Search results for: financial variables
Commenced in January 2007
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Edition: International
Paper Count: 6696

Search results for: financial variables

1386 Prospective Cohort Study on Sequential Use of Catheter with Misoprostol vs Misoprostol Alone for Second Trimester Medical Abortion

Authors: Hanna Teklu Gebregziabher

Abstract:

Background: A variety of techniques for medical termination of second-trimester pregnancy can be used, but there is no consensus about which is the best. Even though most evidence suggests the combined use of intracervical Foley catheter and vaginal misoprostol is safe, effective, and acceptable method for termination of second-trimester pregnancy, which is comparable to mifepristone-misoprostol combination regimen with lower cost and no additional maternal risks. The use of mifepristone and misoprostol alone with no other procedure is still the most common procedure in different institutions for 2nd-trimester pregnancy. Methods: A cross-sectional comparative prospective study design is employed on women who were admitted for 2nd-trimester medical abortion and medical abortion failed or if there was no change in cervical status after 24 hours of 1st dose of misoprostol. The study was conducted at St. Paulose Hospital Millennium Medical College. A sample of 44 participants in each arm was necessary to give a two-tailed test, a type 1 error of 5%, 80% statistical power, and a 1:1 ratio among groups. Thus, a total of 94 cases, 47 from each arm, were recruited. Data was entered and cleaned by using Epi-info and analyzed using SPSS version 29.0 statistical software and was presented in descriptive and tabular forms. Different variables were cross-tabulated and compared for significant differences and statistical analysis using the chi-square test and independent t-test, to conclude. Result: There was a significant difference between the two groups on induction to expulsion time and number of doses used. The mean ± SD of induction to expulsion time for those used misoprostol alone was 48.09 ± 11.86 and those who used trans-cervical catheter sequentially with misoprostol were 36.7 ±6.772. Conclusion: The use of a trans-cervical Foley catheter in conjunction with misoprostol in a sequential manner is a more effective, safe, and easily accessible procedure. In addition, the cost of utilizing the catheter is less compared to the cost of misoprostol and is readily available. As a good substitute, we advised using Trans-cervical Catether even for medical abortions performed in the second trimester.

Keywords: second trimester, medical abortion, catheter, misoprostol

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1385 The Mechanisms of Peer-Effects in Education: A Frame-Factor Analysis of Instruction

Authors: Pontus Backstrom

Abstract:

In the educational literature on peer effects, attention has been brought to the fact that the mechanisms creating peer effects are still to a large extent hidden in obscurity. The hypothesis in this study is that the Frame Factor Theory can be used to explain these mechanisms. At heart of the theory is the concept of “time needed” for students to learn a certain curricula unit. The relations between class-aggregated time needed and the actual time available, steers and hinders the actions possible for the teacher. Further, the theory predicts that the timing and pacing of the teachers’ instruction is governed by a “criterion steering group” (CSG), namely the pupils in the 10th-25th percentile of the aptitude distribution in class. The class composition hereby set the possibilities and limitations for instruction, creating peer effects on individual outcomes. To test if the theory can be applied to the issue of peer effects, the study employs multilevel structural equation modelling (M-SEM) on Swedish TIMSS 2015-data (Trends in International Mathematics and Science Study; students N=4090, teachers N=200). Using confirmatory factor analysis (CFA) in the SEM-framework in MPLUS, latent variables are specified according to the theory, such as “limitations of instruction” from TIMSS survey items. The results indicate a good model fit to data of the measurement model. Research is still in progress, but preliminary results from initial M-SEM-models verify a strong relation between the mean level of the CSG and the latent variable of limitations on instruction, a variable which in turn have a great impact on individual students’ test results. Further analysis is required, but so far the analysis indicates a confirmation of the predictions derived from the frame factor theory and reveals that one of the important mechanisms creating peer effects in student outcomes is the effect the class composition has upon the teachers’ instruction in class.

Keywords: compositional effects, frame factor theory, peer effects, structural equation modelling

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1384 Determinants of Success of University Industry Collaboration in the Science Academic Units at Makerere University

Authors: Mukisa Simon Peter Turker, Etomaru Irene

Abstract:

This study examined factors determining the success of University-Industry Collaboration (UIC) in the science academic units (SAUs) at Makerere University. This was prompted by concerns about weak linkages between industry and the academic units at Makerere University. The study examined institutional, relational, output, and framework factors determining the success of UIC in the science academic units at Makerere University. The study adopted a predictive cross-sectional survey design. Data was collected using a questionnaire survey from 172 academic staff from the six SAUs at Makerere University. Stratified, proportionate, and simple random sampling techniques were used to select the samples. The study used descriptive statistics and linear multiple regression analysis to analyze data. The study findings reveal a coefficient of determination (R-square) of 0.403 at a significance level of 0.000, suggesting that UIC success was 40.3% at a standardized error of estimate of 0.60188. The strength of association between Institutional factors, Relational factors, Output factors, and Framework factors, taking into consideration all interactions among the study variables, was at 64% (R= 0.635). Institutional, Relational, Output and Framework factors accounted for 34% of the variance in the level of UIC success (adjusted R2 = 0.338). The remaining variance of 66% is explained by factors other than Institutional, Relational, Output, and Framework factors. The standardized coefficient statistics revealed that Relational factors (β = 0.454, t = 5.247, p = 0.000) and Framework factors (β = 0.311, t = 3.770, p = 0.000) are the only statistically significant determinants of the success of UIC in the SAU in Makerere University. Output factors (β = 0.082, t =1.096, p = 0.275) and Institutional factors β = 0.023, t = 0.292, p = 0.771) turned out to be statistically insignificant determinants of the success of UIC in the science academic units at Makerere University. The study concludes that Relational Factors and Framework Factors positively and significantly determine the success of UIC, but output factors and institutional factors are not statistically significant determinants of UIC in the SAUs at Makerere University. The study recommends strategies to consolidate Relational and Framework Factors to enhance UIC at Makerere University and further research on the effects of Institutional and Output factors on the success of UIC in universities.

Keywords: university-industry collaboration, output factors, relational factors, framework factors, institutional factors

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1383 Model for Calculating Traffic Mass and Deceleration Delays Based on Traffic Field Theory

Authors: Liu Canqi, Zeng Junsheng

Abstract:

This study identifies two typical bottlenecks that occur when a vehicle cannot change lanes: car following and car stopping. The ideas of traffic field and traffic mass are presented in this work. When there are other vehicles in front of the target vehicle within a particular distance, a force is created that affects the target vehicle's driving speed. The characteristics of the driver and the vehicle collectively determine the traffic mass; the driving speed of the vehicle and external variables have no bearing on this. From a physical level, this study examines the vehicle's bottleneck when following a car, identifies the outside factors that have an impact on how it drives, takes into account that the vehicle will transform kinetic energy into potential energy during deceleration, and builds a calculation model for traffic mass. The energy-time conversion coefficient is created from an economic standpoint utilizing the social average wage level and the average cost of motor fuel. Vissim simulation program measures the vehicle's deceleration distance and delays under the Wiedemann car-following model. The difference between the measured value of deceleration delay acquired by simulation and the theoretical value calculated by the model is compared using the conversion calculation model of traffic mass and deceleration delay. The experimental data demonstrate that the model is reliable since the error rate between the theoretical calculation value of the deceleration delay obtained by the model and the measured value of simulation results is less than 10%. The article's conclusion is that the traffic field has an impact on moving cars on the road and that physical and socioeconomic factors should be taken into account while studying vehicle-following behavior. The deceleration delay value of a vehicle's driving and traffic mass have a socioeconomic relationship that can be utilized to calculate the energy-time conversion coefficient when dealing with the bottleneck of cars stopping and starting.

Keywords: traffic field, social economics, traffic mass, bottleneck, deceleration delay

Procedia PDF Downloads 55
1382 Environmental Justice and Citizenship Rights in the Tehran Health Plan

Authors: Mohammad Parvaresh, Mahdi Babaee, Bahareh Arghand, Davood Nourmohammadi

Abstract:

Environmental degradation is caused by social inequalities and the inappropriate use of nature and a factor in the violation of human rights. Indeed, the right to a safe, healthy and ecologically-balanced environment is an independent human right. Therefore, the relationship between human rights and environmental protection is crucial for the study of social justice and sustainable development, and environmental problems are a result of the failure to realize social and economic justice. In this regard, 'article 50 of the constitution of the Islamic Republic of Iran as a general principle have many of the concepts of sustainable development, including: the growth and improvement of human life, the rights of present and future generations, and the integrity of the inner and outer generation, the prohibition of any environmental degradation'. Also, Charter on Citizen’s Rights, which was conveyed by the President of the Islamic Republic of Iran, Mr. Rouhani refers to the right to a healthy environment and sustainable development. In this regard in 2013, Tehran Province Water and Wastewater Co. defined a plan called 'Tehran’s Health Line' was includes Western and Eastern part by about 26 kilometers of water transferring pipelines varied 1000 to 2000 mm diameters. This project aims to: (1) Transfer water from the northwest water treatment plant to the southwest areas, which suffer from qualitative and quantitative water, in order to mix with the improper wells’ water; (2) Reducing the water consumption provided by harvesting from wells which results in improving the underground water resources, causing the large settlements and stopping the immigrating slums into the center or north side of the city. All of the financial resources accounted for 53,000,000 US$ which is mobilized by Tehran Province Water and Wastewater Co. to expedite the work. The present study examines the Tehran Health Line plan and the purpose of implementation of this plan to achieve environmental protection, environmental justice and citizenship rights for all people who live in Tehran.

Keywords: environmental justice, international environmental law, erga omnes, charter on citizen's rights, Tehran health line

Procedia PDF Downloads 267
1381 Effects of Virtual Reality on the Upper Extremity Spasticity and Motor Function in Patients with Stroke: A Single Blinded Randomized Controlled Trial

Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini, Omid Seyed Esmaeili, Rouzbeh Kezemi, Noushin Mehrbod, Nazanin Vahed, Tahereh Hajiahmad, Noureddin Nakhostin Ansari

Abstract:

Background: Stroke is a disabling neurological disease. Rehabilitative therapies are important treatment methods. This clinical trial was done to compare the effects of VR beside conventional rehabilitation versus conventional rehabilitation alone on spasticity and motor function in stroke patients. Materials and Methods: In this open-label randomized controlled clinical trial, 40 consecutive patients with stable first-ever ischemic stroke in the past three to 12 months that were referred to a rehabilitation clinic in Tehran, Iran, in 2020 were enrolled. After signing the informed written consent form, subjects were randomly assigned by block randomization of five in each block as cases with 1:1 into two groups of 20 cases; conventional plus VR therapy group: 45-minute conventional therapy session plus 15-minute VR therapy, and conventional group: 60-minute conventional therapy session. VR rehabilitation is designed and developed with different stages. Outcomes were modified Ashworth scale, recovery stage score for motor function, range of motion (ROM) of shoulder abduction/wrist extension, and patients’ satisfaction rate. Data were compared after study termination. Results: The satisfaction rate among the patients was significantly better in the combination group (P=0.003). Only wrist extension was varied between groups and was better in the combination group. The variables generally had a statistically significant difference (P < 0.05). Conclusion: Virtual reality plus conventional rehabilitation therapy is superior versus conventional rehabilitation alone on the wrist and elbow spasticity and motor function in patients with stroke.

Keywords: stroke, virtual therapy, rehabilitation, treatment

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1380 Ownership and Shareholder Schemes Effects on Airport Corporate Strategy in Europe

Authors: Dimitrios Dimitriou, Maria Sartzetaki

Abstract:

In the early days of the of civil aviation, airports are totally state-owned companies under the control of national authorities or regional governmental bodies. From that time the picture has totally changed and airports privatisation and airport business commercialisation are key success factors to stimulate air transport demand, generate revenues and attract investors, linked to reliable and resilience of air transport system. Nowadays, airport's corporate strategy deals with policies and actions, affecting essential the business plans, the financial targets and the economic footprint in a regional economy they serving. Therefore, exploring airport corporate strategy is essential to support the decision in business planning, management efficiency, sustainable development and investment attractiveness on one hand; and define policies towards traffic development, revenues generation, capacity expansion, cost efficiency and corporate social responsibility. This paper explores key outputs in airport corporate strategy for different ownership schemes. The airport corporations are grouped in three major schemes: (a) Public, in which the public airport operator acts as part of the government administration or as a corporised public operator; (b) Mixed scheme, in which the majority of the shares and the corporate strategy is driven by the private or the public sector; and (c) Private, in which the airport strategy is driven by the key aspects of globalisation and liberalisation of the aviation sector. By a systemic approach, the key drivers in corporate strategy for modern airport business structures are defined. Key objectives are to define the key strategic opportunities and challenges and assess the corporate goals and risks towards sustainable business development for each scheme. The analysis based on an extensive cross-sectional dataset for a sample of busy European airports providing results on corporate strategy key priorities, risks and business models. The conventional wisdom is to highlight key messages to authorities, institutes and professionals on airport corporate strategy trends and directions.

Keywords: airport corporate strategy, airport ownership, airports business models, corporate risks

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1379 Gender-Specific Vulnerability on Climate Change and Food Security Status - A Catchment Approach on Agroforestry Systems - A Multi-Country Case Study

Authors: Zerihun Yohannes Amare Id, Bernhard Freyer, Ky Serge Stephane, Ouéda Adama, Blessing Mudombi, Jean Nzuma, Mekonen Getachew Abebe, Adane Tesfaye, Birtukan Atinkut Asmare, Tesfahun Asmamaw Kassie

Abstract:

The study was conducted in Ethiopia (Zege Catchment) (ZC), Zimbabwe (Upper Save Catchment) (USC), and Burkina Faso (Nakambe Catchment) (NC). The study utilized a quantitative approach with 180 participants and complemented it with qualitative methods, including 33 key informant interviews and 6 focus group discussions. Households in ZC (58%), NC (55%), and US (40%) do not cover their household food consumption from crop production. The households rely heavily on perennial cash crops rather than annual crop production. Exposure indicators in ZC (0.758), USC (0.774), and NC (0.944), and sensitivity indicators in ZC (0.849) and NC (0.937) show statistically significant and high correlation with vulnerability. In the USC, adaptive capacity (0.746) and exposure (0.774) are also statistically significant and highly correlated with vulnerability. Vulnerability levels of the NC are very high (0.75) (0.85 female and 0.65 male participants) compared to the USC (0.66) (0.69 female and 0.61 male participants) and ZC (0.47) (0.34 female and 0.58 male participants). Female-headed households had statistically significantly lower vulnerability index compared to males in ZC, while male-headed households had statistically significantly lower vulnerability index compared to females in USC and NC. The reason is land certification in ZC (80%) is higher than in the US (10%) and NC (8%). Agroforestry practices variables across the study catchments had statistically significant contributions to households' adaptive capacity. We conclude that agroforestry practices do have substantial benefits in increasing women's adaptive capacity and reducing their vulnerability to climate change and food insecurity.

Keywords: climate change vulnerability, agroforestry, gender, food security, Sub-Saharan Africa

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1378 Re-thinking Trust in Refugee Resettlement: A Contextual Perspective and Proposal for Reciprocal Integration

Authors: Mahfoudha Sid'Elemine

Abstract:

The refugee resettlement process profoundly shapes the trajectories of individuals in their new host countries, exerting lasting effects on their long-term integration. Prevailing literature underscores the pivotal role of trust in facilitating successful refugee resettlement. However, this research challenges the notion of trust as universally paramount, contending that its significance is contingent upon variables such as the nature of resettlement programs and the diverse backgrounds and perspectives of refugees. Rather than advocating for a blanket approach to trust-building, this research contends that for certain resettlement programs, trust may prove counterproductive amidst resource constraints and tight service timelines. Moreover, trust may not uniformly emerge as a primary requisite for all refugees, presenting formidable challenges in its establishment. Focusing specifically on resettlement in the United States, this study illustrates how the temporal constraints of resettlement services, coupled with refugees' varied cultural experiences, can impede the cultivation of trust between aid workers and refugees. As an alternative paradigm, this research proposes an approach centered on fostering opportunities for reciprocal engagement, positioning refugees as active contributors within their newfound communities. Embracing reciprocity as the cornerstone of burgeoning relationships promises to fortify refugees' ties with the broader community, bolster their autonomy, and facilitate sustained integration over time. The research draws upon qualitative analyses of in-depth interviews conducted with a subset of resettled refugees, as well as aid workers and volunteers involved in refugee resettlement endeavors within Hampton Roads, Virginia, over the past decade. Through this nuanced examination, the study offers insights into the complexities of trust dynamics in refugee resettlement contexts and advocates for a paradigm shift towards reciprocal integration strategies.

Keywords: Resettlement programs, Trust dynamics, Reciprocity, Long-term integration

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1377 The Study of Cost Accounting in S Company Based on TDABC

Authors: Heng Ma

Abstract:

Third-party warehousing logistics has an important role in the development of external logistics. At present, the third-party logistics in our country is still a new industry, the accounting system has not yet been established, the current financial accounting system of third-party warehousing logistics is mainly in the traditional way of thinking, and only able to provide the total cost information of the entire enterprise during the accounting period, unable to reflect operating indirect cost information. In order to solve the problem of third-party logistics industry cost information distortion, improve the level of logistics cost management, the paper combines theoretical research and case analysis method to reflect cost allocation by building third-party logistics costing model using Time-Driven Activity-Based Costing(TDABC), and takes S company as an example to account and control the warehousing logistics cost. Based on the idea of “Products consume activities and activities consume resources”, TDABC put time into the main cost driver and use time-consuming equation resources assigned to cost objects. In S company, the objects focuses on three warehouse, engaged with warehousing and transportation (the second warehouse, transport point) service. These three warehouse respectively including five departments, Business Unit, Production Unit, Settlement Center, Security Department and Equipment Division, the activities in these departments are classified by in-out of storage forecast, in-out of storage or transit and safekeeping work. By computing capacity cost rate, building the time-consuming equation, the paper calculates the final operation cost so as to reveal the real cost. The numerical analysis results show that the TDABC can accurately reflect the cost allocation of service customers and reveal the spare capacity cost of resource center, verifies the feasibility and validity of TDABC in third-party logistics industry cost accounting. It inspires enterprises focus on customer relationship management and reduces idle cost to strengthen the cost management of third-party logistics enterprises.

Keywords: third-party logistics enterprises, TDABC, cost management, S company

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1376 Fruits and Vegetable Consumers' Behaviour towards Organised Retailers: Evidence from India

Authors: K. B. Ramappa, A. V. Manjunatha

Abstract:

Consumerism in India is witnessing unprecedented growth driven by favourable demographics, rising young and working population, rising income levels, urbanization and growing brand orientation. In addition, the increasing level of awareness on health, hygiene and quality has made the consumers to think on the fairly traded goods and brands. This has made retailing extremely important to everyone because without retailers’ consumers would not have access to day-to-day products. The increased competition among different retailers has contributed significantly towards rising consumer awareness on quality products and brand loyalty. Many existing empirical studies have mainly focused on net saving of consumers at organised retail via-a-vis unorganised retail shops. In this article, authors have analysed the Bangalore consumers' attitudes towards buying of fruits and vegetables and their choice of retail outlets. The primary data was collected from 100 consumers belonging to the Bangalore City during October 2014. Sample consumers buying at supermarkets, convenience stores and hypermarkets were purposively selected. The collected data was analyzed using descriptive statistics and multinomial logit model. It was found that among all variables, quality and prices were major accountable factors for buying fruits and vegetables at organized retail shops. The empirical result of multinomial logit model reveals that annual net income was positively associated with the Big Bazar and Food World consumers and negatively associated with the Reliance Fresh, More and Niligiris consumers, as compared with the HOPCOMS consumers. Per month expenditure on fruits and vegetables was positively and age of the consumer was negatively related to the consumers’ choice of buying at modern retail markets. Consumers were willing to buy at modern retail outlets irrespective of the distance.

Keywords: organized retailers, consumers' attitude, consumers' preference, fruits, vegetables, multinomial logit, Bangalore

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1375 Reliability Analysis of Variable Stiffness Composite Laminate Structures

Authors: A. Sohouli, A. Suleman

Abstract:

This study focuses on reliability analysis of variable stiffness composite laminate structures to investigate the potential structural improvement compared to conventional (straight fibers) composite laminate structures. A computational framework was developed which it consists of a deterministic design step and reliability analysis. The optimization part is Discrete Material Optimization (DMO) and the reliability of the structure is computed by Monte Carlo Simulation (MCS) after using Stochastic Response Surface Method (SRSM). The design driver in deterministic optimization is the maximum stiffness, while optimization method concerns certain manufacturing constraints to attain industrial relevance. These manufacturing constraints are the change of orientation between adjacent patches cannot be too large and the maximum number of successive plies of a particular fiber orientation should not be too high. Variable stiffness composites may be manufactured by Automated Fiber Machines (AFP) which provides consistent quality with good production rates. However, laps and gaps are the most important challenges to steer fibers that effect on the performance of the structures. In this study, the optimal curved fiber paths at each layer of composites are designed in the first step by DMO, and then the reliability analysis is applied to investigate the sensitivity of the structure with different standard deviations compared to the straight fiber angle composites. The random variables are material properties and loads on the structures. The results show that the variable stiffness composite laminate structures are much more reliable, even for high standard deviation of material properties, than the conventional composite laminate structures. The reason is that the variable stiffness composite laminates allow tailoring stiffness and provide the possibility of adjusting stress and strain distribution favorably in the structures.

Keywords: material optimization, Monte Carlo simulation, reliability analysis, response surface method, variable stiffness composite structures

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1374 Extracorporeal Shock Wave Therapy versus Functional Electrical Stimulation on Spasticity, Function and Gait Parameters in Hemiplegic Cerebral Palsy

Authors: Mohamed A. Eid, Sobhy M. Aly

Abstract:

Background: About 75% of children with spastic hemiplegic cerebral palsy walk independently, but most still show abnormal gait patterns because of contractures across the joints and muscle spasticity. Objective: The purpose of this study was to investigate and compare the effects of extracorporeal shock wave therapy (ESWT) versus functional electrical stimulation (FES) on spasticity, function, and gait parameters in children with hemiplegic cerebral palsy (CP). Methods: A randomized controlled trail was conducted for 45 children with hemiplegic CP ranging in age from 6 to 9 years. They were assigned randomly using opaque envelopes into three groups. Physical Therapy (PT) group consisted of 15 children and received the conventional physical therapy program (CPTP) in addition to ankle foot orthosis (AFO). ESWT group consisted of 15 children and received the CPTP, AFO in addition to ESWT. FES group also consisted of 15 children and received the CPTP, AFO in addition to FES. All groups received the program of treatment 3 days/week for 12 weeks. Evaluation of spasticity by using the Modified Ashworth Scale (MAS), function by using the Pediatric Evaluation Disability Inventory (PEDI) and gait parameters by using the 3-D gait analysis was conducted at baseline and after 12 weeks of the treatment program. Results: Within groups, significant improvements in spasticity, function, and gait (P = 0.05) were observed in both ESWT and FES groups after treatment. While between groups, ESWT group showed significant improvements in all measured variables compared with FES and PT groups (P ˂ 0.05) after treatment. Conclusion: ESWT induced significant improvement than FES in decreasing spasticity and improving function and gait in children with hemiplegic CP. Therefore, ESWT should be included as an adjunctive therapy in the rehabilitation program of these children.

Keywords: cerebral palsy, extracorporeal shock wave therapy, functional electrical stimulation, function, gait, spasticity

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1373 Effect of the Magnetite Nanoparticles Concentration on Biogas and Methane Production from Chicken Litter

Authors: Guadalupe Stefanny Aguilar-Moreno, Miguel Angel Aguilar-Mendez, Teodoro Espinosa-Solares

Abstract:

In the agricultural sector, one of the main emitters of greenhouse gases is manure management, which has been increased considerably in recent years. Biogas is an energy source that can be produced from different organic materials through anaerobic digestion (AD); however, production efficiency is still low. Several techniques have been studied to increase its performance, such as co-digestion, the variation of digestion conditions, and nanomaterials used. Therefore, the aim of this investigation was to evaluate the effect of magnetite nanoparticles (NPs) concentration, synthesized by co-precipitation, on the biogas and methane production in AD using chicken litter as a substrate. Synthesis of NPs was performed according to the co-precipitation method, for which a fractional factorial experimental design 25⁻² with two replications was used. The study factors were concentrations (precursors and passivating), time of sonication and dissolution temperatures, and the response variables were size, hydrodynamic diameter (HD) and zeta potential. Subsequently, the treatment that presented the smallest NPs was chosen for their use on AD. The AD was established in serological bottles with a working volume of 250 mL, incubated at 36 ± 1 °C for 80 days. The treatments consisted of the addition of different concentrations of NPs in the microcosms: chicken litter only (control), 20 mg∙L⁻¹ of NPs + chicken litter, 40 mg∙L⁻¹ of NPs + chicken litter and 60 mg∙L⁻¹ of NPs + chicken litter, all by triplicate. Methane and biogas production were evaluated daily. The smallest HD (49.5 nm) and the most stable NPs (21.22 mV) were obtained with the highest passivating concentration and the lower precursors dissolution temperature, which were the only factors that had a significant effect on the HD. In the transmission electron microscopy performed to these NPs, an average size of 4.2 ± 0.73 nm was observed. The highest biogas and methane production was obtained with the treatment that had 20 mg∙L⁻¹ of NPs, being 29.5 and 73.9%, respectively, higher than the control, while the treatment with the highest concentration of NPs was not statistically different from the control. From the above, it can be concluded that the magnetite NPs promote the biogas and methane production in AD; however, high concentrations may cause inhibitory effects among methanogenic microorganisms.

Keywords: agricultural sector, anaerobic digestion, nanotechnology, waste management

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1372 Freshwater Fish Diversity and IUCN Status of Glacial-fed (Bheri) and Spring-fed (Babai) Rivers in the Wake of Inter-basin Water Transfer

Authors: Kumar Khatri, Bibhuti Ranjan Jha, Smriti Gurung, Udhab Raj Khadka

Abstract:

Freshwater fishes are crucial components of aquatic ecosystems but are being affected by a range of anthropogenic activities. A large number of freshwater bodies in Nepal are under different anthropogenic threats, thereby affecting freshwater biodiversity, including fish fauna. Inter-basin water transfer (IBWT) involving damming and diversion has been considered as one of the major threats to the rivers, yet many such projects are in the pipeline. Impact assessment of such projects include generation of baseline information on different biotic and abiotic variables. The aim of this study was to generate baseline information on fish diversity from the glacial-fed Bheri and the spring-fed Babai rivers and their selected tributaries from Western Nepal in the wake of the first inter-basin water transfer from the former to the latter. A total of 10 sites, 5 each from Bheri and Babai systems, were chosen strategically. Seasonal electrofishing was conducted in 2018 following the standard method. A total of 32 species with Catch per Unite Effort (CPUE) of 46.94±24.06 from Bheri and 42 species with CPUE of 63.02±51.80 from Babai were recorded. Cyprinidae, followed by Nemacheilidae, were the most dominant fish Family in both river systems. Barilius vagra and Schistura beavani were the most dominant species in the Bheri and the Babai systems, respectively. Species richness and abundance showed a significant difference between the rivers. The difference in fish assemblages reflects differences in the ecological regimes of these rivers. Of the total species, at least 8 are in the threatened categories of the IUCN Red List, which need active conservation measures. The findings provide a reference to assess the impacts of water transfers on fish in these river systems and could be helpful to other similar river systems in the future.

Keywords: babai river, bheri river, fish diversity, damming

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1371 An Empirical Exploration of Factors Influencing Lecturers' Acceptance of Open Educational Resources for Enhanced Knowledge Sharing in North-East Nigerian Universities

Authors: Bello, A., Muhammed Ibrahim Abba., Abdullahi, M., Dauda, Sabo, & Shittu, A. T.

Abstract:

This study investigated the Predictors of Lecturers Knowledge Sharing Acceptance on Open Educational Resources (OER) in North-East Nigerian in Universities. The study population comprised of 632 lecturers of Federal Universities in North-east Nigeria. The study sample covered 338 lecturers who were selected purposively from Adamawa, Bauchi and Borno State Federal Universities in Nigeria. The study adopted a prediction correlational research design. The instruments used for data collection was the questionnaire. Experts in the field of educational technology validated the instrument and tested it for reliability checks using Cronbach’s alpha. The constructs on lecturers’ acceptance to share OER yielded a reliability coefficient of; α = .956 for Performance Expectancy, α = .925; for Effort Expectancy, α = .955; for Social Influence, α = .879; for Facilitating Conditions and α = .948 for acceptance to share OER. the researchers contacted the Deanery of faculties of education and enlisted local coordinators to facilitate the data collection process at each university. The data was analysed using multiple sequential regression statistic at a significance level of 0.05 using SPSS version 23.0. The findings of the study revealed that performance expectancy (β = 0.658; t = 16.001; p = 0.000), effort expectancy (β = 0.194; t = 3.802; p = 0.000), social influence (β = 0.306; t = 5.246; p = 0.000), collectively indicated that the variables have a predictive capacity to stimulate lecturer’s acceptance to share their resources on OER repository. However, the finding revealed that facilitating conditions (β = .053; t = .899; p = 0.369), does not have a predictive capacity to stimulate lecturer’s acceptance to share their resources on OER repository. Based on these findings, the study recommends among others that the university management should consider adjusting OER policy to be centered around actualizing lecturers career progression.

Keywords: acceptance, lecturers, open educational resources, knowledge sharing

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1370 Organisational Factors and Total Quality Management Practice in Nigeria Manufacturing Industry: Evidence from Honeywell Flour Mills Plc

Authors: Cornelius Femi Popoola

Abstract:

Nigerian manufacturing industry, particularly the flour producing firms play vital roles in Nigerian economy. This sector’s quality management practice is given a little attention along with organizational factors that hinder successful practice of total quality management which needs to be documented. Honeywell Flour Mills Plc operate in Nigeria with an appreciable number of products that serves this sector of the economy. Internal-external disposition of the company and total quality practice of the company deserve some elucidations. Hence, this study examined the influence of organizational factors on total quality management practice of Nigerian manufacturing industry, using Honeywell Flour Mills Plc as a case study. The study employed the correlational type of descriptive survey research design. The population consisted of 656 staff of Honeywell Flour Mills Plc, out of which 235 members were selected through scientific sampling method developed by Paler-Calmorin and Calmorin. A total of 235 copies of questionnaires titled 'Organisational Factors and Total Quality Management Practices (QF-TQM) Questionnaire' were administered with a response rate of 66 copies returned. The following variables were applied internal organisational factors (IOFs), external organizational factors (EOFs) and total quality management (TQM). Data generated were analysed using frequency distribution and regression analysis at 0.05 level. The findings revealed that IOFs positively and significantly related with TQM (r = .147**, N= 64, P(.000) < .01). Also, EOFs negatively and significantly related with TQM (r = -.117, N= 64, P(.000) < .01). Findings showed that internal and external organizational factors jointly influenced TQM practiced in F₍₂,₆₁₎=22.250; R²=.629; Adj.R²=.603; P(.000) < .05). The study concluded that organizational factors are determinants of TQM practice in Nigerian manufacturing industry. It is recommended that both internal and external organizational factors influencing TQM practices should be considered in the development of TQM strategies.

Keywords: external organizational factors, internal organisational factors, Nigerian manufacturing industry, total quality management

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1369 A Qualitative Study Exploring Factors Influencing the Uptake of and Engagement with Health and Wellbeing Smartphone Apps

Authors: D. Szinay, O. Perski, A. Jones, T. Chadborn, J. Brown, F. Naughton

Abstract:

Background: The uptake of health and wellbeing smartphone apps is largely influenced by popularity indicators (e.g., rankings), rather than evidence-based content. Rapid disengagement is common. This study aims to explore how and why potential users 1) select and 2) engage with such apps, and 3) how increased engagement could be promoted. Methods: Semi-structured interviews and a think-aloud approach were used to allow participants to verbalise their thoughts whilst searching for a health or wellbeing app online, followed by a guided search in the UK National Health Service (NHS) 'Apps Library' and Public Health England’s (PHE) 'One You' website. Recruitment took place between June and August 2019. Adults interested in using an app for behaviour change were recruited through social media. Data were analysed using the framework approach. The analysis is both inductive and deductive, with the coding framework being informed by the Theoretical Domains Framework. The results are further mapped onto the COM-B (Capability, Opportunity, Motivation - Behaviour) model. The study protocol is registered on the Open Science Framework (https://osf.io/jrkd3/). Results: The following targets were identified as playing a key role in increasing the uptake of and engagement with health and wellbeing apps: 1) psychological capability (e.g., reduced cognitive load); 2) physical opportunity (e.g., low financial cost); 3) social opportunity (e.g., embedded social media); 4) automatic motivation (e.g., positive feedback). Participants believed that the promotion of evidence-based apps on NHS-related websites could be enhanced through active promotion on social media, adverts on the internet, and in general practitioner practices. Future Implications: These results can inform the development of interventions aiming to promote the uptake of and engagement with evidence-based health and wellbeing apps, a priority within the UK NHS Long Term Plan ('digital first'). The targets identified across the COM-B domains could help organisations that provide platforms for such apps to increase impact through better selection of apps.

Keywords: behaviour change, COM-B model, digital health, mhealth

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1368 The Transcutaneous Auricular Vagus Nerve Stimulation in Treatment of Depression and Anxiety Disorders in Recovery Patient with Feeding and Eating Disorders

Authors: Y. Melis, E. Apicella, E. Dozio, L. Mendolicchio

Abstract:

Introduction: Feeding and Eating Disorders (FED) represent the psychiatric pathology with the highest mortality rate and one of the major disorders with the highest psychiatric and clinical comorbidity. The vagus nerve represents one of the main components of the sympathetic and parasympathetic nervous system and is involved in important neurophysiological functions. In FED, there is a spectrum of symptoms which with TaVNS (Transcutaneous Auricular Vagus Nerve Stimulation) therapy, is possible to have a therapeutic efficacy. Materials and Methods: Sample subjects are composed of 15 female subjects aged > 18 ± 51. Admitted to a psychiatry community having been diagnosed according to DSM-5: anorexia nervosa (AN) (N= 9), bulimia nervosa (BN) (N= 5), binge eating disorder (BED) (N= 1). The protocol included 9 weeks of Ta-VNS stimulation at a frequency of 1.5-3.5 mA for 4 hours per day. The variables detected are the following: Heart Rate Variability (HRV), Hamilton Depression Rating Scale (HAMD-HDRS-17), Body Mass Index (BMI), Beck Anxiety Index (BAI). Results: Data analysis showed statistically significant differences between recording times (p > 0.05) in HAM-D (t0 = 18.28 ± 5.31; t4 = 9.14 ± 7.15), in BAI (t0 = 24.7 ± 10.99; t4 = 13.8 ± 7.0). The reported values show how during (T0-T4) the treatment there is a decay of the degree in the depressive state, in the state of anxiety, and an improvement in the value of BMI. In particular, the BMI in the AN-BN sub-sample had a minimum gain of 5% and a maximum of 11%. The analysis of HRV did not show a clear change among subjects, thus confirming the discordance of the activity of the sympathetic and parasympathetic nervous system in FED. Conclusions: Although the sample does not possess a relevant value to determine long-term efficacy of Ta-VNS or on a larger population, this study reports how the application of neuro-stimulation in FED may become a further approach therapeutic. Indeed, substantial improvements are highlighted in the results and confirmed hypotheses proposed by the study.

Keywords: feeding and eating disorders, neurostimulation, anxiety disorders, depression

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1367 Decisional Regret in Men with Localized Prostate Cancer among Various Treatment Options and the Association with Erectile Functioning and Depressive Symptoms: A Moderation Analysis

Authors: Caren Hilger, Silke Burkert, Friederike Kendel

Abstract:

Men with localized prostate cancer (PCa) have to choose among different treatment options, such as active surveillance (AS) and radical prostatectomy (RP). All available treatment options may be accompanied by specific psychological or physiological side effects. Depending on the nature and extent of these side effects, patients are more or less likely to be satisfied or to struggle with their treatment decision in the long term. Therefore, the aim of this study was to assess and explain decisional regret in men with localized PCa. The role of erectile functioning as one of the main physiological side effects of invasive PCa treatment, depressive symptoms as a common psychological side effect, and the association of erectile functioning and depressive symptoms with decisional regret were investigated. Men with localized PCa initially managed with AS or RP (N=292) were matched according to length of therapy (mean 47.9±15.4 months). Subjects completed mailed questionnaires assessing decisional regret, changes in erectile functioning, depressive symptoms, and sociodemographic variables. Clinical data were obtained from case report forms. Differences among the two treatment groups (AS and RP) were calculated using t-tests and χ²-tests, relationships of decisional regret with erectile functioning and depressive symptoms were computed using multiple regression. Men were on average 70±7.2 years old. The two treatment groups differed markedly regarding decisional regret (p<.001, d=.50), changes in erectile functioning (p<.001, d=1.2), and depressive symptoms (p=.01, d=.30), with men after RP reporting higher values, respectively. Regression analyses showed that after adjustment for age, tumor risk category, and changes in erectile functioning, depressive symptoms were still significantly associated with decisional regret (B=0.52, p<.001). Additionally, when predicting decisional regret, the interaction of changes in erectile functioning and depressive symptoms reached significance for men after RP (B=0.52, p<.001), but not for men under AS (B=-0.16, p=.14). With increased changes in erectile functioning, the association of depressive symptoms with decisional regret became stronger in men after RP. Decisional regret is a phenomenon more prominent in men after RP than in men under AS. Erectile functioning and depressive symptoms interact in their prediction of decisional regret. Screening and treating depressive symptoms might constitute a starting point for interventions aiming to reduce decisional regret in this target group.

Keywords: active surveillance, decisional regret, depressive symptoms, erectile functioning, prostate cancer, radical prostatectomy

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1366 A Telecoupling Lens to Study Global Sustainability Entanglements along Supply Chains: The Case of Dutch-Kenyan Rose Trade

Authors: Klara Strecker

Abstract:

During times of globalization, socioeconomic systems have become connected across the world through global supply chains. As a result, consumption and production locations have increasingly become spatially decoupled. This decoupling leads to complex entanglements of systems and sustainability challenges across distances -entanglements which can be conceptualized as telecouplings. Through telecouplings, people and environments across the world have become closely connected, bringing challenges as well as opportunities. Some argue that telecoupling dynamics started taking shape during times of colonization when resources were first traded across the world. An example of such a telecoupling is that of the rose. Every third rose sold in Europe is grown in Kenya and enters the European market through the Dutch flower auction system. Many Kenyan farms are Dutch-owned, closely entangling Kenya and the Netherlands through the trade of roses. Furthermore, the globalization of the flower industry and the resulting shift of production away from the Netherlands and towards Kenya has led to significant changes in the Dutch horticulture sector. However, the sustainability effects of this rose telecoupling is limited neither to the horticulture sector nor to the Netherlands and Kenya. Alongside the flow of roses between these countries come complex financial, knowledge-based, and regulatory flows. The rose telecoupling also creates spillover effects to other countries, such as Ethiopia, and other industries, such as Kenyan tourism. Therefore, telecoupling dynamics create complex entanglements that cut across sectors, environments, communities, and countries, which makes effectively governing and managing telecouplings and their sustainability implications challenging. Indeed, sustainability can no longer be studied in spatial and temporal isolation. This paper aims to map the rose telecoupling’s complex environmental and social interactions to identify points of tension guiding sustainability-targeted interventions. Mapping these interactions will provide a more holistic understanding of the sustainability challenges involved in the Dutch-Kenyan rose trade. This interdisciplinary telecoupling approach reframes and integrates interdisciplinary knowledge about the rose trade between the Netherlands, Kenya, and beyond.

Keywords: Dutch-Kenyan rose trade, globalization, socio-ecological system, sustainability, telecoupling

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1365 Knowledge, Perceptions, and Barriers of Preconception Care among Healthcare Workers in Nigeria

Authors: Taiwo Hassanat Bawa-Muhammad, Opeoluwa Hope Adegoke

Abstract:

Introduction: This study aims to examine the knowledge and perceptions of preconception care among healthcare workers in Nigeria, recognizing its crucial role in ensuring safe pregnancies. Despite its significance, awareness of preconception care remains low in the country. The study seeks to assess the understanding of preconception services and identify the barriers that hinder their efficacy. Methods: Through semi-structured interviews, 129 healthcare workers across six states in Nigeria were interviewed between January and March 2023. The interviews explored the healthcare workers' knowledge of preconception care practices, the socio-cultural influences shaping decision-making, and the challenges that limit accessibility and utilization of preconception care services. Results: The findings reveal a limited knowledge of preconception care among healthcare workers, primarily due to inadequate information dissemination within the healthcare system. Additionally, cultural beliefs significantly influence perceptions surrounding preconception care. Furthermore, financial constraints, distance to healthcare facilities, and poor health infrastructure disproportionately restrict access to preconception services, particularly for vulnerable populations. The study also highlights insufficient skills and outdated training among healthcare workers regarding preconception guidance, primarily attributed to limited opportunities for professional development. Discussion: To improve preconception care in Nigeria, comprehensive education programs must be implemented, taking into account the societal influences that shape perceptions and behaviors. These programs should aim to dispel myths and promote evidence-based practices. Additionally, training healthcare workers and integrating preconception care services into primary care settings, with support from religious and community leaders, can help overcome barriers to access. Strategies should prioritize affordability while emphasizing the broader benefits of preconception care beyond fertility concerns alone. Lastly, widespread literacy campaigns utilizing trusted channels are crucial for effectively disseminating information and promoting the adoption of preconception practices in Nigeria.

Keywords: preconception care, knowledge, healthcare workers, Nigeria, barriers, education, training

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1364 Implications of Internationalization for Management and Practice in Higher Education

Authors: Naziema B. Jappie

Abstract:

Internationalization is very complex and multifaceted and has implications for the entire university sector, and the larger community which it serves. Higher education strategic plans require sustainability on all levels of academic engagement and internationalization contributes to the sustainability because of the global competition but, at the same time, ensures diversity on campuses. Universities all over the world are increasingly recognizing the challenges of globalization and the pressures towards internationalization. The past 25 years of internationalization has faded away, and new challenges have emerged. Although internationalization remains a central strategic objective for all universities, for many leaders and education practitioners it has remained a confused concept. It has various interpretations, and it intersects with numerous other national agendas in higher education domain; it often builds upon narrow notions limited to one of its facets –attracting international student fees for financial sustainability or for ensuring a diverse campus culture. It is essential to have clear institutional views, but it is imperative that everyone reflects on the values and beliefs that underpin the internationalization of higher education and have a global focus. This paper draws together the international experience locally and globally to explore the emerging patterns of strategy and practice in internationalizing higher education. This will highlight some critical notions of how the concepts of internationalization and globalization in the context of higher education is understood by those who lead universities and what new challenges are being created as universities seek to become more international. Institutions cannot simply have bullet points in the strategic plan about recruitment of international students; there has to be a complete commitment to an international strategy of inclusivity. This paper will further examine the leadership styles that ensure transformation together with the goals set out for internationalization. The interviews with the senior leadership are in-depth semi-structured recorded interviews of approximately one-hour to learn about their institutional experiences, promotion, and enhancement of the value of internationalisation to the tertiary education sector and initiating discussions around adding the international relations dimension to the curriculum. This paper will address the issues relevant to the cross-border delivery of higher education. To ensure anonymity throughout this study, the interviewees are identified only by their institutions.

Keywords: challenges, globalization, higher education, internationalization, strategic focus

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1363 The Impact of Access to Finances on Survival of Small and Medium Enterprises: The South African Perspective in an Covid-19 Era

Authors: Thabiso Sthembiso Msomi

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SMEs are the main engine of growth in most developing economies. One of the main factors that hinder the development of SME is access to finance. In this study, we explored the factors that hinder the growth and survival of SMEs in South Africa. The capital structure theory formed the theoretical underpinning for the study. The quantitative research design was adopted and data was collected from retail, construction, manufacturing and agriculture sectors of SMEs within the KwaZulu-Natal province of South Africa. The modified version of the Cochran formula was used to determine the sample size as 321 SMEs and analysed using the five-point Likert scale. The purposive sampling technique was used to select owners of SME. Statistical Package for the Social Sciences (SPSS) was used for the data analysis through Exploratory Factor Analysis (EFA) to determine the factor structures of items employed to measure each of the constructs in this study. Then, the Cronbach’s alpha test was conducted to determine the reliability of each construct. Kaiser-Meyer-Olkin (KMO) was used to determine the adequacy of the sample size. Linear regression was done to determine the effect of the independent variables on the dependent variable. The findings suggest that the main constraints facing South African SMEs were the lack of experienced management. Furthermore, the SMEs would fail to raise customer awareness of their products and services, which in turn affects their market access and monthly turnover. The study recommends that SMEs keep up-to-date records of business transactions to enable the business to keep track of its operations. The study recommends that South African banks adopt an SME accounting and bookkeeping program. The finding of this study benefits policymakers in both the private and public sectors.

Keywords: small businesses, access to finances, COVID-19, SMEs survival

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1362 Self-Congruence and Oppositional Brand Loyalty: The Role of Consumer Engagement, Consumer Brand Identification and Gender

Authors: Muhammad Sheeraz, Mehwish Ejaz

Abstract:

This study endeavors to enhance the understanding of the determinants of oppositional brand loyalty, particularly within the context of fans of a sports brand. The primary focus is on investigating how oppositional brand loyalty fosters rivalry among the fans and exploring the interplay between various variables, namely self-congruence, consumer brand identification, consumer brand engagement, and narcissism, in influencing the likelihood of endorsing a rival team. The research adopts a cross-sectional survey methodology, employing a structured questionnaire distributed both online and onsite to gather responses from a representative sample of 460 PSL fans in Pakistan. The data collection process involved obtaining responses from diverse settings, including universities, shopping malls, and other public spaces frequented by PSL enthusiasts. Participants were prompted to indicate their allegiance to a specific PSL team and subsequently respond to the questionnaire based on their preferences. The findings of the study reveal that narcissism, as a moderating factor, exhibits no significant influence on consumer brand identification, consumer brand engagement, and oppositional brand loyalty. However, it does emerge as a significant moderator in the relationship between self-congruence and consumer brand identification. Particularly, consumers express brand identification through self-congruence, elucidating the existence of oppositional sentiments among PSL fans and their counterparts supporting rival teams. The implications of these results underscore the importance for marketers to establish a brand identity that resonates with consumers on a personal level. Such an approach fosters a strong sense of identification with the brand, prompting consumers to vigorously defend and support their favored brands, even in the face of opposition from rival teams. Marketers are encouraged to focus on cultivating long-term consumer loyalty, as it proves pivotal in maintaining a competitive advantage over industry counterparts.

Keywords: oppositional brand loyalty, consumer brand identification, consumer brand engagement, narcissism, self-congruence

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1361 Balancing Electricity Demand and Supply to Protect a Company from Load Shedding: A Review

Authors: G. W. Greubel, A. Kalam

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This paper provides a review of the technical problems facing the South African electricity system and discusses a hypothetical ‘virtual grid’ concept that may assist in solving the problems. The proposed solution has potential application across emerging markets with constrained power infrastructure or for companies who wish to be entirely powered by renewable energy. South Africa finds itself at a confluence of forces where the national electricity supply system is constrained with under-supply primarily from old and failing coal-fired power stations and congested and inadequate transmission and distribution systems. Simultaneously, the country attempts to meet carbon reduction targets driven by both an alignment with international goals and a consumer-driven requirement. The constrained electricity system is an aspect of an economy characterized by very low economic growth, high unemployment, and frequent and significant load shedding. The fiscus does not have the funding to build new generation capacity or strengthen the grid. The under-supply is increasingly alleviated by the penetration of wind and solar generation capacity and embedded roof-top solar. However, this increased penetration results in less inertia, less synchronous generation, and less capability for fast frequency response, with resultant instability. The renewable energy facilities assist in solving the under-supply issues but merely ‘kick the can down the road’ by not contributing to grid stability or by substituting the lost inertia, thus creating an expanding issue for the grid to manage. By technically balancing its electricity demand and supply a company with facilities located across the country can be protected from the effects of load shedding, and thus ensure financial and production performance, protect jobs, and contribute meaningfully to the economy. By treating the company’s load (across the country) and its various distributed generation facilities as a ‘virtual grid’, which by design will provide ancillary services to the grid one is able to create a win-win situation for both the company and the grid.

Keywords: load shedding, renewable energy integration, smart grid, virtual grid, virtual power plant

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1360 Women In Orthopedic Surgery, A Scoping Review

Authors: Katherine van Kampen, Reva Qiu, Patricia Farrugia

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Orthopedic surgery has fallen behind when it comes to gender diversity despite medical school classes reaching gender parity. Studies have shown that orthopedic surgery would require 117 years to reach gender parity with the trainee population, the longest time than any other specialty, including neurosurgery, urology, and otolaryngology. The barriers that face women in orthopedic surgery have been well researched, with contributing factors being on-going stereotypes of the field, lack of women mentors, and gender roles outside of the hospital. Furthermore, women in orthopedic surgery face barriers to achieve promotion, publications, and leadership roles leading to a “leaky pipeline,” resulting in less and less women in key academic roles in the field. It is a complex topic with barriers and challenges faced in medical school, residency, and throughout employment. Our scoping review seeks to understand these challenges across a temporal timeline and to further characterize such barriers and the driving factors behind them. To this date, authors did not find a scoping review that seeks to look broadly at factors impacting the decreased amount of women entering orthopedics and the factors that cause women to hit a “glass ceiling”, the idea that women will not achieve the same success as men despite the same qualifications, upon entering the field. This scoping review is the first of its kind to attempt to summarize the large body of research focusing on women in orthopedic surgery from the preconceptions in medical school impacting their desire to pursue orthopedics all the way to employment, including challenges to academic success and financial success. Literature databases will be searched with the following key terms: women, gender inequity, workforce, orthopedics, and citations will be hand searched and collected. Articles included will discuss gender inequality within orthopedics with non-english, patient related articles excluded. Full-text review will seek to characterize the specific barriers faced by women across medical school, residency, and employment. Themes that are expected to be highlighted are workforce data, women in orthopedic leadership, medical student perspectives on the specialty, and gender bias and discrimination in the field.

Keywords: orthopedics, gender equity, workforce, women in surgery

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1359 Digital Nomads: Current Context, Difficulties, and Opportunities for Costa Rica

Authors: Cristina Gutiérrez Carranza

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Digital nomadism is a trend and lifestyle which combines work and traveling. This tourism tendency is motivated by the desire to have a fixed source of financial income while becoming independent from a specific work location. This study contextualizes Costa Rica and its potential prospects to take advantage of this tourism market niche. It explores the dynamics of digital nomadism in the context of Costa Rica, analyzing the current scenario, challenges, and opportunities related to this global phenomenon. The research covers several areas, including the conceptualization of digital nomadism, its historical background, and contemporary manifestations. The investigation delves into the present state of digital nomadism, evaluating the extent of digitalization in Costa Rica, mobile phone coverage, and fixed internet access. As part of the strategies implemented, as the study develops, mapping the most common destinations of digital nomads is a key factor, bringing a sight on the aspects that make Costa Rica an attractive location for this emerging tourist group. Additionally, the paper draws insights from hosting entrepreneurs and digital nomads with work visas in Costa Rica, offering a comprehensive understanding of the experiences and perspectives from both sides. Hence, the study includes data from a sample of 20 digital nomads holding visas for Costa Rica, offering a detailed analysis of their professional activities, experiences and needs as remote workers in the country. As well it adds in perceptions from 10 entrepreneurs engaged in providing accommodation services to digital nomads contribute to a degree of understanding of the way they have faced this growing movement. This research provides significant insights on the dynamics of digital nomadism in Costa Rica by integrating data from specific sources. Policymakers, entrepreneurs, and other stakeholders are anticipated to gain valuable data from the findings regarding the opportunities and challenges of hosting and accommodating digital nomads, which will ultimately aid in the creation of plans to capitalize on this worldwide trend for the nation's socioeconomic development.

Keywords: digital nomads, tourism, sustainability, digital nomads visa, remote jobs

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1358 Aerodynamic Optimum Nose Shape Change of High-Speed Train by Design Variable Variation

Authors: Minho Kwak, Suhwan Yun, Choonsoo Park

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Nose shape optimizations of high-speed train are performed for the improvement of aerodynamic characteristics. Based on the commercial train, KTX-Sancheon, multi-objective optimizations are conducted for the improvement of the side wind stability and the micro-pressure wave following the optimization for the reduction of aerodynamic drag. 3D nose shapes are modelled by the Vehicle Modeling Function. Aerodynamic drag and side wind stability are calculated by three-dimensional compressible Navier-Stokes solver, and micro pressure wave is done by axi-symmetric compressible Navier-Stokes solver. The Maxi-min Latin Hypercube Sampling method is used to extract sampling points to construct the approximation model. The kriging model is constructed for the approximation model and the NSGA-II algorithm was used as the multi-objective optimization algorithm. Nose length, nose tip height, and lower surface curvature are design variables. Because nose length is a dominant variable for aerodynamic characteristics of train nose, two optimization processes are progressed respectively with and without the design variable, nose length. Each pareto set was obtained and each optimized nose shape is selected respectively considering Honam high-speed rail line infrastructure in South Korea. Through the optimization process with the nose length, when compared to KTX Sancheon, aerodynamic drag was reduced by 9.0%, side wind stability was improved by 4.5%, micro-pressure wave was reduced by 5.4% whereas aerodynamic drag by 7.3%, side wind stability by 3.9%, micro-pressure wave by 3.9%, without the nose length. As a result of comparison between two optimized shapes, similar shapes are extracted other than the effect of nose length.

Keywords: aerodynamic characteristics, design variable, multi-objective optimization, train nose shape

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1357 Sexual Behaviours among Iranian Men and Women Aged 15 to 49 Years in Metropolitan Tehran, Iran: A Cross-Sectional Study

Authors: Mahnaz Motamedi, Mohammad Shahbazi, Shahrzad Rahimi-Naghani, Mehrdad Salehi

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Introduction and Aim: This study assessed sexual behaviours among men and women aged 15 to 49 years in Tehran. Material and Methods: This was a cross-sectional study conducted on 755 men and women aged 15 to 49 years who were residents of Tehran. To select the participants, a multistage, cluster, random sampling method was used and included different regions of Tehran. The data were collected using the WHO-endorsed Questionnaire of Sexual and Reproductive Health. Descriptive, bivariate, and multivariate analyses were conducted using SPSS version 20. Sexual and reproductive health (SRH) behaviours was a scale variable that was constructed from items of six sections: sexual experiences, characteristics of the first sexual partner, characteristics of the first intercourse, next sexual contact and the consequences of the first sexual contact, homosexual experiences and the causes of sexual abstinence. Results: The mean age at the time of sexual intercourse with penetration (vaginal, anal) was 19.88 in men and 21.82 in women. Multivariate analysis using linear regression showed that by controlling for other variables, gender had a significant relationship with having sexual experience, mean age of first sexual intercourse, and being multi-partner. Thus, women with sexual experience were 0.158 units less than men. The mean age of first intercourse in women was 1.57 units higher than men and being a multi-partner in women was 0.247 less than men (P < 0.001). Sexual experience in very religious and relatively religious individuals was 0.332 and 0.218 units less than those for whom religion did not matter (P < 0.001). 25.6% of men and 40.7% of women who did not have sexual experience at the time of the study stated that their reason for abstinence was their unwillingness to have sex (P < 0.05). 35.9% of men and 16.5% of women stated that the reason for abstinence was not providing a suitable opportunity (P < 0.001). 4.7% of men and 1.7% of women had sexual attraction to the same sex. The difference between men and women was significant (P < 0.001). Conclusion: Sexual relation is also present in singles and younger groups and is not limited to married or final marriage candidates. Therefore, more evaluation should be done in national research and interventions for sexual and reproductive health services should be done at the macro level of policy making.

Keywords: sexual behaviours, Iranian men and women, Iran, cross-sectional study

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