Search results for: improve

Authors: Pamela K. Coke, Heidi Frederiksen, Ann Sebald

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Over the past three years, the researchers have been tracking a rise in the number of teacher education candidates leaving the field before completing their university’s educator preparation program. At their institution, this rise is most pronounced in English Education. The purpose of this qualitative research study is to understand English Education teacher candidates' expectations in becoming prepared educators at each phase of their four phase teacher education program at one institution of higher education in the United States. Research questions include: To what extent do we find differences in teacher candidates' expectations of their teacher training program and student teaching experiences based upon undergraduate and graduate programs? Why do (or do not) teacher candidates persist in their teacher training program and student teaching experiences? How do dispositions develop through the course of the teacher training program? What supports do teacher candidates self-identify as needing at each phase of the teacher training program? Based upon participant interviews at each phase of the teacher education program, the researchers, all teacher educators, examine the extent to which English Education students feel prepared to student teach, focusing on preparation, persistence, and dispositions. The Colorado State University Center for Educator Preparation (CEP) provides students with information about teaching dispositions, or desired professional behaviors, throughout their education program. CEP focuses these dispositions around nine categories: Professional Behaviors, Initiative and Dependability, Tact and Judgment, Ethical Behavior and Integrity, Collegiality and Responsiveness, Effective Communicator, Desire to Improve Own Performance, Culturally Responsive, and Commitment to the Profession. Currently, in the first phase of a four phase study, initial results indicate participants expect their greatest joys will be working with and learning from students. They anticipate their greatest challenges will involve discipline and confidence. They predict they will persist in their program because they believe the country needs well-prepared teachers and they have a commitment to their professional growth. None of the participants thus far could imagine why they would leave the program. With regard to strongest and weakest dispositions, results are mixed. Some participants see Tact and Judgment as their strongest disposition; others see it as their weakest. All participants stated mentoring is a necessary support at every phase of the teacher preparation process. This study informs the way teacher educators train and evaluate teacher candidates, and has implications for the frequency and types of feedback students receive from mentors and supervisors. This research contributes to existing work on teacher retention, candidate persistence, and dispositional development.

Keywords: English education, dispositions, persistence, teacher preparation

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Authors: Faezeh Mosallat, Eric L. Bibeau, Tarek El Mekkawy

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Availability of a wide variety of renewable resources, such as large reserves of hydro, biomass, solar and wind in Canada provides significant potential to improve the sustainability of energy uses. As buildings represent a considerable portion of energy use in Canada, application of distributed solar energy systems for heating and cooling may increase the amount of renewable energy use. Parabolic solar trough systems have seen limited deployments in cold northern climates as they are more suitable for electricity production in southern latitudes. Heat production by concentrating solar rays using parabolic troughs can overcome the poor efficiencies of flat panels and evacuated tubes in cold climates. A numerical dynamic model is developed to simulate an installed parabolic solar trough facility in Winnipeg. The results of the numerical model are validated using the experimental data obtained from this system. The model is developed in Simulink and will be utilized to simulate a tri-generation system for heating, cooling and electricity generation in remote northern communities. The main objective of this simulation is to obtain operational data of solar troughs in cold climates as this is lacking in the literature. In this paper, the validated Simulink model is applied to simulate a solar assisted absorption cooling system along with electricity generation using organic Rankine cycle (ORC) and thermal storage. A control strategy is employed to distribute the heated oil from solar collectors among the above three systems considering the temperature requirements. This modeling provides dynamic performance results using real time minutely meteorological data which are collected at the same location the solar system is installed. This is a big step ahead of the current models by accurately calculating the available solar energy at each time step considering the solar radiation fluctuations due to passing clouds. The solar absorption cooling is modeled to use the generated heat from the solar trough system and provide cooling in summer for a greenhouse which is located next to the solar field. A natural gas water heater provides the required excess heat for the absorption cooling at low or no solar radiation periods. The results of the simulation are presented for a summer month in Winnipeg which includes the amount of generated electric power from ORC and contribution of solar energy in the cooling load provision

Keywords: absorption cooling, parabolic solar trough, remote community, validated model

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Authors: R. Tariq, R. Lee

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Background: Additional demands placed on senior clinical teams with ongoing COVID-19 management has accelerated the need to harness the wider healthcare professional resources and upskill them to take on greater clinical responsibility safely. The UK NHS Long Term Plan (2019)¹ emphasises the importance of expanding Advanced Practitioners’ (APs) roles to take on more clinical diagnostic responsibilities to cope with increased demand. In acute settings, APs are often the first point of care for patients and require training to take on initial triage responsibilities efficiently and safely. Critically, their roles include determining which onward services the patients may require, and assessing whether they can be treated at home, avoiding unnecessary admissions to the hospital. Dem Dx is a Clinical Reasoning Platform (CRP) that claims to help frontline healthcare professionals independently assess and triage patients. It guides the clinician from presenting complaints through associated symptoms to a running list of differential diagnoses, media, national and institutional guidelines. The objective of this study was to compare the clinical referral rates and guidelines adherence registered by the HMR Urgent Community Care Team (UCCT)² and Dem Dx recommendations using retrospective cases. Methodology: 192 cases seen by the UCCT were anonymised and reassessed using Dem Dx clinical pathways. We compared the UCCT’s performance with Dem Dx regarding the appropriateness of onward referrals. We also compared the clinical assessment regarding adherence to NICE guidelines recorded on the clinical notes and the presence of suitable guidance in each case. The cases were audited by two medical doctors. Results: Dem Dx demonstrated appropriate referrals in 85% of cases, compared to 47% in the UCCT team (p<0.001). Of particular note, Dem Dx demonstrated an almost 65% (p<0.001) improvement in the efficacy and appropriateness of referrals in a highly experienced clinical team. The effectiveness of Dem Dx is in part attributable to the relevant NICE and local guidelines found within the platform's pathways and was found to be suitable in 86% of cases. Conclusion: This study highlights the potential of clinical decision support, as Dem Dx, to improve the quality of onward clinical referrals delivered by a multidisciplinary team in primary care. It demonstrated that it could support healthcare professionals in making appropriate referrals, especially those that may be overlooked by providing suitable clinical guidelines directly embedded into cases and clear referral pathways. Further evaluation in the clinical setting has been planned to confirm those assumptions in a prospective study.

Keywords: advanced practitioner, clinical reasoning, clinical decision-making, management, multidisciplinary team, referrals, triage

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Authors: Wan-Yu Liu, Tiffany April Lin, Yu-Chieh Tang, Yi-Lin Wang, Chieh-Hui Li

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As the national income in Taiwan has been raised, the life style of the public has also been changed, so that the tourism industry gradually moves from a service industry to an experience economy. The Lihpaoland is one of the most popular theme parks in Taiwan. However, the related works on performance of service quality of the park have been lacking since its re-operation in 2012. Therefore, this study investigates the quality of software/hardware facilities and services of the Lihpaoland, and aims to achieve the following three goals: 1) analyzing how various sample data of tourists leads to different results for service quality of LihpaoLand; 2) analyzing how tourists respond to the service tangibility, service reliability, service responsiveness, service guarantee, and service empathy of LihpaoLand; 3) according to the theoretical and empirical results, proposing how to improve the overall facilities and services of LihpaoLand, and hoping to provide suggestions to the LihpaoLand or other related businesses to make decision. The survey was conducted on the tourists to the LihpaoLand using convenience sampling, and 400 questionnaires were collected successfully. Analysis results show that tourists paid much attention to maintenance of amusement facilities and safety of the park, and were satisfied with them, which are great advantages of the park. However, transportation around the LihpaoLand was inadequate, and the price of the Fullon hotel (which is the hotel closest to the LihpaoLand) were not accepted by tourists – more promotion events are recommended. Additionally, the shows are not diversified, and should be improved with the highest priority. Tourists did not pay attention to service personnel’s clothing and the ticket price, but they were not satisfied with them. Hence, this study recommends to design more distinctive costumes and conduct ticket promotions. Accordingly, the suggestions made in this study for LihpaoLand are stated as follows: 1) Diversified amusement facilities should be provided to satisfy the needs at different ages. 2) Cheep but tasty catering and more distinctive souvenirs should be offered. 3) Diversified propaganda schemes should be strengthened to increase number of tourists. 4) Quality and professional of the service staff should be enhanced to acquire public praise and tourists revisiting. 5) Ticket promotions in peak seasons, low seasons, and special events should be conducted. 6) Proper traffic flows should be planned and combined with technologies to reduce waiting time of tourists. 7) The features of theme landscape in LihpaoLand should be strengthened to increase willingness of the tourists with special preferences to visit the park. 8) Ticket discounts or premier points card promotions should be adopted to reward the tourists with high loyalty.

Keywords: service quality, customers’ satisfaction, theme park, Taiwan

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

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

Keywords: adolescents, children, electroconvulsive, therapy

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Authors: Massimiliano Condotta, Giovanni Borga, Chiara Scanagatta

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Urban systems are places where the various actors involved interact and enter in conflict, in particular with reference to topics such as traffic congestion and security. But topics of discussion, and often clash because of their strong complexity, are air and noise pollution. For air pollution, the complexity stems from the fact that atmospheric pollution is due to many factors, but above all, the observation and measurement of the amount of pollution of a transparent, mobile and ethereal element like air is very difficult. Often the perceived condition of the inhabitants does not coincide with the real conditions, because it is conditioned - sometimes in positive ways other in negative ways - from many other factors such as the presence, or absence, of natural elements such as trees or rivers. These problems are seen with noise pollution as well, which is also less considered as an issue even if it’s problematic just as much as air quality. Starting from these opposite positions, it is difficult to identify and implement valid, and at the same time shared, mitigation solutions for the problem of urban pollution (air and noise pollution). The LOOPER (Learning Loops in the Public Realm) project –described in this paper – wants to build and test a methodology and a platform for participatory co-design, planning, and construction process inside a learning loop process. Novelties in this approach are various; the most relevant are three. The first is that citizens participation starts since from the research of problems and air quality analysis through a participatory data collection, and that continues in all process steps (design and construction). The second is that the methodology is characterized by a learning loop process. It means that after the first cycle of (1) problems identification, (2) planning and definition of design solution and (3) construction and implementation of mitigation measures, the effectiveness of implemented solutions is measured and verified through a new participatory data collection campaign. In this way, it is possible to understand if the policies and design solution had a positive impact on the territory. As a result of the learning process produced by the first loop, it will be possible to improve the design of the mitigation measures and start the second loop with new and more effective measures. The third relevant aspect is that the citizens' participation is carried out via Urban Living Labs that involve all stakeholder of the city (citizens, public administrators, associations of all urban stakeholders,…) and that the Urban Living Labs last for all the cycling of the design, planning and construction process. The paper will describe in detail the LOOPER methodology and the technical solution adopted for the participatory data collection and design and construction phases.

Keywords: air quality, co-design, learning loops, noise pollution, urban living labs

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Authors: Charles St. Geste, Michael Neumann, Catherine Twohig

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Our primary aim is to examine farmer-centered participatory action learning as a tool to improve agricultural production, build resilience to climate shocks and, more broadly, advance community-driven solutions for sustainable development in rural communities across Haiti. For over six years, sixty plus farmers from Deslandes, Haiti, organized in three traditional work groups called konbits, have designed and tested low-input agroecology techniques as part of the Konbit Vanyan Kapab Pwoje Agroekoloji. The project utilizes a participatory action learning approach, emphasizing social inclusion, building on local knowledge, experiential learning, active farmer participation in trial design and evaluation, and cross-community sharing. Mixed methods were used to evaluate changes in knowledge and adoption of agroecology techniques, confidence in advancing agroecology locally, and innovation among Konbit Vanyan Kapab farmers. While skill and knowledge in application of agroecology techniques varied among individual farmers, a majority of farmers successfully adopted techniques outside of the trial farms. The use of agroecology techniques on trial and individual farms has doubled crop production in many cases. Farm income has also increased, and farmers report less damage to crops and property caused by extreme weather events. Furthermore, participatory action strategies have led to greater local self-determination and greater capacity for sustainable community development. With increased self-confidence and the knowledge and skills acquired from participating in the project, farmers prioritized sharing their successful techniques with other farmers and have developed a farmer-to-farmer training program that incorporates participatory action learning. Using adult education methods, farmers, trained as agroecology educators, are currently providing training in sustainable farming practices to farmers from five villages in three departments across Haiti. Konbit Vanyan Kapab farmers have also begun testing production of value-added food products, including a dried soup mix and tea. Key factors for success include: opportunities for farmers to actively participate in all phases of the project, group diversity, resources for application of agroecology techniques, focus on group processes and overcoming local barriers to inclusive decision-making.

Keywords: agroecology, participatory action learning, rural Haiti, sustainable community development

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Authors: Naohiro Nakamura, Takuya Kinoshita, Hiroshi Fukuyama

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The 2011 off The Pacific Coast of Tohoku Earthquake caused considerable damage to wide areas of eastern Japan. A large number of earthquake observation records were obtained at various places. To design more earthquake-resistant buildings and improve earthquake disaster prevention, it is necessary to utilize these data to analyze and evaluate the behavior of a building during an earthquake. This paper presents an earthquake response simulation analysis (hereafter a seismic response analysis) that was conducted using data recorded during the main earthquake (hereafter the main shock) as well as the earthquakes before and after it. The data were obtained at a high-rise steel-reinforced concrete (SRC) building in the bay area of Tokyo. We first give an overview of the building, along with the characteristics of the earthquake motion and the building during the main shock. The data indicate that there was a change in the natural period before and after the earthquake. Next, we present the results of our seismic response analysis. First, the analysis model and conditions are shown, and then, the analysis result is compared with the observational records. Using the analysis result, we then study the effect of soil-structure interaction on the response of the building. By identifying the characteristics of the building during the earthquake (i.e., the 1st natural period and the 1st damping ratio) by the Auto-Regressive eXogenous (ARX) model, we compare the analysis result with the observational records so as to evaluate the accuracy of the response analysis. In this study, a lumped-mass system SR model was used to conduct a seismic response analysis using observational data as input waves. The main results of this study are as follows: 1) The observational records of the 3/11 main shock put it between a level 1 and level 2 earthquake. The result of the ground response analysis showed that the maximum shear strain in the ground was about 0.1% and that the possibility of liquefaction occurring was low. 2) During the 3/11 main shock, the observed wave showed that the eigenperiod of the building became longer; this behavior could be generally reproduced in the response analysis. This prolonged eigenperiod was due to the nonlinearity of the superstructure, and the effect of the nonlinearity of the ground seems to have been small. 3) As for the 4/11 aftershock, a continuous analysis in which the subject seismic wave was input after the 3/11 main shock was input was conducted. The analyzed values generally corresponded well with the observed values. This means that the effect of the nonlinearity of the main shock was retained by the building. It is important to consider this when conducting the response evaluation. 4) The first period and the damping ratio during a vibration were evaluated by an ARX model. Our results show that the response analysis model in this study is generally good at estimating a change in the response of the building during a vibration.

Keywords: ARX model, response analysis, SRC building, the 2011 off the Pacific Coast of Tohoku Earthquake

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Authors: Evangelos G. Ilias, Panagiotis G. Ilias, Vasileios T. Popotas

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The United Kingdom has one of the oldest railway networks in the world dating back to 1825 when the world’s first passenger railway was opened. The network has some 40,000 bridges of various construction types using a wide range of materials including masonry, steel, cast iron, wrought iron, concrete and timber. It is commonly accepted that the successful operation of the network is vital for the economy of the United Kingdom, consequently the cost effective maintenance of the existing infrastructure is a high priority to maintain the operability of the network, prevent deterioration and to extend the life of the assets. Every bridge on the railway network is required to be assessed every eighteen years and a structured approach to assessments is adopted with three main types of progressively more detailed assessments used. These assessment types include Level 0 (standardized spreadsheet assessment tools), Level 1 (analytical hand calculations) and Level 2 (generally finite element analyses). There is a degree of conservatism in the first two types of assessment dictated to some extent by the relevant standards which can lead to some structures not achieving the required load rating. In these situations, a Level 2 Assessment is often carried out using finite element analysis to uncover ‘latent strength’ and improve the load rating. If successful, the more sophisticated analysis can save on costly strengthening or replacement works and avoid disruption to the operational railway. This paper presents the ‘strengthening by assessment’ achieved by Level 2 analyses. The use of more accurate analysis assumptions and the implementation of non-linear modelling and functions (material, geometric and support) to better understand buckling modes and the structural behaviour of historic construction details that are not specifically covered by assessment codes are outlined. Metallic bridges which are susceptible to loss of section size through corrosion have largest scope for improvement by the Level 2 Assessment methodology. Three case studies are presented, demonstrating the effectiveness of the sophisticated Level 2 Assessment methodology using finite element analysis against the conservative approaches employed for Level 0 and Level 1 Assessments. One rail overbridge and two rail underbridges that did not achieve the required load rating by means of a Level 1 Assessment due to the inadequate restraint provided by U-Frame action are examined and the increase in assessed capacity given by the Level 2 Assessment is outlined.

Keywords: assessment, bridges, buckling, finite element analysis, non-linear modelling, strengthening

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Authors: Jay Raval

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Sports and physical fitness have been a vital component of our civilization. It is such a power which, motivates and inspires every individual, communities and even countries to be aware of the physical and mental health. All though, sports play vital role in the overall development of the nation, but in the developing countries such as India, this culture of sports is yet to be motivated. However, in India lack of sporting culture has held back the growth of a similar industry in the past, despite the growing awareness and interest in various different sports besides cricket. Hence, due to a lack of sporting culture, corporate investments in India’s sports have traditionally been limited to only non-profit corporate social responsibility activities and initiatives. From past couple of years, India has come up with new initiatives such as Indian Premier League (Cricket), Hockey India League, Indian Badminton League, Pro Kabaddi League, and Indian Super League (Football) which help to boost Indian sports culture and thereby increase economy of the country. Out of 29 states of India, among all of those competitive states, Gujarat is showing very rapid increase in sports participation. Khel Mahakumbh, the competition conducted for the last six years has been a giant step in this direction and covers rural and urban areas of Gujarat. The objective of the research is to address the overall development of the sports system. Sports system includes infrastructure, coaches, resources, and participants. The current existing system is not disabled friendly. This research paper highlights adequate steps in order to improve and sort out pressing issues in the sports system. Education system is highly academic-centric with a definite trend towards reducing school sports and extra-curricular sports in the Gujarat state. Constituents of this research work make an attempt to evaluate the framework of the Olympic Charter, the Sports Authority of India, the Indian Olympics Association and the National Sports Federations. It explores the areas that need to be revamped, rejuvenated and reoriented to function in an open, democratic, equitable, transparent and accountable manner. Research is based on mixed method approach. It is used for the data collection which includes the personal interviews, document analysis and the use of news article. Quality assurance is also tested by conducting the trustworthiness of the paper. Mixed method helps to strengthen the analysis part and give strong base for the discussion during the analysis.

Keywords: physical development, sports authority of India, sports policy, women empowerment

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Authors: Mesfin Abebe Molla

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This research aims to examine the practices of inclusion of the hard of hearing and deaf students in regular schools. It also focuses on exploring strategies for optimal benefits of students with Hard of Hearing and Deaf (HH-D) from inclusion. Concurrent mixed methods research design was used to collect quantitative and qualitative data. The instruments used to gather data for this study were questionnaire, semi- structured interview, and observations. A total of 102 HH-D students and 42 primary and High School teachers were selected using simple random sampling technique and used as participants to collect quantitative data. Non-probability sampling technique was also employed to select 14 participants (4-school principals, 6-teachers and 4-parents of HH-D students) and they were interviewed to collect qualitative data. Descriptive and inferential statistical techniques (independent sample t-test, one way ANOVA and Multiple regressions) were employed to analyze quantitative data. Qualitative data were also analyzed qualitatively by theme analysis. The findings reported that there were individual principals’, teachers’ and parents’ strong commitment and efforts for practicing inclusion of HH-D students effectively; however, most of the core values of inclusion were missing in both schools. Most of the teachers (78.6 %) and HH-D students (75.5%) had negative attitude and considerable reservations about the feasibility of inclusion of HH-D students in both schools. Furthermore, there was a statistically significant difference of attitude toward to inclusion between the two school’s teachers and the teachers’ who had taken and had not taken additional training on IE and sign language. The study also indicated that there was a statistically significant difference of attitude toward to inclusion between hard of hearing and deaf students. However, the overall contribution of the demographic variables of teachers and HH-D students on their attitude toward inclusion is not statistically significant. The finding also showed that HH-D students did not have access to modified curriculum which would maximize their abilities and help them to learn together with their hearing peers. In addition, there is no clear and adequate direction for the medium of instruction. Poor school organization and management, lack of commitment, financial resources, collaboration and teachers’ inadequate training on Inclusive Education (IE) and sign language, large class size, inappropriate assessment procedure, lack of trained deaf adult personnel who can serve as role model for HH-D students and lack of parents and community members’ involvement were some of the major factors that affect the practicing inclusion of students HH-D. Finally, recommendations are made to improve the practices of inclusion of HH-D students and to make inclusion of HH-D students an integrated part of Ethiopian education based on the findings of the study.

Keywords: deaf, hard of hearing, inclusion, regular schools

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Authors: Meera Tandan, Mohan Timilsina, Martin Cormican, Akke Vellinga

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Background: In general practice, many infections are treated empirically without microbiological confirmation. Understanding susceptibility of antimicrobials during empirical prescribing can be helpful to reduce inappropriate prescribing. This study aims to apply a prediction model using a decision tree approach to predict the antimicrobial resistance (AMR) of urinary tract infections (UTI) based on non-clinical features of patients over 65 years. Decision tree models are a novel idea to predict the outcome of AMR at an initial stage. Method: Data was extracted from the database of the microbiological laboratory of the University Hospitals Galway on all antimicrobial susceptibility testing (AST) of urine specimens from patients over the age of 65 from January 2011 to December 2014. The primary endpoint was resistance to common antimicrobials (Nitrofurantoin, trimethoprim, ciprofloxacin, co-amoxiclav and amoxicillin) used to treat UTI. A classification and regression tree (CART) model was generated with the outcome ‘resistant infection’. The importance of each predictor (the number of previous samples, age, gender, location (nursing home, hospital, community) and causative agent) on antimicrobial resistance was estimated. Sensitivity, specificity, negative predictive (NPV) and positive predictive (PPV) values were used to evaluate the performance of the model. Seventy-five percent (75%) of the data were used as a training set and validation of the model was performed with the remaining 25% of the dataset. Results: A total of 9805 UTI patients over 65 years had their urine sample submitted for AST at least once over the four years. E.coli, Klebsiella, Proteus species were the most commonly identified pathogens among the UTI patients without catheter whereas Sertia, Staphylococcus aureus; Enterobacter was common with the catheter. The validated CART model shows slight differences in the sensitivity, specificity, PPV and NPV in between the models with and without the causative organisms. The sensitivity, specificity, PPV and NPV for the model with non-clinical predictors was between 74% and 88% depending on the antimicrobial. Conclusion: The CART models developed using non-clinical predictors have good performance when predicting antimicrobial resistance. These models predict which antimicrobial may be the most appropriate based on non-clinical factors. Other CART models, prospective data collection and validation and an increasing number of non-clinical factors will improve model performance. The presented model provides an alternative approach to decision making on antimicrobial prescribing for UTIs in older patients.

Keywords: antimicrobial resistance, urinary tract infection, prediction, decision tree

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Authors: Claudio Lamilla, Andrés Santos, Vicente Llanquinao, Jocelyn Hermosilla, Leticia Barrientos

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The industry in general is very interested in improving and optimizing industrial processes in order to reduce the costs involved in obtaining raw materials and production. Thus, an interesting and cost-effective alternative is the incorporation of bioactive metabolites in such processes, being an example of this enzymes which catalyze efficiently a large number of enzymatic reactions of industrial and biotechnological interest. In the search for new sources of these active metabolites, Antarctica is one of the least explored places on our planet where the most drastic cold conditions, salinity, UVA-UVB and liquid water available are present, features that have shaped all life in this very harsh environment, especially bacteria that live in different Antarctic ecosystems, which have had to develop different strategies to adapt to these conditions, producing unique biochemical strategies. In this work the production of cellulolytic enzymes of seven bacterial strains isolated from marine sediments at different sites in the Antarctic was evaluated. Isolation of the strains was performed using serial dilutions in the culture medium at M115°C. The identification of the strains was performed using universal primers (27F and 1492R). The enzyme activity assays were performed on R2A medium, carboxy methyl cellulose (CMC)was added as substrate. Degradation of the substrate was revealed by adding Lugol. The results show that four of the tested strains produce enzymes which degrade CMC substrate. The molecular identifications, showed that these bacteria belong to the genus Streptomyces and Pseudoalteromonas, being Streptomyces strain who showed the highest activity. Only some bacteria in marine sediments have the ability to produce these enzymes, perhaps due to their greater adaptability to degrade at temperatures bordering zero degrees Celsius, some algae that are abundant in this environment and have cellulose as the main structure. The discovery of new enzymes adapted to cold is of great industrial interest, especially for paper, textiles, detergents, biofuels, food and agriculture. These enzymes represent 8% of industrial demand worldwide and is expected to increase their demand in the coming years. Mainly in the paper and food industry are required in extraction processes starch, protein and juices, as well as the animal feed industry where treating vegetables and grains helps improve the nutritional value of the food, all this clearly puts Antarctic microorganisms and their enzymes specifically as a potential contribution to industry and the novel biotechnological applications.

Keywords: antarctic, bacteria, biotechnological, cellulolytic enzymes

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Authors: Neha Bharti, Martin Sénéchal, Danielle R. Bouchard

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Mostly attributed to lack of time, only 15% of adults currently reach the International Physical Activity Guidelines, which state that every adult should achieve minimum of 150 minutes of aerobic exercise per week at moderate to vigorous intensity in minimum bouts of 10 minutes each, in addition to two days of resistance training. Recent studies have suggested that any bout of aerobic exercise reaching moderate intensity has potential to improve health. If one could reach moderate intensity while doing resistance training, this could reduce the total weekly time involvement to reach the International Physical Activity Guidelines. Objectives: 1) To determine whether overweight and older adults can reach a minimum of moderate intensity while doing resistance training compared with young non-overweight adults, 2) To identify if the proportion of time spent at moderate to vigorous intensity is different in overweight adults and older adults when compared with young non-overweight adults when lifting 70% or 80% of maximal load, 3) To determine variables associated with proportion of time spent at moderate to vigorous intensity while doing resistance training. Methods: Sixty participants already doing resistance training were recruited (20 young non-overweight adults, 20 overweight adults, and 20 older adults). Participants visited fitness facility three times, separated by at least 48 hours, and performed eight resistance exercises each time. First visit was to collect baseline measurements and to measure maximal load for each of the eight exercises. Second and third visits were performed wearing a heart rate monitor to record heart rate and to measure exercise intensity. The two exercise sessions were performed at 70% and 80% of maximal capacity. Moderate intensity was defined as 40% of heart rate reserve. Results: The proportion of time spent at moderate to vigorous intensity ranged from 51% to 93% among the three groups. No difference was observed between the young group and the overweight adults group in the proportion of time spent at moderate to vigorous intensity, 82.6% (69.2-94.6) vs 92.5% (73.3-99.1). However, older adults spent lower proportion of time at moderate to vigorous intensity for both sessions 51.5% (22.0-86.6); P < .01. When doing resistance training at 70% and 80% of maximal capacity, the proportion of time spent at moderate to vigorous intensity was 82.3% (56.1-94.7) and 82.0% (59.2-98.0) with no significant difference (P=.83). Conclusion: This study suggests that overweight adults and older adults can reach moderate intensity for at least 51% of the time spent doing resistance training. However, time spent at moderate to vigorous intensity was lower for older adults compared to young non-overweight adults. For adults aged 60 or less, three resistance training sessions of 60 minutes weekly could be enough to reach both aerobic and resistance training components of the International Physical Activity Guidelines. Further research is needed to test if resistance training at moderate to vigorous intensity can have the same health benefits compared with adults completing the International Physical Activity Guidelines as currently suggested.

Keywords: aerobic exercise, international physical activity guidelines, moderate to vigorous intensity, resistance training

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Authors: P. Raajeswari, S. M. Devatha, S. Yuvajanani, U. Rashika

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Edible food packaging are the need of the hour to save life on land and under water by eliminating waste cycle and replacing Single Use Plastics at grass root level as it can be eaten or composted as such. Cassava (Manihot esculenta) selected for making edible films are rich source of starch, and also it exhibit good sheeting propertiesdue to the high amylose: amylopectin content. Cassava starch was extracted by manual method at a laboratory scale and yielded 65 per cent. Edible films were developed by adding food grade plasticizers and water. Glycerol showed good plasticizing property as compared to sorbitol and polylactic acid in both manual (petri dish) and machine (film making machine) production. The thickness of the film is 0.25±0.03 mm. Essential oil and components from peels like pomegranate, orange, pumpkin, onion, and banana brat, and herbs like tulsi and country borage was extracted through the standardized aqueous and alkaline method. In the standardized film, the essential oil and components from selected peel and herbs were added to the casting solution separately and casted the film. It was added to improve the anti-oxidant, anti-microbial and optical properties. By inclusion of extracts, it reduced the bubble formation while casting. FTIR, Water Vapor and Oxygen Transmission Rate (WVTR and OTR), tensile strength, microbial load, shelf life, and degradability of the films were done to analyse the mechanical property of the standardized films. FTIR showed the presence of essential oil. WVTR and OTR of the film was improved after inclusion of essential oil and extracts from 1.312 to 0.811 cm₃/m₂ and 15.12 to 17.81 g/ m₂.d. Inclusion of essential oil from herbs showed better WVTR and OTR than the inclusion of peel extract and standard. Tensile strength and Elongation at break has not changed by essential oil and extracts at 0.86 ± 0.12 mpa and 14 ± 2 at 85 N force. By inclusion of extracts, an optical property of the film enhanced, and it increases the appearance of the packaging material. The films were completely degraded on 84thdays and partially soluble in water. Inclusion of essential oil does not have impact on degradability and solubility. The microbial loads of the active films were decreased from 15 cfu/gm to 7 cfu/gm. The films can be stored at frozen state for 24 days and 48 days at atmospheric temperature when packed with South Indian snacks and savories.

Keywords: active films, cassava starch, plasticizer, characterization

Procedia PDF Downloads 62

Authors: Woolfrey K., Woolfrey M., Bolton C. L., Warchuk D.

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Objectives: Osteoarthritis is the most common joint disease of adults worldwide. Despite total knee arthroplasty (TKA) demonstrating high levels of success, 20% of patients report dissatisfaction with their result. VOXX Wellness Stasis Socks are embedded with a proprietary pattern of neuro-receptor activation points that have been proven to activate a precise neuro-response, according to the pattern theory of haptic perception, which stimulates improvements in pain and function. The use of this technology in TKA patients may prove beneficial as an adjunct to recovery as many patients suffer from deficits to their proprioceptive system caused by ligamentous damage and alterations to mechanoreceptors during the procedure. We hypothesized that VOXX Wellness Stasis Socks are a safe, cost-effective, and easily scalable strategy to support TKA patients through their recovery. Design: Double-blinded, placebo-controlled randomized trial. Participants: Patients scheduled to receive TKA were considered eligible for inclusion in the trial. Interventions: Intervention group (I): VOXX Wellness Stasis socks containing receptor point-activation technology. Control group (C): VOXX Wellness Stasis socks without receptor point-activation technology. Sock use during the waking hours x 6 weeks. Main Outcome Measures: Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) questionnaire completed at baseline, 2 weeks, and 6 weeks to assess pain, stiffness, and physical function. Results: Data analysis using SPSS software. P-values, effect sizes, and confidence intervals are reported to assess clinical relevance of the finding. Physical status classifications were compared using t-test. Within-subject and between-subject differences in the mean WOMAC were analyzed by ANOVA. Effect size was analyzed using Cramer’s V. Consistent improvement in WOMAC scores for pain and stiffness at 2 weeks post op in the I over the C group. The womac scores assessing physical function showed a consistent improvement at both 2 and 6 weeks post op in the I group compared to C group. Conclusions: VOXX proved to be a low cost, safe intervention in TKA to help patients improve with regard to pain, stiffness, and physical function. Disclosures: None

Keywords: osteoarthritis, RCT, pain management, total knee arthroplasty

Procedia PDF Downloads 519

Authors: F. Nur Baran Aksakal, Özge Dinç, H. Tanju Besler, Begüm Mutuş, Özlem Üliç Çatar, Orhan Aydoğdu, Serhat Ünal

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Healthy eating habits are associated not only with the newborn, child, and maternal health but also with longer life expectancy by acting as a protective factor against non-communicable diseases such as obesity, diabetes, cardiovascular diseases, and cancer. The role of nutrition in medical education is to provide information about the relationship between healthy nutrition and malnutrition as well as diet-related non-communicable diseases. Considering the information pollution experienced in the field of nutrition and health in the society, it is seen that more than half of the population receives information from family physicians as the closest counseling unit. However, postgraduate nutrition education programs for physicians and other health professionals who wish to improve their current knowledge of the role of nutrition communication in the prevention and management of chronic diseases are limited worldwide. However, nutrition courses are either not included in the undergraduate medical education curriculum of physicians or they are insufficient. Based on this need, the main aim of the study group was to develop a "Nutrition and Nutrition Communication Training for Physicians" program that would be conducted in cooperation with the Sabri Ülker Foundation and the Federation of Family Physicians Associations (AHEF). This program is the first online nutrition and nutrition communication information platform for physicians in Turkey. This program aims to present the concept of adequate and balanced nutrition to physicians, the importance of nutrition in diseases with scientific data, and to gain communication skills that may be necessary while transferring scientific information to the public. A needs assessment questionnaire was applied to identify pre-program training needs. A study plan was made to allow the participation of all family physicians in the population, and a complete inventory was targeted. In other words, we aimed to reach the whole source without taking a section of the population. Participation in the training is based on volunteerism. The needs assessment study is conducted using 25,102 family physicians for whom email addresses are available. The online questionnaire was sent to all the family physicians with a reminder email one week after the first one, and 1308 responded. Considering the topics determined, a training program was prepared for family physicians under eight online training titles, starting in March 2022, and conducted once every two weeks. The number of audience members present at each session was between 1217 and 1673, and a minimum of 17 and a maximum of 53 questions were received in each session. We strongly believe that to prevent individuals' health problems and to have better control over chronic diseases, the information level of physicians should be increased via these kinds of interventions, and better collaboration between family physicians and dieticians should be established.

Keywords: nutrition communication, nutrition training, communication, nutrition

Procedia PDF Downloads 88

Authors: Adama NS Bah

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

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

Procedia PDF Downloads 95

Authors: Koppula Prawan, Kehinde D. Oyeyemi, Kushal P. Singh

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As people become more conscious of the detrimental consequences of conventional agricultural practices on the environment and human health, organic, sustainable agriculture and plant protection employing microorganisms have grown in importance. Although the use of microorganisms in agriculture is a centuries-old tradition, it has recently attracted renewed interest as a sustainable alternative to chemical-based plant protection and fertilization. Healthy soil is the cornerstone of sustainable agriculture, and microbes are essential to this process. Synthetic fertilizers and pesticides can destroy the beneficial microorganisms in the soil, upsetting the ecosystem's equilibrium. By utilizing organic farming's natural practices, such as the usage of microbes, it aims to maintain and improve the health of the soil. Microbes have several functions in agriculture, including nitrogen fixation, phosphorus solubilization, and disease suppression. Nitrogen fixation is the process by which certain microbes, such as rhizobia and Azotobacter, convert atmospheric nitrogen into a form that plants can use. Phosphorus solubilization involves the conversion of insoluble phosphorus into a soluble form that plants can absorb. Disease suppression involves the use of microbes to control plant diseases by competing with pathogenic organisms for resources or by producing antimicrobial compounds. Microbes can be applied to plants through seed coatings, foliar sprays, or soil inoculants. Seed coatings involve applying a mixture of microbes and nutrients to the surface of seeds before planting. Foliar sprays involve applying microbes and nutrients to the leaves of plants during the growing season. Soil inoculants involve adding microbes to the soil before planting. The use of microbes in plant protection and fertilization has several advantages over conventional methods. Firstly, microbes are natural and non-toxic, making them safe for human health and the environment. Secondly, microbes have the ability to adapt to changing environmental conditions, making them more resilient to drought and other stressors. Finally, the use of microbes can reduce the need for synthetic fertilizers and pesticides, reducing costs and minimizing environmental impact. In conclusion, organic, sustainable agriculture and plant protection using microbes are an effective and sustainable alternatives to conventional farming practices. The use of microbes can help to preserve and enhance soil health, increase plant productivity, and reduce the need for synthetic fertilizers and pesticides. As the demand for organic and sustainable agriculture continues to grow, the use of microbes is likely to become more widespread, providing a more environmentally friendly and sustainable future for agriculture.

Keywords: microbes, inoculants, fertilization, soil health, conventional.

Procedia PDF Downloads 69

Authors: B. Bernabela, P. Bles, A. Bloecker, D. DeRock, M. van Es, M. Gerritse, T. de Jongh, W. Lansing, M. Martinot, J. van de Wetering

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A heated debate has been taking place concerning research and teaching at Dutch universities for the last few years. The ministry of science and education has published reports on its strategy to improve university curricula and position the Netherlands as a globally competitive knowledge economy. These reports have provoked an uproar of responses from think tanks, concerned academics, and the media. At the center of the debate is disagreement over who should determine the Dutch university curricula and how these curricula should look. Many stakeholders in the higher education system have voiced their opinion, and some have not been heard. The result is that the diversity of visions is ignored or taken for granted in the official reports. Recognizing this gap in stakeholder analysis, the aim of this paper is to bring attention to the wide range of perspectives on who should be responsible for designing higher education curricula. Based on a previous analysis by the Rathenau Institute, we distinguish five different groups of stakeholders: government, business sector, university faculty and administration, students, and the societal sector. We conducted semi-structured, in-depth interviews with representatives from each stakeholder group, and distributed quantitative questionnaires to people in the societal sector (i.e. people not directly affiliated with universities or graduates). Preliminary data suggests that the stakeholders have different target points concerning the university curricula. Representatives from the governmental sector tend to place special emphasis on the link between research and education, while representatives from the business sector rather focus on greater opportunities for students to obtain practical experience in the job market. Responses from students reflect a belief that they should be able to influence the curriculum in order to compete with other students on the international job market. On the other hand, university faculty expresses concern that focusing on the labor market puts undue pressure on students and compromises the quality of education. Interestingly, the opinions of members of ‘society’ seem to be relatively unchanged by political and economic shifts. Following a comprehensive analysis of the data, we believe that our results will make a significant contribution to the debate on university education in the Netherlands. These results should be regarded as a foundation for further research concerning the direction of Dutch higher education, for only if we take into account the different opinions and views of the various stakeholders can we decide which steps to take. Moreover, the Dutch experience offers lessons to other countries as well. As the internationalization of higher education is occurring faster than ever before, universities throughout Europe and globally are experiencing many of the same pressures.

Keywords: Dutch University curriculum, higher education, participants’ opinions, stakeholder perspectives

Procedia PDF Downloads 334

Authors: David Sinfield, Thomas Cochrane, Marcos Steagall

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While there is much hype around the potential and development of mobile virtual reality (VR), the two key critical success factors are the ease of user experience and the development of a simple user-generated content ecosystem. Educational technology history is littered with the debris of over-hyped revolutionary new technologies that failed to gain mainstream adoption or were quickly superseded. Examples include 3D television, interactive CDROMs, Second Life, and Google Glasses. However, we argue that this is the result of curriculum design that substitutes new technologies into pre-existing pedagogical strategies that are focused upon teacher-delivered content rather than exploring new pedagogical strategies that enable student-determined learning or heutagogy. Visual Communication design based learning such as Graphic Design, Illustration, Photography and Design process is heavily based on the traditional forms of the classroom environment whereby student interaction takes place both at peer level and indeed teacher based feedback. In doing so, this makes for a healthy creative learning environment, but does raise other issue in terms of student to teacher learning ratios and reduced contact time. Such issues arise when students are away from the classroom and cannot interact with their peers and teachers and thus we see a decline in creative work from the student. Using AR and VR as a means of stimulating the students and to think beyond the limitation of the studio based classroom this paper will discuss the outcomes of a student project considering the virtual classroom and the techniques involved. The Atelier learning environment is especially suited to the Visual Communication model as it deals with the creative processing of ideas that needs to be shared in a collaborative manner. This has proven to have been a successful model over the years, in the traditional form of design education, but has more recently seen a shift in thinking as we move into a more digital model of learning and indeed away from the classical classroom structure. This study focuses on the outcomes of a student design project that employed Augmented Reality and Virtual Reality technologies in order to expand the dimensions of the classroom beyond its physical limits. Augmented Reality when integrated into the learning experience can improve the learning motivation and engagement of students. This paper will outline some of the processes used and the findings from the semester-long project that took place.

Keywords: augmented reality, blogging, design in community, enhanced learning and teaching, graphic design, new technologies, virtual reality, visual communications

Procedia PDF Downloads 232

Authors: Marutani M, Kawajiri H, Usui C, Takai Y, Kawaguchi T

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Background: To build the inclusive society, the Japanese government provides “transition support for employment system” for Persons with Disabilities (PWDs). It is, however, difficult to provide appropriate accommodations due to their changeable health conditions. Mobile phone applications (App) are useful to monitor their health conditions and their environments, and effective to improve reasonable accommodations for PWDs. Purpose: This study aimed to develop an App that PWDs input their self-assessment and make their health conditions and environment conditions visible. To attain the goal, we investigated the items of the App for the first step. Methods: Qualitative and descriptive design was used for this study. Study participants were recruited by snowball sampling in July and August 2023. They had to have had minimum of five-years of experience to support PWDs’ employment. Semi-structured interviews were conducted on their assessment regarding PWDs’ conditions of daily activities, their health conditions, and living and working environment. Verbatim transcript was created from each interview content. We extracted the following items in tree groups from each verbatim transcript: daily activities, health conditions, and living and working. Results: Fourteen participants were involved (average years of experience: 10.6 years). Based on the interviews, tree item groups were enriched. The items of daily activities were divided into fifty-five. The example items were as follows: “have meals on one’s style” “feel like slept well” “wake-up time, bedtime, and mealtime are usually fixed.” “commute to the office and work without barriers.” Thirteen items of health conditions were obtained like “feel no anxiety” “relieve stress” “focus on work and training” “have no pain” “have the physical strength to work for one day.” The items of categories of living and working environments were divided into fifteen-two. The example items were as follows: “have no barrier in home” “have supportive family members” “have time to take medication on time while at work” “commute time is just right” “people at the work understand the symptoms” “room temperature and humidity are just right” “get along well with friends in my own way.” The participants also mentioned the styles to input self-assessment like that a face scale would be preferred to number scale. Conclusion: The items were enriched existent paper-based assessment items in terms of living and working environment because those were obtained from the perspective of PWDs. We have to create the app and examine its usefulness with PWDs toward inclusive society.

Keywords: occupational health, innovatiove tool, people with disability, employment

Procedia PDF Downloads 47

Authors: Karin M. Granstrom

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Paper mills produce wastewater with a high content of organic substances. Treatment usually consists of sedimentation, biological treatment of activated sludge basins, and chemical precipitation. The resulting sludges are currently a waste problem, deposited in landfills or used as low-grade fuels for incineration. There is a growing awareness of the need for energy efficiency and environmentally sound management of sludge. A resource-efficient method would be to digest the wastewater sludges anaerobically to produce biogas, refine the biogas to biomethane for use in the transportation sector, and utilize the resulting digestate for soil improvement. The biomethane yield of pulp and paper wastewater sludge is comparable to that of straw or manure. As a bonus, the digestate has an improved dewaterability compared to the feedstock biosludge. Limitations of this process are predominantly a weak economic viability - necessitating both sufficiently large-scale paper production for the necessary large amounts of produced wastewater sludge, and the resolving of remaining questions on the certifiability of the digestate and thus its sales price. A way to improve the practical and economical feasibility of using paper mill wastewater for biomethane production and soil improvement is to co-digest it with other feedstocks. In this study, pulp and paper sludge were co-digested with (1) silage and manure, (2) municipal sewage sludge, (3) food waste, or (4) microalgae. Biomethane yield analysis was performed in 500 ml batch reactors, using an Automatic Methane Potential Test System at thermophilic temperature, with a 20 days test duration. The results show that (1) the harvesting season of grass silage and manure collection was an important factor for methane production, with spring feedstocks producing much more than autumn feedstock, and pulp mill sludge benefitting the most from co-digestion; (2) pulp and paper mill sludge is a suitable co-substrate to add when a high nitrogen content cause impaired biogas production due to ammonia inhibition; (3) the combination of food waste and paper sludge gave higher methane yield than either of the substrates digested separately; (4) pure microalgae gave the highest methane yield. In conclusion, although pulp and paper mills are an almost untapped resource for biomethane production, their wastewater is a suitable feedstock for such a process. Furthermore, through co-digestion, the pulp and paper mill wastewater and mill sludges can aid biogas production from more nutrient-rich waste streams from other industries. Such co-digestion also enhances the soil improvement properties of the residue digestate.

Keywords: anaerobic, biogas, biomethane, paper, sludge, soil

Procedia PDF Downloads 247

Authors: Robnier Reyes, Andrew J. P. Marques, Joel Ramjist, Chris R. Pasarikovski, Victor X. D. Yang

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Over the past three decades, surgical robotic systems have demonstrated their ability to improve surgical outcomes. The LBR Med is a collaborative robotic arm that is meant to work with a surgeon to streamline surgical workflow. It has 7 degrees of freedom and thus can be easily oriented. Position and torque sensors at each joint allow it to maintain a position accuracy of 150 µm with real-time force and torque feedback, making it ideal for complex surgical procedures. Spinal fusion procedures involve the placement of as many as 20 pedicle screws, requiring a great deal of accuracy due to proximity to the spinal canal and surrounding vessels. Any deviation from intended path can lead to major surgical complications. Assistive surgical robotic systems are meant to serve as collaborative devices easing the workload of the surgeon, thereby improving pedicle screw placement by mitigating fatigue related inaccuracies. Moreover, robotic spinal systems have shown marked improvements over conventional freehanded techniques in both screw placement accuracy and fusion quality and have greatly reduced the need for screw revision, intraoperatively and post-operatively. However, current assistive spinal fusion robots, such as the ROSA Spine, are limited in functionality to positioning surgical instruments. While they offer a small degree of improvement in pedicle screw placement accuracy, they do not alleviate surgeon fatigue, nor do they provide real-time force and torque feedback during screw insertion. We propose a semi-autonomous surgical robot workflow for spinal fusion where the surgeon guides the robot to its initial position and orientation, and the robot drives the pedicle screw accurately into the vertebra. Here, we demonstrate feasibility by inserting pedicle screws into ex-vivo bovine rib bone. The robot monitors position, force and torque with respect to predefined values selected by the surgeon to ensure the highest possible spinal fusion quality. The workflow alleviates the strain on the surgeon by having the robot perform the screw placement while the ability to monitor the process in real-time keeps the surgeon in the system loop. The approach we have taken in terms of level autonomy for the robot reflects its ability to safely collaborate with the surgeon in the operating room without external navigation systems.

Keywords: ex vivo bovine bone, pedicle screw, surgical robot, surgical workflow

Procedia PDF Downloads 159

Authors: Anna Bak-Klimek, Emily Spencer, Siew Lee, Karen Campbell, Wendy McInally

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Background & Significance: Over half of Teenagers and Young Adults (TYAs) say that they experience psychological distress after cancer diagnosis and TYAs with cancer are at higher risk of developing distress compared to other age groups. Despite this there are no age-appropriate interventions to help TYAs manage distress and there is a lack of conceptual understanding of what causes distress in this population group. This makes it difficult to design a targeted, developmentally appropriate intervention. This review aims to identify the key determinants of distress in TYAs affected by cancer and to propose an integrative model of cancer-related distress for TYAs. Method: A literature search was performed in Cochrane Database of Systematic Reviews, MEDLINE, PsycINFO, CINAHL, EMBASE and PsycArticles in May-June, 2022. Quantitative literature was systematically reviewed on the relationship between psychological distress experienced by TYAs affected by cancer and a wide range of factors i.e. individual (demographic, psychological, developmental, and clinical factors) and contextual (social/environmental) factors. Evidence was synthesized and correlates were categorized using the Biopsychosocial Model. The full protocol is available from PROSPERO (CRD42022322069) Results: Thirty eligible quantitative studies met criteria for the review. A total of twenty-six studies were cross-sectional, three were longitudinal and one study was a case control study. The evidence on the relationship between the socio-demographic, illness and treatment-related factors and psychological distress is inconsistent and unclear. There is however consistent evidence on the link between psychological factors and psychological distress. For instance, the use of cognitive and defence coping, negative meta-cognitive beliefs, less optimism, a lack of sense of meaning and lower resilience levels were significantly associated with higher psychological distress. Furthermore, developmental factors such as poor self-image, identity issues and perceived conflict were strongly associated with higher distress levels. Conclusions: The current review suggests that psychological and developmental factors such as ineffective coping strategies, poor self-image and identity issues may play a key role in the development of psychological distress in TYAs affected by cancer. The review proposes a Positive Developmental Psychology Model of Distress for Teenagers and Young Adults affected by cancer. The review highlights that implementation of psychological interventions that foster optimism, improve resilience and address self-image may result in reduced distress in TYA’s with cancer.

Keywords: cancer, determinant, psychological distress, teenager and young adult, theoretical model

Procedia PDF Downloads 86

Authors: Scarlet Tabot Enanga Longsti

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

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

Procedia PDF Downloads 53

Authors: James Beauchemin

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Introduction: The incarceration of people with mental illness and substance use disorders is a major public health issue, with social, clinical, and economic implications. Yoga participation has been associated with numerous psychological benefits; however, there is a paucity of research examining impacts of yoga with incarcerated populations. The purpose of this study was to evaluate effectiveness of a six-week yoga intervention on several mental health-related variables, including emotion regulation, body awareness, and warnings of substance relapse among incarcerated females. Methods: This study utilized a pre-post, three-arm design, with participants assigned to intervention, therapeutic community, or general population groups. A between-groups analysis of covariance (ANCOVA) was conducted across groups to assess intervention effectiveness using the Difficulties in Emotion Regulation Scale (DERS), Scale of Body Connection (SBC), and Warnings of Relapse (AWARE) Questionnaire. Results: ANCOVA results for warnings of relapse (AWARE) revealed significant between-group differences F(2, 80) = 7.15, p = .001; np2 = .152), with significant pairwise comparisons between the intervention group and both the therapeutic community (p = .001) and the general population (p = .005) groups. Similarly, significant differences were found for emotional regulation (DERS) F(2, 83) = 10.521, p = .000; np2 = .278). Pairwise comparisons indicated a significant difference between the intervention and general population (p = .01). Finally, significant differences between the intervention and control groups were found for body awareness (SBC) F(2, 84) = 3.69, p = .029; np2 = .081). Between-group differences were clarified via pairwise comparisons, indicating significant differences between the intervention group and both the therapeutic community (p = .028) and general population groups (p = .020). Implications: Study results suggest that yoga may be an effective addition to integrative mental health and substance use treatment for incarcerated women, and contributes to increasing evidence that holistic interventions may be an important component for treatment with this population. Specifically, given the prevalence of mental health and substance use disorders, findings revealed that changes in body awareness and emotion regulation may be particularly beneficial for incarcerated populations with substance use challenges as a result of yoga participation. From a systemic perspective, this proactive approach may have long-term implications for both physical and psychological well-being for the incarcerated population as a whole, thereby decreasing the need for traditional treatment. By integrating a more holistic, salutogenic model that emphasizes prevention, interventions like yoga may work to improve the wellness of this population, while providing an alternative or complementary treatment option for those with current symptoms.

Keywords: yoga, mental health, incarceration, wellness

Procedia PDF Downloads 125

Authors: Tayo P. Ogundunmade, Adedayo A. Adepoju

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Terrorist attacks in liberal democracies bring about a few pessimistic results, for example, sabotaged public support in the governments they target, disturbing the peace of a protected environment underwritten by the state, and a limitation of individuals from adding to the advancement of the country, among others. Hence, seeking for techniques to understand the different factors involved in terrorism and how to deal with those factors in order to completely stop or reduce terrorist activities is the topmost priority of the government in every country. This research aim is to develop an efficient deep learning-based predictive model for the prediction of future terrorist activities in Nigeria, addressing low-quality prediction accuracy problems associated with the existing solution methods. The proposed predictive AI-based model as a counterterrorism tool will be useful by governments and law enforcement agencies to protect the lives of individuals in society and to improve the quality of life in general. A Heterogeneous Bayesian Neural Network (HETBNN) model was derived with Gaussian error normal distribution. Three primary transfer functions (HOTTFs), as well as two derived transfer functions (HETTFs) arising from the convolution of the HOTTFs, are namely; Symmetric Saturated Linear transfer function (SATLINS ), Hyperbolic Tangent transfer function (TANH), Hyperbolic Tangent sigmoid transfer function (TANSIG), Symmetric Saturated Linear and Hyperbolic Tangent transfer function (SATLINS-TANH) and Symmetric Saturated Linear and Hyperbolic Tangent Sigmoid transfer function (SATLINS-TANSIG). Data on the Terrorist activities in Nigeria gathered through questionnaires for the purpose of this study were used. Mean Square Error (MSE), Mean Absolute Error (MAE) and Test Error are the forecast prediction criteria. The results showed that the HETFs performed better in terms of prediction and factors associated with terrorist activities in Nigeria were determined. The proposed predictive deep learning-based model will be useful to governments and law enforcement agencies as an effective counterterrorism mechanism to understand the parameters of terrorism and to design strategies to deal with terrorism before an incident actually happens and potentially causes the loss of precious lives. The proposed predictive AI-based model will reduce the chances of terrorist activities and is particularly helpful for security agencies to predict future terrorist activities.

Keywords: activation functions, Bayesian neural network, mean square error, test error, terrorism

Procedia PDF Downloads 152

Authors: Sayantan Khanra, Rojers P. Joseph

Abstract:

Background and Significance: This study is aimed at analyzing the role of demographic and service quality variables in the adoption and diffusion of e-government services among the users in India. The study proposes to examine the users' perception about e-Government services and investigate the key variables that are most salient to the Indian populace. Description of the Basic Methodologies: The methodology to be adopted in this study is Hierarchical Regression Analysis, which will help in exploring the impact of the demographic variables and the quality dimensions on the willingness to use e-government services in two steps. First, the impact of demographic variables on the willingness to use e-government services is to be examined. In the second step, quality dimensions would be used as inputs to the model for explaining variance in excess of prior contribution by the demographic variables. Present Status: Our study is in the data collection stage in collaboration with a highly reliable, authentic and adequate source of user data. Assuming that the population of the study comprises all the Internet users in India, a massive sample size of more than 10,000 random respondents is being approached. Data is being collected using an online survey questionnaire. A pilot survey has already been carried out to refine the questionnaire with inputs from an expert in management information systems and a small group of users of e-government services in India. The first three questions in the survey pertain to the Internet usage pattern of a respondent and probe whether the person has used e-government services. If the respondent confirms that he/she has used e-government services, then an aggregate of 15 indicators are used to measure the quality dimensions under consideration and the willingness of the respondent to use e-government services, on a five-point Likert scale. If the respondent reports that he/she has not used e-government services, then a few optional questions are asked to understand the reason(s) behind the same. Last four questions in the survey are dedicated to collect data related to the demographic variables. An indication of the Major Findings: Based on the extensive literature review carried out to develop several propositions; a research model is prescribed to start with. A major outcome expected at the completion of the study is the development of a research model that would help to understand the relationship involving the demographic variables and service quality dimensions, and the willingness to adopt e-government services, particularly in an emerging economy like India. Concluding Statement: Governments of emerging economies and other relevant agencies can use the findings from the study in designing, updating, and promoting e-government services to enhance public participation, which in turn, would help to improve efficiency, convenience, engagement, and transparency in implementing these services.

Keywords: adoption and diffusion of e-government services, demographic variables, hierarchical regression analysis, service quality dimensions

Procedia PDF Downloads 253

Authors: Mesfin Nigussie Ibido

Abstract:

The study is designed to explore the effects of land certification in securing women’s land rights of two rural villages in Robe district at Arsi Zone of Oromia regional state. The land is very critical assets for human life survival and the backbone for rural women livelihood. Equal access and control power to the land have given a chance for rural women to participate in different economic activities and improve their bargaining ability for decision making on their rights. Unfortunately, women were discriminated and marginalized from access and control of land for centuries through customary practices. However, in many countries, legal reform is used as a powerful tool for eliminating discriminatory provisions in property rights. Among other equity and efficiency concerns, the land certification program in Ethiopia attempts to address gender bias concerns of the current land-tenure system. The existed rural land policy was recognizing a women land rights and benefited by strengthened wives awareness of their land rights and contribute to the strong involvement of wives in decision making. However, harmful practices and policy implementation problems still against women do not fully exercise a provision of land rights in a different area of the country. Thus, this study is carried out to examine the effect of land certification in securing women’s land rights by eliminating the discriminatory nature of cultural abuses of study areas. Probability and non-probability sampling types were used, and the sample size was determined by using the sampling distribution of the proportion method. Systematic random sampling method was applied by taking the nth element of the sample frame. Both quantitative and qualitative research methods were applied, and survey respondents of 192 households were conducted and administering questionnaires in the quantitative method. The qualitative method was applied by interviews with focus group discussions with rural women, case stories, Village, and relevant district offices. Triangulation method was applied in data collection, data presentation and in the analysis of findings. Study finding revealed that the existence of land certification is affected by rural women positively by advancing their land rights, but still, some women are challenged by unsolved problems in the study areas. The study forwards recommendation on the existed problems or gaps to ensure women’s equal access to and control over land in the study areas.

Keywords: decision making, effects, land certification, land right, tenure security

Procedia PDF Downloads 190