Search results for: Arvo Pärt
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6851

Search results for: Arvo Pärt

221 Philippine Site Suitability Analysis for Biomass, Hydro, Solar, and Wind Renewable Energy Development Using Geographic Information System Tools

Authors: Jara Kaye S. Villanueva, M. Rosario Concepcion O. Ang

Abstract:

For the past few years, Philippines has depended most of its energy source on oil, coal, and fossil fuel. According to the Department of Energy (DOE), the dominance of coal in the energy mix will continue until the year 2020. The expanding energy needs in the country have led to increasing efforts to promote and develop renewable energy. This research is a part of the government initiative in preparation for renewable energy development and expansion in the country. The Philippine Renewable Energy Resource Mapping from Light Detection and Ranging (LiDAR) Surveys is a three-year government project which aims to assess and quantify the renewable energy potential of the country and to put them into usable maps. This study focuses on the site suitability analysis of the four renewable energy sources – biomass (coconut, corn, rice, and sugarcane), hydro, solar, and wind energy. The site assessment is a key component in determining and assessing the most suitable locations for the construction of renewable energy power plants. This method maximizes the use of both the technical methods in resource assessment, as well as taking into account the environmental, social, and accessibility aspect in identifying potential sites by utilizing and integrating two different methods: the Multi-Criteria Decision Analysis (MCDA) method and Geographic Information System (GIS) tools. For the MCDA, Analytical Hierarchy Processing (AHP) is employed to determine the parameters needed for the suitability analysis. To structure these site suitability parameters, various experts from different fields were consulted – scientists, policy makers, environmentalists, and industrialists. The need to have a well-represented group of people to consult with is relevant to avoid bias in the output parameter of hierarchy levels and weight matrices. AHP pairwise matrix computation is utilized to derive weights per level out of the expert’s gathered feedback. Whereas from the threshold values derived from related literature, international studies, and government laws, the output values were then consulted with energy specialists from the DOE. Geospatial analysis using GIS tools translate this decision support outputs into visual maps. Particularly, this study uses Euclidean distance to compute for the distance values of each parameter, Fuzzy Membership algorithm which normalizes the output from the Euclidean Distance, and the Weighted Overlay tool for the aggregation of the layers. Using the Natural Breaks algorithm, the suitability ratings of each of the map are classified into 5 discrete categories of suitability index: (1) not suitable (2) least suitable, (3) suitable, (4) moderately suitable, and (5) highly suitable. In this method, the classes are grouped based on the best groups similar values wherein each subdivision are set from the rest based on the big difference in boundary values. Results show that in the entire Philippine area of responsibility, biomass has the highest suitability rating with rice as the most suitable at 75.76% suitability percentage, whereas wind has the least suitability percentage with score 10.28%. Solar and Hydro fall in the middle of the two, with suitability values 28.77% and 21.27%.

Keywords: site suitability, biomass energy, hydro energy, solar energy, wind energy, GIS

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220 Supporting Students with Autism Spectrum Disorder: A Model of Partnership and Capacity Building in Hong Kong

Authors: Irene T. Ho

Abstract:

Students with Autism Spectrum Disorder (ASD) studying in mainstream schools often face difficulties adjusting to school life and teachers often find it challenging to meet the needs of these students. The Hong Kong Jockey Club Autism Support Network (JC A-Connect) is an initiative launched in 2015 to enhance support for students with ASD as well as their families and schools. The School Support Programme of the Project aims at building the capacity of schools to provide quality education for these students. The present report provides a summary of the main features of the support model and the related evaluation results. The school support model was conceptualized in response to four observed needs: (1) inadequate teacher expertise in dealing with the related challenges, (2) the need to promote evidence-based practices in schools, (3) less than satisfactory home-school collaboration and whole-school participation, and (4) lack of concerted effort by different parties involved in providing support to schools. The resulting model had partnership and capacity building as two guiding tenets for the School Support Programme. There were two levels of partnership promoted in the project. At the programme support level, a platform that enables effective collaboration among major stakeholders was established, including the funding body that provides the necessary resources, the Education Bureau that helps to engage schools, university experts who provide professional leadership and research support, as well as non-governmental organization (NGO) professionals who provide services to the schools. At the programme implementation level, tripartite collaboration among teachers, parents and professionals was emphasized. This notion of partnership permeated efforts at capacity building targeting students with ASD, school personnel, parents and peers. During 2015 to 2018, school-based programmes were implemented in over 400 primary and secondary schools with the following features: (1) spiral Tier 2 (group) training for students with ASD to enhance their adaptive skills, led by professionals but with strong teacher involvement to promote transfer of knowledge and skills; (2) supplementary programmes for teachers, parents and peers to enhance their capability to support students with ASD; and (3) efforts at promoting continuing or transfer of learning, on the part of both students and teachers, to Tier 1 (classroom practice) and Tier 3 (individual training) contexts. Over 5,000 students participated in the Programme, representing about 50% of students diagnosed with ASD in mainstream public sector schools in Hong Kong. Results showed that the Programme was effective in helping students improve to various extents at three levels: achievement of specific training goals, improvement in adaptive skills in school, and change in ASD symptoms. The sense of competence of teachers and parents in dealing with ASD-related issues, measured by self-report rating scales, was also significantly enhanced. Moreover, effects on enhancing the school system to provide support for students with ASD, assessed according to indicators of inclusive education, were seen. The process and results of this Programme illustrate how obstacles to inclusive education for students with ASD could be overcome by strengthening the necessary partnerships and building the required capabilities of all parties concerned.

Keywords: autism, school support, skills training, teacher development, three-tier model

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219 Health Risk Assessment from Potable Water Containing Tritium and Heavy Metals

Authors: Olga A. Momot, Boris I. Synzynys, Alla A. Oudalova

Abstract:

Obninsk is situated in the Kaluga region 100 km southwest of Moscow on the left bank of the Protva River. Several enterprises utilizing nuclear energy are operating in the town. A special attention in the region where radiation-hazardous facilities are located has traditionally been paid to radioactive gas and aerosol releases into the atmosphere; liquid waste discharges into the Protva river and groundwater pollution. Municipal intakes involve 34 wells arranged 15 km apart in a sequence north-south along the foot of the left slope of the Protva river valley. Northern and southern water intakes are upstream and downstream of the town, respectively. They belong to river valley intakes with mixed feeding, i.e. precipitation infiltration is responsible for a smaller part of groundwater, and a greater amount is being formed by overflowing from Protva. Water intakes are maintained by the Protva river runoff, the volume of which depends on the precipitation fallen out and watershed area. Groundwater contamination with tritium was first detected in a sanitary-protective zone of the Institute of Physics and Power Engineering (SRC-IPPE) by Roshydromet researchers when realizing the “Program of radiological monitoring in the territory of nuclear industry enterprises”. A comprehensive survey of the SRC-IPPE’s industrial site and adjacent territories has revealed that research nuclear reactors and accelerators where tritium targets are applied as well as radioactive waste storages could be considered as potential sources of technogenic tritium. All the above sources are located within the sanitary controlled area of intakes. Tritium activity in water of springs and wells near the SRC-IPPE is about 17.4 – 3200 Bq/l. The observed values of tritium activity are below the intervention levels (7600 Bq/l for inorganic compounds and 3300 Bq/l for organically bound tritium). The risk has being assessed to estimate possible effect of considered tritium concentrations on human health. Data on tritium concentrations in pipe-line drinking water were used for calculations. The activity of 3H amounted to 10.6 Bq/l and corresponded to the risk of such water consumption of ~ 3·10-7 year-1. The risk value given in magnitude is close to the individual annual death risk for population living near a NPP – 1.6·10-8 year-1 and at the same time corresponds to the level of tolerable risk (10-6) and falls within “risk optimization”, i.e. in the sphere for planning the economically sound measures on exposure risk reduction. To estimate the chemical risk, physical and chemical analysis was made of waters from all springs and wells near the SRC-IPPE. Chemical risk from groundwater contamination was estimated according to the EPA US guidance. The risk of carcinogenic diseases at a drinking water consumption amounts to 5·10-5. According to the classification accepted the health risk in case of spring water consumption is inadmissible. The compared assessments of risk associated with tritium exposure, on the one hand, and the dangerous chemical (e.g. heavy metals) contamination of Obninsk drinking water, on the other hand, have confirmed that just these chemical pollutants are responsible for health risk.

Keywords: radiation-hazardous facilities, water intakes, tritium, heavy metal, health risk

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

Authors: Fathonah Siti, Ardiana Irma

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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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217 Strengthening Service Delivery to Improving Cervical Cancer Screening in Southwestern Nigeria: A Pilot Project

Authors: Afolabi K. Esther, Kuye Tolulope, Babafemi, L. Olayemi, Omikunle Yemisi

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Background: Cervical cancer is a potentially preventable disease of public significance. All sexually active women are at risk of cervical cancer; however, the uptake and coverage are low in low-middle resource countries. Hence, the programme explored the feasibility of demonstrating an innovative and low-cost system approach to cervical cancer screening service delivery among reproductive-aged women in low–resource settings in Southwestern Nigeria. This was to promote the uptake and quality improvement of cervical cancer screening services. Methods: This study was an intervention project in three senatorial districts in Osun State that have primary, secondary and tertiary health facilities. The project was in three phases; Pre-intervention, Intervention, and Post-intervention. The study utilised the existing infrastructure, facilities and staff in project settings. The study population was nurse-midwives, community health workers and reproductive-aged women (30-49 years). The intervention phase entailed using innovative, culturally appropriate strategies to create awareness of cervical cancer and preventive health-seeking behaviour among women in the reproductive-aged group (30-49) years. Also, the service providers (community health workers, Nurses, and Midwives) were trained on screening methods and treatment of pre-cancerous lesions, and there was the provision of essential equipment and supplies for cervical cancer screening services at health facilities. Besides, advocacy and engagement were made with relevant stakeholders to integrate the cervical cancer screening services into related reproductive health services and greater allocation of resources. The expected results compared the pre and post-intervention using the baseline and process indicators and the effect of the intervention phase on screening coverage using a plausibility assessment design. The project lasted 12 months; visual Inspection with Acetic acid (VIA) screening for the women for six months and follow-up in 6 months for women receiving treatment. Results: The pre-intervention phase assessed baseline service delivery statistics in the previous 12 months drawn from the retrospective data collected as part of the routine monitoring and reporting systems. The uptake of cervical cancer screening services was low as the number of women screened in the previous 12 months was 156. Service personnel's competency level was fair (54%), and limited availability of essential equipment and supplies for cervical cancer screening services. At the post-intervention phase, the level of uptake had increased as the number of women screened was 1586 within six months in the study settings. This showed about a 100-%increase in the uptake of cervical cancer screening services compared with the baseline assessment. Also, the post-intervention level of competency of service delivery personnel had increased to 86.3%, which indicates quality improvement of the cervical cancer screening service delivery. Conclusion: the findings from the study have shown an effective approach to strengthening and improving cervical cancer screening service delivery in Southwestern Nigeria. Hence, the intervention promoted a positive attitude and health-seeking behaviour among the target population, significantly influencing the uptake of cervical cancer screening services.

Keywords: cervical cancer, screening, nigeria, health system strengthening

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216 Application of Self-Efficacy Theory in Counseling Deaf and Hard of Hearing Students

Authors: Nancy A. Delich, Stephen D. Roberts

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This case study explores using self-efficacy theory in counseling deaf and hard of hearing students in one California school district. Self-efficacy is described as the confidence a student has for performing a set of skills required to succeed at a specific task. When students need to learn a skill, self-efficacy can be a major factor in influencing behavioral change. Self-efficacy is domain specific, meaning that students can have high confidence in their abilities to accomplish a task in one domain, while at the same time having low confidence in their abilities to accomplish another task in a different domain. The communication isolation experienced by deaf and hard of hearing children and adolescents can negatively impact their belief about their ability to navigate life challenges. There is a need to address issues that impact deaf and hard of hearing students’ social-emotional development. Failure to address these needs may result in depression, suicidal ideation, and anxiety among other mental health concerns. Self-efficacy training can be used to address these socio-emotional developmental issues with this population. Four sources of experiences are applied during an intervention: (a) enactive mastery experience, (b) vicarious experience, (c) verbal persuasion, and (d) physiological and affective states. This case study describes the use of self-efficacy training with a coed group of 12 deaf and hard of hearing high school students who experienced bullying at school. Beginning with enactive mastery experience, the counselor introduced the topic of bullying to the group. The counselor educated the students about the different types of bullying while teaching them the terminology, signs and their meanings. The most effective way to increase self-efficacy is through extensive practice. To better understand these concepts, the students practiced through role-playing with the goal of developing self-advocacy skills. Vicarious experience is the perception that students have about their capabilities. Viewing other students advocating for themselves, cognitively rehearsing what actions they will and will not take, and teaching each other how to stand up against bullying can strengthen their belief in successfully overcoming bullying. The third source of self-efficacy beliefs is verbal persuasion. It occurs when others express belief in the capabilities of the student. Didactic training and pedagogic materials on bullying were employed as part of the group counseling sessions. The fourth source of self-efficacy appraisals is physiological and affective states. Students expect positive emotions to be associated with successful skilled performance. When students practice new skills, the counselor can apply several strategies to enhance self-efficacy while reducing and controlling emotional and physical states. The intervention plan incorporated all four sources of self-efficacy training during several interactive group sessions regarding bullying. There was an increased understanding around the issues of bullying, resulting in the students’ belief of their ability to perform protective behaviors and deter future occurrences. The outcome of the intervention plan resulted in a reduction of reported bullying incidents. In conclusion, self-efficacy training can be an effective counseling and teaching strategy in addressing and enhancing the social-emotional functioning with deaf and hard of hearing adolescents.

Keywords: counseling, self-efficacy, bullying, social-emotional development, mental health, deaf and hard of hearing students

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215 Populism as a Society Dividing Discourse in Lithuania: The Case of the Elections of Parliament of the Republic of Lithuania of 2024

Authors: Vaicekauskiene G., Nabazaite E.

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This study analyses the rise of global populism in Western democracies, focusing primarily on the populist rhetoric. Populist rhetoric is based on anti-pluralist ideas, opposing a “homogeneous nation” against “dangerous others” who are pushed out of the nation by populists, and can be citizens from both in-groups and out-groups. This study will examine the case of the elections of Parliament of the Republic of Lithuania of 2024. Fifteen candidate lists of parties and coalitions participated in the elections to the Lithuanian Parliament in 2024. Focus group methodology will be used to analyse the narratives of party supporters actively engaged in politics, trying to identify public support/opposition to populism. Liberal democracy is experiencing a crisis in both the US and Western democracies in Europe. The election results of recent years are increasingly announcing populist victories or the creation of new populist parties. Far-right parties lead the governments in three countries – Hungary, Slovakia, and Italy, and they are part of the ruling coalition in Sweden, Finland, and the Netherlands. It will become clear in the USA whether Donald Trump will be re-elected as president in November of this year. Trump’s victory in 2016 was named by political scientists as the apotheosis of populism. Influential politicians consolidate all bad manners and social categorization in the digital era of demagoguery. The research shows that a significant proportion of democratic societies also support this divisive discourse. Citizens, as consumers of information, often approve of populist communication themselves. New parliament elections were held in Lithuania in October 2024. Ideas that polarize society were amplified in the public space, negativism increased, and with it distrust towards the state, its institutions, and democratically elected politicians, “enemies” were sought and conspiracy theories were created. Problem of the Study. This study analyses the global rise of populism from the perspective of Lithuania with various groups of society, trying to understand the relationship of citizens with democracy through believing in populists, approval/disapproval of the expression of populism. Opinions are an important challenge when trying to find the truth in the age of populism, because democratic societies are based on the culture of discussion and the idea of consensus. Methodology. This study will deconstruct the narratives of Lithuanian citizens from the point of view of populism. Fifteen focus group discussions will be held with supporters of the party lists that participated in the Parliament elections of the Republic of Lithuania during November-December 2024. The main unifying criterion for focus group participants is their political activity, while the distinguishing criteria are age, gender and place of residence. Fifteen focus groups were chosen due to the fact that fifteen candidate lists of parties and coalitions participated in the elections and seeking to ensure the variety of participants. This study aims to emphasize populism as a communication phenomenon in Lithuania. Public testimonies and experiences will reveal new meanings about the understanding of populism and support/opposition towards it.

Keywords: democracy, narratives in populist rhetoric, populist rhetoric, populism

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214 Isolation and Identification of Low-Temperature Tolerant-Yeast Strains from Apple with Biocontrol Activity

Authors: Lachin Mikjtarnejad, Mohsen Farzaneh

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Various microbes, such as fungi and bacteria species, are naturally found in the fruit microbiota, and some of them act as a pathogen and result in fruit rot. Among non-pathogenic microbes, yeasts (single-celled microorganisms belonging to the fungi kingdom) can colonize fruit tissues and interact with them without causing any damage to them. Although yeasts are part of the plant microbiota, there is little information about their interactions with plants in comparison with bacteria and filamentous fungi. According to several existing studies, some yeasts can colonize different plant species and have the biological control ability to suppress some of the plant pathogens. It means those specific yeast-colonized plants are more resistant to some plant pathogens. The major objective of the present investigation is to isolate yeast strains from apple fruit and screen their ability to control Penicillium expansum, the causal agent of blue mold of fruits. In the present study, psychrotrophic and epiphytic yeasts were isolated from apple fruits that were stored at low temperatures (0–1°C). Totally, 42 yeast isolates were obtained and identified by molecular analysis based on genomic sequences of the D1/D2 and ITS1/ITS4 regions of their rDNA. All isolated yeasts were primarily screened by' in vitro dual culture assay against P. expansum by measuring the fungus' relative growth inhibition after 10 days of incubation. The results showed that the mycelial growth of P. expansum was reduced between 41–53% when challenged by promising yeast strains. The isolates with the strongest antagonistic activity belonged to Metschnikowia pulcherrima A13, Rhodotorula mucilaginosa A41, Leucosporidium Scottii A26, Aureobasidium pullulans A19, Pichia guilliermondii A32, Cryptococcus flavescents A25, and Pichia kluyveri A40. The results of seven superior isolates to inhibit blue mold decay on fruit showed that isolates A. pullulans A19, L. scottii A26, and Pi. guilliermondii A32 could significantly reduce the fruit rot and decay with 26 mm, 22 mm and 20 mm zone diameter, respectively, compared to the control sample with 43 mm. Our results show Pi. guilliermondii strain A13 was the most effective yeast isolates in inhibiting P. expansum on apple fruits. In addition, various biological control mechanisms of promising biological isolates against blue mold have been evaluated to date, including competition for nutrients and space, production of volatile metabolites, reduction of spore germination, production of siderophores and production of extracellular lytic enzymes such as chitinase and β-1,3-glucanase. However, the competition for nutrients and the ability to inhibit P. expansum spore growth have been introduced as the prevailing mechanisms among them. Accordingly, in our study, isolates A13, A41, A40, A25, A32, A19 and A26 inhibited the germination of P. expansum, whereas isolates A13 and A19 were the strongest inhibitors of P. expansum mycelia growth, causing 89.13% and 81.75 % reduction in the mycelial surface, respectively. All the promising isolates produced chitinase and β-1,3-glucanase after 3, 5 and 7 days of cultivation. Finally, based on our findings, we are proposing that, Pi. guilliermondiias as an effective biocontrol agent and alternative to chemical fungicides to control the blue mold of apple fruit.

Keywords: yeast, yeast enzymes, biocontrol, post harvest diseases

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213 Combustion Variability and Uniqueness in Cylinders of a Radial Aircraft Piston Engine

Authors: Michal Geca, Grzegorz Baranski, Ksenia Siadkowska

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The work is a part of the project which aims at developing innovative power and control systems for the high power aircraft piston engine ASz62IR. Developed electronically controlled ignition system will reduce emissions of toxic compounds as a result of lowered fuel consumption, optimized combustion and engine capability of efficient combustion of ecological fuels. The tested unit is an air-cooled four-stroke gasoline engine of 9 cylinders in a radial setup, mechanically charged by a radial compressor powered by the engine crankshaft. The total engine cubic capac-ity is 29.87 dm3, and the compression ratio is 6.4:1. The maximum take-off power is 1000 HP at 2200 rpm. The maximum fuel consumption is 280 kg/h. Engine powers aircrafts: An-2, M-18 „Dromader”, DHC-3 „OTTER”, DC-3 „Dakota”, GAF-125 „HAWK” i Y5. The main problems of the engine includes the imbalanced work of cylinders. The non-uniformity value in each cylinder results in non-uniformity of their work. In radial engine cylinders arrangement causes that the mixture movement that takes place in accordance (lower cylinder) or the opposite (upper cylinders) to the direction of gravity. Preliminary tests confirmed the presence of uneven workflow of individual cylinders. The phenomenon is most intense at low speed. The non-uniformity is visible on the waveform of cylinder pressure. Therefore two studies were conducted to determine the impact of this phenomenon on the engine performance: simulation and real tests. Simplified simulation was conducted on the element of the intake system coated with fuel film. The study shows that there is an effect of gravity on the movement of the fuel film inside the radial engine intake channels. Both in the lower and the upper inlet channels the film flows downwards. It follows from the fact that gravity assists the movement of the film in the lower cylinder channels and prevents the movement in the upper cylinder channels. Real tests on aircraft engine ASz62IR was conducted in transients condition (rapid change of the excess air in each cylinder were performed. Calculations were conducted for mass of fuel reaching the cylinders theoretically and really and on this basis, the factors of fuel evaporation “x” were determined. Therefore a simplified model of the fuel supply to cylinder was adopted. Model includes time constant of the fuel film τ, the number of engine transport cycles of non-evaporating fuel along the intake pipe γ and time between next cycles Δt. The calculation results of identification of the model parameters are presented in the form of radar graphs. The figures shows the averages declines and increases of the injection time and the average values for both types of stroke. These studies shown, that the change of the position of the cylinder will cause changes in the formation of fuel-air mixture and thus changes in the combustion process. Based on the results of the work of simulation and experiments was possible to develop individual algorithms for ignition control. This work has been financed by the Polish National Centre for Research and Development, INNOLOT, under Grant Agreement No. INNOLOT/I/1/NCBR/2013.

Keywords: radial engine, ignition system, non-uniformity, combustion process

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212 Parents’ Perceptions of the Consent Arrangements for Dental Public Health Programmes in North London: A Qualitative Exploration

Authors: Charlotte Jeavons, Charitini Stavropoulous, Nicolas Drey

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Background: Over one-third of five-year-olds and almost half of all eight-year-olds in the UK have obvious caries experience that can be detected by visual screening techniques. School-based caries preventions programs to apply fluoride varnish to young children’s teeth operate in many areas in the UK. Their aim is to reduce dental caries in children. The Department of Health guidance (2009) on consent states information must be provided to parents to enable informed autonomous decision-making prior to any treatment involving their young children. Fluoride varnish schemes delivered in primary schools use letters for this purpose. Parents are expected to return these indicating their consent or refusal. A large proportion of parents do not respond. In the absence of positive consent, these children are excluded from the program. Non-response is more common in deprived areas creating inequality. The reason for this is unknown. The consent process used is underpinned by the ethical theory of deontology that is prevalent in clinical dentistry and widely accepted in bio-ethics. Objective: To investigate parents’ views, understanding and experience of the fluoride varnish program taking place in their child’s school, including their views about the practical consent arrangements. Method: Schools participating in the fluoride varnish scheme operating in Enfield, North London, were asked to take part. Parents with children in nursery, reception, or year one were invited to participate via semi-structured interviews and focus groups. Thematic analysis was conducted. Findings: 40 parents were recruited from eight schools. The global theme of ‘trust’ was identified as the strongest influence on parental responses. Six themes were identified; protecting children from harm is viewed by parents as their role, parents have the capability to decide but lack confidence, sharing responsibility for their child’s oral health with the State is welcomed by a parent, existing relationships within parents’ social networks strongly influences consent decisions, official dental information is not communicated effectively, sending a letter to parents’ and excluding them from meeting dental practitioners is ineffective. The information delivered via a letter was not strongly identified by parents as influencing their response. Conclusions: Personal contact with the person(s) providing information and requesting consent has a greater impact on parental consent responses than written information provided alone. This demonstrates that traditional bio-ethical ideas about rational decision-making where emotions are transcended and interference is not justified unless preventing harm to an unaware person are outdated. Parental decision-making is relational and the consent process should be adapted to reflect this. The current system that has a deontology view of decision making at its core impoverishes parental autonomy and may, ultimately, increase dental inequalities as a result.

Keywords: consent, decision, ethics, fluoride, parents

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211 Narratives of Cultural Encounters Revisited: Moroccan Entertainers beyond Borders (1840-1920)

Authors: Lhoussain Simour

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This paper discusses the reordering and reorientation Moroccan Oossified and frozen histories in national and colonial archives. It attempts to reexamine Moroccan non-canonical voices beyond borders, their forgotten experiences and itineraries, with the aim of uncovering cultural discourses pertaining to early cultural and artistic interactions between Morocco and the western countries, namely Britain and America. In fact, less attention has been given to the presence of Moroccan entertainers beyond borders in the archives of history. Moroccan historians and cultural critics seem to have paid little critical consideration to Moroccan artistic encounters with the west, Europe and America as a case in point. They have overlooked to deal with travel performances, professional entertainments, and artistic spectacles, initiated by acrobats, as instances of visual cross-cultural encounters between Morocco and the west. The narratives of these professional artists have hardly found their ways into historiographical writing. This contribution attempts to locate the contesting beginnings of Moroccan professional entertainers in western show business in the nineteenth century which witnessed intricate artistic, discursive and cultural junctures by emphasizing connections between theatrical performances, ethnic exhibition and world fair expositions. Moroccan professional performances grew in Europe and America within a zealous context marked by the rise of a paradigmatic racial consciousness that sought to authenticate and legitimate ethnic discourses of power and exclusion. The ethnic taxonomies and racial hierarchies governed by ethnographic and anthropological documentation fueled up entertainment venues and popular theatrical performances and helped in developing a distinctive view about Self and Other paradigms. Moroccan travelers started their journeys to visit European and American countries to exhibit their acrobatics acts. They, in a certain sense, continued, albeit in varying degrees and circumstances, the whole tradition of travel initiated previously by their ancestor diplomats and ambassadors. Professional entertainers embarked on daring journeys across the Mediterranean and the Atlantic to discover new geographies and cultural spaces, and perform their spectacles beyond borders. These travelers left rich archival documents that reflect important cultural and historical moments. The routes of travel started from the margins of the empire towards metropolitan centers of nineteenth century Europe and America included Moroccan women travelers as acrobats and dancing professional artists as well. These also crossed the straits of Gibraltar and journeyed through the Atlantic Ocean to visit western countries. Moroccan women travelers took part in various Euro-American theatre performances and in circus shows as early as 1850 according to newspapers archives and passengers shipping lists. Najat Amburg, Zahar Ben Tahar, Torquia, Fadma, and many more whose names are now lost to us, moved freely in various western capital cities to entertain nineteenth century western audiences.

Keywords: archives, cultural encounters, self and other, Morocco, travel, Moroccan acrobats, Moorish dancing women

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210 Fabrication of Antimicrobial Dental Model Using Digital Light Processing (DLP) Integrated with 3D-Bioprinting Technology

Authors: Rana Mohamed, Ahmed E. Gomaa, Gehan Safwat, Ayman Diab

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Background: Bio-fabrication is a multidisciplinary research field that combines several principles, fabrication techniques, and protocols from different fields. The open-source-software movement is a movement that supports the use of open-source licenses for some or all software as part of the broader notion of open collaboration. Additive manufacturing is the concept of 3D printing, where it is a manufacturing method through adding layer-by-layer using computer-aided designs (CAD). There are several types of AM system used, and they can be categorized by the type of process used. One of these AM technologies is Digital light processing (DLP) which is a 3D printing technology used to rapidly cure a photopolymer resin to create hard scaffolds. DLP uses a projected light source to cure (Harden or crosslinking) the entire layer at once. Current applications of DLP are focused on dental and medical applications. Other developments have been made in this field, leading to the revolutionary field 3D bioprinting. The open-source movement was started to spread the concept of open-source software to provide software or hardware that is cheaper, reliable, and has better quality. Objective: Modification of desktop 3D printer into 3D bio-printer and the integration of DLP technology and bio-fabrication to produce an antibacterial dental model. Method: Modification of a desktop 3D printer into a 3D bioprinter. Gelatin hydrogel and sodium alginate hydrogel were prepared with different concentrations. Rhizome of Zingiber officinale, Flower buds of Syzygium aromaticum, and Bulbs of Allium sativum were extracted, and extractions were selected on different levels (Powder, aqueous extracts, total oils, and Essential oils) prepared for antibacterial bioactivity. Agar well diffusion method along with the E. coli have been used to perform the sensitivity test for the antibacterial activity of the extracts acquired by Zingiber officinale, Syzygium aromaticum, and Allium sativum. Lastly, DLP printing was performed to produce several dental models with the natural extracted combined with hydrogel to represent and simulate the Hard and Soft tissues. Result: The desktop 3D printer was modified into 3D bioprinter using open-source software Marline and modified custom-made 3D printed parts. Sodium alginate hydrogel and gelatin hydrogel were prepared at 5% (w/v), 10% (w/v), and 15%(w/v). Resin integration with the natural extracts of Rhizome of Zingiber officinale, Flower buds of Syzygium aromaticum, and Bulbs of Allium sativum was done following the percentage 1- 3% for each extract. Finally, the Antimicrobial dental model was printed; exhibits the antimicrobial activity, followed by merging with sodium alginate hydrogel. Conclusion: The open-source movement was successful in modifying and producing a low-cost Desktop 3D Bioprinter showing the potential of further enhancement in such scope. Additionally, the potential of integrating the DLP technology with bioprinting is a promising step toward the usage of the antimicrobial activity using natural products.

Keywords: 3D printing, 3D bio-printing, DLP, hydrogel, antibacterial activity, zingiber officinale, syzygium aromaticum, allium sativum, panax ginseng, dental applications

Procedia PDF Downloads 96
209 Single Stage Holistic Interventions: The Impact on Well-Being

Authors: L. Matthewman, J. Nowlan

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Background: Holistic or Integrative Psychology emphasizes the interdependence of physiological, spiritual and psychological dynamics. Studying “wholeness and well-being” from a systems perspective combines innovative psychological science interventions with Eastern orientated healing wisdoms and therapies. The literature surrounding holistic/integrative psychology focuses on multi-stage interventions in attempts to enhance the mind-body experiences of well-being for participants. This study proposes a new single stage model as an intervention for UG/PG students, time-constrained workplace employees and managers/leaders for improved well-being and life enhancement. The main research objective was to investigate participants’ experiences of holistic and mindfulness interventions for impact on emotional well-being. The main research question asked was if single stage holistic interventions could impact on psychological well-being. This is of consequence because many people report that a reason for not taking part in mind-body or wellness programmes is that they believe that they do not have sufficient time to engage in such pursuits. Experimental Approach: The study employed a mixed methods pre-test/post-test research design. Data was analyzed using descriptive statistics and interpretative phenomenological analysis. Purposive sampling methods were employed. An adapted mindfulness measurement questionnaire (MAAS) was administered to 20 volunteer final year UG student participants prior to the single stage intervention and following the intervention. A further post-test longitudinal follow-up took place one week later. Intervention: The single stage model intervention consisted of a half hour session of mindfulness, yoga stretches and head and neck massage in the following sequence: Mindful awareness of the breath, yoga stretches 1, mindfulness of the body, head and neck massage, mindfulness of sounds, yoga stretches 2 and finished with pure awareness mindfulness. Results: The findings on the pre-test indicated key themes concerning: “being largely unaware of feelings”, “overwhelmed with final year exams”, “juggling other priorities” , “not feeling in control”, “stress” and “negative emotional display episodes”. Themes indicated on the post-test included: ‘more aware of self’, ‘in more control’, ‘immediately more alive’ and ‘just happier’ compared to the pre-test. Themes from post-test 2 indicated similar findings to post-test 1 in terms of themes. but on a lesser scale when scored for intensity. Interestingly, the majority of participants reported that they would now seek other similar interventions in the future and would be likely to engage with a multi-stage intervention type on a longer-term basis. Overall, participants reported increased psychological well-being after the single stage intervention. Conclusion: A single stage one-off intervention model can be effective to help towards the wellbeing of final year UG students. There is little indication to suggest that this would not be generalizable to others in different areas of life and business. However this study must be taken with caution due to low participant numbers. Implications: Single stage one-off interventions can be used to enhance peoples’ lives who might not otherwise sign up for a longer multi-stage intervention. In addition, single stage interventions can be utilized to help participants progress onto longer multiple stage interventions. Finally, further research into one stage well-being interventions is encouraged.

Keywords: holistic/integrative psychology, mindfulness, well-being, yoga

Procedia PDF Downloads 353
208 Accessing Motional Quotient for All Round Development

Authors: Zongping Wang, Chengjun Cui, Jiacun Wang

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The concept of intelligence has been widely used to access an individual's cognitive abilities to learn, form concepts, understand, apply logic, and reason. According to the multiple intelligence theory, there are eight distinguished types of intelligence. One of them is the bodily-kinaesthetic intelligence that links to the capacity of an individual controlling his body and working with objects. Motor intelligence, on the other hand, reflects the capacity to understand, perceive and solve functional problems by motor behavior. Both bodily-kinaesthetic intelligence and motor intelligence refer directly or indirectly to bodily capacity. Inspired by these two intelligence concepts, this paper introduces motional intelligence (MI). MI is two-fold. (1) Body strength, which is the capacity of various organ functions manifested by muscle activity under the control of the central nervous system during physical exercises. It can be measured by the magnitude of muscle contraction force, the frequency of repeating a movement, the time to finish a movement of body position, the duration to maintain muscles in a working status, etc. Body strength reflects the objective of MI. (2) Level of psychiatric willingness to physical events. It is a subjective thing and determined by an individual’s self-consciousness to physical events and resistance to fatigue. As such, we call it subjective MI. Subjective MI can be improved through education and proper social events. The improvement of subjective MI can lead to that of objective MI. A quantitative score of an individual’s MI is motional quotient (MQ). MQ is affected by several factors, including genetics, physical training, diet and lifestyle, family and social environment, and personal awareness of the importance of physical exercise. Genes determine one’s body strength potential. Physical training, in general, makes people stronger, faster and swifter. Diet and lifestyle have a direct impact on health. Family and social environment largely affect one’s passion for physical activities, so does personal awareness of the importance of physical exercise. The key to the success of the MQ study is developing an acceptable and efficient system that can be used to assess MQ objectively and quantitatively. We should apply different accessing systems to different groups of people according to their ages and genders. Field test, laboratory test and questionnaire are among essential components of MQ assessment. A scientific interpretation of MQ score is part of an MQ assessment system as it will help an individual to improve his MQ. IQ (intelligence quotient) and EQ (emotional quotient) and their test have been studied intensively. We argue that IQ and EQ study alone is not sufficient for an individual’s all round development. The significance of MQ study is that it offsets IQ and EQ study. MQ reflects an individual’s mental level as well as bodily level of intelligence in physical activities. It is well-known that the American Springfield College seal includes the Luther Gulick triangle with the words “spirit,” “mind,” and “body” written within it. MQ, together with IQ and EQ, echoes this education philosophy. Since its inception in 2012, the MQ research has spread rapidly in China. By now, six prestigious universities in China have established research centers on MQ and its assessment.

Keywords: motional Intelligence, motional quotient, multiple intelligence, motor intelligence, all round development

Procedia PDF Downloads 166
207 Stakeholder Perception in the Role of Short-term Accommodations on the Place Brand and Real Estate Development of Urban Areas: A Case Study of Malate, Manila

Authors: Virgilio Angelo Gelera Gener

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This study investigates the role of short-term accommodations on the place brand and real estate development of urban areas. It aims to know the perceptions of the general public, real estate developers, as well as city and barangay-level local government units (LGUs) on how these lodgings affect the place brand and land value of a community. It likewise attempts to identify the personal and institutional variables having a great influence on said perceptions in order to provide a better understanding of these establishments and their relevance within urban localities. Using certain sources, Malate, Manila was identified to be the ideal study area of the thesis. This prompted the employment of mixed methods research as the study’s fundamental data gathering and analytical tool. Here, a survey with 350 locals was done, asking them questions that would answer the aforementioned queries. Thereafter, a Pearson Chi-square Test and Multinomial Logistic Regression (MLR) were utilized to determine the variables affecting their perceptions. There were also Focus Group Discussions (FGDs) with the three (3) most populated Malate barangays, as well as Key Informant Interviews (KIIs) with selected city officials and fifteen (15) real estate company representatives. With that, survey results showed that although a 1992 Department of Tourism (DOT) Circular regards short-term accommodations as lodgings mainly for travelers, most people actually use it for their private/intimate moments. Because of this, the survey further revealed that short-term accommodations exhibit a negative place brand among the respondents though they also believe that it’s still one of society’s most important economic players. Statistics from the Pearson Chi-square Test, on the other hand, indicate that there are fourteen (14) out of seventeen (17) variables exhibiting great influence on respondents’ perceptions. Whereas MLR findings show that being born in Malate and being part of a family household was the most significant regardless of socio-economic level and monthly household income. For the city officials, it was revealed that said lodgings are actually the second-highest earners in the City’s lodging industry. It was further stated that their zoning ordinance treats short-term accommodations just like any other lodging enterprise. So it’s perfectly legal for these establishments to situate themselves near residential areas and/or institutional structures. A sit down with barangays, on the other hand, recognized the economic benefits of short-term accommodations but likewise admitted that it contributes a negative place brand to the community. Lastly, real estate developers are amenable to having their projects built near short-term accommodations, for they do not have any bad views against it. They explained that their projects sites have always been motivated by suitability, liability, and marketability factors only. Overall, these findings merit a recalibration of the zoning ordinance and DOT Circular, as well as the imposition of regulations on their sexually suggestive roadside advertisements. Then, once relevant measures are refined for proper implementation, it can also pave the way for spatial interventions (like visual buffer corridors) to better address the needs of the locals, private groups, and government.

Keywords: estate planning, place brand, real estate development, short-term accommodations

Procedia PDF Downloads 167
206 Thai Cane Farmers' Responses to Sugar Policy Reforms: An Intentions Survey

Authors: Savita Tangwongkit, Chittur S Srinivasan, Philip J. Jones

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Thailand has become the world’s fourth largest sugarcane producer and second largest sugar exporter. While there have been a number of drivers of this growth, the primary driver has been wide-ranging government support measures. Recently, the Thai government has emphasized the need for policy reform as part of a broader industry restructuring to bring the sector up-to-date with the current and future developments in the international sugar market. Because of the sectors historical dependence on government support, any such reform is likely to have a very significant impact on the fortunes of Thai cane farmers. This study explores the impact of three policy scenarios, representing a spectrum of policy approaches, on Thai cane producers. These reform scenarios were designed in consultation with policy makers and academics working in the cane sector. Scenario 1 captures the current ‘government proposal’ for policy reform. This scenario removes certain domestic production subsidies but seeks to maintain as much support as is permissible under current WTO rules. The second scenario, ‘protectionism’, maintains the current internal market producer supports, but otherwise complies with international (WTO) commitments. Third, the ‘libertarian scenario’ removes all production support and market interventions, trade and domestic consumption distortions. Most important driver of producer behaviour in all of the scenarios is the producer price of cane. Cane price is obviously highest under the protectionism scenario, followed by government proposal and libertarian scenarios, respectively. Likely producer responses to these three policy scenarios was determined by means of a large-scale survey of cane farmers. The sample was stratified by size group and quotas filled by size group and region. One scenario was presented to each of three sub-samples, consisting of approx.150 farmers. Total sample size was 462 farms. Data was collected by face-to-face interview between June and August 2019. There was a marked difference in farmer response to the three scenarios. Farmers in the ‘Protectionism’ scenario, which maintains the highest cane price and those who farm larger cane areas are more likely to continue cane farming. The libertarian scenario is likely to result in the greatest losses in terms of cane production volume broadly double that of the ‘protectionism’ scenario, primarily due to farmers quitting cane production altogether. Over half of loss cane production volume comes from medium-size farm, i.e. the largest and smallest producers are the most resilient. This result is likely due to the fact that the medium size group are large enough to require hired labour but lack the economies of scale of the largest farms. Over all size groups the farms most heavily specialized in cane production, i.e. those devoting 26-50% of arable land to cane, are also the most vulnerable, with 70% of all farmers quitting cane production coming from this group. This investigation suggests that cane price is the most significant determinant of farmer behaviour. Also, that where scenarios drive significantly lower cane price, policy makers should target support towards mid-sized producers, with policies that encourage efficiency gains and diversification into alternative agricultural crops.

Keywords: farmer intentions, farm survey, policy reform, Thai cane production

Procedia PDF Downloads 111
205 Disaster Preparedness for People with Disabilities through EPPO's Educational Awareness Initiative

Authors: A. Kourou, A. Ioakeimidou, E. Pelli, M. Panoutsopoulou, V. Abramea

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Worldwide there is a growing recognition that education is a critical component of any disaster impacts reduction effort and a great challenge too. Given this challenge, a broad range of awareness raising projects at all levels are implemented and are continuously evaluated by Earthquake Planning and Protection Organization (EPPO). This paper presents an overview of EPPO educational initiative (seminars, lectures, workshops, campaigns and educational material) and its evaluation results. The abovementioned initiative is focused to aware the public, train teachers and civil protection staff, inform students and educate people with disabilities on subjects related to earthquake reduction issues. The better understating of how human activity can link to disaster and what can be done at the individual, family or workplace level to contribute to seismic reduction are the main issues of EPPO projects. Survey results revealed that a high percentage of teachers (included the ones of special schools) from all over the country have taken the appropriate preparedness measures at schools. On the other hand, the implementation of earthquake preparedness measures at various workplaces (kindergartens, banks, utilities etc.) has still significant room for improvement. Results show that the employees in banks and public utilities have substantially higher rates in preventive and preparedness actions in their workplaces than workers in kindergartens and other workplaces. One of the EPPO educational priorities is to enhance earthquake preparedness of people with disabilities. Booklets, posters and applications have been created with the financial support of the Council of Europe, addressed to people who have mobility impairments, learning difficulties or cognitive disability (ή intellectual disabilities). Part of the educational material was developed using the «easy-to-read» method and Makaton language program with the collaboration of experts on special needs education and teams of people with cognitive disability. Furthermore, earthquake safety seminars and earthquake drills have been implemented in order to develop children’s, parents’ and teachers abilities and skills on earthquake impacts reduction. To enhance the abovementioned efforts, EPPO is a partner at prevention and preparedness projects supported by EU Civil Protection Financial Instrument. One of them is E-PreS’ project (Monitoring and Evaluation of Natural Hazard Preparedness at School Environment). The main objectives of E-PreS project are: 1) to create smart tools which define, simulate and evaluate drills procedure at schools, centers of vocational training of people with disabilities or other workplaces, and 2) to involve students or adults with disabilities in the E-PreS system evacuation procedure in case of earthquake, flood, or volcanic occurrence. Two other EU projects (RACCE educational kit and EVANDE educational platform) are also with the aim of contributing to raising awareness among people with disabilities, students, teachers, volunteers etc. It is worth mentioning that even though in Greece many efforts have been done till now to build awareness towards earthquakes and establish preparedness status for prospective earthquakes, there are still actions to be taken.

Keywords: earthquake, emergency plans, E-PreS project, people with disabilities, special needs education

Procedia PDF Downloads 266
204 Cyber-Victimization among Higher Education Students as Related to Academic and Personal Factors

Authors: T. Heiman, D. Olenik-Shemesh

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Over the past decade, with the rapid growth of electronic communication, the internet and, in particular, social networking has become an inseparable part of people's daily lives. Along with its benefits, a new type of online aggression has emerged, defined as cyber bullying, a form of interpersonal aggressive behavior that takes place through electronic means. Cyber-bullying is characterized by repetitive behavior over time of maladaptive authority and power usage using computers and cell phones via sending insulting messages and hurtful pictures. Preliminary findings suggest that the prevalence of involvement in cyber-bullying among higher education students varies between 10 and 35%. As to date, universities are facing an uphill effort in trying to restrain online misbehavior. As no studies examined the relationships between cyber-bullying involvement with personal aspects, and its impacts on academic achievement and work functioning, this present study examined the nature of cyber-bullying involvement among 1,052 undergraduate students (mean age = 27.25, S.D = 4.81; 66.2% female), coping with, as well as the effects of social support, perceived self-efficacy, well-being, and body-perception, in relation to cyber-victimization. We assume that students in higher education are a vulnerable population and at high risk of being cyber-victims. We hypothesize that social support might serve as a protective factor and will moderate the relationships between the socio-emotional variables and the occurrence of cyber- victimization. The findings of this study will present the relationships between cyber-victimization and the social-emotional aspects, which constitute risk and protective factors. After receiving approval from the Ethics Committee of the University, a Google Drive questionnaire was sent to a random sample of students, studying in the various University study centers. Students' participation was voluntary, and they completed the five questionnaires anonymously: Cyber-bullying, perceived self-efficacy, subjective well-being, social support and body perception. Results revealed that 11.6% of the students reported being cyber-victims during last year. Examining the emotional and behavioral reactions to cyber-victimization revealed that female emotional and behavioral reactions were significantly greater than the male reactions (p < .001). Moreover, females reported on a significant higher social support compared to men; male reported significantly on a lower social capability than female; and men's body perception was significantly more positive than women's scores. No gender differences were observed for subjective well-being scale. Significant positive correlations were found between cyber-victimization and fewer friends, lower grades, and work ineffectiveness (r = 0.37- .40, p < 0 .001). The results of the Hierarchical regression indicated significantly that cyber-victimization can be predicted by lower social support, lower body perception, and gender (female), that explained 5.6% of the variance (R2 = 0.056, F(5,1047) = 12.47, p < 0.001). The findings deepen our understanding of the students' involvement in cyber-bullying, and present the relationships of the social-emotional and academic aspects on cyber-victim students. In view of our findings, higher education policy could help facilitate coping with cyber-bullying incidents, and student support units could develop intervention programs aimed at reducing cyber-bullying and its impacts.

Keywords: academic and personal factors, cyber-victimization, social support, higher education

Procedia PDF Downloads 289
203 Leveraging the HDAC Inhibitory Pharmacophore to Construct Deoxyvasicinone Based Tractable Anti-Lung Cancer Agent and pH-Responsive Nanocarrier

Authors: Ram Sharma, Esha Chatterjee, Santosh Kumar Guru, Kunal Nepali

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A tractable anti-lung cancer agent was identified via the installation of a Ring C expanded synthetic analogue of the alkaloid vasicinone [7,8,9,10-tetrahydroazepino[2,1-b] quinazolin-12(6H)-one (TAZQ)] as a surface recognition part in the HDAC inhibitory three-component model. Noteworthy to mention that the candidature of TAZQ was deemed suitable for accommodation in HDAC inhibitory pharmacophore as per the results of the fragment recruitment process conducted by our laboratory. TAZQ was pinpointed through the fragment screening program as a synthetically flexible fragment endowed with some moderate cell growth inhibitory activity against the lung cancer cell lines, and it was anticipated that the use of the aforementioned fragment to generate hydroxamic acid functionality (zinc-binding motif) bearing HDAC inhibitors would boost the antitumor efficacy of TAZQ. Consistent with our aim of applying epigenetic targets to the treatment of lung cancer, a strikingly potent anti-lung cancer scaffold (compound 6) was pinpointed through a series of in-vitro experiments. Notably, the compounds manifested a magnificent activity profile against KRAS and EGFR mutant lung cancer cell lines (IC50 = 0.80 - 0.96 µM), and the effects were found to be mediated through preferential HDAC6 inhibition (IC50 = 12.9 nM). In addition to HDAC6 inhibition, the compounds also elicited HDAC1 and HDAC3 inhibitory activity with an IC50 value of 49.9 nM and 68.5 nM, respectively. The HDAC inhibitory ability of compound 6 was also confirmed from the results of the western blot experiment that revealed its potential to decrease the expression levels of HDAC isoforms (HDAC1, HDAC3, and HDAC6). Noteworthy to mention that complete downregulation of the HDAC6 isoform was exerted by compound 6 at 0.5 and 1 µM. Moreover, in another western blot experiment, treatment with hydroxamic acid 6 led to upregulation of H3 acK9 and α-Tubulin acK40 levels, ascertaining its inhibitory activity toward both the class I HDACs and Class II B HDACs. The results of other assays were also encouraging as treatment with compound 6 led to the suppression of the colony formation ability of A549 cells, induction of apoptosis, and increase in autophagic flux. In silico studies led us to rationalize the results of the experimental assay, and some key interactions of compound 6 with the amino acid residues of HDAC isoforms were identified. In light of the impressive activity spectrum of compound 6, a pH-responsive nanocarrier (hyaluronic acid-compound 6 nanoparticles) was prepared. The dialysis bag approach was used for the assessment of the nanoparticles under both normal and acidic circumstances, and the pH-sensitive nature of hyaluronic acid-compound 6 nanoparticles was confirmed. Delightfully, the nanoformulation was devoid of cytotoxicity against the L929 mouse fibroblast cells (normal settings) and exhibited selective cytotoxicity towards the A549 lung cancer cell lines. In a nutshell, compound 6 appears to be a promising adduct, and a detailed investigation of this compound might yield a therapeutic for the treatment of lung cancer.

Keywords: HDAC inhibitors, lung cancer, scaffold, hyaluronic acid, nanoparticles

Procedia PDF Downloads 95
202 Gamification of eHealth Business Cases to Enhance Rich Learning Experience

Authors: Kari Björn

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Introduction of games has expanded the application area of computer-aided learning tools to wide variety of age groups of learners. Serious games engage the learners into a real-world -type of simulation and potentially enrich the learning experience. Institutional background of a Bachelor’s level engineering program in Information and Communication Technology is introduced, with detailed focus on one of its majors, Health Technology. As part of a Customer Oriented Software Application thematic semester, one particular course of “eHealth Business and Solutions” is described and reflected in a gamified framework. Learning a consistent view into vast literature of business management, strategies, marketing and finance in a very limited time enforces selection of topics relevant to the industry. Health Technology is a novel and growing industry with a growing sector in consumer wearable devices and homecare applications. The business sector is attracting new entrepreneurs and impatient investor funds. From engineering education point of view the sector is driven by miniaturizing electronics, sensors and wireless applications. However, the market is highly consumer-driven and usability, safety and data integrity requirements are extremely high. When the same technology is used in analysis or treatment of patients, very strict regulatory measures are enforced. The paper introduces a course structure using gamification as a tool to learn the most essential in a new market: customer value proposition design, followed by a market entry game. Students analyze the existing market size and pricing structure of eHealth web-service market and enter the market as a steering group of their company, competing against the legacy players and with each other. The market is growing but has its rules of demand and supply balance. New products can be developed with an R&D-investment, and targeted to market with unique quality- and price-combinations. Product cost structure can be improved by investing to enhanced production capacity. Investments can be funded optionally by foreign capital. Students make management decisions and face the dynamics of the market competition in form of income statement and balance sheet after each decision cycle. The focus of the learning outcome is to understand customer value creation to be the source of cash flow. The benefit of gamification is to enrich the learning experience on structure and meaning of financial statements. The paper describes the gamification approach and discusses outcomes after two course implementations. Along the case description of learning challenges, some unexpected misconceptions are noted. Improvements of the game or the semi-gamified teaching pedagogy are discussed. The case description serves as an additional support to new game coordinator, as well as helps to improve the method. Overall, the gamified approach has helped to engage engineering student to business studies in an energizing way.

Keywords: engineering education, integrated curriculum, learning experience, learning outcomes

Procedia PDF Downloads 240
201 Growth Patterns of Pyrite Crystals Studied by Electron Back Scatter Diffraction (EBSD)

Authors: Kirsten Techmer, Jan-Erik Rybak, Simon Rudolph

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Natural formed pyrites (FeS2) are frequent sulfides in sedimentary and metamorphic rocks. Growth textures of idiomorphic pyrite assemblages reflect the conditions during their formation in the geologic sequence, furtheron the local texture analyses of the growth patterns of pyrite assemblages by EBSD reveal the possibility to resolve the growth conditions during the formation of pyrite at the micron scale. The spatial resolution of local texture measurements in the Scanning Electron Microscope used can be in the nanomete scale. Orientation contrasts resulting from domains of smaller misorientations within larger pyrite crystals can be resolved as well. The electron optical studies have been carried out in a Field-Emission Scanning Electron Microscope (FEI Quanta 200) equipped with a CCD camera to study the orientation contrasts along the surfaces of pyrite. Idiomorphic cubic single crystals of pyrite, polycrystalline assemblages of pyrite, spherically grown spheres of pyrite as well as pyrite-bearing ammonites have been studied by EBSD in the Scanning Electron Microscope. Samples were chosen to show no or minor secondary deformation and an idiomorphic 3D crystal habit, so the local textures of pyrite result mainly from growth and minor from deformation. The samples studied derived from Navajun (Spain), Chalchidiki (Greece), Thüringen (Germany) and Unterkliem (Austria). Chemical analyses by EDAX show pyrite with minor inhomogeneities e.g., single crystals of galena and chalcopyrite along the grain boundaries of larger pyrite crystals. Intergrowth between marcasite and pyrite can be detected in one sample. Pyrite may form intense growth twinning lamellae on {011}. Twinning, e.g., contact twinning is abundant within the crystals studied and the individual twinning lamellaes can be resolved by EBSD. The ammonites studied show a replacement of the shale by newly formed pyrite resulting in an intense intergrowth of calcite and pyrite. EBSD measurements indicate a polycrystalline microfabric of both minerals, still reflecting primary surface structures of the ammonites e.g, the Septen. Discs of pyrite (“pyrite dollar”) as well as pyrite framboids show growth patterns comprising a typical microfabric. EBSD studies reveal an equigranular matrix in the inner part of the discs of pyrite and a fiber growth with larger misorientations in the outer regions between the individual segments. This typical microfabric derived from a formation of pyrite crystals starting at a higher nucleation rate and followed by directional crystal growth. EBSD studies show, that the growth texture of pyrite in the samples studied reveals a correlation between nucleation rate and following growth rate of the pyrites, thus leading to the characteristic crystal habits. Preferential directional growth at lower nucleation rates may lead to the formation of 3D framboids of pyrite. Crystallographic misorientations between the individual fibers are similar. In ammonites studied, primary anisotropies of the substrates like e.g., ammonitic sutures, influence the nucleation, crystal growth and habit of the newly formed pyrites along the surfaces.

Keywords: Electron Back Scatter Diffraction (EBSD), growth pattern, Fe-sulfides (pyrite), texture analyses

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200 A Clustering-Based Approach for Weblog Data Cleaning

Authors: Amine Ganibardi, Cherif Arab Ali

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This paper addresses the data cleaning issue as a part of web usage data preprocessing within the scope of Web Usage Mining. Weblog data recorded by web servers within log files reflect usage activity, i.e., End-users’ clicks and underlying user-agents’ hits. As Web Usage Mining is interested in End-users’ behavior, user-agents’ hits are referred to as noise to be cleaned-off before mining. Filtering hits from clicks is not trivial for two reasons, i.e., a server records requests interlaced in sequential order regardless of their source or type, website resources may be set up as requestable interchangeably by end-users and user-agents. The current methods are content-centric based on filtering heuristics of relevant/irrelevant items in terms of some cleaning attributes, i.e., website’s resources filetype extensions, website’s resources pointed by hyperlinks/URIs, http methods, user-agents, etc. These methods need exhaustive extra-weblog data and prior knowledge on the relevant and/or irrelevant items to be assumed as clicks or hits within the filtering heuristics. Such methods are not appropriate for dynamic/responsive Web for three reasons, i.e., resources may be set up to as clickable by end-users regardless of their type, website’s resources are indexed by frame names without filetype extensions, web contents are generated and cancelled differently from an end-user to another. In order to overcome these constraints, a clustering-based cleaning method centered on the logging structure is proposed. This method focuses on the statistical properties of the logging structure at the requested and referring resources attributes levels. It is insensitive to logging content and does not need extra-weblog data. The used statistical property takes on the structure of the generated logging feature by webpage requests in terms of clicks and hits. Since a webpage consists of its single URI and several components, these feature results in a single click to multiple hits ratio in terms of the requested and referring resources. Thus, the clustering-based method is meant to identify two clusters based on the application of the appropriate distance to the frequency matrix of the requested and referring resources levels. As the ratio clicks to hits is single to multiple, the clicks’ cluster is the smallest one in requests number. Hierarchical Agglomerative Clustering based on a pairwise distance (Gower) and average linkage has been applied to four logfiles of dynamic/responsive websites whose click to hits ratio range from 1/2 to 1/15. The optimal clustering set on the basis of average linkage and maximum inter-cluster inertia results always in two clusters. The evaluation of the smallest cluster referred to as clicks cluster under the terms of confusion matrix indicators results in 97% of true positive rate. The content-centric cleaning methods, i.e., conventional and advanced cleaning, resulted in a lower rate 91%. Thus, the proposed clustering-based cleaning outperforms the content-centric methods within dynamic and responsive web design without the need of any extra-weblog. Such an improvement in cleaning quality is likely to refine dependent analysis.

Keywords: clustering approach, data cleaning, data preprocessing, weblog data, web usage data

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199 Via ad Reducendam Intensitatem Energiae Industrialis in Provincia Sino ad Conservationem Energiae

Authors: John Doe

Abstract:

This paper presents the research project “Escape Through Culture”, which is co-funded by the European Union and national resources through the Operational Programme “Competitiveness, Entrepreneurship and Innovation” 2014-2020 and the Single RTDI State Aid Action "RESEARCH - CREATE - INNOVATE". The project implementation is assumed by three partners, (1) the Computer Technology Institute and Press "Diophantus" (CTI), experienced with the design and implementation of serious games, natural language processing and ICT in education, (2) the Laboratory of Environmental Communication and Audiovisual Documentation (LECAD), part of the University of Thessaly, Department of Architecture, which is experienced with the study of creative transformation and reframing of the urban and environmental multimodal experiences through the use of AR and VR technologies, and (3) “Apoplou”, an IT Company with experience in the implementation of interactive digital applications. The research project proposes the design of innovative infrastructure of digital educational escape games for mobile devices and computers, with the use of Virtual Reality and Augmented Reality for the promotion of Greek cultural heritage in Greece and abroad. In particular, the project advocates the combination of Greek cultural heritage and literature, digital technologies advancements and the implementation of innovative gamifying practices. The cultural experience of the players will take place in 3 layers: (1) In space: the digital games produced are going to utilize the dual character of the space as a cultural landscape (the real space - landscape but also the space - landscape as presented with the technologies of augmented reality and virtual reality). (2) In literary texts: the selected texts of Greek writers will support the sense of place and the multi-sensory involvement of the user, through the context of space-time, language and cultural characteristics. (3) In the philosophy of the "escape game" tool: whether played in a computer environment, indoors or outdoors, the spatial experience is one of the key components of escape games. The innovation of the project lies both in the junction of Augmented/Virtual Reality with the promotion of cultural points of interest, as well as in the interactive, gamified practices of literary texts. The digital escape game infrastructure will be highly interactive, integrating the projection of Greek landscape cultural elements and digital literary text analysis, supporting the creation of escape games, establishing and highlighting new playful ways of experiencing iconic cultural places, such as Elefsina, Skiathos etc. The literary texts’ content will relate to specific elements of the Greek cultural heritage depicted by prominent Greek writers and poets. The majority of the texts will originate from Greek educational content available in digital libraries and repositories developed and maintained by CTI. The escape games produced will be available for use during educational field trips, thematic tourism holidays, etc. In this paper, the methodology adopted for infrastructure development will be presented. The research is based on theories of place, gamification, gaming development, making use of corpus linguistics concepts and digital humanities practices for the compilation and the analysis of literary texts.

Keywords: escape games, cultural landscapes, gamification, digital humanities, literature

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198 Understanding What People with Epilepsy and Their Care-Partners Value about an Electronic Patient Portal

Authors: K. Power, M. White, B. Dunleavey, E. Comerford, C. Doherty, N. Delanty, R. Corbridge, M. Fitzsimons

Abstract:

Introduction: Providing people with access to their own healthcare information and engaging them as co-authors of their health record can promote better transparency, trust, and inclusivity in the healthcare system. With the advent of electronic health records, there is a move towards involving patients as partners in their healthcare by providing them with access to their own health data via electronic patient portals (ePortal). For example, a recently developed ePortal to the Irish National Epilepsy Electronic Patient Record (EPR) provides access to summary medical records, tools for Patient Reported Outcomes (PROM), health goal-setting and preparation for clinical appointments. Aim: To determine what people with epilepsy (their families/carers) value about the Irish epilepsy ePortal. Methods: A socio-technical process was employed recruiting 30 families of people with epilepsy who also have an intellectual disability (ID). Family members who are a care partner of the person with epilepsy (PWE) were invited to co-design, develop and implement the ePortal. Family members engaged in usability and utility testing which involved a face to face meeting to learn about the ePortal, register for a user account and evaluate its structure and content. Family members were instructed to login to the portal on at least two separate occasions following the meeting and to complete a self-report evaluation tool during this time. The evaluation tool, based on a Usability Questionnaire (Lewis, 1993), consists of a short assessment of comfort using technology, instructions for using the ePortal and some tasks to complete. Tasks included validating summary record details, assessing ePortal ease of use, evaluation of information presented. Participants were asked for suggestions on how to improve the portal and make it more applicable to PWE who also have an ID. Results: Family members responded positively to the ePortal and valued the ability to share information between clinicians and care partners; use the ePortal as a passport between different healthcare settings (e.g., primary care to hospital). In the context of elderly parents of PWE, the ePortal is valued as a tool for supporting shared care between family members. Participants welcomed the facility to log lists of questions and goals to discuss with the clinician at the next clinical appointment as a means of improving quality of care. Participants also suggested further enhancements to the ePortal such as access to clinic letters which can provide an aide memoir in terms of the careplan agreed with the clinical team. For example, through the ePortal, people could see what investigations or therapies are scheduled. Conclusion: The Epilepsy Patient Portal is accessible via a range of devices such as smartphones and tablets. ePortals have the potential to help personalise care, improve patient involvement in clinical decision making, engage them as quality and safety partners, and help clinicians be more responsive to patient needs. Acknowledgement: The epilepsy ePortal project is part of PISCES, a Lighthouse Project funded by eHealth Ireland and HSE to help build an understanding of the benefits of eHealth technologies in the Irish Healthcare System.

Keywords: electronic patient portal, electronic patient record, epilepsy, intellectual disability, usability testing

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197 The Sense of Recognition of Muslim Women in Western Academia

Authors: Naima Mohammadi

Abstract:

The present paper critically reports on the emergency of Iranian international students in a large public university in Italy. Although the most sizeable diaspora of Iranians dates back to the 1979 revolution, a huge wave of Iranian female students travelled abroad after the Iranian Green Movement (2009) due to the intensification of gender discrimination and Islamization. To explore the experience of Iranian female students at an Italian public university, two complementary methods were adopted: a focus group and individual interviews. Focus groups yield detailed collective conversations and provide researchers with an opportunity to observe the interaction between participants, rather than between participant and researcher, which generates data. Semi-structured interviews allow participants to share their stories in their own words and speak about personal experiences and opinions. Research participants were invited to participate through a public call in a Telegram group of Iranian students. Theoretical and purposive sampling was applied to select participants. All participants were assured that full anonymity would be ensured and they consented to take part in the research. A two-hour focus group was held in English with participants in the presence and some online. They were asked to share their motivations for studying in Italy and talk about their experiences both within and outside the university context. Each of these interviews lasted from 45 to 60 minutes and was mostly carried out online and in Farsi. The focus group consisted of 8 Iranian female post-graduate students. In analyzing the data a blended approach was adopted, with a combination of deductive and inductive coding. According to research findings, although 9/11 was the beginning of the West’s challenges against Muslims, the nuclear threats of Islamic regimes promoted the toughest international sanctions against Iranians as a nation across the world. Accordingly, carrying an Iranian identity contributes to social, political, and economic exclusion. Research findings show that geopolitical factors such as international sanctions and Islamophobia, and a lack of reciprocity in terms of recognition, have created a sense of stigmatization for veiled and unveiled Iranian female students who are the largest groups of ‘non-European Muslim international students’ enrolled in Italian universities. Participants addressed how their nationality has devalued their public image and negatively impacted their self-confidence and self-realization in academia. They highlighted the experience of an unwelcoming atmosphere by different groups of people and institutes, such as receiving marked students’ badges, rejected bank account requests, failed visa processes, secondary security screening selection, and hyper-visibility of veiled students. This study corroborates the need for institutions to pay attention to geopolitical factors and religious diversity in student recruitment and provide support mechanisms and access to basic rights. Accordingly, it is suggested that Higher Education Institutions (HEIs) have a social and moral responsibility towards the discrimination and both social and academic exclusion of Iranian students.

Keywords: Iranian diaspora, female students, recognition theory, inclusive university

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196 Zinc Oxide Varistor Performance: A 3D Network Model

Authors: Benjamin Kaufmann, Michael Hofstätter, Nadine Raidl, Peter Supancic

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ZnO varistors are the leading overvoltage protection elements in today’s electronic industry. Their highly non-linear current-voltage characteristics, very fast response times, good reliability and attractive cost of production are unique in this field. There are challenges and questions unsolved. Especially, the urge to create even smaller, versatile and reliable parts, that fit industry’s demands, brings manufacturers to the limits of their abilities. Although, the varistor effect of sintered ZnO is known since the 1960’s, and a lot of work was done on this field to explain the sudden exponential increase of conductivity, the strict dependency on sinter parameters, as well as the influence of the complex microstructure, is not sufficiently understood. For further enhancement and down-scaling of varistors, a better understanding of the microscopic processes is needed. This work attempts a microscopic approach to investigate ZnO varistor performance. In order to cope with the polycrystalline varistor ceramic and in order to account for all possible current paths through the material, a preferably realistic model of the microstructure was set up in the form of three-dimensional networks where every grain has a constant electric potential, and voltage drop occurs only at the grain boundaries. The electro-thermal workload, depending on different grain size distributions, was investigated as well as the influence of the metal-semiconductor contact between the electrodes and the ZnO grains. A number of experimental methods are used, firstly, to feed the simulations with realistic parameters and, secondly, to verify the obtained results. These methods are: a micro 4-point probes method system (M4PPS) to investigate the current-voltage characteristics between single ZnO grains and between ZnO grains and the metal electrode inside the varistor, micro lock-in infrared thermography (MLIRT) to detect current paths, electron back scattering diffraction and piezoresponse force microscopy to determine grain orientations, atom probe to determine atomic substituents, Kelvin probe force microscopy for investigating grain surface potentials. The simulations showed that, within a critical voltage range, the current flow is localized along paths which represent only a tiny part of the available volume. This effect could be observed via MLIRT. Furthermore, the simulations exhibit that the electric power density, which is inversely proportional to the number of active current paths, since this number determines the electrical active volume, is dependent on the grain size distribution. M4PPS measurements showed that the electrode-grain contacts behave like Schottky diodes and are crucial for asymmetric current path development. Furthermore, evaluation of actual data suggests that current flow is influenced by grain orientations. The present results deepen the knowledge of influencing microscopic factors on ZnO varistor performance and can give some recommendations on fabrication for obtaining more reliable ZnO varistors.

Keywords: metal-semiconductor contact, Schottky diode, varistor, zinc oxide

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195 OASIS: An Alternative Access to Potable Water, Renewable Energy and Organic Food

Authors: Julien G. Chenet, Mario A. Hernandez, U. Leonardo Rodriguez

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The tropical areas are places where there is scarcity of access to potable water and where renewable energies need further development. They also display high undernourishment levels, even though they are one of the resources-richest areas in the world. In these areas, it is common to count on great extension of soils, high solar radiation and raw water from rain, groundwater, surface water or even saltwater. Even though resources are available, access to them is limited, and the low-density habitat makes central solutions expensive and investments not worthy. In response to this lack of investment, rural inhabitants use fossil fuels and timber as an energy source and import agrochemical for soils fertilization, which increase GHG emissions. The OASIS project brings an answer to this situation. It supplies renewable energy, potable water and organic food. The first step is the determination of the needs of the communities in terms of energy, water quantity and quality, food requirements and soil characteristics. Second step is the determination of the available resources, such as solar energy, raw water and organic residues on site. The pilot OASIS project is located in the Vichada department, Colombia, and ensures the sustainable use of natural resources to meet the community needs. The department has roughly 70% of indigenous people. They live in a very scattered landscape, with no access to clean water and energy. They use polluted surface water for direct consumption and diesel for energy purposes. OASIS pilot will ensure basic needs for a 400-students education center. In this case, OASIS will provide 20 kW of solar energy potential and 40 liters per student per day. Water will be treated form groundwater, with two qualities. A conventional one with chlorine, and as the indigenous people are not used to chlorine for direct consumption, second train is with reverse osmosis to bring conservable safe water without taste. OASIS offers a solution to supply basic needs, shifting from fossil fuels, timber, to a no-GHG-emission solution. This solution is part of the mitigation strategy against Climate Change for the communities in low-density areas of the tropics. OASIS is a learning center to teach how to convert natural resources into utilizable ones. It is also a meeting point for the community with high pedagogic impact that promotes the efficient and sustainable use of resources. OASIS system is adaptable to any tropical area and competes technically and economically with any conventional solution, that needs transport of energy, treated water and food. It is a fully automatic, replicable and sustainable solution to sort out the issue of access to basic needs in rural areas. OASIS is also a solution to undernourishment, ensuring a responsible use of resources, to prevent long-term pollution of soils and groundwater. It promotes the closure of the nutrient cycle, and the optimal use of the land whilst ensuring food security in depressed low-density regions of the tropics. OASIS is under optimization to Vichada conditions, and will be available to any other tropical area in the following months.

Keywords: climate change adaptation and mitigation, rural development, sustainable access to clean and renewable resources, social inclusion

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194 Functional Outcome of Speech, Voice and Swallowing Following Excision of Glomus Jugulare Tumor

Authors: B. S. Premalatha, Kausalya Sahani

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Background: Glomus jugulare tumors arise within the jugular foramen and are commonly seen in females particularly on the left side. Surgical excision of the tumor may cause lower cranial nerve deficits. Cranial nerve involvement produces hoarseness of voice, slurred speech, and dysphagia along with other physical symptoms, thereby affecting the quality of life of individuals. Though oncological clearance is mainly emphasized on while treating these individuals, little importance is given to their communication, voice and swallowing problems, which play a crucial part in daily functioning. Objective: To examine the functions of voice, speech and swallowing outcomes of the subjects, following excision of glomus jugulare tumor. Methods: Two female subjects aged 56 and 62 years had come with a complaint of change in voice, inability to swallow and reduced clarity of speech following surgery for left glomus jugulare tumor were participants of the study. Their surgical information revealed multiple cranial nerve palsies involving the left facial, left superior and recurrent branches of the vagus nerve, left pharyngeal, left soft palate, left hypoglossal and vestibular nerves. Functional outcomes of voice, speech and swallowing were evaluated by perceptual and objective assessment procedures. Assessment included the examination of oral structures and functions, dysarthria by Frenchey dysarthria assessment, cranial nerve functions and swallowing functions. MDVP and Dr. Speech software were used to evaluate acoustic parameters of voice and quality of voice respectively. Results: The study revealed that both the subjects, subsequent to excision of glomus jugulare tumor, showed a varied picture of affected oral structure and functions, articulation, voice and swallowing functions. The cranial nerve assessment showed impairment of the vagus, hypoglossal, facial and glossopharyngeal nerves. Voice examination indicated vocal cord paralysis associated with breathy quality of voice, weak voluntary cough, reduced pitch and loudness range, and poor respiratory support. Perturbation parameters as jitter, shimmer were affected along with s/z ratio indicative of voice fold pathology. Reduced MPD(Maximum Phonation Duration) of vowels indicated that disturbed coordination between respiratory and laryngeal systems. Hypernasality was found to be a prominent feature which reduced speech intelligibility. Imprecise articulation was seen in both the subjects as the hypoglossal nerve was affected following surgery. Injury to vagus, hypoglossal, gloss pharyngeal and facial nerves disturbed the function of swallowing. All the phases of swallow were affected. Aspiration was observed before and during the swallow, confirming the oropharyngeal dysphagia. All the subsystems were affected as per Frenchey Dysarthria Assessment signifying the diagnosis of flaccid dysarthria. Conclusion: There is an observable communication and swallowing difficulty seen following excision of glomus jugulare tumor. Even with complete resection, extensive rehabilitation may be necessary due to significant lower cranial nerve dysfunction. The finding of the present study stresses the need for involvement of as speech and swallowing therapist for pre-operative counseling and assessment of functional outcomes.

Keywords: functional outcome, glomus jugulare tumor excision, multiple cranial nerve impairment, speech and swallowing

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193 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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192 Emergency Department Utilisation of Older People Presenting to Four Emergency Departments

Authors: M. Fry, L. Fitzpatrick, Julie Considine, R. Z. Shaban, Kate Curtis

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Introduction: The vast majority of older Australians lives independently and are self-managing at home, despite a growing number living with a chronic illness that requires health intervention. Evidence shows that between 50% and 80% of people presenting to the emergency department (ED) are in pain. Australian EDs manage 7.2 million attendances every year and 1.4 million of these are people aged 65 years or more. Research shows that 28% of ED patients aged 65 years or more have Cognitive impairment (CI) associated with dementia, delirium and neurological conditions. Background: Traditional ED service delivery may not be suitable for older people who present with multiple, complex and ongoing illnesses. Likewise, ED clinical staff often perceive that their role should be focused more on immediate and potential lifethreatening illness and conditions which are episodic in nature. Therefore, the needs of older people and their family/carers may not be adequately addressed in the context of an ED presentation. Aim: We aimed to explore the utilisation and characteristics of older people presenting to four metropolitan EDs. Method: The findings being presented are part of a program of research exploring pain management practices for older persons with long bone fractures. The study was conducted across four metropolitan emergency departments of older patients (65years and over) and involved a 12-month randomised medical record audit (n=255). Results: ED presentations across four ED sites in 2012 numbered 168021, with 44778 (26.6%) patients aged 65 and over. Of the 44778 patients, the average age was 79.1 years (SD 8.54). There were more females 23932 (53.5%). The majority (26925: 85.0%) of older persons self-referred to the ED and lived independently. The majority arrived by ambulance (n=18553: 41.4%) and were allocated triage category was 3 (n=19,507:43.65%) or Triage category 4 at (n=15,389: 34.43%). The top five triage symptom presentations involved pain (n=8088; 18.25%), dyspnoea (n=4735; 10.7%), falls (n=4032; 9.1%), other (n=3984; 9.0%), cardiac (n=2987; 6.7%). The top five system based diagnostic presentations involved musculoskeletal (n=8902; 20.1%), cardiac (n=6704:15.0%), respiratory (n=4933; 11.0%), neurological (n=4909; 11.0%), gastroenterology (n=4321; 9.7%). On review of one tertiary hospital database the vital signs on average at time triage: Systolic Blood Pressure 143.6mmHg. Heart Rate 83.4 beats/minute; Respiratory Rate 18.5 breaths/ minute; Oxygen saturation 97.0% and Tympanic temperature 36.7 and Blood Glucose Level 7.4mmols/litre. The majority presented with a Glasgow Coma Score of 14 or higher. On average the older person stayed in the ED 4:56 (SD 3:28minutes).The average time to be seen was 39 minutes (SD 48 minutes). The majority of older persons were admitted (n=27562: 61.5%), did not wait for treatment (n= 8879: 0.02%) discharged home (n=16256: 36.0%). Conclusion: The vast majority of older persons are living independently, although many require admission on arrival to the ED. Many arrived in pain and with musculoskeletal injuries and or conditions. New models of care need to be considered, which may better support self-management and independent living of the older person and the National Emergency Access Targets.

Keywords: chronic, older person, aged care, emergency department

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