Search results for: metacognitive knowledge

Authors: Guoheng Liu, Zhilong Huang

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For more than the past ten years, oil and gas production from marine shale such as the Barnett shale. In addition, in recent years, major breakthroughs have also been made in lacustrine shale gas exploration, such as the Yanchang Formation of the Ordos Basin in China. Lucaogou Formation shale, which is also lacustrine shale, has also yielded a high production in recent years, for wells such as M1, M6, and ML2, yielding a daily oil production of 5.6 tons, 37.4 tons and 13.56 tons, respectively. Lithologic identification and classification of reservoirs are the base and keys to oil and gas exploration. Lithology and lithofacies obviously control the distribution of oil and gas in lithological reservoirs, so it is of great significance to describe characteristics of lithology and lithofacies of reservoirs finely. Lithofacies is an intrinsic property of rock formed under certain conditions of sedimentation. Fine-grained sedimentary rocks such as shale formed under different sedimentary conditions display great particularity and distinctiveness. Hence, to our best knowledge, no constant and unified criteria and methods exist for fine-grained sedimentary rocks regarding lithofacies definition and classification. Consequently, multi-parameters and multi-disciplines are necessary. A series of qualitative descriptions and quantitative analysis were used to figure out the lithofacies characteristics and its effect on oil accumulation of Lucaogou formation fine-grained sedimentary rocks in Santanghu basin. The qualitative description includes core description, petrographic thin section observation, fluorescent thin-section observation, cathode luminescence observation and scanning electron microscope observation. The quantitative analyses include X-ray diffraction, total organic content analysis, ROCK-EVAL.II Methodology, soxhlet extraction, porosity and permeability analysis and oil saturation analysis. Three types of lithofacies were mainly well-developed in this study area, which is organic-rich massive shale lithofacies, organic-rich laminated and cloddy hybrid sedimentary lithofacies and organic-lean massive carbonate lithofacies. Organic-rich massive shale lithofacies mainly include massive shale and tuffaceous shale, of which quartz and clay minerals are the major components. Organic-rich laminated and cloddy hybrid sedimentary lithofacies contain lamina and cloddy structure. Rocks from this lithofacies chiefly consist of dolomite and quartz. Organic-lean massive carbonate lithofacies mainly contains massive bedding fine-grained carbonate rocks, of which fine-grained dolomite accounts for the main part. Organic-rich massive shale lithofacies contain the highest content of free hydrocarbon and solid organic matter. Moreover, more pores were developed in organic-rich massive shale lithofacies. Organic-lean massive carbonate lithofacies contain the lowest content solid organic matter and develop the least amount of pores. Organic-rich laminated and cloddy hybrid sedimentary lithofacies develop the largest number of cracks and fractures. To sum up, organic-rich massive shale lithofacies is the most favorable type of lithofacies. Organic-lean massive carbonate lithofacies is impossible for large scale oil accumulation.

Keywords: lithofacies classification, tuffaceous shale, oil enrichment, Lucaogou formation

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Authors: Alla Ovsyannikova, Oksana Rymar, Elena Shakhtshneider, Mikhail Voevoda

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In Siberia endocrinologists increasingly noted young patients with the course of diabetes mellitus differing from 1 and 2 types. Therefore we did a molecular genetic study for this group of patients to verify the monogenic forms of diabetes mellitus in them and researched the characteristics of this pathology. When confirming the monogenic form of diabetes, we performed a correction therapy for many patients (transfer from insulin to tablets), prevented specific complications, examined relatives and diagnosed their diabetes at the preclinical stage, revealed phenotypic characteristics of the pathology which led to the high significance of this work. Materials and Methods: We observed 5 patients (4 families). We diagnosed MODY (Maturity Onset Diabetes of the Young) during the molecular genetic testing (direct automatic sequencing). All patients had a full clinical examination, blood samples for biochemical research, determination of C-peptide and TSH, antibodies to b-cells, microalbuminuria, abdominal ultrasound, heart and thyroid ultrasound, examination of ophthalmologist. Results: We diagnosed 3 rare types of MODY: two women had MODY8, one man – MODY6 and man and his mother - MODY12. Patients with types 8 and 12 had clinical features. Age of onset hyperglycemia ranged from 26 to 34 years. In a patient with MODY6 fasting hyperglycemia was detected during a routine examination. Clinical symptoms, complications were not diagnosed. The patient observes a diet. In the first patient MODY8 was detected during first pregnancy, she had itchy skin and mostly postprandial hyperglycemia. Upon examination we determined glycated hemoglobin 7.5%, retinopathy, non-proliferative stage, peripheral neuropathy. She uses a basic bolus insulin therapy. The second patient with MODY8 also had clinical manifestations of hyperglycemia (pruritus, thirst), postprandial hyperglycemia and diabetic nephropathy, a stage of microalbuminuria. The patient was diagnosed autoimmune thyroiditis. She used inhibitors of DPP-4. The patient with MODY12 had an aggressive course. In the detection of hyperglycemia he had complaints of visual impairment, intense headaches, leg cramps. The patient had a history of childhood convulsive seizures of non-epileptic genesis, without organic pathology, which themselves were stopped at the age of 12 years. When we diagnosed diabetes a patient was 28 years, he had hypertriglyceridemia, atherosclerotic plaque in the carotid artery, proliferative retinopathy (lacerocoagulation). Diabetes and early myocardial infarction were observed in three cases in family. We prescribe therapy with sulfonylureas and SGLT-2 inhibitors with a positive effect. At the patient's mother diabetes began at a later age (30 years) and a less aggressive course was observed. She also has hypertriglyceridemia and uses oral hypoglycemic drugs. Conclusions: 1) When young patients with hyperglycemia have extrapancreatic pathologies and diabetic complications with a short duration of diabetes we can assume they have one of type of MODY diabetes. 2) In patients with monogenic forms of diabetes mellitus, the clinical manifestations of hyperglycemia in each succeeding generation are revealed at an earlier age. Research had increased our knowledge of the monogenic forms of diabetes. The reported study was supported by RSCF, research project No. 14-15-00496-P.

Keywords: diabetes mellitus, MODY diabetes, monogenic forms, young patients

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Authors: Yichao Liu, Peter Fransson, Julian Heidecke, Jonas Wallin, Joacim Rockloev

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Dengue, a mosquito-borne viral disease, poses a significant public health challenge in endemic tropical or subtropical countries, including Sri Lanka. To reveal insights into the complexity of the dynamics of this disease and study the drivers, a comprehensive model capable of both robust forecasting and insightful inference of drivers while capturing the co-circulating of several virus strains is essential. However, existing studies mostly focus on only one aspect at a time and do not integrate and carry insights across the siloed approach. While mechanistic models are developed to capture immunity dynamics, they are often oversimplified and lack integration of all the diverse drivers of disease transmission. On the other hand, purely data-driven methods lack constraints imposed by immuno-epidemiological processes, making them prone to overfitting and inference bias. This research presents a hybrid model that combines machine learning techniques with mechanistic modelling to overcome the limitations of existing approaches. Leveraging eight years of newly reported dengue case data, along with socioeconomic factors, such as human mobility, weekly climate data from 2011 to 2018, genetic data detecting the introduction and presence of new strains, and estimates of seropositivity for different districts in Sri Lanka, we derive a data-driven vector (SEI) to human (SEIR) model across 16 regions in Sri Lanka at the weekly time scale. By conducting ablation studies, the lag effects allowing delays up to 12 weeks of time-varying climate factors were determined. The model demonstrates superior predictive performance over a pure machine learning approach when considering lead times of 5 and 10 weeks on data withheld from model fitting. It further reveals several interesting interpretable findings of drivers while adjusting for the dynamics and influences of immunity and introduction of a new strain. The study uncovers strong influences of socioeconomic variables: population density, mobility, household income and rural vs. urban population. The study reveals substantial sensitivity to the diurnal temperature range and precipitation, while mean temperature and humidity appear less important in the study location. Additionally, the model indicated sensitivity to vegetation index, both max and average. Predictions on testing data reveal high model accuracy. Overall, this study advances the knowledge of dengue transmission in Sri Lanka and demonstrates the importance of incorporating hybrid modelling techniques to use biologically informed model structures with flexible data-driven estimates of model parameters. The findings show the potential to both inference of drivers in situations of complex disease dynamics and robust forecasting models.

Keywords: compartmental model, climate, dengue, machine learning, social-economic

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Authors: Catarina Ferreira Rebelo, Luis Madeira de Carvalho, Fernando González González

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The order Passeridae corresponds to the richest and most abundant group of birds, with approximately 6500 species, making it possible to assert that two out of every three bird species are passerines. They are globally distributed and exhibit remarkable morphological and ecological variability. While numerous species of parasites have been identified and described in wild birds, there has been little focus on passeriformes. Seventeen passerines admitted to GREFA, a Wildlife Rehabilitation Center, throughout the months of October, November and December 2022 were analyzed. The species included Aegithalos caudatus, Anthus pratensis, Carduelis chloris, Certhia brachydactyla, Erithacus rubecula, Fringilla coelebs, Parus ater, Passer domesticus, Sturnus unicolor, Sylvia atricapilla, Turdus merula and Turdus philomelos. Data regarding past history was collected, and necropsies were conducted to identify the cause of death and body condition and determine the presence of parasites. Additionally, samples of intestinal content were collected for direct/fecal smear, flotation and sedimentation techniques. Sixteen (94.1%) passerines were considered positive for the presence of parasitic forms in at least one of the techniques used, including parasites detected in necropsy. Adult specimens of both sexes and tritonymphs of Monojoubertia microhylla and ectoparasites of the genus Ornithonyssus were identified. Macroscopic adult endoparasitic forms were also found during necropsies, including Diplotriaena sp., Serratospiculum sp. and Porrocaecum sp.. Parasitism by coccidia was observed with no sporulation. Additionally, eggs of nematodes from various genera were detected, such as Diplotriaena sp., Capillaria sp., Porrocaecum sp., Syngamus sp. and Strongyloides sp., eggs of trematodes, specifically the genus Brachylecithum and cestode oncospheres, whose genera were not identified. To our knowledge, the respiratory nematode Serratospiculum sp. found in this study is being reported for the first time in passerines in the Iberian Peninsula, along with the application of common coprological techniques for the identification of eggs in the intestinal content. The majority of parasites identified utilize intermediary hosts present in the diet of the passerines sampled. Furthermore, the discovery of certain parasites with a direct life cycle could potentially exert greater influence, particularly in specific scenarios such as within nests or during the rehabilitation process in wildlife centers. These parasites may impact intraspecific competition, increase susceptibility to predators or lead to death. However, their cost to wild birds is often not clear, as individuals can endure various parasites without significant harm. Furthermore, wild birds serve as important sources of parasites across different animal groups, including humans and other mammals. This study provides invaluable insights into the parasitic fauna of these birds, not only serving as a cornerstone for future epidemiological investigations but also enhancing our comprehension of these avian species.

Keywords: birds, parasites, passerines, wild, spain

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Authors: Marta Polec

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The paper outlines the problem of street performances in Poland in context of humanistic management studies. The Author perceives activity of street performers of various art and entertainment actions as a phenomenon of informal organizing, self-management and cultural entrepreneurship in urban sphere. What has to be highlighted, performative street art is not currently being an interest of scientific research as often as visual street art. That is why the Author indicates the need of including new approaches of humanistic and social disciplines, especially different management paradigms, in examining various aspects of the activity of street performers. The paper shows the results of ethnographic study based on anthropological interviews, participant observation non-participant observation, shadowing, field notes, audiovisual documentation and text analysis. The fieldwork was performed since 2014 in the old towns and major areas of several the most popular touristic Polish cities, mainly in Gdansk, Cracow, Lublin, Warsaw, and Wroclaw. The research group included street artists of various kinds of performative arts. The investigation was prepared within the ‘Ethnography of the informal organization of street artists in Poland’ project, as a part of Diamond Grant programme (the Ministry of Science and Higher Education in Poland). The first conclusion of the study is that street shows form a way of artistic self-realization and unusual promotion of creative activity in public space. As street performance helps to make some extra money and even earning a living in general, it seems to constitute a new profession. Street performers as a specific environment usually know each other and in many ways cooperate informally to carry on their shows successfully. Secondly, this activity brings plenty benefits for the local communities. Street shows attract inhabitants and tourists quite often by appealing to intangible cultural heritage and memorializing it. They also pose a space for discussing current social issues. Moreover, they disseminate relatively inexpensive public access to culture, but also state an example of social courage of choosing unconventional occupation. Finally, currently being used terms of street performers/street artists/buskers in different languages, as instance as in Polish, are still fluent and undefined. As a consequence, it brings implications for existing common knowledge about street performers, for example in establishing and implementing public policies. It impedes solving many ethical and social dilemmas concerning the question of performances in public sphere, which in some cases seem to be related to, as: children’s work, beggars’ practices or question of harmony of public space. The main aim of this study was to expose street performances as yet undefined profession, including different possibilities of interacting with the audience, based on providing impressions, experiences and memories. Although the issue seems to be current and common, in indicated context there is a lack of equal and unified approach of managing urban sphere, which in practice differs both in informal rules and official policies concerning street performances not only in cities in Poland, but also generally in Europe.

Keywords: informal, organizing, street performance, urban sphere

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Authors: Shelley Y. Hawkins

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Introduction/Background: As technology has grown exponentially in healthcare, nurse educators must prepare Advanced Practice Registered Nurse (APRN) graduates with the knowledge and skills in information systems/technology to support and improve patient care and health care systems. APRN’s are expected to lead in caring for populations who lack accessibility and availability through the use of technology, specifically telehealth. The capacity to effectively and efficiently use technology in patient care delivery is clearly delineated in the American Association of Colleges of Nursing (AACN) Doctor of Nursing Practice (DNP) and Master of Science in Nursing (MSN) Essentials. However, APRN’s have minimal, or no, exposure to formalized telehealth education and lack necessary technical skills needed to incorporate telehealth into their patient care. APRN’s must successfully master the technology using telehealth/telemedicine, electronic health records, health information technology, and clinical decision support systems to advance health. Furthermore, APRN’s must be prepared to lead the coordination and collaboration with other healthcare providers in their use and application. Aim/Goal/Purpose: The purpose of this presentation is to establish and operationalize telehealth-focused educational partnerships between one University School of Nursing and two health care systems in order to enhance the preparation of APRN NP students for practice, teaching, and/or scholarly endeavors. Methods: The proposed project was initially presented by the project director to selected multidisciplinary stakeholders including leadership, home telehealth personnel, primary care providers, and decision support systems within two major health care systems to garner their support for acceptance and implementation. Concurrently, backing was obtained from key university-affiliated colleagues including the Director of Simulation and Innovative Learning Lab and Coordinator of the Health Care Informatics Program. Technology experts skilled in design and production in web applications and electronic modules were secured from two local based technology companies. Results: Two telehealth-focused APRN Program academic/practice partnerships have been established. Students have opportunities to engage in clinically based telehealth experiences focused on: (1) providing patient care while incorporating various technology with a specific emphasis on telehealth; (2) conducting research and/or evidence-based practice projects in order to further develop the scientific foundation regarding incorporation of telehealth with patient care; and (3) participating in the production of patient-level educational materials related to specific topical areas. Conclusions: Evidence-based APRN student telehealth clinical experiences will assist in preparing graduates who can effectively incorporate telehealth into their clinical practice. Greater access for diverse populations will be available as a result of the telehealth service model as well as better care and better outcomes at lower costs. Furthermore, APRN’s will provide the necessary leadership and coordination through interprofessional practice by transforming health care through new innovative care models using information systems and technology.

Keywords: academic/practice partnerships, advanced practice nursing, nursing education, telehealth

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Authors: Ntandazo Dlatu, Benjamin Longo-Mbenza, Andre Renzaho, Ruffin Appalata, Yolande Yvonne Valeria Matoumona Mavoungou, Mbenza Ben Longo, Kenneth Ekoru, Blaise Makoso, Gedeon Longo Longo

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Background: The gap between complexities related to the integration of Tuberculosis /HIV control and evidence-based knowledge motivated the initiation of the study. Therefore, the objective of this study was to explore correlations between national TB management guidelines, multiple deprivation indexes, quantiles, components and levels of Tuberculosis control programme using mathematical modeling in rural O.R. Tambo District Health Facilities, South Africa. Methods: The study design used mixed secondary data analysis and cross-sectional analysis between 2009 and 2013 across O.R Tambo District, Eastern Cape, South Africa using univariate/ bivariate analysis, linear multiple regression models, and multivariate discriminant analysis. Health inequalities indicators and component of an impediment to the tuberculosis control programme were evaluated. Results: In total, 62 400 records for TB notification were analyzed for the period 2009-2013. There was a significant but negative between Financial Year Expenditure (r= -0.894; P= 0.041) Seropositive HIV status(r= -0.979; P= 0.004), Population Density (r = -0.881; P= 0.048) and the number of TB defaulter in all TB cases. It was shown unsuccessful control of TB management program through correlations between numbers of new PTB smear positive, TB defaulter new smear-positive, TB failure all TB, Pulmonary Tuberculosis case finding index and deprivation-concentration-dispersion index. It was shown successful TB program control through significant and negative associations between declining numbers of death in co-infection of HIV and TB, TB deaths all TB and SMIAD gradient/ deprivation-concentration-dispersion index. The multivariate linear model was summarized by unadjusted r of 96%, adjusted R2 of 95 %, Standard Error of estimate of 0.110, R2 changed of 0.959 and significance for variance change for P=0.004 to explain the prediction of TB defaulter in all TB with equation y= 8.558-0.979 x number of HIV seropositive. After adjusting for confounding factors (PTB case finding the index, TB defaulter new smear-positive, TB death in all TB, TB defaulter all TB, and TB failure in all TB). The HIV and TB death, as well as new PTB smear positive, were identified as the most important, significant, and independent indicator to discriminate most deprived deprivation index far from other deprivation quintiles 2-5 using discriminant analysis. Conclusion: Elimination of poverty such as overcrowding, lack of sanitation and environment of highest burden of HIV might end the TB threat in O.R Tambo District, Eastern Cape, South Africa. Furthermore, ongoing adequate budget comprehensive, holistic and collaborative initiative towards Sustainable Developmental Goals (SDGs) is necessary for complete elimination of TB in poor O.R Tambo District.

Keywords: tuberculosis, HIV/AIDS, success, failure, control program, health inequalities, South Africa

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Authors: Liou Shyhnan, Chia Han Yang

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The study aims to investigate the promotion of innovation in the development of cultural and creative industries (CCI) and apply research on culture and creativity to this promotion. Using the research perspectives of culture and creativity as the starting points, this study has examined the challenges, trends, and opportunities that have emerged from the development of the CCI until the present. It is found that a definite context of cause and effect exist between them, and that a homologous theoretical basis can be used to understand and interpret them. Based on the characteristics of the aforementioned challenges and trends, this study has compiled two main theoretical systems for conducting research on culture and creativity: (i) reciprocal process between creativity and culture, and (ii) a mechanism for innovation involving multicultural convergence. Both theoretical systems were then used as the foundation to arrive at possible research propositions relating to the two developmental systems. This was respectively done through identification of the theoretical context through a literature review, and interviews and observations of actual case studies within Taiwan’s CCI. In so doing, the critical factors that can address the aforementioned challenges and trends were discovered. Our results indicated that, for reciprocal process between creativity and culture, we recognize that culture serves as creative resources in cultural and creative industries. According to shared consensus, culture provides symbolic meanings and emotional attachment for products and experiences offered by CCI. Besides, different cultures vary in their effects on creativity processes and standards, thus engendering distinctive preferences for and evaluations of the creative expressions and experiences of CCIs. In addition, we identify that creativity serves as the engine for driving the continuation and rebirth of cultures. Accounting for the core of culture, the employment of technology, design, and business facilitates the transformation and innovation mechanism for promoting culture continuity. In addition, with cultural centered, the digital technology, design thinking, and business model are critical constitutes of the innovation mechanism to promote the cultural continuity. Regarding cultural preservation and regeneration of local spaces and folk customs, we argue that the preservation and regeneration of local spaces and cultural cultures must embody the interactive experiences of present-day life. And cultural space and folk custom would regenerate with interact and experience in modern life. Regarding innovation mechanism for multicultural convergence, we propose that innovative stakeholders from different disciplines (e.g., creators, designers, engineers, and marketers) in CCIs rely on the establishment of a cocreation mechanism to promote interdisciplinary interaction. Furthermore, CCI development needs to develop a cocreation mechanism for enhancing the interdisciplinary collaboration among CCI innovation stakeholders. We further argue multicultural mixing would enhance innovation in developing CCI, and assuming an open and mutually enlightening attitude to enrich one another’s cultures in the multicultural exchanges under globalization will create diversity in homogenous CCIs. Finally, for promoting innovation in developing cultural and creative industries, we further propose a model for joint knowledge creation that can be established for enhancing the mutual reinforcement of theoretical and practical research on culture and creativity.

Keywords: culture and creativity, innovation, cultural and creative industries, cultural mixing

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Authors: Yuliana Wahyu, Ambros Leonangung Edu

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The learning praxis that is proposed by 2013 Curriculum (K-13) is no longer school-oriented as a supply-driven, but now a demand-driven provider. This vision is connected with Jokowi-Kalla Nawacita program to create a competitive nation in the global era. Competition is a social fact that must be faced. Therefore the curriculum will design a process to be the innovators and entrepreneurs.To get this goal, K-13 implements the character education. This aims at creating the innovators and entrepreneurs from an early age (primary school). One part of strengthening it is literacy formations (reading, numeracy, science, ICT, finance, and culture). Thus, science literacy is an integral part of character education. The above outputs are only formed through the innovative process through intra-curricular (blended learning), co-curriculer (hands-on learning) and extra-curricular (personalized learning). Unlike the curriculums before that child cram with the theories dominating the intellectual process, new breakthroughs make natural, social, and cultural phenomena as learning sources. For example, Science in primary schoolsplaceBiology as the platform. And Science places natural, social, and cultural phenomena as a learning field so that students can learn, discover, solve concrete problems, and the prospects of development and application in their everyday lives. Science education not only learns about facts collection or natural phenomena but also methods and scientific attitudes. In turn, Science will form the science literacy. Science literacy have critical, creative, logical, and initiative competences in responding to the issues of culture, science and technology. This is linked with science nature which includes hands-on and minds-on. To sustain the effectiveness of science learning, K-13 opens a new way of viewing a contextual learning model in which facts or natural phenomena are drawn closer to the child's learning environment to be studied and analyzed scientifically. Thus, the topic of elementary science discussion is the practical and contextual things that students encounter. This research is about to contextualize Science in primary schools at Manggarai, NTT, by placing local wisdom as a learning source and media to form the science literacy. Explicitly, this study discovers the concept of science and mathematics in Mbaru Niang. Mbaru Niang is a forgotten potentials of the centralistic-theoretical mainstream curriculum so far. In fact, the traditional Manggarai community stores and inherits much of the science-mathematical indigenous sciences. In the traditional house structures are full of science and mathematics knowledge. Every details have style, sound and mathematical symbols. Learning this, students are able to collaborate and synergize the content and learning resources in student learning activities. This is constructivist contextual learning that will be applied in meaningful learning. Meaningful learning allows students to learn by doing. Students then connect topics to the context, and science literacy is constructed from their factual experiences. The research location will be conducted in Manggarai through observation, interview, and literature study.

Keywords: indigenous science, Mbaru Niang, science literacy, science

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Authors: Breanna Wright, Peter Bragge

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Diagnostic error rates in healthcare are approximately 10% of cases. Diagnostic errors can cause patient harm due to inappropriate, inadequate or delayed treatment, and such errors contribute heavily to medical liability claims globally. Therefore, addressing diagnostic error is a high priority. In most cases, diagnostic errors are the result of faulty information synthesis rather than lack of knowledge. Specifically, the majority of diagnostic errors involve cognitive factors, and in particular, cognitive biases. Emergency Departments are an environment with heightened risk of diagnostic error due to time and resource pressures, a frequently chaotic environment, and patients arriving undifferentiated and with minimal context. This project aimed to develop a behavioural, evidence-informed intervention to reduce diagnostic error in Emergency Departments through co-design with emergency physicians, insurers, researchers, hospital managers, citizens and consumer representatives. The Forum Process was utilised to address this aim. This involves convening a small (4 – 6 member) expert panel to guide a focused literature and practice review; convening of a 10 – 12 person citizens panel to gather perspectives of laypeople, including those affected by misdiagnoses; and a 18 – 22 person structured stakeholder dialogue bringing together representatives of the aforementioned stakeholder groups. The process not only provides in-depth analysis of the problem and associated behaviours, but brings together expertise and insight to facilitate identification of a behaviour change intervention. Informed by the literature and practice review, the Citizens Panel focused on eliciting the values and concerns of those affected or potentially affected by diagnostic error. Citizens were comfortable with diagnostic uncertainty if doctors were honest with them. They also emphasised the importance of open communication between doctors and patients and their families. Citizens expect more consistent standards across the state and better access for both patients and their doctors to patient health information to avoid time-consuming re-taking of long patient histories and medication regimes when re-presenting at Emergency Departments and to reduce the risk of unintentional omissions. The structured Stakeholder Dialogue focused on identifying a feasible behavioural intervention to review diagnoses in Emergency Departments. This needed to consider the role of cognitive bias in medical decision-making; contextual factors (in Victoria, there is a legislated 4-hour maximum time between ED triage and discharge / hospital admission); resource availability; and the need to ensure the intervention could work in large metropolitan as well as small rural and regional ED settings across Victoria. The identified behavioural intervention will be piloted in approximately ten hospital EDs across Victoria, Australia. This presentation will detail the findings of all review and consultation activities, describe the behavioural intervention developed and present results of the pilot trial.

Keywords: behavioural intervention, cognitive bias, decision-making, diagnostic error

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Authors: Muhammad Fayyaz Nazir, Ellen Wayenberg, Shahzadaah Faahed Qureshi

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Introduction: The study is based on the Contextual Interaction Theory (CIT) constructs to explore the role of policy actors in implementing the COVID-19 Disease Prevention and Control (DP&C) Policy. The study analyzes the role of healthcare workers' contextual factors, such as cognition, motives, and resources, and their interactions in implementing Social Distancing (SD). In this way, we test a two actors policy implementation theory, i.e., the CIT in a three-actor context. Methods: Data was collected through document analysis and semi-structured interviews. For a qualitative study design, interviews were conducted with questions on cognition, motives, and resources from the healthcare workers involved in implementing SD in the local context in Multan – Pakistan. The possible interactions resulting from contextual factors of the policy actors – healthcare workers were identified through framework analysis protocol guided by CIT and supported by trustworthiness criterion and data saturation. Results: This inquiry resulted in theory application, addition, and enrichment. The theoretical application in the three actor's contexts illustrates the different levels of motives, cognition, and resources of healthcare workers – senior administrators, managers, and healthcare professionals. The senior administrators working in National Command and Operations Center (NCOC), Provincial Technical Committees (PTCs), and Districts Covid Teams (DCTs) were playing their role with high motivation. They were fully informed about the policy and moderately resourceful. The policy implementors: healthcare managers working on implementing the SD within their respective hospitals were playing their role with high motivation and were fully informed about the policy. However, they lacked the required resources to implement SD. The target medical and allied healthcare professionals were moderately motivated but lack of resources and information. The interaction resulted in cooperation and the need for learning to manage the future healthcare crisis. However, the lack of resources created opposition to the implementation of SD. Objectives of the Study: The study aimed to apply a two actors theory in a multi actors context. We take this as an opportunity to qualitatively test the theory in a novel situation of the Covid-19 pandemic and make way for its quantitative application by designing a survey instrument so that implementation researchers can apply CIT through multivariate analyses or higher-order statistical modeling. Conclusion: Applying two actors' implementation theory in exploring a complex case of healthcare intervention in three actors context is a unique work that has never been done before, up to the best of our knowledge. So, the work will contribute to the policy implementation studies by applying, extending, and enriching an implementation theory in a novel case of the Covi-19 pandemic, ultimately fulfilling the gap in implementation literature. Policy institutions and other low or middle-income countries can learn from this research and improve SD implementation by working on the variables with weak significance levels.

Keywords: COVID-19, disease prevention and control policy, implementation, policy actors, social distancing

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Authors: Mabel Y. C. Yau, Roy C. F. Lai, Hugo Y. H. Or

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This study is a pilot surveillance of hygiene compliance and food microbial safety of both licensed and mobile vendors selling Chinese ready–to-eat snack foods in Hong Kong. The study reflects similar situations in running mobile food vending business on trucks. Hong Kong is about to launch the Food Truck Pilot Scheme by the end of 2016 or early 2017. Technically, selling food on the vehicle is no different from hawking food on the street or vending food on the street. Each type of business bears similar food safety issues and cast the same impact on public health. Present findings demonstrate exemplarily situations that also apply to food trucks. 9 types of Cantonese style snacks of 32 samples in total were selected for microbial screening. A total of 16 vending sites including supermarkets, street markets, and snack stores were visited. The study finally focused on a traditional snack, the steamed rice cake with red beans called Put Chai Ko (PCK). PCK is a type of classical Cantonese pastry sold on push carts on the street. It used to be sold at room temperature and served with bamboo sticks in the old days. Some shops would have them sold steam fresh. Microbial examinations on aerobic counts, yeast, and mould, coliform, salmonella as well as Staphylococcus aureus detections were carried out. Salmonella was not detected in all samples. Since PCK does not contain ingredients of beef, poultry, eggs or dairy products, the risk of the presence of Salmonella in PCK was relatively lower although other source of contamination might be possible. Coagulase positive Staphylococcus aureus was found in 6 of the 14 samples sold at room temperature. Among these 6 samples, 3 were PCK. One of the samples was in an unacceptable range of total colony forming units higher than 105. The rest were only satisfactory. Observational evaluations were made with checklists on personal hygiene, premises hygiene, food safety control, food storage, cleaning and sanitization as well as waste disposals. The maximum score was 25 if total compliance were obtained. The highest score among vendors was 20. Three stores were below average, and two of these stores were selling PCK. Most of the non-compliances were on food processing facilities, sanitization conditions and waste disposal. In conclusion, although no food poisoning outbreaks happened during the time of the investigation, the risk of food hazard existed in these stores, especially among street vendors. Attention is needed in the traditional practice of food selling, and that food handlers might not have sufficient knowledge to properly handle food products. Variations in food qualities existed among supply chains or franchise eateries or shops. It was commonly observed that packaging and storage conditions are not properly enforced in the retails. The same situation could be reflected across the food business. It did indicate need of food safety training in the industry and loopholes in quality control among business.

Keywords: cantonese snacks, food safety, microbial, hygiene, street food

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Authors: Ruth Goldschmidt, Vyacheslav Kalchenko, Lilah Agemy, Rachel Elmoalem, Avigdor Scherz

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Vascular Targeted Photodynamic therapy (VTP) is a new modality for selective cancer treatment that leads to the complete tumor ablation. A photosensitizer, a bacteriochlorophyll derivative in our case, is first administered to the patient and followed by the illumination of the tumor area, by a near-IR laser for its photoactivation. The photoactivated drug releases reactive oxygen species (ROS) in the circulation, which reacts with blood cells and the endothelium leading to the occlusion of the blood vasculature. If the blood vessels are only partially closed, the tumor may recover, and cancer cells could survive. On the other hand, excessive treatment may lead to toxicity of healthy tissues nearby. Simultaneous VTP monitoring and image processing independent of the photoexcitation laser has not yet been reported, to our knowledge. Here we present a method for blood flow monitoring, using a real-time laser speckle imaging (RTLSI) in the tumor during VTP. We have synthesized over the years a library of bacteriochlorophyll derivatives, among them WST11 and STL-6014. Both are water soluble derivatives that are retained in the blood vasculature through their partial binding to HSA. WST11 has been approved in Mexico for VTP treatment of prostate cancer at a certain drug dose, and time/intensity of illumination. Application to other bacteriochlorophyll derivatives or other cancers may require different treatment parameters (such as light/drug administration). VTP parameters for STL-6014 are still under study. This new derivative mainly differs from WST11 by its lack of the central Palladium, and its conjugation to an Arg-Gly-Asp (RGD) sequence. RGD is a tumor-specific ligand that is used for targeting the necrotic tumor domains through its affinity to αVβ3 integrin receptors. This enables the study of cell-targeted VTP. We developed a special RTLSI module, based on Labview software environment for data processing. The new module enables to acquire raw laser speckle images and calculate the values of the laser temporal statistics of time-integrated speckles in real time, without additional off-line processing. Using RTLSI, we could monitor the tumor’s blood flow following VTP in a CT26 colon carcinoma ear model. VTP with WST11 induced an immediate slow down of the blood flow within the tumor and a complete final flow arrest, after some sporadic reperfusions. If the irradiation continued further, the blood flow stopped also in the blood vessels of the surrounding healthy tissue. This emphasizes the significance of light dose control. Using our RTLSI system, we could prevent any additional healthy tissue damage by controlling the illumination time and restrict blood flow arrest within the tumor only. In addition, we found that VTP with STL-6014 was the most effective when the photoactivation was conducted 4h post-injection, in terms of tumor ablation success in-vivo and blood vessel flow arrest. In conclusion, RTSLI application should allow to optimize VTP efficacy vs. toxicity in both the preclinical and clinical arenas.

Keywords: blood vessel occlusion, cancer treatment, photodynamic therapy, real time imaging

Procedia PDF Downloads 225

Authors: Sarah Müller-Sägebrecht

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Today’s volatile environment challenges executives to make the right strategic decisions to gain sustainable success. Entrepreneurship scholars postulate mainly positive effects of environmental changes on entrepreneurship behavior, such as developing new business opportunities, promoting ingenuity, and the satisfaction of resource voids. A strategic solution approach to overcome threatening environmental changes and catch new business opportunities is business model innovation (BMI). Although this research stream has gained further importance in the last decade, BMI research is still insufficient. Especially BMI barriers, such as inefficient strategic decision-making processes, need to be identified. Strategic decisions strongly impact organizational future and are, therefore, usually made in groups. Although groups draw on a more extensive information base than single individuals, group-interaction effects can influence the decision-making process - in a favorable but also unfavorable way. Decisions are characterized by uncertainty and risk, whereby their intensity is perceived individually differently. The individual risk-willingness influences which option humans choose. The special nature of strategic decisions, such as in BMI processes, is that these decisions are not made individually but in groups due to their high organizational scope. These groups consist of different personalities whose individual risk-willingness can vary considerably. It is known from group decision theory that these individuals influence each other, observable in different group-interaction effects. The following research questions arise: i) How does group interaction shape BMI decision-making from managers’ perspective? ii) What are the potential interrelations among managers’ risk-willingness, group biases, and BMI decision-making? After conducting 26 in-depth interviews with executives from the manufacturing industry, applied Gioia methodology reveals the following results: i) Risk-averse decision-makers have an increased need to be guided by facts. The more information available to them, the lower they perceive uncertainty and the more willing they are to pursue a specific decision option. However, the results also show that social interaction does not change the individual risk-willingness in the decision-making process. ii) Generally, it could be observed that during BMI decisions, group interaction is primarily beneficial to increase the group’s information base for making good decisions, less than for social interaction. Further, decision-makers mainly focus on information available to all decision-makers in the team but less on personal knowledge. This work contributes to strategic decision-making literature twofold. First, it gives insights into how group-interaction effects influence an organization’s strategic BMI decision-making. Second, it enriches risk-management research by highlighting how individual risk-willingness impacts organizational strategic decision-making. To date, it was known in BMI research that risk aversion would be an internal BMI barrier. However, with this study, it becomes clear that it is not risk aversion that inhibits BMI. Instead, the lack of information prevents risk-averse decision-makers from choosing a riskier option. Simultaneously, results show that risk-averse decision-makers are not easily carried away by the higher risk-willingness of their team members. Instead, they use social interaction to gather missing information. Therefore, executives need to provide sufficient information to all decision-makers to catch promising business opportunities.

Keywords: business model innovation, cognitive biases, group-interaction effects, strategic decision-making, risk-willingness

Procedia PDF Downloads 79

Authors: Srijata Mitra, Mobina Parveen, Pranab Roy, Narayan Chandra Chattopadhyay

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Chlorinated hydrocarbon can be a major pollution problem in groundwater as well as soil. Many people interact with these chemicals on daily accidentally or by professionally in the laboratory. One of the most common sources for Chlorinated hydrocarbon contamination of soil and groundwater are industrial effluents. The wide use and discharge of Trichloroethylene (TCE), a volatile chlorohydrocarbon from chemical industry, led to major water pollution in rural areas. TCE is an mainly used as an industrial metal degreaser in industries. Biotransformation of TCE to the potent carcinogen vinyl chloride (VC) by consortia of anaerobic bacteria might have role for the above purpose. For these reasons, the aim of current study was to isolate and characterized the genes involved in TCE metabolism and also to investigate the in silico study of those genes. To our knowledge, only one aromatic dioxygenase system, the toluene dioxygenase in Pseudomonas putida F1 has been shown to be involved in TCE degradation. This is first instance where Bacillus cereus group being used in biodegradation of trichloroethylene. A novel bacterial strain 2479 was isolated from oil depot site at Rajbandh, Durgapur (West Bengal, India) by enrichment culture technique. It was identified based on polyphasic approach and ribotyping. The bacterium was gram positive, rod shaped, endospore forming and capable of degrading trichloroethylene as the sole carbon source. On the basis of phylogenetic data and Fatty Acid Methyl Ester Analysis, strain 2479 should be placed within the genus Bacillus and species cereus. However, the present isolate (strain 2479) is unique and sharply different from the usual Bacillus strains in its biodegrading nature. Fujiwara test was done to estimate that the strain 2479 could degrade TCE efficiently. The gene for TCE biodegradation was PCR amplified from genomic DNA of Bacillus cereus 2479 by using todC1 gene specific primers. The 600bp amplicon was cloned into expression vector pUC I8 in the E. coli host XL1-Blue and expressed under the control of lac promoter and nucleotide sequence was determined. The gene sequence was deposited at NCBI under the Accession no. GU183105. In Silico approach involved predicting the physico-chemical properties of deduced Tce1 protein by using ProtParam tool. The tce1 gene contained 342 bp long ORF encoding 114 amino acids with a predicted molecular weight 12.6 kDa and the theoretical pI value of the polypeptide was 5.17, molecular formula: C559H886N152O165S8, total number of atoms: 1770, aliphatic index: 101.93, instability index: 28.60, Grand Average of Hydropathicity (GRAVY): 0.152. Three differentially expressed proteins (97.1, 40 and 30 kDa) were directly involved in TCE biodegradation, found to react immunologically to the antibodies raised against TCE inducible proteins in Western blot analysis. The present study suggested that cloned gene product (TCE1) was capable of degrading TCE as verified chemically.

Keywords: cloning, Bacillus cereus, in silico analysis, TCE

Procedia PDF Downloads 399

Authors: Esther Ranero Carrazana, Maria Karla Ramirez Valdes

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First responders, including firefighters, police officers, and emergency medical personnel, are frequently exposed to high-stress scenarios that significantly increase their risk of mental health issues such as depression, anxiety, and post-traumatic stress disorder (PTSD). Their work involves life-threatening situations, witnessing suffering, and making critical decisions under pressure, all contributing to psychological strain. The objectives of this research on "Stress Reduction Techniques for First Responders: Scientifically Proven Methods" are as follows. One of them is to evaluate the effectiveness of stress reduction techniques. The primary objective is to assess the efficacy of various scientifically proven stress reduction techniques explicitly tailored for first responders. Heart Rate Variability (HRV) Training, Interoception and Exteroception, Sensory Integration, and Body Perception Awareness are scrutinized for their ability to mitigate stress-related symptoms. Furthermore, we evaluate and enhance the understanding of stress mechanisms in first responders by exploring how different techniques influence the physiological and psychological responses to stress. The study aims to deepen the understanding of stress mechanisms in high-risk professions. Additionally, the study promotes psychological resilience by seeking to identify and recommend methods that can significantly enhance the psychological resilience of first responders, thereby supporting their mental health and operational efficiency in high-stress environments. Guide training and policy development is an additional objective to provide evidence-based recommendations that can be used to guide training programs and policy development aimed at improving the mental health and well-being of first responders. Lastly, the study aims to contribute valuable insights to the existing body of knowledge in stress management, specifically tailored to the unique needs of first responders. This study involved a comprehensive literature review assessing the effectiveness of various stress reduction techniques tailored for first responders. Techniques evaluated include Heart Rate Variability (HRV) Training, Interoception and Exteroception, Sensory Integration, and Body Perception Awareness, focusing on their ability to alleviate stress-related symptoms. The review indicates promising results for several stress reduction methods. HRV Training demonstrates the potential to reflect stress vulnerability and enhance physiological and behavioral flexibility. Interoception and Exteroception help modulate the stress response by enhancing awareness of the body's internal state and its interaction with the environment. Sensory integration plays a crucial role in adaptive responses to stress by focusing on individual senses and their integration. Therefore, body perception awareness addresses stress and anxiety through enhanced body perception and mindfulness. The evaluated techniques show significant potential in reducing stress and improving the mental health of first responders. Implementing these scientifically supported methods into routine training could significantly enhance their psychological resilience and operational effectiveness in high-stress environments.

Keywords: first responders, HRV training, mental health, sensory integration, stress reduction

Procedia PDF Downloads 42

Authors: Irene Capecchi, Tommaso Borghini, Iacopo Bernetti

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An important tool for the enhancement of cultural sites is serious games (SG), i.e., games designed for educational purposes; SG is applied in cultural sites through trivia, puzzles, and mini-games for participation in interactive exhibitions, mobile applications, and simulations of past events. The combination of Augmented Reality (AR) and digital cultural content has also produced examples of cultural heritage recovery and revitalization around the world. Through AR, the user perceives the information of the visited place in a more real and interactive way. Another interesting technological development for the revitalization of cultural sites is the combination of AR and Global Positioning System (GPS), which integrated have the ability to enhance the user's perception of reality by providing historical and architectural information linked to specific locations organized on a route. To the author’s best knowledge, there are currently no applications that combine GPS AR and SG for cultural heritage revitalization. The present research focused on the development of an SG based on GPS and AR. The study area is the village of Caldana in Tuscany, Italy. Caldana is a fortified Renaissance village; the most important architectures are the walls, the church of San Biagio, the rectory, and the marquis' palace. The historical information is derived from extensive research by the Department of Architecture at the University of Florence. The storyboard of the SG is based on the history of the three characters who built the village: marquis Marcello Agostini, who was commissioned by Cosimo I de Medici, Grand Duke of Tuscany, to build the village, his son Ippolito and his architect Lorenzo Pomarelli. The three historical characters were modeled in 3D using the freeware MakeHuman and imported into Blender and Mixamo to associate a skeleton and blend shapes to have gestural animations and reproduce lip movement during speech. The Unity Rhubarb Lip Syncer plugin was used for the lip sync animation. The historical costumes were created by Marvelous Designer. The application was developed using the Unity 3D graphics and game engine. The AR+GPS Location plugin was used to position the 3D historical characters based on GPS coordinates. The ARFoundation library was used to display AR content. The SG is available in two versions: for children and adults. the children's version consists of finding a digital treasure consisting of valuable items and historical rarities. Players must find 9 village locations where 3D AR models of historical figures explaining the history of the village provide clues. To stimulate players, there are 3 levels of rewards for every 3 clues discovered. The rewards consist of AR masks for archaeologist, professor, and explorer. At the adult level, the SG consists of finding the 16 historical landmarks in the village, and learning historical and architectural information interactively and engagingly. The application is being tested on a sample of adults and children. Test subjects will be surveyed on a Likert scale to find out their perceptions of using the app and the learning experience between the guided tour and interaction with the app.

Keywords: augmented reality, cultural heritage, GPS, serious game

Procedia PDF Downloads 95

Authors: Jing Zhang, Yvonne Reinwald, Nick Poulson, Alicia El Haj, Chung See, Mike Somekh, Melissa Mather

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Biomedical imaging of native tissue using light offers the potential to obtain excellent structural and functional information in a non-invasive manner with good temporal resolution. Image contrast can be derived from intrinsic absorption, fluorescence, or scatter, or through the use of extrinsic contrast. A major challenge in applying optical microscopy to in vivo tissue imaging is the effects of light attenuation which limits light penetration depth and achievable imaging resolution. Recently Selective Plane Illumination Microscopy (SPIM) has been used to map the 3D distribution of fluorophores dispersed in biological structures. In this approach, a focused sheet of light is used to illuminate the sample from the side to excite fluorophores within the sample of interest. Images are formed based on detection of fluorescence emission orthogonal to the illumination axis. By scanning the sample along the detection axis and acquiring a stack of images, 3D volumes can be obtained. The combination of rapid image acquisition speeds with the low photon dose to samples optical sectioning provides SPIM is an attractive approach for imaging biological samples in 3D. To date all implementations of SPIM rely on the use of fluorescence reporters be that endogenous or exogenous. This approach has the disadvantage that in the case of exogenous probes the specimens are altered from their native stage rendering them unsuitable for in vivo studies and in general fluorescence emission is weak and transient. Here we present for the first time to our knowledge a label-free implementation of SPIM that has downstream applications in the clinical setting. The experimental set up used in this work incorporates both label-free and fluorescent illumination arms in addition to a high specification camera that can be partitioned for simultaneous imaging of both fluorescent emission and scattered light from intrinsic sources of optical contrast in the sample being studied. This work first involved calibration of the imaging system and validation of the label-free method with well characterised fluorescent microbeads embedded in agarose gel. 3D constructs of mammalian cells cultured in agarose gel with varying cell concentrations were then imaged. A time course study to track cell proliferation in the 3D construct was also carried out and finally a native tissue sample was imaged. For each sample multiple images were obtained by scanning the sample along the axis of detection and 3D maps reconstructed. The results obtained validated label-free SPIM as a viable approach for imaging cells in a 3D gel construct and native tissue. This technique has the potential use in a near-patient environment that can provide results quickly and be implemented in an easy to use manner to provide more information with improved spatial resolution and depth penetration than current approaches.

Keywords: bioimaging, optics, selective plane illumination microscopy, tissue imaging

Procedia PDF Downloads 250

Authors: Thomas D. Collin, Rachel Cunningham, Bruce Jefferson, Raffaella Villa

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Fats, oils and grease (FOG) are by-products of food preparation and cooking processes. FOG enters wastewater systems through a variety of sources such as households, food service establishments, and industrial food facilities. Over time, if no source control is in place, FOG builds up on pipe walls, leading to blockages, and potentially to sewer overflows which are a major risk to the Environment and Human Health. UK water utilities spend millions of pounds annually trying to control FOG. Despite UK legislation specifying that discharge of such material is against the law, it is often complicated for water companies to identify and prosecute offenders. Hence, it leads to uncertainties regarding the attitude to take in terms of FOG management. Research is needed to seize the full potential of implementing current practices. The aim of this research was to undertake a comprehensive study to document the extent of FOG problems in sewer lines and reinforce existing knowledge. Data were collected to develop a model estimating quantities of FOG available for recovery within Thames Water wastewater catchments. Geographical Information System (GIS) software was used in conjunction to integrate data with a geographical component. FOG was responsible for at least 1/3 of sewer blockages in Thames Water waste area. A waste-based approach was developed through an extensive review to estimate the potential for FOG collection and recovery. Three main sources were identified: residential, commercial and industrial. Commercial properties were identified as one of the major FOG producers. The total potential FOG generated was estimated for the 354 wastewater catchments. Additionally, raw and settled sewage were sampled and analysed for FOG (as hexane extractable material) monthly at 20 sewage treatment works (STW) for three years. A good correlation was found with the sampled FOG and population equivalent (PE). On average, a difference of 43.03% was found between the estimated FOG (waste-based approach) and sampled FOG (raw sewage sampling). It was suggested that the approach undertaken could overestimate the FOG available, the sampling could only capture a fraction of FOG arriving at STW, and/or the difference could account for FOG accumulating in sewer lines. Furthermore, it was estimated that on average FOG could contribute up to 12.99% of the primary sludge removed. The model was further used to investigate the relationship between estimated FOG and number of blockages. The higher the FOG potential, the higher the number of FOG-related blockages is. The GIS-based tool was used to identify critical areas (i.e. high FOG potential and high number of FOG blockages). As reported in the literature, FOG was one of the main causes of sewer blockages. By identifying critical areas (i.e. high FOG potential and high number of FOG blockages) the model further explored the potential for source-control in terms of ‘sewer relief’ and waste recovery. Hence, it helped targeting where benefits from implementation of management strategies could be the highest. However, FOG is still likely to persist throughout the networks, and further research is needed to assess downstream impacts (i.e. at STW).

Keywords: fat, FOG, GIS, grease, oil, sewer blockages, sewer networks

Procedia PDF Downloads 211

Authors: Eleonora Di Salvo, Antonio Panebianco, Graziella Ziino

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Background: Vibrio parahaemolyticus is a human pathogen that is widely distributed in marine environments. It is frequently isolated from raw seafood, particularly shellfish. Consumption of raw or undercooked seafood contaminated with V. parahaemolyticus may lead to acute gastroenteritis. Vibrio spp. has excellent resistance to low temperatures so it can be found in frozen products for a long time. Recently, the viable but non-culturable state (VBNC) of bacteria has attracted great attention, and more than 85 species of bacteria have been demonstrated to be capable of entering this state. VBNC cells cannot grow in conventional culture medium but are viable and maintain metabolic activity, which may constitute an unrecognized source of food contamination and infection. Also V. parahaemolyticus could exist in VBNC state under nutrient starvation or low-temperature conditions. Aim: The aim of the present study was to optimize methods and investigate V. parahaemolyticus VBNC cells and their presence in frozen bivalve molluscs, regularly marketed. Materials and Methods: propidium monoazide (PMA) was integrated with real-time polymerase chain reaction (qPCR) targeting the tl gene to detect and quantify V. parahaemolyticus in the VBNC state. PMA-qPCR resulted highly specific to V. parahaemolyticus with a limit of detection (LOD) of 10-1 log CFU/mL in pure bacterial culture. A standard curve for V. parahaemolyticus cell concentrations was established with the correlation coefficient of 0.9999 at the linear range of 1.0 to 8.0 log CFU/mL. A total of 77 samples of frozen bivalve molluscs (35 mussels; 42 clams) were subsequently subjected to the qualitative (on alkaline phosphate buffer solution) and quantitative research of V. parahaemolyticus on thiosulfate-citrate-bile salts-sucrose (TCBS) agar (DIFCO) NaCl 2.5%, and incubation at 30°C for 24-48 hours. Real-time PCR was conducted on homogenate samples, in duplicate, with and without propidium monoazide (PMA) dye, and exposed for 45 min under halogen lights (650 W). Total DNA was extracted from cell suspension in homogenate samples according to bolliture protocol. The Real-time PCR was conducted with species-specific primers for V. parahaemolitycus. The RT-PCR was performed in a final volume of 20 µL, containing 10 µL of SYBR Green Mixture (Applied Biosystems), 2 µL of template DNA, 2 µL of each primer (final concentration 0.6 mM), and H2O 4 µL. The qPCR was carried out on CFX96 TouchTM (Bio-Rad, USA). Results: All samples were negative both to the quantitative and qualitative detection of V. parahaemolyticus by the classical culturing technique. The PMA-qPCR let us individuating VBNC V. parahaemolyticus in the 20,78% of the samples evaluated with a value between the Log 10-1 and Log 10-3 CFU/g. Only clams samples were positive for PMA-qPCR detection. Conclusion: The present research is the first evaluating PMA-qPCR assay for detection of VBNC V. parahaemolyticus in bivalve molluscs samples, and the used method was applicable to the rapid control of marketed bivalve molluscs. We strongly recommend to use of PMA-qPCR in order to identify VBNC forms, undetectable by the classic microbiological methods. A precise knowledge of the V.parahaemolyticus in a VBNC form is fundamental for the correct risk assessment not only in bivalve molluscs but also in other seafood.

Keywords: food safety, frozen bivalve molluscs, PMA dye, Real-time PCR, VBNC state, Vibrio parahaemolyticus

Procedia PDF Downloads 140

Authors: Mohsina Aktar, Bishawjit Mallick

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Bangladesh faces the multidimensional manifestations of climate change e.g. flood, cyclone, sea level rise, drainage congestion, salinity, etc. This study aimed at to find out the community’s perception of the perceived impact of climate change on their wetland resource based livelihood, to analyze their present livelihood scenario and to find out required institutional setup to strengthen present livelihood scenario. Therefore, this study required both quantitative analysis like quantification of wetland resources, occupation, etc. and also exploratory information like policy and institutional reform. For quantitative information 200 questionnaire survey and in some cases observation survey and for socially shareable qualitative and quantitative issues case study and focus group discussion were conducted. In-Depth interview was conducted for socially non-shareable qualitative issues. The overall findings of this study have been presented maintaining a sequence- perception about climate change effect, livelihood scenario and required institutional support of the wetland community. Flood has been ranked where cyclone effect is comparatively less disastrous in this area. Heavy rainfall comes after the cyclone. Female members responded almost same about the ranking and effects of frequently occurred and devastating effects of climate change. People are much more aware of the impact of climate change. Training of Care in RVCC project helps to increase their knowledge level. If the level of education can be increased, people can fight against calamity and poverty with more confidence. People seem to overcome the problems of water logging and thus besides involving in Hydroponics (33.3%) as prime occupation in monsoon; they are also engaged in other business related activities. January to May is the low-income season for the farmers. But some people don’t want to change their traditional occupation and their age is above 45. The young earning member wants to utilize their lean income period by alternative occupation. People who do not have own land and performing water transportation or other types of occupation are now interested about Hydroponics. People who give their land on rent are now thinking about renting their land in monsoon as through that they can earn a sound amount rather than get nothing. What they require is just seed, training, and capital. Present marketing system faces the problem of communication. So this sector needed to be developed. Involvement of women in income earning activity is very low (5.1%), and 100% women are housewives. They became inferior due to their educational level and dominance of their husband. Only one NGO named BCAS (Bangladesh Center for Advanced Studies) has been found engage training facilities and advocacy for this purpose. Upazilla agricultural extension office like other GO remains inactive to give support the community for extension and improvement of Hydroponics agriculture. If the community gets proper support and inspiration, they can fight against crisis of low-income and climate change, with the Hydroponics cultivation system successfully.

Keywords: wetland community, hydroponics, climate change adaptation, livelihood

Procedia PDF Downloads 274

Authors: Nynne Nørup, Julie Helles Eriksen, Rikke M. Moalem, Else Skjold

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Despite a growing focus on the high environmental impact of textiles, textile waste is only recently considered as part of the waste field. Consequently, there is a general lack of knowledge and data within this field. Particularly the lack of a common perception of textiles generates several problems e.g., to recognize the full material potential the fraction contains, which is cruel if the textile must enter the circular economy. This study aims to qualify a method to make the resources in textile waste visible in a way that makes it possible to move them as high up in the waste hierarchy as possible. Textiles are complex and cover many different types of products, fibers and combinations of fibers and production methods. In garments alone, there is a great variety, even when narrowing it to only undergarments. However, textile waste is often reduced to one fraction, assessed solely by quantity, and compared to quantities of other waste fractions. Disregarding the complexity and reducing textiles to a single fraction that covers everything made of textiles increase the risk of neglecting the value of the materials, both with regards to their properties and economical. Instead of trying to fit textile waste into the current primarily linear waste system where volume is a key part of the business models, this study focused on integrating textile waste as a resource in the design and production phase. The study combined interdisciplinary methods for determining replacement rates used in Life Cycle Assessments and Mass Flow Analysis methods with the designer’s toolbox to hereby activate the properties of textile waste in a way that can unleash its potential optimally. It was hypothesized that by activating Denmark's tradition for design and high level of craftsmanship, it is possible to find solutions that can be used today and create circular resource models that reduce the use of virgin fibers. Through waste samples, case studies, and testing of various design approaches, this study explored how to functionalize the method so that the product after the end-use is kept as a material and only then processed at fiber level to obtain the best environmental utilization. The study showed that the designers' ability to decode the properties of the materials and understanding of craftsmanship were decisive for how well the materials could be utilized today. The later in the life cycle the textiles appeared as waste, the more demanding the description of the materials to be sufficient, especially if to achieve the best possible use of the resources and thus a higher replacement rate. In addition, it also required adaptation in relation to the current production because the materials often varied more. The study found good indications that part of the solution is to use geodata i.e., where in the life cycle the materials were discarded. An important conclusion is that a fully developed method can help support better utilization of textile resources. However, it stills requires a better understanding of materials by the designers, as well as structural changes in business and society.

Keywords: circular economy, development of sustainable processes, environmental impacts, environmental management of textiles, environmental sustainability through textile recycling, interdisciplinary method development, resource optimization, recycled textile materials and the evaluation of recycling, sustainability and recycling opportunities in the textile and apparel sector

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Authors: Johnas Buhori, Meinrad Haule Lembuka

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Introduction: Social work expands its boundary to accommodate indigenous knowledge and practice for better competence and services. In Tanzania, Mama Mkubwa Mkubwa (MMM) (Mother’s elder sister) is an indigenous practice of alternative child care that represents other traditional practices across African societies known as Ubuntu practice. Ubuntu is African Humanism with values and approaches that are connected to the social work. MMM focuses on using the elder sister of a deceased mother or father, a trusted elder woman from the extended family or indigenous community to provide alternative care to an orphan or vulnerable child. In Ubuntu's perspective, it takes a whole village or community to raise a child, meaning that every person in the community is responsible for child care. Methodology: A desk review method guided by Ubuntu theory was applied to enrich the study. Findings: MMM resembles the Ubuntu ideal of traditional child protection of those in need as part of alternative child care throughout Tanzanian history. Social work practice, along with other formal alternative child care, was introduced in Tanzania during the colonial era in 1940s and socio-economic problems of 1980s affected the country’s formal social welfare system, and suddenly HIV/AIDS pandemic triggered the vulnerability of children and hampered the capacity of the formal sector to provide social welfare services, including alternative child care. For decades, AIDS has contributed to an influx of orphans and vulnerable children that facilitated the re-emerging of traditional alternative child care at the community level, including MMM. MMM strongly practiced in regions where the AIDS pandemic affected the community, like Njombe, Coastal region, Kagera, etc. Despite of existing challenges, MMM remained to be the remarkably alternative child care practiced in both rural and urban communities integrated with social welfare services. Tanzania envisions a traditional mechanism of family or community environment for alternative child care with the notion that sometimes institutionalization care fails to offer children all they need to become productive members of society, and later, it becomes difficult to reconnect in the society. Implications to Social Work: MMM is compatible with social work by using strengths perspectives; MMM reflects Ubuntu's perspective on the ground of humane social work, using humane methods to achieve human goals. MMM further demonstrates the connectedness of those who care and those cared for and the inextricable link between them as Ubuntu-inspired models of social work that view children from family, community, environmental, and spiritual perspectives. Conclusion: Social work and MMM are compatible at the micro and mezzo levels; thus, application of MMM can be applied in social work practice beyond Tanzania when properly designed and integrated into other systems. When MMM is applied in social work, alternative care has the potential to support not only children but also empower families and communities. Since MMM is a community-owned and voluntary base, it can relieve the government, social workers, and other formal sectors from the annual burden of cost in the provision of institutionalized alternative child care.

Keywords: ubuntu, indigenous social work, african social work, ubuntu social work, child protection, child alternative care

Procedia PDF Downloads 69

Authors: Kuo-Kai Lin, Po-Lun Chang

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Research Background and Purpose: Following the development of the Internet and multimedia, the Internet and information technology have become crucial avenues of modern communication and knowledge acquisition. The advantages of using mobile devices for learning include making learning borderless and accessible. Mobile learning has become a trend in disease management and health promotion in recent years. End-stage renal disease (ESRD) is an irreversible chronic disease, and patients who do not receive kidney transplants can only rely on hemodialysis or peritoneal dialysis to survive. Due to the complexities in caregiving for patients with ESRD that stem from their advanced age and other comorbidities, the patients’ incapacity of self-care leads to an increase in the need to rely on their families or primary caregivers, although whether the primary caregivers adequately understand and implement patient care is a topic of concern. Therefore, this study explored whether primary caregivers’ health care provisions can be improved through the intervention of an automatic speech intelligent system, thereby improving the objective health outcomes of patients undergoing long-term dialysis. Method: This study developed an automatic speech intelligent system with healthcare functions such as health information voice prompt, two-way feedback, real-time push notification, and health information delivery. Convenience sampling was adopted to recruit eligible patients from a hemodialysis center at a regional teaching hospital as research participants. A one-group pretest-posttest design was adopted. Descriptive and inferential statistics were calculated from the demographic information collected from questionnaires answered by patients and primary caregivers, and from a medical record review, a health care scale (recorded six months before and after the implementation of intervention measures), a subjective health assessment, and a report of objective physiological indicators. The changes in health care behaviors, subjective health status, and physiological indicators before and after the intervention of the proposed automatic speech intelligent system were then compared. Conclusion and Discussion: The preliminary automatic speech intelligent system developed in this study was tested with 20 pretest patients at the recruitment location, and their health care capacity scores improved from 59.1 to 72.8; comparisons through a nonparametric test indicated a significant difference (p < .01). The average score for their subjective health assessment rose from 2.8 to 3.3. A survey of their objective physiological indicators discovered that the compliance rate for the blood potassium level was the most significant indicator; its average compliance rate increased from 81% to 94%. The results demonstrated that this automatic speech intelligent system yielded a higher efficacy for chronic disease care than did conventional health education delivered by nurses. Therefore, future efforts will continue to increase the number of recruited patients and to refine the intelligent system. Future improvements to the intelligent system can be expected to enhance its effectiveness even further.

Keywords: automatic speech intelligent system for health care, primary caregiver, long-term hemodialysis, health care capabilities, health outcomes

Procedia PDF Downloads 110

Authors: Márcia Afonso, Cristina Fael, Marisa Dinis-Almeida

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Population growth in cities has led to an increase in the infrastructures construction, including buildings and roadways. This aspect leads directly to the soils waterproofing. In turn, changes in precipitation patterns are developing into higher and more frequent intensities. Thus, these two conjugated aspects decrease the rainwater infiltration into soils and increase the volume of surface runoff. The practice of green and sustainable urban solutions has encouraged research in these areas. The porous asphalt pavement, as a green infrastructure, is part of practical solutions set to address urban challenges related to land use and adaptation to climate change. In this field, permeable pavements with porous asphalt mixtures (PA) have several advantages in terms of reducing the runoff generated by the floods. The porous structure of these pavements, compared to a conventional asphalt pavement, allows the rainwater infiltration in the subsoil, and consequently, the water quality improvement. This green infrastructure solution can be applied in cities, particularly in streets or parking lots to mitigate the floods effects. Over the years, the pores of these pavements can be filled by sediment, reducing their function in the rainwater infiltration. Thus, double layer porous asphalt (DLPA) was developed to mitigate the clogging effect and facilitate the water infiltration into the lower layers. This study intends to deepen the knowledge of the performance of DLPA when subjected to clogging. The experimental methodology consisted on four evaluation phases of the DLPA infiltration capacity submitted to three precipitation events (100, 200 and 300 mm/h) in each phase. The evaluation first phase determined the behavior after DLPA construction. In phases two and three, two 500 g/m² clogging cycles were performed, totaling a 1000 g/m² final simulation. Sand with gradation accented in fine particles was used as clogging material. In the last phase, the DLPA was subjected to simple sweeping and vacuuming maintenance. A precipitation simulator, type sprinkler, capable of simulating the real precipitation was developed for this purpose. The main conclusions show that the DLPA has the capacity to drain the water, even after two clogging cycles. The infiltration results of flows lead to an efficient performance of the DPLA in the surface runoff attenuation, since this was not observed in any of the evaluation phases, even at intensities of 200 and 300 mm/h, simulating intense precipitation events. The infiltration capacity under clogging conditions decreased about 7% on average in the three intensities relative to the initial performance that is after construction. However, this was restored when subjected to simple maintenance, recovering the DLPA hydraulic functionality. In summary, the study proved the efficacy of using a DLPA when it retains thicker surface sediments and limits the fine sediments entry to the remaining layers. At the same time, it is guaranteed the rainwater infiltration and the surface runoff reduction and is therefore a viable solution to put into practice in permeable pavements.

Keywords: clogging, double layer porous asphalt, infiltration capacity, rainfall intensity

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Authors: Alexis Grandcoin, Stephanie Piel, Estelle Baures

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Brittany (France) is an agricultural region, where emerging pollutants are highly at risk to reach water bodies. Among them, pesticides metabolites are frequently detected in surface waters. The Vilaine watershed (11 000 km²) is of great interest, as a large drinking water treatment plant (100 000 m³/day) is located at the extreme downstream of it. This study aims to provide an evaluation of the pesticides metabolites pollution in the Vilaine watershed, and an understanding of their availability, in order to protect the water resource. Hydroclimatic conditions, land use, and water quality parameters controlling metabolites availability are emphasized. Later this knowledge will be used to understand the favoring conditions resulting in metabolites export towards surface water. 19 sampling points have been strategically chosen along the 220 km of the Vilaine river and its 3 main influents. Furthermore, the intakes of two drinking water plants have been sampled, one is located at the extreme downstream of the Vilaine river and the other is the riparian groundwater under the Vilaine river. 5 sampling campaigns with various hydroclimatic conditions have been carried out. Water quality parameters and hydroclimatic conditions have been measured. 15 environmentally relevant pesticides and metabolites have been analyzed. Also, these compounds are recalcitrant to classic water treatment that is why they have been selected. An evaluation of the watershed contamination has been done in 2016-2017. First observations showed that aminomethylphosphonic acid (AMPA) and metolachlor ethanesulfonic acid (MESA) are the most detected compounds in surface waters samples with 100 % and 98 % frequency of detection respectively. They are the main pollutants of the watershed regardless of the hydroclimatic conditions. AMPA concentration in the river strongly increases downstream of Rennes agglomeration (220k inhabitants) and reaches a maximum of 2.3 µg/l in low waters conditions. Groundwater contains mainly MESA, Diuron and metazachlor ESA at concentrations close to limits of quantification (LOQ) (0.02 µg/L). Metolachlor, metazachlor and alachlor due to their fast degradation in soils were found in small amounts (LOQ – 0.2 µg/L). Conversely glyphosate was regularly found during warm and sunny periods up to 0.6 µg/L. Soil uses (agricultural cultures types, urban areas, forests, wastewater treatment plants implementation), water quality parameters, and hydroclimatic conditions have been correlated to pesticides and metabolites concentration in waters. Statistical treatments showed that chloroacetamides metabolites and AMPA behave differently regardless of the hydroclimatic conditions. Chloroacetamides are correlated to each other, to agricultural areas and to typical agricultural tracers as nitrates. They are present in waters the whole year, especially during rainy periods, suggesting important stocks in soils. Also Chloroacetamides are negatively correlated with AMPA, the different forms of phosphorus, and organic matter. AMPA is ubiquitous but strongly correlated with urban areas despite the recent French regulation, restricting glyphosate to agricultural and private uses. This work helps to predict and understand metabolites present in the water resource used to craft drinking water. As the studied metabolites are difficult to remove, this project will be completed by a water treatment part.

Keywords: agricultural watershed, AMPA, metolachlor-ESA, water resource

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Authors: Saneeya Qureshi

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This paper reports doctoral research into the impact of Special Educational Needs Coordinators (SENCOs) on teachers in England, UK. Since 1994, it has been compulsory for all mainstream schools in the UK to have a SENCO who co-ordinates assessment and provision for supporting pupils with Special Educational Needs (SEN), helping teachers to develop and implement optimal SEN planning and resources. SENCOs’ roles have evolved as various policies continually redefined SEN provision, impacting their positioning within the school hierarchical structure. SENCOs in England are increasingly recognised as key members of school senior management teams. In this paper, It will be argued that despite issues around the transformative ‘professionalisation’ of their role, and subsequent conflict around boundaries and power relations, SENCOs enhance teachers’ abilities in terms of delivering optimal SEN provision. There is a significant international dimension to the issue: a similar role in respect of SEN management already exists in countries such as Ireland, Finland and Singapore, whilst in other countries, such as Italy and India, the introduction of a role similar to that of a SENCO is currently under discussion. The research question addressed is: do SENCOs enhance teachers’ abilities to be effective teachers of children with Special Educational Needs? The theoretical framework of the project is that of interpretivism, as it is acknowledged that there are contexts and realities are social constructions. The study applied a mixed method approach consisting of two phases. The first phase involved a purposive survey (n=42) of 223 primary school SENCOs, which enabled a deeper insight into SENCOs’ perceptions of their roles in relation to teachers. The second phase consisted of semi-structured interviews (n=36) of SENCOs, teachers and head teachers, in addition to school SEN-related documentation scrutiny. ‘Trustworthiness’ was accomplished through data and methodological triangulation, in addition to a rigorous process of coding and thematic analysis. The research was informed by an Ethical Code as per national guidelines. Research findings point to the evolutionary aspect of the SENCO role having engendered a culture of expectations amongst practitioners, as SENCOs transition from being ‘fixers’ to being ‘enablers’ of teachers. Outcomes indicate that SENCOs can empower teaching staff through the dissemination of specialist knowledge. However, there must be resources clearly identified for such dissemination to take place. It is imperative that both SENCOs and teachers alike address the issue of absolution of responsibility that arises when the ownership and accountability for the planning and implementation of SEN provision are not clarified so as to ensure the promotion of a positive school ethos around inclusive practices. Optimal outcomes through effective SEN interventions and teaching practices are positively correlated with the inclusion of teachers in the planning and execution of SEN provisions. An international audience can consider how the key findings are being manifest in a global context, with reference to their own educational settings. Research outcomes can aid the development of specific competencies needed to shape optimal inclusive educational settings in accordance with the official global priorities pertaining to inclusion.

Keywords: inclusion, school professionals, school leadership, special educational needs (SEN), special educational needs coordinators (SENCOs)

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Authors: Enrico Maria la Forgia

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Since the 80ies, in specific situations, France’s Muslims have enacted political actions to reply to attacks on their identity or assimilation attempts, using their religious affiliation as a resource for the organization and expression of collective claims. Indeed, despite Islam's internal sectarian and ethnic differences, religion may be politicized when minorities’ social and cultural rights are under attack. French Civil Society organizations, in this specific case with an Islamic background (ICSO - Islamic Civil Society Organizations), play an essential role in defending Muslims’ social and cultural rights. As a matter of fact, Civil Society organized on an ethnic or religious base is a way to strengthen minoritarian communities and their role as political actors, especially in multicultural contexts. Since the first 1983’s “Marche des Beurs” (slang word referring to French citizens with foreign origins), which involved many Muslims, the development of ICSO contributed to the strenghtening of Islam in France, here meant as a Social Movement aiming to constitute a French version of Islam, defending minorities’ cultural and religious rights, and change the perception of Islam itself in national society. However, since a visible and stigmatized minority, ICSO do not relate only to protests as a strategy to achieve their goals: on several occasions, pressure on authorities through personal networks and connections, or the introduction into public debates of bargaining through the exploitation of national or international crisis, might appear as more successfully - public discourses on minorities and Islam are generally considered favorable conditions to advance requests for cultural legitimation. The proposed abstract, based on a literary review and theoretical/methodological reflection on the state of knowledge on the topic, aims to open a new branch of studies and analysis of Civil Society and Social Movements in Europe, focusing on the French Islamic community as a political actor relating on ICSO to pressure society, local, and national authorities to improve Muslims' rights. The opted methodology relies on a qualitative approach based on ethnography and face-to-face interviews addressing heads and middle-high level activists from ICSO, in an attempt to individuate the strategies enacted by ICSO for mobilizing Muslims and build relations with, on one hand, local and national authorities; into the other, with actors belonging to the Civil Society/political sphere. The theoretical framework, instead, relies on the main Social Movements Theories (resources mobilization, political opportunity structure, and contentious/non-contentious movements), aiming to individuate eventual gaps in the analysis of Islamic Social Movements and Civil Society in minoritarian contexts.

Keywords: Islam, islamophobia, civil society, social movements, sociology, qualitative methodology, Islamic activism in social movement theory, political change, Islam as social movement, religious movements, protest and politics, France, Islamic civil society

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Authors: Timothy Gray

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This paper will present work and discuss lessons learned during a semester-long travel study based in Southeast Asia, which was run in the Spring Semester of 2019 and again in the summer of 2023. The first travel group consisted of fifteen students, and the second group consisted of twelve students ranging from second-year to graduate level, student participants majoring in either architecture or planning. Students worked in interdisciplinary teams, each team beginning their travel study, living together in a separate small town for over a month in (relatively) remote conditions in rural Thailand. Students became intimately familiar with these towns, forged strong personal relationships, and built reservoirs of knowledge one conversation at a time. Rather than impose external ideas and solutions, students were asked to learn from and be open to lessons from the people and the place. The following design statement was used as a point of departure for their investigations: It is our shared premise that architecture exists in small villages and towns of Southeast Asia in the ingenuity of the people, that architecture exists in a shared language of making, modifying, and reusing. It is a modest but vibrant architecture, an architecture that is alive and evolving, an architecture that is small in scale, accessible, and one that emerges from the people. It is an architecture that can exist in a modified bicycle, a woven bamboo bridge, or a self-built community. Students were challenged to engage in existing conditions as design professionals, both empowering and lending coherence to the energies that already existed in the place. As one of the student teams noted in their design narrative: “During our field study, we had the unique opportunity to tour a number of informal settlements and meet and talk to residents through interpreters. We found that many of the residents work in nearby factories for dollars a day. Others find employment in self-generated informal economies such as hand carving and textiles. Despite extreme poverty, we found these places to be vibrant and full of life as people navigate these challenging conditions to live lives with purpose and dignity.” Students worked together with local community members and colleagues to develop a series of varied proposals that emerged from their interrogations of place and partnered with community members and professional colleagues in the development of these proposals. Project partners included faculty and student colleagues Yangon University, the mayor's Office, Planning Department Officials and religious leaders in Sawankhalok, Thailand, and community leaders in Natonchan, Thailand, to name a few. This paper will present a series of student community-based design projects that emerged from these conditions. The paper will also discuss this model of travel study as a way of building an architecture which uses social and cultural issues as a catalyst for design. The paper will discuss lessons relative to sustainable development that the Western students learned through their travels in Southeast Asia.

Keywords: travel study, CAPasia, architecture of empowerment, modular housing

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Authors: Eda Ozkara San

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Nurse educators have been charged by several nursing organizations and accrediting bodies to provide innovative and evidence-based educational experiences, both didactic and clinical, to help students to develop the knowledge, skills, and attitudes needed to provide culturally competent nursing care to patients. Clinical simulation, which offers the opportunity for students to practice nursing skills in a risk-free, controlled environment and helps develop self-efficacy (confidence) within the nursing role. As one simulation method, the standardized patients (SPs) simulation helps educators to teach nursing students variety of skills in nursing, medicine, and other health professions. It can be a helpful tool for nurse educators to enhance cultural competence of nursing students. An alarming gap exists within the literature concerning the effectiveness of SP strategy to enhance cultural competence development of diverse student groups, who must work with patients from various backgrounds. This grant-supported, longitudinal, one-group, pretest and post-test educational intervention study aimed to examine the effect of the Diverse Standardized Patient Simulation (DSPS) cultural competence education strategy on students’ (n = 53) transcultural self-efficacy (TSE). The researcher-developed multidimensional DSPS strategy involved careful integration of transcultural nursing skills guided by the Cultural Competence and Confidence (CCC) model. As a carefully orchestrated teaching and learning strategy by specifically utilizing the SP pedagogy, the DSPS also followed international guidelines and standards for the design, implementation, evaluation, and SP training; and had content validity review. The DSPS strategy involved two simulation scenarios targeting underrepresented patient populations (Muslim immigrant woman with limited English proficiency and Irish-Italian American gay man with his partner (Puerto Rican) to be utilized in a second-semester, nine-credit, 15-week medical-surgical nursing course at an urban public US university. Five doctorally prepared content experts reviewed the DSPS strategy for content validity. The item-level content validity index (I-CVI) score was calculated between .80-1.0 on the evaluation forms. Jeffreys’ Transcultural Self-Efficacy Tool (TSET) was administered as a pretest and post-test to assess students’ changes in cognitive, practical, and affective dimensions of TSE. Results gained from this study support that the DSPS cultural competence education strategy assisted students to develop cultural competence and caused statistically significant changes (increase) in students’ TSE perceptions. Results also supported that all students, regardless of their background, benefit (and require) well designed cultural competence education strategies. The multidimensional DSPS strategy is found to be an effective way to foster nursing students’ cultural competence development. Step-by-step description of the DSPS provides an easy adaptation of this strategy with different student populations and settings.

Keywords: cultural competence development, the cultural competence and confidence model, CCC model, educational intervention, transcultural self-efficacy, TSE, transcultural self-efficacy tool, TSET

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