Search results for: holistic healthcare
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2202

Search results for: holistic healthcare

1392 Classifying Facial Expressions Based on a Motion Local Appearance Approach

Authors: Fabiola M. Villalobos-Castaldi, Nicolás C. Kemper, Esther Rojas-Krugger, Laura G. Ramírez-Sánchez

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This paper presents the classification results about exploring the combination of a motion based approach with a local appearance method to describe the facial motion caused by the muscle contractions and expansions that are presented in facial expressions. The proposed feature extraction method take advantage of the knowledge related to which parts of the face reflects the highest deformations, so we selected 4 specific facial regions at which the appearance descriptor were applied. The most common used approaches for feature extraction are the holistic and the local strategies. In this work we present the results of using a local appearance approach estimating the correlation coefficient to the 4 corresponding landmark-localized facial templates of the expression face related to the neutral face. The results let us to probe how the proposed motion estimation scheme based on the local appearance correlation computation can simply and intuitively measure the motion parameters for some of the most relevant facial regions and how these parameters can be used to recognize facial expressions automatically.

Keywords: facial expression recognition system, feature extraction, local-appearance method, motion-based approach

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1391 Improving Collective Health and Social Care through a Better Consideration of Sex and Gender: Analytical Report by the French National Authority for Health

Authors: Thomas Suarez, Anne-Sophie Grenouilleau, Erwan Autin, Alexandre Biosse-Duplan, Emmanuelle Blondet, Laurence Chazalette, Marie Coniel, Agnes Dessaigne, Sylvie Lascols, Andrea Lasserre, Candice Legris, Pierre Liot, Aline Metais, Karine Petitprez, Christophe Varlet, Christian Saout

Abstract:

Background: The role of biological sex and gender identity -whether assigned or chosen- as health determinants are far from a recent discovery: several reports have stressed out how being a woman or a man could affect health on various scales. However, taking it into consideration beyond stereotypes and rigid binary assumptions still seems to be a work in progress. Method: The report is a synthesis on a variety of specific topics, each of which was studied by a specialist from the French National Authority for Health (HAS), through an analysis of existing literature on both healthcare policy construction process and instruments (norms, data analysis, clinical trials, guidelines, and professional practices). This work also implied a policy analysis of French recent public health laws and a retrospective study of guidelines with a gender mainstreaming approach. Results: The analysis showed that though sex and gender were well-known determinants of health, their consideration by both public policy and health operators was often incomplete, as it does not incorporate how sex and gender interact, as well as how they interact with other factors. As a result, the health and social care systems and their professionals tend to reproduce some stereotypical and inadequate habits. Though the data available often allows to take sex and gender into consideration, such data is often underused in practice guidelines and policy formulation. Another consequence is a lack of inclusiveness towards transgender or intersex persons. Conclusions: This report first urges for raising awareness of all the actors of health, in its broadest definition, that sex and gender matter beyond first-look conclusions. It makes a series of recommendations in order to reshape policy construction in the health sector on the one hand and to design public health instruments to make them more inclusive regarding sex and gender on the other hand. The HAS finally committed to integrate sex and gender preoccupations in its workings methods, to be a driving force in the spread of these concerns.

Keywords: biological sex, determinants of health, gender, healthcare policy instruments, social accompaniment

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1390 Adopting Quality Assurance Cycles in Accreditation and Strategic Planning in Higher Education Institutions

Authors: Fouzia Shersad, Sabeena Salam

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Introduction: Quality assurance cycles like RADAR, PDCA, ADRI are cycles of planning, implementation, assessment and improvement. These cycles are required when institutions apply for reaccreditation to accreditation bodies and for adoption of holistic models of institutional quality. Method of Study: The adoption of these cycles at the higher education institutions under the Dubai Medical University is studied to explore the feasibility and the benefits in institutions outcomes. After adequate faculty training, these steps were incorporated in all new activities and embedded in every new initiative and approach undertaken at unit and institutional levels. Conclusions: Improvement in student satisfaction rates and performance levels has been achieved. Wherever weaknesses or deficits have been identified, improvement strategies are implemented in a timely manner. The feedback has become an incentive for faculty members to implement new ideas. Implementation of these cycles for core processes at micro and macro levels have ensured that a systematic mechanism for corrective actions existed. This has led to increasing adoption of innovative initiatives. Another outcome was the recognition through national level awards for the overall institutions which have been certified by external reviewers.

Keywords: higher education, quality, accreditation, institutional improvement

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1389 Mindfulness Meditation in Higher Education

Authors: Steve Haberlin

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United States college students are experiencing record-high stress and anxiety rates, and due to technological advances, there are more distractions in the classroom. With these challenges comes the need to explore additional, non-traditional pedagogical strategies that can help students de-stress, become centered, and feel more deeply connected to content. In addition, embedding contemplative practices, such as mindfulness meditation, in the higher education classroom could assist faculty in presenting a more holistic education that encourages students to develop self-awareness, emotional intelligence, compassion, interconnectedness, and other “non-academic” qualities. Brief meditation may help students de-stress, focus, and connect. A facilitation guide could also help faculty implement classroom meditation practices; however, additional research is needed to determine how to best train faculty, what meditation techniques work best with students, and how to handle resistance. In this paper, a two-phase study is presented that involves a mindfulness meditation intervention with 180 undergraduate students at a private college in the southeastern United States. Data were collected through qualitative surveys and journaling and analyzed for themes. Findings included a majority of students reporting improved calm, reduced stress, and increased focus and ability to transition to classroom instruction.

Keywords: college students, higher education, mindfulness meditation, stress

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1388 Access to Inclusive and Culturally Sensitive Mental Healthcare in Pharmacy Students and Residents

Authors: Esha Thakkar, Ina Liu, Kalynn Hosea, Shana Katz, Katie Marks, Sarah Hall, Cat Liu, Suzanne Harris

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Purpose: Inequities in mental healthcare accessibility are cited as an international public health concern by the World Health Organization (WHO) and National Alliance on Mental Illness (NAMI). These disparities are further exacerbated in racial and ethnic minority groups and are especially concerning in health professional training settings such as Doctor of Pharmacy (PharmD) programs and postgraduate residency training where mental illness rates are high. The purpose of the study was to determine baseline access to culturally sensitive mental healthcare and how to improve such access and communication for racially and ethnically minoritized pharmacy students and residents at one school of pharmacy and a partnering academic medical center in the United States. Methods: This IRB-exempt study included 60-minute focus groups conducted in person or online from November 2021 to February 2022. Eligible participants included PharmD students in their first (P1), second (P2), third (P3), or fourth year (P4) or pharmacy residents completing a postgraduate year 1 (PGY1) or PGY2 who identify as Black, Indigenous, or Person of Color (BIPOC). There were four core theme questions asked during the focus groups to lead the discussion, specifically on the core themes of personal barriers, identities, areas that are working well, and areas for improvement. Participant responses were transcribed and analyzed using an open coding system with two individual reviews, followed by collaborative and intentional discussion and, as needed, an external audit of the coding by a third research team member to reach a consensus on themes. Results: This study enrolled 26 participants, with eight P1, five P2, seven P3, two P4, and four resident participants. Within the four core themes of barriers, identities, areas working well, and areas for improvement, emerging subthemes included: lack of time, access to resources, and stigma under barriers; lack of representation, cultural and family stigma, and gender identities for identity barriers; supportive faculty, sense of community and culture supporting paid time off for areas going well; and wellness days, reduced workload and diversity of the workforce in areas of improvement. Subthemes sometimes varied within a core theme depending on the participant year. Conclusions: There is a gap in the literature in addressing barriers and disparities in mental health access for pharmacy trainees who identify as BIPOC. We identified key findings in regards to barriers, identities, areas going well and areas for improvement that can inform the School and the Residency Program in two priority initiatives of well-being and diversity equity and inclusion in creating actionable recommendations for trainees, program directors, and employers of our institutions, and also has the potential to provide insight for other organizations about the structures influencing access to culturally sensitive care in BIPOC trainees. These findings can inform organizations on how to continue building on communication with those who identify as BIPOC and improve access to care.

Keywords: mental health, disparities, minorities, wellbeing, identity, communication, barriers

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1387 An Analytical View of Albanian and French Legislation on Access to Health Care Benefits

Authors: Oljana Hoxhaj

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The integration process of Albania into the European family carries many difficulties. In this context, the Albanian legislator is inclined to implement in the domestic legal framework models which have been successful in other countries. Our paper aims to present an analytical and comparative approach to the health system in Albania and France, mainly focusing on citizen’s access to these services. Different standards and cultures between states, in the context of an approximate model, will be the first challenge of our paper. Over the last few years, the Albanian government has undertaken concrete reforms in this sector, aiming to transform the vision on which the previous health system was structured. In this perspective, the state fulfills not only an obligation to its citizens, but also consolidates progressive steps toward alignment with European Union standards. The necessity to undertake a genuine reform in this area has come as an exigency of society, which has permanently identified problems within this sector, considering it ineffective, out of standards, and corrupt. The inclusion of health services on the Albanian government agenda reflects its will in the function of good governance, transparency, and broadening access to the provision of quality health services in the public and private sectors. The success of any initiative in the health system consists of giving priority to patient needs. Another objective that should be in the state's consideration is to create the premise to provide a comprehensive process on whose foundations partnership and broader co-operation with beneficiary entities are established in any decision-making that is directly related to their interests. Some other important and widespread impacts on the effective realization of citizens' access to the healthcare system coincide with the construction of appropriate infrastructure, increasing the professionalism and qualification of medical staff, and the allocation of a higher budget. France has one of the most effective healthcare models in Europe. That is why we have chosen to analyze this country, aiming to highlight the advantages of this system, as well as the commitment of the French state to drafting effective health policies. In the framework of the process of harmonization of the Albanian legislation with that of the European Union, through our work, we aim to identify the space to implement the whole of these legislative innovations in the Albanian legislation.

Keywords: effective service, harmonization level, innovation, reform

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1386 The Exploration of Preschool Teachers' Understanding of the Role of Socio-Emotional Development in School Readiness

Authors: A. Pedro, T. Goldschmidt

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Socio-emotional development is considered to be an essential prerequisite for school readiness. To our best knowledge, research on socio-emotional development specifically from the views of teachers in the South African context is limited. This study explored preschool teachers’ understanding of the role that socio-emotional development plays in preparing the child for school. Using the social learning theory, a qualitative approach with an exploratory design was used for the study. A total of 12 preschool teachers from both community-based and school-based preschools were purposively recruited. Upon receiving ethics clearance from the University of the Western Cape and the Western Cape Education Department, semi-structured interviews were conducted and analysed by utilizing Braun and Clarke’s (2006) six phases of thematic analysis. Participants’ rights, anonymity, and confidentiality were upheld throughout the research process. Findings reveal that preschool teachers emphasise the importance of holistic development for school readiness. Teachers deemed socio-emotional development as absolutely crucial for preparing children for school as it eases the transition to formal schooling and adaptation to the classroom environment.

Keywords: early childhood, preschool teachers, school readiness, socio-emotional development

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1385 Subjective Time as a Marker of the Present Consciousness

Authors: Anastasiya Paltarzhitskaya

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Subjective time plays an important role in consciousness processes and self-awareness at the moment. The concept of intrinsic neural timescales (INT) explains the difference in perceiving various time intervals. The capacity to experience the present builds on the fundamental properties of temporal cognition. The challenge that both philosophy and neuroscience try to answer is how the brain differentiates the present from the past and future. In our work, we analyze papers which describe mechanisms involved in the perception of ‘present’ and ‘non-present’, i.e., future and past moments. Taking into account that we perceive time intervals even during rest or relaxation, we suppose that the default-mode network activity can code time features, including the present moment. We can compare some results of time perceptual studies, where brain activity was shown in states with different flows of time, including resting states and during “mental time travel”. According to the concept of mental traveling, we employ a range of scenarios which demand episodic memory. However, some papers show that the hippocampal region does not activate during time traveling. It is a controversial result that is further complicated by the phenomenological aspect that includes a holistic set of information about the individual’s past and future.

Keywords: temporal consciousness, time perception, memory, present

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1384 Mapping Context, Roles, and Relations for Adjudicating Robot Ethics

Authors: Adam J. Bowen

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Abstract— Should robots have rights or legal protections. Often debates concerning whether robots and AI should be afforded rights focus on conditions of personhood and the possibility of future advanced forms of AI satisfying particular intrinsic cognitive and moral attributes of rights-holding persons. Such discussions raise compelling questions about machine consciousness, autonomy, and value alignment with human interests. Although these are important theoretical concerns, especially from a future design perspective, they provide limited guidance for addressing the moral and legal standing of current and near-term AI that operate well below the cognitive and moral agency of human persons. Robots and AI are already being pressed into service in a wide range of roles, especially in healthcare and biomedical contexts. The design and large-scale implementation of robots in the context of core societal institutions like healthcare systems continues to rapidly develop. For example, we bring them into our homes, hospitals, and other care facilities to assist in care for the sick, disabled, elderly, children, or otherwise vulnerable persons. We enlist surgical robotic systems in precision tasks, albeit still human-in-the-loop technology controlled by surgeons. We also entrust them with social roles involving companionship and even assisting in intimate caregiving tasks (e.g., bathing, feeding, turning, medicine administration, monitoring, transporting). There have been advances to enable severely disabled persons to use robots to feed themselves or pilot robot avatars to work in service industries. As the applications for near-term AI increase and the roles of robots in restructuring our biomedical practices expand, we face pressing questions about the normative implications of human-robot interactions and collaborations in our collective worldmaking, as well as the moral and legal status of robots. This paper argues that robots operating in public and private spaces be afforded some protections as either moral patients or legal agents to establish prohibitions on robot abuse, misuse, and mistreatment. We already implement robots and embed them in our practices and institutions, which generates a host of human-to-machine and machine-to-machine relationships. As we interact with machines, whether in service contexts, medical assistance, or home health companions, these robots are first encountered in relationship to us and our respective roles in the encounter (e.g., surgeon, physical or occupational therapist, recipient of care, patient’s family, healthcare professional, stakeholder). This proposal aims to outline a framework for establishing limiting factors and determining the extent of moral or legal protections for robots. In doing so, it advocates for a relational approach that emphasizes the priority of mapping the complex contextually sensitive roles played and the relations in which humans and robots stand to guide policy determinations by relevant institutions and authorities. The relational approach must also be technically informed by the intended uses of the biomedical technologies in question, Design History Files, extensive risk assessments and hazard analyses, as well as use case social impact assessments.

Keywords: biomedical robots, robot ethics, robot laws, human-robot interaction

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1383 Farmers’ Perceptions of Extension Personnel’s Technical Capabilities: Evidence from India

Authors: Ankit Nagar, Dinesh Kumar Nauriyal, S. P. Singh

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This paper examines farmers' perceptions of the efficacy of extension services in equipping them with the necessary information and skills required to maximise agricultural productivity. It is based on primary data collected through an interview schedule in India's Western Uttar Pradesh region. It uses descriptive statistics, factor analysis, and MANOVA to determine the typical farmer's view of an extension worker's technical prowess and behavioural traits, as well as the key factors associated with farmers' perception and the demographic characteristics that affect farmer's perception variations. The vast majority of farmers appear to consider extension personnel's efficiency and accessibility unfavourably. Farmers feel that extension personnel are well-trained notwithstanding their disagreements on the viability of their technical advice. Small and marginal farmers view the effectiveness, objectivity, and cooperativeness of extension agents less favourably than large farmers. This study proposes strategies such as routine follow-ups, practical demonstrations, and regular extension professional training camps as part of a holistic plan to increase farmer trust in the agricultural extension system. In addition, it proposes ensuring their accountability.

Keywords: agriculture extension, farmers’ perception, extension agents, factor analysis

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1382 Adult-Child Relationships: Nurturing Development and Well-Being

Authors: Obafemi Richard Jegede

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The relationship between adults and children is pivotal for the social, emotional, and cognitive development of the latter. This paper explores the multifaceted dynamics of adult-child relationships, emphasizing their significance in fostering positive outcomes for children's well-being. It delves into dimensions such as attachment, communication, and parenting styles, addressing their impact on children's mental health and development. Furthermore, the role of supportive environments and interventions in enhancing adult-child relationships is examined. Understanding the complexities of these relationships is crucial for promoting healthy and nurturing interactions that contribute to children's holistic development. Positive interactions with caring adults promote children's self-regulation, empathy, and resilience, while negative or inconsistent relationships can lead to emotional distress and impaired social skills. Creating supportive environments that prioritize positive adult-child relationships is essential for promoting children's well-being. By comprehensively understanding the factors that shape adult-child relationships, we can better support children's development and well-being. This paper aims to provide insights into the complexities of adult-child relationships and their profound impact on children's development and overall well-being.

Keywords: impact on children's development, supportive environments and interventions, parenting style, communication between adult and children

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1381 Factors Motivating Experienced Secondary Teachers to Remain in the Teaching Profession

Authors: Joselito Castro Gutierrez, Herbert Orteza, Jervie Boligon, Kenneth Esteves, Edrick Kevin Ferrer, Mark Kevin Torres, Patrick Vergara

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Teaching is a noble profession that involves an effective imparting of holistic learning. Consequently, it requires a driving force called motivation. This research aims to determine the motivating factors, problems encountered, solutions made by experienced secondary school teachers to remain in the teaching profession. A mixed unstructured/structured questionnaire was used for gathering data among public secondary school teachers. The researchers have arrived to a conclusion that the dominant motivating factors of teachers to stay in the profession are altruism, extrinsic factors, and self-efficacy. Meanwhile, the prevalent problems these experienced secondary teachers experienced are mutual dilemma, work overload, and personal issues. Teachers have varied methods on solving the problem which are: a) Direct Solution; b) Indirect Solution; and c) Pseudo-Solutions. Lastly, the factors, problems, and solutions, have influential effects on how long a teacher would sustain in teaching which would manifest as positive, negative and neutral effects.

Keywords: motivation, common problems of teachers, strategies in solving problems, teaching profession

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1380 The Internal View of the Mu'min: Natural Law Theories in Islam

Authors: Gianni Izzo

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The relation of Islam to its legal precepts, reflected in the various jurisprudential 'schools of thought' (madhahib), is one expressed in a version of 'positivism' (fiqh) providing the primary theory for deducing Qurʾan rulings and those from the narrations (hadith) of the Prophet Muhammad. Scholars of Islam, including Patricia Crone (2004) and others chronicled by Anver Emon (2005), deny the influence of natural law theories as extra-scriptural indices of revelation’s content. This paper seeks to dispute these claims by reference to historical and canonical examples within Shiʿa legal thought that emphasize the salient roles of ‘aql (reason), fitrah (primordial human nature), and lutf (divine grace). These three holistic features, congenital to every human, and theophanically reflected in nature make up a mode of moral intelligibility antecedent to prophetic revelation. The debate between the 'traditionalist' Akhbaris and 'rationalist' Usulis over the nature of deriving legal edicts in Islam is well-covered academic ground. Instead, an attempt is made to define and detail the built-in assumptions of natural law revealed in the jurisprudential summa of Imami Shiʿism, whether of either dominant school, that undergird its legal prescriptions and methods of deduction.

Keywords: Islam, fiqh, natural law, legal positivism, aql

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1379 Survey of the Role of Contextualism in the Designing of Cultural Constructions Based on Rapoport Views

Authors: E. Zarei, M. Bazaei, A. Seifi, A. Keshavarzi

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Amos Rapoport, based on his anthropology approach, believed that the space origins from the human body and influences on human body mutually. As a holistic approach in architecture, Contextualism describes a collection of views in philosophy which emphasize the context in which an action, utterance, or expression occurs, and argues that, in some important respect, the action, utterance, or expression can only be understood relative to that context. In this approach, the main goal – studying the role of cultural component in the Contextualism construction shaping up, based on Amos Rapoport’s anthropology approach- has being done by descriptive- analytic method. The results of the research indicate that in the field of Contextualism designing, referring to the cultural aspects are as necessary as the physical dimensions of a construction. Rapoport believes that the shape of a construction is influenced by cultural aspects and he suggests a kind of mutual interaction between human and environment that should be considered in housing. The mail goal of contextual architecture is to establish an interaction between environment, human and culture. According to this approach, a desirable design should be in harmony with this approach.

Keywords: Amos Rapoport, anthropology, contextual architecture, culture

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1378 Risk Based Building Information Modeling (BIM) for Urban Infrastructure Transportation Project

Authors: Debasis Sarkar

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Building Information Modeling (BIM) is a holistic documentation process for operational visualization, design coordination, estimation and project scheduling. BIM software defines objects parametrically and it is a tool for virtual reality. Primary advantage of implementing BIM is the visual coordination of the building structure and systems such as Mechanical, Electrical and Plumbing (MEP) and it also identifies the possible conflicts between the building systems. This paper is an attempt to develop a risk based BIM model which would highlight the primary advantages of application of BIM pertaining to urban infrastructure transportation project. It has been observed that about 40% of the Architecture, Engineering and Construction (AEC) companies use BIM but primarily for their outsourced projects. Also, 65% of the respondents agree that BIM would be used quiet strongly for future construction projects in India. The 3D models developed with Revit 2015 software would reduce co-ordination problems amongst the architects, structural engineers, contractors and building service providers (MEP). Integration of risk management along with BIM would provide enhanced co-ordination, collaboration and high probability of successful completion of the complex infrastructure transportation project within stipulated time and cost frame.

Keywords: building information modeling (BIM), infrastructure transportation, project risk management, underground metro rail

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1377 Handy EKG: Low-Cost ECG For Primary Care Screening In Developing Countries

Authors: Jhiamluka Zservando Solano Velasquez, Raul Palma, Alejandro Calderon, Servio Paguada, Erick Marin, Kellyn Funes, Hana Sandoval, Oscar Hernandez

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Background: Screening cardiac conditions in primary care in developing countries can be challenging, and Honduras is not the exception. One of the main limitations is the underfunding of the Healthcare System in general, causing conventional ECG acquisition to become a secondary priority. Objective: Development of a low-cost ECG to improve screening of arrhythmias in primary care and communication with a specialist in secondary and tertiary care. Methods: Design a portable, pocket-size low-cost 3 lead ECG (Handy EKG). The device is autonomous and has Wi-Fi/Bluetooth connectivity options. A mobile app was designed which can access online servers with machine learning, a subset of artificial intelligence to learn from the data and aid clinicians in their interpretation of readings. Additionally, the device would use the online servers to transfer patient’s data and readings to a specialist in secondary and tertiary care. 50 randomized patients volunteer to participate to test the device. The patients had no previous cardiac-related conditions, and readings were taken. One reading was performed with the conventional ECG and 3 readings with the Handy EKG using different lead positions. This project was possible thanks to the funding provided by the National Autonomous University of Honduras. Results: Preliminary results show that the Handy EKG performs readings of the cardiac activity similar to those of a conventional electrocardiograph in lead I, II, and III depending on the position of the leads at a lower cost. The wave and segment duration, amplitude, and morphology of the readings were similar to the conventional ECG, and interpretation was possible to conclude whether there was an arrhythmia or not. Two cases of prolonged PR segment were found in both ECG device readings. Conclusion: Using a Frugal innovation approach can allow lower income countries to develop innovative medical devices such as the Handy EKG to fulfill unmet needs at lower prices without compromising effectiveness, safety, and quality. The Handy EKG provides a solution for primary care screening at a much lower cost and allows for convenient storage of the readings in online servers where clinical data of patients can then be accessed remotely by Cardiology specialists.

Keywords: low-cost hardware, portable electrocardiograph, prototype, remote healthcare

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1376 Decoding Mental Disorders: The Value of Practical Experience in Perceptions of Autism Spectrum Disorder

Authors: Ryan Tehini

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The purpose of this paper is to explore the value of practical experience with Autism Spectrum Disorder (ASD) as a microcosm of mental disorders, in psychology students’ attempt to fully understand it in all of its intricacies. The study follows a one-year program where students of psychology volunteer at a school for Autistic children of ages 3-18. The individual levels of experience with, and theoretical understanding of, ASD varies measurably amongst the volunteers; these volunteers are then intermittently interviewed, observed and surveyed throughout the program in order to determine any decline or growth in their understanding of Autism Spectrum Disorder. A panel of professionals all of whom are active in the world of ASD (headmasters of Autistic schools, psychologists, child development specialists, special needs teachers, parents of autistic children and Occupational Therapists) were used specifically for this study, in order to develop the guideline for understanding ASD that will be used comparatively against the information gained from the volunteers in order to establish the individual results. The paper concludes by illustrating how psychology has a responsibility to the community to understand disorders past what is academic and theoretical, and how increasing student experience with a disorder can aid in a more holistic psychological approach to mental disorders in the future.

Keywords: autism, mental disorders, practical experience, psychology

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1375 Medical Student's Responses to Emotional Content in Doctor-Patient Communication: To Explore Differences in Communication Training of Medical Students and Its Impact on Doctor-Patient Communication

Authors: Stephanie Yun Yu Law

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Background: This study aims to investigate into communication between trainee doctors and patients, especially how doctor’s reaction to patient’s emotional issues expressed in the consultation affect patient’s satisfaction. Objectives: Thus, there are three aims in this study, 1.) how do trainee doctors react to patients emotional cues in OSCE station? 2.) Any differences in the respond type to emotional cues between first year students and third year students? 3.) Is response type (reducing space) related to OSCE outcome (patient satisfaction and expert rating)? Methods: Fifteen OSCE stations was videotaped, in which 9 were stations with first-year students and 6 were with third-year students. OSCE outcomes were measured by Communication Assessment Tool and Examiners Checklist. Analyses: All patient’s cues/concerns and student’s reaction were coded by Verona Coding Definitions of Emotional Sequence. Descriptive data was gathered from Observer XT and logistic regression (two-level) was carried out to see if occurrence of reducing space response can be predicted by OSCE outcomes. Results: Reducing space responses from all students were slightly less than a half in total responses to patient’s cues. The mean percentage of reducing space behaviours was lower among first year students when compared to third year students. Patient’s satisfaction significantly (p<0.05) and negatively predicted reducing space behaviours. Conclusions: Most of the medical students, to some extent, did not provide adequate responses for patient’s emotional cues. But first year students did provide more space for patients to talk about their emotional issues when compared to third year students. Lastly, patients would feel less satisfied if trainee doctors use more reducing space responses in reaction to patient’s expressed emotional cues/concerns. Practical implications: Firstly, medical training programme can be tailored on teaching students how to detect and respond appropriately to emotional cues in order to improve underperformed student’s communication skills in healthcare setting. Furthermore, trainee doctor’s relationship with patients in clinical practice can also be improved by reacting appropriately to patient’s emotive cues in consultations (such as limit the use of reducing space behaviours).

Keywords: doctors-patients communication, applied clinical psychology, health psychology, healthcare professionals

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1374 On the Combination of Patient-Generated Data with Data from a Secure Clinical Network Environment: A Practical Example

Authors: Jeroen S. de Bruin, Karin Schindler, Christian Schuh

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With increasingly more mobile health applications appearing due to the popularity of smartphones, the possibility arises that these data can be used to improve the medical diagnostic process, as well as the overall quality of healthcare, while at the same time lowering costs. However, as of yet there have been no reports of a successful combination of patient-generated data from smartphones with data from clinical routine. In this paper, we describe how these two types of data can be combined in a secure way without modification to hospital information systems, and how they can together be used in a medical expert system for automatic nutritional classification and triage.

Keywords: mobile health, data integration, expert systems, disease-related malnutrition

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1373 Multi-Criteria Decision-Making Evaluations for Oily Waste Management of Marine Oil Spill

Authors: Naznin Sultana Daisy, Mohammad Hesam Hafezi, Lei Liu

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Nowadays, oily solid waste management has become an important issue for many countries due to frequent oil spill accidents and the increase of industrial oily wastewater. The historical oil spill data show that marine oil spills that affect the shoreline can, in extreme cases, produce up to 30 or 40 times more waste than the volume of oil initially released. Hence, responsive authorities aim to develop the most effective oily waste management solution in a timely manner to manage and minimize the waste generated. In this study initially, we tried to develop the roadmap of oily waste management for three-tiered spill scenarios for Atlantic Canada. For that purpose, three oily waste disposal scenarios are evaluated via six criteria which are determined according to the opinions of the experts from the field. Consequently, through sustainable response strategies, the most appropriate and feasible scenario is determined. The results of this study will assist to develop an integrated oily waste management system for identifying the optimal waste-generation-allocation-disposal schemes and generating the optimal management alternatives based on the holistic consideration of environmental, technological, economic, social, and regulatory factors.

Keywords: oily waste management, marine oil spill, multi-criteria decision making, oil spill response

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1372 The Safe Introduction of Tocilizumab for the Treatment of SARS-CoV-2 Pneumonia at an East London District General Hospital

Authors: Andrew Read, Alice Parry, Kate Woods

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Since the advent of the SARS-CoV-2 pandemic, the search for medications that can reduce mortality and morbidity has been a global research priority. Several multi-center trials have recently demonstrated improved mortality associated with the use of Tocilizumab, an interleukin-6 receptor antagonist, in patients with severe SARS-CoV-2 pneumonia. Initial data supported the administration in patients requiring respiratory support (non-invasive or invasive ventilation), but more recent data has shown benefit in all hypoxic patients. At the height of the second wave of COVID-19 infections in London, our hospital introduced the use of Tocilizumab for patients with severe COVID-19. Tocilizumab is licensed for use in chronic inflammatory conditions and has been associated with an increased risk of severe bacterial and fungal infections, as well as reactivation of chronic viral infections (e.g., hepatitis B). It is a specialist drug that suppresses the formation of C-reactive protein (CRP) for 6 – 12 weeks. It is not widely used by the general medical community. We aimed to assess Tocilizumab use in our hospital and to implement changes to the protocol as required to ensure administration was safe and appropriate. A retrospective study design was used to assess prescriptions over an initial 3-week period in both intensive care and on the medical wards. This amounted to a total of 13 patients. The initial data collection identified four key areas of concern: adherence to national and local inclusion & exclusion criteria; a collection of appropriate screening blood prior to administration; documentation of informed consent or best interest decision and documentation of Tocilizumab administration on patient discharge information, to alert future healthcare providers that typical measures of inflammation and infection, such as CRP, are unreliable for up to 3-months. Data were collected from electronic notes, blood results and observation charts, and cross referenced with pharmacy data. Initial results showed that all four key areas were completed in approximately 50% of cases. Of particular concern was adherence to exclusion criteria, such as current evidence of bacterial infection, and ensuring the correct screening blood was sent to exclude infections such as hepatitis. To remedy this and improve patient safety, the initial data was presented to relevant healthcare professionals. Subsequently, three interventions were introduced and education on each provided to hospital staff. An electronic ‘order set’ collating the appropriate screening blood was created simplifying the screening process. Pre-formed electronic documentation which can be inserted into the notes was created to provide a framework for consent discussions and reduce the time needed for junior doctors to complete this task. Additionally, a ‘Tocilizumab’ administration card was created and administered via pharmacy. This was distributed to each patient on discharge to ensure future healthcare professionals were aware of the potential effects of Tocilizumab administration, including suppression of CRP. Following these changes, repeat data collection over two months illustrated that each of the 4 safety aspects was met with a 100% success rate in every patient. Although this demonstrates good progress and effective interventions the challenge will be to maintain this progress. The audit data collection is ongoing

Keywords: education, patient safety , SARS-CoV-2, Tocilizumab

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1371 Increasing Access to Upper Limb Reconstruction in Cervical Spinal Cord Injury

Authors: Michelle Jennett, Jana Dengler, Maytal Perlman

Abstract:

Background: Cervical spinal cord injury (SCI) is a devastating event that results in upper limb paralysis, loss of independence, and disability. People living with cervical SCI have identified improvement of upper limb function as a top priority. Nerve and tendon transfer surgery has successfully restored upper limb function in cervical SCI but is not universally used or available to all eligible individuals. This exploratory mixed-methods study used an implementation science approach to better understand these factors that influence access to upper limb reconstruction in the Canadian context and design an intervention to increase access to care. Methods: Data from the Canadian Institute for Health Information’s Discharge Abstracts Database (CIHI-DAD) and the National Ambulatory Care Reporting System (NACRS) were used to determine the annual rate of nerve transfer and tendon transfer surgeries performed in cervical SCI in Canada over the last 15 years. Semi-structured interviews informed by the consolidated framework for implementation research (CFIR) were used to explore Ontario healthcare provider knowledge and practices around upper limb reconstruction. An inductive, iterative constant comparative process involving descriptive and interpretive analyses was used to identify themes that emerged from the data. Results: Healthcare providers (n = 10 upper extremity surgeons, n = 10 SCI physiatrists, n = 12 physical and occupational therapists working with individuals with SCI) were interviewed about their knowledge and perceptions of upper limb reconstruction and their current practices and discussions around upper limb reconstruction. Data analysis is currently underway and will be presented. Regional variation in rates of upper limb reconstruction and trends over time are also currently being analyzed. Conclusions: Utilization of nerve and tendon transfer surgery to improve upper limb reconstruction in Canada remains low. There are a complex array of interrelated individual-, provider- and system-level barriers that prevent individuals with cervical SCI from accessing upper limb reconstruction. In order to offer equitable access to care, a multi-modal approach addressing current barriers is required.

Keywords: cervical spinal cord injury, nerve and tendon transfer surgery, spinal cord injury, upper extremity reconstruction

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1370 A Bibliometric Assessment of the Nexus Between Corporate Social Responsibility and Sustainable Development

Authors: Trilochana Dash, Chandan Kumar Sahoo

Abstract:

In today's environment of intensive industrialization, the role of business in societal modernization is critical. The concept of corporate social responsibility (CSR) arose due to rising societal awareness of company conduct. Corporations that practice CSR devote a portion of their profits to society’s sustainable development (SD). The concept of CSR and SD has increased the impact of industries on society. In this study, bibliometric analysis was conducted using the “R” programming language to determine the comprehensiveness of CSR and SD. From 2003 to 2022, bibliometric data was collected from two databases: Scopus and Web of Science (WOS). According to the findings, CSR and SD research has risen exponentially in the past two decades, and “Corporate Social Responsibility and Environment Management” emerged as the most influential journal in this field. The findings also show that relatively very few researchers collaborate in CSR and SD research in the last twenty years. It is widely acknowledged that most CSR and SD research is conducted in developed countries and developing countries undergoing fast industrialization. Thematic evolution and cluster analysis clearly show that the notion of CSR and SD among scholars has been quite popular over the last two decades. Finally, limitations and future directions are discussed.

Keywords: corporate social responsibility, sustainable development, bibliometric analysis, “R” programming language, visualization, holistic picture

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1369 Fabrication of a High-Performance Polyetherimide Membrane for Helium Separation

Authors: Y. Alqaheem, A. Alomair, F. Altarkait, F. Alswaileh, Nusrat Tanoli

Abstract:

Helium market is continuously growing due to its essential uses in the electronic and healthcare sectors. Currently, helium is produced by cryogenic distillation but the process is uneconomical especially for low production volumes. On the other hand, polymeric membranes can provide a cost-effective solution for helium purification due to their low operating energy. However, the preparation of membranes involves the use of very toxic solvents such as chloroform. In this work, polyetherimide membranes were prepared using a less toxic solvent, n-methylpyrrolidone with a polymer-to-solvent ratio of 27 wt%. The developed membrane showed a superior helium permeability of 15.9 Barrer that surpassed the permeability of membranes made by chloroform.

Keywords: helium separation, polyetherimide, dense membrane, gas permeability

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1368 Framework for Integrating Big Data and Thick Data: Understanding Customers Better

Authors: Nikita Valluri, Vatcharaporn Esichaikul

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With the popularity of data-driven decision making on the rise, this study focuses on providing an alternative outlook towards the process of decision-making. Combining quantitative and qualitative methods rooted in the social sciences, an integrated framework is presented with a focus on delivering a much more robust and efficient approach towards the concept of data-driven decision-making with respect to not only Big data but also 'Thick data', a new form of qualitative data. In support of this, an example from the retail sector has been illustrated where the framework is put into action to yield insights and leverage business intelligence. An interpretive approach to analyze findings from both kinds of quantitative and qualitative data has been used to glean insights. Using traditional Point-of-sale data as well as an understanding of customer psychographics and preferences, techniques of data mining along with qualitative methods (such as grounded theory, ethnomethodology, etc.) are applied. This study’s final goal is to establish the framework as a basis for providing a holistic solution encompassing both the Big and Thick aspects of any business need. The proposed framework is a modified enhancement in lieu of traditional data-driven decision-making approach, which is mainly dependent on quantitative data for decision-making.

Keywords: big data, customer behavior, customer experience, data mining, qualitative methods, quantitative methods, thick data

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1367 Ubuntu: A Holistic Social Framework for Preserving Ecosystem Amidst the Climate Change Challenges

Authors: Gabriel Sunday Ayayia

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The paper argues that Ubuntu, as a philosophy that emphasizes the interconnectedness of all living things and importance of community and mutual support, can be used as a social framework to address the problems of climate change and promote environmental sustainability. The research demonstrate that Ubuntu is an ideological concept that encourages collective action on climate change, with the emphasis on individual and collective commitment to taking concrete action to address the problems of climate change. The paper shows that Ubuntu can be employed as a social tool that would enhance the cultivation of shared identity and promote the sense of shared response responsibility to develop the resilience to cope with climate change. Using qualitative and quantitative methodologies, the study establishes the imperativeness of mutual support and cooperation through the lens of Ubuntu as a human-centered scalable response to the debacle of climate change. It recommends that we can build a society that values the environment and promotes sustainable practices by encouraging community involvement in sustainable initiatives by integrating Ubuntu-based principles to our decision-making processes, collaboration, leadership, human agency and governance.

Keywords: ubuntu, climate change, humanity, collective actions, community-based

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1366 Corporate Socially Responsible and Financial Performance in the Tourism-Related Industries

Authors: Yu Shan Wang

Abstract:

Different from other industries, the structure of the tourism industry depends to a large degree the environmental and cultural resources. The industry has to undertake social responsibilities for its commercial behaviour. This paper refers to the seven dimensions of the KLD STATS in 1991-2011 as the indicator to CSR practices. The purpose is to investigate what CSR activities create significant impacts on accounting-based financials and firm values by delving into different CSR dimensions. Meanwhile, this paper takes into consideration S&P 500 and control variables (firm sizes and financial leverage). In fact, the commercial behavior of the tourism-related industry may result in negative impacts on the economy and the society. Therefore, this paper classifies a positive set of CSR elements and a negative set of CSR elements for the tourism-related industry in order to examine their respective effects on short-term profitability and long-term firm values. This can shed light on which CSR dimensions exhibit significant impacts on CFP better than holistic CSR indicators, and hence provide more useful information to investors and corporates. This paper uses quantile regressions to avoid the impact of outliers in the data set. This helps to offer specific information so that companies can make informed decisions.

Keywords: corporate social responsibility, CSR, firm value, tourism, corporate financial performance, CFP

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1365 Line Manager’s Role Involvement towards Creating a Coaching Culture in Nursing Area

Authors: N. S. A. Rahim, N. N. Abu Mansor, M. I. Saidi, N. R. A. Rahim, K. F. Adrutdin

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The use of coaching as one of organizational culture with the contribution of the involvement of line manager roles is an important to update employees’ knowledge and skills continuously. In healthcare sector, it is dynamic that nurse must update their knowledge and skills to keep pace with change. This paper attempts to discuss the involvement of line manager roles towards creating a coaching culture who give their support and innovation towards motivate nurses to give their best performance either in public or private hospitals.

Keywords: nursing, line managers’ roles, coaching, coaching culture

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1364 Utilising Sociodrama as Classroom Intervention to Develop Sensory Integration in Adolescents who Present with Mild Impaired Learning

Authors: Talita Veldsman, Elzette Fritz

Abstract:

Many children attending special education present with sensory integration difficulties that hamper their learning and behaviour. These learners can benefit from therapeutic interventions as part of their classroom curriculum that can address sensory development and allow for holistic development to take place. A research study was conducted by utilizing socio-drama as a therapeutic intervention in the classroom in order to develop sensory integration skills. The use of socio-drama as therapeutic intervention proved to be a successful multi-disciplinary approach where education and psychology could build a bridge of growth and integration. The paper describes how socio-drama was used in the classroom and how these sessions were designed. The research followed a qualitative approach and involved six Afrikaans-speaking children attending special secondary school in the age group 12-14 years. Data collection included observations during the session, reflective art journals, semi-structured interviews with the teacher and informal interviews with the adolescents. The analysis found improved self-confidence, better social relationships, sensory awareness and self-regulation in the participants after a period of a year.

Keywords: education, sensory integration, sociodrama, classroom intervention, psychology

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1363 The Circularity of Re-Refined Used Motor Oils: Measuring Impacts and Ensuring Responsible Procurement

Authors: Farah Kanani

Abstract:

Blue Tide Environmental is a company focused on developing a network of used motor oil recycling facilities across the U.S. They initiated the redesign of its recycling plant in Texas, and aimed to establish an updated carbon footprint of re-refined used motor oils compared to an equivalent product derived from virgin stock that is not re-refined. The aim was to quantify emissions savings of a circular alternative to conventional end-of-life combustion of used motor oil (UMO). To do so, they mandated an ISO-compliant carbon footprint, utilizing complex models requiring geographical and temporal accuracy to accommodate the U.S. refinery market. The quantification of linear and circular flows, proxies for fuel substitution and system expansion for multi-product outputs were all critical methodological choices and were tested through sensitivity analyses. The re-refined system consisted of continuous recycling of UMO and thus, end-of-life is considered non-existent. The unique perspective to this topic will be from a life cycle i.e. holistic one and essentially demonstrate using this example of how a cradle-to-cradle model can be used to quantify a comparative carbon footprint. The intended audience is lubricant manufacturers as the consumers, motor oil industry professionals and other industry members interested in performing a cradle-to-cradle modeling.

Keywords: circularity, used motor oil, re-refining, systems expansion

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