Search results for: statistical assessment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9282

Search results for: statistical assessment

762 Exploring the Differences between Self-Harming and Suicidal Behaviour in Women with Complex Mental Health Needs

Authors: Sophie Oakes-Rogers, Di Bailey, Karen Slade

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Female offenders are a uniquely vulnerable group, who are at high risk of suicide. Whilst the prevention of self-harm and suicide remains a key global priority, we need to better understand the relationship between these challenging behaviours that constitute a pressing problem, particularly in environments designed to prioritise safety and security. Method choice is unlikely to be random, and is instead influenced by a range of cultural, social, psychological and environmental factors, which change over time and between countries. A key aspect of self-harm and suicide in women receiving forensic care is the lack of free access to methods. At a time where self-harm and suicide rates continue to rise internationally, understanding the role of these influencing factors and the impact of current suicide prevention strategies on the use of near-lethal methods is crucial. This poster presentation will present findings from 25 interviews and 3 focus groups, which enlisted a Participatory Action Research approach to explore the differences between self-harming and suicidal behavior. A key element of this research was using the lived experiences of women receiving forensic care from one forensic pathway in the UK, and the staffs who care for them, to discuss the role of near-lethal self-harm (NLSH). The findings and suggestions from the lived accounts of the women and staff will inform a draft assessment tool, which better assesses the risk of suicide based on the lethality of methods. This tool will be the first of its kind, which specifically captures the needs of women receiving forensic services. Preliminary findings indicate women engage in NLSH for two key reasons and is determined by their history of self-harm. Women who have a history of superficial non-life threatening self-harm appear to engage in NLSH in response to a significant life event such as family bereavement or sentencing. For these women, suicide appears to be a realistic option to overcome their distress. This, however, differs from women who appear to have a lifetime history of NLSH, who engage in such behavior in a bid to overcome the grief and shame associated with historical abuse. NLSH in these women reflects a lifetime of suicidality and indicates they pose the greatest risk of completed suicide. Findings also indicate differences in method selection between forensic provisions. Restriction of means appears to play a role in method selection, and findings suggest it causes method substitution. Implications will be discussed relating to the screening of female forensic patients and improvements to the current suicide prevention strategies.

Keywords: forensic mental health, method substitution, restriction of means, suicide

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761 Impact of Financial and Nutrition Support on Blood Health, Dietary Intake, and Well-Being among Female Student-Athletes

Authors: Kaila A. Vento

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Within the field of sports science, financial situations have been reported as a key barrier in purchasing high-quality foods. A lack of proper nutrition leads to insecurities of health, impairs training, and diminishes optimal performances. Consequently, insufficient nutrient intake, disordered eating patterns, and eating disorders may arise, leading to poor health and well-being. Athletic scholarships, nutrition resources, and meal programs are available, yet are disproportionally allocated, favoring male sports, Caucasian athletes, and higher sport levels. Direct athlete finances towards nutrition at various sport levels and the role race influences aid received has yet to be examined. Additionally, a diverse female athlete population is missing in the sports science literature, specifically in nutrition. To address this gap, the current project assesses how financial and nutrition support and nutrition knowledge impacts physical health, dietary intake, and overall quality of life of a diverse sample of female athletes at the National Collegiate Athletic Association (NCAA), National Junior Collegiate Athletic Association (NJCAA), and cub sport levels. The project will identify differences in financial support in relation to race, as well. Approximately (N = 120) female athletes will participate in a single 30-minute lab visit. At this visit, body composition (i.e., height, weight, body mass index, and fat percent), blood health indicators (fasted blood glucose and lipids), and resting blood pressure are measured. In addition, three validated questionnaires pertaining to nutrition knowledge (Sports Nutrition Knowledge Questionnaire; SNKQ), dietary intake (Rapid Eating Assessment for Participants; REAP), and quality of life (World Health Organization Quality of Life Brief; WHOQL-B) are gathered. Body composition and blood health indicators will be compared with the results of self-reported sports nutrition knowledge, dietary intake, and quality of life questionnaires. It is hypothesized that 1) financial and nutrition support and nutrition knowledge will differ between the sport levels and 2) financial and nutrition support and nutrition knowledge will have a positive association with quality of dietary intake and blood health indicators, 3) financial and nutrition support will differ significantly among racial background across the various competition levels, and 4) dietary intake will influence blood health indicators and quality of life. The findings from this study could have positive implications on athletic associations' policies on equity of financial and nutrition support to improve the health and safety of all female athletes across several sport levels.

Keywords: athlete, equity, finances, health, resources

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760 Assessment of Physical Activity Patterns in Patients with Cardiopulmonary Diseases

Authors: Ledi Neçaj

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Objectives: The target of this paper is (1) to explain objectively physical activity model throughout three chronic cardiopulmonary conditions, and (2) to study the connection among physical activity dimensions with disease severity, self-reported physical and emotional functioning, and exercise performance. Material and Methods: This is a cross-sectional study of patients in their domestic environment. Patients with cardiopulmonary diseases were: chronic obstructive pulmonary disease (COPD), (n-63), coronary heart failure (n=60), and patients with implantable cardioverter defibrillator (n=60). Main results measures: Seven ambulatory physical activity dimensions (total steps, percentage time active, percentage time ambulating at low, medium, and hard intensity, maximum cadence for 30 non-stop minutes, and peak performance) have been measured with an accelerometer. Results: Subjects with COPD had the lowest amount of ambulatory physical activity compared with topics with coronary heart failure and cardiac dysrhythmias (all 7 interest dimensions, P<.05); total step counts have been: 5319 as opposed to 7464 as opposed to 9570, respectively. Six-minute walk distance becomes correlated (r=.44-.65, P<.01) with all physical activity dimensions inside the COPD pattern, the most powerful correlations being with total steps and peak performance. In topics with cardiac impairment, maximal oxygen intake had the most effective small to slight correlations with five of the physical activity dimensions (r=.22-.40, P<.05). In contrast, correlations among 6-minute walk test distance and physical activity have been higher (r=.48-.61, P<.01) albeit in a smaller pattern of most effective patients with coronary heart failure. For all three samples, self-reported physical and mental health functioning, age, frame mass index, airflow obstruction, and ejection fraction had both exceptionally small and no significant correlations with physical activity. Conclusions: Findings from this study present a profitable benchmark of physical activity patterns in individuals with cardiopulmonary diseases for comparison with future studies. All seven dimensions of ambulatory physical activity have disfavor between subjects with COPD, heart failure, and cardiac dysrhythmias. Depending on the research or clinical goal, the use of one dimension, such as total steps, may be sufficient. Although physical activity had high correlations with performance on a six-minute walk test relative to other variables, accelerometers-based physical activity monitoring provides unique, important information about real-world behavior in patients with cardiopulmonary not already captured with existing measures.

Keywords: ambulatory physical activity, walking, monitoring, COPD, heart failure, implantable defibrillator, exercise performance

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759 Exploring Faculty Attitudes about Grades and Alternative Approaches to Grading: Pilot Study

Authors: Scott Snyder

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Grading approaches in higher education have not changed meaningfully in over 100 years. While there is variation in the types of grades assigned across countries, most use approaches based on simple ordinal scales (e.g, letter grades). While grades are generally viewed as an indication of a student's performance, challenges arise regarding the clarity, validity, and reliability of letter grades. Research about grading in higher education has primarily focused on grade inflation, student attitudes toward grading, impacts of grades, and benefits of plus-minus letter grade systems. Little research is available about alternative approaches to grading, varying approaches used by faculty within and across colleges, and faculty attitudes toward grades and alternative approaches to grading. To begin to address these gaps, a survey was conducted of faculty in a sample of departments at three diverse colleges in a southeastern state in the US. The survey focused on faculty experiences with and attitudes toward grading, the degree to which faculty innovate in teaching and grading practices, and faculty interest in alternatives to the point system approach to grading. Responses were received from 104 instructors (21% response rate). The majority reported that teaching accounted for 50% or more of their academic duties. Almost all (92%) of respondents reported using point and percentage systems for their grading. While all respondents agreed that grades should reflect the degree to which objectives were mastered, half indicated that grades should also reflect effort or improvement. Over 60% felt that grades should be predictive of success in subsequent courses or real life applications. Most respondents disagreed that grades should compare students to other students. About 42% worried about their own grade inflation and grade inflation in their college. Only 17% disagreed that grades mean different things based on the instructor while 75% thought it would be good if there was agreement. Less than 50% of respondents felt that grades were directly useful for identifying students who should/should not continue, identify strengths/weaknesses, predict which students will be most successful, or contribute to program monitoring of student progress. Instructors were less willing to modify assessment than they were to modify instruction and curriculum. Most respondents (76%) were interested in learning about alternative approaches to grading (e.g., specifications grading). The factors that were most associated with willingness to adopt a new grading approach were clarity to students and simplicity of adoption of the approach. Follow-up studies are underway to investigate implementations of alternative grading approaches, expand the study to universities and departments not involved in the initial study, examine student attitudes about alternative approaches, and refine the measure of attitude toward adoption of alternative grading practices within the survey. Workshops about challenges of using percentage and point systems for determining grades and workshops regarding alternative approaches to grading are being offered.

Keywords: alternative approaches to grading, grades, higher education, letter grades

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758 Ultra-Sensitive Point-Of-Care Detection of PSA Using an Enzyme- and Equipment-Free Microfluidic Platform

Authors: Ying Li, Rui Hu, Shizhen Chen, Xin Zhou, Yunhuang Yang

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Prostate cancer is one of the leading causes of cancer-related death among men. Prostate-specific antigen (PSA), a specific product of prostatic epithelial cells, is an important indicator of prostate cancer. Though PSA is not a specific serum biomarker for the screening of prostate cancer, it is recognized as an indicator for prostate cancer recurrence and response to therapy for patient’s post-prostatectomy. Since radical prostatectomy eliminates the source of PSA production, serum PSA levels fall below 50 pg/mL, and may be below the detection limit of clinical immunoassays (current clinical immunoassay lower limit of detection is around 10 pg/mL). Many clinical studies have shown that intervention at low PSA levels was able to improve patient outcomes significantly. Therefore, ultra-sensitive and precise assays that can accurately quantify extremely low levels of PSA (below 1-10 pg/mL) will facilitate the assessment of patients for the possibility of early adjuvant or salvage treatment. Currently, the commercially available ultra-sensitive ELISA kit (not used clinically) can only reach a detection limit of 3-10 pg/mL. Other platforms developed by different research groups could achieve a detection limit as low as 0.33 pg/mL, but they relied on sophisticated instruments to get the final readout. Herein we report a microfluidic platform for point-of-care (POC) detection of PSA with a detection limit of 0.5 pg/mL and without the assistance of any equipment. This platform is based on a previously reported volumetric-bar-chart chip (V-Chip), which applies platinum nanoparticles (PtNPs) as the ELISA probe to convert the biomarker concentration to the volume of oxygen gas that further pushes the red ink to form a visualized bar-chart. The length of each bar is used to quantify the biomarker concentration of each sample. We devised a long reading channel V-Chip (LV-Chip) in this work to achieve a wide detection window. In addition, LV-Chip employed a unique enzyme-free ELISA probe that enriched PtNPs significantly and owned 500-fold enhanced catalytic ability over that of previous V-Chip, resulting in a significantly improved detection limit. LV-Chip is able to complete a PSA assay for five samples in 20 min. The device was applied to detect PSA in 50 patient serum samples, and the on-chip results demonstrated good correlation with conventional immunoassay. In addition, the PSA levels in finger-prick whole blood samples from healthy volunteers were successfully measured on the device. This completely stand-alone LV-Chip platform enables convenient POC testing for patient follow-up in the physician’s office and is also useful in resource-constrained settings.

Keywords: point-of-care detection, microfluidics, PSA, ultra-sensitive

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757 Assessment of Community Perceptions of Mangrove Ecosystem Services and Their Link to SDGs in Vanga, Kenya

Authors: Samson Obiene, Khamati Shilabukha, Geoffrey Muga, James Kairo

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Mangroves play a vital role in the achievement of multiple goals of global sustainable development (SDG’s), particularly SDG SDG 14 (life under water). Their management, however, is faced with several shortcomings arising from inadequate knowledge on the perceptions of their ecosystem services, hence a need to map mangrove goods and services within SDGs while interrogating the disaggregated perceptions. This study therefore aimed at exploring the parities and disparities in attitudes and perceptions of mangrove ecosystem services among community members of Vanga and the link of the ecosystem services (ESs) to specific SDG targets. The study was based at the Kenya-Tanzania transboundary area in Vanga; where a carbon-offset project on mangroves is being up scaled. Mixed methods approach employing surveys, focus group discussions (FGDs) and reviews of secondary data were used in the study. A two stage cluster samplings was used to select the study population and the sample size. FGDs were conducted purposively selecting active participants in mangrove related activities with distinct socio-demographic characteristics. Sampled respondents comprised of males and females of different occupations and age groups. Secondary data review was used to select specific SDG targets against which mangrove ecosystem services identified through a value chain analysis were mapped. In Vanga, 20 ecosystem services were identified and categorized under supporting, cultural and aesthetic, provisioning and regulating services. According to the findings of this study, 63.9% (95% ci 56.6-69.3) perceived of the ESs as very important for economic development, 10.3% (95% ci 0-21.3) viewed them as important for environmental and ecological development while 25.8% (95% ci 2.2-32.8) were not sure of any role they play in development. In the social-economic disaggregation, ecosystem service values were found to vary with the level of interaction with the ecosystem which depended on gender and other social-economic classes within the study area. The youths, low income earners, women and those with low education levels were also identified as the primary beneficiaries of mangrove ecosystem services. The study also found that of the 17 SDGs, mangroves have a potential of influencing the achievement 12, including, SDGs 1, 2, 3, 4, 6, 8 10, 12, 13, 14, 15 and 17 either directly or indirectly. Generally therefore, the local community is aware of the critical importance mangroves for enhanced livelihood and ecological services but challenges in sustainability still occur as a result the diverse values and of the services and the contradicting interests of the different actors around the ecosystem. It is therefore important to consider parities in values and perception to avoid a ‘tragedy of the commons’ while striving to enhance sustainability of the Mangrove ecosystem.

Keywords: sustainable development, community values, socio-demographics, Vanga, mangrove ecosystem services

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756 Assessment of Agricultural Intervention on Ecosystem Services in the Central-South Zone of Chile

Authors: Steven Hidalgo, Patricio Neumann

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The growth of societies has increased the consumption of raw materials and food obtained from nature. This has influenced the services offered by ecosystems to humans, mainly supply and regulation services. One of the indicators used to evaluate these services is Net Primary Productivity (NPP), which is understood as the energy stored in the form of biomass by primary organisms through the process of photosynthesis and respiration. The variation of NPP by defined area produces changes in the properties of terrestrial and aquatic ecosystems, which alter factors such as biodiversity, nutrient cycling, carbon storage and water quality. The analysis of NPP to evaluate variations in ecosystem services includes harvested NPP (understood as provisioning services), which is the raw material from agricultural systems used by humans as a source of energy and food, and the remaining NPP (expressed as a regulating service) or the amount of biomass that remains in ecosystems after the harvesting process, which is mainly related to factors such as biodiversity. Given that agriculture is a fundamental pillar of Chile's integral development, the purpose of this study is to evaluate provisioning and regulating ecosystem services in the agricultural sector, specifically in cereal production, in the communes of the central-southern regions of Chile through a conceptual framework based on the quantification of the fraction of Human Appropriation of Net Primary Productivity (HANPP) and the fraction remaining in the ecosystems (NPP remaining). A total of 161 communes were analyzed in the regions of O'Higgins, Maule, Ñuble, Bio-Bío, La Araucanía and Los Lagos, which are characterized by having the largest areas planted with cereals. It was observed that the region of La Araucanía produces the greatest amount of dry matter, understood as provisioning service, where Victoria is the commune with the highest cereal production in the country. In addition, the maximum value of HANPP was in the O'Higgins region, highlighting the communes of Coltauco, Quinta de Tilcoco, Placilla and Rengo. On the other hand, the communes of Futrono, Pinto, Lago Ranco and Pemuco, whose cereal production was important during the study, had the highest values of remaining NPP as a regulating service. Finally, an inverse correlation was observed between the provisioning and regulating ecosystem services, i.e., the higher the cereal or dry matter production in a defined area, the lower the net primary production remaining in the ecosystems. Based on this study, future research will focus on the evaluation of ecosystem services associated with other crops, such as forestry plantations, whose activity is an important part of the country's productive sector.

Keywords: provisioning services, regulating services, net primary productivity, agriculture

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755 A Player's Perspective of University Elite Netball Programmes in South Africa

Authors: Wim Hollander, Petrus Louis Nolte

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University sport in South Africa is not isolated from the complexity of globalization and professionalization of sport, as it forms an integral part of the sports development environment in South Africa. In order to align their sports programs with global and professional requirements, several universities opted to develop elite sports programs; recruit specialized personnel such as coaches, administrators, and athletes; provide expert coaching; scientific and medical services; sports testing; fitness, technical and tactical expertise; sport psychological and rehabilitation support; academic guidance and career assistance; and student-athlete accommodation. In addition, universities provide administrative support and high-quality physical resources (training facilities) for the benefit of the overall South African sport system. Although it is not compulsory for universities to develop elite sports programs to prepare their teams for competitions, elite competitions such as the annual Varsity Sport, University Sport South Africa (USSA) and local club competitions and leagues within international university competitions where universities not only compete but also deliver players for representative national netball teams. The aim of this study is, therefore, to describe the perceptions of players of the university elite netball programs they were participating in. This study adopted a descriptive design with a quantitative approach, utilizing a self-structured questionnaire as a research technique. As this research formed part of a national research project for NSA with a population of 172 national and provincial netball players, a sample of 92 university netball players from the population was selected. Content validity of the self-structured questionnaire was secured through a test-retest process, with construct validity through a member of the Statistical Consultation Services (STATCON) of the University of Johannesburg that provided feedback on the structural format of the questionnaire. Reliability was measured utilizing Cronbach Alpha on p < 0.005 level of significance. A reliability score of 0.87 was measured. The research was approved by the Board of Netball South Africa and ethical conduct implemented according to the processes and procedures approved by the Ethics Committees of the Faculty of Health Sciences, the University of Johannesburg with clearance number REC-01-30-2019. From the results, it is evident that university elite netball programs are professional, especially with regards to the employment of knowledgeable and competent coaches and technical officials such as team managers and sport sciences staff. These professionals have access to elite training facilities, support staff, and relatively large groups of elite players, all elements of an elite program that could enhance the national federation’s (Netball South Africa) system. Universities could serve the dual purpose of serving as university netball clubs, as well as providing elite training services and facilities as performance hubs for national players.

Keywords: elite sport programmes, university netball, player experiences, varsity sport netball

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754 A Qualitative Assessment of the Internal Communication of the College of Comunication: Basis for a Strategic Communication Plan

Authors: Edna T. Bernabe, Joshua Bilolo, Sheila Mae Artillero, Catlicia Joy Caseda, Liezel Once, Donne Ynah Grace Quirante

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Internal communication is significant for an organization to function to its full extent. A strategic communication plan builds an organization’s structure and makes it more systematic. Information is a vital part of communication inside the organization as this lays every possible outcome—be it positive or negative. It is, therefore, imperative to assess the communication structure of a particular organization to secure a better and harmonious communication environment in any organization. Thus, this research was intended to identify the internal communication channels used in Polytechnic University of the Philippines-College of Communication (PUP-COC) as an organization, to identify the flow of information specifically in downward, upward, and horizontal communication, to assess the accuracy, consistency, and timeliness of its internal communication channels; and to come up with a proposed strategic communication plan of information dissemination to improve the existing communication flow in the college. The researchers formulated a framework from Input-Throughout-Output-Feedback-Goal of General System Theory and gathered data to assess the PUP-COC’s internal communication. The communication model links the objectives of the study to know the internal organization of the college. The qualitative approach and case study as the tradition of inquiry were used to gather deeper understanding of the internal organizational communication in PUP-COC, using Interview, as the primary methods for the study. This was supported with a quantitative data which were gathered through survey from the students of the college. The researchers interviewed 17 participants: the College dean, the 4 chairpersons of the college departments, the 11 faculty members and staff, and the acting Student Council president. An interview guide and a standardized questionnaire were formulated as instruments to generate the data. After a thorough analysis of the study, it was found out that two-way communication flow exists in PUP-COC. The type of communication channel the internal stakeholders use varies as to whom a particular person is communicating with. The members of the PUP-COC community also use different types of communication channels depending on the flow of communication being used. Moreover, the most common types of internal communication are the letters and memoranda for downward communication, while letters, text messages, and interpersonal communication are often used in upward communication. Various forms of social media have been found out to be of use in horizontal communication. Accuracy, consistency, and timeliness play a significant role in information dissemination within the college. However, some problems have also been found out in the communication system. The most common problem are the delay in the dissemination of memoranda and letters and the uneven distribution of information and instruction to faculty, staff, and students. This has led the researchers to formulate a strategic communication plan which aims to propose strategies that will solve the communication problems that are being experienced by the internal stakeholders.

Keywords: communication plan, downward communication, internal communication, upward communication

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753 Systematic Review of Digital Interventions to Reduce the Carbon Footprint of Primary Care

Authors: Anastasia Constantinou, Panayiotis Laouris, Stephen Morris

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Background: Climate change has been reported as one of the worst threats to healthcare. The healthcare sector is a significant contributor to greenhouse gas emissions with primary care being responsible for 23% of the NHS’ total carbon footprint. Digital interventions, primarily focusing on telemedicine, offer a route to change. This systematic review aims to quantify and characterize the carbon footprint savings associated with the implementation of digital interventions in the setting of primary care. Methods: A systematic review of published literature was conducted according to PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analyses) guidelines. MEDLINE, PubMed, and Scopus databases as well as Google scholar were searched using key terms relating to “carbon footprint,” “environmental impact,” “sustainability”, “green care”, “primary care,”, and “general practice,” using citation tracking to identify additional articles. Data was extracted and analyzed in Microsoft Excel. Results: Eight studies were identified conducted in four different countries between 2010 and 2023. Four studies used interventions to address primary care services, three studies focused on the interface between primary and specialist care, and one study addressed both. Digital interventions included the use of mobile applications, online portals, access to electronic medical records, electronic referrals, electronic prescribing, video-consultations and use of autonomous artificial intelligence. Only one study carried out a complete life cycle assessment to determine the carbon footprint of the intervention. It estimate that digital interventions reduced the carbon footprint at primary care level by 5.1 kgCO2/visit, and at the interface with specialist care by 13.4 kg CO₂/visit. When assessing the relationship between travel-distance saved and savings in emissions, we identified a strong correlation, suggesting that most of the carbon footprint reduction is attributed to reduced travel. However, two studies also commented on environmental savings associated with reduced use of paper. Patient savings in the form of reduced fuel cost and reduced travel time were also identified. Conclusion: All studies identified significant reductions in carbon footprint following implementation of digital interventions. In the future, controlled, prospective studies incorporating complete life cycle assessments and accounting for double-consulting effects, use of additional resources, technical failures, quality of care and cost-effectiveness are needed to fully appreciate the sustainable benefit of these interventions

Keywords: carbon footprint, environmental impact, primary care, sustainable healthcare

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752 Effects of an Online Positive Psychology Program on Stress, Depression, and Anxiety Symptoms of Emerging Adults

Authors: Gabriela R. Silveira, Claudia S. Rocha, Lais S. Vitti, Jeane L. Borges, Helen B. Durgante

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Emerging adulthood occurs after adolescence in a period that maybe be marked by experimentation, identity reconfigurations, labor life demands, and insertion in the work environment, which tends to generate stress and emotional instability. Health promotion programs for the development of strengths and virtues, based on Positive Psychology, for emerging adults are sparse in Brazil. The aim of this study was to evaluate the preliminary effects of an online multi-component Positive Psychology program for the health promotion of emerging adults based on Cognitive Behavioural Therapy and Positive Psychology. The program included six online (synchronous) weekly group sessions of approximately two hours each and homework (asynchronous) activities. The themes worked were Values and self-care/Prudence, Optimism, Empathy, Gratitude, Forgiveness, and Meaning of life and work. This study presents data from a longitudinal, pre-experimental design with pre (T1) and post-test (T2) evaluation in the intervention group. 47 individuals aged between 19-30 years old participated, mean age of 24.53 years (SD=3.13), 37 females (78.7%). 42 (89.4%) self-defined as heterosexual, four (8.5%) as homosexual, and one (2.5%) as bisexual. 33 (70.2%) had incomplete higher education, four (8.5%) completed higher education, and seven (14.9%) had a graduate level of education. 27 participants worked (57.4%), out of which 25 were health workers (53.2%). 14 (29.8%) were caregivers, 27 (57.4%) had a spiritual belief, 36 (76.6%) had access to leisure, and 38 (80.9%) had perceived social support. The instruments used were a sociodemographic questionnaire, the 10-item Perceived Stress Scale, and the 12-item General Health Questionnaire. The program was advertised on social networks and interested participants filled out the Consent Form and the evaluation protocol at T1 and T2 via Google Docs form. The main research was approved (CEP n.1,899,368; 4,143,219; CAAE: 61997516.5.0000.5334) and complied with sanitary and Ethics criteria in research with human beings. Wilcoxon statistics revealed significant improvements in indicators of perceived stress between T1 (X=22.21, SD=6.79) and T2 (X=15.10, SD=5.82); (Z=-4.353; p=0.001) as well as depression and anxiety symptoms (T1:X=26.72, SD=8.84; T2: X=19.23, SD=4.68); (Z=-3.945, p=0.001) of the emerging adults after their participation in the programme. The programme has an innovative character not only for presenting an online Positive Psychology approach but also for being based on an intervention developed, evaluated, and manualized in Brazil. By focusing on emerging adults, this study contributes to advancing research on a relatively new field in developmental studies. As a limitation, this is a pre-experimental and pilot study, requiring an increase in sample size for greater statistical robustness, also qualitative data analysis is crucial for methodological complementarity. The importance of investing efforts to accompany this age group and provide advances in longitudinal research in the area of health promotion and disease prevention is highlighted.

Keywords: emerging adults, disease prevention, health promotion, online program

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751 Ideas for Musical Activities and Games in the Early Year (IMAGINE-Autism): A Case Study Approach

Authors: Tania Lisboa, Angela Voyajolu, Adam Ockelford

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The positive impact of music on the development of children with autism is widely acknowledged: music offers a unique channel for communication, wellbeing and self-regulation, as well as access to culture and a means of creative engagement. Yet, no coherent program exists for parents, carers and teachers to follow with their children in the early years, when the need for interventions is often most acute. Hence, research and the development of resources is urgently required. Autism is a project with children on the autism spectrum. The project aims at promoting the participants’ engagement with music through involvement in specially-designed musical activities with parents and carers. The main goal of the research is to verify the effectiveness of newly designed resources and strategies, which are based on the Sounds of Intent in the Early Years (SoI-EY) framework of musical development. This is a pilot study, comprising case studies of five children with autism in the early years. The data comprises semi-structured interviews, observations of videos, and feedback from parents on resources. Interpretative Phenomenological Analysis was chosen to analyze the interviews. The video data was coded in relation to the SoI-EY framework. The feedback from parents was used to evaluate the resources (i.e. musical activity cards). The participants’ wider development was also assessed through selected elements of the Early Years Foundation Stage (EYFS), a national assessment framework used in England: specifically, communication, language and social-emotional development. Five families of children on the autism spectrum (aged between 4-8 years) participated in the pilot. The research team visited each family 4 times over a 3-month period, during which the children were observed, and musical activities were suggested based on the child’s assessed level of musical development. Parents then trialed the activities, providing feedback and gathering further video observations of their child’s musical engagement between visits. The results of one case study will be featured in this paper, in which the evidence suggests that specifically tailored musical activity may promote communication and social engagement for a child with language difficulties on the autism spectrum. The resources were appropriate for the children’s involvement in musical activities. Findings suggest that non-specialist musical engagement with family and carers can be a powerful means to foster communication. The case study featured in this paper illustrates this with a child of limited verbal ability. There is a need for further research and development of resources that can be made available to all those working with children on the autism spectrum.

Keywords: autism, development, music education, resources

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750 Barrier Membrane Influence Histology of Guided Bone Regenerations: A Systematic Review and Meta-Analysis

Authors: Laura Canagueral-Pellice, Antonio Munar-Frau, Adaia Valls-Ontanon, Joao Carames, Federico Hernandez-Alfaro, Jordi Caballe-Serrano

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Objective: Guided bone regeneration (GBR) aims to replace the missing bone with a new structure to achieve long-term stability of rehabilitations. The aim of the present systematic review and meta-analysis is to determine the effect of barrier membranes on histological outcomes after GBR procedures. Moreover, the effect of the grafting material and tissue gain were analyzed. Materials & methods: Two independent reviewers performed an electronic search in Pubmed and Scopus, identifying all eligible publications up to March 2020. Only randomized controlled trials (RCTs) assessing a histological analysis of augmented areas were included. Results: A total of 6 publications were included for the present systematic review. A total of 110 biopsied sites were analysed; 10 corresponded to vertical bone augmentation procedures, whereas 100 analysed horizontal regeneration procedures. A mean tissue gain of 3 ± 1.48mm was obtained for horizontal defects. Histological assessment of new bone formation, residual particle and sub-epithelial connective tissue (SCT) was reported. The four main barrier membranes used were natural collagen membranes, e-PTFE, polylactic resorbable membranes and acellular dermal matrix membranes (AMDG). The analysis demonstrated that resorbable membranes result in higher values of new bone formation and lower values of residual particles and SCT. Xenograft resulted in lower new bone formation compared to allograft; however, no statistically significant differences were observed regarding residual particle and SCT. Overall, regeneration procedures adding autogenous bone, plasma derivate or growth factors achieved in general greater new bone formation and tissue gain. Conclusions: There is limited evidence favoring the effect of a certain type of barrier membrane in GBR. Data needs to be evaluated carefully; however, resorbable membranes are correlated with greater new bone formation values, especially when combined with allograft materials and/or the addition of autogenous bone, platelet reach plasma (PRP) or growth factors in the regeneration area. More studies assessing the histological outcomes of different GBR protocols and procedures testing different biomaterials are needed to maximize the clinical and histological outcomes in bone regeneration science.

Keywords: barrier membrane, graft material, guided bone regeneration, implant surgery, histology

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749 Principles and Guidance for the Last Days of Life: Te Ara Whakapiri

Authors: Tania Chalton

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In June 2013, an independent review of the Liverpool Care Pathway (LCP) identified a number of problems with the implementation of the LCP in the UK and recommended that it be replaced by individual care plans for each patient. As a result of the UK findings, in November 2013 the Ministry of Health (MOH) commissioned the Palliative Care Council to initiate a programme of work to investigate an appropriate approach for the care of people in their last days of life in New Zealand (NZ). The Last Days of Life Working Group commenced a process to develop national consensus on the care of people in their last days of life in April 2014. In order to develop its advice for the future provision of care to people in their last days of life, the Working Group (WG) established a comprehensive work programme and as a result has developed a series of working papers. Specific areas of focus included: An analysis of the UK Independent Review findings and an assessment of these findings to the NZ context. A stocktake of services providing care to people in their last days of life, including aged residential care (ARC); hospices; hospitals; and primary care. International and NZ literature reviews of evidence and best practice. Survey of family to understand the consumer perspective on the care of people in their last days of life. Key aspects of care that required further considerations for NZ were: Terminology: clarify terminology used in the last days of life and in relation to death and dying. Evidenced based: including specific review of evidence regarding, spiritual, culturally appropriate care as well as dementia care. Diagnosis of dying: need for both guidance around the diagnosis of dying and communication with family. Workforce issues: access to an appropriate workforce after hours. Nutrition and hydration: guidance around appropriate approaches to nutrition and hydration. Symptom and pain management: guidance around symptom management. Documentation: documentation of the person’s care which is robust enough for data collection and auditing requirements, not ‘tick box’ approach to care. Education and training: improved consistency and access to appropriate education and training. Leadership: A dedicated team or person to support and coordinate the introduction and implementation of any last days of life model of care. Quality indicators and data collection: model of care to enable auditing and regular reviews to ensure on-going quality improvement. Cultural and spiritual: address and incorporate any cultural and spiritual aspects. A final document was developed incorporating all the evidence which provides guidance to the health sector on best practice for people at end of life: “Principles and guidance for the last days of life: Te Ara Whakapiri”.

Keywords: end of life, guidelines, New Zealand, palliative care

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748 L2 Anxiety, Proficiency, and L2 Willingness to Communicate in the Classroom, Outside the Classroom, and in Digital Setting: Insights from Ethiopian Preparatory Schools

Authors: Merih Welay Welesilassie, Marianne Nikolov

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Research into second and foreign language (L2) acquisitions has demonstrated that L2 anxiety, perceived proficiency, and L2 willingness to communicate (L2WTC) profoundly impact language learning outcomes. However, the complex interplay between these variables has yet to be fully explored, as these factors are dynamic and context-specific and can vary across different learners and learning environments. This study, therefore, utilized a cross-sectional quantitative survey research design to scrutinise the causal relationships between L2 anxiety, English proficiency, and L2WTC of 609 Ethiopian preparatory school students. The model for the L2WTC, both inside and outside the classroom, has been expanded to include an additional sub-scale known as the L2WTC in a digital setting. Moreover, in contrast to the commonly recognised debilitative-focused L2 anxiety, the construct of L2 anxiety has been divided into facilitative and debilitative anxiety. This method allows to measure not only the presence or absence of anxiety but also evaluate if anxiety helps or hinders the L2 learning experience. A self-assessment proficiency measure was also developed specifically for Ethiopian high school students. The study treated facilitative and debilitative anxiety as independent variables while considering self-assessed English proficiency and L2WTC in the classroom, outside the classroom, and in digital settings as dependent variables. Additionally, self-assessed English proficiency was used as an independent variable to predict L2WTC in these three settings. The proposed model, including these variables, was tested using structural equation modelling (SEM). According to the descriptive analysis, the mean scores of L2WTC in the three settings were generally low, ranging from 2.30 to 2.84. Debilitative anxiety casts a shadow on the positive aspects of anxiety. Self-assessed English proficiency was also too low. According to SEM, debilitative anxiety displayed a statistically significant negative impact on L2WTC inside the classroom, outside the classroom, in digital settings, and in self-assessed levels of English proficiency. In contrast, facilitative anxiety was found to positively contribute to L2WTC outside the classroom, in digital settings, and in self-assessed English proficiency. Self-assessed English proficiency made a statistically significant and positive contribution to L2WTC within the classroom, outside the classroom, and in digital contexts. L2WTC inside the classroom was found to positively contribute to L2WTC outside the classrooms and in digital contexts. The findings were systematically compared with existing studies, and the pedagogical implications, limitations, and potential avenues for future research were elucidated. The outcomes of the study have the potential to significantly contribute to the advancement of theoretical and empirical knowledge about improving English education, learning, and communication not only in Ethiopia but also in similar EFL contexts, thereby providing valuable insights for educators, researchers, and policymakers.

Keywords: debilitative anxiety, facilitative anxiety, L2 willingness to communicate, self-assessed English proficiency

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747 Analysis of Thermal Comfort in Educational Buildings Using Computer Simulation: A Case Study in Federal University of Parana, Brazil

Authors: Ana Julia C. Kfouri

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A prerequisite of any building design is to provide security to the users, taking the climate and its physical and physical-geometrical variables into account. It is also important to highlight the relevance of the right material elements, which arise between the person and the agent, and must provide improved thermal comfort conditions and low environmental impact. Furthermore, technology is constantly advancing, as well as computational simulations for projects, and they should be used to develop sustainable building and to provide higher quality of life for its users. In relation to comfort, the more satisfied the building users are, the better their intellectual performance will be. Based on that, the study of thermal comfort in educational buildings is of relative relevance, since the thermal characteristics in these environments are of vital importance to all users. Moreover, educational buildings are large constructions and when they are poorly planned and executed they have negative impacts to the surrounding environment, as well as to the user satisfaction, throughout its whole life cycle. In this line of thought, to evaluate university classroom conditions, it was accomplished a detailed case study on the thermal comfort situation at Federal University of Parana (UFPR). The main goal of the study is to perform a thermal analysis in three classrooms at UFPR, in order to address the subjective and physical variables that influence thermal comfort inside the classroom. For the assessment of the subjective components, a questionnaire was applied in order to evaluate the reference for the local thermal conditions. Regarding the physical variables, it was carried out on-site measurements, which consist of performing measurements of air temperature and air humidity, both inside and outside the building, as well as meteorological variables, such as wind speed and direction, solar radiation and rainfall, collected from a weather station. Then, a computer simulation based on results from the EnergyPlus software to reproduce air temperature and air humidity values of the three classrooms studied was conducted. The EnergyPlus outputs were analyzed and compared with the on-site measurement results to be possible to come out with a conclusion related to the local thermal conditions. The methodological approach included in the study allowed a distinct perspective in an educational building to better understand the classroom thermal performance, as well as the reason of such behavior. Finally, the study induces a reflection about the importance of thermal comfort for educational buildings and propose thermal alternatives for future projects, as well as a discussion about the significant impact of using computer simulation on engineering solutions, in order to improve the thermal performance of UFPR’s buildings.

Keywords: computer simulation, educational buildings, EnergyPlus, humidity, temperature, thermal comfort

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746 The Disease That 'Has a Woman Face': Feminization of HIV/AIDS in Nagaland, North-East India

Authors: Kitoholi V. Zhimo

Abstract:

Unlike the cases of cases of homosexuals, haemophilic and or drug users in USA, France, Africa and other countries, in India the first case of HIV/AIDS was detected in heterosexual female sex workers (FSW) in Chennai in 1986. This image played an important role in understanding HIV/AIDS scenario in the country. Similar to popular and dominant metaphors on HIV/AIDS such as ‘gay plague’, ‘new cancer’, ‘lethal disease’, ‘slim disease’, ‘foreign disease’, ‘junkie disease’, etc. around the world, the social construction of the virus was largely attributed to women in India. It was established that women particularly sex workers are ‘carrier’ and ‘transmitter’ of virus and were categorised as High Risk Groups (HRG’s) alongside homosexuals, transgenders and injecting drug users. Recent literature reveals growing rate of HIV infection among housewives since 1997 which revolutionised public health scenario in India. This means shift from high risk group to general public through ‘bridge population’ encompassing long distance truckers and migrant labours who at the expense of their nature of work and mobility comes in contact with HRG’s and transmit the virus to the general public especially women who are confined to the domestic space. As HIV epidemic expands, married women in monogamous relationship/marriage stand highly susceptible to infection with limited control, right and access over their sexual and reproductive health and planning. In context of Nagaland, a small state in North-eastern part of India HIV/AIDS transmission through injecting drug use dominated the early scene of the epidemic. However, paradigm shift occurred with declining trend of HIV prevalence among injecting drug users (IDU’s) over the past years with the introduction of Opioid Substitution Therapy (OST) and easy access/availability of syringes and injecting needles. Reflection on statistical data reveals that out of 36 states and union territories in India, the position of Nagaland in HIV prevalence among IDU’s has significantly dropped down from 6th position in 2003 to 16th position in 2017. The present face of virus in Nagaland is defined by (hetero) sexual mode of transmission which accounts for about 91% of as reported by Nagaland state AIDS control society (NSACS) in 2016 wherein young and married woman were found to be most affected leading to feminization of HIV/AIDS epidemic in the state. Thus, not only is HIV epidemic feminised but emerged victim to domestic violence which is more often accepted as normal part of heterosexual relationship. In the backdrop of these understanding, the present paper based on ethnographic fieldwork explores the plight, lived experiences and images of HIV+ve women with regard to sexual and reproductive rights against the backdrop of patriarchal system in Nagaland.

Keywords: HIV/AIDS, monogamy, Nagaland, sex worker disease, women

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745 A Comparison of Tsunami Impact to Sydney Harbour, Australia at Different Tidal Stages

Authors: Olivia A. Wilson, Hannah E. Power, Murray Kendall

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Sydney Harbour is an iconic location with a dense population and low-lying development. On the east coast of Australia, facing the Pacific Ocean, it is exposed to several tsunamigenic trenches. This paper presents a component of the most detailed assessment of the potential for earthquake-generated tsunami impact on Sydney Harbour to date. Models in this study use dynamic tides to account for tide-tsunami interaction. Sydney Harbour’s tidal range is 1.5 m, and the spring tides from January 2015 that are used in the modelling for this study are close to the full tidal range. The tsunami wave trains modelled include hypothetical tsunami generated from earthquakes of magnitude 7.5, 8.0, 8.5, and 9.0 MW from the Puysegur and New Hebrides trenches as well as representations of the historical 1960 Chilean and 2011 Tohoku events. All wave trains are modelled for the peak wave to coincide with both a low tide and a high tide. A single wave train, representing a 9.0 MW earthquake at the Puysegur trench, is modelled for peak waves to coincide with every hour across a 12-hour tidal phase. Using the hydrodynamic model ANUGA, results are compared according to the impact parameters of inundation area, depth variation and current speeds. Results show that both maximum inundation area and depth variation are tide dependent. Maximum inundation area increases when coincident with a higher tide, however, hazardous inundation is only observed for the larger waves modelled: NH90high and P90high. The maximum and minimum depths are deeper on higher tides and shallower on lower tides. The difference between maximum and minimum depths varies across different tidal phases although the differences are slight. Maximum current speeds are shown to be a significant hazard for Sydney Harbour; however, they do not show consistent patterns according to tide-tsunami phasing. The maximum current speed hazard is shown to be greater in specific locations such as Spit Bridge, a narrow channel with extensive marine infrastructure. The results presented for Sydney Harbour are novel, and the conclusions are consistent with previous modelling efforts in the greater area. It is shown that tide must be a consideration for both tsunami modelling and emergency management planning. Modelling with peak tsunami waves coinciding with a high tide would be a conservative approach; however, it must be considered that maximum current speeds may be higher on other tides.

Keywords: emergency management, sydney, tide-tsunami interaction, tsunami impact

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744 Assessing Spatial Associations of Mortality Patterns in Municipalities of the Czech Republic

Authors: Jitka Rychtarikova

Abstract:

Regional differences in mortality in the Czech Republic (CR) may be moderate from a broader European perspective, but important discrepancies in life expectancy can be found between smaller territorial units. In this study territorial units are based on Administrative Districts of Municipalities with Extended Powers (MEP). This definition came into force January 1, 2003. There are 205 units and the city of Prague. MEP represents the smallest unit for which mortality patterns based on life tables can be investigated and the Czech Statistical Office has been calculating such life tables (every five-years) since 2004. MEP life tables from 2009-2013 for males and females allowed the investigation of three main life cycles with the use of temporary life expectancies between the exact ages of 0 and 35; 35 and 65; and the life expectancy at exact age 65. The results showed regional survival inequalities primarily in adult and older ages. Consequently, only mortality indicators for adult and elderly population were related to census 2011 unlinked data for the same age groups. The most relevant socio-economic factors taken from the census are: having a partner, educational level and unemployment rate. The unemployment rate was measured for adults aged 35-64 completed years. Exploratory spatial data analysis methods were used to detect regional patterns in spatially contiguous units of MEP. The presence of spatial non-stationarity (spatial autocorrelation) of mortality levels for male and female adults (35-64), and elderly males and females (65+) was tested using global Moran’s I. Spatial autocorrelation of mortality patterns was mapped using local Moran’s I with the intention to depict clusters of low or high mortality and spatial outliers for two age groups (35-64 and 65+). The highest Moran’s I was observed for male temporary life expectancy between exact ages 35 and 65 (0.52) and the lowest was among women with life expectancy of 65 (0.26). Generally, men showed stronger spatial autocorrelation compared to women. The relationship between mortality indicators such as life expectancies and socio-economic factors like the percentage of males/females having a partner; percentage of males/females with at least higher secondary education; and percentage of unemployed males/females from economically active population aged 35-64 years, was evaluated using multiple regression (OLS). The results were then compared to outputs from geographically weighted regression (GWR). In the Czech Republic, there are two broader territories North-West Bohemia (NWB) and North Moravia (NM), in which excess mortality is well established. Results of the t-test of spatial regression showed that for males aged 30-64 the association between mortality and unemployment (when adjusted for education and partnership) was stronger in NM compared to NWB, while educational level impacted the length of survival more in NWB. Geographic variation and relationships in mortality of the CR MEP will also be tested using the spatial Durbin approach. The calculations were conducted by means of ArcGIS 10.6 and SAS 9.4.

Keywords: Czech Republic, mortality, municipality, socio-economic factors, spatial analysis

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743 The Use of Video Conferencing to Aid the Decision in Whether Vulnerable Patients Should Attend In-Person Appointments during a COVID Pandemic

Authors: Nadia Arikat, Katharine Blain

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During the worst of the COVID pandemic, only essential treatment was provided for patients needing urgent care. With the prolonged extent of the pandemic, there has been a return to more routine referrals for paediatric dentistry advice and treatment for specialist conditions. However, some of these patients and/or their carers may have significant medical issues meaning that attending in-person appointments carries additional risks. This poses an ethical dilemma for clinicians. This project looks at how a secure video conferencing platform (“Near Me”) has been used to assess the need and urgency for in-person new patient visits, particularly for patients and families with additional risks. “Near Me” is a secure online video consulting service used by NHS Scotland. In deciding whether to bring a new patient to the hospital for an appointment, the clinical condition of the teeth together with the urgency for treatment need to be assessed. This is not always apparent from the referral letter. In addition, it is important to judge the risks to the patients and carers of such visits, particularly if they have medical issues. The use and effectiveness of “Near Me” consultations to help decide whether vulnerable paediatric patients should have in-person appointments will be illustrated and discussed using two families: one where the child is medically compromised (Alagille syndrome with previous liver transplant), and the other where there is a medically compromised parent (undergoing chemotherapy and a bone marrow transplant). In both cases, it was necessary to take into consideration the risks and moral implications of requesting that they attend the dental hospital during a pandemic. The option of remote consultation allowed further clinical information to be evaluated and the families take part in the decision-making process about whether and when such visits should be scheduled. These cases will demonstrate how medically compromised patients (or patients with vulnerable carers), could have their dental needs assessed in a socially distanced manner by video consultation. Together, the clinician and the patient’s family can weigh up the risks, with regards to COVID-19, of attending for in-person appointments against the benefit of having treatment. This is particularly important for new paediatric patients who have not yet had a formal assessment. The limitations of this technology will also be discussed. It is limited by internet availability, the strength of the connection, the video quality and families owning a device which allows video calls. For those from a lower socio-economic background or living in some rural areas, this may not be possible or limit its usefulness. For the two patients discussed in this project, where the urgency of their dental condition was unclear, video consultation proved beneficial in deciding an appropriate outcome and preventing unnecessary exposure of vulnerable people to a hospital environment during a pandemic, demonstrating the usefulness of such technology when it is used appropriately.

Keywords: COVID-19, paediatrics, triage, video consultations

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742 Turkish Validation of the Nursing Outcomes for Urinary Incontinence and Their Sensitivities on Nursing Interventions

Authors: Dercan Gencbas, Hatice Bebis, Sue Moorhead

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In the nursing process, many of the nursing classification systems were created to be used in international. From these, NANDA-I, Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC). In this direction, the main objective of this study is to establish a model for caregivers in hospitals and communities in Turkey and to ensure that nursing outputs are assessed by NOC-based measures. There are many scales to measure Urinary Incontinence (UI), which is very common in children, in old age, vaginal birth, NOC scales are ideal for use in the nursing process for comprehensive and holistic assessment, with surveys available. For this reason, the purpose of this study is to evaluate the validity of the NOC outputs and indicators used for UI NANDA-I. This research is a methodological study. In addition to the validity of scale indicators in the study, how much they will contribute to recovery after the nursing intervention was assessed by experts. Scope validations have been applied and calculated according to Fehring 1987 work model. According to this, nursing inclusion criteria and scores were determined. For example, if experts have at least four years of clinical experience, their score was 4 points or have at least one year of the nursing classification system, their score was 1 point. The experts were a publication experience about nursing classification, their score was 1 point, or have a doctoral degree in nursing, their score was 2 points. If the expert has a master degree, their score was 1 point. Total of 55 experts rated Fehring as a “senior degree” with a score of 90 according to the expert scoring. The nursing interventions to be applied were asked to what extent these indicators would contribute to recovery. For coverage validity tailored to Fehring's model, each NOC and NOC indicator from specialists was asked to score between 1-5. Score for the significance of indicators was from 1=no precaution to 5=very important. After the expert opinion, these weighted scores obtained for each NOC and NOC indicator were classified as 0.8 critical, 0.8 > 0.5 complements, > 0.5 are excluded. In the NANDA-I / NOC / NIC system (guideline), 5 NOCs proposed for nursing diagnoses for UI were proposed. These outputs are; Urinary Continence, Urinary Elimination, Tissue Integrity, Self CareToileting, Medication Response. After the scales are translated into Turkish, the weighted average of the scores obtained from specialists for the coverage of all 5 NOCs and the contribution of nursing initiatives exceeded 0.8. After the opinions of the experts, 79 of the 82 indicators were calculated as critical, 3 of the indicators were calculated as supplemental. Because of 0.5 > was not obtained, no substance was removed. All NOC outputs were identified as valid and usable scales in Turkey. In this study, five NOC outcomes were verified for the evaluation of the output of individuals who have received nursing knowledge of UI and variant types. Nurses in Turkey can benefit from the outputs of the NOC scale to perform the care of the elderly incontinence.

Keywords: nursing outcomes, content validity, nursing diagnosis, urinary incontinence

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741 Determine Causal Factors Affecting the Responsiveness and Productivity of Non-Governmental Universities

Authors: Davoud Maleki

Abstract:

Today, education and investment in human capital is a long-term investment without which the economy will be stagnant Stayed. Higher education represents a type of investment in human resources by providing and improving knowledge, skills and Attitudes help economic development. Providing efficient human resources by increasing the efficiency and productivity of people and on the other hand with Expanding the boundaries of knowledge and technology and promoting technology such as the responsibility of training human resources and increasing productivity and efficiency in High specialized levels are the responsibility of universities. Therefore, the university plays an infrastructural role in economic development and growth because education by creating skills and expertise in people and improving their ability.In recent decades, Iran's higher education system has been faced with many problems, therefore, scholars have looked for it is to identify and validate the causal factors affecting the responsiveness and productivity of non-governmental universities. The data in the qualitative part is the result of semi-structured interviews with 25 senior and middle managers working in the units It was Islamic Azad University of Tehran province, which was selected by theoretical sampling method. In data analysis, stepwise method and Analytical techniques of Strauss and Corbin (1992) were used. After determining the central category (answering for the sake of the beneficiaries) and using it in order to bring the categories, expressions and ideas that express the relationships between the main categories and In the end, six main categories were identified as causal factors affecting the university's responsiveness and productivity.They are: 1- Scientism 2- Human resources 3- Creating motivation in the university 4- Development based on needs assessment 5- Teaching process and Learning 6- University quality evaluation. In order to validate the response model obtained from the qualitative stage, a questionnaire The questionnaire was prepared and the answers of 146 students of Master's degree and Doctorate of Islamic Azad University located in Tehran province were received. Quantitative data in the form of descriptive data analysis, first and second stage factor analysis using SPSS and Amos23 software were analyzed. The findings of the research indicated the relationship between the central category and the causal factors affecting the response The results of the model test in the quantitative stage confirmed the generality of the conceptual model.

Keywords: accountability, productivity, non-governmental, universities, foundation data theory

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740 Associated Factors of Hypercholesterolemia, Hyperuricemia and Double Burden of Hypercuricémia-Hypercholesterolemia in Gout Patients: Hospital Based Study

Authors: Pierre Mintom, Armel Assiene Agamou, Leslie Toukem, William Dakam, Christine Fernande Nyangono Biyegue

Abstract:

Context: Hyperuricemia, the presence of high levels of uric acid in the blood, is a known precursor to the development of gout. Recent studies have suggested a strong association between hyperuricemia and disorders of lipoprotein metabolism, specifically hypercholesterolemia. Understanding the factors associated with these conditions in gout patients is essential for effective treatment and management. Research Aim: The objective of this study was to determine the prevalence of hyperuricemia, hypercholesterolemia, and the double burden of hyperuricemia-hypercholesterolemia in the gouty population. Additionally, the study aimed to identify the factors associated with these conditions. Methodology: The study utilized a database from a survey of 150 gouty patients recruited at the Laquintinie Hospital in Douala between August 2017 and February 2018. The database contained information on anthropometric parameters, biochemical markers, and the food and drugs consumed by the patients. Hyperuricemia and hypercholesterolemia were defined based on specific serum uric acid and total cholesterol thresholds, and the double burden was defined as the co-occurrence of hyperuricemia and hypercholesterolemia. Findings: The study found that the prevalence rates for hyperuricemia, hypercholesterolemia, and the double burden were 61.3%, 76%, and 50.7% respectively. Factors associated with these conditions included hypertriglyceridemia, atherogenicity index TC/HDL ratio, atherogenicity index LDL/HDL ratio, family history, and the consumption of specific foods and drinks. Theoretical Importance: The study highlights the strong association between hyperuricemia and dyslipidemia, providing important insights for guiding treatment strategies in gout patients. Additionally, it emphasizes the significance of nutritional education in managing these metabolic disorders, suggesting the need to address eating habits in gout patients. Data Collection and Analysis Procedures: Data was collected through surveys and medical records of gouty patients. Information on anthropometric parameters, biochemical markers, and dietary habits was recorded. Prevalence rates and associated factors were determined through statistical analysis, employing odds ratios to assess the risks. Question Addressed: The study aimed to address the prevalence rates and associated factors of hyperuricemia, hypercholesterolemia, and the double burden in gouty patients. It sought to understand the relationships between these conditions and determine their implications for treatment and nutritional education. Conclusion: Findings show that it’s exists an association between hyperuricemia and hypercholesterolemia in gout patients, thus creating a double burden. The findings underscore the importance of considering family history and eating habits in addressing the double burden of hyperuricemia-hypercholesterolemia. This study provides valuable insights for guiding treatment approaches and emphasizes the need for nutritional education in gout patients. This study specifically focussed on the sick population. A case–control study between gouty and non-gouty populations would be interesting to better compare and explain the results observed.

Keywords: gout, hyperuricemia, hypercholesterolemia, double burden

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739 HRCT of the Chest and the Role of Artificial Intelligence in the Evaluation of Patients with COVID-19

Authors: Parisa Mansour

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Introduction: Early diagnosis of coronavirus disease (COVID-19) is extremely important to isolate and treat patients in time, thus preventing the spread of the disease, improving prognosis and reducing mortality. High-resolution computed tomography (HRCT) chest imaging and artificial intelligence (AI)-based analysis of HRCT chest images can play a central role in the treatment of patients with COVID-19. Objective: To investigate different chest HRCT findings in different stages of COVID-19 pneumonia and to evaluate the potential role of artificial intelligence in the quantitative assessment of lung parenchymal involvement in COVID-19 pneumonia. Materials and Methods: This retrospective observational study was conducted between May 1, 2020 and August 13, 2020. The study included 2169 patients with COVID-19 who underwent chest HRCT. HRCT images showed the presence and distribution of lesions such as: ground glass opacity (GGO), compaction, and any special patterns such as septal thickening, inverted halo, mark, etc. HRCT findings of the breast at different stages of the disease (early: andlt) 5 days, intermediate: 6-10 days and late stage: >10 days). A CT severity score (CTSS) was calculated based on the extent of lung involvement on HRCT, which was then correlated with clinical disease severity. Use of artificial intelligence; Analysis of CT pneumonia and quot; An algorithm was used to quantify the extent of pulmonary involvement by calculating the percentage of pulmonary opacity (PO) and gross opacity (PHO). Depending on the type of variables, statistically significant tests such as chi-square, analysis of variance (ANOVA) and post hoc tests were applied when appropriate. Results: Radiological findings were observed in HRCT chest in 1438 patients. A typical pattern of COVID-19 pneumonia, i.e., bilateral peripheral GGO with or without consolidation, was observed in 846 patients. About 294 asymptomatic patients were radiologically positive. Chest HRCT in the early stages of the disease mostly showed GGO. The late stage was indicated by such features as retinal enlargement, thickening and the presence of fibrous bands. Approximately 91.3% of cases with a CTSS = 7 were asymptomatic or clinically mild, while 81.2% of cases with a score = 15 were clinically severe. Mean PO and PHO (30.1 ± 28.0 and 8.4 ± 10.4, respectively) were significantly higher in the clinically severe categories. Conclusion: Because COVID-19 pneumonia progresses rapidly, radiologists and physicians should become familiar with typical TC chest findings to treat patients early, ultimately improving prognosis and reducing mortality. Artificial intelligence can be a valuable tool in treating patients with COVID-19.

Keywords: chest, HRCT, covid-19, artificial intelligence, chest HRCT

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738 Case Report: Ocular Helminth – In Unusual Site (Lens)

Authors: Chandra Shekhar Majumder, Shamsul Haque, Khondaker Anower Hossain, Rafiqul Islam

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Introduction: Ocular helminths are parasites that infect the eye or its adnexa. They can be either motile worms or sessile worms that form cysts. These parasites require two hosts for their life cycle, a definite host (usually a human) and an intermediate host (usually an insect). While there have been reports of ocular helminths infecting various structures of the eye, including the anterior chamber and subconjunctival space, there is no previous record of such a case involving the lens. Research Aim: The aim of this case report is to present a rare case of ocular helminth infection in the lens and to contribute to the understanding of this unusual site of infection. Methodology: This study is a case report, presenting the details and findings of an 80-year-old retired policeman who presented with severe pain, redness, and vision loss in the left eye. The examination revealed the presence of a thread-like helminth in the lens. The data for this case report were collected through clinical examination and medical records of the patient. The findings were described and presented in a descriptive manner. No statistical analysis was conducted. Case report: An 80-year-old retired policeman attended the OPD, Faridpur Medical College Hospital with the complaints of severe pain, redness and gross dimness of vision of the left eye for 5 days. He had a history of diabetes mellitus and hypertension for 3 years. On examination, L/E visual acuity was PL only, moderate ciliary congestion, KP 2+, cells 2+ and posterior synechia from 5 to 7 O’clock position was found. Lens was opaque. A thread like helminth was found under the anterior of the lens. The worm was moving and changing its position during examination. On examination of R/E, visual acuity was 6/36 unaided, 6/18 with pinhole. There was lental opacity. Slit-lamp and fundus examination were within normal limit. Patient was admitted in Faridpur Medical College Hospital. Diabetes mellitus was controlled with insulin. ICCE with PI was done on the same day of admission under depomedrol coverage. The helminth was recovered from the lens. It was thread like, about 5 to 6 mm in length, 1 mm in width and pinkish in colour. The patient followed up after 7 days, VA was HM, mild ciliary congestion, few KPs and cells were present. Media was hazy due to vitreous opacity. The worm was sent to the department of Parasitology, NIPSOM, Dhaka for identification. Theoretical Importance: This case report contributes to the existing literature on ocular helminth infections by reporting a unique case involving the lens. It highlights the need for further research to understand the mechanism of entry of helminths in the lens. Conclusion: To the best of our knowledge, this is the first reported case of ocular helminth infection in the lens. The presence of the helminth in the lens raises interesting questions regarding its pathogenesis and entry mechanism. Further study and research are needed to explore these aspects. Ophthalmologists and parasitologists should be aware of the possibility of ocular helminth infections in unusual sites like the lens.

Keywords: helminth, lens, ocular, unusual

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737 Groundwater Quality Assessment in the Vicinity of Tannery Industries in Warangal, India

Authors: Mohammed Fathima Shahanaaz, Shaik Fayazuddin, M. Uday Kiran

Abstract:

Groundwater quality is deteriorating day by day in different parts of the world due to various reasons, toxic chemicals are being discharged without proper treatment into inland water bodies and land which in turn add pollutants to the groundwater. In this kind of situation, the rural communities which do not have municipal drinking water have to rely on groundwater though it is polluted for various uses. Tannery industry is one of the major industry which provides economy and employment to India. Since most of the developed countries stopped using chemicals which are toxic, the tanning industry which uses chromium as its major element are being shifted towards developing countries. Most of the tanning industries in India can be found in clusters concentrated mainly in states of Tamilnadu, West Bengal, Uttar Pradesh and limited places of Punjab. Limited work is present in the case of tanneries of Warangal. There exists 18 group of tanneries in Desaipet, Enamamula region of Warangal, out of which 4 are involved in dry process and are low responsible for groundwater pollution. These units of tanneries are discharging their effluents after treatment into Sai Cheruvu. Though the treatment effluents are being discharged, the Sai Cheruvu is turned in to Pink colour, with higher levels of BOD, COD, chromium, chlorides, total hardness, TDS and sulphates. An attempt was made to analyse the groundwater samples around this polluted Sai Cheruvu region since literature shows that a single tannery can pollute groundwater to a radius of 7-8 kms from the point of disposal. Sample are collected from 6 different locations around Sai Cheruvu. Analysis was performed for determining various constituents in groundwater such as pH, EC, TDS, TH, Ca+2, Mg+2, HCO3-, Na+, K+, Cl-, SO42-, NO3-, F and Cr+6. The analysis of these constitutes gave values greater than permissible limits. Even chromium is also present in groundwater samples which is exceeding permissible limits People in Paidepally and Sardharpeta villages already stopped the usage of groundwater. They are buying bottle water for drinking purpose. Though they are not using groundwater for drinking purpose complaints are made about using this water for washing also. So treatment process should be adopted for groundwater which should be simple and efficient. In this study rice husk silica (RHS) is used to treat pollutants in groundwater with varying dosages of RHS and contact time. Rice husk is treated, dried and place in a muffle furnace for 6 hours at 650°C. Reduction is observed in total hardness, chlorides and chromium levels are observed after the application RHS. Pollutants reached permissible limits for 27.5mg/l and 50 mg/l of dosage for a contact time of 130 min at constant pH and temperature.

Keywords: chromium, groundwater, rice husk silica, tanning industries

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736 Assessment of Physical Activity and Sun Exposure of Saudi Patients with Type 2 Diabetes Mellitus in Ramadan and Non-Ramadan Periods

Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris

Abstract:

Background: Physical activity is an important factor in the treatment and prevention of type 2 diabetes mellitus (T2DM). Reduction in HbA1c level, an important diabetes biomarker, was reported in patients who increased their daily physical activity. Although the ambient temperature was reported to be positively correlated to a negative impact on health and increase the incidences of diabetes, the exposure to bright sunlight was recently found to be associated with enhanced insulin sensitivity and improved beta-cell function. How Ramadan alters physical activity, and especially sunlight exposure, has not been adequately investigated. Aim: This study aimed to assess the physical activity and sun exposure of Saudis with T2DM over different periods (before, during, and after Ramadan) and related this to HbA1c levels. Methods: This study recruited 82 Saudis with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for this study were obtained from De Montfort University and Saudi Ministry of Health. Physical activity and sun exposure were assessed by a self-administered questionnaire. Physical activity was estimated using the International Physical Activity Questionnaire (IPAQ), while the sun exposure was assessed by asking the patients about their hours per week of direct exposure to the sun, and daily hours spent outdoors. Blood samples were collected in each period for measuring HbA1c. Results: Low physical activity was observed in more than 60% of the patients, with no significant changes between periods. There were no significant variances between periods in the daily hours spent outdoors and the total number of weekly hours of direct exposure to the sun. The majority of patients reported only few hours of exposure to the sun (1h or less per week) and time spent outdoors (1h or less per day). The mean HbA1c significantly changed between periods (P = 0.001), with lowest level during Ramadan. There were significant differences in the mean HbA1c between the groups for the level of physical activity (P < 0.001), with significant lower mean HbA1c in the higher-level group. There were no significant variances in the mean of HbA1c between the groups for the daily hours spent outdoors. The mean HbA1c of the patients, who reported never in their total weekly hours of exposure to the sun, was significantly lower than the mean HbA1c of those who reported 1 hour or less (P = 0.001). Conclusion: Physical inactivity was prevalent among the study population with very little exposure to the sun or time spent outdoors. Higher level of physical activity was associated with lower mean HbA1c levels. Encouraging T2DM patients to achieve the recommended levels of physical activity may help them to obtain greater benefits of Ramadan fasting, such as reducing their HbA1c levels. The impact of low direct exposure to the sun and the time spent outdoors needs to be further investigated in both healthy and diabetic patients.

Keywords: diabetes, fasting, physical activity, sunlight, Ramadan

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735 The Impact of Information and Communications Technology (ICT)-Enabled Service Adaptation on Quality of Life: Insights from Taiwan

Authors: Chiahsu Yang, Peiling Wu, Ted Ho

Abstract:

From emphasizing economic development to stressing public happiness, the international community mainly hopes to be able to understand whether the quality of life for the public is becoming better. The Better Life Index (BLI) constructed by OECD uses living conditions and quality of life as starting points to cover 11 areas of life and to convey the state of the general public’s well-being. In light of the BLI framework, the Directorate General of Budget, Accounting and Statistics (DGBAS) of the Executive Yuan instituted the Gross National Happiness Index to understand the needs of the general public and to measure the progress of the aforementioned conditions in residents across the island. Whereas living conditions consist of income and wealth, jobs and earnings, and housing conditions, health status, work and life balance, education and skills, social connections, civic engagement and governance, environmental quality, personal security. The ICT area consists of health care, living environment, ICT-enabled communication, transportation, government, education, pleasure, purchasing, job & employment. In the wake of further science and technology development, rapid formation of information societies, and closer integration between lifestyles and information societies, the public’s well-being within information societies has indeed become a noteworthy topic. the Board of Science and Technology of the Executive Yuan use the OECD’s BLI as a reference in the establishment of the Taiwan-specific ICT-Enabled Better Life Index. Using this index, the government plans to examine whether the public’s quality of life is improving as well as measure the public’s satisfaction with current digital quality of life. This understanding will enable the government to gauge the degree of influence and impact that each dimension of digital services has on digital life happiness while also serving as an important reference for promoting digital service development. The content of the ICT Enabled Better Life Index. Information and communications technology (ICT) has been affecting people’s living styles, and further impact people’s quality of life (QoL). Even studies have shown that ICT access and usage have both positive and negative impact on life satisfaction and well-beings, many governments continue to invest in e-government programs to initiate their path to information society. This research is the few attempts to link the e-government benchmark to the subjective well-being perception, and further address the gap between user’s perception and existing hard data assessment, then propose a model to trace measurement results back to the original public policy in order for policy makers to justify their future proposals.

Keywords: information and communications technology, quality of life, satisfaction, well-being

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734 In vitro Antioxidant Activity and Total Phenolic Content of Dillenia indica and Garcinia penducalata, Commonly Used Fruits in Assamese Cuisine

Authors: M. Das, B. P. Sarma, G. Ahmed

Abstract:

Human diet can be a major source of antioxidants. Poly¬phenols, which are organic compounds present in the regular human diet, have good antioxidant property. Most of the diseases are detected too late and that cause irre¬versible damage to the body. Therefore food that forms the natural source of antioxidants can prevent free radi¬cals from damaging our body tissues. Dillenia indica and Garcinia penducalata are two major fruits, easily available in Assam, North eastern Indian state. In the present study, the in vitro antioxi¬dant properties of the fruits of these plants are compared as the decoction of these fruits form a major part of Assamese cuisine. DPPH free radical scavenging activity of the methanol, petroleum ether and water extracts of G. penducalata and D. indica fruits were carried out by the methods of Cotelle A et al. (1996). Different concentrations ranging from 10–110 ug/ml of the extracts were added to 100 uM of DPPH (2,2, Diphenyl-2-picryl hydrazyl) and the absor¬bance was read at 517 nm after incubation. Ascorbic acid was used as the standard. Different concentrations of the methanol, petroleum ether and water extracts of G. penducalata and D. indica fruits were mixed with sodium nitroprusside and incubated. Griess reagent was added to the mixtures and their optical density was read at 546 nm following the method of Marcocci et al. (1994). Ascorbic acid was used as the standard. In order to find the scavenging activity of the extracts against hydroxyl radicals, the method of Kunchandy & Ohkawa (1990) was followed.The superoxide scavenging activity of the methanol, petroleum ether and water extracts of the fruits was deter¬mined by the method of Robak & Gryglewski (1998).Six replicates were maintained in each of the experiments and their SEM was evaluated based on which, non linear regres¬sion (curve fit), exponential growth were derived to calculate the IC50 values of the SAWE and standard compounds. All the statistical analyses were done by using paired t test. The hydroxyl radical scavenging activity of the various extracts of D. indica exhibited IC50 values < 110 ug/ml concentration, the scavenging activity of the extracts of G. penducalata was surprisingly>110 ug/ml.Similarly the oxygen free radical scavenging activity of the different extracts of D. indica exhibited an IC50 value of <110 ug/ml but the methanolic extract of the same exhib¬ited a better free radical scavenging activity compared to that of vitamin C. The methanolic extract of D. indica exhibited an IC50 value better than that of vitamin C. The DPPH scavenging activities of the various extracts of D. indica and G. penducalata were <110 ug/ml but the methanolic extract of D. indica exhibited an IC50 value bet¬ter than that of vitaminc C.The higher amounts of phenolic content in the methanolic extract of D. indica might be one of the major causes for its enhanced in vitro antioxidant activity.The present study concludes that Dillenia indica and Garcinia penducalata both possesses anti oxidant activi¬ties. The anti oxidant activity of Dillenia indica is superior to that of Garcinia penducalata due to its higher phenolic content

Keywords: antioxidants, free radicals, phenolic, scavenging

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733 Marketization of Higher Education in the UK and Its Impacts on Teaching Practitioners

Authors: Hossein Rezaie

Abstract:

Academic institutions, esp. universities, have been known as cradles of learning and teaching great thinkers while creating the type of knowledge that is supposed to be bereft of utilitarian motives. Nonetheless, it seems that such intellectual centers have entered into a competition with each other for attracting the attention of potential clients. The traditional values of (higher) education such as nurturing criticality and fostering intellectuality in students have been replaced with strategic planning, quality assurance, performance assessment, and academic audits. Not being immune from the whims and wishes of marketization, the system of higher education in the UK has been recalibrated by policy makers to address the demand and supply of student education, academic research and other university activities on the basis of monetary factors. As an immediate example in this vein, the Russell Group in the UK, which is comprised of 24 leading UK research universities, has explicitly expressed it policy on its official website as follows: ‘Russell Group universities are global businesses competing for staff, students and funding with the best in the world’. Furthermore, certain attempts have been made to corporatize the system of HE which have been manifested in remodeling of university governing bodies on corporate lines and developing measurement scales for indicating the performance of teaching practitioners. Nevertheless, it seems that such structural changes in policies toward the system of HE have bearing on the practices of practitioners and educators as well as the identity of students who are the customers of educational services. The effects of marketization have been examined mainly in terms of students’ perceptions and motivation, institutional policies and university management. However, the teaching practitioner side seems to be an under-studied area with regard to any changes in its expectations, satisfaction and perception of professional identity in the aftermath of introducing market-wise values into HE of the UK. As a result, this research aims to investigate the possible outcomes of market-driven values on the practitioner side of HE in the UK and finally seeks to address the following research questions: 1-How is the change in the mission of HE in the UK reflected in institutional documents? 1-A- How is the change of mission represented in job adverts? 1-B- How is the change of mission represented in university prospectuses? 2-How are teaching practitioners represented regarding their roles and obligations in the prospectuses and job ads published by UK HE institutions? In order to address these questions, the researcher will analyze 30 prospectuses and job ads published by Russel Group universities by taking Critical Discourse Analysis as his point of departure and the analytical methods of genre analysis and Systemic Functional Linguistics to probe into the generic features and representation of participants, in this case teaching practitioners, in the selected corpus.

Keywords: higher education, job advertisements, marketization of higher education, prospectuses

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