Search results for: gender in defense policy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6408

Search results for: gender in defense policy

798 Application of Bundle Care to Reduce Invasive Catheter-Associated Infection in High Risk Units at a Medical Center

Authors: Hsin-Hsin Chang, Jann-Tay Wang, Wang-Huei Sheng

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Background: Hospital-associated infections (HAIs) have significant medical and social resource consumption. In view of medical technology change rapidly and the prolonged average life expectancy, the patients' chances of receiving invasive medical devices have also increased. As well as the potential disease of the patients, the aging, and immune dysfunction makes the disease more serious, raising the risk of HAIs. In our adult intensive care units, catheter-associated urinary tract infections (CAUTIs) have an average of 4.6% in 2014, which is much higher than that of the National Healthcare Safety Network (NHSN). Therefore, we started the intervention of CAUTI bundle care. Methods: This 3-year intervention was conducted in adults’ intensive care units (ICUs) during January 2015 to December 2017. The implementation of CAUTI bundle care in order to reduce invasive catheter-associated infections were built on evidence-based infection control measures. Prospective surveillance was performed on all patients admitted to hospital. The four major directions are 'Leader Engagement', 'Educate Personnel', 'Executive Multidisciplinary Teamwork', 'Innovation and Improvement of Tools'. Results: During the intervention period, there were 167,024 patient-days with a total of 508 episodes of CAUTIs in the entire adult ICUs identified. The incidence of CAUTIs in adult ICU was significantly decreased in the intervention period (from 2015 to 2017), from 4.6 to 3.6 per 1000 catheter days (p=0.05). Conclusion: The necessity for the implementation of CAUTI bundle care in the health care system plays an important role in the quality and policy of infection control. Multidisciplinary teamwork, education, a comprehensive checklist and from time to time audit feedback to improve healthcare workers’ compliance are the keys to success.

Keywords: bundle care, hospital-associated infections, leader engagement, multidisciplinary team work

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797 Impact of Climate Change on Forest Ecosystem Services: In situ Biodiversity Conservation and Sustainable Management of Forest Resources in Tropical Forests

Authors: Rajendra Kumar Pandey

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Forest genetic resources not only represent regional biodiversity but also have immense value as the wealth for securing livelihood of poor people. These are vulnerable to ecological due to depletion/deforestation and /or impact of climate change. These resources of various plant categories are vulnerable on the floor of natural tropical forests, and leading to the threat on the growth and development of future forests. More than 170 species, including NTFPs, are in critical condition for their survival in natural tropical forests of Central India. Forest degradation, commensurate with biodiversity loss, is now pervasive, disproportionately affecting the rural poor who directly depend on forests for their subsistence. Looking ahead the interaction between forest and water, soil, precipitation, climate change, etc. and its impact on biodiversity of tropical forests, it is inevitable to develop co-operation policies and programmes to address new emerging realities. Forests ecosystem also known as the 'wealth of poor' providing goods and ecosystem services on a sustainable basis, are now recognized as a stepping stone to move poor people beyond subsistence. Poverty alleviation is the prime objective of the Millennium Development Goals (MDGs). However, environmental sustainability including other MDGs, is essential to ensure successful elimination of poverty and well being of human society. Loss and degradation of ecosystem are the most serious threats to achieving development goals worldwide. Millennium Ecosystem Assessment (MEA, 2005) was an attempt to identify provisioning and regulating cultural and supporting ecosystem services to provide livelihood security of human beings. Climate change may have a substantial impact on ecological structure and function of forests, provisioning, regulations and management of resources which can affect sustainable flow of ecosystem services. To overcome these limitations, policy guidelines with respect to planning and consistent research strategy need to be framed for conservation and sustainable development of forest genetic resources.

Keywords: climate change, forest ecosystem services, sustainable forest management, biodiversity conservation

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796 International Entrepreneurial Orientation and Institutionalism: The Effect on International Performance for Latin American SMEs

Authors: William Castillo, Hugo Viza, Arturo Vargas

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The Pacific Alliance is a trade bloc that is composed of four emerging economies: Chile, Colombia, Peru, and Mexico. These economies have gained macroeconomic stability in the past decade and as a consequence present future economic progress. Under this positive scenario, international business firms have flourished. However, the literature in this region has been widely unexamined. Therefore, it is critical to fill this theoretical gap, especially considering that Latin America is starting to become a global player and it possesses a different institutional context than developed markets. This paper analyzes the effect of international entrepreneurial orientation and institutionalism on international performance, for the Pacific Alliance small-to-medium enterprises (SMEs). The literature considers international entrepreneurial orientation to be a powerful managerial capability – along the resource based view- that firms can leverage to obtain a satisfactory international performance. Thereby, obtaining a competitive advantage through the correct allocation of key resources to exploit the capabilities here involved. Entrepreneurial Orientation is defined around five factors: innovation, proactiveness, risk-taking, competitive aggressiveness, and autonomy. Nevertheless, the institutional environment – both local and foreign, adversely affects International Performance; this is especially the case for emerging markets with uncertain scenarios. In this way, the study analyzes an Entrepreneurial Orientation, key endogenous variable of international performance, and Institutionalism, an exogenous variable. The survey data consists of Pacific Alliance SMEs that have foreign operations in at least another country in the trade bloc. Findings are still in an ongoing research process. Later, the study will undertake a structural equation modeling (SEM) using the variance-based partial least square estimation procedure. The software that is going to be used is the SmartPLS. This research contributes to the theoretical discussion of a largely postponed topic: SMEs in Latin America, that has had limited academic research. Also, it has practical implication for decision-makers and policy-makers, providing insights into what is behind international performance.

Keywords: institutional theory, international entrepreneurial orientation, international performance, SMEs, Pacific Alliance

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795 Perceptions and Expectations by Participants of Monitoring and Evaluation Short Course Training Programmes in Africa

Authors: Mokgophana Ramasobana

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Background: At the core of the demand to utilize evidence-based approaches in the policy-making cycle, prioritization of limited financial resources and results driven initiatives is the urgency to develop a cohort of competent Monitoring and Evaluation (M&E) practitioners and public servants. The ongoing strides in the evaluation capacity building (ECB) initiatives are a direct response to produce the highly-sought after M&E skills. Notwithstanding the rapid growth of M&E short courses, participants perceived value and expectation of M&E short courses as a panacea for ECB have not been empirically quantified or measured. The objective of this article is to explicitly illustrate the importance of measuring ECB interventions and understanding what works in ECB and why it works. Objectives: This article illustrates the importance of establishing empirical ECB measurement tools to evaluate ECB interventions in order to ascertain its contribution to the broader evaluation practice. Method: The study was primarily a desktop review of existing literature, juxtaposed by a survey of the participants across the African continent based on the 43 M&E short courses hosted by the Centre for Learning on Evaluation and Results Anglophone Africa (CLEAR-AA) in collaboration with the Department of Planning Monitoring and Evaluation (DPME) Results: The article established that participants perceive short course training as a panacea to improve their M&E practical skill critical to executing their organizational duties. In tandem, participants are likely to demand customized training as opposed to general topics in Evaluation. However, the organizational environments constrain the application of the newly acquired skills. Conclusion: This article aims to contribute to the 'how to' measure ECB interventions discourse and contribute towards the improvement to evaluate ECB interventions. The study finds that participants prefer training courses with longer duration to cover more topics. At the same time, whilst organizations call for customization of programmes, the study found that individual participants demand knowledge of generic and popular evaluation topics.

Keywords: evaluation capacity building, effectiveness and training, monitoring and evaluation (M&E) short course training, perceptions and expectations

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794 Need for Eye Care Services, Clinical Characteristics, Surgical Outcome and Prognostic Predictors of Cataract in Adult Participants with Intellectual Disability

Authors: Yun-Shan Tsai, Si-Ping Lin, En-Chieh Lin, Xin-Hong Chen, Shin-Yun Ho, Shin-Hong Huang, Ching-ju Hsieh

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Background and significance: Uncorrected refractive errors and cataracts are the main visually debilitating ophthalmological abnormalities in adult participants with intellectual disability (ID). However, not all adult participants with ID may receive a regular and timely ophthalmological assessment. Consequently, some of the ocular diseases may not be diagnosed until late, thereby causing unnecessary ocular morbidity. In addition, recent clinical practice and researches have also suggested that eye-care services for this group are neglected. Purpose: To investigate the unmet need for eye care services, clinical characteristics of cataract, visual function, surgical outcome and prognostic predictors in adult participants with ID at Taipei City Hospital in Taiwan. Methods: This is a one-year prospective clinical study. We recruited about 120 eyes of 60 adult participants with ID who were received cataract surgery. Caregivers of all participants received a questionnaire on current eye care services. Clinical demographic data, such as age, gender, and associated systemic diseases or syndromes, were collected. All complete ophthalmologic examinations were performed 1 month preoperatively and 3 months postoperatively, including ocular biometry, visual function, refractive status, morphology of cataract, associated ocular features, anesthesia methods, surgical types, and complications. Morphology of cataract, visual and surgical outcome was analyzed. Results: A total of 60 participants with mean age 43.66 ± 13.94 years, including 59.02% male and 40.98% female, took part in comprehensive eye-care services. The prevalence of unmet need for eye care services was high (about 70%). About 50% of adult participants with ID have bilateral cataracts at the time of diagnosis. White cataracts were noted in about 30% of all adult participants with ID at the time of presentation. Associated ocular disorders were included myopic maculopathy (4.54%), corneal disorders (11.36%), nystagmus (20.45%), strabismus (38.64%) and glaucoma (2.27%). About 26.7% of adult participants with ID underwent extracapsular cataract extraction whereas a phacoemulsification was performed in 100% of eyes. Intraocular lens implantation was performed in all eyes. The most common postoperative complication was posterior capsular opacification (30%). The mean best-corrected visual acuity was significantly improved from preoperatively (mean log MAR 0.48 ± 0.22) to at 3 months postoperatively (mean log MAR 0.045 ± 0.22) (p < .05). Conclusions: Regular follow up will help address the need for eye-care services in participants with ID. A high incidence of bilateral cataracts, as well as white cataracts, was observed in adult participants with ID. Because of early diagnosis and early intervention of cataract, the visual and surgical outcomes of cataract are good, but the visual outcomes are suboptimal due to associated ocular comorbidities.

Keywords: adult participants with intellectual disability, cataract, cataract surgery

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793 Applying Risk Taking in Islamic Finance: A Fiqhī Viewpoint

Authors: Mohamed Fairooz Abdul Khir

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The linkage between liability for risk and legitimacy of reward is a governing principle that must be fully observed in financial transactions. It is the cornerstone of any Islamic business or financial deal. The absence of risk taking principle may give rise to numerous prohibited elements such as ribā, gharar and gambling that violate the objectives of financial transactions. However, fiqhī domains from which it emanates have not been clearly spelled out by the scholars. In addition, the concept of risk taking in relation to contemporary risks associated with financial contracts, such as credit risk, liquidity risk, reputational risk and market risk, needs further scrutiny as regard their Sharīʿah bases. Hence, this study is imperatively significant to prove that absence of risk taking concept in Islamic financial instruments give rise to prohibited elements particularly ribā. This study is primarily intended to clarify the concept of risk in Islamic financial transactions from the fiqhī perspective and evaluate analytically the selected issues involving risk taking based on the established concept of risk taking from fiqhī viewpoint. The selected issues are amongst others charging cost of fund on defaulting customers, holding the lessee liable for total loss of leased asset under ijārah thumma al-bayʿ and capital guarantee under mushārakah based instruments. This is a library research in which data has been collected from various materials such as classical fiqh books, regulators’ policy guidelines and journal articles. This study employed deductive and inductive methods to analyze the data critically in search for conclusive findings. It suggests that business risks have to be evaluated based on their subjects namely (i) property (māl) and (ii) work (ʿamal) to ensure that Islamic financial instruments structured based on certain Sharīʿah principles are not diverted from the risk taking concept embedded in them. Analysis of the above selected cases substantiates that when risk taking principle is breached, the prohibited elements such as ribā, gharar and maysir do arise and that they impede the realization of the maqāṣid al-Sharīʿah intended from Islamic financial contracts.

Keywords: Islamic finance, ownership risk, ribā, risk taking

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792 The Interventricular Septum as a Site for Implantation of Electrocardiac Devices - Clinical Implications of Topography and Variation in Position

Authors: Marcin Jakiel, Maria Kurek, Karolina Gutkowska, Sylwia Sanakiewicz, Dominika Stolarczyk, Jakub Batko, Rafał Jakiel, Mateusz K. Hołda

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Proper imaging of the interventricular septum during endocavital lead implantation is essential for successful procedure. The interventricular septum is located oblique to the 3 main body planes and forms angles of 44.56° ± 7.81°, 45.44° ± 7.81°, 62.49° (IQR 58.84° - 68.39°) with the sagittal, frontal and transverse planes, respectively. The optimal left anterior oblique (LAO) projection is to have the septum aligned along the radiation beam and will be obtained for an angle of 53.24° ± 9,08°, while the best visualization of the septal surface in the right anterior oblique (RAO) projection is obtained by using an angle of 45.44° ± 7.81°. In addition, the RAO angle (p=0.003) and the septal slope to the transverse plane (p=0.002) are larger in the male group, but the LAO angle (p=0.003) and the dihedral angle that the septum forms with the sagittal plane (p=0.003) are smaller, compared to the female group. Analyzing the optimal RAO angle in cross-sections lying at the level of the connections of the septum with the free wall of the right ventricle from the front and back, we obtain slightly smaller angle values, i.e. 41.11° ± 8.51° and 43.94° ± 7.22°, respectively. As the septum is directed leftward in the apical region, the optimal RAO angle for this area decreases (16.49° ± 7,07°) and does not show significant differences between the male and female groups (p=0.23). Within the right ventricular apex, there is a cavity formed by the apical segment of the interventricular septum and the free wall of the right ventricle with a depth of 12.35mm (IQR 11.07mm - 13.51mm). The length of the septum measured in longitudinal section, containing 4 heart cavities, is 73.03mm ± 8.06mm. With the left ventricular septal wall formed by the interventricular septum in the apical region at a length of 10.06mm (IQR 8.86 - 11.07mm) already lies outside the right ventricle. Both mentioned lengths are significantly larger in the male group (p<0.001). For proper imaging of the septum from the right ventricular side, an oblique position of the visualization devices is necessary. Correct determination of the RAO and LAO angle during the procedure allows to improve the procedure performed, and possible modification of the visual field when moving in the anterior, posterior and apical directions of the septum will avoid complications. Overlooking the change in the direction of the interventricular septum in the apical region and a significant decrease in the RAO angle can result in implantation of the lead into the free wall of the right ventricle with less effective pacing and even complications such as wall perforation and cardiac tamponade. The demonstrated gender differences can also be helpful in setting the right projections. A necessary addition to the analysis will be a description of the area of the ventricular septum, which we are currently working on using autopsy material.

Keywords: anatomical variability, angle, electrocardiological procedure, intervetricular septum

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791 Gendered Appartus of a Military: The Role of Military Wives in Defining Security

Authors: Taarika Singh

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Military wives – women married to army officers have largely been recognized as mere supporters or as auxiliaries to military men rather than propagators of thought and ideologies. The military wife (and her participation) is often dismissed as 'private', 'domestic', or 'trivial' and is acknowledged, if at all, only as an (inevitable/normative) entity, seen as a natural product/outcome of militarization. It is because the military wife has come to be constructed and accepted as normative by states and militaries that women of the military are easily ‘trivialised’ and are made to appear to be socially, politically, or theoretically irrelevantand/or insignificant. This paper, using ethnography-- structured and semi-structured interviews -- makes a gendered analysis of militarization, by bringing the military wife to the forefront and placing her at the nexus of the military and state apparatus. Moving away from gendered analyses that focus on the impact of militarization on women or draw attention to the ways in which militarization has been challenged/resisted by women, the paper pays attention to the centrality of women in shaping, validating, and perpetuating militarization, patriarchal control, and gendered hierarchies. The paper will demonstrate how military wives accept and comply with patriarchy as an institutional form of social organization that extends beyond the family and kinship relations into the military as an organization of the state. The paper will draw attention to the ways in which military norms, patriarchal values, and belief systems shape the social personhood, identity, and worldview of military wives; as a consequence of which, women play a central role in upholding and reproducing social inequalities and hierarchies; in shaping social status, and power relationships amongst men and women within and outside the military. The paper will allude to the processes and ideologies via which womena) accept and reproducemen as exclusive holders of power, status, and privilege; and b) recognize international relations, politics, andmatters related to security to be male dominated arenas inviting overwhelming masculine participation. In doing so, the paper will argue that women of the military play a critical role in perpetuating and upholding gendered meanings associated with the notion of and discourse around security. The paper will illustratehow military wives accept and assume security to be inherently a gendered idea -- a masculine notion, a male dominated arena, as something granted by men. In other words, the paper will demonstrate how the militarization of the military wives and the perpetuation of militarization by military wives plays a crucial role in propagating and perpetuating security to be a masculine notion or a male dominated arena. The paper will then question the degree to which such gendered analyses can shape the broader meanings, definitions, and discourses around security, matters related to security, and security threats.

Keywords: gender, militarisation, security, women

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790 Examining Smallholder Farmers’ Perceptions of Climate Change and Barriers to Strategic Adaptation in Todee District, Liberia

Authors: Joe Dorbor Wuokolo

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Thousands of smallholder farmers in Todee District, Montserrado county, are currently vulnerable to the negative impact of climate change. The district, which is the agricultural hot spot for the county, is faced with unfavorable changes in the daily temperature due to climate change. Farmers in the district have observed a dramatic change in the ratio of rainfall to sunshine, which has caused a chilling effect on their crop yields. However, there is a lack of documentation regarding how farmers perceive and respond to these changes and challenges. A study was conducted in the region to examine the perceptions of smallholder farmers regarding the negative impact of climate change, the adaptation strategies practice, and the barriers that hinder the process of advancing adaptation strategy. On purpose, a sample of 41 respondents from five towns was selected, including five town chiefs, five youth leaders, five women leaders, and sixteen community members. Women and youth leaders were specifically chosen to provide gender balance and enhance the quality of the investigation. Additionally, to validate the barriers farmers face during adaptation to climate change, this study interviewed eight experts from local and international organizations and government ministries and agencies involved in climate change and agricultural programs on what they perceived as the major barrier in both local and national level that impede farmers adaptation to climate change impact. SPSS was used to code the data, and descriptive statistics were used to analyze the data. The weighted average index (WAI) was used to rank adaptation strategies and the perceived importance of adaptation practices among farmers. On a scale from 0 to 3, 0 indicates the least important technique, and 3 indicates the most effective technique. In addition, the Problem Confrontation Index (PCI) was used to rank the barriers that prevented farmers from implementing adaptation measures. According to the findings, approximately 60% of all respondents considered the use of irrigation systems to be the most effective adaptation strategy, with drought-resistant varieties making up 30% of the total. Additionally, 80% of respondents placed a high value on drought-resistant varieties, while 63% percent placed it on irrigation practices. In addition, 78% of farmers ranked and indicated that unpredictability of the weather is the most significant barrier to their adaptation strategies, followed by the high cost of farm inputs and lack of access to financing facilities. 80% of respondents believe that the long-term changes in precipitation (rainfall) and temperature (hotness) are accelerating. This suggests that decision-makers should adopt policies and increase the capacity of smallholder farmers to adapt to the negative impact of climate change in order to ensure sustainable food production.

Keywords: adaptation strategies, climate change, farmers’ perception, smallholder farmers

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789 A Study of the Prevalence of Trichinellosis in Domestic and Wild Animals for the Region of Sofia, Bulgaria

Authors: Valeria Dilcheva, Svetlozara Petkova, Ivelin Vladov

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Nemathodes of the genus Trichinella are zoonotic parasites with a cosmopolitan distribution. More than 100 species of mammals, birds and reptiles are involved in the natural cycle of this nematode. At present, T. spiralis, T. pseudospiralis, and T. britovi have been found in Bulgaria. The existence of natural wildlife and domestic reservoirs of Trichinella spp. can be a serious threat to human health. Three trichinella isolates caused human trichinella infection outbreaks from three regions of Sofia City Province were used for the research: sample No. 1 - Ratus norvegicus, sample No. 2 – domestic pig (Sus scrofa domestica), sample No. 3 - domestic pig (Sus scrofa domestica). Trichinella larvae of the studied species were isolated via digestive method (pepsin, hydrochloric acid, water) at 37ºC by standard procedure and were determined by gender (male and female) based on their morphological characteristics. As a reference trichinella species were used: T. spiralis, T. pseudospiralis, T. nativa and T. britovi. Single male and female larvae of the three isolates were crossed with single male and female larvae of the reference trichinella species as well as reciprocally. As a result of cross-breeding, offspring of muscular larvae with T. spiralis and T. britovi were obtained, while in experiments with T. pseudospiralis and T. nativa, trichinella larvae were not found in the laboratory mice. The results obtained in the control groups indicate that the trichinella larvae used from the isolates and the four trichinella species are infective. Also, the infective ability of the F1 offspring from the successful cross-breeding between isolates and reference species was investigated. Through the data obtained in the experiment was found that isolates No. 1 and No. 2 belong to the species T. spiralis, and isolate No. 3 belongs to the species T. britovi. The results were confirmed by PCR and real-time PCR analysis. Thus the presence and circulation of the species T. spiralis and T. britovi in Bulgaria was confirmed. Probably the rodents (rats) are involved in the distribution of T. spiralis in urban environment. The species T. britovi found in a domestic pig speaks of some contact with wild animals for which T. britovi is characteristic. The probable reason is that a large number of farmers in Bulgaria practice the free-range breeding of domestic pigs. Part of the farmers also used as food for domestic pigs waste products from the game (foxes, jackals, bears, wolves) and probably thus the infection was obtained. The distribution range of trichinella species in Bulgaria is not strictly outlined. It is believed that T. spiralis is most common in domestic animals and T. britovi and T. pseudospiralis are characteristic of wildlife. To answer the question whether wild and synanthropic animals are infected with the same or different trichinella species, which species predominate in nature and what their distribution among different hosts is, further research is required.

Keywords: cross-breeding, Sofia, trichinellosis, Trichinella britovi, Trichinella spiralis

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788 White-Rot Hymenomycetes as Oil Palm Log Treatments: Accelerating Biodegradation of Basal Stem Rot-Affected Oil Palm Stumps

Authors: Yuvarani Naidu, Yasmeen Siddiqui, Mohd Yusof Rafii , Abu Seman Idris

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Sustainability of oil palm production in Southeast Asia, especially in Indonesia and Malaysia, is jeopardized by Ganoderma boninense, the fungus which causes basal stem rot (BSR) in oil palm. The root contact with unattended infected debris left in the plantations during replanting is known to be the primary source of inoculum. Abiding by the law, potentially effective technique of managing Ganoderma infected oil palm debris is deemed necessary because of the zero-burning policy in Malaysian oil palm plantations. White-rot hymenomycetes antagonistic to Ganoderma sp were selected to test their efficacy as log treatments in degrading Ganoderma infected oil palm logs and to minimize the survival of Ganoderma inoculum. Decay rate in terms of mass loss was significantly higher after the application of solid-state cultivation (SSC) of Trametes lactinea FBW (64% ±1.2), followed by Pycnoporus sanguineus FBR (55% ±1.7) in infected log block tissues, after 10 months of treatments. The degradation pattern was clearly distinguished between the treated and non-treated log blocks with the developed SSC formulations. The control infected log blocks showed the highest, whereas infected log blocks treated with either P. sanguineus FBR or T. lactinea FBW SSC formulations exhibited statistically lowest number of Ganoderma spp. recovery on Ganoderma Selective Medium (GSM), after 8 months of treatment. Out of that, the lowest recovery of Ganoderma spp. was reported in infected log blocks inoculated with the strain T. lactinea FBW (21% ± 0.9) followed by P. sanguineus FBR (33% ± 2.2), after 8 months, Further, no recovery of Ganoderma was noticeable, 10 months after treatment applications in log blocks treated with both of the formulations. This is the first nursery-base study to substantiate the initial colonization of white-rot hymenomycetes on oil palm log blocks previously infected with BSR pathogen, G. boninense. The present study has indicated that log blocks treatment with white-rot hymenomycetes significantly affected the mass loss of diseased and healthy log block tissues. This study provides a basis of biotechnological approaches inefficient degradation of oil palm-generated crop debris, under natural conditions with an ultimate aim of reducing the Ganoderma inoculum under heavy BSR infection pressure in eco-friendly manner.

Keywords: basal stem rot disease, ganoderma boninense, oil palm, white-rot fungi

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787 Third Places for Social Sustainability: A Planning Framework Based on Local and International Comparisons

Authors: Z. Goosen, E. J. Cilliers

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Social sustainability, as an independent perspective of sustainable development, has gained some acknowledgement, becoming an important aspect in sustainable urban planning internationally. However, limited research aiming at promoting social sustainability within urban areas exists within the South African context. This is mainly due to the different perspectives of sustainable development (e.g., Environmental, Economic, and Social) not being equally prioritized by policy makers and supported by implementation strategies, guidelines, and planning frameworks. The enhancement of social sustainability within urban areas relies on urban dweller satisfaction and the quality of urban life. Inclusive cities with high-quality public spaces are proposed within this research through implementing the third place theory. Third places are introduced as any place other than our homes (first place) and work (second place) and have become an integrated part of sustainable urban planning. As Third Places consist of every place 'in between', the approach has taken on a large role of the everyday life of city residents, and the importance of planning for such places can only be measured through identifying and highlighting the social sustainability benefits thereof. The aim of this research paper is to introduce third place planning within the urban area to ultimately enhance social sustainability. Selected background planning approaches influencing the planning of third places will briefly be touched on, as the focus will be placed on the social sustainability benefits provided through third place planning within an urban setting. The study will commence by defining and introducing the concept of third places within urban areas as well as a discussion on social sustainability, acting as one of the three perspectives of sustainable development. This will gain the researcher an improved understanding on social sustainability in order for the study to flow into an integrated discussion of the benefits Third places provide in terms of social sustainability and the impact it has on improved quality of life within urban areas. Finally, a visual case study comparison of local and international examples of third places identified will be illustrated. These international case studies will contribute towards the conclusion of this study where a local gap analysis will be formulated, based on local third place evidence and international best practices in order to formulate a strategic planning framework on improving social sustainability through third place planning within the local South African context.

Keywords: planning benefits, social sustainability, third places, urban area

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786 The EU Omnipotence Paradox: Inclusive Cultural Policies and Effects of Exclusion

Authors: Emmanuel Pedler, Elena Raevskikh, Maxime Jaffré

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Can the cultural geography of European cities be durably managed by European policies? To answer this question, two hypotheses can be proposed. (1) Either European cultural policies are able to erase cultural inequalities between the territories through the creation of new areas of cultural attractiveness in each beneficiary neighborhood, city or country. Or, (2) each European region historically rooted in a number of endogenous socio-historical, political or demographic factors is not receptive to exogenous political influences. Thus, the cultural attractiveness of a territory is difficult to measure and to impact by top-down policies in the long term. How do these two logics - European and local - interact and contribute to the emergence of a valued, popular sense of a common European cultural identity? Does this constant interaction between historical backgrounds and new political concepts encourage a positive identification with the European project? The European cultural policy programs, such as ECC (European Capital of Culture), seek to develop new forms of civic cohesion through inclusive and participative cultural events. The cultural assets of a city elected ‘ECC’ are mobilized to attract a wide range of new audiences, including populations poorly integrated into local cultural life – and consequently distant from pre-existing cultural offers. In the current context of increasingly heterogeneous individual perceptions of Europe, the ECC program aims to promote cultural forms and institutions that should accelerate both territorial and cross-border European cohesion. The new cultural consumption pattern is conceived to stimulate integration and mobility, but also to create a legitimate and transnational ideal European citizen type. Our comparative research confronts contrasting cases of ‘European Capitals of Culture’ from the south and from the north of Europe, cities recently concerned by the ECC political mechanism and cities that were elected ECC in the past, multi-centered cultural models vs. highly centralized cultural models. We aim to explore the impacts of European policies on the urban cultural geography, but also to understand the current obstacles for its efficient implementation.

Keywords: urbanism, cultural policies, cultural institutions, european cultural capitals, heritage industries, exclusion effects

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785 The Impact of Geopolitical Risks and the Oil Price Fluctuations on the Kuwaiti Financial Market

Authors: Layal Mansour

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The aim of this paper is to identify whether oil price volatility or geopolitical risks can predict future financial stress periods or economic recessions in Kuwait. We construct the first Financial Stress Index for Kuwait (FSIK) that includes informative vulnerable indicators of the main financial sectors: the banking sector, the equities market, and the foreign exchange market. The study covers the period from 2000 to 2020, so it includes the two recent most devastating world economic crises with oil price fluctuation: the Covid-19 pandemic crisis and Ukraine-Russia War. All data are taken by the central bank of Kuwait, the World Bank, IMF, DataStream, and from Federal Reserve System St Louis. The variables are computed as the percentage growth rate, then standardized and aggregated into one index using the variance equal weights method, the most frequently used in the literature. The graphical FSIK analysis provides detailed information (by dates) to policymakers on how internal financial stability depends on internal policy and events such as government elections or resignation. It also shows how monetary authorities or internal policymakers’ decisions to relieve personal loans or increase/decrease the public budget trigger internal financial instability. The empirical analysis under vector autoregression (VAR) models shows the dynamic causal relationship between the oil price fluctuation and the Kuwaiti economy, which relies heavily on the oil price. Similarly, using vector autoregression (VAR) models to assess the impact of the global geopolitical risks on Kuwaiti financial stability, results reveal whether Kuwait is confronted with or sheltered from geopolitical risks. The Financial Stress Index serves as a guide for macroprudential regulators in order to understand the weakness of the overall Kuwaiti financial market and economy regardless of the Kuwaiti dinar strength and exchange rate stability. It helps policymakers predict future stress periods and, thus, address alternative cushions to confront future possible financial threats.

Keywords: Kuwait, financial stress index, causality test, VAR, oil price, geopolitical risks

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784 Peace through Language Policy as a Solution to the Ethnic Conflict in Sri Lanka

Authors: R. M. W. Rajapakshe

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Sri Lanka, which is officially called the Democratic Socialist Republic of Sri Lanka is an island nation situated near India. It is a multi-lingual, multi- religious and multi – ethnic country, where Sinhalese form the majority and the Tamils form the largest ethnic minority. The composition of the population (ethnic basis) in Sri Lanka is as follows: Sinhalese: 74.5%, Tamil (Sri Lankan): 12.6%, Muslim: 7.5 %, Tamil (Indian): 5.5%, Malay: 0.3%, Burgher: 0.3 %, other: 0.2 %. The Tamil people use the Tamil language as their mother tongue and the Sinhala people use the Sinhala language as their mother tongue. A very few people in both communities use English as their mother tongue and however, a large number of people use English as a second language. The Sinhala Language was declared the only official language in Sri Lanka in 1959. However, it was not acceptable to Tamil politicians as well as to the common Tamil people and it was the beginning of long standing ethnic crisis which later became a military war where a lot of blood was shed. As a solution to the above ethnic crisis the thirteenth amendment to the constitution of Sri Lanka was introduced in 1987 and according to it both Sinhala and Tamil were declared official languages and English as the link language in Sri Lanka. Thus, a new programme namely, second language teaching programme under which Sinhala was taught to Tamil students and Tamil was taught to Sinhala students, was introduced at government schools. Language teaching includes knowledge of the culture of the target language. As all cultures are mixed and have common features students have reduced their enmity about the other community and learned to respect the other culture. On the other hand as all languages are mixed, students came to the understanding that there are no pure languages. Thus, they learned to respect the other language. In the case of Sri Lanka the Sinhala language is mixed with the Tamil language and vice versa. Thus, the development of second language teaching is the prominent way to solve the above ethnic problem and this study clearly shows it. However, the above programme suffers with lack of trained second language teachers, infrastructure facilities and insufficient funds and, they can be considered as the main obstacles to develop the second language teaching programme. Yet, there are no satisfactory answers to those problems. The data were collected from relevant books, articles and other documents based on research and forty five recordings, each with one hour duration, of natural conversations covering all factions of the Sinhala community.

Keywords: ethnic crisis, official language, second language teaching, Sinhala, Tami

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783 PhD Students’ Challenges with Impact-Factor in Kazakhstan

Authors: Duishon Shamatov

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This presentation is about Kazakhstan’s PhD students’ experiences with impact-factor publication requirement. Since the break-up of the USSR, Kazakhstan has been attempting to improve its higher education system at undergraduate and graduate levels. From March, 2010 Kazakhstan joined Bologna process and entered European space of higher education. To align with the European system of higher education, three level of preparation of specialists (undergraduate, master and PhD) was adopted to replace the Soviet system. The changes were aimed at promoting high quality higher education that meets the demands of labor market and growing needs of the industrial-innovative development of the country, and meeting the international standards. The shift to the European system has brought many benefits, but there are also some serious challenges. One of those challenges is related to the requirements for the PhD candidates to publish in national and international journals. Thus, a PhD candidate should have 7 publications in total, out of which one has to be in an international impact factor journal. A qualitative research was conducted to explore the PhD students’ views of their experiences with impact-factor publications. With the help of purposeful sampling, 30 PhD students from seven universities across Kazakhstan were selected for individual and focus group interviews. The key findings of the study are as follows. While the Kazakh PhD students have no difficulties in publishing in local journals, they face great challenges in attempting to publish in impact-factor journals for a range of reasons. They include but not limited to lack of research and publication skills, poorer knowledge of academic English, not familiarity with the peer review publication processes and expectations, and very short time to get published due to their PhD programme requirements. This situation is pushing some these young scholars explore alternative ways to get published in impact factor journals and they seek to publish by any means and often by any costs (which means even paying large sum of money for a publication). This in turn, creates a myth in the scholars’ circles in Kazakhstan, that to get published in impact factor journals, one should necessarily pay much money. This paper offers some policy recommendations on how to improve preparation of future PhD candidates in Kazakhstan.

Keywords: Bologna process, impact-factor publications, post-graduate education, Kazakhstan

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782 'Innovations among People' in Selected Social Economy Enterprises in Poland

Authors: Hanna Kroczak

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In Poland, the system of social and professional reintegration of people at risk of social exclusion is, in fact, based on the activity of social economy enterprises. Playing this significant role these entities have to cope with various problems, related to the necessity of being successful on the open market, location on the peripheral (especially rural) areas or the “socialist heritage” in social and economic relations, which is certainly not favorable for implementing the idea of activation policy. One of the main objectives of the project entitled “Innovation among people. The analysis of the innovations creation and implementation in companies and social economy enterprises operating in Poland”, was to investigate the innovativeness of Polish social economy entities as a possible way for them to be prosperous (the project was funded by the Polish National Science Centre grant on the decision DEC-2013/11/B/HS4/00691). The ethnographic research in this matter was conducted in 2015 in two parts: six three-day studies using participant observation and individual in-depth interview (IDI) techniques (in three social cooperatives and three social integration centres) and two one-month shadowings (in one social cooperative and one social integration centre). Enterprises were selected from various provinces in Poland on the basis of data from previous computer-assisted telephone interviewing (CATI) research, where they declared that innovation management is a central element of their strategy. The ethnographic study revealed that they, indeed, create innovations and the main types of them are social and organisational innovations – but not always and not all the employees are aware of that. Moreover, it turned out that wherever the research was conducted, researchers found some similar opportunities of innovations creating process, like a “charismatic leader”, true passion and commitment not depended on the earned money or building local institutional networks, and similar threats, e.g. under-staffed offices or the great bureaucracy of some institutions. The primary conclusion for the studied entities is that being innovative is not only their challenge and opportunity for well-being at the same time, but even a necessity, something deeply rooted in their specific organisational structures. Explanations and illustrations for the statements above will be presented in the proposed paper.

Keywords: ethnographic research, innovation, Polish social economy, professional reintegration, social economy enterprises, social reintegration

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781 Evaluation of Role of Surgery in Management of Pediatric Germ Cell Tumors According to Risk Adapted Therapy Protocols

Authors: Ahmed Abdallatif

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Background: Patients with malignant germ cell tumors have age distribution in two peaks, with the first one during infancy and the second after the onset of puberty. Gonadal germ cell tumors are the most common malignant ovarian tumor in females aged below twenty years. Sacrococcygeal and retroperitoneal abdominal tumors usually presents in a large size before the onset of symptoms. Methods: Patients with pediatric germ cell tumors presenting to Children’s Cancer Hospital Egypt and National Cancer Institute Egypt from January 2008 to June 2011 Patients underwent stratification according to risk into low, intermediate and high risk groups according to children oncology group classification. Objectives: Assessment of the clinicopathologic features of all cases of pediatric germ cell tumors and classification of malignant cases according to their stage, and the primary site to low, intermediate and high risk patients. Evaluation of surgical management in each group of patients focusing on surgical approach, the extent of surgical resection according to each site, ability to achieve complete surgical resection and perioperative complications. Finally, determination of the three years overall and disease-free survival in different groups and the relation to different prognostic factors including the extent of surgical resection. Results: Out of 131 cases surgically explored only 26 cases had re exploration with 8 cases explored for residual disease 9 cases for remote recurrence or metastatic disease and the other 9 cases for other complications. Patients with low risk kept under follow up after surgery, out of those of low risk group (48 patients) only 8 patients (16.5%) shifted to intermediate risk. There were 20 patients (14.6%) diagnosed as intermediate risk received 3 cycles of compressed (Cisplatin, Etoposide and Bleomycin) and all high risk group patients 69patients (50.4%) received chemotherapy. Stage of disease was strongly and significantly related to overall survival with a poorer survival in late stages (stage IV) as compared to earlier stages. Conclusion: Overall survival rate at 3 three years was (76.7% ± 5.4, 3) years EFS was (77.8 % ±4.0), however 3 years DFS was much better (89.8 ± 3.4) in whole study group with ovarian tumors had significantly higher Overall survival (90% ± 5.1). Event Free Survival analysis showed that Male gender was 3 times likely to have bad events than females. Patients who underwent incomplete resection were 4 times more than patients with complete resection to have bad events. Disease free survival analysis showed that Patients who underwent incomplete surgery were 18.8 times liable for recurrence compared to those who underwent complete surgery, and patients who were exposed to re-excision were 21 times more prone to recurrence compared to other patients.

Keywords: extragonadal, germ cell tumors, gonadal, pediatric

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780 Tracing Syrian Refugees Urban Mobilities: The Case of Egypt and Canada

Authors: N. Elgendy, N. Hussein

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The current Syrian crisis has caused unprecedented practices of global mobility. The process of forced eviction and the resettlement of refugees could be seen through the insights of the “new mobilities paradigm”. The mobility of refugees in terms of meaning and practice is a subject that calls for further studies. There is a need for the development of an approach to human mobility to understand a practice that is turning into a phenomenon in the 21st century. This paper aims at studying, from a qualitative point of view, the process of movement within the six constituents of mobility defined as the first phase of the journey of a refugee. The second phase would include the process of settling in and re-defining the host country as new “home” to refugees. The change in the refugee state of mind and crossing the physical and mental borders from a “foreigner” to a citizen is encouraged by both the governmental policies and the local communities’ efforts to embrace these newcomers. The paper would focus on these policies of social and economic integration. The concept of integration connotes the idea that refugees would enjoy the opportunities, rights and services available to the citizens of the refugee’s new community. So, this paper examines this concept through showcasing the two hosting countries of Canada and Egypt, as they provide two contrasting situations in terms of cultural, geographical, economic and political backgrounds. The analysis would highlight the specific policies defined towards the refugees including the mass communication, media calls, and access to employment. This research is part of a qualitative research project on the process of Urban Mobility practiced by the Syrian Refugees, drawing on conversational interviews with new-settlers who have moved to the different hosting countries, from their home in Syria. It explores these immigrants’ practical and emotional relationships with the process of movement and settlement. It uses the conversational interviews as a tool to document analysis and draw relationships in an attempt to establish an understanding of the factors that contribute to the new-settlers feeling of home and integration within the new community.

Keywords: integration, mobility, policy, refugees

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779 The Nexus between Social Entrepreneurship and Youth Empowerment

Authors: Aaron G. Laylo

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This paper mainly assumes that social entrepreneurship contributes significantly to youth empowerment i.e., work and community engagement. Two questions are thus raised in order to establish this hypothesis: 1) First, how does social entrepreneurship contribute to youth empowerment?; and 2) secondly, why is social entrpreneurship significantly incremental to youth empowerment? This research aims a) to investigate on the social aspect of entrepreneurship; b) to explore challenges in youth empowerment particularly in respect to work and community engagement; and c) to inquire into whether social enterprises have truly served as a catalyst for, thus an effective response to, youth empowerment. It must be emphasized that young people, which comprise 1.8 billion in a world of seven billion are an asset; Apparently, how to maximize that potential is crucial. By utilizing exploratory research design, the paper endeavors to generate new ideas in regards to both components, develop tentative theories on social entrepreneurship, and refine certain issues that are under observation and seek scholarly attention— a rather emerging phenomenon vis a vis the challenge to empower a significant cluster of the society. Case studies will be utilized as an approach in order to comparatively analyze youth-driven social enterprises in the Philippines that have been widely recognized as successful insofar as social impact is concerned. As most scholars attested, social entrepreneurship is still at its infancy stage. Youth empowerment, meanwhile, is yet a vast area to explore insofar as academic research is concerned. Programs and projects that advocate the pursuit of these components abound. However, academic research is yet to be undertaken to see and understand their social and economic relevance. This research is also an opportunity for scholars to explore, understand, and make sense of the promise that lies in social entrepreneurship research and how it can serve as a catalyst for youth empowerment. Youth-driven social enterprises can be an influential tool in sustaining development across the globe as they intend to provide opportunities for optimal economic productivity that recognizes social inclusion. Ultimately, this study should be able to contribute to both research and development-in-practice communities for the greater good of the society. By establishing the nexus between these two components, the research may contribute to fostering greater exploration of the benefits that both may yield to human progress as well as the gaps that have to be filled in by various policy stakeholders relevant to these units.

Keywords: social entpreneurship, youth, empowerment, social inclusion

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778 Young Adult Gay Men's Healthcare Access in the Era of the Affordable Care Act

Authors: Marybec Griffin

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Purpose: The purpose of this cross-sectional study was to get a better understanding of healthcare usage and satisfaction among young adult gay men (YAGM), including the facility used as the usual source of healthcare, preference for coordinated healthcare, and if their primary care provider (PCP) adequately addressed the health needs of gay men. Methods: Interviews were conducted among n=800 YAGM in New York City (NYC). Participants were surveyed about their sociodemographic characteristics and healthcare usage and satisfaction access using multivariable logistic regression models. The surveys were conducted between November 2015 and June 2016. Results: The mean age of the sample was 24.22 years old (SD=4.26). The racial and ethnic background of the participants is as follows: 35.8% (n=286) Black Non-Hispanic, 31.9% (n=225) Hispanic/Latino, 20.5% (n=164) White Non-Hispanic, 4.4% (n=35) Asian/Pacific Islander, and 6.9% (n=55) reporting some other racial or ethnic background. 31.1% (n=249) of the sample had an income below $14,999. 86.7% (n=694) report having either public or private health insurance. For usual source of healthcare, 44.6% (n=357) of the sample reported a private doctor’s office, 16.3% (n=130) reported a community health center, and 7.4% (n=59) reported an urgent care facility, and 7.6% (n=61) reported not having a usual source of healthcare. 56.4% (n=451) of the sample indicated a preference for coordinated healthcare. 54% (n=334) of the sample were very satisfied with their healthcare. Findings from multivariable logistical regression models indicate that participants with higher incomes (AOR=0.54, 95% CI 0.36-0.81, p < 0.01) and participants with a PCP (AOR=0.12, 95% CI 0.07-0.20, p < 0.001) were less likely to use a walk-in facility as their usual source of healthcare. Results from the second multivariable logistic regression model indicated that participants who experienced discrimination in a healthcare setting were less likely to prefer coordinated healthcare (AOR=0.63, 95% CI 0.42-0.96, p < 0.05). In the final multivariable logistic model, results indicated that participants who had disclosed their sexual orientation to their PCP (AOR=2.57, 95% CI 1.25-5.21, p < 0.01) and were comfortable discussing their sexual activity with their PCP (AOR=8.04, 95% CI 4.76-13.58, p < 0.001) were more likely to agree that their PCP adequately addressed the healthcare needs of gay men. Conclusion: Understanding healthcare usage and satisfaction among YAGM is necessary as the healthcare landscape changes, especially given the relatively recent addition of urgent care facilities. The type of healthcare facility used as a usual source of care influences the ability to seek comprehensive and coordinated healthcare services. While coordinated primary and sexual healthcare may be ideal, individual preference for this coordination among YAGM is desired but may be limited due to experiences of discrimination in primary care settings.

Keywords: healthcare policy, gay men, healthcare access, Affordable Care Act

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777 The Overseas Promotion of National Identity by France and Japan for Global Outreach: A Comparative and Discursive Analysis of Their Narratives on Public Diplomacy since the End of the Cold War

Authors: Natsuko D'Aprile

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The construction of Nation-States is a historical process that produces a type of national identity and culture that States nowadays mobilise for global outreach. National culture, as a set of norms and values influencing individuals’ actions and decisions, produces a type of policy making of various strategies that impact how a Nation is promoted overseas. The 1990s were marked by a resurgence of the debates on national identity. This period is believed to have paved the way for nationalism and witnessed increased attention to analytical approaches to identity. Public diplomacy is a concrete example of how national culture is mobilised to project a favourable image of a Nation abroad, especially in the narratives on national identity mobilised by diplomatic actors. Public diplomacy is understood as providing tools for States to build and project strategic narratives that represent events and identities in an attempt to influence domestic and foreign audiences, be they domestic or foreign. France and Japan received little attention on the matter. This research hence aims to investigate how France and Japan have mobilised narratives on national identity since the 1990s in the context of their public diplomacy. To understand how identities are framed, qualitative and quantitative discourse analysis has been performed on a corpus of various speeches held by French and Japanese political actors in which they present their diplomacy goals, as well as official documents provided by both Ministries of Foreign Affairs. This analysis showed that the French discourse integrates a narrative on France’s universal vocation, relying on the expression of a Nation whose model is worldly applicable and has the legitimacy to influence international decisions. The Japanese discourse does not concretely emphasise Japanese or Asian values, except for some narratives integrating Confucian and Shintō values. It rather revolves around the need for Japan to ensure its citizens’ security and prosperity, hence the need for the Government to contribute to peace in the Asia-Pacific region and the world.

Keywords: comparative politics, culture, discourse analysis, narratives, public diplomacy

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776 The Surgical Trainee Perception of the Operating Room Educational Environment

Authors: Neal Rupani

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Background: A surgical trainee has limited learning opportunities in the operating room in order to gain an ever-increasing standard of surgical skill, competency, and proficiency. These opportunities continue to decline due to numerous factors such as the European Working Time Directive and increasing requirement for service provision. It is therefore imperative to obtain the highest educational value from each educational opportunity. A measure that has yet to be validated in England on surgical trainees called the Operating Room Educational Environment Measure (OREEM) has been developed to identify and evaluate each component of the educational environment with a view to steer future change in optimising educational events in theatre. Aims: The aims of the study are to assess the reliability of the OREEM within England and to evaluate the surgical trainee’s objective perspective of the current operating room educational environment within one region within England. Methods: Using a quantitative study approach, data was collected over one month from surgical trainees within Health Education Thames Valley (Oxford) using an online questionnaire consisting of demographic data, the OREEM, a global satisfaction score. Results: 140 surgical trainees were invited to the study, with an online response of 54 participants (response rate = 38.6%). The OREEM was shown to have good internal consistency (α = 0.906, variables = 40) and unidimensionality, along with all four of its subgroups. The mean OREEM score was 79.16%. The areas highlighted for improvement predominantly focused on improving learning opportunities (average subscale score = 72.9%) and conducting pre- and post-operative teaching (average score = 70.4%). The trainee perception is most satisfactory for the level of supervision and workload (average subscale score = 82.87%). There was no differences found between gender (U = 191.5, p = 0.535) or type of hospital (U = 258.0, p = 0.099), but the learning environment was favoured towards senior trainees (U = 223.5, p = 0.017). There was strong correlation between OREEM and the global satisfaction score (r = 0.755, p<0.001). Conclusions: The OREEM was shown to be reliable in measuring the educational environment in the operating room. This can be used to identify potentially modifiable components for improvement and as an audit tool to ensure high standards are being met. The current perception of the education environment in Health Education Thames Valley is satisfactory, and modifiable internal and external factors such as reducing service provision requirements, empowering trainees to plan lists, creating a team-working ethic between all personnel, and using tools that maximise learning from each operation have been identified to improve learning in the future. There is a favourable attitude to use of such improvement tools, especially for those currently dissatisfied.

Keywords: education environment, surgery, post-graduate education, OREEM

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775 Health Information Needs and Utilization of Information and Communication Technologies by Medical Professionals in a Northern City of India

Authors: Sonika Raj, Amarjeet Singh, Vijay Lakshmi Sharma

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Introduction: In 21st century, due to revolution in Information and Communication Technologies (ICTs), there has been phenomenal development in quality and quantity of knowledge in the field of medical science. So, the access to relevant information to physicians is critical to the delivery of effective healthcare services to patients. The study was conducted to assess the information needs and attitudes of the medical professionals; to determine the sources and channels of information used by them; to ascertain the current usage of ICTs and the barriers faced by them in utilization of ICTs in health information access. Methodology: This descriptive cross-sectional study was carried in 2015 on hundred medical professionals working in public and private sectors of Chandigarh. The study used both quantitative and qualitative method for data collection. A semi structured questionnaire and interview schedule was used to collect data on information seeking needs, access to ICTs and barriers to healthcare information access. Five Data analysis was done using SPSS-16 and qualitative data was analyzed using thematic approach. Results: The most preferred sources to access healthcare information were internet (85%), trainings (61%) and communication with colleagues (57%). They wanted information on new drug therapy and latest developments in respective fields. All had access to computer with but almost half assessed their computer knowledge as average and only 3% had received training regarding usage. Educational status (p=0.004), place of work (p=0.004), number of years in job (p=0.004) and sector of job (p=0.04) of doctors were found to be significantly associated with their active search for information. The major themes that emerged from in-views were need; types and sources of healthcare information; exchange of information among different levels of healthcare providers; usage of ICTs to obtain and share information; barriers to access of healthcare information and quality of health information materials and involvement in their development process Conclusion and Recommendations: The medical professionals need information in their in their due course of work. However, information needs of medical professionals were not being adequately met. There should be training of professional regarding internet skills and the course on bioinformatics should be incorporated in the curricula of medical students. The policy framework must be formulated that will encourage and promote the use of ICTs as tools for health information access and dissemination.

Keywords: health information, ICTs, medical professionals, qualitative

Procedia PDF Downloads 336
774 Factors Related to Health Promotion Behavior of Older Employees in Factory

Authors: Kanda Janyam, Piyaporn Vijit

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Background: As a consequence of sustained declines in fertility and mortality during the last three decades of the 20th century, Thailand faces a rapidly growing population of older persons. This demographic change directly affect Thailand workforce. Therefore, the study of health promotion behaviour of the older employees will benefit the employers as they can then develop the preparation for promoting well-being in older persons. Purpose: The current study aims to investigate health promotion behaviour and factors related to health promotion behaviour of older employees in factory. Methodology: The research instrument was questionnaire on health promotion behaviour and semi-structured interviews. The questionnaire was launched with 326 employees aged between 45-59 years in three factories in Songkhla Province, southern Thailand. The data collection started in December 2011. The data were analysed with mean, standard deviation, and correlation. Results: The results revealed that overall health promotion behaviour of the older employees in factory was at a high level. Moreover, when considered by aspect, it was found that their responsibility for health, nutrition, success in life, interpersonal relationship were at a high level while stress management, and exercise were at a moderate level. The results from correlation analysis indicated that the overall health promotion behaviour was positively related to knowledge of health promotion behaviour, attitude toward health promotion behaviour, health perception, the policy of health promotion, participation in health promotion activities, convenience in obtaining health promotion services, health resources, advice from people supporting health, and information received from the media. In addition, the results of the interviews with four key informants helped to confirm the factors related to health promotion behaviour of older employees in factory. Therefore, health promotion for elderly employees in factory is likely to be successful, if the support is given to the four health promotion factors that are divided into: leading factors consisting of attitude toward health promotion behaviour, and health perception, and supporting factors consisting of advice from other people, and information on health from various media. Practical implications: The results of the study identified the factors related to health promotion behaviour of older employees in factory. Such information will benefit employers as they can then develop specific strategies to increase their staffs’ well-being and, hence, presumably enhance the organization productivity.

Keywords: health promotion behavior, older, employee, factory

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773 Relationship between Different Heart Rate Control Levels and Risk of Heart Failure Rehospitalization in Patients with Persistent Atrial Fibrillation: A Retrospective Cohort Study

Authors: Yongrong Liu, Xin Tang

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Background: Persistent atrial fibrillation is a common arrhythmia closely related to heart failure. Heart rate control is an essential strategy for treating persistent atrial fibrillation. Still, the understanding of the relationship between different heart rate control levels and the risk of heart failure rehospitalization is limited. Objective: The objective of the study is to determine the relationship between different levels of heart rate control in patients with persistent atrial fibrillation and the risk of readmission for heart failure. Methods: We conducted a retrospective dual-centre cohort study, collecting data from patients with persistent atrial fibrillation who received outpatient treatment at two tertiary hospitals in central and western China from March 2019 to March 2020. The collected data included age, gender, body mass index (BMI), medical history, and hospitalization frequency due to heart failure. Patients were divided into three groups based on their heart rate control levels: Group I with a resting heart rate of less than 80 beats per minute, Group II with a resting heart rate between 80 and 100 beats per minute, and Group III with a resting heart rate greater than 100 beats per minute. The readmission rates due to heart failure within one year after discharge were statistically analyzed using propensity score matching in a 1:1 ratio. Differences in readmission rates among the different groups were compared using one-way ANOVA. The impact of varying levels of heart rate control on the risk of readmission for heart failure was assessed using the Cox proportional hazards model. Binary logistic regression analysis was employed to control for potential confounding factors. Results: We enrolled a total of 1136 patients with persistent atrial fibrillation. The results of the one-way ANOVA showed that there were differences in readmission rates among groups exposed to different levels of heart rate control. The readmission rates due to heart failure for each group were as follows: Group I (n=432): 31 (7.17%); Group II (n=387): 11.11%; Group III (n=317): 90 (28.50%) (F=54.3, P<0.001). After performing 1:1 propensity score matching for the different groups, 223 pairs were obtained. Analysis using the Cox proportional hazards model showed that compared to Group I, the risk of readmission for Group II was 1.372 (95% CI: 1.125-1.682, P<0.001), and for Group III was 2.053 (95% CI: 1.006-5.437, P<0.001). Furthermore, binary logistic regression analysis, including variables such as digoxin, hypertension, smoking, coronary heart disease, and chronic obstructive pulmonary disease as independent variables, revealed that coronary heart disease and COPD also had a significant impact on readmission due to heart failure (p<0.001). Conclusion: The correlation between the heart rate control level of patients with persistent atrial fibrillation and the risk of heart failure rehospitalization is positive. Reasonable heart rate control may significantly reduce the risk of heart failure rehospitalization.

Keywords: heart rate control levels, heart failure rehospitalization, persistent atrial fibrillation, retrospective cohort study

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772 Morphological Investigation of Sprawling Along Emerging Peri-Urban Transit Corridor of Mowe-Ibafo Axis of the Lagos Megacity Region

Authors: Folayele Oluyemi Akindeju, Tobi Joseph Ajoro

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The city as a complex system exhibiting chaotic behaviour is in a state of constant change, in response to prevailing social, economic, environmental and technological factors. Without adequate investigation and control mechanisms to tame the sporadic nature of growth in most urban areas of cities in developing regions, organic sprawling visibly manifests with its attendant problems, most especially at peri-urban areas. The Lagos Megacity region in southwest Nigeria, as one of the largest megacities in the world contends with the challenges of sprawling at the peri-urban areas especially along emerging transit corridors. Due to the seemingly unpredictable nature of this growth, this paper attempts a morphological investigation into the growth of peri-urban settlements along the Mowe-Ibafo transit corridor of the Megacity region over a temporal space of three decades (1984-2014). This study adopts the application of the Fractal Analysis and Regression Analysis methods through the correlation of population density and fractal dimension values to establish the pattern and nature of growth, due to the inadequacies of conventional methods of urban analysis which cannot deal with the unpredictability of such complex urban forms as the peri-urban areas. It was deduced that the dynamic urban expansion in the last three decades resulted in about 74.2% urban change rate between 1984 and 2000 and 63.4% urban change rate between 2000 and 2014. With the R2 value between the fractal dimension and population density been 1, the regression model indicates a positive correlation between Fractal Dimension (D) and Population Density (pop/km2), where the increase in the population density from 5740 pop/km2 to 8060 pop/km2 and later decrease to 7580 pop/km2 leads to an increase in the fractal dimension of urban growth from 1.451 in 1984 to 1.853 in 2014. This, therefore, justifies the ability to predict and determine the nature and direction of growth of complex entities and is sufficient to substantially suggest the need for adequate policy framework towards sustainable urban planning and infrastructural provision in the Peri-urban areas.

Keywords: fractal analysis, Lagos Megacity, peri-urban, sprawling, urban morphology

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771 Impacts on Marine Ecosystems Using a Multilayer Network Approach

Authors: Nelson F. F. Ebecken, Gilberto C. Pereira, Lucio P. de Andrade

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Bays, estuaries and coastal ecosystems are some of the most used and threatened natural systems globally. Its deterioration is due to intense and increasing human activities. This paper aims to monitor the socio-ecological in Brazil, model and simulate it through a multilayer network representing a DPSIR structure (Drivers, Pressures, States-Impacts-Responses) considering the concept of Management based on Ecosystems to support decision-making under the National/State/Municipal Coastal Management policy. This approach considers several interferences and can represent a significant advance in several scientific aspects. The main objective of this paper is the coupling of three different types of complex networks, the first being an ecological network, the second a social network, and the third a network of economic activities, in order to model the marine ecosystem. Multilayer networks comprise two or more "layers", which may represent different types of interactions, different communities, different points in time, and so on. The dependency between layers results from processes that affect the various layers. For example, the dispersion of individuals between two patches affects the network structure of both samples. A multilayer network consists of (i) a set of physical nodes representing entities (e.g., species, people, companies); (ii) a set of layers, which may include multiple layering aspects (e.g., time dependency and multiple types of relationships); (iii) a set of state nodes, each of which corresponds to the manifestation of a given physical node in a layer-specific; and (iv) a set of edges (weighted or not) to connect the state nodes among themselves. The edge set includes the intralayer edges familiar and interlayer ones, which connect state nodes between layers. The applied methodology in an existent case uses the Flow cytometry process and the modeling of ecological relationships (trophic and non-trophic) following fuzzy theory concepts and graph visualization. The identification of subnetworks in the fuzzy graphs is carried out using a specific computational method. This methodology allows considering the influence of different factors and helps their contributions to the decision-making process.

Keywords: marine ecosystems, complex systems, multilayer network, ecosystems management

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770 A Conceptual Framework for Knowledge Integration in Agricultural Knowledge Management System Development

Authors: Dejen Alemu, Murray E. Jennex, Temtim Assefa

Abstract:

Agriculture is the mainstay of the Ethiopian economy; however, the sector is dominated by smallholder farmers resulting in land fragmentation and suffering from low productivity. Due to these issues, much effort has been put into the transformation of the sector to bring about more sustainable rural economic development. Technological advancements have been applied for the betterment of farmers resulting in the design of tools that are potentially capable of supporting the agricultural sector; however, their use and relevance are still alien to the local rural communities. The notion of the creating, capturing and sharing of knowledge has also been repetitively raised by many international donor agencies to transform the sector, yet the most current approaches to knowledge dissemination focus on knowledge that originates from the western view of scientific rationality while overlooking the role of indigenous knowledge (IK). Therefore, in agricultural knowledge management system (KMS) development, the integration of IKS with scientific knowledge is a critical success factor. The present study aims to contribute in the discourse on how to best integrate scientific and IK in agricultural KMS development. The conceptual framework of the research is anchored in concepts drawn from the theory of situated learning in communities of practice (CoPs): knowledge brokering. Using the KMS development practices of Ethiopian agricultural transformation agency as a case area, this research employed an interpretive analysis using primary and secondary qualitative data acquired through in-depth semi-structured interviews and participatory observations. As a result, concepts are identified for understanding the integration of the two major knowledge systems (i.e., indigenous and scientific knowledge) and participation of relevant stakeholders in particular the local farmers in agricultural KMS development through the roles of extension agent as a knowledge broker including crossing boundaries, in-between position, translation and interpretation, negotiation, and networking. The research shall have a theoretical contribution in addressing the incorporation of a variety of knowledge systems in agriculture and practically to provide insight for policy makers in agriculture regarding the importance of IK integration in agricultural KMS development and support marginalized small-scale farmers.

Keywords: communities of practice, indigenous knowledge, knowledge management system development, knowledge brokering

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769 Identifying the Determinants of the Shariah Non-Compliance Risk via Principal Axis Factoring

Authors: Muhammad Arzim Naim, Saiful Azhar Rosly, Mohamad Sahari Nordin

Abstract:

The objective of this study is to investigate the factors affecting the rise of Shariah non-compliance risk that can bring Islamic banks to succumb to monetary loss. Prior literatures have never analyzed such risk in details despite lots of it arguing on the validity of some Shariah compliance products. The Shariah non-compliance risk in this context is looking to the potentially failure of the facility to stand from the court test say that if the banks bring it to the court for compensation from the defaulted clients. The risk may also arise if the customers refuse to make the financing payments on the grounds of the validity of the contracts, for example, when relinquishing critical requirement of Islamic contract such as ownership, the risk that may lead the banks to suffer loss when the customer invalidate the contract through the court. The impact of Shariah non-compliance risk to Islamic banks is similar to that of legal risks faced by the conventional banks. Both resulted into monetary losses to the banks respectively. In conventional banking environment, losses can be in the forms of summons paid to the customers if they won the case. In banking environment, this normally can be in very huge amount. However, it is right to mention that for Islamic banks, the subsequent impact to them can be rigorously big because it will affect their reputation. If the customers do not perceive them to be Shariah compliant, they will take their money and bank it in other places. This paper provides new insights of risks faced by credit intensive Islamic banks by providing a new extension of knowledge with regards to the Shariah non-compliance risk by identifying its individual components that directly affecting the risk together with empirical evidences. Not limited to the Islamic banking fraternities, the regulators and policy makers should be able to use findings in this paper to evaluate the components of the Shariah non-compliance risk and make the necessary actions. The paper is written based on Malaysia’s Islamic banking practices which may not directly related to other jurisdictions. Even though the focuses of this study is directly towards to the Bay Bithaman Ajil or popularly known as BBA (i.e. sale with deferred payments) financing modality, the result from this study may be applicable to other Islamic financing vehicles.

Keywords: Islamic banking, Islamic finance, Shariah Non-compliance risk, Bay Bithaman Ajil (BBA), principal axis factoring

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