Search results for: cognitive rehabilitation training

Authors: Neha Bhattacharyya, Soumendra Singh, Amrita Banerjee, Ria Ghosh, Oindrila Sinha, Nairit Das, Rajkumar Gayen, Somya Subhra Pal, Sahely Ganguly, Tanmoy Dasgupta, Tanusree Dasgupta, Pulak Mondal, Aniruddha Adhikari, Sharmila Sarkar, Debasish Bhattacharyya, Asim Kumar Mallick, Om Prakash Singh, Samir Kumar Pal

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Background: We aim to develop an integrated device comprised of single-probe EEG and CCD-based motion sensors for a more objective measure of Attention-deficit Hyperactivity Disorder (ADHD). While the integrated device (MAHD) relies on the EEG signal (spectral density of beta wave) for the assessment of attention during a given structured task (painting three segments of a circle using three different colors, namely red, green and blue), the CCD sensor depicts movement pattern of the subjects engaged in a continuous performance task (CPT). A statistical analysis of the attention and movement patterns was performed, and the accuracy of the completed tasks was analysed using indigenously developed software. The device with the embedded software, called MAHD, is intended to improve certainty with criterion E (i.e. whether symptoms are better explained by another condition). Methods: We have used the EEG signal from a single-channel dry sensor placed on the frontal lobe of the head of the subjects (3-5 years old pre-schoolers). During the painting of three segments of a circle using three distinct colors (red, green, and blue), absolute power for delta and beta EEG waves from the subjects are found to be correlated with relaxation and attention/cognitive load conditions. While the relaxation condition of the subject hints at hyperactivity, a more direct CCD-based motion sensor is used to track the physical movement of the subject engaged in a continuous performance task (CPT) i.e., separation of the various colored balls from one table to another. We have used our indigenously developed software for the statistical analysis to derive a scale for the objective assessment of ADHD. We have also compared our scale with clinical ADHD evaluation. Results: In a limited clinical trial with preliminary statistical analysis, we have found a significant correlation between the objective assessment of the ADHD subjects with that of the clinician’s conventional evaluation. Conclusion: MAHD, the integrated device, is supposed to be an auxiliary tool to improve the accuracy of ADHD diagnosis by supporting greater criterion E certainty.

Keywords: ADHD, CPT, EEG signal, motion sensor, psychometric test

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Authors: Junjun Chen, Yingxiu Li

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The occupational well-being of school principals has played a vital role in the pursuit of individual and school wellness and success. However, principals’ well-being worldwide is under increasing threat because of the challenging and complex nature of their work and growing demands for school standardisation and accountability. Pressure is particularly acute in the post-pandemicfuture as principals attempt to deal with the impact of the pandemic on top of more regular demands. This is particularly true in Hong Kong, as school principals are increasingly wedged between unparalleled political, social, and academic responsibilities. Recognizing the semantic breadth of well-being, scholars have not determined a single, mutually agreeable definition but agreed that the concept of well-being has multiple dimensions across various disciplines. The multidimensional approach promises more precise assessments of the relationships between well-being and other concepts than the ‘affect-only’ approach or other single domains for capturing the essence of principal well-being. The multiple-dimension well-being concept is adopted in this project to understand principal well-being in this study. This study aimed to understand the situation of principal well-being and its influential drivers with a sample of 670 principals from Hong Kong and Mainland China. An online survey was sent to the participants after the breakout of COVID-19 by the researchers. All participants were well informed about the purposes and procedure of the project and the confidentiality of the data prior to filling in the questionnaire. Confirmatory factor analysis and structural equation modelling performed with Mplus were employed to deal with the dataset. The data analysis procedure involved the following three steps. First, the descriptive statistics (e.g., mean and standard deviation) were calculated. Second, confirmatory factor analysis (CFA) was used to trim principal well-being measurement performed with maximum likelihood estimation. Third, structural equation modelling (SEM) was employed to test the influential factors of principal well-being. The results of this study indicated that the overall of principal well-being were above the average mean score. The highest ranking in this study given by the principals was to their psychological and social well-being (M = 5.21). This was followed by spiritual (M = 5.14; SD = .77), cognitive (M = 5.14; SD = .77), emotional (M = 4.96; SD = .79), and physical well-being (M = 3.15; SD = .73). Participants ranked their physical well-being the lowest. Moreover, professional autonomy, supervisor and collegial support, school physical conditions, professional networking, and social media have showed a significant impact on principal well-being. The findings of this study will potentially enhance not only principal well-being, but also the functioning of an individual principal and a school without sacrificing principal well-being for quality education in the process. This will eventually move one step forward for a new future - a wellness society advocated by OECD. Importantly, well-being is an inside job that begins with choosing to have wellness, whilst supports to become a wellness principal are also imperative.

Keywords: well-being, school principals, quantitative, influential factors

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Authors: Sau Kam Adeline Chan

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World Health Organization had listed ‘Communication during Patient Care Handovers’ as one of its highest 5 patient safety initiatives. Clinical handover means transfer of accountability and responsibility of clinical information from one health professional to another. The main goal of clinical handover is to convey patient’s current condition and treatment plan accurately. Ineffective communication at point of care is globally regarded as the main cause of the sentinel event. Situation, Background, Assessment and Recommendation (SBAR), a communication tool, is extensively regarded as an effective communication tool in healthcare setting. Nonetheless, just by scenario-based program in nursing school or attending workshops on SBAR would not be enough for freshly graduated nurses to apply it competently in a complex clinical practice. To what extend and in-depth of information should be conveyed during handover process is not easy to learn. As such, on-site coaching is essential to upgrade their expertise on the usage of SBAR and ultimately to avoid any clinical error. On-site coaching for all freshly graduated nurses on the usage of SBAR in clinical handover was commenced in August 2014. During the preceptorship period, freshly graduated nurses were coached by the preceptor. After that, they were gradually assigned to take care of a group of patients independently. Nurse leaders would join in their shift handover process at patient’s bedside. Feedback and support were given to them accordingly. Discrepancies on their clinical handover process were shared with them and documented for further improvement work. Owing to the constraint of manpower in nurse leader, about coaching for 30 times were provided to a nurse in a year. Staff satisfaction survey was conducted to gauge their feelings about the coaching and look into areas for further improvement. Number of clinical error avoided was documented as well. The nurses reported that there was a significant improvement particularly in their confidence and knowledge in clinical handover process. In addition, the sense of empowerment was developed when liaising with senior and experienced nurses. Their proficiency in applying SBAR was enhanced and they become more alert to the critical criteria of an effective clinical handover. Most importantly, accuracy of transferring patient’s condition was improved and repetition of information was avoided. Clinical errors were prevented and quality patient care was ensured. Using SBAR as a communication tool looks simple. The tool only provides a framework to guide the handover process. Nevertheless, without on-site training, loophole on clinical handover still exists, patient’s safety will be affected and clinical error still happens.

Keywords: freshly graduated nurse, competency of clinical handover, quality, clinical error

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Authors: Alene Toulany, Elizabeth Dettmer, Seena Grewal, Kaley Roosen, Andrea Regina, Cathleen Steinegger, Kate Stadelman, Melissa Chambers, Lindsay Lochhead, Kelsey Gallagher, Alissa Steinberg, Andrea Leyser, Allison Lougheed, Jill Hamilton

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Obesity and psychiatric disorders occur together so frequently that the combination has been coined an epidemic within an epidemic. Youth living with obesity are at increased risk for trauma, depression, anxiety and disordered eating. Although symptoms of binge eating disorder are common in paediatric obesity management programs, they are often not identified or addressed within treatment. At The Hospital for Sick Children (SickKids), a tertiary care paediatric hospital in Toronto, Canada, adolescents with obesity are treated in an interdisciplinary outpatient clinic (1-2 hours/week). This intensity of care is simply not enough to help these extremely complex patients. Existing day treatment programs for eating, and psychiatric disorders are not well suited for patients with obesity. In order to address this identified care gap, a unique collaboration was formed between the obesity, psychiatry, and eating disorder programs at SickKids in 2015. The aim of this collaboration was to provide an enhanced treatment arm to our general psychiatry day hospital program that addresses both the mental health issues and the lifestyle challenges common to youth with obesity and binge eating. The program is currently in year-one of a two-year pilot project and is designed for a length of stay of approximately 6 months. All youth participate in daily group therapy, academics, and structured mealtimes. The groups are primarily skills-based and are informed by cognitive/dialectical behavioural therapies. Weekly family therapy and individual therapy, as well as weekly medical appointments with a psychiatrist and a nurse, are provided. Youth in the enhanced treatment arm also receive regular sessions with a dietitian to establish normalized eating behaviours and monthly multifamily meal sessions to address challenges related to behaviour change and mealtimes in the home. Outcomes that will be evaluated include measures of mental health, anthropometrics, metabolic status, and healthcare satisfaction. At the end of the two years, it is expected that we will have had about 16 youth participants. This model of care delivery will be the first of its kind in Canada and is expected to inform future paediatric treatment practices.

Keywords: adolescent, binge eating, mental illness, obesity

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Authors: Brooke Sweeney, David White, Felix Amparano, Nick A. Clark, Amy R. Beck, Mathew Lindquist, Lora Edwards, Julie Vandal, Jennifer Lisondra, Katie Cox, Renee Arensberg, Allen Cummins, Jazmine Cedeno, Jason D. Fraser, Kelsey Dean, Helena H. Laroche, Cristina Fernandez

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Background: National organizations call for standardized pre-surgical requirements and education to optimize postoperative outcomes. Since 2017 our surgery program has used defined protocols and educational curricula pre- and post-surgery. In response to patient outcomes, our educational content was refined to include quizzes to assess patient knowledge and surgical preparedness. We aim to optimize adolescent pre-bariatric surgery preparedness by improving overall aggregate pre-surgical assessment performance from 68% to 80% within 12 months. Methods: A multidisciplinary improvement team was developed within the weight management clinic (WMC) of our tertiary care, free-standing children’s hospital. A manual has been utilized since 2017, with limitations in consistent delivery and patient uptake of information. The curriculum has been improved to include quizzes administered during WMC visits prior to bariatric surgery. The initial outcome measure is the pre-surgical quiz score of adolescents preparing for bariatric surgery. Process measure was the number of questions answered correctly to test the questions. Baseline performance was determined by a patient assessment survey of pre-surgical preparedness at patient visits. Plan-Do-Study-Act cycles (PDSA) included: 1) creation and implementation of a refined curriculum, 2) development of 5 new quizzes based upon learning objectives, and 3) improving provider-lead teaching and quiz administration within clinic workflow. Run charts assessed impact over time. Results: A total of 346 quiz questions were administered to 34 adolescents. The outcome measure improved from a baseline mean of 68% to 86% following PDSA 2 cycles, and it was sustained. Conclusion/Implication: Patient/family comprehension of surgical preparedness improved with standardized education via team member-led teaching and assessment using quizzes during pre-surgical clinic visits. The next steps include launching redesigned teaching materials with modules correlated to quizzes and assessment of comprehension and outcomes post-surgically.

Keywords: bariatric surgery, adolescent, clinic, pre-bariatric training

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Authors: Katarzyna Wyka, Dana Sylvan, JoAnn Difede

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Background and significance: The following disaster, population-based screening programs are routinely established to assess physical and psychological consequences of exposure. These data sets are highly skewed as only a small percentage of trauma-exposed individuals develop health issues. Commonly used statistical methodology in post-disaster mental health generally involves population-averaged models. Such models aim to capture the overall response to the disaster and its aftermath; however, they may not be sensitive enough to accommodate population heterogeneity in symptomatology, such as post-traumatic stress or depressive symptoms. Methods: We use an archival longitudinal data set from Weill-Cornell 9/11 Mental Health Screening Program established following the World Trade Center (WTC) terrorist attacks in New York in 2001. Participants are rescue and recovery workers who participated in the site cleanup and restoration (n=2960). The main outcome is the post-traumatic stress symptoms (PTSD) severity score assessed via clinician interviews (CAPS). For a detailed understanding of response to the disaster and its aftermath, we are adapting quantile regression methodology with particular focus on predictors of extreme distress and resilience to trauma. Results: The response variable was defined as the quantile of the CAPS score for each individual under two different scenarios specifying the unconditional quantiles based on: 1) clinically meaningful CAPS cutoff values and 2) CAPS distribution in the population. We present graphical summaries of the differential effects. For instance, we found that the effect of the WTC exposures, namely seeing bodies and feeling that life was in danger during rescue/recovery work was associated with very high PTSD symptoms. A similar effect was apparent in individuals with prior psychiatric history. Differential effects were also present for age and education level of the individuals. Conclusion: We evaluate the utility of quantile regression in disaster research in contrast to the commonly used population-averaged models. We focused on assessing the distribution of risk factors for post-traumatic stress symptoms across quantiles. This innovative approach provides a comprehensive understanding of the relationship between dependent and independent variables and could be used for developing tailored training programs and response plans for different vulnerability groups.

Keywords: disaster workers, post traumatic stress, PTSD, quantile regression

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Authors: Quoc Hung Le Pham

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In the field of language study, classifier is an interesting research feature. In the world’s languages, some languages have classifier system, some do not. Mandarin Chinese and Vietnamese languages are a rich classifier system, however, because of the language system, the cognitive, cultural differences, so that the syntactic structure of classifier of them also dissimilar. When using Mandarin Chinese classifiers must collocate with nouns or verbs, in the lexical category it is not like nouns or verbs, belong to the open class. But some scholars believe that Mandarin Chinese measure words are similar to English and other Indo European languages. The word hanging on the structure and word formation (suffix), is a closed class. Compared to other languages, such as Chinese, Vietnamese, Thai and other Asian languages are still belonging to the classifier language’s second type, this type of language is classifier, it is in the majority of quantity must exist, and following deictic, anaphoric or quantity appearing together, not separation between its modified noun, also known as numeral classifier language. Main syntactic structure of Chinese classifiers are as follows: ‘quantity+measure+noun’, ‘pronoun+measure+noun’, ‘pronoun+quantity+measure+noun’, ‘prefix+quantity+measure +noun’, ‘quantity +adjective + measure +noun’, ‘ quantity (above 10 whole number), + duo (多)measure +noun’, ‘ quantity (around 10) + measure + duo (多) +noun’. Main syntactic structure of Vietnamese classifiers are: ‘quantity+measure+noun’, ‘ measure+noun+pronoun’, ‘quantity+measure+noun+pronoun’, ‘measure+noun+prefix+ quantity’, ‘quantity+measure+noun+adjective', ‘duo (多) +quanlity+measure+noun’, ‘quantity+measure+adjective+pronoun (quantity word could not be 1)’, ‘measure+adjective+pronoun’, ‘measure+pronoun’. In daily life, classifiers are commonly used, if Chinese learners failed to standardize this using catergory, because the negative impact might occur on their verbal communication. The richness of the Chinese classifier system contributes to the complexity in the study of the system by foreign learners, especially in the inter language of Vietnamese learners. As above mentioned, Vietnamese language also has a rich system of classifiers, however, the basic structure order of two languages are similar but both still have differences. These similarities and dissimilarities between Chinese and Vietnamese classifier systems contribute significantly to the common errors made by Vietnamese students while they acquire Chinese, which are distinct from the errors made by students from the other language background. This article from a comparative perspective of language, has an orientation towards Chinese and Vietnamese languages commonly used in classifiers semantics and structural form two aspects. This comparative study aims to identity Vietnamese students while learning Chinese classifiers may face some negative transference of mother language, beside that through the analysis of the classifiers questionnaire, find out the causes and patterns of the errors they made. As the preliminary analysis shows, Vietnamese students while learning Chinese classifiers made some errors such as: overuse classifier ‘ge’(个); misuse the other classifiers ‘*yi zhang ri ji’(yi pian ri ji), ‘*yi zuo fang zi’(yi jian fang zi), ‘*si zhang jin pai’(si mei jin pai); homonym words ‘dui, shuang, fu, tao’ (对、双、副、套), ‘ke, li’ (颗、粒).

Keywords: acquisition, classifiers, negative transfer, Vietnamse learners

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Authors: Eleanor Sweeney, Chunyuan Di

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The metaphors people use in everyday discourse do not arise randomly; rather, they develop from our physical experiences in our social and cultural environments. Conceptual Metaphor Theory (CMT) explains that through metaphor, we apply our embodied understanding of the physical world to non-material concepts to understand and express abstract concepts. Our most productive source domains derive from our embodied understanding and allow us to develop primary metaphors, and from primary metaphors, an elaborate, creative world of culturally constructed complex metaphors. Cognitive Linguistics researchers draw upon individual embodied experience for primary metaphors. Socioculturally embodied experience through music has long furnished linguistic expressions in diverse languages, as conceptual metaphors or everyday expressions.  Can a socially embodied experience function in the same way as an individually embodied experience in the creation of conceptual metaphors? The authors argue that since music is inherently social and embodied, musical experiences function as a richly motivated source domain. The focus of this study is socially embodied musical experience which is then reflected and expressed through metaphors. This cross-linguistic study explores music as a source domain for metaphors of social alignment in English, French, and Chinese. The authors explored two public discourse sites, Facebook and Linguée, in order to collect linguistic metaphors from three different languages. By conducting this cross-linguistic study, cross-cultural similarities and differences in metaphors for which music is the source domain can be examined. Different musical elements, such as melody, speed, rhythm and harmony, are analyzed for their possible metaphoric meanings of social alignment. Our findings suggest that the general metaphor cooperation is music is a productive metaphor with some subcases, and that correlated social behaviors can be metaphorically expressed with certain elements in music. For example, since performance is a subset of the category behavior, there is a natural mapping from performance in music to behavior in social settings: social alignment is musical performance. Musical performance entails a collective social expectation that exerts control over individual behavior.  When individual behavior does not align with the collective social expectation, music-related expressions are often used to express how the individual is violating social norms. Moreover, when individuals do align their behavior with social norms, similar musical expressions are used. Cooperation is a crucial social value in all cultures, indeed it is a key element of survival, and music provides a coherent, consistent, and rich source domain—one based upon a universal and definitive cultural practice.

Keywords: Chinese, Conceptual Metaphor Theory, cross-linguistic, culturally embodied experience, English, French, metaphor, music

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Authors: Tamadu Perry Egedegu

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Rapid growth in the use of electronic data has affected both the employee and work place. Our experience shows that jobs that have multiple risk factors have a greater likelihood of causing Work Related Musculoskeletal Disorder (WRMSDs), depending on the duration, frequency and/or magnitude of exposure to each. The study investigated musculoskeletal disorder among office workers. Thus, it is important that ergonomic risk factors be considered in light of their combined effect in causing or contributing to WRMSDs. Fast technological growth in the use of electronic system; have affected both workers and the work environment. Awkward posture and long hours in front of these visual display terminals can result in work-related musculoskeletal disorders (WRMSD). The study shall contribute to the awareness creation on the causes and consequences of WRMSDs due to lack of ergonomics training. The study was conducted using an observational cross-sectional design. A sample of 109 respondents was drawn from the target population through purposive sampling method. The sources of data were both primary and secondary. Primary data were collected through questionnaires and secondary data were sourced from journals, textbooks, and internet materials. Questionnaires were the main instrument for data collection and were designed in a YES or NO format according to the study objectives. Content validity approval was used to ensure that the variables were adequately covered. The reliability of the instrument was done through test-retest method, yielding a reliability index at 0.84. The data collected from the field were analyzed with a descriptive statistics of chart, percentage and mean. The study found that the most affected body regions were the upper back, followed by the lower back, neck, wrist, shoulder and eyes, while the least affected body parts were the knee calf and the ankle. Furthermore, the prevalence of work-related 'musculoskeletal' malfunctioning was linked with long working hours (6 - 8 hrs.) per day, lack of back support on their seats, glare on the monitor, inadequate regular break, repetitive motion of the upper limbs, and wrist when using the computer. Finally, based on these findings some recommendations were made to reduce the prevalent of WRMSDs among office workers.

Keywords: work related musculoskeletal disorder, Nigeria, office computer users, ergonomic risk factor

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Authors: Babarina Maria, Andropova Margarita

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Introduction: Hypoparathyroidism (HypoPT) is a rare endocrine disorder with an estimated prevalence of 0.25 per 1000 individuals. The most common cause of HypoPT is the loss of active parathyroid tissue following thyroid or parathyroid surgery. Sometimes permanent postoperative HypoPT occures, manifested by hypocalcemia in combination with low levels of PTH during 6 months or more after surgery. Cognitive impairments in patients with hypocalcemia due to chronic HypoPT are observed, and this can lead to problems and challenges in everyday living: memory loss and impaired concentration, that may be the cause of poor compliance. Clinical case: Patient K., 66 years old, underwent thyroidectomy in 2013 (at the age of 55) because of papillary thyroid cancer T1NxMx, histopathology findings confirmed the diagnosis. 5 years after the surgery, she was followed up on an outpatient basis, TSH levelsonly were monitored, and the dose of levothyroxine was adjusted. In 2018 due to, increasing complaints include tingling and cramps in the arms and legs, memory loss, sleep disorder, fatigue, anxiety, hair loss, muscle pain, tachycardia, positive Chvostek, and Trousseau signs were diagnosed during examination, also in blood analyses: total Ca 1.86 mmol/l (2.15-2.55), Ca++ 0.96 mmol/l (1.12-1.3), P 1.55 mmol/l (0.74-1.52), Mg 0.79 mmol/l (0.66-1.07) - chronic postoperative HypoPT was diagnosed. Therapy was initiated: alfacalcidol 0.5 mcg per day, calcium carbonate 2000 mg per day, cholecalciferol 1000 IU per day, magnesium orotate 3000 mg per day. During the case follow-up, hypocalcemia, hyperphosphatemia persisted, hypercalciuria15.7 mmol/day (2.5-6.5) was diagnosed. Dietary recommendations were given because of the high content of phosphorus rich foods, and therapy was adjusted: the dose of alfacalcidol was increased to 2.5 mcg per day, and the dose of calcium carbonate was reduced to 1500 mg per day. As part of the screening for complications of hypoPT, data for cataracts, Fahr syndrome, nephrocalcinosis, and kidney stone disease were not obtained. However, HypoPT compensation was not achieved, and therefore hydrochlorothiazide 25 mg was initiated, the dose of alfacalcidol was increased to 3 mcg per day, calcium carbonate to 3000 mg per day, magnesium orotate and cholecalciferol were continued at the same doses. Therapeutic goals were achieved: calcium phosphate product <4.4 mmol2/l2, there were no episodes of hypercalcemia, twenty-four-hour urinary calcium excretion was significantly reduced. Conclusion: Timely prescription, careful explanation of drugs usage rules, and monitoring and maintaining blood and urine parameters within the target contribute to the prevention of HypoPT complications development and life-threatening events.

Keywords: hypoparathyroidism, hypocalcemia, hyperphosphatemia, hypercalciuria

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Authors: Danny Hjeij, Karine Bilodeau, Caroline Arbour

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Background: Chemotherapy infusions often lead to a cluster of co-occurring and difficult-to-treat symptoms (nausea, tingling, etc.), which may negatively impact the treatment experience at the outpatient clinic. Although several complementary approaches have shown beneficial effects for chemotherapy-induced symptom management, they are not easily implementable during chemotherapy infusion. In response to this limitation, comfort talk (CT), a simple, fast conversational method inspired by the language principles of clinical hypnosis, is known to optimize the management of symptoms related to antineoplastic treatments. However, the perception of nurses who have had to integrate this practice into their care has never been documented. Study design: A qualitative descriptive study with iterative content analysis was conducted among oncology nurses working in a chemotherapy outpatient clinic who had previous experience with CT. Semi-structured interviews were conducted by phone, using a pre-tested interview guide and a sociodemographic survey to document their perception of CT. The conceptual framework. Results: A total of six nurses (4 women, 2 men) took part in the interviews (N=6). The average age of participants was 49 years (36-61 years). Participants had an average of 24 years of experience (10-38 years) as a nurse, including 14.5 years in oncology (5-32 years). Data saturation (i.e., redundancy of words) was observed around the fifth interview. A sixth interview was conducted as confirmation. Six themes emerged: two addressing contextual and organizational obstacles at the chemotherapy outpatient clinic, and three addressing the added value of CT for oncology nursing care. Specific themes included: 1) the outpatient oncology clinic, a saturated care setting, 2) the keystones that support the integration of CT into care, 3) added value for patients, 4) a positive and rewarding experience for nurses, 5) collateral benefits, and 6) CT an approach to consider during the COVID-19 pandemic. Conclusion: For the first time, this study describes nurses' perception of the integration of CT into the care surrounding the administration of chemotherapy at the outpatient oncology clinic. In summary, contextual and organizational difficulties, as well as the lack of training, are among the main obstacles that could hinder the integration of CT in oncology. Still, the experience was reported mostly as positive. Indeed, nurses saw HC as an added value to patient care and meeting their need for holistic care. HC also appears to be beneficial for patients on several levels (for pain management in particular). Results will be used to inform future knowledge transfer activities related to CT in oncology nursing.

Keywords: cancer, chemotherapy, comfort talk, oncology nursing role

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Authors: Luis Fernando Calvo Prieto, Raul Herrero Martínez, Mónica Santamarta Llorente, Sergio Paniagua Bermejo

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The project that is presented starts from the questioning about the compartmentalization of knowledge that occurs in university higher education. There are several authors who describe the problems associated with this reality (Rodamillans, M) indicating a lack of integration of the knowledge acquired by students throughout the subjects taken in their university degree. Furthermore, this disintegration is accentuated by the enrollment system of some Faculties and/or Schools of Engineering, which allows the student to take subjects outside the recommended curricular path. This problem is accentuated in an ostentatious way when trying to find an integration between humanistic subjects and the world of experimental sciences or engineering. This abrupt separation between humanities and sciences can be observed in any study plan of Spanish degrees. Except for subjects such as economics or English, in the Faculties of Sciences and the Schools of Engineering, the absence of any humanistic content is striking. At some point it was decided that the only value to take into account when designing their study plans was “usefulness”, considering the humanities systematically useless for their training, and therefore banishing them from the study plans. forgetting the role they have on the capacity of both Leadership and Civic Humanism in our professionals of tomorrow. The teaching guides for the different subjects in the branch of science or engineering do not include any competency, not even transversal, related to leadership capacity or the need, in today's world, for social, civic and humanitarian knowledge part of the people who will offer medical, pharmaceutical, environmental, biotechnological or engineering solutions to a society that is generated thanks to more or less complex relationships based on human relationships and historical events that have occurred so far. If we want professionals who know how to deal effectively and rationally with their leadership tasks and who, in addition, find and develop an ethically civic sense and a humanistic profile in their functions and scientific tasks, we must not leave aside the importance that it has, for the themselves, know the causes, facts and consequences of key events in the history of humanity. The words of the humanist Paul Preston are well known: “he who does not know his history is condemned to repeat the mistakes of the past.” The idea, therefore, that today there can be men of science in the way that the scientists of the Renaissance were, becomes, at the very least, difficult to conceive. To think that a Leonardo da Vinci can be repeated in current times is a more than crazy idea; and although at first it may seem that the specialization of a professional is inevitable but beneficial, there are authors who consider (Sánchez Inarejos) that it has an extremely serious negative side effect: the entrenchment behind the different postulates of each area of knowledge, disdaining everything. what is foreign to it.

Keywords: STEM, higher education, social sciences, history

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Authors: Jesika A. Walker, Mohammed Aswad, Guy Lacroix, Denis Cousineau

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There is a fundamental disconnect between the experience of time passing and the chronometric units by which time is quantified. Specifically, there appears to be no relationship between the passage of time judgments (PoTJs) and verbal duration estimates at short durations (e.g., < 2000 milliseconds). When a duration is longer than several minutes, however, evidence suggests that a slower feeling of time passing is predictive of overestimation. Might the length of a task moderate the relation between PoTJs and duration estimates? Similarly, the estimation paradigm (prospective vs. retrospective) and the mental effort demanded of a task (task demand) have both been found to influence duration estimates. However, only a handful of experiments have investigated these effects for tasks of long durations, and the results have been mixed. Thus, might the length of a task also moderate the effects of the estimation paradigm and task demand on duration estimates? To investigate these questions, 273 participants performed either an easy or difficult visual and memory search task for either eight or 58 minutes, under prospective or retrospective instructions. Afterward, participants provided a duration estimate in minutes, followed by a PoTJ on a Likert scale (1 = very slow, 7 = very fast). A 2 (prospective vs. retrospective) × 2 (eight minutes vs. 58 minutes) × 2 (high vs. low difficulty) between-subjects ANOVA revealed a two-way interaction between task demand and task duration on PoTJs, p = .02. Specifically, time felt faster in the more challenging task, but only in the eight-minute condition, p < .01. Duration estimates were transformed into RATIOs (estimate/actual duration) to standardize estimates across durations. An ANOVA revealed a two-way interaction between estimation paradigm and task duration, p = .03. Specifically, participants overestimated the task more if they were given prospective instructions, but only in the eight-minute task. Surprisingly, there was no effect of task difficulty on duration estimates. Thus, the demands of a task may influence ‘feeling of time’ and ‘estimation time’ differently, contributing to the existing theory that these two forms of time judgement rely on separate underlying cognitive mechanisms. Finally, a significant main effect of task duration was found for both PoTJs and duration estimates (ps < .001). Participants underestimated the 58-minute task (m = 42.5 minutes) and overestimated the eight-minute task (m = 10.7 minutes). Yet, they reported the 58-minute task as passing significantly slower on a Likert scale (m = 2.5) compared to the eight-minute task (m = 4.1). In fact, a significant correlation was found between PoTJ and duration estimation (r = .27, p <.001). This experiment thus provides evidence for a compensatory effect at longer durations, in which people underestimate a ‘slow feeling condition and overestimate a ‘fast feeling condition. The results are discussed in relation to heuristics that might alter the relationship between these two variables when conditions range from several minutes up to almost an hour.

Keywords: duration estimates, long durations, passage of time judgements, task demands

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Authors: Olayemi Bakre

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The majoritant of the South African rural populace are directly or indirectly engaged in agricultural practices for a livelihood. However, impediments such as the climate change and inadequacy of governmental support has undermined the once thriving subsistence farming communities of South Africa. Furthermore, the poor leadership in hydrology, coupled with lack of depths in skills to facilitate the understanding and acceptance of groundwater from national level to local governance has made it near impossible for subsistence farmers to optimally benefit from the groundwater beneath their feet. The 2012 drought experienced in South Africa paralysed the farming activities across several subsistence farming communities across the KwaZulu-Natal Province. To revamp subsistence farming, a variety of interventions and strategies such as the Resource Poor Farmers (RPF) and Water Allocation Reforms (WAR) have been launched by the Department of Water and Sanitation (DWS) as an agendum to galvanising the defunct subsistence farming communities of KwaZulu-Natal as well as other subsistence farming communities across South Africa. Despite the enormous resources expended on the subsistence farming communities whom often fall under the Historically Disadvantaged Individuals (HDI); indicators such as the unsustainable farming practices, poor crop yield, pitiable living condition as well as the poor standard of living, are evidential to the claim that these afore cited interventions and a host of other similar strategies indicates that these initiatives have not yield the desired result. Thus, this paper seeks to suggest practicable interventions aimed at salvaging the vulnerability of subsistence farmers within the province understudy. The study pursued a qualitative approach as the view of experts on ground water and similarly related fields from the DWS were solicited as an agendum to obtaining in-depth perspective into the current study. Some of the core challenges undermining the sustainability and growth of subsistence farming in the area of study were - inadequacy of experts (engineers, scientist, researchers) in ground water; water shortages; lack of political will as well as lack of coordination among stakeholders. As an agendum to optimising the ground water usage for subsistence farming, this paper advocates the strengthening of geohydrological skills, development of technical training capacity, interactive participation among stakeholders as well as the initiation of Participatory Action Research as an agenda to optimising the available ground water in KwaZulu-Natal which is intended to orchestrate a sustainable and viable subsistence farming practice within the province.

Keywords: subsistence farming, ground water optimisation, resource poor farmers, and water allocation reforms, hydrology

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Authors: Joel Thomas, Alexa Squirini

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The key argument of this research is that every element of systems interoperability is an enabler of regional disaster resilience, and arguably should become a focal point for standardized measurement of communities’ ability to work together. Few resilience research efforts have focused on the development and application of solutions that measurably improve communities’ ability to work together at a regional level, yet a majority of the most devastating and disruptive disasters are those that have had a regional impact. The key findings of the research include a unique theoretical, mathematical, and operational approach to tangibly and defensibly measure and assess systems interoperability required to support crisis information management activities performed by governments, the private sector, and humanitarian organizations. A most effective way for communities to measurably improve regional disaster resilience is through deliberately executed disaster preparedness activities. Developing interoperable crisis information management capabilities is a crosscutting preparedness activity that greatly affects a community’s readiness and ability to work together in times of crisis. Thus, improving communities’ human and technical posture to work together in advance of a crisis, with the ultimate goal of enabling information sharing to support coordination and the careful management of available resources, is a primary means by which communities may improve regional disaster resilience. This model describes how systems interoperability can be qualitatively and quantitatively assessed when characterized as five forms of capital: governance; standard operating procedures; technology; training and exercises; and usage. The unique measurement framework presented defines the relationships between systems interoperability, information sharing and safeguarding, operational coordination, community preparedness and regional disaster resilience, and offers a means by which to implement real-world solutions and measure progress over the course of a multi-year program. The model is being developed and piloted in partnership with the U.S. Department of Homeland Security (DHS) Science and Technology Directorate (S&T) and the North Atlantic Treaty Organization (NATO) Advanced Regional Civil Emergency Coordination Pilot (ARCECP) with twenty-three organizations in Bosnia and Herzegovina, Croatia, Macedonia, and Montenegro. The intended effect of the model implementation is to enable communities to answer two key questions: 'Have we measurably improved crisis information management capabilities as a result of this effort?' and, 'As a result, are we more resilient?'

Keywords: disaster, interoperability, measurement, resilience

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Authors: Mahshid Arabi

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With the rapid expansion of digital technologies and the internet, information security has become a critical priority for organizations and individuals. The widespread use of digital tools such as smartphones and internet networks facilitates the storage of vast amounts of data, but simultaneously, vulnerabilities and security threats have significantly increased. The aim of this study is to examine and analyze modern methods of information security management and to develop a comprehensive model to counteract threats and information misuse. This study employs a mixed-methods approach, including both qualitative and quantitative analyses. Initially, a systematic review of previous articles and research in the field of information security was conducted. Then, using the Delphi method, interviews with 30 information security experts were conducted to gather their insights on security challenges and solutions. Based on the results of these interviews, a comprehensive model for information security management was developed. The proposed model includes advanced encryption techniques, machine learning-based intrusion detection systems, and network security protocols. AES and RSA encryption algorithms were used for data protection, and machine learning models such as Random Forest and Neural Networks were utilized for intrusion detection. Statistical analyses were performed using SPSS software. To evaluate the effectiveness of the proposed model, T-Test and ANOVA statistical tests were employed, and results were measured using accuracy, sensitivity, and specificity indicators of the models. Additionally, multiple regression analysis was conducted to examine the impact of various variables on information security. The findings of this study indicate that the comprehensive proposed model reduced cyber-attacks by an average of 85%. Statistical analysis showed that the combined use of encryption techniques and intrusion detection systems significantly improves information security. Based on the obtained results, it is recommended that organizations continuously update their information security systems and use a combination of multiple security methods to protect their data. Additionally, educating employees and raising public awareness about information security can serve as an effective tool in reducing security risks. This research demonstrates that effective and up-to-date information security management requires a comprehensive and coordinated approach, including the development and implementation of advanced techniques and continuous training of human resources.

Keywords: data protection, digital technologies, information security, modern management

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Authors: Wing Mui Winnie So, Tian Luo, Zeyu Han

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To fully explore and develop the potentials of gifted students systematically and strategically by providing them with opportunities to receive education at appropriate levels, schools in Hong Kong are encouraged to adopt the "Three-Tier Implementation Model" to plan and implement the school-based gifted education, with Level Three refers to the provision of learning opportunities for the exceptionally gifted students in the form of specialist training outside the school setting by post-secondary institutions, non-government organisations, professional bodies and technology enterprises. Due to the growing concern worldwide about low interest among students in pursuing STEM (Science, Technology, Engineering, and Mathematics) careers, cultivating and boosting STEM career interest has been an emerging research focus worldwide. Although numerous studies have explored its critical contributors, little research has examined the effectiveness of comprehensive interventions such as “Studying with STEM professional”. This study aims to examine the effect on gifted students’ career interest during their participation in an off-school support programme designed and supervised by a team of STEM educators and STEM professionals from a university. Gifted students were provided opportunities and tasks to experience STEM career topics that are not included in the school syllabus, and to experience how to think and work like a STEM professional in their learning. Participants involved 40 primary school students joining the intervention programme outside the normal school setting. Research methods included adopting the STEM career interest survey and drawing tasks supplemented with writing before and after the programme, as well as interviews before the end of the programme. The semi-structured interviews focused on students’ views regarding STEM professionals; what’s it like to learn with a STEM professional; what’s it like to work and think like a STEM professional; and students’ STEM identity and career interest. The changes in gifted students’ STEM career interest and its well-recognised significant contributors, for example, STEM stereotypes, self-efficacy for STEM activities, and STEM outcome expectation, were collectively examined from the pre- and post-survey using T-test. Thematic analysis was conducted for the interview records to explore how studying with STEM professional intervention can help students understand STEM careers; build STEM identity; as well as how to think and work like a STEM professional. Results indicated a significant difference in STEM career interest before and after the intervention. The influencing mechanism was also identified from the measurement of the related contributors and the analysis of drawings and interviews. The potential of off-school support programme supervised by STEM educators and professionals to develop gifted students’ STEM career interest is argued to be further unleashed in future research and practice.

Keywords: gifted students, STEM career, STEM education, STEM professionals

Procedia PDF Downloads 55

Authors: T. Poppendieker

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A new innovative tool for self-myofascial release is widely and increasingly used among athletes of various sports. The application of the foam roll is suggested to improve muscle performance and flexibility. Attempts to examine acute and somewhat long term effects of either have been conducted over the past ten years. However, the results of muscle performance have been inconsistent. It is suggested that regular use over a long period of time results in a different, muscle performance improving outcome. This study examines long-term effects of regular foam rolling combined with a short plyometric routine vs. solely the same plyometric routine on muscle performance and flexibility over a period of six weeks. Results of counter movement jump (CMJ), squat jump (SJ), and isometric maximal force (IMF) of a 90° horizontal squat in a leg-press will serve as parameters for muscle performance. Data on the range of motion (ROM) of the sit and reach test will be used as a parameter for the flexibility assessment. Muscle activation will be measured throughout all tests. Twenty male and twenty female members of a Frankfurt area fitness center chain (7.11) with an average age of 25 years will be recruited. Women and men will be randomly assigned to a foam roll (FR) and a control group. All participants will practice their assigned routine three times a week over the period of six weeks. Tests on CMJ, SJ, IMF, and ROM will be taken before and after the intervention period. The statistic software program SPSS 22 will be used to analyze the data of CMJ, SJ, IMF, and ROM under consideration of muscle activation by a 2 x 2 x 2 (time of measurement x gender x group) analysis of variance with repeated measures and dependent t-test analysis of pre- and post-test. The alpha level for statistic significance will be set at p ≤ 0.05. It is hypothesized that a significant difference in outcome based on gender differences in all four tests will be observed. It is further hypothesized that both groups may show significant improvements in their performance in the CMJ and SJ after the six-week period. However, the FR group is hypothesized to achieve a higher improvement in the two jump tests. Moreover, the FR group may increase IMF as well as flexibility, whereas the control group may not show likewise progress. The results of this study are crucial for the understanding of long-term effects of regular foam roll application. The collected information on the matter may help to motivate the incorporation of foam rolling into training routines, in order to improve athletic performances.

Keywords: counter movement jump, foam rolling, isometric maximal force, long term effects, self-myofascial release, squat jump

Procedia PDF Downloads 274

Authors: Sandra Figueiredo, Alexandra Pereira, Ana Oliveira, Idia Brito, Ivaniltan Jones, Joana Moreira, Madalena Silva, Maria Paraíba, Milene Silva, Tânia Pinho

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In the present society, we are facing behaviours mainly in young individuals that might be considered trends of culture or psychopathology. Both contexts are challenges for Education, Psychology and Health. This paper examines nine case studies specifically in Educational Psychology with the main goal to identify and define phenomena contexts in school culture, the psychopathology involved and to present a psychological intervention for each case. The research was conducted by university students in the period of March 2017-June 2017, in Portugal, and the childhood was focused. The case studies explored the cyberbullying; the bullying - victims and bullies’ perspectives; the obsessive compulsive disorder; perception and inclusion of children from homoparental families; inclusion of foreign students in the higher education system; blindness and the inclusion in physical curricular activities; influence of doc-reality and media in attitudes and self-esteem; and the morningness and eveningness types learning in the same school timetables. The university students were supervised during their research analysis and two methods were available for the intervention research study: the meta-analysis and the empirical study. In the second phase, the pedagogical intervention was designed for the different educational contexts in analysis, especially concerning the school environments. The evidence of literature and the empirical studies showed new trends of school’ behaviours and educational disturbances that require further research and effective (and adequate to age, gender, nationality and culture) pedagogical instruments. Respecting the instruments, on the one hand, to identify behaviors, habits or pathologies and highlight the role and training of teachers, psychologists and health professionals, on the other hand, to promote the early intervention and to enhance healthy child development and orientation of the families. To respond to both milestones, this paper present nine pedagogical techniques and measures that will be discussed on their impact concerning advances for the psychological and educational intervention, centered in the individual and in the new generations of family’ cultures.

Keywords: behaviour, culture trends, educational intervention, psychopathology, obsessive compulsive disorder, cyberbullying, bullying, homoparental families, sleep influence, blindness and sports at school, inclusion of foreign students, media influence in behaviour

Procedia PDF Downloads 193

Authors: R. Tariq, R. Lee

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Background: Additional demands placed on senior clinical teams with ongoing COVID-19 management has accelerated the need to harness the wider healthcare professional resources and upskill them to take on greater clinical responsibility safely. The UK NHS Long Term Plan (2019)¹ emphasises the importance of expanding Advanced Practitioners’ (APs) roles to take on more clinical diagnostic responsibilities to cope with increased demand. In acute settings, APs are often the first point of care for patients and require training to take on initial triage responsibilities efficiently and safely. Critically, their roles include determining which onward services the patients may require, and assessing whether they can be treated at home, avoiding unnecessary admissions to the hospital. Dem Dx is a Clinical Reasoning Platform (CRP) that claims to help frontline healthcare professionals independently assess and triage patients. It guides the clinician from presenting complaints through associated symptoms to a running list of differential diagnoses, media, national and institutional guidelines. The objective of this study was to compare the clinical referral rates and guidelines adherence registered by the HMR Urgent Community Care Team (UCCT)² and Dem Dx recommendations using retrospective cases. Methodology: 192 cases seen by the UCCT were anonymised and reassessed using Dem Dx clinical pathways. We compared the UCCT’s performance with Dem Dx regarding the appropriateness of onward referrals. We also compared the clinical assessment regarding adherence to NICE guidelines recorded on the clinical notes and the presence of suitable guidance in each case. The cases were audited by two medical doctors. Results: Dem Dx demonstrated appropriate referrals in 85% of cases, compared to 47% in the UCCT team (p<0.001). Of particular note, Dem Dx demonstrated an almost 65% (p<0.001) improvement in the efficacy and appropriateness of referrals in a highly experienced clinical team. The effectiveness of Dem Dx is in part attributable to the relevant NICE and local guidelines found within the platform's pathways and was found to be suitable in 86% of cases. Conclusion: This study highlights the potential of clinical decision support, as Dem Dx, to improve the quality of onward clinical referrals delivered by a multidisciplinary team in primary care. It demonstrated that it could support healthcare professionals in making appropriate referrals, especially those that may be overlooked by providing suitable clinical guidelines directly embedded into cases and clear referral pathways. Further evaluation in the clinical setting has been planned to confirm those assumptions in a prospective study.

Keywords: advanced practitioner, clinical reasoning, clinical decision-making, management, multidisciplinary team, referrals, triage

Procedia PDF Downloads 129

Authors: Henda Gnakate Biba, Ndassa Mouafon Issa

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Dictionaries modeled on the Western model [tonic accent languages] are not suitable and do not account for tonal languages phonologically, which is why the [prosodic and phonological] ethnographic dictionary was designed. It is a glossary that expresses the tones and the rhythm of words. It recreates exactly the speaking or singing of a tonal language, and allows the non-speaker of this language to pronounce the words as if they were a native. It is a dictionary adapted to tonal languages. It was built from ethnomusicological theorems and phonological processes, according to Jean. J. Rousseau 1776 hypothesis /To say and to sing were once the same thing/. Each word in the French dictionary finds its corresponding language, ekaη. And each word ekaη is written on a musical staff. This ethnographic dictionary is also an inventive, original and innovative research thesis, but it is also an inventive, original and innovative research thesis. A contribution to the theoretical, musicological, ethno musicological and linguistic conceptualization of languages, giving rise to the practice of interlocution between the social and cognitive sciences, the activities of artistic creation and the question of modeling in the human sciences: mathematics, computer science, translation automation and artificial intelligence. When you apply this theory to any text of a folksong of a world-tone language, you do not only piece together the exact melody, rhythm, and harmonies of that song as if you knew it in advance but also the exact speaking of this language. The author believes that the issue of the disappearance of tonal languages and their preservation has been structurally resolved, as well as one of the greatest cultural equations related to the composition and creation of tonal, polytonal and random music. The experimentation confirming the theorization designed a semi-digital, semi-analog application which translates the tonal languages of Africa (about 2,100 languages) into blues, jazz, world music, polyphonic music, tonal and anatonal music and deterministic and random music). To test this application, I use a music reading and writing software that allows me to collect the data extracted from my mother tongue, which is already modeled in the musical staves saved in the ethnographic (semiotic) dictionary for automatic translation ( volume 2 of the book). Translation is done (from writing to writing, from writing to speech and from writing to music). Mode of operation: you type a text on your computer, a structured song (chorus-verse), and you command the machine a melody of blues, jazz and, world music or, variety etc. The software runs, giving you the option to choose harmonies, and then you select your melody.

Keywords: music, language, entenglement, science, research

Procedia PDF Downloads 44

Authors: Gulnaz Erkomaishvili

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Introduction: The paper assesses the impact of the COVID-19 pandemic on the activities of small and medium-sized enterprises in Georgia, identifies their problems, and analyzes the state economic policy measures. During the pandemic, entrepreneurs named the imposition of restrictions, access to financial resources, shortage of qualified personnel, high tax rates, unhealthy competition in the market, etc. as the main challenges. The Georgian government has had to take special measures to mitigate the crisis impact caused by the pandemic. For example - in 2020, they mobilized more than 1,6 billion Gel for various eventsto support entrepreneurs. Small and medium-sized entrepreneurship development strategy is presented based on the research; Corresponding conclusions are made, and recommendations are developed. Objectives: The object of research is small and medium-sized enterprises and economic-political decisions aimed at their promotion.Methodology: This paper uses general and specific methods, in particular, analysis, synthesis, induction, deduction, scientific abstraction, comparative and statistical methods, as well as experts’ evaluation. In-depth interviews with experts were conducted to determine quantitative and qualitative indicators; Publications of the National Statistics Office of Georgia are used to determine the regularity between analytical and statistical estimations. Also, theoretical and applied research of international organizations and scientist-economists are used. Contributions: The COVID-19pandemic has had a significant impact on small and medium-sized enterprises. For them, Lockdown is a major challenge. Total sales volume decreased. At the same time, the innovative capabilities of enterprises and the volume of sales in remote channels have increased. As for the assessment of state support measures by small and medium-sizedentrepreneurs, despite the existence of support programs, a large number of entrepreneurs still do not evaluate the measures taken by the state positively. Among the desirable measures to be taken by the state, which would improve the activities of small and medium-sized entrepreneurs, who negatively or largely negatively assessed the activity of the state, named: tax incentives/exemption from certain taxes at the initial stage; Need for periodic trainings/organization of digital technologies, marketing training courses to improve the qualification of employees; Logic and adequacy of criteria when awarding grants and funding; Facilitating the finding of investors; Less bureaucracy, etc.

Keywords: small and medium enterprises, small and medium entrepreneurship, economic policy for small and medium entrepreneurship development, government regulations in Georgia, COVID-19 pandemic

Procedia PDF Downloads 135

Authors: Atucungwiire Rwebiita

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Introduction: In Uganda, provision of adolescent sexual reproductive health and rights (SRHR) services for key population is still hindered by negative attitudes, stigma and discrimination (S&D) at both the community and facility levels. To address this barrier, Integrated Community Based Initiatives (ICOBI) with support from SIDA is currently implementing a quality improvement (QI) innovative approach for strengthening the capacity of key population (KP) peer leaders and health workers to deliver friendly SRHR services without S&D. Methods: Our innovative approach involves continuous mentorship and coaching of 8 QI teams at 8 health facilities and their catchment areas. Each of the 8 teams (comprised of 5 health workers and 5 KP peer leaders) are facilitated twice a month by two QI Mentors in a 2-hour mentorship session over a period of 4 months. The QI mentors were provided a 2-weeks training on QI approaches for reducing S&D against young key populations in the delivery of SRHR Services. The mentorship sessions are guided by a manual where teams base to analyse root causes of S&D and develop key performance indicators (KPIs) in the 1st and 2nd second sessions respectively. The teams then develop action plans in the 3rd session and review implementation progress on KPIs at the end of subsequent sessions. The KPIs capture information on the attitude of health workers and peer leaders and the general service delivery setting as well as clients’ experience. A dashboard is developed to routinely track the KPIs for S&D across all the supported health facilities and catchment areas. After 4 months, QI teams share documented QI best practices and tested change packages on S&D in a learning and exchange session involving all the teams. Findings: The implementation of this approach is showing positive results. So far, QI teams have already identified the root causes of S&D against key populations including: poor information among health workers, fear of a perceived risk of infection, perceived links between HIV and disreputable behaviour. Others are perceptions that HIV & STIs are divine punishment, sex work and homosexuality are against religion and cultural values. They have also noted the perception that MSM are mentally sick and a danger to everyone. Eight QI teams have developed action plans to address the root causes of S&D. Conclusion: This approach is promising, offers a novel and scalable means to implement stigma-reduction interventions in facility and community settings.

Keywords: key populations, sexual reproductive health and rights, stigma and discrimination , quality improvement approach

Procedia PDF Downloads 146

Authors: Juan Li, Hui Tian, Min Wang

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In China, under the considerable pressure of 'Gaokao' –the highly competitive college entrance examination, high school teachers and parents often worry that doing physical activity would take away the students’ precious study time and may have a negative impact on the academic grades. There was a tendency to achieve high academic scores at the cost of physical exercise. Therefore, the purpose of this study was to examine the relationship between the physical fitness and academic achievement of Chinese high school students. The participants were 968 grade one (N=457) and grade two students (N=511) with an average age of 16 years from three high schools of different levels in Beijing, China. 479 were boys, and 489 were girls. One of the schools is a top high school in China, another is a key high school in Beijing, and the other is an ordinary high school. All analyses were weighted using SAS 9.4 to ensure the representatives of the sample. The weights were based on 12 strata of schools, sex, and grades. Physical fitness data were collected using the scores of the National Physical Fitness Test, which is an annual official test administered by the Ministry of Education in China. It includes 50m run, sits and reach test, standing long jump, 1000m run (for boys), 800m run (for girls), pull-ups for 1 minute (for boys), and bent-knee sit-ups for 1 minute (for girls). The test is an overall evaluation of the students’ physical health on the major indexes of strength, endurance, flexibility, and cardiorespiratory function. Academic scores were obtained from the three schools with the students’ consent. The statistical analysis was conducted with SPSS 24. Independent-Samples T-test was used to examine the gender group differences. Spearman’s Rho bivariate correlation was adopted to test for associations between physical test results and academic performance. Statistical significance was set at p<.05. The study found that girls obtained higher fitness scores than boys (p=.000). The girls’ physical fitness test scores were positively associated with the total academic grades (rs=.103, p=.029), English (rs=.096, p=.042), physics (rs=.202, p=.000) and chemistry scores (rs=.131, p=.009). No significant relationship was observed in boys. Cardiorespiratory fitness had a positive association with physics (rs=.196, p=.000) and biology scores (rs=.168, p=.023) in girls, and with English score in boys (rs=.104, p=.029). A possible explanation for the greater association between physical fitness and academic achievement in girls rather than boys was that girls showed stronger motivation in achieving high scores in whether academic tests or fitness tests. More driven by the test results, girls probably tended to invest more time and energy in training for the fitness test. Higher fitness levels were associated with an academic benefit among girls generally in Chinese high schools. Therefore, physical fitness needs to be given greater emphasis among Chinese adolescents and gender differences need to be taken into consideration.

Keywords: physical fitness; adolescents; academic achievement; high school

Procedia PDF Downloads 108

Authors: Meera Tandan, Mohan Timilsina, Martin Cormican, Akke Vellinga

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Background: In general practice, many infections are treated empirically without microbiological confirmation. Understanding susceptibility of antimicrobials during empirical prescribing can be helpful to reduce inappropriate prescribing. This study aims to apply a prediction model using a decision tree approach to predict the antimicrobial resistance (AMR) of urinary tract infections (UTI) based on non-clinical features of patients over 65 years. Decision tree models are a novel idea to predict the outcome of AMR at an initial stage. Method: Data was extracted from the database of the microbiological laboratory of the University Hospitals Galway on all antimicrobial susceptibility testing (AST) of urine specimens from patients over the age of 65 from January 2011 to December 2014. The primary endpoint was resistance to common antimicrobials (Nitrofurantoin, trimethoprim, ciprofloxacin, co-amoxiclav and amoxicillin) used to treat UTI. A classification and regression tree (CART) model was generated with the outcome ‘resistant infection’. The importance of each predictor (the number of previous samples, age, gender, location (nursing home, hospital, community) and causative agent) on antimicrobial resistance was estimated. Sensitivity, specificity, negative predictive (NPV) and positive predictive (PPV) values were used to evaluate the performance of the model. Seventy-five percent (75%) of the data were used as a training set and validation of the model was performed with the remaining 25% of the dataset. Results: A total of 9805 UTI patients over 65 years had their urine sample submitted for AST at least once over the four years. E.coli, Klebsiella, Proteus species were the most commonly identified pathogens among the UTI patients without catheter whereas Sertia, Staphylococcus aureus; Enterobacter was common with the catheter. The validated CART model shows slight differences in the sensitivity, specificity, PPV and NPV in between the models with and without the causative organisms. The sensitivity, specificity, PPV and NPV for the model with non-clinical predictors was between 74% and 88% depending on the antimicrobial. Conclusion: The CART models developed using non-clinical predictors have good performance when predicting antimicrobial resistance. These models predict which antimicrobial may be the most appropriate based on non-clinical factors. Other CART models, prospective data collection and validation and an increasing number of non-clinical factors will improve model performance. The presented model provides an alternative approach to decision making on antimicrobial prescribing for UTIs in older patients.

Keywords: antimicrobial resistance, urinary tract infection, prediction, decision tree

Procedia PDF Downloads 234

Authors: Tianjie Zhang, Bingqian Cheng, Peng Zeng

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Engineering science and technology progress and innovation have become an important engine to promote social development. The reform exploration of "new engineering" in China has drawn extensive attention around the world, with its connotation as "to cultivate future diversified, innovative and outstanding engineering talents by taking ‘fostering character and civic virtue’ as the guide, responding to changes and shaping the future as the construction concept, and inheritance and innovation, crossover and fusion, coordination and sharing as the principal approach". In this context, Tianjin University, as a traditional Chinese university with advantages in engineering, further launched the CCII (Coherent-Collaborative-Interdisciplinary-Innovation) program, raising the cultivation idea of integrating new liberal arts education, multidisciplinary engineering education and personalized professional education. As urban planning practice in China has undergone the evolution of "physical planning -- comprehensive strategic planning -- resource management-oriented planning", planning education has also experienced the transmutation process of "building foundation -- urban scientific foundation -- multi-disciplinary integration". As a characteristic and advantageous discipline of Tianjin University, the major of Urban and Rural Planning, in accordance with the "CCII Program of Tianjin University", aims to build China's top and world-class major, and implements the following educational reform measures: 1. Adding corresponding English courses, such as advanced course on GIS Analysis, courses on comparative studies in international planning involving ecological resources and the sociology of the humanities, etc. 2. Holding "Academician Forum", inviting international academicians to give lectures or seminars to track international frontier scientific research issues. 3. Organizing "International Joint Workshop" to provide students with international exchange and design practice platform. 4. Setting up a business practice base, so that students can find problems from practice and solve them in an innovative way. Through these measures, the Urban and Rural Planning major of Tianjin University has formed a talent training system with multi-disciplinary cross integration and orienting to the future science and technology.

Keywords: China, higher education reform, innovation, new engineering education, rural and urban planning, Tianjin University

Procedia PDF Downloads 104

Authors: Sara De Pelsmaeker, Catarina Ferreira da Silva, Janne Prawit

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Recent studies show that enzymatically hydrolysed collagen is absorbed and distributed to joint tissues, where it has analgesic and active anti-inflammatory properties. Reviews of the associated relevant literature also support this theory. However, these studies are all using hydrolyzed collagen from animal hide or skin. This study looks into the effect of daily supplementation of hydrolyzed cartilage collagen (HCC), which has a different composition. A consumer study was set up using a double-blind placebo-controlled design with a control group using twice a day 0.5gr of maltodextrin and an experimental group using twice 0.5g of HCC, over a trial period of 12 weeks. A follow-up phase of 4 weeks without supplementation was taken into the experiment to investigate the ‘wash-out’ phase. As this consumer study was conducted during the lockdown periods, a specific app was designed to follow up with the participants. The app had the advantage that in this way, the motivation of the participants was enhanced and the drop-out range of participants was lower than normally seen in consumer studies. Participants were recruited via various sports and health clubs across the UK as we targeted a general population of people that considered themselves in good health. Exclusion criteria were ‘not experiencing any medical conditions’ and ‘not taking any prescribed medication’. A minimum requirement was that they regularly engaged in some level of physical activity. The participants had to log the type of activity that they conducted and the duration of the activity. Weekly, participants were providing feedback on their joint health and subjective pain using the validated pain measuring instrument Visual Analogue Scale (VAS). The weekly repoAbstract Public Health and Wellbeing Conferencerting section in the app was designed with simplicity and based on the accuracy demonstrated in previous similar studies to track subjective pain measures of participants. At the beginning of the trial, each participant indicated their baseline on joint pain. The results of this consumer study indicated that HCC significantly improved joint health and subjective pain scores compared to the placebo group. No significant differences were found between different demographic groups (age or gender). The level of activity, going from high intensive training to regular walking, did not significantly influence the effect of the HCC. The results of the wash-out phase indicated that when the participants stopped the HCC supplementation, their subjective pain scores increased again to the baseline. In conclusion, the results gave a positive indication that the daily supplementation of HCC can contribute to the overall mobility and wellbeing of a general active population

Keywords: VAS-score, food supplement, mobility, joint health

Procedia PDF Downloads 144

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

The impact of metabolic syndrome (MetS) on cognition and functions of the brain is being investigated. Iron deficiency and deficiencies of B9 (folate) as well as B12 (cobalamin) vitamins are best-known nutritional anemias. They are associated with cognitive disorders and learning difficulties. The antidepressant effects of vitamin D are known and the deficiency state affects mental functions negatively. The aim of this study is to investigate possible correlations of MetS with serum brain-derived neurotrophic factor (BDNF), iron, folate, cobalamin and vitamin D in pediatric patients. 30 children, whose age- and sex-dependent body mass index (BMI) percentiles vary between 85 and 15, 60 morbid obese children with above 99^th percentiles constituted the study population. Anthropometric measurements were taken. BMI values were calculated. Age- and sex-dependent BMI percentile values were obtained using the appropriate tables prepared by the World Health Organization (WHO). Obesity classification was performed according to WHO criteria. Those with MetS were evaluated according to MetS criteria. Serum BDNF was determined by enzyme-linked immunosorbent assay. Serum folate was analyzed by an immunoassay analyzer. Serum cobalamin concentrations were measured using electrochemiluminescence immunoassay. Vitamin D status was determined by the measurement of 25-hydroxycholecalciferol [25-hydroxy vitamin D3, 25(OH)D] using high performance liquid chromatography. Statistical evaluations were performed using SPSS for Windows, version 16. The p values less than 0.05 were accepted as statistically significant. Although statistically insignificant, lower folate and cobalamin values were found in MO children compared to those observed for children with normal BMI. For iron and BDNF values, no alterations were detected among the groups. Significantly decreased vitamin D concentrations were noted in MO children with MetS in comparison with those in children with normal BMI (p ≤ 0.05). The positive correlation observed between iron and BDNF in normal-BMI group was not found in two MO groups. In THE MetS group, the partial correlation among iron, BDNF, folate, cobalamin, vitamin D controlling for waist circumference and BMI was r = -0.501; p ≤ 0.05. None was calculated in MO and normal BMI groups. In conclusion, vitamin D should also be considered during the assessment of pediatric MetS. Waist circumference and BMI should collectively be evaluated during the evaluation of MetS in children. Within this context, BDNF appears to be a key biochemical parameter during the examination of obesity degree in terms of mental functions, cognition and learning capacity. The association observed between iron and BDNF in children with normal BMI was not detected in MO groups possibly due to development of inflammation and other obesity-related pathologies. It was suggested that this finding may contribute to mental function impairments commonly observed among obese children.

Keywords: brain-derived neurotrophic factor, iron, vitamin B9, vitamin B12, vitamin D

Procedia PDF Downloads 97

Authors: Laura Micheli, Majd Hijazi, Mahmoud Faytarouni

Abstract:

The damage reported by oil and gas industrial facilities revealed the utmost vulnerability of steel liquid storage tanks to seismic events. The failure of steel storage tanks may yield devastating and long-lasting consequences on built and natural environments, including the release of hazardous substances, uncontrolled fires, and soil contamination with hazardous materials. It is, therefore, fundamental to reliably predict the damage that steel liquid storage tanks will likely experience under future seismic hazard events. The seismic performance of steel liquid storage tanks is usually assessed using vulnerability curves obtained from the numerical simulation of a tank under different hazard scenarios. However, the computational demand of high-fidelity numerical simulation models, such as finite element models, makes the vulnerability assessment of liquid storage tanks time-consuming and often impractical. As a solution, this paper presents a surrogate model-based strategy for predicting seismic-induced damage in steel liquid storage tanks. In the proposed strategy, the surrogate model is leveraged to reduce the computational demand of time-consuming numerical simulations. To create the data set for training the surrogate model, field damage data from past earthquakes reconnaissance surveys and reports are collected. Features representative of steel liquid storage tank characteristics (e.g., diameter, height, liquid level, yielding stress) and seismic excitation parameters (e.g., peak ground acceleration, magnitude) are extracted from the field damage data. The collected data are then utilized to train a surrogate model that maps the relationship between tank characteristics, seismic hazard parameters, and seismic-induced damage via a data-driven surrogate model. Different types of surrogate algorithms, including naïve Bayes, k-nearest neighbors, decision tree, and random forest, are investigated, and results in terms of accuracy are reported. The model that yields the most accurate predictions is employed to predict future damage as a function of tank characteristics and seismic hazard intensity level. Results show that the proposed approach can be used to estimate the extent of damage in steel liquid storage tanks, where the use of data-driven surrogates represents a viable alternative to computationally expensive numerical simulation models.

Keywords: damage prediction , data-driven model, seismic performance, steel liquid storage tanks, surrogate model

Procedia PDF Downloads 128

Authors: Ndibarafinia Young Tobin, Simon Burnett

Abstract:

In spite of the benefits of implementing whole life costing technique as a valuable approach for comparing alternative building designs allowing operational cost benefits to be evaluated against any initial cost increases and also as part of procurement in the construction industry, its adoption has been relatively slow due to the lack of tangible evidence, ‘know-how’ skills and knowledge of the practice, i.e. the lack of professionals in many establishments with knowledge and training on the use of whole life costing technique, this situation is compounded by the absence of available data on whole life costing from relevant projects, lack of data collection mechanisms and so on. This has proved to be very challenging to those who showed some willingness to employ the technique in a construction project. The knowledge generated from a project can be considered as best practices learned on how to carry out tasks in a more efficient way, or some negative lessons learned which have led to losses and slowed down the progress of the project and performance. Knowledge management in whole life costing practice can enhance whole life costing analysis execution in a construction project, as lessons learned from one project can be carried on to future projects, resulting in continuous improvement, providing knowledge that can be used in the operation and maintenance phases of an assets life span. Purpose: The purpose of this paper is to report an effective approach which can be utilised in capturing knowledge in whole life costing practice in a construction project. Design/methodology/approach: An extensive literature review was first conducted on the concept of knowledge management and whole life costing. This was followed by a semi-structured interview to explore the existing and good practice knowledge management in whole life costing practice in a construction project. The data gathered from the semi-structured interview was analyzed using content analysis and used to structure an effective knowledge capturing approach. Findings: From the results obtained in the study, it shows that the practice of project review is the common method used in the capturing of knowledge and should be undertaken in an organized and accurate manner, and results should be presented in the form of instructions or in a checklist format, forming short and precise insights. The approach developed advised that irrespective of how effective the approach to knowledge capture, the absence of an environment for sharing knowledge, would render the approach ineffective. Open culture and resources are critical for providing a knowledge sharing setting, and leadership has to sustain whole life costing knowledge capture, giving full support for its implementation. The knowledge capturing approach has been evaluated by practitioners who are experts in the area of whole life costing practice. The results have indicated that the approach to knowledge capture is suitable and efficient.

Keywords: whole life costing, knowledge capture, project review, construction industry, knowledge management

Procedia PDF Downloads 246