Search results for: early childhood settings
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5135

Search results for: early childhood settings

4445 Generic Early Warning Signals for Program Student Withdrawals: A Complexity Perspective Based on Critical Transitions and Fractals

Authors: Sami Houry

Abstract:

Complex systems exhibit universal characteristics as they near a tipping point. Among them are common generic early warning signals which precede critical transitions. These signals include: critical slowing down in which the rate of recovery from perturbations decreases over time; an increase in the variance of the state variable; an increase in the skewness of the state variable; an increase in the autocorrelations of the state variable; flickering between different states; and an increase in spatial correlations over time. The presence of the signals has management implications, as the identification of the signals near the tipping point could allow management to identify intervention points. Despite the applications of the generic early warning signals in various scientific fields, such as fisheries, ecology and finance, a review of literature did not identify any applications that address the program student withdrawal problem at the undergraduate distance universities. This area could benefit from the application of generic early warning signals as the program withdrawal rate amongst distance students is higher than the program withdrawal rate at face-to-face conventional universities. This research specifically assessed the generic early warning signals through an intensive case study of undergraduate program student withdrawal at a Canadian distance university. The university is non-cohort based due to its system of continuous course enrollment where students can enroll in a course at the beginning of every month. The assessment of the signals was achieved through the comparison of the incidences of generic early warning signals among students who withdrew or simply became inactive in their undergraduate program of study, the true positives, to the incidences of the generic early warning signals among graduates, the false positives. This was achieved through significance testing. Research findings showed support for the signal pertaining to the rise in flickering which is represented in the increase in the student’s non-pass rates prior to withdrawing from a program; moderate support for the signals of critical slowing down as reflected in the increase in the time a student spends in a course; and moderate support for the signals on increase in autocorrelation and increase in variance in the grade variable. The findings did not support the signal on the increase in skewness of the grade variable. The research also proposes a new signal based on the fractal-like characteristic of student behavior. The research also sought to extend knowledge by investigating whether the emergence of a program withdrawal status is self-similar or fractal-like at multiple levels of observation, specifically the program level and the course level. In other words, whether the act of withdrawal at the program level is also present at the course level. The findings moderately supported self-similarity as a potential signal. Overall, the assessment of the signals suggests that the signals, with the exception with the increase of skewness, could be utilized as a predictive management tool and potentially add one more tool, the fractal-like characteristic of withdrawal, as an additional signal in addressing the student program withdrawal problem.

Keywords: critical transitions, fractals, generic early warning signals, program student withdrawal

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4444 A Dialectical Behavioral Therapy Adaptation in Reducing Depression, Anxiety, and Self-Harm in Older Adults

Authors: Valerie Alexander, Amanda Gutierrez, Veronica Campbell, Dara Schwartz, B. Charles Tatum

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It has long been assumed that personality disorders (PD) originate in adolescence or early adulthood and that the maladaptive behaviors significantly attenuate over time. The Diagnostic and Statistical Manual of Mental Disorders-5 supports early onset of PD and views the pattern of behaviors as enduring and stable. The premise of this study is that PD may not always begin early in life, that behaviors may change over the lifespan, and that current treatment modalities may be beneficial in seniors. Self-injurious behaviors (SIB) exhibited earlier in life may, in older adults, be manifested in less overt high-risk behaviors but by refusal to take medication and get necessary medical treatment. Dialectical Behavioral Therapy is a well-known treatment modality for teaching emotional regulation and distress tolerance and thus reducing self-injurious behaviors yet very little has been studied about SIB and treatment in older adults. The population for this study was older adults, with a history of SIB, a PD, and depression and/or anxiety. Participants learned an adapted version of Dialectical Behavioral Therapy (DBT) as developed by DBT trained therapists. The results provided clinical potentials for the efficacy of DBT to reduce SIB, decrease depression and anxiety in the older adult population.

Keywords: anxiety, depression, dialectical behavioral therapy, personality disorders, self-harm behavior, treatment in older adults

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4443 The Need for a More Defined Role for Psychologists in Adult Consultation Liaison Services in Hospital Settings

Authors: Ana Violante, Jodie Maccarrone, Maria Fimiani

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In the United States, over 30 million people are hospitalized annually for conditions that require acute, 24-hour, supervised care. The experience of hospitalization can be traumatic, exposing the patient to loss of control, autonomy, and productivity. Furthermore, 40% of patients admitted to hospitals for general medical illness have a comorbid psychiatric diagnosis. Research suggests individuals admitted with psychiatric comorbidities experience poorer health outcomes, higher utilization rates and increased overall cost of care. Empirical work suggests hospital settings that include a consultation liaison (CL) service report reduced length of stay, lower costs per patient, improved medical staff and patient satisfaction and reduced readmission after 180 days. Despite the overall positive impact CL services can have on patient care, it is estimated that only 1% - 2.8% of hospital admits receive these services, and most research has been conducted by the field of psychiatry. Health psychologists could play an important role in increasing access to this valuable service, though the extent to which health psychologists participate in CL settings is not well known. Objective: Outline the preliminary findings from an empirical study to understand how many APPIC internship training programs offer adult consultation liaison rotations within inpatient hospital settings nationally, as well as describe the specific nature of these training experiences. Research Method/Design: Data was exported into Excel from the 2022-2023 APPIC Directory categorized as “health psychology” sites. It initially returned a total of 537 health training programs out 1518 total programs (35% of all APPIC programs). A full review included a quantitative and qualitative comprehensive review of the APPIC program summary, the site website, and program brochures. The quantitative review extracted the number of training positions; amount of stipend; location or state of program, patient, population, and rotation. The qualitative review examined the nature of the training experience. Results: 29 (5%) of all APPIC health psychology internship training programs (2%) respectively of all APPIC training internship programs offering internship CL training were identified. Of the 29 internship training programs, 16 were exclusively within a pediatric setting (55%), 11 were exclusively within an adult setting (38%), and two were a mix of pediatric and adult settings (7%). CL training sites were located to 19 states, offering a total of 153 positions nationally, with Florida containing the largest number of programs (4). Only six programs offered 12-month training opportunities while the rest offered CL as a major (6 month) to minor (3-4 month) rotation. The program’s stipend for CL training positions ranged from $25,000 to $62,400, with an average of $32,056. Conclusions: These preliminary findings suggest CL training and services are currently limited. Training opportunities that do exist are mostly limited to minor, short rotations and governed by psychiatry. Health psychologists are well-positioned to better define the role of psychology in consultation liaison services and enhance and formalize existing training protocols. Future research should explore in more detail empirical outcomes of CL services that employ psychology and delineate the contributions of psychology from psychiatry and other disciplines within an inpatient hospital setting.

Keywords: consultation liaison, health psychology, hospital setting, training

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4442 Early Marriage and Women's Empowerment: The Case of Chil-bride in East Hararghe Zone of Oromia National Regional State, Ethiopia

Authors: Emad Mohammed Sani

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Women encounter exclusion and discrimination in varying degrees, particularly those who marry as minors. The detrimental custom of getting married young is still prevalent worldwide and affects millions of people. It has been less common over time, although it is still widespread in underdeveloped nations. Oromia Regional State is the region in Ethiopia with the highest proportion of child brides. This study aimed at evaluating the effects of early marriage on its survivors’ life conditions – specifically, empowerment and household decision-making – in Eastern Hararghe Zone of Oromia Region. This study employed community-based cross-sectional study design. It adopted mixed method approach – survey, in-depth interview and focus group discussion (FGD) – to collect, analyses and interpret data on early marriage and its effects on household decision-making processes. Narratives and analytical descriptions were integrated to substantiate and/or explain observed quantitative results, or generate contextual themes. According to this study, married women who were married at or after the age of eighteen participated more in household decision-making than child brides. Child brides were more likely to be victims of violence and other types of spousal abuse in their marriages. These changes are mostly caused by an individual's age at first marriage. Delaying marriage had a large positive impact on women's empowerment at the household level, and age at first marriage had a considerable negative impact. In order to advance women's welfare and emancipation, we advise more research to concentrate on the relationship between the home and the social-structural forms that appear at the individual and communal levels.

Keywords: child-bride, early marriage, women, ethiopia

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4441 Time Optimal Control Mode Switching between Detumbling and Pointing in the Early Orbit Phase

Authors: W. M. Ng, O. B. Iskender, L. Simonini, J. M. Gonzalez

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A multitude of factors, including mechanical imperfections of the deployment system and separation instance of satellites from launchers, oftentimes results in highly uncontrolled initial tumbling motion immediately after deployment. In particular, small satellites which are characteristically launched as a piggyback to a large rocket, are generally allocated a large time window to complete detumbling within the early orbit phase. Because of the saturation risk of the actuators, current algorithms are conservative to avoid draining excessive power in the detumbling phase. This work aims to enable time-optimal switching of control modes during the early phase, reducing the time required to transit from launch to sun-pointing mode for power budget conscious satellites. This assumes the usage of B-dot controller for detumbling and PD controller for pointing. Nonlinear Euler's rotation equations are used to represent the attitude dynamics of satellites and Commercial-off-the-shelf (COTS) reaction wheels and magnetorquers are used to perform the manoeuver. Simulation results will be based on a spacecraft attitude simulator and the use case will be for multiple orbits of launch deployment general to Low Earth Orbit (LEO) satellites.

Keywords: attitude control, detumbling, small satellites, spacecraft autonomy, time optimal control

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4440 The Impact of Dog-Assisted Wellbeing Intervention on Student Motivation and Affective Engagement in the Primary and Secondary School Setting

Authors: Yvonne Howard

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This project currently under development is centered around current learning processes, including a thorough literature review and ongoing practical experiences gained as a deputy head in a school. These daily experiences with students engaging in animal-assisted interventions and the school therapy dog form a strong base for this research. The primary objective of this research is to comprehensively explore the impact of dog-assisted well-being interventions on student motivation and affective engagement within primary and secondary school settings. The educational domain currently encounters a significant challenge due to the lack of substantial research in this area. Despite the perceived positive outcomes of such interventions being acknowledged and shared in various settings, the evidence supporting their effectiveness in an educational context remains limited. This study aims to bridge the gap in the research and shed light on the potential benefits of dog-assisted well-being interventions in promoting student motivation and affective engagement. The significance of this topic recognizes that education is not solely confined to academic achievement but encompasses the overall well-being and emotional development of students. Over recent years, there has been a growing interest in animal-assisted interventions, particularly in healthcare settings. This interest has extended to the educational context. While the effectiveness of these interventions in these areas has been explored in other fields, the educational sector lacks comprehensive research in this regard. Through a systematic and thorough research methodology, this study seeks to contribute valuable empirical data to the field, providing evidence to support informed decision-making regarding the implementation of dog-assisted well-being interventions in schools. This research will utilize a mixed-methods design, combining qualitative and quantitative measures to assess the research objectives. The quantitative phase will include surveys and standardized scales to measure student motivation and affective engagement, while the qualitative phase will involve interviews and observations to gain in-depth insights from students, teachers, and other stakeholders. The findings will contribute evidence-based insights, best practices, and practical guidelines for schools seeking to incorporate dog-assisted interventions, ultimately enhancing student well-being and improving educational outcomes.

Keywords: therapy dog, wellbeing, engagement, motivation, AAI, intervention, school

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4439 Gender Diversity in Early Years Education: An Exploratory Study Applied to Preschool Curriculum System in Romania

Authors: Emilia-Gheorghina Negru

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As an EU goal, gender diversity in early year’s education aims and promotes equality of chances and respect for gender peculiarities of the pupils which are involved in formal educational activities. Early year’s education, as the first step to the Curriculum, prints to teachers the need to identify the role of the gender dimension on this stage, depending on the age level of preschool children through effective, complex, innovative and analytical awareness of gender diversity teaching and management strategies. Through gender educational work we, as teachers, will examine the effectiveness of the PATHS (Promoting Alternative Thinking Strategies) curriculum the gender development of school-aged children. PATHS and a school-based preventive intervention model are necessary to be designed to improve children's ability to discuss and understand equality and gender concepts. Our teachers must create an intervention model and provide PATHS lessons during the school year. Results of the intervention will be effective for both low- and high-risk children in improving their range of math’s skills for girls and vocabulary, fluency and emotional part for boys in discussing gender experiences, their efficacy beliefs regarding the management of equality in gender area, and their developmental understanding of some aspects of gender.

Keywords: gender, gender differences, gender equality, gender role, gender stereotypes

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4438 Improving Early Detection, Diagnosis And Intervention For Children With Autism Spectrum Disorder: A Cross-sectional Survey In China

Authors: Yushen Dai, Tao Deng, Miaoying Chen, Baoqin Huang, Yan Ji, Yongshen Feng, Shaofei Liu, Dongmei Zhong, Tao Zhang, Lifeng Zhang

Abstract:

Background: Detection and diagnosis are prerequisites for early interventions in the care of children with Autism Spectrum Disorder (ASD). However, few studies have focused on this topic. Aim: This study aims to characterize the timing from symptom detection to intervention in children with ASD and to identify the potential predictors of early detection, diagnosis, and intervention. Methods and procedures: A cross-sectional survey was conducted with 314 parents of children with ASD in Guangzhou, China. Outcomes and Results: This study found that most children (76.24%) were diagnosed within one year after detection, and 25.8% of them did not receive the intervention after diagnosis. Predictors to ASD diagnosis included ASD-related symptoms identified at a younger age, more serious symptoms, and initial symptoms with abnormal development and sensory anomalies. ASD-related symptoms observed at an older age, initial symptoms with the social deficit, sensory anomalies, and without language impairment, parents as the primary caregivers, family with lower income and less social support utilization increased the odds of the time lag between detection and diagnosis. Children whose fathers had a lower level of education were less likely to receive the intervention. Conclusions and Implications: The study described the time for detection, diagnosis, and interventions of children with ASD. Findings suggest that the ASD-related symptoms, the timing at which symptoms first become a concern, primary caregivers’ roles, father’s educational level, and the family economic status should be considered when offering support to improve early detection, diagnosis, and intervention. Helping children and their families take full advantage of support is also important.

Keywords: autism spectrum disorder, child, detection, diagnosis, intervention, social support

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4437 Challenges of Management of Acute Pancreatitis in Low Resource Setting

Authors: Md. Shakhawat Hossain, Jimma Hossain, Md. Naushad Ali

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Acute pancreatitis is a dangerous medical emergency in the practice of gastroenterology. Management of acute pancreatitis needs multidisciplinary approach with support starts from emergency to ICU. So, there is a chance of mismanagement in every steps, especially in low resource settings. Other factors such as patient’s financial condition, education, social custom, transport facility, referral system from periphery may also challenge the current guidelines for management. The present study is intended to determine the clinico-pathological profile, severity assessment and challenges of management of acute pancreatitis in a government laid tertiary care hospital to image the real scenario of management in a low resource place. A total 100 patients of acute pancreatitis were studied in this prospective study, held in the Department of Gastroenterology, Rangpur medical college hospital, Bangladesh from July 2017 to July 2018 within one year. Regarding severity, 85 % of the patients were mild, whereas 13 were moderately severe, and 2 had severe acute pancreatitis according to the revised Atlanta criteria. The most common etiologies of acute pancreatitis in our study were gall stone (15%) and biliary sludge (15%), whereas 54% were idiopathic. The most common challenges we faced were delay in hospital admission (59%) and delay in hospital diagnosis (20%). Others are non-adherence of patient party, and lack of investigation facility, physician’s poor knowledge about current guidelines. We were able to give early aggressive fluid to only 18% of patients as per current guideline. Conclusion: Management of acute pancreatitis as per guideline is challenging when optimum facility is lacking. So, modified guidelines for assessment and management of acute pancreatitis should be prepared for low resource setting.

Keywords: acute pancreatitis, challenges of management, severity, prognosis

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4436 An Empirical Dynamic Fuel Cell Model Used for Power System Verification in Aerospace

Authors: Giuliano Raimondo, Jörg Wangemann, Peer Drechsel

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In systems development involving Fuel Cells generators, it is important to have from an early stage of the project a dynamic model for the electrical behavior of the stack to be shared between involved development parties. It allows independent and early design and tests of fuel cell related power electronic. This paper presents an empirical Fuel Cell system model derived from characterization tests on a real system. Moreover, it is illustrated how the obtained model is used to build and validate a real-time Fuel Cell system emulator which is used for aerospace electrical integration testing activities.

Keywords: fuel cell, modelling, real time emulation, testing

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4435 A Convolutional Deep Neural Network Approach for Skin Cancer Detection Using Skin Lesion Images

Authors: Firas Gerges, Frank Y. Shih

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Malignant melanoma, known simply as melanoma, is a type of skin cancer that appears as a mole on the skin. It is critical to detect this cancer at an early stage because it can spread across the body and may lead to the patient's death. When detected early, melanoma is curable. In this paper, we propose a deep learning model (convolutional neural networks) in order to automatically classify skin lesion images as malignant or benign. Images underwent certain pre-processing steps to diminish the effect of the normal skin region on the model. The result of the proposed model showed a significant improvement over previous work, achieving an accuracy of 97%.

Keywords: deep learning, skin cancer, image processing, melanoma

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4434 The Impact of Speech Style on the Production of Spanish Vowels by Spanish-English Bilinguals and Spanish Monolinguals

Authors: Vivian Franco

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There has been a great deal of research about vowel production of second language learners of Spanish, vowel variation across Spanish dialects, and more recently, research related to Spanish heritage speakers’ vowel production based on speech style. However, there is little investigation reported on Spanish heritage speakers’ vowel production in regard to task modality by incorporating own comparison groups of monolinguals and late bilinguals. Thus, the present study investigates the influence of speech style on Spanish heritage speakers’ vowel production by comparing Spanish-English early and late bilinguals and Spanish monolinguals. The study was guided by the following research question: How do early bilinguals (heritage speakers) differ/relate to advanced L2 speakers of Spanish (late bilinguals) and Spanish monolinguals in their vowel quality (acoustic distribution) and quantity (duration) based on speech style? The participants were a total of 11 speakers of Spanish: 7 early Spanish-English bilinguals with a similar linguistic background (simultaneous bilinguals of the second generation); 2 advanced L2 speakers of Spanish; and 2 Spanish monolinguals from Mexico. The study consisted of two tasks. The first one adopted a semi-spontaneous style by a solicited narration of life experiences and a description of a favorite movie with the purpose to collect spontaneous speech. The second task was a reading activity in which the participants read two paragraphs of a Mexican literary essay 'La nuez.' This task aimed to obtain a more controlled speech style. From this study, it can be concluded that early bilinguals and monolinguals show a smaller formant vowel space overall compared to the late bilinguals in both speech styles. In terms of formant values by stress, the early bilinguals and the late bilinguals resembled in the semi-spontaneous speech style as their unstressed vowel space overlapped with that of the unstressed vowels different from the monolinguals who displayed a slightly reduced unstressed vowel space. For the controlled data, the early bilinguals were similar to the monolinguals as their stressed and unstressed vowel spaces overlapped in comparison to the late bilinguals who showed a more clear reduction of unstressed vowel space. In regard to stress, the monolinguals revealed longer vowel duration overall. However, findings of duration by stress showed that the early bilinguals and the monolinguals remained stable with shorter values of unstressed vowels in the semi-spontaneous data and longer duration in the controlled data when compared to the late bilinguals who displayed opposite results. These findings suggest an implication for Spanish heritage speakers and L2 Spanish vowels research as it has been frequently argued that Spanish bilinguals differ from the Spanish monolinguals by their vowel reduction and centralized vowel space influenced by English. However, some Spanish varieties are characterized by vowel reduction especially in certain phonetic contexts so that some vowels present more weakening than others. Consequently, it would not be conclusive to affirm an English influence on the Spanish of these bilinguals.

Keywords: Spanish-English bilinguals, Spanish monolinguals, spontaneous and controlled speech, vowel production.

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4433 Science Process Skill and Interest Preschooler in Learning Early Science through Mobile Application

Authors: Seah Siok Peh, Hashimah Mohd Yunus, Nor Hashimah Hashim, Mariam Mohamad

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A country needs a workforce that encompasses knowledge, skilled labourers to generate innovation, productivity and being able to solve problems creatively via technology. Science education experts believe that the mastery of science skills help preschoolers to generate such knowledge on scientific concepts by providing constructive experiences. Science process skills are skills used by scientists to study or investigate a problem, issue, problem or phenomenon of science. In line with the skills used by scientists. The purpose of this study is to investigate the basic science process skill and interest in learning early science through mobile application. This study aimed to explore six spesific basic science process skills by the use of a mobile application as a learning support tool. The descriptive design also discusses on the extent of the use of mobile application in improving basic science process skill in young children. This study consists of six preschoolers and two preschool teachers from two different classes located in Perak, Malaysia. Techniques of data collection are inclusive of observations, interviews and document analysis. This study will be useful to provide information and give real phenomena to policy makers especially Ministry of education in Malaysia.

Keywords: science education, basic science process skill, interest, early science, mobile application

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4432 Community Based Heritage Tourism in the Old City of Nazareth

Authors: Alon Gelbman, Daniel Laven

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The paper focuses on a case study of a small-scale heritage tourism venture that seeks to influence tourism development in Nazareth’s old city. This is an exploratory case study that uses qualitative research methods including extensive participant observation and in-depth interviews with the venture’s senior management group and selected employees. Study findings indicate a model of the relationship between community-based tourism development, heritage, and peace-building in a city that has experienced a wide range of cross-cultural conflicts. This model represents an alternative view to the notion that heritage serves to enhance differences and dissonance between different cultural groups. In contrast, findings from this study suggest that heritage in the form of tourism; can help create shared interests between different communities in settings characterized by cross-cultural conflict. This model represents an alternative view to the notion that heritage serves to enhance differences and dissonance between different cultural groups. In contrast, findings from this study suggest that heritage in the form of tourism; can help create shared interests between different communities in settings characterized by cross-cultural conflict.

Keywords: cultural heritage tourism, tourism and peace, community-based tourism, sustainable tourism, cross-cultural conflict, Nazareth historic city

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4431 Changes in Air Quality inside Vehicles and in Working Conditions of Professional Drivers during COVID-19 Pandemic in Paris Area

Authors: Melissa Hachem, Lynda Bensefa-Colas, Isabelle Momas

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We evaluated the impact of the first lockdown restriction measures (March-May 2020) in the Paris area on (1) the variation of in-vehicle ultrafine particle (UFP) and black carbon (BC) concentrations between pre-and post-lockdown period and (2) the professional drivers working conditions and practices. The study was conducted on 33 Parisian taxi drivers. UFP and BC were measured inside their vehicles with DiSCmini® and microAeth®, respectively, on two typical working days before and after the first lockdown. The job-related characteristics were self-reported. Our results showed that after the first lockdown, the number of clients significantly decreased as well as the taxi driver's journey duration. Taxi drivers significantly opened their windows more and reduced the use of air recirculation. UFP decreased significantly by 32% and BC by 31% after the first lockdown, with a weaker positive correlation compared to before the lockdown. The reduction of in-vehicle UFP was explained mainly by the reduction of traffic flow and ventilation settings, though the latter probably varied according to the traffic condition. No predictor explained the variation of in-vehicle BC concentration between pre-and post-lockdown periods, suggesting different sources of UFP and BC. The road traffic was not anymore the dominant source of BC post-lockdown. We emphasize the role of traffic emissions on in-vehicle air pollution and that preventive measures such as ventilation settings will help to better manage air quality inside a vehicle in order to minimize exposure of professional drivers, as well as passengers, to air pollutants.

Keywords: black carbon, COVID-19, France, lockdown, taxis, ultrafine particles

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4430 A Review on Disaster Risk Reduction and Sustainable Development in Nigeria

Authors: Kudu Dangana

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The occurrences of disaster often call for the support of both government and non-government organization. Consequently, disaster relief remains extremely important in disaster management. However, this approach alone does not proactively address the need to adduce the human and environment impacts of future disasters. Recent thinking in the area of disaster management is indicative of the need for a new paradigm that focuses on reducing the risk of disasters with the involvement and participation of communities. This paper reviews the need for communities to place more emphasis on a holistic approach to disaster risk reduction. This approach involves risk assessment, risk reduction, early warning and disaster preparedness in order to effectively address the reduction of social, economic, and environmental costs of disasters nationally and at the global level.

Keywords: disaster, early, management, warning, relief, risk vulnerability

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4429 Gas Network Noncooperative Game

Authors: Teresa Azevedo PerdicoúLis, Paulo Lopes Dos Santos

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The conceptualisation of the problem of network optimisation as a noncooperative game sets up a holistic interactive approach that brings together different network features (e.g., com-pressor stations, sources, and pipelines, in the gas context) where the optimisation objectives are different, and a single optimisation procedure becomes possible without having to feed results from diverse software packages into each other. A mathematical model of this type, where independent entities take action, offers the ideal modularity and subsequent problem decomposition in view to design a decentralised algorithm to optimise the operation and management of the network. In a game framework, compressor stations and sources are under-stood as players which communicate through network connectivity constraints–the pipeline model. That is, in a scheme similar to tatonnementˆ, the players appoint their best settings and then interact to check for network feasibility. The devolved degree of network unfeasibility informs the players about the ’quality’ of their settings, and this two-phase iterative scheme is repeated until a global optimum is obtained. Due to network transients, its optimisation needs to be assessed at different points of the control interval. For this reason, the proposed approach to optimisation has two stages: (i) the first stage computes along the period of optimisation in order to fulfil the requirement just mentioned; (ii) the second stage is initialised with the solution found by the problem computed at the first stage, and computes in the end of the period of optimisation to rectify the solution found at the first stage. The liability of the proposed scheme is proven correct on an abstract prototype and three example networks.

Keywords: connectivity matrix, gas network optimisation, large-scale, noncooperative game, system decomposition

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4428 Detecting Local Clusters of Childhood Malnutrition in the Island Province of Marinduque, Philippines Using Spatial Scan Statistic

Authors: Novee Lor C. Leyso, Maylin C. Palatino

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Under-five malnutrition continues to persist in the Philippines, particularly in the island Province of Marinduque, with prevalence of some forms of malnutrition even worsening in recent years. Local spatial cluster detection provides a spatial perspective in understanding this phenomenon as key in analyzing patterns of geographic variation, identification of community-appropriate programs and interventions, and focused targeting on high-risk areas. Using data from a province-wide household-based census conducted in 2014–2016, this study aimed to determine and evaluate spatial clusters of under-five malnutrition, across the province and within each municipality at the individual level using household location. Malnutrition was defined as weight-for-age z-score that fall outside the 2 standard deviations from the median of the WHO reference population. The Kulldorff’s elliptical spatial scan statistic in binomial model was used to locate clusters with high-risk of malnutrition, while adjusting for age and membership to government conditional cash transfer program as proxy for socio-economic status. One large significant cluster of under-five malnutrition was found southwest of the province, in which living in these areas at least doubles the risk of malnutrition. Additionally, at least one significant cluster were identified within each municipality—mostly located along the coastal areas. All these indicate apparent geographical variations across and within municipalities in the province. There were also similarities and disparities in the patterns of risk of malnutrition in each cluster across municipalities, and even within municipality, suggesting underlying causes at work that warrants further investigation. Therefore, community-appropriate programs and interventions should be identified and should be focused on high-risk areas to maximize limited government resources. Further studies are also recommended to determine factors affecting variations in childhood malnutrition considering the evidence of spatial clustering found in this study.

Keywords: Binomial model, Kulldorff’s elliptical spatial scan statistic, Philippines, under-five malnutrition

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4427 Effect of Combining Return Policy and Early Order Commitment on Supply Chain Performance

Authors: Hamed Homaei, Seyed Reza Hejazi, Iraj Mahdavi

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Return policy (RP) is a strategy for supply chain coordination, whereby the retailer returns the unsold products to the manufacturer or the manufacturer offers a credit on unsold products to the retailer at the end of selling season. Early order commitment (EOC) is another efficient mechanism for channel coordination wherein the retailer commits to purchasing from the manufacturer a fixed order quantity a few periods in advance of the regular delivery lead time. This paper studies the coordination issue of a two-level supply chain with one retailer and one manufacturer through combining two mentioned contracts. The main purpose of this paper is to present an analytical model to show that how the contract which is created by combining RP and EOC can improve supply chain performance. Numerical analyses show that the supply chain coordination through mentioned contract in compare with EOC mechanism, can improve supply chain performance under certain ranges of model parameters. Furthermore, some numerical analyses are done to determine the best buyback price in order to achieve maximum cost saving in the supply chain. Finally, a revenue sharing scheme is presented in order to achieve a win-win condition in the supply chain.

Keywords: supply chain coordination, early order commitment, return policy, revenue sharing

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4426 A Secular Advent: A Video-Ethnographic Study of the Preparations for Christmas in Swedish Preschools

Authors: Tunde Puskas, Anita Andersson

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In Swedish early childhood education research, the issues related to religious identifications and practices have often been marginalized or relegated either to the realm of diversity and multiculturalism or to the realm of national traditions. This paper is part of a research project about whether religion is considered as part of Swedish cultural heritage in Swedish preschools. Our aim in this paper is to explore how a Swedish preschool balance between keeping the education non-confessional and at the same time introducing the traditions associated with advent and Christmas. Christmas was chosen because of the religious background of the holiday and because it is a tradition widely celebrated in Swedish preschools. In Swedish education system, the concept of freedom of religion is understood in the sense that education is declared to be non-confessional. Nevertheless, as the major state holidays in Sweden are tied to Lutheran Christian traditions, and according to the curriculum preschool educators, are given the task to pass on a cultural heritage, defined in terms of values, traditions, history, language, and knowledge, it is the preschool teams or individual preschool teachers who determine whether and to what extent religious considerations are/ought to be seen as part of the cultural heritage the preschool passes on. The data consists of ten video taped observations from two preschools. The video data was transcribed and the transcripts were thereafter analysed through content analysis. In the analysis, we draw on the concept of banal religiosity that has helped us to draw attention to the workings of religious considerations that are so familiar that they rarely are noticed as religious and on Ninian Smart’s theory on the dimensions of religion. The analysis shows that what the adults actually do with religion fulfils six of seven dimensions common to religious traditions as outlined by Smart. At the same time, Christmas is performed as a lived tradition within which the commercial and religious rituals intersect and result in a banal, national religiosity.

Keywords: secular advent, banal religiosity, dimensions of religion, rites

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4425 Prognostic Impact of Pre-transplant Ferritinemia: A Survival Analysis Among Allograft Patients

Authors: Mekni Sabrine, Nouira Mariem

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Background and aim: Allogeneic hematopoietic stem cell transplantation is a curative treatment for several hematological diseases; however, it has a non-negligible morbidity and mortality depending on several prognostic factors, including pre-transplant hyperferritinemia. The aim of our study was to estimate the impact of hyperferritinemia on survivals and on the occurrence of post-transplant complications. Methods: It was a longitudinal study conducted over 8 years and including all patients who had a first allograft. The impact of pretransplant hyperferritinemia (ferritinemia ≥1500) on survivals was studied using the Kaplan Meier method and the COX model for uni- and multivariate analysis. The Khi-deux test and binary logistic regression were used to study the association between pretransplant ferritinemia and post-transplant complications. Results: One hundred forty patients were included with an average age of 26.6 years and a sex ratio (M/F)=1.4. Hyperferritinemia was found in 33% of patients. It had no significant impact on either overall survival (p=0.9) or event -free survival (p=0.6). In multivariate analysis, only the type of disease was independently associated with overall survival (p=0.04) and event-free survival (p=0.002). For post-allograft complications: The occurrence of early documented infections was independently associated with pretransplant hyperferritinemia (p=0.02) and the presence of acute graft versus host disease( GVHD) (p<10-3). The occurrence of acute GVHD was associated with early documented infection (p=0.002) and Cytomegalovirus reactivation (p<10-3). The occurrence of chronic GVHD was associated with the presence of Cytomegalovirus reactivation (p=0.006) and graft source (p=0.009). Conclusion: Our study showed the significant impact of pre-transplant hyperferritinemia on the occurrence of early infections but not on survivals. Early and more accurate assessment iron overload by other tests such as liver magnetic resonance imaging with initiation of chelating treatment could prevent the occurrence of such complications after transplantation.

Keywords: allogeneic, transplants, ferritin, survival

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4424 Delegation or Assignment: Registered Nurses’ Ambiguity in Interpreting Their Scope of Practice in Long Term Care Settings

Authors: D. Mulligan, D. Casey

Abstract:

Introductory Statement: Delegation is when a registered nurse (RN) transfers a task or activity that is normally within their scope of practice to another person (delegatee). RN delegation is common practice with unregistered staff, e.g., student nurses and health care assistants (HCAs). As the role of the HCA is increasingly embedded as a direct care and support role, especially in long-term residential care for older adults, there is RN uncertainty as to their role as a delegator. The assignment is when a task is transferred to a person that is within the role specification of the delegatee. RNs in long-term care (LTC) for older people are increasingly working in teams where there are less RNs and more HCAs providing direct care to the residents. The RN is responsible and accountable for their decision to delegate and assign tasks to HCAs. In an interpretive, multiple case studies to explore how delegation of tasks by RNs to HCAs occurred in long-term care settings in Ireland the importance of the RN understanding their scope of practice emerged. Methodology: Focus group interviews and individual interviews were undertaken as part of a multiple case study. Both cases, anonymized as Case A and Case B, were within the public health service in Ireland. The case study sites were long-term care settings for older adults located in different social care divisions, and in different geographical areas. Four focus group interviews with staff nurses and three individual interviews with CNMs were undertaken. The interactive data analysis approach was the analytical framework used, with within-case and cross-case analysis. The theoretical lens of organizational role theory, applying the role episode model (REM), was used to understand, interpret, and explain the findings. Study Findings: RNs and CNMs understood the role of the nurse regulator and the scope of practice. RNs understood that the RN was accountable for the care and support provided to residents. However, RNs and CNM2s could not describe delegation in the context of their scope of practice. In both cases, the RNs did not have a standardized process for assessing HCA competence to undertake nursing tasks or interventions. RNs did not routinely supervise HCAs. Tasks were assigned and not delegated. There were differences between the cases in relation to understanding which nursing tasks required delegation. HCAs in Case A undertook clinical vital sign assessments and documentation. HCAs in Case B did not routinely undertake these activities. Delegation and assignment were influenced by the organizational factors, e.g., model of care, absence of delegation policies, inadequate RN education on delegation, and a lack of RN and HCA role clarity. Concluding Statement: Nurse staffing levels and skill mix in long-term care settings continue to change with more HCAs providing more direct care and support. With decreasing RN staffing levels RNs will be required to delegate and assign more direct care to HCAs. There is a requirement to distinguish between RN assignment and delegation at policy, regulation, and organizational levels.

Keywords: assignment, delegation, registered nurse, scope of practice

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4423 Early Initiation of Breastfeeding among Postpartum Mothers at Two Rwandan Hospitals

Authors: Joella Mukashyaka, Rose Mukarubayiza, Emmanuel Habumugisha, Francois-Xavier Sunday, Kellen Muganwa, Valens Mbarushimana, Pamela Meharry

Abstract:

Background: Breastfeeding in the first hour post-birth can decrease neonatal morbidity and mortality. Disease prevention and health outcomes differ immensely between newborns who receive human milk and those who do not. Rwanda has high breastfeeding rates, though factors associated with early initiation of breastfeeding (EIBF) are unknown. Objective: To assess factors associated with EIBF among mothers in immediate postpartum units at two hospitals. Methods: A cross-sectional study design and a convenience sample of 187 mothers were used. An interviewer-administered questionnaire was used for data collection. A Chi-square test showed the relationship between EIBF and sociodemographic factors. Results: The findings showed less than one quarter (20.5%) breastfed within the first hour after birth. The majority was < 25 years (52.4%), had some primary education (27.7%) employed (66.7%), urban dweller (58.1%), attendance of one ANC visit or more (81.3%), vaginal birth (58.8%), and did not receive EIBF health education (92.0%). The majority (78.5%) was too tired to initiate breastfeeding, and many supplemented (41.9%) due to perceived insufficient breastmilk. Conclusion: Most mothers did not initiate breastfeeding within the first hour after birth. Sociodemographic factors were associated with EIBF. A program to promote, protect, and support EIBF is urgently needed the community.

Keywords: breastfeeding, early initiation, neonates, morbidity, mortality, sub-Saharan Africa

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4422 Identification of Potential Predictive Biomarkers for Early Diagnosis of Preeclampsia Growth Factors to microRNAs

Authors: Sadia Munir

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Preeclampsia is the contributor to the worldwide maternal mortality of approximately 100,000 deaths a year. It complicates about 10% of all pregnancies and is the first cause of maternal admission to intensive care units. Predicting preeclampsia is a major challenge in obstetrics. More importantly, no major progress has been achieved in the treatment of preeclampsia. As placenta is the main cause of the disease, the only way to treat the disease is to extract placental and deliver the baby. In developed countries, the cost of an average case of preeclampsia is estimated at £9000. Interestingly, preeclampsia may have an impact on the health of mother or infant, beyond the pregnancy. We performed a systematic search of PubMed including the combination of terms such as preeclampsia, biomarkers, treatment, hypoxia, inflammation, oxidative stress, vascular endothelial growth factor A, activin A, inhibin A, placental growth factor, transforming growth factor β-1, Nodal, placenta, trophoblast cells, microRNAs. In this review, we have summarized current knowledge on the identification of potential biomarkers for the diagnosis of preeclampsia. Although these studies show promising data in early diagnosis of preeclampsia, the current value of these factors as biomarkers, for the precise prediction of preeclampsia, has its limitation. Therefore, future studies need to be done to support some of the very promising and interesting data to develop affordable and widely available tests for early detection and treatment of preeclampsia.

Keywords: activin, biomarkers, growth factors, miroRNA

Procedia PDF Downloads 441
4421 Discover a New Technique for Cancer Recognition by Analysis and Determination of Fractal Dimension Images in Matlab Software

Authors: Saeedeh Shahbazkhany

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Cancer is a terrible disease that, if not diagnosed early, therapy can be difficult while it is easily medicable if it is diagnosed in early stages. So it is very important for cancer diagnosis that medical procedures are performed. In this paper we introduce a new method. In this method, we only need pictures of healthy cells and cancer cells. In fact, where we suspect cancer, we take a picture of cells or tissue in that area, and then take some pictures of the surrounding tissues. Then, fractal dimension of images are calculated and compared. Cancer can be easily detected by comparing the fractal dimension of images. In this method, we use Matlab software.

Keywords: Matlab software, fractal dimension, cancer, surrounding tissues, cells or tissue, new method

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4420 Knowledge-Attitude-Practice Survey Regarding High Alert Medication in a Teaching Hospital in Eastern India

Authors: D. S. Chakraborty, S. Ghosh, A. Hazra

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Objective: Medication errors are a reality in all settings where medicines are prescribed, dispensed and used. High Alert Medications (HAM) are those that bear a heightened risk of causing significant patient harm when used in error. We conducted a knowledge-attitude-practice survey, among residents working in a teaching hospital, to assess the ground situation with regard to the handling of HAM. Methods: We plan to approach 242 residents among the approximately 600 currently working in the hospital through purposive sampling. Residents in all disciplines (clinical, paraclinical and preclinical) are being targeted. A structured questionnaire that has been pretested on 5 volunteer residents is being used for data collection. The questionnaire is being administered to residents individually through face-to-face interview, by two raters, while they are on duty but not during rush hours. Results: Of the 156 residents approached so far, data from 140 have been analyzed, the rest having refused participation. Although background knowledge exists for the majority of respondents, awareness levels regarding HAM are moderate, and attitude is non-uniform. The number of respondents correctly able to identify most ( > 80%) HAM in three common settings– accident and emergency, obstetrics and intensive care unit are less than 70%. Several potential errors in practice have been identified. The study is ongoing. Conclusions: Situation requires corrective action. There is an urgent need for improving awareness regarding HAM for the sake of patient safety. The pharmacology department can take the lead in designing awareness campaign with support from the hospital administration.

Keywords: high alert medication, medication error, questionnaire, resident

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4419 Identification and Origins of Multiple Personality: A Criterion from Wiggins

Authors: Brittany L. Kang

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One familiar theory of the origin of multiple personalities focuses on how symptoms of trauma or abuse are central causes, as seen in paradigmatic examples of the condition. The theory states that multiple personalities constitute a congenital condition, as babies all exhibit multiplicity, and that generally alters only remain separated due to trauma. In more typical cases, the alters converge and become a single identity; only in cases of trauma, according to this account, do the alters remain separated. This theory is misleading in many aspects, the most prominent being that not all multiple personality patients are victims of child abuse or trauma, nor are all cases of multiple personality observed in early childhood. The use of this criterion also causes clinical problems, including an inability to identify multiple personalities through the variety of symptoms and traits seen across observed cases. These issues present a need for revision in the currently applied criterion in order to separate the notion of child abuse and to be able to better understand the origins of multiple personalities itself. Identifying multiplicity through the application of identity theories will improve the current criterion, offering a bridge between identifying existing cases and understanding their origins. We begin by applying arguments from Wiggins, who held that each personality within a multiple was not a whole individual, but rather characters who switch off. Wiggins’ theory is supported by observational evidence of how such characters are differentiated. Alters of older ages are seen to require different prescription lens, in addition to having different handwriting. The alters may also display drastically varying styles of clothing, preferences in food, their gender, sexuality, religious beliefs and more. The definitions of terms such as 'personality' or 'persons' also become more distinguished, leading to greater understanding of who is exactly able to be classified as a patient of multiple personalities. While a more common meaning of personality is a designation of specific characteristics which account for the entirety of a person, this paper argues from Wiggins’ theory that each 'personality' is in fact only partial. Clarification of the concept in question will allow for more successful future clinical applications.

Keywords: identification, multiple personalities, origin, Wiggins' theory

Procedia PDF Downloads 242
4418 Creation of an Integrated Development Environment to Assist and Optimize the Learning the Languages C and C++

Authors: Francimar Alves, Marcos Castro, Marllus Lustosa

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In the context of the teaching of computer programming, the choice of tool to use is very important in the initiation and continuity of learning a programming language. The literature tools do not always provide usability and pedagogical dynamism clearly and accurately for effective learning. This hypothesis implies fall in productivity and difficulty of learning a particular programming language by students. The integrated development environments (IDEs) Dev-C ++ and Code :: Blocks are widely used in introductory courses for undergraduate courses in Computer Science for learning C and C ++ languages. However, after several years of discontinuity maintaining the source code of Dev-C ++ tool, the continued use of the same in the teaching and learning process of the students of these institutions has led to difficulties, mainly due to the lack of update by the official developers, which resulted in a sequence of problems in using it on educational settings. Much of the users, dissatisfied with the IDE Dev-C ++, migrated to Code :: Blocks platform targeting the more dynamic range in the learning process of the C and C ++ languages. Nevertheless, there is still the need to create a tool that can provide the resources of most IDE's software development literature, however, more interactive, simple, accurate and efficient. This motivation led to the creation of Falcon C ++ tool, IDE that brings with features that turn it into an educational platform, which focuses primarily on increasing student learning index in the early disciplines of programming and algorithms that use the languages ​​C and C ++ . As a working methodology, a field research to prove the truth of the proposed tool was used. The test results and interviews with entry-level students and intermediate in a postsecondary institution gave basis for the composition of this work, demonstrating a positive impact on the use of the tool in teaching programming, showing that the use of Falcon C ++ software is beneficial in the teaching process of the C and C ++ programming languages.

Keywords: ide, education, learning, development, language

Procedia PDF Downloads 443
4417 The Effectiveness of Treating Anxiety with Reiki

Authors: Erika Humphreys

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The effectiveness of treating anxiety with Reiki is explored within ten quantitative studies. The methodology utilized for a critical appraisal and systematic review of the literature is explained with inclusion and exclusion criteria. The theoretical framework for the project is grounded in the work of Hildegard Peplau, whose nursing theory based on the therapeutic use of self is foundational for Reiki implementation. A thorough critique of the literature is conducted for key components of robustness and believability. This critique is conducted using a structured guide addressing synthesized strengths and weaknesses of the body of literature. A synthesis of the literature explores the findings of the studies. This synthesis reports on Reiki’s effectiveness in treating anxiety within a variety of patient settings and populations, its effect on subscales of anxiety, physiological manifestations of anxiety, and pain associated with anxiety. Cultural considerations affecting Reiki’s potential effectiveness are discussed. Gaps in the literature are examined, including the studies’ narrow sample population, lack of participant exclusionary factors for controlled outcome data, and the lack of studies across time. Implications for future research are discussed with recommendations for expanded research that includes a broader variety of settings, age groups, and patient diagnoses, including anxiety disorders, for research data that is transferable. Implications for further practice for the advanced practice registered nurse (APRN) are explored, with the potential benefits for both providers and patients, including improved patient satisfaction and expansion of provider treatment modalities.

Keywords: Reiki, anxiety, complementary alternative medicine, pandemic

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4416 The Magnification of Early Detect Nutrition Case through Local Potential Utilization in Urban Region, Indonesia

Authors: Oktia Woro Kasmini Handayani, Sri Ratna Rahayu, Efa Nugroho, Bertakalswa Hermawati

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The double burden of nutrition problem must be faced by Indonesia as developing country. The implemented program did not improve the nutritional status, therefore need to consider to utilize local potential. The objective of this research was to find out the effectivity of magnification model of early detect through local potential utilization in urban region, Semarang, Central Java, Indonesia. The research used an experimental design with the quantitative-qualitative approach. The population was all toddlers under five within the research region, sample determination by purposive sampling, as many as 216 toddlers. Quantitative data analysis used effectively criteria by Sugiono. Qualitative data was analyzed using NVivo. The optimization of local potential in the effort of nutrition status improvement shows number of nutrition case found was increased 225% (very effective), number of cases treated was increased 175% (very effective), number of cases counselled was increased 200% (effective), and number of cases that have improvement increase 75% (effective). The local potential need to be utilized in the effort of nutrition program improvement one of it is through the community empowerment, particularly health care and health high education institution as partner.

Keywords: early detection, nutrition status, local potential, health cadre

Procedia PDF Downloads 274