO-Fe₃O₄ nanofiller showed the least biodegradability% among all the tested microorganisms. Whereas GO-Fe₃O4 with 5 wt.% nanofiller possessed the highest biodegradability% potency by all the microorganisms. We successfully developed non-toxic and low cost nanostructured FR composite coating with high antifouling-resistance, reproducible superhydrophobic character, and enhanced service-time for maritime navigation.

Keywords: silicone antifouling, environmentally friendly, nanocomposites, nanofillers, fouling repellency, hydrophobicity

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Authors: Marie Bountrogianni, Leonora Zefi, Krystle Phirangee, Naza Djafarova

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Faculty development is critical for any institution as it impacts students’ learning experiences and faculty performance with regards to course delivery. With that in mind, The Chang School at Ryerson University embarked on an initiative to develop a comprehensive, relevant faculty development program for online faculty and instructors. Teaching Adult Learners Online (TALO) is a professional development program designed to build capacity among online teaching faculty to enhance communication/facilitation skills for online instruction and establish a Community of Practice to allow for opportunities for online faculty to network and exchange ideas and experiences. TALO is comprised of four online modules and each module provides three hours of learning materials. The topics focus on online teaching and learning experience, principles and practices, opportunities and challenges in online assessments as well as course design and development. TALO offers a unique experience for online instructors who are placed in the role of a student and an instructor through interactivities involving discussions, hands-on assignments, peer mentoring while experimenting with technological tools available for their online teaching. Through exchanges and informal peer mentoring, a small interdisciplinary community of practice has started to take shape. Successful participants have to meet four requirements for completion: i) participate actively in online discussions and activities, ii) develop a communication plan for the course they are teaching, iii) design one learning activity/or media component, iv) design one online learning module. This study adopted a mixed methods exploratory sequential design. For the qualitative phase of this study, a thorough literature review was conducted on what constitutes effective faculty development programs. Based on that review, the design team identified desired competencies for online teaching/facilitation and course design. Once the competencies were identified, a focus group interview with The Chang School teaching community was conducted as a needs assessment and to validate the competencies. In the quantitative phase, questionnaires were distributed to instructors and faculty after the program was launched to continue ongoing evaluation and revisions, in hopes of further improving the program to meet the teaching community’s needs. Four faculty members participated in a one-hour focus group interview. Major findings from the focus group interview revealed that for the training program, faculty wanted i) to better engage students online, ii) to enhance their online teaching with specific strategies, iii) to explore different ways to assess students online. 91 faculty members completed the questionnaire in which findings indicated that: i) the majority of faculty stated that they gained the necessary skills to demonstrate instructor presence through communication and use of technological tools provided, ii) increased faculty confidence with course management strategies, iii) learning from peers is most effective – the Community of Practice is strengthened and valued even more as program alumni become facilitators. Although this professional development program is not mandatory for online instructors, since its launch in Fall 2014, over 152 online instructors have successfully completed the program. A Community of Practice emerged as a result of the program and participants continue to exchange thoughts and ideas about online teaching and learning.

Keywords: community of practice, customized, faculty development, inclusive design

Procedia PDF Downloads 176

Authors: Arlinda Memetaj

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A sound system of administrative justice represents a vital element of democratic governance. The proper control of public administration consists not only of a sound civil service framework and legislative oversight, but empowerment of the public and courts to hold public officials accountable for their decision-making through the application of fair administrative procedural rules and the use of appropriate administrative appeals processes and judicial review. The establishment of effective public administration, has been since 1990s among the most 'important and urgent' final strategic objectives of the Republic of Macedonia. To this aim the country has so far adopted a huge series of legislative and strategic documents related to any aspects of the administrative justice system. The latter is designed to strengthen the legal position of citizens, businesses, civic organizations, and other societal subjects. 'Changes and reforms' in this field have been thus the most frequent terms being used in the country for the last more than 20 years. Several years ago the County established Administrative Courts, while permanently amending the Law on the General Administrative procedure (LGAP). The new LGAP was adopted in 2015 and it introduced considerable innovations concerned. The most recent inputs in this regard includes the National Public Administration Reform Strategy 2017 – 2022, one of the key expected result of which includes both providing effective protection of the citizens` rights. In doing the aforesaid however there is still a series of interrelated shortcomings in this regard, such as (just to mention few) the complex appeal procedure, delays in enforcing court rulings, etc. Against the above background, the paper firstly describes the Macedonian institutional and legislative framework in the above field, and then illustrates the shortcomings therein. It finally claims that the current status quo situation may be overcome only if there is a proper implementation of the administrative courts decisions and far stricter international monitoring process thereof. A new approach and strong political commitment from the highest political leadership is thus absolutely needed to ensure the principles of transparency, accountability and merit in public administration. The main method used in this paper is the descriptive, analytical and comparative one due to the very character of the paper itself.

Keywords: administrative justice, administrative procedure, administrative courts/disputes, European Human Rights Court, human rights, monitoring, reform, benefit.

Procedia PDF Downloads 157

Authors: Kalidas Sarma

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Fraud is a social problem changing with social change and it has a regional and global impact. Introduction of private domain in higher education along with public institutions has led to commercialization of higher education which encourages unprecedented mushrooming of private institutions resulting in fraudulent activities in higher educational institutions in Assam, India. Presently, fraud has been noticed in in-service promotion, fake entry qualification by teachers in different levels of work-place by using fake master degrees, master of philosophy and doctor of philosophy degree certificates. The aim and objective of the study are to identify grey areas in maintenance of quality in higher educational institutions in Assam and also to draw the contour for planning and implementation. This study is based on both primary and secondary data collected through questionnaire and seeking information through Right to Information Act 2005. In Assam, there are 301 undergraduate and graduate colleges distributed in 27 (Twenty seven) administrative districts with 11000 (Eleven thousand) college teachers. Total 421 (Four hundred twenty one) college teachers from the 14 respondent colleges have been taken for analysis. Data collected has been analyzed by using 'Hypertext Pre-processor' (PhP) application with My Sequel Structure Query Language (MySQL) and Google Map Application Programming Interface (APIs). Graph has been generated by using open source tool Chart.js. Spatial distribution maps have been generated with the help of geo-references of the colleges. The result shows: (i) the violation of University Grants Commission's (UGCs) Regulation for the awards of M. Phil/Ph.D. clearly exhibits. (ii) There is a gap between apex regulatory bodies of higher education at national and as well as state level to check fraud. (iii) Mala fide 'No Objection Certificate' (NOC) issued by the Government of Assam have played pivotal role in the occurrence of fraudulent practices in higher educational institutions of Assam. (iv) Violation of verdict of the Hon'ble Supreme Court of India regarding territorial jurisdiction of Universities for the awards of Ph.D. and M. Phil degrees in distance mode/study centre is also a responsible factor for the spread of these academic frauds in Assam and other states. The challenges and mitigation of these issues have been discussed.

Keywords: Assam, fraud, higher education, mitigation

Procedia PDF Downloads 169

Authors: Cagdas Agirdas

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Background: The Affordable Care Act (ACA) requires non-grandfathered private insurance plans, starting with plan years on or after September 23rd, 2010, to provide certain preventive care services without any cost sharing in the form of deductibles, copayments or co-insurance. This requirement may affect racial and ethnic disparities in preventive care as it provides the largest copay reduction in preventive care. Objectives: We ask whether the ACA’s free preventive care benefits are associated with a reduction in racial and ethnic disparities in the utilization of four preventive services: cholesterol screenings, colonoscopies, mammograms, and pap smears. Methods: We use a data set of over 6,000 individuals from the 2009, 2010, and 2013 Medical Expenditure Panel Surveys (MEPS). We restrict our data set only to individuals who are old enough to be eligible for each preventive service. Our difference-in-differences logistic regression model classifies privately-insured Hispanics, African Americans, and Asians as the treatment groups and 2013 as the after-policy year. Our control group consists of non-Hispanic whites on Medicaid as this program already covered preventive care services for free or at a low cost before the ACA. Results: After controlling for income, education, marital status, preferred interview language, self-reported health status, employment, having a usual source of care, age and gender, we find that the ACA is associated with increases in the probability of the median, privately-insured Hispanic person to get a colonoscopy by 3.6% and a mammogram by 3.1%, compared to a non-Hispanic white person on Medicaid. Similarly, we find that the median, privately-insured African American person’s probability of receiving these two preventive services improved by 2.3% and 2.4% compared to a non-Hispanic white person on Medicaid. We do not find any significant improvements for any racial or ethnic group for cholesterol screenings or pap smears. Furthermore, our results do not indicate any significant changes for Asians compared to non-Hispanic whites in utilizing the four preventive services. These reductions in racial/ethnic disparities are robust to reconfigurations of time periods, previous diagnosis, and residential status. Conclusions: Early effects of the ACA’s provision of free preventive care are significant for Hispanics and African Americans. Further research is needed for the later years as more individuals became aware of these benefits.

Keywords: preventive care, Affordable Care Act, cost sharing, racial disparities

Procedia PDF Downloads 153

Authors: Maisam Rafiee, Chikashi Deguchi, Akio Odake, Minoru Matsui, Takanori Sata

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Cities in Afghanistan have been rapidly urbanized; however, many parts of these cities have been developed with no detailed land use plan or infrastructure. In other words, they have been informally developed without any government leadership. The new government started the In-situ Upgrading Project in Kabul to upgrade roads, the water supply network system, and the surface water drainage system on the existing street layout in 2002, with the financial support of international agencies. This project is an appropriate emergency improvement for living life, but not an essential improvement of living conditions and infrastructure problems because the life expectancies of the improved facilities are as short as 10–15 years, and residents cannot obtain land tenure in the unplanned areas. The Land Readjustment System (LRS) conducted in Japan has good advantages that rearrange irregularly shaped land lots and develop the infrastructure effectively. This study investigates the effects of the In-situ Upgrading Project on private investment, land prices, and residents’ satisfaction with projects in Kart-e-Char, where properties are registered, and in Afshar-e-Silo Lot 1, where properties are unregistered. These projects are located 5 km and 7 km from the CBD area of Kabul, respectively. This study discusses whether LRS should be applied to the unplanned area based on the questionnaire and interview responses of experts experienced in the In-situ Upgrading Project who have knowledge of LRS. The analysis results reveal that, in Kart-e-Char, a lot of private investment has been made in the construction of medium-rise (five- to nine-story) buildings for commercial and residential purposes. Land values have also incrementally increased since the project, and residents are commonly satisfied with the road pavement, drainage systems, and water supplies, but dissatisfied with the poor delivery of electricity as well as the lack of public facilities (e.g., parks and sport facilities). In Afshar-e-Silo Lot 1, basic infrastructures like paved roads and surface water drainage systems have improved from the project. After the project, a few four- and five-story residential buildings were built with very low-level private investments, but significant increases in land prices were not evident. The residents are satisfied with the contribution ratio, drainage system, and small increase in land price, but there is still no drinking water supply system or tenure security; moreover, there are substandard paved roads and a lack of public facilities, such as parks, sport facilities, mosques, and schools. The results of the questionnaire and interviews with the four engineers highlight the problems that remain to be solved in the unplanned areas if LRS is applied—namely, land use differences, types and conditions of the infrastructure still to be installed by the project, and time spent for positive consensus building among the residents, given the project’s budget limitation.

Keywords: in-situ upgrading, Kabul city, land readjustment, land value, planned area, private investment, residents' satisfaction, unplanned area

Procedia PDF Downloads 205

Authors: Vilma Zydziunaite, Simona Kersiene

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The concept of focused leadership means that the leader gathers the entire community in various ways to communicate and cooperate with each other, to share their knowledge and responsibility, to get involved in problem-solving, to create a safe and trusting environment and to satisfy the needs and interests of each community member. The study's aim is to analyze the teamwork of teachers working in kindergartens and schools and its CEOs by implementing confused leadership. A mixed research design was used for the research study. Quantitative research used the teamwork test "Team-Puls" (2003). Data is processed by the IBM SPSS version 29.0 software package. Semi-structured interviews were used for data collection, and qualitative content analysis was applied for data analysis. The results of quantitative research show that there is no statistically significant difference between the evaluation averages of kindergarten and school teachers. Likewise, the effectiveness and evaluation of teacher teamwork in educational institutions depend on different characteristics and processes, such as the number of participating teachers, the involvement of the institution's administration or the stages of team formation. In the qualitative research, the components of the focused leadership categories applied by the kindergarten and school CEOs emerged. The categories reflect the components of shared leadership. In the study, the sharing of responsibilities and cooperation among teachers and the sharing of knowledge among themselves is distinguished. This shows that the action takes place between the teachers when they participate in the processes voluntarily, according to their wishes or for certain reasons. Distributed leadership components occurs when leadership responsibility is extended beyond the school CEO. The components of servant leadership are expressed when the CEO achieves organizational goals in the service of others. Servant leadership is helping and striving for others, creating a safe environment. The level of the educational institution does not affect working teachers in the evaluation of working in a team. Giving freedom to teachers, the role of the CEO is dividing responsibilities and creating cooperation between teachers as well as ensuring teachers' interests, needs, emotional well-being and professional development.

Keywords: teamwork, school, teacher, school CEO, school environment, mixed research, Team-Puls test, semi-structured interview, questioning survey, qualitative content analysis, focused leadership, teacher leadership

Procedia PDF Downloads 62

Authors: Fernanda Piculo, Giovana Vesentini, Gabriela Marini, Debora Cristina Damasceno, Angelica Mercia Pascon Barbosa, Marilza Vieira Cunha Rudge

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Introduction: Women with previous gestational diabetes mellitus (GDM) were significantly more likely to have urinary incontinence (UI) and pelvic floor muscle dysfunction compared to non-diabetic women two years after a cesarean section. Additional results demonstrated that induced diabetes causes detrimental effects on pregnant rat urethral muscle. These results indicate the need for exploration of the mechanistic role of a recovery factor in female UI. Chemokine ligand 7 (CCL7) was significantly over expressed in rat serum, urethral and vaginal tissues immediately following induction of stress UI in a rat model simulating birth trauma. CCL7 over expression has shown potency for stimulating targeted stem cell migration and provide a translational link (clinical measurement) which further provide opportunities for treatment. The aim of this study was to investigate the CCL7 levels profile in diabetic pregnant women with urinary incontinence during pregnancy over the first year postpartum. Methods: This study was conducted in the Perinatal Diabetes Research Center of the Botucatu Medical School/UNESP, and was approved by the Research Ethics Committee of the Institution (CAAE: 20639813.0.0000.5411). The diagnosis of GDM was established between 24th and 28th gestational weeks, by the 75 g-OGTT test according to ADA’s criteria. Urinary incontinence was defined according to the International Continence Society and the CCL7 levels was measured by ELISA (R&D Systems, Catalog Number DCC700). Two hundred twelve women were classified into four study groups: normoglycemic continent (NC), normoglycemic incontinent (NI), diabetic continent (DC) and diabetic incontinent (DI). They were evaluated at six-time-points: 12-18, 24-28 and 34-38 gestational weeks, 24-48 hours, 6 weeks and 6-12 months postpartum. Results: At 12-18 weeks, it was possible to consider only two groups, continent and incontinent, because at this early gestational period has not yet been the diagnosis of GDM. The group with GDM and UI (DI group) showed lower levels of CCL7 in all time points during pregnancy and postpartum, compared to normoglycemic groups (NC and NI), indicating that these women have not recovered from child birth induced UI during the 6-12 months postpartum compared to their controls, and that the progression of UI and/or lack of recovery throughout the first postpartum year can be related with lower levels of CCL7. Instead, serum CCL7 was significantly increased in the NC group. Taken together, these findings of overexpression of CCL7 in the NC group and decreased levels in the DI group, could confirm that diabetes delays the recovery from child birth induced UI, and that CCL7 could potentially be used as a serum marker of injury. Conclusion: This study demonstrates lower levels of CCL7 in the DI group during pregnancy and postpartum and suggests that the progression of UI in diabetic women and/or lack of recovery throughout the first postpartum year can be related with low levels of CCL7. This provides a translational potential where CCL7 measurement could be used as a surrogate for injury after delivery. Successful controlled CCL7 mediated stem cell homing to the lower urinary tract could one day introduce the potential for non-operative treatment or prevention of stress urinary incontinence.

Keywords: CCL7, gestational diabetes, pregnancy, urinary incontinence

Procedia PDF Downloads 339

Authors: Matej Komanec, Jan Bohata, Stanislav Zvanovec, Tomas Nemecek, Jan Broucek, Josef Beran

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With the exponential growth of social networks, video streaming and increasing demands on data rates, the number of newly built data centers rises proportionately. The data centers, however, have to adjust to the rapidly increased amount of data that has to be processed. For this purpose, multi-mode (MM) fiber based infrastructures are often employed. It stems from the fact, the connections in data centers are typically realized within a short distance, and the application of MM fibers and components considerably reduces costs. On the other hand, the usage of MM components brings specific requirements for installation service conditions. Moreover, it has to be taken into account that MM fiber components have a higher production tolerance for parameters like core and cladding diameters, eccentricity, etc. Due to the high demands for the reliability of data center components, the determination of properly excited optical field inside the MM fiber core belongs to the key parameters while designing such an MM optical system architecture. Appropriately excited mode field of the MM fiber provides optimal power budget in connections, leads to the decrease of insertion losses (IL) and achieves effective modal bandwidth (EMB). The main parameter, in this case, is the encircled flux (EF), which should be properly defined for variable optical sources and consequent different mode-field distribution. In this paper, we present detailed investigation and measurements of the mode field distribution for short MM links purposed in particular for data centers with the emphasis on reliability and safety. These measurements are essential for large MM network design. The various scenarios, containing different fibers and connectors, were tested in terms of IL and mode-field distribution to reveal potential challenges. Furthermore, we focused on estimation of particular defects and errors, which can realistically occur like eccentricity, connector shifting or dust, were simulated and measured, and their dependence to EF statistics and functionality of data center infrastructure was evaluated. The experimental tests were performed at two wavelengths, commonly used in MM networks, of 850 nm and 1310 nm to verify EF statistics. Finally, we provide recommendations for data center systems and networks, using OM3 and OM4 MM fiber connections.

Keywords: optical fiber, multi-mode, data centers, encircled flux

Procedia PDF Downloads 377

Authors: Samantha R. Dutra

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There are many issues that students face in college, such as academic-based struggles, financial issues, family responsibilities, and vocational problems. Students with dyslexia struggle even more with these problems compared to other students. This qualitative study examines faculty perceptions of instructing students with dyslexia. This study is important to the human services and post-secondary educational fields due to the increase in disabled students enrolled in college. This study is also substantial because of the reported bias faced by students with dyslexia and their academic failure. When students with LDs such as dyslexia experience bias, discrimination, and isolation, they are more apt to not seek accommodations, lack communication with faculty, and are more likely to drop out or fail. College students with dyslexia often take longer to complete their post-secondary education and are more likely to withdraw or drop out without earning a degree. Faculty attitudes and academic cultures are major barriers to the success and use of accommodations as well as modified instruction for students with disabilities, which leads to student success. Faculty members are often uneducated or misinformed regarding students with dyslexia. More importantly, many faculty members are unaware of the many ethical and legal implications that they face regarding accommodating students with dyslexia. Instructor expectations can generally be defined as the understanding and perceptions of students regarding their academic success. Skewed instructor expectations can affect how instructors interact with their students and can also affect student success. This is true for students with dyslexia in that instructors may have lower and biased expectations of these students and, therefore, directly impact students’ academic successes and failures. It is vital to understand how instructor attitudes affect the academic achievement of dyslexic students. This study will examine faculty perceptions of instructing students with dyslexia and faculty attitudes towards accommodations and institutional support. The literature concludes that students with dyslexia have many deficits and several learning needs. Furthermore, these are the students with the highest dropout and failure rates, as well as the lowest retention rates. Disabled students generally have many reasons why accommodations and supports just do not help. Some research suggests that accommodations do help students and show positive outcomes. Many improvements need to be made between student support service personnel, faculty, and administrators regarding providing access and adequate supports for students with dyslexia. As the research also suggests, providing more efficient and effective accommodations may increase positive student as well as faculty attitudes in college, and may improve student outcomes overall.

Keywords: dyslexia, faculty perception, higher education, learning disability

Procedia PDF Downloads 139

Authors: Mandy Wilson, Emma Vieira, Jocelyn Jones, Alice V. Brown, Lindey Andrews, Louise Southalan, Jackie Oakley, Dorothy Bagshaw, Patrick Egan, Laura Dent, Duc Dau, Lucy Spanswick

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Alcohol and drug dependency are pertinent issues for those experiencing homelessness. This includes Aboriginal and Torres Strait Islander people, Australia’s traditional owners, living in Perth, Western Australia (WA). Societal narratives around the drivers behind drug and alcohol dependency in Aboriginal communities, particularly those experiencing homelessness, have been biased and unchanging, with little regard for complexity. This can include the idea that Aboriginal people have ‘chosen’ to use alcohol or other drugs without consideration for intergenerational trauma and the trauma of homelessness that may influence their choices. These narratives have flow-on impacts on policies and services that directly impact Aboriginal people experiencing homelessness. In 2021, we commenced a project which aimed to listen to and elevate the voices of 70-90 Aboriginal people experiencing homelessness in Perth. The project is community-driven, led by an Aboriginal Community Controlled Organisation in partnership with a university research institute. A community-ownership group of Aboriginal Elders endorsed the project’s methods, chosen to ensure their suitability for the Aboriginal community. In this paper, we detail these methods, including semi-structured interviews influenced by an Aboriginal yarning approach – an important style of conversation for Aboriginal people which follows cultural protocols; and photovoice – supporting people to share their stories through photography. Through these engagements, we detail the reasons Aboriginal people in Perth shared for using alcohol or other drugs while experiencing homelessness. These included supporting their survival on the streets, managing their mental health, and coping while on the journey to finding support. We also detail why they sought to discontinue alcohol and other drug use, including wanting to reconnect with family and changing priorities. Finally, we share how Aboriginal people experiencing homelessness have said they are impacted by their family’s alcohol and other drug use, including feeling uncomfortable living with a family who is drug and alcohol-dependent and having to care for grandchildren despite their own homelessness. These findings provide a richer understanding of alcohol and drug use for Aboriginal people experiencing homelessness in Perth, shedding light on potential changes to targeted policy and service approaches.

Keywords: Aboriginal and Torres Strait Islander peoples, alcohol and other drugs, homelessness, community-led research

Procedia PDF Downloads 134

Authors: Thippharat Wongsilarat, Parichat tuntilanon, Chonlakan Prataksitorn

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Recurrent adverse drug reactions are harmful to patients with mild to fatal illnesses, and affect not only patients but also their relatives, and organizations. To compare safe use of medicine among patients before and after using the recurrent adverse drug reaction prevention program . Quasi-experimental research with the target population of 598 patients with drug allergy history. Data were collected through an observation form tested for its validity by three experts (IOC = 0.87), and analyzed with a descriptive statistic (percentage). The research was conducted jointly with a multidisciplinary team to analyze and determine the weak points and strong points in the recurrent adverse drug reaction prevention system during the past three years, and 546, 329, and 498 incidences, respectively, were found. Of these, 379, 279, and 302 incidences, or 69.4; 84.80; and 60.64 percent of the patients with drug allergy history, respectively, were found to have caused by incomplete warning system. In addition, differences in practice in caring for patients with drug allergy history were found that did not cover all the steps of the patient care process, especially a lack of repeated checking, and a lack of communication between the multidisciplinary team members. Therefore, the recurrent adverse drug reaction prevention program was developed with complete warning points in the information technology system, the repeated checking step, and communication among related multidisciplinary team members starting from the hospital identity card room, patient history recording officers, nurses, physicians who prescribe the drugs, and pharmacists. Including in the system were surveillance, nursing, recording, and linking the data to referring units. There were also training concerning adverse drug reactions by pharmacists, monthly meetings to explain the process to practice personnel, creating safety culture, random checking of practice, motivational encouragement, supervising, controlling, following up, and evaluating the practice. The rate of prescribing drugs to which patients were allergic per 1,000 prescriptions was 0.08, and the incidence rate of recurrent drug reaction per 1,000 prescriptions was 0. Surveillance of recurrent adverse drug reactions covering all service providing points can ensure safe use of medicine for patients.

Keywords: recurrent drug, adverse reaction, safety, use of medicine

Procedia PDF Downloads 457

Authors: Keneilwe Matlhaku

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Crosslinguistic studies (theoretical and clinical) have shown delays and significant misarticulation in the acquisition of the rhotics. This article provides a detailed analysis of the early development of the rhotic phoneme, an apical trill /r/, by monolingual Setswana (Tswana S30) children of age ranges between 1 and 4 years. The data display the following trends: (1) late acquisition of /r/; (2) a wide range of substitution patterns involving this phoneme (i.e., gliding, coronal stopping, affrication, deletion, lateralization, as well as, substitution to a dental and uvular fricative). The primary focus of the article is on the potential origins of these variations of /r/, even within the same language. Our data comprises naturalistic longitudinal audio recordings of 6 children (2 males and 4 females) whose speech was recorded in their homes over a period of 4 months with no or only minimal disruptions in their daily environments. Phon software (Rose et al. 2013; Rose & MacWhinney 2014) was used to carry out the orthographic and phonetic transcriptions of the children’s data. Phon also enabled the generation of the children’s phonological inventories for comparison with adult target IPA forms. We explain the children’s patterns through current models of phonological emergence (MacWhinney 2015) as well as McAllister Byun, Inkelas & Rose (2016); Rose et al., (2022), which highlight the perceptual and articulatory factors influencing the development of sounds and sound classes. We highlight how the substitution patterns observed in the data can be captured through a consideration of the auditory properties of the target speech sounds, combined with an understanding of the types of articulatory gestures involved in the production of these sounds. These considerations, in turn, highlight some of the most central aspects of the challenges faced by the child toward learning these auditory-articulatory mappings. We provide a cross-linguistic survey of the acquisition of rhotic consonants in a sample of related and unrelated languages in which we show that the variability and volatility in the substitution patterns of /r/ is also brought about by the properties of the children’s ambient languages. Beyond theoretical issues, this article sets an initial foundation for developing speech-language pathology materials and services for Setswana learning children, an emerging area of public service in Botswana.

Keywords: rhotic, apical trill, Phon, phonological emergence, auditory, articulatory, mapping

Procedia PDF Downloads 40

Authors: Zahra Jandaghian, Mehdi Ghobadi, Michal Bartko, Alex Hayes, Marianne Armstrong, Alexandra Thompson, Michael Lacasse

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The Intergovernmental Panel on Climate Change (IPCC) report stated the urgent need to cut greenhouse gas emissions to avoid the adverse impacts of climatic changes. The United Nations has forecasted that nearly 70 percent of people will live in urban areas by 2050 resulting in a doubling of the global building stock. Given that buildings are currently recognised as emitting 40 percent of global carbon emissions, there is thus an urgent incentive to decarbonize existing buildings and to build net-zero carbon buildings. To attain net zero carbon emissions in communities in the future requires action in two directions: I) reduction of emissions; and II) removal of on-going emissions from the atmosphere once de-carbonization measures have been implemented. Nature-based solutions (NBS) have a significant role to play in achieving net zero carbon communities, spanning both emission reductions and removal of on-going emissions. NBS for the decarbonisation of buildings can be achieved by using green roofs and green walls – increasing vertical and horizontal vegetation on the building envelopes – and using nature-based materials that either emit less heat to the atmosphere thus decreasing photochemical reaction rates, or store substantial amount of carbon during the whole building service life within their structure. The NBS approach can also mitigate urban flooding and overheating, improve urban climate and air quality, and provide better living conditions for the urban population. For existing buildings, de-carbonization mostly requires retrofitting existing envelopes efficiently to use NBS techniques whereas for future construction, de-carbonization involves designing new buildings with low carbon materials as well as having the integrity and system capacity to effectively employ NBS. This paper presents the opportunities and challenges in respect to the de-carbonization of buildings using NBS for both building retrofits and new construction. This review documents the effectiveness of NBS to de-carbonize Canadian buildings, identifies the missing links to implement these techniques in cold climatic conditions, and determine a road map and immediate approaches to mitigate the adverse impacts of climate change such as urban heat islanding. Recommendations are drafted for possible inclusion in the Canadian building and energy codes.

Keywords: decarbonization, nature-based solutions, GHG emissions, greenery enhancement, buildings

Procedia PDF Downloads 94

Authors: S. MacDougall-Davis, S. Wysling, R. Willmore

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Background: The application of good non-technical skills, also known as crew resource management (CRM), is central to the delivery of safe, effective healthcare. The authors have been running remote trauma courses for over 10 years, primarily focussing on developing participants’ CRM in time-critical, high-stress clinical situations. The course has undergone an iterative process over the past 10 years. We employ a number of experiential learning techniques for improving CRM, including small group workshops, military command tasks, high fidelity simulations with reflective debriefs, and a ‘flipped classroom’, where participants are asked to create their own simulations and assess and debrief their colleagues’ CRM. We created a randomised simulation study to assess the impact of our course on UK medical students’ CRM, both at an individual and a teams level. Methods: Sixteen students took part. Four clinical scenarios were devised, designed to be of similar urgency and complexity. Professional moulage effects and experienced clinical actors were used to increase fidelity and to further simulate high-stress environments. Participants were block randomised into teams of 4; each team was randomly assigned to one pre-course simulation. They then underwent our 5 day remote trauma CRM course. Post-course, students were re-randomised into four new teams; each was randomly assigned to a post-course simulation. All simulations were videoed. The footage was reviewed by two independent CRM-trained assessors, who were blinded to the before/after the status of the simulations. Assessors used the internationally validated team emergency assessment measure (TEAM) to evaluate key areas of team performance, as well as a global outcome rating. Prior to the study, assessors had scored two unrelated scenarios using the same assessment tool, demonstrating 89% concordance. Participants also completed pre- and post-course questionnaires. Likert scales were used to rate individuals’ perceived NTS ability and their confidence to work in a team in time-critical, high-stress situations. Results: Following participation in the course, a significant improvement in CRM was observed in all areas of team performance. Furthermore, the global outcome rating for team performance was markedly improved (40-70%; mean 55%), thus demonstrating an impact at Level 4 of Kirkpatrick’s hierarchy. At an individual level, participants’ self-perceived CRM improved markedly after the course (35-70% absolute improvement; mean 55%), as did their confidence to work in a team in high-stress situations. Conclusion: Our study demonstrates that with a short, cost-effective course, using easily reproducible teaching sessions, it is possible to significantly improve participants’ CRM skills, both at an individual and, perhaps more importantly, at a teams level. The successful functioning of multi-disciplinary teams is vital in a healthcare setting, particularly in high-stress, time-critical situations. Good CRM is of paramount importance in these scenarios. The authors believe that these concepts should be introduced from the earliest stages of medical education, thus promoting a culture of effective CRM and embedding an early appreciation of the importance of these skills in enabling safe and effective healthcare.

Keywords: crew resource management, non-technical skills, training, simulation

Procedia PDF Downloads 135

Authors: Sheillah Hlamalani Mboweni, Lufuno Makhado

Abstract:

Background: The increasing number of people who tested HIV positive and who demand antiretroviral therapy (ART) prompted the National Department of Health to adopt WHO recommendations of task shifting where Professional Nurses(PNs) initiate ART rather than doctors in the hospital. This resulted in the decentralization of services to primary health care(PHC), generating a need to capacitate PNs on NIMART. After years of training, the impact of NIMART was assessed where it was established that even though there was an increased number who accessed ART, the quality of care is of serious concern. The study aims to answer the following question: What are the challenges influencing NIMART implementation in primary health care. Objectives: This study explores challenges influencing NIMART training and implementation and makes recommendations to improve patient and HIV program outcomes. Methods: A qualitative explorative program evaluation research design. The study was conducted in the rural districts of North West province. Purposive sampling was used to sample PNs trained on NIMART. FGDs were used to collect data with 6-9 participants and data was analysed using ATLAS ti. Results: Five FGDs, n=28 PNs and three program managers were interviewed. The study results revealed two themes: inadequacy in NIMART training and the health care system challenges. Conclusion: The deficiency in NIMART training and health care system challenges is a public health concern as it compromises the quality of HIV management resulting in poor patients’ outcomes and retard the goal of ending the HIV epidemic. These should be dealt with decisively by all stakeholders. Recommendations: The national department of health should improve NIMART training and HIV management: standardization of NIMART training curriculum through the involvement of all relevant stakeholders skilled facilitators, the introduction of pre-service NIMART training in institutions of higher learning, support of PNs by district and program managers, plan on how to deal with the shortage of staff, negative attitude to ensure compliance to guidelines. There is a need to develop a conceptual framework that provides guidance and strengthens NIMART implementation in PHC facilities.

Keywords: antiretroviral therapy, nurse initiated management of retroviral therapy, primary health care, professional nurses

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