Search results for: planning and policy

Authors: Suzan Sayegh, Izzeldin Ibrahim, Mercia Van Der Walt, Mohamed Al-Kuwari

Abstract:

Background: Walking is the most common form of physical activity which can promote a healthy well-being among people of different age groups. In this regard, pedometers are becoming more popular within research and are considered useful tools in monitoring physical activity levels based on individuals’ daily steps. A value of ˂5,000 steps/day is identified as a sedentary lifestyle index where individuals are physically inactive. Those achieving 5,000-7,499 steps/day have a low active lifestyle as they do not meet the moderate-to-vigorous physical activity (MVPA) recommendations. Moreover, individuals achieving ≥7,500 steps/day are classified as physically active. The objective of this study is to assess the physical activity levels of adult population in Qatar through a pedometer-based program over a one-year period. Methods: A cross-sectional analysis, as part of a longitudinal study, was carried out over one year to assess the daily step count. “Step into Health” is a community-based program launched by Aspire as an approach for the purpose of improving physical activity across the population of Qatar. The program involves distribution of pedometers to registered members which is supported by a self-monitoring online account and linked to a web database. Daily habitual physical activity (daily total step count) was assessed through Omron HJ-324U pedometer. Analyses were done on data extracted from the web database. Results: A total of 1,988 members were included in this study (males: n=1,143, 57%; females: n=845, 43%). Average age was 37.8±10.9 years distributed as 60% of age between age 25-54 (n=1,186), 27% of age 45-64 (n=546), and 13% of age 18-24 years (n=256). Majority were non-Qataris, 81% (n=1,609) compared with 19% of the Qatari nationality (n=379). Average body mass index (BMI) was 27.8±6.1 (kg/m2) where most of them (41%, n=809) were found to be overweight, between 25-30 kg/m2. Total average step count was 5,469±3,884. Majority were found to be sedentary (n=1110, 55.8%). Middle aged individuals were more active than the other two age groups. Males were seen as more active than females. Those who were less active had a higher BMI. Older individuals were more active. There was a variation in the physical activity level throughout the year period. Conclusion: It is essential to further develop the available intervention programs and increase their physical activity behavior. Planning such physical activity interventions for female population should involve aspects such as time, environmental variables and aerobic steps.

Keywords: adults, pedometer, physical activity, step-count

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Authors: Mili Dutta, Lokender Prashad

Abstract:

Introduction: Population ageing is a phenomenon that can be observed around the globe. The health-related quality of life (HRQOL) is a measurement of health status of an individual, and it describes the effect of physical and mental health disorders on the well-being of a person. The present study is aimed to describe the influence of socio-economic characteristics of elderly on their health-related quality of life in India. Methods: EQ-5D instrument and population-based EQ-5D index score has been measured to access the HRQOL among elderly. Present study utilized the Study on Global Ageing and Adult Health (SAGE) data which was conducted in 2007 in India. Multiple Logistic Regression model and Multivariate Linear Regression model has been employed. Result: In the present study, it was found that the female are more likely to have problems in mobility (OR=1.41, 95% Cl: 1.14 to 1.74), self-care (OR=1.26, 95% Cl: 1.01 to 1.56) and pain or discomfort (OR=1.50, 95% Cl: 1.16 to 1.94). Elderly residing in rural area are more likely to have problems in pain/discomfort (OR=1.28, 95% Cl: 1.01 to 1.62). More older and non-working elderly are more likely whereas higher educated and highest wealth quintile elderly are less likely to have problems in all the dimensions of EQ-5D viz. mobility, self-care, usual activity, pain/discomfort and anxiety/depression. The present study has also shown that oldest old people, residing in rural area and currently not working elderly are more likely to report low EQ-5D index score whereas elderly with high education level and high wealth quintile are more likely to report high EQ-5D index score than their counterparts. Conclusion: The present study has found EQ-5D instrument as the valid measure for assessing the HRQOL of elderly in India. The study indicates socio-economic characteristics of elderly such as female, more older people, residing in rural area, non-educated, poor and currently non-working as the major risk groups of having poor HRQOL in India. Findings of the study will be helpful for the programmes and policy makers, researchers, academician and social workers who are working in the field of ageing.

Keywords: ageing, HRQOL, India, EQ-5D, SAGE, socio-economic characteristics

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Authors: Alexandra Telitsyna, Galina Semya, Elvira Garifulina

Abstract:

Introduction: Starting from 2012 Russia conducts deinstitutionalization policy and now the main indicator of success is the number of children living in institutions. Active family placement process has resulted in residents of the institution now mainly consists of adolescents with behavioral and emotional problems, children with disabilities and groups of siblings. Purpose of science research: The purpose of science research is to identify factors for child’s wellbeing while temporary stay in an orphanage and the subjective assessment of children's level of well-being (psychological well-being). Methods: The data used for this project was collected by the questionnaire of 72 indicators, a tool for monitoring the behavior of children and caregivers, an additional questionnaire for children; well-being assessment questionnaire containing 10 scales for three age groups from preschool to older adolescents. In 2016-2018, the research was conducted in 1873 institution in 85 regions of Russia. In each region a team of academics, specialists from Non-profits, independent experts was created. Training was conducted for team members through a series of webinars prior to undertaking the assessment. The results: To ensure the well-being of the children, the following conditions are necessary: 1- Life of children in institution is organised according to the principles of family care (including the creation of conditions for attachment to be formed); 2- Contribution to find family-based placement for children (including reintegration into the primary family); 3- Work with parents of children, who are placed in an organization at the request of parents; 4- Children attend schools according to their needs; 5- Training of staff and volunteers; 6- Special environment and services for children with special needs and children with disabilities; 7- Cooperation with NGOs; 8 - Openness and accessibility of the organization. Conclusion: A study of the psychological well-being of children showed that the most emotionally stressful for children were questions about the presence and frequency of contact with relatives, and the level of well-being is higher in the presence of a trusted adult and respect for rights. The greatest contribution to the trouble is made by the time the child is in the orphanage, the lack of contact with parents and relatives, the uncertainty of the future.

Keywords: identifying factors, orphans, Russia, wellbeing

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Authors: Tsu-Yin Wu, Jenni Hoffman, Lydia McMurrows, Sarah Lally

Abstract:

Recent events of the Flint Water Crisis and elevated lead levels in Detroit public school water have highlighted a specific public health disparity and shown the need for better education of healthcare providers on lead education. Identifying children and pregnant women with a high risk for lead poisoning and ensuring lead testing is completed is critical. The purpose of this study is to explore the impact of an educational intervention on knowledge and confidence levels among nursing students enrolled in the prelicensure Bachelor of Science in Nursing (BSN) and Registered Nurse to BSN program (R2B). The study used both quantitative and qualitative research methods to assess the impact of multi-modal pedagogy on knowledge and confidence of lead screening and prevention among prelicensure and R2B nursing students. The students received lead poisoning and prevention content in addition to completing an e-learning module developed by the Pediatric Environmental Health Specialty Units. A total of 115 students completed the pre-and post-test instrument that consisted of demographic, lead knowledge, and confidence items. Despite the increase of total knowledge, three dimensions of lead poisoning, and confidence from pre- to post-test scores for both groups, there was no statistical significance on the increase between prelicensure and R2B students. Thematic analysis of qualitative data showed five themes from participants' learning experiences: lead exposure, signs and symptoms of lead poisoning, screening and diagnosis, prevention, and policy and statewide issues. The study is limited by a small sample and participants recalling some correct answers from the pretest, thus, scoring higher on the post-test. The results contribute to the minimally existent literature examining a critical public health concern regarding lead health exposure and prevention education of nursing students. Incorporating such content area into the nursing curriculum is essential in ensuring that such public health disparities are mitigated.

Keywords: lead poisoning, emerging public health issue, community health, nursing edducation

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Authors: Adeosun, Festus Idowu; Omoniyi, Isaac Tunde, Adeosun, Olamide Modinat

Abstract:

This study assessed the association between household livelihood diversification and fisheries conservation policies among fishermen in coastal areas of Ogun State, Nigeria by adopting a multistage sampling procedure. The sample size was 90 fishermen from six randomly selected fishing communities (Abureji, Agbalegiyo, Ilamo, Imosan, Iseku and Wharf) along the coastline in Ogun State, Nigeria. Data were collected using pre-validated interview schedule and subjected to descriptive and inferential analytical techniques. Results revealed that majority of the fishermen were married (98.9%), in the age bracket of 41-60 years (71.1%) with mean age of 49 years, had household size of 6-15 persons (91.1%) with mean household size being 9 persons, from extended families (90.0%), either either no formal (43.3%) or only primary education (41.1%), were non-members of social groups (62.2%), and had no other occupations (93.3%). It was also reported that there was generally low level of household livelihood diversification across the fishing communities. Gill nets were the most commonly used fishing gears across the fishing communities (80.0%). This was followed by seine nets (63.3%), traps (56.7%) and trawl nets (53.3%) while fish aggregating devices (35.6%), cast nets (37.8%) and hook and line (24.4%) were the least used fishing gears in the study locations. Results further revealed that coastal fishery was characterised by conflicts among water users (64.4%), absence of protected fishing areas (81.1%), and experience of water pollution (36.7%). Majority (71.1%) of the fishermen across the study locations agreed with closed season policy as a coastal fisheries conservation strategy. This was followed by gear restriction (30.0%). Results of Chi-square analysis revealed that there were significant associations between level of household livelihood diversification and fishermen’s agreement with gear restriction (χ2 = 15.545, df = 5), and closed season (χ2 = 11.214, df = 4). The study concluded that coastal fisheries is in a poor state and that it could be improved through the introduction of gear restriction and closed season policies. The study recommended that youths in the coastal areas should venture into fishing, and that government and non-governmental agencies should organize sensitization programmes on fisheries conservation policies across the coastal areas in Ogun State.

Keywords: coastal, fisheries, conservation, livelihood

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Authors: Mariia Timofeeva, Andrew Ooi, Eric K. W. Poon, Peter Barlis

Abstract:

Atherosclerotic plaque build-up, commonly known as stenosis, limits blood flow and hence oxygen and nutrient supplies to the heart muscle. Thus, assessment of its severity is of great interest to health professionals. Numerical simulation of the fractional flow reserve (FFR) has proved to be well correlated with invasively measured FFR used for physiological assessment of the severity of coronary stenosis in arteries. Atherosclerosis may impact the diseased artery in several locations causing serial stenoses, which is a complicated subset of coronary artery disease that requires careful treatment planning. However, hemodynamic of the serial sequential stenoses in coronary arteries has not been extensively studied. The hemodynamics of the serial stenoses is complex because the stenoses in the series interact and affect the flow through each other. To address this, serial stenoses in a 3.4 mm left anterior descending (LAD) artery are examined in this study. Two diameter stenoses (DS) are considered, 30 and 50 percent of the reference diameter. Serial stenoses configurations are divided into three groups based on the order of the stenoses in the series, spacing between them, and deviation of the stenoses’ symmetry (eccentricity). A patient-specific pulsatile waveform is used in the simulations. Blood flow within the stenotic artery is assumed to be laminar, Newtonian, and incompressible. Results for the FFR are reported. Based on the simulation results, it can be deduced that the larger drop in pressure (smaller value of the FFR) is expected when the percentage of the second stenosis in the series is bigger. Varying the distance between the stenoses affects the location of the maximum drop in the pressure, while the minimal FFR in the artery remains unchanged. Eccentric serial stenoses are characterized by a noticeably larger decrease in pressure through the stenoses and by the development of the chaotic flow downstream of the stenoses. The largest drop in the pressure (about 4% difference compared to the axisymmetric case) is obtained for the serial stenoses, where both the stenoses are highly eccentric with the centerlines deflected to the different sides of the LAD. In conclusion, varying configuration of the sequential serial stenoses results in a different distribution of FFR through the LAD. Results presented in this study provide insight into the clinical assessment of the severity of the coronary serial stenoses, which is proved to depend on the relative position of the stenoses and the deviation of the stenoses’ symmetry.

Keywords: computational fluid dynamics, coronary artery, fractional flow reserve, serial stenoses

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Authors: Souzan Al Sayegh, Izzeldin Ibrahim, Mercia Van Der Walt, Mohamed Al-Kuwari

Abstract:

Background: Walking is the most common form of physical activity which can promote a healthy well-being among people of different age groups. In this regard, pedometers are becoming more popular within research and are considered useful tools in monitoring physical activity levels based on individuals’ daily steps. A value of ˂5,000 steps/day is identified as a sedentary lifestyle index where individuals are physically inactive. Those achieving 5,000-7,499 steps/day have a low active lifestyle as they do not meet the moderate-to-vigorous physical activity (MVPA) recommendations. Moreover, individuals achieving ≥7,500 steps/day are classified as physically active. The objective of this study is to assess the physical activity levels of adult population in Qatar through a pedometer-based program over a one-year period. Methods: A cross-sectional analysis, as part of a longitudinal study, was carried out over one year to assess the daily step count. 'Step into Health' is a community-based program launched by Aspire as an approach for the purpose of improving physical activity across the population of Qatar. The program involves the distribution of pedometers to registered members which is supported by a self-monitoring online account and linked to a web database. Daily habitual physical activity (daily total step count) was assessed through Omron HJ-324U pedometer. Analyses were done on data extracted from the web database. Results: A total of 1,988 members were included in this study (males: n=1,143, 57%; females: n=845, 43%). Average age was 37.8±10.9 years distributed as 60% of age between age 25-54 (n=1,186), 27% of age 45-64 (n=546), and 13% of age 18-24 years (n=256). Majority were non-Qataris, 81% (n=1,609) compared with 19% of the Qatari nationality (n=379). Average body mass index (BMI) was 27.8±6.1 (kg/m2) where most of them (41%, n=809) were found to be overweight, between 25-30 kg/m2. Total average step count was 5,469±3,884. Majority were found to be sedentary (n=1110, 55.8%). Middle aged individuals were more active than the other two age groups. Males were seen as more active than females. Those who were less active had a higher BMI. Older individuals were more active. There was a variation in the physical activity level throughout the year period. Conclusion: It is essential to further develop the available intervention programs and increase their physical activity behavior. Planning such physical activity interventions for female population should involve aspects such as time, environmental variables and aerobic steps.

Keywords: adults, pedometer, physical activity, step-count

Procedia PDF Downloads 282

Authors: Evangelia-Chrysanthi Kouklari, Evdokia Tagkouli, Vassiliki Ntre, Artemios Pehlivanidis, Stella Tsermentseli, Gerasimos Kolaitis, Katerina Papanikolaou

Abstract:

Executive Function (EF) is a set of goal-directed cognitive skills essentially needed in problem-solving and social behavior. Developmental EF research has indicated that EF emerges early in life and marks dramatic changes before the age of 5. Research evidence has suggested that it may continue to develop up to adolescence as well, following the development of the prefrontal cortex. Over the last decade, research evidence has suggested distinguished domains of cool and hot EF, but traditionally the development of EF in Autism Spectrum Disorder (ASD) has been examined mainly with tasks that address the “cool” cognitive aspects of EF. Thus, very little is known about the development of “hot” affective EF processes and whether the cross-sectional developmental pathways of cool and hot EF present similarities in ASD. Cool EF has also been proven to have a strong correlation with Theory of Mind (ToM) in young and middle childhood in typical development and in ASD, but information about the relationship of hot EF to ToM skills is minimal. The present study’s objective was to explore the age-related changes of cool and hot EF in ASD participants from middle childhood to adolescence, as well as their relationship to ToM. This study employed an approach of cross-sectional developmental trajectories to investigate patterns of cool and hot EF relative to chronological age within ASD. Eighty-two participants between 7 and 16 years of age were recruited to undertake measures that assessed cool EF (working memory, cognitive flexibility, planning & inhibition), hot EF (affective decision making & delay discounting) and ToM (false belief and mental state/emotion recognition). Results demonstrated that trajectories of all cool EF presented age-related changes in ASD (improvements with age). With regards to hot EF, affective decision-making presented age-related changes, but for delay discounting, there were no statistically significant changes found across younger and older ASD participants. ToM was correlated only to cool EF. Theoretical implications are discussed as the investigation of the cross-sectional developmental trajectories of the broader EF (cool and hot domains) may contribute to better defining cognitive phenotypes in ASD. These findings highlight the need to examine developmental trajectories of both hot and cool EF in research and clinical practice as they may aid in enhancing diagnosis or better-informed intervention programs.

Keywords: autism spectrum disorder, developmental trajectories, executive function, theory of mind

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Authors: Elvis Munyoka

Abstract:

While the number of African refugees settling in Australia has significantly increased since the mid-1990s, the marginalisation and exclusion of young people from refugee backgrounds in employment remain a critical challenge. Unemployment or underemployment can negatively impact refugees in multiple areas, such as income, housing, life satisfaction, and social status. Higher rates of unemployment among refugees are linked in part to the intersection of pre-migration and daily challenges like trauma, racism, gender identity, and English language competency, all of which generate multiple employability disadvantages. However, the intersection of gender, race, social class, and age in impacting African refugee youth’s access to employment has received less attention. Using a qualitative case study approach, the presentation will explore how gender, race, social class, and age influence African refugee youth graduates’ access to employment in South Australia. The intersectionality theory and capability approach to social justice is used to explore intersecting factors impacting African refugee youth’s access to employment in South Australia. Participants were 16 African refugee graduates aged 18-30 living in South Australia who took part in the study for one year. Based on the trends in the data, the results suggest that long-term unemployment and underemployment, coupled with ongoing racism and marginalisation, have the potential to make refugees more vulnerable to several mental disorders such as depression, hopelessness, and suicidal thoughts. The analysis also reveals that resettlement challenges may limit refugees’ ability to recover from pre-migration trauma. The impact of resettlement challenges on refugee mental health highlights the need for comprehensive policy interventions to address the barriers refugees face in finding employment in resettlement communities. With African refugees constituting such an important part of Australian society, they should have equal access to meaningful employment, as decent work promotes good mental health, successful resettlement, hope, and self-sufficiency.

Keywords: African refugees, employment, mental health, Australia, underemployment

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Authors: Apurva Sapra

Abstract:

The aim of this research was to study and compare the nature of expected, feared and hoped-for selves in institutionalized adolescent boys in two residential settings – an observation home with children in conflict with the law, and a children’s home with children in need of care and protection. The study uses a concurrent mixed methods design, in which eight adolescent boys from each group, aged 13-17, were asked to respond to a questionnaire, followed by an in-depth interview. The questionnaire looked into the total scores on current, probable and hoped-for/feared positive and negative self-descriptors. Possible selves of both groups were found to be influenced by their unique histories, such as with their experience of violence, interaction with the police and emphasis given on education. Expected selves and hoped-for selves were similar within the two groups. However, they were more concrete and attainable in the observation home and more ambitious in the children’s home. Quantitative results showed that on the positive self-descriptors, the participants in the observation home had a slightly lower total score on the current parameter as on the probable and hoped-for parameters. The participants in the children’s home showed similar results on current and probable positive self-descriptors, with higher scores on the hoped-for parameter. For most of the negative self-descriptors, the current score for the observation home group was lower than the expected score, and for the children’s home group, they were feared slightly more than they were expected. Along with the nature of possible selves, the study also looked into threats and support to desired and feared possible selves, as well as strategies to attain the desired possible selves and avoid feared possible selves. While threats to possible selves were identified as external and internal in both groups, the participants in the children’s home tended to identify threats as external. The categories of support were similar across the two groups, although the nature of support provided differed. Strategies adopted by participants in the observation home could be clearly divided as past, present and future strategies, while those adopted by participants in the children’s home had an overlap with past and future strategies. The institution was perceived as having a negative influence for the future in the observation home group, but positive in the children’s home group. Limitations of the study and recommendations for future research, policy setting and the counselling profession are discussed.

Keywords: adolescents, expected self, feared self, hoped-for self, institutions, possible selves

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Authors: Pakinee Pooprasert, Wanxin Wang, Tina Parmar, Dana Ahnood, Tafadzwa Young-Zvandasara, James Morgan

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Homelessness has been shown to be correlated to poor health outcomes, including increased visual health morbidity. Despite this, there are relatively few studies regarding visual health in the homeless population, especially in the UK. This research aims to investigate visual disability and access barriers prevalent in the homeless population in Cardiff, South Wales. Data was collected from 100 homeless participants in three different shelters. Visual outcomes included near and distance visual acuity as well as non-cycloplegic refraction. Qualitative data was collected via a questionnaire and included socio-demographic profile, ocular history, subjective visual acuity and level of access to healthcare facilities. Based on the participants’ presenting visual acuity, the total prevalence of myopia and hyperopia was 17.0% and 19.0% respectively based on spherical equivalent from the eye with the greatest absolute value. The prevalence of astigmatism was 8.0%. The mean absolute spherical equivalent was 0.841D and 0.853D for right and left eye respectively. The number of participants with sight loss (as defined by VA= 6/12-6/60 in the better-seeing eye) was 27.0% in comparison to 0.89% and 1.1% in the general Cardiff and Wales population respectively (p-value is < 0.05). Additionally, 1.0% of the homeless subjects were registered blind (VA less than 3/60), in comparison to 0.17% for the national consensus after age standardization. Most participants had good knowledge regarding access to prescription glasses and eye examination services. Despite this, 85.0% never had their eyes examined by a doctor and 73.0% had their last optometrist appointment in more than 5 years. These findings suggested that there was a significant disparity in ocular health, including visual acuity and refractive error amongst the homeless in comparison to the general population. Further, the homeless were less likely to receive the same level of support and continued care in the community due to access barriers. These included a number of socio-economic factors such as travel expenses and regional availability of services, as well as administrative shortcomings. In conclusion, this research demonstrated unmet visual health needs within the homeless, and that inclusive policy changes may need to be implemented for better healthcare outcomes within this marginalized community.

Keywords: homelessness, refractive error, visual disability, Wales

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Authors: Henda J Thomas, Cornelia PJ Harmse, Cecile Schultz

Abstract:

Wearables are one of the technologies that will flourish within the fourth industrial revolution and digital transformation arenas, allowing employers to integrate collected data into organisational information systems. The study aimed to investigate whether wearable technology readiness can predict employees’ acceptance to wear wearables in the workplace. The factors of technology readiness predisposition that predict acceptance and positive attitudes towards wearable use in the workplace were examined. A quantitative research approach was used. The population consisted of 8 081 South African Department of Employment and Labour employees (DEL). Census sampling was used, and questionnaires to collect data were sent electronically to all 8 081 employees, 351 questionnaires were received back. The measuring instrument called the Technology Readiness and Acceptance Model (TRAM) was used in this study. Four hypotheses were formulated to investigate the relationship between readiness and acceptance of wearables in the workplace. The results found consistent predictions of technology acceptance (TA) by eagerness, optimism, and discomfort in the technology readiness (TR) scales. The TR scales of optimism and eagerness were consistent positive predictors of the TA scales, while discomfort proved to be a negative predictor for two of the three TA scales. Insecurity was found not to be a predictor of TA. It was recommended that the digital transformation policy of the DEL should be revised. Wearables in the workplace should be embraced from the viewpoint of convenience, automation, and seamless integration with the DEL information systems. The empirical contribution of this study can be seen in the fact that positive attitude emerged as a factor that extends the TRAM. In this study, positive attitude is identified as a new dimension to the TRAM not found in the original TA model and subsequent studies of the TRAM. Furthermore, this study found that Perceived Usefulness (PU) and Behavioural Intention to Use and (BIU) could not be separated but formed one factor. The methodological contribution of this study can lead to the development of a Wearable Readiness and Acceptance Model (WRAM). To the best of our knowledge, no author has yet introduced the WRAM into the body of knowledge.

Keywords: technology acceptance model, technology readiness index, technology readiness and acceptance model, wearable devices, wearable technology, fourth industrial revolution

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Authors: Kristin Prentice, Carri Hand

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As the Canadian population ages and chronic health conditions continue to escalate, older adults will require various types of housing, such as long term care or retirement homes. Moving to a new home may require a change in leisure activities and social networks, which could be challenging to maintain identity and create a sense of home. Leisure has been known to help older adults maintain or increase their quality of life and life satisfaction and may help older adults in moving to new homes. Sense of home and identity within older adults' transitions to new homes are concepts that may also relate to leisure engagement. Literature is scant regarding the role of leisure in older adults moving to new homes and how the sense of home and identity inter-relate. This study aims to explore how leisure may play a role in older adults' transitioning to new homes, including how sense of home and identity inter-relate. An ethnographic approach will be used to understand the culture of older adults transitioning to new homes. This study will involve older adults who have recently relocated to a mid-sized city in Ontario, Canada. The study will focus on the older adult’s interactions with and connections to their home environment through leisure. Data collection will take place via video-conferencing and will include a narrative interview and two other interviews to discuss an activity diary of leisure engagement pre and post move and mental maps to capture spaces where participants engaged in leisure. Participants will be encouraged to share photographs of leisure engagement taken inside and outside their home to help understand the social spaces the participants refer to in their activity diaries and mental maps. Older adults attempt to adjust to their new homes by maintaining their identity, developing a sense of home through creating attachment to place, and maintaining social networks, all of which have been linked to engaging in leisure. This research will provide insight into the role of leisure in this transition process and the extent that the home and community can contribute to aiding their transition to the new home. This research will contribute to existing literature on the inter-relationships of leisure, sense of home, and identity and how they relate to older adults moving to new homes. This research also has potential for influencing policy and practice for meeting the housing needs of older adults.

Keywords: leisure, older adults, transition, identity

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Authors: Julie Lucille H. Del Valle

Abstract:

To improve its public school education, the Philippines took a radical curriculum reform in 2012, by launching the K-to-12 program which not only added two years to its basic education but also mandated for a replacement of traditional teaching with learner-centered pedagogy, an instruction whose western underpinnings suggest improving student achievement, thus, making pedagogies in the country more or less similar with those in Europe and USA. This policy, however, placed learner-centered pedagogy in a binary opposition against teacher-centered instruction, creating a simplistic dichotomy between good and bad teaching. It is in this dichotomy that this study seeks to explore, using Critical Pedagogy of the Place as the lens, in understanding what constitutes good teaching across a range of learner-centered and teacher-centered pedagogies in the context of public schools in disadvantaged communities. Furthermore, this paper examines how pedagogical homogeneity, arguably influenced by dominant global imperatives with economic agenda – often referred as economisation of education – not only thins out local identities as structures of global schooling become increasingly similar but also limits the concept of good teaching to student outcomes and corporate employability. This paper draws from qualitative research on students, thus addressing the gap created by studies on good teaching which looked mainly into the perceptions of teachers and administrators, while overlooking those of students whose voices must be considered in the formulation of inclusive policies that advocate for true education reform. Using ethnographic methods including student focus groups, classroom observations, and teacher interviews, responses from students of disadvantaged schools reveal that good teaching includes both learner-centered and teacher-centered practices that incorporate ‘academic caring’ which sustains their motivation to achieve in school despite the challenging learning environments. The combination of these two pedagogies equips students with life-long skills necessary to gain equal access to sustainable economic opportunities in their local communities.

Keywords: critical pedagogy of the place, good teaching, learner-centered pedagogy, placed-based instruction

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Authors: Akinwale Adeyinka

Abstract:

Critical natural resources such as clean ground water, fertile topsoil, and biodiversity are diminishing at an exponential rate, orders of magnitude above that at which they can be regenerated. Based on news on world population record, over 6 billion people on earth, and almost a quarter million added each day, the scale of human activity and environmental impact is unprecedented. Soaring human population growth over the past century has created a visible challenge to earth’s life support systems. In addition, the world faces an onslaught of other environmental threats including degenerated global climate change, global warming, intensified acid rain, stratospheric ozone depletion and health threatening pollution. Overpopulation and the use of deleterious technologies combine to increase the scale of human activities to a level that underlies these entire problems. These intensifying trends cannot continue indefinitely, hopefully, through increased understanding and valuation of ecosystems and their services, earth’s basic life-support system will be protected for the future.To say the fact, human civilization is now the dominant cause of change in the global environment. Now that our relationship to the earth has change so utterly, we have to see that change and understand its implication. These are actually 2 aspects to the challenges which we should believe. The first is to realize that our power to harm the earth can indeed have global and even permanent effects. Second is to realize that the only way to understand our new role as a co-architect of nature is to see ourselves as part of a complex system that does operate according to the same simple rules of cause and effect we are used to. So understanding the physical/biological dimension of earth system is an important precondition for making sensible policy to protect our environment. Because we believe Sustainable Development Is a matter of reconciling respect for the environment, social equity and economic profitability. Also, we strongly believe that environmental protection is naturally about reducing air and water pollution, but it also includes the improvement of the environmental performance of existing process. That is why we should always have it at the heart of our business that the environmental problem is not our effect on the environment so much as our relationship with the environment. We should always think of being environmental friendly in our operation.

Keywords: Stratospheric ozone depletion ion , Climate Change, global warming, social equity and economic profitability

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Authors: Wei Wang, Yannick Liu, Lu Zhen, H. Wang

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Maritime transport plays an important role in global economic development but also inevitably faces increasing pressures from all sides, such as ship operating cost reduction and environmental protection. An ideal innovation to address these pressures is electric ships. The electric ship is in the early stage. Considering the special characteristics of electric ships, i.e., travel range limit, to guarantee the efficient operation of electric ships, the service network needs to be re-designed carefully. This research designs a cost-efficient and environmentally friendly service network for electric ships, including the location of charging stations, charging plan, route planning, ship scheduling, and ship deployment. The problem is formulated as a mixed-integer linear programming model with the objective of minimizing total cost comprised of charging cost, the construction cost of charging stations, and fixed cost of ships. A case study using data of the shipping network along the Yangtze River is conducted to evaluate the performance of the model. Two operating scenarios are used: an electric ship scenario where all the transportation tasks are fulfilled by electric ships and a conventional ship scenario where all the transportation tasks are fulfilled by fuel oil ships. Results unveil that the total cost of using electric ships is only 42.8% of using conventional ships. Using electric ships can reduce 80% SOx, 93.47% NOx, 89.47% PM, and 42.62% CO2, but will consume 2.78% more time to fulfill all the transportation tasks. Extensive sensitivity analyses are also conducted for key operating factors, including battery capacity, charging speed, volume capacity, and a service time limit of transportation task. Implications from the results are as follows: 1) it is necessary to equip the ship with a large capacity battery when the number of charging stations is low; 2) battery capacity will influence the number of ships deployed on each route; 3) increasing battery capacity will make the electric ship more cost-effective; 4) charging speed does not affect charging amount and location of charging station, but will influence the schedule of ships on each route; 5) there exists an optimal volume capacity, at which all costs and total delivery time are lowest; 6) service time limit will influence ship schedule and ship cost.

Keywords: cost reduction, electric ship, environmental protection, sustainable shipping

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Authors: Naziema B. Jappie

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Over the last 23 years leaders in government, political parties and universities have been spending much time on identifying and discussing various gaps in the system that impact systematically on students especially those from historically Black communities. Equity and access to higher education were two critical aspects that featured in achieving the transformation goals together with a funding model for those previously disadvantaged. Free education was not a feasible option for the government. Institutional leaders in higher education face many demands on their time and resources. Often, the time for crisis management planning or consideration of being proactive and preventative is not a standing agenda item. With many issues being priority in academia, people become complacent and think that crisis may not affect them or they will cross the bridge when they get to it. Historically South Africa has proven to be a country of militancy, strikes and protests in most industries, some leading to disastrous outcomes. Higher education was not different between October 2015 and late 2016 when the #Rhodes Must Fall which morphed into the # Fees Must Fall protest challenged the establishment, changed the social fabric of universities, bringing the sector to a standstill. Some institutional leaders and administrators were better at handling unexpected, high-consequence situations than others. At most crisis leadership is viewed as a situation more than a style of leadership which is usually characterized by crisis management. The objective of this paper is to show how institutions managed catastrophes of disastrous proportions, down through unexpected incidents of 2015/2016. The content draws on the vast past crisis management experience of the presenter and includes the occurrences of the recent protests giving an event timeline. Using responses from interviews with institutional leaders and administrators as well as students will ensure first-hand information on their experiences and the outcomes. Students have tasted the power of organized action and they demand immediate change, if not the revolt will continue. This paper will examine the approaches that guided institutional leaders and their crisis teams and sector crisis response. It will further expand on whether the solutions effectively changed governance in higher education or has it minimized the need for more protests. The conclusion will give an insight into the future of higher education in South Africa from a leadership perspective.

Keywords: crisis, governance, intervention, leadership, strategies, protests

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Authors: S. M. Amin Hosseini, Oriol Pons, Carmen Mendoza Arroyo, Albert de la Fuente

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In the aftermath of a natural disaster, the major challenge most cities and societies face, regardless of their diverse level of prosperity, is to provide temporary housing (TH) for the displaced population (DP). However, the features of TH, which have been applied in previous recovery programs, greatly varied from case to case. This situation demonstrates that providing temporary accommodation for DP in a short period time and usually in great numbers is complicated in terms of satisfying all the beneficiaries’ needs, regardless of the societies’ welfare levels. Furthermore, when previously used strategies are applied to different areas, the chosen strategies are most likely destined to fail, unless the strategies are context and culturally based. Therefore, as the population of disaster-prone cities are increasing, decision-makers need a platform to help to determine all the factors, which caused the outcomes of the prior programs. To this end, this paper aims to assess the problems, requirements, limitations, potential responses, chosen strategies, and their outcomes, in order to determine the main elements that have influenced the TH process. In this regard, and in order to determine a customizable strategy, this study analyses the TH programs of five different cases as: Marmara earthquake, 1999; Bam earthquake, 2003; Aceh earthquake and tsunami, 2004; Hurricane Katrina, 2005; and, L’Aquila earthquake, 2009. The research results demonstrate that the main vertexes of TH are: (1) local characteristics, including local potential and affected population features, (2) TH properties, which needs to be considered in four phases: planning, provision/construction, operation, and second life, and (3) natural hazards impacts, which embraces intensity and type. Accordingly, this study offers decision-makers the opportunity to discover the main vertexes, their subsets, interactions, and the relation between strategies and outcomes based on the local conditions of each case. Consequently, authorities may acquire the capability to design a customizable method in the face of complicated post-disaster housing in the wake of future natural disasters.

Keywords: post-disaster temporary accommodation, urban resilience, natural disaster, local characteristic

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Authors: Elvis Munyoka

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While the number of African refugees settling in Australia has significantly increased since the mid-1990s, the marginalisation and exclusion of young people from refugee backgrounds in employment remain a critical challenge. Unemployment or underemployment can negatively impact refugees in multiple areas, such as income, housing, life satisfaction, and social status. Higher rates of unemployment among refugees are linked in part to the intersection of pre-migration and daily challenges like trauma, racism, gender identity, and English language competency, all of which generate multiple employability disadvantages. However, the intersection of gender, race, social class, and age in impacting African refugee youth’s access to employment has received less attention. Using a qualitative case study approach, the paper will explore how gender, race, social class, and age influence African refugee youth graduates’ access to employment in South Australia. The intersectionality theory and capability approach to social justice is used to explore intersecting factors impacting African refugee youth’s access to employment in South Australia. Participants were 16 African refugee graduates aged 18-30 living in South Australia who took part in the study for one year. Based on the trends in the data, the results suggest that long-term unemployment and underemployment, coupled with ongoing racism and marginalisation, have the potential to make refugees more vulnerable to several mental disorders such as depression, hopelessness, and suicidal thoughts. The analysis also reveals that resettlement challenges may limit refugees’ ability to recover from pre-migration trauma. The impact of resettlement challenges on refugee mental health highlights the need for comprehensive policy interventions to address the barriers refugees face in finding employment in resettlement communities. With African refugees constituting such an important part of Australian society, they should have equal access to meaningful employment, as decent work promotes good mental health, successful resettlement, hope, and self-sufficiency.

Keywords: African refugee youth, mental health, employment, resettlement, racism

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Authors: Opeyemi Awau Adepoju

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The task of nation-building for Nigeria, like other developing nations, has continued to be riddled with audacious challenges that kept threatening to consume the state itself. Among the destabilizing factors that are sometimes mutually reinforcing are poverty and insecurity. Nigeria has been bedeviled with poverty since the onset of the 1980s when the country metamorphosed from an agricultural to an oil-based economy coupled with unbridled political corruption and wasteful management of resources by successive governments. The crippling poverty started manifesting in the scourge of criminalities and a general state of insecurity. Poverty gradually becomes the breeder of insecurity and threats to human life in Nigeria. Interestingly, successive governments tended to recognize the destructive tendencies of poverty and took several interventionist initiatives towards abating or slowing down the spate of poverty so as to reverse the trend of insecurity, but none of those initiatives can be adjudged good or enduring legacies. The emergence of the Buhari administration in 2015 provided a new opportunity to tackle poverty and, in turn, insecurity that had permeated every aspect of national life before that year’s presidential elections. Expectedly, the government took ambitious steps through its innovative ideas of intervention through its National Social Intervention Programmes (NSIP). Therefore, this paper is an assessment of the Buhari administration’s initiatives in poverty eradication in Nigeria as one of its strategies to fight insecurity, and the paper adopted a qualitative approach. The theoretical arguments put up by this paper are with respect to the connection between poverty and insecurity sourced from the theory of Relative Deprivation. The paper found that the Buhari administration has done better than any government since 1999 in inventing a social intervention program and that the poverty of the people has been addressed to a notable extent. However, the problem of politicization of intervention programs has continued to be the practice under the administration, and if this is not abated, the post-Buhari era may as well be like the eras before it. The paper recommends legislation that can make poverty ameliorating programs permanent, at least for some years to come, so as to avoid the usual policy summersault at every instance of political transition, which has limited the sustainability of public policies and indeed hindered nation-building efforts in Nigeria.

Keywords: insecurity, poverty alleviation, public policies, social intervention

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Authors: Balazs Kulcsar

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Professional energy organizations perform analyses mainly on the global and national levels about the expected development of the share of renewables in electric power generation, heating, and cooling, as well as the transport sectors. There are just a few publications, research institutions, non-profit organizations, and national initiatives with a focus on studies in the individual towns, settlements. Issues concerning the self-supply of energy on the settlement level have not become too wide-spread. The goal of our energy geographic studies is to determine the share of local renewable energy sources in the settlement-based electricity supply across Hungary. The Hungarian energy supply system defines four categories based on the installed capacities of electric power generating units. From these categories, the theoretical annual electricity production of small-sized household power plants (SSHPP) featuring installed capacities under 50 kW and small power plants with under 0.5 MW capacities have been taken into consideration. In the above-mentioned power plant categories, the Hungarian Electricity Act has allowed the establishment of power plants primarily for the utilization of renewable energy sources since 2008. Though with certain restrictions, these small power plants utilizing renewable energies have the closest links to individual settlements and can be regarded as the achievements of the host settlements in the shift of energy use. Based on the 2017 data, we have ranked settlements to reflect the level of self-sufficiency in electricity production from renewable energy sources. The results show that the supply of all the energy demanded by settlements from local renewables is within reach now in small settlements, e.g., in the form of the small power plant categories discussed in the study, and is not at all impossible even in small towns and cities. In Hungary, 30 settlements produce more renewable electricity than their own annual electricity consumption. If these overproductive settlements export their excess electricity towards neighboring settlements, then full electricity supply can be realized on further 29 settlements from renewable sources by local small power plants. These results provide an opportunity for governmental planning of the realization of energy shift (legislative background, support system, environmental education), as well as framing developmental forecasts and scenarios until 2030.

Keywords: energy geography, Hungary, local small power plants, renewable energy sources, self-sufficiency settlements

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Authors: Hala Obeid

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Among the cities that have been touched by hard events and have been experiencing this polemic of existence, one can quote Beirut. A city that defies and confronts itself for its own existence. Beirut materialized all the social complexity; it has also preserved the memory of a society that has been able to build and reflect a certain unique identity. In spite of its glory, Lebanon’s civil war has marked a turning point in Beirut’s history. It has caused many deaths and opposed religious communities. Once this civil war has ended, the reconstruction of the city center, however, saw the spatial exclusion of manual labor, small local commerce, and middle-class residences. The urban functions that characterized the pre-war center were removed, and the city’s spontaneous evolutions were replaced by a historical urban planning, which neglected the city’s memory and identity. The social and spatial fragmentation that has erupted since the war has led to a breakdown of spatial and social boundaries within the city. The aim of this study is to evaluate the impact of fragmentation and boundaries on the city of Beirut in spatial, social, religious and ethnic terms. The method used in this research is what we call the mixed method which is a combination between the quantitative method and the qualitative one. These two approaches, in this case, do not oppose but complement each other in order to study the city of Beirut physically and socially. The main purpose of the qualitative approach is to describe and analyze the social phenomenon of the fragmentation of the city; this method can be summarized by the field observation and study. While the quantitative approach is based on filling out questionnaires that leads to statistics analyzes. Together, these two approaches will mark the course of the research. As a result, Beirut is not only a divided city but is fragmented spatially into many fragments and socially into many groups. This fragmentation is creating immaterial boundaries between fragments and therefore between groups. These urban and social boundaries are specifically religious and ethnic limits. As a conclusion, one of the most important and discussed boundary in Beirut is a spatial and religious boundary called ‘the green line’ or the demarcation line, a true caesura within the city. It marks the opposition of two urban groups and the aggravated fragmentation between them. This line divided Beirut into two compartments: East Beirut (for Christians) and West Beirut (for Muslims). This green line has become an urban void that holds the past in suspension. Finally, to think of Beirut as an urban unit becomes an insoluble problem.

Keywords: Beirut, boundaries, fragmentation, identity

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Authors: Mokhtar Nikgoo

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Today's industrial world has undergone tremendous changes in certain periods. These changes are called environmental changes. And they have a direct impact on organizations and bodies. Therefore, the importance of knowing these changes is clear. This importance has caused the manufacturing organizations to move towards multiple products and constantly change and expand their system. This research tries to show how the organization moves in this category by defining the basic steps of implementing a project. One of the most important features of a hard-to-order production organization is the definition of different production projects from different customers. Therefore, the lack of sufficient understanding of the type of work causes the project to be defined for the organization in question, and the managers of the organization (in every organizational level) are constantly involved with different projects. In the implementation of the production project of the aforementioned organizations, directing the facilities and people of the organization towards the implementation of the project is of particular importance. Therefore, it is felt necessary to define the project manager and his basic duties. Considering the importance of this topic, the project chapter deals with project management and its importance and examines all the different issues in that category from the perspective of implementation. A project includes certain activities of the organization that require the use of different resources and all the activities of the organization in order to implement the project with defined facilities and at the designated times. Project management is planning, organizing and controlling the organization's resources for a short-term goal that has been created for short-term and medium-term goals and objectives. Project management has the important task of centering and integrating (coordinating) task and line managers. In other words, project management requires having a strong and appropriate relationship with the internal people of the system to carry out the assigned activities and must have a general and technical knowledge related to various activities in the project environment. It seems that everything with project management in It is communication. One of the characteristics of production organizations under the order is the relationship between the customer (customers) and the organization until the completion of the defined project. Due to the nature of the work, it is necessary for a person to establish this relationship between the client and the organization's people and to establish this relationship in such a way that it does not cause a lack of coordination in the organization's activities. Therefore, project management has a very important role at this stage, because the relationship between the client and his organization will be any problems and problems and points of view that the client has, he must inform the management so that he can implement the cases with its analysis and special processes. To be transferred to other departments and line managers.

Keywords: project management, crisis management, project delays bill, project duration

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Authors: Eyup Dogan

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The number of research articles analyzing the integration properties of energy variables has rapidly increased in the energy literature for about a decade. The stochastic behaviors of energy variables are worth knowing due to several reasons. For instance, national policies to conserve or promote energy consumption, which should be taken as shocks to energy consumption, will have transitory effects in energy consumption if energy consumption is found to be stationary in one country. Furthermore, it is also important to know the order of integration to employ an appropriate econometric model. Despite being an important subject for applied energy (economics) and having a huge volume of studies, several known limitations still exist with the existing literature. For example, many of the studies use aggregate energy consumption and national level data. In addition, a huge part of the literature is either multi-country studies or solely focusing on the U.S. This is the first study in the literature that considers a form of energy consumption by sectors at sub-national level. This research study aims at investigating unit root properties of electricity consumption for 12 regions of Turkey by four sectors in addition to total electricity consumption for the purpose of filling the mentioned limits in the literature. In this regard, we analyze stationarity properties of 60 cases . Because the use of multiple unit root tests make the results robust and consistent, we apply Dickey-Fuller unit root test based on Generalized Least Squares regression (DFGLS), Phillips-Perron unit root test (PP) and Zivot-Andrews unit root test with one endogenous structural break (ZA). The main finding of this study is that electricity consumption is trend stationary in 7 cases according to DFGLS and PP, whereas it is stationary process in 12 cases when we take into account the structural change by applying ZA. Thus, shocks to electricity consumption have transitory effects in those cases; namely, agriculture in region 1, region 4 and region 7, industrial in region 5, region 8, region 9, region 10 and region 11, business in region 4, region 7 and region 9, total electricity consumption in region 11. Regarding policy implications, policies to decrease or stimulate the use of electricity have a long-run impact on electricity consumption in 80% of cases in Turkey given that 48 cases are non-stationary process. On the other hand, the past behavior of electricity consumption can be used to predict the future behavior of that in 12 cases only.

Keywords: unit root, electricity consumption, sectoral data, subnational data

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Authors: Carlos Roberto De Rolt, Julio da Silva Dias, Rafael Tezza, Luca Foschini, Matteo Mura

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The seasonal population fluctuation presents a challenge to touristic cities since the number of inhabitants can double according to the season. The aim of this work is to develop a model that correlates the waste collected with the population of the city and also allow cooperation between the inhabitants and the local government. The model allows public managers to evaluate the impact of the seasonal population fluctuation on waste generation and also to improve planning resource utilization throughout the year. The study uses data from the company that collects the garbage in Florianópolis, a Brazilian city that presents the profile of a city that attracts tourists due to numerous beaches and warm weather. The fluctuations are caused by the number of people that come to the city throughout the year for holidays, summer time vacations or business events. Crowdsensing will be accomplished through smartphones with access to an app for data collection, with voluntary participation of the population. Crowdsensing participants can access information collected in waves for this portal. Crowdsensing represents an innovative and participatory approach which involves the population in gathering information to improve the quality of life. The management of crowdsensing solutions plays an essential role given the complexity to foster collaboration, establish available sensors and collect and process the collected data. Practical implications of this tool described in this paper refer, for example, to the management of seasonal tourism in a large municipality, whose public services are impacted by the floating of the population. Crowdsensing and big data support managers in predicting the arrival, permanence, and movement of people in a given urban area. Also, by linking crowdsourced data to databases from other public service providers - e.g., water, garbage collection, electricity, public transport, telecommunications - it is possible to estimate the floating of the population of an urban area affected by seasonal tourism. This approach supports the municipality in increasing the effectiveness of resource allocation while, at the same time, increasing the quality of the service as perceived by citizens and tourists.

Keywords: big data, dashboards, floating population, smart city, urban management solutions

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Authors: May Newisar, Richard Kingston, Philip Black

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Heritage-led regeneration developments have been considered as one of the cornerstones of the economic and social revival of historic towns and cities in the UK. However, this approach has proved its deficiency within the development of Liverpool World Heritage site. This is due to the conflict between sustaining the tangible and intangible values as well as achieving the aimed economic developments. Accordingly, the development of such areas is influenced by a top-down approach which considers heritage as consumable experience and urban regeneration as the economic development for it. This neglects the heritage sites characteristics and values as well as the design criteria for public open spaces that overlap with the heritage sites. Currently, knowledge regarding the relationship between the physical built environment of the heritage sites including the intangible values and the design development of the public open spaces is limited. Public open spaces have been studied from different perspectives such as increasing walkability, a source of social cohesion, provide a good quality of life as well as understanding users’ perception. While heritage sites have been discussed heavily on how to maintain the physical environment, understanding the courses of threats and how to be protected. In addition to users’ experiences and motivations of visiting such areas. Furthermore, new approaches tried to overcome the gap such as the historic urban landscape approach. This approach is focusing on the entire human environment with all its tangible and intangible qualities. However, this research aims to understand the relationship between the heritage sites and public open spaces and how the overlap of the design and development of both could be used as a quality to enhance the heritage sites and improve users’ experience. A meaning-making approach will be used in order to understand and articulate how the development of Liverpool World Heritage site and its value could influence and shape the design of public open space Pier Head in order to attract a different level of tourists to be used as a tool for economic development. Consequently, this will help in bridging the gap between the planning and conservation areas’ policies through an understanding of how flexible is the system in order to adopt alternative approaches for the design and development strategies for those areas.

Keywords: historic urban landscape, environmental psychology, urban governance, identity

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Authors: Yi-Chun Kuo, Jo-Chieh Lin

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The objective of a supply chain strategy is to reduce waste and increase efficiency to attain cost benefits, and to guarantee supply chain flexibility when facing the ever-changing market environment in order to meet customer requirements. Strategy implementation aims to fulfill common goals and attain benefits by integrating upstream and downstream enterprises, sharing information, conducting common planning, and taking part in decision making, so as to enhance the overall performance of the supply chain. With the rise of outsourcing and globalization, the increasing dependence on suppliers and customers and the rapid development of information technology, the complexity and uncertainty of the supply chain have intensified, and supply chain vulnerability has surged, resulting in adverse effects on supply chain performance. Thus, this study aims to use supply chain vulnerability as a moderating variable and apply structural equation modeling (SEM) to determine the relationships among supply chain strategy, supply chain integration, and supply chain performance, as well as the moderating effect of supply chain vulnerability on supply chain performance. The data investigation of this study was questionnaires which were collected from the management level of enterprises in Taiwan and China, 149 questionnaires were received. The result of confirmatory factor analysis shows that the path coefficients of supply chain strategy on supply chain integration and supply chain performance are positive (0.497, t= 4.914; 0.748, t= 5.919), having a significantly positive effect. Supply chain integration is also significantly positively correlated to supply chain performance (0.192, t = 2.273). The moderating effects of supply chain vulnerability on supply chain strategy and supply chain integration to supply chain performance are significant (7.407; 4.687). In Taiwan, 97.73% of enterprises are small- and medium-sized enterprises (SMEs) focusing on receiving original equipment manufacturer (OEM) and original design manufacturer (ODM) orders. In order to meet the needs of customers and to respond to market changes, these enterprises especially focus on supply chain flexibility and their integration with the upstream and downstream enterprises. According to the observation of this research, the effect of supply chain vulnerability on supply chain performance is significant, and so enterprises need to attach great importance to the management of supply chain risk and conduct risk analysis on their suppliers in order to formulate response strategies when facing emergency situations. At the same time, risk management is incorporated into the supply chain so as to reduce the effect of supply chain vulnerability on the overall supply chain performance.

Keywords: supply chain integration, supply chain performance, supply chain vulnerability, structural equation modeling

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Authors: E. M. D. Akuoko, Eliana Vasquez Osorio, Marcel Van Herk, Marianne Aznar

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Radiotherapy is an integral part of treatment for many patients with breast cancer. However, side effects can occur, e.g., fibrosis or erythema. If patients at higher risks of radiation-induced side effects could be identified before treatment, they could be given more individual information about the risks and benefits of radiotherapy. We hypothesize that breast density is correlated with the risk of side effects and present a novel method for automatic evaluation based on radiotherapy planning CT scans. Methods: 799 supine CT scans of breast radiotherapy patients were available from the REQUITE dataset. The methodology was first established in a subset of 114 patients (cohort 1) before being applied to the whole dataset (cohort 2). All patients were scanned in the supine position, with arms up, and the treated breast (ipsilateral) was identified. Manual experts contour available in 96 patients for both the ipsilateral and contralateral breast in cohort 1. Breast tissue was segmented using atlas-based automatic contouring software, ADMIRE® v3.4 (Elekta AB, Sweden). Once validated, the automatic segmentation method was applied to cohort 2. Breast density was then investigated by thresholding voxels within the contours, using Otsu threshold and pixel intensity ranges based on Hounsfield units (-200 to -100 for fatty tissue, and -99 to +100 for fibro-glandular tissue). Volumetric breast density (VBD) was defined as the volume of fibro-glandular tissue / (volume of fibro-glandular tissue + volume of fatty tissue). A sensitivity analysis was performed to verify whether calculated VBD was affected by the choice of breast contour. In addition, we investigated the correlation between volumetric breast density (VBD) and patient age and breast size. VBD values were compared between ipsilateral and contralateral breast contours. Results: Estimated VBD values were 0.40 (range 0.17-0.91) in cohort 1, and 0.43 (0.096-0.99) in cohort 2. We observed ipsilateral breasts to be denser than contralateral breasts. Breast density was negatively associated with breast volume (Spearman: R=-0.5, p-value < 2.2e-16) and age (Spearman: R=-0.24, p-value = 4.6e-10). Conclusion: VBD estimates could be obtained automatically on a large CT dataset. Patients’ age or breast volume may not be the only variables that explain breast density. Future work will focus on assessing the usefulness of VBD as a predictive variable for radiation-induced side effects.

Keywords: breast cancer, automatic image segmentation, radiotherapy, big data, breast density, medical imaging

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Authors: W. L. Tsang, H. Y. Li, S. L. Wong, T. Y. Kwok, S. C. Yuen, S. S. Kwok, P. S. Ko, S. Y. Lau

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Introduction: Palliative care is no doubt necessary in surgery. When one looks at studies of what patients with life-threatening illness want and compares to what they experience in surgical units, the gap is huge. Surgical nurses, being patient advocates, should engage with patients and families sooner rather than later in their illness trajectories to consider how to manage the illness, not just their capacity to survive. Objective: This clinical practice guide aims to fill the service gap of palliative care in surgery by producing a quality-driven, evidence-based yet straightforward clinical practice guide based on a focus strategy. Methodology: In line with Guide to Good Nursing Practice: End-of-Life Care recommended by Nursing Council of Hong Kong and the strategic goal of improving quality of palliative care proposed in HA Strategic Plan 2017-2022, multiple phases of work were undertaken from July 2015 to December 2017. A pragmatic clinical practice guide for surgical patients facing life-threatening conditions was developed based on assessments on knowledge of and attitudes towards end-of-life care of surgical nurses. Key domains, including preparation for bereavement, nursing care for imminently dying patients and at the dying scene were crystallized according to the results of the assessments and the palliative care checklist formulated by UCH Palliative Care Team. After a year of rollout, its content was refined through analyses of implementation in routine practice and consensus opinions from frontline nurses. Results and Outcomes: This clinical practice guide inspires surgical nurses with the art of care to provide for patients’ comfort, function, and longevity. It provides practical directions and assists nurses to master the skills on advance care planning and learn how to be clear with patients, families and themselves about the realities of the disease pictures. Through the implementation, patients and families are included in the decision process, and their wishes are honored. The delivery of explicit and high-quality palliative care maintains good nurse-to-patient relations and enhances satisfaction of hospital care of patients and families. Conclusion: Surgical nursing has always been up to the unique challenges of the era. This clinical practice guide has become an island of credibility for our nurses as they traverse the often stormy waters of life-limiting illness.

Keywords: palliative care delivery, palliative care in surgery, hospice care, end-of-life care

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Authors: Janne Engblom, Elias Oikarinen

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The understanding of housing price dynamics is of importance to a great number of agents: to portfolio investors, banks, real estate brokers and construction companies as well as to policy makers and households. A panel dataset is one that follows a given sample of individuals over time, and thus provides multiple observations on each individual in the sample. Panel data models include a variety of fixed and random effects models which form a wide range of linear models. A special case of panel data models is dynamic in nature. A complication regarding a dynamic panel data model that includes the lagged dependent variable is endogeneity bias of estimates. Several approaches have been developed to account for this problem. In this paper, the panel models were estimated using the Common Correlated Effects estimator (CCE) of dynamic panel data which also accounts for cross-sectional dependence which is caused by common structures of the economy. In presence of cross-sectional dependence standard OLS gives biased estimates. In this study, U.S housing price dynamics were examined empirically using the dynamic CCE estimator with first-difference of housing price as the dependent and first-differences of per capita income, interest rate, housing stock and lagged price together with deviation of housing prices from their long-run equilibrium level as independents. These deviations were also estimated from the data. The aim of the analysis was to provide estimates with comparisons of estimates between 1980-1999 and 2000-2012. Based on data of 50 U.S cities over 1980-2012 differences of short-run housing price dynamics estimates were mostly significant when two time periods were compared. Significance tests of differences were provided by the model containing interaction terms of independents and time dummy variable. Residual analysis showed very low cross-sectional correlation of the model residuals compared with the standard OLS approach. This means a good fit of CCE estimator model. Estimates of the dynamic panel data model were in line with the theory of housing price dynamics. Results also suggest that dynamics of a housing market is evolving over time.

Keywords: dynamic model, panel data, cross-sectional dependence, interaction model

Procedia PDF Downloads 239