Search results for: English as an international language
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7927

Search results for: English as an international language

1897 Left Ventricular Adaptations of Elite Volleyball Players Based on the Playing Position

Authors: Shihab Aldin Al Riyami, Khosrow Ebrahim, Sajad Ahmadizad

Abstract:

Hemodynamic changes and ventricular loading during exercise lead to left ventricular (LV) hypertrophy. In athletes, volume load induces enlargement of the LV internal diameter and a proportional increase of wall thickness; while, pressure load would induce thickening of the ventricular wall. These adaptations are not similar in all athletes and are related to the types of sport. Volleyball players have different types of activity and roles based on their playing. Therefore, their physiological adaptations and requirements are different. The aim of the current study was to investigate the LV adaptationsinelite volleyball players based on their playing position. Sixty male elite volleyball players (age, 30.55±3.64 years)from Brazil, Serbia, Poland, Iran, Colombia, Cameroon, Japan, Egypt, Qatar, and Tunisia were investigated (from all five volleyball play positions). All participants had the experience of at least 3 years of participation at a professional level and international tournaments. LV characteristics were evaluated and measured using the echocardiography technique. Statistical analyses revealed significant differences (P<0.05)among the five groups of players forLV internal dimension (LVID), posterior wall thickness (PWT), and intact ventricular septum (IVS). Post-hoc analysis showed that opposite position players had significant higher value of LVID, PWT, and IVS when compared with other players, including outside hitter, middle blocker, setter, and libero (p<0.05). Additionally, in libero players, PWT was significantly lower when compared with other players (p<0.05). Based on the findings of the present study, it is concluded that LV adaptations in volleyball players are related to their playing position and that the opposite players had the highest LV adaptations when compared to other positions.

Keywords: athletes, cardiac adaptations, echocardio graphy, heart, sport

Procedia PDF Downloads 279
1896 Detection and Quantification of Ochratoxin A in Food by Aptasensor

Authors: Moez Elsaadani, Noel Durand, Brice Sorli, Didier Montet

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Governments and international instances are trying to improve the food safety system to prevent, reduce or avoid the increase of food borne diseases. This food risk is one of the major concerns for the humanity. The contamination by mycotoxins is a threat to the health and life of humans and animals. One of the most common mycotoxin contaminating feed and foodstuffs is Ochratoxin A (OTA), which is a secondary metabolite, produced by Aspergillus and Penicillium strains. OTA has a chronic toxic effect and proved to be mutagenic, nephrotoxic, teratogenic, immunosuppressive, and carcinogenic. On the other side, because of their high stability, specificity, affinity, and their easy chemical synthesis, aptamer based methods are applied to OTA biosensing as alternative to traditional analytical technique. In this work, five aptamers have been tested to confirm qualitatively and quantitatively their binding with OTA. In the same time, three different analytical methods were tested and compared based on their ability to detect and quantify the OTA. The best protocol that was established to quantify free OTA from linked OTA involved an ultrafiltration method in green coffee solution with. OTA was quantified by HPLC-FLD to calculate the binding percentage of all five aptamers. One aptamer (The most effective with 87% binding with OTA) has been selected to be our biorecognition element to study its electrical response (variation of electrical properties) in the presence of OTA in order to be able to make a pairing with a radio frequency identification (RFID). This device, which is characterized by its low cost, speed, and a simple wireless information transmission, will implement the knowledge on the mycotoxins molecular sensors (aptamers), an electronic device that will link the information, the quantification and make it available to operators.

Keywords: aptamer, aptasensor, detection, Ochratoxin A

Procedia PDF Downloads 187
1895 Regulating Issues concerning Data Protection in Cloud Computing: Developing a Saudi Approach

Authors: Jumana Majdi Qutub

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Rationale: Cloud computing has rapidly developed the past few years. Because of the importance of providing protection for personal data used in cloud computing, the role of data protection in promoting trust and confidence in users’ data has become an important policy priority. This research examines key regulatory challenges rose by the growing use and importance of cloud computing with focusing on protection of individuals personal data. Methodology: Describing and analyzing governance challenges facing policymakers and industry in Saudi Arabia, with an account of anticipated governance responses. The aim of the research is to describe and define the regulatory challenges on cloud computing for policy making in Saudi Arabia and comparing it with potential complied issues rose in respect of transported data to EU member state. In addition, it discusses information privacy issues. Finally, the research proposes policy recommendation that would resolve concerns surrounds the privacy and effectiveness of clouds computing frameworks for data protection. Results: There are still no clear regulation in Saudi Arabia specialized in legalizing cloud computing and specialty regulations in transferring data internationally and locally. Decision makers need to review the applicable law in Saudi Arabia that protect information in cloud computing. This should be from an international and a local view in order to identify all requirements surrounding this area. It is important to educate cloud computing users about their information value and rights before putting it in the cloud to avoid further legal complications, such as making an educational program to prevent giving personal information to a bank employee. Therefore, with many kinds of cloud computing services, it is important to have it covered by the law in all aspects.

Keywords: cloud computing, cyber crime, data protection, privacy

Procedia PDF Downloads 263
1894 Teachers Handbook: A Key to Imparting Teaching in Multilingual Classrooms at Kalinga Institute of Social Sciences (KISS)

Authors: Sushree Sangita Mohanty

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The pedagogic system, which is used to work with indigenous groups, who have equally different socio-economic, socio-cultural & multi-lingual conditions with differing cognitive capabilities, makes the education situation complex. As a result, educating the indigenous people became just the dissemination of facts and information, but advancement in knowledge and possibilities somewhere hides. This gap arises complexities due to the language barrier and the teachers from a conventional background of teaching practices are unable to understand or connect with the students in the schools. This paper presents the research work of the Mother Tongue Based Multilingual Education (MTB-MLE) project that has developed a creative pedagogic endeavor for the students of Kalinga Institute of Social Sciences (KISS) for facilitating Multilingual Education (MLE) teaching. KISS is a home for 25,000 indigenous children. The students enrolled here are from 62 different indigenous communities who speak around 24 different languages with geographical articulation. The book contents include concept, understanding languages, similitudes among languages, the need of mother tongue in teaching and learning, skill development (Listening-Speaking-Reading-Writing), teachers activities for teaching in multilingual schools, the process of teaching, training format of multilingual teaching and procedures for basic data collection regarding multilingual schools and classroom handle.

Keywords: indigenous, multi-lingual, pedagogic, teachers, teaching practices

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1893 Enhancing Information Technologies with AI: Unlocking Efficiency, Scalability, and Innovation

Authors: Abdal-Hafeez Alhussein

Abstract:

Artificial Intelligence (AI) has become a transformative force in the field of information technologies, reshaping how data is processed, analyzed, and utilized across various domains. This paper explores the multifaceted applications of AI within information technology, focusing on three key areas: automation, scalability, and data-driven decision-making. We delve into how AI-powered automation is optimizing operational efficiency in IT infrastructures, from automated network management to self-healing systems that reduce downtime and enhance performance. Scalability, another critical aspect, is addressed through AI’s role in cloud computing and distributed systems, enabling the seamless handling of increasing data loads and user demands. Additionally, the paper highlights the use of AI in cybersecurity, where real-time threat detection and adaptive response mechanisms significantly improve resilience against sophisticated cyberattacks. In the realm of data analytics, AI models—especially machine learning and natural language processing—are driving innovation by enabling more precise predictions, automated insights extraction, and enhanced user experiences. The paper concludes with a discussion on the ethical implications of AI in information technologies, underscoring the importance of transparency, fairness, and responsible AI use. It also offers insights into future trends, emphasizing the potential of AI to further revolutionize the IT landscape by integrating with emerging technologies like quantum computing and IoT.

Keywords: artificial intelligence, information technology, automation, scalability

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1892 Identifying Applicant Potential Through Admissions Testing

Authors: Belinda Brunner

Abstract:

Objectives: Communicate common test constructs of well-known higher education admissions tests. Discuss influences on admissions test construct definition and design and discuss research on related to factors influencing success in academic study. Discuss how admissions tests can be used to identify relevant talent. Examine how admissions test can be used to facilitate educational mobility and inform selection decisions when the prerequisite curricula is not standardized Observations: Generally speaking, constructs of admissions tests can be placed along a continuum from curriculum-related knowledge to more general reasoning abilities. For example, subject-specific achievement tests are more closely aligned to a prescribed curriculum, while reasoning tests are typically not associated with a specific curriculum. This session will draw reference from the test-constructs of well-known international higher education admissions tests, such as the UK clinical aptitude test (UKCAT) which is used for medicine and dentistry admissions. Conclusions: The purpose of academic admissions testing is to identify potential students with the prerequisite skills set needed to succeed in the academic environment, but how can the test construct help achieve this goal? Determination of the appropriate test construct for tests used in the admissions selection decisions should be influenced by a number of factors, including the preceding academic curricula, other criteria influencing the admissions decision, and the principal purpose for testing. Attendees of this session will learn the types of aptitudes and knowledge that are assessed higher education admissions tests and will have the opportunity to gain insight into how careful and deliberate consideration of the desired test constructs can aid in identifying potential students with the greatest likelihood of success in medical school.

Keywords: admissions, measuring success, selection, identify skills

Procedia PDF Downloads 493
1891 Understanding the Underutilization of Electroconvulsive Therapy in Children and Adolescents

Authors: Carlos M. Goncalves, Luisa Duarte, Teresa Cartaxo

Abstract:

The aim of this work was to understand the reasons behind the underutilization of electroconvulsive therapy (ECT) in the younger population and raise possible solutions. We conducted a non-systematic review of literature throughout a search on PubMed, using the terms ‘children’, ‘adolescents’ and ‘electroconvulsive’, ‘therapy’. Candidate articles written in languages other than English were excluded. Articles were selected according to title and/or abstract’s content relevance, resulting in a total of 5 articles. ECT is a recognized effective treatment in adults for several psychiatric conditions. As in adults, ECT in children and adolescents is proven most beneficial in the treatment of severe mood disorders, catatonia, and, to a lesser extent, schizophrenia. ECT in adults has also been used to treat autism’s self-injurious behaviours, Tourette’s syndrome and resistant first-episode schizophrenia disorder. Despite growing evidence on its safety and effectiveness in children and adolescents, like those found in adults, ECT remains a controversial and underused treatment in patients this age, even when it is clearly indicated. There are various possible reasons to this; limited awareness among professionals (lack of knowledge and experience among child psychiatrists), stigmatic public opinion (despite positive feedback from patients and families, there is an unfavourable and inaccurate representation in the media, contributing to a negative public opinion), legal restrictions and ethical controversies (restrictive regulations such as a minimum age for administration), lack of randomized trials (the currently available studies are retrospective, with small size samples, and most of the publications are either case reports or case series). This shows the need to raise awareness and knowledge, not only for mental health professionals, but also to the general population, through the media, regarding indications, methods and safety of ECT in order to provide reliable information to the patient and families. Large-scale longitudinal studies are also useful to further demonstrate the efficacy and safety of ECT and can aid in the formulation of algorithms and guidelines as without these changes, the availability of ECT to the younger population will remain restricted by regulations and social stigma. In conclusion, these results highlight that lack of adequate knowledge and accurate information are the most important factors behind the underutilization of ECT in younger population. Mental healthcare professionals occupy a cornerstone position; if data is given by a well-informed healthcare professional instead of the media, general population (including patients and their families) will probably regard the procedure in a more favourable way. So, the starting point should be to improve health care professional’s knowledge and experience on this choice of treatment.

Keywords: adolescents, children, electroconvulsive, therapy

Procedia PDF Downloads 126
1890 Chaotic Representation: Translating Gender in Cantonese Opera Performances

Authors: Kar Yue Chan

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Cantonese opera is a valuable heritage originated from South China, and started to span its influence across the area to Hong Kong, and became extremely popular back in the 1950s to the 1970s. It has also been honoured and recognized as one treasurable item on the Intangible Cultural Heritage of Humanity on the Representative List of UNESCO since 2009. A certain level of difficulty is encountered when one identifies the gender roles and representations from a usual performance of Cantonese opera, as conventional practices of Cantonese opera display to the audience that many of the male hero roles are played by female upon the prior knowledge of all audience, and it is understandable for them as well because in the past there were insufficient male actors and performers on the market. Female actresses, in some senses, are more capable to sing near-male voices, and their appearances in heroic operatic attires are more appreciated by general audience. Therefore, perspectives of 'feminine representation' and the 'Reception Theory' in literature are conducive to analyzing such phenomenon. In spite of some 'normal' performances with romantic love stories or historical accounts involving often a talented intellectual and a beautiful wise lady (in Chinese caizi jiaren 才子佳人), in which the male role is actually male and the female role is actually female, there have still been some opera titles specifically manifesting these extreme gender associations by putting together displacement of gender roles in the same performance in view of such chaotic complication. On top of all other factors, translators dealing with any operatic texts face plenty of challenges upon transferring Cantonese operatic performances into English. It is found that translators need to deal with cultural elements embedded in the lyrics; the form (which is as delicate as those deriving from classical Chinese poetry); the gender misplacements that affect the mood and tone of the lyrics that much when they are in the process of translating. Some lyrics and tunes are specifically designed for a particular gender role to perform, while some others are more generic; both of which require different and specific translation strategies. After scrutinizing the various sources of reference, readers of this paper should be well informed of a significance which lies in the refined nature of the poetic form and content that signifies in the way the distinguished gender voice segregation of the discourse from which the lyrics are derived, and definitely also through the on-stage performability aspect of the task. In order to produce a relatively short and concise translated version which fits performance needs, all of the above factors will be looked at in this paper with relevant examples and analysis.

Keywords: Cantonese opera, translation, chaotic gender, performance

Procedia PDF Downloads 130
1889 Impact of Lifelong-Learning Mindset on Career Success of the Accounting and Finance Professionals

Authors: R. W. A. V. A. Wijenayake, P. M. R. N. Fernando, S. Nilesh, M. D. G. M. S. Diddeniya, M. Weligodapola, P. Shamila

Abstract:

The study is designed to examine the impact of a lifelong learning mindset on the career success of accounting and finance professionals in the western province of Sri Lanka. The learning mindset impacts the career success of accounting and finance professionals. The main objective of this study is to identify how the lifelong-learning mindset impacts on the career success of accounting and finance professionals. The lifelong learning mindset is the desire to learn new things and curiosity, resilience, and strategic thinking are the selected constructs to measure the lifelong learning mindset. Career success refers to certain objectives and emotional measures of improvement in one’s work life. The related variables of career success are measured through the number of promotions that have been granted in his/her work life. Positivism is the research paradigm, and the deductive approach is involved as this study relies on testing an existing theory. To conduct the study, the accounting and finance professionals in the western province in Sri Lanka were selected because most reputed international and local companies and specifically, headquarters of most of the companies are in western province. The responses cannot be collected from the whole population. Therefore, this study used a simple random sampling method, and the sample size was 120. Therefore, to identify the impact, 5-point Likert scale is used to perform this quantitative data. Required data gathered through an online questionnaire and the final outputs of the study will offer certain important recommendations to several parties such as universities, undergraduates, companies, and the policymakers to improve, help mentally and financially and motivate the students and the employees to continue their studies without ceasing after completion of their degree.

Keywords: career success, curiosity, lifelong learning mindset, resilience, strategic thinking

Procedia PDF Downloads 91
1888 Productivity Effect of Urea Deep Placement Technology: An Empirical Analysis from Irrigation Rice Farmers in the Northern Region of Ghana

Authors: Shaibu Baanni Azumah, Ignatius Tindjina, Stella Obanyi, Tara N. Wood

Abstract:

This study examined the effect of Urea Deep Placement (UDP) technology on the output of irrigated rice farmers in the northern region of Ghana. Multi-stage sampling technique was used to select 142 rice farmers from the Golinga and Bontanga irrigation schemes, around Tamale. A treatment effect model was estimated at two stages; firstly, to determine the factors that influenced farmers’ decision to adopt the UDP technology and secondly, to determine the effect of the adoption of the UDP technology on the output of rice farmers. The significant variables that influenced rice farmers’ adoption of the UPD technology were sex of the farmer, land ownership, off-farm activity, extension service, farmer group participation and training. The results also revealed that farm size and the adoption of UDP technology significantly influenced the output of rice farmers in the northern region of Ghana. In addition to the potential of the technology to improve yields, it also presents an employment opportunity for women and youth, who are engaged in the deep placement of Urea Super Granules (USG), as well as in the transplantation of rice. It is recommended that the government of Ghana work closely with the IFDC to embed the UDP technology in the national agricultural programmes and policies. The study also recommends an effective collaboration between the government, through the Ministry of Food and Agriculture (MoFA) and the International Fertilizer Development Center (IFDC) to train agricultural extension agents on UDP technology in the rice producing areas of the country.

Keywords: Northern Ghana, output , irrigation rice farmers, treatment effect model, urea deep placement

Procedia PDF Downloads 440
1887 Variability of the Speaker's Verbal and Non-Verbal Behaviour in the Process of Changing Social Roles in the English Marketing Discourse

Authors: Yuliia Skrynnik

Abstract:

This research focuses on the interaction of verbal, non-verbal, and super-verbal communicative components used by the speaker changing social roles in the marketing discourse. The changing/performing of social roles is implemented through communicative strategies and tactics, the structural, semantic, and linguo-pragmatic means of which are characterized by specific features and differ for the performance of either a role of a supplier or a customer. Communication within the marketing discourse is characterized by symmetrical roles’ relation between communicative opponents. The strategy of a supplier’s social role realization and the strategy of a customer’s role realization influence the discursive personality's linguistic repertoire in the marketing discourse. This study takes into account that one person can be both a supplier and a customer under different circumstances, thus, exploring the one individual who can be both a supplier and a customer. Cooperative and non-cooperative tactics are the instruments for the implementation of these strategies. In the marketing discourse, verbal and non-verbal behaviour of the speaker performing a customer’s social role is highly informative for speakers who perform the role of a supplier. The research methods include discourse, context-situational, pragmalinguistic, pragmasemantic analyses, the method of non-verbal components analysis. The methodology of the study includes 5 steps: 1) defining the configurations of speakers’ social roles on the selected material; 2) establishing the type of the discourse (marketing discourse); 3) describing the specific features of a discursive personality as a subject of the communication in the process of social roles realization; 4) selecting the strategies and tactics which direct the interaction in different roles configurations; 5) characterizing the structural, semantic and pragmatic features of the strategies and tactics realization, including the analysis of interaction between verbal and non-verbal components of communication. In the marketing discourse, non-verbal behaviour is usually spontaneous but not purposeful. Thus, the adequate decoding of a partner’s non-verbal behavior provides more opportunities both for the supplier and the customer. Super-verbal characteristics in the marketing discourse are crucial in defining the opponent's social status and social role at the initial stage of interaction. The research provides the scenario of stereotypical situations of the play of a supplier and a customer. The performed analysis has perspectives for further research connected with the study of discursive variativity of speakers' verbal and non-verbal behaviour considering the intercultural factor influencing the process of performing the social roles in the marketing discourse; and the formation of the methods for the scenario construction of non-stereotypical situations of social roles realization/change in the marketing discourse.

Keywords: discursive personality, marketing discourse, non-verbal component of communication, social role, strategy, super-verbal component of communication, tactic, verbal component of communication

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1886 Manufacturing of Race Car Case Study AGH Racing

Authors: Hanna Faron, Wojciech Marcinkowski, Daniel Prusak

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The aim of this article is to familiarize with the activity of AGH Racing scientific circle, pertaining to the international project -Formula Student, giving the opportunity to young engineers from all around the world to validate their talent and knowledge in the real world conditions, under the pressure of time, and the design requirements. Every year, the team begins the process of building a race car from the formation of human resources. In case of the public sector, to which public universities can be included, the scientific circles represent the structure uniting students with the common interests and level of determination. Due to the scientific nature of the project which simulates the market conditions, they have a chance to verify previously acquired knowledge in practice. High level of the innovation and competitiveness of participating in the project Formula Student teams, requires an intelligent organizational system, which is characterized by a high dynamics. It is connected with the necessity of separation of duties, setting priorities, selecting optimal solutions which is often a compromise between the available technology and a limited budget. Proper selection of the adequate guidelines in the design phase allows an efficient transition to the implementation stage, which is process-oriented implementation of the project. Four dynamic and three static competitions are the main verification and evaluation of year-round work and effort put into the process of building a race car. Acquired feedback flowing during the race is a very important part while monitoring the effectiveness of AGH Racing scientific circle, as well as the main criterion while determining long-term goals and all the necessary improvements in the team.

Keywords: SAE, formula student, race car, public sector, automotive industry

Procedia PDF Downloads 351
1885 Litigating Innocence in the Era of Forensic Law: The Problem of Wrongful Convictions in the Absence of Effective Post-Conviction Remedies in South Africa

Authors: Tapiwa Shumba

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The right to fairness and access to appeals and reviews enshrined under the South African Constitution seeks to ensure that justice is served. In essence, the constitution and the law have put in place mechanisms to ensure that a miscarriage of justice through wrongful convictions does not occur. However, once convicted and sentenced on appeal the procedural safeguards seem to resign as if to say, the accused has met his fate. The challenge with this construction is that even within an ideally perfect legal system wrongful convictions would still occur. Therefore, it is not so much of the failings of a legal system that demand attention but mechanisms to redress the results of such failings where evidence becomes available that a wrongful conviction occurred. In this context, this paper looks at the South African criminal procedural mechanisms for litigating innocence post-conviction. The discussion focuses on the role of section 327 of the South African Criminal Procedure Act and its apparent shortcomings in providing an avenue for victims of miscarriages to litigate their innocence by adducing new evidence at any stage during their wrongful incarceration. By looking at developments in other jurisdiction such as the United Kingdom, where South African criminal procedure draws much of its history, and the North Carolina example which in itself was inspired by the UK Criminal Cases Review Commission, this paper is able to make comparisons and draw invaluable lessons for the South African criminal justice system. Lessons from these foreign jurisdictions show that South African post-conviction criminal procedures need reform in line with constitutional values of human dignity, equality before the law, openness and transparency. The paper proposes an independent review of the current processes to assess the current post-conviction procedures under section 327. The review must look into the effectiveness of the current system and how it can be improved in line with new substantive legal provisions creating access to DNA evidence for post-conviction exonerations. Although the UK CCRC body should not be slavishly followed, its operations and the process leading to its establishment certainly provide a good point of reference and invaluable lessons for the South African criminal justice system seeing that South African law on this aspect has generally followed the English approach except that current provisions under section 327 are a mirror of the discredited system of the UK’s previous dispensation. A new independent mechanism that treats innocent victims of the criminal justice system with dignity away from the current political process is proposed to enable the South African criminal justice to benefit fully from recent and upcoming advances in science and technology.

Keywords: innocence, forensic law, post-conviction remedies, South African criminal justice system, wrongful conviction

Procedia PDF Downloads 236
1884 The Effects of Peer Education on Condom Use Intentions: A Comprehensive Sex Education Quality Improvement Project

Authors: Janell Jayamohan

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A pilot project based on the Theory of Planned Behavior was completed at a single sex female international high school in order to improve the quality of comprehensive sex education in a 12th grade classroom. The student sample is representative of a growing phenomenon of “Third Culture Kids” or global nomads; often in today’s world, culture transcends any one dominant influence and blends values from multiple sources. The Objective was to improve intentions of condom use during the students’ first or next intercourse. A peer-education session which focused on condom attitudes, social norms, and self-efficacy - central tenets of the Theory of Planned Behavior - was added to an existing curriculum in order to achieve this objective. Peer educators were given liberty of creating and executing the lesson to their homeroom, a sample of 23 senior students, with minimal intervention from faculty, the desired outcome being that the students themselves would be the best judge of what is culturally relevant and important to their peers. The school nurse and school counselor acted as faculty facilitators but did not assist in the creation or delivery of the lesson, only checked for medical accuracy. The participating sample of students completed a pre and post-test with validated questions assessing changes in attitudes and overall satisfaction with the peer education lesson. As this intervention was completed during the Covid-19 pandemic, the peer education session was completed in a virtual classroom environment, limiting the modes of information delivery available to the peer educators, but is planned to be replicated in an in-person environment in subsequent cycles.

Keywords: adolescents, condoms, peer education, sex education, theory of planned behavior, third culture kids

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1883 A Memristive Device with Intrinsic Rectification Behavior and Performace of Crossbar Arrays

Authors: Yansong Gao, Damith C.Ranasinghe, Siad F. Al-Sarawi, Omid Kavehei, Derek Abbott

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Passive crossbar arrays is in principle the simplest functional electrical circuit, together with memristive device in cross-point, holding great promise in future high-density, non-volatile memories. However, the greatest problem of crossbar array is the sneak path current. In this paper, we investigate one type of memristive device with intrinsic rectification behavior to address the sneak path currents. Firstly, a SPICE behavior model written in Verilog-A language of the memristive device is presented to fit experimental data published in literature. Next, systematic performance simulations including read margin and power consumption of crossbar array, which uses the self-rectifying memristive device as storage element at cross-point, with respect to different crossbar sizes, interconnect resistance, ratio of HRS/LRS (High Resistance State/ Low Resistance State), rectification ratio and different read schemes are conducted. Subsequently, Trade-offs among reading margin, power consumption, and reading schemes are analyzed to provide guidelines for circuit design. Finally, performance comparison between the memristive device with/without intrinsic rectification behavior is given to show the worthiness of this intrinsic rectification behavior.

Keywords: memristive device, memristor, crossbar, RRAM, read margin, power consumption

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1882 Exploring Critical Thinking Skill Development in the 21st Century College Classroom: A Multi-Case Study

Authors: Kimberlyn Greene

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Employers today expect college graduates to not only develop and demonstrate content-specific knowledge but also 21st century skillsets such as critical thinking. International assessments suggest students enrolled in United States (U.S.) educational institutions are underperforming in comparison to their global peers in areas such as critical thinking and technology. This multi-case study examined how undergraduate digital literacy courses at a four-year university in the U.S., as implemented by instructors, fostered students’ development of critical thinking skills. The conceptual framework for this study presumed that as students engaged in complex thinking within the context of a digital literacy course, their ability to deploy critical thinking was contingent upon whether the course was designed with the expectation for students to use critical thinking skills as well as the instructor’s approach to implementing the course. Qualitative data collected from instructor interviews, classroom observations, and course documents were analyzed with an emphasis on exploring the course design and instructional methods that provided opportunities to foster critical thinking skill development. Findings from the cross-case analysis revealed that although the digital literacy courses were designed and implemented with the expectation students would deploy critical thinking; there was no explicit support for students to develop these skills. The absence of intentional skill development resulted in inequitable opportunities for all students to engage in complex thinking. The implications of this study suggest that if critical thinking is to remain a priority, then universities must expand their support of pedagogical and instructional training for faculty regarding how to support students’ critical thinking skill development.

Keywords: critical thinking skill development, curriculum design, digital literacy, pedagogy

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1881 Epidemiology of Gestational Choriocarcinoma: A Systematic Review

Authors: Farah Amalina Mohamed Affandi, Redhwan Ahmad Al-Naggar, Seok Mui Wang, Thanikasalam Kathiresan

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Gestational choriocarcinoma is a condition in which there is an abnormal growth or a tumor inside the women’s uterus after conception. It is a type of gestational trophoblastic disease which is relatively rare and malignant. The current epidemiological data of this disease are inadequate. The purposes of this study are to examine the epidemiology of choriocarcinoma and their risk factors based on all available population-based and hospital-based data of the disease. In this study, we searched The MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases using the keywords ‘choriocarcinoma’, ‘gestational’, ‘gestational choriocarcinoma’ and ‘epidemiology’. We included only human studies published in English between 1995 and 2015 to ensure up to date evidence. Case studies, case reports, animal studies, letters to the editor, news, and review articles were excluded. Retrieved articles were screened in three phases. In the first phase, any articles that did not match the inclusion criteria based solely on titles were excluded. In the second phase, the abstracts of remaining articles were screened thoroughly; any articles that did not meet our inclusion criteria were excluded. In the final phase, full texts of the remaining articles were read and assessed to exclude articles that did not meet the inclusion criteria or any articles that fulfilled the exclusion criteria. Duplicates articles were also removed. Systematic reviews and meta-analysis were excluded. Extracted data were summarized in table and figures descriptively. The reference lists of included studies were thoroughly reviewed in search for other relevant studies. A total of ten studies met all the selection criteria. Nine were retrospective studies and one was cohort study. Total numbers of 4563 cases of choriocarcinoma were reviewed from several countries which are Korea, Japan, South Africa, USA, New Mexico, Finland, Turkey, China, Brazil and The Netherlands. Different studies included different range of age with their mean age of 28.5 to 30.0 years. All studies investigated on the disease’s incidence rate, only two studies examined on the risk factors or associations of the disease. Approximately 20% of the studies showed a reduction in the incidence of choriocarcinoma while the other 80% showed inconsistencies in rate. Associations of age, fertility age, occupations and socio-demographic with the status remains unclear. There is limited information on the epidemiological aspects of gestational choriocarcinoma. The observed results indicated there was a decrease in the incidence rate of gestational choriocarcinoma globally. These could be due to the reduction in the incidence of molar pregnancy and the efficacy of the treatment, mainly by chemotherapy.

Keywords: epidemiology, gestational choriocarcinoma, incidence, prevalence, risk factor

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1880 Intellectual Property and SMEs in the Baltic Sea Region: A Comparative Study on the Use of the Utility Model Protection

Authors: Christina Wainikka, Besrat Tesfaye

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Several of the countries in the Baltic Sea region are ranked high in international innovations rankings, such as the Global Innovation Index and European Innovation Scoreboard. There are however some concerns in the performance of different countries. For example, there is a widely spread notion about “The Swedish Paradox”. Sweden is ranked high due to investments in R&D and patent activity, but the outcome is not as high as could be expected. SMEs in Sweden are also below EU average when it comes to registering intellectual property rights such as patents and trademarks. This study is concentrating on the protection of utility model. This intellectual property right does not exist in Sweden, but in for example Finland and Germany. The utility model protection is sometimes referred to as a “patent light” since it is easier to obtain than the patent protection but at the same time does cover technical solutions. In examining statistics on patent activities and activities in registering utility models it is clear that utility model protection is scarcely used in the countries that have the protection. In Germany 10 577 applications were made in 2021. In Finland there were 259 applications made in 2021. This can be compared with patent applications that were 58 568 in Germany in 2021 and 1 662 in Finland in 2021. In Sweden there has never been a protection for utility models. The only protection for technical solutions is patents and business secrets. The threshold for obtaining a patent is high, due to the legal requirements and the costs. The patent protection is there for often not chosen by SMEs in Sweden. This study examines whether the protection of utility models in other countries in the Baltic region provide SMEs in these countries with better options to protect their innovations. The legal methodology is comparative law. In order to study the effects of the legal differences statistics are examined and interviews done with SMEs from different industries.

Keywords: baltic sea region, comparative law, SME, utility model

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1879 The Impact of Culture on Tourists’ Evaluation of Hotel Service Experiences

Authors: Eid Alotaibi

Abstract:

The purpose of this study is to investigate the impact of tourists’ culture on perception and evaluation of hotel service experience and behavioral intentions. Drawing on Hofested’s cultural dimensions, this study seeks to further contribute towards understanding the effect of culture on perception and evaluation of hotels’ services, and whether there are differences between Saudi and European tourists’ perceptions of hotel services evaluation. A descriptive cross-sectional design was used in this study. Data were collected from tourists staying in five-star hotels in Saudi Arabia using the self-completion technique. The findings show that evaluations of hotel services differ from one culture to another. T-test results reveal that Saudis were more tolerant and reported significantly higher levels of satisfaction, were more likely to return and recommend the hotel, and perceived the price for the hotel stay as being good value for money as compared to their European counterparts. The sample was relatively small and specific to only five-star hotel evaluations. As a result, findings cannot be generalized to the wider tourist population. The results of this research have important implications for management within the Saudi hospitality industry. The study contributes to the tourist cultural theory by emphasizing the relative importance of cultural dimensions in-service evaluation. The author argues that no studies could be identified that compare Saudis and Europeans in their evaluations of their experiences staying at hotels. Therefore, the current study would enhance understanding of the effects of cultural factors on service evaluations and provide valuable input for international market segmentation and resource allocation in the Saudi hotel industry.

Keywords: culture, tourist, service experience, hotel industry, Hofested’s cultural dimensions

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1878 Perceptions and Spatial Realities: Women and the City of Limassol

Authors: Anna Papadopoulou

Abstract:

Women’s relationship to the post-industrial city has been defined by a reciprocal relationship between women’s identity and urban form. Women’s place within the social structure has been influenced by often limiting conditions set by the built environment, and, concurrently, women’s active role in social processes has definitively impacted urban development. Cities in Cyprus present unique locations for urban investigations pertaining to gender because of the country’s particular urban history: unlike most prominent European cities that have experienced approximately five hundred years of urban growth spurred by industrial development, Cypriot cities did not begin to form until the end of the Ottoman occupation that occurred in the last quarter of the nineteenth century. Consequently, Cyprus’ urban history is distinctive in that it coincides with international awakenings towards gender equality. This paper is drawn from a study of a contemporary urban narrative of Limassolian women and aims to elucidate spatial and perceptual boundaries that are inherent, constructed and implied. Within the context of this study, gender - in its socially constructed form - becomes a tool for reading and understanding the urban landscape, as well as a vehicle to impact the production and consumption of space. The investigation evaluates urban changes through the lens of women’s entry into the workforce which is a profound event in the social process and consequently explores issues of space and time, connectivity, and access, perceptions and awareness. A narrative of gendered urbanism has been derived from semi-structured interviews where the findings are studied, organised, analysed and synthesised through a grounded theory approach. These qualitative findings have been complemented and specialised by a series of informal observations and mappings.

Keywords: boundaries, gender, Limassol, urbanism

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1877 Improvement in Oral Health-Related Quality of Life of Adult Patients After Rehabilitation With Partial Dentures: A Systematic Review and Meta-Analysis

Authors: Adama NS Bah

Abstract:

Background: Loss of teeth has a negative influence on essential oral functions such as phonetics, mastication, and aesthetics. Dentists treat people with prosthodontic rehabilitation to recover essential oral functions. The oral health quality of life inventory reflects the success of prosthodontic rehabilitation. In many countries, the current conventional care delivered to replace missing teeth for adult patients involves the provision of removable partial dentures. Aim: The aim of this systematic review and meta-analysis is to gather the best available evidence to determine patients’ oral health-related quality of life improvement after treatment with partial dentures. Methods: We searched electronic databases from January 2010 to September 2019, including PubMed, ProQuest, Science Direct, Scopus and Google Scholar. In this paper, studies were included only if the average age was 30 years and above and also published in English. Two reviewers independently screened and selected all the references based on inclusion criteria using the PRISMA guideline, and assessed the quality of the included references using the Joanna Briggs Institute quality assessment tools. Data extracted were analyzed in RevMan 5.0 software, the heterogeneity between the studies was assessed using Forest plot, I2 statistics and chi-square test with a statistical P value less than 0.05 to indicate statistical significance. Random effect models were used in case of moderate or high heterogeneity. Four studies were included in the systematic review and three studies were pooled for meta-analysis. Results: Four studies included in the systematic review and three studies included in the meta-analysis with a total of 285 patients comparing the improvement in oral health-related quality of life before and after rehabilitation with partial denture, the pooled results showed a better improvement of oral health-related quality of life after treatment with partial dentures (mean difference 5.25; 95% CI [3.81, 6.68], p < 0.00001) favoring the wearing of partial dentures. In order to ascertain the reliability of the included studies for meta-analysis risk of bias was assessed and found to be low in all included studies for meta-analysis using the Cochrane collaboration tool for risk of bias assessment. Conclusion: There is high evidence that rehabilitation with partial dentures can improve the patient’s oral health-related quality of life measured with Oral Health Impact Profile 14. This review has clinical evidence value for dentists treating the expanding vulnerable adult population.

Keywords: meta-analysis, oral health impact profile, partial dentures, systematic review

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1876 Integrated Water Resources Management to Ensure Water Security of Arial Khan River Catchment

Authors: Abul Kalam Azad

Abstract:

Water security has become an increasingly important issue both at the national and international levels. Bangladesh having an abundance of water during monsoon while the shortage of water during the dry season is far from being water secured. Though water security has been discussed discretely at a different level but a holistic effort to ensure water security is yet to be made. The elements of water security such as sectoral demands of water, conflicting requirements amongst the sectors, balancing between demand and supply including the quality of water can best be understood and managed in a catchment as it is the standard functioning unit. The Arial Khan River catchment consists of parts of Faridpur, Madaripur, Shariatpur and Barishal districts have all the components of water demands such as agriculture, domestic, commercial, industrial, forestry, fisheries, navigation or recreation and e-flow requirements. Based on secondary and primary data, water demands of various sectors have been determined. CROPWAT 8.0 has been used to determine the Agricultural Water Demand. Mean Annual Flow (MAF) and Flow Duration Curve (FDC) have been used to determine the e-flow requirements. Water Evaluation and Planning System (WEAP) based decision support tool as part of Integrated Water Resources Management (IWRM) has been utilized for ensuring the water security of the Arial Khan River catchment. Studies and practice around the globe connected with water security were consulted to mitigate the pressure on demand and supply including the options available to ensure the water security. Combining all the information, a framework for ensuring water security has been suggested for Arial Khan River catchment which can further be projected to river basin as well as for the country. This will assist planners and researchers to introduce the model for integrated water resources management of any catchment/river basins.

Keywords: water security, water demand, water supply, WEAP, CROPWAT

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1875 Machiavellian Language at Work: The Signs of Machiavellianism in Work-Related Interviews

Authors: Gyongyver Csapo, Andrea Czibor

Abstract:

Machiavellianism is a personality trait based on the exploitation and deception of others. Machiavellian individuals are motivated to gain and to maintain power with the help of their strategic thinking, manipulation tactics, and interpersonal skills. Consequently, Machiavellianism is treated as a personality trait that can affect an individual’s career and work-related behavior. The aim of our research is to provide a narrative psychological approach to Machiavellianism in order to get a more comprehensive picture about the attitudes, values, and work-related behaviors of Machiavellian individuals. In this study, semi-structured interviews were made with employees (N=275) about their work-related experiences. Additionally, participants completed questionnaires about their turnover intention and perceived stress. The interviews were examined with narrative psychological content analysis and thematic analyzes. Based on the thematic analysis, mentioning of two topics (recognition at work and control) were associated with Machiavellianism. Scientific narrative psychological content analysis showed a negative association between Machiavellianism and positive emotions. Turnover intention and the magnitude of perceived work-related stress showed a significant positive correlation with Machiavellianism. In this study, qualitative and quantitative methodologies were combined in order to get a deeper insight of Machiavellianism from an organizational psychological perspective. Our research can contribute to a better understanding of this personality trait and provides an excellent basis for further investigations.

Keywords: machiavellianism, narrative psychology, turnover intention, work-related stress

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1874 Analysis of Intra-Varietal Diversity for Some Lebanese Grapevine Cultivars

Authors: Stephanie Khater, Ali Chehade, Lamis Chalak

Abstract:

The progressive replacement of the Lebanese autochthonous grapevine cultivars during the last decade by the imported foreign varieties almost resulted in the genetic erosion of the local germplasm and the confusion with cultivars' names. Hence there is a need to characterize these local cultivars and to assess the possible existing variability at the cultivar level. This work was conducted in an attempt to evaluate the intra-varietal diversity within Lebanese traditional cultivars 'Aswad', 'Maghdoushe', 'Maryame', 'Merweh', 'Meksese' and 'Obeide'. A total of 50 accessions distributed over five main geographical areas in Lebanon were collected and submitted to both ampelographic description and ISSR DNA analysis. A set of 35 ampelographic descriptors previously established by the International Office of Vine and Wine and related to leaf, bunch, berry, and phenological stages, were examined. Variability was observed between accessions within cultivars for blade shape, density of prostrate and erect hairs, teeth shape, berry shape, size and color, cluster shape and size, and flesh juiciness. At the molecular level, nine ISSR (inter-simple sequence repeat) primers, previously developed for grapevine, were used in this study. These primers generated a total of 35 bands, of which 30 (85.7%) were polymorphic. Totally, 29 genetic profiles were differentiated, of which 9 revealed within 'Obeide', 6 for 'Maghdoushe', 5 for 'Merweh', 4 within 'Maryame', 3 for 'Aswad' and 2 within 'Meksese'. Findings of this study indicate the existence of several genotypes that form the basis of the main indigenous cultivars grown in Lebanon and which should be further considered in the establishment of new vineyards and selection programs.

Keywords: ampelography, autochthonous cultivars, ISSR markers, Lebanon, Vitis vinifera L.

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1873 Long-Term Modal Changes in International Traffic - Example of the Polish Eastern Border

Authors: Tomasz Komornicki

Abstract:

The possibilities of cross-border traffic depend on the degree of permeability of a given border as well as the state of the existing transport infrastructure. The aim of this paper is to identify the impact of economic transformation, EU accession, and infrastructure development on modal shifts in border traffic through the Polish eastern boundary. In the 1980s railway was still the main mode of cross-border transport in Poland. At the beginning of the 1990s, the role of the road and rail transborder passenger traffic was similar, but since 1993, the role of rail was decreasing. The general decline in rail infrastructure in Poland continued uninterruptedly until accession to the European Union. The slow opposite trend can be observed later as a result of the inflow of European funds. In the countries neighbouring Poland from the east, these processes took place with some delay, and the loss of railway position was not so drastic. Therefore, cross-border railway connections have been maintained for quite a long time since the break-up of the USSR. However, finally, cross-border rail transport proved to be completely inflexible in relation to both economic, geopolitical, and transport transformations. It has been shown that the current modal split of the passenger border traffic was shaped by the following factors: a) closure of many transborder railway lines, especially local ones; b) the signing of an agreement on minor border traffic with Ukraine; c) rapidly growing number of citizens of Ukraine working in Poland (unofficial transportation of workers by car directly to their workplaces in Poland); d) the emergence of low-cost air connections between Ukraine and Poland and the growing role of air transport in the Russia-Poland relationship. The summary points to the possibility of a renewed increase in the importance of rail transport on the eastern border of the European Union.

Keywords: modal change, border, rail transport, Poland

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1872 The Role of Artificial Intelligence in Criminal Procedure

Authors: Herke Csongor

Abstract:

The artificial intelligence (AI) has been used in the United States of America in the decisionmaking process of the criminal justice system for decades. In the field of law, including criminal law, AI can provide serious assistance in decision-making in many places. The paper reviews four main areas where AI still plays a role in the criminal justice system and where it is expected to play an increasingly important role. The first area is the predictive policing: a number of algorithms are used to prevent the commission of crimes (by predicting potential crime locations or perpetrators). This may include the so-called linking hot-spot analysis, crime linking and the predictive coding. The second area is the Big Data analysis: huge amounts of data sets are already opaque to human activity and therefore unprocessable. Law is one of the largest producers of digital documents (because not only decisions, but nowadays the entire document material is available digitally), and this volume can only and exclusively be handled with the help of computer programs, which the development of AI systems can have an increasing impact on. The third area is the criminal statistical data analysis. The collection of statistical data using traditional methods required enormous human resources. The AI is a huge step forward in that it can analyze the database itself, based on the requested aspects, a collection according to any aspect can be available in a few seconds, and the AI itself can analyze the database and indicate if it finds an important connection either from the point of view of crime prevention or crime detection. Finally, the use of AI during decision-making in both investigative and judicial fields is analyzed in detail. While some are skeptical about the future role of AI in decision-making, many believe that the question is not whether AI will participate in decision-making, but only when and to what extent it will transform the current decision-making system.

Keywords: artificial intelligence, international criminal cooperation, planning and organizing of the investigation, risk assessment

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1871 Cyber Security and Risk Assessment of the e-Banking Services

Authors: Aisha F. Bushager

Abstract:

Today we are more exposed than ever to cyber threats and attacks at personal, community, organizational, national, and international levels. More aspects of our lives are operating on computer networks simply because we are living in the fifth domain, which is called the Cyberspace. One of the most sensitive areas that are vulnerable to cyber threats and attacks is the Electronic Banking (e-Banking) area, where the banking sector is providing online banking services to its clients. To be able to obtain the clients trust and encourage them to practice e-Banking, also, to maintain the services provided by the banks and ensure safety, cyber security and risks control should be given a high priority in the e-banking area. The aim of the study is to carry out risk assessment on the e-banking services and determine the cyber threats, cyber attacks, and vulnerabilities that are facing the e-banking area specifically in the Kingdom of Bahrain. To collect relevant data, structured interviews were taken place with e-banking experts in different banks. Then, collected data where used as in input to the risk management framework provided by the National Institute of Standards and Technology (NIST), which was the model used in the study to assess the risks associated with e-banking services. The findings of the study showed that the cyber threats are commonly human errors, technical software or hardware failure, and hackers, on the other hand, the most common attacks facing the e-banking sector were phishing, malware attacks, and denial-of-service. The risks associated with the e-banking services were around the moderate level, however, more controls and countermeasures must be applied to maintain the moderate level of risks. The results of the study will help banks discover their vulnerabilities and maintain their online services, in addition, it will enhance the cyber security and contribute to the management and control of risks that are facing the e-banking sector.

Keywords: cyber security, e-banking, risk assessment, threats identification

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1870 Bauhaus Exhibition 1922: New Weapon of Anti-Colonial Resistance in India

Authors: Suneet Jagdev

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The development of the original Bauhaus occurred at a time in the beginning of the 20th century when the industrialization of Germany had reached a climax. The cities were a reflection of the new living conditions of an industrialized society. The Bauhaus can be interpreted as an ambitious attempt to find appropriate answers to the challenges by using architecture-urban development and design. The core elements of the conviction of the day were the belief in the necessary crossing of boundaries between the various disciplines and courage to experiment for a better solution. Even after 100 years, the situation in our cities is shaped by similar complexity. The urban consequences of developments are difficult to estimate and to predict. The paper critically reflected on the central aspects of the history of the Bauhaus and its role in bringing the modernism in India by comparative studies of the methodology adopted by the artists and designer in both the countries. The paper talked in detail about how the Bauhaus Exhibition in 1922 offered Indian artists a new weapon of anti-colonial resistance. The original Bauhaus fought its aesthetic and political battles in the context of economic instability and the rise of German fascism. The Indians had access to dominant global languages and in a particular English. The availability of print media and a vibrant indigenous intellectual culture provided Indian people a tool to accept technology while denying both its dominant role in culture and the inevitability of only one form of modernism. The indigenous was thus less an engagement with their culture as in the West than a tool of anti-colonial struggle. We have shown how the Indian people used Bauhaus as a critique of colonialism itself through an undermining of its typical modes of representation and as a means of incorporating the Indian desire for spirituality into art and as providing the cultural basis for a non-materialistic and anti-industrial form of what we might now term development. The paper reflected how through painting the Bauhaus entered the artistic consciousness of the sub-continent not only for its stylistic and technical innovations but as a tool for a critical and even utopian modernism that could challenge both the hegemony of academic and orientalist art and as the bearer of a transnational avant-garde as much political as it was artistic, and as such the basis of a non-Eurocentric but genuinely cosmopolitan alternative to the hierarchies of oppression and domination that had long bound India and were at that moment rising once again to a tragic crescendo in Europe. We have talked about how the Bauhaus of today can offer an innovative orientation towards discourse around architecture and design.

Keywords: anti-colonial struggle, art over architecture, Bauhaus exhibition of 1922, industrialization

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1869 Music in the Early Stages of Life: Considerations from Working with Groups of Mothers and Babies

Authors: Ana Paula Melchiors Stahlschmidt

Abstract:

This paper discusses the role of music as a ludic activity and constituent element of voice in the construction and consolidation of the relationship of the baby and his/her mother or caretaker, evaluating its implications in his/her psychic structure and constitution as a subject. The work was based on the research developed as part of the author’s doctoral activities carried out from her insertion in a project of the Music Department of Federal University of Rio Grande do Sul - UFRGS, which objective was the development of musical activities with groups of babies from 0 to 24 months old and their caretakers. Observations, video recordings of the meetings, audio testemonies, and evaluation tools applied to group participants were used as instruments for this research. Information was collected on the participation of 195 babies, among which 8 were more focused on through interviews with their mothers or caretakers. These interviews were analyzed based on the referential of French Discourse Analysis, Psychoanalysis, Psychology of Development and Musical Education. The results of the research were complemented by other posterior experiences that the author developed with similar groups, in a context of a private clinic. The information collected allowed the observation of the ludic and structural functions of musical activities, when developed in a structured environment, as well as the importance of the musicality of the mother’s voice to the psychical structuring of the baby, allowing his/her insertion in the language and his/her constituition as a subject.

Keywords: music and babies, maternal voice, Psychoanalysis and music, psychology and music

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1868 Interventions to Improve the Performance of Community Based Health Insurance in Low- and Lower Middle-Income-Countries: a Systematic Review

Authors: Scarlet Tabot Enanga Longsti

Abstract:

Community-Based Health Insurance (CBHI) schemes have been proposed as a possible means to achieve affordable health care in low-and lower-middle-income countries. The existing evidence provides mixed results on the impact of CBHI schemes on healthcare utilisation and out -of-pocket payments (OOPP) for healthcare. Over 900 CBHI schemes have been implemented in underdeveloped countries, and these schemes have undergone different modifications over the years. Prior reviews have suggested that different designs of CBHI schemes may result in different outcomes. Objectives: This review sought to determine the interventions that affect the impact of CBHI schemes on OOPP and health service utilisation. Interventions in this study referred to any action or modification in the design of a CBHI scheme that affected the impact of the scheme on OOPP and/or healthcare utilization. Methods: Any CBHI study that was done in a lower middle-income country, that used an experimental design, that included OOPP or health care utilisation as outcome variables, and that was published in either English or French was included in this study. Studies were searched for in MEDLINE, Embase, CINAHL, EconLit, IBSS, Web of Science, Cochrane Library, and Global Index Medicus from July to August 2023. Bias was assessed using Joanna Brigs Institute tools for quality assessment for randomized control trials and quasi experimental studies. A narrative synthesis was done. Results: 12 studies were included in the review, with a total of 69 villages, 13,653 households, and 62,786 participants. Average premium collection was 4.8 USD/year. Most CBHI schemes had flat rates. The study revealed that a range of interventions impact OOPP and health care utilisation. Five categories of interventions were identified. The intervention with the highest impact on OOPP and utilisation was “Audit visits”. Next in line came external funds, training scheme workers, and engaging community leaders and village heads to advertise the scheme. Free healthcare led to a significant increase in utilisation of health services, a significant reduction in Catastrophic health expenditure, but an insignificant effect on OOPP among insured compared with uninsured. Conclusions: Community-Based Health Insurance could pave the way for Universal Health Care in low and middle-income countries. However, this can only be possible if careful thought is given to how schemes are designed. Due to the heterogeneity of studies and results on CBHI schemes, there is need for further research for more effective designs to be developed.

Keywords: community based health insurance, developing countries, health service utilisation, out of pocket payment

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