Search results for: individual care plan
Commenced in January 2007
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Edition: International
Paper Count: 9248

Search results for: individual care plan

398 3D Design of Orthotic Braces and Casts in Medical Applications Using Microsoft Kinect Sensor

Authors: Sanjana S. Mallya, Roshan Arvind Sivakumar

Abstract:

Orthotics is the branch of medicine that deals with the provision and use of artificial casts or braces to alter the biomechanical structure of the limb and provide support for the limb. Custom-made orthoses provide more comfort and can correct issues better than those available over-the-counter. However, they are expensive and require intricate modelling of the limb. Traditional methods of modelling involve creating a plaster of Paris mould of the limb. Lately, CAD/CAM and 3D printing processes have improved the accuracy and reduced the production time. Ordinarily, digital cameras are used to capture the features of the limb from different views to create a 3D model. We propose a system to model the limb using Microsoft Kinect2 sensor. The Kinect can capture RGB and depth frames simultaneously up to 30 fps with sufficient accuracy. The region of interest is captured from three views, each shifted by 90 degrees. The RGB and depth data are fused into a single RGB-D frame. The resolution of the RGB frame is 1920px x 1080px while the resolution of the Depth frame is 512px x 424px. As the resolution of the frames is not equal, RGB pixels are mapped onto the Depth pixels to make sure data is not lost even if the resolution is lower. The resulting RGB-D frames are collected and using the depth coordinates, a three dimensional point cloud is generated for each view of the Kinect sensor. A common reference system was developed to merge the individual point clouds from the Kinect sensors. The reference system consisted of 8 coloured cubes, connected by rods to form a skeleton-cube with the coloured cubes at the corners. For each Kinect, the region of interest is the square formed by the centres of the four cubes facing the Kinect. The point clouds are merged by considering one of the cubes as the origin of a reference system. Depending on the relative distance from each cube, the three dimensional coordinate points from each point cloud is aligned to the reference frame to give a complete point cloud. The RGB data is used to correct for any errors in depth data for the point cloud. A triangular mesh is generated from the point cloud by applying Delaunay triangulation which generates the rough surface of the limb. This technique forms an approximation of the surface of the limb. The mesh is smoothened to obtain a smooth outer layer to give an accurate model of the limb. The model of the limb is used as a base for designing the custom orthotic brace or cast. It is transferred to a CAD/CAM design file to design of the brace above the surface of the limb. The proposed system would be more cost effective than current systems that use MRI or CT scans for generating 3D models and would be quicker than using traditional plaster of Paris cast modelling and the overall setup time is also low. Preliminary results indicate that the accuracy of the Kinect2 is satisfactory to perform modelling.

Keywords: 3d scanning, mesh generation, Microsoft kinect, orthotics, registration

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397 Challenges in Self-Managing Vitality: A Qualitative Study about Staying Vital at Work among Dutch Office Workers

Authors: Violet Petit-Steeghs, Jochem J. R. Van Roon, Jacqueline E. W. Broerse

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Last decennia the retirement age in Europe is gradually increasing. As a result, people have to continue working for a longer period of time. Health problems due to increased sedentary behavior and mental conditions like burn-out, pose a threat in fulfilling employees’ working life. In order to stimulate the ability and willingness to work in the present and future, it is important to stay vital. Vitality is regarded in literature as a sense of energy, motivation and resilience. It is assumed that by increasing their vitality, employees will stay healthier and be more satisfied with their job, leading to a more sustainable employment and less absenteeism in the future. The aim of this project is to obtain insights into the experiences and barriers of employees, and specifically office workers, with regard to their vitality. These insights are essential in order to develop appropriate measures in the future. To get more insights in the experiences of office workers on their vitality, 8 focus group discussions were organized with 6-10 office workers from 4 different employers (an university, a national construction company and a large juridical and care service organization) in the Netherlands. The discussions were transcribed and analyzed via open coding. This project is part of a larger consortium project Provita2, and conducted in collaboration with University of Technology Eindhoven. Results showed that a range of interdependent factors form a complex network that influences office workers’ vitality. These factors can be divided in three overarching groups: (1) personal (2) organizational and (3) environmental factors. Personal intrinsic factors, relating to the office worker, comprise someone’s physical health, coping style, life style, needs, and private life. Organizational factors, relating to the employer, are the workload, management style and the structure, vision and culture of the organization. Lastly, environmental factors consist of the air, light, temperature at the workplace and whether the workplace is inspiring and workable. Office workers experienced barriers to improve their own vitality due to a lack of autonomy. On the one hand, because most factors were not only intrinsic but extrinsic, like work atmosphere or the temperature in the room. On the other hand, office workers were restricted in adapting both intrinsic as well as extrinsic factors. Restrictions to for instance the flexibility of working times and the workload, can set limitations for improving vitality through personal factors like physical activity and mental relaxation. In conclusion, a large range of interdependent factors influence the vitality of office workers. Office workers are often regarded to have a responsibility to improve their vitality, but are limitedly autonomous in adapting these factors. Measures to improve vitality should therefore not only focus on increasing awareness among office workers, but also on empowering them to fulfill this responsibility. A holistic approach that takes the complex mutual dependencies between the different factors and actors (like managers, employees and HR personnel) into account is highly recommended.

Keywords: occupational health, perspectives office workers, sustainable employment, vitality at work, work & wellbeing

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396 Modeling Driving Distraction Considering Psychological-Physical Constraints

Authors: Yixin Zhu, Lishengsa Yue, Jian Sun, Lanyue Tang

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Modeling driving distraction in microscopic traffic simulation is crucial for enhancing simulation accuracy. Current driving distraction models are mainly derived from physical motion constraints under distracted states, in which distraction-related error terms are added to existing microscopic driver models. However, the model accuracy is not very satisfying, due to a lack of modeling the cognitive mechanism underlying the distraction. This study models driving distraction based on the Queueing Network Human Processor model (QN-MHP). This study utilizes the queuing structure of the model to perform task invocation and switching for distracted operation and control of the vehicle under driver distraction. Based on the assumption of the QN-MHP model about the cognitive sub-network, server F is a structural bottleneck. The latter information must wait for the previous information to leave server F before it can be processed in server F. Therefore, the waiting time for task switching needs to be calculated. Since the QN-MHP model has different information processing paths for auditory information and visual information, this study divides driving distraction into two types: auditory distraction and visual distraction. For visual distraction, both the visual distraction task and the driving task need to go through the visual perception sub-network, and the stimuli of the two are asynchronous, which is called stimulus on asynchrony (SOA), so when calculating the waiting time for switching tasks, it is necessary to consider it. In the case of auditory distraction, the auditory distraction task and the driving task do not need to compete for the server resources of the perceptual sub-network, and their stimuli can be synchronized without considering the time difference in receiving the stimuli. According to the Theory of Planned Behavior for drivers (TPB), this study uses risk entropy as the decision criterion for driver task switching. A logistic regression model is used with risk entropy as the independent variable to determine whether the driver performs a distraction task, to explain the relationship between perceived risk and distraction. Furthermore, to model a driver’s perception characteristics, a neurophysiological model of visual distraction tasks is incorporated into the QN-MHP, and executes the classical Intelligent Driver Model. The proposed driving distraction model integrates the psychological cognitive process of a driver with the physical motion characteristics, resulting in both high accuracy and interpretability. This paper uses 773 segments of distracted car-following in Shanghai Naturalistic Driving Study data (SH-NDS) to classify the patterns of distracted behavior on different road facilities and obtains three types of distraction patterns: numbness, delay, and aggressiveness. The model was calibrated and verified by simulation. The results indicate that the model can effectively simulate the distracted car-following behavior of different patterns on various roadway facilities, and its performance is better than the traditional IDM model with distraction-related error terms. The proposed model overcomes the limitations of physical-constraints-based models in replicating dangerous driving behaviors, and internal characteristics of an individual. Moreover, the model is demonstrated to effectively generate more dangerous distracted driving scenarios, which can be used to construct high-value automated driving test scenarios.

Keywords: computational cognitive model, driving distraction, microscopic traffic simulation, psychological-physical constraints

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395 Strengthening Adult Literacy Programs in Order to End Female Genital Mutilation to Achieve Sustainable Development Goals

Authors: Odenigbo Veronica Ngozi, Lorreta Chika Ukwuaba

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This study focuses on how the strengthening adult literacy program can help accelerate transformative strategies to end female genital mutilation (FGM) in Nigeria, specifically in Nsukka Local Government Area. The research delves into the definition of FGM, adult literacy programs, and how to achieve ending FGM to attain Sustainable Development Goals (SDGs) in 2030. It further discusses the practice of FGM in Nigeria and emphasizes the statement of the problem. The main aim of the study is to investigate how strengthening adult literacy programs can help accelerate transformative strategies to end FGM in Nigeria and achieve SDGs in 2030. The researchers utilized a survey research design to conduct the study in Nsukka L.G.A. The population was composed of 26 facilitators and adult learners in five adult learning centers in the area. The entire population was used as a sample, and structured questionnaires were employed to elicit information. The items on the questionnaire were face-validated by three experts, and the reliability of the instrument was verified using Cronbach Alpha Reliability Technique. The research questions were analyzed using means and standard deviation while the hypothesis was tested at 0.05 level of degree of significance using a t-test. The findings show that through adult literacy program acceleration of transformative strategies, the practices of FGM can be ended. Strengthening adult literacy programs is a good channel to end or stop FGM through the knowledge and skill acquired from the learning centers. The theoretical importance of the study lies in the fact that it highlights the role of adult literacy programs in accelerating transformative strategies to combat harmful cultural practices such as FGM. It further supports the importance of education and knowledge in achieving sustainable development goals by 2030. Structured questionnaires were distributed to an entire population of 26 facilitators and adult learners in five adult learning centers in Nsukka L.G.A. The questionnaire items were face–validated by three experts, and the reliability of the instrument was verified using Cronbach Alpha Reliability Technique. The research questions were analyzed using means and standard deviation, while the hypothesis was tested using a t-test at 0.05 level of degree of significance. The study addressed the question of how strengthening adult literacy programs can help accelerate transformative strategies to end FGM in Nigeria and achieve SDGs by 2030. In conclusion, the study found that adult literacy is a good tool to end FGM in Nigeria. The recommendations were that government, non-governmental organizations (NGOs), Community-based organizations (CBOs), and individuals should support the funding and establishment of adult literacy centers in communities so as to reach every illiterate parent or individual and acquire the knowledge and skill needed to understand the negative effect of FGM in the life of a girl child.

Keywords: adult literacy, female genital mutilation, learning centers, SDGs, strengthening

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394 Lesbians, Gays and Bisexuals of Botswana: Progressive Steps by the Botswana Court of Appeal towards Recognition and Advancement of Fundamental Human Rights of the Most Vulnerable within Society

Authors: Tashwill Esterhuizen

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Throughout Africa, several countries continue to have laws which criminalise same-sex sexual activities, which increases the vulnerability of the LGBT community to stigma, discrimination, and persecution. These criminal provisions often form the basis upon which states deny LGBT activists the right to freely associate with other like-minded individuals and form organizations that protect their interests and advocate for the rights and aspirations of the LGBT community. Over the past year, however, there has been significant progress in the advancement of universal, fundamental rights of LGBT persons throughout Africa. In many instances, these advancements came about through the bravery of activists who have publically insisted (in environments where same-sex sexual practices are criminalised) that their rights should be respected. Where meaningful engagement with the State was fruitless, activists took their plight to the judiciary and have successfully sought to uphold the fundamental rights of LGBT persons, paving the way for a more inclusive and tolerant society. Litigation Progress: Botswana is a prime example. For several years, the State denied a group of LGBT activists their right to freely associate and form their organisation Lesbians, Gays, and Bisexuals of Botswana (LEGABIBO), which aimed to promote the interests of the LGBT community in Botswana. In March 2016, the Botswana Court of Appeal found that the government’s refusal to register LEGABIBO violated the activists’ right to associate freely. The Court held that the right freedom of association applies to all persons regardless of their sexual orientation or gender identity. It does not matter that the views of the organisation are unpopular or unacceptable amongst the majority. In particular, the Court rejected the government of Botswana’s contention that registering LEGABIBO would disturb public peace and is contrary to public morality. Quite remarkably, the Court of Appeal recognised that while LGBT individuals are a minority group within the country, they are nonetheless persons entitled to constitutional protections of their dignity, regardless of whether they are unacceptable to others on religious or any other grounds. Furthermore, the Court held that human rights and fundamental freedoms are granted to all, including criminals or social outcasts because the denial of an individual’s humanity is the denial of their human dignity. This is crucial observation by the Court of Appeal, as once it is accepted that human rights apply to all human beings, then it becomes much easier for vulnerable groups to assert their own rights. Conclusion: The Botswana Court of Appeal decision, therefore, represents significant progress in the promotion of the rights of lesbian, gay, bisexual and transgender persons. The judgment has broader implications for many other countries which do not provide recognition of sexual minorities. It highlights the State’s duty to uphold basic rights and to ensure dignity, tolerance, and acceptance for marginalised persons.

Keywords: acceptance, freedom of association, freedom of expression, fundamental rights and freedoms, gender identity, human rights are universal, inclusive, inherent human dignity, progress, sexual orientation, tolerance

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393 Writing the Roaming Female Self: Identity and Romantic Selfhood in Mary Wollstonecraft’s Letters Written during a Short Stay in Sweden, Denmark, and Norway (1796)

Authors: Kalyani Gandhi

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The eighteenth century in Britain saw a great burst of activity in writing (letters, journals, newspapers, essays); often these modes of writing had a public-spirited bent in-step with the prevailing intellectual atmosphere. Mary Wollstonecraft was one of the leading intellectuals of that period who utilized letter writing to convey her thoughts on the exciting political developments of the late eighteenth century. Fusing together her anxieties and concerns about humanity in general and herself in particular, Wollstonecraft’s views of the world around her are filtered through the lens of her subjectivity. Thus, Wollstonecraft’s letters covered a wide range of topics on both the personal and political level (for the two are often entwined in Wollstonecraft’s characteristic style of analysis) such as sentiment, gender, nature, peasantry, the class system, the legal system, political duties and rights of both rulers and subjects, death, immortality, religion, family and education. Therefore, this paper intends to examine the manner in which Wollstonecraft utilizes letter-writing to constitute and develop Romantic self-hood, understand the world around her and illustrate her ideas on the political and social happenings in Europe. The primary text analyzed will be Mary Wollstonecraft's Letters Written During a Short Stay in Sweden, Denmark and Norway (1796) and the analysis of this text will be supplemented by researching 18th-century British letter writing culture, with a special emphasis on the epistolary habits of women. Within this larger framework, this paper intends to examine the manner in which this hybrid of travel and epistolary writing aided Mary Wollstonecraft's expression on Romantic selfhood and how it was complicated by ideas of gender. This paper reveals Wollstonecraft's text to be wrought with anxiety about the world around her and within her; thus, the personal-public nature of the epistolary format particularly suits her characteristic point of view that looks within and without. That is to say, Wollstonecraft’s anxieties about gender and self, are as much about the women she sees in the world around her as much as they are about her young daughter and herself. Wollstonecraft constantly explores and examines this anxiety within the different but interconnected realms of politics, economics, history and society. In fact, it is her complex technique of entwining these aforementioned concerns with a closer look at interpersonal relationships among men and women (she often mentions specific anecdotes and instances) that make Wollstonecraft's Letters so engaging and insightful. Thus, Wollstonecraft’s Letters is an exemplar of British Romantic writing due to the manner in which it explores the bond between the individual and society. Mary Wollstonecraft's nuances this exploration by incorporating her concerns about women and the playing out of gender in society. Thus, Wollstonecraft’s Letters is an invaluable contribution to the field of British Romanticism, particularly as it offers crucial insight on female Romantic writing that can broaden and enrich the current academic understanding of the field.

Keywords: British romanticism, letters, feminism, travel writing

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392 Accuracy of Fitbit Charge 4 for Measuring Heart Rate in Parkinson’s Patients During Intense Exercise

Authors: Giulia Colonna, Jocelyn Hoye, Bart de Laat, Gelsina Stanley, Jose Key, Alaaddin Ibrahimy, Sule Tinaz, Evan D. Morris

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Parkinson’s disease (PD) is the second most common neurodegenerative disease and affects approximately 1% of the world’s population. Increasing evidence suggests that aerobic physical exercise can be beneficial in mitigating both motor and non-motor symptoms of the disease. In a recent pilot study of the role of exercise on PD, we sought to confirm exercise intensity by monitoring heart rate (HR). For this purpose, we asked participants to wear a chest strap heart rate monitor (Polar Electro Oy, Kempele). The device sometimes proved uncomfortable. Looking forward to larger clinical trials, it would be convenient to employ a more comfortable and user friendly device. The Fitbit Charge 4 (Fitbit Inc) is a potentially comfortable, user-friendly solution since it is a wrist-worn heart rate monitor. Polar H10 has been used in large trials, and for our purposes, we treated it as the gold standard for the beat-to-beat period (R-R interval) assessment. In previous literature, it has been shown that Fitbit Charge 4 has comparable accuracy to Polar H10 in healthy subjects. It has yet to be determined if the Fitbit is as accurate as the Polar H10 in subjects with PD or in clinical populations, generally. Goal: To compare the Fitbit Charge 4 to the Polar H10 for monitoring HR in PD subjects engaging in an intensive exercise program. Methods: A total of 596 exercise sessions from 11 subjects (6 males) were collected simultaneously by both devices. Subjects with early-stage PD (Hoehn & Yahr <=2) were enrolled in a 6 months exercise training program designed for PD patients. Subjects participated in 3 one-hour exercise sessions per week. They wore both Fitbit and Polar H10 during each session. Sessions included rest, warm-up, intensive exercise, and cool-down periods. We calculated the bias in the HR via Fitbit under rest (5min) and intensive exercise (20min) by comparing the mean HR during each of the periods to the respective means measured by the Polar (HRFitbit – HRPolar). We also measured the sensitivity and specificity of Fitbit for detecting HRs that exceed the threshold for intensive exercise, defined as 70% of an individual’s theoretical maximum HR. Different types of correlation between the two devices were investigated. Results: The mean bias was 1.68 bpm at rest and 6.29 bpm during high intensity exercise, with an overestimation by Fitbit in both conditions. The mean bias of Fitbit across both rest and intensive exercise periods was 3.98 bpm. The sensitivity of the device in identifying high intensity exercise sessions was 97.14 %. The correlation between the two devices was non-linear, suggesting a saturation tendency of Fitbit to saturate at high values of HR. Conclusion: The performance of Fitbit Charge 4 is comparable to Polar H10 for assessing exercise intensity in a cohort of PD subjects. The device should be considered a reasonable replacement for the more cumbersome chest strap technology in future similar studies of clinical populations.

Keywords: fitbit, heart rate measurements, parkinson’s disease, wrist-wearable devices

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391 Sand Production Modelled with Darcy Fluid Flow Using Discrete Element Method

Authors: M. N. Nwodo, Y. P. Cheng, N. H. Minh

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In the process of recovering oil in weak sandstone formations, the strength of sandstones around the wellbore is weakened due to the increase of effective stress/load from the completion activities around the cavity. The weakened and de-bonded sandstone may be eroded away by the produced fluid, which is termed sand production. It is one of the major trending subjects in the petroleum industry because of its significant negative impacts, as well as some observed positive impacts. For efficient sand management therefore, there has been need for a reliable study tool to understand the mechanism of sanding. One method of studying sand production is the use of the widely recognized Discrete Element Method (DEM), Particle Flow Code (PFC3D) which represents sands as granular individual elements bonded together at contact points. However, there is limited knowledge of the particle-scale behavior of the weak sandstone, and the parameters that affect sanding. This paper aims to investigate the reliability of using PFC3D and a simple Darcy flow in understanding the sand production behavior of a weak sandstone. An isotropic tri-axial test on a weak oil sandstone sample was first simulated at a confining stress of 1MPa to calibrate and validate the parallel bond models of PFC3D using a 10m height and 10m diameter solid cylindrical model. The effect of the confining stress on the number of bonds failure was studied using this cylindrical model. With the calibrated data and sample material properties obtained from the tri-axial test, simulations without and with fluid flow were carried out to check on the effect of Darcy flow on bonds failure using the same model geometry. The fluid flow network comprised of every four particles connected with tetrahedral flow pipes with a central pore or flow domain. Parametric studies included the effects of confining stress, and fluid pressure; as well as validating flow rate – permeability relationship to verify Darcy’s fluid flow law. The effect of model size scaling on sanding was also investigated using 4m height, 2m diameter model. The parallel bond model successfully calibrated the sample’s strength of 4.4MPa, showing a sharp peak strength before strain-softening, similar to the behavior of real cemented sandstones. There seems to be an exponential increasing relationship for the bigger model, but a curvilinear shape for the smaller model. The presence of the Darcy flow induced tensile forces and increased the number of broken bonds. For the parametric studies, flow rate has a linear relationship with permeability at constant pressure head. The higher the fluid flow pressure, the higher the number of broken bonds/sanding. The DEM PFC3D is a promising tool to studying the micromechanical behavior of cemented sandstones.

Keywords: discrete element method, fluid flow, parametric study, sand production/bonds failure

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390 Wetland Community and Their Livelihood Opportunities in the Face of Changing Climatic Condition in Southwest Bangladesh

Authors: Mohsina Aktar, Bishawjit Mallick

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

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

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389 Traditional Practices of Conserving Biodiversity: A Case Study around Jim Corbett National Park, Uttarakhand, India

Authors: Rana Parween, Rob Marchant

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With the continued loss of global biodiversity despite the application of modern conservation techniques, it has become crucial to investigate non-conventional methods. Accelerated destruction of ecosystems due to altered land use, climate change, cultural and social change, necessitates the exploration of society-biodiversity attitudes and links. While the loss of species and their extinction is a well-known and well-documented process that attracts much-needed attention from researchers, academics, government and non-governmental organizations, the loss of traditional ecological knowledge and practices is more insidious and goes unnoticed. The growing availability of 'indirect experiences' such as the internet and media are leading to a disaffection towards nature and the 'Extinction of Experience'. Exacerbated by the lack of documentation of traditional practices and skills, there is the possibility for the 'extinction' of traditional practices and skills before they are fully recognized and captured. India, as a mega-biodiverse country, is also known for its historical conservation strategies entwined in traditional beliefs. Indigenous communities hold skillsets, knowledge, and traditions that have accumulated over multiple generations and may play an important role in conserving biodiversity today. This study explores the differences in knowledge and attitudes towards conserving biodiversity, of three different stakeholder groups living around Jim Corbett National Park, based on their age, traditions, and association with the protected area. A triangulation designed multi-strategy investigation collected qualitative and quantitative data through a questionnaire survey of village elders, the general public, and forest officers. Following an inductive approach to analyzing qualitative data, the thematic content analysis was followed. All coding and analysis were completed using NVivo 11. Although the village elders and some general public had vast amounts of traditional knowledge, most of it was related to animal husbandry and the medicinal value of plants. Village elders were unfamiliar with the concept of the term ‘biodiversity’ albeit their way of life and attitudes ensured that they care for the ecosystem without having the scientific basis underpinning biodiversity conservation. Inherently, village elders were keen to conserve nature; the superimposition of governmental policies without any tangible benefit or consultation was seen as detrimental. Alienating villagers and consequently the village elders who are the reservoirs of traditional knowledge would not only be damaging to the social network of the area but would also disdain years of tried and tested techniques held by the elders. Forest officers advocated for biodiversity and conservation education for women and children. Women, across all groups, when questioned about nature conservation, showed more interest in learning and participation. Biodiversity not only has an ethical and cultural value, but also plays a role in ecosystem function and, thus, provides ecosystem services and supports livelihoods. Therefore, underpinning and using traditional knowledge and incorporating them into programs of biodiversity conservation should be explored with a sense of urgency.

Keywords: biological diversity, mega-biodiverse countries, traditional ecological knowledge, society-biodiversity links

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388 Molecular Characterization, Host Plant Resistance and Epidemiology of Bean Common Mosaic Virus Infecting Cowpea (Vigna unguiculata L. Walp)

Authors: N. Manjunatha, K. T. Rangswamy, N. Nagaraju, H. A. Prameela, P. Rudraswamy, M. Krishnareddy

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The identification of virus in cowpea especially potyviruses is confusing. Even though there are several studies on viruses causing diseases in cowpea, difficult to distinguish based on symptoms and serological detection. The differentiation of potyviruses considering as a constraint, the present study is initiated for molecular characterization, host plant resistance and epidemiology of the BCMV infecting cowpea. The etiological agent causing cowpea mosaic was identified as Bean Common Mosaic Virus (BCMV) on the basis of RT-PCR and electron microscopy. An approximately 750bp PCR product corresponding to coat protein (CP) region of the virus and the presence of long flexuous filamentous particles measuring about 952 nm in size typical to genus potyvirus were observed under electron microscope. The characterized virus isolate genome had 10054 nucleotides, excluding the 3’ terminal poly (A) tail. Comparison of polyprotein of the virus with other potyviruses showed similar genome organization with 9 cleavage sites resulted in 10 functional proteins. The pairwise sequence comparison of individual genes, P1 showed most divergent, but CP gene was less divergent at nucleotide and amino acid level. A phylogenetic tree constructed based on multiple sequence alignments of the polyprotein nucleotide and amino acid sequences of cowpea BCMV and potyviruses showed virus is closely related to BCMV-HB. Whereas, Soybean variant of china (KJ807806) and NL1 isolate (AY112735) showed 93.8 % (5’UTR) and 94.9 % (3’UTR) homology respectively with other BCMV isolates. This virus transmitted to different leguminous plant species and produced systemic symptoms under greenhouse conditions. Out of 100 cowpea genotypes screened, three genotypes viz., IC 8966, V 5 and IC 202806 showed immune reaction in both field and greenhouse conditions. Single marker analysis (SMA) was revealed out of 4 SSR markers linked to BCMV resistance, M135 marker explains 28.2 % of phenotypic variation (R2) and Polymorphic information content (PIC) value of these markers was ranged from 0.23 to 0.37. The correlation and regression analysis showed rainfall, and minimum temperature had significant negative impact and strong relationship with aphid population, whereas weak correlation was observed with disease incidence. Path coefficient analysis revealed most of the weather parameters exerted their indirect contributions to the aphid population and disease incidence except minimum temperature. This study helps to identify specific gaps in knowledge for researchers who may wish to further analyse the science behind complex interactions between vector-virus and host in relation to the environment. The resistant genotypes identified are could be effectively used in resistance breeding programme.

Keywords: cowpea, epidemiology, genotypes, virus

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387 A Negotiation Model for Understanding the Role of International Law in Foreign Policy Crises

Authors: William Casto

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Studies that consider the actual impact of international law upon foreign affairs crises are flawed by an unrealistic model of decision making. The common, unexamined assumption is that a nation has a unitary executive or ruler who considers a wide variety of considerations, including international law, in attempting to resolve a crisis. To the extent that negotiation theory is considered, the focus is on negotiations between or among nations. The unsettling result is a shallow focus that concentrates on each country’s public posturing about international law. The country-to-country model ignores governments’ internal negotiations that lead to their formal position in a crisis. The model for foreign policy crises needs to be supplemented to include a model of internal negotiations. Important foreign policy decisions come from groups within a government committee, advisers, etc. Within these groups, participants may have differing agendas and resort to international law to bolster their positions. To understand the influence of international law in international crises, these internal negotiations must be considered. These negotiations are crucial to creating a foreign policy agenda or recommendations. External negotiations between the two nations are significant, but the internal negotiations provide a better understanding of the actual influence of international law upon international crises. Discovering the details of specific internal negotiations is quite difficult but not necessarily impossible. The present proposal will use a specific crisis to illustrate the role of international law. In 1861 during the American Civil War, a United States navy captain stopped a British mail ship and removed two ambassadors of the rebelling southern states. The result was what is commonly called the Trent Affair. In the wake of the captain’s unauthorized and rash action, Great Britain seriously considered going to war against the United States. A detailed analysis of the Trent Affair is possible using the available and extensive internal British correspondence and memoranda to reach an understanding of the effect of international law upon decision making. The extensive trove of internal British documents is particularly valuable because in 1861, the only effective means of communication was face-to-face or through letters. Telephones did not exist, and travel by horse and carriage was tedious. The British documents tell us how individual participants viewed the process. We can approach an accurate understanding of what actually happened as the British government strove to resolve the crisis. For example, British law officers initially concluded that the American captain’s rash act was permissible under international law. Later, the law officers revised their opinion. A model of internal negotiation is particularly valuable because it strips away nations’ public posturing about disputed international law principles. In internal decision making, there is room for meaningful debate over the relevant principles. This fluid debate tells how international law is used to develop a hard, public bargaining position. The Trent Affair indicates that international law had an actual influence upon the crisis and that law was not mere window dressing for the government’s public position.

Keywords: foreign affairs crises, negotiation, international law, Trent affair

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386 Cicadas: A Clinician-assisted, Closed-loop Technology, Mobile App for Adolescents with Autism Spectrum Disorders

Authors: Bruno Biagianti, Angela Tseng, Kathy Wannaviroj, Allison Corlett, Megan DuBois, Kyu Lee, Suma Jacob

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Background: ASD is characterized by pervasive Sensory Processing Abnormalities (SPA) and social cognitive deficits that persist throughout the course of the illness and have been linked to functional abnormalities in specific neural systems that underlie the perception, processing, and representation of sensory information. SPA and social cognitive deficits are associated with difficulties in interpersonal relationships, poor development of social skills, reduced social interactions and lower academic performance. Importantly, they can hamper the effects of established evidence-based psychological treatments—including PEERS (Program for the Education and Enrichment of Relationship Skills), a parent/caregiver-assisted, 16-weeks social skills intervention—which nonetheless requires a functional brain capable of assimilating and retaining information and skills. As a matter of fact, some adolescents benefit from PEERS more than others, calling for strategies to increase treatment response rates. Objective: We will present interim data on CICADAS (Care Improving Cognition for ADolescents on the Autism Spectrum)—a clinician-assisted, closed-loop technology mobile application for adolescents with ASD. Via ten mobile assessments, CICADAS captures data on sensory processing abnormalities and associated cognitive deficits. These data populate a machine learning algorithm that tailors the delivery of ten neuroplasticity-based social cognitive training (NB-SCT) exercises targeting sensory processing abnormalities. Methods: In collaboration with the Autism Spectrum and Neurodevelopmental Disorders Clinic at the University of Minnesota, we conducted a fully remote, three-arm, randomized crossover trial with adolescents with ASD to document the acceptability of CICADAS and evaluate its potential as a stand-alone treatment or as a treatment enhancer of PEERS. Twenty-four adolescents with ASD (ages 11-18) have been initially randomized to 16 weeks of PEERS + CICADAS (Arm A) vs. 16 weeks of PEERS + computer games vs. 16 weeks of CICADAS alone (Arm C). After 16 weeks, the full battery of assessments has been remotely administered. Results: We have evaluated the acceptability of CICADAS by examining adherence rates, engagement patterns, and exit survey data. We found that: 1) CICADAS is able to serve as a treatment enhancer for PEERS, inducing greater improvements in sensory processing, cognition, symptom reduction, social skills and behaviors, as well as the quality of life compared to computer games; 2) the concurrent delivery of PEERS and CICADAS induces greater improvements in study outcomes compared to CICADAS only. Conclusion: While preliminary, our results indicate that the individualized assessment and treatment approach designed in CICADAS seems effective in inducing adaptive long-term learning about social-emotional events. CICADAS-induced enhancement of processing and cognition facilitates the application of PEERS skills in the environment of adolescents with ASD, thus improving their real-world functioning.

Keywords: ASD, social skills, cognitive training, mobile app

Procedia PDF Downloads 213
385 Analysis of Electric Mobility in the European Union: Forecasting 2035

Authors: Domenico Carmelo Mongelli

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The context is that of great uncertainty in the 27 countries belonging to the European Union which has adopted an epochal measure: the elimination of internal combustion engines for the traction of road vehicles starting from 2035 with complete replacement with electric vehicles. If on the one hand there is great concern at various levels for the unpreparedness for this change, on the other the Scientific Community is not preparing accurate studies on the problem, as the scientific literature deals with single aspects of the issue, moreover addressing the issue at the level of individual countries, losing sight of the global implications of the issue for the entire EU. The aim of the research is to fill these gaps: the technological, plant engineering, environmental, economic and employment aspects of the energy transition in question are addressed and connected to each other, comparing the current situation with the different scenarios that could exist in 2035 and in the following years until total disposal of the internal combustion engine vehicle fleet for the entire EU. The methodologies adopted by the research consist in the analysis of the entire life cycle of electric vehicles and batteries, through the use of specific databases, and in the dynamic simulation, using specific calculation codes, of the application of the results of this analysis to the entire EU electric vehicle fleet from 2035 onwards. Energy balance sheets will be drawn up (to evaluate the net energy saved), plant balance sheets (to determine the surplus demand for power and electrical energy required and the sizing of new plants from renewable sources to cover electricity needs), economic balance sheets (to determine the investment costs for this transition, the savings during the operation phase and the payback times of the initial investments), the environmental balances (with the different energy mix scenarios in anticipation of 2035, the reductions in CO2eq and the environmental effects are determined resulting from the increase in the production of lithium for batteries), the employment balances (it is estimated how many jobs will be lost and recovered in the reconversion of the automotive industry, related industries and in the refining, distribution and sale of petroleum products and how many will be products for technological innovation, the increase in demand for electricity, the construction and management of street electric columns). New algorithms for forecast optimization are developed, tested and validated. Compared to other published material, the research adds an overall picture of the energy transition, capturing the advantages and disadvantages of the different aspects, evaluating the entities and improvement solutions in an organic overall picture of the topic. The results achieved allow us to identify the strengths and weaknesses of the energy transition, to determine the possible solutions to mitigate these weaknesses and to simulate and then evaluate their effects, establishing the most suitable solutions to make this transition feasible.

Keywords: engines, Europe, mobility, transition

Procedia PDF Downloads 61
384 Loss Quantification Archaeological Sites in Watershed Due to the Use and Occupation of Land

Authors: Elissandro Voigt Beier, Cristiano Poleto

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The main objective of the research is to assess the loss through the quantification of material culture (archaeological fragments) in rural areas, sites explored economically by machining on seasonal crops, and also permanent, in a hydrographic subsystem Camaquã River in the state of Rio Grande do Sul, Brazil. The study area consists of different micro basins and differs in area, ranging between 1,000 m² and 10,000 m², respectively the largest and the smallest, all with a large number of occurrences and outcrop locations of archaeological material and high density in intense farm environment. In the first stage of the research aimed to identify the dispersion of points of archaeological material through field survey through plot points by the Global Positioning System (GPS), within each river basin, was made use of concise bibliography on the topic in the region, helping theoretically in understanding the old landscaping with preferences of occupation for reasons of ancient historical people through the settlements relating to the practice observed in the field. The mapping was followed by the cartographic development in the region through the development of cartographic products of the land elevation, consequently were created cartographic products were to contribute to the understanding of the distribution of the absolute materials; the definition and scope of the material dispersed; and as a result of human activities the development of revolving letter by mechanization of in situ material, it was also necessary for the preparation of materials found density maps, linking natural environments conducive to ancient historical occupation with the current human occupation. The third stage of the project it is for the systematic collection of archaeological material without alteration or interference in the subsurface of the indigenous settlements, thus, the material was prepared and treated in the laboratory to remove soil excesses, cleaning through previous communication methodology, measurement and quantification. Approximately 15,000 were identified archaeological fragments belonging to different periods of ancient history of the region, all collected outside of its environmental and historical context and it also has quite changed and modified. The material was identified and cataloged considering features such as object weight, size, type of material (lithic, ceramic, bone, Historical porcelain and their true association with the ancient history) and it was disregarded its principles as individual lithology of the object and functionality same. As observed preliminary results, we can point out the change of materials by heavy mechanization and consequent soil disturbance processes, and these processes generate loading of archaeological materials. Therefore, as a next step will be sought, an estimate of potential losses through a mathematical model. It is expected by this process, to reach a reliable model of high accuracy which can be applied to an archeological site of lower density without encountering a significant error.

Keywords: degradation of heritage, quantification in archaeology, watershed, use and occupation of land

Procedia PDF Downloads 277
383 The Use of Remotely Sensed Data to Model Habitat Selections of Pileated Woodpeckers (Dryocopus pileatus) in Fragmented Landscapes

Authors: Ruijia Hu, Susanna T.Y. Tong

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Light detection and ranging (LiDAR) and four-channel red, green, blue, and near-infrared (RGBI) remote sensed imageries allow an accurate quantification and contiguous measurement of vegetation characteristics and forest structures. This information facilitates the generation of habitat structure variables for forest species distribution modelling. However, applications of remote sensing data, especially the combination of structural and spectral information, to support evidence-based decisions in forest managements and conservation practices at local scale are not widely adopted. In this study, we examined the habitat requirements of pileated woodpecker (Dryocopus pileatus) (PW) in Hamilton County, Ohio, using ecologically relevant forest structural and vegetation characteristics derived from LiDAR and RGBI data. We hypothesized that the habitat of PW is shaped by vegetation characteristics that are directly associated with the availability of food, hiding and nesting resources, the spatial arrangement of habitat patches within home range, as well as proximity to water sources. We used 186 PW presence or absence locations to model their presence and absence in generalized additive model (GAM) at two scales, representing foraging and home range size, respectively. The results confirm PW’s preference for tall and large mature stands with structural complexity, typical of late-successional or old-growth forests. Besides, the crown size of dead trees shows a positive relationship with PW occurrence, therefore indicating the importance of declining living trees or early-stage dead trees within PW home range. These locations are preferred by PW for nest cavity excavation as it attempts to balance the ease of excavation and tree security. In addition, we found that PW can adjust its travel distance to the nearest water resource, suggesting that habitat fragmentation can have certain impacts on PW. Based on our findings, we recommend that forest managers should use different priorities to manage nesting, roosting, and feeding habitats. Particularly, when devising forest management and hazard tree removal plans, one needs to consider retaining enough cavity trees within high-quality PW habitat. By mapping PW habitat suitability for the study area, we highlight the importance of riparian corridor in facilitating PW to adjust to the fragmented urban landscape. Indeed, habitat improvement for PW in the study area could be achieved by conserving riparian corridors and promoting riparian forest succession along major rivers in Hamilton County.

Keywords: deadwood detection, generalized additive model, individual tree crown delineation, LiDAR, pileated woodpecker, RGBI aerial imagery, species distribution models

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382 Adapting Inclusive Residential Models to Match Universal Accessibility and Fire Protection

Authors: Patricia Huedo, Maria José Ruá, Raquel Agost-Felip

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Ensuring sustainable development of urban environments means guaranteeing adequate environmental conditions, being resilient and meeting conditions of safety and inclusion for all people, regardless of their condition. All existing buildings should meet basic safety conditions and be equipped with safe and accessible routes, along with visual, acoustic and tactile signals to protect their users or potential visitors, and regardless of whether they undergo rehabilitation or change of use processes. Moreover, from a social perspective, we consider the need to prioritize buildings occupied by the most vulnerable groups of people that currently do not have specific regulations tailored to their needs. Some residential models in operation are not only outside the scope of application of the regulations in force; they also lack a project or technical data that would allow knowing the fire behavior of the construction materials. However, the difficulty and cost involved in adapting the entire building stock to current regulations can never justify the lack of safety for people. Hence, this work develops a simplified model to assess compliance with the basic safety conditions in case of fire and its compatibility with the specific accessibility needs of each user. The purpose is to support the designer in decision making, as well as to contribute to the development of a basic fire safety certification tool to be applied in inclusive residential models. This work has developed a methodology to support designers in adapting Social Services Centers, usually intended to vulnerable people. It incorporates a checklist of 9 items and information from sources or standards that designers can use to justify compliance or propose solutions. For each item, the verification system is justified, and possible sources of consultation are provided, considering the possibility of lacking technical documentation of construction systems or building materials. The procedure is based on diagnosing the degree of compliance with fire conditions of residential models used by vulnerable groups, considering the special accessibility conditions required by each user group. Through visual inspection and site surveying, the verification model can serve as a support tool, significantly streamlining the diagnostic phase and reducing the number of tests to be requested by over 75%. This speeds up and simplifies the diagnostic phase. To illustrate the methodology, two different buildings in the Valencian Region (Spain) have been selected. One case study is a mental health facility for residential purposes, located in a rural area, on the outskirts of a small town; the other one, is a day care facility for individuals with intellectual disabilities, located in a medium-sized city. The comparison between the case studies allow to validate the model in distinct conditions. Verifying compliance with a basic security level can allow a quality seal and a public register of buildings adapted to fire regulations to be established, similarly to what is being done with other types of attributes such as energy performance.

Keywords: fire safety, inclusive housing, universal accessibility, vulnerable people

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381 The Development of Assessment Criteria Framework for Sustainable Healthcare Buildings in China

Authors: Chenyao Shen, Jie Shen

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The rating system provides an effective framework for assessing building environmental performance and integrating sustainable development into building and construction processes; as it can be used as a design tool by developing appropriate sustainable design strategies and determining performance measures to guide the sustainable design and decision-making processes. Healthcare buildings are resource (water, energy, etc.) intensive. To maintain high-cost operations and complex medical facilities, they require a great deal of hazardous and non-hazardous materials, stringent control of environmental parameters, and are responsible for producing polluting emission. Compared with other types of buildings, the impact of healthcare buildings on the full cycle of the environment is particularly large. With broad recognition among designers and operators that energy use can be reduced substantially, many countries have set up their own green rating systems for healthcare buildings. There are four main green healthcare building evaluation systems widely acknowledged in the world - Green Guide for Health Care (GGHC), which was jointly organized by the United States HCWH and CMPBS in 2003; BREEAM Healthcare, issued by the British Academy of Building Research (BRE) in 2008; the Green Star-Healthcare v1 tool, released by the Green Building Council of Australia (GBCA) in 2009; and LEED Healthcare 2009, released by the United States Green Building Council (USGBC) in 2011. In addition, the German Association of Sustainable Building (DGNB) has also been developing the German Sustainable Building Evaluation Criteria (DGNB HC). In China, more and more scholars and policy makers have recognized the importance of assessment of sustainable development, and have adapted some tools and frameworks. China’s first comprehensive assessment standard for green building (the GBTs) was issued in 2006 (lately updated in 2014), promoting sustainability in the built-environment and raise awareness of environmental issues among architects, engineers, contractors as well as the public. However, healthcare building was not involved in the evaluation system of GBTs because of its complex medical procedures, strict requirements of indoor/outdoor environment and energy consumption of various functional rooms. Learn from advanced experience of GGHC, BREEAM, and LEED HC above, China’s first assessment criteria for green hospital/healthcare buildings was finally released in December 2015. Combined with both quantitative and qualitative assessment criteria, the standard highlight the differences between healthcare and other public buildings in meeting the functional needs for medical facilities and special groups. This paper has focused on the assessment criteria framework for sustainable healthcare buildings, for which the comparison of different rating systems is rather essential. Descriptive analysis is conducted together with the cross-matrix analysis to reveal rich information on green assessment criteria in a coherent manner. The research intends to know whether the green elements for healthcare buildings in China are different from those conducted in other countries, and how to improve its assessment criteria framework.

Keywords: assessment criteria framework, green building design, healthcare building, building performance rating tool

Procedia PDF Downloads 146
380 Comparison of Nutritional Status of Asthmatic vs Non-Asthmatic Adults

Authors: Ayesha Mushtaq

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Asthma is a pulmonary disease in which blockade of the airway takes place due to inflammation as a response to certain allergens. Breathing troubles, cough, and dyspnea are one of the few symptoms. Several studies have indicated a significant effect on asthma due to changes in dietary routines. Certain food items, such as oily foods and other materials, are known to cause an increase in the symptoms of asthma. Low dietary intake of fruits and vegetables may be important in relation to asthma prevalence. The objective of this study is to assess and compare the nutritional status of asthmatic and non-asthmatic patients. The significance of this study lies in the factor that it will help nutritionists to arrange a feasible dietary routine for asthmatic patients. This research was conducted at the Pulmonology Department of the Pakistan Institute of Medical Science Islamabad. About thirty hundred thirty-four million people are affected by asthma worldwide. Pakistan is on the verge of being an uplifted urban population and asthma cases are increasingly high these days. Several studies suggest an increase in the Asthmatic patient population due to improper diet. This is a cross-sectional study aimed at assessing the nutritious standing of Asthmatic and non-asthmatic patients. This research took place at the Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan. The research included asthmatic and non-asthmatic patients coming to the pulmonology department clinic at the Pakistan Institute of Medical Sciences (PIMS). These patients were aged between 20-60 years. A questionnaire was developed for these patients to estimate their dietary plans in these patients. The methodology included four sections. The first section was the Socio-Demographic profile, which included age, gender, monthly income and occupation. The next section was anthropometric measurements which included the weight, height and body mass index (BMI) of an individual. The next section, section three, was about the biochemical attributes, such as for biochemical profiling, pulmonary function testing (PFT) was performed. In the next section, Dietary habits were assessed by a food frequency questionnaire (FFQ) through food habits and consumption pattern was assessed. The next section life style data, in which the person's level of physical activity, sleep and smoking habits were assessed. The next section was statistical analysis. All the data obtained from the study were statistically analyzed and assessed. Most of the asthma Patients were females, with weight more than normal or even obese. Body Mass Index (BMI) was higher in asthma Patients than those in non-Asthmatic ones. When the nutritional Values were assessed, we came to know that these patients were low on certain nutrients and their diet included more junk and oily food than healthy vegetables and fruits. Beverages intake was also included in the same assessment. It is evident from this study that nutritional status has a contributory effect on asthma. So, patients on the verge of developing asthma or those who have developed asthma should focus on their diet, maintain good eating habits and take healthy diets, including fruits and vegetables rather than oily foods. Proper sleep may also contribute to the control of asthma.

Keywords: BMI, nutrition, PAL, diet

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379 Modeling the Demand for the Healthcare Services Using Data Analysis Techniques

Authors: Elizaveta S. Prokofyeva, Svetlana V. Maltseva, Roman D. Zaitsev

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Rapidly evolving modern data analysis technologies in healthcare play a large role in understanding the operation of the system and its characteristics. Nowadays, one of the key tasks in urban healthcare is to optimize the resource allocation. Thus, the application of data analysis in medical institutions to solve optimization problems determines the significance of this study. The purpose of this research was to establish the dependence between the indicators of the effectiveness of the medical institution and its resources. Hospital discharges by diagnosis; hospital days of in-patients and in-patient average length of stay were selected as the performance indicators and the demand of the medical facility. The hospital beds by type of care, medical technology (magnetic resonance tomography, gamma cameras, angiographic complexes and lithotripters) and physicians characterized the resource provision of medical institutions for the developed models. The data source for the research was an open database of the statistical service Eurostat. The choice of the source is due to the fact that the databases contain complete and open information necessary for research tasks in the field of public health. In addition, the statistical database has a user-friendly interface that allows you to quickly build analytical reports. The study provides information on 28 European for the period from 2007 to 2016. For all countries included in the study, with the most accurate and complete data for the period under review, predictive models were developed based on historical panel data. An attempt to improve the quality and the interpretation of the models was made by cluster analysis of the investigated set of countries. The main idea was to assess the similarity of the joint behavior of the variables throughout the time period under consideration to identify groups of similar countries and to construct the separate regression models for them. Therefore, the original time series were used as the objects of clustering. The hierarchical agglomerate algorithm k-medoids was used. The sampled objects were used as the centers of the clusters obtained, since determining the centroid when working with time series involves additional difficulties. The number of clusters used the silhouette coefficient. After the cluster analysis it was possible to significantly improve the predictive power of the models: for example, in the one of the clusters, MAPE error was only 0,82%, which makes it possible to conclude that this forecast is highly reliable in the short term. The obtained predicted values of the developed models have a relatively low level of error and can be used to make decisions on the resource provision of the hospital by medical personnel. The research displays the strong dependencies between the demand for the medical services and the modern medical equipment variable, which highlights the importance of the technological component for the successful development of the medical facility. Currently, data analysis has a huge potential, which allows to significantly improving health services. Medical institutions that are the first to introduce these technologies will certainly have a competitive advantage.

Keywords: data analysis, demand modeling, healthcare, medical facilities

Procedia PDF Downloads 144
378 Mesalazine-Induced Myopericarditis in a Professional Athlete

Authors: Tristan R. Fraser, Christopher D. Steadman, Christopher J. Boos

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Myopericarditis is an inflammation syndrome characterised by clinical diagnostic criteria for pericarditis, such as chest pain, combined with evidence of myocardial involvement, such as elevation of biomarkers of myocardial damage, e.g., troponins. It can rarely be a complication of therapeutics used for dysregulated immune-mediated diseases such as inflammatory bowel disease (IBD), for example, mesalazine. The infrequency of mesalazine-induced myopericarditis adds to the challenge in its recognition. Rapid diagnosis and the early introduction of treatment are crucial. This case report follows a 24-year-old professional footballer with a past medical history of ulcerative colitis, recently started on mesalazine for disease control. Three weeks after mesalazine was initiated, he was admitted with fever, shortness of breath, and chest pain worse whilst supine and on deep inspiration, as well as elevated venous blood cardiac troponin T level (cTnT, 288ng/L; normal: <13ng/L). Myocarditis was confirmed on initial inpatient cardiac MRI, revealing the presence of florid myocarditis with preserved left ventricular systolic function and an ejection fraction of 67%. This was a longitudinal case study following the progress of a single individual with myopericarditis over four acute hospital admissions over nine weeks, with admissions ranging from two to five days. Parameters examined included clinical signs and symptoms, serum troponin, transthoracic echocardiogram, and cardiac MRI. Serial measurements of cardiac function, including cardiac MRI and transthoracic echocardiogram, showed progressive deterioration of cardiac function whilst mesalazine was continued. Prior to cessation of mesalazine, transthoracic echocardiography revealed a small global pericardial effusion of < 1cm and worsening left ventricular systolic function with an ejection fraction of 45%. After recognition of mesalazine as a potential cause and consequent cessation of the drug, symptoms resolved, with cardiac MRI performed as an outpatient showing resolution of myocardial oedema. The patient plans to make a return to competitive sport. Patients suffering from myopericarditis are advised to refrain from competitive sport for at least six months in order to reduce the risk of cardiac remodelling and sudden cardiac death. Additional considerations must be taken in individuals for whom competitive sport is an essential component of their livelihood, such as professional athletes. Myopericarditis is an uncommon, however potentially serious medical condition with a wide variety of aetiologies, including viral, autoimmune, and drug-related causes. Management is mainly supportive and relies on prompt recognition and removal of the aetiological process. Mesalazine-induced myopericarditis is a rare condition; as such increasing awareness of mesalazine as a precipitant of myopericarditis is vital for optimising the management of these patients.

Keywords: myopericarditis, mesalazine, inflammatory bowel disease, professional athlete

Procedia PDF Downloads 135
377 Effect of the Diverse Standardized Patient Simulation Cultural Competence Education Strategy on Nursing Students' Transcultural Self-Efficacy Perceptions

Authors: Eda Ozkara San

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

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

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376 The Philosophical Hermeneutics Contribution to Form a Highly Qualified Judiciary in Brazil

Authors: Thiago R. Pereira

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The philosophical hermeneutics is able to change the Brazilian Judiciary because of the understanding of the characteristics of the human being. It is impossible for humans, to be invested in the function of being a judge, making absolutely neutral decisions, but the philosophical hermeneutics can assist the judge making impartial decisions, based on the federal constitution. The normative legal positivism imagined a neutral judge, a judge able to try without any preconceived ideas, without allowing his/her background to influence him/her. When a judge arbitrates based on legal rules, the problem is smaller, but when there are no clear legal rules, and the judge must try based on principles, the risk of the decision is based on what they believe in. Solipsistically, this issue gains a huge dimension. Today, the Brazilian judiciary is independent, but there must be a greater knowledge of philosophy and the philosophy of law, partially because the bigger problem is the unpredictability of decisions made by the judiciary. Actually, when a lawsuit is filed, the result of this judgment is absolutely unpredictable. It is almost a gamble. There must be the slightest legal certainty and predictability of judicial decisions, so that people, with similar cases, may not receive opposite sentences. The relativism, since classical antiquity, believes in the possibility of multiple answers. Since the Greeks in in the sixth century before Christ, through the Germans in the eighteenth century, and even today, it has been established the constitution as the great law, the Groundnorm, and thus, the relativism of life can be greatly reduced when a hermeneut uses the Constitution as North interpretational, where all interpretation must act as the hermeneutic constitutional filter. For a current philosophy of law, that inside a legal system with a Federal Constitution, there is a single correct answer to a specific case. The challenge is how to find this right answer. The only answer to this question will be that we should use the constitutional principles. But in many cases, a collision between principles will take place, and to resolve this issue, the judge or the hermeneut will choose a solipsism way, using what they personally believe to be the right one. For obvious reasons, that conduct is not safe. Thus, a theory of decision is necessary to seek justice, and the hermeneutic philosophy and the linguistic turn will be necessary for one to find the right answer. In order to help this difficult mission, it will be necessary to use philosophical hermeneutics in order to find the right answer, which is the constitutionally most appropriate response. The constitutionally appropriate response will not always be the answer that individuals agree to, but we must put aside our preferences and defend the answer that the Constitution gives us. Therefore, the hermeneutics applied to Law, in search constitutionally appropriate response, should be the safest way to avoid judicial individual decisions. The aim of this paper is to present the science of law starting from the linguistic turn, the philosophical hermeneutics, moving away from legal positivism. The methodology used in this paper is qualitative, academic and theoretical, philosophical hermeneutics with the mission to conduct research proposing a new way of thinking about the science of law. The research sought to demonstrate the difficulty of the Brazilian courts to depart from the secular influence of legal positivism. Moreover, the research sought to demonstrate the need to think science of law within a contemporary perspective, where the linguistic turn, philosophical hermeneutics, will be the surest way to conduct the science of law in the present century.

Keywords: hermeneutic, right answer, solipsism, Brazilian judiciary

Procedia PDF Downloads 350
375 Making Haste Slowly: South Africa's Transition from a Medical to a Social Model regarding Persons with Disabilities

Authors: Leoni Van Der Merwe

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Historically, in South Africa, disability has been viewed as a dilemma of the individual. The discourse surrounding the definition of disability and applicable theories are as fluid as the differing needs of persons with disabilities within society. In 1997, the Office of the Deputy President published the White Paper on the Integrated National Disability Strategy (WPINDS) which sought to integrate disability issues in all governmental development strategies, planning and programs as well as to solidify the South African government’s stance that disability was to be considered according to the social model and not the, previously utilized, medical model of disability. The models of disability are conceptual frameworks for understanding disability and can provide some insight into why certain attitudes exist and how they are reinforced in society. Although the WPINDS was regarded as a critical milestone in the history of the disability rights struggle in South Africa; it has taken approximately twenty years for the publication of a similar document taking into account South Africa’s changing social, economic, political and technological dispensation. December 2015 marked the approval of the White Paper on the Rights of Persons with Disabilities (WPRPD) which seeks to update the WPINDS, integrate principles contained in international law instruments and endorse a mainstreaming trajectory for realizing the rights of persons with disabilities. While the WPINDS and the WPRPD were published two decades apart, both documents contain an emphasis on a transition from the medical model to the social model. Whereas, the medical model presupposes that disability is mainly a health and welfare matter and is focused on an individualistic and dependency-based approach; the social model requires a paradigm shift in the manner in which disability is constructed so as to highlight the shortcomings of society in respect of disability and to bring to the fore the capabilities of persons with disabilities. The social model has led to unmatched success in changing the perceptions surrounding disability. This article seeks to investigate the progress made in the implementation of the social model in South Africa by taking into account the effect of the diverse political and cultural landscape in promoting the historically entrenched medical model and the rise of disability activism prior to the new democratic dispensation as well as legislation, case law, policy documents and barriers in respect of persons with disabilities that are pervasive in South African society. The research paper will conclude that although numerous interventions have been identified and implemented to promote the consideration of disability within a social construct in South Africa, such interventions require increased national and international collaboration, resources and pace to ensure that the efforts made lead to sustainable results. For persons with disabilities, what remains to be seen is whether the proliferation of activism by interest groups, social awareness as well as the development of policy documents, legislation and case law will serve as the impetus to dissipate the view that disability is burden to be carried solely on the shoulders of the person with the disability.

Keywords: disability, medical model, social model, societal barriers, South Africa

Procedia PDF Downloads 377
374 Li2o Loss of Lithium Niobate Nanocrystals during High-Energy Ball-Milling

Authors: Laura Kocsor, Laszlo Peter, Laszlo Kovacs, Zsolt Kis

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The aim of our research is to prepare rare-earth-doped lithium niobate (LiNbO3) nanocrystals, having only a few dopant ions in the focal point of an exciting laser beam. These samples will be used to achieve individual addressing of the dopant ions by light beams in a confocal microscope setup. One method for the preparation of nanocrystalline materials is to reduce the particle size by mechanical grinding. High-energy ball-milling was used in several works to produce nano lithium niobate. Previously, it was reported that dry high-energy ball-milling of lithium niobate in a shaker mill results in the partial reduction of the material, which leads to a balanced formation of bipolarons and polarons yielding gray color together with oxygen release and Li2O segregation on the open surfaces. In the present work we focus on preparing LiNbO3 nanocrystals by high-energy ball-milling using a Fritsch Pulverisette 7 planetary mill. Every ball-milling process was carried out in zirconia vial with zirconia balls of different sizes (from 3 mm to 0.1 mm), wet grinding with water, and the grinding time being less than an hour. Gradually decreasing the ball size to 0.1 mm, an average particle size of about 10 nm could be obtained determined by dynamic light scattering and verified by scanning electron microscopy. High-energy ball-milling resulted in sample darkening evidenced by optical absorption spectroscopy measurements indicating that the material underwent partial reduction. The unwanted lithium oxide loss decreases the Li/Nb ratio in the crystal, strongly influencing the spectroscopic properties of lithium niobate. Zirconia contamination was found in ground samples proved by energy-dispersive X-ray spectroscopy measurements; however, it cannot be explained based on the hardness properties of the materials involved in the ball-milling process. It can be understood taking into account the presence of lithium hydroxide formed the segregated lithium oxide and water during the ball-milling process, through chemically induced abrasion. The quantity of the segregated Li2O was measured by coulometric titration. During the wet milling process in the planetary mill, it was found that the lithium oxide loss increases linearly in the early phase of the milling process, then a saturation of the Li2O loss can be seen. This change goes along with the disappearance of the relatively large particles until a relatively narrow size distribution is achieved in accord with the dynamic light scattering measurements. With the 3 mm ball size and 1100 rpm rotation rate, the mean particle size achieved is 100 nm, and the total Li2O loss is about 1.2 wt.% of the original LiNbO3. Further investigations have been done to minimize the Li2O segregation during the ball-milling process. Since the Li2O loss was observed to increase with the growing total surface of the particles, the influence of ball-milling parameters on its quantity has also been studied.

Keywords: high-energy ball-milling, lithium niobate, mechanochemical reaction, nanocrystals

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373 Sociocultural Influences on Men of Color’s Body Image Concerns: A Structural Equation Modeling Study

Authors: Zikun Li, Regine Talleyrand

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Negative body image is one of the most common causes of eating disorders, and it is not only happening to women. Regardless of the increasing attention that researchers and practitioners have been paying to the male population and their body image concerns, men of color have yet to be fully represented or studied. Given the consensus that the sociocultural experiences of people of color may play a significant role in their health and well-being, this study focused on assessing the mechanism through which sociocultural factors may influence men of color’s perceptions of body image. In particular, this study focused on untangling how interpersonal and media pressure, as well as ethnic-racial identities and perceptions, would impact body dissatisfaction in terms of muscularity, body fat, and height in men of color and how this mechanism is moderated across different ethnic-racial groups. The structural equation modeling approach was therefore applied to achieve the research goal. With the sample size of 181 self-identified Black, Indigenous, and People of Color male participants aged 20-50 (M=33.33, SD=6.9) through surveying on Amazon’s MTurk platform, the proposed model achieved a modestly acceptable model fit with the pooled sample, X2(836) = 1412.184, CFI = 0.900, RMSEA = 0.062 [0.056, 0.067]. And SRMR = 0.088, And it explained 89.5% of the variance in body dissatisfaction. The results showed that of all the direct effects on body dissatisfaction, interpersonal appearance pressure exhibited the strongest effect (β = 0.410***), followed by media appearance pressure (β = 0.272**) and self-hatred feeling (β = 0.245**). The ethnic-racial related factors (i.e., stereotype endorsement, ethnic-racial salience, and nationalistic assimilation) statistically influenced body dissatisfaction through the mediators of media appearance pressure and/or self-hatred feeling. Furthermore, the moderation analysis between Black/African American men and non-Black/African American men revealed the substantial differences in how ethnic/racial identity impacts one’s perception of body image, and the Black/African American men were found to be influenced by sociocultural factors at a higher level, compared with their counterparts. The impacts of demographic characteristics (i.e., SES, weight, height) on body dissatisfaction were also examined. Instead of considering interpersonal appearance pressure and media pressure as two subscales under one construct, this study considered them as two separate and distinct sociocultural factors. The good model fit to the data indicates this rationality and encourages scholars to reconsider the impacts of two sources of social pressures on body dissatisfaction. In addition, this study also provided empirical evidence of the moderation effect existing within the population of men of color, which reveals the heterogeneity existing across different ethnic-racial groups and implies the necessity to study individual ethnic-racial groups so as to better understand the mechanism of sociocultural influences on men of color’s body dissatisfaction. These findings strengthened the current understanding of the body image concerns exciting among men of color and meanwhile provided empirical evidence for practitioners to provide tailored health prevention and treatment options for this growing population in the United States.

Keywords: men of color, body image concerns, sociocultural factors, structural equation modeling

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372 Crafting Robust Business Model Innovation Path with Generative Artificial Intelligence in Start-up SMEs

Authors: Ignitia Motjolopane

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Small and medium enterprises (SMEs) play an important role in economies by contributing to economic growth and employment. In the fourth industrial revolution, the convergence of technologies and the changing nature of work created pressures on economies globally. Generative artificial intelligence (AI) may support SMEs in exploring, exploiting, and transforming business models to align with their growth aspirations. SMEs' growth aspirations fall into four categories: subsistence, income, growth, and speculative. Subsistence-oriented firms focus on meeting basic financial obligations and show less motivation for business model innovation. SMEs focused on income, growth, and speculation are more likely to pursue business model innovation to support growth strategies. SMEs' strategic goals link to distinct business model innovation paths depending on whether SMEs are starting a new business, pursuing growth, or seeking profitability. Integrating generative artificial intelligence in start-up SME business model innovation enhances value creation, user-oriented innovation, and SMEs' ability to adapt to dynamic changes in the business environment. The existing literature may lack comprehensive frameworks and guidelines for effectively integrating generative AI in start-up reiterative business model innovation paths. This paper examines start-up business model innovation path with generative artificial intelligence. A theoretical approach is used to examine start-up-focused SME reiterative business model innovation path with generative AI. Articulating how generative AI may be used to support SMEs to systematically and cyclically build the business model covering most or all business model components and analyse and test the BM's viability throughout the process. As such, the paper explores generative AI usage in market exploration. Moreover, market exploration poses unique challenges for start-ups compared to established companies due to a lack of extensive customer data, sales history, and market knowledge. Furthermore, the paper examines the use of generative AI in developing and testing viable value propositions and business models. In addition, the paper looks into identifying and selecting partners with generative AI support. Selecting the right partners is crucial for start-ups and may significantly impact success. The paper will examine generative AI usage in choosing the right information technology, funding process, revenue model determination, and stress testing business models. Stress testing business models validate strong and weak points by applying scenarios and evaluating the robustness of individual business model components and the interrelation between components. Thus, the stress testing business model may address these uncertainties, as misalignment between an organisation and its environment has been recognised as the leading cause of company failure. Generative AI may be used to generate business model stress-testing scenarios. The paper is expected to make a theoretical and practical contribution to theory and approaches in crafting a robust business model innovation path with generative artificial intelligence in start-up SMEs.

Keywords: business models, innovation, generative AI, small medium enterprises

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371 Determinants of Child Nutritional Inequalities in Pakistan: Regression-Based Decomposition Analysis

Authors: Nilam Bano, Uzma Iram

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Globally, the dilemma of undernutrition has become a notable concern for the researchers, academicians, and policymakers because of its severe consequences for many centuries. The nutritional deficiencies create hurdles for the people to achieve goals related to live a better lifestyle. Not only at micro level but also at the macro level, the consequences of undernutrition affect the economic progress of the country. The initial five years of a child’s life are considered critical for the physical growth and brain development. In this regard, children require special care and good quality food (nutrient intake) to fulfill their nutritional demand of the growing body. Having the sensitive stature and health, children specially under the age of 5 years are more vulnerable to the poor economic, housing, environmental and other social conditions. Beside confronting economic challenges and political upheavals, Pakistan is also going through from a rough patch in the context of social development. Majority of the children are facing serious health problems in the absence of required nutrition. The complexity of this issue is getting severe day by day and specially children are left behind with different type of immune problems and vitamins and mineral deficiencies. It is noted that children from the well-off background are less likely affected by the undernutrition. In order to underline this issue, the present study aims to highlight the existing nutritional inequalities among the children of under five years in Pakistan. Moreover, this study strives to decompose those factors that severely affect the existing nutritional inequality and standing in the queue to capture the consideration of concerned authorities. Pakistan Demographic and Health Survey 2012-13 was employed to assess the relevant indicators of undernutrition such as stunting, wasting, underweight and associated socioeconomic factors. The objectives were executed through the utilization of the relevant empirical techniques. Concentration indices were constructed to measure the nutritional inequalities by utilizing three measures of undernutrition; stunting, wasting and underweight. In addition to it, the decomposition analysis following the logistic regression was made to unfold the determinants that severely affect the nutritional inequalities. The negative values of concentration indices illustrate that children from the marginalized background are affected by the undernutrition more than their counterparts who belong from rich households. Furthermore, the result of decomposition analysis indicates that child age, size of a child at birth, wealth index, household size, parents’ education, mother’s health and place of residence are the most contributing factors in the prevalence of existing nutritional inequalities. Considering the result of the study, it is suggested to the policymakers to design policies in a way so that the health sector of Pakistan can stimulate in a productive manner. Increasing the number of effective health awareness programs for mothers would create a notable difference. Moreover, the education of the parents must be concerned by the policymakers as it has a significant association with the present research in terms of eradicating the nutritional inequalities among children.

Keywords: concentration index, decomposition analysis, inequalities, undernutrition, Pakistan

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370 Purpose-Driven Collaborative Strategic Learning

Authors: Mingyan Hong, Shuozhao Hou

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Collaborative Strategic Learning (CSL) teaches students to use learning strategies while working cooperatively. Student strategies include the following steps: defining the learning task and purpose; conducting ongoing negotiation of the learning materials by deciding "click" (I get it and I can teach it – green card, I get it –yellow card) or "clunk" (I don't get it – red card) at the end of each learning unit; "getting the gist" of the most important parts of the learning materials; and "wrapping up" key ideas. Find out how to help students of mixed achievement levels apply learning strategies while learning content area in materials in small groups. The design of CSL is based on social-constructivism and Vygotsky’s best-known concept of the Zone of Proximal Development (ZPD). The definition of ZPD is the distance between the actual acquisition level as decided by individual problem solution case and the level of potential acquisition level, similar to Krashen (1980)’s i+1, as decided through the problem-solution case under the facilitator’s guidance, or in group work with other more capable members (Vygotsky, 1978). Vygotsky claimed that learners’ ideal learning environment is in the ZPD. An ideal teacher or more-knowledgable-other (MKO) should be able to recognize a learner’s ZPD and facilitates them to develop beyond it. Then the MKO is able to leave the support step by step until the learner can perform the task without aid. Steven Krashen (1980) proposed Input hypothesis including i+1 hypothesis. The input hypothesis models are the application of ZPD in second language acquisition and have been widely recognized until today. Krashen (2019)’s optimal language learning environment (2019) further developed the application of ZPD and added the component of strategic group learning. The strategic group learning is composed of desirable learning materials learners are motivated to learn and desirable group members who are more capable and are therefore able to offer meaningful input to the learners. Purpose-driven Collaborative Strategic Learning Model is a strategic integration of ZPD, i+1 hypothesis model, and Optimal Language Learning Environment Model. It is purpose driven to ensure group members are motivated. It is collaborative so that an optimal learning environment where meaningful input from meaningful conversation can be generated. It is strategic because facilitators in the model strategically assign each member a meaningful and collaborative role, e.g., team leader, technician, problem solver, appraiser, offer group learning instrument so that the learning process is structured, and integrate group learning and team building making sure holistic development of each participant. Using data collected from college year one and year two students’ English courses, this presentation will demonstrate how purpose-driven collaborative strategic learning model is implemented in the second/foreign language classroom, using the qualitative data from questionnaire and interview. Particular, this presentation will show how second/foreign language learners grow from functioning with facilitator or more capable peer’s aid to performing without aid. The implication of this research is that purpose-driven collaborative strategic learning model can be used not only in language learning, but also in any subject area.

Keywords: collaborative, strategic, optimal input, second language acquisition

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369 The Efficacy of Video Education to Improve Treatment or Illness-Related Knowledge in Patients with a Long-Term Physical Health Condition: A Systematic Review

Authors: Megan Glyde, Louise Dye, David Keane, Ed Sutherland

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Background: Typically patient education is provided either verbally, in the form of written material, or with a multimedia-based tool such as videos, CD-ROMs, DVDs, or via the internet. By providing patients with effective educational tools, this can help to meet their information needs and subsequently empower these patients and allow them to participate within medical-decision making. Video education may have some distinct advantages compared to other modalities. For instance, whilst eHealth is emerging as a promising modality of patient education, an individual’s ability to access, read, and navigate through websites or online modules varies dramatically in relation to health literacy levels. Literacy levels may also limit patients’ ability to understand written education, whereas video education can be watched passively by patients and does not require high literacy skills. Other benefits of video education include that the same information is provided consistently to each patient, it can be a cost-effective method after the initial cost of producing the video, patients can choose to watch the videos by themselves or in the presence of others, and they can pause and re-watch videos to suit their needs. Health information videos are not only viewed by patients in formal educational sessions, but are increasingly being viewed on websites such as YouTube. Whilst there is a lot of anecdotal and sometimes misleading information on YouTube, videos from government organisations and professional associations contain trustworthy and high-quality information and could enable YouTube to become a powerful information dissemination platform for patients and carers. This systematic review will examine the efficacy of video education to improve treatment or illness-related knowledge in patients with various long-term conditions, in comparison to other modalities of education. Methods: Only studies which match the following criteria will be included: participants will have a long-term physical health condition, video education will aim to improve treatment or illness related knowledge and will be tested in isolation, and the study must be a randomised controlled trial. Knowledge will be the primary outcome measure, with modality preference, anxiety, and behaviour change as secondary measures. The searches have been conducted in the following databases: OVID Medline, OVID PsycInfo, OVID Embase, CENTRAL and ProQuest, and hand searching for relevant published and unpublished studies has also been carried out. Screening and data extraction will be conducted independently by 2 researchers. Included studies will be assessed for their risk of bias in accordance with Cochrane guidelines, and heterogeneity will also be assessed before deciding whether a meta-analysis is appropriate or not. Results and Conclusions: Appropriate synthesis of the studies in relation to each outcome measure will be reported, along with the conclusions and implications.

Keywords: long-term condition, patient education, systematic review, video

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