Search results for: evidence based practice
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 32304

Search results for: evidence based practice

31554 Technical Aspects of Closing the Loop in Depth-of-Anesthesia Control

Authors: Gorazd Karer

Abstract:

When performing a diagnostic procedure or surgery in general anesthesia (GA), a proper introduction and dosing of anesthetic agents are one of the main tasks of the anesthesiologist. However, depth of anesthesia (DoA) also seems to be a suitable process for closed-loop control implementation. To implement such a system, one must be able to acquire the relevant signals online and in real-time, as well as stream the calculated control signal to the infusion pump. However, during a procedure, patient monitors and infusion pumps are purposely unable to connect to an external (possibly medically unapproved) device for safety reasons, thus preventing closed-loop control. The paper proposes a conceptual solution to the aforementioned problem. First, it presents some important aspects of contemporary clinical practice. Next, it introduces the closed-loop-control-system structure and the relevant information flow. Focusing on transferring the data from the patient to the computer, it presents a non-invasive image-based system for signal acquisition from a patient monitor for online depth-of-anesthesia assessment. Furthermore, it introduces a UDP-based communication method that can be used for transmitting the calculated anesthetic inflow to the infusion pump. The proposed system is independent of a medical device manufacturer and is implemented in Matlab-Simulink, which can be conveniently used for DoA control implementation. The proposed scheme has been tested in a simulated GA setting and is ready to be evaluated in an operating theatre. However, the proposed system is only a step towards a proper closed-loop control system for DoA, which could routinely be used in clinical practice.

Keywords: closed-loop control, depth of anesthesia (DoA), modeling, optical signal acquisition, patient state index (PSi), UDP communication protocol

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31553 Empathy in the Work of Physiotherapists in Slovakia

Authors: Vladimir Littva, Peter Kutis

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Based on common practice, we know that an empathic approach to a patient is one of the characteristics of a physiotherapist. Although empathy is regarded as an essential condition of the psychotherapeutic relationship, it has taken quite a while for attention to be paid to it in clinical practice. Patients who are experiencing a sense of understanding from health care providers are more willing to cooperate, and treatment within the optimistic attunes a more comfortable framework of care. Age, experience, family, education and the working environment may have an impact on the degree of empathy for paramedics. Within the KEGA project no. 003KU-4-2021, we decided to investigate the level of empathy in the work of physiotherapists in Slovakia. Research sample and Methods: The sample comprised 194 respondents – physiotherapists working on the territory of Slovakia. 112 were men and 82 women. The age of respondents was between 21 and 64 years of age. 133 were married, 51 were single and ten were divorced. 98 were living in the countryside and 96 in towns. Twenty-two grew up without siblings, 95 with one sibling and 77 with two and more siblings. In the survey, we used the Empathy Assessment Questionnaire (EAQ) with 18 questions with four possible answers: strongly disagree, disagree, agree; and strongly agree, which we validated linguistically and psychometrically. All data were statistically processed by SPSS 25. Results: We evaluated the intrinsic reliability of the questionnaire EAQ using Cronbach's Alpha and the coefficient is 0.756 in the whole set. This means that the questionnaire is a quite strong and reliable measurement tool. The mean for individual questions ranged from 2.39 to 3.74 (maximum was 4). In Pearson's correlations, we confirmed the significant differences between the groups regarding sex in 8 questions out of 18, regarding age in 5 questions, regarding family status in 4 questions and regarding siblings in 4 questions out of 18 at the level 5% (p <0.05). Conclusion: The results obtained during the research show the importance of adequate communication with the patient due to his health and well-being. Empathy in the physiotherapists’ profession is very important. It would be worthwhile if the students of physiotherapy would receive a course during their study that would deal exclusively with empathy, empathic approach, burnout, or psycho-emotional hygiene.

Keywords: empathy, approach, clinical practice, physiotherapists

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31552 In vitro Modulation of Cytokine Expression by an Aqueous Licorice Extract in Canine

Authors: A. Watson, G. Telford, D. I. Pritchard

Abstract:

Objective: We investigated the immunomodulatory ability of licorice (Glycyrrhiza glabra). Such activities could have value for the management of common immunological diseases in dogs, such as environmental allergy. This study investigated the potential of a Licorice root extract (LRE) to influence the relative expression of Th-1, Th-2, and Th-17 cytokines in canine peripheral blood mononuclear cells (PBMC). Methods: A LRE was prepared using an alcoholic-aqueous-based solvent method. The extract was tested in three in vitro assays using canine leukocytes to determine its toxicity and immunoregulatory profile. Extract toxicity was assessed using the human T-lymphocyte cell line, Jurkat E6.1. The impact of the extract on the proliferation of concanavalin-activated canine PBMC was also determined. Finally, the extract was assessed for its ability to influence cytokine release in activated PBMC, measuring culture medium concentrations of interleukin-17, interferon gamma, and interleukin-4. One-way ANOVA followed by Dunnett’s post-test was used for statistics using concanavalin positive control as reference (p ≤ 0.05). Results: There was evidence that the LRE had specific immunomodulatory properties, causing significant inhibition of IL4 expression over a non-toxic/non-cytostatic concentration range (p < 0.001). In the same cell incubations, there was no significant impact on IL17 nor IFNg over the same non-toxic/non-cytostatic concentration range. Conclusion: The study provides in vitro evidence that LRE preferentially reduces the expression of a Th-2-type cytokine, IL4. The dog population, as with humans, is prone to conditions associated with a Th-2 bias of the immune system, such as environmental allergy. Based on these results, licorice merits further evaluation as a useful immune modulator for such allergic diseases.

Keywords: cytokine, Glycyrrhiza glabra, peripheral blood mononuclear cells, T-cell activation

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31551 Literary Theatre and Embodied Theatre: A Practice-Based Research in Exploring the Authorship of a Performance

Authors: Rahul Bishnoi

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Theatre, as Ann Ubersfld calls it, is a paradox. At once, it is both a literary work and a physical representation. Theatre as a text is eternal, reproducible, and identical while as a performance, theatre is momentary and never identical to the previous performances. In this dual existence of theatre, who is the author? Is the author the playwright who writes the dramatic text, or the director who orchestrates the performance, or the actor who embodies the text? From the poststructuralist lens of Barthes, the author is dead. Barthes’ argument of discrete temporality, i.e. the author is the before, and the text is the after, does not hold true for theatre. A published literary work is written, edited, printed, distributed and then gets consumed by the reader. On the other hand, theatrical production is immediate; an actor performs and the audience witnesses it instantaneously. Time, so to speak, does not separate the author, the text, and the reader anymore. The question of authorship gets further complicated in Augusto Boal’s “Theatre of the Oppressed” movement where the audience is a direct participant like the actors in the performance. In this research, through an experimental performance, the duality of theatre is explored with the authorship discourse. And the conventional definition of authorship is subjected to additional complexity by erasing the distinction between an actor and the audience. The design/methodology of the experimental performance is as follows: The audience will be asked to produce a text under an anonymous virtual alias. The text, as it is being produced, will be read and performed by the actor. The audience who are also collectively “authoring” the text, will watch this performance and write further until everyone has contributed with one input each. The cycle of writing, reading, performing, witnessing, and writing will continue until the end. The intention is to create a dynamic system of writing/reading with the embodiment of the text through the actor. The actor is giving up the power to the audience to write the spoken word, stage instruction and direction while still keeping the agency of interpreting that input and performing in the chosen manner. This rapid conversation between the actor and the audience also creates a conversion of authorship. The main conclusion of this study is a perspective on the nature of dynamic authorship of theatre containing a critical enquiry of the collaboratively produced text, an individually performed act, and a collectively witnessed event. Using practice as a methodology, this paper contests the poststructuralist notion of the author as merely a ‘scriptor’ and breaks it further by involving the audience in the authorship as well.

Keywords: practice based research, performance studies, post-humanism, Avant-garde art, theatre

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31550 The Art of Contemporary Arabic Calligraphy in Oman: Salman Alhajri as an Example

Authors: Salman Amur Alhajri

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Purpose: This paper explores the art of contemporary Arabic calligraphy in Oman. It explains the aesthetic features of Arabic calligraphy as a unique icon of Islamic art. This paper also explores the profile of one Omani artist, Salman Alhajri, as an example of Omani artists who have developed unique styles in this art stream. Methodology and approach: The paper is based on a theoretical study using a descriptive and case-study approach. Omani artists are fascinated by the art forms of Arabic calligraphy, which combine both spiritual meaning and aesthetic beauty. Artist Salman Alhajri is an example of a contemporary Arabic artist who uses Arabic calligraphy as the main theme in his art. Dr. Alhajri is trying to introduce the beauty of Arabic letters from a new aesthetic point of view. He also aims to create unusual visual effects that viewers can easily interact with. Even though words and phrases appear in Alhajri’s artwork, they are not conveying direct meanings: viewers can create their own meaning or expressions from them by appreciating the compositions of the artwork. Results: Arabic writing is directly related to the identity of Omani artists and their cultural background. This paper shows how the beauty of Arabic letters comes from its indefinite possibilities in designing calligraphic expressions, even within a single word, because letters can be stretched and transformed in various ways to create different compositions. Omani artists are interested in employing new media applications in this kind of practice to find new techniques for creating artwork based on Arabic writing. It is really important for all Omani artists to practice this art style because Arabic calligraphy and its flexibility introduce infinite possibilities that involve further exploration and investigation.

Keywords: Islamic art, contemporary Arabic calligraphy, new techniques, Omani artist

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31549 Optimization Model for Identification of Assembly Alternatives of Large-Scale, Make-to-Order Products

Authors: Henrik Prinzhorn, Peter Nyhuis, Johannes Wagner, Peter Burggräf, Torben Schmitz, Christina Reuter

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Assembling large-scale products, such as airplanes, locomotives, or wind turbines, involves frequent process interruptions induced by e.g. delayed material deliveries or missing availability of resources. This leads to a negative impact on the logistical performance of a producer of xxl-products. In industrial practice, in case of interruptions, the identification, evaluation and eventually the selection of an alternative order of assembly activities (‘assembly alternative’) leads to an enormous challenge, especially if an optimized logistical decision should be reached. Therefore, in this paper, an innovative, optimization model for the identification of assembly alternatives that addresses the given problem is presented. It describes make-to-order, large-scale product assembly processes as a resource constrained project scheduling (RCPS) problem which follows given restrictions in practice. For the evaluation of the assembly alternative, a cost-based definition of the logistical objectives (delivery reliability, inventory, make-span and workload) is presented.

Keywords: assembly scheduling, large-scale products, make-to-order, optimization, rescheduling

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31548 Negotiating Space, Reconstructing Identity, and Community Literacy Practices: Case Study of Indonesian Domestic Workers in Hong Kong

Authors: Pratiwi Retnaningdyah, Sofie Dewayani

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Foreign domestic workers are arguably one of the most exploited and subordinated groups of women in the labor division under global capitalism. However, foreign domestic workers (FDWs) actively engage in activities to negotiate the prevailing structures of power in the transnational labor market. This paper seeks to understand the significance of Indonesian Domestic Workers (IDWs) cultural representations in relation to the themes of literacy and space. In particular, this paper addresses the issue of how IDWs in Hong Kong make use of the practice of suitcase libraries to make meaning of space within material limits. The term ‘suitcase libraries’ is used to refer to a literacy practice of book borrowing at outdoor public spaces in Hong Kong during IDWs’ days off. The books are displayed in open suitcases and mats, with IDWs both as administrators and consumers engaged in the practice. This paper argues that suitcase libraries can be considered representing Thirdspace in the form of a vernacular, grassroots literacy practice that creates a productive space of resistance and community empowerment. Employing participant observation and a textual analysis of IDWs’ literacy narratives, the study traced IDWs’ literacy trajectories to the period of IDWs’ permanent return to Indonesia. Through extended engagement in community literacy practices in their hometowns, former IDWs develop their literacy capital and break the stereotypes of uneducated and passive maids and change them into literate figures. In the context of literacy movement that has gained momentum in Indonesia recently, the practice of IDWs’ suitcase libraries is also useful as a reference point to further investigate how community literacy sponsors in Indonesia also create Thirdspace and develop literacy capital through community libraries (TBM, Taman Baca Masyarakat).

Keywords: identity, Indonesian domestic workers, literacy narratives, Thirdspace

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31547 Reliability Evidence of the Child Behavior Checklist (CBCL) Based on a Chinese Sample

Authors: Zhidong Zhang, Zhi-Chao Zhang, Georgiana Duarte

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The Chinese version of the Child Behavior Checklist (CBCL) is the one of the Achenbach systems of empirically based assessment (ASEBA) scales, by which behavioral and emotional problems of early adolescents were examined. In order to further understand the robustness of the scale, its reliability has been examined. CBCL consists of 8 problems to measure internalizing, externalizing and social problems. In internalizing problem, there are Anxious, Withdrawn and Somatic Complaints. In this study, as an example, we only examined the anxious aspect which consisted of 13 questions. Cronbach alpha and factor analysis methods were used to examine the reliability of the scale. The result indicated that Cronbach alpha value was above 0.80.

Keywords: anxious/depressed problems, ASEBA, CBCL, Cronbach Alpha, reliability

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31546 Observations of Conformity in the Health Professions

Authors: Tanya Beran, Michelle Drefs, Ghazwan Altabbaa, Nouf Al Harbi, Noof Al Baz, Elizabeth Oddone Paolucci

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Although research shows that interprofessional practice has desirable effects on patient care, its implementation can present challenges to its team members. In particular, they may feel pressured to agree with or conform to other members who share information that is contrary to their own understanding. Obtaining evidence of this phenomenon is challenging, as team members may underreport their conformity behaviors due to reasons such as social desirability. In this paper, a series of studies are reviewed in which several approaches to assessing conformity in the health care professions are tested. Simulations, questionnaires, and behavior checklists were developed to measure conformity behaviors. Insights from these studies show that a significant proportion of people conform either in the presence or absence of others, express a variety of verbal and nonverbal behaviors when considering whether to conform to others, may shift between conforming and moments later not conforming (and vice versa), and may not accurately report whether they conformed. A new method of measuring conformity using the implicit bias test is also discussed. People at all levels in the healthcare system are encouraged to develop both formal and informal.

Keywords: conformity, decision-making, inter-professional teams, simulation

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31545 Vocal Training and Practice Methods: A Glimpse on the South Indian Carnatic Music

Authors: Raghavi Janaswamy, Saraswathi K. Vasudev

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Music is one of the supreme arts of expressions, next to the speech itself. Its evolution over centuries has paved the way with a variety of training protocols and performing methods. Indian classical music is one of the most elaborate and refined systems with immense emphasis on the voice culture related to range, breath control, quality of the tone, flexibility and diction. Several exercises namely saraliswaram, jantaswaram, dhatuswaram, upper stayi swaram, alamkaras and varnams lay the required foundation to gain the voice culture and deeper understanding on the voice development and further on to the intricacies of the raga system. This article narrates a few of the Carnatic music training methods with an emphasis on the advanced practice methods for articulating the vocal skills, continuity in the voice, ability to produce gamakams, command in the multiple speeds of rendering with reasonable volume. The creativity on these exercises and their impact on the voice production are discussed. The articulation of the outlined conscious practice methods and vocal exercises bestow the optimum use of the natural human vocal system to not only enhance the signing quality but also to gain health benefits.

Keywords: Carnatic music, Saraliswaram, Varnam, vocal training

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31544 A Paradigm Shift into the Primary Teacher Education Program in Bangladesh

Authors: Happy Kumar Das, Md. Shahriar Shafiq

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This paper portrays an assumed change in the primary teacher education program in Bangladesh. An initiative has been taken with a vision to ensure an integrated approach to developing trainee teachers’ knowledge and understanding about learning at a deeper level, and with that aim, the Diploma in Primary Education (DPEd) program replaces the Certificate-in-Education (C-in-Ed) program in Bangladeshi context for primary teachers. The stated professional values of the existing program such as ‘learner-centered’, ‘reflective’ approach to pedagogy tend to contradict the practice exemplified through the delivery mechanism. To address the challenges, through the main two components (i) Training Institute-based learning and (ii) School-based learning, the new program tends to cover knowledge and value that underpin the actual practice of teaching. These two components are given approximately equal weighting within the program in terms of both time, content and assessment as the integration seeks to combine theoretical knowledge with practical knowledge and vice versa. The curriculum emphasizes a balance between the taught modules and the components of the practicum. For example, the theories of formative and summative assessment techniques are elaborated through focused reflection on case studies as well as observation and teaching practice in the classroom. The key ideology that is reflected through this newly developed program is teacher’s belief in ‘holistic education’ that can lead to creating opportunities for skills development in all three (Cognitive, Social and Affective) domains simultaneously. The proposed teacher education program aims to address these areas of generic skill development alongside subject-specific learning outcomes. An exploratory study has been designed in this regard where 7 Primary Teachers’ Training Institutes (PTIs) in 7 divisions of Bangladesh was used for experimenting DPEd program. The analysis was done based on document analysis, periodical monitoring report and empirical data gathered from the experimental PTIs. The findings of the study revealed that the intervention brought positive change in teachers’ professional beliefs, attitude and skills along with improvement of school environment. Teachers in training schools work together for collective professional development where they support each other through lesson study, action research, reflective journals, group sharing and so on. Although the DPEd program addresses the above mentioned factors, one of the challenges of the proposed program is the issue of existing capacity and capabilities of the PTIs towards its effective implementation.

Keywords: Bangladesh, effective implementation, primary teacher education, reflective approach

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31543 From E-Government to Cloud-Government Challenges of Jordanian Citizens' Acceptance for Public Services

Authors: Abeer Alkhwaldi, Mumtaz Kamala

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On the inception of the third millennium, there is much evidence that cloud technologies have become the strategic trend for many governments not only developed countries (e.g., UK, Japan, and USA), but also developing countries (e.g. Malaysia and the Middle East region), who have launched cloud computing movements for enhanced standardization of IT resources, cost reduction, and more efficient public services. Therefore, cloud-based e-government services considered as one of the high priorities for government agencies in Jordan. Although of their phenomenal evolution, government cloud-services still suffering from the adoption challenges of e-government initiatives (e.g. technological, human-aspects, social, and financial) which need to be considered carefully by governments contemplating its implementation. This paper presents a pilot study to investigate the citizens' perception of the extent in which these challenges affect the acceptance and use of cloud computing in Jordanian public sector. Based on the data analysis collected using online survey some important challenges were identified. The results can help to guide successful acceptance of cloud-based e-government services in Jordan.

Keywords: challenges, cloud computing, e-government, acceptance, Jordan

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31542 Trends of Municipal Council Members in Practicing His Role on Municipality's Main Municipal Activities in the Kingdom of Saudi Arabia

Authors: Ameer Alalwan

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Summary: The aim of this research is to identify trends of municipal council member in practicing his administrative control, decision-making, and counsultive role on municipalities' main municipal activities in the kingdom of Saudi Arabia. This research is conducted after the implementation of the new municipal system resolution no. (M\61) in 1435 in the work of municipal councils for the third session. To achieve the goal of this research, a questionnaire has been designed to obtain the opinion of municipal councils on this matter. This questionnaire has been tested for reliability and validity. The results of this research show that in general performance of municipal council is moderate after the implementation of the new municipal system resolution no. (M\61) in 1435 in the work of municipal councils for the third session. Also, extend that municipal council member practice his roles on the main municipality activities is moderate and weak. In addition, results show that municipal council member practice big role in decision-making, and moderate role in administrative control, and weaker role in giving opinion on municipality main issues. Furthermore, the results show that there is a significant difference between municipal council member's responses by the change of their Personal characteristics. Educated and appointed municipal council members practicing their role more than others do. In addition, municipal council presidents, and vice presidents, and in regional and sub-regional municipalities practice their role more than others do. Finally, this research in general recommened that muincialty council member must be empowered, so that he can practice his role on muicipality main activities. In addition, research suggest, granting municipal council member the authority, resources needed, training and appointment of qualified members, so that they will be able to practice their roles. Furthermore, this research suggest for the time being maintain certain percent of municipal council's appointed until this experience mature in the kingdom.

Keywords: municipal council, municipal council member, municipality, decision-making role

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31541 Challenges and Practical Tips for Advance Care Planning and End-of-Life Communications With Cancer Patients in Global Pandemic

Authors: Poonam Goswami

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Background: The diagnosis of a serious illness like cancer can have an impact on a patient’s emotional well-being and may result in psychological symptoms, anxiety, depression, and loss of control. Advance care planning discussions ensure patients’ values and goals of care, including patients’ freedom to choose their place of death, are respected. Unfortunately, these discussions are often delayed and are not initiated early in patients’ cancer trajectory. As a result, patients’ wishes often remains unknown until the last phase of their life. Evidence suggests that many patients inappropriately receive aggressive treatment near the end of life, which does lead to higher resource utilization, decreased quality of life, and increased cost. Additionally, the novel coronavirus disease 2019 (COVID-19) pandemic challenged the health care systems worldwide and raised important ethical issues, especially regarding the potential need for rationing health care in the context of scarce resources and crisis capacity. The importance of goal concordant care is now even substantially important and is heightened in the context of this pandemic. Problem: Although there is growing evidence on the effects of the ACP on the completion of advanced directives, improved patient and family concordance for preferences for medical care, and receipt of care, there is still a lack of standardized ACP conversation strategies for patients with cancer. Methods: The Key concepts of ACP include (1) assessing patient and family readiness, (2) identifying a surrogate decision maker ( medical power of attorney), (3) exploring patient and family understanding of the disease and treatment options,(4) discussing the values and goals of care, and options for end-of-life care, (5) documenting patient preferences in the medical record, and (6) revisiting the discussions at every change in the treatment plan and /or change in clinical status, including at every hospitalization. Conclusion/Implication for practice: Advance Care Planning (ACP) and end-of-life (EOL) discussions are important for patients, families, and health care providers. Adopting the verbal and nonverbal communication strategies can help overcome the barriers to effective communication on these difficult discussions. ACP with goals of care discussions should not be delayed until the patient is hospitalized.

Keywords: advance care planning, end of life, cancer, global, pandemic

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31540 Improvement of Contractor’s Competitiveness through Sustainable Construction Practices in UAE

Authors: Sareh Rajabi, Taha Anjamrooz, Salwa Bheiry

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Sustainability of construction projects is an important issue to be addressed since the sector will continue to be developed in the coming years, especially in developing countries. Thus, it is significant to discover approaches and solutions for improving sustainability. Currently, the construction industry is the largest consumer of natural resources. This is the same in other countries in the Gulf region, and the United Arab Emirates (UAE) has limited natural resources such as water, electricity, etc. Recently, the UAE has taken several actions in order to implement sustainable initiatives within its construction industry. Within the industry, the contractors’ role is significant in promoting sustainable development by taking the responsibility to minimize their negative impacts on the environment and society, and maximize their economic distribution. In this research, sustainability will be studied as an important key to bring competitive advantages to contracting organizations. The contractors should understand the need to improve their sustainable performance in order to expand their business competitiveness. Competitiveness at the construction project level refers to a contractor’s ability to compete for a project. There is less focus on how to improve contractors’ competitiveness by implementing sustainable construction practices. Based on an inclusive literature review on the relationship between sustainability performance and business competitiveness, this research will conduct a study of sustainable practice in the construction industry and the relationship between sustainability performance and business competitiveness in order to develop a framework for evaluating how contractors can improve their competitiveness in terms of more efficient processes, enhancements in productivity, and lower costs of compliance in order to reduce the initial project cost and obtain market opportunities in the UAE. The research findings will provide a framework that can be a useful guideline for contractors to develop their sustainability policy, strategy and practice for meeting the increased requirements for sustainable development in construction.

Keywords: sustainable construction practice, sustainability, competitiveness, construction industry, contractors

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31539 Heterogeneous Intelligence Traders and Market Efficiency: New Evidence from Computational Approach in Artificial Stock Markets

Authors: Yosra Mefteh Rekik

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A computational agent-based model of financial markets stresses interactions and dynamics among a very diverse set of traders. The growing body of research in this area relies heavily on computational tools which by-pass the restrictions of an analytical method. The main goal of this research is to understand how the stock market operates and behaves how to invest in the stock market and to study traders’ behavior within the context of the artificial stock markets populated by heterogeneous agents. All agents are characterized by adaptive learning behavior represented by the Artificial Neuron Networks. By using agent-based simulations on artificial market, we show that the existence of heterogeneous agents can explain the price dynamics in the financial market. We investigate the relation between market diversity and market efficiency. Our empirical findings demonstrate that greater market heterogeneity play key roles in market efficiency.

Keywords: agent-based modeling, artificial stock market, heterogeneous expectations, financial stylized facts, computational finance

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31538 Integrating Flipped Instruction to Enhance Second Language Acquisition

Authors: Borja Ruiz de Arbulo Alonso

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This paper analyzes the impact of flipped instruction in adult learners of Spanish as a second language in a face-to-face course at Boston University. Given the limited amount of contact hours devoted to studying world languages in the American higher education system, implementing strategies to free up classroom time for communicative language practice is key to ensure student success in their learning process. In an effort to improve the way adult learners acquire a second language, this paper examines the role that regular pre-class and web-based exposure to Spanish grammar plays in student performance at the end of the academic term. It outlines different types of web-based pre-class activities and compares this approach to more traditional classroom practice. To do so, this study works for three months with two similar groups of adult learners in an intermediate-level Spanish class. Both groups use the same course program and have the same previous language experience, but one receives an additional set of instructor-made online materials containing a variety of grammar explanations and online activities that need to be reviewed before attending class. Since the online activities cover material and concepts that have not yet been studied in class, students' oral and written production in both groups is measured by means of a writing activity and an audio recording at the end of the three-month period. These assessments will ascertain the effects of exposing the control group to the grammar of the target language prior to each lecture throughout and demonstrate where flipped instruction helps adult learners of Spanish achieve higher performance, but also identify potential problems.

Keywords: educational technology, flipped classroom, second language acquisition, student success

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31537 Phillips Curve Estimation in an Emerging Economy: Evidence from Sub-National Data of Indonesia

Authors: Harry Aginta

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Using Phillips curve framework, this paper seeks for new empirical evidence on the relationship between inflation and output in a major emerging economy. By exploiting sub-national data, the contribution of this paper is threefold. First, it resolves the issue of using on-target national inflation rates that potentially causes weakening inflation-output nexus. This is very relevant for Indonesia as its central bank has been adopting inflation targeting framework based on national consumer price index (CPI) inflation. Second, the study tests the relevance of mining sector in output gap estimation. The test for mining sector is important to control for the effects of mining regulation and nominal effects of coal prices on real economic activities. Third, the paper applies panel econometric method by incorporating regional variation that help to improve model estimation. The results from this paper confirm the strong presence of Phillips curve in Indonesia. Positive output gap that reflects excess demand condition gives rise to the inflation rates. In addition, the elasticity of output gap is higher if the mining sector is excluded from output gap estimation. In addition to inflation adaptation, the dynamics of exchange rate and international commodity price are also found to affect inflation significantly. The results are robust to the alternative measurement of output gap

Keywords: Phillips curve, inflation, Indonesia, panel data

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31536 Employees' Attitude towards Corporate Governance without Unions

Authors: Bamidele Olufemi Ifenowo

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The study examined the practice of managing business organizations in Nigeria today without unions. It explored how this phenomenon evolved and became popular in the newly emerging mega banks in Nigeria. Attitudes of selected banks' employees to this phenomenon were surveyed.Simple statistical tools were used for data analysis. The findings revealed that most new employees who form the bulk of the sample never really cared about unionism. On the other hand, old and experienced employees were positively disposed towards unionism. This category of employees abhorred the current display of authoritarianism cum paternalism which seemed to characterize the managerial practice of most new generation banks in Nigeria today.

Keywords: authoritarianism, corporate governance, deunionisation, unionization, paternalism

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31535 An Enhanced Digital Forensic Model for Internet of Things Forensic

Authors: Tina Wu, Andrew Martin

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The expansion of the Internet of Things (IoT) brings a new level of threat. Attacks on IoT are already being used by criminals to form botnets, launch Distributed Denial of Service (DDoS) and distribute malware. This opens a whole new digital forensic arena to develop forensic methodologies in order to have the capability to investigate IoT related crimes. However, existing proposed IoT forensic models are still premature requiring further improvement and validation, many lack details on the acquisition and analysis phase. This paper proposes an enhanced theoretical IoT digital forensic model focused on identifying and acquiring the main sources of evidence in a methodical way. In addition, this paper presents a theoretical acquisition framework of the different stages required in order to be capable of acquiring evidence from IoT devices.

Keywords: acquisition, Internet of Things, model, zoning

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31534 Malaria and Environmental Sanitation

Authors: Soorya Vennila

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A comprehensive study of malaria in 165 villages (hamlets) in Harur block, Dharmapuri district, has revealed the fact that there are distinct episodes of malaria due to An. culicifacies, the vector, causes persistent transmission in the revenue village called Vedakatamaduvu. A total of 300 household adult samples are randomly selected to study both quantitatively and qualitatively the vulnerability of malaria. On the basis of the response, the problem uncommon with groups was identified as the outdoor routine, particularly open defecation, with which the samples needed to be stratified into two major groups; users of toilets 21 and those who practice open defecation 279. Open defecation, as the habit-based vulnerability, is measured with the Pearson correlation coefficient to estimate the relationship between malaria and open defecation. It is also verified from the literature that plant fluids provide mosquitoes not only with energy but also with nutrition, to the extent that they can develop fertile eggs. In the endemic areas, the bushy Presopis Juliflora, which naturally serves as a feeding and resting spot for mosquitoes, serves as a cover to practice open defecation as well. Eventually, those who get resort to Presopis for open defecation have a higher chance of getting exposed to mosquito bites and being infected with malaria. The study concludes that the combination of bushy Prosopis Juliflora and open defecation leaves the place perpetually vulnerable to malaria.

Keywords: Malaria, open defecation, endemic, presopis juliflora

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31533 Drivers of E-Participation: Case of Saudi Arabia

Authors: R. Alrashedi, A. Persaud

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This study provides insights into the readiness of users to participate in e-government activities in Saudi Arabia. A user-centric model of e-participation is developed based on a review of the literature and empirically tested. The findings are based on an online survey of a sample of 200 hundred Saudi citizens and residents living in Saudi Arabia. The study found that trust of the government, attitude towards e-participation, e-participation through the use of social media, and social influence and social identity positively influence e-participation while perceived benefits of e-government is negatively related to e-participation. This study contributes to the literature by providing empirical evidence of the drivers of e-participation. The study also provides insights that could be used by policymakers to increase the level of e-participation in Saudi Arabia.

Keywords: e-government, e-participation, social media, trust, social influence and social identity

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31532 Alpha Lipoic Acid: An Antioxidant for Infertility

Authors: Chiara Di Tucci, Giulia Galati, Giulia Mattei, Valentina Bonanni, Oriana Capri, Renzo D'Amelio, Ludovico Muzii, Pierluigi Benedetti Panici

Abstract:

Objective: Infertility is an increasingly frequent health condition, which may depend on female or male factors. Oxidative stress (OS), resulting from a disrupted balance between reactive oxygen species (ROS) and protective antioxidants, affects the reproductive lifespan of men and women. In this review, we examine if alpha lipoic acid (ALA), among the oral supplements currently in use, has an evidence-based beneficial role in the context of female and male infertility. Methods: We performed a search from English literature using the PubMed database with the following keywords: 'female infertility', 'male infertility', 'semen', 'sperm', 'sub-fertile man', 'alpha-lipoic acid', ' alpha lipoic acid', 'lipoid acid', 'endometriosis', 'chronic pelvic pain', 'follicular fluid' and 'oocytes'. We included clinical trials, multicentric studies, and reviews. The total number of references found after automatically and manually excluding duplicates was 180. After the primary and secondary screening, 28 articles were selected. Results: The available literature demonstrates the positive effects of ALA in multiple processes, from oocyte maturation (0.87 ± 0.9% of oocyte in MII vs 0.81 ± 3.9%; p < .05) to fertilization, embryo development (57.7% vs 75.7% grade 1 embryo; p < .05) and reproductive outcomes. Its regular administration both in sub-fertile women and men has been shown to reduce pelvic pain in endometriosis (p < .05), regularize menstrual flow and metabolic disorders (p < .01), and improve sperm quality (p < .001). Conclusions: ALA represents a promising new molecule in the field of couple infertility. More clinical studies are needed in order to enhance its use in clinical practice.

Keywords: alpha lipoic acid, endometriosis, infertility, male factor, polycystic ovary syndrome

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31531 Rupture in the Paradigm of the International Policy of Illicit Drugs in the Field of Public Health and within the Framework of the World Health Organization, 2001 to 2016

Authors: Emy Nayana Pinto, Denise Bomtempo Birche De Carvalho

Abstract:

In the present study, the harmful use of illicit drugs is seen as a public health problem and as one of the expressions of the social question, since its consequences fall mainly on the poorer classes of the population. This perspective is a counterpoint to the dominant paradigm on illicit drug policy at the global level, whose centrality lies within the criminal justice arena. The 'drug problem' is internationally combated through fragmented approaches that focus its actions on banning and criminalizing users. In this sense, the research seeks to answer the following key questions: What are the influences of the prohibitionism in the recommendations of the United Nations (UN), the World Health Organization (WHO), and the formulation of drug policies in member countries? What are the actors that have been provoking the prospect of breaking with the prohibitionist paradigm? What is the WHO contribution to the rupture with the prohibitionist paradigm and the displacement of the drug problem in the field of public health? The general objective of this work is to seek evidence from the perspective of rupture with the prohibitionist paradigm in the field of drugs policies at the global and regional level, through analysis of documents of the World Health Organization (WHO), between the years of 2001 to 2016. The research was carried out in bibliographical and documentary sources. The bibliographic sources contributed to the approach with the object and the theoretical basis of the research. The documentary sources served to answer the research questions and evidence the existence of the perspective of change in drug policy. Twenty-two documents of the UN system were consulted, of which fifteen had the contribution of the World Health Organization (WHO). In addition to the documents that directly relate to the subject of the research, documents from various agencies, programs, and offices, such as the Joint United Nations Program on HIV/AIDS (UNAIDS) and the United Nations Office on Drugs and Crime (UNODC), which also has drugs as the central or transversal theme of its performance. The results showed that from the 2000s it was possible to find in the literature review and in the documentary analysis evidence of the critique of the prohibitionist paradigm parallel to the construction of a new perspective for drug policy at the global level and the displacement of criminal justice approaches for the scope of public health, with the adoption of alternative and pragmatic interventions based on human rights, scientific evidence and the reduction of social damages and health by the misuse of illicit drugs.

Keywords: illicit drugs, international organizations, prohibitionism, public health, World Health Organization

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31530 Engineered Biopolymers as Novel Sustainable Resin Binder for Wood Composites

Authors: Somaieh Salehpour, Douglas Ireland, Chris Anderson, Charles Markessini

Abstract:

Over the last few years, advancements have been made around improving sustainability for wood composite boards. One of the last and most challenging sustainability hurdles is finding a viable alternative to petroleum-based resin binders. In today’s market, no longer is formaldehyde emission control sufficient to meet the requirements of many architects and end-use consumers. Even the use of highly reactive isocyanates is considered by many as not sustainable enough since these chemicals are manufactured from classical fossil fuel sources. The emergence of biopolymers specifically engineered for usage as wood composite binders has been successfully demonstrated in this paper as a viable option towards a truly renewable wood composite board. Recent technology advancements driven by EcoSynthetix and CHIMAR have exploited the advantages of using an engineered biopolymer. The evidence shows that this renewable technology has the potential to be used as a partial up to full replacement of classical formaldehyde technologies. Numerous trials, both in the lab and at industrial scale, have shown that a renewable binder of the proposed technology can produce a commercially viable board in a traditional industrial setting. The ultimate goal of this work is to provide evidence that a sustainable binder alternative can be used to make a commercial board while at the same time improving the total cost of manufacturing.

Keywords: no added formaldehyde, renewable, biopolymers, sustainable wood composites, engineered biopolymers

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31529 Impact of Primary Care Telemedicine Consultations On Health Care Resource Utilisation: A Systematic Review

Authors: Anastasia Constantinou, Stephen Morris

Abstract:

Background: The adoption of synchronous and asynchronous telemedicine modalities for primary care consultations has exponentially increased since the COVID-19 pandemic. However, there is limited understanding of how virtual consultations influence healthcare resource utilization and other quality measures including safety, timeliness, efficiency, patient and provider satisfaction, cost-effectiveness and environmental impact. Aim: Quantify the rate of follow-up visits, emergency department visits, hospitalizations, request for investigations and prescriptions and comment on the effect on different quality measures associated with different telemedicine modalities used for primary care services and primary care referrals to secondary care Design and setting: Systematic review in primary care Methods: A systematic search was carried out across three databases (Medline, PubMed and Scopus) between August and November 2023, using terms related to telemedicine, general practice, electronic referrals, follow-up, use and efficiency and supported by citation searching. This was followed by screening according to pre-defined criteria, data extraction and critical appraisal. Narrative synthesis and metanalysis of quantitative data was used to summarize findings. Results: The search identified 2230 studies; 50 studies are included in this review. There was a prevalence of asynchronous modalities in both primary care services (68%) and referrals from primary care to secondary care (83%), and most of the study participants were females (63.3%), with mean age of 48.2. The average follow-up for virtual consultations in primary care was 28.4% (eVisits: 36.8%, secure messages 18.7%, videoconference 23.5%) with no significant difference between them or F2F consultations. There was an average annual reduction of primary care visits by 0.09/patient, an increase in telephone visits by 0.20/patient, an increase in ED encounters by 0.011/patient, an increase in hospitalizations by 0.02/patient and an increase in out of hours visits by 0.019/patient. Laboratory testing was requested on average for 10.9% of telemedicine patients, imaging or procedures for 5.6% and prescriptions for 58.7% of patients. When looking at referrals to secondary care, on average 36.7% of virtual referrals required follow-up visit, with the average rate of follow-up for electronic referrals being higher than for videoconferencing (39.2% vs 23%, p=0.167). Technical failures were reported on average for 1.4% of virtual consultations to primary care. When using carbon footprint estimates, we calculate that the use of telemedicine in primary care services can potentially provide a net decrease in carbon footprint by 0.592kgCO2/patient/year. When follow-up rates are taken into account, we estimate that virtual consultations reduce carbon footprint for primary care services by 2.3 times, and for secondary care referrals by 2.2 times. No major concerns regarding quality of care, or patient satisfaction were identified. 5/7 studies that addressed cost-effectiveness, reported increased savings. Conclusions: Telemedicine provides quality, cost-effective, and environmentally sustainable care for patients in primary care with inconclusive evidence regarding the rates of subsequent healthcare utilization. The evidence is limited by heterogeneous, small-scale studies and lack of prospective comparative studies. Further research to identify the most appropriate telemedicine modality for different patient populations, clinical presentations, service provision (e.g. used to follow-up patients instead of initial diagnosis) as well as further education for patients and providers alike on how to make best use of this service is expected to improve outcomes and influence practice.

Keywords: telemedicine, healthcare utilisation, digital interventions, environmental impact, sustainable healthcare

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31528 Predicting Root Cause of a Fire Incident through Transient Simulation

Authors: Mira Ezora Zainal Abidin, Siti Fauzuna Othman, Zalina Harun, M. Hafiz M. Pikri

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In a fire incident involving a Nitrogen storage tank that over-pressured and exploded, resulting in a fire in one of the units in a refinery, lack of data and evidence hampered the investigation to determine the root cause. Instrumentation and fittings were destroyed in the fire. To make it worst, this incident occurred during the COVID-19 pandemic, making collecting and testing evidence delayed. In addition to that, the storage tank belonged to a third-party company which requires legal agreement prior to the refinery getting approval to test the remains. Despite all that, the investigation had to be carried out with stakeholders demanding answers. The investigation team had to devise alternative means to support whatever little evidence came out as the most probable root cause. International standards, practices, and previous incidents on similar tanks were referred. To narrow down to just one root cause from 8 possible causes, transient simulations were conducted to simulate the overpressure scenarios to prove and eliminate the other causes, leaving one root cause. This paper shares the methodology used and details how transient simulations were applied to help solve this. The experience and lessons learned gained from the event investigation and from numerous case studies via transient analysis in finding the root cause of the accident leads to the formulation of future mitigations and design modifications aiming at preventing such incidents or at least minimize the consequences from the fire incident.

Keywords: fire, transient, simulation, relief

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31527 Chaupadi Practice: A Cruel Discrimination against Women a Case Study of Achham District of Nepal

Authors: Santosh Thapa, Sankar Gurung

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Chaupadi is a tradition widely practiced in the far and mid-western region of Nepal. It is a practice where girls and women are not allowed to inter the house and touch the food, water and milk during their menstruation period of 4-7 days. They have to spend all the nights during the period in a specific hut (Chhaupadi Goth) which is a bit far from their residence where they faces various kinds of risk and violence like bullying, snakes and insect bite, wild animal attack etc. Sometimes the girls even do not go to school during their menstruation periods. After childbirth, the woman must stay in a cow shed for 11 days in such Chhaupadi practiced areas. This study limits the Achham district of the far western region which is the most vulnerable Chhaupadi practicing district. Several governmental and non-governmental organizations have been involving and spending huge amount of money for capacity building and awareness raising campaign for last 2 decades but still 9 out of 75 Village Development Committees (VDCs) have been partially practicing Chaupadi in the district. This study shows that the school attendance rate of the girls during the period have visibly increased which helps to increase the number of the girl graduation as well. Similarly, the practice of Chhaupadi is one of the reasons for increasing the number of cases of uterus prolapsus and poor reproductive health of women and girls. Triggering tools are the one of the best ways to accelerate the awareness campaign in the VDCs. This study recommends that the local bodies should coordinate and lead the overall awareness campaign program to sustain the Chaupadi free VDCs.

Keywords: awareness campaign, chaupadi practice, gender discrimination, violence

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31526 COVID-19 Laws and Policy: The Use of Policy Surveillance For Better Legal Preparedness

Authors: Francesca Nardi, Kashish Aneja, Katherine Ginsbach

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The COVID-19 pandemic has demonstrated both a need for evidence-based and rights-based public health policy and how challenging it can be to make effective decisions with limited information, evidence, and data. The O’Neill Institute, in conjunction with several partners, has been working since the beginning of the pandemic to collect, analyze, and distribute critical data on public health policies enacted in response to COVID-19 around the world in the COVID-19 Law Lab. Well-designed laws and policies can help build strong health systems, implement necessary measures to combat viral transmission, enforce actions that promote public health and safety for everyone, and on the individual level have a direct impact on health outcomes. Poorly designed laws and policies, on the other hand, can fail to achieve the intended results and/or obstruct the realization of fundamental human rights, further disease spread, or cause unintended collateral harms. When done properly, laws can provide the foundation that brings clarity to complexity, embrace nuance, and identifies gaps of uncertainty. However, laws can also shape the societal factors that make disease possible. Law is inseparable from the rest of society, and COVID-19 has exposed just how much laws and policies intersects all facets of society. In the COVID-19 context, evidence-based and well-informed law and policy decisions—made at the right time and in the right place—can and have meant the difference between life or death for many. Having a solid evidentiary base of legal information can promote the understanding of what works well and where, and it can drive resources and action to where they are needed most. We know that legal mechanisms can enable nations to reduce inequities and prepare for emerging threats, like novel pathogens that result in deadly disease outbreaks or antibiotic resistance. The collection and analysis of data on these legal mechanisms is a critical step towards ensuring that legal interventions and legal landscapes are effectively incorporated into more traditional kinds of health science data analyses. The COVID-19 Law Labs see a unique opportunity to collect and analyze this kind of non-traditional data to inform policy using laws and policies from across the globe and across diseases. This global view is critical to assessing the efficacy of policies in a wide range of cultural, economic, and demographic circumstances. The COVID-19 Law Lab is not just a collection of legal texts relating to COVID-19; it is a dataset of concise and actionable legal information that can be used by health researchers, social scientists, academics, human rights advocates, law and policymakers, government decision-makers, and others for cross-disciplinary quantitative and qualitative analysis to identify best practices from this outbreak, and previous ones, to be better prepared for potential future public health events.

Keywords: public health law, surveillance, policy, legal, data

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31525 An Analysis of Institutional Environments on Corporate Social Responsibility Practices in Nigerian Renewable Energy Firms

Authors: Bolanle Deborah Motilewa, E. K. Rowland Worlu, Gbenga Mayowa Agboola, Ayodele Maxwell Olokundun

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Several studies have proposed a one-size fit all approach to Corporate Social Responsibility (CSR) practices, such that CSR as it applies to developed countries is adapted to developing countries, ignoring the differing institutional environments (such as the regulative, economic, social and political environments), which affects the profitability and practices of businesses operating in them. CSR as it applies to filling institutional gaps in developing countries, was categorized into four themes: environmental protection, product and service innovation, social innovation and local cluster development. Based on the four themes, the study employed a qualitative research approach through the use of interviews and review of available publications to study the influence of institutional environments on CSR practices engaged in by three renewable energy firms operating in Nigeria. Over the course of three 60-minutes sessions with the top management and selected workers of the firms, four propositions were made: regulatory environment influences environmental protection practice of Nigerian renewable firms, economic environment influences product and service innovation practice of Nigerian renewable energy firms, the social environment impacts on social innovation in Nigerian renewable energy firms, and political environment affects local cluster development practice of Nigerian renewable energy firms. It was also observed that beyond institutional environments, the international exposure of an organization’s managers reflected in their approach to CSR. This finding on the influence of international exposure on CSR practices creates an area for further study. Insights from this paper are set to help policy makers in developing countries, CSR managers, and future researchers.

Keywords: corporate social responsibility, renewable energy firms, institutional environment, social entrepreneurship

Procedia PDF Downloads 271