Search results for: training school
Commenced in January 2007
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Paper Count: 6455

Search results for: training school

95 Universal Health Coverage 2019 in Indonesia: The Integration of Family Planning Services in Current Functioning Health System

Authors: Fathonah Siti, Ardiana Irma

Abstract:

Indonesia is currently on its track to achieve Universal Health Coverage (UHC) by 2019. The program aims to address issues on disintegration in the implementation and coverage of various health insurance schemes and fragmented fund pooling. Family planning service is covered as one of benefit packages under preventive care. However, little has been done to examine how family planning program are appropriately managed across levels of governments and how family planning services are delivered to the end user. The study is performed through focus group discussion to related policy makers and selected programmers at central and district levels. The study is also benefited from relevant studies on family planning in the UHC scheme and other supporting data. The study carefully investigates some programmatic implications when family planning is integrated in the UHC program encompassing the need to recalculate contraceptive logistics for beneficiaries (eligible couple); policy reformulation for contraceptive service provision including supply chain management; establishment of family planning standard of procedure; and a call to update Management Information System. The study confirms that there is a significant increase in the numbers of contraceptive commodities needs to be procured by the government. Holding an assumption that contraceptive prevalence rate and commodities cost will be as expected increasing at 0.5% annually, the government need to allocate almost IDR 5 billion by 2019, excluded fee for service. The government shifts its focus to maintain eligible health facilities under National Population and Family Planning Board networks. By 2019, the government has set strategies to anticipate the provision of family planning services to 45.340 health facilities distributed in 514 districts and 7 thousand sub districts. Clear division of authorities has been established among levels of governments. Three models of contraceptive supply planning have been developed and currently in the process of being institutionalized. Pre service training for family planning services has been piloted in 10 prominent universities. The position of private midwives has been appreciated as part of the system. To ensure the implementation of quality and health expenditure control, family planning standard has been established as a reference to determine set of services required to deliver to the clients properly and types of health facilities to conduct particular family planning services. Recognition to individual status of program participation has been acknowledged in the Family Enumeration since 2015. The data is precisely recorded by name by address for each family and its members. It supplies valuable information to 15.131 Family Planning Field Workers (FPFWs) to provide information and education related to family planning in an attempt to generate demand and maintain the participation of family planning acceptors who are program beneficiaries. Despite overwhelming efforts described above, some obstacles remain. The program experiences poor socialization and yet removes geographical barriers for those living in remote areas. Family planning services provided for this sub population conducted outside the scheme as a complement strategy. However, UHC program has brought remarkable improvement in access and quality of family planning services.

Keywords: beneficiary, family planning services, national population and family planning board, universal health coverage

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94 Promoting Resilience in Adolescents: Integrating Adolescent Medicine and Child Psychology Perspectives

Authors: Xu Qian

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This abstract examines the concept of resilience in adolescents from both adolescent medicine and child psychology perspectives. It discusses the role of healthcare providers in fostering resilience among adolescents, encompassing physical, psychological, and social aspects. The paper highlights evidence-based interventions and practical strategies for promoting resilience in this population. Introduction: Resilience plays a crucial role in the healthy development of adolescents, enabling them to navigate through the challenges of this transitional period. This abstract explores the concept of resilience from the perspectives of adolescent medicine and child psychology, shedding light on the collective efforts of healthcare providers in fostering resilience. By integrating the principles and practices of these two disciplines, this abstract emphasizes the multidimensional nature of resilience and its significance in the overall well-being of adolescents. Methods: A comprehensive literature review was conducted, encompassing research articles, empirical studies, and expert opinions from both adolescent medicine and child psychology fields. The search included databases such as PubMed, PsycINFO, and Google Scholar, focusing on publications from the past decade. The review aimed to identify evidence-based interventions and practical strategies employed by healthcare providers to promote resilience among adolescents. Results: The review revealed several key findings regarding the promotion of resilience in adolescents. Firstly, resilience is a dynamic process influenced by individual characteristics, environmental factors, and the interaction between the two. Secondly, healthcare providers play a critical role in fostering resilience by addressing the physical, psychological, and social needs of adolescents. This entails comprehensive healthcare services that integrate medical care, mental health support, and social interventions. Thirdly, evidence-based interventions such as cognitive-behavioral therapy, social skills training, and positive youth development programs have shown promising outcomes in enhancing resilience. Discussion: The integration of adolescent medicine and child psychology perspectives provides a comprehensive framework for promoting resilience in adolescents. By acknowledging the interplay between physical health, psychological well-being, and social functioning, healthcare providers can tailor interventions to address the specific needs and challenges faced by adolescents. Collaborative efforts between medical professionals, psychologists, educators, and families are vital in creating a supportive environment that fosters resilience. Additionally, the findings highlight the importance of early identification and intervention, emphasizing the need for routine screening and assessment to identify adolescents at risk and provide timely support. Conclusion: Promoting resilience in adolescents requires a holistic approach that integrates adolescent medicine and child psychology perspectives. By recognizing the multifaceted nature of resilience, healthcare providers can implement evidence-based interventions and practical strategies to enhance the well-being of adolescents. The collaboration between healthcare professionals from different disciplines, alongside the involvement of families and communities, is crucial for creating a resilient support system. By investing in the promotion of resilience during adolescence, we can empower young individuals to overcome adversity and thrive in their journey toward adulthood.

Keywords: psychology, clinical psychology, child psychology, adolescent psychology, adolescent

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93 Using Health Literacy and Medico-Legal Guidance to Improve Restorative Dentistry Patient Information Leaflets

Authors: Hasneet K. Kalsi, Julie K. Kilgariff

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Introduction: Within dentistry, the process for gaining informed consent has become more complex. To consent for treatment, patients must understand all reasonable treatment options and associated risks and benefits. Consenting is therefore deeply embedded in health literacy. Patients attending for dental consultation are often presented with an array of information and choices, yet studies show patients recall less than half of the information provided immediately after. Appropriate and comprehensible patient information leaflets (PILs) may be useful aid memories. In 2016 the World Health Organisation set improving health literacy as a global priority. Soon after, Scotland’s 2017-2025 Making it Easier: A Health Literacy Action Plan followed. This project involved the review of Restorative PILs used within Dundee Dental Hospital to assess the Content and Readability. Method: The current PIL on Root Canal Treatment (RCT) was created in 2011. This predates the Montgomery vs. NHS Lanarkshire case, a ruling which significantly impacted dental consenting processes, as well as General Dental Council’s (GDC’s) Standards for the Dental Team and Faculty of General Dental Practice’s Good Practice Guidance on Clinical Examination and Record-Keeping. Current evidence-based guidance, including that stipulated by the GDC, was reviewed. A 20-point Essential Content Checklist was designed to conform to best practice guidance for valid consenting processes. The RCT leaflet was scored against this to ascertain if the content was satisfactory. Having ensured the content satisfied medicolegal requirements, health literacy considerations were reviewed regarding readability. This was assessed using McLaughlin’s Simple Measure of Gobbledygook (SMOG) formula, which identifies school stages that would have to be achieved to comprehend the PIL. The sensitivity of the results to alternative readability methods were assessed. Results: The PIL was not sufficient for modern consenting processes and reflected a suboptimal level of health literacy. Evaluation of the leaflet revealed key content was missing, including information pertaining to risks and benefits. Only five points out of the 20-point checklist were present. The readability score was 16, equivalent to a level 2 in National Adult Literacy Standards/Scottish Credit and Qualification Framework Level 5; 62% of Scottish adults are able to read to this standard. Discussion: Assessment of the leaflet showed it was no longer fit for purpose. Reasons include a lack of pertinent information, a text-heavy leaflet lacking flow, and content errors. The SMOG score indicates a high level of comprehension is required to understand this PIL, which many patients may not possess. A new PIL, compliant with medicolegal and health literacy guidance, was designed with patient-driven checklists, notes spaces for annotations/ questions and areas for clinicians to highlight important case-specific information. It has been tested using the SMOG formula. Conclusion: PILs can be extremely useful. Studies show that interactive use can enhance their effectiveness. PILs should reflect best practice guidance and be understood by patients. The 2020 leaflet designed and implemented aims to fulfill the needs of a modern healthcare system and its service users. It embraces and embeds Scotland’s Health Literacy Action Plan within the consenting process. A review of further leaflets using this model is ongoing.

Keywords: consent, health literacy, patient information leaflet, restorative dentistry

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92 Leveraging Digital Cyber Technology for Self-Care and Improved Management of DMPA-SC Clients

Authors: Oluwaseun Adeleke, Grace Amarachi Omenife, Jennifer Adebambo, Mopelola Raji, Anthony Nwala, Mogbonjubade Adesulure

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Introduction: The incorporation of digital technology in healthcare systems is instrumental in transforming the delivery, management, and overall experience of healthcare and holds the potential to scale up access through over 200 million active mobile phones used in Nigeria. Digital tools enable increased access to care, stronger client engagement, progress in research and data-driven insights, and more effective promotion of self-care and do-it-yourself practices. The Delivering Innovation in Self-Care (DISC) project 2021 has played a pivotal role in granting women greater autonomy over their sexual and reproductive health (SRH) through a variety of approaches, including information and training to self-inject contraception (DMPA-SC). To optimize its outcomes, the project also leverages digital technology platforms like social media: Facebook, Instagram, and Meet Tina (Chatbot) via WhatsApp, Customer Relationship Management (CRM) applications Freshworks, and Viamo. Methodology: The project has been successful at optimizing in-person digital cyberspace interaction to sensitize individuals effectively about self-injection and provide linkages to SI services. This platform employs the Freshworks CRM software application, along with specially trained personnel known as Cyber IPC Agents and DHIS calling centers. Integration of Freshworks CRM software with social media allows a direct connection with clients to address emerging issues, schedule follow-ups, send reminders to improve compliance with self-injection schedules, enhance the overall user experience for self-injection (SI) clients, and generate comprehensive reports and analytics on client interactions. Interaction covers a range of topics, including – How to use SI, learning more about SI, side-effects and its management, accessing services, fertility, ovulation, other family planning methods, inquiries related to Sexual Reproductive Health as well as uses an address log to connect them with nearby facilities or online pharmaceuticals. Results: Between the months of March to September, a total of 5,403 engagements were recorded. Among these, 4,685 were satisfactorily resolved. Since the program's inception, digital advertising has created 233,633,075 impressions, reached 12,715,582 persons, and resulted in 3,394,048 clicks. Conclusion: Leveraging digital technology has proven to be an invaluable tool in client management and improving client experience. The use of Cyber technology has enabled the successful development and maintenance of client relationships, which have been effective at providing support, facilitating delivery and compliance with DMPA-SC self-injection services, and ensuring overall client satisfaction. Concurrently, providing qualitative data, including user experience feedback, has enabled the derivation of crucial insights that inform the decision-making process and guide in normalizing self-care behavior.

Keywords: selfcare, DMPA-SC self-injection, digital technology, cyber technology, freshworks CRM software

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91 Professional Working Conditions, Mental Health And Mobility In The Hungarian Social Sector Preliminary Findings From A Multi-method Study

Authors: Ágnes Győri, Éva Perpék, Zsófia Bauer, Zsuzsanna Elek

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The aim of the research (funded by Hungarian national grant, NFKI- FK 138315) is to examine the professional mobility, mental health and work environment of social workers with a complex approach. Previous international and Hungarian research has pointed out that those working in the helping professions are strongly exposed to the risk of emotional-mental-physical exhaustion due to stress. Mental and physical strain, as well as lack of coping (can) cause health problems, but its role in career change and high labor turnover has also been proven. Even though satisfaction with working conditions of those employed in the human service sector in the context of the stress burden has been researched extensively, there is a lack of large-sample international and Hungarian domestic studies exploring the effects of profession-specific conditions. Nor has it been examined how the specific features of the social profession and mental health affect the career mobility of the professionals concerned. In our research, these factors and their correlations are analyzed by means of mixed methodology, utilizing the benefits of netnographic big data analysis and a sector-specific quantitative survey. The netnographic analysis of open web content generated inside and outside the social profession offers a holistic overview of the influencing factors related to mental health and the work environment of social workers. On the one hand, the topics and topoi emerging in the external discourse concerning the sector are examined, and on the other hand, focus on mentions and streams of comments regarding the profession, burnout, stress, coping, as well as labor turnover and career changes among social professionals. The analysis focuses on new trends and changes in discourse that have emerged during and after the pandemic. In addition to the online conversation analysis, a survey of social professionals with a specific focus has been conducted. The questionnaire is based on input from the first two research phases. The applied approach underlines that the mobility paths of social professionals can only be understood if, apart from the general working conditions, the specific features of social work and the effects of certain aspects of mental health (emotional-mental-physical strain, resilience) are taken into account as well. In this paper, the preliminary results from this innovative methodological mix are presented, with the aim of highlighting new opportunities and dimensions in the research on social work. A gap in existing research is aimed to be filled both on a methodological and empirical level, and the Hungarian domestic findings can create a feasible and relevant framework for a further international investigation and cross-cultural comparative analysis. Said results can contribute to the foundation of organizational and policy-level interventions, targeted programs whereby the risk of burnout and the rate of career abandonment can be reduced. Exploring different aspects of resilience and mapping personality strengths can be a starting point for stress-management, motivation-building, and personality-development training for social professionals.

Keywords: burnout, mixed methods, netnography, professional mobility, social work

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90 EEG and DC-Potential Level Сhanges in the Elderly

Authors: Irina Deputat, Anatoly Gribanov, Yuliya Dzhos, Alexandra Nekhoroshkova, Tatyana Yemelianova, Irina Bolshevidtseva, Irina Deryabina, Yana Kereush, Larisa Startseva, Tatyana Bagretsova, Irina Ikonnikova

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In the modern world the number of elderly people increases. Preservation of functionality of an organism in the elderly becomes very important now. During aging the higher cortical functions such as feelings, perception, attention, memory, and ideation are gradual decrease. It is expressed in the rate of information processing reduction, volume of random access memory loss, ability to training and storing of new information decrease. Perspective directions in studying of aging neurophysiological parameters are brain imaging: computer electroencephalography, neuroenergy mapping of a brain, and also methods of studying of a neurodynamic brain processes. Research aim – to study features of a brain aging in elderly people by electroencephalogram (EEG) and the DC-potential level. We examined 130 people aged 55 - 74 years that did not have psychiatric disorders and chronic states in a decompensation stage. EEG was recorded with a 128-channel GES-300 system (USA). EEG recordings are collected while the participant sits at rest with their eyes closed for 3 minutes. For a quantitative assessment of EEG we used the spectral analysis. The range was analyzed on delta (0,5–3,5 Hz), a theta - (3,5–7,0 Hz), an alpha 1-(7,0–11,0 Hz) an alpha 2-(11–13,0 Hz), beta1-(13–16,5 Hz) and beta2-(16,5–20 Hz) ranges. In each frequency range spectral power was estimated. The 12-channel hardware-software diagnostic ‘Neuroenergometr-KM’ complex was applied for registration, processing and the analysis of a brain constant potentials level. The DC-potential level registered in monopolar leads. It is revealed that the EEG of elderly people differ in higher rates of spectral power in the range delta (р < 0,01) and a theta - (р < 0,05) rhythms, especially in frontal areas in aging. By results of the comparative analysis it is noted that elderly people 60-64 aged differ in higher values of spectral power alfa-2 range in the left frontal and central areas (р < 0,05) and also higher values beta-1 range in frontal and parieto-occipital areas (р < 0,05). Study of a brain constant potential level distribution revealed increase of total energy consumption on the main areas of a brain. In frontal leads we registered the lowest values of constant potential level. Perhaps it indicates decrease in an energy metabolism in this area and difficulties of executive functions. The comparative analysis of a potential difference on the main assignments testifies to unevenness of a lateralization of a brain functions at elderly people. The results of a potential difference between right and left hemispheres testify to prevalence of the left hemisphere activity. Thus, higher rates of functional activity of a cerebral cortex are peculiar to people of early advanced age (60-64 years) that points to higher reserve opportunities of central nervous system. By 70 years there are age changes of a cerebral power exchange and level of electrogenesis of a brain which reflect deterioration of a condition of homeostatic mechanisms of self-control and the program of processing of the perceptual data current flow.

Keywords: brain, DC-potential level, EEG, elderly people

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89 Formation of Self Help Groups (SHGs) Protected Human Rights and Ensured Human Security of Female Sex Workers at Brothel in Bangladesh

Authors: Md. Nurul Alom Siddikqe

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The purpose of this intervention was to describe how the marginalized people protect their rights and increase their self-dignity and self-esteem among brothel-based sex workers in 6 cities which are the victim of trafficked who came from different periphery areas Bangladesh. Eventually the sex workers are tortured by the pimp, clients, Msahi (so called guardian of bonded sex workers), Babu (So called husband) highly discriminated, vulnerable and stigmatized due to their occupation, movement, behavior and activities, which has got social disapproval. However, stigma, discrimination and violation of human rights not only bar them to access legal services, education of their kids, health, movement of outside of brothel, deprived of funeral after death, but also make them inaccessible due to their invisibility. Conducted an assessment among brothel-based sex workers setup to know their knowledge on human rights and find out their harassment and violence in their community. Inspired them to think about to be united and also assisted them to formation of self help group (SHG). Developed capacity of the SHG and developed leadership of its members through different trainings like administrative, financial management, public speaking and resource mobilization. Developed strategy to enhance the capacity of SHG so that they can collectively claim their rights and develop strategic partnership and network with the relevant service provider’s for restoring all sorts of rights. Conducted meeting with stakeholder including duty bearers, civil society organizations, media people and local government initiatives. Developed Networking with human rights commission, local elite, religious leaders and form human right watch committees at community level. Organized rally and observed national and international days along with government counterparts. By utilizing the project resources the members of SHG became capable to raise their collective voices against violence, discrimination and stigma as well as protected them from insecurity. The members of SHG have been participating in social program/event the SHG got membership of district level NGO coordination meeting through invitation from Deputy Commissioner, Civil Surgeon and Social welfare office of Government of Bangladesh. The Law Enforcement Agency is ensuring safety and security and the education department of government enrolled their children in primary level education. The Government provided land for grave yard after death for the Muslim sex workers and same for the other religious group. The SHGs are registered with government respective authorities. The SHGs are working with support from different development partners and implementing different projects sometime as consortium leaders. Opportunity created to take the vocational training from the government reputed department. The harassment by the clients reduced remarkably, babu, Mashi and other counterparts recognized the sex workers rights and ensure security with government counterpart access increased in legal, health and education. Indications are that the brothel based sex workers understood about their rights and became capable of ensuring their security through working under the self-help groups meaningfully.

Keywords: brothel, discrimination, harassment, stigma

Procedia PDF Downloads 333
88 Perception of Health Care Providers on the Use of Modern Contraception by Adolescents in Rwanda

Authors: Jocelyne Uwibambe, Ange Thaina Ndizeye, Dinah Ishimwe, Emmanuel Mugabo Byakagaba

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Background: In low- and middle-income countries (LMICs), the use of modern contraceptive methods among women, including adolescents, is still low despite the desire to avoid pregnancy. In addition, countries have set a minimum age for marriage, which is 21 years for most countries, including Rwanda. The Rwandan culture, to a certain extent, and religion, to a greater extent, however, limit the freedom of young women to use contraceptive services because it is wrongly perceived as an encouragement for premarital sexual intercourse. In the end, what doesn’t change is that denying access to contraceptives to either male or female adolescents does not translate into preventing them from sexual activities, hence leading to an ever-increasing number of unwanted pregnancies, possible STIs, HIV, Human Papilloma Virus, and subsequent unsafe abortion followed by avoidable expensive complications. The purpose of this study is to evaluate the perception of healthcare providers regarding contraceptive use among adolescents. Methodology: This was a qualitative study. Interviews were done with different healthcare providers, including doctors, nurses, midwives, and pharmacists, through focused group discussions and in-depth interviews, then the audio was transcribed, translated and thematic coding was done. Results: This study explored the perceptions of healthcare workers regarding the provision of modern contraception to adolescents in Rwanda. The findings revealed that while healthcare providers had a good understanding of family planning and contraception, they were hesitant to provide contraception to adolescents. Sociocultural beliefs played a significant role in shaping their attitudes, as many healthcare workers believed that providing contraception to adolescents would encourage promiscuous behavior and go against cultural norms. Religious beliefs also influenced their reluctance, with some healthcare providers considering premarital sex and contraception as sinful. Lack of knowledge among parents and adolescents themselves was identified as a contributing factor to unwanted pregnancies, as inaccurate information from peers and social media influenced risky sexual behavior. Conditional policies, such as the requirement for parental consent, further hindered adolescents' access to contraception. The study suggested several solutions, including comprehensive sexual and reproductive health education, involving multiple stakeholders, ensuring easy access to contraception, and involving adolescents in policymaking. Overall, this research highlights the need for addressing sociocultural beliefs, improving healthcare providers' knowledge, and revisiting policies to ensure adolescents' reproductive health rights are met in Rwanda. Conclusion: The study highlights the importance of enhancing healthcare provider training, expanding access to modern contraception, implementing community-based interventions, and strengthening policy and programmatic support for adolescent contraception. Addressing these challenges is crucial for improving the provision of family planning services to adolescents in Rwanda and achieving the Sustainable Development Goals related to sexual and reproductive health. Collaborative efforts involving various stakeholders and organizations can contribute to overcoming these barriers and promoting the well-being of adolescents in Rwanda.

Keywords: adolescent, health care providers, contraception, reproductive health

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87 Maternal Obesity in Nigeria: An Exploratory Study

Authors: Ojochenemi J. Onubi, Debbi Marais, Lorna Aucott, Friday Okonofua, Amudha Poobalan

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Background: Obesity is a worldwide epidemic with major health and economic consequences. Pregnancy is a trigger point for the development of obesity, and maternal obesity is associated with significant adverse effects in the mother and child. Nigeria is experiencing a double burden of under- and over-nutrition with rising levels of obesity particularly in women. However, there is scarcity of data on maternal obesity in Nigeria and other African countries. Aims and Objectives: This project aimed at identifying crucial components of potential interventions for maternal obesity in Nigeria. The objectives were to assess the prevalence, effects, and distribution of maternal obesity; knowledge, attitude and practice (KAP) of pregnant women and maternal healthcare providers; and identify existing interventions for maternal obesity in Nigeria. Methodology: A systematic review and meta-analysis were initially conducted to appraise the existing literature on maternal obesity in Africa. Following this, a quantitative questionnaire survey of the KAP of pregnant women and a qualitative interview study of the KAP of Health Care Workers (HCW) were conducted in seven secondary and tertiary hospitals across Nigeria. Quantitative data was analysed using SPSS statistical software, while thematic analysis was conducted for qualitative data. Results: Twenty-nine studies included in the systematic review showed significant prevalence, socio-demographic associations, and adverse effects of maternal obesity on labour, maternal, and child outcomes in Africa. The questionnaire survey of 435 mothers revealed a maternal obesity prevalence of 17.9% among mothers who registered for antenatal care in the first trimester. The mothers received nutrition information from different sources and had insufficient knowledge of their own weight category or recommended Gestational Weight Gain (GWG), causes, complications, and safe ways to manage maternal obesity. However, majority of the mothers were of the opinion that excess GWG is avoided in pregnancy and some practiced weight management (diet and exercise) during pregnancy. For the qualitative study, four main themes were identified: ‘Concerns about obesity in pregnancy’, ‘Barriers to care for obese pregnant women’, ‘Practice of care for obese pregnant women’, and ‘Improving care for obese pregnant women’. HCW expressed concerns about rising levels of maternal obesity, lack of guidelines for the management of obese pregnant women and worries about unintended consequences of antenatal interventions. ‘Barriers’ included lack of contact with obese women before pregnancy, late registration for antenatal care, and perceived maternal barriers such as socio-cultural beliefs of mothers and poverty. ‘Practice’ included anticipatory care and screening for possible complications, general nutrition education during antenatal care and interdisciplinary care for mothers with complications. HCW offered suggestions on improving care for obese women including timing, type, and settings of interventions; and the need for involvement of other stake holders in caring for obese pregnant women. Conclusions: Culturally adaptable/sensitive interventions should be developed for the management of obese pregnant women in Africa. Education and training of mothers and health care workers, and provision of guidelines are some of the components of potential interventions in Nigeria.

Keywords: Africa, maternal, obesity, pregnancy

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86 Scenario-Based Learning Using Virtual Optometrist Applications

Authors: J. S. M. Yang, G. E. T. Chua

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Diploma in Optometry (OPT) course is a three-year program offered by Ngee Ann Polytechnic (NP) to train students to provide primary eye care. Students are equipped with foundational conceptual knowledge and practical skills in the first three semesters before clinical modules in fourth to six semesters. In the clinical modules, students typically have difficulties in integrating the acquired knowledge and skills from the past semesters to perform general eye examinations on public patients at NP Optometry Centre (NPOC). To help the students overcome the challenge, a web-based game Virtual Optometrist (VO) was developed to help students apply their skills and knowledge through scenario-based learning. It consisted of two interfaces, Optical Practice Counter (OPC) and Optometric Consultation Room (OCR), to provide two simulated settings for authentic learning experiences. In OPC, students would recommend and provide appropriate frame and lens selection based on virtual patient’s case history. In OCR, students would diagnose and manage virtual patients with common ocular conditions. Simulated scenarios provided real-world clinical situations that required contextual application of integrated knowledge from relevant modules. The stages in OPC and OCR are of increasing complexity to align to expected students’ clinical competency as they progress to more senior semesters. This prevented gameplay fatigue as VO was used over the semesters to achieve different learning outcomes. Numerous feedback opportunities were provided to students based on their decisions to allow individualized learning to take place. The game-based learning element in VO was achieved through the scoreboard and leader board to enhance students' motivation to perform. Scores were based on the speed and accuracy of students’ responses to the questions posed in the simulated scenarios, preparing the students to perform accurately and effectively under time pressure in a realistic optometric environment. Learning analytics was generated in VO’s backend office based on students’ responses, offering real-time data on distinctive and observable learners’ behavior to monitor students’ engagement and learning progress. The backend office allowed versatility to add, edit, and delete scenarios for different intended learning outcomes. Likert Scale was used to measure students’ learning experience with VO for OPT Year 2 and 3 students. The survey results highlighted the learning benefits of implementing VO in the different modules, such as enhancing recall and reinforcement of clinical knowledge for contextual application to develop higher-order thinking skills, increasing efficiency in clinical decision-making, facilitating learning through immediate feedback and second attempts, providing exposure to common and significant ocular conditions, and training effective communication skills. The results showed that VO has been useful in reinforcing optometry students’ learning and supporting the development of higher-order thinking, increasing efficiency in clinical decision-making, and allowing students to learn from their mistakes with immediate feedback and second attempts. VO also exposed the students to diverse ocular conditions through simulated real-world clinical scenarios, which may otherwise not be encountered in NPOC, and promoted effective communication skills.

Keywords: authentic learning, game-based learning, scenario-based learning, simulated clinical scenarios

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85 Providing Leadership in Nigerian University Education Research Enterprise: The Imperative of Research Ethics

Authors: O. O. Oku, K. S. Jerry-Alagbaoso

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It is universally acknowledged that the primary function of universities is the generation and dissemination of knowledge. This mission is pursued through the research component of the university programme especially at the post-graduate level. The senior academic staff teach, supervise and provide general academic leadership to post-graduate students who are expected to carry out research leading to the presentation of dissertation as requirement for the award of doctoral degree in their various disciplines. Carrying out the research enterprises involves a lot of corroboration among individuals and communities. The need to safeguard the interest of everyone involved in the enterprise makes the development of ethical standard in research imperative. Ensuring the development and effective application of such ethical standard falls within the leadership role of the vice –chancellors, Deans of post-graduate schools/ faculties, Heads of Departments and supervisors. It is the relevance and application of such ethical standard in Nigerian university research efforts that this study discussed. The study adopted the descriptive research design. A researcher-made 4 point rating scale was used to elicit information from the post-graduate dissertation supervisors sampled from one university each from the six geo-political zones in Nigeria using the purposive sampling technique. The data collected was analysed using the mean score and standard deviation. The findings of the study include among others that there are several cases of unethical practices by Ph.D dissertation students in Nigerian universities. Prominent among these include duplicating research topics, making unauthorized copies of data paper or computer programme, failing to acknowledge contributions of relevant people and authors, rigging an experiment to prempt the result among others. Some of the causes of the unethical practices according to the respondents include inadequate funding of universities resulting in inadequate remuneration for university teachers, inadequacy of equipment and infrastructures, poor supervision of Ph.D students,’ poverty on the side of the student researchers and non-application of sanctions on violators. Improved funding of the Nigerian universities system with emphasis on both staff and student research efforts, admitting academic oriented students into the Ph.D programme and ensuring the application of appropriate sanctions in cases of unethical conduct in research featured prominently in the needed leadership imperatives. Based on the findings of the study, the researchers recommend the development of university research policies that is closely tied to each university’s strategic plan. Such plan should explain the research focus that will attract more funding and direct students interest towards it without violating the principle of academic freedom. The plan should also incorporate the establishment of a research administration office to provide the necessary link between the students and funding agencies and also organise training for supervisors on leadership activities expected of them while educating students on the processes involved in carrying out a qualitative and acceptable research study. Such exercise should include the ethical principles and guidelines that comprise all parts of research from research topic through the literature review to the design and the truthful reporting of results.

Keywords: academic leadership, ethical standards, research stakeholders, research enterprise

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84 A Vision-Based Early Warning System to Prevent Elephant-Train Collisions

Authors: Shanaka Gunasekara, Maleen Jayasuriya, Nalin Harischandra, Lilantha Samaranayake, Gamini Dissanayake

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One serious facet of the worsening Human-Elephant conflict (HEC) in nations such as Sri Lanka involves elephant-train collisions. Endangered Asian elephants are maimed or killed during such accidents, which also often result in orphaned or disabled elephants, contributing to the phenomenon of lone elephants. These lone elephants are found to be more likely to attack villages and showcase aggressive behaviour, which further exacerbates the overall HEC. Furthermore, Railway Services incur significant financial losses and disruptions to services annually due to such accidents. Most elephant-train collisions occur due to a lack of adequate reaction time. This is due to the significant stopping distance requirements of trains, as the full braking force needs to be avoided to minimise the risk of derailment. Thus, poor driver visibility at sharp turns, nighttime operation, and poor weather conditions are often contributing factors to this problem. Initial investigations also indicate that most collisions occur in localised “hotspots” where elephant pathways/corridors intersect with railway tracks that border grazing land and watering holes. Taking these factors into consideration, this work proposes the leveraging of recent developments in Convolutional Neural Network (CNN) technology to detect elephants using an RGB/infrared capable camera around known hotspots along the railway track. The CNN was trained using a curated dataset of elephants collected on field visits to elephant sanctuaries and wildlife parks in Sri Lanka. With this vision-based detection system at its core, a prototype unit of an early warning system was designed and tested. This weatherised and waterproofed unit consists of a Reolink security camera which provides a wide field of view and range, an Nvidia Jetson Xavier computing unit, a rechargeable battery, and a solar panel for self-sufficient functioning. The prototype unit was designed to be a low-cost, low-power and small footprint device that can be mounted on infrastructures such as poles or trees. If an elephant is detected, an early warning message is communicated to the train driver using the GSM network. A mobile app for this purpose was also designed to ensure that the warning is clearly communicated. A centralized control station manages and communicates all information through the train station network to ensure coordination among important stakeholders. Initial results indicate that detection accuracy is sufficient under varying lighting situations, provided comprehensive training datasets that represent a wide range of challenging conditions are available. The overall hardware prototype was shown to be robust and reliable. We envision a network of such units may help contribute to reducing the problem of elephant-train collisions and has the potential to act as an important surveillance mechanism in dealing with the broader issue of human-elephant conflicts.

Keywords: computer vision, deep learning, human-elephant conflict, wildlife early warning technology

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83 Lessons Learnt from Industry: Achieving Net Gain Outcomes for Biodiversity

Authors: Julia Baker

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Development plays a major role in stopping biodiversity loss. But the ‘silo species’ protection of legislation (where certain species are protected while many are not) means that development can be ‘legally compliant’ and result in biodiversity loss. ‘Net Gain’ (NG) policies can help overcome this by making it an absolute requirement that development causes no overall loss of biodiversity and brings a benefit. However, offsetting biodiversity losses in one location with gains elsewhere is controversial because people suspect ‘offsetting’ to be an easy way for developers to buy their way out of conservation requirements. Yet the good practice principles (GPP) of offsetting provide several advantages over existing legislation for protecting biodiversity from development. This presentation describes the learning from implementing NG approaches based on GPP. It regards major upgrades of the UK’s transport networks, which involved removing vegetation in order to construct and safely operate new infrastructure. While low-lying habitats were retained, trees and other habitats disrupting the running or safety of transport networks could not. Consequently, achieving NG within the transport corridor was not possible and offsetting was required. The first ‘lessons learnt’ were on obtaining a commitment from business leaders to go beyond legislative requirements and deliver NG, and on the institutional change necessary to embed GPP within daily operations. These issues can only be addressed when the challenges that biodiversity poses for business are overcome. These challenges included: biodiversity cannot be measured easily unlike other sustainability factors like carbon and water that have metrics for target-setting and measuring progress; and, the mindset that biodiversity costs money and does not generate cash in return, which is the opposite of carbon or waste for example, where people can see how ‘sustainability’ actions save money. The challenges were overcome by presenting the GPP of NG as a cost-efficient solution to specific, critical risks facing the business that also boost industry recognition, and by using government-issued NG metrics to develop business-specific toolkits charting their NG progress whilst ensuring that NG decision-making was based on rich ecological data. An institutional change was best achieved by supporting, mentoring and training sustainability/environmental managers for these ‘frontline’ staff to embed GPP within the business. The second learning was from implementing the GPP where business partnered with local governments, wildlife groups and land owners to support their priorities for nature conservation, and where these partners had a say in decisions about where and how best to achieve NG. From this inclusive approach, offsetting contributed towards conservation priorities when all collaborated to manage trade-offs between: -Delivering ecologically equivalent offsets or compensating for losses of one type of biodiversity by providing another. -Achieving NG locally to the development whilst contributing towards national conservation priorities through landscape-level planning. -Not just protecting the extent and condition of existing biodiversity but ‘doing more’. -The multi-sector collaborations identified practical, workable solutions to ‘in perpetuity’. But key was strengthening linkages between biodiversity measures implemented for development and conservation work undertaken by local organizations so that developers support NG initiatives that really count.

Keywords: biodiversity offsetting, development, nature conservation planning, net gain

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82 A Randomised Simulation Study to Assess the Impact of a Focussed Crew Resource Management Course on UK Medical Students

Authors: S. MacDougall-Davis, S. Wysling, R. Willmore

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Background: The application of good non-technical skills, also known as crew resource management (CRM), is central to the delivery of safe, effective healthcare. The authors have been running remote trauma courses for over 10 years, primarily focussing on developing participants’ CRM in time-critical, high-stress clinical situations. The course has undergone an iterative process over the past 10 years. We employ a number of experiential learning techniques for improving CRM, including small group workshops, military command tasks, high fidelity simulations with reflective debriefs, and a ‘flipped classroom’, where participants are asked to create their own simulations and assess and debrief their colleagues’ CRM. We created a randomised simulation study to assess the impact of our course on UK medical students’ CRM, both at an individual and a teams level. Methods: Sixteen students took part. Four clinical scenarios were devised, designed to be of similar urgency and complexity. Professional moulage effects and experienced clinical actors were used to increase fidelity and to further simulate high-stress environments. Participants were block randomised into teams of 4; each team was randomly assigned to one pre-course simulation. They then underwent our 5 day remote trauma CRM course. Post-course, students were re-randomised into four new teams; each was randomly assigned to a post-course simulation. All simulations were videoed. The footage was reviewed by two independent CRM-trained assessors, who were blinded to the before/after the status of the simulations. Assessors used the internationally validated team emergency assessment measure (TEAM) to evaluate key areas of team performance, as well as a global outcome rating. Prior to the study, assessors had scored two unrelated scenarios using the same assessment tool, demonstrating 89% concordance. Participants also completed pre- and post-course questionnaires. Likert scales were used to rate individuals’ perceived NTS ability and their confidence to work in a team in time-critical, high-stress situations. Results: Following participation in the course, a significant improvement in CRM was observed in all areas of team performance. Furthermore, the global outcome rating for team performance was markedly improved (40-70%; mean 55%), thus demonstrating an impact at Level 4 of Kirkpatrick’s hierarchy. At an individual level, participants’ self-perceived CRM improved markedly after the course (35-70% absolute improvement; mean 55%), as did their confidence to work in a team in high-stress situations. Conclusion: Our study demonstrates that with a short, cost-effective course, using easily reproducible teaching sessions, it is possible to significantly improve participants’ CRM skills, both at an individual and, perhaps more importantly, at a teams level. The successful functioning of multi-disciplinary teams is vital in a healthcare setting, particularly in high-stress, time-critical situations. Good CRM is of paramount importance in these scenarios. The authors believe that these concepts should be introduced from the earliest stages of medical education, thus promoting a culture of effective CRM and embedding an early appreciation of the importance of these skills in enabling safe and effective healthcare.

Keywords: crew resource management, non-technical skills, training, simulation

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81 'Go Baby Go'; Community-Based Integrated Early Childhood and Maternal Child Health Model Improving Early Childhood Stimulation, Care Practices and Developmental Outcomes in Armenia: A Quasi-Experimental Study

Authors: Viktorya Sargsyan, Arax Hovhannesyan, Karine Abelyan

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Introduction: During the last decade, scientific studies have proven the importance of Early Childhood Development (ECD) interventions. These interventions are shown to create strong foundations for children’s intellectual, emotional and physical well-being, as well as the impact they have on learning and economic outcomes for children as they mature into adulthood. Many children in rural Armenia fail to reach their full development potential due to lack of early brain stimulation (playing, singing, reading, etc.) from their parents, and lack of community tools and services to follow-up children’s neurocognitive development. This is exacerbated by high rates of stunting and anemia among children under 3(CU3). This research study tested the effectiveness of an integrated ECD and Maternal, Newborn and Childhood Health (MNCH) model, called “Go Baby, Go!” (GBG), against the traditional (MNCH) strategy which focuses solely on preventive health and nutrition interventions. The hypothesis of this quasi-experimental study was: Children exposed to GBG will have better neurocognitive and nutrition outcomes compared to those receiving only the MNCH intervention. The secondary objective was to assess the effect of GBG on parental child care and nutrition practices. Methodology: The 14 month long study, targeted all 1,300 children aged 0 to 23 months, living in 43 study communities the in Gavar and Vardenis regions (Gegharkunik province, Armenia). Twenty-three intervention communities, 680 children, received GBG, and 20 control communities, 630 children, received MCHN interventions only. Baseline and evaluation data on child development, nutrition status and parental child care and nutrition practices were collected (caregiver interview, direct child assessment). In the intervention sites, in addition to MNCH (maternity schools, supportive supervision for Health Care Providers (HCP), the trained GBG facilitators conducted six interactive group sessions for mothers (key messages, information, group discussions, role playing, video-watching, toys/books preparation, according to GBG curriculum), and two sessions (condensed GBG) for adult family members (husbands, grandmothers). The trained HCPs received quality supervision for ECD counseling and screening. Findings: The GBG model proved to be effective in improving ECD outcomes. Children in the intervention sites had 83% higher odd of total ECD composite score (cognitive, language, motor) compared to children in the control sites (aOR 1.83; 95 percent CI: 1.08-3.09; p=0.025). Caregivers also demonstrated better child care and nutrition practices (minimum dietary diversity in intervention site is 55 percent higher compared to control (aOR=1.55, 95 percent CI 1.10-2.19, p =0.013); support for learning and disciplining practices (aOR=2.22, 95 percent CI 1.19-4.16, p=0.012)). However, there was no evidence of stunting reduction in either study arm. he effect of the integrated model was more prominent in Vardenis, a community which is characterised by high food insecurity and limited knowledge of positive parenting skills. Conclusion: The GBG model is effective and could be applied in target areas with the greatest economic disadvantages and parenting challenges to improve ECD, care practices and developmental outcomes. Longitudinal studies are needed to view the long-term effects of GBG on learning and school readiness.

Keywords: early childhood development, integrated interventions, parental practices, quasi-experimental study

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80 Concept Mapping to Reach Consensus on an Antibiotic Smart Use Strategy Model to Promote and Support Appropriate Antibiotic Prescribing in a Hospital, Thailand

Authors: Phenphak Horadee, Rodchares Hanrinth, Saithip Suttiruksa

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Inappropriate use of antibiotics has happened in several hospitals, Thailand. Drug use evaluation (DUE) is one strategy to overcome this difficulty. However, most community hospitals still encounter incomplete evaluation resulting overuse of antibiotics with high cost. Consequently, drug-resistant bacteria have been rising due to inappropriate antibiotic use. The aim of this study was to involve stakeholders in conceptualizing, developing, and prioritizing a feasible intervention strategy to promote and support appropriate antibiotic prescribing in a community hospital, Thailand. Study antibiotics included four antibiotics such as Meropenem, Piperacillin/tazobactam, Amoxicillin/clavulanic acid, and Vancomycin. The study was conducted for the 1-year period between March 1, 2018, and March 31, 2019, in a community hospital in the northeastern part of Thailand. Concept mapping was used in a purposive sample, including doctors (one was an administrator), pharmacists, and nurses who involving drug use evaluation of antibiotics. In-depth interviews for each participant and survey research were conducted to seek the problems for inappropriate use of antibiotics based on drug use evaluation system. Seventy-seven percent of DUE reported appropriate antibiotic prescribing, which still did not reach the goal of 80 percent appropriateness. Meropenem led other antibiotics for inappropriate prescribing. The causes of the unsuccessful DUE program were classified into three themes such as personnel, lack of public relation and communication, and unsupported policy and impractical regulations. During the first meeting, stakeholders (n = 21) expressed the generation of interventions. During the second meeting, participants who were almost the same group of people in the first meeting (n = 21) were requested to independently rate the feasibility and importance of each idea and to categorize them into relevant clusters to facilitate multidimensional scaling and hierarchical cluster analysis. The outputs of analysis included the idealist, cluster list, point map, point rating map, cluster map, and cluster rating map. All of these were distributed to participants (n = 21) during the third meeting to reach consensus on an intervention model. The final proposed intervention strategy included 29 feasible and crucial interventions in seven clusters: development of information technology system, establishing policy and taking it into the action plan, proactive public relations of the policy, action plan and workflow, in cooperation of multidisciplinary teams in drug use evaluation, work review and evaluation with performance reporting, promoting and developing professional and clinical skill for staff with training programs, and developing practical drug use evaluation guideline for antibiotics. These interventions are relevant and fit to several intervention strategies for antibiotic stewardship program in many international organizations such as participation of the multidisciplinary team, developing information technology to support antibiotic smart use, and communication. These interventions were prioritized for implementation over a 1-year period. Once the possibility of each activity or plan is set up, the proposed program could be applied and integrated into hospital policy after evaluating plans. Effectiveness of each intervention could be promoted to other community hospitals to promote and support antibiotic smart use.

Keywords: antibiotic, concept mapping, drug use evaluation, multidisciplinary teams

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79 Improving Junior Doctor Induction Through the Use of Simple In-House Mobile Application

Authors: Dmitriy Chernov, Maria Karavassilis, Suhyoun Youn, Amna Izhar, Devasenan Devendra

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Introduction and Background: A well-structured and comprehensive departmental induction improves patient safety and job satisfaction amongst doctors. The aims of our Project were as follows: 1. Assess the perceived preparedness of junior doctors starting their rotation in Acute Medicine at Watford General Hospital. 2. Develop a supplemental Induction Guide and Pocket reference in the form of an iOS mobile application. 3. To collect feedback after implementing the mobile application following a trial period of 8 weeks with a small cohort of junior doctors. Materials and Methods: A questionnaire was distributed to all new junior trainees starting in the department of Acute Medicine to assess their experience of current induction. A mobile Induction application was developed and trialled over a period of 8 weeks, distributed in addition to the existing didactic induction session. After the trial period, the same questionnaire was distributed to assess improvement in induction experience. Analytics data were collected with users’ consent to gauge user engagement and identify areas of improvement of the application. A feedback survey about the app was also distributed. Results: A total of 32 doctors used the application during the 8-week trial period. The application was accessed 7259 times in total, with the average user spending a cumulative of 37 minutes 22 seconds on the app. The most used section was Clinical Guidelines, accessed 1490 times. The App Feedback survey revealed positive reviews: 100% of participants (n=15/15) responded that the app improved their overall induction experience compared to other placements; 93% (n=14/15) responded that the app improved overall efficiency in completing daily ward jobs compared to previous rotations; and 93% (n=14/15) responded that the app improved patient safety overall. In the Pre-App and Post-App Induction Surveys, participants reported: a 48% improvement in awareness of practical aspects of the job; a 26% improvement of awareness on locating pathways and clinical guidelines; a 40% reduction of feelings of overwhelmingness. Conclusions and recommendations: This study demonstrates the importance of technology in Medical Education and Clinical Induction. The mobile application average engagement time equates to over 20 cumulative hours of on-the-job training delivered to each user, within an 8-week period. The most used and referred to section was clinical guidelines. This shows that there is high demand for an accessible pocket guide for this type of material. This simple mobile application resulted in a significant improvement in feedback about induction in our Department of Acute Medicine, and will likely impact workplace satisfaction. Limitations of the application include: post-app surveys had a small number of participants; the app is currently only available for iPhone users; some useful sections are nested deep within the app, lacks deep search functionality across all sections; lacks real time user feedback; and requires regular review and updates. Future steps for the app include: developing a web app, with an admin dashboard to simplify uploading and editing content; a comprehensive search functionality; and a user feedback and peer ratings system.

Keywords: mobile app, doctor induction, medical education, acute medicine

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78 Organisational Mindfulness Case Study: A 6-Week Corporate Mindfulness Programme Significantly Enhances Organisational Well-Being

Authors: Dana Zelicha

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A 6-week mindfulness programme was launched to improve the well being and performance of 20 managers (including the supervisor) of an international corporation in London. A unique assessment methodology was customised to the organisation’s needs, measuring four parameters: prioritising skills, listening skills, mindfulness levels and happiness levels. All parameters showed significant improvements (p < 0.01) post intervention, with a remarkable increase in listening skills and mindfulness levels. Although corporate mindfulness programmes have proven to be effective, the challenge remains the low engagement levels at home and the implementation of these tools beyond the scope of the intervention. This study has offered an innovative approach to enforce home engagement levels, which yielded promising results. The programme launched with a 2-day introduction intervention, which was followed by a 6-week training course (1 day a week; 2 hours each). Participants learned all basic principles of mindfulness such as mindfulness meditations, Mindfulness Based Stress Reduction (MBSR) techniques and Mindfulness Based Cognitive Therapy (MBCT) practices to incorporate into their professional and personal lives. The programme contained experiential mindfulness meditations and innovative mindfulness tools (OWBA-MT) created by OWBA - The Well Being Agency. Exercises included Mindful Meetings, Unitasking and Mindful Feedback. All sessions concluded with guided discussions and group reflections. One fundamental element of this programme was engagement level outside of the workshop. In the office, participants connected with a mindfulness buddy - a team member in the group with whom they could find support throughout the programme. At home, participants completed online daily mindfulness forms that varied according to weekly themes. These customised forms gave participants the opportunity to reflect on whether they made time for daily mindfulness practice, and to facilitate a sense of continuity and responsibility. At the end of the programme, the most engaged team member was crowned the ‘mindful maven’ and received a special gift. The four parameters were measured using online self-reported questionnaires, including the Listening Skills Inventory (LSI), Mindfulness Attention Awareness Scale (MAAS), Time Management Behaviour Scale (TMBS) and a modified version of the Oxford Happiness Questionnaire (OHQ). Pre-intervention questionnaires were collected at the start of the programme, and post-intervention data was collected 4-weeks following completion. Quantitative analysis using paired T-tests of means showed significant improvements, with a 23% increase in listening skills, a 22% improvement in mindfulness levels, a 12% increase in prioritising skills, and an 11% improvement in happiness levels. Participant testimonials exhibited high levels of satisfaction and the overall results indicate that the mindfulness programme substantially impacted the team. These results suggest that 6-week mindfulness programmes can improve employees’ capacities to listen and work well with others, to effectively manage time and to experience enhanced satisfaction both at work and in life. Limitations noteworthy to consider include the afterglow effect and lack of generalisability, as this study was conducted on a small and fairly homogenous sample.

Keywords: corporate mindfulness, listening skills, organisational well being, prioritising skills, mindful leadership

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77 Transformers in Gene Expression-Based Classification

Authors: Babak Forouraghi

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A genetic circuit is a collection of interacting genes and proteins that enable individual cells to implement and perform vital biological functions such as cell division, growth, death, and signaling. In cell engineering, synthetic gene circuits are engineered networks of genes specifically designed to implement functionalities that are not evolved by nature. These engineered networks enable scientists to tackle complex problems such as engineering cells to produce therapeutics within the patient's body, altering T cells to target cancer-related antigens for treatment, improving antibody production using engineered cells, tissue engineering, and production of genetically modified plants and livestock. Construction of computational models to realize genetic circuits is an especially challenging task since it requires the discovery of flow of genetic information in complex biological systems. Building synthetic biological models is also a time-consuming process with relatively low prediction accuracy for highly complex genetic circuits. The primary goal of this study was to investigate the utility of a pre-trained bidirectional encoder transformer that can accurately predict gene expressions in genetic circuit designs. The main reason behind using transformers is their innate ability (attention mechanism) to take account of the semantic context present in long DNA chains that are heavily dependent on spatial representation of their constituent genes. Previous approaches to gene circuit design, such as CNN and RNN architectures, are unable to capture semantic dependencies in long contexts as required in most real-world applications of synthetic biology. For instance, RNN models (LSTM, GRU), although able to learn long-term dependencies, greatly suffer from vanishing gradient and low-efficiency problem when they sequentially process past states and compresses contextual information into a bottleneck with long input sequences. In other words, these architectures are not equipped with the necessary attention mechanisms to follow a long chain of genes with thousands of tokens. To address the above-mentioned limitations of previous approaches, a transformer model was built in this work as a variation to the existing DNA Bidirectional Encoder Representations from Transformers (DNABERT) model. It is shown that the proposed transformer is capable of capturing contextual information from long input sequences with attention mechanism. In a previous work on genetic circuit design, the traditional approaches to classification and regression, such as Random Forrest, Support Vector Machine, and Artificial Neural Networks, were able to achieve reasonably high R2 accuracy levels of 0.95 to 0.97. However, the transformer model utilized in this work with its attention-based mechanism, was able to achieve a perfect accuracy level of 100%. Further, it is demonstrated that the efficiency of the transformer-based gene expression classifier is not dependent on presence of large amounts of training examples, which may be difficult to compile in many real-world gene circuit designs.

Keywords: transformers, generative ai, gene expression design, classification

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76 Deep Learning for SAR Images Restoration

Authors: Hossein Aghababaei, Sergio Vitale, Giampaolo Ferraioli

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In the context of Synthetic Aperture Radar (SAR) data, polarization is an important source of information for Earth's surface monitoring. SAR Systems are often considered to transmit only one polarization. This constraint leads to either single or dual polarimetric SAR imaging modalities. Single polarimetric systems operate with a fixed single polarization of both transmitted and received electromagnetic (EM) waves, resulting in a single acquisition channel. Dual polarimetric systems, on the other hand, transmit in one fixed polarization and receive in two orthogonal polarizations, resulting in two acquisition channels. Dual polarimetric systems are obviously more informative than single polarimetric systems and are increasingly being used for a variety of remote sensing applications. In dual polarimetric systems, the choice of polarizations for the transmitter and the receiver is open. The choice of circular transmit polarization and coherent dual linear receive polarizations forms a special dual polarimetric system called hybrid polarimetry, which brings the properties of rotational invariance to geometrical orientations of features in the scene and optimizes the design of the radar in terms of reliability, mass, and power constraints. The complete characterization of target scattering, however, requires fully polarimetric data, which can be acquired with systems that transmit two orthogonal polarizations. This adds further complexity to data acquisition and shortens the coverage area or swath of fully polarimetric images compared to the swath of dual or hybrid polarimetric images. The search for solutions to augment dual polarimetric data to full polarimetric data will therefore take advantage of full characterization and exploitation of the backscattered field over a wider coverage with less system complexity. Several methods for reconstructing fully polarimetric images using hybrid polarimetric data can be found in the literature. Although the improvements achieved by the newly investigated and experimented reconstruction techniques are undeniable, the existing methods are, however, mostly based upon model assumptions (especially the assumption of reflectance symmetry), which may limit their reliability and applicability to vegetation and forest scenarios. To overcome the problems of these techniques, this paper proposes a new framework for reconstructing fully polarimetric information from hybrid polarimetric data. The framework uses Deep Learning solutions to augment hybrid polarimetric data without relying on model assumptions. A convolutional neural network (CNN) with a specific architecture and loss function is defined for this augmentation problem by focusing on different scattering properties of the polarimetric data. In particular, the method controls the CNN training process with respect to several characteristic features of polarimetric images defined by the combination of different terms in the cost or loss function. The proposed method is experimentally validated with real data sets and compared with a well-known and standard approach from the literature. From the experiments, the reconstruction performance of the proposed framework is superior to conventional reconstruction methods. The pseudo fully polarimetric data reconstructed by the proposed method also agree well with the actual fully polarimetric images acquired by radar systems, confirming the reliability and efficiency of the proposed method.

Keywords: SAR image, polarimetric SAR image, convolutional neural network, deep learnig, deep neural network

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75 The Ecuador Healthy Food Environment Policy Index (Food-EPI)

Authors: Samuel Escandón, María J. Peñaherrera-Vélez, Signe Vargas-Rosvik, Carlos Jerves Córdova, Ximena Vélez-Calvo, Angélica Ochoa-Avilés

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Overweight and obesity are considered risk factors in childhood for developing nutrition-related non-communicable diseases (NCDs), such as diabetes, cardiovascular diseases, and cancer. In Ecuador, 35.4% of 5- to 11-year-olds and 29.6% of 12- to 19-year-olds are overweight or obese. Globally, unhealthy food environments characterized by high consumption of processed/ultra-processed food and rapid urbanization are highly related to the increasing nutrition-related non-communicable diseases. The evidence shows that in low- and middle-income countries (LMICs), fiscal policies and regulatory measures significantly reduce unhealthy food environments, achieving substantial advances in health. However, in some LMICs, little is known about the impact of governments' action to implement healthy food-environment policies. This study aimed to generate evidence on the state of implementation of public policy focused on food environments for the prevention of overweight and obesity in children and adolescents in Ecuador compared to global best practices and to target key recommendations for reinforcing the current strategies. After adapting the INFORMAS' Healthy Food Environment Policy Index (Food‐EPI) to the Ecuadorian context, the Policy and Infrastructure support components were assessed. Individual online interviews were performed using fifty-one indicators to analyze the level of implementation of policies directly or indirectly related to preventing overweight and obesity in children and adolescents compared to international best practices. Additionally, a participatory workshop was conducted to identify the critical indicators and generate recommendations to reinforce or improve the political action around them. In total, 17 government and non-government experts were consulted. From 51 assessed indicators, only the one corresponding to the nutritional information and ingredients labelling registered an implementation level higher than 60% (67%) compared to the best international practices. Among the 17 indicators determined as priorities by the participants, those corresponding to the provision of local products in school meals and the limitation of unhealthy-products promotion in traditional and digital media had the lowest level of implementation (34% and 11%, respectively) compared to global best practices. The participants identified more barriers (e.g., lack of continuity of effective policies across government administrations) than facilitators (e.g., growing interest from the Ministry of Environment because of the eating-behavior environmental impact) for Ecuador to move closer to the best international practices. Finally, within the participants' recommendations, we highlight the need for policy-evaluation systems, information transparency on the impact of the policies, transformation of successful strategies into laws or regulations to make them mandatory, and regulation of power and influence from the food industry (conflicts of interest). Actions focused on promoting a more active role of society in the stages of policy formation and achieving more articulated actions between the different government levels/institutions for implementing the policy are necessary to generate a noteworthy impact on preventing overweight and obesity in children and adolescents. Including systems for internal evaluation of existing strategies to strengthen successful actions, create policies to fill existing gaps and reform policies that do not generate significant impact should be a priority for the Ecuadorian government to improve the country's food environments.

Keywords: children and adolescents, food-EPI, food policies, healthy food environment

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74 Urban Sprawl: A Case Study of Suryapet Town in Nalgonda District of Telangana State, a Geoinformatic Approach

Authors: Ashok Kumar Lonavath, V. Sathish Kumar

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Urban sprawl is the uncontrolled and uncoordinated outgrowth of towns and cities. The process of urban sprawl can be described by change in pattern over time, like proportional increase in built-up surface to population leading to rapid urban spatial expansion. Significant economic and livelihood opportunities in the urban areas results in lack of basic amenities due to the unplanned growth The patterns, processes, dynamic causes and consequences of sprawl can be explored and designed with the help of spatial planning support system. In India context the urban area is defined as the population more than 5000, density more than 400 persons per sq. km and 75% of the population is involved in non-agricultural occupations. India’s urban population is increasing at the rate of 2.35% pa. The class I town’s population of India according to 2011 census is 18.8% that accounts for 60.4% of total unban population. Similarly in Erstwhile Andhra Pradesh it is 22.9% which accounts for 68.8% of total urban population. Suryapet town has historical recognition as ‘Gate Way of Telangana’ in the Indian State of Andhra Pradesh. The Municipality was constituted in 1952 as Grade-III, later upgraded into Grade-II in 1984 and to Grade-I in 1998. The area is 35 Sq.kms. Three major tanks located in three different directions and Musi River is flowing from a distance of 8 kms. The average ground water table is about 50m below ground. It is a fast growing town with a population of 1, 06,805 and 25,448 households. Density is 3051pp sq km, It is a Class I city as per population census. It secured the ISO 14001-2004 certificate for establishing and maintaining an environment-friendly system for solid waste disposal. It is the first municipality in the country to receive such a certificate. It won HUDCO award under environment management, award of appreciation and cash from Ministry of Housing and Poverty Elevation from Government of India and undivided Andhra Pradesh under UN Human Settlement Programme, Greentech Excellance award, Supreme Courts appreciation for solid waste management. Foreign delegates from different countries and also from various other states of India visited Suryapet municipality for study tour and training programs as part of their official visit Suryapet is located at 17°5’ North Latitude and 79°37’ East Longitude. The average elevation is 266m, annual mean temperature is 36°C and average rainfall is 821.0 mm. The people of this town are engaged in Commercial and agriculture activities hence the town has become a centre for marketing and stocking agricultural produce. It is also educational centre in this region. The present paper on urban sprawl is a theoretical framework to analyze the interaction of planning and governance on the extent of outgrowth and level of services. The GIS techniques, SOI Toposheet, satellite imageries and image analysis techniques are extensively used to explore the sprawl and measure the urban land-use. This paper concludes outlining the challenges in addressing urban sprawl while ensuring adequate level of services that planning and governance have to ensure towards achieving sustainable urbanization.

Keywords: remote sensing, GIS, urban sprawl, urbanization

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73 Kinematic Gait Analysis Is a Non-Invasive, More Objective and Earlier Measurement of Impairment in the Mdx Mouse Model of Duchenne Muscular Dystrophy

Authors: P. J. Sweeney, T. Ahtoniemi, J. Puoliväli, T. Laitinen, K. Lehtimäki, A. Nurmi, D. Wells

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Duchenne muscular dystrophy (DMD) is caused by an X linked mutation in the dystrophin gene; lack of dystrophin causes a progressive muscle necrosis which leads to a progressive decrease in mobility in those suffering from the disease. The MDX mouse, a mutant mouse model which displays a frank dystrophinopathy, is currently widely employed in pre clinical efficacy models for treatments and therapies aimed at DMD. In general the end-points examined within this model have been based on invasive histopathology of muscles and serum biochemical measures like measurement of serum creatine kinase (sCK). It is established that a “critical period” between 4 and 6 weeks exists in the MDX mouse when there is extensive muscle damage that is largely sub clinical but evident with sCK measurements and histopathological staining. However, a full characterization of the MDX model remains largely incomplete especially with respect to the ability to aggravate of the muscle damage beyond the critical period. The purpose of this study was to attempt to aggravate the muscle damage in the MDX mouse and to create a wider, more readily translatable and discernible, therapeutic window for the testing of potential therapies for DMD. The study consisted of subjecting 15 male mutant MDX mice and 15 male wild-type mice to an intense chronic exercise regime that consisted of bi-weekly (two times per week) treadmill sessions over a 12 month period. Each session was 30 minutes in duration and the treadmill speed was gradually built up to 14m/min for the entire session. Baseline plasma creatine kinase (pCK), treadmill training performance and locomotor activity were measured after the “critical period” at around 10 weeks of age and again at 14 weeks of age, 6 months, 9 months and 12 months of age. In addition, kinematic gait analysis was employed using a novel analysis algorithm in order to compare changes in gait and fine motor skills in diseased exercised MDX mice compared to exercised wild type mice and non exercised MDX mice. In addition, a morphological and metabolic profile (including lipid profile), from the muscles most severely affected, the gastrocnemius muscle and the tibialis anterior muscle, was also measured at the same time intervals. Results indicate that by aggravating or exacerbating the underlying muscle damage in the MDX mouse by exercise a more pronounced and severe phenotype in comes to light and this can be picked up earlier by kinematic gait analysis. A reduction in mobility as measured by open field is not apparent at younger ages nor during the critical period, but changes in gait are apparent in the mutant MDX mice. These gait changes coincide with pronounced morphological and metabolic changes by non-invasive anatomical MRI and proton spectroscopy (1H-MRS) we have reported elsewhere. Evidence of a progressive asymmetric pathology in imaging parameters as well as in the kinematic gait analysis was found. Taken together, the data show that chronic exercise regime exacerbates the muscle damage beyond the critical period and the ability to measure through non-invasive means are important factors to consider when performing preclinical efficacy studies in the MDX mouse.

Keywords: Gait, muscular dystrophy, Kinematic analysis, neuromuscular disease

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72 Deep Learning Based Polarimetric SAR Images Restoration

Authors: Hossein Aghababaei, Sergio Vitale, Giampaolo ferraioli

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In the context of Synthetic Aperture Radar (SAR) data, polarization is an important source of information for Earth's surface monitoring . SAR Systems are often considered to transmit only one polarization. This constraint leads to either single or dual polarimetric SAR imaging modalities. Single polarimetric systems operate with a fixed single polarization of both transmitted and received electromagnetic (EM) waves, resulting in a single acquisition channel. Dual polarimetric systems, on the other hand, transmit in one fixed polarization and receive in two orthogonal polarizations, resulting in two acquisition channels. Dual polarimetric systems are obviously more informative than single polarimetric systems and are increasingly being used for a variety of remote sensing applications. In dual polarimetric systems, the choice of polarizations for the transmitter and the receiver is open. The choice of circular transmit polarization and coherent dual linear receive polarizations forms a special dual polarimetric system called hybrid polarimetry, which brings the properties of rotational invariance to geometrical orientations of features in the scene and optimizes the design of the radar in terms of reliability, mass, and power constraints. The complete characterization of target scattering, however, requires fully polarimetric data, which can be acquired with systems that transmit two orthogonal polarizations. This adds further complexity to data acquisition and shortens the coverage area or swath of fully polarimetric images compared to the swath of dual or hybrid polarimetric images. The search for solutions to augment dual polarimetric data to full polarimetric data will therefore take advantage of full characterization and exploitation of the backscattered field over a wider coverage with less system complexity. Several methods for reconstructing fully polarimetric images using hybrid polarimetric data can be found in the literature. Although the improvements achieved by the newly investigated and experimented reconstruction techniques are undeniable, the existing methods are, however, mostly based upon model assumptions (especially the assumption of reflectance symmetry), which may limit their reliability and applicability to vegetation and forest scenarios. To overcome the problems of these techniques, this paper proposes a new framework for reconstructing fully polarimetric information from hybrid polarimetric data. The framework uses Deep Learning solutions to augment hybrid polarimetric data without relying on model assumptions. A convolutional neural network (CNN) with a specific architecture and loss function is defined for this augmentation problem by focusing on different scattering properties of the polarimetric data. In particular, the method controls the CNN training process with respect to several characteristic features of polarimetric images defined by the combination of different terms in the cost or loss function. The proposed method is experimentally validated with real data sets and compared with a well-known and standard approach from the literature. From the experiments, the reconstruction performance of the proposed framework is superior to conventional reconstruction methods. The pseudo fully polarimetric data reconstructed by the proposed method also agree well with the actual fully polarimetric images acquired by radar systems, confirming the reliability and efficiency of the proposed method.

Keywords: SAR image, deep learning, convolutional neural network, deep neural network, SAR polarimetry

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71 Human Identification and Detection of Suspicious Incidents Based on Outfit Colors: Image Processing Approach in CCTV Videos

Authors: Thilini M. Yatanwala

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CCTV (Closed-Circuit-Television) Surveillance System is being used in public places over decades and a large variety of data is being produced every moment. However, most of the CCTV data is stored in isolation without having integrity. As a result, identification of the behavior of suspicious people along with their location has become strenuous. This research was conducted to acquire more accurate and reliable timely information from the CCTV video records. The implemented system can identify human objects in public places based on outfit colors. Inter-process communication technologies were used to implement the CCTV camera network to track people in the premises. The research was conducted in three stages and in the first stage human objects were filtered from other movable objects available in public places. In the second stage people were uniquely identified based on their outfit colors and in the third stage an individual was continuously tracked in the CCTV network. A face detection algorithm was implemented using cascade classifier based on the training model to detect human objects. HAAR feature based two-dimensional convolution operator was introduced to identify features of the human face such as region of eyes, region of nose and bridge of the nose based on darkness and lightness of facial area. In the second stage outfit colors of human objects were analyzed by dividing the area into upper left, upper right, lower left, lower right of the body. Mean color, mod color and standard deviation of each area were extracted as crucial factors to uniquely identify human object using histogram based approach. Color based measurements were written in to XML files and separate directories were maintained to store XML files related to each camera according to time stamp. As the third stage of the approach, inter-process communication techniques were used to implement an acknowledgement based CCTV camera network to continuously track individuals in a network of cameras. Real time analysis of XML files generated in each camera can determine the path of individual to monitor full activity sequence. Higher efficiency was achieved by sending and receiving acknowledgments only among adjacent cameras. Suspicious incidents such as a person staying in a sensitive area for a longer period or a person disappeared from the camera coverage can be detected in this approach. The system was tested for 150 people with the accuracy level of 82%. However, this approach was unable to produce expected results in the presence of group of people wearing similar type of outfits. This approach can be applied to any existing camera network without changing the physical arrangement of CCTV cameras. The study of human identification and suspicious incident detection using outfit color analysis can achieve higher level of accuracy and the project will be continued by integrating motion and gait feature analysis techniques to derive more information from CCTV videos.

Keywords: CCTV surveillance, human detection and identification, image processing, inter-process communication, security, suspicious detection

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70 Construction Engineering and Cocoa Agriculture: A Synergistic Approach for Improved Livelihoods of Farmers

Authors: Felix Darko-Amoah, Daniel Acquah

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In contemporary ecosystems for developing countries like Ghana, the need to explore innovative solutions for sustainable livelihoods of farmers is more important than ever. With Ghana’s population growing steadily and the demand for food, fiber and shelter increasing, it is imperative that the construction industry and agriculture come together to address the challenges faced by farmers in the country. In order to enhance the livelihoods of cocoa farmers in Ghana, this paper provides an innovative strategy that aims to integrate the areas of civil engineering and cash crop agriculture. This study focuses on cocoa cultivation in poorer nations, where farmers confront a variety of difficulties include restricted access to financing, subpar infrastructure, and insufficient support services. We seek to improve farmers' access to financing, improve infrastructure, and provide support services that are essential to their success by combining the fields of building engineering and cocoa production. The findings of the study are beneficial to cocoa producers, community extension agents, and construction engineers. In order to accomplish our objectives, we conducted 307 of field investigations in particular cocoa growing communities in the Western Region of Ghana. Several studies have shown that there is a lack of adequate infrastructure and financing, leading to low yields, subpar beans, and low farmer profitability in developing nations like Ghana. Our goal is to give farmers access to better infrastructure, better financing, and support services that are crucial to their success through the fusion of construction engineering and cocoa production. Based on data gathered from the field investigations, the results show that the employment of appropriate technology and methods for developing structures, roads, and other infrastructure in rural regions is one of the essential components of this strategy. For instance, we find that using affordable, environmentally friendly materials like bamboo, rammed earth, and mud bricks can assist to cut expenditures while also protecting the environment. By applying simple relational techniques to the data gathered, the results also show that construction engineers are crucial in planning and building infrastructure that is appropriate for the local environment and circumstances and resilient to natural disasters like floods. Thus, the convergence of construction engineering and cash crop cultivation is another crucial component of the agriculture-construction interplay. For instance, farmers can receive financial assistance to buy essential inputs, such as seeds, fertilizer, and tools, as well as training in proper farming methods. Moreover, extension services can be offered to assist farmers in marketing their crops and enhancing their livelihoods and revenue. In conclusion, our analysis of responses from the 307 participants depicts that the combination of construction engineering and cash crop agriculture offers an innovative approach to improving farmers' livelihoods in cocoa farming communities in Ghana. In conclusion, by inculcating the findings of this study into core decision-making, policymakers can help farmers build sustainable and profitable livelihoods by addressing challenges such as limited access to financing, poor infrastructure, and inadequate support services.

Keywords: cocoa agriculture, construction engineering, farm buildings and equipment, improved livelihoods of farmers

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69 A Peg Board with Photo-Reflectors to Detect Peg Insertion and Pull-Out Moments

Authors: Hiroshi Kinoshita, Yasuto Nakanishi, Ryuhei Okuno, Toshio Higashi

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Various kinds of pegboards have been developed and used widely in research and clinics of rehabilitation for evaluation and training of patient’s hand function. A common measure in these peg boards is a total time of performance execution assessed by a tester’s stopwatch. Introduction of electrical and automatic measurement technology to the apparatus, on the other hand, has been delayed. The present work introduces the development of a pegboard with an electric sensor to detect moments of individual peg’s insertion and removal. The work also gives fundamental data obtained from a group of healthy young individuals who performed peg transfer tasks using the pegboard developed. Through trails and errors in pilot tests, two 10-hole peg-board boxes installed with a small photo-reflector and a DC amplifier at the bottom of each hole were designed and built by the present authors. The amplified electric analogue signals from the 20 reflectors were automatically digitized at 500 Hz per channel, and stored in a PC. The boxes were set on a test table at different distances (25, 50, 75, and 125 mm) in parallel to examine the effect of hole-to-hole distance. Fifty healthy young volunteers (25 in each gender) as subjects of the study performed successive fast 80 time peg transfers at each distance using their dominant and non-dominant hands. The data gathered showed a clear-cut light interruption/continuation moment by the pegs, allowing accurately (no tester’s error involved) and precisely (an order of milliseconds) to determine the pull out and insertion times of each peg. This further permitted computation of individual peg movement duration (PMD: from peg-lift-off to insertion) apart from hand reaching duration (HRD: from peg insertion to lift-off). An accidental drop of a peg led to an exceptionally long ( < mean + 3 SD) PMD, which was readily detected from an examination of data distribution. The PMD data were commonly right-skewed, suggesting that the median can be a better estimate of individual PMD than the mean. Repeated measures ANOVA using the median values revealed significant hole-to-hole distance, and hand dominance effects, suggesting that these need to be fixed in the accurate evaluation of PMD. The gender effect was non-significant. Performance consistency was also evaluated by the use of quartile variation coefficient values, which revealed no gender, hole-to-hole, and hand dominance effects. The measurement reliability was further examined using interclass correlation obtained from 14 subjects who performed the 25 and 125 mm hole distance tasks at two 7-10 days separate test sessions. Inter-class correlation values between the two tests showed fair reliability for PMD (0.65-0.75), and for HRD (0.77-0.94). We concluded that a sensor peg board developed in the present study could provide accurate (excluding tester’s errors), and precise (at a millisecond rate) time information of peg movement separated from that used for hand movement. It could also easily detect and automatically exclude erroneous execution data from his/her standard data. These would lead to a better evaluation of hand dexterity function compared to the widely used conventional used peg boards.

Keywords: hand, dexterity test, peg movement time, performance consistency

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68 Enhancing Seismic Resilience in Urban Environments

Authors: Beatriz González-rodrigo, Diego Hidalgo-leiva, Omar Flores, Claudia Germoso, Maribel Jiménez-martínez, Laura Navas-sánchez, Belén Orta, Nicola Tarque, Orlando Hernández- Rubio, Miguel Marchamalo, Juan Gregorio Rejas, Belén Benito-oterino

Abstract:

Cities facing seismic hazard necessitate detailed risk assessments for effective urban planning and vulnerability identification, ensuring the safety and sustainability of urban infrastructure. Comprehensive studies involving seismic hazard, vulnerability, and exposure evaluations are pivotal for estimating potential losses and guiding proactive measures against seismic events. However, broad-scale traditional risk studies limit consideration of specific local threats and identify vulnerable housing within a structural typology. Achieving precise results at neighbourhood levels demands higher resolution seismic hazard exposure, and vulnerability studies. This research aims to bolster sustainability and safety against seismic disasters in three Central American and Caribbean capitals. It integrates geospatial techniques and artificial intelligence into seismic risk studies, proposing cost-effective methods for exposure data collection and damage prediction. The methodology relies on prior seismic threat studies in pilot zones, utilizing existing exposure and vulnerability data in the region. Emphasizing detailed building attributes enables the consideration of behaviour modifiers affecting seismic response. The approach aims to generate detailed risk scenarios, facilitating prioritization of preventive actions pre-, during, and post-seismic events, enhancing decision-making certainty. Detailed risk scenarios necessitate substantial investment in fieldwork, training, research, and methodology development. Regional cooperation becomes crucial given similar seismic threats, urban planning, and construction systems among involved countries. The outcomes hold significance for emergency planning and national and regional construction regulations. The success of this methodology depends on cooperation, investment, and innovative approaches, offering insights and lessons applicable to regions facing moderate seismic threats with vulnerable constructions. Thus, this framework aims to fortify resilience in seismic-prone areas and serves as a reference for global urban planning and disaster management strategies. In conclusion, this research proposes a comprehensive framework for seismic risk assessment in high-risk urban areas, emphasizing detailed studies at finer resolutions for precise vulnerability evaluations. The approach integrates regional cooperation, geospatial technologies, and adaptive fragility curve adjustments to enhance risk assessment accuracy, guiding effective mitigation strategies and emergency management plans.

Keywords: assessment, behaviour modifiers, emergency management, mitigation strategies, resilience, vulnerability

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67 Advances and Challenges in Assessing Students’ Learning Competencies in 21st Century Higher Education

Authors: O. Zlatkin-Troitschanskaia, J. Fischer, C. Lautenbach, H. A. Pant

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In 21st century higher education (HE), the diversity among students has increased in recent years due to the internationalization and higher mobility. Offering and providing equal and fair opportunities based on students’ individual skills and abilities instead of their social or cultural background is one of the major aims of HE. In this context, valid, objective and transparent assessments of students’ preconditions and academic competencies in HE are required. However, as analyses of the current states of research and practice show, a substantial research gap on assessment practices in HE still exists, calling for the development of effective solutions. These demands lead to significant conceptual and methodological challenges. Funded by the German Federal Ministry of Education and Research, the research program 'Modeling and Measuring Competencies in Higher Education – Validation and Methodological Challenges' (KoKoHs) focusses on addressing these challenges in HE assessment practice by modeling and validating objective test instruments. Including 16 cross-university collaborative projects, the German-wide research program contributes to bridging the research gap in current assessment research and practice by concentrating on practical and policy-related challenges of assessment in HE. In this paper, we present a differentiated overview of existing assessments of HE at the national and international level. Based on the state of research, we describe the theoretical and conceptual framework of the KoKoHs Program as well as results of the validation studies, including their key outcomes. More precisely, this includes an insight into more than 40 developed assessments covering a broad range of transparent and objective methods for validly measuring domain-specific and generic knowledge and skills for five major study areas (Economics, Social Science, Teacher Education, Medicine and Psychology). Computer-, video- and simulation-based instruments have been applied and validated to measure over 20,000 students at the beginning, middle and end of their (bachelor and master) studies at more than 300 HE institutions throughout Germany or during their practical training phase, traineeship or occupation. Focussing on the validity of the assessments, all test instruments have been analyzed comprehensively, using a broad range of methods and observing the validity criteria of the Standards for Psychological and Educational Testing developed by the American Educational Research Association, the American Economic Association and the National Council on Measurement. The results of the developed assessments presented in this paper, provide valuable outcomes to predict students’ skills and abilities at the beginning and the end of their studies as well as their learning development and performance. This allows for a differentiated view of the diversity among students. Based on the given research results practical implications and recommendations are formulated. In particular, appropriate and effective learning opportunities for students can be created to support the learning development of students, promote their individual potential and reduce knowledge and skill gaps. Overall, the presented research on competency assessment is highly relevant to national and international HE practice.

Keywords: 21st century skills, academic competencies, innovative assessments, KoKoHs

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66 Advancing Early Intervention Strategies for United States Adolescents and Young Adults with Schizophrenia in the Post-COVID-19 Era

Authors: Peggy M. Randon, Lisa Randon

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Introduction: The post-COVID-19 era has presented unique challenges for addressing complex mental health issues, particularly due to exacerbated stress, increased social isolation, and disrupted continuity of care. This article outlines relevant health disparities and policy implications within the context of the United States while maintaining international relevance. Methods: A comprehensive literature review (including studies, reports, and policy documents) was conducted to examine concerns related to childhood-onset schizophrenia and the impact on patients and their families. Qualitative and quantitative data were synthesized to provide insights into the complex etiology of schizophrenia, the effects of the pandemic, and the challenges faced by socioeconomically disadvantaged populations. Case studies were employed to illustrate real-world examples and areas requiring policy reform. Results: Early intervention in childhood is crucial for preventing or mitigating the long-term impact of complex psychotic disorders, particularly schizophrenia. A comprehensive understanding of the genetic, environmental, and physiological factors contributing to the development of schizophrenia is essential. The COVID-19 pandemic worsened symptoms and disrupted treatment for many adolescent patients with schizophrenia, emphasizing the need for adaptive interventions and the utilization of virtual platforms. Health disparities, including stigma, financial constraints, and language or cultural barriers, further limit access to care, especially for socioeconomically disadvantaged populations. Policy implications: Current US health policies inadequately support patients with schizophrenia. The limited availability of longitudinal care, insufficient resources for families, and stigmatization represent ongoing policy challenges. Addressing these issues necessitates increased research funding, improved access to affordable treatment plans, and cultural competency training for healthcare providers. Public awareness campaigns are crucial to promote knowledge, awareness, and acceptance of mental health disorders. Conclusion: The unique challenges faced by children and families in the US affected by schizophrenia and other psychotic disorders have yet to be adequately addressed on institutional and systemic levels. The relevance of findings to an international audience is emphasized by examining the complex factors contributing to the onset of psychotic disorders and their global policy implications. The broad impact of the COVID-19 pandemic on mental health underscores the need for adaptive interventions and global responses. Addressing policy challenges, improving access to care, and reducing the stigma associated with mental health disorders are crucial steps toward enhancing the lives of adolescents and young adults with schizophrenia and their family members. The implementation of virtual platforms can help overcome barriers and ensure equitable access to support and resources for all patients, enabling them to lead healthy and fulfilling lives.

Keywords: childhood, schizophrenia, policy, United, States, health, disparities

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