Search results for: supporting electrolytes
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1304

Search results for: supporting electrolytes

584 Parental Involvement and Students' Outcomes: A Study in a Special Education School in Singapore

Authors: E. Er, Y. S. Cheng

Abstract:

The role of parents and caregivers in their children’s education is pivotal. Parental involvement (PI) is often associated with a range of student outcomes. This includes academic achievements, socioemotional development, adaptive skills, physical fitness and school attendance. This study is the first in Singapore to (1) explore the relationship between parental involvement and student outcomes; (2) determine the effects of family structure and socioeconomic status (SES) on parental involvement and (3) investigate factors that inform involvement in parents of children with specific developmental disabilities. Approval for the study was obtained from Nanyang Technological University’s Institutional Review Board in Singapore. The revised version of a comprehensive theoretical model on parental involvement was used as the theoretical framework in this study. Parents were recruited from a SPED school in Singapore which caters to school-aged children (7 to 21 years old). Pearson’s product moment correlation, analysis of variance and multiple regression analyses were used as statistical techniques in this study. Results indicate that there are significant associations between parental involvement and educational outcomes in students with developmental disabilities. Next, SES has a significant impact on levels of parental involvement. In addition, parents in the current study reported being more involved at home, in school activities and the community, when teachers specifically requested their involvement. Home-based involvement was also predicted by parents’ perceptions of their time and energy, efficacy and beliefs in supporting their child’s education, as well as their children’s invitations to be more involved. An interesting and counterintuitive inverse relationship was found between general school invitations and parental involvement at home. Research findings are further discussed, and suggestions are put forth to increase involvement for this specific group of parents.

Keywords: autism, developmental disabilities, intellectual disabilities, parental involvement, Singapore

Procedia PDF Downloads 178
583 Integrated Dynamic Analysis of Semi-Submersible Flap Type Concept

Authors: M. Rafiur Rahman, M. Mezbah Uddin, Mohammad Irfan Uddin, M. Moinul Islam

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With a rapid development of offshore renewable energy industry, the research activities in regards of harnessing power from offshore wind and wave energy are increasing day by day. Integration of wind turbines and wave energy converters into one combined semi-submersible platform might be a cost-economy and beneficial option. In this paper, the coupled integrated dynamic analysis in the time domain (TD) of a simplified semi-submersible flap type concept (SFC) is accomplished via state-of-the-art numerical code referred as Simo-Riflex-Aerodyn (SRA). This concept is a combined platform consisting of a semi-submersible floater supporting a 5 MW horizontal axis wind turbine (WT) and three elliptical shaped flap type wave energy converters (WECs) on three pontoons. The main focus is to validate the numerical model of SFC with experimental results and perform the frequency domain (FD) and TD response analysis. The numerical analysis is performed using potential flow theory for hydrodynamics and blade element momentum (BEM) theory for aerodynamics. A variety of environmental conditions encompassing the functional & survival conditions for short-term sea (1-hour simulation) are tested to evaluate the sustainability of the SFC. The numerical analysis is performed in full scale. Finally, the time domain analysis of heave, pitch & surge motions is performed numerically using SRA and compared with the experimental results. Due to the simplification of the model, there are some discrepancies which are discussed in brief.

Keywords: coupled integrated dynamic analysis, SFC, time domain analysis, wave energy converters

Procedia PDF Downloads 207
582 High Aspect Ratio Sio2 Capillary Based On Silicon Etching and Thermal Oxidation Process for Optical Modulator

Authors: Nguyen Van Toan, Suguru Sangu, Tetsuro Saito, Naoki Inomata, Takahito Ono

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This paper presents the design and fabrication of an optical window for an optical modulator toward image sensing applications. An optical window consists of micrometer-order SiO2 capillaries (porous solid) that can modulate transmission light intensity by moving the liquid in and out of porous solid. A high optical transmittance of the optical window can be achieved due to refractive index matching when the liquid is penetrated into the porous solid. Otherwise, its light transmittance is lower because of light reflection and scattering by air holes and capillary walls. Silicon capillaries fabricated by deep reactive ion etching (DRIE) process are completely oxidized to form the SiO2 capillaries. Therefore, high aspect ratio SiO2 capillaries can be achieved based on silicon capillaries formed by DRIE technique. Large compressive stress of the oxide causes bending of the capillary structure, which is reduced by optimizing the design of device structure. The large stress of the optical window can be released via thin supporting beams. A 7.2 mm x 9.6 mm optical window area toward a fully integrated with the image sensor format is successfully fabricated and its optical transmittance is evaluated with and without inserting liquids (ethanol and matching oil). The achieved modulation range is approximately 20% to 35% with and without liquid penetration in visible region (wavelength range from 450 nm to 650 nm).

Keywords: thermal oxidation process, SiO2 capillaries, optical window, light transmittance, image sensor, liquid penetration

Procedia PDF Downloads 472
581 Assessment of the Road Safety Performance in National Scale

Authors: Abeer K. Jameel, Harry Evdorides

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The Assessment of the road safety performance is a challengeable issue. This is not only because of the ineffective and unreliability of road and traffic crash data system but also because of its systematic character. Recent strategic plans and interventions implemented in some of the developed countries where a significant decline in the rate of traffic and road crashes considers that the road safety is a system. This system consists of four main elements which are: road user, road infrastructure, vehicles and speed in addition to other supporting elements such as the institutional framework and post-crash care system. To assess the performance of a system, it is required to assess all its elements. To present an understandable results of the assessment, it is required to present a unique term representing the performance of the overall system. This paper aims to develop an overall performance indicator which may be used to assess the road safety system. The variables of this indicators are the main elements of the road safety system. The data regarding these variables will be collected from the World Health Organization report. Multi-criteria analysis method is used to aggregate the four sub-indicators for the four variables. Two weighting methods will be assumed, equal weights and different weights. For the different weights method, the factor analysis method is used. The weights then will be converting to scores. The total score will be the overall indicator for the road safety performance in a national scale. This indicator will be used to compare and rank countries according to their road safety performance indicator. The country with the higher score is the country which provides most sustainable and effective interventions for successful road safety system. These indicator will be tested by comparing them with the aggregate real crash rate for each country.

Keywords: factor analysis, Multi-criteria analysis, road safety assessment, safe system indicator

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580 Destructive Groups: The Impact on Adolescent Mental Health and Social Integration

Authors: Dušica Kovačević

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This study explores the influence of destructive groups on the mental health and social integration of high school students in Loznica, Serbia. Despite increasing concerns, there is a significant lack of research on the impact of these groups on adolescents in this region. This qualitative study aims to fill this gap by examining the prevalence of destructive groups, their psychological effects on students, and their broader social implications. Data were collected through surveys and in-depth interviews with high school students, educators, and mental health professionals. The study focuses on key mental health indicators, such as anxiety, depression, and identity formation, alongside social factors, including peer relationships and community engagement. Additionally, it defines coping mechanisms and supporting strategies employed by students affected by these groups. The findings reveal substantial psychological and social challenges faced by students exposed to destructive groups, including increased levels of anxiety and depression, disrupted identity development, and impaired social integration. Insights into the personal experiences of these students provide a detailed understanding of the groups’ impact, underscoring the need for targeted interventions. This research offers evidence-based recommendations for educators, mental health practitioners, and policymakers. It emphasizes the importance of developing effective educational programs and support services to enhance the well-being of high school advocates for proactive measures to protect adolescent mental health and promote healthy social values within educational and community settings.

Keywords: adolescents, mental health, destructive groups, social integration, qualitative study, high school students, Serbia

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579 Development of Patient Satisfaction Questionnaire for Diabetes Management in Thailand and Lao People Democratic Republic

Authors: Phoutsathaphone Sibounheuang, Phayom Sookaneknun Olson, Chanuttha Ploylearmsang, Santiparp Sookaneknun, Chanthanom Manithip

Abstract:

Patient satisfaction is an outcome that can be measured and used to improve diabetes care and management. There are limited instruments for assessing patient satisfaction covering the whole process of diabetes management. In this study, the questionnaire was developed with items pooled from a systematic review of qualitative studies of patients’ and healthcare providers’ perspectives in diabetes management. The questionnaire consists of 11 domains with 45 items. The Thai version was translated to Lao and then checked by back-translating it into Thai. We tested the questionnaire on 150 diabetes patients in Thailand and 150 in Lao People Democratic Republic (PDR). Validity was performed by factor analysis and Pearson correlation. Internal consistency reliability was estimated by calculating Cronbach’s alpha. The study was approved by the Mahasarakham University Ethics Committee, and the National Ethics Committee for Health Research, Lao PDR. The Thai and Lao versions showed the construct validity by principal component analysis. This consisted of 11 domains which account for 71.23% of the variance (Thai version) and 71.66% of the variance (Lao version) in the total patient satisfaction scores. The Kaiser-Meyer-Olkin (KMO) measures were 0.85 for the Thai version and 0.75 for the Lao version. The Bartlett tests of sphericity of both versions were significant (p < 0.001). The factor loadings of all items in both versions were > 0.40. The convergent validity of the Thai and Lao versions was 93.63% and 79.54% respectively. The discriminant validity for the Thai and Lao versions was 92.68% and 88.68% respectively. Cronbach’s alpha was 0.95 in both versions. The Patient Satisfaction Questionnaire (PSQ) in both versions had acceptable properties. This study has yielded evidence supporting the validity and reliability of both versions.

Keywords: construct validity, diabetes management, patient satisfaction, questionnaire development, reliability

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578 Disparities in Suicide and Mental Health among Student Athletes of Ethnic and Racial Minorities Compared to Their White Non-latinx Counterparts

Authors: Elizabeth Russo, Angelica Terepka

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The present paper reviews literature examining trends among suicide, suicidal ideation, and mental illness rates in ethnic and racial minority student-athletes. While the rates of suicide amongst student athlete populations is lower than rates of suicide seen in the general student populations, there is a discrepancy amongst rates of suicide in student athletes; specifically, those identifying with racial and ethnic minority backgrounds endorse higher rates of suicidal ideation. The samples from the existing literature consisted of White, Black, Hispanic/Latinx, Asian/ Pacific Islander, Multiracial, and Native American student-athletes. Studies suggest that ethnic and racial minority students are more susceptible to suicide, depression, and other mental health concerns compared to their white counterparts. Across the literature, White student athletes appeared to have more social and academic support from fellow classmates, university administration and professors, and staff within their athletic departments. Student athletes who did not identify as White endorsed higher rates of loneliness, felt ethnically and racially underrepresented within their athletic department, and endorsed lack of appropriate medical treatment for injuries by athletic department medical staff. Additionally, non-White student athletes receive less peer support and must balance additional stressors such as discrimination in contrast to their White/non-Latinx peers. Recommendations for athletic departments and mental health providers supporting student athletes who identify as racial and ethnic minorities are discussed.

Keywords: racial and ethnic minority, suicide, student-athlete, suicidal ideation

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577 Determination of Geogrid Reinforced Ballast Behavior Using Finite Element Modeling

Authors: Buğra Sinmez

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In some countries, such as China, Turkey, andseveralEuropeanUnionnations, the therailwaypavementstructuralsystem has recently undergonerapid growth as a vital element of the transportation infrastructure, particularlyfortheuse of high-speed trains. It is vitaltoconsiderthe High-SpeedInfrastructureDemandwhendevelopingandconstructingtherailwaypavementstructure. HSRL can create more substantial ldifficultiestotheballastorbaselayer of regularlyusedballastedrailwaypavementsthanstandardrailwaytrains. The deterioration of the theballastorbaselayermayleadtosubstructuredegradation, which might lead to safety concerns and catastrophicincidents. As a result, the efficiency of railways will be impactedbylargecargoesorhigh-speed trains. A railwaypavement construction can be strengthened using geosyntheticmaterials in theballastorfoundationlayer as a countermeasure. However, there is still a need in the literature to quantifytheinfluence of geosynthetic materials, particularlygeogrid, on the mechanical responses of railwaypavementstructuresto HSRL loads which is essential knowledge in supporting the selection of appropriate material and geogridinstallationposition. As a result, the purpose of this research is to see how a geogridreinforcementlayermayaffectthekeyfeatures of a ballastedrailwaypavementstructure, with a particular focus on the materialtypeandgeogridplacementpositionthatmayassistreducethe rate of degradation of the therailwaypavementstructuresystem. Thisstudyusesnumericalmodeling in a genuinerailwaycontexttovalidatethebenefit of geogrid reinforcement. The usage of geogrids in the railway system has been thoroughly researched in the technical literature. Three distinct types of geogrid installed at two distinct positions (i.e.,withintheballastlayer, betweentheballastandthesub-ballast layer) within a railwaypavementconstructionwereevaluatedunder a variety of verticalwheelloadsusing a three-dimensional (3D) finite element model. As a result, fouralternativegeogridreinforcementsystemsweremodeledtoreflectdifferentconditions in the ballastedrailwaysystems (G0: no reinforcement; G1: reinforcedwithgeogridhavingthelowestdensityandYoung'smodulus; G2: reinforcedwithgeogridhavingtheintermediateYoung'smodulusanddensity; G3: reinforcedwithgeogridhavingthegreatestdensityandYoung'smodulus). Themechanicalreactions of the railway, such as verticalsurfacedeflection, maximumprimarystressandstrain, andmaximumshearstress, werestudiedandcomparedbetweenthefourgeogridreinforcementscenariosandfourverticalwheelloadlevels (i.e., 75, 100, 150, and 200 kN). Differences in the mechanical reactions of railwaypavementconstructionsowingtotheuse of differentgeogridmaterialsdemonstratethebenefits of suchgeosynthetics in ballast. In comparison to a non-reinforcedrailwaypavementconstruction, thereinforcedconstructionsfeaturedecreasedverticalsurfacedeflection, maximum shear stress at the sleeper-ballast contact, and maximum main stress at the bottom of the ballast layer. As a result, addinggeogridtotheballastlayerandbetweentheballastandsub-ballast layer in a ballastedrailwaypavementconstruction has beenfoundtolowercriticalshearand main stresses as well as verticalsurfacedeflection.

Keywords: geosynthetics, geogrid, railway, transportation

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576 Potential Usefulness of Video Lectures as a Tool to Improve Synchronous and Asynchronous the Online Education

Authors: Omer Shujat Bhatti, Afshan Huma

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Online educational system were considered a great opportunity for distance learning. In recent days of COVID19 pandemic, it enable the continuation of educational activities at all levels of education, from primary school to the top level universities. One of the key considered element in supporting the online educational system is video lectures. The current research explored the usefulness of the video lectures delivered to technical students of masters level with a focus on MSc Sustainable Environmental design students who have diverse backgrounds in the formal educational system. Hence they were unable to cope right away with the online system and faced communication and understanding issues in the lecture session due to internet and allied connectivity issues. Researcher used self prepared video lectures for respective subjects and provided them to the students using Youtube channel and subject based Whatsapp groups. Later, students were asked about the usefulness of the lectures towards a better understanding of the subject and an overall enhanced learning experience. More than 80% of the students appreciated the effort and requested it to be part of the overall system. Data collection was done using an online questionnaire which was prior briefed to the students with the purpose of research. It was concluded that video lectures should be considered an integral part of the lecture sessions and must be provided prior to the lecture session, ensuring a better quality of delivery. It was also recommended that the existing system must be upgraded to support the availability of these video lectures through the portal. Teachers training must be provided to help develop quality video content ensuring that is able to cover the content and courses taught.

Keywords: video lectures, online distance education, synchronous instruction, asynchronous communication

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575 Development of Competitive Advantage for the Apparel Manufacturing Industry of South Africa

Authors: Sipho Mbatha, Anne Mastament-Mason

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The Multi-Fibre Arrangement (MFA) which regulated all trade in the Apparel Manufacturing Industries (AMI) for four decades was dissolved in 2005. Since 2005, the Apparel Manufacturing Industry of South Africa (AMISA) has been battling to adjust to an environment of liberalised trade, mainly due to strategic, infrastructural and skills factors. In developing competitive advantage strategy for the AMISA, the study aimed to do the following (1) to apply Porter’s diamond model’s determinant “Factor Condition” as framework to develop competitive advantage strategies. (2) Examine the effectiveness of government policy Industrial Policy Action Plan (IPAP 2007) in supporting AMISA. (3) Examine chance events that could be used as bases for competitive advantage strategies for the AMISA. This study found that the lack of advanced skills and poor infrastructure are affecting the competitive advantage of AMISA. The then Clothing, Textiles, Leather and Footwear Sector Education and Training Authority (CTLF-SETA) has also fallen short of addressing the skills gap within the apparel manufacturing industries. The only time that AMISA have shown signs of competitive advantage was when they made use of government grants and incentives available to only compliant AMISA. The findings have shown that the apparel retail groups have shown support for the AMISA by shouldering raw material costs, making it easier to manufacture the required apparel at acceptable lead times. AMISA can compete in low end apparel, provided quick response is intensified, the development of local textiles and raw materials is expedited.

Keywords: compliance rule, apparel manufacturing idustry, factor conditions, advance skills, industrial policy action plan of South Africa

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574 Experiences of Family Carers of People Intellectual Disabilities During the COVID-19 Pandemic

Authors: Mark Linden, Michael Brown, Lynne Marsh, Maria Truesdale, Stuart Todd, Nathan Hughes, Trisha Forbes, Rachel Leonard

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Background: The COVID-19 pandemic exacerbated the already significant strain placed on family carers of people with profound and multiple intellectual disabilities (PMID), given the withdrawal of many services during lockdown. The aim of this study was to explore the experiences of family carers of people with PMID during the COVID-19 pandemic. Methods: Online focus groups were conducted with family carers (n=126) from across the UK and the Republic of Ireland. Participants were asked about their experiences of the COVID-19 pandemic, coping strategies, and challenges faced. Focus groups were audio recorded, transcribed verbatim and analyzed through thematic analysis. Findings: Three themes emerged from our analysis of the data: (i) COVID-19 as a double-edged sword, (ii) The struggle for support (iii) the Constant nature of caring. These included 11 subthemes: (i) ‘COVID-19 as a catalyst for change’, ‘Challenges during COVID-19: dealing with change’, ‘Challenges during COVID-19: fear of COVID-19’, ‘The online environment: the new normal’ (ii) ‘Invisibility of male carers’, ‘Carers supporting carers’, ‘The only service you get is lip service: non-existent services’, ‘Knowing your rights’ (iii) ‘Emotional response to the caring role: Feeling devalued’, ‘Emotional response to the caring role: Desperation of caring’, ‘Multiple demands of the caring role.’ Conclusions: Poor or inconsistent access to services and support has been an ongoing difficulty for many family carers. The COVID-19 pandemic has only further intensified these difficulties, increasing family carers' stress. There is an urgent need to design services, such as online support programs, in partnership with family carers that adequately address their needs.

Keywords: intellectual disabilities, family carer, COVID-19, disability

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573 Structuring After-School Physical Education Programs That are Engaging, Diverse, and Inclusive

Authors: Micah J. Dobson

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After-school programs of physical education provide children with opportunities to engage in physical activities while developing healthy habits. To ensure that these programs are inclusive, diverse, and engaging, however, schools must consider various factors when designing and implementing them. This study sought to bring out efficient strategies for structuring after-school programs of physical education. The literature review was conducted using various databases and search engines. Some databases that index the journals include ERIC, Google Scholar, Scopus, Web of Science, and EBSCOhost. The search terms were combinations of keywords such as “after-school,” “physical education,” “inclusion,” “diversity,” “engagement,” “program design,” “program implementation,” “program effectiveness,” and “best practices.” The findings of this study suggest that schools that desire inclusivity must consider four key factors when designing and implementing after-school physical education programs. First, the programs must be designed with variety and fun by incorporating activities such as dance, sports, and games that appeal to all students. Second, instructors must be trained to create supportive and positive environments that foster student engagement while promoting physical literacy. Third, schools must collaborate with community stakeholders and organizations to ensure that programs are culturally inclusive and responsive. Fourth, schools can incorporate technology into their programs to enhance engagement and provide additional growth and learning opportunities.In conclusion, this study provides valuable insights into efficient strategies for structuring after-school programs of physical education that are inclusive, diverse, and engaging for all students. By considering these factors when designing and implementing their programs, schools can promote physical activity while supporting students’ overall well-being and health.

Keywords: after-school programs of physical education, community partnership, inclusivity, instructor training, technology

Procedia PDF Downloads 59
572 Role of Cellulose Fibers in Tuning the Microstructure and Crystallographic Phase of α-Fe₂O₃ and α-FeOOH Nanoparticles

Authors: Indu Chauhan, Bhupendra S. Butola, Paritosh Mohanty

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It is very well known that properties of material changes as their size approach to nanoscale level due to the high surface area to volume ratio. However, in last few decades, a tenet ‘structure dictates function’ is quickly being adopted by researchers working with nanomaterials. The design and exploitation of nanoparticles with tailored shape and size has become one of the primary goals of materials science researchers to expose the properties of nanostructures. To date, various methods, including soft/hard template/surfactant assisted route hydrothermal reaction, seed mediated growth method, capping molecule-assisted synthesis, polyol process, etc. have been adopted to synthesize the nanostructures with controlled size and shape and monodispersity. However controlling the shape and size of nanoparticles is an ultimate challenge of modern material research. In particular, many efforts have been devoted to rational and skillful control of hierarchical and complex nanostructures. Thus in our research work, role of cellulose in manipulating the nanostructures has been discussed. Nanoparticles of α-Fe₂O₃ (diameter ca. 15 to 130 nm) were immobilized on the cellulose fiber surface by a single step in situ hydrothermal method. However, nanoflakes of α-FeOOH having thickness ca. ~25 nm and length ca. ~250 nm were obtained by the same method in absence of cellulose fibers. A possible nucleation and growth mechanism of the formation of nanostructures on cellulose fibers have been proposed. The covalent bond formation between the cellulose fibers and nanostructures has been discussed with supporting evidence from the spectroscopic and other analytical studies such as Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy. The role of cellulose in manipulating the nanostructures has been discussed.

Keywords: cellulose fibers, α-Fe₂O₃, α-FeOOH, hydrothermal, nanoflakes, nanoparticles

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571 Reaching a Mobile and Dynamic Nose after Rhinoplasty: A Pilot Study

Authors: Guncel Ozturk

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Background: Rhinoplasty is the most commonly performed cosmetic operations in plastic surgery. Maneuvers used in rhinoplasty lead to a firm and stiff nasal tip in the early postoperative months. This unnatural stability of the nose may easily cause distortion in the reshaped nose after severe trauma. Moreover, a firm nasal tip may cause difficulties in performing activities such as touching, hugging, or kissing. Decreasing the stability and increasing the mobility of the nasal tip would help rhinoplasty patients to avoid these small but relatively important problems. Methods: We use delivery approach with closed rhinoplasty and changed positions of intranasal incisions to reach a dynamic and mobile nose. A total of 203 patients who had undergone primary closed rhinoplasty in private practice were inspected retrospectively. Posterior strut flap that was connected with connective tissues in the caudal of septum and the medial crurals were formed. Cartilage of the posterior strut graft was left 2 mm thick in the distal part of septum, it was cut vertically, and the connective tissue in the distal part was preserved. Results: The median patient age was 24 (range 17-42) years. The median follow-up period was15.2 (range12-26) months. Patient satisfaction was assessed with the 'Rhinoplasty Outcome Evaluation' (ROE) questionnaire. Twelve months after surgeries, 87.5% of patients reported excellent outcomes, according to ROE. Conclusion: The soft tissue connections between that segment and surrounding structures should be preserved to save the support of the tip while having a mobile tip at the same time with this method. These modifications would access to a mobile, non-stiff, and dynamic nasal tip in the early postoperative months. Further and prospective studies should be performed for supporting this method.

Keywords: closed rhinoplasty, dynamic, mobile, tip

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570 System for Mechanical Stimulation of the Mesenchymal Stem Cells Supporting Differentiation into Osteogenic Cells

Authors: Jana Stepanovska, Roman Matejka, Jozef Rosina, Marta Vandrovcova, Lucie Bacakova

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The aim of this study was to develop a system for mechanical and also electrical stimulation controlling in vitro osteogenesis under conditions more similar to the in vivo bone microenvironment than traditional static cultivation, which would achieve good adhesion, growth and other specific behaviors of osteogenic cells in cultures. An engineered culture system for mechanical stimulation of the mesenchymal stem cells on the charged surface was designed. The bioreactor allows efficient mechanical loading inducing an electrical response and perfusion of the culture chamber with seeded cells. The mesenchymal stem cells were seeded to specific charged materials, like polarized hydroxyapatite (Hap) or other materials with piezoelectric and ferroelectric features, to create electrical potentials for stimulating of the cells. The material of the matrix was TiNb alloy designed for these purposes, and it was covered by BaTiO3 film, like a kind of piezoelectric material. The process of mechanical stimulation inducing electrical response is controlled by measuring electrical potential in the chamber. It was performed a series of experiments, where the cells were seeded, perfused and stimulated up to 48 hours under different conditions, especially pressure and perfusion. The analysis of the proteins expression was done, which demonstrated the effective mechanical and electrical stimulation. The experiments demonstrated effective stimulation of the cells in comparison with the static culture. This work was supported by the Ministry of Health, grant No. 15-29153A and the Grant Agency of the Czech Republic grant No. GA15-01558S.

Keywords: charged surface, dynamic cultivation, electrical stimulation, ferroelectric layers, mechanical stimulation, piezoelectric layers

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569 Percentage Contribution of Lower Limb Moments to Vertical Ground Reaction Force in Normal Walking

Authors: Salam M. Elhafez, Ahmed A. Ashour, Naglaa M. Elhafez, Ghada M. Elhafez, Azza M. Abdelmohsen

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Patients suffering from gait disturbances are referred by having muscle group dysfunctions. There is a need for more studies investigating the contribution of muscle moments of the lower limb to the vertical ground reaction force using 3D gait analysis system. The purpose of this study was to investigate how the hip, knee and ankle moments in the sagittal plane contribute to the vertical ground reaction force in healthy subjects during normal speed of walking. Forty healthy male individuals volunteered to participate in this study. They were filmed using six high speed (120 Hz) Pro-Reflex Infrared cameras (Qualisys) while walking on an AMTI force platform. The data collected were the percentage contribution of the moments of the hip, knee and ankle joints in the sagittal plane at the instant of occurrence of the first peak, second peak, and the trough of the vertical ground reaction force. The results revealed that at the first peak of the ground reaction force (loading response), the highest contribution was generated from the knee extension moment, followed by the hip extension moment. Knee flexion and ankle plantar flexion moments produced high contribution to the trough of the ground reaction force (midstance) with approximately equal values. The second peak of the ground reaction force was mainly produced by the ankle plantar flexion moment. Conclusion: Hip and knee flexion and extension moments and ankle plantar flexion moment play important roles in the supporting phase of normal walking.

Keywords: gait analysis, ground reaction force, moment contribution, normal walking

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568 Nutritionists' Perspective on the Conception of a Telenutrition Platform for Diabetes Care: Qualitative Study

Authors: Choumous Mannoubi, Dahlia Kairy, Brigitte Vachon

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The use of technology allows clinicians to provide an individualized approach in a cost-effective manner and to reach a broader client base more easily. Such interventions can be effective in ensuring self-management and follow-up of people with diabetes, reducing the risk of complications by improving accessibility to care services, and better adherence to health recommendations. Consideration of users' opinions and fears to inform the design and implementation stages of these telehealth services seems to be essential to improve their acceptance and usability. The objective of this study is to describe the telepractice of nutritionists supporting the therapeutic management of diabetic patients and document the functional requirements of nutritionists for the design of a tele-nutrition platform. To best identify the requirements and constraints of nutritionists, we conducted individual semi-structured interviews with 10 nutritionists who offered tele-nutrition services. Using a qualitative design with a descriptive approach based on the Nutrition Care Process Model (mNCP) framework, we explored in depth the state of nutritionists' telepractice in public and private health care settings, as well as their requirements for teleconsultation. Qualitative analyses revealed that nutritionists primarily used telephone calls during the COVID 19 pandemic to provide teleconsultations. Nutritionists identified the following important features for the design of a tele-nutrition platform: it should support interprofessional collaboration, allow for the development and monitoring of a care plan, integrate with the existing IT environment, be easy to use, accommodate different levels of patient literacy, and allow for easy sharing of educational materials to support nutrition education.

Keywords: telehealth, nutrition, diabetes, telenutrition, teleconsultation, telemonitoring

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567 A Case Study Using Sounds Write and The Writing Revolution to Support Students with Literacy Difficulties

Authors: Emilie Zimet

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During our department meetings for teachers of children with learning disabilities and difficulties, we often discuss the best practices for supporting students who come to school with literacy difficulties. After completing Sounds Write and Writing Revolution courses, it seems there is a possibility to link approaches and still maintain fidelity to a program and provide individualised instruction to support students with such difficulties and disabilities. In this case study, the researcher has been focussing on how best to use the knowledge acquired to provide quality intervention that targets the varied areas of challenge that students require support in. Students present to school with a variety of co-occurring reading and writing deficits and with complementary approaches, such as The Writing Revolution and Sounds Write, it is possible to support students to improve their fundamental skills in these key areas. Over the next twelve weeks, the researcher will collect data on current students with whom this approach will be trialled and then compare growth with students from last year who received support using Sounds-Write only. Maintaining fidelity may be a potential challenge as each approach has been tested in a specific format for best results. The aim of this study is to determine if approaches can be combined, so the implementation will need to incorporate elements of both reading (from Sounds Write) and writing (from The Writing Revolution). A further challenge is the time length of each session (25 minutes), so the researcher will need to be creative in the use of time to ensure both writing and reading are targeted while ensuring the programs are implemented. The implementation will be documented using student work samples and planning documents. This work will include a display of findings using student learning samples to demonstrate the importance of co-targeting the reading and writing challenges students come to school with.

Keywords: literacy difficulties, intervention, individual differences, methods of provision

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566 Residential High-Rises and Meaningful Places: Missing Actions in the Isle of Dogs Regeneration

Authors: Elena Kalcheva, Ahmad Taki, Yuri Hadi

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Urban regeneration often includes residential high-rises as a way of optimum use of land. However, high-rises are in many cases connected to placelessness, this is not due to some intrinsic characteristic of the typology, but more to a failure to provide meaningful places in connection to them. The reason to study the Isle of the Dogs regeneration is the successful process that led to vibrant area with strong identity and social sustainability. Therefore, the purpose of this research is to identify the gaps into the sound strategy for the development of the area and in its implementation which will make the place more sustainable. The paper addresses four research questions: are the residential high-rises supporting a proper physical form; is there deployed properly scaled mix of land uses and functions in connection with residential high-rises; are there possible quality activities in quality places near the residential high-rises; and is there a strong sense of place created with the residential high-rise buildings and their surroundings. The methodology relies on observational survey of the researched area together with structured questions, to evaluate the external qualities of the residential high-rises and their surroundings. Visual information can help identify the mistakes and the omissions of the provided project examples. It can provide insight on how can be improved imageability, legibility and human scale. In this connection, the paper argues that although the quality of the architecture of the high-rises is superb, there is a failure to create meaningful, high quality public realm in connection with them. As such, it does not function as well as the designers intended to do: the functional quality of the public realm is quite low. The implications of the study suggest that actions need to take place in order to improve and foster further regeneration of the area.

Keywords: high-rises, isle of the dogs, public realm, regeneration

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565 Validity and Reliability of a Questionaire for Measuring Behaviour Change of Low Performance Employee

Authors: Hazaila Binti Hassan, Abu Yazid Bin Abu Bakar, Salleh Amat

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This study is to get the validity and reliability of the questionnaire for behaviour change on low-performing officers. This study aimed to develop and evaluate the behaviour of low performing officers. There are 75 items in this questionnaire which involves 5 subscales, which are the 5 dimensions intended to be studied: 1st emotional stability, 2nd psycho-spiritual enhancement, 3rd social skills development, 4th cognitive and rationality improvement and 5th behavioural alignment and adjustment. There are 2 processes in this research whereby to check the validity and reliability. Both use quantitative methods. Validity content testing has been conducted to validate the behavioural change questionnaire of the low performing officers. For the face validity, 4 people are involved, two are psychologists who carried out the program and the other two are officers of the same rank, i.e. supporting officers. They are involved in correction of sentences, languages, and grammar as well as the sentence structures so that it tallies with the purpose of studies. The questionnaire underwent content validity by the experts. Five experts are appointed to attend this session, 3 are directly involved in the construction of this questionnaire and 2 others are experts from the university with a background in questionnaire development. The result shows that the content validity obtained a high coefficient of 0.745 with a minimum and maximum value of more than 0.60 which satisfies the characteristic of Content Value Ratio. The Cronbach’s alpha result is 0.867. The highest scores are the behavioural alignment and adjustment sub-scale recorded the highest value, followed by social skills development sub-scale, cognitive and rational improvements sub-scale, psycho-spiritual enhancement sub-scale, and lastly emotional stability. Therefore, both of validity and reliability result were accepted that this questionnaire is valid and reliable can be used in the study of behaviour changes of low performing officers in the civil service.

Keywords: content validity, reliability, five dimension, low-performing officers, questionnaire

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564 Institutional Capacity of Health Care Institutes for Diagnosis and Management of Common Genetic Diseases-a Study from a North Coastal District of Andhra Pradesh, India

Authors: Koteswara Rao Pagolu, Raghava Rao Tamanam

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In India, genetic disease is a disregarded service element in the community health- protection system. This study aims to gauge the accessibility of services for treating genetic disorders and also to evaluate the practices on deterrence and management services in the district health system. A cross-sectional survey of selected health amenities in the government health sector was conducted from 15 primary health centers (PHC’s), 4 community health centers (CHC’s), 1 district government hospital (DGH) and 3 referral hospitals (RH’s). From these, the existing manpower like 130 medical officers (MO’s), 254 supporting staff, 409 nursing staff (NS) and 45 lab technicians (LT’s) was examined. From the side of private health institutions, 25 corporate hospitals (CH’s), 3 medical colleges (MC’s) and 25 diagnostic laboratories (DL’s) were selected for the survey and from these, 316 MO’s, 995 NS and 254 LT’s were also reviewed. The findings show that adequate staff was in place at more than 70% of health centers, but none of the staff have obtained any operative training on genetic disease management. The largest part of the DH’s had rudimentary infrastructural and diagnostic facilities. However, the greater part of the CHC’s and PHC’s had inadequate diagnostic facilities related to genetic disease management. Biochemical, molecular, and cytogenetic services were not available at PHC’s and CHC’s. DH’s, RH’s, and all selected medical colleges were found to have offered the basic Biochemical genetics units during the survey. The district health care infrastructure in India has a shortage of basic services to be provided for the genetic disorder. With some policy resolutions and facility strengthening, it is possible to provide advanced services for a genetic disorder in the district health system.

Keywords: district health system, genetic disorder, infrastructural amenities, management practices

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563 An Interpretative Phenomenological Analysis on the Concept of Friends of Children in Conflict with the Law

Authors: Karla Kristine Bay, Jovie Ann Gabin, Allana Joyce Sasotona

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This research employed an Interpretative Phenomenological Analysis to explore the experiences of Children in Conflict with the Law (CICL) which gave light to their concept of ‘friends’. Derived from this context are the following objectives of the study: 1) determining the differentiation of the forms of friends of the CICL; 2) presenting the process of attachment towards detachment in the formation of friendship; and 3) discussing the experiences, and reflections of the CICL on the ‘self’ out of their encounter with friendship. Using the data gathered from the individual drawings of the CICL of their representations of the self, family, friends, community, and Bahay Kalinga as subjects in the meaning-making process utilizing Filipino Psychology methods of pagtatanong-tanong (interview), and pakikipagkwentuhan (conversation), data analysis produced a synthesis of seventeen individual cases. Overall results generated three superordinate themes on the differentiation of the forms of friends which include friends with good influences, friends with bad influences, and friends within the family. While two superordinate themes were produced on the process of attachment towards detachment, namely social, emotional, and psychological experiences on the process of attachment, and emotional and psychological experiences on the process of detachment. Lastly, two superordinate themes were created on the experiences, and reflections of the CICL on the ‘self’ out of their encounter with friendship. This consists of the recognition of the ‘self’ as a responsible agent in developing healthy relationships between the self and others, and reconstruction of the self from the collective experiences of healing, forgiveness, and acceptance. These findings, together with supporting theories discussed the impact of friendship on the emergence of criminal behavior and other dispositions; springing from the child’s dissociation from the family that led to finding belongingness from an external group called friends.

Keywords: children in conflict with the law, criminal behavior, friends, interpretative phenomenological analysis

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562 Human Bone Marrow Stem Cell Behavior on 3D Printed Scaffolds as Trabecular Bone Grafts

Authors: Zeynep Busra Velioglu, Deniz Pulat, Beril Demirbakan, Burak Ozcan, Ece Bayrak, Cevat Erisken

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Bone tissue has the ability to perform a wide array of functions including providing posture, load-bearing capacity, protection for the internal organs, initiating hematopoiesis, and maintaining the homeostasis of key electrolytes via calcium/phosphate ion storage. The most common cause for bone defects is extensive trauma and subsequent infection. Bone tissue has the self-healing capability without a scar tissue formation for the majority of the injuries. However, some may result with delayed union or fracture non-union. Such cases include reconstruction of large bone defects or cases of compromised regenerative process as a result of avascular necrosis and osteoporosis. Several surgical methods exist to treat bone defects, including Ilizarov method, Masquelete technique, growth factor stimulation, and bone replacement. Unfortunately, these are technically demanding and come with noteworthy disadvantages such as lengthy treatment duration, adverse effects on the patient’s psychology, repeated surgical procedures, and often long hospitalization times. These limitations associated with surgical techniques make bone substitutes an attractive alternative. Here, it was hypothesized that a 3D printed scaffold will mimic trabecular bone in terms of biomechanical properties and that such scaffolds will support cell attachment and survival. To test this hypothesis, this study aimed at fabricating poly(lactic acid), PLA, structures using 3D printing technology for trabecular bone defects, characterizing the scaffolds and comparing with bovine trabecular bone. Capacity of scaffolds on human bone marrow stem cell (hBMSC) attachment and survival was also evaluated. Cubes with a volume of 1 cm³ having pore sizes of 0.50, 1.00 and 1.25 mm were printed. The scaffolds/grafts were characterized in terms of porosity, contact angle, compressive mechanical properties as well cell response. Porosities of the 3D printed scaffolds were calculated based on apparent densities. For contact angles, 50 µl distilled water was dropped over the surface of scaffolds, and contact angles were measured using ‘Image J’ software. Mechanical characterization under compression was performed on scaffolds and native trabecular bone (bovine, 15 months) specimens using a universal testing machine at a rate of 0.5mm/min. hBMSCs were seeded onto the 3D printed scaffolds. After 3 days of incubation with fully supplemented Dulbecco’s modified Eagle’s medium, the cells were fixed using 2% formaldehyde and glutaraldehyde mixture. The specimens were then imaged under scanning electron microscopy. Cell proliferation was determined by using EZQuant dsDNA Quantitation kit. Fluorescence was measured using microplate reader Spectramax M2 at the excitation and emission wavelengths of 485nm and 535nm, respectively. Findings suggested that porosity of scaffolds with pore dimensions of 0.5mm, 1.0mm and 1.25mm were not affected by pore size, while contact angle and compressive modulus decreased with increasing pore size. Biomechanical characterization of trabecular bone yielded higher modulus values as compared to scaffolds with all pore sizes studied. Cells attached and survived in all surfaces, demonstrating higher proliferation on scaffolds with 1.25mm pores as compared with those of 1mm. Collectively, given lower mechanical properties of scaffolds as compared to native bone, and biocompatibility of the scaffolds, the 3D printed PLA scaffolds of this study appear as candidate substitutes for bone repair and regeneration.

Keywords: 3D printing, biomechanics, bone repair, stem cell

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561 Fuel Cells and Offshore Wind Turbines Technology for Eco-Friendly Ports with a Case Study

Authors: Ibrahim Sadek Sedik Ibrahim, Mohamed M. Elgohary

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Sea ports are considered one of the factors affecting the progress of economic globalization and the international trade; consequently, they are considered one of the sources involved in the deterioration of the maritime environment due to the excessive amount of exhaust gases emitted from their activities. The majority of sea ports depend on the national electric grid as a source of power for the domestic and ships’ electric demands. This paper discusses the possibility of shifting ports from relying on the national grid electricity to green power-based ports. Offshore wind turbines and hydrogenic PEM fuel cell units appear as two typical promising clean energy sources for ports. As a case study, the paper investigates the prospect of converting Alexandria Port in Egypt to be an eco-friendly port with the study of technical, logistic, and financial requirements. The results show that the fuel cell, followed by a combined system of wind turbines and fuel cells, is the best choice regarding electricity production unit cost by 0.101 and 0.107 $/kWh, respectively. Furthermore, using of fuel cells and offshore wind turbine as green power concept will achieving emissions reduction quantity of CO₂, NOx, and CO emissions by 80,441, 20.814, and 133.025 ton per year, respectively. Finally, the paper highlights the role that renewable energy can play when supplying Alexandria Port with green energy to lift the burden on the government in supporting the electricity, with a possibility of achieving a profit of 3.85% to 22.31% of the annual electricity cost compared with the international prices.

Keywords: fuel cells, green ports, IMO, national electric grid, offshore wind turbines, port emissions, renewable energy

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560 Delisting Wave: Corporate Financial Distress, Institutional Investors Perception and Performance of South African Listed Firms

Authors: Adebiyi Sunday Adeyanju, Kola Benson Ajeigbe, Fortune Ganda

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In the past three decades, there has been a notable increase in the number of firms delisting from the Johannesburg Stock Exchange (JSE) in South Africa. The recent increasing rate of delisting waves of corporate listed firms motivated this study. This study aims to explore the influence of institutional investor perceptions on the financial distress experienced by delisted firms within the South African market. The study further examined the impact of financial distress on the corporate performance of delisted firms. Using the data of delisted firms spanning from 2000 to 2023 and the FGLS (Feasible Generalized Least Squares) for the short run and PCSE (Panel-Corrected Standard Errors) for the long run effects of the relationship. The finding indicated that a decline in institutional investors’ perceptions was associated with the corporate financial distress of the delisted firms, particularly during the delisting year and the few years preceding the announcement of the delisting. This study addressed the importance of investor recognition in corporate financial distress and the delisting wave among listed firms- a finding supporting the stakeholder theory. This study is an insight for companies’ managements, investors, governments, policymakers, stockbrokers, lending institutions, bankers, the stock market, and other stakeholders in their various decision-making endeavours. Based on the above findings, it was recommended that corporate managements should improve their governance strategies that can help companies’ financial performances. Accountability and transparency through governance must also be improved upon with government support through the introduction of policies and strategies and enabling an easy environment that can help companies perform better.

Keywords: delisting wave, institutional investors, financial distress, corporate performance, investors’ perceptions

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559 Carbon Blacks: A Broad Type of Carbon Materials with Different Electrocatalytic Activity to Produce H₂O₂

Authors: Alvaro Ramírez, Martín Muñoz-Morales, Ester López- Fernández, Javier Llanos, C. Ania

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Carbon blacks are value-added materials typically produced through the incomplete combustion or thermal decomposition of hydrocarbons. Traditionally, they have been used as catalysts in many different applications, but in the last decade, their potential in green chemistry has gained significant attention. Among them, the electrochemical production of H₂O₂ has attracted interest because of their properties as high oxidant capacity or their industrial interest as a bleaching agent. Carbon blacks are commonly used in this application in a catalytic ink that is drop-casted on supporting electrodes and acts as catalysts for the electrochemical production of H₂O₂ through oxygen reduction reaction (ORR). However, the different structural and electrochemical behaviors of each type of carbon black influence their applications. In this line, the term ‘carbon black’, has to be considered as a generic name that does not guarantee any physicochemical properties if any further description is mentioned. In fact, different specific surface area (SSA), surface functional groups, porous structure, and electro catalysts effect seem very important for electrochemical applications, and considerable differences were found during the analysis of four types of carbon blacks. Thus, the aim of this work is to evaluate the influence of SSA, porous structure, oxygen functional groups, and structural defects to differentiate among these carbon blacks (e.g. Vulcan XC72, Superior Graphite Co, Printex XE2, and Prolabo) for H₂O₂ production via ORR, using carbon paper as electrode support with improved selectivity and efficiency. Results indicate that the number and size of pores, along with surface functional groups, are key parameters that significantly affect the overall process efficiency.

Keywords: carbon blacks, oxygen reduction reaction, hydrogen peroxide, porosity, surface functional groups

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558 Engineering a Band Gap Opening in Dirac Cones on Graphene/Tellurium Heterostructures

Authors: Beatriz Muñiz Cano, J. Ripoll Sau, D. Pacile, P. M. Sheverdyaeva, P. Moras, J. Camarero, R. Miranda, M. Garnica, M. A. Valbuena

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Graphene, in its pristine state, is a semiconductor with a zero band gap and massless Dirac fermions carriers, which conducts electrons like a metal. Nevertheless, the absence of a bandgap makes it impossible to control the material’s electrons, something that is essential to perform on-off switching operations in transistors. Therefore, it is necessary to generate a finite gap in the energy dispersion at the Dirac point. Intense research has been developed to engineer band gaps while preserving the exceptional properties of graphene, and different strategies have been proposed, among them, quantum confinement of 1D nanoribbons or the introduction of super periodic potential in graphene. Besides, in the context of developing new 2D materials and Van der Waals heterostructures, with new exciting emerging properties, as 2D transition metal chalcogenides monolayers, it is fundamental to know any possible interaction between chalcogenide atoms and graphene-supporting substrates. In this work, we report on a combined Scanning Tunneling Microscopy (STM), Low Energy Electron Diffraction (LEED), and Angle-Resolved Photoemission Spectroscopy (ARPES) study on a new superstructure when Te is evaporated (and intercalated) onto graphene over Ir(111). This new superstructure leads to the electronic doping of the Dirac cone while the linear dispersion of massless Dirac fermions is preserved. Very interestingly, our ARPES measurements evidence a large band gap (~400 meV) at the Dirac point of graphene Dirac cones below but close to the Fermi level. We have also observed signatures of the Dirac point binding energy being tuned (upwards or downwards) as a function of Te coverage.

Keywords: angle resolved photoemission spectroscopy, ARPES, graphene, spintronics, spin-orbitronics, 2D materials, transition metal dichalcogenides, TMDCs, TMDs, LEED, STM, quantum materials

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557 Entrepreneurship And Heritage Tourism: Identifying Opportunities Around Tsodilo Hills World Heritage Site

Authors: O. Nthoi-Molefe, V. Makwinja

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In the North West district of Botswana, Heritage tourism has the potential to offer tremendous economic and social opportunities for local communities in terms of supporting Tourism product development and entrepreneurship. This paper Identifies that Cultural Heritage Entrepreneur brings to the market goods and services, organizes and runs cultural heritage in a commercial or non-profit manner depending on characteristics of cultural resources identified. Data was collected through a series of focus group discussions that included sixteen village community members within the region. Data collected was transcribed and then further analyzed thematically to bring forward results to be analysed. Using Tsodilo Hills World Heritage Site as a case study, the researchers acknowledged that Cultural Heritage Entrepreneurs in that area should use a creative approach in order toidentify suitable solutions for financing different tourism activities starting with sponsored events, grant funds, donations, including the benefits of financial opportunities brough be foreign visitors and domestic tourists alike. The researchers also identified a need for specialized training for the identified entrepreneurs in order to maintain quality services of tourism products and sites (interpretation), information for tourists, visitation services, diversification, and upgrading of the heritage experience. The research reveals that the identified Cultural Heritage Entrepreneurs prefer economic motivation, exploitation over the cultural value of their resources, further calling for recommendations of the research that emphasize on the need for detailed training on how to valorize their cultural resources for the growth of Tourism in the area.

Keywords: education, community development, entrepreneurship, cultural tourism

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556 WWSE School Development in German Christian Schools Revisited: Organizational Development Taken to a Test

Authors: Marco Sewald

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WWSE School Development (Wahrnehmungs- und wertorientierte Schulentwicklung) contains surveys on pupils, teachers and parents and enables schools to align the development to the requirements mentioned by these three stakeholders. WWSE includes a derivative set of questions for Christian schools, meeting their specific needs. The conducted research on WWSE is reflecting contemporary questions on school development, questioning the quality of the implementation of the results of past surveys, delivered by WWSE School Development in Christian schools in Germany. The research focused on questions connected to organizational development, including leadership and change management. This is done contoured to the two other areas of WWSE: human resources development and development of school teaching methods. The chosen research methods are: (1) A quantitative triangulation on three sets of data. Data from a past evaluation taken in 2011, data from a second evaluation covering the same school conducted in 2014 and a structured survey among the teachers, headmasters and members of the school board taken within the research. (2) Interviews with teachers and headmasters have been conducted during the research as a second stage to fortify the result of the quantitative first stage. Results: WWSE is supporting modern school development. While organizational development, leadership, and change management are proofed to be important for modern school development, these areas are widespread underestimated by teachers and headmasters. Especially in comparison to the field of human resource development and to an even bigger extent in comparison to the area of development of school teaching methods. The research concluded, that additional efforts in the area of organizational development are necessary to meet modern demands and the research also shows which areas are the most important ones.

Keywords: school as a social organization, school development, school leadership, WWSE, Wahrnehmungs- und wertorientierte Schulentwicklung

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555 Making Waves: Preparing the Next Generation of Bilingual Medical Doctors

Authors: Edith Esparza-Young, Ángel M. Matos, Yaritza Gonzalez, Kirthana Sugunathevan

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Introduction: This research describes the existing medical school program which supports a multicultural setting and bilingualism. The rise of Spanish speakers in the United States has led to the recruitment of bilingual medical students who can serve the evolving demographics. This paper includes anecdotal evidence, narratives and the latest research on the outcomes of supporting a multilingual academic experience in medical school and beyond. People in the United States will continue to need health care from physicians who have experience with multicultural competence. Physicians who are bilingual and possess effective communication skills will be in high demand. Methodologies: This research is descriptive. Through this descriptive research, the researcher will describe the qualities and characteristics of the existing medical school programs, curriculum, and student services. Additionally, the researcher will shed light on the existing curriculum in the medical school and also describe specific programs which help to serve as safety nets to support diverse populations. The method included observations of the existing program and the implementation of the medical school program, specifically the Accelerated Review Program, the Language Education and Professional Communication Program, student organizations and the Global Health Institute. Concluding Statement: This research identified and described characteristics of the medical school’s program. The research explained and described the current and present phenomenon of this medical program, which has focused on increasing the graduation of bilingual and minority physicians. The findings are based on observations of the curriculum, programs and student organizations which evolves and remains innovative to stay current with student enrollment.

Keywords: bilingual, English, medicine, doctor

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