Search results for: Massive Open Online Course (MOOC)
Commenced in January 2007
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Edition: International
Paper Count: 5904

Search results for: Massive Open Online Course (MOOC)

684 The Importance of Country-of-Origin Information and Perceived Product Quality in Uzbekistan

Authors: Begzod Nishanov, Farhod Karimov

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Globalization and the internet have completely changed the way in which businesses operate as well as has equipped customers with endless potential. Today, consumers’ product choice is not only affected by branding, price and quality of the product, but also by the country-of-origin information. Precisely, ‘Made In’ label is considered as one of the driving factors which directly impact on consumers’ preferences. Generally, it is obvious that products manufactured in less developed countries are considered to be of lower quality and riskier compared to the products made in developed countries. In this regard, it is worth to note that this phenomenon is mainly applicable to western developed countries. However, there is a lack of empirical research on underlying the influence of country-of-origin phenomenon in emerging economies such as Uzbekistan. Today, Uzbek market is being dominated by growing number of foreign made products. Uzbek manufacturers are facing intense competition not only from local producers but also from the availability of foreign goods suppliers. Consequently, consumers are given wider choice of products than ever before. In this regard, it is important to define the importance of country-of-origin information in order to understand Uzbek consumers’ preference. The methodology of the research is formulated based on the methodology of previous papers. A total 527 online questionnaires were completed. Data analysis was conducted using factor analysis and analysis of variance test (ANOVA). Findings of the research support the view that Uzbek consumers attach great importance to the country-of-origin information of products. Precisely, it can be stated that Uzbek people perceive product quality by its ‘Made in...’ label, especially when buying high involvement goods such as car or refrigerator. Another findings of the paper show that products manufactured in developed countries including Germany, Japan and USA are found to be of high quality, while products manufactured in less developed countries are considered to be of lower quality. Marketers can use this information for segmentation purposes. For example, products manufactured in less developed countries can be targeted for low-to-middle income families while goods manufactured in developed countries can be targeted for higher income families. In conclusion, it can be stated that perceived product quality of products that are made in Uzbekistan has slightly increased since 18 years. It implies that nowadays products under ‘Made in Uzbekistan’ label is continually becoming available to many consumers in foreign markets, especially among Commonwealth of Independent States (CIS) countries. Therefore, conducting further research to explore the phenomenon of country-of-origin information and perceived product quality in emerging markets is of paramount importance.

Keywords: country-of-origin, consumer behavior, product evaluation, perceived quality

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683 An Institutional Mapping and Stakeholder Analysis of ASEAN’s Preparedness for Nuclear Power Disaster

Authors: Nur Azha Putra Abdul Azim, Denise Cheong, S. Nivedita

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Currently, there are no nuclear power reactors among the Association of Southeast Asian Nations (ASEAN) member states (AMS) but there are seven operational nuclear research reactors, and Indonesia is about to construct the region’s first experimental power reactor by the end of the decade. If successful, the experimental power reactor will lay the foundation for the country’s and region’s first nuclear power plant. Despite projecting confidence during the period of nuclear power renaissance in the region in the last decade, none of the AMS has committed to a political decision on the use of nuclear energy and this is largely due to the Fukushima nuclear power accident in 2011. Of the ten AMS, Vietnam, Indonesia and Malaysia have demonstrated the most progress in developing nuclear energy based on the nuclear power infrastructure development assessments made by the International Atomic Energy Agency. Of these three states, Vietnam came closest to building its first nuclear power plant but decided to delay construction further due to safety and security concerns. Meanwhile, Vietnam along with Indonesia and Malaysia continue with their nuclear power infrastructure development and the remaining SEA states, with the exception of Brunei and Singapore, continue to build their expertise and capacity for nuclear power energy. At the current rate of progress, Indonesia is expected to make a national decision on the use of nuclear power by 2023 while Malaysia, the Philippines, and Thailand have included the use of nuclear power in their mid to long-term power development plans. Vietnam remains open to nuclear power but has not placed a timeline. The medium to short-term power development projection in the region suggests that the use of nuclear energy in the region is a matter of 'when' rather than 'if'. In lieu of the prospects for nuclear energy in Southeast Asia (SEA), this presentation will review the literature on ASEAN radiological emergency and preparedness response (EPR) plans and examine ASEAN’s disaster management and emergency framework. Through a combination of institutional mapping and stakeholder analysis methods, which we examine in the context of the international EPR, and nuclear safety and security regimes, we will identify the issues and challenges in developing a regional radiological EPR framework in the SEA. We will conclude with the observation that ASEAN faces serious structural, institutional and governance challenges due to the AMS inherent political structures and history of interstate conflicts, and propose that ASEAN should either enlarge the existing scope of its disaster management and response framework or that its radiological EPR framework should exist as a separate entity.

Keywords: nuclear power, nuclear accident, ASEAN, Southeast Asia

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682 Examining the Investment Behavior of Arab Women in the Stock Market

Authors: Razan Salem

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Gender plays a vital role in the stock markets because men and women differ in their behavior when investing in stocks. Accordingly, the role of gender differences in investment behavior is an increasingly important strand in the field of behavioral finance research. The investment behaviors of women relative to men have been examined in the behavioral finance literature, mainly for comparison purposes. Women's roles in the stock market have not been examined in the behavioral finance literature, however, particularly with respect to the Arab region. This study aims to contribute towards a better understanding of the investment behavior of Arab women (in regards to their risk tolerance, investment confidence, and investment literacy levels) relative to Arab men; using a sample from Arab women and men investors living in Saudi Arabia and Jordan. In order to achieve the study's main aim, the researcher used non-parametric tests, as Mann-Whitney U test, along with frequency distribution analysis to analyze the study’s primary data. The researcher distributed close-ended online questionnaires to a sample of 550 Arab male and female individuals investing in stocks in both Saudi Arabia and Jordan. The results confirm that the sample Arab women invest less in stocks compared to Arab men due to their risk-averse behaviors and limited confidence levels. The results also reveal that due to Arab women’s very low investment literacy levels, they fear from taking the risk and invest often in stocks relative to Arab men. Overall, the study’s main variables (risk tolerance, investment confidence, and investment literacy levels) have a combined effect on the investment behavior of Arab women and their limited participation in the stock market. Hence, this study is one of the very first studies that indicate the combined effect of the three main variables (which are usually studied separately in the existing literature) on the investment behavior of women, particularly Arab women. This study makes three important contributions to the growing literature on gender differences in investment behavior. First, while the behavioral finance literature documents evidence on gender differences in investment behaviors in many developed countries, there are very limited studies that investigate such differences in Arab countries. Arab women investors, generally, are ignored from the behavioral finance literature due probably to cultural barriers and data collection difficulties. Thus, this study extends the literature to include Arab women and their investment behaviors when trading stock relative to Arab men. Moreover, the study associates women investment literacy and confidence levels with their financial risk behaviors and participation in the stock market. This study provides direct evidence on Arab women's investment behaviors when trading stocks. Overall, studying Arab women investors is important to investigate whether the investment behavior identified for Western women investors are also found in Arab women investors.

Keywords: Arab women, gender differences, investment behavior, stock markets

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681 Socioeconomic Burden of a Diagnosis of Cervical Cancer in Women in Rural Uganda: Findings from a Phenomenological Study

Authors: Germans Natuhwera, Peter Ellis, Acuda Wilson, Anne Merriman, Martha Rabwoni

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Objective: The aim of the study was to diagnose the socio-economic burden and impact of a diagnosis of cervical cancer (CC) in rural women in the context of low-resourced country Uganda, using a phenomenological enquiry. Methods: This was a multi-site phenomenological inquiry, conducted at three hospice settings; Mobile Hospice Mbarara in southwestern, Little Hospice Hoima in Western, and Hospice Africa Uganda Kampala in central Uganda. A purposive sample of women with a histologically confirmed diagnosis of CC was recruited. Data was collected using open-ended audio-recorded interviews conducted in the native languages of participants. Interviews were transcribed verbatim in English, and Braun and Clarke’s (2019) framework of thematic analysis was used. Results: 13 women with a mean age of 49.2 and age range 29-71 participated in the study. All participants were of low socioeconomic status. The majority (84.6%) had advanced disease at diagnosis. A fuller reading of transcripts produced four major themes clustered under; (1) socioeconomic characteristics of women, (2) impact of CC on women’s relationships, (3) disrupted and impaired activities of daily living (ADLs), and (4) economic disruptions. Conclusions: A diagnosis of CC introduces significant socio-economic disruptions in a woman’s and her family’s life. CC causes disability, impairs the woman and her family’s productivity hence exacerbating levels of poverty in the home. High and expensive out-of-pocket expenditure on treatment, investigations, and transport costs further compound the socio-economic burden. Decentralizing cancer care services to regional centers, scaling up screening services, subsidizing costs of cancer care services, or making cervical cancer care treatment free of charge, strengthening monitoring mechanisms in public facilities to curb the vice of healthcare workers soliciting bribes from patients, increased mass awareness campaigns about cancer, training more healthcare professionals in cancer investigation and management, and palliative care, and introducing an introductory course on gynecologic cancers into all health training institutions are recommended.

Keywords: activities of daily living, cervical cancer, out-of-pocket, expenditure, phenomenology, socioeconomic

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680 The Effect of Using Universal Design for Learning to Improve the Quality of Vocational Programme with Intellectual Disabilities and the Challenges Facing This Method from the Teachers' Point of View

Authors: Ohud Adnan Saffar

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This study aims to know the effect of using universal design for learning (UDL) to improve the quality of vocational programme with intellectual disabilities (SID) and the challenges facing this method from the teachers' point of view. The significance of the study: There are comparatively few published studies on UDL in emerging nations. Therefore, this study will encourage the researchers to consider a new approaches teaching. Development of this study will contribute significant information on the cognitively disabled community on a universal scope. In order to collect and evaluate the data and for the verification of the results, this study has been used the mixed research method, by using two groups comparison method. To answer the study questions, we were used the questionnaire, lists of observations, open questions, and pre and post-test. Thus, the study explored the advantages and drawbacks, and know about the impact of using the UDL method on integrating SID with students non-special education needs in the same classroom. Those aims were realized by developing a workshop to explain the three principles of the UDL and train (16) teachers in how to apply this method to teach (12) students non-special education needs and the (12) SID in the same classroom, then take their opinion by using the questionnaire and questions. Finally, this research will explore the effects of the UDL on the teaching of professional photography skills for the SID in Saudi Arabia. To achieve this goal, the research method was a comparison of the performance of the SID using the UDL method with that of female students with the same challenges applying other strategies by teachers in control and experiment groups, we used the observation lists, pre and post-test. Initial results: It is clear from the previous response to the participants that most of the answers confirmed that the use of UDL achieves the principle of inclusion between the SID and students non-special education needs by 93.8%. In addition, the results show that the majority of the sampled people see that the most important advantages of using UDL in teaching are creating an interactive environment with using new and various teaching methods, with a percentage of 56.2%. Following this result, the UDL is useful for integrating students with general education, with a percentage of 31.2%. Moreover, the finding indicates to improve understanding through using the new technology and exchanging the primitive ways of teaching with the new ones, with a percentage of 25%. The result shows the percentages of the sampled people's opinions about the financial obstacles, and it concluded that the majority see that the cost is high and there is no computer maintenance available, with 50%. There are no smart devices in schools to help in implementing and applying for the program, with a percentage of 43.8%.

Keywords: universal design for learning, intellectual disabilities, vocational programme, the challenges facing this method

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679 Management of Postoperative Pain, Intercultural Differences Among Registered Nurses: Czech Republic and Kingdom of Saudi Arabia

Authors: Denisa Mackova, Andrea Pokorna

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The management of postoperative pain is a meaningful part of quality care. The experience and knowledge of registered nurses in postoperative pain management can be influenced by local know-how. Therefore, the research helps to understand the cultural differences between two countries with the aim of evaluating the management of postoperative pain management among the nurses from the Czech Republic and the Kingdom of Saudi Arabia. Both countries have different procedures on managing postoperative pain and the research will provide an understanding of both the advantages and disadvantages of the procedures and also highlight the knowledge and experience of registered nurses in both countries. Between the Czech Republic and the Kingdom of Saudi Arabia, the expectation is for differing results in the usage of opioid analgesia for the patients postoperatively and in the experience of registered nurses with Patient Controlled Analgesia. The aim is to evaluate the knowledge and awareness of registered nurses and to merge the data with the postoperative pain management in the early postoperative period in the Czech Republic and the Kingdom of Saudi Arabia. Also, the aim is to assess the knowledge and experience of registered nurses by using Patient Controlled Analgesia and epidural analgesia treatment in the early postoperative period. The criteria for those providing input into the study, are registered nurses, working in surgical settings (standard departments, post-anesthesia care unit, day care surgery or ICU’s) caring for patients in the postoperative period. Method: Research is being conducted by questionnaires. It is a quantitative research, a comparative study of registered nurses in the Czech Republic and the Kingdom of Saudi Arabia. Questionnaire surveys were distributed through an electronic Bristol online survey. Results: The collection of the data in the Kingdom of Saudi Arabia has been completed successfully, with 550 respondents, 77 were excluded and 473 respondents were included for statistical data analysis. The outcome of the research is expected to highlight the differences in treatment through Patient Controlled Analgesia, with more frequent use in the Kingdom of Saudi Arabia. A similar assumption is expected for treatment conducted by analgesia. We predict that opioids will be used more regularly in the Kingdom of Saudi Arabia, whilst therapy through NSAID’s being the most common approach in the Czech Republic. Discussion/Conclusion: The majority of respondents from the Kingdom of Saudi Arabia were female registered nurses from a multitude of nations. We are expecting a similar split in gender between the Czech Republic respondents; however, there will be a smaller number of nationalities. Relevance for research and practice: Output from the research will assess the knowledge, experience and practice of patient controlled analgesia and epidural analgesia treatment. Acknowledgement: This research was accepted and affiliated to the project: Postoperative pain management, knowledge and experience registered nurses (Czech Republic and Kingdom of Saudi Arabia) – SGS05/2019-2020.

Keywords: acute postoperative pain, epidural analgesia, nursing care, patient controlled analgesia

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678 Peers' Alterity in Inverted Inclusion: A Case Study

Authors: Johanna Sagner, María José Sandoval

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At the early stages of adolescence, young people, regardless of a disability or not, start to establish closer friendship ties. Unlike previous developmental phases, these ties are rather reciprocal, more committed, and require more time. Friendship ties during adolescence allow the development of social and personal skills, specifically the skills to start constructing identity. In an inclusive context that incorporates young people with a disability, friendship among peers also takes place. Nonetheless, the relation is shaped, among others, by the alterity construction about the other with disability. Research about peers’ relation between young people with and without disability in an inclusive context has shown that the relation tends to become a helper-helpee relation, where those with a disability are seen as people in need. Prejudices about the others’ condition or distancing from the other because of his/hers disability are common. In this sense, the helper-helpee relation, as a non-reciprocal and protective relation, will not promote friendship between classmates, but a rather asymmetric alterity. Our research is an explorative case study that wants to know how the relation between peers is shaped within a different inclusive program, were also the integrated group has special educational needs. Therefore, we analyze from a qualitative and quantitative approach the data of an inverted inclusive program. This is a unique case of a special public school for visual disability in Germany that includes young people from a mainstream school who had learning difficulties. For the research, we analyze data from interviews, focal interviews and open-ended questions with an interpretative phenomenological analysis approach. The questionnaires include a five point Likert scale, for which we calculate the acceptance rate. The findings show that the alterity relation between pupils is less asymmetrical and represents a rather horizontal alterity. The helper-helpee relation is marked by exchange, since both groups have special educational needs and therefore, those with visual disability and those with learning difficulties help each other indistinctly. Friendship is more present among classmates. The horizontal alterity peers’ relation is influenced by a sort of tie, where none of the groups need more or less help than other groups. Both groups identify that they themselves and the other have special needs. The axiological axe of alterity is not of superiority or inferiority, recognizing each other’s differences and otherness. Another influential factor relates with the amount of time they spend together, since the program does not have a resource room or a teacher who teaches parallel lessons. Two probable causes for that rather equal peer relation might be the constellation of fewer pupils per classroom and the differentiated lessons taught by teachers with a special educational formation.

Keywords: alterity, disability, inverted inclusion, peers’ relation

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677 Comparative Study of Static and Dynamic Representations of the Family Structure and Its Clinical Utility

Authors: Marietta Kékes Szabó

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The patterns of personality (mal)function and the individuals’ psychosocial environment influence the healthy status collectively and may lie in the background of psychosomatic disorders. Although the patients with their diversified symptoms usually do not have any organic problems, the experienced complaint, the fear of serious illness and the lack of social support often lead to increased anxiety and further enigmatic symptoms. The role of the family system and its atmosphere seem to be very important in this process. More studies explored the characteristics of dysfunctional family organization: inflexible family structure, hidden conflicts that are not spoken about by the family members during their daily interactions, undefined role boundaries, neglect or overprotection of the children by the parents and coalition between generations. However, questionnaires that are used to measure the properties of the family system are able to explore only its unit and cannot pay attention to the dyadic interactions, while the representation of the family structure by a figure placing test gives us a new perspective to better understand the organization of the (sub)system(s). Furthermore, its dynamic form opens new perspectives to explore the family members’ joint representations, which gives us the opportunity to know more about the flexibility of cohesion and hierarchy of the given family system. In this way, the communication among the family members can be also examined. The aim of my study was to collect a great number of information about the organization of psychosomatic families. In our research we used Gehring’s Family System Test (FAST) both in static and dynamic forms to mobilize the family members’ mental representations about their family and to get data in connection with their individual representations as well as cooperation. There were four families in our study, all of them with a young adult person. Two families with healthy participants and two families with asthmatic patient(s) were involved in our research. The family members’ behavior that could be observed during the dynamic situation was recorded on video for further data analysis with Noldus Observer XT 8.0 program software. In accordance with the previous studies, our results show that the family structure of the families with at least one psychosomatic patient is more rigid than it was found in the control group and the certain (typical, ideal, and conflict) dynamic representations reflected mainly the most dominant family member’s individual concept. The behavior analysis also confirmed the intensified role of the dominant person(s) in the family life, thereby influencing the family decisions, the place of the other family members, as well as the atmosphere of the interactions, which could also be grasped well by the applied methods. However, further research is needed to learn more about the phenomenon that can open the door for new therapeutic approaches.

Keywords: psychosomatic families, family structure, family system test (FAST), static and dynamic representations, behavior analysis

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676 Effect of Malnutrition at Admission on Length of Hospital Stay among Adult Surgical Patients in Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia: Prospective Cohort Study, 2022

Authors: Yoseph Halala Handiso, Zewdi Gebregziabher

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Background: Malnutrition in hospitalized patients remains a major public health problem in both developed and developing countries. Despite the fact that malnourished patients are more prone to stay longer in hospital, there is limited data regarding the magnitude of malnutrition and its effect on length of stay among surgical patients in Ethiopia, while nutritional assessment is also often a neglected component of the health service practice. Objective: This study aimed to assess the prevalence of malnutrition at admission and its effect on the length of hospital stay among adult surgical patients in Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia, 2022. Methods: A facility-based prospective cohort study was conducted among 398 adult surgical patients admitted to the hospital. Participants in the study were chosen using a convenient sampling technique. Subjective global assessment was used to determine the nutritional status of patients with a minimum stay of 24 hours within 48 hours after admission (SGA). Data were collected using the open data kit (ODK) version 2022.3.3 software, while Stata version 14.1 software was employed for statistical analysis. The Cox regression model was used to determine the effect of malnutrition on the length of hospital stay (LOS) after adjusting for several potential confounders taken at admission. Adjusted hazard ratio (HR) with a 95% confidence interval was used to show the effect of malnutrition. Results: The prevalence of hospital malnutrition at admission was 64.32% (95% CI: 59%-69%) according to the SGA classification. Adult surgical patients who were malnourished at admission had higher median LOS (12 days: 95% CI: 11-13) as compared to well-nourished patients (8 days: 95% CI: 8-9), means adult surgical patients who were malnourished at admission were at higher risk of reduced chance of discharge with improvement (prolonged LOS) (AHR: 0.37, 95% CI: 0.29-0.47) as compared to well-nourished patients. Presence of comorbidity (AHR: 0.68, 95% CI: 0.50-90), poly medication (AHR: 0.69, 95% CI: 0.55-0.86), and history of admission (AHR: 0.70, 95% CI: 0.55-0.87) within the previous five years were found to be the significant covariates of the length of hospital stay (LOS). Conclusion: The magnitude of hospital malnutrition at admission was found to be high. Malnourished patients at admission had a higher risk of prolonged length of hospital stay as compared to well-nourished patients. The presence of comorbidity, polymedication, and history of admission were found to be the significant covariates of LOS. All stakeholders should give attention to reducing the magnitude of malnutrition and its covariates to improve the burden of LOS.

Keywords: effect of malnutrition, length of hospital stay, surgical patients, Ethiopia

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675 Systematic Review of Digital Interventions to Reduce the Carbon Footprint of Primary Care

Authors: Anastasia Constantinou, Panayiotis Laouris, Stephen Morris

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Background: Climate change has been reported as one of the worst threats to healthcare. The healthcare sector is a significant contributor to greenhouse gas emissions with primary care being responsible for 23% of the NHS’ total carbon footprint. Digital interventions, primarily focusing on telemedicine, offer a route to change. This systematic review aims to quantify and characterize the carbon footprint savings associated with the implementation of digital interventions in the setting of primary care. Methods: A systematic review of published literature was conducted according to PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analyses) guidelines. MEDLINE, PubMed, and Scopus databases as well as Google scholar were searched using key terms relating to “carbon footprint,” “environmental impact,” “sustainability”, “green care”, “primary care,”, and “general practice,” using citation tracking to identify additional articles. Data was extracted and analyzed in Microsoft Excel. Results: Eight studies were identified conducted in four different countries between 2010 and 2023. Four studies used interventions to address primary care services, three studies focused on the interface between primary and specialist care, and one study addressed both. Digital interventions included the use of mobile applications, online portals, access to electronic medical records, electronic referrals, electronic prescribing, video-consultations and use of autonomous artificial intelligence. Only one study carried out a complete life cycle assessment to determine the carbon footprint of the intervention. It estimate that digital interventions reduced the carbon footprint at primary care level by 5.1 kgCO2/visit, and at the interface with specialist care by 13.4 kg CO₂/visit. When assessing the relationship between travel-distance saved and savings in emissions, we identified a strong correlation, suggesting that most of the carbon footprint reduction is attributed to reduced travel. However, two studies also commented on environmental savings associated with reduced use of paper. Patient savings in the form of reduced fuel cost and reduced travel time were also identified. Conclusion: All studies identified significant reductions in carbon footprint following implementation of digital interventions. In the future, controlled, prospective studies incorporating complete life cycle assessments and accounting for double-consulting effects, use of additional resources, technical failures, quality of care and cost-effectiveness are needed to fully appreciate the sustainable benefit of these interventions

Keywords: carbon footprint, environmental impact, primary care, sustainable healthcare

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674 Increasing The Role of Civil Society through LAPOR!: National Complaint Handling System in Indonesia

Authors: Izzati Nabiyla Risfa

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The role of civil society has become an important issue in national and international level nowadays. Government all over the world started to realize that the involvement of civil society can boost up public services and better policy making. Global Policy Forum stated that there are five good reasons for civil society to be engaged in global governance; (1) to conferring legitimacy on policy decisions; (2) to increasing the pool of policy ideas; (3) to support less powerful governments; (4) countering a lack of political will; and (5) helping states to put nationalism aside. Indonesia also keeps up with this good trend. In November 2011, Indonesian Government set up LAPOR! (means “to report” in Indonesian), an online portal for complaints about public services, which is accessible through its website lapor.ukp.go.id. LAPOR! also accessible through social media (Twitter, Facebook) and text message. This program is an initiative from the government to provide an integrated and accessible portal for the Indonesian public to submit complaints and inquiries as a means of enhancing public participation in national development programs. LAPOR! aims to catalyze public participation as well as to have a more coordinated national complaint handling mechanism. The goal of this program is to increase the role of civil society in order to develop better public services. Thus, LAPOR! works in a simplest way possible. Public can submit any complaints or report their problem concerning development programs and public services simply through the website, short message services to 1708 and mobile applications for BlackBerry and Android. LAPOR! will then transfer every validated input to relevant institutions to be featured and responded on the website. LAPOR! is now integrated with 81 Ministries, 5 local government, and 44 State Owned Enterprise. Public can also give comments, likes or share them through Facebook and Twitter to have a discussion and to ensure the completeness of the reports. LAPOR! has unexpectedly contributed to various successful cases concerning public services. So far the portal has over 280,704 registered users, receiving an average of 1,000 reports every day. Government's response rate increase time to time, with 81% of complaints and inquiries have been solved or are being investigated. This paper will examine the effectiveness of LAPOR! as a tools to increase the role of civil society in order to develop better public services in Indonesia. Beside their promising story, there still are various difficulties that need to be solved. With qualitative approach as methodology for this research, writers will also explore potential improvement of LAPOR! so it can perform effectively as a leading national complaint handling system in Indonesia.

Keywords: civil society, government, Indonesia, public services

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673 Date Palm Fruits from Oman Attenuates Cognitive and Behavioral Defects and Reduces Inflammation in a Transgenic Mice Model of Alzheimer's Disease

Authors: M. M. Essa, S. Subash, M. Akbar, S. Al-Adawi, A. Al-Asmi, G. J. Guillemein

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Transgenic (tg) mice which contain an amyloid precursor protein (APP) gene mutation, develop extracellular amyloid beta (Aβ) deposition in the brain, and severe memory and behavioral deficits with age. These mice serve as an important animal model for testing the efficacy of novel drug candidates for the treatment and management of symptoms of Alzheimer's disease (AD). Several reports have suggested that oxidative stress is the underlying cause of Aβ neurotoxicity in AD. Date palm fruits contain very high levels of antioxidants and several medicinal properties that may be useful for improving the quality of life in AD patients. In this study, we investigated the effect of dietary supplementation of Omani date palm fruits on the memory, anxiety and learning skills along with inflammation in an AD mouse model containing the double Swedish APP mutation (APPsw/Tg2576). The experimental groups of APP-transgenic mice from the age of 4 months were fed custom-mix diets (pellets) containing 2% and 4% Date palm fruits. We assessed spatial memory and learning ability, psychomotor coordination, and anxiety-related behavior in Tg and wild-type mice at the age of 4-5 months and 18-19 months using the Morris water maze test, rota rod test, elevated plus maze test, and open field test. Further, inflammatory parameters also analyzed. APPsw/Tg2576 mice that were fed a standard chow diet without dates showed significant memory deficits, increased anxiety-related behavior, and severe impairment in spatial learning ability, position discrimination learning ability and motor coordination along with increased inflammation compared to the wild type mice on the same diet, at the age of 18-19 months In contrast, PPsw/Tg2576 mice that were fed a diet containing 2% and 4% dates showed a significant improvements in memory, learning, locomotor function, and anxiety with reduced inflammatory markers compared to APPsw/Tg2576 mice fed the standard chow diet. Our results suggest that dietary supplementation with dates may slow the progression of cognitive and behavioral impairments in AD. The exact mechanism is still unclear and further extensive research needed.

Keywords: Alzheimer's disease, date palm fruits, Oman, cognitive decline, memory loss, anxiety, inflammation

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672 Relocating Migration for Higher Education: Analytical Account of Students' Perspective

Authors: Sumit Kumar

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The present study aims to identify the factors responsible for the internal migration of students other than push & pull factors; associated with the source region and destination region, respectively, as classified in classical geography. But in this classification of factors responsible for the migration of students, an agency of individual and the family he/she belongs to, have not been recognized which has later become the centre of the argument for describing and analyzing migration in New Economic theory of migration and New Economics of labour migration respectively. In this backdrop, the present study aims to understand the agency of an individual and the family members regarding one’s migration for higher education. Therefore, this study draws upon New Economic theory of migration and New Economics of labour migration for identifying the agency of individual or family in the context of migration. Further, migration for higher education consists not only the decision to migrate but also where to migrate (location), which university, which college and which course to pursue, also. In order to understand the role of various individuals at various stage of student migration, present study seeks help from the social networking approach for migration which identifies the individuals who facilitate the process of migration by reducing negative externalities of migration through sharing information and various other sorts of help to the migrant. Furthermore, this study also aims to rank those individuals who have helped migrants at various stages of migration for higher education in taking a decision, along with the factors responsible for their migration on the basis of their perception. In order to fulfill the above mentioned objectives of this study, quantification of qualitative data (perception of respondents) has been done employing through frequency distribution analysis. Qualitative data has been collected at two levels but questionnaire survey was the tool for data collection at both the occasions. Twenty five students who have migrated to other state for the purpose of higher education have been approached for pre-questionnaire survey consisting open-ended questions while one hundred students belonging to the same clientele have been approached for questionnaire survey consisting close-ended questions. This study has identified social pressure, peer group pressure and parental pressure; variables not constituting push & pull factors, very important for students’ migration. They have been even assigned better ranked by the respondents than push factors. Further, self (migrant themselves) have been ranked followed by parents by the respondents when it comes to take various decisions attached with the process of migration. Therefore, it can be said without sounding cynical that there are other factors other than push & pull factors which do facilitate the process of migration for higher education not only at the level to migrate but also at other levels intrinsic to the process of migration for higher education.

Keywords: agency, migration for higher education, perception, push and pull factors

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671 The Use of Gender-Fair Language in CS National Exams

Authors: Moshe Leiba, Doron Zohar

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Computer Science (CS) and programming is still considered a boy’s club and is a male-dominated profession. This is also the case in high schools and higher education. In Israel, not different from the rest of the world, there are less than 35% of female students in CS studies that take the matriculation exams. The Israeli matriculation exams are written in a masculine form language. Gender-fair language (GFL) aims at reducing gender stereotyping and discrimination. There are several strategies that can be employed to make languages gender-fair and to treat women and men symmetrically (especially in languages with grammatical gender, among them neutralization and using the plural form. This research aims at exploring computer science teachers’ beliefs regarding the use of gender-fair language in exams. An exploratory quantitative research methodology was employed to collect the data. A questionnaire was administered to 353 computer science teachers. 58% female and 42% male. 86% are teaching for at least 3 years, with 59% of them have a teaching experience of 7 years. 71% of the teachers teach in high school, and 82% of them are preparing students for the matriculation exam in computer science. The questionnaire contained 2 matriculation exam questions from previous years and open-ended questions. Teachers were asked which form they think is more suited: (a) the existing form (mescaline), (b) using both gender full forms (e.g., he/she), (c) using both gender short forms, (d) plural form, (e) natural form, and (f) female form. 84% of the teachers recognized the need to change the existing mescaline form in the matriculation exams. About 50% of them thought that using the plural form was the best-suited option. When examining the teachers who are pro-change and those who are against, no gender differences or teaching experience were found. The teachers who are pro gender-fair language justified it as making it more personal and motivating for the female students. Those who thought that the mescaline form should remain argued that the female students do not complain and the change in form will not influence or affect the female students to choose to study computer science. Some even argued that the change will not affect the students but can only improve their sense of identity or feeling toward the profession (which seems like a misconception). This research suggests that the teachers are pro-change and believe that re-formulating the matriculation exams is the right step towards encouraging more female students to choose to study computer science as their major study track and to bridge the gap for gender equality. This should indicate a bottom-up approach, as not long after this research was conducted, the Israeli ministry of education decided to change the matriculation exams to gender-fair language using the plural form. In the coming years, with the transition to web-based examination, it is suggested to use personalization and adjust the language form in accordance with the student's gender.

Keywords: compter science, gender-fair language, teachers, national exams

Procedia PDF Downloads 104
670 Information Needs and Seeking Behaviour of Postgraduate Students of Kohat University of Science and Technology, Khyber Pakhtunkhwa, Pakistan

Authors: Saeed Ullah Jan, Muhammad Ali, Misbah Ullah Awan

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Purpose: This study investigated the information needs and seeking behaviour, and hurdles to information seeking of Post Graduate students of Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa. It focused on the information requirements of the post-graduate students of the university, the pattern they use for seeking information, and the difficulties they face while seeking information. Design/Methodology/approach: This study used a quantitative approach, adapting a survey questionnaire method for data collection. The population of this study was composed of M.Phil. and Ph.D. students of 2019 and 2020 in the faculties of Physical and Numerical Sciences, Chemical and Pharmaceutical Sciences, Biological Sciences, and Social Sciences of KUST. The sample size was 260. Students were selected randomly. The study response rate was 77%, and data were analyzed through SPSS (22 versions). Key findings: The study revealed that Most students' information needs were for study and research activities, new knowledge, and career development. To fulfill these needs, the scholars use various sources and resources. The sources they used for information needs were journal articles, textbooks, and research projects commonly. For the information-seeking purpose, often, students prefer books that have some importance. The other factors that played an essential role in selecting material were topical relevance, Novelty, Recommended by colleagues, and publisher's reputation. Most of the students thought that Book Exhibitions, Open Access systems in the Library, and the Display of new arrivals could enhance the students' information-seeking. The main problem seeking information was faced by them was a shortage of printed information resources. Overall they wanted more facilities, enhancement in the library collection, and better services. Delimitations of the study: This study has not included 1) BS and M.Sc. Students of KUST; 2) The colleges and institutions affiliated with KUST; 3) This study was delimited only to the Post Graduate students of KUST. Practical implication(s): The findings of the study motivate the policymakers and authorities of KUST to restructure the information literacy programs to fulfill the scholars' information needs. It may inform the policymakers to know the difficulties faced by scholars during information seeking. Contribution to the knowledge: No significant work has been done on the students' information needs and seeking behaviour at KUST. The study analyzed the information needs and seeking behaviour of post graduate students. It brought a clear picture of information needs and seeking behaviour of scholars and addressed the problems faced by them during the seeking process.

Keywords: information needs of Pakistan, information-seeking behaviors, postgraduate students, university libraries, Kohat university of science and technology, Khyber Pakhtunkhwa, Pakistan

Procedia PDF Downloads 80
669 The Use of Video Conferencing to Aid the Decision in Whether Vulnerable Patients Should Attend In-Person Appointments during a COVID Pandemic

Authors: Nadia Arikat, Katharine Blain

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During the worst of the COVID pandemic, only essential treatment was provided for patients needing urgent care. With the prolonged extent of the pandemic, there has been a return to more routine referrals for paediatric dentistry advice and treatment for specialist conditions. However, some of these patients and/or their carers may have significant medical issues meaning that attending in-person appointments carries additional risks. This poses an ethical dilemma for clinicians. This project looks at how a secure video conferencing platform (“Near Me”) has been used to assess the need and urgency for in-person new patient visits, particularly for patients and families with additional risks. “Near Me” is a secure online video consulting service used by NHS Scotland. In deciding whether to bring a new patient to the hospital for an appointment, the clinical condition of the teeth together with the urgency for treatment need to be assessed. This is not always apparent from the referral letter. In addition, it is important to judge the risks to the patients and carers of such visits, particularly if they have medical issues. The use and effectiveness of “Near Me” consultations to help decide whether vulnerable paediatric patients should have in-person appointments will be illustrated and discussed using two families: one where the child is medically compromised (Alagille syndrome with previous liver transplant), and the other where there is a medically compromised parent (undergoing chemotherapy and a bone marrow transplant). In both cases, it was necessary to take into consideration the risks and moral implications of requesting that they attend the dental hospital during a pandemic. The option of remote consultation allowed further clinical information to be evaluated and the families take part in the decision-making process about whether and when such visits should be scheduled. These cases will demonstrate how medically compromised patients (or patients with vulnerable carers), could have their dental needs assessed in a socially distanced manner by video consultation. Together, the clinician and the patient’s family can weigh up the risks, with regards to COVID-19, of attending for in-person appointments against the benefit of having treatment. This is particularly important for new paediatric patients who have not yet had a formal assessment. The limitations of this technology will also be discussed. It is limited by internet availability, the strength of the connection, the video quality and families owning a device which allows video calls. For those from a lower socio-economic background or living in some rural areas, this may not be possible or limit its usefulness. For the two patients discussed in this project, where the urgency of their dental condition was unclear, video consultation proved beneficial in deciding an appropriate outcome and preventing unnecessary exposure of vulnerable people to a hospital environment during a pandemic, demonstrating the usefulness of such technology when it is used appropriately.

Keywords: COVID-19, paediatrics, triage, video consultations

Procedia PDF Downloads 86
668 Degradation Kinetics of Cardiovascular Implants Employing Full Blood and Extra-Corporeal Circulation Principles: Mimicking the Human Circulation In vitro

Authors: Sara R. Knigge, Sugat R. Tuladhar, Hans-Klaus HöFfler, Tobias Schilling, Tim Kaufeld, Axel Haverich

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Tissue engineered (TE) heart valves based on degradable electrospun fiber scaffold represent a promising approach to overcome the known limitations of mechanical or biological prostheses. But the mechanical stress in the high-pressure system of the human circulation is a severe challenge for the delicate materials. Hence, the prediction of the scaffolds` in vivo degradation kinetics must be as accurate as possible to prevent fatal events in future animal or even clinical trials. Therefore, this study investigates whether long-term testing in full blood provides more meaningful results regarding the degradation behavior than conventional tests in simulated body fluids (SBF) or Phosphate Buffered Saline (PBS). Fiber mats were produced from a polycaprolactone (PCL)/tetrafluoroethylene solution by electrospinning. The morphology of the fiber mats was characterized via scanning electron microscopy (SEM). A maximum physiological degradation environment utilizing a test set-up with porcine full blood was established. The set-up consists of a reaction vessel, an oxygenator unit, and a roller pump. The blood parameters (pO2, pCO2, temperature, and pH) were monitored with an online test system. All tests were also carried out in the test circuit with SBF and PBS to compare conventional degradation media with the novel full blood setting. The polymer's degradation is quantified by SEM picture analysis, differential scanning calorimetry (DSC), and Raman spectroscopy. Tensile and cyclic loading tests were performed to evaluate the mechanical integrity of the scaffold. Preliminary results indicate that PCL degraded slower in full blood than in SBF and PBS. The uptake of water is more pronounced in the full blood group. Also, PCL preserved its mechanical integrity longer when degraded in full blood. Protein absorption increased during the degradation process. Red blood cells, platelets, and their aggregates adhered on the PCL. Presumably, the degradation led to a more hydrophilic polymeric surface which promoted the protein adsorption and the blood cell adhesion. Testing degradable implants in full blood allows for developing more reliable scaffold materials in the future. Material tests in small and large animal trials thereby can be focused on testing candidates that have proven to function well in an in-vivo-like setting.

Keywords: Electrospun scaffold, full blood degradation test, long-term polymer degradation, tissue engineered aortic heart valve

Procedia PDF Downloads 135
667 The Evaluation of a Novel Cardiac Index derived from Anthropometric and Biochemical Parameters in Pediatric Morbid Obesity and Metabolic Syndrome

Authors: Mustafa Metin Donma

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Metabolic syndrome (MetS) components are noteworthy among children with obesity and morbid obesity because they point out the cases with MetS, which have the great tendency to severe health problems such as cardiovascular diseases both in childhood and adulthood. In clinical practice, considerable efforts are being observed to bring into the open the striking differences between morbid obese cases and those with MetS findings. The most privileged aspect is concerning cardiometabolic features. The aim of this study was to derive an index which behaves different in children with and without MetS from the cardiac point of view. For the purpose, aspartate transaminase (AST), a cardiac enzyme still being used independently to predict cardiac-related problems, was used. One hundred and twenty four children were recruited from the outpatient clinic of Department of Pediatrics in Tekirdag Namik Kemal University, Faculty of Medicine. Forty-three children with normal body mass index, forty-one and forty morbid obese (MO) children with MetS and without the characteristic features of MetS, respectively, were included in the study. Weight, height, waist circumference (WC), hip C (HC), head C (HdC), neck C (NC), systolic and diastolic blood pressure values were measured and recorded. Body mass index and anthropometric ratios were calculated. Fasting blood glucose (FBG), insulin (INS), triglycerides (TRG), high density lipoprotein cholesterol (HDL-C) analyses were performed. The values for AST, alanin transaminase (ALT) and AST/ALT were obtained. Advanced Donma cardiac index (ADCI) values were calculated. The formula for the index was [(TRG/HDL-C) * (INS/FBG)] * [(WC+HC)/Height] * [(HdC+NC)/Height]. Statistical evaluations including correlation analysis were done by a statistical package program. The statistical significance degree was accepted as p<0.05. The index, ADCI, was developed from both anthropometric and biochemical parameters. All anthropometric measurements except weight were included in the equation. Besides all biochemical parameters concerning MetS components were also added. This index was tested in each of three groups. Its performance was compared with the performance of cardiometabolic index (CMI). It was also checked whether it was compatible with AST activity. The performance of ADCI was better than that of CMI. Instead of double increase, the increase of three times was observed in children with MetS compared to MO children. The index was correlated with AST in MO group and with AST/ALT in MetS group. In conclusion, this index was superior in discovering cardiac problems in MO and in diagnosing MetS in MetS groups. It was also arbiter to point out cardiovascular and MetS aspects among the groups.

Keywords: aspartate transaminase, cardiac, children, index, obesity

Procedia PDF Downloads 55
666 Optimization of the Administration of Intravenous Medication by Reduction of the Residual Volume, Taking User-Friendliness, Cost Efficiency, and Safety into Account

Authors: A. Poukens, I. Sluyts, A. Krings, J. Swartenbroekx, D. Geeroms, J. Poukens

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Introduction and Objectives: It has been known for many years that with the administration of intravenous medication, a rather significant part of the planned to be administered infusion solution, the residual volume ( the volume that remains in the IV line and or infusion bag), does not reach the patient and is wasted. This could possibly result in under dosage and diminished therapeutic effect. Despite the important impact on the patient, the reduction of residual volume lacks attention. An optimized and clearly stated protocol concerning the reduction of residual volume in an IV line is necessary for each hospital. As described in my Master’s thesis, acquiring the degree of Master in Hospital Pharmacy, administration of intravenous medication can be optimized by reduction of the residual volume. Herewith effectiveness, user-friendliness, cost efficiency and safety were taken into account. Material and Methods: By usage of a literature study and an online questionnaire sent out to all Flemish hospitals and hospitals in the Netherlands (province Limburg), current flush methods could be mapped out. In laboratory research, possible flush methods aiming to reduce the residual volume were measured. Furthermore, a self-developed experimental method to reduce the residual volume was added to the study. The current flush methods and the self-developed experimental method were compared to each other based on cost efficiency, user-friendliness and safety. Results: There is a major difference between the Flemish and the hospitals in the Netherlands (Province Limburg) concerning the approach and method of flushing IV lines after administration of intravenous medication. The residual volumes were measured and laboratory research showed that if flushing was done minimally 1-time equivalent to the residual volume, 95 percent of glucose would be flushed through. Based on the comparison, it became clear that flushing by use of a pre-filled syringe would be the most cost-efficient, user-friendly and safest method. According to laboratory research, the self-developed experimental method is feasible and has the advantage that the remaining fraction of the medication can be administered to the patient in unchanged concentration without dilution. Furthermore, this technique can be applied regardless of the level of the residual volume. Conclusion and Recommendations: It is recommendable to revise the current infusion systems and flushing methods in most hospitals. Aside from education of the hospital staff and alignment on a uniform substantiated protocol, an optimized and clear policy on the reduction of residual volume is necessary for each hospital. It is recommended to flush all IV lines with rinsing fluid with at least the equivalent volume of the residual volume. Further laboratory and clinical research for the self-developed experimental method are needed before this method can be implemented clinically in a broader setting.

Keywords: intravenous medication, infusion therapy, IV flushing, residual volume

Procedia PDF Downloads 119
665 Evaluation of Regional Anaesthesia Practice in Plastic Surgery: A Retrospective Cross-Sectional Study

Authors: Samar Mousa, Ryan Kerstein, Mohanad Adam

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Regional anaesthesia has been associated with favourable outcomes in patients undergoing a wide range of surgeries. Beneficial effects have been demonstrated in terms of postoperative respiratory and cardiovascular endpoints, 7-day survival, time to ambulation and hospital discharge, and postoperative analgesia. Our project aimed at assessing the regional anaesthesia practice in the plastic surgery department of Buckinghamshire trust and finding out ways to improve the service in collaboration with the anaesthesia team. It is a retrospective study associated with a questionnaire filled out by plastic surgeons and anaesthetists to get the full picture behind the numbers. The study period was between 1/3/2022 and 23/5/2022 (12 weeks). The operative notes of all patients who had an operation under plastic surgery, whether emergency or elective, were reviewed. The criteria of suitable candidates for the regional block were put by the consultant anaesthetists as follows: age above 16, single surgical site (arm, forearm, leg, foot), no drug allergy, no pre-existing neuropathy, no bleeding disorders, not on ant-coagulation, no infection to the site of the block. For 12 weeks, 1061 operations were performed by plastic surgeons. Local cases were excluded leaving 319 cases. Of the 319, 102 patients were suitable candidates for regional block after applying the previously mentioned criteria. However, only seven patients had their operations under the regional block, and the rest had general anaesthesia that could have been easily avoided. An online questionnaire was filled out by both plastic surgeons and anaesthetists of different training levels to find out the reasons behind the obvious preference for general over regional anaesthesia, even if this was against the patients’ interest. The questionnaire included the following points: training level, time taken to give GA or RA, factors that influence the decision, percentage of RA candidates that had GA, reasons behind this percentage, recommendations. Forty-four clinicians filled out the questionnaire, among which were 23 plastic surgeons and 21 anaesthetists. As regards the training level, there were 21 consultants, 4 associate specialists, 9 registrars, and 10 senior house officers. The actual percentage of patients who were good candidates for RA but had GA instead is 93%. The replies estimated this percentage as between 10-30%. 29% of the respondents thought that this percentage is because of surgeons’ preference to have GA rather than RA for their operations without medical support for the decision. 37% of the replies thought that anaesthetists prefer giving GA even if the patient is a suitable candidate for RA. 22.6% of the replies thought that patients refused to have RA, and 11.3% had other causes. The recommendations were in 5 main accesses, which are protocols and pathways for regional blocks, more training opportunities for anaesthetists on regional blocks, providing a separate block room in the hospital, better communication between surgeons and anaesthetists, patient education about the benefits of regional blocks.

Keywords: regional anaesthesia, regional block, plastic surgery, general anaesthesia

Procedia PDF Downloads 78
664 Exploring the Potential of Mobile Learning in Distance Higher Education: A Case Study of the University of Jammu, Jammu, and Kashmir

Authors: Darshana Sharma

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Distance Education has emerged as a viable alternative to serve the higher educational needs of the socially and economically disadvantaged people of the remote, rural areas of Jammu region. The University of Jammu is a National Accreditation, and Assessment Council accredited, A+ university and has been accorded graded autonomy by the University Grants Commission. It is a dual mode university offering academic programmes through the regular departments and through the Directorate of Distance Education. The Directorate of Distance Education, University of Jammu still uses printed study material as a mode of instructional delivery. The development of technologies has assured increased interaction and communication for distance learners throughout the distance open learning institutions. Though it is tempting and convenient to adopt technology already being used by others, it may not prove effective for the simple reason that two institutions may be unlike in some respect. The use of technology must be conceived in view of the needs of the learners; geographical socio-economic-cultural and technological contexts and financial, administrative and academic resources of the institution. Mobile learning (m-learning) is a novel approach to knowledge acquisition and dissemination and is gaining global attention. It has evolved as one of the useful channels of distance learning promoting interaction between learners and teachers. It is felt that the Directorate of Distance Education, University of Jammu also needs to adopt new technologies to provide more effective academic and information support to distance learners in order to keep them motivated and also to develop self-learning skills. The chief objective of the research on which this paper is based was to measure the opinion of the distance learners of the DDE, the University of Jammu about the merits of mobile learning. It also explores their preferences for implementing mobile learning. The survey research design of descriptive research has been used. The data was collected from 400 distance learners enrolled with undergraduate and post-graduate programmes using self-constructed questionnaire containing five-point Likert scale items arranging from strongly agree, agree, indifferent, disagree and strongly disagree. Percentages were used to analyze the data. The findings lead to conclude that mobile learning has a great potential for the DDE for reaching out to the rural, remotely located distance learners of the Jammu region and also to improve the teaching-learning environment. The paper also finds out the challenges in the implementation of mobile learning in the region and further makes suggestions for effective implementation of mobile learning in DDE, University of Jammu.

Keywords: directorate of distance education, mobile learning, national accreditation and assessment council, university of Jammu

Procedia PDF Downloads 116
663 Revolutions and Cyclic Patterns in Chinese Town Planning: The Case-Study of Shenzhen

Authors: Domenica Bona

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Colin Chant and David Goodman argue that historians of Chinese pre-industrial cities tend to underestimate revolutions and overestimate cyclic patterns: periods of peace and prosperity in the earl part of each d nast , followed b peasants’ rebellions and upheavals. Boyd described these cyclic patterns as part of the background of Chinese town planning and architecture. Thus old ideals of city planning-square plan, southward orientation and a palace along the central axis - are revived again and again in the ascendant phases of several d nastic c cles (e.g. Chang’an, Kaifen, and Beijing). Along this line of thought, m paper questions the relationship between the “magic square rule” and modern Chinese urban- planning. As a matter of fact, the classical theme of “cosmic Taoist urbanism” is still a reference for planning cities and new urban developments, whenever there is the intention to express nationalist ideals and “cultural straightforwardness.” Besides, some case studies can be related to “modern d nasties”: the first Republic under the Kuo Min Tang, the red People’s Republic and the post-Maoist open country of Deng Xiao Ping. Considering the project for the new capital of Nanjing in the Thirties, Beijing’s Tianan Men area in the ifties, and Shenzhen’s utian CBD in late 20th century, I argue that cyclic patterns are still in place, though with deformations related to westernization, private interests and lack of spirituality. How far new Chinese cities are - or simply seem to be - westernized? Symbolism, invisible frameworks, repeating features and behavioural patterns make urban China just “superficiall” western. This can be well noticed in cities previousl occupied b foreigners, like Hong Kong, or in newly founded ones, like Shenzhen, where both Asians and non-Asian people can feel the gender-shift from New-York-like landscapes to something else. Current planning in main metropolitan areas shows a blurred relationship between public policies and private investments: two levels of decisions and actions, one addressing the larger scale and infrastructures, the other concerning the micro scale and development of single plots. While zoning is instrumental in this process, master plans are often laid out over a very poor cartography, so much that any relation between the formal characters of new cities and the centuries-old structure of the related territory gets lost.

Keywords: China, contemporary cities, cultural heritage, shenzhen, urban planning

Procedia PDF Downloads 350
662 Clinicians' and Nurses' Documentation Practices in Palliative and Hospice Care: A Mixed Methods Study Providing Evidence for Quality Improvement at Mobile Hospice Mbarara, Uganda

Authors: G. Natuhwera, M. Rabwoni, P. Ellis, A. Merriman

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Aims: Health workers are likely to document patients’ care inaccurately, especially when using new and revised case tools, and this could negatively impact patient care. This study set out to; (1) assess nurses’ and clinicians’ documentation practices when using a new patients’ continuation case sheet (PCCS) and (2) explore nurses’ and clinicians’ experiences regarding documentation of patients’ information in the new PCCS. The purpose of introducing the PCCS was to improve continuity of care for patients attending clinics at which they were unlikely to see the same clinician or nurse consistently. Methods: This was a mixed methods study. The cross-sectional inquiry retrospectively reviewed 100 case notes of active patients on hospice and palliative care program. Data was collected using a structured questionnaire with constructs formulated from the new PCCS under study. The qualitative element was face-to-face audio-recorded, open-ended interviews with a purposive sample of one palliative care clinician, and four palliative care nurse specialists. Thematic analysis was used. Results: Missing patients’ biogeographic information was prevalent at 5-10%. Spiritual and psychosocial issues were not documented in 42.6%, and vital signs in 49.2%. Poorest documentation practices were observed in past medical history part of the PCCS at 40-63%. Four themes emerged from interviews with clinicians and nurses-; (1) what remains unclear and challenges, (2) comparing the past with the present, (3) experiential thoughts, and (4) transition and adapting to change. Conclusions: The PCCS seems to be a comprehensive and simple tool to be used to document patients’ information at subsequent visits. The comprehensiveness and utility of the PCCS does paper to be limited by the failure to train staff in its use prior to introducing. The authors find the PCCS comprehensive and suitable to capture patients’ information and recommend it can be adopted and used in other palliative and hospice care settings, if suitable introductory training accompanies its introduction. Otherwise, the reliability and validity of patients’ information collected by this PCCS can be significantly reduced if some sections therein are unclear to the clinicians/nurses. The study identified clinicians- and nurses-related pitfalls in documentation of patients’ care. Clinicians and nurses need to prioritize accurate and complete documentation of patient care in the PCCS for quality care provision. This study should be extended to other sites using similar tools to ensure representative and generalizable findings.

Keywords: documentation, information case sheet, palliative care, quality improvement

Procedia PDF Downloads 132
661 Evaluation of Cardiac Rhythm Patterns after Open Surgical Maze-Procedures from Three Years' Experiences in a Single Heart Center

Authors: J. Yan, B. Pieper, B. Bucsky, H. H. Sievers, B. Nasseri, S. A. Mohamed

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In order to optimize the efficacy of medications, the regular follow-up with long-term continuous monitoring of heart rhythmic patterns has been facilitated since clinical introduction of cardiac implantable electronic monitoring devices (CIMD). Extensive analysis of rhythmic circadian properties is capable to disclose the distributions of arrhythmic events, which may support appropriate medication according rate-/rhythm-control strategy and minimize consequent afflictions. 348 patients (69 ± 0.5ys, male 61.8%) with predisposed atrial fibrillation (AF), undergoing primary ablating therapies combined to coronary or valve operations and secondary implantation of CIMDs, were involved and divided into 3 groups such as PAAF (paroxysmal AF) (n=99, male 68.7%), PEAF (persistent AF) (n=94, male 62.8%), and LSPEAF (long-standing persistent AF) (n=155, male 56.8%). All patients participated in three-year ambulant follow-up (3, 6, 9, 12, 18, 24, 30 and 36 months). Burdens of atrial fibrillation recurrence were assessed using cardiac monitor devices, whereby attacks frequencies and their circadian patterns were systemically analyzed. Anticoagulants and regular anti-arrhythmic medications were evaluated and the last were listed in terms of anti-rate and anti-rhythm regimens. Patients in the PEAF-group showed the least AF-burden after surgical ablating procedures compared to both of the other subtypes (p < 0.05). The AF-recurrences predominantly performed such attacks’ property as shorter than one hour, namely within 10 minutes (p < 0.05), regardless of AF-subtypes. Concerning circadian distribution of the recurrence attacks, frequent AF-attacks were mostly recorded in the morning in the PAAF-group (p < 0.05), while the patients with predisposed PEAF complained less attack-induced discomforts in the latter half of the night and the ones with LSPEAF only if they were not physically active after primary surgical ablations. Different AF-subtypes presented distinct therapeutic efficacies after appropriate surgical ablating procedures and recurrence properties in sense of circadian distribution. An optimization of medical regimen and drug dosages to maintain the therapeutic success needs more attention to detailed assessment of the long-term follow-up. Rate-control strategy plays a much more important role than rhythm-control in the ongoing follow-up examinations.

Keywords: atrial fibrillation, CIMD, MAZE, rate-control, rhythm-control, rhythm patterns

Procedia PDF Downloads 147
660 An Exploratory Study on the Effect of a Fermented Dairy Product on Self-Reported Gut Complaints in US Recreational Athletes

Authors: Kersch-Counet C., Fransen K. H. S., Broyd M., Nyakayiru J. D. O. A., Schoemaker M. H., Mallee L. F., Bovee-Oudenhoven I. M. J.

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Background: Around one third of people, including athletes, suffer from feelings of gut discomfort. Fermentation of dairy is a process that has been associated with products that can improve gut health. However, insight in (potential) health benefits of most fermented foods is limited to chemical analyses and in-vitro models. Objective: The aim of this open-label, single-arm explorative trial was to investigate in a real life setting the effect of consumption of a fermented whey product for 3 weeks on self-perceived physical and mental wellbeing and digestive issues in 150 US recreational athletes (20-50 years of age) with self-reported gut complaints at enrolment. Methods: Participants living at the West-Coast of the US received for 3 weeks a daily powder of 15 g of BiotisTM Fermentis to be mixed in water using a supplied shaker. Weekly questionnaires were conducted by MMR research to study the effect on physical/mental health issues and self-perceived gut complaints. Non-parametric tests (e.g., Friedman test) were used to assess statistical differences over time while the Kruskal-Wallis and Wilcoxon signed-rank tests were used for sub-groups analysis. Results: Bloating, stress and anxiety were the top 3 issues of the US recreational athletes. Satisfaction of physical wellbeing increased significantly throughout the 3-weeks of fermented whey product consumption (p<0.0005). Combined digestive issues decreased significantly after 2- and 3-weeks of product consumption, with bloating showing a significant reduction (p<0.05). There was a trend that self-reported stress levels reduced after 3 weeks and participants said to significantly feel more active, energetic, and vital (p<0.05). Subgroup analysis showed that gender and habitual protein supplement consumption were associated with specific health issues and modulated the response to the fermented dairy product. Conclusion: Daily consumption of the fermented BiotisTM Fermentis product is associated with a reduction in self-perceived gastrointestinal symptoms and improved overall wellbeing and mood state in US recreational athletes. This large nutrition and health consumer study brings valuable insights in self-reported gut complaints of recreational athletes in the US and their response to a fermented dairy product. A controlled clinical trial in a targeted population is recommended to scientifically substantiate the product effect as observed in this explorative study.

Keywords: real-life study, digestive health, fermented whey, sports

Procedia PDF Downloads 244
659 How to Empower People to Provide Good Nutrition to Children: Bengkel Gizi Terpadu (Integrated Nutrition Workshop)

Authors: Anggun Yuliana Putri, Melisa Rahmadini

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The Ministry of National Development Planning in Indonesia has reported that more than eight million Indonesian children are still malnourished. Based on national statistics, and a recent ranking from NGO Save the Children, Indonesia is one of 15 countries making the fastest gains in cutting child malnutrition among 165 developing countries. According to a United Nations Children’s Fund, at least 7.6 million Indonesian children under the age of 5 or one out of every three suffer from stunted growth, a primary manifestation of malnutrition in early childhood, the report ranked Indonesia as having the fifth largest number of children under 5 suffering from stunted growth worldwide. Addressing the problem of malnutrition in Indonesia, Aksi Cepat Tanggap (ACT) Foundation, a humanitarian organization working with Carrefour, acts as donor and pursues several solutions to the problem, especially of malnourished children and infants in South Tangerang area, Indonesia. The objective of this study was to examine the community empowerment driven by ACT Foundation in order to maintain the good status continuity of child and toddler after the children malnutrition recovered. Research was conducted using qualitative approach through in-depth interview and observation to find out how the Bengkel Gizi Terpadu (Integrated Nutrion Workshop) programs make people empowered. Bengkel Gizi Terpadu (BGT) is divided into 3 sequences of activities, there were: integrated malnutrition rehabilitation; provision of health education to mothers of infants and young children; and family economic empowerment to head of household. Results showed that after empowerment process has been done through training and provision of knowledge to the mothers and families about the important of nutrition and health, there were 30 of 100 mothers who participated actively. Then, there were 45 of 100 heads of household who participated in business training were able to open a business on their own which provided and controlled by ACT as stakeholder in this program. The further findings revealed that BGT programs are able to form community health workers and provide employment opportunities to community. This study believes that integrated nutrition workshop program is the solution to maintain good nutrition among children in South Tangerang, through empowerment of parents and community members, via education and business training program. Both programs prepared parents with economic sustenance and necessary information, a pre-requisite to end malnutrition in children.

Keywords: community, empowerment, malnutrition, training

Procedia PDF Downloads 318
658 Increment of Panel Flutter Margin Using Adaptive Stiffeners

Authors: S. Raja, K. M. Parammasivam, V. Aghilesh

Abstract:

Fluid-structure interaction is a crucial consideration in the design of many engineering systems such as flight vehicles and bridges. Aircraft lifting surfaces and turbine blades can fail due to oscillations caused by fluid-structure interaction. Hence, it is focussed to study the fluid-structure interaction in the present research. First, the effect of free vibration over the panel is studied. It is well known that the deformation of a panel and flow induced forces affects one another. The selected panel has a span 300mm, chord 300mm and thickness 2 mm. The project is to study, the effect of cross-sectional area and the stiffener location is carried out for the same panel. The stiffener spacing is varied along both the chordwise and span-wise direction. Then for that optimal location the ideal stiffener length is identified. The effect of stiffener cross-section shapes (T, I, Hat, Z) over flutter velocity has been conducted. The flutter velocities of the selected panel with two rectangular stiffeners of cantilever configuration are estimated using MSC NASTRAN software package. As the flow passes over the panel, deformation takes place which further changes the flow structure over it. With increasing velocity, the deformation goes on increasing, but the stiffness of the system tries to dampen the excitation and maintain equilibrium. But beyond a critical velocity, the system damping suddenly becomes ineffective, so it loses its equilibrium. This estimated in NASTRAN using PK method. The first 10 modal frequencies of a simple panel and stiffened panel are estimated numerically and are validated with open literature. A grid independence study is also carried out and the modal frequency values remain the same for element lengths less than 20 mm. The current investigation concludes that the span-wise stiffener placement is more effective than the chord-wise placement. The maximum flutter velocity achieved for chord-wise placement is 204 m/s while for a span-wise arrangement it is augmented to 963 m/s for the stiffeners location of ¼ and ¾ of the chord from the panel edge (50% of chord from either side of the mid-chord line). The flutter velocity is directly proportional to the stiffener cross-sectional area. A significant increment in flutter velocity from 218m/s to 1024m/s is observed for the stiffener lengths varying from 50% to 60% of the span. The maximum flutter velocity above Mach 3 is achieved. It is also observed that for a stiffened panel, the full effect of stiffener can be achieved only when the stiffener end is clamped. Stiffeners with Z cross section incremented the flutter velocity from 142m/s (Panel with no stiffener) to 328 m/s, which is 2.3 times that of simple panel.

Keywords: stiffener placement, stiffener cross-sectional area, stiffener length, stiffener cross sectional area shape

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657 Current Status and Influencing Factors of Transition Status of Newly Graduated Nurses in China: A Multi-center Cross-sectional Study

Authors: Jia Wang, Wanting Zhang, Yutong Xv, Zihan Guo, Weiguang Ma

Abstract:

Background: Before becoming qualified nurses, newly graduated nurses(NGNs) must experience a painful transition period, even transition shocks. Transition shocks are public health issues. To address the transition issue of NGNs, many programs or interventions have been developed and implemented. However, there are no studies to understand and assess the transition state of newly graduated nurses from work to life, from external abilities to internal emotions. Aims: Assess the transition status of newly graduated nurses in China. Identify the factors influencing the transition status of newly graduated nurses. Methods: The multi-center cross-sectional study design was adopted. From May 2022 to June 2023, 1261 newly graduated nurse in hospitals were surveyed online with the the Demographic Questionnaire and Transition Status Scale for Newly Graduated Nurses. SPSS 26.0 were used for data input and statistical analysis. Statistic description were adopted to evaluate the demographic characteristics and transition status of NGNs. Independent-samples T-test, Analysis of Variance and Multiple regression analysis was used to explore the influencing factors of transition status. Results: The total average score of Transition Status Scale for Newly Graduated Nurses was 4.00(SD = 0.61). Among the various dimensions of Transition Status, the highest dimension was competence for nursing work, while the lowest dimension was balance between work and life. The results showed factors influencing the transition status of NGNs include taught by senior nurses, night shift status, internship department, attribute of working hospital, province of work and residence, educational background, reasons for choosing nursing, types of hospital, and monthly income. Conclusion: At present, the transition status score of new nurses in China is relatively high, and NGNs are more likely to agree with their own transition status, especially the dimension of competence for nursing work. However, they have a poor level of excess in terms of life-work balance. Nursing managers should reasonably arrange the working hours of NGNs, promote their work-life balance, increase the salary and reward mechanism of NGNs, arrange experienced nursing mentors to teach, optimize the level of hospitals, provide suitable positions for NGNs with different educational backgrounds, pay attention to the culture shock of NGNs from other provinces, etc. Optimize human resource management by intervening in these factors that affect the transition of new nurses and promote a better transition of new nurses.

Keywords: newly graduated nurse, transition, humanistic car, nursing management, nursing practice education

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656 Working From Home: On the Relationship Between Place Attachment to Work Place, Extraversion and Segmentation Preference to Burnout

Authors: Diamant Irene, Shklarnik Batya

Abstract:

In on to its widespread effects on health and economic issues, Covid-19 shook the work and employment world. Among the prominent changes during the pandemic is the work-from-home trend, complete or partial, as part of social distancing. In fact, these changes accelerated an existing tendency of work flexibility already underway before the pandemic. Technology and means of advanced communications led to a re-assessment of “place of work” as a physical space in which work takes place. Today workers can remotely carry out meetings, manage projects, work in groups, and different research studies point to the fact that this type of work has no adverse effect on productivity. However, from the worker’s perspective, despite numerous advantages associated with work from home, such as convenience, flexibility, and autonomy, various drawbacks have been identified such as loneliness, reduction of commitment, home-work boundary erosion, all risk factors relating to the quality of life and burnout. Thus, a real need has arisen in exploring differences in work-from-home experiences and understanding the relationship between psychological characteristics and the prevalence of burnout. This understanding may be of significant value to organizations considering a future hybrid work model combining in-office and remote working. Based on Hobfoll’s Theory of Conservation of Resources, we hypothesized that burnout would mainly be found among workers whose physical remoteness from the workplace threatens or hinders their ability to retain significant individual resources. In the present study, we compared fully remote and partially remote workers (hybrid work), and we examined psychological characteristics and their connection to the formation of burnout. Based on the conceptualization of Place Attachment as the cognitive-emotional bond of an individual to a meaningful place and the need to maintain closeness to it, we assumed that individuals characterized with Place Attachment to the workplace would suffer more from burnout when working from home. We also assumed that extrovert individuals, characterized by the need of social interaction at the workplace and individuals with segmentationpreference – a need for separation between different life domains, would suffer more from burnout, especially among fully remote workers relative to partially remote workers. 194 workers, of which 111 worked from home in full and 83 worked partially from home, aged 19-53, from different sectors, were tested using an online questionnaire through social media. The results of the study supported our assumptions. The repercussions of these findings are discussed, relating to future occupational experience, with an emphasis on suitable occupational adjustment according to the psychological characteristics and needs of workers.

Keywords: working from home, burnout, place attachment, extraversion, segmentation preference, Covid-19

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655 Quality Care from the Perception of the Patient in Ambulatory Cancer Services: A Qualitative Study

Authors: Herlin Vallejo, Jhon Osorio

Abstract:

Quality is a concept that has gained importance in different scenarios over time, especially in the area of health. The nursing staff is one of the actors that contributes most to the care process and the satisfaction of the users in the evaluation of quality. However, until now, there are few tools to measure the quality of care in specialized performance scenarios. Patients receiving ambulatory cancer treatments can face various problems, which can increase their level of distress, so improving the quality of outpatient care for cancer patients should be a priority for oncology nursing. The experience of the patient in relation to the care in these services has been little investigated. The purpose of this study was to understand the perception that patients have about quality care in outpatient chemotherapy services. A qualitative, exploratory, descriptive study was carried out in 9 patients older than 18 years, diagnosed with cancer, who were treated at the Institute of Cancerology, in outpatient chemotherapy rooms, with a minimum of three months of treatment with curative intention and which had given your informed consent. The total of participants was determined by the theoretical saturation, and the selection of these was for convenience. Unstructured interviews were conducted, recorded and transcribed. The analysis of the information was done under the technique of content analysis. Three categories emerged that reflect the perception that patients have regarding quality care: patient-centered care, care with love and effects of care. Patients highlighted situations that show that care is centered on them, incorporating elements of patient-centered care from the institutional, infrastructure, qualities of care and what for them, in contrast, means inappropriate care. Care with love as a perception of quality care means for patients that the nursing staff must have certain qualities, perceive caring with love as a family affair, limits on care with love and the nurse-patient relationship. Quality care has effects on both the patient and the nursing staff. One of the most relevant effects was the confidence that the patient develops towards the nurse, besides to transform the unreal images about cancer treatment with chemotherapy. On the other hand, care with quality generates a commitment to self-care and is a facilitator in the transit of oncological disease and chemotherapeutic treatment, but from the perception of a healing transit. It is concluded that care with quality from the perception of patients, is a construction that goes beyond the structural issues and is related to an institutional culture of quality that is reflected in the attitude of the nursing staff and in the acts of Care that have positive effects on the experience of chemotherapy and disease. With the results, it contributes to better understand how quality care is built from the perception of patients and to open a range of possibilities for the future development of an individualized instrument that allows evaluating the quality of care from the perception of patients with cancer.

Keywords: nursing care, oncology service hospital, quality management, qualitative studies

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