Search results for: some guidelines for implementation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5758

Search results for: some guidelines for implementation

5158 Audit Is a Production Performance Tool

Authors: Lattari Samir

Abstract:

The performance of a production process is the result of proper operation where the management tools appear as the key to success through process management which consists of managing and implementing a quality policy, organizing and planning the manufacturing, and thus defining an efficient logic as the main areas covered by production management. To carry out this delicate mission, which requires reconciling often contradictory objectives, the auditor is called upon, who must be able to express an opinion on the effectiveness of the operation of the "production" function. To do this, the auditor must structure his mission in three phases, namely, the preparation phase to assimilate the particularities of this function, the implementation phase and the conclusion phase. The audit is a systematic and independent examination of all the stages of a manufacturing process intended to determine whether the pre-established arrangements for the combination of production factors are respected, whether their implementation is effective and whether they are relevant in relation to the goals.

Keywords: audit, performance of process, independent examination, management tools, audit of accounts

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5157 The Implementation of a Numerical Technique to Thermal Design of Fluidized Bed Cooler

Authors: Damiaa Saad Khudor

Abstract:

The paper describes an investigation for the thermal design of a fluidized bed cooler and prediction of heat transfer rate among the media categories. It is devoted to the thermal design of such equipment and their application in the industrial fields. It outlines the strategy for the fluidization heat transfer mode and its implementation in industry. The thermal design for fluidized bed cooler is used to furnish a complete design for a fluidized bed cooler of Sodium Bicarbonate. The total thermal load distribution between the air-solid and water-solid along the cooler is calculated according to the thermal equilibrium. The step by step technique was used to accomplish the thermal design of the fluidized bed cooler. It predicts the load, air, solid and water temperature along the trough. The thermal design for fluidized bed cooler revealed to the installation of a heat exchanger consists of (65) horizontal tubes with (33.4) mm diameter and (4) m length inside the bed trough.

Keywords: fluidization, powder technology, thermal design, heat exchangers

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5156 Sustainable Project Management Necessarily Implemented in the Chinese Wine Market Due to Climate Variation

Authors: Ruixin Zhang, Joel Carboni, Songchenchen Gong

Abstract:

Since the Sustainable Development Goals (SDGs) officially became the 17 development goals set by the United Nations in 2015, it has become an inevitable trend in project management development globally. Since Sustainability and glob-alization are the main focus and trends in the 21st century, project management contains system-based optimization, and or-ganizational humanities, environmental protection, and economic development. As a populous country globally, with the advanced development of economy and technology, China becomes one of the biggest markets in the wine industry. However, the develop-ment of society also brings specific environmental issues. Climate changes have already brought severe impacts on the Chinese wine market, including consumer behavior, wine production activities, and organizational humanities. Therefore, the implementation of sustainable project management in Chinese wine market is essential. Surveys based analysis is the primary method to interpret how the climate variation effect the Chinese wine market and the importance of sustainable project management implementation for green market growth in China. This paper proposes the CWW Conceptual model that can be used in the wine industry, the new 7 Drivers Model, and SPM Framework to interpret the main drivers that impact project management implementation in the wine industry and to offer the directions to wine companies in China which would help them to achieve the green growth.

Keywords: project management, sustainability, green growth, climate changes, Chinese wine market

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5155 Choking among Babies, Toddlers and Children with Special Needs: A Review of Mechanisms, Implications, Incidence, and Recommendations of Professional Prevention Guidelines

Authors: Ella Abaev, Shany Segal, Miri Gabay

Abstract:

Background: Choking is a blockage of airways that prevents efficient breathing and air flow to the lungs. Choking may be partial or full and is an emergency situation. Complete or prolonged choking leads to apnea, lack of oxygen in the tissues of the body and brain, and can cause death. There are three mechanisms of choking: obstruction of internal respiratory tracts by food or object aspiration, any material that blocks or covers external air passages, external pressure on the neck or trapping between objects. Children's airways are narrower than that of adults and therefore the risk of choking is greater, due to the aspiration of food and other foreign bodies into the lungs. In the Child Development Center at Safra Children’s Hospital, Tel Hashomer in Israel are treated infants, toddlers, and children aged 0-18 years with various developmental disabilities. Due to the increase in reports of ‘almost an event’ of choking in the past year and the serious consequences of choking event, it was decided to give an emphasis to the issue. Incidence and methods: The number of reports of ‘almost an event’ or a choking event was examined at the center during the years 2013-2018 and a thorough research work was conducted on the subject in order to build a prevention program. Findings: Between 2013 and 2018 the center reported about ten cases of ‘almost choking events’. In the middle of 2018 alone three cases of ‘almost an event’ were reported. Objective: Providing knowledge leads to awareness raise, change of perception, change in behavior and prevention. The center employs more than 130 staff members from various sectors so that it is the work of multi-professional teams to promote the quality and safety of the treatment. The familiarity of the staff with risk factors, prevention guidelines, identification of choking signs, and treatment are most important and significant in determining the outcome of a choking event. Conclusions and recommendations: After in-depth research work was carried out in cooperation with the Risk Management Unit on the subject of choking, which include a description of the definitions, mechanisms, risk factors, treatment methods and extensive recommendations for prevention (e.g. using treatment and stimulation accessories with standards association stamps and adjustment of the type of food and the way it is served to match to the child's age and the ability to swallow). The expected stages of development and emphasis on the population of children with special needs were taken into account. The research findings will be published by the staff and parents of the patients, professional publications, and lectures and there is an expectation to decrease the number of choking events in the next years.

Keywords: children with special needs, choking, educational system, prevention guidelines

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5154 Situated Professional Development: Examining Strengths, Challenges, and Ways Forward

Authors: Youmen Chaaban

Abstract:

The study examined the influence of a situated professional development program (PD) aimed at enhancing English language teachers’ knowledge and skills and improving their instructional practices. The PD model under examination was developed upon sound theoretical underpinnings, taking into consideration research-based principles of effective PD. However, the implementation of the PD model within several school contexts required further investigation from the perspectives of the teachers, who were receiving the PD activities, and the instructional coaches, who were providing them. The paper, thus, presents the results of a qualitative study examining the perceptions of seventeen English language teachers and nineteen instructional coaches about the strengths of the PD program, the challenges they faced in the implementation of the program, and their suggestions for the improvement of the program’s implementation and outcomes. Comparisons were further made between the two groups of participants to uncover agreements and contradictions in their perceptions. Data were collected from the teachers through in-depth interviews and observations, while the data collected from the instructional coaches were open-ended surveys followed by focus group interviews. The findings of the study confirm the necessity of structuring PD activities around sound theoretical underpinnings. However, practical considerations specific to the contexts where the PD activities take place should be considered when evaluating the PD’s effectiveness. Finally, the study provides several recommendations for maximizing the influence of the PD program on teachers’ practices and beliefs.

Keywords: English language teachers, situated professional development, teacher beliefs, teacher practices

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5153 Design and Implementation of Active Radio Frequency Identification on Wireless Sensor Network-Based System

Authors: Che Z. Zulkifli, Nursyahida M. Noor, Siti N. Semunab, Shafawati A. Malek

Abstract:

Wireless sensors, also known as wireless sensor nodes, have been making a significant impact on human daily life. The Radio Frequency Identification (RFID) and Wireless Sensor Network (WSN) are two complementary technologies; hence, an integrated implementation of these technologies expands the overall functionality in obtaining long-range and real-time information on the location and properties of objects and people. An approach for integrating ZigBee and RFID networks is proposed in this paper, to create an energy-efficient network improved by the benefits of combining ZigBee and RFID architecture. Furthermore, the compatibility and requirements of the ZigBee device and communication links in the typical RFID system which is presented with the real world experiment on the capabilities of the proposed RFID system.

Keywords: mesh network, RFID, wireless sensor network, zigbee

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5152 An Implementation of Meshless Method for Modeling an Elastoplasticity Coupled to Damage

Authors: Sendi Zohra, Belhadjsalah Hedi, Labergere Carl, Saanouni Khemais

Abstract:

The modeling of mechanical problems including both material and geometric nonlinearities with Finite Element Method (FEM) remains challenging. Meshless methods offer special properties to get rid of well-known drawbacks of the FEM. The main objective of Meshless Methods is to eliminate the difficulty of meshing and remeshing the entire structure by simply insertion or deletion of nodes, and alleviate other problems associated with the FEM, such as element distortion, locking and others. In this study, a robust numerical implementation of an Element Free Galerkin Method for an elastoplastic coupled to damage problem is presented. Several results issued from the numerical simulations by a DynamicExplicit resolution scheme are analyzed and critically compared with Element Finite Method results. Finally, different numerical examples are carried out to demonstrate the efficiency of this method.

Keywords: damage, dynamic explicit, elastoplasticity, isotropic hardening, meshless

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5151 Implementation of the Interlock Protocol to Enhance Security in Unmanned Aerial Vehicles

Authors: Vikram Prabhu, Mohammad Shikh Bahaei

Abstract:

This paper depicts the implementation of a new infallible technique to protect an Unmanned Aerial Vehicle from cyber-attacks. An Unmanned Aerial Vehicle (UAV) could be vulnerable to cyber-attacks because of jammers or eavesdroppers over the network which pose as a threat to the security of the UAV. In the field of network security, there are quite a few protocols which can be used to establish a secure connection between UAVs and their Operators. In this paper, we discuss how the Interlock Protocol could be implemented to foil the Man-in-the-Middle Attack. In this case, Wireshark has been used as the sniffer (man-in-the-middle). This paper also shows a comparison between the Interlock Protocol and the TCP Protocols using cryptcat and netcat and at the same time highlights why the Interlock Protocol is the most efficient security protocol to prevent eavesdropping over the communication channel.

Keywords: interlock protocol, Diffie-Hellman algorithm, unmanned aerial vehicles, control station, man-in-the-middle attack, Wireshark

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5150 The Nursing Rounds System: Effect of Patient's Call Light Use, Bed Sores, Fall and Satisfaction Level

Authors: Bassem Saleh, Hussam Nusair, Nariman Al Zubadi, Shams Al Shloul, Usama Saleh

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The nursing round system (NRS) means checking patients on an hourly basis during the A (0700–2200 h) shift and once every 2 h during the B (2200–0700 h) by the assigned nursing staff. The overall goal of this prospective study is to implement an NRS in a major rehabilitation centre—Sultan Bin Abdulaziz Humanitarian City—in the Riyadh area of the Kingdom of Saudi Arabia. The purposes of this study are to measure the effect of the NRS on: (i) the use of patient call light; (ii) the number of incidences of patients’ fall; (iii) the number of incidences of hospital-acquired bed sores; and (iv) the level of patients’ satisfaction. All patients hospitalized in the male stroke unit will be involved in this study. For the period of 8 weeks (17 December 2009–17 February 2010) All Nursing staff on the unit will record each call light and the patient’s need. Implementation of the NRS would start on 18 February 2010 and last for 8 weeks, until 18 April 2010. Data collected throughout this period will be compared with data collected during the 8 weeks period immediately preceding the implementation of the NRS (17 December 2009–17 February 2010) in order to measure the impact of the call light use. The following information were collected on all subjects involved in the study: (i) the Demographic Information Form; (ii) authors’ developed NRS Audit Form; (iii) Patient Call Light Audit Form; (iv) Patient Fall Audit Record; (v) Hospital-Acquired Bed Sores Audit Form; and (vi) hospital developed Patient Satisfaction Records. The findings suggested that a significant reduction on the use of call bell (P < 0.001), a significant reduction of fall incidence (P < 0.01) while pressure ulcer reduced by 50% before and after the implementation of NRS. In addition, the implementation of NRS increased patient satisfaction by 7/5 (P < 0.05).

Keywords: call light, patient-care management, patient safety, patient satisfaction, rounds

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5149 Assessment of the Impact of Family Care Team in the District Health System of Regional Health, Thailand

Authors: Nithra Kitreerawutiwong, Sunsanee Mekrungrongwong, Artitaya Wongwonsin, Chakkraphan Phetphoom, Buaploy Phromjang

Abstract:

Background: Thailand has implemented a district health system based on the concept of primary health care. Since 2014, Family Care Team (FCT) was launched to improve the quality of care through a multidisciplinary team include not only the health sector but also social sector work together. FCT classified into 3 levels: district, sub-district, and community. This system now consists of 66,353 teams, including 3,890 teams at district level, 12,237 teams at the sub-district level, and 50,326 teams at the community level. There is a report regarding assessment the situation and perception on FCT, however, relatively few examined the operationality of this policy. This study aimed to explore the perception of district manager on the process of the implementation of FCT policy and the factors associating to implement FCT in the district health system. Methods/Results: Forty in-depth interviews were performed: 5 of primary care manager at the provincial medical health office, 5 of community hospital director, 5 of district administrative health office, 10 of sub-district health promoting hospital, and 10 of local organization. Semi-structure interview guidelines were used in the discussions. The data was analyzed by thematic analysis. This policy was formulated based on the demographic change and epidemiology transition to serve a long term care for elderly. Facilitator factors are social capital in district health systems such as family health leader and multidisciplinary team. Barrier factors are communication to the frontline provider and local organization. The output of this policy in relation to the structure of FCT is well-defined. Unanticipated effects include training of FCT in community level. Conclusion: Early feedback from healthcare manager is valuable information for the improvement of FCT to function optimally. Moreover, in the long term, health outcome need to be evaluated.

Keywords: family care team, district health system, primary care, qualitative study

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5148 Architectural Approaches to a Sustainable Community with Floating Housing Units Adapting to Climate Change and Sea Level Rise in Vietnam

Authors: Nguyen Thi Thu Trang

Abstract:

Climate change and sea level rise is one of the greatest challenges facing human beings in the 21st century. Because of sea level rise, several low-lying coastal areas around the globe are at risk of being completely submerged, disappearing under water. Particularly in Viet Nam, the rise in sea level is predicted to result in more frequent and even permanently inundated coastal plains. As a result, land reserving fund of coastal cities is going to be narrowed in near future, while construction ground is becoming increasingly limited due to a rapid growth in population. Faced with this reality, the solutions are being discussed not only in tradition view such as accommodation is raised or moved to higher areas, or “living with the water”, but also forwards to “living on the water”. Therefore, the concept of a sustainable floating community with floating houses based on the precious value of long term historical tradition of water dwellings in Viet Nam would be a sustainable solution for adaptation of climate change and sea level rise in the coastal areas. The sustainable floating community is comprised of sustainability in four components: architecture, environment, socio-economic and living quality. This research paper is focused on sustainability in architectural component of floating community. Through detailed architectural analysis of current floating houses and floating communities in Viet Nam, this research not only accumulates precious values of traditional architecture that need to be preserved and developed in the proposed concept, but also illustrates its weaknesses that need to address for optimal design of the future sustainable floating communities. Based on these studies the research would provide guidelines with appropriate architectural solutions for the concept of sustainable floating community with floating housing units that are adapted to climate change and sea level rise in Viet Nam.

Keywords: guidelines, sustainable floating community, floating houses, Vietnam

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5147 Developing a Framework for Sustainable Social Housing Delivery in Greater Port Harcourt City Rivers State, Nigeria

Authors: Enwin Anthony Dornubari, Visigah Kpobari Peter

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This research has developed a framework for the provision of sustainable and affordable housing to accommodate the low-income population of Greater Port Harcourt City. The objectives of this study among others, were to: examine UN-Habitat guidelines for acceptable and sustainable social housing provision, describe past efforts of the Rivers State Government and the Federal Government of Nigeria to provide housing for the poor in the Greater Port Harcourt City area; obtain a profile of prospective beneficiaries of the social housing proposed by this research as well as perceptions of their present living conditions, and living in the proposed self-sustaining social housing development, based on the initial simulation of the proposal; describe the nature of the framework, guideline and management of the proposed social housing development and explain the modalities for its implementation. The study utilized the mixed methods research approach, aimed at triangulating findings from the quantitative and qualitative paradigms. Opinions of professional of the built environment; Director, Development Control, Greater Port Harcourt City Development Authority; Directors of Ministry of Urban Development and Physical Planning; Housing and Property Development Authority and managers of selected Primary Mortgage Institutions were sought and analyzed. There were four target populations for the study, namely: members of occupational sub-groups for FGDs (Focused Group Discussions); development professionals for KIIs (Key Informant Interviews), household heads in selected communities of GPHC; and relevant public officials for IDI (Individual Depth Interview). Focus Group Discussions (FGDs) were held with members of occupational sub-groups in each of the eight selected communities (Fisherfolk). The table shows that there were forty (40) members across all occupational sub-groups in each selected community, yielding a total of 320 in the eight (8) communities of Mgbundukwu (Mile 2 Diobu), Rumuodomaya, Abara (Etche), Igwuruta-Ali(Ikwerre), Wakama(Ogu-Bolo), Okujagu (Okrika), Akpajo (Eleme), and Okoloma (Oyigbo). For key informant interviews, two (2) members were judgmentally selected from each of the following development professions: urban and regional planners; architects; estate surveyors; land surveyors; quantity surveyors; and engineers. Concerning Population 3-Household Heads in Selected Communities of GPHC, a stratified multi-stage sampling procedure was adopted: Stage 1-Obtaining a 10% (a priori decision) sample of the component communities of GPHC in each stratum. The number in each stratum was rounded to one whole number to ensure representation of each stratum. Stage 2-Obtaining the number of households to be studied after applying the Taro Yamane formula, which aided in determining the appropriate number of cases to be studied at the precision level of 5%. Findings revealed, amongst others, that poor implementation of the UN-Habitat global shelter strategy, lack of stakeholder engagement, inappropriate locations, undue bureaucracy, lack of housing fairness and equity and high cost of land and building materials were the reasons for the failure of past efforts towards social housing provision in the Greater Port Harcourt City area. The study recommended a public-private partnership approach for the implementation and management of the framework. It also recommended a robust and sustained relationship between the management of the framework and the UN-Habitat office and other relevant government agencies responsible for housing development and all investment partners to create trust and efficiency.

Keywords: development, framework, low-income, sustainable, social housing

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5146 A Methodological Approach to Digital Engineering Adoption and Implementation for Organizations

Authors: Sadia H. Syeda, Zain H. Malik

Abstract:

As systems continue to become more complex and the interdependencies of processes and sub-systems continue to grow and transform, the need for a comprehensive method of tracking and linking the lifecycle of the systems in a digital form becomes ever more critical. Digital Engineering (DE) provides an approach to managing an authoritative data source that links, tracks, and updates system data as it evolves and grows throughout the system development lifecycle. DE enables the developing, tracking, and sharing system data, models, and other related artifacts in a digital environment accessible to all necessary stakeholders. The DE environment provides an integrated electronic repository that enables traceability between design, engineering, and sustainment artifacts. The DE activities' primary objective is to develop a set of integrated, coherent, and consistent system models for the program. It is envisioned to provide a collaborative information-sharing environment for various stakeholders, including operational users, acquisition personnel, engineering personnel, and logistics and sustainment personnel. Examining the processes that DE can support in the systems engineering life cycle (SELC) is a primary step in the DE adoption and implementation journey. Through an analysis of the U.S Department of Defense’s (DoD) Office of the Secretary of Defense (OSD’s) Digital Engineering Strategy and their implementation, examples of DE implementation by the industry and technical organizations, this paper will provide descriptions of the current DE processes and best practices of implementing DE across an enterprise. This will help identify the capabilities, environment, and infrastructure needed to develop a potential roadmap for implementing DE practices consistent with its business strategy. A capability maturity matrix will be provided to assess the organization’s DE maturity emphasizing how all the SELC elements interlink to form a cohesive ecosystem. If implemented, DE can increase efficiency and improve the systems engineering processes' quality and outcomes.

Keywords: digital engineering, digital environment, digital maturity model, single source of truth, systems engineering life-cycle

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5145 Dermoscopy Compliance: Improving Melanoma Detection Pathways Through Quality Improvement

Authors: Max Butler

Abstract:

Melanoma accounts for 80% of skin cancer-related deaths globally. The poor prognosis and increasing incidence of melanoma impose a significant burden on global healthcare systems. Early detection, precise diagnosis, and preventative strategies are critical to improving patient outcomes. Dermoscopy is the gold standard for specialist assessments of pigmented skin lesions, as it can differentiate between benign and malignant growths with greater accuracy than visual inspection. In the United Kingdom, guidelines from the National Institute of Clinical Excellence (NICE) state dermoscopy should be used in all specialist assessments of pigmented skin lesions. Compliance with this guideline is low, resulting in missed and delayed melanoma diagnoses. To address this problem, a quality improvement project was initiated at Buckinghamshire Healthcare Trust (BHT) within the plastic surgery department. The target group was a trainee and consultant plastic surgeons conducting outpatient skin cancer clinics. Analysis of clinic documentation over a one-month period found that only 62% (38/61) of patients referred with pigmented skin lesions were examined using dermoscopy. To increase dermoscopy rates, teaching was delivered to the department highlighting national guidelines and the evidence base for dermoscopic examination. In addition, clinic paperwork was redesigned to include a text box for dermoscopic examination. Reauditing after the intervention found a significant increase in dermoscopy rates (52/61, p = 0.014). In conclusion, implementing a quality improvement project with targeted teaching and documentation template templates successfully increased dermoscopy rates. This is a promising step toward improving early melanoma detection and patient outcomes.

Keywords: melanoma, dermoscopy, plastic surgery, quality improvement

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5144 A Critical Evaluation of Occupational Safety and Health Management Systems' Implementation: Case of Mutare Urban Timber Processing Factories, Zimbabwe

Authors: Johanes Mandowa

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The study evaluated the status of Occupational Safety and Health Management Systems’ (OSHMSs) implementation by Mutare urban timber processing factories. A descriptive cross sectional survey method was utilized in the study. Questionnaires, interviews and direct observations were the techniques employed to extract primary data from the respondents. Secondary data was acquired from OSH encyclopedia, OSH journals, newspaper articles, internet, past research papers, African Newsletter on OSH and NSSA On-guard magazines among others. Analysis of data collected was conducted using statistical and descriptive methods. Results revealed an unpleasant low uptake rate (16%) of OSH Management Systems by Mutare urban timber processing factories. On a comparative basis, low implementation levels were more pronounced in small timber processing factories than in large factories. The low uptake rate of OSH Management Systems revealed by the study validates the Government of Zimbabwe and its social partners’ observation that the dismal Zimbabwe OSH performance was largely due to non implementation of safety systems at most workplaces. The results exhibited a relationship between availability of a SHE practitioner in Mutare urban timber processing factories and OSHMS implementation. All respondents and interviewees’ agreed that OSH Management Systems are handy in curbing occupational injuries and diseases. It emerged from the study that the top barriers to implementation of safety systems are lack of adequate financial resources, lack of top management commitment and lack of OSHMS implementation expertise. Key motivators for OSHMSs establishment were cited as provision of adequate resources (76%), strong employee involvement (64%) and strong senior management commitment and involvement (60%). Study results demonstrated that both OSHMSs implementation barriers and motivators affect all Mutare urban timber processing factories irrespective of size. The study recommends enactment of a law by Ministry of Public Service, Labour and Social Welfare in consultation with NSSA to make availability of an OSHMS and qualified SHE practitioner mandatory at every workplace. More so, the enacted law should prescribe minimum educational qualification required for one to practice as a SHE practitioner. Ministry of Public Service, Labour and Social Welfare and NSSA should also devise incentives such as reduced WCIF premiums for good OSH performance to cushion Mutare urban timber processing factories from OSHMS implementation costs. The study recommends the incorporation of an OSH module in the academic curriculums of all programmes offered at tertiary institutions so as to ensure that graduates who later end up assuming influential management positions in Mutare urban timber processing factories are abreast with the necessity of OSHMSs in preventing occupational injuries and diseases. In the quest to further boost management’s awareness on the importance of OSHMSs, NSSA and SAZ are urged by the study to conduct OSHMSs awareness breakfast meetings targeting executive management on a periodic basis. The Government of Zimbabwe through the Ministry of Public Service, Labour and Social Welfare should also engage ILO Country Office for Zimbabwe to solicit for ILO’s technical assistance so as to enhance the effectiveness of NSSA’s and SAZ’s OSHMSs promotional programmes.

Keywords: occupational safety health management system, national social security authority, standard association of Zimbabwe, Mutare urban timber processing factories, ministry of public service, labour and social welfare

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5143 Increasing Sexual Safety Awareness and Capacity for Mental Health Professionals

Authors: Tara Hunter, Kristine Concepcion, Wendy Cheng, Brianna Pike, Jane Estoesta, Anne Stuart

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In 2015, Family Planning NSW was contracted by the NSW Ministry of Health to design and deliver Sexual Safety Policy training (SSPT) to mental health professionals across NSW. The training was based on their current guidelines and developed in consultation with an expert reference group. From October 2015 to April 2017 it was delivered to over 2,400 mental health professionals with a view to supporting implementation of consistent prevention and intervention related to sexual safety in the mental health setting. An evaluation was undertaken to determine the knowledge and confidence of participants related to sexual safety before and after the training, and whether any improvements were translated into changes in practice. Participants were invited to complete a survey prior to the training, upon completion and three to six months thereafter. Telephone interviews were conducted among service managers and mental health champions six months post-training. Prior to training, the majority of mental health professionals reported being slightly to moderately confident in identifying a sexual safety incident. When asked on their understanding of sexual safety, gender sensitive practice and trauma informed care, they reported no confidence, slight confidence and moderate confidence. Immediately after the training, 54.5% reported being very confident and 10.9% extremely confident in identifying a sexual safety incident. More than half felt very confident or extremely confident in their understanding of sexual safety principles. The impact survey (six months later) found that the majority of participants (91%) were highly confident in identifying a sexual safety incident. Telephone interviewees reported a change in workplace culture and increased awareness after the training. Mental health professionals experienced increased knowledge and confidence about sexual safety principles following the training and were able to implement positive changes and concrete actions to better address sexual safety issues in their workplace.

Keywords: sexual safety, mental health professionals, trauma informed care, policy training

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5142 A Method Intensive Top-down Approach for Generating Guidelines for an Energy-Efficient Neighbourhood: A Case of Amaravati, Andhra Pradesh, India

Authors: Rituparna Pal, Faiz Ahmed

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Neighbourhood energy efficiency is a newly emerged term to address the quality of urban strata of built environment in terms of various covariates of sustainability. The concept of sustainability paradigm in developed nations has encouraged the policymakers for developing urban scale cities to envision plans under the aegis of urban scale sustainability. The concept of neighbourhood energy efficiency is realized a lot lately just when the cities, towns and other areas comprising this massive global urban strata have started facing a strong blow from climate change, energy crisis, cost hike and an alarming shortfall in the justice which the urban areas required. So this step of urban sustainability can be easily referred more as a ‘Retrofit Action’ which is to cover up the already affected urban structure. So even if we start energy efficiency for existing cities and urban areas the initial layer remains, for which a complete model of urban sustainability still lacks definition. Urban sustainability is a broadly spoken off word with end number of parameters and policies through which the loop can be met. Out of which neighbourhood energy efficiency can be an integral part where the concept and index of neighbourhood scale indicators, block level indicators and building physics parameters can be understood, analyzed and concluded to help emerge guidelines for urban scale sustainability. The future of neighbourhood energy efficiency not only lies in energy efficiency but also important parameters like quality of life, access to green, access to daylight, outdoor comfort, natural ventilation etc. So apart from designing less energy-hungry buildings, it is required to create a built environment which will create less stress on buildings to consume more energy. A lot of literary analysis has been done in the Western countries prominently in Spain, Paris and also Hong Kong, leaving a distinct gap in the Indian scenario in exploring the sustainability at the urban strata. The site for the study has been selected in the upcoming capital city of Amaravati which can be replicated with similar neighbourhood typologies in the area. The paper suggests a methodical intent to quantify energy and sustainability indices in detail taking by involving several macro, meso and micro level covariates and parameters. Several iterations have been made both at macro and micro level and have been subjected to simulation, computation and mathematical models and finally to comparative analysis. Parameters at all levels are analyzed to suggest the best case scenarios which in turn is extrapolated to the macro level finally coming out with a proposal model for energy efficient neighbourhood and worked out guidelines with significance and correlations derived.

Keywords: energy quantification, macro scale parameters, meso scale parameters, micro scale parameters

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5141 The Implementation of Entrepreneurial Marketing in Small Business Enterprise

Authors: Iin Mayasari

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This study aims at exploring the influence of aspects of entrepreneurial marketing on a firm’s performance. Entrepreneurs are not only supported by resources control to obtain sustainable competitive advantage, but it should also be supported by intangible resources. Entrepreneurial marketing provides the opportunity for entrepreneurs to proactively find better ways to create value for desired customers, to create innovation, and to build customer equity. Entrepreneurial marketing has the medium between entrepreneurship and marketing, and serves as an umbrella for many of the emergent perspectives on marketing. It has eight underlying dimensions. They are proactiveness, calculated risk-taking, innovativeness, an opportunity focus, entrepreneurial orientation, resource leveraging, customer intensity, and value creating. The research method of the study was a qualitative study by having an interview with 8 small companies in Kudus Region, the Central Java, Indonesia. The interviewees were the owner and the manager of the company that had the scope work of small business enterprise in wood crafting industry. The interview was related to the implementation of the elements of the entrepreneurial marketing. The result showed that the small business enterprises had implemented the elements of entrepreneurial marketing in supporting their daily activities. The understanding based on the theoretical implementation was well executed by the owner and managers. The problems in managing small business enterprises were related to the full support by the government and the branding management. Furthermore, the innovation process should be improved especially the use of internet to promote the product, to expand the market and to increase the firm’s performance.

Keywords: entrepreneurial marketing, innovativeness, risk taking, opportunity focus

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5140 Strategies for a Sustainable Neighbourhood in a Smart City: A Case of Pattoor, Thiruvananthapuram

Authors: Vijaya Nhaloor, Suja Kumari Leela, Jose Devadasan

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Planning of neighbourhood development strategies in Tier 2 Indian city is highly significant when it has also been selected as a Smart city by the Ministry of Urban Development in India. Smart city mission of India proposes the development of infrastructure in a city in an inclusive way. Thiruvananthapuram, the capital city of Kerala state, India, has been selected as the city to conduct the research. The master plan for the city of Thiruvananthapuram envisions it as a Compact city and proposes densification as a tool for development. Densification may adversely affect the quality of life after a tipping point. This may lead to urban decay which in turn directly or indirectly affects the surrounding neighbourhoods also, thus spreading blight areas in the city. The author thinks that density in urban planning is not a well detailed subject in India, with respect to its varied links on infrastructure, quality of life, transportation, scope of vertical planning, affordability etc. Neighbourhoods are vital tissues of an urban area, and their development directly affects the development of the region. The methodology would involve skimming of proactive neighbourhood planning principles compatible with the Smart city mission in India. United Nations proposes sustainability as a way of planning development of a neighbourhood. After defining various terminologies involved, a framework shall be developed to analyse an existing neighbourhood and prepare planning guidelines in a sustainable manner. The framework shall comply with international and national policy guidelines. The research shall explore and identify a neighbourhood with the potential to meet the housing demand from the investment regions nearby and analyse its potential and weakness as per this framework. Later, a set of indicators shall be enlisted to guide the development of the neighbourhood, leading to recommendations that shall serve as a replicable model for the other neighbourhoods in the Smart city.

Keywords: key indicators, neighbourhood planning, sustainability, smart city

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5139 Multi-dimensional Approach to Resilience and Support in Advanced School-based Mental Health Service Delivery (MARS-SMHSD) Framework Development for Low-Resource Areas

Authors: Wan You Ning

Abstract:

Addressing the rising prevalence of mental health issues among youths, the Multi-dimensional Approach to Resilience and Support in Advanced School-based Mental Health Service Delivery (MARS-ASMHSD) framework proposes the implementation of advanced mental health services in low-resource areas to further instil mental health resilience among students in a school-based setting. Recognizing the unsustainability of direct service delivery due to rapidly growing demands and costs, the MARS-ASMHSD framework endorses the deinstitutionalization of mental healthcare and explores a tiered, multi-dimensional approach in mental healthcare provision, establishing advanced school-based mental health service delivery. The framework is developed based on sustainable and credible evidence-based practices and modifications of existing mental health service deliveries in Asia, including Singapore, Thailand, Malaysia, Japan, and Taiwan. Dissemination of the framework model for implementation will enable a more progressive and advanced school-based mental health service delivery in low-resource areas. Through the evaluation of the mental health landscape and the role of stakeholders in the respective countries, the paper concludes with a multi-dimensional framework model for implementation in low-resource areas. A mixed-method independent research study is conducted to facilitate the framework's development.

Keywords: mental health, youths, school-based services, framework development

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5138 Rethinking the Air Quality Health Index: Harmonizing Health Protection and Climate Mitigation

Authors: Kimberly Tasha Jiayi Tang, Changqing Lin, Zhe Wang, Tze-Wai Wong, Md. Shakhaoat Hossain, Jian Yu, Alexis Lau

Abstract:

Hong Kong has practiced a risk-based Air Quality Health Index (AQHI) system that sums hospitalization risks associated with short-term exposure to air pollu-tants. As an air pollution risk communication tool, it informs the public about the current air quality, anchoring around the World Health Organization's (WHO) 2005 Air Quality Guidelines (AQGs). Given the WHO's recent update in 2021, assessing how Hong Kong’s air quality risk communication can be en-hanced using these updated guidelines is essential. Hong Kong’s AQHI is lim-ited by solely focusing on short-term health risks, which could lead the public to underestimate cumulative health impacts. Therefore, we propose the intro-duction of a composite AQHI that reports both long-term and short-term health risks. Additionally, the WHO interim targets will be considered as anchor points for various health risk categories. Furthermore, with the increasing ozone levels in Hong Kong and Southern China due to improved NOx mitigation measures, it has been a challenging task in balancing health protection against climate mitigation. However, our findings present a promising outlook. Despite the rise in ozone levels, the combined health risks in Hong Kong and Guang-dong have seen a decline, largely due to reductions in NO2 and PM concentra-tions, both having significant health implications. By shifting from a concentra-tion-based approach to a health risk-based system like the AQHI, our study highlights the prospective of harmonizing health protection and climate mitiga-tion goals. This health-focused framework suggests that rigorous NOx controls can effective-ly serve both objectives in parallel.

Keywords: air quality management, air quality health index, health risk management, air pollution

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5137 Service Users’ Opinions and Experiences of Health Care Practitioners’ Right to Conscientiously Object to Abortion: A Liberal Feminist Approach

Authors: B. Self, V. Fleming, C. Maxwell

Abstract:

The fourth clause of the UK 1967 Abortion Act allows individuals (including health care practitioners) to conscientiously object to participating in an abortion. Individuals are able to object if they consider that participating is incompatible with their religious, moral, philosophical, ethical, or personal beliefs. Currently, there is no research on service users’ opinions and understandings of conscientious objection or the impact of conscientious objection from the UK service users’ perspective. This perspective is imperative in understanding the real-world consequences and impact of conscientious objection and essential when creating policy and guidelines. This qualitative research took a liberal feminist approach. It provided a platform for service users to share their experiences of abortion and conscientious objection, as well as their opinions and understandings of conscientious objection. The method employed was semi-structured interviews. Findings indicated that conscientious objection could work in practice. However, it is currently failing some individuals, as health care practitioners are not always referring and informing service users. Participants didn’t experience burdens such as long waiting times and were still able to access legal abortion. However, participants did experience negative emotional effects, as they were often left feeling scared, angry, and hopeless when they were not referred. Moreover, participants’ opinions on conscientious objection in the UK varied greatly. The majority supported the most common approach within the literature and in practice, whereby health care practitioners are able to object so long as they refer and inform the service user. However, the opinion that health care practitioners should not be allowed to object or should be able to object without referring and informing was also present. Without this research, the impact that conscientious objection is having on service users in the UK and service users’ opinions on conscientious objection wouldn’t be known. These findings will be used to inform national policy and guidelines, making access to abortion fairer and safer for all.

Keywords: conscientious objection, abortion, medical ethics, reproductive justice

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5136 The Development of Clinical Nursing Practice Guidelines for Preventing of Infection during Intubation in Patients with Suspected or Confirmed COVID-19

Authors: Sarinra Thongmee, Krittaporn Prakobsaeng, Adithep Mingsuan, Chanyapak Polkhet, Supattra Wongsuk

Abstract:

The purposes of this research and developmentwasto develop and evaluation of the clinical nursingpractice guideline (CNPG) for the prevention infection during intubation in patient with suspected or confirmedCOVID-19 patient. This study was developed by using the evidencebased practice model of Soukup (2000) asa conceptual framework. The study consisted of 4 steps: 1) situational analysis of intubation service in patientswith confirmed COVID-19; 2) development of the CNPG; 3) apply the NPG to trial; and 4) evaluation of the CNPG. The sample consisted of 52 nurse anesthetists and 25 infected or suspected COVID-19 patients. The research instrument consisted of 1) the CNPG, which was developed by the researchers; 2) the nurses anesthetist opinion questionnaire to the guideline; 3) the evaluation practice form; and 4) the nurse anesthetist knowledge test on nursing care of patients infected with COVID-19. Data were analyzed by using descriptive statistics, and Wilcoxon matched-pairs signed rank test. The results revealed this developed CNPG consists of 4 sections: 1)the CNPG for airborne precautions2) the preparation of anesthetic and intubation equipments3) the roles and duties of the intubation team, 4) the guidelines for intubation in suspected or confirmed COVID-19 patients. The results of CNPG use found that 1)the provider: using NPG in providers revealed that nurse anesthetist had a higher mean of knowledge scores than before using CNPG statistically significant at the 0.05 level (p<0.01) and able to follow the NPG 100% inall activities. The anesthetic team was not infected with COVID-19 from intubation outside the operating room. 2)the client: the patient was safe, with no complications from intubation. Summary CNPG to prevent infection during reintubation of suspected or confirmedCOVID-19patient was appropriate and applicable to practice.

Keywords: clinical nursing practice guideline, prevention of infection, endotracheal intubation, COVID-19

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5135 Training to Evaluate Creative Activity in a Training Context, Analysis of a Learner Evaluation Model

Authors: Massy Guillaume

Abstract:

Introduction: The implementation of creativity in educational policies or curricula raises several issues, including the evaluation of creativity and the means to do so. This doctoral research focuses on the appropriation and transposition of creativity assessment models by future teachers. Our objective is to identify the elements of the models that are most transferable to practice in order to improve their implementation in the students' curriculum while seeking to create a new model for assessing creativity in the school environment. Methods: In order to meet our objective, this preliminary quantitative exploratory study by questionnaire was conducted at two points in the participants' training: at the beginning of the training module and throughout the practical work. The population is composed of 40 people of diverse origins with an average age of 26 (s:8,623) years. In order to be as close as possible to our research objective and to test our questionnaires, we set up a pre-test phase during the spring semester of 2022. Results: The results presented focus on aspects of the OECD Creative Competencies Assessment Model. Overall, 72% of participants support the model's focus on skill levels as appropriate for the school context. More specifically, the data indicate that the separation of production and process in the rubric facilitates observation by the assessor. From the point of view of transposing the grid into teaching practice, the participants emphasised that production is easier to plan and observe in students than in the process. This difference is reinforced by a lack of knowledge about certain concepts such as innovation or risktaking in schools. Finally, the qualitative results indicate that the addition of multiple levels of competencies to the OECD rubric would allow for better implementation in the classroom. Conclusion: The identification by the students of the elements allowing the evaluation of creativity in the school environment generates an innovative approach to the training contents. These first data, from the test phase of our research, demonstrate the difficulty that exists between the implementation of an evaluation model in a training program and its potential transposition by future teachers.

Keywords: creativity, evaluation, schooling, training

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5134 Social Work in Rehabilitation: Improving Practice Through Action Research

Authors: Poglajen Andrej, Malečihar Špela

Abstract:

Social work in rehabilitation needs constant development and embetterment of its practitioners. This became even more evident during the covid pandemic at times when outside sources of help, care and support were non-existent, or the access to such sources was severely limited. Social workers are, at our core, researchers of the rehabilitated world – from a personal and intrapersonal to a systematic perspective. This is also why a method of research was used in order to see if clinical social work practice can be further improved. The first stage of research showcased how action research and social work practice share many of the core values, whereas the Implementation of the new behaviour principle was severely lacking and thus became the main focus of the follow-up research. Twenty randomly selected case files of clinical social work practice in rehabilitation were qualitatively analyzed and potential benefits of action research on practice were assessed in the process of intervention while also getting feedback of the usefulness by the patients themselves using pre and post evaluation forms where a mixed-method approach was used. Implementation of new behaviour principle was recognized as a potential, improving factor of clinical social work practice in most analyzed cases, while it wasn’t deemed necessary in all of them. Potential improvements of newly implemented behaviour span across different areas of life and were also noted in the feedback from the rehabilitates. Despite the benefits of practice embetterment, the inclusion and focus on Implementation of new behaviour principle also caused additional workload, lack of time and stressful situations for the practitioners, which showcased the need to address certain systemic obstacles in the context of social work in healthcare in Slovenia.

Keywords: action research, practice, rehabilitation, social work

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5133 Evaluation of Adequacy of Caspofungin Prescription in a Tunisian Hospital Cohort

Authors: Mariem Meddeb Sidhom, Souhayel Hedfi, Rjaibia Houda, Mehdi Dridi, Mohamed Ali Yousfi, Sâadia Gargouri

Abstract:

Considering the important increase in costs of caspofungin treatments and ahead the evolution of its indication, pharmacy department was prompted to realize a review of the adequacy of prescriptions in the medical intensive care units (ICU). A retrospective observational study was conducted in Tunis military hospital concerning ICU prescriptions of caspofungin from 2008 until 2013. A pharmacist had returned to the patient’s medical records to collect data and to the microbiology department for parasitological results. The adequacy of prescriptions was evaluated by a pharmacist and an infectiologist parasitologist, referring to predefined scale of criteria resuming the indications of the marketing authorization (MA) and grade AI-AII of the guidelines of the Infectious Diseases Society of America (IDSA). Sixty two ICU patients have been treated with caspofungin during the period of study; however, 8 files were lost. Thus, 54 patients were included in the study having received 55 prescriptions of caspofungin. Males were a majority with 64.8% of the population. Mean age was 51 years. Caspofungin was indicated in accordance with the IDSA recommendations in 43.6% of the cases. The most case of non respect to the guidelines was the indication of caspofungin as empirical treatment in non neutropenic patients. Caspofungin was utilized as a first line treatment in 9 cases where it was possible to give fluconazole first, as germs were fluconazole- sensitive. Caspofungin was indicated in 2 patients with good renal function and in which nor amphotericin B, liposomal ampho B neither itraconazole had been previously used, as indicates the MA. The posology of caspofungin was respected in all prescriptions with a loading dose of 70 mg in the first day and a maintenance dose of 50 mg daily. Seven patients had received a daily dose of 70 mg, the recommended dose for people weighing more than 80 Kg. Caspofungin prescriptions are far to be adequately done. There is a clear need of optimization in indicating this molecule and that must be done in collaboration between the pharmacy department, the ICUs and parasitology department.

Keywords: caspofungin, prescription, intensive care units, marketing authorization, Tunisian hospital cohort

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5132 Evaluating the Implementation of Public Procurement Principles at Tendering Stage: SME Contractors' Perspective

Authors: Charles Poleni Mukumba, Kahilu Kajimo-Shakantu

Abstract:

Purpose: Principles of public procurement are the foundation of good public procurement, representing best practices in delivering public services by the government and its organs. They provide guidance in the public procurement cycle to achieve the best value for public resources. Tendering stage in the procurement cycle is the most critical, as tendering information is made available to bidders. The paper evaluates the implementation of public procurement principles at the tendering stage. Design/Methodology/Approach: The research was conducted by using qualitative methods with 18 SME contractors in Lusaka as the sample. The samples are business owners and managers of purposively selected SME contractors. The collected data was analysed using thematic and content analysis. Findings: The findings indicate inconsistency in accessing information critical for tendering success by bidders. Further, the findings suggest that adjustments to technical specifications are made to suit certain preferred bidders by procuring officials. Research Limitations/Implications: The interviews were limited to SME contractors registered with the national council for construction and involved in public sector construction works in Lusaka, Zambia. Practical Implications: Implementing principles of public procurement at the tendering stage creates equal, open, and fair competition for the bidders in cost terms to deliver standardised and quality works to the public sector. Original/Value: The findings reveal how principles of public procurement play a critical role in enhancing the efficient performance of the procurement cycle at the tendering stage.

Keywords: evaluating, implementation, public procurement principles, tendering stage, SME contractors

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5131 The Impact of International Human Rights Law on Local Efforts to Address Women’s Realities of Violence: Lessons from Jamaica

Authors: Ramona Georgeta Biholar

Abstract:

Gender-based violence against women plagues societies around the world. The work to eliminate it is an ongoing battle. At the international level, Article 5 (a) CEDAW establishes an agenda for social and cultural transformation: it imposes on States parties to CEDAW an obligation to modify sex roles and stereotypical social and cultural patterns of conduct. Also, it provides for the protection of women from violence stemming from such gender norms. Yet, the lived realities of women are frequently disconnected from this agenda. Nonetheless, it is the reality of the local that is crucial for the articulation, implementation and realization of women’s rights in general, and for the elimination of gender-based violence against women in particular. In this paper we discuss the transformation of sex roles and gender stereotyping with a view to realize women’s right to be free from gender-based violence. This paper is anchored in qualitative data collection undertaken in Jamaica and socio-legal research. Based on this research, 1) We explain the process of vernacularisation as a strategy that enables women’s human rights to hit the ground and benefit rights holders, and 2) We present a synergistic model for the implementation of Article 5 (a) CEDAW so that women’s right to be free from gender-based violence can be realized in a concrete national jurisdiction. This model is grounded in context-based demands and recommendations for social and cultural transformation as a remedy for the incidence of gender-based violence against women. Moreover, the synergistic model offers directions that have a general application for the implementation of CEDAW and Article 5 (a) CEDAW in particular, with a view to realize women’s right to be free from gender-based violence. The model is thus not only a conceptual tool of analysis, but also a prescriptive tool for action. It contributes to the work of both academics and practitioners, such as Governmental officials, and national and local civil society representatives. Overall, this paper contributes to understanding the process necessary to bridge that gap between women’s human rights norms and women’s life realities of discrimination and violence.

Keywords: CEDAW, gender-based violence against women, international human rights law, women’s rights implementation, the Caribbean

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5130 Improving Public Sectors’ Policy Direction on Large Infrastructure Investment Projects: A Developmental Approach

Authors: Ncedo Cameron Xhala

Abstract:

Several public sector institutions lack policy direction on how to successfully implement their large infrastructure investment projects. It is significant to improve strategic policy direction in public sector institutions in order to improve planning, management and implementation of large infrastructure investment projects. It is significant to improve an understanding of internal and external pressures that exerts pressure on large infrastructure projects. The significance is to fulfill the public sector’s mandate, align the sectors’ scarce resources, stakeholders and to improve project management processes. The study used a case study approach which was underpinned by a constructionist approach. The study used a theoretical sampling technique when selecting study participants, and was followed by a snowball sampling technique that was used to select an identified case study project purposefully. The study was qualitative in nature, collected and analyzed qualitative empirical data from the purposefully selected five subject matter experts and has analyzed the case study documents. The study used a semi-structured interview approach, analysed case study documents in a qualitative approach. The interviews were on a face-to-face basis and were guided by an interview guide with focused questions. The study used a three coding process step comprising of one to three steps when analysing the qualitative empirical data. Findings reveal that an improvement of strategic policy direction in public sector institutions improves the integration in planning, management and on implementation on large infrastructure investment projects. Findings show the importance of understanding the external and internal pressures when implementing public sector’s large infrastructure investment projects. The study concludes that strategic policy direction in public sector institutions results in improvement of planning, financing, delivery, monitoring and evaluation and successful implementation of the public sector’s large infrastructure investment projects.

Keywords: implementation, infrastructure, investment, management

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5129 Deorbiting Performance of Electrodynamic Tethers to Mitigate Space Debris

Authors: Giulia Sarego, Lorenzo Olivieri, Andrea Valmorbida, Carlo Bettanini, Giacomo Colombatti, Marco Pertile, Enrico C. Lorenzini

Abstract:

International guidelines recommend removing any artificial body in Low Earth Orbit (LEO) within 25 years from mission completion. Among disposal strategies, electrodynamic tethers appear to be a promising option for LEO, thanks to the limited storage mass and the minimum interface requirements to the host spacecraft. In particular, recent technological advances make it feasible to deorbit large objects with tether lengths of a few kilometers or less. To further investigate such an innovative passive system, the European Union is currently funding the project E.T.PACK – Electrodynamic Tether Technology for Passive Consumable-less Deorbit Kit in the framework of the H2020 Future Emerging Technologies (FET) Open program. The project focuses on the design of an end of life disposal kit for LEO satellites. This kit aims to deploy a taped tether that can be activated at the spacecraft end of life to perform autonomous deorbit within the international guidelines. In this paper, the orbital performance of the E.T.PACK deorbiting kit is compared to other disposal methods. Besides, the orbital decay prediction is parametrized as a function of spacecraft mass and tether system performance. Different values of length, width, and thickness of the tether will be evaluated for various scenarios (i.e., different initial orbital parameters). The results will be compared to other end-of-life disposal methods with similar allocated resources. The analysis of the more innovative system’s performance with the tape coated with a thermionic material, which has a low work-function (LWT), for which no active component for the cathode is required, will also be briefly discussed. The results show that the electrodynamic tether option can be a competitive and performant solution for satellite disposal compared to other deorbit technologies.

Keywords: deorbiting performance, H2020, spacecraft disposal, space electrodynamic tethers

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