Search results for: family eating practice

Authors: Nuttapimon Bhirommuang, Kulapong Jayanama

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Background: Prevalence of malnutrition in hospitalized patient is higher than general population. As a result of the unawareness of consequence and the more concerning in the other aspects of care, many patients with high risk of malnutrition are unrecognized. Even if malnutrition has been identified as affecting in many patient outcomes, the impact may differ in each population and group of patients. Objectives: The aims of this study were to examine the association between the nutritional status and the length of stay and hospital costs in hospitalized patients, to investigate the factors related these outcomes and to determine the frequency of malnutrition in hospitals. Method: This retrospective cohort study enrolled all patients aged 15 years old or older and admitted in SDMC, Ramathibodi Hospital between 1st January 2016 and 30th September 2016. The nutritional status assessment by Nutrition Alert Form (NAF) was performed by well-trained nurses in all patients at admission. Baseline characteristics were recorded. Length of stay and hospital costs were collected during their hospitalization. Univariate analysis, nonparametric rank test, Kruskal-Wallis test were used to compare means in the case of nonnormally and noncontinuously distributed data. Chi-square used to analyze categorical variables, the nutritional status and the length of stay and hospital costs and identify possible confounding factors (data were analyzed using SPSS version 18.0). Result: Of the 2,906 patients, 3.9% were severe malnutrition (NAF-C score > 10) and 11.4% were moderate malnutrition (NAF-B score 6 - 10). Both length of stay and hospital costs were found significantly higher in more severe malnutrition group (p < 0.001), NAF = A: 3.21 days, 95% CI 3.06-3.35 and 111,544.25 THB, 95% CI 106,994.41 – 116,094.1; NAF = B: 7.54 days, 95% CI 6.32 – 8.76 and 162,302.4 THB, 95% CI 129,557.88 – 195,046.92; NAF =C: 14.77 days, 95% CI 11.34 – 18.2 and 323,572.11 THB, 95% CI 226,958.1 – 420,096.13 (1 THB = 0.03019 USD). Age of each nutritional status group had also significant increase from NAF A to NAF C (p < 0.001): 55.07, 67.03 and 73.88 years old, respectively. Conclusion: The prevalence of malnutrition in Ramathibodi hospital is voluminous. Severe malnutrition screening by NAF is significantly correlated with worse clinical outcome, especially higher length of stay and hospital costs. Elderly is also a significant factor which correlates with malnutrition. The results of this study could change the awareness of health personnel and the practice protocol. Moreover, the further study concerning nutritional support in high-risk group of malnutrition is ongoing to confirm this hypothesis.

Keywords: malnutrition, NAF, length of stay, hospital costs

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Authors: Yasser Sanad, Thu Trang Dao

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Introduction: Implementing the One Health (OH) approach requires an integrated, interdisciplinary, and cross-sectoral methodology. OH is a key tool for developing and implementing programs and projects and includes developing ambitious policies that consider the common needs and benefits of human, animal, plant, and ecosystem health. OH helps humanity readjust its path to environmentally friendly and impartial sustainability. As co-leader of the Global Health Security Agenda’s Zoonotic Disease Action Package, Vietnam pioneered a strong OH approach to effectively address early waves of the COVID-19 outbreak in-country. Context and Aim: The repeated surges in COVID-19 in Vietnam challenged the capabilities of the national system and disclosed the gaps in multi-sectoral coordination and resilience. To address this, FHI 360 advocated for the standardization of the OH platform by government actors to increase the resiliency of the system during and post COVID-19. Methods: FHI 360 coordinated technical resources to develop and implement evidence-based OH policies, promoting high-level policy dialogue between the Ministries of Health, Agriculture, and the Environment, and policy research to inform developed policies and frameworks. Through discussions, an OH-building Partnership (OHP) was formed, linking climate change, the environment, and human and animal health. Findings: The OHP Framework created a favorable policy environment within and between sectors, as well as between governments and international health security partners. It also promoted strategic dialogue, resource mobilization, policy advocacy, and integration of international systems with National Steering Committees to ensure accountability and emphasize national ownership. Innovative contribution to policy, practice and/or research: OHP was an effective evidence-based research-to-policy platform linking to the National One Health Strategic Plan (2021-2025). Collectively they serve as a national framework for the implementation and monitoring of OH activities. Through the adoption of policies and plans, the risk of zoonotic pathogens, environmental agent spillover, and antimicrobial resistance can be minimized through strengthening multi-sectoral OH collaboration for health security.

Keywords: one health, national policies, health security, COVID-19, Vietnam

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Authors: K. Ismail, A. Ali, R. C. Hasan, I. Khalil, Z. Bachok, N. M. Said, A. M. Muslim, M. S. Che Din, W. S. Chong

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The marine ecosystem in Malaysia holds invaluable potential in terms of economics, food security, pharmaceuticals components and protection from natural hazards. Although exploration of oil and gas industry and fisheries are active within Malaysian waters, knowledge of the seascape and ecological functioning of benthic habitats is still extremely poor in the marine parks around Malaysia due to the lack of detailed seafloor information. Consequently, it is difficult to manage marine resources effectively, protect ecologically important areas and set legislation to safeguard the marine parks. The limited baseline data hinders scientific linkage to support effective marine spatial management in Malaysia. This became the main driver behind the first seabed mapping effort at the national level. Taman Laut Labuan (TLL) is located to the west coast of Sabah and to the east of South China Sea. The total area of TLL is approximately 158.15 km2, comprises of three islands namely Pulau Kuraman, Rusukan Besar and Rusukan Kecil and is characterised by shallow fringing reef with few submerged shallow reef. The unfamiliar rocky shorelines limit the survey of multibeam echosounder to area with depth more than 10 m. Whereas, singlebeam and side scan sonar systems were used to acquire the data for area with depth less than 10 m. By integrating data from multibeam bathymetry and backscatter with singlebeam bathymetry and side sonar images, we produce a substrate map and coral coverage map for the TLL using i) marine landscape mapping technique and ii) RSOBIA ArcGIS toolbar (developed by T. Le Bas). We take the initiative to explore the ability of aerial drone and satellite image (WorldView-3) to derive the depths and substrate type within the intertidal and subtidal zone where it is not accessible via acoustic mapping. Although the coverage was limited, the outcome showed a promising technique to be incorporated towards establishing a guideline to facilitate a standard practice for efficient marine spatial management in Malaysia.

Keywords: habitat mapping, marine spatial management, South China Sea, National seabed mapping

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Authors: Gunjan Srivastava, Shamila Kalia

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Dalbergia sissoo Roxb., (Family- Leguminosae; Subfamily- Papilionoideae), is an economically and ecologically important tree species having medicinal value. Of the rich complex of insect fauna, ten have been recognized as potential pests of nurseries and plantations. Present study was conducted to explore an effective ecofriendly control of Dichomeris eridantis Meyrick, an important defoliator pest of D. sissoo. Health and environmental concerns demanded devising a bio-intensive pest management strategy and employing ecofriendly measures. In the present laboratory bioassay two entomopathogenic fungi Acremonium perscinum and Beauveria bassiana were tested and compared for evaluating the efficacy of their seven different concentrations (besides control) against the 3rd, 4th and 5th instar larvae of D. eridantis, on the basis of mean percent mortality data recorded and tabulated for seven days after treatment application. Analysis showed that both treatments vary significantly among themselves. Also, variations amongst instars and duration with respect to their mortality were highly significant (p < .001). All their interactions were found to vary significantly. B. bassiana at 0.25x107 spores / ml spore concentration caused maximum mean percent mortality (62.38%) followed by mean percent mortality at its 0.25x106 spores / ml concentration (56.67%). Mean percent mortality at maximum spore concentration (0.054x107 spores / ml) and next highest spore concentration (0.054 x106 spores / ml) due to A. perscinum treatment were far less effective (mean percent mortality of 45.40% and 31.29%, respectively). At 168 hours mean percent mortality of larval instars due to both fungal treatment applications reached its maximum (52.99%) whereas, at 24 hours mean percent mortality remained least (5.70%). In both cases, treatments were most effective against 3rd instar larvae and least effective against 5th instar larvae. A comparative acccount of efficacy of B. bassiana and A. perscinum on the 3rd, 4th and 5th instar larvae of D. eridantis on 5th, 6th and 7th post treatment observation days after their application, on the basis of their median lethal concentrations (LC50) proved B. bassiana to be more potential microbial pathogen of the two fungal microbes, for all the three instars (3rd, 4th and 5th) of D. eridantis, on all the three days (5th, 6th and 7th post observation days after application of both treatments). Percent mortality of D. eridantis increased in a dose dependent manner. Koch’s Postulates tested positive, thus confirming the pathogenicity of B. bassiana against the larval instars of D. eridantis. LC90 values of 0.280x1011 spores/ml, 0.301x108 spores/ml and 0.262x108 spores/ml concentrations of B. bassiana were standardized which can effectively cause mortality of all the larval instars of D. eridantis in the field after 5th, 6th and 7th day of their application, respectively. Therefore, these concentrations can be safely used in nurseries as well as plantations of D. sissoo for effective control of D. eridantis larvae.

Keywords: Acremonium perscinum, Beauveria bassiana, Dalbergia sissoo, Dichomeris eridantis

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Authors: Evgeni Baratashvili, Giorgi Sulashvili, Malkhaz Sulashvili, Bela Khotenashvili, Irma Makharashvili

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The most investment decision-making principle of regional travel firm's management and its partner is the formulation of the aims of investment programs. The investments can be targeted in order to reduce the firm's production costs and to purchase good transport equipment. In attractive region, in order to develop firm’s activities, the investment program can be targeted for increasing of provided services. That is the case where the sales already have been used in the market. The investment can be directed to establish the affiliate firms, branches, to construct new hotels, to create food and trade enterprises, to develop entertainment enterprises, etc. Economic development is of great importance to regional development. International experience shows that inclusive economic growth largely depends on not only the national, but also regional development planning and implementation of a strong and competitive regions. Regional development is considered as the key factor in achieving national success. Establishing a modern institute separate entities if the pilot centers will constitute a promotion, international best practice-based public-private partnership to encourage the use of models. Regional policy directions and strategies adopted in accordance with the successful implementation of major importance in the near future specific action plans for inclusive development and implementation, which will be provided in accordance with the effective monitoring and evaluation tools and measurable indicators combined. All of these above-mentioned investments are characterized by different levels, which are related to the following fact: How successful tourism marketing service is, whether it is able to determine the proper market's reaction according to the particular firm's actions. In the sphere of regional tourism industry and in the investment decision possible variants it can be developed the some specter of models. Each of the models can be modified and specified according to the situation, and characteristic skills of the existing problem that must be solved. Besides, while choosing the proper model, the process is affected by the regulation system of economic processes. Also, it is influenced by liberalization quality and by the level of state participation.

Keywords: net income of travel firm, economic growth, Investment profitability, regional development, tourist product, tourism development

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Authors: Anshu Gupta, Charu Gupta

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Background: Adolescence is the transitional period between puberty and adulthood. It is marked by immense turmoil in emotional and behavioral spheres. Adolescents are at risk of an array of behavioral and emotional problems, resulting in social, academic and vocational function impairments. Conflicts in the family and inability of the parents to cope with the changing demands of an adolescent have a negative impact on the overall development of the child. This augers ill for the individual’s future, resulting in depression, delinquency and suicides among other problems. Aim: The aim of the study was to compare the prevalence of behavioral and emotional problems in school going adolescents aged 13 to 15 years residing in Ludhiana city. Method: A total of 1380 school children in the age group of 13 to 15 years were assessed by the adolescent health screening questionnaire (FAPS) and Youth Self-Report (2001) questionnaire. Statistical significance was ascertained by t-test, chi-square test (x²) and ANOVA, as appropriate. Results: A considerably high prevalence of behavioral and emotional problems was found in school going adolescents (26.5%), more in girls (31.7%) than in boys (24.4%). In case of boys, the maximum problem was in the 13 year age group, i.e., 28.2%, followed by a significant decline by the age of 14 years, i.e., 24.2% and 15 years, i.e., 19.6%. In case of girls also, the maximum problem was in the 13 year age group, i.e., 32.4% followed by a marginal decline in the 14 years i.e., 31.8% and 15 year age group, i.e., 30.2%. Demographic factors were non contributory. Internalizing syndrome (22.4%) was the most common problem followed by the neither internalizing nor externalizing (17.6%) group. In internalizing group, most (26.5%) of the students were observed to be anxious/ depressed. Social problem was observed to be the most frequent (10.6%) among neither internalizing nor externalizing group. Aggressive behavior was the commonest (8.4%) among externalizing group. Internalizing problems, mainly anxiety and depression, were commoner in females (30.6%) than males (24.6%). More boys (16%) than girls (13.4%) were reported to suffer from externalizing disorders. A critical review of the data showed that most of the adolescents had poor knowledge about reproductive health. Almost 36% reported that the source of their information on sexual and reproductive health being friends and the electronic media. There was a high percentage of adolescents who reported being worried about sexual abuse (20.2%) with majority of them being girls (93.6%) reflecting poorly on the social setup in the country. About 41% of adolescents reported being concerned about body weight and most of them being girls (92.4%). Up to 14.5% reported having thoughts of using alcohol or drugs perhaps due to the easy availability of substances of abuse in this part of the country. 12.8% (mostly girls) reported suicidal thoughts. Summary/conclusion: There is a high prevalence of emotional and behavioral problems among school-going adolescents. Resolution of these problems during adolescence is essential for attaining a healthy adulthood. The need of the hour is to spread awareness among caregivers and formulation of effective management strategies including school mental health programme.

Keywords: adolescence, behavioral, emotional, internalizing problem

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Authors: C. S. Chen, F. Y. Hui, B. S. Farhana, J. De Leon

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Introduction: Stroke can lead to long-term disability, affecting one’s quality of life. Providing stroke education to patient and family members is essential to optimize stroke recovery and prevent recurrent stroke. Currently, nurses conduct stroke education by handing out pamphlets and explaining their contents to patients. However, this is not always effective as nurses have varying levels of knowledge and depth of content discussed with the patient may not be consistent. With the advancement of information technology, health education is increasingly being disseminated via electronic software and studies have shown this to have benefitted patients. Hence, a multi-disciplinary team consisting of doctors, nurses and allied health professionals was formed to create the stroke journey map software to deliver consistent and concise stroke education. Research Objectives: To evaluate the effectiveness of using a stroke journey map software in improving patients’ perceived knowledge in the acute stroke unit during hospitalization. Methods: Patients admitted to the acute stroke unit were given stroke journey map software during patient education. The software consists of 31 interactive slides that are brightly coloured and 4 videos, based on input provided by the multi-disciplinary team. Participants were then assessed with pre-and-post survey questionnaires before and after viewing the software. The questionnaire consists of 10 questions with a 5-point Likert scale which sums up to a total score of 50. The inclusion criteria are patients diagnosed with ischemic stroke and are cognitively alert and oriented. This study was conducted between May 2017 to October 2017. Participation was voluntary. Results: A total of 33 participants participated in the study. The results demonstrated that the use of a stroke journey map as a stroke education medium was effective in improving patients’ perceived knowledge. A comparison of pre- and post-implementation data of stroke journey map revealed an overall mean increase in patients’ perceived knowledge from 24.06 to 40.06. The data is further broken down to evaluate patients’ perceived knowledge in 3 domains: (1) Understanding of disease process; (2) Management and treatment plans; (3) Post-discharge care. Each domain saw an increase in mean score from 10.7 to 16.2, 6.9 to 11.9 and 6.6 to 11.7 respectively. Project Impact: The implementation of stroke journey map has a positive impact in terms of (1) Increasing patient’s perceived knowledge which could contribute to greater empowerment of health; (2) Reducing need for stroke education material printouts making it environmentally friendly; (3) Decreasing time nurses spent on giving education resulting in more time to attend to patients’ needs. Conclusion: This study has demonstrated the benefit of using stroke journey map as a platform for stroke education. Overall, it has increased patients’ perceived knowledge in understanding their disease process, the management and treatment plans as well as the discharge process.

Keywords: acute stroke, education, ischemic stroke, knowledge, stroke

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Authors: Andreas Kapardis, Maria Krambia-Kapardis, Sofia Michaelides-Mateou

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Corruption and economic crime is a serious problem affecting the sustainability of businesses in the 21st century. Nowadays, many corruption or fraud cases come to light thanks to whistleblowers. This article will first discuss the concept of whistleblowing as well as some relevant legislation enacted around the world. Secondly, it will discuss the findings of a survey of whistleblowers or could-have-been whistleblowers. Finally, suggestions for the development of a comprehensive whistleblowing framework will be considered. Whistleblowing can be described as expressing a concern about a wrongdoing within an organization, such as a corporation, an association, an institution or a union. Such concern must be in the public interest and in good faith and should relate to the cover up of matters that could potentially result in a miscarriage of justice, a crime, criminal offence and threats to health and safety. Whistleblowing has proven to be an effective anti-corruption mechanism and a powerful tool that helps deterring fraud, violations, and malpractices within organizations, corporations and the public sector. Research in the field of whistleblowing has concentrated on the reasons for whistleblowing and financial bounties; the effectiveness of whistleblowing; whistleblowing being a prosocial behavior with a psychological perspective and consequences; as a tool in protecting shareholders, saving lives and billions of dollars of public funds. Whilst, no other study of whistleblowing has been carried out on whistleblowers or intended whistleblowers. The study reported in the current paper analyses the findings of 74 whistleblowers or intended whistleblowers, the reasons behind their decision to blow the whistle, or not to proceed to blow the whistle and any regrets they may have had. In addition a profile of a whistleblower is developed concerning their age, gender, marital and family status and position in an organization. Lessons learned from the intended whistleblowers and in response to the questions if they would be willing to blow the whistle again show that enacting legislation to protect the whistleblower is not enough. Similarly, rewarding the whistleblower does not appear to provide the whistleblower with an incentive since the majority noted that “work ethics is more important than financial rewards”. We recommend the development of a comprehensive and holistic framework for the protection of the whistleblower and to ensure that remedial actions are immediately taken once a whistleblower comes forward. The suggested framework comprises (a) hard legislation in ensuring the whistleblowers follow certain principles when blowing the whistle and, in return, are protected for a period of 5 years from being fired, dismissed, bullied, harassed; (b) soft legislation in establishing an agency to firstly ensure psychological and legal advice is provided to the whistleblowers and secondly any required remedial action is immediately taken to avert the undesirable events reported by a whistleblower from occurring and, finally; (c) mechanisms to ensure the coordination of actions taken.

Keywords: whistleblowing, business ethics, legislation, business

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Authors: Kelly Jo Hollingsworth

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Conversational Solfege, a research-based, 12-step music literacy instructional method using the sound-before-sight approach, was used to teach rhythm-reading to 128-second grade students at a public school in the southeastern United States. For each step, multiple scripted techniques are supplied to teach each skill. Unit one was the focus of this study, which is quarter note and barred eighth note rhythms. During regular weekly music instruction, students completed method steps one through five, which includes aural discrimination, decoding familiar and unfamiliar rhythm patterns, and improvising rhythmic phrases using quarter notes and barred eighth notes. Intact classes were randomly assigned to two treatment groups for teaching steps six through eight, which was the visual presentation and identification of quarter notes and barred eighth notes, visually presenting and decoding familiar patterns, and visually presenting and decoding unfamiliar patterns using said notation. For three weeks, students practiced steps six through eight during regular weekly music class. One group spent five-minutes of class time on steps six through eight technique work, while the other group spends ten-minutes of class time practicing the same techniques. A pretest and posttest were administered, and ANOVA results reveal both the five-minute (p < .001) and ten-minute group (p < .001) reached statistical significance suggesting Conversational Solfege is an efficient, effective approach to teach rhythm-reading to second grade students. After two weeks of no instruction, students were retested to measure retention. Using a repeated-measures ANOVA, both groups reached statistical significance (p < .001) on the second posttest, suggesting both the five-minute and ten-minute group retained rhythm-reading skill after two weeks of no instruction. Statistical significance was not reached between groups (p=.252), suggesting five-minutes is equally as effective as ten-minutes of rhythm-reading practice using Conversational Solfege techniques. Future research includes replicating the study with other grades and units in the text.

Keywords: conversational solfege, length of instructional time, rhythm-reading, rhythm instruction

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Authors: Jui Hsuan Hung, Jeng Yi Tzeng

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Engineering education in the higher education is always male dominated. Therefore, women learning in this environment is an important research topic for feminists, gender researchers and engineering education researchers, especially in the era of gender mainstreaming. The research topics are from the dialectical discussion of feminism and science development history, gender issues of science education, to the subject choice of female students. These researches enrich the field of gender study in engineering education but lack of describing the detailed images of women in engineering education, including their learning, obstacles, needs or feelings. Otherwise, in order to keep up with the industrial trends of emphasizing group collaboration, engineering education turns from traditional lecture to creative group inquiry pedagogy in recent years. Creative project based learning is one of the creative group inquiry pedagogy which the engineering education in higher education adopts often, and it is seen as a gender-inclusive pedagogy in engineering education. Therefore, in order to understand the real situation of women learning in engineering education, this study took place in a course (Introduction to Engineering) offered by the school of engineering of a university in Taiwan. This course is designed for freshman students to establish basic understanding engineering from four departments (Chemical Engineering, Power Mechanical Engineering, Materials Science, Industrial Engineering and Engineering Management). One section of this course is to build a Hydraulic Robot designed by the Department of Power Mechanical Engineering. 321 students in the school of engineering took this course and all had the reflection questionnaire. These students are divided into groups of 5 members to work on this project. The videos of process of discussion of five volunteered groups with different gender composition are analyzed, and six women of these five groups are interviewed. We are still on the process of coding and analyzing videos and the qualitative data, but several tentative findings have already emerged. (1) The activity models of groups of both genders are gender segregation, and not like women; men never be the ‘assistants’. (2) The culture of the group is developed by the major gender, but men always dominate the process of practice in all kinds of gender composition groups. (3) Project based learning is supposed to be a gender-inclusive learning model in creative engineering education, but communication obstacles between men and women make it less women friendly. (4) Gender identity, not professional identity, is adopted by these women while they interact with men in their groups. (5) Gender composition and project-based learning pedagogy are not the key factors for women learning in engineering education, but the gender conscience awareness is.

Keywords: engineering education, gender education, creative project based learning, women learning

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Authors: Rahimi-Movaghar Vafa, Mansouri Pejman, Chardoli Mojtaba, Rezvani Samina

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Introduction: Blunt abdominal trauma is one of the leading causes of morbidity and mortality in all age groups, but diagnosis of serious intra-abdominal pathology is difficult and most of the damages are obscure in the initial investigation. There is still controversy about which patients should undergo abdomen/pelvis CT, which patients needs more observation and which patients can be discharged safely The aim of this study was to determine that is it safe to discharge patients with blunt abdominal trauma with normal initial findings. Methods: This non-randomized cross-sectional study was conducted from September 2013 to September 2014 at two levels I trauma centers, Sina hospital and Rasoul-e-Akram hospital (Tehran, Iran). Our inclusion criteria were all patients were admitted for suspicious BAT and our exclusion criteria were patients that have serious head and neck, chest, spine and limb injuries which need surgical intervention, those who have unstable vital signs, pregnant women with a gestational age over 3 months and homeless or without exact home address. 390 patients with blunt trauma abdomen examined and the necessary data, including demographic data, the abdominal examination, FAST result, patients’ lab test results (hematocrit, base deficit, urine analysis) on admission and at 6 and 12 hours after admission were recorded. Patients with normal physical examination, laboratory tests and FAST were discharged from the ED during 12 hours with the explanation of the alarm signs and were followed up after 24 hours and 1 week by a telephone call. Patients with abnormal findings in physical examination, laboratory tests, and FAST underwent abdomino-pelvic CT scan. Results: The study included 390 patients with blunt abdominal trauma between 12 and 80 years of age (mean age, 37.0 ± 13.7 years) and the mean duration of hospitalization in patients was 7.4 ± 4.1 hours. 88.6% of the patients were discharged from hospital before 12 hours. Odds ratio (OR) for having any symptoms for discharge after 6 hours was 0.160 and after 12 hours was 0.117 hours, which is statistically significant. Among the variables age, systolic and diastolic blood pressure, heart rate, respiratory rate, hematocrit and base deficit at admission, 6 hours and 12 hours after admission showed no significant statistical relationship with discharge time. From our 390 patients, 190 patients have normal initial physical examination, lab data and FAST findings that didn’t show any signs or symptoms in their next assessment and in their follow up by the phone call. Conclusion: It is recommended that patients with no symptoms at admission (completely normal physical examination, ultrasound, normal hematocrit and normal base deficit and lack of microscopic hematuria) and good family and social status can be safely discharged from the emergency department.

Keywords: blunt abdominal trauma, patient discharge, emergency department, FAST

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Authors: Yan Yan, Erhong Sun, Lin Peng, Xuchun Ye

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Aims: The present study aimed to explore Intensive Care Unit (ICU) nurses’ mental workload (MWL) and associated factors with it in performing human-machine tasks. Background: A wide range of emerging technologies have penetrated widely in the field of health care, and ICU nurses are facing a dramatic increase in nursing human-machine tasks. However, there is still a paucity of literature reporting on the general MWL of ICU nurses performing human-machine tasks and the associated influencing factors. Methods: A cross-sectional survey was employed. The data was collected from January to February 2021 from 9 tertiary hospitals in 6 provinces (Shanghai, Gansu, Guangdong, Liaoning, Shandong, and Hubei). Two-stage sampling was used to recruit eligible ICU nurses (n=427). The data were collected with an electronic questionnaire comprising sociodemographic characteristics and the measures of MWL, self-efficacy, system usability, and task difficulty. The univariate analysis, two-way analysis of variance (ANOVA), and a linear mixed model were used for data analysis. Results: Overall, the mental workload of ICU nurses in performing human-machine tasks was medium (score 52.04 on a 0-100 scale). Among the typical nursing human-machine tasks selected, the MWL of ICU nurses in completing first aid and life support tasks (‘Using a defibrillator to defibrillate’ and ‘Use of ventilator’) was significantly higher than others (p < .001). And ICU nurses’ MWL in performing human-machine tasks was also associated with age (p = .001), professional title (p = .002), years of working in ICU (p < .001), willingness to study emerging technology actively (p = .006), task difficulty (p < .001), and system usability (p < .001). Conclusion: The MWL of ICU nurses is at a moderate level in the context of a rapid increase in nursing human-machine tasks. However, there are significant differences in MWL when performing different types of human-machine tasks, and MWL can be influenced by a combination of factors. Nursing managers need to develop intervention strategies in multiple ways. Implications for practice: Multidimensional approaches are required to perform human-machine tasks better, including enhancing nurses' willingness to learn emerging technologies actively, developing training strategies that vary with tasks, and identifying obstacles in the process of human-machine system interaction.

Keywords: mental workload, nurse, ICU, human-machine, tasks, cross-sectional study, linear mixed model, China

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Authors: Constanza Levicán, Andrés Aparicio, Rodrigo F. Cádiz

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The artistic usage of Brain-computer interfaces (BCI), initially intended for medical purposes, has increased in the past few years as they become more affordable and available for the general population. One interesting question that arises from this practice is whether it is possible to compose or perform music by using only the brain as a musical instrument. In order to approach this question, we propose a BCI for musical composition, based on the representation of some mental states as the musician thinks about sounds. We developed software, called Insight2OSC, that allows the usage of the Emotiv Insight device as a musical instrument, by sending the EEG data to audio processing software such as MaxMSP through the OSC protocol. We provide two compositional applications bundled with the software, which we call Mapping your Mental State and Thinking On. The signals produced by the brain have different frequencies (or rhythms) depending on the level of activity, and they are classified as one of the following waves: delta (0.5-4 Hz), theta (4-8 Hz), alpha (8-13 Hz), beta (13-30 Hz), gamma (30-50 Hz). These rhythms have been found to be related to some recognizable mental states. For example, the delta rhythm is predominant in a deep sleep, while beta and gamma rhythms have higher amplitudes when the person is awake and very concentrated. Our first application (Mapping your Mental State) produces different sounds representing the mental state of the person: focused, active, relaxed or in a state similar to a deep sleep by the selection of the dominants rhythms provided by the EEG device. The second application relies on the physiology of the brain, which is divided into several lobes: frontal, temporal, parietal and occipital. The frontal lobe is related to abstract thinking and high-level functions, the parietal lobe conveys the stimulus of the body senses, the occipital lobe contains the primary visual cortex and processes visual stimulus, the temporal lobe processes auditory information and it is important for memory tasks. In consequence, our second application (Thinking On) processes the audio output depending on the users’ brain activity as it activates a specific area of the brain that can be measured using the Insight device.

Keywords: BCI, music composition, emotiv insight, OSC

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Authors: Ann Enright

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More than ever, animal shelters need to identify ways to reduce the number of animals entering shelter facilities and the incidence of euthanasia. Managing animal overpopulation using euthanasia can have detrimental health and emotional consequences for the shelter staff involved. There are also community expectations with moral and financial implications to consider. To achieve the goals of reducing animal intake and the incidence of euthanasia, shelter best practice involves combining programs, procedures and partnerships to increase live release rates (LRR), reduce the incidence of disease, length of stay (LOS) and shelter intake whilst overall remaining financially viable. Analysing daily processes, tracking outcomes and implementing simple strategies enabled shelter staff to more effectively focus their efforts and achieve amazing results. The objective of this retrospective study was to assess the effect of implementing the capacity for care (C4C) management model. Data focusing on the average daily number of animals on site for a two year period (2016 – 2017) was exported from a shelter management system, Customer Logic (CL) Vet to Excel for manipulation and comparison. Following the implementation of C4C practices the average daily number of animals on site was reduced by >50%, (2016 average 103 compared to 2017 average 49), average LOS reduced by 50% from 8 weeks to 4 weeks and incidence of disease reduced from ≥ 70% to less than 2% of the cats on site at the completion of the study. The total number of stray cats entering the shelter due to council contracts reduced by 50% (486 to 248). Improved cat outcomes were attributed to strategies that increased adoptions and reduced euthanasia of poorly socialized cats, including foster programs. To continue to achieve improvements in LRR and LOS, strategies to decrease intake further would be beneficial, for example, targeted sterilisation programs. In conclusion, the study highlighted the benefits of using C4C as a management tool, delivering a significant reduction in animal intake and euthanasia with positive emotional, financial and community outcomes.

Keywords: animal welfare, capacity for care, cat, euthanasia, length of stay, managed intake, shelter

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Authors: Hennie Boeije, Renate Verkaik, Joke Korevaar

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In Dutch national policy, it is promoted that the elderly remain living at home longer. They are less often admitted to a nursing home or only later in life. While living at home, it is important that they experience a good quality of life. Care providers in primary care support this. In this study, it was investigated what quality of life means for the elderly and which characteristics care should have that supports living at home longer with quality of life. To explore this topic, a qualitative methodology was used. Four focus groups were conducted: two with elderly people who live at home and their family caregivers, one with district nurses employed in-home care services and one with elderly care physicians working in primary care. Next to this individual interviews were employed with general practitioners (GPs). In total 32 participants took part in the study. The data were thematically analysed with MaxQDA software for qualitative analysis and reported. Quality of life is a multi-faceted term for elderly. The essence of their description is that they can still undertake activities that matter to them. Good physical health, mental well-being and social connections enable them to do this. Own control over their life is important for some. They are of opinion that how they experience life and manage old age is related to their resilience and coping. Key terms in the definitions of quality of life by GPs are also physical and mental health and social contacts. These are the three pillars. Next, to this elderly care, physicians mention security and safety and district nurses add control over their own life and meaningful daily activities. They agree that with frail elderly people, the balance is delicate and a change in one of the three pillars can cause it to collapse like a house of cards. When discussing what support is needed, professionals agree on access to care with a low threshold, prevention, and life course planning. When care is provided in a timely manner, a worsening of the situation can be prevented. They agree that hospital care often is not needed since most of the problems with the elderly have to do with care and security rather than with a cure per se. GPs can consult elderly care physicians to lower their workload and to bring in specific knowledge. District nurses often signal changes in the situation of the elderly. According to them, the elderly predominantly need someone to watch over them and provide them with a feeling of security. Life course planning and advance care planning can contribute to uniform treatment in line with older adults’ wishes. In conclusion, all stakeholders, including elderly persons, agree on what entails quality of life and the quality of care that is needed to support that. A future challenge is to shape conditions for the right skill mix of professionals, cooperation between the professions and breaking down differences in financing and supply. For the elderly, the challenge is preparing for aging.

Keywords: elderly living at home, quality of life, quality of care, professional cooperation, life course planning, advance care planning

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Authors: Heping Dang, Raymond Yu Wang

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The Langcang-Mekong River is the most important international watercourse in mainland Southeast Asia. In recent years, the six riparian states, China, Myanmar, Laos, Thailand, Cambodia and Vietnam, have confronted increasing disputes over the use of the trans-boundary water. To settle these disputes and protect the fundamental right to water, quite a few inter-state mechanisms have been established, such as the Mekong River Commission, the economic cooperation program of the Greater Mekong Subregion, the ‘Belt and Road Initiative’ and the ‘Lancang-Mekong Cooperation Mechanism’ and the ‘Lower Mekong Initiative’. Non-Governmental Organizations (NGOs) have also been an important and constructive institutional entrepreneur in trans-boundary water governance. Although the status and extent of the right to water are yet to be clearly defined, this paper aims to 1) unpack how the right to water is interpreted and exercised in the Lancang-Mekong River Basin Dispute; and 2) to evaluate the roles of the right to water in settling international water disputes. To achieve these objectives, Secondary data such as archival documents of international law and relevant stakeholders will be compiled for analysis. First-hand information about the organizational structure, accountability, values and strategies of the international mechanisms and NGOs in question will also be collected through fieldwork in the Mekong river basin. Semi-structural interviews, group discussions and participatory observation will be conducted to collect data. The authors have access to the fieldwork because they have abundant experience of collaborating with Mekong-based international NGOs in previous research projects. This research will display how the concepts and principles of international law and the UN guidelines are interpreted in practice. These principles include the definition and extent of the right to water, the practical use of ‘vital human need’, the indicators of ‘adequacy of water’ including ‘availability, quality and accessibility’, and how the right to water is related to the progressive realization of the right to life. This down-to earth research will enrich the theoretical discussion of international law, particularly international human rights law, within the UN framework. Moreover, the outcomes of this research will provide new insights into the roles that the right to water might play in consensus-building and dispute settlement in a rapidly changing context, where water is pivotal for poverty alleviation, biodiversity conservation and the promotion of sustainable livelihoods.

Keywords: international water dispute, Lancang-Mekong River, right to water, state and non-state actors

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Authors: Deirdre Mc Grath, Joanne Reid

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Background: Ovarian cancer is the leading cause of mortality among gynaecologic cancers in developed countries and the seventh most common cancer worldwide, with nearly 240,000 women diagnosed each year. Although it is recognized engaging in exercise results in positive health care outcomes, women with ovarian cancer are reluctant to participate. No evidence currently exists focusing on how to successfully implement an exercise intervention program for patients with ovarian cancer, using a realist approach. There is a requirement for the implementation of exercise programmes within the oncology health care setting as engagement in such interventions has positive health care outcomes for women with ovarian cancer both during and following treatment. Aim: To co-design the implementation of an exercise intervention for women following treatment for ovarian cancer. Methods: This study is a realist evaluation using quantitative and qualitative methods of data collection and analysis. Realist evaluation is well-established within the health and social care setting and has, in relation to this study, enabled a flexible approach to investigate how to optimise implementation of an exercise intervention for this patient population. This single centre study incorporates three stages in order to identify the underlying contexts and mechanisms which lead to the successful implementation of an exercise intervention for women who have had treatment for ovarian cancer. Stage 1 - A realist literature review. Stage 2 -Co-design of the implementation of an exercise intervention with women following treatment for ovarian cancer, their carer’s, and health care professionals. Stage 3 –Implementation of an exercise intervention with women following treatment for ovarian cancer. Evaluation of the implementation of the intervention from the perspectives of the women who participated in the intervention, their informal carers, and health care professionals. The underlying programme theory initially conceptualised before and during the realist review was developed further during the co-design stage. The evolving programme theory in relation to how to successfully implement an exercise for these women is currently been refined and tested during the final stage of this realist evaluation which is the implementation and evaluation stage. Results: This realist evaluation highlights key issues in relation to the implementation of an exercise intervention within this patient population. The underlying contexts and mechanisms which influence recruitment, adherence, and retention rates of participants are identified. Conclusions: This study will inform future research on the implementation of exercise interventions for this patient population. It is anticipated that this intervention will be implemented into practice as part of standard care for this group of patients.

Keywords: exercise, ovarian cancer, co-design, implementation

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Authors: Ajay Kumar Sinha, Sharad Singh, Anukriti Sinha

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Passive energy dissipation method for earthquake protection of structures is undergoing developments for improved performance. Combined use of different types of damping mechanisms has shown positive results in the near past. Different supplemental damping methods like viscous damping, frictional damping and metallic damping are being combined together for optimum performance. The conventional method of connecting passive dampers to structures is a parallel connection between the damper unit and structural member. Researchers are investigating coupling effect of different types of dampers. The most popular choice among the research community is coupling of viscous dampers and frictional dampers. The series and parallel coupling of these damping units are being studied for relative performance of the coupled system on response control of structures against earthquake. In this paper an attempt has been made to couple Fluid Viscous Dampers and Frictional Dampers in series and parallel to form a single unit of damping system. The relative performance of the coupled units has been studied on three dimensional reinforced concrete framed structure. The current theories of structural dynamics in practice for viscous damping and frictional damping have been incorporated in this study. The time history analysis of the structural system with coupled damper units, uncoupled damper units as well as of structural system without any supplemental damping has been performed in this study. The investigations reported in this study show significant improved performance of coupled system. A higher natural frequency of the system outside the forcing frequency has been obtained for structural systems with coupled damper units as against the other cases. The structural response of the structure in terms of storey displacement and storey drift show significant improvement for the case with coupled damper units as against the cases with uncoupled units or without any supplemental damping. The results are promising in terms of improved response of the structure with coupled damper units. Further investigations in this regard for a comparative performance of the series and parallel coupled systems will be carried out to study the optimum behavior of these coupled systems for enhanced response control of structural systems.

Keywords: frictional damping, parallel coupling, response control, series coupling, supplemental damping, viscous damping

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Authors: Ya-Hsing Yeh, I-Chun Tai, Ming-Chieh Lin, Li-Ting Lee, Ping-Ting Hsieh, Yi-Chen Ling, Jhia-Ying Du, Li-Ping Chang, Guan-Long Yu

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Objective: To understand the connection between children/adolescents and those who they miss, as well as the correlation between connection and their emotions. Method: Based on the objective, a close-ended questionnaire was made into a formal questionnaire after experts evaluated its validity. In February 2017, the paper-based questionnaire was adopted. Twenty-one elementary schools and junior high schools in Taiwan were sampled by purposive sampling approach and the fifth to ninth graders were our participants. A total of 2,502 valid questionnaires were retrieved. Results: Forty-four-point three percent of children/adolescents missed a person in mind, or they thought a person as a significant other in mind, but they had no connection with them. The highest proportion of those they wanted to contact with was ‘Friends and classmates’, and the others were ‘immediate family’, such as parents and grandparents, and ‘academic or vocational instructors, such as home-room teachers, coaches, cram school teachers and so on, respectively. Only 14% of children/adolescents would actively contact those they missed. The proportion of what children/adolescents ‘often’ actively keeping in touch with those they missed felt happy or cheerful was higher compared with those who ‘seldom’ actively keeping in touch with people they missed whenever they recalled who they missed, or the person actively contacted with them. Sixty-one-point seven percent of participants haven’t connected with those they missed for more than one year. The main reason was ‘environmental factors’, such as school/class transfer or moving, and then ‘academic or personal factors’, ‘communication tools’, and ‘personalities’, respectively. In addition to ‘greetings during festivals and holidays’, ‘hearing from those they missed’, and ‘knowing the latest information about those they missed on their Internet communities’, children/adolescents would like to actively contact with them when they felt ‘happy’ and ‘depressed or frustrated. The first three opinions of what children/adolescents regarded truly connection were ‘listening to people they missed attentively’, ‘sharing their secrets’, and ‘contacting with people they regularly missed with real actions’. In terms of gender, girls’ proportion on ‘showing with actions, including contacting with people they missed regularly or expressing their feelings openly’, and ‘sharing secrets’ was higher than boys’, while boy’s proportion on ‘the attitudes when contacting people they missed, including listening attentively or without being distracted’ was higher than girls’. Conclusions: I. The more ‘active’ connection they have, the more happiness they feel. II. Teachers can teach children how to manage their emotions and express their feelings appropriately. III. It is very important to turn connection into ‘action.’ Teachers can set a good example and share their moods with others whatever they are in the mood. This is a kind of connection.

Keywords: children, connection, emotion, mental health

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Authors: Dieudonne Uwizeye, Reuben Muhayiteto

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Teenage pregnancy is a challenging problem for sustainable development due to restrictions it poses to socioeconomic opportunities for young mothers, their children and families. Being unable to take appropriate economic and social responsibilities, teen mothers get trapped into poverty and become economic burden to their family and country. Besides, teenage pregnancy is also a health problem because children born to very young mothers are vulnerable with greater risk of illnesses and deaths, and teenage mothers are more likely to be exposed to greater risk of maternal mortality and to other health and psychological problems. In Kigali city, in Rwanda, teenage pregnancy rate is currently high and its increase in recent years is worrisome. However, only individual factors influencing the teenage pregnancy tend to be the basis of interventions. It is important to understand the important socioeconomic factors at the household level that are associated with teenage pregnancy to help government, parents, and other stakeholders to appropriately address the problem with sustainable measures. This study analyzed secondary data from the Fifth Rwanda Demographic and Health Survey (RDHS-V 2014-2015) conducted by the National Institute of Statistics of Rwanda (NISR). The aim was to examine household socio-economic factors that are associated with incidence of teenage pregnancies in Kigali city. In addition to descriptive analysis, Pearson’s Chi Square and Binary Logistic Regression were used in the analysis. Findings indicate that marital status and age of household head, number of members in a household, number of rooms used for sleeping, educational level of the household head and household's wealth are significantly associated with teenage pregnancy in Rwanda ( p< 0.05). It was found that teenagers living with parents, those having parents with higher education and those from richer families are less likely to become pregnant. Age of household head was pinpointed as factor to teenage pregnancy, with teenage-headed households being more vulnerable. The findings also revealed that household composition correlates with the probability of teenage pregnancy (p < 0.05) with teenagers from households with less number of members being more vulnerable. Regarding the size of the house, the study suggested that the more rooms available in households, the less incidences of teenage pregnancy are likely to be observed (p < 0.05). However, teenage pregnancy was not significantly associated with physical violence among parents (p = 0.65) and sex of household heads (p = 0.52), except in teen-headed households of which female are predominantly heads. The study concludes that teenage pregnancy remains a serious social, economic and health problem in Rwanda. The study informs government officials, parents and other stakeholders to take interventions and preventive measures through community sex education, policies and strategies to foster effective parental guidance, care and control of young girls through meeting their necessary social and financial needs within households.

Keywords: household socio-economic factors, Rwanda, Rwanda demographic and health survey, teenage pregnancy

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Authors: Dohun Kim

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Technological innovations have stimulated flipped learning in many disciplines, including language teaching. It is a specific type of blended learning, which combines onsite (i.e. face-to-face) with online experiences to produce effective, efficient and flexible learning. Flipped learning literally ‘flips’ conventional teaching and learning activities upside down: it leverages technologies to deliver a lecture and direct instruction—other asynchronous activities as well—outside the classroom to reserve onsite time for interaction and activities in the upper cognitive realms: applying, analysing, evaluating and creating. Unlike the conventional flipped approaches, which focused on video lecture, followed by face-to-face or on-site session, new innovative methods incorporate various means and structures to serve the needs of different academic disciplines and classrooms. In the light of such innovations, this study adopted ‘student-engaged’ approaches to interpreter training and contrasts them with traditional classrooms. To this end, students were also encouraged to engage in asynchronous activities online, and innovative technologies, such as Telepresence, were employed. Based on the class implementation, a thorough examination was conducted to examine how we can structure and implement flipped classrooms for language and interpreting training while actively engaging learners. This study adopted a quantitative research method, while complementing it with a qualitative one. The key findings suggest that the significance of the instructor’s role does not dwindle, but his/her role changes to a moderator and a facilitator. Second, we can apply flipped learning to both theory- and practice-oriented modules. Third, students’ integration into the community of inquiry is of significant importance to foster active and higher-order learning. Fourth, cognitive presence and competence can be enhanced through strengthened and integrated teaching and social presences. Well-orchestrated teaching presence stimulates students to find out the problems and voices the convergences and divergences, while fluid social presence facilitates the exchanges of knowledge and the adjustment of solutions, which eventually contributes to consolidating cognitive presence—a key ingredient that enables the application and testing of the solutions and reflection thereon.

Keywords: blended learning, Community of Inquiry, flipped learning, interpreter training, student-centred learning

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Authors: Danylo Brindak, Viktor Liashko, Olexander Chepurniy

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Despite considerable experience in implementation of the best international approaches and services within response to epidemy of multi-drug resistant tuberculosis, the results of situation analysis indicate the presence of faults in this area. In 2014, Ukraine (for the first time) was included in the world’s five countries with the highest level of drug-resistant tuberculosis. The effectiveness of its treatment constitutes only 35% in the country. In this context, the increase in allocation of funds to control the epidemic of multidrug-resistant tuberculosis does not produce perceptible positive results. During 2001-2016, only the Global Fund to fight AIDS, Tuberculosis, and Malaria allocated to Ukraine more than USD 521,3 million for programs of tuberculosis and HIV/AIDS control. However, current conditions in post-Semashko system create little motivation for rational use of resources or cost control at inpatient TB facilities. There is no motivation to reduce overdue hospitalization and to target resources to priority sectors of modern tuberculosis control, including a model of care focused on the patient. In the presence of a line-item budget at medical institutions, based on the input factors as the ratios of beds and staff, there is a passive disposal of budgetary funds by health care institutions and their employees who have no motivation to improve quality and efficiency of service provision. Outpatient treatment of tuberculosis is being implemented in Ukraine since 2011 and has many risks, namely creation of parallel systems, low consistency through dependence on funding for the project, reduced the role of the family doctor, the fragmentation of financing, etc. In terms of reforming approaches to health system financing, which began in Ukraine in late 2016, NGO Infection Control in Ukraine conducted piloting of a new, motivating method of remuneration of employees in primary health care. The innovative aspect of this funding mechanism is cost according to results of treatment. The existing method of payment on the basis of the standard per inhabitant (per capita ratio) was added with motivating costs according to results of work. The effectiveness of such treatment of TB patients at the outpatient stage is 90%, while in whole on the basis of a current system the effectiveness of treatment of newly diagnosed pulmonary TB with positive swab is around 60% in the country. Even though Ukraine has 5.24 TB beds per 10 000 citizens. Implemented pilot model of ambulatory treatment will be used for the creation of costs system according to results of activities, the integration of TB and primary health and social services and their focus on achieving results, the reduction of inpatient treatment of tuberculosis.

Keywords: health care reform, multi-drug resistant tuberculosis, outpatient treatment efficiency, tuberculosis

Procedia PDF Downloads 141

Authors: K. Petrosyan, R. Piwowarczyk, K. Ruraż, S. Thijs, J. Vangronsveld, W. Kaca

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Holoparasitic plants are flowering heterotrophic angiosperms which with the help of an absorbing organ - haustorium, attach to another plant, the so-called the host. Due to the different hosts, unusual lifestyle, lack of roots, chlorophylls and photosynthesis, these plants are interesting and unique study objects for global biodiversity. The seeds germination of the parasitic plants also is unique: they germinate only in response to germination stimulants, namely strigolactones produced by the root of an appropriate host. Resistance of the seeds on different environmental conditions allow them to stay viable in the soil for more than 20 years. Among the wide range of plant protection mechanisms the endophytic communities have a specific role. In this way, they have the potential to mitigate the impacts of adverse conditions such as soil salinization. The major objective of our study was to compare the bacterial endo-microbiomes from seeds of two holoparasitic plants from Orobanchaceae family, Cistanche – C. armena (Armenia) and C. phelypaea (Portugal) – from saline habitats different in soil water status. The research aimed to perform how environmental conditions influence on the diversity of the bacterial communities of C. armena and C. phelypaea seeds. This was achieved by comparison of the endophytic microbiomes of two species and isolation of culturable bacteria. A combination of culture-dependent and molecular techniques was employed for the identification of the seed endomicrobiome (culturable and unculturable). Using the V3-V4 hypervariable region of the 16S rRNA gene, four main taxa were identified: Proteobacteria, Actinobacteria, Bacteroidetes, Firmicutes, but the relative proportion of the taxa was different in each type of seed. Generally, sixteen phyla, 323 genera and 710 bacterial species were identified, mainly Gram negative, halotolerant bacteria with an environmental origin. However, also some unclassified and unexplored taxonomic groups were found in the seeds of both plants. 16S rRNA gene sequencing analysis from both species identified the gram positive, endospore forming, halotolerant and alkaliphile Bacillus spp. which suggests that the endophytic bacteria of examined seeds possess traits that are correlated with the natural habitat of their hosts. The cultivable seed endophytes from C. armena and C. phelypaea were rather similar, notwithstanding the big distances between their growth habitats - Armenia and Portugal. Although the seed endophytic microbiomes of C. armena and C. phelypaea contain a high number of common bacterial taxa, also remarkable differences exist. We demonstrated that the environmental conditions or abiotic stresses influence on diversity of the bacterial communities of holoparasiotic seeds. To the best of our knowledge the research is the first report of endophytes from seeds of holoparasitic Cistanche armena and C. phelypaea plants.

Keywords: microbiome, parasitic plant, salinity, seeds

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Authors: Fuseina Mahama, Lieselot Vanhaverbeke

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This research investigates the impact of patronage determinants on the distance consumers are willing to travel to patronize a tire shop. Although store patronage has been acknowledged as an important domain and has received substantial research interest, most of the studies so far conducted focus on grocery retail, leaving other categories of goods widely unexplored. In this study, we focus on car tires and provide a new perspective to the specific factors that influence tire shop patronage. An online survey of consumers’ tyre purchasing behaviour was conducted among private car owners in Belgium. A sample of 864 respondents was used in the study, with almost four out of five of them being male. 84% of the respondents had purchased a car tyre in the last 24 months and on average travelled 22.4kms to patronise a tyre shop. We tested the direct and mediated effects of store choice determinants on distance consumers are willing to travel. All hypotheses were tested using Structural Equation Modelling (SEM). Our findings show that with an increase in the consumer’s age the distance they were willing to travel to a tire shop decreased. Similarly, consumers who deemed proximity an important determinant of a tire shop our findings confirmed a negative effect on willingness to travel. On the other hand, the determinants price, personal contact and professionalism all had a positive effect on distance. This means that consumers actively sought out tire shops with these characteristics and were willing to travel longer distances in order to visit them. The indirect effects of the determinants flexible opening hours, family recommendation, dealer reputation, receiving auto service at home and availability of preferred brand on distance are mediated by dealer trust. Gender had a minimal effect on distance, with females exhibiting a stronger relation in terms of dealer trust as compared to males. Overall, we found that market relevant factors were better predictors of distance; and proximity, dealer trust and professionalism have the most profound effects on distance that consumers are willing to travel. This is related to the fact that the nature of shopping goods (among which are car tires) typically reinforces consumers to be more engaged in the shopping process, therefore factors that have to do with the store (e.g. location) and shopping process play a key role in store choice decision. These findings are very specific to shopping goods and cannot be generalized to other categories of goods. For marketers and retailers these findings can have direct implications on their location strategies. The factors found to be relevant to tire shop patronage will be used in our next study to calibrate a location model to be utilised to identify the optimum location for siting new tyre shop outlets and service centres.

Keywords: dealer trust, distance to store, tire store patronage, willingness to travel

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Authors: Stephanie Yun Yu Law

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Background: This study aims to investigate into communication between trainee doctors and patients, especially how doctor’s reaction to patient’s emotional issues expressed in the consultation affect patient’s satisfaction. Objectives: Thus, there are three aims in this study, 1.) how do trainee doctors react to patients emotional cues in OSCE station? 2.) Any differences in the respond type to emotional cues between first year students and third year students? 3.) Is response type (reducing space) related to OSCE outcome (patient satisfaction and expert rating)? Methods: Fifteen OSCE stations was videotaped, in which 9 were stations with first-year students and 6 were with third-year students. OSCE outcomes were measured by Communication Assessment Tool and Examiners Checklist. Analyses: All patient’s cues/concerns and student’s reaction were coded by Verona Coding Definitions of Emotional Sequence. Descriptive data was gathered from Observer XT and logistic regression (two-level) was carried out to see if occurrence of reducing space response can be predicted by OSCE outcomes. Results: Reducing space responses from all students were slightly less than a half in total responses to patient’s cues. The mean percentage of reducing space behaviours was lower among first year students when compared to third year students. Patient’s satisfaction significantly (p<0.05) and negatively predicted reducing space behaviours. Conclusions: Most of the medical students, to some extent, did not provide adequate responses for patient’s emotional cues. But first year students did provide more space for patients to talk about their emotional issues when compared to third year students. Lastly, patients would feel less satisfied if trainee doctors use more reducing space responses in reaction to patient’s expressed emotional cues/concerns. Practical implications: Firstly, medical training programme can be tailored on teaching students how to detect and respond appropriately to emotional cues in order to improve underperformed student’s communication skills in healthcare setting. Furthermore, trainee doctor’s relationship with patients in clinical practice can also be improved by reacting appropriately to patient’s emotive cues in consultations (such as limit the use of reducing space behaviours).

Keywords: doctors-patients communication, applied clinical psychology, health psychology, healthcare professionals

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Authors: Berfu Guley Goren, Ayse Lale Berkoz

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The aim of the study is to analyze the concept of universal design and accessibility to make the city which allows equality and independence for individuals. In the content of the study, literature researches and observations of samples in Istanbul, Turkey are analyzed. As a result proposals are going to be developed to create the cities which are designed for everyone. In globalization process, in cities, population have been increasing dramatically with social and economic activities. Medical developments have been effective in prolonging human life and the disability that comes with aging has also increased in parallel with the disabled population. Nowadays disability is an important phenomenon. Because approximately 1 billion people live with disabilities. The heterogeneous structure formed by the rapid gathering of individuals with different social, economic and physical characteristics in the cities creates great spatial diversity and richness in the cities with different needs brought together. Unlike the cultural and physical wealth in these places and the potential to integrate and diversify the urban people, unfortunately, the designs in practice cause the urban areas to break apart, the urbanities to tear themselves apart, to interfere with their communication and interactions. The social and physical structure of the city is important to feel belonging to the urban society. In most cities when an observation is made, obstructions for people with disabilities can be seen in urban physical structure and design. With these obstructions, people with disabilities cannot live in urban space, and they are desolated in urban life. The city, which offers equal opportunity, the relation between economic development, social justice and built environment must be planned synchronous. Isolation and stigmatization must be abolished by regulations, activities of awareness and universal urban design. Without regard to social, economical and physical features every individual has the same right, which is using the freedom of movement. Supporting freedom of movement of every individual may be ensured by universal design and its principles. So urban spaces are going to be for every individual. For equal opportunity in urban services, urban design must be the focus on every individual including people with disabilities. In built environment practices, democratic suitable spaces should be created. In this respect, urban planners, architects, political decision-makers and other relevant actors should work together and should think very versatile.

Keywords: disability, equality, universal design, urban design

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Authors: Marius Zemp

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Evidentials indicate how the speaker obtained the information conveyed in a statement. Detailed diachronic-functional accounts of evidential contrasts found in the Greater Himalayan Region (GHR) reveal that contrasting evidentials are not only defined against each other but also that most of them once had different aspecto-temporal (TA) values which must have aligned when their contrast was conventionalized. Based on these accounts, the present paper sheds light on hitherto unidentified mechanisms of grammatical change. The main insights of the present study were facilitated by ‘functional reconstruction’, which (i) revolves around morphemes which appear to be used in divergent ways within a language and/or across different related languages, (ii) persistently devises hypotheses as to how these functional divergences may have developed, and (iii) retains those hypotheses which most plausibly and economically account for the data. Based on the dense and detailed grammatical literature on the Tibetic language family, the author of this study is able to reconstruct the initial steps by which its evidentiality systems developed: By the time Proto-Tibetan started to be spread across much of Central Asia in the 7th century CE, verbal concatenations with and without a connective -s had become common. As typical for resultative constructions around the globe, Proto-Tibetan *V-s-’dug ‘was there, having undergone V’ (employing the simple past of ’dug ‘stay, be there’) allowed both for a perfect reading (‘the state resulting from V holds at the moment of speech’) and an inferential reading (‘(I infer from its result that) V has taken place’). In Western Tibetic, *V-s-’dug grammaticalized in its perfect meaning as it became contrasted with perfect *V-s-yod ‘is there, having undergone V’ (employing the existential copula yod); that is, *V-s-’dug came to mean that the speaker directly witnessed the profiled result of V, whereas *V-s-yod came to mean that the speaker does not depend on direct evidence of the result, as s/he simply knows that it holds. In Eastern Tibetic, on the other hand, V-s-’dug grammaticalized in its inferential past meaning as it became contrasted with past *V-thal ‘went past V-ing’ (employing the simple past of thal ‘go past’); that is, *V-s-’dug came to mean that the profiled past event was inferred from its result, while *V-thal came to mean that it was directly witnessed. Hence, depending on whether it became contrasted with a perfect or a past construction, resultative V-s-’dug grammaticalized either its direct evidential perfect or its inferential past function. This means that in both cases, evidential readings of constructions with distinct but overlapping TA-values became contrasted, and in order for their contrasting meanings to grammaticalize, the constructions had to agree on their tertium comparationis, which was their shared TA-value. By showing that other types of evidential contrasts in the GHR are also TA-aligned, while no single markers (or privative contrasts) are found to have grammaticalized evidential functions, the present study suggests that, at least in this region of the world, evidential meanings grammaticalize only in equipollent contrasts, which always end up TA-aligned.

Keywords: evidential contrasts, functional-diachronic accounts, grammatical change, himalayan languages, tense/aspect-alignment

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Authors: Rodrique Watong Tchounkeu

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This paper investigated the implementation and impact of inclusive education practices in early childhood settings (ages 3-6) with the overarching aim of fostering a diverse learning environment. The primary objectives were to assess the then-current state of inclusive practices, identify effective methodologies for accommodating diverse learning needs, and evaluate the outcomes of implementing inclusive education in early childhood settings. To achieve these objectives, a mixed-methods approach was employed, combining qualitative interviews with early childhood educators and parents, along with quantitative surveys distributed to a diverse sample of participants. The qualitative phase involved semi-structured interviews with 30 educators and 50 parents, selected through purposive sampling. The interviews aimed to gather insights into the challenges faced in implementing inclusive education, the strategies employed, and the perceived benefits and drawbacks. The quantitative phase included surveys administered to 300 early childhood educators across various settings, measuring their familiarity with inclusive practices, their perceived efficacy, and their willingness to adapt teaching methods. The results revealed a significant gap between the theoretical understanding and practical implementation of inclusive education in early childhood settings. While educators demonstrated a high level of theoretical knowledge, they faced challenges in effectively translating these concepts into practice. Parental perspectives highlighted the importance of collaboration between educators and parents in supporting inclusive education. The surveys indicated a positive correlation between educators' familiarity with inclusive practices and their willingness to adapt teaching methods, emphasizing the need for targeted professional development. The implications of this study suggested the necessity for comprehensive training programs for early childhood educators focused on the practical implementation of inclusive education strategies. Additionally, fostering stronger partnerships between educators and parents was crucial for creating a supportive learning environment for all children. By addressing these findings, this research contributed to the advancement of inclusive education practices in early childhood settings, ultimately leading to more inclusive and effective learning environments for diverse groups of young learners.

Keywords: inclusive education, early childhood settings, diverse learning, young learners, practical implementation, parental collaboration

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Authors: Huei Jiun Chen, Hui Mei Huan

Abstract:

Introduction: Pain is an unpleasant experience for hospitalized patients that impacts both their physical and mental well-being. It is important to select appropriate pain assessment tools to ensure effective pain management. Therefore, it is suggested to use Verbal Rating Scale (VRS) instead for better assessment. The Wong-Baker FACES Pain Rating Scale(WBS) is a widely used pain assessment tool in Taiwan to help individuals communicate the intensity of their pain. However, in clinical practice, even when using various assessment tools to evaluate pain, Numeric Rating Scale-11 (NRS-11) is still commonly utilized to quantify the intensity of pain. The correlation between NRS and other pain assessment tools has not been extensively explored in Taiwan. Additionally, the influence of gender and education level on pain assessment among elderly individuals has not been extensively studied in Taiwan. The aim of this study is to investigate the correlation between pain assessment scales (NRS-11, VRS, WBS) in assessing pain intensity among elderly inpatients. The secondary objective of this study is to examine how gender and education level influence pain assessment among individuals, as well as to explore their preferences regarding pain assessment tools. Method: In this study, a questionnaire survey and purposive sampling were employed to recruit participants from a medical center located in central Taiwan. Participants were requested to assess their pain intensity in the past 24 hours using NRS-11, VRS, and WBS. Additionally, the study investigated their preferences for pain assessment tools. Result: A total of 252 participants were included in this study, with a mean age of 71.1 years (SD=6.2). Of these participants, 135 were male (53.6%), and 44.4% had a primary level or below education. Participants were asked to use NRS-11, VRS, and WBS to assess their current, maximum, and minimum pain intensity experienced in the past 24 hours. The findings indicated a significant correlation (p< .01) among all three pain assessment tools. No significant differences were observed in gender across the three pain assessment scales. For severe pain, there were significant differences in self-rated pain scales among the elderly participants with different education levels (F=3.08, p< .01; X²=17.25, X²=17.21, p< .01), but there were no significant differences observed for mild pain. Regarding preferences for pain assessment tools, 158 participants (62.7%) favored VRS, followed by WBS; gender and education level had no influence on their preferences. Conclusion: Most elderly participants prefer using VRS (Verbal Rating Scale) to self-reported their pain. The reason for this preference may be attributed to the verbal nature of VRS, as it is simple and easy to understand. Furthermore, it could be associated with the level of education among the elderly participants. The pain assessment using VRS demonstrated a significant correlation with NRS-11 and WBS, and gender was not found to have any influence on these assessment. Further research is needed to explore the effect of different education levels on self-reported pain intensity among elderly people in Taiwan.

Keywords: pain assessment, elderly, gender, education

Procedia PDF Downloads 58

Authors: Masih Nikgou

Abstract:

ICU nurses or intensive care nurses are highly specialized and trained healthcare personnel. These nurses provide nursing care for patients with life-threatening illnesses or conditions. They provide the experience, knowledge and specialized skills that patients need to survive and recover. Intensive care nurses (ICU) are trained to make momentary decisions and act quickly when the patient's condition changes. Their primary work environment is in the hospital in intensive care units. Typically, ICU patients require a high level of care. ICU nurses work in challenging and complex fields in their nursing profession. They have the primary duty of caring for and saving patients who are fighting for their lives. Intensive care (ICU) nurses are highly trained to provide exceptional care to patients who depend on 24/7 nursing care. A patient in the ICU is often equipped with a ventilator, intubated and connected to several life support machines and medical equipment. Intensive Care Nurses (ICU) have full expertise in considering all aspects of bringing back their patients. Some of the specific responsibilities of ICU nurses include (a) Assessing and monitoring the patient's progress and identifying any sudden changes in the patient's medical condition. (b) Administration of drugs intravenously by injection or through gastric tubes. (c) Provide regular updates on patient progress to physicians, patients, and their families. (d) According to the clinical condition of the patient, perform the approved diagnostic or treatment methods. (e) In case of a health emergency, informing the relevant doctors. (f) To determine the need for emergency interventions, evaluate laboratory data and vital signs of patients. (g) Caring for patient needs during recovery in the ICU. (h) ICU nurses often provide emotional support to patients and their families. (i) Regulating and monitoring medical equipment and devices such as medical ventilators, oxygen delivery devices, transducers, and pressure lines. (j) Assessment of pain level and sedation needs of patients. (k) Maintaining patient reports and records. As the name suggests, critical care nurses work primarily in ICU health care units. ICUs are completely healthy and have proper lighting with strict adherence to health and safety from medical centers. ICU nurses usually move between the intensive care unit, the emergency department, the operating room, and other special departments of the hospital. ICU nurses usually follow a standard shift schedule that includes morning, afternoon, and night schedules. There are also other relocation programs depending on the hospital and region. Nurses who are passionate about data and managing a patient's condition and outcomes typically do well as ICU nurses. An inquisitive mind and attention to processes are equally important. ICU nurses are completely compassionate and are not afraid to advocate for their patients and family members. who are distressed.

Keywords: nursing, intensive care unit, pediatric intensive care unit, mobile intensive care unit, surgical intensive care unite

Procedia PDF Downloads 58