Search results for: orthopedic nurse practitioners
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1341

Search results for: orthopedic nurse practitioners

471 Neurosciences in Entrepreneurship: The Multitasking Case in Favor of Social Entrepreneurship Innovation

Authors: Berger Aida

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Social entrepreneurship has emerged as an active area of practice and research within the last three decades and has called for a focus on Social Entrepreneurship innovation. Areas such as academics, practitioners , institutions or governments have placed Social Entrepreneurship on the priority list of reflexion and action. It has been accepted that Social entrepreneurship (SE) shares large similarities with its parent, Traditional Entrepreneurship (TE). SE has grown over the past ten years exploring entrepreneurial cognition and the analysis of the ways of thinking of entrepreneurs. The research community believes that value exists in grounding entrepreneurship in neuroscience and notes that SE, like Traditional Entrepreneurship, needs to undergo efforts in clarification, definition and differentiation. Moreover, gaps in SE research call for integrative multistage and multilevel framework for further research. The cognitive processes underpinning entrepreneurial action are similar for SE and TE even if Social Entrepreneurship orientation shows an increased empathy value. Theoretically, there is a need to develop sound models of how to process functions and how to work more effectively as entrepreneurs and research on efficiency improvement calls for the analysis of the most common practices in entrepreneurship. Multitasking has been recognized as a daily and unavoidable habit of entrepreneurs. Hence, we believe in the need of analyzing the multiple task phenomena as a methodology for skill acquisition. We will conduct our paper including Social Entrepreneurship within the wider spectrum of Traditional Entrepreneurship, for the purpose of simplifying the neuroscientific lecture of the entrepreneurial cognition. A question to be inquired is to know if there is a way of developing multitasking habits in order to improve entrepreneurial skills such as speed of information processing , creativity and adaptability . Nevertheless, the direct link between the neuroscientific approach to multitasking and entrepreneurship effectiveness is yet to be uncovered. That is why an extensive Literature Review on Multitasking is a propos.

Keywords: cognitive, entrepreneurial, empathy, multitasking

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470 Role of Radiologic Technologist Specialist in Plain Image Interpretation of Adults in the Middle East: A Radiologist’s Perspective

Authors: Awad Mohamed Elkhadir, Rajab M. Ben Yousef

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Background/Aim: Radiological technologists are medical professionals who perform diagnostic imaging tests such as X-rays, magnetic resonance imaging (MRI) scans, and computer tomography (CT) scans. Despite the recognition of image interpretation by British radiologists, it is still considered a problem in the Arab world. This study evaluates the perceptions of radiologists in the Middle East concerning the plain image interpretation of adults by radiologic technologist specialists. Methods: This is a cross-sectional study that follows a quantitative approach. A close-ended questionnaire was distributed among 103 participants who were radiologists by profession from various hospitals in Saudi Arabia and Sudan. The gathered data was then analyzed through Statistical Package for Social Sciences (SPSS). Results: The results showed that 29% recognized the Radiologic Technologist Specialist (RTS) role of writing image reports, while 61% did not. A total of 38% of participants believed that RTS image interpretation would help diagnose unreported radiographs. 47% of the sample responded that the workload and stress on radiologists would reduce by allowing reporting for RTS, while 37% did not. Lastly, 43% believe that image interpretation by RTS can be introduced into the Middle East in the future. Conclusion: The study's findings reveal that the combination of image reporting and radiography improves the care of the patients. The study's outcomes also show that the burden of the medical practitioners reduces due to image reporting of the radiographers. Further researches need to be conducted in the Arab World to obtain and measure the associated factors of the desired criteria.

Keywords: Arab world, image interpretation, radiographer, radiologist, Saudi Arabia, Sudan

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469 A Systematic Review on Dietary Interventions for Iron Deficiency Anemia (IDA) in Under-Five Children in Nigeria

Authors: Justina Ijeoma Ezebuwa, Catherine C. Ikewuchi, Eka B. Essien, Francis C. Anacletus

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Iron deficiency anemia (IDA) is a significant problem in Nigeria, especially in children under five. Intervention options for treating anemia in under-five children have also been the subject of research. This study aims to synthesize the evidence on dietary interventions for managing iron deficiency anemia in under-five children in Nigeria. This study uses a systematic review method to collect relevant studies to answer the research questions and a narrative synthesis to analyze and synthesize the findings of this study. Cochrane, PubMed, and ScienceDirect databases were thoroughly searched, and five (5) articles were selected for this study. The results show that dietary interventions, such as daily multi-nutrient fortified dairy-based drinks, biofortified (yellow/ white) cassava rich in pro-vitamin A, iron supplementation in foods, and ready-to-use therapeutic food (RUTF) may be relevant to the management of iron deficiency anemia in under-five children in Nigeria. The study also shows that daily multi-nutrient fortified dairy-based drinks may be more effective, feasible, and culturally acceptable for managing anemia in under-5 children in Nigeria. In addition, daily multi-nutrient fortified dairy-based drinks and ready-to-use therapeutic food (RUTF) were reported to have the potential to improve the growth, cognitive development, and overall health outcomes of under-five children with iron deficiency anemia in Nigeria. Recommendations for future studies in this research area and for public health practitioners and policymakers were provided.

Keywords: dietary intervention, iron deficiency anemia, under-five children, Nigeria

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468 The Gap between Curriculum, Pedagogy, and National Standards of Vietnamese English Language Teacher Education

Authors: Thi Phuong Lan Nguyen

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Vietnamese English Language Teacher Education (ELTE) has been changing a lot in response to the rapidly evolving socio-economic context requirements. The Vietnamese government assigns the Ministry of Education and Training (MOET) primary tasks to have policy changes to prepare for ELTE development in the globalization and socialization process. Many educational policies have been made to develop ELTE, however, they seem not to address the new global or social demands. The issue is that there are still significant disparities between the national policy and the institutional implementation. This study is to investigate the alignment between ELTE institutional curriculum, pedagogies, and MOET standards. This study used a mixed-method with the data sources from policy documents, a survey, and 33 interviews conducted with the lecturers and administrators from eleven Vietnamese ELTE institutions. The data have been analysed to understand the gap between policy and practice. The initial findings are (i) a low alignment of curriculum and language proficiency standards and (ii) a moderate alignment between curriculum and future-career skills standards. Many pedagogical challenges have been found. In order to address these gaps, it is necessary for the curriculum to be standards-based designed. It is also vital for professional development in order to improve the quality teaching. The study offers multiple perspectives on a complex issue. The study is meaningful not only to educational governance, but also to teaching practitioners, English language researchers, and English language learners. The significance lies in its relevance to English teaching careers across all parts of Vietnam, it yet remains relevant to ELTE in other countries teaching English as a foreign language.

Keywords: alignment, curriculum, educational policy, English language teaching, pedagogy, standards

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467 The Influence of Career Optimism and Relationship Status on University Students’ Wellbeing

Authors: Didem Kepir Savoly, Selen Demirtas Zorbaz

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This research focuses on the unique developmental stage of university students, known as emerging adulthood, which can be filled with stressors relating to academics, career aspirations, and relationships. The impact of these factors on the wellbeing and mental health of students is not well understood and requires further investigation. The aim of this study is to investigate the influence of career optimism and relationship status on the wellbeing/life satisfaction of university students. The specific hypotheses being tested are: 1) University students with higher career optimism will exhibit a higher level of life satisfaction, and 2) University students in relationships will report a higher level of life satisfaction. This research adopts a quantitative approach, utilizing scales and questionnaires to collect data from university students in Turkey. The data was collected from university students in Turkey through the administration of the Career Optimism Scale, The Satisfaction with Life Scale, and the Perceived Romantic Relationship Quality Scale. The data is then analyzed using scale implementation, correlational analysis, and group comparison. One-way ANOVA, regression, and t-test analysis techniques are employed. The research findings provide insights into the relationship between career optimism and university students’ life satisfaction, as well as the influence of relationship status on their life satisfaction. The results suggest that life satisfaction was predicted by career optimism but not by relationship status. Moreover, significant relationships between life satisfaction and relationship quality were found among the university students who were in a relationship. These results can be utilized by practitioners, particularly those in counseling centers and career services at universities, to develop tailored psychoeducational and intervention programs aimed at promoting the mental health of university students.

Keywords: career optimism, relationship status, university students, wellbeing

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466 “It Just Feels Risky”: Intuition vs Evidence in Child Sexual Abuse Cases. Proposing an Empirically Derived Risk and Protection Protocol

Authors: Christian Perrin, Nicholas Blagden, Louise Allen, Sarah Impey

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Social workers in the UK and professionals globally are faced with a particular challenge when dealing with allegations of child sexual abuse (CSA) in the community. In the absence of a conviction or incontestable evidence, staff can often find themselves unable to take decisive action to remove a child from harm, even though there may be a credible threat to their welfare. Conversely, practitioners may over-calculate risk through fear of being accountable for harm. This is, in part, due to the absence of a structured and evidence-based risk assessment tool which can predict the likelihood of a person committing child sexual abuse. Such assessments are often conducted by forensic professionals who utilise offence-specific data and personal history information to calculate risk. In situations where only allegations underpin a case, this mode of assessment is not viable. There are further ethical issues surrounding the assessment of risk in this area which require expert consideration and sensitive planning. This paper explores this entangled problem extant in the wider call to prevent sexual and child sexual abuse in the community. To this end, 32 qualitative interviews were undertaken with social workers dealing with CSA cases. Results were analysed using thematic analysis and operationalised to formulate a risk and protection protocol for use in case management. This paper reports on the early findings associated with the initial indications of protocol reliability. Implications for further research and practice are discussed.

Keywords: sexual offending, child sexual offence, offender rehabilitation, risk assessment, offence prevention

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465 Under-Reporting and Under-Recording of Hate Crimes against Muslim Women in Italy

Authors: Broccolo Cinzia, Grigaliunaite Ruta, Saint-Nom Cloé, Savasta Guido

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The present article analyses the root causes of under-reporting and under-recording of hate crimes against Muslim women in Italy. The main findings emerged from the survey conducted between May and September 2022 within the framework of the TRUST project (co-funded by the CERV programme (CERV-2021-EQUAL) of the European Union) with relevant practitioners and members of the Muslim community, including first-generation and second-generation Muslim women residing in Italy. The findings reveal that multiple factors contribute to the low reporting rate as well as to the flaws in recording episodes of intolerance and hatred against the above-mentioned group. Lack of trust in the judiciary or the police may represent one of the main causes of under-reporting; however, the phenomenon is not limited to such aspects, and additional factors and sources of discrimination paving the way to under-recording have been identified during the survey. The significant “tendency” to not report a case of intolerance as the difficulties in identifying the discriminatory nature of the crime are two faces of the same coin and are particularly intertwined; despite this, at first, both issues need to be assessed and analysed separately in order to take their own specificities into duly consideration. By contrast, the potential solution to low recording and reporting trends should be found collectively, namely by involving all the relevant parties and bodies facing the above-mentioned issues. In this regard, a participatory and multi-agency approach may curb the root causes leading Muslim women not to report and, besides this, support law enforcement officials as well as public authorities in providing a more effective service to the victims of hatred, whether offline or online.

Keywords: hate crime, under-reporting, under-recording, Islamophobia, Muslim women

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464 A Look into Surgical Site Infections: Impact of Collective Interventions

Authors: Lisa Bennett, Cynthia Walters, Cynthia Argani, Andy Satin, Geeta Sood, Kerri Huber, Lisa Grubb, Woodrow Noble, Melissa Eichelberger, Darlene Zinalabedini, Eric Ausby, Jeffrey Snyder, Kevin Kirchoff

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Background: Surgical site infections (SSIs) within the obstetric population pose a variety of complications, creating clinical and personal challenges for the new mother and her neonate during the postpartum period. Our journey to achieve compliance with the SSI core measure for cesarean sections revealed many opportunities to improve these outcomes. Objective: Achieve and sustain core measure compliance keeping surgical site infection rates below the national benchmark pooled mean of 1.8% in post-operative patients, who delivered via cesarean section at the Johns Hopkins Bayview Medical Center. Methods: A root cause analysis was performed and revealed several environmental, pharmacologic, and clinical practice opportunities for improvement. A multidisciplinary approach led by the OB Safety Nurse, OB Medical Director, and Infectious Disease Department resulted in the implementation of fourteen interventions over a twenty-month period. Interventions included: post-operative dressing changes, standardizing operating room attire, broadening pre-operative antibiotics, initiating vaginal preps, improving operating room terminal cleaning, testing air quality, and re-educating scrub technicians on technique. Results: Prior to the implementation of our interventions, the SSI quarterly rate in Obstetrics peaked at 6.10%. Although no single intervention resulted in dramatic improvement, after implementation of all fourteen interventions, the quarterly SSI rate has subsequently ranged from to 0.0% to 2.70%. Significance: Taking an introspective look at current practices can reveal opportunities for improvement which previously were not considered. Collectively the benefit of these interventions has shown a significant decrease in surgical site infection rates. The impact of this quality improvement project highlights the synergy created when members of the multidisciplinary team work in collaboration to improve patient safety, and achieve a high quality of care.

Keywords: cesarean section, surgical site infection, collaboration and teamwork, patient safety, quality improvement

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463 Knowledge Level of Mothers in Wet Nursery and Breast Milk Banking

Authors: Seyda Can, Meryem Unulu

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Objective: Breast milk is the most fundamental nutritional element for the healthy growth and development of newborns as they supply all the necessary components. Various obstacles such as diseases of mother and child, allergies of the baby, and insufficient breastmilk affect breast-feeding adversely. The wet nursery or breast milk banking is the most important source in providing the nutrients closest to the ideal for the newborn. Despite increasing opinions about its benefits, breast milk banking practice is controversial because of reasons such as ethical problems, traditional beliefs and attitudes, security concerns of families and lack of knowledge. It is thought that the results of this study will create the data for studies to raise the awareness of the society regarding wet nursery, and milk banks. Method: The study was planned and performed in descriptive type. The population of the study consists of mothers that gave birth between October-November 2017 in a public hospital in Turkey, and the sample consisted of 205 mothers chosen by improbable sampling method from the population and accepted to participate in the study. While gathering data, a survey consisting of 33 questions designed to determine the socio-demographic characteristics and their views on wet nursery and breast milk banking. Written ethical committee and institution permit was taken. Before the interview, participants were informed about the purpose and content of the study and oral permit was taken. Result: When the distribution of 205 mothers according to their individual characteristics, it was detected that their age average was 28,16±5,23 and 63,4 of mothers (n=130) had normal delivery. It was determined that clear majority of mothers, 75,6% (n=155) had no breast-feeding problems and 75,1% (n=154) fed the baby only with breast milk. It was detected that 18,5% (n=38) would accept a stranger to be a wet nurse and 60% (n=123) would donate milk if there is a breast milk bank. It was detected 33,2 % (n=68) of participant mothers want to make use of breast milk bank if there is a situation that prevents breast feeding, 38,5 % (n=79) of mothers think breast milk bank would be problematic religiously. Statistical difference was detected between the educational status of women and the rate of wanting breast milk bank practice. As the educational status of mothers increased, their rate of wanting breast milk bank practice increased. Conclusion: It is essential that every baby is breastfed by its mother primarily. However, when this is not possible, in order to implement wet nursery and breast milk banking as an extension of national breast-feeding policy, regulations need to be made and worries should be eased. Also, organizing training programs are also really important to raise awareness of the society and mothers.

Keywords: breast feeding, breast milk, milk banks, wet nursery

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462 Exploration of Professional Skepticism among Entry-level Auditors in China from Psychological and Cultural Perspectives

Authors: Sammy Xiaoyan Ying

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Professional skepticism remains one of the most important and controversial topics in auditing. This study examines the influence of client cooperativeness and fraud risk on judgments of professional skepticism among Chinese entry-level auditors in the context of evaluation of client-provided audit evidence. Given that the essence of auditors’ PS rests on distrust of clients, this study invokes trust-related theories from psychological and cultural perspectives. Specifically, invoking psychology theories of trust concerning positive relationship between risk and distrust, this study hypothesizes that professional skepticism is likely to be positively associated with client fraud risk. The results support the hypothesis and show that lower (higher) levels of client fraud risk lead to lower (higher) levels of professional skepticism. Furthermore, drawing on analysis of relationship between cooperation and trust, with particular reference to guanxi dynamics in the Chinese culture, this study hypothesizes that professional skepticism is likely to be negatively associated with client cooperativeness. The results support the hypothesis and show that higher (lower) levels of client cooperativeness lead to lower (higher) levels of professional skepticism. The findings may assist audit firms and auditing educators in improving training and education programs and enhancing entry-level auditors’ abilities to maintain professional skepticism. Also, practitioners and regulators may benefit from increasing awareness of psychological factors in influencing professional skepticism.

Keywords: audit judgment, Chinese culture, entry-level auditor, professional skepticism

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461 A Study of Adult Lifelong Learning Consulting and Service System in Taiwan

Authors: Wan Jen Chang

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Back ground: Taiwan's current adult lifelong learning services have expanded from vocational training to universal lifelong learning. However, both the professional knowledge training of learning guidance and consulting services and the provision of adult online learning consulting service systems still need to be established. Purpose: The purposes of this study are as follows: 1. Analyze the professional training mechanism for cultivating adult lifelong learning consultation and coaching; 2. Explore the feasibility of constructing a system that uses network technology to provide adult learning consultation services. Research design: This study conducts a literature analysis of counseling and coaching policy reports on lifelong learning in European countries and the United States. There are two focus discussions were conducted with 15 lifelong learning scholars, experts and practitioners as research subjects. The following two topics were discussed and suggested: 1. The current situation, needs and professional ability training mechanism of "Adult Lifelong Learning Consulting and Services"; 2. Strategies for establishing an "Adult Lifelong Learning Consulting and Service internet System". Conclusion: 1.Based on adult lifelong learning consulting and service needs, plan a professional knowledge training and certification system.2.Adult lifelong learning consulting and service professional knowledge and skills training should include the use of network technology to provide consulting service skills.3.To establish an adult lifelong learning consultation and service system, the Ministry of Education should promulgate policies and measures at the central level and entrust local governments or private organizations to implement them.4.The adult lifelong learning consulting and service system can combine the national qualifications framework, private sector and NPO to expand learning consulting service partners.

Keywords: adult lifelong learning, profesional knowledge, consulting and service, network system

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460 An Audit on Tracheal Tube Cuff Pressure Check and Monitoring during Current Practice

Authors: Mahmoud Hassanin, Roshan Thawale, Kiran Yelamati

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Background: During current practice, intraoperative regular endotracheal cuff pressure monitoring is not routine, despite the significant number of clinicians interested in checking it after intubation to ensure a good seal and adequate ventilation. Aims and objectives: to highlight that the current practice has no guidance related to regular intra-operative monitoring of the endotracheal tube cuff pressure, which can improve patient safety and post-operative experience. Methods: local department survey was done targeting anaesthetists' current practice, measuring their knowledge and problem awareness to improve patient satisfaction and change the current approach. Results: The participants were not using the manometer, despite their interest in ensuring that the cuff pressure was high enough and there was a proper seal. More than 50% of the participant don't know the ideal range of the endotracheal tube cuff pressure range, and 32% don't know whether it is available or not in the theatre. Despite the previous finding, 100% of the participants used different methods to ensure adequate cuff pressure. The collected data revealed that at least 26% of the participant confirmed that they had seen patients having post-intubation complications. Conclusion: There is an increasing importance placed on quality assurance. Clinical practice varies widely among practitioners, with the only consistency being the omission of cuff manometers during routine intra-operative management, despite their proven benefit and efficacy. Encourage the anaesthetists and ODPs to use cuff pressure manometers. The availability of portable pressure manometers can help to maintain safe cuff pressures in patients requiring endotracheal intubation.

Keywords: endotracheal cuff pressure, intra-operative monitoring, current practice, patient satisfaction

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459 Toxicological Standardization of Heavy Metals and Microbial Contamination Haematinic Herbal Formulations Marketed in India

Authors: A. V. Chandewar, Sanjay Bais

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Backgound: In India, drugs of herbal origin have been used in traditional systems of medicines such as Unani and Ayurveda since ancient times. WHO limit for Escherichia coli is 101/gm cfu, for Staphylococus aureus 105/gm cfu, and for Pseudomonas aeruginosa 103/gm cfu and for Salmonella species nil cfu. WHO mentions maximum permissible limits in raw materials only for arsenic, cadmium, and lead, which amount to 1.0, 0.3, and 10 ppm, respectively. Aim: The main purpose of the investigation was to document evidence for the users, and practitioners of marketed haematinic herbal formulations. In the present study haematinic herbal formulations marketed in Yavatmal India were determined for the presence of microbial and heavy metal content. Method: The investigations were performed by using specific medias and atomic absorption spectrometry. Result: The present work indicates the presence of heavy metal contents in herbal formulations selected for study. It was found that arsenic content in formulations was below the permissible limit in all formulations. The cadmium and lead content in six formulations were above the permissible limits. Such formulations are injurious to health of patient if consumed regularly. The specific medias were used to determining the presence of Escherichia coli 4 samples, Staphylococcus aureus 3 samples, and P. aeruginosa 4 samples. The data indicated suggest that there is requirement of in process improvement to provide better quality for consumer health in order to be competitive in international markets. Summary/Conclusion: The presence of microbial and heavy metal content above WHO limits indicates that the GMP was not followed during manufacturing of herbal formulations marketed in India.

Keywords: toxicological standardization, heavy metals, microbial contamination, haematinic herbal formulations

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458 The Concept of Accounting in Islamic Transactions

Authors: Ahmad Abdulkadir Ibrahim

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The Islamic law of transactions laid down the methods and instruments of accounting and analyzed its basic assumptions in the modern world. There is a need to examine the implications of accounting initiatives in the Muslim world and attempt to outline the important characteristics of Islamic accounting and how Islamic accounting resolves the problem of measuring the cost of Murabaha goods in case of exchange rate variation. The research tends to discuss an analytical approach to the Islamic accounting concept as well as elaborating the jurisprudential matter and practical aspects of accounting in Islamic financial transactions. It also aims to alert the practitioners of accounting in the Islamic world to be aware of the concept of accounting in Islamic jurisprudence and its historical development. The methodology adopted in this research is the qualitative method through the consultation of relevant literature, which focuses on the thematic study of the subject matter. This is followed by an analysis and discussion of the contents of the materials used. It is concluded that Islamic accounting is unique in its norms as it has been characterized by fairness, accuracy in measuring tools, truthfulness, mutual trust, moderation in making a profit, and tolerance. It was also qualified by capacity and flexibility in terms of the tools and terminology used and invented by Islamic jurisprudence in the accounting system, which indicates its validity and consistency anytime and anywhere. An important conclusion of the research also lies in the refutation of the popular idea that an Italian writer known as Luca Pacilio was the first writer who developed the basis of double-entry due to the presented proofs by Muslim scholars of critical accounting developments, which cannot be ignored. It concludes further that Islamic jurisprudence draws the accounting system codified in the foundations of a market that is far from usury, fraud, cheating, and unfair competition in all areas.

Keywords: accounting, Islamic accounting, Islamic transactions, Islamic jurisprudence, double entry, murabaha, characteristics

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457 A West Coast Estuarine Case Study: A Predictive Approach to Monitor Estuarine Eutrophication

Authors: Vedant Janapaty

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Estuaries are wetlands where fresh water from streams mixes with salt water from the sea. Also known as “kidneys of our planet”- they are extremely productive environments that filter pollutants, absorb floods from sea level rise, and shelter a unique ecosystem. However, eutrophication and loss of native species are ailing our wetlands. There is a lack of uniform data collection and sparse research on correlations between satellite data and in situ measurements. Remote sensing (RS) has shown great promise in environmental monitoring. This project attempts to use satellite data and correlate metrics with in situ observations collected at five estuaries. Images for satellite data were processed to calculate 7 bands (SIs) using Python. Average SI values were calculated per month for 23 years. Publicly available data from 6 sites at ELK was used to obtain 10 parameters (OPs). Average OP values were calculated per month for 23 years. Linear correlations between the 7 SIs and 10 OPs were made and found to be inadequate (correlation = 1 to 64%). Fourier transform analysis on 7 SIs was performed. Dominant frequencies and amplitudes were extracted for 7 SIs, and a machine learning(ML) model was trained, validated, and tested for 10 OPs. Better correlations were observed between SIs and OPs, with certain time delays (0, 3, 4, 6 month delay), and ML was again performed. The OPs saw improved R² values in the range of 0.2 to 0.93. This approach can be used to get periodic analyses of overall wetland health with satellite indices. It proves that remote sensing can be used to develop correlations with critical parameters that measure eutrophication in situ data and can be used by practitioners to easily monitor wetland health.

Keywords: estuary, remote sensing, machine learning, Fourier transform

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456 Empowering Transformers for Evidence-Based Medicine

Authors: Jinan Fiaidhi, Hashmath Shaik

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Breaking the barrier for practicing evidence-based medicine relies on effective methods for rapidly identifying relevant evidence from the body of biomedical literature. An important challenge confronted by medical practitioners is the long time needed to browse, filter, summarize and compile information from different medical resources. Deep learning can help in solving this based on automatic question answering (Q&A) and transformers. However, Q&A and transformer technologies are not trained to answer clinical queries that can be used for evidence-based practice, nor can they respond to structured clinical questioning protocols like PICO (Patient/Problem, Intervention, Comparison and Outcome). This article describes the use of deep learning techniques for Q&A that are based on transformer models like BERT and GPT to answer PICO clinical questions that can be used for evidence-based practice extracted from sound medical research resources like PubMed. We are reporting acceptable clinical answers that are supported by findings from PubMed. Our transformer methods are reaching an acceptable state-of-the-art performance based on two staged bootstrapping processes involving filtering relevant articles followed by identifying articles that support the requested outcome expressed by the PICO question. Moreover, we are also reporting experimentations to empower our bootstrapping techniques with patch attention to the most important keywords in the clinical case and the PICO questions. Our bootstrapped patched with attention is showing relevancy of the evidence collected based on entropy metrics.

Keywords: automatic question answering, PICO questions, evidence-based medicine, generative models, LLM transformers

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455 A Stochastic Diffusion Process Based on the Two-Parameters Weibull Density Function

Authors: Meriem Bahij, Ahmed Nafidi, Boujemâa Achchab, Sílvio M. A. Gama, José A. O. Matos

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Stochastic modeling concerns the use of probability to model real-world situations in which uncertainty is present. Therefore, the purpose of stochastic modeling is to estimate the probability of outcomes within a forecast, i.e. to be able to predict what conditions or decisions might happen under different situations. In the present study, we present a model of a stochastic diffusion process based on the bi-Weibull distribution function (its trend is proportional to the bi-Weibull probability density function). In general, the Weibull distribution has the ability to assume the characteristics of many different types of distributions. This has made it very popular among engineers and quality practitioners, who have considered it the most commonly used distribution for studying problems such as modeling reliability data, accelerated life testing, and maintainability modeling and analysis. In this work, we start by obtaining the probabilistic characteristics of this model, as the explicit expression of the process, its trends, and its distribution by transforming the diffusion process in a Wiener process as shown in the Ricciaardi theorem. Then, we develop the statistical inference of this model using the maximum likelihood methodology. Finally, we analyse with simulated data the computational problems associated with the parameters, an issue of great importance in its application to real data with the use of the convergence analysis methods. Overall, the use of a stochastic model reflects only a pragmatic decision on the part of the modeler. According to the data that is available and the universe of models known to the modeler, this model represents the best currently available description of the phenomenon under consideration.

Keywords: diffusion process, discrete sampling, likelihood estimation method, simulation, stochastic diffusion process, trends functions, bi-parameters weibull density function

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454 Factors Contributing to Delayed Diagnosis and Treatment of Breast Cancer and Its Outcome in Jamhoriat Hospital Kabul, Afghanistan

Authors: Ahmad Jawad Fardin

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Over 60% of patients with breast cancer in Afghanistan present late with advanced stage III and IV, a major cause for the poor survival rate. The objectives of this study were to identify the contributing factors for the diagnosis and treatment delay and its outcome. This cross-sectional study was conducted on 318 patients with histologically confirmed breast cancer in the oncology department of Jamhoriat hospital, which is the first and only national cancer center in Afghanistan; data were collected from medical records and interviews conducted with women diagnosed with breast cancer, linear regression and logistic regression were used for analysis. Patient delay was defined as the time from first recognition of symptoms until first medical consultation and doctor form first consultation with a health care provider until histological confirmation of breast cancer. The mean age of patients was 49.2+_ 11.5years. The average time for the final diagnosis of breast cancer was 8.5 months; most patients had ductal carcinoma 260.7 (82%). Factors associated with delay were low education level 76% poor socioeconomic and cultural conditions 81% lack of cancer center 73% lack of screening 19%. The stage distribution was as follows stage IV 4 22% stage III 44.4% stage II 29.3% stage I 4.3%. Complex associated factors were identified to delayed the diagnosis of breast cancer and increased adverse outcomes consequently. Raising awareness and education in women, the establishment of cancer centers and providing accessible diagnosis service and screening, training of general practitioners; required to promote early detection, diagnosis and treatment.

Keywords: delayed diagnosis and poor outcome, breast cancer in Afghanistan, poor outcome of delayed breast cancer treatment, breast cancer delayed diagnosis and treatment in Afghanistan

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453 Value Creation of Public Financial Management Reforms through Their Long-Term Impacts

Authors: Christoph Schuler, Oriana Ponta

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Public Financial Management (PFM) reforms are promoted by various international organizations such as the International Monetary Fund (IMF) or the World Bank, local development banks and the donor country community to strengthen governance and accountability in developing countries across the world. Reform efforts undertaken are often systematically measured against international best practice by the application of standardized analytical instruments such as the Public Expenditure and Financial Accountability Framework (PEFA) or the Poverty Reduction Action Plan (PARP). While those instruments analyze direct achievements of PFM reforms, the long-term benefits of such reforms for society remain untapped. This gives rise to the question why the concept of impact evaluation with its experimental or quasi-experimental settings in the form of randomized control trials has rarely been applied in the context of PFM reforms. To close this gap, this study provides examples where the concept of impact evaluation can be applied to PFM reforms and thereby shifting the focus from outcome towards a long-term impact. As it is a new approach, this study does not attempt to conduct a fully flagged impact evaluation of a certain PFM reform. However, it will outline, as a form of pre-test the applicability of the impact evaluation methodology in this context, for example, by more closely analyzing the commonly used indicators (for example within PEFA or PARP). This would mean to scrutinize these indicators as to how they were designed and how they are related to the long-term impact, they should be producing. The analysis of PFM reform indicators and their relation to long-term impacts should provide practitioners and scholars alike with new insights on how to strengthen the accountability of public service delivery through successful and sustainable PFM reforms.

Keywords: accountability, impact evaluation, PFM reforms, public financial management

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452 Impact of Acculturation Stress and Work-Family Conflict on the Health and Wellbeing of African Immigrants in the US: A Case Study of Ghanaian Immigrants

Authors: Rodlyn Remina Hines

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Africans who migrate to the United States (U.S.) go through an acculturation period. When they join the U.S. workforce during the period they are still acquainting to the new geographic area and culture, they may experience work and family conflict in addition to the stressors of acculturation. This study investigated the impact of acculturation stress and work-family conflict on the health and wellbeing of African immigrants in the U.S. using a growing immigrant population. Ghanaian immigrants (n = 100, males= 43%; females= 56%) residing in New York and Massachusetts, United States (U.S.), were recruited via purposive sampling to investigate the role acculturation stress and work-family conflict play on the health and wellbeing of African immigrants in the U.S. Using the Sociocultural theory, three hypotheses were proposed: (1) High acculturation stress will lead to high work-family conflict, (2) High work-family conflict will result in poor health and wellbeing, and (3) Work-family conflict will mediate the relationship between acculturation stress and health and wellbeing. The results fully supported the first hypothesis and partially supported the second and third. High acculturation stress led to high work-family conflict. Although high work-family conflict resulted in poorer health and wellbeing, high family support mediated work-family conflict and health and wellbeing. Participants who reported poor health also reported a lack of family or other support and those who reported strong family or other support also reported excellent health and wellbeing even with high work-family conflict. The latter group did not expect their health and wellbeing to get worse. I draw on these findings to conclude that African immigrants in the U.S. experience significant acculturation stress and work-family conflict resulting in poor health and wellbeing during their acculturation period if there is a lack of family or other support. These findings have implications for practitioners and policymakers.

Keywords: acculturation stress, work-family conflict, Ghanaian immigrants, health and wellbeing

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451 Promoting Open Educational Resources (OER) in Theological/Religious Education in Nigeria

Authors: Miracle Ajah

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One of the biggest challenges facing Theological/Religious Education in Nigeria is access to quality learning materials. For instance at the Trinity (Union) Theological College, Umuahia, it was difficult for lecturers to access suitable and qualitative materials for instruction especially the ones that would suit the African context and stimulate a deep rooted interest among the students. Some textbooks written by foreign authors were readily available in the School Library, but were lacking in the College bookshops for students to own copies. Even when the College was able to order some of the books from abroad, it did not usher in the needed enthusiasm expected from the students because they were either very expensive or very difficult to understand during private studies. So it became necessary to develop contextual materials which were affordable and understandable, though with little success. The National Open University of Nigeria (NOUN)’s innovation in the development and sharing of learning resources through its Open Course ware is a welcome development and of great assistance to students. Apart from NOUN students who could easily access the materials, many others from various theological/religious institutes across the nation have benefited immensely. So, the thesis of this paper is that the promotion of open educational resources in theological/religious education in Nigeria would facilitate a better informed/equipped religious leadership, which would in turn impact its adherents for a healthier society and national development. Adopting a narrative and historical approach within the context of Nigeria’s educational system, the paper discusses: educational traditions in Nigeria; challenges facing theological/religious education in Nigeria; and benefits of open educational resources. The study goes further to making recommendations on how OER could positively influence theological/religious education in Nigeria. It is expected that theologians, religious educators, and ODL practitioners would find this work very useful.

Keywords: OER, theological education, religious education, Nigeria

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450 Academic Education and Internship towards Architecture Professional Practice

Authors: Sawsan Saridar masri, Hisham Arnaouty

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Architecture both defines and is defined by social, cultural, political and financial constraints: this is where the discipline and the profession of architecture meet. This mutual sway evolves wherever interferences in the built environment are thought-out and can be strengthened or weakened by the many ways in which the practice of architecture can be undertaken. The more familiar we are about the concerns and factors that control what can be made, the greater the opportunities to propose and make appropriate architectures. Apparently, the criteria in any qualification policy should permit flexibility of approach and will – for reasons including cultural choice, political issues, and son on – vary significantly from country to country. However the weighting of the various criteria have to ensure adequate standards both in educational system as in the professional training. This paper develops, deepens and questions about the regulatory entry routes to the professional practice of architecture in the Arab world. It is also intended to provide an informed basis about strategies for conventional and unconventional models of practice in preparation for the next stages of architect’s work experience and professional experience. With the objective of promoting the implementation of adequate built environment in the practice of architecture, a comprehensive analysis of various pathways of access to the profession are selected as case studies, encompassing examples from across the world. The review of such case studies allows the creation of a comprehensive picture in relation to the conditions for qualification of practitioners of the built environment at the level of the Middle Eastern countries and the Arab World. Such investigation considers the following aspects: professional title and domain of practice, accreditation of courses, internship and professional training, professional examination and continuing professional development.

Keywords: architecture, internship, mobility, professional practice

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449 The Determinants of Customer’s Purchase Intention of Islamic Credit Card: Evidence from Pakistan

Authors: Nasir Mehmood, Muhammad Yar Khan, Anam Javeed

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This study aims to scrutinize the dynamics which tend to impact customer’s purchasing intention of Islamic credit card and nexus of product’s knowledge and religiosity with the attitude of potential Islamic credit card’s customer. The theory of reasoned action strengthened the idea that intentions due to its proven predictive power are most likely to instigate intended consumer behavior. Particularly, the study examines the relationships of perceived financial cost (PFC), subjective norms (SN), and attitude (ATT) with the intention to purchase Islamic credit cards. Using a convenience sampling approach, data have been collected from 450 customers of banks located in Rawalpindi and Islamabad. A five-point Likert scale self-administered questionnaire was used to collect the data. The data were analyzed using the Statistical Package of Social Sciences (SPSS) through the procedures of principal component and multiple regression analysis. The results suggested that customer’s religiosity and product knowledge are strong indicators of attitude towards buying Islamic credit cards. Likewise, subjective norms, attitude, and perceived financial cost have a significant positive impact on customers’ purchase intent of Islamic bank’s credit cards. This study models a useful path for future researchers to further investigate the underlined phenomenon along with a variety of psychodynamic factors which are still in its infancy, at least in the Pakistani banking sector. The study also provides an insight to the practitioners and Islamic bank managers for directing their efforts toward educating customers regarding the use of Islamic credit cards and other financial products.

Keywords: attitude, Islamic credit card, religiosity, subjective norms

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448 Servant Leadership for Elder Care in St. Camillus Health Systems, USA

Authors: Anthoni Jeorge

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Throughout the history of the world, servant leadership has been researched, and favourable results such as individual, team, and organizational have been linked to the construct. This research paper designates St. Camillus de Lellis, a practitioner of servant leadership and founder of the Ministers of the Sick as a servant leader in his approach to care for the sick. Service is the visible face of his servant leadership. First of all, despite many challenges, St. Camillus de Lellis practiced leadership by the example of compassionate service to the sick. Second, he made service to the sick the highest priority of his life. Third, Camillus displayed servant leadership such that his manner of leadership gave birth to a New School of Service to the Sick. The paper identifies the distinctive dimensions and essential elements which characterized his service-centered leadership. Furthermore, discuss the six major characteristics of a servant leader as set forth by St. Camillus’s life example. The research illustrates the transformational power of servant leadership infield healthcare in general and, in doing so, provides servant leadership seekers ways servant leadership can transform elder care in one’s own field (St. Camillus Health Systems). Thus, it ascertains that servant leadership is best-fit for humanized elder care. Supported by the review of literature, the paper ascertains that Camillus, by identifying himself with the sick, gained deeper insights concerning the pain and suffering of the population. Uniquely drawn from his true grit, Camillus’ service-centered leadership is value-based, people-oriented, and compassion-filled. His way of service to the sick is the prolongation of gestures of mercy and compassion. It is hoped that the results of this study will help health care workers and servant leadership practitioners to humanize elder care and cultivate servant leadership attitude in their health care services to the sick. By incorporating such service-oriented elements into their leadership orientation, health care workers will be true servant leaders of the sick.

Keywords: leadership, service, healthcare, compassion

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447 A Socio-political Analysis of Mindfulness Practice in Hong Kong

Authors: Pinqiao Wang

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Mindfulness, derived from Buddhism, has been developed to improve individuals' well-being, first in the West and then gaining growing popularity in Asia. Numerous research studies have proven the effectiveness of mindfulness among clinical groups and the public all over the world. However, as enthusiasm surges, reflections on mindfulness and its commodification and instrumentalization arise. Hong Kong was seen as the model of a free market by neoliberal economists. The relationships between its socioeconomic neoliberalism, Western-inspired democracy aspiration, and political harmonization with China Mainland have been fraught with tensions, which have been further exacerbated by socio-political changes since the 2010s. Under such circumstances, mental health problems have come into the spotlight in Hong Kong recently. Mindfulness has gained growing popularity in Hong Kong, with its influence reaching from primary schools to corporate settings. A more comprehensive socio-political analysis of mindfulness within the Hong Kong context warrants further exploration. Drawing on interview responses from mindfulness practitioners, we examine the connections between the ideologies underlying mindfulness and contemporary capitalist society. On the one hand, mindfulness focuses on the present moment and self-improvement, representing neoliberal capitalist spirituality and reinforcing existing power relations. On the other hand, mindfulness fosters the acceptance of difference, which is argued to demonstrate the potential for advancing democracy at both the individual and community levels. Academically, this research provides empirical evidence to advance the current discussions and debates surrounding the socio-political potential of mindfulness. Practically, it serves as a reflection on mindfulness practices to optimize their impact on individuals and society.

Keywords: neoliberal subjectivity, qualitative analysis, social construction, technologies of the self, therapeutic culture

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446 In vivo Antidiarrheal and ex-vivo Spasmolytic Activities of the Aqueous Extract of the Roots of Echinops kebericho Mesfin in Rodents and Isolated Guinea-Pig Ileum

Authors: Fisseha Shiferie (Bpharm, Mpharm)

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Diarrhea is a common gastrointestinal disorder characterized by an increase in stool frequency and a change in stool consistency. Inspite of the availability of many drugs as antidiarrheal agents, the search for a drug with affordable cost and better efficacy is essential to overcome diarrheal problems. The root extract of Echinops kebericho, is used by traditional practitioners for the treatment of diarrhea. However, the scientific basis for this usage has not been yet established. The purpose of the present study was to evaluate the antidiarrheal and spasmolytic activities of the aqueous extract of the roots of E. kebericho in rodents and isolated guinea-pig ileum preparations. In the castor oil induced intestinal transit test, E. kebericho produced a significant (p < 0.01) dose dependent decrease in propulsion with peristaltic index values of 45.05±3.3, 42.71±2.25 and 33.17±3.3%, respectively at doses of 100, 200 and 400 mg/kg compared with 63.43±7.3% for control. In the castor oil-induced diarrhea test, the mean defecation was reduced from 1.81±0.18 to 0.99 ± 0.21 compared with 2.59 ±0.81 for control. The extract (at doses stated above) significantly decreased the volume of intestinal fluid secretion induced by castor oil (2.31±0.1 to 2.01±0.2) in relation to 3.28±0.3 for control. When tested on a guinea-pig ileum, root extract of Echinops kebericho exhibited a dose dependent spasmolytic effect, 23.07 % being its highest inhibitory effect. The results obtained in this study give some scientific support to the use of Echinops kebericho as an antidiarrheal agent due to its inhibitory effects on the different diarrheal parameters used in this study.

Keywords: antidiarrheal activity, E. kebericho, traditional medicine, diarrhea, enteropooling, and intestinal transit

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445 Young Social Beings: An Investigation into the Social Interactions and Relationships of a Year Five Class

Authors: A. Sewell

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The paper reports a research project which investigated the social interactions of nine to ten-year-olds in a mainstream primary school. The project implemented an adaption of a whole class, behavioural intervention known as 'The Good Behaviour Game (TGBG)'. TGBG is an evidence-based intervention traditionally used to reduce low-level disruptive behaviours in a classroom setting. TGBG was adapted to encourage pupil’s engagement in pro-social behaviour during lessons. A mixed methods research design was employed to evaluate intervention effects and pupil’s perceptions of their social interactions and relationships with others. Single-case research design was used to evaluate behaviour change, and Personal Construct Psychology (PCP) repertory grids were used to explore pupil’s perceptions. The findings demonstrated that TGBG could be successfully adapted to positively influence pupil’s engagement in pro-social behaviours. The findings from the PCP repertory grid interviews revealed the complexities of how children construct their social interactions and relationships with others, and how an understanding of these could be used to design better social skills interventions. It is concluded that TGBG is a cost-effective, simple to implement intervention for promoting positive social interactions and relationships at the whole class level. The paper presents the aims, design, findings, and conclusions of the study in further detail and relates limitations and potential future extensions of the research. The outcomes have direct application and relevance for practitioners interested in children’s social development and how to promote positive outcomes in this critical aspect of childhood.

Keywords: social skills, social development, social competency, the good behaviour game

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444 Factor Associated with Uncertainty Undergoing Hematopoietic Stem Cell Transplantation

Authors: Sandra Adarve, Jhon Osorio

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Uncertainty has been studied in patients with different types of cancer, except in patients with hematologic cancer and undergoing transplantation. The purpose of this study was to identify factors associated with uncertainty in adults patients with malignant hemato-oncology diseases who are scheduled to undergo hematopoietic stem cell transplantation based on Merle Mishel´s Uncertainty theory. This was a cross-sectional study with an analytical purpose. The study sample included 50 patients with leukemia, myeloma, and lymphoma selected by non-probability sampling by convenience and intention. Sociodemographic and clinical variables were measured. Mishel´s Scale of Uncertainty in Illness was used for the measurement of uncertainty. A bivariate and multivariate analyses were performed to explore the relationships and associations between the different variables and uncertainty level. For this analysis, the distribution of the uncertainty scale values was evaluated through the Shapiro-Wilk normality test to identify statistical tests to be used. A multivariate analysis was conducted through a logistic regression using step-by-step technique. Patients were 18-74 years old, with a mean age of 44.8. Over time, the disease course had a median of 9.5 months, an opportunity was found in the performance of the transplantation of < 20 days for 50% of the patients. Regarding the uncertainty scale, a mean score of 95.46 was identified. When the dimensions of the scale were analyzed, the mean score of the framework of stimuli was 25.6, of cognitive ability was 47.4 and structure providers was 22.8. Age was identified to correlate with the total uncertainty score (p=0.012). Additionally, a statistically significant difference was evidenced between different religious creeds and uncertainty score (p=0.023), education level (p=0.012), family history of cancer (p=0.001), the presence of comorbidities (p=0.023) and previous radiotherapy treatment (p=0.022). After performing logistic regression, previous radiotherapy treatment (OR=0.04 IC95% (0.004-0.48)) and family history of cancer (OR=30.7 IC95% (2.7-349)) were found to be factors associated with the high level of uncertainty. Uncertainty is present in high levels in patients who are going to be subjected to bone marrow transplantation, and it is the responsibility of the nurse to assess the levels of uncertainty and the presence of factors that may contribute to their presence. Once it has been valued, the uncertainty must be intervened from the identified associated factors, especially all those that have to do with the cognitive capacity. This implies the implementation and design of intervention strategies to improve the knowledge related to the disease and the therapeutic procedures to which the patients will be subjected. All interventions should favor the adaptation of these patients to their current experience and contribute to seeing uncertainty as an opportunity for growth and transcendence.

Keywords: hematopoietic stem cell transplantation, hematologic diseases, nursing, uncertainty

Procedia PDF Downloads 155
443 An Exploration of Why Insider Fraud Is the Biggest Threat to Your Business

Authors: Claire Norman-Maillet

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Insider fraud, otherwise known as occupational, employee, or internal fraud, is a financial crime threat. Perpetrated by defrauding (or attempting to defraud) one’s current, prospective, or past employer, an ‘employee’ covers anyone employed by the company, including board members and contractors. The Coronavirus pandemic has forced insider fraud into the spotlight, and it isn’t dimming. As the focus of most academics and practitioners has historically been on that of ‘external fraud’, insider fraud is often overlooked or not considered to be a real threat. However, since COVID-19 changed the working world, pushing most of us into remote or hybrid working, employers cannot easily keep an eye on what their staff are doing, which has led to reliance on trust and transparency. This, therefore, brings about an increased risk of insider fraud perpetration. The objective of this paper is to explore why insider fraud is, therefore, now the biggest threat to a business. To achieve the research objective, participating individuals within the financial crime sector (either as a practitioner or consultants) attended semi-structured interviews with the researcher. The principal recruitment strategy for these individuals was via the researcher’s LinkedIn network. The main findings in the research suggest that insider fraud has been ignored and rejected as a threat to a business, owing to a reluctance to admit that a colleague may perpetrate. A positive of the Coronavirus pandemic is that it has forced insider fraud into a more prominent position and giving it more importance on a business’ agenda and risk register. Despite insider fraud always having been a possibility (and therefore a risk) within any business, it is very rare that a business has given it the attention it requires until now, if at all. The research concludes that insider fraud needs to prioritised by all businesses, and even ahead of external fraud. The research also provides advice on how a business can add new or enhance existing controls to mitigate the risk.

Keywords: insider fraud, occupational fraud, COVID-19, COVID, coronavirus, pandemic, internal fraud, financial crime, economic crime

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442 Sustainability in Luxury Hotels: Between a Necessary Evolution and a Way of Differentiation

Authors: Katharina Schuck

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For a long time, luxury hotels devoted little effort to sustainability, and also scientists were fairly attracted to this subject. While some luxury hotels are now increasingly showing engagement in sustainability, the extent of their commitment varies greatly, which makes the whole industry quite intransparent when it comes to sustainable practices. In general, each hotel companyand each individual hotel can decide for themselves to what extent they commit to sustainability as long as there are no legally prescribed minimum requirements in the respective countries. Despite pleading and compelling calls from industry experts and representatives of relevant sustainability institutions, this is still reality – although climate change and environmental disasters as well as poor treatment of workers and the local population are also issues in progressive and hotel-dense European cities. This paper therefore deals with the question which sustainability activities (environmental and social) have been established by European luxury hotels so far and to what extent these activities are rather a way to differentiate in the market or are simply evaluated as part of a necessary adaptation of the luxury hotel industry. For this purpose, interviews were conducted with both industry experts and hotel representatives in order to obtain a diverse picture of the current status. The studyrevealed that a clear agenda is missing so far, which takes luxury hotels by the handand supports them in the process towards more sustainable hotel management. While a large part of the luxury hotels addressed have already established initiatives and activities regarding sustainability, they are extremely diverse, and range from recyclable toiletries use to comprehensive concepts for energy generation. The study's findings provide insights for both practitioners who seek to implement sustainability in a luxury hotel setting as well as offer an extension of the existing research base on sustainability in hospitality.

Keywords: luxury hospitality, qualitative research methods, sustainability, sustainable hotels

Procedia PDF Downloads 102