Search results for: educational outcomes
Commenced in January 2007
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Paper Count: 6107

Search results for: educational outcomes

557 The Display of Age-Period/Age-Cohort Mortality Trends Using 1-Year Intervals Reveals Period and Cohort Effects Coincident with Major Influenza A Events

Authors: Maria Ines Azambuja

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Graphic displays of Age-Period-Cohort (APC) mortality trends generally uses data aggregated within 5 or 10-year intervals. Technology allows one to increase the amount of processed data. Displaying occurrences by 1-year intervals is a logic first step in the direction of attaining higher quality landscapes of variations in temporal occurrences. Method: 1) Comparison of UK mortality trends plotted by 10-, 5- and 1-year intervals; 2) Comparison of UK and US mortality trends (period X age and cohort X age) displayed by 1-year intervals. Source: Mortality data (period, 1x1, males, 1933-1912) uploaded from the Human Mortality Database to Excel files, where Period X Age and Cohort X Age graphics were produced. The choice of transforming age-specific trends from calendar to birth-cohort years (cohort = period – age) (instead of using cohort 1x1 data available at the HMD resource) was taken to facilitate the comparison of age-specific trends when looking across calendar-years and birth-cohorts. Yearly live births, males, 1933 to 1912 (UK) were uploaded from the HFD. Influenza references are from the literature. Results: 1) The use of 1-year intervals unveiled previously unsuspected period, cohort and interacting period x cohort effects upon all-causes mortality. 2) The UK and US figures showed variations associated with particular calendar years (1936, 1940, 1951, 1957-68, 72) and, most surprisingly, with particular birth-cohorts (1889-90 in the US, and 1900, 1918-19, 1940-41 and 1946-47, in both countries. Also, the figures showed ups and downs in age-specific trends initiated at particular birth-cohorts (1900, 1918-19 and 1947-48) or a particular calendar-year (1968, 1972, 1977-78 in the US), variations at times restricted to just a range of ages (cohort x period interacting effects). Importantly, most of the identified “scars” (period and cohort) correlates with the record of occurrences of Influenza A epidemics since the late 19th Century. Conclusions: The use of 1-year intervals to describe APC mortality trends both increases the amount of information available, thus enhancing the opportunities for patterns’ recognition, and increases our capability of interpreting those patterns by describing trends across smaller intervals of time (period or birth-cohort). The US and the UK mortality landscapes share many but not all 'scars' and distortions suggested here to be associated with influenza epidemics. Different size-effects of wars are evident, both in mortality and in fertility. But it would also be realistic to suppose that the preponderant influenza A viruses circulating in UK and US at the beginning of the 20th Century might be different and the difference to have intergenerational long-term consequences. Compared with the live births trend (UK data), birth-cohort scars clearly depend on birth-cohort sizes relatives to neighbor ones, which, if causally associated with influenza, would result from influenza-related fetal outcomes/selection. Fetal selection could introduce continuing modifications on population patterns of immune-inflammatory phenotypes that might give rise to 'epidemic constitutions' favoring the occurrence of particular diseases. Comparative analysis of mortality landscapes may help us to straight our record of past circulation of Influenza viruses and document associations between influenza recycling and fertility changes.

Keywords: age-period-cohort trends, epidemic constitution, fertility, influenza, mortality

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556 Evaluating and Supporting Student Engagement in Online Learning

Authors: Maria Hopkins

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Research on student engagement is founded on a desire to improve the quality of online instruction in both course design and delivery. A high level of student engagement is associated with a wide range of educational practices including purposeful student-faculty contact, peer to peer contact, active and collaborative learning, and positive factors such as student satisfaction, persistence, achievement, and learning. By encouraging student engagement, institutions of higher education can have a positive impact on student success that leads to retention and degree completion. The current research presents the results of an online student engagement survey which support faculty teaching practices to maximize the learning experience for online students. The ‘Indicators of Engaged Learning Online’ provide a framework that measures level of student engagement. Social constructivism and collaborative learning form the theoretical basis of the framework. Social constructivist pedagogy acknowledges the social nature of knowledge and its creation in the minds of individual learners. Some important themes that flow from social constructivism involve the importance of collaboration among instructors and students, active learning vs passive consumption of information, a learning environment that is learner and learning centered, which promotes multiple perspectives, and the use of social tools in the online environment to construct knowledge. The results of the survey indicated themes that emphasized the importance of: Interaction among peers and faculty (collaboration); Timely feedback on assignment/assessments; Faculty participation and visibility; Relevance and real-world application (in terms of assignments, activities, and assessments); and Motivation/interest (the need for faculty to motivate students especially those that may not have an interest in the coursework per se). The qualitative aspect of this student engagement study revealed what instructors did well that made students feel engaged in the course, but also what instructors did not do well, which could inform recommendations to faculty when expectations for teaching a course are reviewed. Furthermore, this research provides evidence for the connection between higher student engagement and persistence and retention in online programs, which supports our rationale for encouraging student engagement, especially in the online environment because attrition rates are higher than in the face-to-face environment.

Keywords: instructional design, learning effectiveness, online learning, student engagement

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555 On the Weightlessness of Vowel Lengthening: Insights from Arabic Dialect of Yemen and Contribution to Psychoneurolinguistics

Authors: Sadeq Al Yaari, Muhammad Alkhunayn, Montaha Al Yaari, Ayman Al Yaari, Aayah Al Yaari, Adham Al Yaari, Sajedah Al Yaari, Fatehi Eissa

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Introduction: It is well established that lengthening (longer duration) is considered one of the correlates of lexical and phrasal prominence. However, it is unexplored whether the scope of vowel lengthening in the Arabic dialect of Yemen (ADY) is differently affected by educated and/or uneducated speakers from different dialectal backgrounds. Specifically, the research aims to examine whether or not linguistic background acquired through different educational channels makes a difference in the speech of the speaker and how that is reflected in related psychoneurolinguistic impairments. Methods: For the above mentioned purpose, we conducted an articulatory experiment wherein a set of words from ADY were examined in the dialectal speech of thousand and seven hundred Yemeni educated and uneducated speakers aged 19-61 years growing up in five regions of the country: Northern, southern, eastern, western and central and were, accordingly, assigned into five dialectal groups. A seven-minute video clip was shown to the participants, who have been asked to spontaneously describe the scene they had just watched before the researchers linguistically and statistically analyzed recordings to weigh vowel lengthening in the speech of the participants. Results: The results show that vowels (monophthongs and diphthongs) are lengthened by all participants. Unexpectedly, educated and uneducated speakers from northern and central dialects lengthen vowels. Compared with uneducated speakers from the same dialect, educated speakers lengthen fewer vowels in their dialectal speech. Conclusions: These findings support the notion that extensive exposure to dialects on account of standard language can cause changes to the patterns of dialects themselves, and this can be seen in the speech of educated and uneducated speakers of these dialects. Further research is needed to clarify the phonemic distinctive features and frequency of lengthening in other open class systems (i.e., nouns, adjectives, and adverbs). Phonetic and phonological report measures are needed as well as validation of existing measures for assessing phonemic vowel length in the Arabic population in general and Arabic individuals with voice, speech, and language impairments in particular.

Keywords: vowel lengthening, Arabic dialect of Yemen, phonetics, phonology, impairment, distinctive features

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554 Survey Study of Key Motivations and Drivers for Students to Enroll in Online Programs of Study

Authors: Tina Stavredes

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Increasingly borderless learning opportunities including online learning are expanding. Singapore University of Social Science (SUSS) conducted research in February of 2017 to determine the level of consumer interest in undertaking a completely online distance learning degree program across three countries in the Asian Pacific region. The target audience was potential bachelor degree and post-degree students from Malaysia, Indonesia, and Vietnam. The results gathered were used to assess the market size and ascertain the business potential of online degree programs in Malaysia, Indonesia and Vietnam. Secondly, the results were used to determine the most receptive markets to prioritise entry and identify the most receptive student segments. In order to achieve the key outcomes, the key points of understanding were as follows: -Motivations for higher education & factors that influence the choice of institution, -Interest in online learning, -Interest in online learning from a Singapore university relative to other foreign institutions, -Key drivers and barriers of interest in online learning. An online survey was conducted from from 7th Feb 2017 to 27th Feb 2017 amongst n=600 respondents aged 21yo-45yo, who have a basic command of English, A-level qualifications and above, and who have an intent to further their education in the next 12 months. Key findings from the study regarding enrolling in an online program include the need for a marriage between intrinsic and extrinsic motivation factors and the flexibility and support offered in an online program. Overall, there was a high interest for online learning. Survey participants stated they are intrinsically motivated to learn because of their interest in the program of study and the need for extrinsic rewards including opportunities for employment or salary increment in their current job. Seven out of ten survey participants reported they are motivated to further their education and expand their knowledge to become more employable. Eight in ten claims that the feasibility of furthering their education depends on cost and maintaining a work-life balance. The top 2 programs of interest are business and information and communication technology. They describe their choice of university as a marriage of both motivational and feasibility factors including cost, choice, quality of support facilities, and the reputation of the institution. Survey participants reported flexibility as important and stated that appropriate support assures and grows their intent to enrol in an online program. Respondents also reported the importance of being able to work while studying as the main perceived advantage of online learning. Factors related to the choice of an online university emphasized the quality of support services. Despite concerns, overall there was a high interest for online learning. One in two expressed strong intent to enrol in an online programme of study. However, unfamiliarity with online learning is a concern including the concern with the lack of face-to-face interactions. Overall, the findings demonstrated an interest in online learning. A main driver was the ability to earn a recognised degree while still being able to be with the family and the ability to achieve a ‘better’ early career growth.

Keywords: distance education, student motivations, online learning, online student needs

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553 Evaluation of Sustained Improvement in Trauma Education Approaches for the College of Emergency Nursing Australasia Trauma Nursing Program

Authors: Pauline Calleja, Brooke Alexander

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In 2010 the College of Emergency Nursing Australasia (CENA) undertook sole administration of the Trauma Nursing Program (TNP) across Australia. The original TNP was developed from recommendations by the Review of Trauma and Emergency Services-Victoria. While participant and faculty feedback about the program was positive, issues were identified that were common for industry training programs in Australia. These issues included didactic approaches, with many lectures and little interaction/activity for participants. Participants were not necessarily encouraged to undertake deep learning due to the teaching and learning principles underpinning the course, and thus participants described having to learn by rote, and only gain a surface understanding of principles that were not always applied to their working context. In Australia, a trauma or emergency nurse may work in variable contexts that impact on practice, especially where resources influence scope and capacity of hospitals to provide trauma care. In 2011, a program review was undertaken resulting in major changes to the curriculum, teaching, learning and assessment approaches. The aim was to improve learning including a greater emphasis on pre-program preparation for participants, the learning environment and clinically applicable contextualized outcomes participants experienced. Previously if participants wished to undertake assessment, they were given a take home examination. The assessment had poor uptake and return, and provided no rigor since assessment was not invigilated. A new assessment structure was enacted with an invigilated examination during course hours. These changes were implemented in early 2012 with great improvement in both faculty and participant satisfaction. This presentation reports on a comparison of participant evaluations collected from courses post implementation in 2012 and in 2015 to evaluate if positive changes were sustained. Methods: Descriptive statistics were applied in analyzing evaluations. Since all questions had more than 20% of cells with a count of <5, Fisher’s Exact Test was used to identify significance (p = <0.05) between groups. Results: A total of fourteen group evaluations were included in this analysis, seven CENA TNP groups from 2012 and seven from 2015 (randomly chosen). A total of 173 participant evaluations were collated (n = 81 from 2012 and 92 from 2015). All course evaluations were anonymous, and nine of the original 14 questions were applicable for this evaluation. All questions were rated by participants on a five-point Likert scale. While all items showed improvement from 2012 to 2015, significant improvement was noted in two items. These were in regard to the content being delivered in a way that met participant learning needs and satisfaction with the length and pace of the program. Evaluation of written comments supports these results. Discussion: The aim of redeveloping the CENA TNP was to improve learning and satisfaction for participants. These results demonstrate that initial improvements in 2012 were able to be maintained and in two essential areas significantly improved. Changes that increased participant engagement, support and contextualization of course materials were essential for CENA TNP evolution.

Keywords: emergency nursing education, industry training programs, teaching and learning, trauma education

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552 A Cross-Sectional Study on Clinical Self-Efficacy of Final Year School of Nursing Students among Universities of Tigray Region, Northern Ethiopia

Authors: Awole Seid, Yosef Zenebe, Hadgu Gerensea, Kebede Haile Misgina

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Background: Clinical competence is one of the ultimate goals of nursing education. Clinical skills are more than successfully performing tasks; it incorporates client assessment, identification of deficits and the ability to critically think to provide solutions. Assessment of clinical competence, particularly identifying gaps that need improvement and determining the educational needs of nursing students have great importance in nursing education. Thus this study aims determining clinical self-efficacy of final year school of nursing students in three universities of Tigray Region. Methods: A cross-sectional study was conducted on 224 final year school of nursing students from department of nursing, psychiatric nursing, and midwifery on three universities of Tigray region. Anonymous self-administered questionnaire was administered to generate data collected on June, 2017. The data were analyzed using SPSS version 20. The result is described using tables and charts as required. Logistic regression was employed to test associations. Result: The mean age of students was 22.94 + 1.44. Generally, 21% of students have been graduated in the department in which they are not interested. The study demonstrated 28.6% had poor and 71.4% had good perceived clinical self-efficacy. Beside this, 43.8% of psychiatric nursing and 32.6% of comprehensive nursing students have poor clinical self-efficacy. Among the four domains, 39.3% and 37.9% have poor clinical self- efficacy with regard to ‘Professional development’ and ‘Management of care’. Place of the institution [AOR=3.480 (1.333 - 9.088), p=0.011], interest during department selection [AOR=2.202 (1.045 - 4.642), p=.038], and theory-practice gap [AOR=0.224 (0.110 - 0.457), p=0.000] were significantly associated with perceived clinical self-efficacy. Conclusion: The magnitude of students with poor clinically self efficacy was high. Place of institution, theory-practice gap, students interest to the discipline were the significant predictors of clinical self-efficacy. Students from youngest universities have good clinical self-efficacy. During department selection, student’s interest should be respected. The universities and other stakeholders should improve the capacity of surrounding affiliate teaching hospitals to set and improve care standards in order to narrow the theory-practice gap. School faculties should provide trainings to hospital staffs and monitor standards of clinical procedures.

Keywords: clinical self-efficacy, nursing students, Tigray, northern Ethiopia

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551 Motivation and Self-Concept in Language Learning: An Exploratory Study of English Language Learners

Authors: A. van Staden, M. M. Coetzee

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Despite numerous efforts to increase the literacy level of South African learners, for example, through the implementation of educational policies such as the Revised National Curriculum statement, advocating mother-tongue instruction (during a child's formative years), in reality, the majority of South African children are still being educated in a second language (in most cases English). Moreover, despite the fact that a significant percentage of our country's budget is spent on the education sector and that both policy makers and educationalists have emphasized the importance of learning English in this globalized world, the poor overall academic performance and English literacy level of a large number of school leavers are still a major concern. As we move forward in an attempt to comprehend the nuances of English language and literacy development in our country, it is imperative to explore both extrinsic and intrinsic factors that contribute or impede the effective development of English as a second language. In the present study, the researchers set out to investigate how intrinsic factors such as motivation and self-concept contribute to or affect English language learning amongst high school learners in South Africa. Emanating from the above the main research question that guided this research is the following: Is there a significant relationship between high school learners' self-concept, motivation, and English second language performances? In order to investigate this hypothesis, this study utilized quantitative research methodology to investigate the interplay of self-concept and motivation in English language learning. For this purpose, we sampled 201 high school learners from various schools in South Africa. Methods of data gathering inter alia included the following: A biographical questionnaire; the Academic Motivational Scale and the Piers-Harris Self-Concept Scale. Pearson Product Moment Correlation Analyses yielded significant correlations between L2 learners' motivation and their English language proficiency, including demonstrating positive correlations between L2 learners' self-concept and their achievements in English. Accordingly, researchers have argued that the learning context, in which students learn English as a second language, has a crucial influence on students' motivational levels. This emphasizes the important role the teacher has to play in creating learning environments that will enhance L2 learners' motivation and improve their self-concepts.

Keywords: motivation, self-concept, language learning, English second language learners (L2)

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550 Humanitarian Storytelling through Photographs with and for Resettled Refugees in Wellington

Authors: Ehsan K. Hazaveh

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This research project explores creative methods of storytelling through photography to portray a vulnerable and marginalised community: former refugees living in Wellington, New Zealand. The project explores photographic representational techniques that can not only empower and give voice to those communities but also challenge dominant stereotypes about refugees and support humanitarian actions. The aims of this study are to develop insights surrounding issues associated with the photographic representation of refugees and to explore the collaborative construction of possible counter-narratives that might lead to the formulation of a practice framework for representing refugees using photography. In other words, the goal of this study is to explore representational and narrative strategies that frame refugees as active community members and as individuals with specific histories and expertise. These counter-narratives will bring the diversity of refugees to the surface by offering personal stories, contextualising their experience, raising awareness about the plight and human rights of the refugee community in New Zealand, evoking empathy and, therefore, facilitating the process of social change. The study has designed a photographic narrative framework by determining effective methods of photo storytelling, framing, and aesthetic techniques, focusing on different ways of taking, selecting, editing and curating photographs. Photo elicitation interviews have been used to ‘explore’, ‘produce’ and ‘co-curate’ the counter-narrative along with participants. Photo elicitation is a qualitative research method that employs images to evoke data in order to find out how other people experience their world - the researcher shows photographs to the participant and asks open-ended questions to get them to talk about their life experiences and the world around them. The qualitative data have been collected and produced through interactions with four former refugees living in Wellington, New Zealand. In this way, this project offers a unique account of their conditions and basic knowledge about their living experience and their stories. The participants of this study have engaged with PhotoVoice, a photo elicitation methodology that employs photography and storytelling, to share activities, emotions, hopes, and aspects of their lived experiences. PhotoVoice was designed to empower members of marginalised populations. It involves a series of meeting sessions, in which participants share photographs they have taken and discuss stories about the photographs to identify, represent, and enhance the issues important to their lives and communities. Finally, the data provide a basis for systematically producing visual counter-narratives that highlight the experiences of former- refugees. By employing these methods, refugees can represent their world as well as interpret it. The process of developing this research framing has enabled the development of powerful counter-narratives that challenge prevailing stereotypical depictions which in turn have the potential to shape improved humanitarian outcomes, shifts in public attitudes and political perspectives in New Zealand.

Keywords: media, photography, refugees, photo-elicitation, storytelling

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549 Harnessing Renewable Energy as a Strategy to Combating Climate Change in Sub Saharan Africa

Authors: Gideon Nyuimbe Gasu

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Sub Saharan Africa is at a critical point, experiencing rapid population growth, particularly in urban areas and young growing force. At the same time, the growing risk of catastrophic global climate change threatens to weaken food production system, increase intensity and frequency of drought, flood, and fires and undermine gains on development and poverty reduction. Although the region has the lowest per capital greenhouse gas emission level in the world, it will need to join global efforts to address climate change, including action to avoid significant increases and to encourage a green economy. Thus, there is a need for the concept of 'greening the economy' as was prescribed at Rio Summit of 1992. Renewable energy is one of the criterions to achieve this laudable goal of maintaining a green economy. There is need to address climate change while facilitating continued economic growth and social progress as energy today is critical to economic growth. Fossil fuels remain the major contributor of greenhouse gas emission. Thus, cleaner technologies such as carbon capture storage, renewable energy have emerged to be commercially competitive. This paper sets out to examine how to achieve a low carbon economy with minimal emission of carbon dioxide and other greenhouse gases which is one of the outcomes of implementing a green economy. Also, the paper examines the different renewable energy sources such as nuclear, wind, hydro, biofuel, and solar voltaic as a panacea to the looming climate change menace. Finally, the paper assesses the different renewable energy and energy efficiency as a propeller to generating new sources of income and jobs and in turn reduces carbon emission. The research shall engage qualitative, evaluative and comparative methods. The research will employ both primary and secondary sources of information. The primary sources of information shall be drawn from the sub Saharan African region and the global environmental organizations, energy legislation, policies and related industries and the judicial processes. The secondary sources will be made up of some books, journal articles, commentaries, discussions, observations, explanations, expositions, suggestions, prescriptions and other material sourced from the internet on renewable energy as a panacea to climate change. All information obtained from these sources will be subject to content analysis. The research result will show that the entire planet is warming as a result of the activities of mankind which is clear evidence that the current development is fundamentally unsustainable. Equally, the study will reveal that a low carbon development pathway in the sub Saharan African region should be embraced to minimize emission of greenhouse gases such as using renewable energy rather than coal, oil, and gas. The study concludes that until adequate strategies are devised towards the use of renewable energy the region will continue to add and worsen the current climate change menace and other adverse environmental conditions.

Keywords: carbon dioxide, climate change, legislation/law, renewable energy

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548 Self-Care and Risk Behaviors in Primary Caregiver of Cancer Patients

Authors: Ivonne N. Pérez-Sánchez. María L. Rascón- Gasca, Angélica Riveros-Rosas, Rebeca Robles García

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Introduction: Primary caregivers of cancer patients have health problems related to their lack of time, stress, and fiscal strain. Their health problems could affect their patients’ health and also increase the expenses in public health. Aim: To describe self-care and risk behaviors in a sample of Mexican primary caregiver and the relation of these behaviors with emotional distress (caregiver burden, anxiety and depression symptoms), coping and sociodemographic variables. Method: Participated in this study 173 caregivers of a third level reference medical facility (age: M=49.4, SD=13.5) females 78%, males 22%, 57.5% were caregivers of patients with terminal cancer (CPTC), and 40.5% were caregivers of patients on oncology treatment (CPOT). Results: The 75.7% of caregivers reported to have had health problem in last six months as well as several symptoms which were related to emotional distress, these symptoms were more frequently between CPTC and female caregivers. A half (47.3%) of sample reported have had difficulties in caring their health; these difficulties were related to emotional distress and lower coping, more affected caregivers were who attend male patients and CPTC. The 76.8% of caregivers had health problems in last six months, but 26.5% of them waited to search medical care until they were very sick, and 11% didn't do it. Also, more than a half of sample (56.1%) admitted to have risk behaviors as drink alcohol, smoke or overeating for feeling well, these caregivers showed high emotional distress and lower coping. About caregivers healthy behaviors, 80% of them had a hobby; 27.2% do exercise usually and between 12% to 60% did medical checkups (glucose tests, blood pressure and cholesterol tests, eye exams and watched their weight), these caregivers had lower emotional distress and high coping, some variables related health behaviors were: care only one patient or a female patient and be a CPOT, social support, high educational level and experience as a caregiver in past. The half of caregivers were worrying to develop cancer in the future; this idea was 2.5 times more frequent in caregiver with problems to care their health. Conclusions: The results showed a big proportion of caregivers with medical problems. High emotional distress and low coping were related to physical symptoms, risk behaviors, and low self-care; poor self-care was frequently even in caregiver who have chronic illness.

Keywords: cancer, primary caregiver, risk behaviors, self-care

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547 Living or Surviving in an Intercultural Context: A Study on Transformative Learning of UK Students in China and Chinese Students in the UK

Authors: Yiran Wang

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As international education continues to expand countries providing such opportunities not only benefit but also face challenges. For traditional destinations, including the United States and the United Kingdom, the number of international students has been falling. At the same time emerging economies, such as China, are witnessing a rapid increase in the number of international students enrolled in their universities. China is, therefore, beginning to play an important role in the competitive global market for higher education. This study analyses and compares the experiences of international students in the UK and China using Transformative Learning theory. While there is an extensive literature on both international higher education and also Transformative Learning theory there are currently three contributions this study makes. First, this research applies the theory to two international student groups: UK students in Chinese universities and Chinese students in UK universities.Second, this study includes a focus on the intercultural learning of Chinese doctoral students in the UK filling a gap in current research. Finally, this investigation has extended the very limited number of current research projects on UK students in China. It is generally acknowledged that international students will experience various challenges when they are in a culturally different context. Little research has focused on how, why, and why not learners are transformed through exposure to their new environment. This study applies Transformative Learning theory to address two research questions: first, do UK international students in Chinese universities and Chinese international students in UK universities experience transformational learning in/during their overseas studies? Second, what factors foster or impede international students’ experience of transformative learning? To answer the above questions, semi-structured interviews were used to investigate international students’ academic and social experiences. Based on the insights provided by Mezirow,Taylor,and previous studies on international students, this study argues that international students’ intercultural experience is a complex process.Transformation can occur in various ways and social and personal perspectives underpin the transformative learning of the students studied. Contributing factors include culture shock, educational conventions,the student’s motivation, expectations, personality, gender and previous work experience.The results reflect the significance of differences in teaching styles in the UK and China and the impact this can have on the student teaching and learning process when they move to a new university.

Keywords: intercultural learning, international higher education, transformative learning, UK and Chinese international students

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546 Categorical Metadata Encoding Schemes for Arteriovenous Fistula Blood Flow Sound Classification: Scaling Numerical Representations Leads to Improved Performance

Authors: George Zhou, Yunchan Chen, Candace Chien

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Kidney replacement therapy is the current standard of care for end-stage renal diseases. In-center or home hemodialysis remains an integral component of the therapeutic regimen. Arteriovenous fistulas (AVF) make up the vascular circuit through which blood is filtered and returned. Naturally, AVF patency determines whether adequate clearance and filtration can be achieved and directly influences clinical outcomes. Our aim was to build a deep learning model for automated AVF stenosis screening based on the sound of blood flow through the AVF. A total of 311 patients with AVF were enrolled in this study. Blood flow sounds were collected using a digital stethoscope. For each patient, blood flow sounds were collected at 6 different locations along the patient’s AVF. The 6 locations are artery, anastomosis, distal vein, middle vein, proximal vein, and venous arch. A total of 1866 sounds were collected. The blood flow sounds are labeled as “patent” (normal) or “stenotic” (abnormal). The labels are validated from concurrent ultrasound. Our dataset included 1527 “patent” and 339 “stenotic” sounds. We show that blood flow sounds vary significantly along the AVF. For example, the blood flow sound is loudest at the anastomosis site and softest at the cephalic arch. Contextualizing the sound with location metadata significantly improves classification performance. How to encode and incorporate categorical metadata is an active area of research1. Herein, we study ordinal (i.e., integer) encoding schemes. The numerical representation is concatenated to the flattened feature vector. We train a vision transformer (ViT) on spectrogram image representations of the sound and demonstrate that using scalar multiples of our integer encodings improves classification performance. Models are evaluated using a 10-fold cross-validation procedure. The baseline performance of our ViT without any location metadata achieves an AuROC and AuPRC of 0.68 ± 0.05 and 0.28 ± 0.09, respectively. Using the following encodings of Artery:0; Arch: 1; Proximal: 2; Middle: 3; Distal 4: Anastomosis: 5, the ViT achieves an AuROC and AuPRC of 0.69 ± 0.06 and 0.30 ± 0.10, respectively. Using the following encodings of Artery:0; Arch: 10; Proximal: 20; Middle: 30; Distal 40: Anastomosis: 50, the ViT achieves an AuROC and AuPRC of 0.74 ± 0.06 and 0.38 ± 0.10, respectively. Using the following encodings of Artery:0; Arch: 100; Proximal: 200; Middle: 300; Distal 400: Anastomosis: 500, the ViT achieves an AuROC and AuPRC of 0.78 ± 0.06 and 0.43 ± 0.11. respectively. Interestingly, we see that using increasing scalar multiples of our integer encoding scheme (i.e., encoding “venous arch” as 1,10,100) results in progressively improved performance. In theory, the integer values do not matter since we are optimizing the same loss function; the model can learn to increase or decrease the weights associated with location encodings and converge on the same solution. However, in the setting of limited data and computation resources, increasing the importance at initialization either leads to faster convergence or helps the model escape a local minimum.

Keywords: arteriovenous fistula, blood flow sounds, metadata encoding, deep learning

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545 The Application of Sensory Integration Techniques in Science Teaching Students with Autism

Authors: Joanna Estkowska

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The Sensory Integration Method is aimed primarily at children with learning disabilities. It can also be used as a complementary method in treatment of children with cerebral palsy, autistic, mentally handicapped, blind and deaf. Autism is holistic development disorder that manifests itself in the specific functioning of a child. The most characteristic are: disorders in communication, difficulties in social relations, rigid patterns of behavior and impairment in sensory processing. In addition to these disorders may occur abnormal intellectual development, attention deficit disorders, perceptual disorders and others. This study was focused on the application sensory integration techniques in science education of autistic students. The lack of proper sensory integration causes problems with complicated processes such as motor coordination, movement planning, visual or auditory perception, speech, writing, reading or counting. Good functioning and cooperation of proprioceptive, tactile and vestibular sense affect the child’s mastery of skills that require coordination of both sides of the body and synchronization of the cerebral hemispheres. These include, for example, all sports activities, precise manual skills such writing, as well as, reading and counting skills. All this takes place in stages. Achieving skills from the first stage determines the development of fitness from the next level. Any deficit in the scope of the first three stages can affect the development of new skills. This ultimately reflects on the achievements at school and in further professional and personal life. After careful analysis symptoms from the emotional and social spheres appear to be secondary to deficits of sensory integration. During our research, the students gained knowledge and skills in the classroom of experience by learning biology, chemistry and physics with application sensory integration techniques. Sensory integration therapy aims to teach the child an adequate response to stimuli coming to him from both the outside world and the body. Thanks to properly selected exercises, a child can improve perception and interpretation skills, motor skills, coordination of movements, attention and concentration or self-awareness, as well as social and emotional functioning.

Keywords: autism spectrum disorder, science education, sensory integration, special educational needs

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544 The Lived Experience of Caregiving as a Vulnerable Person: Preliminary Findings of an Applied Hermeneutic Phenomenology Study

Authors: Amanda Aliende da Matta

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In different fields, there are people who have something that stands out. In the educational world, for example, it is clear when some teachers have something: they are the best teachers, but this is not directly attributed to their disciplines, methodologies, etc. It is that they have something that captivates, inspires, and motivates. But we also find this something in other contexts. In this thesis, the interest is in something that some marginalized people, such as Ab (fictitious name), have. Ab was born in a rural community and saw the lifestyle of his family change drastically as a consequence of structural changes in his village. The community became impoverished, and together with a group of teenagers, he decided to migrate to Spain in search of opportunities. His best friend drowned during the crossing. After arriving, he lived in indecent conditions and felt unsafe. He now suffers from anxiety and frequently faints from it. Yet, he’s linked to Joves x la pau (a Christian project, although he is a Muslim), distributing food for people who live on the streets every Thursday afternoon. When he asked about what happens on cold and rainy days, he explained simply: "if it rains, I distribute the food, and immediately I get home, take a bath, and sleep warm under my roof. That is when we most have to go." This something he has will be called caring. And one of the general objectives of the thesis is to discover what are the meaning structures of this caring what is the lived experience of this caring. In this communication, preliminary results of an Applied Hermeneutic Phenomenology (AHP) study on the lived experience of caring as a vulnerable person are presented. The research means to answer what is the lived experience of caring as a vulnerable person. That is, to describe and explain what it is like to caregive for a vulnerable person, what it is, essentially, to caregive for a vulnerable person, what makes the lived experience of caregiving for a vulnerable person different from any other. In order to investigate the meaning of the phenomenon of caregiving as a vulnerable person, as already stated, the method used will be Applied Hermeneutic Phenomenology (AHP). We base ourselves, initially, on the proposal of Raquel Ayala-Carabajo and Max Van Manen. As Van Manen (1990) explains, AHP is a method that works essentially through fieldwork, with the collection of data on lived experience (experiential material). It is a phenomenology of practice. We here present the provisional themes we found: caregiving as a vulnerable person is seeing yourself in the other, identifying with the care-receiver; Caregiving as a vulnerable person is putting the other’s need before oneself’s; Caregiving as a vulnerable person is temporarily overcoming your weaknesses to make yourself strong for the other; Caregiving as a vulnerable person is going beyond the conventional approach; and Caregiving as a vulnerable person is taking responsibility even if it’s not yours.

Keywords: applied hermeneutic phenomenology, care ethics, hermeneutics, phenomenology

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543 Understanding the Construction of Social Enterprises in India: Through Identity and Context of Social Entrepreneurs

Authors: K. Bose

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India is one of the largest democracies in the global south, which demonstrates the highest social enterprise activities in the subcontinent. Although there has been a meteoric rise in social enterprise activities, it is not a new phenomenon, as it dates back to Vinoba Bhave's Land Gift movement in 1950. India also has a rich history of a welfare mix where non-governmental organisations played a significant role in the public welfare provision. Lately, the government’s impetus on entrepreneurship has contributed to a burgeoning social enterprise sector in the country; however, there is a lack in understanding of how social enterprises are constructed in India. Social entrepreneurship as practice has been conceptualised as a multi-dimensional concept, which is predominantly explained through the characteristics of a social entrepreneur. Social enterprise organisation, which is a component of social entrepreneurship practice are also classified through the role of the social entrepreneur; thus making social entrepreneur a vital unit shaping organisation and practice. Hence, individual identity of the social entrepreneur acts as a steering agent for defining organisation and practice. Individual identity does not operate in a vacuum and different isomorphic pressures (resource-rich actors/institutions) leads to negotiation in these identities. Dey and Teasdale's work investigated this identity work of non-profit practitioners within the practice of social enterprises in England. Furthermore, the construction of social enterprises is predominantly understood through two approaches i.e. an institutional logic perspective emerging from Europe and process and outcome perspective derived from the United States. These two approaches explain social enterprise as an inevitable institutional outcome in a linear and simplistic manner. Such linear institutional transition is inferred from structural policy reforms and austerity measures adopted by the government, which led to heightened competition for funds in the non-profit sector. These political and economic challenges were specific to the global north, which is different from transitions experienced in the global south, thus further investigation would help understand social enterprise activities as a contextual phenomenon. There is a growing interest in understanding the role of the context within the entrepreneurship literature, additionally, there is growing recognition in entrepreneurship research that economic behaviour is realised far better within its historical, temporal, institutional, spatial and social context, as these contexts provide boundaries to individuals in terms of opportunities and actions. Social enterprise phenomenon too is realised as contextual phenomenon though it differs from traditional entrepreneurship in terms of its dual mission (social and economic), however, the understanding of the role of context in social entrepreneurship has been limited. Hence, this work in progress study integrates identity work of social entrepreneur and the role of context. It investigates the identities of social entrepreneur and its negotiation within its context. Further, how this negotiated identity transcends into organisational practice in turn shaping how social enterprises are constructed in a specific region. The study employs a qualitative inquiry of semi-structured interviews and ethnographic institutionalism. Interviews were analysed using critical discourse analysis and the preliminary outcomes are currently a work in progress.

Keywords: context, Dey and Teasdale, identity, social entrepreneurs, social enterprise, social entrepreneurship

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542 Examining the Impact of De-Escalation Training among Emergency Department Nurses

Authors: Jonathan D. Recchi

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Introduction: Workplace violence is a major concern for nurses throughout the United States and is a rising occupational health hazard that has been exacerbated by both the Covid-19 pandemic and increasing patient and family member incivility. De-escalation training has been found to be an evidence-based tool for emergency department nurses to help avoid or mitigate high-risk situations that could lead to workplace violence. Many healthcare organizations either do not provide de-escalation training to their staff or only provide it sparingly, such as during new employee orientation. There is limited research in the literature on the psychological benefits of de-escalation training. Purpose: The purpose of this study is to determine if there are psychological and organizational advantages to providing emergency department nurses with de-escalation training. Equipping emergency department nurses with skills that are essential to de-escalate violent or potentially violent patients may help prevent physical, mental, and/or psychological damage to the nurse because of violence and/or threatening acts. The hypothesis is that providing de-scalation training to emergency department nurses will lead to increased nurse confidence in dealing with aggressive patients, increased resiliency, increased professional quality of life, and increased intention to stay with their current organization. This study aims to show that organizations would benefit from providing de-escalation training to all nurses operating in high-risk areas on a regular basis. Significance: Showing psychological benefits to providing evidence-based de-escalation training can provide healthcare organizations with the ability to retain a more resilient and prepared workforce. Method: This study uses a pre-experimental cross-sectional pre-/post-test design using a convenience sample of emergency department registered nurses employed across Jefferson Health Northeast (Jefferson Torresdale, Jefferson Bucks, and Jefferson Frankford. Inclusion criteria include registered nurses who work full or part-time, with 51% or more of their clinical time spent in direct clinical care. Excluded from participation are registered nurses in orientation, per-diem nurses, temporary and/or travel nurses, nurses who spend less than 51% of their time in direct patient care, and nurses who have received de-escalation training within the past two years. This study uses the Connor-Davidson Resilience Scale 10 (CD-RISC-10), the Clinician Confidence in Coping with Patient Aggression Scale, the Press Ganey Intention To Stay question, and the Professional Quality of Life Scale. Results: A Paired t-Test will be used to analyze the mean scores of the three scales and one question pre and post-intervention to determine if there is a statistically significant difference in RN resiliency, confidence in coping with patient aggression, intention to stay, and professional quality of life. Discussion and Conclusions: Upon completion, the outcomes of this intervention will show the importance of providing evidence-based de-escalation training to all nurses operating within the emergency department.

Keywords: de-escalation, nursing, emergency department, workplace violence

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541 Gender Perspective in Peace Operations: An Analysis of 14 UN Peace Operations

Authors: Maressa Aires de Proenca

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The inclusion of a gender perspective in peace operations is based on a series of conventions, treaties, and resolutions designed to protect and include women addressing gender mainstreaming. The UN Security Council recognizes that women's participation and gender equality within peace operations are indispensable for achieving sustainable development and peace. However, the participation of women in the field of peace and security is still embryonic. There are gaps when we think about female participation in conflict resolution and peace promotion spaces, and it does not seem clear how women are present in these spaces. This absence may correspond to silence about representation and the guarantee of the female perspective within the context of peace promotion. Thus, the present research aimed to describe the panorama of the participation of women who are currently active in the 14 active UN peace operations, which are: 1) MINUJUSTH, Haiti, 2) MINURSO, Western Sahara, 3) MINUSCA, Central African Republic, 4) MINUSMA, Mali, 5) MONUSCO, the Democratic Republic of the Congo, 6) UNAMID, Darfur, 7) UNDOF, Golan, 8) UNFICYP, Cyprus, 9) UNIFIL, Lebanon, 10) UNISFA, Abyei, 11) UNMIK, Kosovo, 12) UNMISS, South Sudan, 13) UNMOGIP, India, and Pakistan, and 14) UNTSO, Middle East. A database was constructed that reported: (1) position held by the woman in the peace operation, (2) her profession, (3) educational level, (4) marital status, (5) religion, (6) nationality, (8) number of years working with peace operations, (9) whether the operation in which it operates has provided training on gender issues. For the construction of this database, official reports and statistics accessed through the UN Peacekeeping Resource Hub were used; The United Nations Statistical Commission, Peacekeeping Master Open Datasets, The Armed Conflict Database (ACD), The International Institute for Strategic Studies (IISS) database; Armed Conflict Location & Event Data Project (ACLED) database; from the Evidence and Data for Gender Equality (EDGE) database. In addition to access to databases, peacekeeping operations will be contacted directly, and data requested individually. The database showed that the presence of women in these peace operations is still incipient, but growing. There are few women in command positions, and most of them occupy administrative or human-care positions.

Keywords: women, peace and security, peacekeeping operations, peace studies

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540 A Multilingual Model in the Multicultural World

Authors: Marina Petrova

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Language policy issues related to the preservation and development of the native languages of the Russian peoples and the state languages of the national republics are increasingly becoming the focus of recent attention of educators and parents, public and national figures. Is it legal to teach the national language or the mother tongue as the state language? Due to that dispute language phobia moods easily evolve into xenophobia among the population. However, a civilized, intelligent multicultural personality can only be formed if the country develops bilingualism and multilingualism, and languages as a political tool help to find ‘keys’ to sufficiently closed national communities both within a poly-ethnic state and in internal relations of multilingual countries. The purpose of this study is to design and theoretically substantiate an efficient model of language education in the innovatively developing Republic of Sakha. 800 participants from different educational institutions of Yakutia worked at developing a multilingual model of education. This investigation is of considerable practical importance because researchers could build a methodical system designed to create conditions for the formation of a cultural language personality and the development of the multilingual communicative competence of Yakut youth, necessary for communication in native, Russian and foreign languages. The selected methodology of humane-personal and competence approaches is reliable and valid. Researchers used a variety of sources of information, including access to related scientific fields (philosophy of education, sociology, humane and social pedagogy, psychology, effective psychotherapy, methods of teaching Russian, psycholinguistics, socio-cultural education, ethnoculturology, ethnopsychology). Of special note is the application of theoretical and empirical research methods, a combination of academic analysis of the problem and experienced training, positive results of experimental work, representative series, correct processing and statistical reliability of the obtained data. It ensures the validity of the investigation’s findings as well as their broad introduction into practice of life-long language education.

Keywords: intercultural communication, language policy, multilingual and multicultural education, the Sakha Republic of Yakutia

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539 Global Health Student Selected Components in Undergraduate Medical Education: Analysis of Student Feedback and Reflective Writings

Authors: Harriet Bothwell, Lowri Evans, Kevin Jones

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Background: The University of Bristol provides all medical students the opportunity to undertake student selected components (SSCs) at multiple stages of the undergraduate programme. SSCs enable students to explore areas of interest that are not necessarily covered by the curriculum. Students are required to produce a written report and most use SSCs as an opportunity to undertake an audit or small research project. In 2013 Swindon Academy, based at the Great Western Hospital, offered eight students the opportunity of a global health SSC which included a two week trip to rural hospital in Uganda. This SSC has since expanded and in 2017 a total of 20 students had the opportunity to undertake small research projects at two hospitals in rural Uganda. 'Tomorrows Doctors' highlights the importance of understanding healthcare from a 'global perspective' and student feedback from previous SSCs suggests that self-assessed knowledge of global health increases as a result of this SSC. Through the most recent version of this SSC students had the opportunity to undertake projects in a wide range of specialties including paediatrics, palliative care, surgery and medical education. Methods: An anonymous online questionnaire was made available to students following the SSC. There was a response rate of 80% representing 16 out of the 20 students. This questionnaire surveyed students’ satisfaction and experience of the SSC including the level of academic, project and spiritual support provided as well as perceived challenges in completing the project and barriers to healthcare delivery in the low resource setting. This survey had multiple open questions allowing the collection of qualitative data. Further qualitative data was collected from the students’ project report. The suggested format included a reflection and all students completed these. All qualitative data underwent thematic analysis. Results: All respondents rated the overall experience of the SSC as 'good' or 'excellent'. Preliminary data suggest that students’ confidence in their knowledge of global health, diagnosis of tropical diseases and management of tropical diseases improved after completing this SSC. Thematic analysis of students' reflection is ongoing but suggests that students gain far more than improved knowledge of tropical diseases. Students reflect positively on having the opportunity to research in a low resource setting and feel that by completing these projects they will be 'useful' to the hospital. Several students reflect the stark contrast to healthcare delivery in the UK and recognise the 'privilege' of having a healthcare system that is free at the point of access. Some students noted the different approaches that clinicians in Uganda had to train in 'taking ownership' of their own learning. Conclusions: Students completing this SSC report increased knowledge of global health and tropical medicine. However, their reflections reveal much broader learning outcomes and demonstrate considerable insight in multiple topics including conducting research in the low resource setting, training and healthcare inequality.

Keywords: global health, medical education, student feedback, undergraduate

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538 Chinese Early Childhood Parenting Style as a Moderator of the Development of Social Competence Based on Mindreading

Authors: Arkadiusz Gut, Joanna Afek

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The first issue that we discuss in this paper is a battery of research demonstrating that culture influences children’s performance in tasks testing their theory of mind, also known as mindreading. We devote special attention to research done within Chinese culture; namely, studies with children speaking Cantonese and Mandarin natively and growing up in an environment dominated by the Chinese model of informal home education. Our attention focuses on the differences in development and functioning of social abilities and competences between children from China and the West. Another matter we turn to is the description of the nature of Chinese early childhood education. We suggest that the differences between the Chinese model and that of the West reveal a set of modifiers responsible for the variation observed in empirical research on children’s theory of mind (mindreading). The modifiers we identify are the following: (1) early socialization – that is, the transformation of the child into a member of the family and society that set special value by the social and physical environment; (2) the Confucian model of education – that is, the Chinese alphabet and tradition that determine a certain way of education in China; (3) the authoritarian style of upbringing – that is, reinforcing conformism, discouraging voicing of private opinions, and respect for elders; (4) the modesty of children and protectiveness of parents – that is, obedience as a desired characteristic in the child, overprotectiveness of parents, especially mothers; and (5) gender differences – that is, different educational styles for girls and boys. In our study, we conduct a thorough meta-analysis of empirical data on the development of mindreading and ToM (children’s theory of mind), as well as a cultural analysis of early childhood education in China. We support our analyses with questionnaire and narrative studies conducted in China that use the ‘Children’s Social Understanding Scale’ questionnaire, conversations based on the so-called ‘Scenarios Presented to Parents’, and questions designed to measure the ‘my child and I’ relation. With our research we aim to identify the factors in early childhood education that serve as moderators explaining the nature of the development and functioning of social cognition based on mind reading in China. Additionally, our study provides a valuable insight for comparative research of social cognition between China and the West.

Keywords: early childhood education, China, mindreading, parenting

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537 The Effects of Aging on Visuomotor Behaviors in Reaching

Authors: Mengjiao Fan, Thomson W. L. Wong

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It is unavoidable that older adults may have to deal with aging-related motor problems. Aging is highly likely to affect motor learning and control as well. For example, older adults may suffer from poor motor function and quality of life due to age-related eye changes. These adverse changes in vision results in impairment of movement automaticity. Reaching is a fundamental component of various complex movements, which is therefore beneficial to explore the changes and adaptation in visuomotor behaviors. The current study aims to explore how aging affects visuomotor behaviors by comparing motor performance and gaze behaviors between two age groups (i.e., young and older adults). Visuomotor behaviors in reaching under providing or blocking online visual feedback (simulated visual deficiency) conditions were investigated in 60 healthy young adults (Mean age=24.49 years, SD=2.12) and 37 older adults (Mean age=70.07 years, SD=2.37) with normal or corrected-to-normal vision. Participants in each group were randomly allocated into two subgroups. Subgroup 1 was provided with online visual feedback of the hand-controlled mouse cursor. However, in subgroup 2, visual feedback was blocked to simulate visual deficiency. The experimental task required participants to complete 20 times of reaching to a target by controlling the mouse cursor on the computer screen. Among all the 20 trials, start position was upright in the center of the screen and target appeared at a randomly selected position by the tailor-made computer program. Primary outcomes of motor performance and gaze behaviours data were recorded by the EyeLink II (SR Research, Canada). The results suggested that aging seems to affect the performance of reaching tasks significantly in both visual feedback conditions. In both age groups, blocking online visual feedback of the cursor in reaching resulted in longer hand movement time (p < .001), longer reaching distance away from the target center (p<.001) and poorer reaching motor accuracy (p < .001). Concerning gaze behaviors, blocking online visual feedback increased the first fixation duration time in young adults (p<.001) but decreased it in older adults (p < .001). Besides, under the condition of providing online visual feedback of the cursor, older adults conducted a longer fixation dwell time on target throughout reaching than the young adults (p < .001) although the effect was not significant under blocking online visual feedback condition (p=.215). Therefore, the results suggested that different levels of visual feedback during movement execution can affect gaze behaviors differently in older and young adults. Differential effects by aging on visuomotor behaviors appear on two visual feedback patterns (i.e., blocking or providing online visual feedback of hand-controlled cursor in reaching). Several specific gaze behaviors among the older adults were found, which imply that blocking of visual feedback may act as a stimulus to seduce extra perceptive load in movement execution and age-related visual degeneration might further deteriorate the situation. It indeed provides us with insight for the future development of potential rehabilitative training method (e.g., well-designed errorless training) in enhancing visuomotor adaptation for our aging population in the context of improving their movement automaticity by facilitating their compensation of visual degeneration.

Keywords: aging effect, movement automaticity, reaching, visuomotor behaviors, visual degeneration

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536 Risking Injury: Exploring the Relationship between Risk Propensity and Injuries among an Australian Rules Football Team

Authors: Sarah A. Harris, Fleur L. McIntyre, Paola T. Chivers, Benjamin G. Piggott, Fiona H. Farringdon

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Australian Rules Football (ARF) is an invasion based, contact field sport with over one million participants. The contact nature of the game increases exposure to all injuries, including head trauma. Evidence suggests that both concussion and sub-concussive traumas such as head knocks may damage the brain, in particular the prefrontal cortex. The prefrontal cortex may not reach full maturity until a person is in their early twenties with males taking longer to mature than females. Repeated trauma to the pre-frontal cortex during maturation may lead to negative social, cognitive and emotional effects. It is also during this period that males exhibit high levels of risk taking behaviours. Risk propensity and the incidence of injury is an unexplored area of research. Little research has considered if the level of player’s (especially younger players) risk propensity in everyday life places them at an increased risk of injury. Hence the current study, investigated if a relationship exists between risk propensity and self-reported injuries including diagnosed concussion and head knocks, among male ARF players aged 18 to 31 years. Method: The study was conducted over 22 weeks with one West Australian Football League (WAFL) club during the 2015 competition. Pre-season risk propensity was measured using the 7-item self-report Risk Propensity Scale. Possible scores ranged from 9 to 63, with higher scores indicating higher risk propensity. Players reported their self-perceived injuries (concussion, head knocks, upper body and lower body injuries) fortnightly using the WAFL Injury Report Survey (WIRS). A unique ID code was used to ensure player anonymity, which also enabled linkage of survey responses and injury data tracking over the season. A General Linear Model (GLM) was used to analyse whether there was a relationship between risk propensity score and total number of injuries for each injury type. Results: Seventy one players (N=71) with an age range of 18.40 to 30.48 years and a mean age of 21.92 years (±2.96 years) participated in the study. Player’s mean risk propensity score was 32.73, SD ±8.38. Four hundred and ninety five (495) injuries were reported. The most frequently reported injury was head knocks representing 39.19% of total reported injuries. The GLM identified a significant relationship between risk propensity and head knocks (F=4.17, p=.046). No other injury types were significantly related to risk propensity. Discussion: A positive relationship between risk propensity and head trauma in contact sports (specifically WAFL) was discovered. Assessing player’s risk propensity therefore, may identify those more at risk of head injuries. Potentially leading to greater monitoring and education of these players throughout the season, regarding self-identification of head knocks and symptoms that may indicate trauma to the brain. This is important because many players involved in WAFL are in their late teens or early 20’s hence, may be at greater risk of negative outcomes if they experience repeated head trauma. Continued education and research into the risks associated with head injuries has the potential to improve player well-being.

Keywords: football, head injuries, injury identification, risk

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535 A Meta Analysis of the Recent Work-Related Research of BEC-Teachers in the Graduate Programs of the Selected HEIs in Region I and CAR

Authors: Sherelle Lou Sumera Icutan, Sheila P. Cayabyab, Mary Jane Laruan, Paulo V. Cenas, Agustina R. Tactay

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This study critically analyzed the recent theses and dissertations of the Basic Education Curriculum (BEC) teachers who finished their graduate programs in selected higher educational institutions in Region I and CAR to be able to come up with a unified result from the varied results of the analyzed research works. All theses and dissertations completed by the educators/teachers/school personnel in the secondary and elementary public and private schools in Region 1 and CAR from AY 2003–2004 to AY 2007–2008 were classified first–as to work or non-work related; second–as to the different aspects of the curriculum: implementation, content, instructional materials, assessment instruments, learning, teaching, and others; third–as to being eligible for meta-analysis or not. Only studies found eligible for meta-analysis were subjected to the procedure. Aside from documentary analysis, the statistical treatments used in meta-analysis include the standardized effect size, Pearson’s correlation (r), the chi-square test of homogeneity and the inverse of the Fisher transformation. This study found out that the BEC-teachers usually probe on work-related researchers with topics that are focused on the learning performances of the students and on factors related to teaching. The development of instructional materials and assessment of implemented programs are also equally explored. However, there are only few researches on content and assessment instrument. Research findings on the areas of learning and teaching are the only aspects that are meta-analyzable. The research findings across studies in Region I and CAR of BEC teachers that focused on similar variables correlated to teaching do not vary significantly. On the contrary, research findings across studies in Region I and CAR that focused on variables correlated to learning performance significantly vary. Within each region, variations on the findings of research works related to learning performance that considered similar variables still exist. The combined finding on the effect size or relationship of the variables that are correlated to learning performance are low which means that effect is small but definite while the combined findings on the relationship of the variables correlated to teaching are slight or almost negligible.

Keywords: meta-analysis, BEC teachers, work-related research,

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534 Teachers Leadership Dimension in History Learning

Authors: Lee Bih Ni, Zulfhikar Rabe, Nurul Asyikin Hassan

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The Ministry of Education Malaysia dynamically and drastically made the subject of History mandatory to be in force in 2013. This is in recognition of the nation's heritage and treasures in maintaining true facts and information for future generations of the State. History reveals the civilization of a nation and the fact of national cultural heritage. Civilization needs to be preserved as a legacy of sovereign heritage. Today's generation is the catalyst for future heirs who will support the principle and direction of the country. In line with the National Education Philosophy that aims to shape the potential development of individuals holistically and uniquely in order to produce a balanced and harmonious student in terms of intellectual, spiritual, emotional and physical. Hence, understanding the importance of studying the history subject as a pillar of identity and the history of nationhood is to be a priority in the pursuit of knowledge and empowering the spirit of statehood that is nurtured through continuous learning at school. Judging from the aspect of teacher leadership role in integrating history in a combined way based on Teacher Education Philosophy. It empowers the teaching profession towards the teacher to support noble character. It also supports progressive and scientific views. Teachers are willing to uphold the State's aspirations and celebrate the country's cultural heritage. They guarantee individual development and maintain a united, democratic, progressive and disciplined society. Teacher's role as a change and leadership agent in education begins in the classroom through formal or informal educational processes. This situation is expanded in schools, communities and countries. The focus of this paper is on the role of teacher leadership influencing the effectiveness of teaching and learning history in the classroom environment. Leadership guides to teachers' perceptions on the role of teacher leadership, teaching leadership, and the teacher leadership role and effective teacher leadership role. Discussions give emphasis on aspects of factors affecting the classroom environment, forming the classroom agenda, effective classroom implementation methods, suitable climate for historical learning and teacher challenges in implicating the effectiveness of teaching and learning processes.

Keywords: teacher leadership, leadership lessons, effective classroom, effective teacher

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533 Investigating the Role of Social Media in Supporting Parents and Teachers of Students with Down Syndrome: Focus on Early Intervention Services in the Kingdom of Saudi Arabia

Authors: Awatif Habeeb Al-Shamare

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The number of social media users amongst special education teachers and parents of children with Down Syndrome (DS) is increasing annually. This is also the case in the Kingdom of Saudi Arabia (KSA). However, according to the best of the author’s knowledge, there are no qualitative studies which testify to the true nature of the interaction between teachers and parents when using social media, nor the role of social media in supporting and assisting parents and teachers with regards to the children’s educational needs in KSA. Therefore, this ongoing study aims to identify the role of social media in supporting parents and teachers of DS students, with a special emphasis on early intervention services in KSA. By bridging the knowledge gap on social media and special education in KSA and presenting socially relevant and applied information on the topic, this research provides a theoretical and practical base for the establishment of appropriate and effective programmes between the ministries of Information and Special Education in particular. A qualitative approach was selected because it was the most suitable approach for exploring the participants’ experiences, which could not be determined through scientific tests. Interviewing, chosen as the research instrument, allowed the researcher to obtain a detailed understanding of the topic linked to the study objectives. Initially, a pilot study was conducted at the Daycare Center in May 2016. Its aim was to examine and refine the methodology and assess whether the questions were understood with the potential for re-drafting them, if necessary. The main study consists of five teachers and five mothers with experience of using social media and with links to the Daycare Center. Thematic Analysis has been chosen for analysing the findings because it is a flexible method that allows themes to emerge from the data. Results of the current study are still in the initial stages, but the preliminary findings are as follows: (1) social media is an important tool in encouraging parents and teachers to access the necessary information and knowledge about, and experience in, early intervention services; (2) it acts as a support network for the parents; (3) it helps raise awareness about DS and the need for early intervention; (4) it can be used to put pressure on the government for an expansion in early intervention services, and finally (5) its use can be problematic in that parents and teachers face some difficulties and challenges when using the different platforms. It can be concluded that social media plays a significant role in the lives of teachers and parents with special needs children in KSA.

Keywords: down syndrome, early intervention services, social media, support parents and teachers

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532 Neuroanatomical Specificity in Reporting & Diagnosing Neurolinguistic Disorders: A Functional & Ethical Primer

Authors: Ruairi J. McMillan

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Introduction: This critical analysis aims to ascertain how well neuroanatomical aetiologies are communicated within 20 case reports of aphasia. Neuroanatomical visualisations based on dissected brain specimens were produced and combined with white matter tract and vascular taxonomies of function in order to address the most consistently underreported features found within the aphasic case study reports. Together, these approaches are intended to integrate aphasiological knowledge from the past 20 years with aphasiological diagnostics, and to act as prototypal resources for both researchers and clinical professionals. The medico-legal precedent for aphasia diagnostics under Canadian, US and UK case law and the neuroimaging/neurological diagnostics relative to the functional capacity of aphasic patients are discussed in relation to the major findings of the literary analysis, neuroimaging protocols in clinical use today, and the neuroanatomical aetiologies of different aphasias. Basic Methodology: Literature searches of relevant scientific databases (e.g, OVID medline) were carried out using search terms such as aphasia case study (year) & stroke induced aphasia case study. A series of 7 diagnostic reporting criteria were formulated, and the resulting case studies were scored / 7 alongside clinical stroke criteria. In order to focus on the diagnostic assessment of the patient’s condition, only the case report proper (not the discussion) was used to quantify results. Statistical testing established if specific reporting criteria were associated with higher overall scores and potentially inferable increases in quality of reporting. Statistical testing of whether criteria scores were associated with an unclear/adjusted diagnosis were also tested, as well as the probability of a given criterion deviating from an expected estimate. Major Findings: The quantitative analysis of neuroanatomically driven diagnostics in case studies of aphasia revealed particularly low scores in the connection of neuroanatomical functions to aphasiological assessment (10%), and in the inclusion of white matter tracts within neuroimaging or assessment diagnostics (30%). Case studies which included clinical mention of white matter tracts within the report itself were distributed among higher scoring cases, as were case studies which (as clinically indicated) related the affected vascular region to the brain parenchyma of the language network. Concluding Statement: These findings indicate that certain neuroanatomical functions are integrated less often within the patient report than others, despite a precedent for well-integrated neuroanatomical aphasiology also being found among the case studies sampled, and despite these functions being clinically essential in diagnostic neuroimaging and aphasiological assessment. Therefore, ultimately the integration and specificity of aetiological neuroanatomy may contribute positively to the capacity and autonomy of aphasic patients as well as their clinicians. The integration of a full aetiological neuroanatomy within the reporting of aphasias may improve patient outcomes and sustain autonomy in the event of medico-ethical investigation.

Keywords: aphasia, language network, functional neuroanatomy, aphasiological diagnostics, medico-legal ethics

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531 ADAM10 as a Potential Blood Biomarker of Cognitive Frailty

Authors: Izabela P. Vatanabe, Rafaela Peron, Patricia Manzine, Marcia R. Cominetti

Abstract:

Introduction: Considering the increase in life expectancy of world population, there is an emerging concern in health services to allocate better care and care to elderly, through promotion, prevention and treatment of health. It has been observed that frailty syndrome is prevalent in elderly people worldwide and this complex and heterogeneous clinical syndrome consist of the presence of physical frailty associated with cognitive dysfunction, though in absence of dementia. This can be characterized by exhaustion, unintentional weight loss, decreased walking speed, weakness and low level of physical activity, in addition, each of these symptoms may be a predictor of adverse outcomes such as hospitalization, falls, functional decline, institutionalization, and death. Cognitive frailty is a recent concept in literature, which is defined as the presence of physical frailty associated with mild cognitive impairment (MCI) however in absence of dementia. This new concept has been considered as a subtype of frailty, which along with aging process and its interaction with physical frailty, accelerates functional declines and can result in poor quality of life of the elderly. MCI represents a risk factor for Alzheimer's disease (AD) in view of high conversion rate for this disease. Comorbidities and physical frailty are frequently found in AD patients and are closely related to heterogeneity and clinical manifestations of the disease. The decreased platelets ADAM10 levels in AD patients, compared to cognitively healthy subjects, matched by sex, age and education. Objective: Based on these previous results, this study aims to evaluate whether ADAM10 platelet levels of could act as a biomarker of cognitive frailty. Methods: The study was approved by Ethics Committee of Federal University of São Carlos (UFSCar) and conducted in the municipality of São Carlos, headquarters of Federal University of São Carlos (UFSCar). Biological samples of subjects were collected, analyzed and then stored in a biorepository. ADAM10 platelet levels were analyzed by western blotting technique in subjects with MCI and compared to subjects without cognitive impairment, both with and without presence of frailty. Statistical tests of association, regression and diagnostic accuracy were performed. Results: The results have shown that ADAM10/β-actin ratio is decreased in elderly individuals with cognitive frailty compared to non-frail and cognitively healthy controls. Previous studies performed by this research group, already mentioned above, demonstrated that this reduction is still higher in AD patients. Therefore, the ADAM10/β-actin ratio appears to be a potential biomarker for cognitive frailty. The results bring important contributions to an accurate diagnosis of cognitive frailty from the perspective of ADAM10 as a biomarker for this condition, however, more experiments are being conducted, using a high number of subjects, and will help to understand the role of ADAM10 as biomarker of cognitive frailty and contribute to the implementation of tools that work in the diagnosis of cognitive frailty. Such tools can be used in public policies for the diagnosis of cognitive frailty in the elderly, resulting in a more adequate planning for health teams and better quality of life for the elderly.

Keywords: ADAM10, biomarkers, cognitive frailty, elderly

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530 The Use of Telecare in the Re-design of Overnight Supports for People with Learning Disabilities: Implementing a Cluster-based Approach in North Ayrshire

Authors: Carly Nesvat, Dominic Jarrett, Colin Thomson, Wilma Coltart, Thelma Bowers, Jan Thomson

Abstract:

Introduction: Within Scotland, the Same As You strategy committed to moving people with learning disabilities out of long-stay hospital accommodation into homes in the community. Much of the focus of this movement was on the placement of people within individual homes. In order to achieve this, potentially excessive supports were put in place which created dependence, and carried significant ongoing cost primarily for local authorities. The greater focus on empowerment and community participation which has been evident in more recent learning disability strategy, along with the financial pressures being experienced across the public sector, created an imperative to re-examine that provision, particularly in relation to the use of expensive sleepover supports to individuals, and the potential for this to be appropriately scaled back through the use of telecare. Method: As part of a broader programme of redesigning overnight supports within North Ayrshire, a cluster of individuals living in close proximity were identified, who were in receipt of overnight supports, but who were identified as having the capacity to potentially benefit from their removal. In their place, a responder service was established (an individual staying overnight in a nearby service user’s home), and a variety of telecare solutions were placed within individual’s homes. Active and passive technology was connected to an Alarm Receiving Centre, which would alert the local responder service when necessary. Individuals and their families were prepared for the change, and continued to be informed about progress with the pilot. Results: 4 individuals, 2 of whom shared a tenancy, had their sleepover supports removed as part of the pilot. Extensive data collection in relation to alarm activation was combined with feedback from the 4 individuals, their families, and staff involved in their support. Varying perspectives emerged within the feedback. 3 of the individuals were clearly described as benefitting from the change, and the greater sense of independence it brought, while more concerns were evident in relation to the fourth. Some family members expressed a need for greater preparation in relation to the change and ongoing information provision. Some support staff also expressed a need for more information, to help them understand the new support arrangements for an individual, as well as noting concerns in relation to the outcomes for one participant. Conclusion: Developing a telecare response in relation to a cluster of individuals was facilitated by them all being supported by the same care provider. The number of similar clusters of individuals being identified within North Ayrshire is limited. Developing other solutions such as a response service for redesign will potentially require greater collaboration between different providers of home support, as well as continuing to explore the full range of telecare, including digital options. The pilot has highlighted the need for effective preparatory and ongoing engagement with staff and families, as well as the challenges which can accompany making changes to long-standing packages of support.

Keywords: challenges, change, engagement, telecare

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529 Development of an Improved Paradigm for the Tourism Sector in the Department of Huila, Colombia: A Theoretical and Empirical Approach

Authors: Laura N. Bolivar T.

Abstract:

The tourism importance for regional development is mainly highlighted by the collaborative, cooperating and competitive relationships of the involved agents. The fostering of associativity processes, in particular, the cluster approach emphasizes the beneficial outcomes from the concentration of enterprises, where innovation and entrepreneurship flourish and shape the dynamics for tourism empowerment. Considering the department of Huila, it is located in the south-west of Colombia and holds the biggest coffee production in the country, although it barely contributes to the national GDP. Hence, its economic development strategy is looking for more dynamism and Huila could be consolidated as a leading destination for cultural, ecological and heritage tourism, if at least the public policy making processes for the tourism management of La Tatacoa Desert, San Agustin Park and Bambuco’s National Festival, were implemented in a more efficient manner. In this order of ideas, this study attempts to address the potential restrictions and beneficial factors for the consolidation of the tourism sector of Huila-Colombia as a cluster and how could it impact its regional development. Therefore, a set of theoretical frameworks such as the Tourism Routes Approach, the Tourism Breeding Environment, the Community-based Tourism Method, among others, but also a collection of international experiences describing tourism clustering processes and most outstanding problematics, is analyzed to draw up learning points, structure of proceedings and success-driven factors to be contrasted with the local characteristics in Huila, as the region under study. This characterization involves primary and secondary information collection methods and comprises the South American and Colombian context together with the identification of involved actors and their roles, main interactions among them, major tourism products and their infrastructure, the visitors’ perspective on the situation and a recap of the related needs and benefits regarding the host community. Considering the umbrella concepts, the theoretical and the empirical approaches, and their comparison with the local specificities of the tourism sector in Huila, an array of shortcomings is analytically constructed and a series of guidelines are proposed as a way to overcome them and simultaneously, raise economic development and positively impact Huila’s well-being. This non-exhaustive bundle of guidelines is focused on fostering cooperating linkages in the actors’ network, dealing with Information and Communication Technologies’ innovations, reinforcing the supporting infrastructure, promoting the destinations considering the less known places as well, designing an information system enabling the tourism network to assess the situation based on reliable data, increasing competitiveness, developing participative public policy-making processes and empowering the host community about the touristic richness. According to this, cluster dynamics would drive the tourism sector to meet articulation and joint effort, then involved agents and local particularities would be adequately assisted to cope with the current changing environment of globalization and competition.

Keywords: innovative strategy, local development, network of tourism actors, tourism cluster

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528 The Multidisciplinary Treatment in Residence Care Clinic for Treatment of Feeding and Eating Disorders

Authors: Yuri Melis, Mattia Resteghini, Emanuela Apicella, Eugenia Dozio, Leonardo Mendolicchio

Abstract:

Aim: This retrospective study was created to analyze the psychometric, anthropometric and body composition values in patients at the beginning and the discharge of their of hospitalization in the residential care clinic for eating and feeding disorders (EFD’s). Method: The sample was composed by (N=59) patients with mean age N= 33,50, divided in subgroups: Anorexia Nervosa (AN) (N=28), Bulimia Nervosa (BN) (N=13) and Binge Eating Disorders (BED) (N=14) recruited from a residential care clinic for eating and feeding disorders. The psychometrics level was measured with self-report questionnaires: Eating Disorders Inventory-3 (EDI-3) The Body Uneasiness Test (BUT), Minnesota Multiphasic Personality Inventory (MMPI – 2). The anthropometric and nutritional values was collected by Body Impedance Assessment (B.I.A), Body mass index (B.M.I.). Measurements were made at the beginning and at the end of hospitalization, with an average time of recovery of about 8,6 months. Results: The all data analysis showed a statistical significance (p-value >0,05 | power size N=0,950) in variation from T0 (start of recovery) to T1 (end of recovery) in the clinical scales of MMPI-2, AN group (Hypocondria T0 64,14 – T1 56,39) (Depression T0 72,93 – T1 59,50) (Hysteria T0 61,29 – T1 56,17) (Psychopathic deviation T0 64,00 – T1 60,82) (Paranoia T0 63,82 – T1 56,14) (Psychasthenia T0 63,82 – T1 57,86) (Schizophrenia T0 64,68 – T1 60,43) (Obsessive T0 60,36 – T1 55,68); BN group (Hypocondria T0 64,08 – T1 47,54) (Depression T0 67,46 – T1 52,46) (Hysteria T0 60,62 – T1 47,84) (Psychopathic deviation T0 65,69 – T1 58,92) (Paranoia T0 67,46 – T1 55,23) (Psychasthenia T0 60,77 – T1 53,77) (Schizophrenia T0 64,68 – T1 60,43) (Obsessive T0 62,92 – T1 54,08); B.E.D groups (Hypocondria T0 59,43 – T1 53,14) (Depression T0 66,71 – T1 54,57) (Hysteria T0 59,86 – T1 53,82) (Psychopathic deviation T0 67,39 – T1 59,03) (Paranoia T0 58,57 – T1 53,21) (Psychasthenia T0 61,43 – T1 53,00) (Schizophrenia T0 62,29 – T1 56,36) (Obsessive T0 58,57 – T1 48,64). EDI-3 report mean value is higher than clinical cut-off at T0, in T1, there is a significant reduction of the general mean of value. The same result is present in the B.U.T. test in the difference between T0 to T1. B.M.I mean value in AN group is (T0 14,83 – T1 18,41) BN group (T0 20 – T1 21,33) BED group (T0 42,32 – T1 34,97) Phase Angle results: AN group (T0 4,78 – T1 5,64) BN (T0 6 – T1 6,53) BED group (T0 6 – T1 6,72). Discussion and conclusion: The evident presence that on the whole sample, we have an altered serious psychiatric and clinic conditions at the beginning of recovery. The interesting conclusions that we can draw from this analysis are that a multidisciplinary approach that includes the entire care of the subject: from the pharmacological treatment, analytical psychotherapy, Psychomotricity, nutritional rehabilitation, and rehabilitative, educational activities. Thus, this Multidisciplinary treatment allows subjects in our sample to be able to restore psychopathological and metabolic values to below the clinical cut-off.

Keywords: feeding and eating disorders, anorexia nervosa, care clinic treatment, multidisciplinary treatment

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