Search results for: open access
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6018

Search results for: open access

588 Case-Based Options Counseling Panel To Supplement An Indiana Medical School’s Pre-Clinical Family Planning and Abortion Education Curriculum

Authors: Alexandra McKinzie, Lucy Brown, Sarah Komanapalli, Sarah Swiezy, Caitlin Bernard

Abstract:

Background: While 25% of US women will seek an abortion before age 45, targeted laws have led to a decline in abortion clinics, subsequently leaving 96% of Indiana counties and the 70% of Hoosier women residing in these counties without access to services they desperately need.1,2 Despite the need for a physician workforce that is educated and able to provide full-spectrum reproductive health care, few medical institutions have a standardized family planning and abortion pre-clinical curriculum. Methods: A Qualtrics survey was disseminated to students from Indiana University School of Medicine (IUSM) to evaluate (1) student interest in curriculum reform, (2) self-assessed preparedness to counsel on contraceptive and pregnancy options, and (3) preferred modality of instruction for family planning and abortion topics. Based on the pre-panel survey feedback, a case-based pregnancy options counseling panel will be implemented in the students’ pre-clinical, didactic course Endocrine, Reproductive, Musculoskeletal, Dermatologic Systems (ERMD) in February 2022. A Qualtrics post-panel survey will be disseminated to evaluate students’ perceived efficacy and quality of the panel, as well as their self-assessed preparedness to counsel on pregnancy options. Results: Participants in the pre-panel survey (n=303) were primarily female (61.72%) and White (74.43%). Across all class levels, many (60.80%) students expected to learn about family planning and abortion in their pre-clinical education. While most (84-88%) participants felt prepared to counsel about common, non-controversial pharmacotherapies (e.g. beta-blockers and diuretics), only 20% of students felt prepared to counsel on abortion options. Overall, 85.67% of students believed that IUSM should enhance its reproductive health coverage in pre-clinical, didactic courses. Traditional lectures, panels, and direct clinical exposure were the most popular instructional modalities. Expected Results: The authors predict that following the panel, students will indicate improved confidence in providing pregnancy options counseling. Additionally, students will provide constructive feedback on the structure and content of the panel for incorporation into future years’ curriculum. Conclusions: IUSM students overwhelmingly expressed interest in expanding their pre-clinical curriculum’s coverage of family planning and abortion topics. To specifically improve students’ self-assessed preparedness to provide pregnancy options counseling and address students’ self-cited learning gaps, a case-based provider panel session will be implemented in response to students’ preferred modality feedback.

Keywords: options counseling, family planning, abortion, curriculum reform, case-based panel

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587 The Superior Performance of Investment Bank-Affiliated Mutual Funds

Authors: Michelo Obrey

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Traditionally, mutual funds have long been esteemed as stand-alone entities in the U.S. However, the prevalence of the fund families’ affiliation to financial conglomerates is eroding this striking feature. Mutual fund families' affiliation with financial conglomerates can potentially be an important source of superior performance or cost to the affiliated mutual fund investors. On the one hand, financial conglomerates affiliation offers the mutual funds access to abundant resources, better research quality, private material information, and business connections within the financial group. On the other hand, conflict of interest is bound to arise between the financial conglomerate relationship and fund management. Using a sample of U.S. domestic equity mutual funds from 1994 to 2017, this paper examines whether fund family affiliation to an investment bank help the affiliated mutual funds deliver superior performance through private material information advantage possessed by the investment banks or it costs affiliated mutual fund shareholders due to the conflict of interest. Robust to alternative risk adjustments and cross-section regression methodologies, this paper finds that the investment bank-affiliated mutual funds significantly outperform those of the mutual funds that are not affiliated with an investment bank. Interestingly the paper finds that the outperformance is confined to holding return, a return measure that captures the investment talent that is uninfluenced by transaction costs, fees, and other expenses. Further analysis shows that the investment bank-affiliated mutual funds specialize in hard-to-value stocks, which are not more likely to be held by unaffiliated funds. Consistent with the information advantage hypothesis, the paper finds that affiliated funds holding covered stocks outperform affiliated funds without covered stocks lending no support to the hypothesis that affiliated mutual funds attract superior stock-picking talent. Overall, the paper findings are consistent with the idea that investment banks maximize fee income by monopolistically exploiting their private information, thus strategically transferring performance to their affiliated mutual funds. This paper contributes to the extant literature on the agency problem in mutual fund families. It adds to this stream of research by showing that the agency problem is not only prevalent in fund families but also in financial organizations such as investment banks that have affiliated mutual fund families. The results show evidence of exploitation of synergies such as private material information sharing that benefit mutual fund investors due to affiliation with a financial conglomerate. However, this research has a normative dimension, allowing such incestuous behavior of insider trading and exploitation of superior information not only negatively affect the unaffiliated fund investors but also led to an unfair and unleveled playing field in the financial market.

Keywords: mutual fund performance, conflicts of interest, informational advantage, investment bank

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586 A Qualitative Study Identifying the Complexities of Early Childhood Professionals' Use and Production of Data

Authors: Sara Bonetti

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The use of quantitative data to support policies and justify investments has become imperative in many fields including the field of education. However, the topic of data literacy has only marginally touched the early care and education (ECE) field. In California, within the ECE workforce, there is a group of professionals working in policy and advocacy that use quantitative data regularly and whose educational and professional experiences have been neglected by existing research. This study aimed at analyzing these experiences in accessing, using, and producing quantitative data. This study utilized semi-structured interviews to capture the differences in educational and professional backgrounds, policy contexts, and power relations. The participants were three key professionals from county-level organizations and one working at a State Department to allow for a broader perspective at systems level. The study followed Núñez’s multilevel model of intersectionality. The key in Núñez’s model is the intersection of multiple levels of analysis and influence, from the individual to the system level, and the identification of institutional power dynamics that perpetuate the marginalization of certain groups within society. In a similar manner, this study looked at the dynamic interaction of different influences at individual, organizational, and system levels that might intersect and affect ECE professionals’ experiences with quantitative data. At the individual level, an important element identified was the participants’ educational background, as it was possible to observe a relationship between that and their positionality, both with respect to working with data and also with respect to their power within an organization and at the policy table. For example, those with a background in child development were aware of how their formal education failed to train them in the skills that are necessary to work in policy and advocacy, and especially to work with quantitative data, compared to those with a background in administration and/or business. At the organizational level, the interviews showed a connection between the participants’ position within the organization and their organization’s position with respect to others and their degree of access to quantitative data. This in turn affected their sense of empowerment and agency in dealing with data, such as shaping what data is collected and available. These differences reflected on the interviewees’ perceptions and expectations for the ECE workforce. For example, one of the interviewees pointed out that many ECE professionals happen to use data out of the necessity of the moment. This lack of intentionality is a cause for, and at the same time translates into missed training opportunities. Another interviewee pointed out issues related to the professionalism of the ECE workforce by remarking the inadequacy of ECE students’ training in working with data. In conclusion, Núñez’s model helped understand the different elements that affect ECE professionals’ experiences with quantitative data. In particular, what was clear is that these professionals are not being provided with the necessary support and that we are not being intentional in creating data literacy skills for them, despite what is asked of them and their work.

Keywords: data literacy, early childhood professionals, intersectionality, quantitative data

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585 Burnout in the Resident Physician and a Simple Means of Improvement

Authors: Jacob Dangerfield, Jacob Pollard, Jennifer DeCou

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Introduction: Burnout, anxiety, and depression are three conditions that are prevalent in medical providers. This is especially the case in the field of anesthesia, which has a high number of providers suffering from burnout and burnout syndrome. A major contributor to this issue is isolation in the workplace, with a perceived lack of peer support as a major risk factor for burnout. Two organizational interventions that can be done to help improve this issue are small group sessions and providing affordable mental health services. Per American College of Graduate Medical Education (ACGME) Guidelines, these affordable mental health services are a requirement of all residency programs, but for a variety of reasons, many residents do not access them. As physicians, we are often not good at asking for help. With this in mind, we hypothesized that carrying out small group resiliency sessions facilitated by Graduate Medical Education (GME) Wellness Counselors would improve both resident peer support as well as the likelihood that a resident will reach out to GME Wellness in a time of need. Methods: We held small group resiliency sessions with the GME Wellness Mental Health Professionals during protected didactic time. These sessions were small groups, including the members of one’s class (i.e., first-year residents on their own), and were facilitated by 1-2 mental health professionals. After these sessions, we surveyed residents who attended using a short Google Forms survey and using a 5-point Likert Scale, asked residents about some outcomes from the session. A “strongly agree” or “agree” was considered a positive response. Results: Results from our survey showed that the resident sessions had multiple positive outcomes. This survey was sent to 29 residents, and we had a 62% response rate. We found out through this survey that these small group sessions had a perceived positive impact on resident personal well-being, increased perceived peer support from classmates, and made residents more likely to reach out to GME Wellness in the future. Perceived positive impact on well-being was found in 83% of resident respondents, improved perceived peer support in 83% of respondents, and 78% of resident respondents stated that this session increased their likelihood of reaching out to mental health professionals. Conclusions: Through this study, we can conclude that our hypothesis was correct in that Small Group Resiliency Sessions that are facilitated by GME Wellness Counselors improve both resident peer support as well as the likelihood a resident reaches out to these mental health professionals in time of need. We believe these findings are very important as they address two important factors that can aid in decreasing a provider’s risk of experiencing burnout. Through this simple means, we believe other residency programs can help the well-being of their residents, and together, we can decrease the number of cases of burnout in anesthesia.

Keywords: anesthesiology, burnout, wellness, depression, residents, trainees, mental health

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584 Elucidation of Dynamics of Murine Double Minute 2 Shed Light on the Anti-cancer Drug Development

Authors: Nigar Kantarci Carsibasi

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Coarse-grained elastic network models, namely Gaussian network model (GNM) and Anisotropic network model (ANM), are utilized in order to investigate the fluctuation dynamics of Murine Double Minute 2 (MDM2), which is the native inhibitor of p53. Conformational dynamics of MDM2 are elucidated in unbound, p53 bound, and non-peptide small molecule inhibitor bound forms. With this, it is aimed to gain insights about the alterations brought to global dynamics of MDM2 by native peptide inhibitor p53, and two small molecule inhibitors (HDM201 and NVP-CGM097) that are undergoing clinical stages in cancer studies. MDM2 undergoes significant conformational changes upon inhibitor binding, carrying pieces of evidence of induced-fit mechanism. Small molecule inhibitors examined in this work exhibit similar fluctuation dynamics and characteristic mode shapes with p53 when complexed with MDM2, which would shed light on the design of novel small molecule inhibitors for cancer therapy. The results showed that residues Phe 19, Trp 23, Leu 26 reside in the minima of slowest modes of p53, pointing to the accepted three-finger binding model. Pro 27 displays the most significant hinge present in p53 and comes out to be another functionally important residue. Three distinct regions are identified in MDM2, for which significant conformational changes are observed upon binding. Regions I (residues 50-77) and III (residues 90-105) correspond to the binding interface of MDM2, including (α2, L2, and α4), which are stabilized during complex formation. Region II (residues 77-90) exhibits a large amplitude motion, being highly flexible, both in the absence and presence of p53 or other inhibitors. MDM2 exhibits a scattered profile in the fastest modes of motion, while binding of p53 and inhibitors puts restraints on MDM2 domains, clearly distinguishing the kinetically hot regions. Mode shape analysis revealed that the α4 domain controls the size of the cleft by keeping the cleft narrow in unbound MDM2; and open in the bound states for proper penetration and binding of p53 and inhibitors, which points to the induced-fit mechanism of p53 binding. P53 interacts with α2 and α4 in a synchronized manner. Collective modes are shifted upon inhibitor binding, i.e., second mode characteristic motion in MDM2-p53 complex is observed in the first mode of apo MDM2; however, apo and bound MDM2 exhibits similar features in the softest modes pointing to pre-existing modes facilitating the ligand binding. Although much higher amplitude motions are attained in the presence of non-peptide small molecule inhibitor molecules as compared to p53, they demonstrate close similarity. Hence, NVP-CGM097 and HDM201 succeed in mimicking the p53 behavior well. Elucidating how drug candidates alter the MDM2 global and conformational dynamics would shed light on the rational design of novel anticancer drugs.

Keywords: cancer, drug design, elastic network model, MDM2

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583 Journey to Inclusive School: Description of Crucial Sensitive Concepts in the Context of Situational Analysis

Authors: Denisa Denglerova, Radim Sip

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Academic sources as well as international agreements and national documents define inclusion in terms of several criteria: equal opportunities, fulfilling individual needs, development of human resources, community participation. In order for these criteria to be met, the community must be cohesive. Community cohesion, which is a relatively new concept, is not determined by homogeneity, but by the acceptance of diversity among the community members and utilisation of its positive potential. This brings us to a central category of inclusion - appreciating diversity and using it to a positive effect. However, school diversity is a real phenomenon, which schools need to tackle more and more often. This is also indicated by the number of publications focused on diversity in schools. These sources present recent analyses of using identity as a tool of coping with the demands of a diversified society. The aim of this study is to identify and describe in detail the processes taking place in selected schools, which contribute to their pro-inclusive character. The research is designed around a multiple case study of three pro-inclusive schools. Paradigmatically speaking, the research is rooted in situational epistemology. This is also related to the overall framework of interpretation, for which we are going to use innovative methods of situational analysis. In terms of specific research outcomes this will manifest itself in replacing the idea of “objective theory” by the idea of “detailed cartography of a social world”. The cartographic approach directs both the logic of data collection and the choice of methods of their analysis and interpretation. The research results include detection of the following sensitive concepts: Key persons. All participants can contribute to promoting an inclusion-friendly environment; however, some do so with greater motivation than others. These could include school management, teachers with a strong vision of equality, or school counsellors. They have a significant effect on the transformation of the school, and are themselves deeply convinced that inclusion is necessary. Accordingly, they select suitable co-workers; they also inspire some of the other co-workers to make changes, leading by example. Employees with strongly opposing views gradually leave the school, and new members of staff are introduced to the concept of inclusion and openness from the beginning. Manifestations of school openness in working with diversity on all important levels. By this we mean positive manipulation with diversity both in the relationships between “traditional” school participants (directors, teachers, pupils) and school-parent relationships, or relationships between schools and the broader community, in terms of teaching methods as well as ways how the school culture affects the school environment. Other important detected concepts significantly helping to form a pro-inclusive environment in the school are individual and parallel classes; freedom and responsibility of both pupils and teachers, manifested on the didactic level by tendencies towards an open curriculum; ways of asserting discipline in the school environment.

Keywords: inclusion, diversity, education, sensitive concept, situational analysis

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582 The Effect of Social Media Influencer on Boycott Participation through Attitude toward the Offending Country in a Situational Animosity Context

Authors: Hsing-Hua Stella Chang, Mong-Ching Lin, Cher-Min Fong

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Using surrogate boycotts as a coercive tactic to force the offending party into changing its approaches has been increasingly significant over the last several decades, and is expected to increase in the future. Research shows that surrogate boycotts are often triggered by controversial international events, and particular foreign countries serve as the offending party in the international marketplace. In other words, multinational corporations are likely to become surrogate boycott targets in overseas markets because of the animosity between their home and host countries. Focusing on the surrogate boycott triggered by a severe situation animosity, this research aims to examine how social media influencers (SMIs) serving as electronic key opinion leaders (EKOLs) in an international crisis facilitate and organize a boycott, and persuade consumers to participate in the boycott. This research suggests that SMIs could be a particularly important information source in a surrogate boycott sparked by a situation of animosity. This research suggests that under such a context, SMIs become a critical information source for individuals to enhance and update their understanding of the event because, unlike traditional media, social media serve as a platform for instant and 24-hour non-stop information access and dissemination. The Xinjiang cotton event was adopted as the research context, which was viewed as an ongoing inter-country conflict, reflecting a crisis, which provokes animosity against the West. Through online panel services, both studies recruited Mainland Chinese nationals to be respondents to the surveys. The findings show that: 1. Social media influencer message is positively related to a negative attitude toward the offending country. 2. Attitude toward the offending country is positively related to boycotting participation. To address the unexplored question – of the effect of social media influencer influence on consumer participation in boycotts, this research presents a finer-grained examination of boycott motivation, with a special focus on a situational animosity context. This research is split into two interrelated parts. In the first part, this research shows that attitudes toward the offending country can be socially constructed by the influence of social media influencers in a situational animosity context. The study results show that consumers perceive different strengths of social pressure related to various levels of influencer messages and thus exhibit different levels of attitude toward the offending country. In the second part, this research further investigates the effect of attitude toward the offending country on boycott participation. The study findings show that such attitude exacerbated the effect of social media influencer messages on boycott participation in a situation of animosity.

Keywords: animosity, social media marketing, boycott, attitude toward the offending country

Procedia PDF Downloads 87
581 Qualitative Analysis of Occupant’s Satisfaction in Green Buildings

Authors: S. Srinivas Rao, Pallavi Chitnis, Himanshu Prajapati

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The green building movement in India commenced in 2003. Since then, more than 4,300 projects have adopted green building concepts. For last 15 years, the green building movement has grown strong across the country and has resulted in immense tangible and intangible benefits to the stakeholders. Several success stories have demonstrated the tangible benefit experienced in green buildings. However, extensive data interpretation and qualitative analysis are required to report the intangible benefits in green buildings. The emphasis is now shifting to the concept of people-centric design and productivity, health and wellbeing of occupants are gaining importance. This research was part of World Green Building Council’s initiative on 'Better Places for People' which aims to create a world where buildings support healthier and happier lives. The overarching objective of this study was to understand the perception of users living and working in green buildings. The study was conducted in twenty-five IGBC certified green buildings across India, and a comprehensive questionnaire was designed to capture occupant’s perception and experience in the built environment. The entire research focussed on the eight attributes of healthy buildings. The factors considered for the study include thermal comfort, visual comfort, acoustic comfort, ergonomics, greenery, fitness, green transit and sanitation and hygiene. The occupant’s perception and experience were analysed to understand their satisfaction level. The macro level findings of the study indicate that green buildings have addressed attributes of healthy buildings to a larger extent. Few important findings of the study focussed on the parameters such as visual comfort, fitness, greenery, etc. The study indicated that occupants give tremendous importance to the attributes such as visual comfort, daylight, fitness, greenery, etc. 89% occupants were comfortable with the visual environment, on account of various lighting element incorporated as part of the design. Tremendous importance to fitness related activities is highlighted by the study. 84% occupants had actively utilised sports and meditation facilities provided in their facility. Further, 88% occupants had access to the ample greenery and felt connected to the natural biodiversity. This study aims to focus on the immense advantages gained by users occupying green buildings. This will empower green building movement to achieve new avenues to design and construct healthy buildings. The study will also support towards implementing human-centric measures and in turn, will go a long way in addressing people welfare and wellbeing in the built environment.

Keywords: health and wellbeing, green buildings, Indian green building council, occupant’s satisfaction

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580 Underage Internal Migration from Rural to Urban Areas of Ethiopia: The Perspective of Social Marketing in Controlling Child Labor

Authors: Belaynesh Tefera, Ahmed Mohammed, Zelalem Bayisa

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This study focuses on the issue of underage internal migration from rural to urban areas in Ethiopia, specifically in the context of child labor. It addresses the significant disparities in living standards between rural and urban areas, which motivate individuals from rural areas to migrate to urban areas in search of better economic opportunities. The study was conducted in Addis Ababa, where there is a high prevalence of underage internal migrants engaged in child labor due to extreme poverty in rural parts of the country. The aim of this study is to explore the life experiences of shoe-makers who have migrated from rural areas of Ethiopia to Addis Ababa. The focus is on understanding the factors that push these underage individuals to migrate, the challenges they face, and the implications for child labor. This study adopts a qualitative approach, using semistructured face-to-face interviews with underage migrants. A total of 27 interviews were conducted in Addis Ababa, Ethiopia, until the point of data saturation. The criteria for selecting interviewees include working as shoemakers and migrating to Addis Ababa underage, below 16 years old. The interviews were audio-taped, transcribed into Amharic, and then translated into English for analysis. The study reveals that the major push factors for underage internal migration are socioeconomic and environmental factors. Despite improvements in living standards for underage migrants and their families, there is a high prevalence of child labor and lack of access to education among them. Most interviewees migrated without the accompaniment of their family members and faced various challenges, including sleeping on the streets. This study highlights the role of social marketing in addressing the issues of underage internal migration and child labor. It suggests that social marketing can be an effective strategy to protect children from abuse, loneliness, and harassment during their migration process. The data collection involved conducting in-depth interviews with the underage migrants. The interviews were transcribed and translated for analysis. The analysis focused on identifying common themes and patterns within the interview data. The study addresses the factors contributing to underage internal migration, the challenges faced by underage migrants, the prevalence of child labor, and the potential role of social marketing in addressing these issues. The study concludes that although Ethiopia has policies against child internal migration, it is difficult to protect underage laborers who migrate from rural to urban areas due to the voluntary nature of their migration. The study suggests that social marketing can serve as a solution to protect children from abuse and other challenges faced during migration.

Keywords: underage, internal migration, social marketing, child labor, Ethiopia

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579 Decentralized Forest Policy for Natural Sal (Shorea robusta) Forests Management in the Terai Region of Nepal

Authors: Medani Prasad Rijal

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The study outlines the impacts of decentralized forest policy on natural Sal (shorea robusta) forests in the Terai region of Nepal. The government has implemented community forestry program to manage the forest resources and improve the livelihood of local people collectively. The forest management authorities such as conserve, manage, develop and use of forest resources were shifted to the local communities, however, the ownership right of the forestland retained by the government. Local communities took the decision on harvesting, distribution, and sell of forest products by fixing the prices independently. The local communities were putting the low value of forest products and distributed among the user households on the name of collective decision. The decision of low valuation is devaluating the worth of forest products. Therefore, the study hypothesized that decision-making capacities are equally prominent next to the decentralized policy and program formulation. To accomplish the study, individual to group level discussions and questionnaire survey methods were applied with executive committee members and user households. The study revealed that the local intuition called Community Forest User Group (CFUG) committee normally took the decisions on consensus basis. Considering to the access and affording capacity of user households having poor economic backgrounds, low pricing mechanism of forest products has been practiced, even though the Sal timber is far expensive in the local market. The local communities thought that low pricing mechanism is accessible to all user households from poor to better off households. However, the analysis of forest products distribution opposed the assumption as most of the Sal timber, which is the most valuable forest product of community forest only purchased by the limited households of better economic conditions. Since the Terai region is heterogeneous by socio-economic conditions, better off households always have higher affording capacity and possibility of taking higher timber benefits because of low price mechanism. On the other hand, the minimum price rate of forest products has poor contribution in community fund collection. Consequently, it has poor support to carry out poverty alleviation activities to poor people. The local communities have been fixed Sal timber price rate around three times cheaper than normal market price, which is a strong evidence of forest product devaluation itself. Finally, the study concluded that the capacity building of local executives as the decision-makers of natural Sal forests is equally indispensable next to the policy and program formulation for effective decentralized forest management. Unilateral decentralized forest policy may devaluate the forest products rather than devolve of power to the local communities and empower to them.

Keywords: community forestry program, decentralized forest policy, Nepal, Sal forests, Terai

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578 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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577 Energy Harvesting and Storage System for Marine Applications

Authors: Sayem Zafar, Mahmood Rahi

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Rigorous international maritime regulations are in place to limit boat and ship hydrocarbon emissions. The global sustainability goals are reducing the fuel consumption and minimizing the emissions from the ships and boats. These maritime sustainability goals have attracted a lot of research interest. Energy harvesting and storage system is designed in this study based on hybrid renewable and conventional energy systems. This energy harvesting and storage system is designed for marine applications, such as, boats and small ships. These systems can be utilized for mobile use or off-grid remote electrification. This study analyzed the use of micro power generation for boats and small ships. The energy harvesting and storage system has two distinct systems i.e. dockside shore-based system and on-board system. The shore-based system consists of a small wind turbine, photovoltaic (PV) panels, small gas turbine, hydrogen generator and high-pressure hydrogen storage tank. This dockside system is to provide easy access to the boats and small ships for supply of hydrogen. The on-board system consists of hydrogen storage tanks and fuel cells. The wind turbine and PV panels generate electricity to operate electrolyzer. A small gas turbine is used as a supplementary power system to contribute in case the hybrid renewable energy system does not provide the required energy. The electrolyzer performs the electrolysis on distilled water to produce hydrogen. The hydrogen is stored in high-pressure tanks. The hydrogen from the high-pressure tank is filled in the low-pressure tanks on-board seagoing vessels to operate the fuel cell. The boats and small ships use the hydrogen fuel cell to provide power to electric propulsion motors and for on-board auxiliary use. For shore-based system, a small wind turbine with the total length of 4.5 m and the disk diameter of 1.8 m is used. The small wind turbine dimensions make it big enough to be used to charge batteries yet small enough to be installed on the rooftops of dockside facility. The small dimensions also make the wind turbine easily transportable. In this paper, PV, sizing and solar flux are studied parametrically. System performance is evaluated under different operating and environmental conditions. The parametric study is conducted to evaluate the energy output and storage capacity of energy storage system. Results are generated for a wide range of conditions to analyze the usability of hybrid energy harvesting and storage system. This energy harvesting method significantly improves the usability and output of the renewable energy sources. It also shows that small hybrid energy systems have promising practical applications.

Keywords: energy harvesting, fuel cell, hybrid energy system, hydrogen, wind turbine

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576 Exploring the Spatial Characteristics of Mortality Map: A Statistical Area Perspective

Authors: Jung-Hong Hong, Jing-Cen Yang, Cai-Yu Ou

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The analysis of geographic inequality heavily relies on the use of location-enabled statistical data and quantitative measures to present the spatial patterns of the selected phenomena and analyze their differences. To protect the privacy of individual instance and link to administrative units, point-based datasets are spatially aggregated to area-based statistical datasets, where only the overall status for the selected levels of spatial units is used for decision making. The partition of the spatial units thus has dominant influence on the outcomes of the analyzed results, well known as the Modifiable Areal Unit Problem (MAUP). A new spatial reference framework, the Taiwan Geographical Statistical Classification (TGSC), was recently introduced in Taiwan based on the spatial partition principles of homogeneous consideration of the number of population and households. Comparing to the outcomes of the traditional township units, TGSC provides additional levels of spatial units with finer granularity for presenting spatial phenomena and enables domain experts to select appropriate dissemination level for publishing statistical data. This paper compares the results of respectively using TGSC and township unit on the mortality data and examines the spatial characteristics of their outcomes. For the mortality data between the period of January 1st, 2008 and December 31st, 2010 of the Taitung County, the all-cause age-standardized death rate (ASDR) ranges from 571 to 1757 per 100,000 persons, whereas the 2nd dissemination area (TGSC) shows greater variation, ranged from 0 to 2222 per 100,000. The finer granularity of spatial units of TGSC clearly provides better outcomes for identifying and evaluating the geographic inequality and can be further analyzed with the statistical measures from other perspectives (e.g., population, area, environment.). The management and analysis of the statistical data referring to the TGSC in this research is strongly supported by the use of Geographic Information System (GIS) technology. An integrated workflow that consists of the tasks of the processing of death certificates, the geocoding of street address, the quality assurance of geocoded results, the automatic calculation of statistic measures, the standardized encoding of measures and the geo-visualization of statistical outcomes is developed. This paper also introduces a set of auxiliary measures from a geographic distribution perspective to further examine the hidden spatial characteristics of mortality data and justify the analyzed results. With the common statistical area framework like TGSC, the preliminary results demonstrate promising potential for developing a web-based statistical service that can effectively access domain statistical data and present the analyzed outcomes in meaningful ways to avoid wrong decision making.

Keywords: mortality map, spatial patterns, statistical area, variation

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575 The Mental Health Policy in the State of EspíRito Santo, Brazil: Judicialization

Authors: Fabiola Xavier Leal, Lara Campanharo, Sueli Aparecida Rodrigues Lucas

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The phenomenon of judicialization in health policy brings with it a great deal of problematization, but in general, it means that some issues that were previously solved by traditional political bodies are being decided by the Judiciary bodies. It is, therefore, a controversial topic that has generated many reflections both in the academic and political fields, considering that not only a dispute of public funds is at stake, but also the debate on access to social rights provided for in the Brazilian Federal Constitution of 1988 and in the various public policies, such as healthcare. With regard to the phenomenon in the Mental Health Policy focusing on people who use drugs, the disputes that permeate this scenario are evident: moral, cultural, sanitary, economic, psychological aspects. There are also the individual and collective dimensions of suffering. And in this process, we all question: What is the role of the Brazilian State in this matter? In this context, another question that needs to be answered is the amount spent on this procedure in the state of Espírito Santo (ES), Brazil (in the last 04 years, around R$121,978,591.44 were paid only for compulsory hospitalization of individuals) in the field in question, which is the financing of the services of the Psychosocial Care Network (RAPS). Therefore, this article aims to problematize the phenomenon of judicialization in Mental Health Policy through the compulsory hospitalization of people who use drugs in Espírito Santo (ES). We proposed a study that sought to understand how this has been occurring and making an impact on the provision of RAPS services in the Espírito Santo scenario. Therefore, the general objective of this study is to analyze the expenses with compulsory hospitalizations for drug use carried out by the State Health Department (SESA) between 2014 and 2019, in which we will seek to identify its destination and the impact of these actions on public health policy. For the purposes of this article, we will present the preliminary data of this study, such as the amount spent by the state and the receiving institutions. For data collection, the following data sources were used: documents available publicly on the Transparency Portal (payments made per year, institutions that received, subjects hospitalized, period and the amount of the daily rates paid); as well as the processes generated by SESA through its own system - ONBASE. For qualitative analysis, content analysis was used; and for quantitative analysis, descriptive statistics was used. Thus, we seek to problematize the issue of judicialization for compulsory hospitalizations, considering the current situation in which this resource has been widely requested to legitimize the war on drugs. This scenario highlights the moral-legal discourse, pointing out strategies through the control of bodies and through faith as an alternative.

Keywords: compulsory hospitalization, drugs, judicialization, mental health

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574 Lateral Retroperitoneal Transpsoas Approach: A Practical Minimal Invasive Surgery Option for Treating Pyogenic Spondylitis of the Lumbar Vertebra

Authors: Sundaresan Soundararajan, Chor Ngee Tan

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Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.

Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF

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573 History of Russian Women: The Historical Overview of the Images and Roles of Women in Old and Modern Russia

Authors: Elena Chernyak

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The status of Russian women has changed dramatically over the course of Russian history and under different leadership and economic, political, and social conditions. The perception of women, their submissive roles, and low social status cause gender conflict that affects society: demographical issues, increased numbers of divorces, alcoholism, drug abuse, and crime. Despite the fact that around the world women are becoming more independent, protected by law, and play more important roles in society, Russian women are still dependent on men financially, socially, and psychologically. This paper critically explores the experience of Russian women over the course of over a thousand year of Russian history and how the position and image of women changed in Russian Empire, Soviet and post-Soviet Russia and what role women play in contemporary Russia. This paper is a result of deep examination of historical and religious literature, mass media, internet sources, and documents. This analysis shows that throughout history, the role and image of women in society have repeatedly varied depending on ideological and social conditions. In particular, the history of Russian women may be divided into five main periods. The first was the period of paganism, when almost all areas of life were open for women and when women were almost equal in social roles with men. During the second period, starting with the beginning of the Mongol invasion in the 13th century, the position of women was diminishing due to social transformation to the patriarchal society in which women started playing subordinate role in family and society. The third period – the period from the fourteenth through the sixteenth centuries - is a period of the total seclusion of Russian women from each part of social life. The fourth, Soviet period started after the Revolution of 1917. During that time, the position of women was drastically changed due to the transformation of traditional gender roles under the Bolshevik government. Woman's role was seen as worker-mothers who had a double duty: a worker and a mother. The final period began after the collapse of the Soviet Union. The restructuring (Perestroika) and post-Restructuring periods have had contradictory consequences and tremendous impact on Russian society. The image of women as partners and equal to men, which was promoted during the Soviet regime, has been replaced with the traditional functionalist views on family and the role of women, in which men and women have different but supposedly complementary roles. Modern Russia, despite publicly stating its commitment to equal rights, during last two decades has been reverting to an older social model with its emphasis on traditional gender roles, patriarchal ideas of dominant masculinity, and adverse attitudes to women, which are further supported and reinforced by the reviving Russian Orthodox Church. As demonstrated in this review, Russian women have never possessed the same rights as men and have always been subordinate to men. During all period of Russian history, patriarchal ideology maintained and reinforced in Russian society has always subjected women to manipulation, oppression, and victimization and portrayed women as not a ‘full human being’.

Keywords: women, Russia, patriarchy, religion, Russian Orthodox Church

Procedia PDF Downloads 148
572 The Impact of the Global Financial Crisis on the Performance of Czech Industrial Enterprises

Authors: Maria Reznakova, Michala Strnadova, Lukas Reznak

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The global financial crisis that erupted in 2008 is associated mainly with the debt crisis. It quickly spread globally through financial markets, international banks and trade links, and affected many economic sectors. Measured by the index of the year-on-year change in GDP and industrial production, the consequences of the global financial crisis manifested themselves with some delay also in the Czech economy. This can be considered a result of the overwhelming export orientation of Czech industrial enterprises. These events offer an important opportunity to study how financial and macroeconomic instability affects corporate performance. Corporate performance factors have long been given considerable attention. It is therefore reasonable to ask whether the findings published in the past are also valid in the times of economic instability and subsequent recession. The decisive factor in effective corporate performance measurement is the existence of an appropriate system of indicators that are able to assess progress in achieving corporate goals. Performance measures may be based on non-financial as well as on financial information. In this paper, financial indicators are used in combination with other characteristics, such as the firm size and ownership structure. Financial performance is evaluated based on traditional performance indicators, namely, return on equity and return on assets, supplemented with indebtedness and current liquidity indices. As investments are a very important factor in corporate performance, their trends and importance were also investigated by looking at the ratio of investments to previous year’s sales and the rate of reinvested earnings. In addition to traditional financial performance indicators, the Economic Value Added was also used. Data used in the research were obtained from a questionnaire survey administered in industrial enterprises in the Czech Republic and from AMADEUS (Analyse Major Database from European Sources), from which accounting data of companies were obtained. Respondents were members of the companies’ senior management. Research results unequivocally confirmed that corporate performance dropped significantly in the 2010-2012 period, which can be considered a result of the global financial crisis and a subsequent economic recession. It was reflected mainly in the decreasing values of profitability indicators and the Economic Value Added. Although the total year-on-year indebtedness declined, intercompany indebtedness increased. This can be considered a result of impeded access of companies to bank loans due to the credit crunch. Comparison of the results obtained with the conclusions of previous research on a similar topic showed that the assumption that firms under foreign control achieved higher performance during the period investigated was not confirmed.

Keywords: corporate performance, foreign control, intercompany indebtedness, ratio of investment

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571 An Exploratory Study in Nursing Education: Factors Influencing Nursing Students’ Acceptance of Mobile Learning

Authors: R. Abdulrahman, A. Eardley, A. Soliman

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The proliferation in the development of mobile learning (m-learning) has played a vital role in the rapidly growing electronic learning market. This relatively new technology can help to encourage the development of in learning and to aid knowledge transfer a number of areas, by familiarizing students with innovative information and communications technologies (ICT). M-learning plays a substantial role in the deployment of learning methods for nursing students by using the Internet and portable devices to access learning resources ‘anytime and anywhere’. However, acceptance of m-learning by students is critical to the successful use of m-learning systems. Thus, there is a need to study the factors that influence student’s intention to use m-learning. This paper addresses this issue. It outlines the outcomes of a study that evaluates the unified theory of acceptance and use of technology (UTAUT) model as applied to the subject of user acceptance in relation to m-learning activity in nurse education. The model integrates the significant components across eight prominent user acceptance models. Therefore, a standard measure is introduced with core determinants of user behavioural intention. The research model extends the UTAUT in the context of m-learning acceptance by modifying and adding individual innovativeness (II) and quality of service (QoS) to the original structure of UTAUT. The paper goes on to add the factors of previous experience (of using mobile devices in similar applications) and the nursing students’ readiness (to use the technology) to influence their behavioural intentions to use m-learning. This study uses a technique called ‘convenience sampling’ which involves student volunteers as participants in order to collect numerical data. A quantitative method of data collection was selected and involves an online survey using a questionnaire form. This form contains 33 questions to measure the six constructs, using a 5-point Likert scale. A total of 42 respondents participated, all from the Nursing Institute at the Armed Forces Hospital in Saudi Arabia. The gathered data were then tested using a research model that employs the structural equation modelling (SEM), including confirmatory factor analysis (CFA). The results of the CFA show that the UTAUT model has the ability to predict student behavioural intention and to adapt m-learning activity to the specific learning activities. It also demonstrates satisfactory, dependable and valid scales of the model constructs. This suggests further analysis to confirm the model as a valuable instrument in order to evaluate the user acceptance of m-learning activity.

Keywords: mobile learning, nursing institute students’ acceptance of m-learning activity in Saudi Arabia, unified theory of acceptance and use of technology model (UTAUT), structural equation modelling (SEM)

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570 The Affordances and Challenges of Online Learning and Teaching for Secondary School Students

Authors: Hahido Samaras

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In many cases, especially with the pandemic playing a major role in fast-tracking the growth of the digital industry, online learning has become a necessity or even a standard educational model nowadays, reliably overcoming barriers such as location, time and cost and frequently combined with a face-to-face format (e.g., in blended learning). This being the case, it is evident that students in many parts of the world, as well as their parents, will increasingly need to become aware of the pros and cons of online versus traditional courses. This fast-growing mode of learning, accelerated during the years of the pandemic, presents an abundance of exciting options especially matched for a large number of secondary school students in remote places of the world where access to stimulating educational settings and opportunities for a variety of learning alternatives are scarce, adding advantages such as flexibility, affordability, engagement, flow and personalization of the learning experience. However, online learning can also present several challenges, such as a lack of student motivation and social interactions in natural settings, digital literacy, and technical issues, to name a few. Therefore, educational researchers will need to conduct further studies focusing on the benefits and weaknesses of online learning vs. traditional learning, while instructional designers propose ways of enhancing student motivation and engagement in virtual environments. Similarly, teachers will be required to become more and more technology-capable, at the same time developing their knowledge about their students’ particular characteristics and needs so as to match them with the affordances the technology offers. And, of course, schools, education programs, and policymakers will have to invest in powerful tools and advanced courses for online instruction. By developing digital courses that incorporate intentional opportunities for community-building and interaction in the learning environment, as well as taking care to include built-in design principles and strategies that align learning outcomes with learning assignments, activities, and assessment practices, rewarding academic experiences can derive for all students. This paper raises various issues regarding the effectiveness of online learning on students by reviewing a large number of research studies related to the usefulness and impact of online learning following the COVID-19-induced digital education shift. It also discusses what students, teachers, decision-makers, and parents have reported about this mode of learning to date. Best practices are proposed for parties involved in the development of online learning materials, particularly for secondary school students, as there is a need for educators and developers to be increasingly concerned about the impact of virtual learning environments on student learning and wellbeing.

Keywords: blended learning, online learning, secondary schools, virtual environments

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569 Functional Ingredients from Potato By-Products: Innovative Biocatalytic Processes

Authors: Salwa Karboune, Amanda Waglay

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Recent studies indicate that health-promoting functional ingredients and nutraceuticals can help support and improve the overall public health, which is timely given the aging of the population and the increasing cost of health care. The development of novel ‘natural’ functional ingredients is increasingly challenging. Biocatalysis offers powerful approaches to achieve this goal. Our recent research has been focusing on the development of innovative biocatalytic approaches towards the isolation of protein isolates from potato by-products and the generation of peptides. Potato is a vegetable whose high-quality proteins are underestimated. In addition to their high proportion in the essential amino acids, potato proteins possess angiotensin-converting enzyme-inhibitory potency, an ability to reduce plasma triglycerides associated with a reduced risk of atherosclerosis, and stimulate the release of the appetite regulating hormone CCK. Potato proteins have long been considered not economically feasible due to the low protein content (27% dry matter) found in tuber (Solanum tuberosum). However, potatoes rank the second largest protein supplying crop grown per hectare following wheat. Potato proteins include patatin (40-45 kDa), protease inhibitors (5-25 kDa), and various high MW proteins. Non-destructive techniques for the extraction of proteins from potato pulp and for the generation of peptides are needed in order to minimize functional losses and enhance quality. A promising approach for isolating the potato proteins was developed, which involves the use of multi-enzymatic systems containing selected glycosyl hydrolase enzymes that synergistically work to open the plant cell wall network. This enzymatic approach is advantageous due to: (1) the use of milder reaction conditions, (2) the high selectivity and specificity of enzymes, (3) the low cost and (4) the ability to market natural ingredients. Another major benefit to this enzymatic approach is the elimination of a costly purification step; indeed, these multi-enzymatic systems have the ability to isolate proteins, while fractionating them due to their specificity and selectivity with minimal proteolytic activities. The isolated proteins were used for the enzymatic generation of active peptides. In addition, they were applied into a reduced gluten cookie formulation as consumers are putting a high demand for easy ready to eat snack foods, with high nutritional quality and limited to no gluten incorporation. The addition of potato protein significantly improved the textural hardness of reduced gluten cookies, more comparable to wheat flour alone. The presentation will focus on our recent ‘proof-of principle’ results illustrating the feasibility and the efficiency of new biocatalytic processes for the production of innovative functional food ingredients, from potato by-products, whose potential health benefits are increasingly being recognized.

Keywords: biocatalytic approaches, functional ingredients, potato proteins, peptides

Procedia PDF Downloads 364
568 Measuring Emotion Dynamics on Facebook: Associations between Variability in Expressed Emotion and Psychological Functioning

Authors: Elizabeth M. Seabrook, Nikki S. Rickard

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Examining time-dependent measures of emotion such as variability, instability, and inertia, provide critical and complementary insights into mental health status. Observing changes in the pattern of emotional expression over time could act as a tool to identify meaningful shifts between psychological well- and ill-being. From a practical standpoint, however, examining emotion dynamics day-to-day is likely to be burdensome and invasive. Utilizing social media data as a facet of lived experience can provide real-world, temporally specific access to emotional expression. Emotional language on social media may provide accurate and sensitive insights into individual and community mental health and well-being, particularly with focus placed on the within-person dynamics of online emotion expression. The objective of the current study was to examine the dynamics of emotional expression on the social network platform Facebook for active users and their relationship with psychological well- and ill-being. It was expected that greater positive and negative emotion variability, instability, and inertia would be associated with poorer psychological well-being and greater depression symptoms. Data were collected using a smartphone app, MoodPrism, which delivered demographic questionnaires, psychological inventories assessing depression symptoms and psychological well-being, and collected the Status Updates of consenting participants. MoodPrism also delivered an experience sampling methodology where participants completed items assessing positive affect, negative affect, and arousal, daily for a 30-day period. The number of positive and negative words in posts was extracted and automatically collated by MoodPrism. The relative proportion of positive and negative words from the total words written in posts was then calculated. Preliminary analyses have been conducted with the data of 9 participants. While these analyses are underpowered due to sample size, they have revealed trends that greater variability in the emotion valence expressed in posts is positively associated with greater depression symptoms (r(9) = .56, p = .12), as is greater instability in emotion valence (r(9) = .58, p = .099). Full data analysis utilizing time-series techniques to explore the Facebook data set will be presented at the conference. Identifying the features of emotion dynamics (variability, instability, inertia) that are relevant to mental health in social media emotional expression is a fundamental step in creating automated screening tools for mental health that are temporally sensitive, unobtrusive, and accurate. The current findings show how monitoring basic social network characteristics over time can provide greater depth in predicting risk and changes in depression and positive well-being.

Keywords: emotion, experience sampling methods, mental health, social media

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567 Effects of Virtual Reality Treadmill Training on Gait and Balance Performance of Patients with Stroke: Review

Authors: Hanan Algarni

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Background: Impairment of walking and balance skills has negative impact on functional independence and community participation after stroke. Gait recovery is considered a primary goal in rehabilitation by both patients and physiotherapists. Treadmill training coupled with virtual reality technology is a new emerging approach that offers patients with feedback, open and random skills practice while walking and interacting with virtual environmental scenes. Objectives: To synthesize the evidence around the effects of the VR treadmill training on gait speed and balance primarily, functional independence and community participation secondarily in stroke patients. Methods: Systematic review was conducted; search strategy included electronic data bases: MEDLINE, AMED, Cochrane, CINAHL, EMBASE, PEDro, Web of Science, and unpublished literature. Inclusion criteria: Participant: adult >18 years, stroke, ambulatory, without severe visual or cognitive impartments. Intervention: VR treadmill training alone or with physiotherapy. Comparator: any other interventions. Outcomes: gait speed, balance, function, community participation. Characteristics of included studies were extracted for analysis. Risk of bias assessment was performed using Cochrane's ROB tool. Narrative synthesis of findings was undertaken and summary of findings in each outcome was reported using GRADEpro. Results: Four studies were included involving 84 stroke participants with chronic hemiparesis. Interventions intensity ranged (6-12 sessions, 20 minutes-1 hour/session). Three studies investigated the effects on gait speed and balance. 2 studies investigated functional outcomes and one study assessed community participation. ROB assessment showed 50% unclear risk of selection bias and 25% of unclear risk of detection bias across the studies. Heterogeneity was identified in the intervention effects at post training and follow up. Outcome measures, training intensity and durations also varied across the studies, grade of evidence was low for balance, moderate for speed and function outcomes, and high for community participation. However, it is important to note that grading was done on few numbers of studies in each outcome. Conclusions: The summary of findings suggests positive and statistically significant effects (p<0.05) of VR treadmill training compared to other interventions on gait speed, dynamic balance skills, function and participation directly after training. However, the effects were not sustained at follow up in two studies (2 weeks-1 month) and other studies did not perform follow up measurements. More RCTs with larger sample sizes and higher methodological quality are required to examine the long term effects of VR treadmill effects on function independence and community participation after stroke, in order to draw conclusions and produce stronger robust evidence.

Keywords: virtual reality, treadmill, stroke, gait rehabilitation

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566 Modern Contraceptives versus Traditional Contraceptives and Abortion: An Ethnography of Fertiliy Control Practices in Burkina Faso

Authors: Seydou Drabo

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This paper examines how traditional contraceptives and abortion practices challenges the use of modern contraceptives in Burkina Faso. It demonstrates how fears and ‘superstitions’ interact with knowledge about modern contraceptives methods to determine use in a context where other way of controlling fertility (traditional contraceptives, abortion) are available to women in the public, private and traditional health sectors. Furthermore, these issues come at the time when Burkina Faso is among countries with a high fertility rate which (6.0 in 2010) and a very low used of contraceptives as only 16% of married women of childbearing age were using a contraceptive method in 2010. The country also has a young population since 33 % of the population is between 10-24 years old and this number is expected to increase by 2050, generating fears that a growing population of youth will put excessive pressure on available resources, including access to education, health services, and employment. Despite over two decades of dedicated policy attention, 24% of women of reproductive age (15-49) was estimated to have an unmet need for contraception in 2010. This paper draws on ethnographic fieldwork conducted since march 2016 (The research is still in progress) in Burkina Faso. Data were collected from 25 women (users and non-users of modern contraceptives and /or traditional contraceptives, post abortion care patients), 4 street drugs vendors and 3 traditional healers through formal and informal interviews, as well as direct observation. The findings show that a variety of contraceptives methods and abortion drugs or methods, both traditional and modern circulate and are available to women. Traditional contraceptives called African contraceptives by some of our participants refer to several birth control method including plants decoction, magical ring, waist necklace, a ritual done with a mixture of lay coming from termite mound and menses. Abortion is a practice that is done in secret through the use of abortion drugs or through intra uterine manoeuvres. Modern contraceptives include Oral contraceptive, implants, injectable. Stereotypes about modern contraceptives, having regular menstrual cycles and adopt of natural birth control methods, bad experience with modern contraceptives methods, the side effect of modern contraceptives, irregularity of sexual activities and the availability of emergency contraceptives are among factors that limit their use among women. In addition, a negative perception is built around modern contraceptives seen as the drug of ‘white people’. In general, the information on these drugs circulates in women’s social network (first line of information on contraceptive). Some women prefer using what they call African contraceptives or inducing an abortion over modern contraceptives because of their side effect. Furthermore, the findings show that women practices and attitudes in controlling birth varies throughout different phases of their lives. Beyond global discourses and technical solution, the issue of Family planning is all about social practices.

Keywords: abortion, Burkina Faso, contraception, culture, women

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565 How to Assess the Attractiveness of Business Location According to the Mainstream Concepts of Comparative Advantages

Authors: Philippe Gugler

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Goal of the study: The concept of competitiveness has been addressed by economic theorists and policymakers for several hundreds of years, with both groups trying to understand the drivers of economic prosperity and social welfare. The goal of this contribution is to address the major useful theoretical contributions that permit to identify the main drivers of a territory’s competitiveness. We first present the major contributions found in the classical and neo-classical theories. Then, we concentrate on two majors schools providing significant thoughts on the competitiveness of locations: the Economic Geography (EG) School and the International Business (IB) School. Methodology: The study is based on a literature review of the classical and neo-classical theories, on the economic geography theories and on the international business theories. This literature review establishes links between these theoretical mainstreams. This work is based on the academic framework establishing a meaningful literature review aimed to respond to our research question and to develop further research in this field. Results: The classical and neo-classical pioneering theories provide initial insights that territories are different and that these differences explain the discrepancies in their levels of prosperity and standards of living. These theories emphasized different factors impacting the level and the growth of productivity in a given area and therefore the degree of their competitiveness. However, these theories are not sufficient to more precisely identify the drivers and enablers of location competitiveness and to explain, in particular, the factors that drive the creation of economic activities, the expansion of economic activities, the creation of new firms and the attraction of foreign firms. Prosperity is due to economic activities created by firms. Therefore, we need more theoretical insights to scrutinize the competitive advantages of territories or, in other words, their ability to offer the best conditions that enable economic agents to achieve higher rates of productivity in open markets. Two major theories provide, to a large extent, the needed insights: the economic geography theory and the international business theory. The economic geography studies scrutinized in this study from Marshall to Porter, aim to explain the drivers of the concentration of specific industries and activities in specific locations. These activity agglomerations may be due to the creation of new enterprises, the expansion of existing firms, and the attraction of firms located elsewhere. Regarding this last possibility, the international business (IB) theories focus on the comparative advantages of locations as far as multinational enterprises (MNEs) strategies are concerned. According to international business theory, the comparative advantages of a location serves firms not only by exploiting their ownership advantages (mostly as far as market seeking, resource seeking and efficiency seeking investments are concerned) but also by augmenting and/or creating new ownership advantages (strategic asset seeking investments). The impact of a location on the competitiveness of firms is considered from both sides: the MNE’s home country and the MNE’s host country.

Keywords: competitiveness, economic geography, international business, attractiveness of businesses

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564 Revolutionizing Healthcare Communication: The Transformative Role of Natural Language Processing and Artificial Intelligence

Authors: Halimat M. Ajose-Adeogun, Zaynab A. Bello

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Artificial Intelligence (AI) and Natural Language Processing (NLP) have transformed computer language comprehension, allowing computers to comprehend spoken and written language with human-like cognition. NLP, a multidisciplinary area that combines rule-based linguistics, machine learning, and deep learning, enables computers to analyze and comprehend human language. NLP applications in medicine range from tackling issues in electronic health records (EHR) and psychiatry to improving diagnostic precision in orthopedic surgery and optimizing clinical procedures with novel technologies like chatbots. The technology shows promise in a variety of medical sectors, including quicker access to medical records, faster decision-making for healthcare personnel, diagnosing dysplasia in Barrett's esophagus, boosting radiology report quality, and so on. However, successful adoption requires training for healthcare workers, fostering a deep understanding of NLP components, and highlighting the significance of validation before actual application. Despite prevailing challenges, continuous multidisciplinary research and collaboration are critical for overcoming restrictions and paving the way for the revolutionary integration of NLP into medical practice. This integration has the potential to improve patient care, research outcomes, and administrative efficiency. The research methodology includes using NLP techniques for Sentiment Analysis and Emotion Recognition, such as evaluating text or audio data to determine the sentiment and emotional nuances communicated by users, which is essential for designing a responsive and sympathetic chatbot. Furthermore, the project includes the adoption of a Personalized Intervention strategy, in which chatbots are designed to personalize responses by merging NLP algorithms with specific user profiles, treatment history, and emotional states. The synergy between NLP and personalized medicine principles is critical for tailoring chatbot interactions to each user's demands and conditions, hence increasing the efficacy of mental health care. A detailed survey corroborated this synergy, revealing a remarkable 20% increase in patient satisfaction levels and a 30% reduction in workloads for healthcare practitioners. The poll, which focused on health outcomes and was administered to both patients and healthcare professionals, highlights the improved efficiency and favorable influence on the broader healthcare ecosystem.

Keywords: natural language processing, artificial intelligence, healthcare communication, electronic health records, patient care

Procedia PDF Downloads 56
563 Assessment of Current and Future Opportunities of Chemical and Biological Surveillance of Wastewater for Human Health

Authors: Adam Gushgari

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The SARS-CoV-2 pandemic has catalyzed the rapid adoption of wastewater-based epidemiology (WBE) methodologies both domestically and internationally. To support the rapid scale-up of pandemic-response wastewater surveillance systems, multiple federal agencies (i.e. US CDC), non-government organizations (i.e. Water Environment Federation), and private charities (i.e. Bill and Melinda Gates Foundation) have funded over $220 million USD supporting development and expanding equitable access of surveillance methods. Funds were primarily distributed directly to municipalities under the CARES Act (90.6%), followed by academic projects (7.6%), and initiatives developed by private companies (1.8%). In addition to federal funding for wastewater monitoring primarily conducted at wastewater treatment plants, state/local governments and private companies have leveraged wastewater sampling to obtain health and lifestyle data on student, prison inmate, and employee populations. We explore the viable paths for expansion of the WBE m1ethodology across a variety of analytical methods; the development of WBE-specific samplers and real-time wastewater sensors; and their application to various governments and private sector industries. Considerable investment in, and public acceptance of WBE suggests the methodology will be applied to other future notifiable diseases and health risks. Early research suggests that WBE methods can be applied to a host of additional “biological insults” including communicable diseases and pathogens, such as influenza, Cryptosporidium, Giardia, mycotoxin exposure, hepatitis, dengue, West Nile, Zika, and yellow fever. Interest in chemical insults is also likely, providing community health and lifestyle data on narcotics consumption, use of pharmaceutical and personal care products (PPCP), PFAS and hazardous chemical exposure, and microplastic exposure. Successful application of WBE to monitor analytes correlated with carcinogen exposure, community stress prevalence, and dietary indicators has also been shown. Additionally, technology developments of in situ wastewater sensors, WBE-specific wastewater samplers, and integration of artificial intelligence will drastically change the landscape of WBE through the development of “smart sewer” networks. The rapid expansion of the WBE field is creating significant business opportunities for professionals across the scientific, engineering, and technology industries ultimately focused on community health improvement.

Keywords: wastewater surveillance, wastewater-based epidemiology, smart cities, public health, pandemic management, substance abuse

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562 Making Meaning, Authenticity, and Redefining a Future in Former Refugees and Asylum Seekers Detained in Australia

Authors: Lynne McCormack, Andrew Digges

Abstract:

Since 2013, the Australian government has enforced mandatory detention of anyone arriving in Australia without a valid visa, including those subsequently identified as a refugee or seeking asylum. While consistent with the increased use of immigration detention internationally, Australia’s use of offshore processing facilities both during and subsequent to refugee status determination processing has until recently remained a unique feature of Australia’s program of deterrence. The commonplace detention of refugees and asylum seekers following displacement is a significant and independent source of trauma and a contributory factor in adverse psychological outcomes. Officially, these individuals have no prospect of resettlement in Australia, are barred from applying for substantive visas, and are frequently and indefinitely detained in closed facilities such as immigration detention centres, or alternative places of detention, including hotels. It is also important to note that the limited access to Australia’s immigration detention population made available to researchers often means that data available for secondary analysis may be incomplete or delayed in its release. Further, studies into the lived experience of refugees and asylum seekers are typically cross-sectional and convenience sampled, employing a variety of designs and research methodologies that limit comparability and focused on the immediacy of the individual’s experience. Consequently, how former detainees make sense of their experience, redefine their future trajectory upon release, and recover a sense of authenticity and purpose, is unknown. As such, the present study sought the positive and negative subjective interpretations of 6 participants in Australia regarding their lived experiences as refugees and asylum seekers within Australia’s immigration detention system and its impact on their future sense of self. It made use of interpretative phenomenological analysis (IPA), a qualitative research methodology that is interested in how individuals make sense of, and ascribe meaning to, their unique lived experiences of phenomena. Underpinned by phenomenology, hermeneutics, and critical realism, this idiographic study aimed to explore both positive and negative subjective interpretations of former refugees and asylum seekers held in detention in Australia. It sought to understand how they make sense of their experiences, how detention has impacted their overall journey as displaced persons, and how they have moved forward in the aftermath of protracted detention in Australia. Examining the unique lived experiences of previously detained refugees and asylum seekers may inform the future development of theoretical models of posttraumatic growth among this vulnerable population, thereby informing the delivery of future mental health and resettlement services.

Keywords: mandatory detention, refugee, asylum seeker, authenticity, Interpretative phenomenological analysis

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561 Planckian Dissipation in Bi₂Sr₂Ca₂Cu₃O₁₀₋δ

Authors: Lalita, Niladri Sarkar, Subhasis Ghosh

Abstract:

Since the discovery of high temperature superconductivity (HTSC) in cuprates, several aspects of this phenomena have fascinated physics community. The most debated one is the linear temperature dependence of normal state resistivity over wide range of temperature in violation of with Fermi liquid theory. The linear-in-T resistivity (LITR) is the indication of strongly correlated metallic, known as “strange metal”, attributed to non Fermi liquid theory (NFL). The proximity of superconductivity to LITR suggests that there may be underlying common origin. The LITR has been shown to be due to unknown dissipative phenomena, restricted by quantum mechanics and commonly known as ‘‘Planckian dissipation” , the term first coined by Zaanen and the associated inelastic scattering time τ and given by 1/τ=αkBT/ℏ, where ℏ, kB and α are reduced Planck’s constant, Boltzmann constant and a dimensionless constant of order of unity, respectively. Since the first report, experimental support for α ~ 1 is appearing in literature. There are several striking issues which remain to be resolved if we desire to find out or at least get a clue towards microscopic origin of maximal dissipation in cuprates. (i) Universality of α ~ 1, recently some doubts have been raised in some cases. (ii) So far, Planckian dissipation has been demonstrated in overdoped Cuprates, but if the proximity to quantum criticality is important, then Planckian dissipation should be observed in optimally doped and marginally underdoped cuprates. The link between Planckian dissipation and quantum criticality still remains an open problem. (iii) Validity of Planckian dissipation in all cuprates is an important issue. Here, we report reversible change in the superconducting behavior of high temperature superconductor Bi2Sr2Ca2Cu3O10+δ (Bi-2223) under dynamic doping induced by photo-excitation. Two doped Bi-223 samples, which are x = 0.16 (optimal-doped), x = 0.145 (marginal-doped) have been used for this investigation. It is realized that steady state photo-excitation converts magnetic Cu2+ ions to nonmagnetic Cu1+ ions which reduces superconducting transition temperature (Tc) by killing superfluid density. In Bi-2223, one would expect the maximum of suppression of Tc should be at charge transfer gap. We have observed suppression of Tc starts at 2eV, which is the charge transfer gap in Bi-2223. We attribute this transition due to Cu-3d9(Cu2+) to Cu-3d10(Cu+), known as d9 − d10 L transition, photoexcitation makes some Cu ions in CuO2 planes as spinless non-magnetic potential perturbation as Zn2+ does in CuO2 plane in case Zn-doped cuprates. The resistivity varies linearly with temperature with or without photo-excitation. Tc can be varied by almost by 40K be photoexcitation. Superconductivity can be destroyed completely by introducing ≈ 2% of Cu1+ ions for this range of doping. With this controlled variation of Tc and resistivity, detailed investigation has been carried out to reveal Planckian dissipation underdoped to optimally doped Bi-2223. The most important aspect of this investigation is that we could vary Tc dynamically and reversibly, so that LITR and associated Planckian dissipation can be studied over wide ranges of Tc without changing the doping chemically.

Keywords: linear resistivity, HTSC, Planckian dissipation, strange metal

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560 The Role of Social Media in the Rise of Islamic State in India: An Analytical Overview

Authors: Yasmeen Cheema, Parvinder Singh

Abstract:

The evolution of Islamic State (acronym IS) has an ultimate goal of restoring the caliphate. IS threat to the global security is main concern of international community but has also raised a factual concern for India about the regular radicalization of IS ideology among Indian youth. The incident of joining Arif Ejaz Majeed, an Indian as ‘jihadist’ in IS has set strident alarm in law & enforcement agencies. On 07.03.2017, many people were injured in an Improvised Explosive Device (IED) blast on-board of Bhopal Ujjain Express. One perpetrator of this incident was killed in encounter with police. But, the biggest shock is that the conspiracy was pre-planned and the assailants who carried out the blast were influenced by the ideology perpetrated by the Islamic State. This is the first time name of IS has cropped up in a terror attack in India. It is a red indicator of violent presence of IS in India, which is spreading through social media. The IS have the capacity to influence the younger Muslim generation in India through its brutal and aggressive propaganda videos, social media apps and hatred speeches. It is a well known fact that India is on the radar of IS, as well on its ‘Caliphate Map’. IS uses Twitter, Facebook and other social media platforms constantly. Islamic State has used enticing videos, graphics, and articles on social media and try to influence persons from India & globally that their jihad is worthy. According to arrested perpetrator of IS in different cases in India, the most of Indian youths are victims to the daydreams which are fondly shown by IS. The dreams that the Muslim empire as it was before 1920 can come back with all its power and also that the Caliph and its caliphate can be re-established are shown by the IS. Indian Muslim Youth gets attracted towards these euphemistic ideologies. Islamic State has used social media for disseminating its poisonous ideology, recruitment, operational activities and for future direction of attacks. IS through social media inspired its recruits & lone wolfs to continue to rely on local networks to identify targets and access weaponry and explosives. Recently, a pro-IS media group on its Telegram platform shows Taj Mahal as the target and suggested mode of attack as a Vehicle Born Improvised Explosive Attack (VBIED). Islamic State definitely has the potential to destroy the Indian national security & peace, if timely steps are not taken. No doubt, IS has used social media as a critical mechanism for recruitment, planning and executing of terror attacks. This paper will therefore examine the specific characteristics of social media that have made it such a successful weapon for Islamic State. The rise of IS in India should be viewed as a national crisis and handled at the central level with efficient use of modern technology.

Keywords: ideology, India, Islamic State, national security, recruitment, social media, terror attack

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559 Leveraging Power BI for Advanced Geotechnical Data Analysis and Visualization in Mining Projects

Authors: Elaheh Talebi, Fariba Yavari, Lucy Philip, Lesley Town

Abstract:

The mining industry generates vast amounts of data, necessitating robust data management systems and advanced analytics tools to achieve better decision-making processes in the development of mining production and maintaining safety. This paper highlights the advantages of Power BI, a powerful intelligence tool, over traditional Excel-based approaches for effectively managing and harnessing mining data. Power BI enables professionals to connect and integrate multiple data sources, ensuring real-time access to up-to-date information. Its interactive visualizations and dashboards offer an intuitive interface for exploring and analyzing geotechnical data. Advanced analytics is a collection of data analysis techniques to improve decision-making. Leveraging some of the most complex techniques in data science, advanced analytics is used to do everything from detecting data errors and ensuring data accuracy to directing the development of future project phases. However, while Power BI is a robust tool, specific visualizations required by geotechnical engineers may have limitations. This paper studies the capability to use Python or R programming within the Power BI dashboard to enable advanced analytics, additional functionalities, and customized visualizations. This dashboard provides comprehensive tools for analyzing and visualizing key geotechnical data metrics, including spatial representation on maps, field and lab test results, and subsurface rock and soil characteristics. Advanced visualizations like borehole logs and Stereonet were implemented using Python programming within the Power BI dashboard, enhancing the understanding and communication of geotechnical information. Moreover, the dashboard's flexibility allows for the incorporation of additional data and visualizations based on the project scope and available data, such as pit design, rock fall analyses, rock mass characterization, and drone data. This further enhances the dashboard's usefulness in future projects, including operation, development, closure, and rehabilitation phases. Additionally, this helps in minimizing the necessity of utilizing multiple software programs in projects. This geotechnical dashboard in Power BI serves as a user-friendly solution for analyzing, visualizing, and communicating both new and historical geotechnical data, aiding in informed decision-making and efficient project management throughout various project stages. Its ability to generate dynamic reports and share them with clients in a collaborative manner further enhances decision-making processes and facilitates effective communication within geotechnical projects in the mining industry.

Keywords: geotechnical data analysis, power BI, visualization, decision-making, mining industry

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