Search results for: hospital building
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6139

Search results for: hospital building

829 The Determinants of Co-Production for Value Co-Creation: Quadratic Effects

Authors: Li-Wei Wu, Chung-Yu Wang

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Recently, interest has been generated in the search for a new reference framework for value creation that is centered on the co-creation process. Co-creation implies cooperative value creation between service firms and customers and requires the building of experiences as well as the resolution of problems through the combined effort of the parties in the relationship. For customers, values are always co-created through their participation in services. Customers can ultimately determine the value of the service in use. This new approach emphasizes that a customer’s participation in the service process is considered indispensable to value co-creation. An important feature of service in the context of exchange is co-production, which implies that a certain amount of participation is needed from customers to co-produce a service and hence co-create value. Co-production no doubt helps customers better understand and take charge of their own roles in the service process. Thus, this proposal is to encourage co-production, thus facilitating value co-creation of that is reflected in both customers and service firms. Four determinants of co-production are identified in this study, namely, commitment, trust, asset specificity, and decision-making uncertainty. Commitment is an essential dimension that directly results in successful cooperative behaviors. Trust helps establish a relational environment that is fundamental to cross-border cooperation. Asset specificity motivates co-production because this determinant may enhance return on asset investment. Decision-making uncertainty prompts customers to collaborate with service firms in making decisions. In other words, customers adjust their roles and are increasingly engaged in co-production when commitment, trust, asset specificity, and decision-making uncertainty are enhanced. Although studies have examined the preceding effects, to our best knowledge, none has empirically examined the simultaneous effects of all the curvilinear relationships in a single study. When these determinants are excessive, however, customers will not engage in co-production process. In brief, we suggest that the relationships of commitment, trust, asset specificity, and decision-making uncertainty with co-production are curvilinear or are inverse U-shaped. These new forms of curvilinear relationships have not been identified in existing literature on co-production; therefore, they complement extant linear approaches. Most importantly, we aim to consider both the bright and the dark sides of the determinants of co-production.

Keywords: co-production, commitment, trust, asset specificity, decision-making uncertainty

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828 Effect of Pressure and Glue Spread on the Bonding Properties of CLT Panels Made from Low-Grade Hardwood

Authors: Sumanta Das, Miroslav Gašparík, Tomáš Kytka, Anil Kumar Sethy

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In this modern century, Cross-laminated timber (CLT) evolved as an excellent material for building and high load-bearing structural applications worldwide. CLT is produced mainly from softwoods such as Norway spruce, White fir, Scots pine, European larch, Douglas fir, and Swiss stone pine. The use of hardwoods in CLT production is still at an early stage, and the utilization of hardwoods is expected to provide the opportunity for obtaining higher bending stiffness and shear resistance to CLT panels. In load-bearing structures like CLT, bonding is an important character that is needed to evaluate. One particular issue with using hardwood lumber in CLT panels is that it is often more challenging to achieve a strong, durable adhesive bond. Several researches in the past years have already evaluated the bonding properties of CLT panels from hardwood both from higher and lower densities. This research aims to identify the effect of pressure and glue spread and evaluate which poplar lumber characteristics affect adhesive bond quality. Three-layered CLT panels were prepared from poplar wood with one-component polyurethane (PUR) adhesive by applying pressure of 0.6 N/mm2 and 1 N/mm2 with a glue spread rate of 160 and 180 g/m2. The delamination and block shear tests were carried out as per EN 16351:2015, and the wood failure percentage was also evaluated. The results revealed that glue spread rate and applied pressure significantly influenced both the shear bond strength and wood failure percentage of the CLT. However, samples with lower pressure 0.6 N/mm2 and less glue spread rate showed delamination, and in samples with higher pressure 1 N/mm2 and higher glue spread rate, no delamination was observed. All the properties determined by this study met the minimum requirement mentioned in EN 16351:2015 standard.

Keywords: cross-laminated timber, delamination, glue spread rate, poplar, pressure, PUR, shear strength, wood failure percentage

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827 Big Data Analytics and Public Policy: A Study in Rural India

Authors: Vasantha Gouri Prathapagiri

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Innovations in ICT sector facilitate qualitative life style for citizens across the globe. Countries that facilitate usage of new techniques in ICT, i.e., big data analytics find it easier to fulfil the needs of their citizens. Big data is characterised by its volume, variety, and speed. Analytics involves its processing in a cost effective way in order to draw conclusion for their useful application. Big data also involves into the field of machine learning, artificial intelligence all leading to accuracy in data presentation useful for public policy making. Hence using data analytics in public policy making is a proper way to march towards all round development of any country. The data driven insights can help the government to take important strategic decisions with regard to socio-economic development of her country. Developed nations like UK and USA are already far ahead on the path of digitization with the support of Big Data analytics. India is a huge country and is currently on the path of massive digitization being realised through Digital India Mission. Internet connection per household is on the rise every year. This transforms into a massive data set that has the potential to improvise the public services delivery system into an effective service mechanism for Indian citizens. In fact, when compared to developed nations, this capacity is being underutilized in India. This is particularly true for administrative system in rural areas. The present paper focuses on the need for big data analytics adaptation in Indian rural administration and its contribution towards development of the country on a faster pace. Results of the research focussed on the need for increasing awareness and serious capacity building of the government personnel working for rural development with regard to big data analytics and its utility for development of the country. Multiple public policies are framed and implemented for rural development yet the results are not as effective as they should be. Big data has a major role to play in this context as can assist in improving both policy making and implementation aiming at all round development of the country.

Keywords: Digital India Mission, public service delivery system, public policy, Indian administration

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826 Representation and Agency in the Life Writings of Taiwanese Disabled Women

Authors: Su-Lin Yu

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In recent years, we have witnessed the growing scholarship on transnational theorizing and activism within disability. In particular, the universalizing discourses of disability formulated in the Global North seem inadequate in engaging the vast diversity of discourses of disability that emerge in global and local policies as well as the everyday experiences of disabled people in the Global South. This study will further consider the future possibilities of how Taiwanese and global disability studies might interchange disability knowledge. First, this study will determine how a local literature of disability can be formed in Taiwan by examining life writings written by Taiwanese disabled women. Both the texts and the personal experiences are treated as social products which can, through their discourses, offer insight into the socio-cultural practices and norms of disability and womanhood in Taiwan. This paper argues that more than by the impairment in itself, the experiences of disabled women are shaped by the social and cultural discourses and practices that define disability and womanhood as well as the normative roles, places, and contexts associated with them. Simultaneous analysis of disability and womanhood exemplifies the way in which disability operates in a complex interaction with the socio-cultural discourses and practices of womanhood, thus producing gender-differentiated disabling obstacles for disabled women. Another purpose of this study is to gain an understanding of the transformative experience of women with disabilities and their perceptions of the self. Designed to provide positive, realistic pictures of the lives of women with disabilities and the social, economic, and political issues they face, their life writings demonstrate how they as disabled women simultaneously struggle with writing a new identity and creating an ethical narrative. These strong and articulate women construct narratives that attempt to recount the remarkable journey that transformed them from dependent women to community activists and writers who speak forcefully about the needs of people with disabilities. More than a story of one woman's struggle for independence, their writing, then, is a testimony to the importance of community building and organizing to enable local people with disabilities to live fulfilling lives.

Keywords: gender, disability, representation, agency

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825 Computational Fluid Dynamicsfd Simulations of Air Pollutant Dispersion: Validation of Fire Dynamic Simulator Against the Cute Experiments of the Cost ES1006 Action

Authors: Virginie Hergault, Siham Chebbah, Bertrand Frere

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Following in-house objectives, Central laboratory of Paris police Prefecture conducted a general review on models and Computational Fluid Dynamics (CFD) codes used to simulate pollutant dispersion in the atmosphere. Starting from that review and considering main features of Large Eddy Simulation, Central Laboratory Of Paris Police Prefecture (LCPP) postulates that the Fire Dynamics Simulator (FDS) model, from National Institute of Standards and Technology (NIST), should be well suited for air pollutant dispersion modeling. This paper focuses on the implementation and the evaluation of FDS in the frame of the European COST ES1006 Action. This action aimed at quantifying the performance of modeling approaches. In this paper, the CUTE dataset carried out in the city of Hamburg, and its mock-up has been used. We have performed a comparison of FDS results with wind tunnel measurements from CUTE trials on the one hand, and, on the other, with the models results involved in the COST Action. The most time-consuming part of creating input data for simulations is the transfer of obstacle geometry information to the format required by SDS. Thus, we have developed Python codes to convert automatically building and topographic data to the FDS input file. In order to evaluate the predictions of FDS with observations, statistical performance measures have been used. These metrics include the fractional bias (FB), the normalized mean square error (NMSE) and the fraction of predictions within a factor of two of observations (FAC2). As well as the CFD models tested in the COST Action, FDS results demonstrate a good agreement with measured concentrations. Furthermore, the metrics assessment indicate that FB and NMSE meet the tolerance acceptable.

Keywords: numerical simulations, atmospheric dispersion, cost ES1006 action, CFD model, cute experiments, wind tunnel data, numerical results

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824 A Qualitative Study to Analyze Clinical Coders’ Decision Making Process of Adverse Drug Event Admissions

Authors: Nisa Mohan

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Clinical coding is a feasible method for estimating the national prevalence of adverse drug event (ADE) admissions. However, under-coding of ADE admissions is a limitation of this method. Whilst the under-coding will impact the accurate estimation of the actual burden of ADEs, the feasibility of the coded data in estimating the adverse drug event admissions goes much further compared to the other methods. Therefore, it is necessary to know the reasons for the under-coding in order to improve the clinical coding of ADE admissions. The ability to identify the reasons for the under-coding of ADE admissions rests on understanding the decision-making process of coding ADE admissions. Hence, the current study aimed to explore the decision-making process of clinical coders when coding cases of ADE admissions. Clinical coders from different levels of coding job such as trainee, intermediate and advanced level coders were purposefully selected for the interviews. Thirteen clinical coders were recruited from two Auckland region District Health Board hospitals for the interview study. Semi-structured, one-on-one, face-to-face interviews using open-ended questions were conducted with the selected clinical coders. Interviews were about 20 to 30 minutes long and were audio-recorded with the approval of the participants. The interview data were analysed using a general inductive approach. The interviews with the clinical coders revealed that the coders have targets to meet, and they sometimes hesitate to adhere to the coding standards. Coders deviate from the standard coding processes to make a decision. Coders avoid contacting the doctors for clarifying small doubts such as ADEs and the name of the medications because of the delay in getting a reply from the doctors. They prefer to do some research themselves or take help from their seniors and colleagues for making a decision because they can avoid a long wait to get a reply from the doctors. Coders think of ADE as a small thing. Lack of time for searching for information to confirm an ADE admission, inadequate communication with clinicians, along with coders’ belief that an ADE is a small thing may contribute to the under-coding of the ADE admissions. These findings suggest that further work is needed on interventions to improve the clinical coding of ADE admissions. Providing education to coders about the importance of ADEs, educating clinicians about the importance of clear and confirmed medical records entries, availing pharmacists’ services to improve the detection and clear documentation of ADE admissions, and including a mandatory field in the discharge summary about external causes of diseases may be useful for improving the clinical coding of ADE admissions. The findings of the research will help the policymakers to make informed decisions about the improvements. This study urges the coding policymakers, auditors, and trainers to engage with the unconscious cognitive biases and short-cuts of the clinical coders. This country-specific research conducted in New Zealand may also benefit other countries by providing insight into the clinical coding of ADE admissions and will offer guidance about where to focus changes and improvement initiatives.

Keywords: adverse drug events, clinical coders, decision making, hospital admissions

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823 Improving Patient Outcomes for Aspiration Pneumonia

Authors: Mary Farrell, Maria Soubra, Sandra Vega, Dorothy Kakraba, Joanne Fontanilla, Moira Kendra, Danielle Tonzola, Stephanie Chiu

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Pneumonia is the most common infectious cause of hospitalizations in the United States, with more than one million admissions annually and costs of $10 billion every year, making it the 8th leading cause of death. Aspiration pneumonia is an aggressive type of pneumonia that results from inhalation of oropharyngeal secretions and/or gastric contents and is preventable. The authors hypothesized that an evidence-based aspiration pneumonia clinical care pathway could reduce 30-day hospital readmissions and mortality rates, while improving the overall care of patients. We conducted a retrospective chart review on 979 patients discharged with aspiration pneumonia from January 2021 to December 2022 at Overlook Medical Center. The authors identified patients who were coded with aspiration pneumonia and/or stable sepsis. Secondarily, we identified 30-day readmission rates for aspiration pneumonia from a SNF. The Aspiration Pneumonia Clinical Care Pathway starts in the emergency department (ED) with the initiation of antimicrobials within 4 hours of admission and early recognition of aspiration. Once this is identified, a swallow test is initiated by the bedside nurse, and if the patient demonstrates dysphagia, they are maintained on strict nothing by mouth (NPO) followed by a speech and language pathologist (SLP) referral for an appropriate modified diet recommendation. Aspiration prevention techniques included the avoidance of straws, 45-degree positioning, no talking during meals, taking small bites, placement of the aspiration wrist band, and consuming meals out of the bed in a chair. Nursing education was conducted with a newly created online learning module about aspiration pneumonia. The authors identified 979 patients, with an average age of 73.5 years old, who were diagnosed with aspiration pneumonia on the index hospitalization. These patients were reviewed for a 30-day readmission for aspiration pneumonia or stable sepsis, and mortality rates from January 2021 to December 2022 at Overlook Medical Center (OMC). The 30-day readmission rates were significantly lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011). When evaluating the mortality rates in the pre and post intervention cohort the authors discovered the mortality rates were lower in the post intervention cohort (23.7% vs 22.4%, p = 0.61) Mortality among non-white (self-reported as non-white) patients were lower in the post intervention cohort (34.4% vs. 21.0% , p = 0.05). Patients who reported as a current smoker/vaper in the pre and post cohorts had increased mortality rates (5.9% vs 22%). There was a decrease in mortality for the male population but an increase in mortality for women in the pre and post cohorts (19% vs. 25%). The authors attributed this increase in mortality in the post intervention cohort to more active smokers, more former smokers, and more being admitted from a SNF. This research identified that implementation of an Aspiration Pneumonia Clinical Care Pathway showed a statistically significant decrease in readmission rates and mortality rates in non-whites. The 30-day readmission rates were lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011).

Keywords: aspiration pneumonia, mortality, quality improvement, 30-day pneumonia readmissions

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822 Common Used Non-Medical Practice and Perceived Benefits in Couples with Fertility Problems in Turkey

Authors: S. Fata, M. A. Tokat, N. Bagardi, B. Yilmaz

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Nowadays, various traditional practices are used throughout the world with aim to improve fertility. Various traditional remedies, acupuncture, religious practices such as sacrifice are frequently used. Studies often evaluate the traditional practices used by the women. But the use of this non-medical practice by couples and specific application reasons of this methods has been less investigated. The aim of this study was to evaluate the common used non-medical practices and determine perceived benefits by couples with fertility problems in Turkey. This is a descriptive study. Research data were collected between May-July 2016, in Izmir Ege Birth Education and Research Hospital Assisted Reproduction Clinic, from 151 couples with fertility problem. Personal Information Form and Non-Medical Practices Used for Fertility Evaluation Form was used. Number 'GOA 2649' permission letter from Dokuz Eylul University Non-Invasive Research Ethics Board, permission letter from the institution and the written consent from participants has been received to carry out the study. In the evaluation of the data, frequencies and proportions analysis were used. The average age of women participating in the study was 32.87, the 35.8% were high school graduates, 60.3% were housewife and the 58.9% lived in city. The 30.5% of husbands were high school graduates, the 96.7% were employed and the 60.9% lived in city. The 78.1% of couples lived as a nuclear family, the average marriage year was 7.58, in 33.8% the fertility problem stems from women, 42.4% of them received a diagnosis for 1-2 years, 35.1% were being treated for 1-2 years. The 35.8% of women reported use of non-medical applications. The 24.4% of women used figs, onion cure, hacemat, locust, bee-pollen milk, the 18.2% used herbs, the 13.1% vowed, the 12.1% went to the tomb, the 10.1% did not bath a few days after the embryo transfer, the 9.1% used thermal water baths, the 5.0% manually corrected the womb, the 5.0% printed amulets by Hodja, the 3.0% went to the Hodja/pilgrims. Among the perceived benefits of using non-medical practices; facilitate pregnancy and implantation, improve oocyte quality were the most recently expressed. Women said that they often used herbs to develop follicles, did not bath after embryo transfer with aim to provide implantation, and used thermal waters to get rid of the infection. Compared to women, only the 25.8% of men used the non-medical practice. The 52.1% reported that they used peanuts, hacemat, locust, bee-pollen milk, the 14.9% used herbs, the 12.8% vowed, the 10.1% went to the tomb, the 10.1% used thermal water baths. Improve sperm number, motility and quality were the most expected benefits. Men said that they often used herbs to improve sperm number, used peanuts, hacemat, locust, bee-pollen milk to improve sperm motility and quality. Couples in Turkey often use non-medical practices to deal with fertility problems. Some of the practices considered as useful can adversely affect health. Healthcare providers should evaluate the use of non-medical practices and should inform if the application is known adverse effects on health.

Keywords: fertility, couples, non-medical practice, perceived benefit

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821 Personal Data Protection: A Legal Framework for Health Law in Turkey

Authors: Veli Durmus, Mert Uydaci

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Every patient who needs to get a medical treatment should share health-related personal data with healthcare providers. Therefore, personal health data plays an important role to make health decisions and identify health threats during every encounter between a patient and caregivers. In other words, health data can be defined as privacy and sensitive information which is protected by various health laws and regulations. In many cases, the data are an outcome of the confidential relationship between patients and their healthcare providers. Globally, almost all nations have own laws, regulations or rules in order to protect personal data. There is a variety of instruments that allow authorities to use the health data or to set the barriers data sharing across international borders. For instance, Directive 95/46/EC of the European Union (EU) (also known as EU Data Protection Directive) establishes harmonized rules in European borders. In addition, the General Data Protection Regulation (GDPR) will set further common principles in 2018. Because of close policy relationship with EU, this study provides not only information on regulations, directives but also how they play a role during the legislative process in Turkey. Even if the decision is controversial, the Board has recently stated that private or public healthcare institutions are responsible for the patient call system, for doctors to call people waiting outside a consultation room, to prevent unlawful processing of personal data and unlawful access to personal data during the treatment. In Turkey, vast majority private and public health organizations provide a service that ensures personal data (i.e. patient’s name and ID number) to call the patient. According to the Board’s decision, hospital or other healthcare institutions are obliged to take all necessary administrative precautions and provide technical support to protect patient privacy. However, this application does not effectively and efficiently performing in most health services. For this reason, it is important to draw a legal framework of personal health data by stating what is the main purpose of this regulation and how to deal with complicated issues on personal health data in Turkey. The research is descriptive on data protection law for health care setting in Turkey. Primary as well as secondary data has been used for the study. The primary data includes the information collected under current national and international regulations or law. Secondary data include publications, books, journals, empirical legal studies. Consequently, privacy and data protection regimes in health law show there are some obligations, principles and procedures which shall be binding upon natural or legal persons who process health-related personal data. A comparative approach presents there are significant differences in some EU member states due to different legal competencies, policies, and cultural factors. This selected study provides theoretical and practitioner implications by highlighting the need to illustrate the relationship between privacy and confidentiality in Personal Data Protection in Health Law. Furthermore, this paper would help to define the legal framework for the health law case studies on data protection and privacy.

Keywords: data protection, personal data, privacy, healthcare, health law

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820 Knowledge, Attitudes, and Practices of Army Soldiers on Prehospital Trauma Care in Matara District

Authors: Hatharasinghe Liyanage Saneetha Chathaurika, Shreenika De Silva Weliange

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Background and Significance of the Study: Natural and human-induced disasters have become more common due to rapid development and climate change. Therefore hospitalization due to injuries has increased in the midst of advancement in medicine. Prehospital trauma care is critical in reducing morbidity and mortality following injury. Army soldiers are one of the first responder categories after a major disaster causing injury. Thus, basic life support measures taken by trained lay first responders is life-saving, it is important to build up their capacities by updating their knowledge and practices while cultivating positive attitudes toward it. Objective: To describe knowledge, attitudes and practices on prehospital trauma care among army soldiers in Matara District. Methodology: A descriptive cross sectional study was carried out among army soldiers in Matara district. The whole population was studied belonging to the above group during the study period. Self-administered questionnaire was used as the study instrument. Cross tabulations were done to identify the possible associations using chi square statistics. Knowledge and practices were categorized in to two groups as “Poor” and “Good” taking 50% as the cut off. Results: The study population consists of 266 participants (response rate 97.79%).The overall level of knowledge on prehospital trauma care is poor (78.6%) while knowledge on golden hour of trauma (77.1%), triage system (74.4%), cardio pulmonary resuscitation (92.5%) and transportation of patients with spinal cord injury (69.2%) was markedly poor. Good knowledge is significantly associated with advance age, higher income and higher level of education whereas it has no significant association with work duration. More than 80% of them had positive attitudes on most aspects of prehospital trauma care while majority thinks it is good to have knowledge on this topic and they would have performed better in disaster situations if they were trained on pre-hospital trauma care. With regard to the practice, majority (62.8%) is included in the group of poor level of practice. They lack practice on first-aid, cardiopulmonary resuscitation and safe transportation of the patients. Moreover, they had less opportunity to participate in drills/simulation programs done on disaster events. Good practice is significantly associated with advance age and higher level of education but not associated with level of income and working duration of army soldiers. Highly significant association was observed between the level of knowledge and level of practice on prehospital trauma care of army soldiers. It is observed that higher the knowledge practices become better. Conclusion: A higher proportion of army soldiers had poor knowledge and practice on prehospital trauma care while majority had positive attitudes regarding it. Majority lacks knowledge and practice in first-aid and cardiopulmonary resuscitation. Due to significant association observed between knowledge and practice it can be recommended to include a training session on prehospital trauma care in the basic military curriculum which will enhance the ability to act as first responders effectively. Further research is needed in this area of prehospital trauma care to enhance the qualitative outcome.

Keywords: disaster, prehospital trauma care, first responders, army soldiers

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819 Integrating Natural Language Processing (NLP) and Machine Learning in Lung Cancer Diagnosis

Authors: Mehrnaz Mostafavi

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The assessment and categorization of incidental lung nodules present a considerable challenge in healthcare, often necessitating resource-intensive multiple computed tomography (CT) scans for growth confirmation. This research addresses this issue by introducing a distinct computational approach leveraging radiomics and deep-learning methods. However, understanding local services is essential before implementing these advancements. With diverse tracking methods in place, there is a need for efficient and accurate identification approaches, especially in the context of managing lung nodules alongside pre-existing cancer scenarios. This study explores the integration of text-based algorithms in medical data curation, indicating their efficacy in conjunction with machine learning and deep-learning models for identifying lung nodules. Combining medical images with text data has demonstrated superior data retrieval compared to using each modality independently. While deep learning and text analysis show potential in detecting previously missed nodules, challenges persist, such as increased false positives. The presented research introduces a Structured-Query-Language (SQL) algorithm designed for identifying pulmonary nodules in a tertiary cancer center, externally validated at another hospital. Leveraging natural language processing (NLP) and machine learning, the algorithm categorizes lung nodule reports based on sentence features, aiming to facilitate research and assess clinical pathways. The hypothesis posits that the algorithm can accurately identify lung nodule CT scans and predict concerning nodule features using machine-learning classifiers. Through a retrospective observational study spanning a decade, CT scan reports were collected, and an algorithm was developed to extract and classify data. Results underscore the complexity of lung nodule cohorts in cancer centers, emphasizing the importance of careful evaluation before assuming a metastatic origin. The SQL and NLP algorithms demonstrated high accuracy in identifying lung nodule sentences, indicating potential for local service evaluation and research dataset creation. Machine-learning models exhibited strong accuracy in predicting concerning changes in lung nodule scan reports. While limitations include variability in disease group attribution, the potential for correlation rather than causality in clinical findings, and the need for further external validation, the algorithm's accuracy and potential to support clinical decision-making and healthcare automation represent a significant stride in lung nodule management and research.

Keywords: lung cancer diagnosis, structured-query-language (SQL), natural language processing (NLP), machine learning, CT scans

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818 A Systematic Review on Development of a Cost Estimation Framework: A Case Study of Nigeria

Authors: Babatunde Dosumu, Obuks Ejohwomu, Akilu Yunusa-Kaltungo

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Cost estimation in construction is often difficult, particularly when dealing with risks and uncertainties, which are inevitable and peculiar to developing countries like Nigeria. Direct consequences of these are major deviations in cost, duration, and quality. The fundamental aim of this study is to develop a framework for assessing the impacts of risk on cost estimation, which in turn causes variabilities between contract sum and final account. This is very important, as initial estimates given to clients should reflect the certain magnitude of consistency and accuracy, which the client builds other planning-related activities upon, and also enhance the capabilities of construction industry professionals by enabling better prediction of the final account from the contract sum. In achieving this, a systematic literature review was conducted with cost variability and construction projects as search string within three databases: Scopus, Web of science, and Ebsco (Business source premium), which are further analyzed and gap(s) in knowledge or research discovered. From the extensive review, it was found that factors causing deviation between final accounts and contract sum ranged between 1 and 45. Besides, it was discovered that a cost estimation framework similar to Building Cost Information Services (BCIS) is unavailable in Nigeria, which is a major reason why initial estimates are very often inconsistent, leading to project delay, abandonment, or determination at the expense of the huge sum of money invested. It was concluded that the development of a cost estimation framework that is adjudged an important tool in risk shedding rather than risk-sharing in project risk management would be a panacea to cost estimation problems, leading to cost variability in the Nigerian construction industry by the time this ongoing Ph.D. research is completed. It was recommended that practitioners in the construction industry should always take into account risk in order to facilitate the rapid development of the construction industry in Nigeria, which should give stakeholders a more in-depth understanding of the estimation effectiveness and efficiency to be adopted by stakeholders in both the private and public sectors.

Keywords: cost variability, construction projects, future studies, Nigeria

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817 Role of Web Graphics and Interface in Creating Visitor Trust

Authors: Pramika J. Muthya

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This paper investigates the impact of web graphics and interface design on building visitor trust in websites. A quantitative survey approach was used to examine how aesthetic and usability elements of website design influence user perceptions of trustworthiness. 133 participants aged 18-25 who live in urban Bangalore and engage in online transactions were recruited via convenience sampling. Data was collected through an online survey measuring trust levels based on website design, using validated constructs like the Visual Aesthetic of Websites Inventory (VisAWI). Statistical analysis, including ordinal regression, was conducted to analyze the results. The findings show a statistically significant relationship between web graphics and interface design and the level of trust visitors place in a website. The goodness-of-fit statistics and highly significant model fitting information provide strong evidence for rejecting the null hypothesis of no relationship. Well-designed visual aesthetics like simplicity, diversity, colorfulness, and craftsmanship are key drivers of perceived credibility. Intuitive navigation and usability also increase trust. The results emphasize the strategic importance for companies to invest in appealing graphic design, consistent with existing theoretical frameworks. There are also implications for taking a user-centric approach to web design and acknowledging the reciprocal link between pre-existing user trust and perception of visuals. While generalizable, limitations include possible sampling and self-report biases. Further research can build on these findings to deepen understanding of nuanced cultural and temporal factors influencing online trust. Overall, this study makes a significant contribution by providing empirical evidence that reinforces the crucial impact of thoughtful graphic design in fostering lasting user trust in websites.

Keywords: web graphics, interface design, visitor trust, website design, aesthetics, user experience, online trust, visual design, graphic design, user perceptions, user expectations

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816 Increasing Sulfur Handling Cost Efficiency Using the Eco Sulfur Paving Block Method at PT Pertamina EP Field Cepu

Authors: Adha Bayu Wijaya, A. Zainal Abidin, Naufal Baihaqi, Joko Suprayitno, Astika Titistiti, Muslim Adi Wijaya, Endah Tri Lestari, Agung Wibowo

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Sulfur is a non-metallic chemical element in the form of a yellow crystalline solid with the chemical formula, and is formed from several types of natural and artificial chemical reactions. Commercial applications of sulfur processed products can be found in various aspects of life, for example in the use of processed sulfur as paving blocks. The Gundih Central Processing Plant (CPP) is capable of producing 14 tons/day of sulfur pellets. This amount comes from the high H2S content of the wells with a total concentration of 20,000 ppm and a volume accumulation of 14 MMSCFD acid gas. H2S is converted to sulfur using the thiobacillus microbe in the Biological Sulfur Recovery Unit (BSRU) with a sulfur product purity level greater than 95%. In 2018 sulfur production at Gundih CPP was recorded at 4044 tons which could potentially trigger serious problems from an environmental aspect. The use of sulfur as material for making paving blocks is an alternative solution in addressing the potential impact on the environment, as regulated by Government Regulation No.22 of Year 2021 concerning the Waste Management of Non-Hazardous and Toxic Substances (B3), and the high cost of handling sulfur by third parties. The design mix of ratio sulfur paving blocks is 22% cements, rock ash 67%, and 11% of sulfur pellets. The sulfur used in making the paving mixture is pure sulfur, namely the side product category without any contaminants, thereby eliminating the potential for environmental pollution when implementing sulfur paving. Strength tests of sulfur paving materials have also been confirmed by external laboratories. The standard used in making sulfur paving blocks refers to the SNI 03-0691-1996 standard. With the results of sulfur paving blocks made according to quality B. Currently, sulfur paving blocks are used in building access to wells locations and in public roads in the Cepu Field area as a contribution from Corporate Social Responsibility (CSR).

Keywords: sulphur, innovation, paving block, CSR, sulphur paving

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815 India’s Developmental Assistance in Africa: Analyzing India’s Aid and Developmental Projects

Authors: Daniel Gidey, Kunwar Siddarth Dadhwal

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By evaluating India's aid systems and ongoing development initiatives, this conference paper offers light on India's role as a source of developmental assistance in Africa. This research attempts to provide insights into the developing landscape of foreign aid and development cooperation by focusing on understanding India's motivations and strategy. In recent years, India's connection with Africa has grown significantly, driven by economic, political, and strategic reasons. This conference paper covers India's many forms of aid, including financial, capacity building efforts, technical assistance, and infrastructure development projects, via a thorough investigation. The article seeks to establish India's priorities and highlight the possible impacts of its development assistance in Africa by examining the industries and locations of concentration. Using secondary data sources, the investigation delves into the underlying goals of India's aid policy in Africa. It investigates whether India's development assistance is consistent with its broader geopolitical aims, such as access to resources, competing with regional rivals, or strengthening diplomatic ties. Furthermore, the article investigates how India's aid policy combines the ideals of South-South cooperation and mutual development, as well as the ramifications for recipient countries. Furthermore, the paper assesses the efficacy and sustainability of India's aid operations in Africa. It takes into account the elements that influence their success, the problems they face, and the amount to which they contribute to local development goals, community empowerment, and poverty alleviation. The study also focuses on the accountability systems, transparency, and knowledge transfer aspects of India's development assistance. By providing a detailed examination of India's aid endeavors in Africa, the paper adds to the current literature on international development cooperation. By offering fresh insights into the motives, strategies, and impacts of India's assistance programs, it seeks to enhance understanding of the emerging patterns in South-South cooperation and the complex dynamics of contemporary international aid architecture.

Keywords: India, Africa, developmental assistance, aid projects and South-South cooperation

Procedia PDF Downloads 47
814 Bariatric Surgery Referral as an Alternative to Fundoplication in Obese Patients Presenting with GORD: A Retrospective Hospital-Based Cohort Study

Authors: T. Arkle, D. Pournaras, S. Lam, B. Kumar

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Introduction: Fundoplication is widely recognised as the best surgical option for gastro-oesophageal reflux disease (GORD) in the general population. However, there is controversy surrounding the use of conventional fundoplication in obese patients. Whilst the intra-operative failure of fundoplication, including wrap disruption, is reportedly higher in obese individuals, the more significant issue surrounds symptom recurrence post-surgery. Could a bariatric procedure be considered in obese patients for weight management, to treat the GORD, and to also reduce the risk of recurrence? Roux-en-Y gastric bypass, a widely performed bariatric procedure, has been shown to be highly successful both in controlling GORD symptoms and in weight management in obese patients. Furthermore, NICE has published clear guidelines on eligibility for bariatric surgery, with the main criteria being type 3 obesity or type 2 obesity with the presence of significant co-morbidities that would improve with weight loss. This study aims to identify the proportion of patients who undergo conventional fundoplication for GORD and/or hiatus hernia, which would have been eligible for bariatric surgery referral according to NICE guidelines. Methods: All patients who underwent fundoplication procedures for GORD and/or hiatus hernia repair at a single NHS foundation trust over a 10-year period will be identified using the Trust’s health records database. Pre-operative patient records will be used to find BMI and the presence of significant co-morbidities at the time of consideration for surgery. This information will be compared to NICE guidelines to determine potential eligibility for the bariatric surgical referral at the time of initial surgical intervention. Results: A total of 321 patients underwent fundoplication procedures between January 2011 and December 2020; 133 (41.4%) had available data for BMI or to allow BMI to be estimated. Of those 133, 40 patients (30%) had a BMI greater than 30kg/m², and 7 (5.3%) had BMI >35kg/m². One patient (0.75%) had a BMI >40 and would therefore be automatically eligible according to NICE guidelines. 4 further patients had significant co-morbidities, such as hypertension and osteoarthritis, which likely be improved by weight management surgery and therefore also indicated eligibility for referral. Overall, 3.75% (5/133) of patients undergoing conventional fundoplication procedures would have been eligible for bariatric surgical referral, these patients were all female, and the average age was 60.4 years. Conclusions: Based on this Trust’s experience, around 4% of obese patients undergoing fundoplication would have been eligible for bariatric surgical intervention. Based on current evidence, in class 2/3 obese patients, there is likely to have been a notable proportion with recurrent disease, potentially requiring further intervention. These patient’s may have benefitted more through undergoing bariatric surgery, for example a Roux-en-Y gastric bypass, addressing both their obesity and GORD. Use of patient written notes to obtain BMI data for the 188 patients with missing BMI data and further analysis to determine outcomes following fundoplication in all patients, assessing for incidence of recurrent disease, will be undertaken to strengthen conclusions.

Keywords: bariatric surgery, GORD, Nissen fundoplication, nice guidelines

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813 Environmental Education and Water Resources Management in the City of Belem, Para, Brazil

Authors: Naiara de Almeida Rios

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The environmental education, from Tbilisi, is signaled as an important instrument for conservation and environmental management. However, the social, economic, political and environmental aspects of each place require an environmental management that corresponds to the reality to which they are inserted, as well as environmental education practices. The city of Belém, the capital of the State of Pará, is one of the most important cities in the Amazon Region, and its vast water dimension requires that its watersheds take a careful look at their socio-environmental management. The Estrada Nova Hydrographic Basin is considered as one of the most critical river basins in the city due to flooding, lack of basic sanitation and degradation of water bodies. In this context, environmental education is understood as one of the necessary conditions to reduce environmental degradation. Environmental education presents itself as an instrument of social transformation and conservation of natural resources (especially water resources), where thinking about the sustainability of natural resources is moving towards dialogue on the importance of building an environmental awareness. The commitment that environmental education proposes covers all spheres of society, since the main objective of the same is the transformation of thought and attitudes from the understanding of reality. Therefore, to analyze how the government is managing the basin, as well as the environmental education practices developed in it, is fundamental, so that government can be charged with improvements for the population and for the natural environment. Therefore, the objective of this study is to analyze the influence of environmental education actions developed by local public authorities in the management of the Estrada Nova Hydrographic Basin, Belém/PA. For the accomplishment of this study, some methodological procedures will be used, like documentary analysis, bibliographical survey and fieldwork. If the multivariate statistical method is used to analyze the results obtained in the field. Unfortunately, public policies in the area of ​environmental education in Belém are still moving in short steps, since government interests have had very little dialogue with the socio-environmental problems that affect the Estrada Nova Hydrographic Basin. Both formal and informal environmental education has been poorly developed, hampering the continuous process proposed by water resources management.

Keywords: environmental education, environmental management, hydrographic basin, water resources

Procedia PDF Downloads 174
812 The Incidence of Inferior Alveolar Nerve Dysfunction Following Bilateral Sagittal Split Osteotomies: A Single Centre Retrospective Audit in the United Kingdom

Authors: Krupali Mukeshkumar, Jinesh Shah

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Background: Bilateral Sagittal Split Osteotomy (BSSO), used for the correction of mandibular deformities, is a common oral and maxillofacial surgical procedure. Inferior alveolar nerve dysfunction is commonly reported post-operatively by patients as paresthesia or anesthesia. The current literature lacks a consensus on the incidence of inferior alveolar nerve dysfunction as patients are not routinely assessed pre and post-operatively with an objective assessment. The range of incidence varies from 9% to 85% of patients, with some authors arguing that 100% of patients experience nerve dysfunction immediately post-surgery. Systematic reviews have shown a difference between incidence rates at different follow-up periods using objective and subjective methods. Aim: To identify the incidence of inferior alveolar nerve dysfunction following BSSO. Gold standard: Nerve dysfunction incidence rates similar or lower than current literature of 83% day one post-operatively and 18.4% at one year follow up. Setting: A retrospective cross-sectional audit of patients treated between 2017-2019 at the Royal Stoke University Hospital, Maxillofacial and Orthodontic departments. Sample: All patients who underwent a BSSO (with or without le fort one osteotomy) between 2017–2019 were identified from the database. Patients with pre-existing neurosensory disturbance, those who had a genioplasty at the same time and those with no follow-up were excluded. The sample consisted of 121 patients, 37 males and 84 females between the ages of 17-50 years at the time of surgery. Methods: Clinical records of 121 cases were reviewed to assess the age, sex, type of mandibular osteotomy, status of the nerve during the surgical procedure, type of bony split and incidence of nerve dysfunction at follow-up appointments. The surgical procedure was carried out by three Maxillo-facial surgeons and follow-up appointments were carried out in the Orthodontic and Oral and Maxillo-facial departments. Results: 120 patients were treated to correct the mandibular facial deformity and 1 patient was treated for sleep apnoea. Seventeen patients had a mandibular setback and 104 patients had mandibular advancement. 68 patients reported inferior alveolar nerve dysfunction at one week following their surgery. Seventy-six patients had temporary paresthesia present between 2 weeks and 12 months post-surgery. 13 patients had persistent nerve dysfunction at 12 months, of which 1 had a bad bony split during the BSSO. The incidence of nerve dysfunction postoperatively was 6.6% after 1 day, 56.1% at 1 week, 62.8% at 2 weeks, 59.5% between 3-6 weeks, 43.0% between 8-16 weeks and 10.7% at 1 year. Conclusions: The results of this audit show a similar incidence rate to the research gold standard at the one-year follow-up. Future Recommendations: No changes to surgical procedure or technique are indicated, but a need for improved documentation and a standardized approach for assessment of post-operative nerve dysfunction would be beneficial.

Keywords: bilateral sagittal split osteotomy, inferior alveolar nerve, mandible, nerve dysfunction

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811 Utilizing Dowel-Laminated Mass Timber Components in Residential Multifamily Structures: A Case Study

Authors: Theodore Panton

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As cities in the United States experience critical housing shortages, mass timber presents the opportunity to address this crisis in housing supply while taking advantage of the carbon-positive benefits of sustainably forested wood fiber. Mass timber, however, currently has a low level of adoption in residential multifamily structures due to the risk-averse nature of change within the construction financing, Architecture / Engineering / Contracting (AEC) communities, as well as various agency approval challenges. This study demonstrates how mass timber can be used within the cost and feasibility parameters of a typical multistory residential structure and ultimately address the need for dense urban housing. This study will utilize The Garden District, a mixed-use market-rate housing project in Woodinville, Washington, as a case study to illuminate the potential of mass timber in this application. The Garden District is currently in final stages of permit approval and will commence construction in 2023. It will be the tallest dowel-laminated timber (DLT) residential structure in the United States when completed. This case study includes economic, technical, and design reference points to demonstrate the relevance of the use of this system and its ability to deliver “triple bottom line” results. In terms of results, the study establishes scalable and repeatable approaches to project design and delivery of mass timber in multifamily residential uses and includes economic data, technical solutions, and a summary of end-user advantages. This study discusses the third party tested systems for satisfying acoustical requirements within dwelling units, a key to resolving the use of mass timber within multistory residential use. Lastly, the study will also compare the mass timber solution with a comparable cold formed steel (CFS) system with a similar program, which indicates a net carbon savings of over three million tons over the life cycle of the building.

Keywords: DLT, dowell laminated timber, mass timber, market rate multifamily

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810 The Studies of the Impact of Biomimicry and Sustainability on Urban Design

Authors: Nourhane Mohamed El Haridi, Mostafa El Arabi, Zeyad El Sayad

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Biomimicry is defined, by Benyus the natural sciences writer, as imitating or taking inspiration from nature’s forms and processes to solve human problems. Biomimicry is the conscious emulation of life’s genius. As the design community realizes the tremendous impact human constructions have on the world, environmental designers look to new approaches like biomimicry to advance sustainable design. Building leading the declaration made by biomimicry scientists that a full imitation of nature engages form, ecosystem, and process; this paper uses a logic approach to interpret human and environmental wholeness. Designers would benefit from both integrating social theory with environmental thinking and from combining their substantive skills with techniques for getting sustainable biomimic urban design. Integrating biomimicryʹs “Life’s Principles” into a built environment process model will make biomimicry more accessible and thus more widely accepted throughout the industry, and the sustainability of all species will benefit. The Biomimicry Guild hypothesizes the incorporation of these principles, called Lifeʹs Principles, increase the likelihood of sustainability for a respective design, and make it more likely that the design will have a greater impact on sustainability for future generations of all species as mentioned by Benyus in her book. This thesis utilizes Life’s Principles as a foundation for a design process model intended for application on built environment projects at various scales. This paper takes a look at the importance of the integration of biomimicry in urban design to get more sustainable cities and better life, by analyzing the principles of both sustainability and biomimicry, and applying these ideas on futuristic or existing cities to make a biomimic sustainable city more healthier and more conductive to life, and get a better biomimic urban design. A group of experts, architects, biologists, scientists, economists and ecologists should work together to face all the financial and designing difficulties, to have better solutions and good innovative ideas for biomimic sustainable urban design, it is not the only solution, but it is one of the best studies for a better future.

Keywords: biomimicry, built environment, sustainability, urban design

Procedia PDF Downloads 509
809 The Experience of Middle Grade Teachers in a Culture of Collaboration

Authors: Tamara Tallman

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Collaboration is a powerful tool for professional development and central for creating opportunities for teachers to reflect on their practice. However, school districts continue to have difficulty both implementing and sustaining collaboration. The purpose of this research was to investigate the experience of the teacher in a creative, instructional collaboration. The teachers in this study found that teacher-initiated collaboration offered them trust and they were more open with their partners. An interpretative phenomenological analysis was used for this study as it told the story of the teacher’s experience. Interpretative Phenomenological Analysis was chosen for this study to capture the complex and contextual nature of the teacher experience from a creative, instructional collaborative experience. This study sought to answer the question of how teachers in a private, faith-based school experience collaboration. In particular, the researcher engaged the study’s participants in interviews where they shared their unique perspectives on their experiences in relation to this phenomenon. Through the use of interpretative phenomenological analysis, the researcher interpreted the experiences of each participant in an attempt to gain deeper insight into how teachers made sense of their understanding of collaboration. In addition to the researcher’s interpreting the meaning of this construct for each research participant, this study gave a voice to the individual experiences and positionality of each participant at the research site. Moreover, the key findings presented in this study shed light on how teachers within this particular context participated in and made sense of their experience of creating an instructional collaborative. The research presented the findings that speak to the meaning that each research participant experienced in their relation to participating in building a collaborative culture and its effect on professional and personal growth. The researcher provided recommendations for future practice and research possibilities. The research findings demonstrated the unique experiences of each participant as well as a connection to the literature within the field of teacher professional development. The results also supported the claim that teacher collaboration can facilitate school reform. Participating teachers felt less isolation and developed more teacher knowledge.

Keywords: collaboration, personal grwoth, professional development, teachers

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808 Building Care Networks for Patients with Life-Limiting Illnesses: Perspectives from Health Care and Social Service Providers

Authors: Lindy Van Vliet, Saloni Phadke, Anthea Nelson, Ann Gallant

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Comprehensive and compassionate palliative care and support requires an integrated system of care that draws on formal health and social service providers working together with community and informal networks to ensure that patients and families have access to the care they need. The objective of this study is to further explore and understand the community supports, services, and informal networks that health care professionals and social service providers rely on to allow their patients to die in their homes and communities. Drawing on an interpretivist, exploratory, qualitative design, our multidisciplinary research team (medicine, nursing and social work) conducted interviews with 15 health care and social service providers in the Ottawa region. Interview data was audio-recorded, transcribed and analyzed using a reflexive thematic analysis approach. The data deepens our understandings of the facilitators and barriers that arise as health care and social service providers attempt to build networks of care for patients with life limiting illnesses and families. Three main findings emerged: First, the variability that arises due to systemic barriers in accessing and providing care; second, the exceptionally challenging workload that providers are facing as they work to address complex social care needs (housing, disability, food security), along with escalating palliative care needs; and, finally, the lack of structural support that providers and informal care networks receive. Conclusion: These findings will facilitate and build stronger person-centred/relationship-centred principles and practices between providers, patients, community, and informal care networks by highlighting the systemic barriers to accessing and providing person-centred care. Further, they will have important implications for future partnerships in integrated care delivery programs and initiatives, community policies, education programs, and provincial and national palliative care strategies.

Keywords: public health palliative care, palliative care nursing, care networks, informal care, integrated health care

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807 Exploring the Prebiotic Potential of Glucosamine

Authors: Shilpi Malik, Ramneek Kaur, Archita Gupta, Deepshikha Yadav, Ashwani Mathur, Manisha Singh

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Glucosamine (GS) is the most abundant naturally occurring amino monosaccharide and is normally produced in human body via cellular glucose metabolism. It is regarded as the building block of cartilage matrix and is also an essential component of cartilage matrix repair mechanism. Besides that, it can also be explored for its prebiotic potential as many bacterial species are known to utilize the amino sugar by acquiring them to form peptidoglycans and lipopolysaccharides in the bacterial cell wall. Glucosamine can therefore be considered for its fermentation by bacterial species present in the gut. Current study is focused on exploring the potential of glucosamine as prebiotic. The studies were done to optimize considerable concentration of GS to reach GI tract and being fermented by the complex gut microbiota and food grade GS was added to various Simulated Fluids of Gastro-Intestinal Tract (GIT) such as Simulated Saliva, Gastric Fluid (Fast and Fed State), Colonic fluid, etc. to detect its degradation. Since it was showing increase in microbial growth (CFU) with time, GS was Further, encapsulated to increase its residential time in the gut, which exhibited improved resistance to the simulated Gut conditions. Moreover, prepared microspehres were optimized and characterized for their encapsulation efficiency and toxicity. To further substantiate the prebiotic activity of Glucosamine, studies were also performed to determine the effect of Glucosamine on the known probiotic bacterial species, i.e. Lactobacillus delbrueckii (MTCC 911) and Bifidobacteriumbifidum (MTCC 5398). Culture conditions for glucosamine will be added in MRS media in anaerobic tube at 0.20%, 0.40%, 0.60%, 0.80%, and 1.0%, respectively. MRS media without GS was included in this experiment as the control. All samples were autoclaved at 118° C for 15 min. Active culture was added at 5% (v/v) to each anaerobic tube after cooling to room temperature and incubated at 37° C then determined biomass and pH and viable count at incubation 18h. The experiment was completed in triplicate and the results were presented as Mean ± SE (Standard error).The experimental results are conclusive and suggest Glucosamine to hold prebiotic properties.

Keywords: gastro intestinal tract, microspheres, peptidoglycans, simulated fluid

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806 The Implication of Small Group Therapy on Sexuality in Breast Cancer Survivors

Authors: Cherng-Jye Jeng, Ming-Feng Hou, Hsing-Yuan Liu, Chuan-Feng Chang, Lih-Rong Wang, Yen-Chin Lin

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Introduction: The incidence of breast cancer has gradually increased in Taiwan, and the characteristic of younger ages impact these women in their middle age, and may also cause challenges in terms of family, work, and illness. Breasts are symbols of femininity, as well as of sex. For women, breasts are important organs for the female identity and sexual expression. Losing breasts not only affects the female role, but would also affect sexual attraction and sexual desire. Thus, women with breast cancer who have need for mastectomies experience physical incompletion, which affects women’s self-confidence, physical image, and self-orientation. Purposes: 1. To understand the physical experience of women with breast cancer. 2. To explore the issue of sexual issues on the health effects of women with breast cancer. 3. To construct a domestic sex life issue group model for domestic women with breast cancer. 4. To explore the accompaniment experiences and sexual relationship adjustments of spouses when women have breast cancer. Method: After the research plan passes IRB review, participants will be recruited at breast surgery clinic in the affiliated hospital, to screen suitable subjects for entry into the group. Between March and May 2015, two sexual health and sex life consultation groups were conducted, which were (1) 10 in postoperative groups for women with cancer; (2) 4 married couples group for postoperative women with cancer. After sharing experiences and dialogue, women can achieve mutual support and growth. Data organization and analysis underwent descriptive analysis in qualitative research, and the group process was transcribed into transcripts for overall-content and category-content analysis. Results: Ten women with breast cancer believed that participating in group can help them exchange experiences, and elevate sexual health. The main issues include: (1) after breast cancer surgery, patients generally received chemotherapy or estrogen suppressants, causing early menopause; in particular, vaginal dryness can cause pain or bleeding in intercourse, reducing their desire for sexual activity; (2) breast cancer accentuates original spousal or family and friend relationships; some people have support and care from their family, and spouses emphasize health over the appearance of breasts; however, some people do not have acceptance and support from their family, and some even hear spousal sarcasm about loss of breasts; (3) women with breast cancer have polarized expressions of optimism and pessimism in regards to their emotions, beliefs, and body image regarding cancer; this is related to the women’s original personalities, attribution of causes of cancer, and extent of worry about relapse. Conclusion: The research results can be provided as a reference to medical institutions or breast cancer volunteer teams, to pay attention to maintaining the health of women with breast cancer.

Keywords: women with breast cancer, experiences of objectifying the body, quality of sex life, sexual health

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805 Machine Learning Approach for Predicting Students’ Academic Performance and Study Strategies Based on Their Motivation

Authors: Fidelia A. Orji, Julita Vassileva

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This research aims to develop machine learning models for students' academic performance and study strategy prediction, which could be generalized to all courses in higher education. Key learning attributes (intrinsic, extrinsic, autonomy, relatedness, competence, and self-esteem) used in building the models are chosen based on prior studies, which revealed that the attributes are essential in students’ learning process. Previous studies revealed the individual effects of each of these attributes on students’ learning progress. However, few studies have investigated the combined effect of the attributes in predicting student study strategy and academic performance to reduce the dropout rate. To bridge this gap, we used Scikit-learn in python to build five machine learning models (Decision Tree, K-Nearest Neighbour, Random Forest, Linear/Logistic Regression, and Support Vector Machine) for both regression and classification tasks to perform our analysis. The models were trained, evaluated, and tested for accuracy using 924 university dentistry students' data collected by Chilean authors through quantitative research design. A comparative analysis of the models revealed that the tree-based models such as the random forest (with prediction accuracy of 94.9%) and decision tree show the best results compared to the linear, support vector, and k-nearest neighbours. The models built in this research can be used in predicting student performance and study strategy so that appropriate interventions could be implemented to improve student learning progress. Thus, incorporating strategies that could improve diverse student learning attributes in the design of online educational systems may increase the likelihood of students continuing with their learning tasks as required. Moreover, the results show that the attributes could be modelled together and used to adapt/personalize the learning process.

Keywords: classification models, learning strategy, predictive modeling, regression models, student academic performance, student motivation, supervised machine learning

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804 Exploratory Factor Analysis of Natural Disaster Preparedness Awareness of Thai Citizens

Authors: Chaiyaset Promsri

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Based on the synthesis of related literatures, this research found thirteen related dimensions that involved the development of natural disaster preparedness awareness including hazard knowledge, hazard attitude, training for disaster preparedness, rehearsal and practice for disaster preparedness, cultural development for preparedness, public relations and communication, storytelling, disaster awareness game, simulation, past experience to natural disaster, information sharing with family members, and commitment to the community (time of living).  The 40-item of natural disaster preparedness awareness questionnaire was developed based on these thirteen dimensions. Data were collected from 595 participants in Bangkok metropolitan and vicinity. Cronbach's alpha was used to examine the internal consistency for this instrument. Reliability coefficient was 97, which was highly acceptable.  Exploratory Factor Analysis where principal axis factor analysis was employed. The Kaiser-Meyer-Olkin index of sampling adequacy was .973, indicating that the data represented a homogeneous collection of variables suitable for factor analysis. Bartlett's test of Sphericity was significant for the sample as Chi-Square = 23168.657, df = 780, and p-value < .0001, which indicated that the set of correlations in the correlation matrix was significantly different and acceptable for utilizing EFA. Factor extraction was done to determine the number of factors by using principal component analysis and varimax.  The result revealed that four factors had Eigen value greater than 1 with more than 60% cumulative of variance. Factor #1 had Eigen value of 22.270, and factor loadings ranged from 0.626-0.760. This factor was named as "Knowledge and Attitude of Natural Disaster Preparedness".  Factor #2 had Eigen value of 2.491, and factor loadings ranged from 0.596-0.696. This factor was named as "Training and Development". Factor #3 had Eigen value of 1.821, and factor loadings ranged from 0.643-0.777. This factor was named as "Building Experiences about Disaster Preparedness".  Factor #4 had Eigen value of 1.365, and factor loadings ranged from 0.657-0.760. This was named as "Family and Community". The results of this study provided support for the reliability and construct validity of natural disaster preparedness awareness for utilizing with populations similar to sample employed.

Keywords: natural disaster, disaster preparedness, disaster awareness, Thai citizens

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803 Health Care Teams during COVID-19: Roles, Challenges, Emotional State and Perceived Preparedness to the Next Pandemic

Authors: Miriam Schiff, Hadas Rosenne, Ran Nir-Paz, Shiri Shinan Altman

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To examine (1) the level, predictors, and subjective perception of professional quality of life (PRoQL), posttraumatic growth, roles, task changes during the pandemic, and perceived preparedness for the next pandemic. These variables were added as part of an international study on social workers in healthcare stress, resilience, and perceived preparedness we took part in, along with Australia, Canada, China, Hong Kong, Singapore, and Taiwan. (2) The extent to which background variables, rate of exposure to the virus, working in COVID wards, profession, personal resilience, and resistance to organizational change predict posttraumatic growth, perceived preparedness, and PRoQL (the latter was examined among social workers only). (3) The teams' perceptions of how the pandemic impacted them at the personal, professional, and organizational levels and what assisted them. Methodologies: Mixed quantitative and qualitative methods were used. 1039 hospital healthcare workers from various professions participated in the quantitative study while 32 participated in in-depth interviews. The same methods were used in six other countries. Findings: The level of PRoQL was moderate, with higher burnout and secondary traumatization level than during routine times. Differences between countries in the level of PRoQL were found as well. Perceived preparedness for the next pandemic at the personal level was moderate and similar among the different health professions. Higher exposure to the virus was associated with lower perceived preparedness of the hospitals. Compared to other professions, doctors and nurses perceived hospitals as significantly less prepared for the next pandemic. The preparedness of the State of Israel for the next pandemic is perceived as low by all healthcare professionals. A moderate level of posttraumatic growth was found. Staff who worked at the COVID ward reported a greater level of growth. Doctors reported the lowest level of growth. The staff's resilience was high, with no differences among professions or levels of exposure. Working in the COVID ward and resilience predicted better preparedness, while resistance to organizational change predicted worse preparedness. Findings from the qualitative part of the study revealed that healthcare workers reported challenges at the personal, professional and organizational level during the different waves of the pandemic. They also report on internal and external resources they either owned or obtained during that period. Conclusion: Exposure to the COVID-19 virus is associated with secondary traumatization on one hand and personal posttraumatic growth on the other hand. Personal and professional discoveries and a sense of mission helped cope with the pandemic that was perceived as a historical event, war, or mass casualty event. Personal resilience, along with the support of colleagues, family, and direct management, were seen as significant components of coping. Hospitals should plan ahead and improve their preparedness to the next pandemic.

Keywords: covid-19, health-care, social workers, burnout, preparedness, international perspective

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802 Case Study: Institutionalization of CSR Activities of MRGC through an NGO (OSDI)

Authors: Aasim Siddiqui

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In a country where 45.6 per cent of the total population lives below the poverty line, according to the Human Development Report 2014 by UNDP, an increasing number of private companies are now dedicating their resources to remedy this situation of chronic poverty. Most corporations in Pakistan now have a separate and dedicated department for Corporate Social Responsibility (CSR), albeit with varying goals and hence different strategies for achieving those goals. Similarly, Marine Group of Companies (MRGC) also has a robust CSR policy which the group implements through a Non-Government Organization (NGO) called Organization for Social Development Initiatives (OSDI). This organization, which operates under the ambit of MRGC’s CSR division, has a concentrated focus on helping the poorest communities in the rural areas of Pakistan to break out of intergenerational poverty. This paper maps the theoretical strategies as well as practical activities undertaken by OSDI for poverty alleviation via rural development in Pakistan. To obtain in-depth information of demographics, livelihood and socio-economic indicators in OSDI’s focused districts; a combination of quantitative and qualitative research methodologies was used during the course of this research. The paper highlights and explains OSDI’s unique three-pronged approach which aims at reducing poverty through income generation via the livelihood assistance program and through the provision of access to the most basic services (including health and education) via the community development and food security programs. Modeled on the concept of capacity building, OSDI’s modus operandi is centered on disbursing timely microcredit facilities to farmers who can benefit from these funds by investing in productive assets to foster financial capability for the future. With a focus on increasing the income of poor farmers, OSDI’s approach is to integrate all the socio-economic facets: education, health and sanitation and food security, to induce a sustained positive impact on their living standards.

Keywords: CSR, poverty, rural, sustainability

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801 European Standardization in Nanotechnologies and Relation with International Work: The Standardization Can Help Industry and Regulators in Developing Safe Products

Authors: Patrice Conner

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Nanotechnologies have enormous potential to contribute to human flourishing in responsible and sustainable ways. They are rapidly developing field of science, technology and innovation. As enabling technologies, their full scope of applications is potentially very wide. Major implications are expected in many areas, e.g. healthcare, information and communication technologies, energy production and storage, materials science/chemical engineering, manufacturing, environmental protection, consumer products, etc. However, nanotechnologies are unlikely to realize their full potential unless their associated societal and ethical issues are adequately attended. Namely nanotechnologies and nanoparticles may expose humans and the environment to new health risks, possibly involving quite different mechanisms of interference with the physiology of human and environmental species. One of the building blocks of the ‘safe, integrated and responsible’ approach is standardization. Both the Economic and Social Committee and the European Parliament have highlighted the importance to be attached to standardization as a means to accompany the introduction on the market of nanotechnologies and nanomaterials, and a means to facilitate the implementation of regulation. ISO and CEN have respectively started in 2005 and 2006 to deal with selected topics related to this emerging and enabling technology. In the beginning of 2010, EC DG ‘Enterprise and Industry’ addressed the mandate M/461 to CEN, CENELEC and ETSI for standardization activities regarding nanotechnologies and nanomaterials. Thus CEN/TC 352 ‘Nanotechnologies’ has been asked to take the leadership for the coordination in the execution of M/461 (46 topics to be standardized) and to contact relevant European and International Technical committees and interested stakeholders as appropriate (56 structures have been identified). Prior requests from M/461 deal with characterization and exposure of nanomaterials and any matters related to Health, Safety and Environment. Answers will be given to: - What are the structures and how they work? - Where are we right now and how work is going from now onwards? - How CEN’s work and targets deal with and interact with global matters in this field?

Keywords: characterization, environmental protection, exposure, health risks, nanotechnologies, responsible and sustainable ways, safety

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800 Synthesis and Optimization of Bio Metal-Organic Framework with Permanent Porosity

Authors: Tia Kristian Tajnšek, Matjaž Mazaj, Nataša Zabukovec Logar

Abstract:

Metal-organic frameworks (MOFs) with their specific properties and the possibility of tuning the structure represent excellent candidates for use in the biomedical field. Their advantage lies in large pore surfaces and volumes, as well as the possibility of using bio-friendly or bioactive constituents. So-called bioMOFs are representatives of MOFs, which are constructed from at least one biomolecule (metal, a small bioactive molecule in metal clusters and/or linker) and are intended for bio-application (usually in the field of medicine; most commonly drug delivery). When designing a bioMOF for biomedical applications, we should adhere to some guidelines for an improved toxicological profile of the material. Such as (i) choosing an endogenous/nontoxic metal, (ii) GRAS (generally recognized as safe) linker, and (iii) nontoxic solvents. Design and synthesis of bioNICS-1 (bioMOF of National Institute of Chemistry Slovenia – 1) consider all these guidelines. Zinc (Zn) was chosen as an endogenous metal with an agreeable recommended daily intake (RDI) and LD50 value, and ascorbic acid (Vitamin C) was chosen as a GRAS and active linker. With these building blocks, we have synthesized a bioNICS-1 material. The synthesis was done in ethanol using a solvothermal method. The synthesis protocol was further optimized in three separate ways. Optimization of (i) synthesis parameters to improve the yield of the synthesis, (ii) input reactant ratio and addition of specific modulators for production of larger crystals, and (iii) differing of the heating source (conventional, microwave and ultrasound) to produce nano-crystals. With optimization strategies, the synthesis yield was increased. Larger crystals were prepared for structural analysis with the use of a proper species and amount of modulator. Synthesis protocol was adjusted to different heating sources, resulting in the production of nano-crystals of bioNICS-1 material. BioNICS-1 was further activated in ethanol and structurally characterized, resolving the crystal structure of new material.

Keywords: ascorbic acid, bioMOF, MOF, optimization, synthesis, zinc ascorbate

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