Search results for: team engagement

Authors: Noah Wayne, Andrea Tuka, Adrian Norbash, Bryan Garber, Paul Ritvo

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Program/Intervention Description: The Canadian Armed Forces(CAF) Mental Health Clinicstreat a full spectrum of mental disorder, addictions, and psychosocial issues that include Major Depressive Disorder, Post-Traumatic Stress Disorder, Generalized Anxiety Disorder, and other diagnoses. We evaluated the feasibility of an online health coach interventiondelivering mindfulness based cognitive behavioral therapy (M-CBT) and behaviour changesupport for individuals receiving treatment at CAF Clinics. Participants were provided accounts on NexJ Connected Wellness, a digital health platform, and 16 weeks of phone-based health coaching,emphasizingmild to moderate aerobic exercise, a healthy diet, and M-CBT content. The primary objective was to assess the feasibility of the online deliverywith CAF members. Evaluation Methods: Feasibility was evaluated in terms of recruitment, engagement, and program satisfaction. Weadditionallyevaluatedhealth behavior change, program completion, and mental health symptoms (i.e. PHQ-9, GAD-7, PCL-5) at three time points. Results: Service members were referred from Vancouver, Esquimalt, and Edmonton CAF bases between August 2020 and January 2021. N=106 CAF personnel were referred, and n=77 consented.N=66 participated, and n=44 completed 4-month and follow-up measures. The platform received a mean rating of76.5 on the System Usability Scale, and health coaching was judged the most helpful program feature (95.2% endorsement), while reminders (53.7%), secure messaging (51.2%), and notifications (51.2%) were also identified. Improvements in mental health status during active interventions were observed on the PHQ-9 (-5.4, p<0.001), GAD-7 (-4.0, p<0.001), and PCL-5 (-4.1, p<0.05). Conclusion: Online health coaching was well-received amidst the COVID-19 pandemic and related lockdowns. Uptake and engagement were positively reported. Participants valuedcontacts and reported strong therapeutic alliances with coaches. Healthy diet, regular exercise, and mindfulness practice are important for physical and mental health. Engagements in these behaviors are associated with reduced symptoms. An online health coach program appears feasible for assisting Canadian Armed Forces personnel.

Keywords: coaching, CBT, military, depression, mental health, digital

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Authors: Yiu K. C. Jacky, Tang S. K. Eric, W. Y. Tsang, C. Y. Li, C. K. Leung

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Objectives : (1) To enhance the competence of nurses on using IPMOE for drug administration; (2) To ensure the transition on implementation of IPMOE in safer and smooth way hospital-wide. Methodology: (1) Well-structured Governance: To make provision for IPMOE implementation, multidisciplinary governance structure at Corporate and Local levels are well established. (2) Staff Engagement: A series of staff engagement events were conducted including Staff Forum, IPMOE Hospital Visit, Kick-off Ceremony and establishment of IPMOE Webpage for familiarizing the forthcoming implementation with frontline staff. (3) Well-organized training program: from Workshop to Workplace Two different IPMOE training programs were tailor-made which aimed at introducing the core features of administration module. Fifty-five identical training classes and six train-the-trainer workshops were organized at 2-3Q 2015. Lending Scheme on IPMOE hardware for hands-on practicing was launched and further extended the training from workshop to workplace. (4) Standard Guidelines and Workflow: the related workflow and guidelines are developed which facilitates users to acquire the competence towards IPMOE and fully familiarize with the standardized contingency plan. (5) Facilities and Equipment: The installations of IPMOE hardware were promptly arranged for rollout. Besides, IPMOE training venue was well-established for staff training. (6) Risk Management Strategy: UCH Medication Safety Forum is organized in December 2015 for sharing “Tricks & Tips” on IPMOE which further disseminate at webpage for arousal of medication safety. Hospital-wide annual audit on drug administration was planned to figure out the compliance and deliberate the rooms for improvement. Results: Through the comprehensive training plan, over 1,000 UCH nurses attended the training program with positive feedback. They agreed that their competence on using IPMOE was enhanced. By the end of November 2015, 28 wards (over 1,000 Inpatient-bed) involving departments of M&G, SUR, O&T and O&G have been successfully rolled out IPMOE in 5-month. A smooth and safe transition of implementation of IPMOE was achieved. Eventually, we all get prepared for embedding IPMOE into daily nursing and work altogether for medication safety at UCH.

Keywords: drug administration, inpatient medication order entry system, medication safety, nursing informatics

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Authors: Alsnosy Balbaa, Mohamed Nabil Elnabawi, Yasmin El Meladi

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With the ever-growing concerns of climate change, Mediterranean ports, as vital economic and transport hubs face unique challenges in maintaining operations and infrastructure. This empirical study seeks to understand the current adaptations and preparedness levels of Egyptian Mediterranean ports against climate-induced disruptions. Drawing from a structured questionnaire, the research gathers insights on observed climate impacts, infrastructure adaptations, operational changes, and stakeholder engagement, aiming to shed light on the resilience of these ports in the face of a changing climate.

Keywords: climate, infrastructures, port, mediterranean

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Authors: Abbas Khosravi

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This paper discusses the use of cooperation without communication in a multi-agent, unpredictable, dynamic real-time environment. The architecture of the Persian Gulf agent consists of three layers: fixed rule, low level, and high level layers, allowing for cooperation without direct communication. A scenario is presented to each agent in the form of a file, specifying each player's role and actions in the game. The scenario helps in cases of miscommunication, improving team performance. Cooperation without communication enhances reliability and coordination among agents, leading to better results in challenging situations.

Keywords: multi-agent systems, communication, Robocop, software engineering

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Authors: Chantell Gouws, Lourens Millard, Anne Naude, Jan-Wessel Meyer, Brandon Stuwart Shaw, Ina Shaw

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Background: Millions of South African youths participate in team sports, with netball and rugby being two of the largest worldwide. This increased participation and professionalism have resulted in an increase in the number of musculoskeletal injuries. Objective: This study examined the extent to which sport coaching knowledge translates to the injuries and prevention of injuries in adolescents participating in netball and rugby. Methods: Thirty-four South African sports coaches participated in the study. Eighteen netball coaches and 16 rugby coaches with varying levels of coaching experience were selected to participate. An adapted version of Nash and Sproule’s questionnaire was used to investigate the coaches’ knowledge with regards to sport-specific common injuries, injury prevention, fitness/conditioning, individual technique development, training programs, mental training, and preparation of players. The analysis of data was carried out using a number of different techniques outlined by Nash and Sproule (2012). These techniques were determined by the type of data. Descriptive data was used to provide statistical analysis. Quantitative data was used to determine the educational framework and knowledge of sports coaches on injury prevention. Numerical data was obtained through questions on sports injuries, as well as coaches’ sports knowledge levels. Participants’ knowledge was measured using a standardized scoring system. Results: For the 0-4 years of netball coaching experience, 76.4% of the coaches had knowledge and experience and 33.3% appropriate first aid knowledge, while for the 9-12 years and 13-16 years, 100% of the coaches had knowledge and experience and first aid knowledge. For the 0-4 years in rugby coaching experience, 59.1% had knowledge and experience and 71% the appropriate first aid knowledge; for the 17-20 years, 100% had knowledge and experience and first aid, while for higher or equal to 25 years, 45.5% had knowledge and experience. In netball, 90% of injuries consisted of ankle injuries, followed by 70% for knee, 50% for shoulder, 20% for lower leg, and 15% for finger injuries. In rugby, 81% of the injuries occurred at the knee, followed by 50% for the shoulder, 40% for the ankle, 31% for the head and neck, and 25% for hamstring injuries. Six hours of training resulted in a 13% chance of injuries in netball and a 32% chance in rugby. For 10 hours of training, the injury prevalence was 10% in netball and 17% in rugby, while 15 hours resulted in an injury incidence of 58% in netball players and a 25% chance in rugby players. Conclusion: This study highlights the need for coaches to improve their knowledge in relation to injuries and injury prevention, along with factors that act as a preventative measure and promotes players’ well-being.

Keywords: musculoskeletal injury, sport coaching, sport trauma

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Authors: Nirajan Shrestha

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Karnali is one of the most vulnerable provinces in Nepal, facing challenges from climate change, poverty, and natural calamities across different regions. In recent years, the province has been severely impacted by climate change stress such as temperature rises in glacier lake of mountainous region and spring source water shortages, particularly in hilly areas where settlements are located, and water sources have depleted from their original ground levels. As a result, Karnali could face a future without enough water for all. Deep causes of sustainable safe water supply have always been neglected in rural areas of Nepal, and communities are unfairly burdened with a challenge of keeping water facilities functioning in areas affected by frequent natural disasters where there is a substantial, well-documented funding gap between the revenues from user payments and the full cost of sustained services. The key importance of a permanent system to support communities in service delivery has been always underrated so far. The complexity of water service sustainability as a topic should be simplified to one clear indicator: the functionality rate, which can be expressed as uptime or the percentage of time that the service is delivered over the total time. For example, a functionality rate of 80% means that the water service is operational 80% of the time, while 20% of the time the system is not functioning. This represents 0.2 multiplied by 365, which equals 73 days every year, or roughly two and a half months without water. This percentage should be widely understood and used in Karnali. All local governments should report their targets and performance in improving it, and there should be a broader discussion about what target is acceptable and what can be realistically achieved. In response to these challenges, the Sustainable WASH for All (SUSWA) project has introduced innovative models and policy formulation strategies in various working local government. SUSWA’s approach, which delegates rural water supply and sanitation responsibilities to local governments, has been instrumental in addressing these issues. To keep pace with the growing demand, the province has adopted a service support center model, linking local governments with federal authorities to ensure effective service delivery to the communities By enhancing WASH governance through local governments engagement, capacity building and inclusive WASH policy frameworks, there is potential to address WASH gaps while fostering a circular economy. This strategy emphasizes resource recovery, waste minimization and the creation of local employment generation opportunities. The research highlights key governance mechanisms, innovative practices and policy interventions that can be scaled up across other regions. It also provides recommendations on how to leverage Karnali’s unique socio-economic and environmental context nature-based solutions to inspire innovation and drive sustainable WASH solutions. Key findings suggest that with strong ownership and leadership of local governments, community engagement and appropriate technology, Karnali Province can become a model for integrating WASH governance with circular economy concept, providing broader lessons for other regions in Nepal.

Keywords: vulnerable provinces, natural calamities, climate change stres, spring source depletion, resources recovery, governance mechanisms, appropriate technology, community engagement, innovation

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Authors: Marta Lisowska

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The growing trend of market specialization imposes upon translators the need for proficiency in the working knowledge of specialist discourse. The notion of specialization differs from a broad general category to a highly specialized narrow field. The specialised discourse is used in the channel of communication based upon distinctive features typical for communities of practice whose co-existence is codified and hermetically locked against outsiders. Consequently, any translator deprived of professional discourse competence and social skills is incapable of providing competent translation product from source language into target language. In this paper, we report on research that explores the pedagogical practices aiming to bridge the dichotomy between the professionals and the specialist translators, while accounting for the reality of the world of professional communities entered by undergraduates on two levels: the text-based generic, and the social one. Drawing from the functional social constructivist approach, seen here as situated learning, this paper reports on the case of English-Polish, Polish-English undergraduate BA Level LSP of law translation class run in line with the simulated classroom-based and the reality-based (apprenticeship) approach. This blended method serves the purpose of introducing the young trainees to the professional world. The research provides new insights into how the LSP translation undergraduates become legitimized through discursive and social participation and engagement. The undergraduates, situated peripherally at the outset, experience their own transformation towards becoming members of these professional groups. With subjective evaluation, the trainees take a stance on this dual mode class and development of their skills. Comparing and contrasting their own work done in line with two models of translation teaching: authentic and near-authentic, the undergraduates answer research questions devised by a questionnaire survey The responses take us closer to how students feel about their LSP translation competence development. The major findings show how the trainees perceive the benefits and hardships of their functional translation class. In terms of skills, they related to communication as the most enhanced one; they highly valued the fact of being ‘exposed’ to a variety of texts (cf. multi literalism), team work, learning how to schedule work, IT skills boost and the ability to learn how to work individually. Another finding indicates that students struggled most with specialized language, and co-working with other students. The short-term research shows the momentum when the undergraduate LSP translation trainees entered the path of transformation i.e. gained consciousness of ‘how it is’ to be a participant-translator of real-life communities of practice, gaining pragmatic dint of the social and linguistic skills understood here as discursive competence (text > genre > discourse > professional practice). The undergraduates need to be aware of the work they have to do and challenges they are to face before arriving at the expert level of professional translation competence.

Keywords: communities of practice in LSP translation teaching, learning LSP translation as situated experience, peripheral participation, professional discourse for LSP translation teaching, professional translation competence

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Authors: Yue Xu

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This paper establishes the fund manager’s capital raising ability as an important managerial skill that fund firms exploit to generate higher firm revenues. Fund firms reallocate fund managers with high capital raising ability to other funds with large outflows. Investors demand the capital raising ability of managers and reward it by investing more capital despite lower future alphas. A team with a larger experience difference between reallocated managers and existing managers attracts more capital inflows, suggesting that there is a synergy effect on the fund manager’s capital raising ability.

Keywords: mutual fund, manager, fund firm, reallocation, revenue

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Authors: Kamal Ahmed, Othman Ayman, Refat Mostafa

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The post-construction phase represents a critical milestone in the project lifecycle. This is because design errors and omissions, as well as construction defects, are examined during this phase. The traditional procurement approaches that are commonly adopted in construction projects separate design from construction, which ultimately inhibits contractors, suppliers and other parties from providing the design team with constructive comments and feedback to improve the project design. As a result, a lack of considering maintainability aspects during the design process results in increasing maintenance and operation costs as well as reducing building performance. This research aims to investigate the role of Early Supplier Involvement (ESI) in the design process as an approach to enhancing building maintainability. In order to achieve this aim, a research methodology consisting of a literature review, case studies and a survey questionnaire was designed to accomplish four objectives. Firstly, a literature review was used to examine the concepts of building maintenance, maintainability, the design process and ESI. Secondly, three case studies were presented and analyzed to investigate the role of ESI in enhancing building maintainability during the design process. Thirdly, a survey questionnaire was conducted with a representative sample of Architectural Design Firms (ADFs) in Egypt to investigate their perception and application of ESI towards enhancing building maintainability during the design process. Finally, the research developed a framework to facilitate ESI in the design process in ADFs in Egypt. Data analysis showed that the ‘Difficulty of trusting external parties and sharing information with transparency’ was ranked the highest challenge of ESI in ADFs in Egypt, followed by ‘Legal competitive advantage restrictions’. Moreover, ‘Better estimation for operation and maintenance costs’ was ranked the highest contribution of ESI towards enhancing building maintainability, followed by ‘Reduce the number of operation and maintenance problems or reworks’. Finally, ‘Innovation, technical expertise, and competence’ was ranked the highest supplier’s selection criteria, while ‘paying consultation fees for offering advice and recommendations to the design team’ was ranked the highest form of supplier’s remuneration. The proposed framework represents a synthesis that is creative in thought and adds value to the knowledge in a manner that has not previously occurred.

Keywords: maintenance, building maintainability, building life cycle cost (ICC), material supplier

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Authors: K. C. Wong, K. L. Siu, S. N. Ng, K. N. Yip, Y. Y. Yuen, K. W. Lee, K. W. Wong, C. C. Li, H. P. Lam

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Background: Occupational injuries among nursing profession were found related to repeated bedside nursing care, such as transfer, lifting and manual handling patients from previous studies. Likewise, undergraduate nursing students are also exposed to potential safety hazard due to their similar work nature of registered nurses. Especially, those students who worked as Temporary undergraduate nursing students (TUNS) which is a part-time clinical job in hospitals in Hong Kong who mainly assisted in providing bedside cares appeared to at high risk of work-related injuries. Several studies suggested the level of compliance with safe work behaviors was highly associated with work-related injuries. Yet, it had been limitedly studied among nursing students. This study was conducted to assess and compare the compliance with safe work behaviors and the levels of awareness of different workplace safety issues between undergraduate nursing students with or without TUNS experiences. Methods: This is a quantitative descriptive study using convenience sampling. 362 undergraduate nursing students in Hong Kong were recruited. The Safe Work Behavior relating to Patient Handling (SWB-PH) was used to assess their compliance of safe-work behaviors and the level of awareness of different workplace safety issues. Results: The results showed that most of the participants (n=250, 69.1%) who were working as TUNS. However, students who worked as TUNS had significantly lower safe-work behaviors compliance (mean SWB-PH score = 3.64±0.54) than those did not worked as TUNS (SWB-PH score=4.21±0.54) (p<0.001). Particularly, these students had higher awareness to seek help and use assistive devices but lower awareness of workplace safety issues and awareness of proper work posture than students without TUNS experiences. The students with TUNS experiences had higher engagement in help-seeking behaviors might be possibly explained by their richer clinical experiences which served as a facilitator to seek help from clinical staff whenever necessary. Besides, these experienced students were more likely to bear risks for occupational injuries and worked alone when no available aid which might be related to the busy working environment, heightened work pressures and high expectations of TUNS. Eventually, students who worked as TUNS might target on completing the assigned tasks and gradually neglecting the occupational safety. Conclusion: The findings contributed to an understanding of the level of compliance with safe work behaviors among nursing students with different clinical experiences. The results might guide the modification of current safety protocols and the introduction of multiple clinical training courses to improve nursing student’s engagement in safe work behaviors.

Keywords: Occupational safety, Safety compliance, Safe-work behavior, Nursing students

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Authors: Samuel Attias, Elad Schiff, Zahi Arnon, Eran Ben-Arye, Yael Keshet, Ibrahim Matter, Boker Lital Keinan

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Background: Despite the extensive use of manual therapies, reflexology in particular, no validated tools have been developed to evaluate patients' beliefs, attitudes and expectations regarding reflexology. Such tools however are essential to improve the results of the reflexology treatment, by better adjusting it to the patients' attitudes and expectations. The tool also enables assessing correlations with clinical results of interventional studies using reflexology. Methods: The IBEAR (Inpatient Beliefs, Expectations and Attitudes toward Reflexology) tool contains 25 questions (8 demographic and 17 specifically addressing reflexology), and was constructed in several stages: brainstorming by a multidisciplinary team of experts; evaluation of each of the proposed questions by the experts' team; and assessment of the experts' degree of agreement per each question, based on a Likert 1-7 scale (1 – don't agree at all; 7 – agree completely). Cronbach's Alpha was computed to evaluate the questionnaire's reliability while the Factor analysis test was used for further validation (228 patients). The questionnaire was tested and re-tested (48h) on a group of 199 patients to assure clarity and reliability, using the Pearson coefficient and the Kappa test. It was modified based on these results into its final form. Results: After its construction, the IBEAR questionnaire passed the expert group's preliminary consensus, evaluation of the questions' clarity (from 5.1 to 7.0), inner validation (from 5.5 to 7) and structural validation (from 5.5 to 6.75). Factor analysis pointed to two content worlds in a division into 4 questions discussing attitudes and expectations versus 5 questions on belief and attitudes. Of the 221 questionnaires collected, a Cronbach's Alpha coefficient was calculated on nine questions relating to beliefs, expectations, and attitudes regarding reflexology. This measure stood at 0.716 (satisfactory reliability). At the Test-Retest stage, 199 research participants filled in the questionnaire a second time. The Pearson coefficient for all questions ranged between 0.73 and 0.94 (good to excellent reliability). As for dichotomic answers, Kappa scores ranged between 0.66 and 1.0 (mediocre to high). One of the questions was removed from the IBEAR following questionnaire validation. Conclusions: The present study provides evidence that the proposed IBEAR-16 questionnaire is a valid and reliable tool for the characterization of potential reflexology patients and may be effectively used in settings which include the evaluation of inpatients' beliefs, expectations, and attitudes toward reflexology.

Keywords: reflexology, attitude, expectation, belief, CAM, inpatient

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Authors: Michael Ray Brunt

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China has been the site of some of the most significant earthquakes in history; however, earthquake monitoring has long been the provenance of universities and research institutions. The China Digital Seismographic Network was initiated in 1983 and improved significantly during 1992-1993. Data from the CDSN is widely used by government and research institutions, and, generally, this data is not readily accessible to middle and high school students. An educational seismic network in China is needed to provide collaboration and research opportunities for students and engaging students around the country in scientific understanding of earthquake hazards and risks while promoting community awareness. In 2022, the Tsinghua International School (THIS) Seismology Team, made up of enthusiastic students and facilitated by two experienced teachers, was established. As a group, the team’s objective is to install seismographs in schools throughout China, thus creating an educational seismic network that shares data from the THIS Educational Seismic Network (THIS-ESN) and facilitates collaboration. The THIS-ESN initiative will enhance education and outreach in China about earthquake risks and hazards, introduce seismology to a wider audience, stimulate interest in research among students, and develop students’ programming, data collection and analysis skills. It will also encourage and inspire young minds to pursue science, technology, engineering, the arts, and math (STEAM) career fields. The THIS-ESN utilizes small, low-cost RaspberryShake seismographs as a powerful tool linked into a global network, giving schools and the public access to real-time seismic data from across China, increasing earthquake monitoring capabilities in the perspective areas and adding to the available data sets regionally and worldwide helping create a denser seismic network. The RaspberryShake seismograph is compatible with free seismic data viewing platforms such as SWARM, RaspberryShake web programs and mobile apps are designed specifically towards teaching seismology and seismic data interpretation, providing opportunities to enhance understanding. The RaspberryShake is powered by an operating system embedded in the Raspberry Pi, which makes it an easy platform to teach students basic computer communication concepts by utilizing processing tools to investigate, plot, and manipulate data. THIS Seismology Team believes strongly in creating opportunities for committed students to become part of the seismological community by engaging in analysis of real-time scientific data with tangible outcomes. Students will feel proud of the important work they are doing to understand the world around them and become advocates spreading their knowledge back into their homes and communities, helping to improve overall community resilience. We trust that, in studying the results seismograph stations yield, students will not only grasp how subjects like physics and computer science apply in real life, and by spreading information, we hope students across the country can appreciate how and why earthquakes bear on their lives, develop practical skills in STEAM, and engage in the global seismic monitoring effort. By providing such an opportunity to schools across the country, we are confident that we will be an agent of change for society.

Keywords: collaboration, outreach, education, seismology, earthquakes, public awareness, research opportunities

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Authors: Sawyer Spurry

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Problem: Palliative care providers at an academic medical center in Maryland stated medical intensive care unit (MICU) patients are often referred late in their hospital stay. The MICU has performed well below the hospital quality performance metric of 80% of patients who expire with expected outcomes should have received a palliative care consult within 48 hours of admission. Purpose: The purpose of this quality improvement (QI) project is to increase palliative care utilization in the MICU through the implementation of a Nurse-Driven PalliativeTriggerTool to prompt the need for specialty palliative care consult. Methods: MICU nursing staff and providers received education concerning the implications of underused palliative care services and the literature data supporting the use of nurse-driven palliative care tools as a means of increasing utilization of palliative care. A MICU population specific criteria of palliative triggers (Palliative Care Trigger Tool) was formulated by the QI implementation team, palliative care team, and patient care services department. Nursing staff were asked to assess patients daily for the presence of palliative triggers using the Palliative Care Trigger Tool and present findings during bedside rounds. MICU providers were asked to consult palliative medicinegiven the presence of palliative triggers; following interdisciplinary rounds. Rates of palliative consult, given the presence of triggers, were collected via electronic medical record e-data pull, de-identified, and recorded in the data collection tool. Preliminary Results: Over 140 MICU registered nurses were educated on the palliative trigger initiative along with 8 nurse practitioners, 4 intensivists, 2 pulmonary critical care fellows, and 2 palliative medicine physicians. Over 200 patients were admitted to the MICU and screened for palliative triggers during the 15-week implementation period. Primary outcomes showed an increase in palliative care consult rates to those patients presenting with triggers, a decreased mean time from admission to palliative consult, and increased recognition of unmet palliative care needs by MICU nurses and providers. Conclusions: Anticipatory findings of this QI project would suggest a positive correlation between utilizing palliative care trigger criteria and decreased time to palliative care consult. The direct outcomes of effective palliative care results in decreased length of stay, healthcare costs, and moral distress, as well as improved symptom management and quality of life (QOL).

Keywords: palliative care, nursing, quality improvement, trigger tool

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Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana

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Background: Soldiers' physical rehabilitation and long term health status has been hindered due to limited investment in and access to rehabilitation services. Home-based rehabilitation programmes could offer a potentially feasible alternative to facilitate long-term recovery. Objectives: To explore Sri Lankan soldiers' perceptions of barriers and facilitators to a home-based physical rehabilitation programme.Methods and Materials: We conducted qualitative semi-structured interviews with community re-integrated army veterans who had undergone unilateral lower limb amputation following war related trauma. Veterans were identified from five districts of Sri Lanka, based on a priori knowledge of veteran community settlements (Disabled Category Registry) obtained from Directorate of Rehabilitation, MoD, Sri Lanka. Individuals were stratified for purposive selection. The interview guide was developed from existing methods and adapted for context. Verbatim transcripts of interviews were analyzed for emerging themes using an inductive approach. Following consent, participants met the researcher (AW- a trained physiotherapist fluent in Sinhalese). Results: Twenty-five Interviews were conducted, totaling 7.2 hours of new data (Mean±SD: 0.28±0.11). All participants were male, aged 30-55 years (Mean±SD: 46.1±7.4), and had experienced traumatic amputation as a result of conflict. Twenty-four sub themes were identified. Inadequate space for exercises, absence of equipment and assistance to conduct the exercises at home, alongside absence of community healthcare services were all barriers. Burden of comorbidities, including chronic pain and disability level, were also barriers. Social support systems, including soldier societies, family, and kinship with other amputees, were seen as facilitators to an at-home programme. Motivation for independence was a strong indicator of engagement. Conclusion: Environment, chronic pain, and absence of well-established community health services were key barriers. Family and soldier support was a facilitator. Engagement with community healthcare providers (physiotherapist and primary care physicians) will be essential to the success of an at-home rehabilitation program.

Keywords: physical rehabilitation, home-based, soldiers, disability, lower-limb amputation, qualitative

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Authors: Onur Ozveri, Korkut Karabag, Cagri Keles

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It is an important issue that the occurring of production downtime and repair costs when machines fail in the machine intensive production industries. In the case of failure of more than one machine at the same time, which machines will have the priority to repair, how to determine the optimal repair time should be allotted for this machines and how to plan the resources needed to repair are the key issues. In recent years, Business Process Management (BPM) technique, bring effective solutions to different problems in business. The main feature of this technique is that it can improve the way the job done by examining in detail the works of interest. In the industries, maintenance and repair works are operating as a process and when a breakdown occurs, it is known that the repair work is carried out in a series of process. Maintenance main-process and repair sub-process are evaluated with process management technique, so it is thought that structure could bring a solution. For this reason, in an international manufacturing company, this issue discussed and has tried to develop a proposal for a solution. The purpose of this study is the implementation of maintenance and repair works which is integrated with process management technique and at the end of implementation, analyzing the maintenance related parameters like quality, cost, time, safety and spare part. The international firm that carried out the application operates in a free region in Turkey and its core business area is producing original equipment technologies, vehicle electrical construction, electronics, safety and thermal systems for the world's leading light and heavy vehicle manufacturers. In the firm primarily, a project team has been established. The team dealt with the current maintenance process again, and it has been revised again by the process management techniques. Repair process which is sub-process of maintenance process has been discussed again. In the improved processes, the ABC equipment classification technique was used to decide which machine or machines will be given priority in case of failure. This technique is a prioritization method of malfunctioned machine based on the effect of the production, product quality, maintenance costs and job security. Improved maintenance and repair processes have been implemented in the company for three months, and the obtained data were compared with the previous year data. In conclusion, breakdown maintenance was found to occur in a shorter time, with lower cost and lower spare parts inventory.

Keywords: ABC equipment classification, business process management (BPM), maintenance, repair performance

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Authors: Mercedes Rodriguez Sanchez, Laura Luceño Casals

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With the rise of social media, creative people and brands everywhere are constantly generating content. The students with Bachelor's Degrees in Fashion Design use platforms such as Instagram or TikTok to look for inspiration and entertainment, as well as a way to develop their own ideas and share them with a wide audience. Information and Communications Technologies (ICT) have become a central aspect of higher education, virtually affecting every aspect of the student experience. Following the current trend, during the first semester of the second year, a collaborative project across two subjects –Design Management and History of Fashion Design– was implemented. After an introductory class focused on the relationship between fashion and cinema, as well as a brief history of 20th-century fashion, the students freely chose a work team and an iconic look from a movie costume. They researched the selected movie and its sociocultural context, analyzed the costume and the work of the designer, and studied the style, fashion magazines and most popular films of the time. Students then redesigned and recreated the costume, for which they were compelled to recycle the materials they had available at home as an unavoidable requirement of the activity. Once completed the garment, students delivered in-class, team-based presentations supported by the final design, a project summary poster and a making-of video, which served as a documentation tool of the costume design process. The methodologies used include Challenge-Based Learning (CBL), debates, Internet research, application of Information and Communications Technologies, and viewing clips of classic films, among others. After finishing the projects, students were asked to complete two electronic surveys to measure the acquisition of transversal and specific competencies of each subject. Results reveal that this activity helped the students' knowledge acquisition, a deeper understanding of both subjects and their skills development. The classroom dynamic changed. The multidisciplinary approach encouraged students to collaborate with their peers, while educators were better able to keep students' interest and promote an engaging learning process. As a result, the activity discussed in this paper confirmed the research hypothesis: it is positive to propose innovative teaching projects that combine academic research with playful learning environments.

Keywords: cinema, cooperative learning, fashion design, higher education, upcycling

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Authors: Humaira Saeed Malik, Salma Saad

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Introduction: Fowler's syndrome, first described by Clare Fowler in 1985, is a rare urological condition characterized by difficulty in urination due to the abnormal function of the urethral sphincter. It predominantly affects young women and leads to chronic urinary retention. The main concern in managing this condition is ensuring regular bladder emptying. Clam cystoplasty is a bladder augmentation surgery in which the bladder is clam-shelled open, and a segment of the intestine is used to increase the bladder's capacity and reduce bladder pressure. The Mitrofanoff procedure, a surgical creation of a continent urinary diversion, is often performed in patients with Fowler's syndrome who require long-term catheterization. This procedure involves creating a conduit (from the appendix or a segment of the small intestine) between the bladder and the skin, allowing for intermittent self-catheterization to manage urinary retention. Study: This case study examines a 39-year-old gravida 3, para 0+2 woman with a BMI of 40, Fowler's syndrome, type I diabetes, and post-traumatic stress disorder (PTSD), presenting at Dumfries and Galloway Royal Infirmary at 8 weeks of gestation. Diagnosed with Fowler's syndrome at 23, . A sacral nerve stimulator (SNS) device was initially placed but was subsequently removed after one year due to malfunction caused by trauma, subsequently she had undergone clam cystoplasty and the Mitrofanoff procedure for bladder management. Her pregnancy was complicated by vaginal bleeding at 10 weeks, treated with progesterone pessaries, and a urinary tract infection at 14 weeks, managed with antibiotics. Despite these challenges, she continued self-catheterization through the Mitrofanoff stoma and was placed on prophylactic antibiotics. Her diabetes was well-controlled on insulin, and a 20-week fetal anomaly scan was normal. The multidisciplinary team, including an obstetrician and a urologist, planned for serial growth scans and the initiation of low molecular weight heparin (LMWH) from 28 weeks due to the intermediate risk of venous thromboembolism (VTE) and to continue six weeks after delivery. A planned cesarean delivery at 37 weeks was arranged, with an MRI scan scheduled later in the pregnancy to assist in surgical planning, ensuring the preservation of the Mitrofanoff stoma's function. The surgery will occur in an elective setting and include a consultant urologist. Conclusion: Pregnancy in women with Fowler's syndrome who have undergone Clam cystoplasty and the Mitrofanoff procedure is rare, and management requires careful planning and a multidisciplinary approach. This case highlights the importance of individualized care plans and close monitoring of both mother and fetus. The patient's risk of recurrent UTIs, coupled with her diabetes and high BMI, necessitated coordinated care across specialties to ensure the best possible outcomes. The Mitrofanoff procedure proved effective in managing her urinary retention, allowing her to maintain self-catheterization during pregnancy. The multidisciplinary team approach was crucial in addressing her complex medical needs, involving obstetrics, urology, and endocrinology. This case adds valuable information to the limited literature on pregnancy management in patients with Fowler's syndrome who have undergone the Mitrofanoff procedure, highlighting the need for comprehensive, individualized care and the involvement of a multidisciplinary team to achieve the best results.

Keywords: fowler's syndrome, clam cystoplasty, mitrofanoff procedure, pregnancy

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Background: The Delivering Innovations in Selfcare (DISC) project aims to increase access to self-care options for women of reproductive age, starting with self-inject subcutaneous depot medroxyprogesterone acetate (DMPA-SC) contraception services. However, the project has faced challenges in ensuring the continuous availability of the commodity in health facilities. Although most states in the country rely on the federal ministry of Health for supplies, some are gradually funding the procurement of Family Planning (FP) commodities. This attempt is, however, often accompanied by procurement delays and purchases inadequate to meet demand. This dilemma was further exacerbated by the commencement of demand generation activities by the project in supported states which geometrically increased commodity utilization rates and resulted in receding stock and occasional service disruptions. Strategies: The project deployed various strategies were implemented to ensure the continuous availability of commodities. These include facilitating inter-facility transfer, monthly tracking of commodity utilization, and alerting relevant authorities when stock levels reach a minimum. And supporting state-level procurement of DMPA-SC commodities through catalytic interventions. Results: Effective monitoring of commodity inventory at the facility level and strategic engagement with federal and state-level logistics units have proven successful in mitigating stock-out of commodities. It has helped secure up to 13,000 units of DMPA-SC commodities from federal logistics units and enabled state units to prioritize supported sites. This has ensured the continuity of DMPA-SC services and an increasing trend in the practice of self-injection. Conclusion: A functional supply chain is crucial to achieving commodity security, and without it, health programs cannot succeed. Stakeholder engagement, stock management and catalytic interventions have provided both short- and long-term measures to mitigate stock-outs and ensured a consistent supply of commodities to clients.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, commodities, stock-out

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Authors: Şule Yanık, Emel Ertürk-Mustul, Zerrin Turan, Hasan Gürgür

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It is known that there are policies that will support the early special education (ESE) for children requiring special care including the children with hearing loss (CHL) in many countries that give importance to early childhood (0-6 years) education, accordingly ESE services have been gradually increasing and these services provide positive contributions to the child and family. These services begin with medical diagnostics, provision of the use of assistive technologies for hearing and the orientation of children towards early education program (EEP) for the CHL. In 0-3 years of age EEP, education and support services are provided to the children and their families. In 3-6 years of age, children are supported in a pre-school education program (PSE) in which their peers and teachers are present. Therefore, the children with hearing loss and their families are going through a series of medical, educational and social transition process after diagnosed with hearing loss. Depending on their age and development, CHL also go through a transition period from hospital to home, from home to EEP and from EEP to PSE. It is seen that there is no legal regulation regarding the transition process in Turkey and hence different processes have been carried out in the transition process from EEP to PSE. The aim of this study is to reveal the problems confronted by the CHL during the transition period from EEP to PSE and the solution proposals for these problems. In this study, a document review was made by reviewing the national and international studies about transition processes of the CHL in Turkey from EEP to PSE. Accordingly, in the study carried out in two stages, firstly, a review of the body of literature was performed by creating key words related to the subject. Secondly, the problems confronted by the CHL in Turkey during the transition period from EEP to PSE and the solution proposals for these problems were demonstrated by analyzing the obtained data. According to the body of literature, it is seen that there are no laws concerning the transition processes of the children who require special care including the CHL in Turkey from EEP (sending) to PSE (receiving), and correspondingly numerous problems have been experienced during the transition period. It seems that the EEP adopts family-centered approaches for strengthening the families of the CHL. However, PSE program aims to prepare the children to school life by focusing on their social and academical development rather with the adoption of children-centered approaches. Therefore, while the families feel an inseparable part of the team in EEP, they indicated that they felt like a stranger in the school team after their children have started to PSE. Therefore, families find the transition processes worrisome and state that they are not satisfied with the process. We discovered that in the process of transition from EEP to PSE, families are not informed, there is a limited number of PSE options available, children cannot adapt to the new educational environment and cannot benefit from the existing PSE.

Keywords: early education program, early special education, children with hearing loss, transition

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Authors: Rachel Cherner

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Introduction: The current study investigates several user characteristics that may predict the adoption of digital mental health supports. The extent to which individual characteristics predict preferences for functional elements of computer-mediated social support (CMSS) platforms and mental health (MH) apps is relatively unstudied. Aims: The present study seeks to illuminate the relationship between broad user characteristics and perceived attraction to CMSS platforms and MH apps. Methods: Participants (n=353) were recruited using convenience sampling methods (i.e., digital flyers, email distribution, and online survey forums). The sample was 68% male, and 32% female, with a mean age of 29. Participant racial and ethnic breakdown was 75% White, 7%, 5% Asian, and 5% Black or African American. Participants were asked to complete a 25-minute self-report questionnaire that included empirically validated measures assessing a battery of characteristics (i.e., subjective levels of anxiety/depression via PHQ-9 (Patient Health Questionnaire 9-item) and GAD-7 (Generalized Anxiety Disorder 7-item); attachment style via MAQ (Measure of Attachment Qualities); personality types via TIPI (The 10-Item Personality Inventory); growth mindset and mental health-seeking attitudes via GM (Growth Mindset Scale) and MHSAS (Mental Help Seeking Attitudes Scale)) and subsequent attitudes toward CMSS platforms and MH apps. Results: A stepwise linear regression was used to test if user characteristics significantly predicted attitudes towards key features of CMSS platforms and MH apps. The overall regression was statistically significant (R² =.20, F(1,344)=14.49, p<.000). Conclusion: This original study examines the clinical and sociocultural factors influencing decisions to use CMSS platforms and MH apps. Findings provide valuable insight for increasing adoption and engagement with digital mental health support. Fostering a growth mindset may be a method of increasing participant/patient engagement. In addition, CMSS platforms and MH apps may empower under-resourced and minority groups to gain basic access to mental health support. We do not assume this final model contains the best predictors of use; this is merely a preliminary step toward understanding the psychology and attitudes of CMSS platform/MH app users.

Keywords: computer-mediated social support platforms, digital mental health, growth mindset, health-seeking attitudes, mental health apps, user characteristics

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Authors: Natnicha Hasoontree

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This purpose of this paper was to investigate the influence of loyalty of inbound tourists towards tourist destinations in Bangkok, Thailand. The antecedents of loyalty in this study included tourists’ satisfaction towards tourist destinations, perceived value of tourist destinations, feelings of engagement with tourist destinations, acquaintance with tourist destinations, and seeking novelty. By using multi-stage sampling technique, 400 tourists were sampled: 200 male and 200 female inbound tourists. The findings revealed that inbound tourists’ satisfaction was the most important factor that could influence the factor of loyalty. The findings indicated that the overall antecedents had a mean of 4.416 with the overall standard deviation of 0.808.

Keywords: antecedents, loyalty, inbound tourists, tourist destinations

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Authors: Lu-Chiu Huang, Pei-Pei Chen, Li-Chin Yu, Chiao-Wen Kuo, Tsui-Tao Liu, Rung-Chuang Feng

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Purpose: People put increasing emphasis on demands of medical quality and protecting their interests. Patients' or family's dissatisfaction with medical care may easily lead to medical dispute. Physician-family communication plays an essential role in medical care. A sound communication cannot only strengthen patients' belief in the medical team but make patient have definite insight into treatment course of the disease. A family meeting provides an effective platform for communication between clinical staff, patients and family. Decisions and consensuses formed in family meetings can promote patients' or family's satisfaction with medical care. Clinical staff's attitudes toward family meeting may determine behavioral intentions to hold family meeting. This study aims to explore clinical staff's difficulties in holding family meeting and evaluate how their attitudes and behavior influence the effect of family meetings. Methods: This was a cross-sectional study. It was conducted at a regional teaching hospital in Taipei city. The research team developed its own structural questionnaires, whose expert validity was checked by the nursing experts. Participants filled in the questionnaires online. Data were collected by convenience sampling. A total of 568 participants were invited. They included doctors, nurses, social workers, and so on. Results: 1) The average score of ‘clinical staff’s attitudes to family meetings’ was 5.15 (SD=0.898). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. It indicated that clinical staff had positive attitudes toward family meetings, 2) The average score of ‘clinical staff’s behavior to family meetings’ was 5.61 (SD=0.937). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. It meant clinical staff tended to have positive behavior at the family meeting, and 3) The average score of ‘Difficulty in conducting family meetings’ was 5.15 (SD=0.897). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. The higher the score was, the less difficulty the clinical staff felt. It demonstrated clinical staff felt less difficulty in conducting family meetings. Clinical staff's identification with family meetings brought favored effects. Persistent and active promotion for family meetings can bring patients and family more benefits. Implications for practice: Understanding clinical staff's difficulty in participating family meeting and exploring their attitudes or behavior toward physician-family communication are helpful to develop modes of interaction. Consequently, quality and satisfaction of physician-family communication can be increased.

Keywords: clinical staff, communication, family meeting, physician-family

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Authors: Agnes Simone

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A 52-year-old male with unknown psychiatric and medical history was brought to the Psychiatric Emergency Room by ambulance directly from jail. He had been detained for three weeks for possession of a firearm while intoxicated. On initial evaluation, the patient was unable to provide a reliable history. He presented with odd jerking movements of his extremities and catatonic features, including mutism and stupor. His vital signs were stable. Patient was transferred to the medical emergency department for work-up of altered mental status. Due to suspicion for opioid overdose, the patient was given naloxone (Narcan) with no improvement. Laboratory work-up included complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, vitamin B12, folate, magnesium, rapid plasma reagin, HIV, blood alcohol level, aspirin, and Tylenol blood levels, urine drug screen, and urinalysis, which were all negative. CT head and chest X-Ray were also negative. With this negative work-up, the medical team concluded there was no organic etiology and requested inpatient psychiatric admission. Upon re-evaluation by psychiatry, it was evident that the patient continued to have an altered mental status. Of note, the medical team did not include substance withdrawal in the differential diagnosis due to stable vital signs and a negative urine drug screen. The psychiatry team decided to check California's prescription drug monitoring program (CURES) and discovered that the patient was prescribed benzodiazepine alprazolam (Xanax) 2mg BID, a sedative-hypnotic, and hydrocodone/acetaminophen 10mg/325mg (Norco) QID, an opioid. After a thorough chart review, his daughter's contact information was found, and she confirmed his benzodiazepine and opioid use, with recent escalation and misuse. It was determined that the patient was experiencing alprazolam withdrawal, given this collateral information, his current symptoms, negative urine drug screen, and recent abrupt discontinuation of medications while incarcerated. After admission to the medical unit and two doses of alprazolam 2mg, the patient's mental status, alertness, and orientation improved, but he had no memory of the events that led to his hospitalization. He was discharged with a limited supply of alprazolam and a close follow-up to arrange a taper. Accompanying this case report, a qualitative review of presentations with alprazolam withdrawal was completed. This case and the review highlights: (1) Alprazolam withdrawal can occur at low doses and within just one week of use. (2) Alprazolam withdrawal can present without any vital sign instability. (3) Alprazolam withdrawal does not respond to short-acting benzodiazepines but does respond to certain long-acting benzodiazepines due to its unique chemical structure. (4) Alprazolam withdrawal is distinct from and more severe than other benzodiazepine withdrawals. This case highlights (1) the importance of physician utilization of drug-monitoring programs. This case, in particular, relied on California's drug monitoring program. (2) The importance of obtaining collateral information, especially in cases in which the patient is unable to provide a reliable history. (3) The importance of including substance intoxication and withdrawal in the differential diagnosis even when there is a negative urine drug screen. Toxidrome of withdrawal can be delayed. (4) The importance of discussing addiction and withdrawal risks of medications with patients.

Keywords: addiction risk of benzodiazepines, alprazolam withdrawal, altered mental status, benzodiazepines, drug monitoring programs, sedative-hypnotics, substance use disorder

Procedia PDF Downloads 138

Authors: Yiqiao Yin

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Many scholars and educators have dedicated their lives in K12 education system and there has been an exploding amount of attention to implement technical foundations for Artificial Intelligence Education for high school and precollege level students. This paper focuses on the development and use of resources to support K-12 education in Artificial Intelligence (AI). The author and his team have more than three years of experience coaching students from pre-college level age from 15 to 18. This paper is a culmination of the experience and proposed online tools, software demos, and structured activities for high school students. The paper also addresses a portfolio of AI concepts as well as the expected learning outcomes. All resources are provided with online videos and Github repositories for immediate use.

Keywords: K12 education, AI4ALL, pre-college education, pre-college AI

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Authors: Julie Devine

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This presentation will look at the approaches to teaching grammar taken over two years with students studying Japanese in the last two years of high school. The main focus is an enquiry based approach to grammar introduction and a three tier system using videos and online support material to allow for differentiation and personalised learning in the classroom. The aim is to create space for motivated students to do some higher order activities using the target pattern to solve problems and create scenarios. Less motivated students have time to complete basic exercises and struggling students have some time with the teacher in smaller groups.

Keywords: differentiation, digital technologies, personalised learning plans, student engagement

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Authors: Niyi Awofeso, Yunes Gaber, Moyosola Bamidele

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Since most social media platforms are accessible anytime and anywhere where Internet connections and smartphones are available, the invisibility of the reader raises questions about accuracy, appropriateness and comprehensibility of social media communication. Furthermore, the identity and motives of individuals and organizations who post articles on social media sites are not always transparent. In the health sector, through socially networked platforms constitute a common source of health-related information, given their purported wealth of information. Nevertheless, fake blogs and sponsored postings for marketing 'natural cures' pervade most commonly used social media platforms, thus complicating readers’ abilities to access and understand trustworthy health-related information. This purposive sampling study of 120 participants aged 18-35 year in UAE was conducted between September and December 2017, and explored commonly used social media platforms, frequency of use of social media for accessing health related information, and approaches for assessing the trustworthiness of health information on social media platforms. Results indicate that WhatsApp (95%), Instagram (87%) and Youtube (82%) were the most commonly used social media platforms among respondents. Majority of respondents (81%) indicated that they regularly access social media to get health-associated information. More than half of respondents (55%) with non-chronic health status relied on unsolicited messages to obtain health-related information. Doctors’ health blogs (21%) and social media sites of international healthcare organizations (20%) constitute the most trusted source of health information among respondents, with UAE government health agencies’ social media accounts trusted by 15% of respondents. Cardiovascular diseases, diabetes, and hypertension were the most commonly searched topics on social media (29%), followed by nutrition (20%) and skin care (16%). Majority of respondents (41%) rely on reliability of hits on Google search engines, 22% check for health information only from 'reliable' social media sites, while 8% utilize 'logic' to ascertain reliability of health information. As social media has rapidly become an integral part of the health landscape, it is important that health care policy makers, healthcare providers and social media companies collaborate to promote the positive aspects of social media for young people, whilst mitigating the potential negatives. Utilizing popular social media platforms for posting reader-friendly health information will achieve high coverage. Improving youth digital literacy will facilitate easier access to trustworthy information on the internet.

Keywords: social media, United Arab Emirates, youth engagement, digital literacy

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Authors: Michael Adebayo, Saheed Lawal

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The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.

Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality

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Authors: Gerhard Peter

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In this paper, we present an integrated framework that governs the introduction of social media into enterprises and its evaluation. It is argued that the framework should address the following issues: (1) the contribution of social media for increasing efficiency and improving the quality of working life; (2) the level on which this contribution happens (i.e., individual, team, or organisation); (3) a description of the processes for implementing and evaluating social media; and the role of (4) organisational culture and (5) management. We also report the results of a case study where the framework has been employed to introduce a social networking platform at a German enterprise. This paper only considers the internal use of social media.

Keywords: case study, enterprise 2.0, framework, introducing and evaluating social media, social media

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Authors: Marthinus Conradie

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The conversational dynamics of democratically orientated deliberation continue to stimulate critical scholarship for its potential to bolster robust engagement between different sections of pluralist societies. Several axes of deliberation that have attracted academic attention include face-to-face vs. online interaction, and citizen-to-citizen communication vs. engagement between citizens and political elites. In all these areas, numerous researchers have explored deliberative procedures aimed at achieving instrumental goals such a securing consensus on policy issues, against procedures that prioritise expressive outcomes such as broadening the range of argumentative repertoires that discursively construct and mediate specific political issues. The study that informs this paper, works in the latter stream. Drawing its data from the reader-comments section of a South African broadsheet newspaper, the study investigates online, citizen-to-citizen deliberation by analysing the discursive practices through which competing understandings of social problems are articulated and contested. To advance this agenda, the paper deals specifically with user-generated comments posted in response to news stories on questions of race and racism in South Africa. The analysis works to discern and interpret the various sets of discourse practices that shape how citizens deliberate contentious political issues, especially racism. Since the website in question is designed to encourage the critical comparison of divergent interpretations of news events, without feeding directly into national policymaking, the study adopts an analytic framework that traces how citizens articulate arguments, rather than the instrumental effects that citizen deliberations might exert on policy. The paper starts from the argument that such expressive interactions are particularly crucial to current trends in South African politics, given that the precise nature of race and racism remain contested and uncertain. Centred on a sample of 2358 conversational moves in 814 posts to 18 news stories emanating from issues of race and racism, the analysis proceeds in a two-step fashion. The first stage conducts a qualitative content analysis that offers insights into the levels of reciprocity among commenters (do readers engage with each other or simply post isolated opinions?), as well as the structures of argumentation (do readers support opinions by citing evidence?). The second stage involves a more fine-grained discourse analysis, based on a theorisation of argumentation that delineates it into three components: opinions/conclusions, evidence/data to support opinions/conclusions and warrants that explicate precisely how evidence/data buttress opinions/conclusions. By tracing the manifestation and frequency of specific argumentative practices, this study contributes to the archive of research currently aggregating around the practices that characterise South Africans’ engagement with provocative political questions, especially racism and racial inequity. Additionally, the study also contributes to recent scholarship on the affordances of Web 2.0 software by eschewing a simplistic bifurcation between cyber-optimist vs. pessimism, in favour of a more nuanced and context-specific analysis of the patterns that structure online deliberation.

Keywords: online deliberation, discourse analysis, qualitative content analysis, racism

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Authors: Catherine P. Bradshaw, Elise T. Pas, Katrina J. Debnam, Jessika H. Bottiani, Michael Rosenberg

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Worldwide, ethnically and culturally diverse students are at increased risk for school failure, discipline problems, and dropout. Despite decades of concern about this issue of disparities in education and other fields (e.g., 'school to prison pipeline'), there has been limited empirical examination of models that can actually reduce these gaps in schools. Moreover, few studies have examined the effectiveness of in-service teacher interventions and supports specifically designed to reduce discipline disparities and improve student engagement. This session provides an overview of the evidence-based Double Check model which serves as a framework for teachers to use culturally-responsive strategies to engage ethnically and culturally diverse students in the classroom and reduce discipline problems. Specifically, Double Check is a school-based prevention program which includes three core components: (a) enhancements to the school-wide Positive Behavioral Interventions and Supports (PBIS) tier-1 level of support; (b) five one-hour professional development training sessions, each of which addresses five domains of cultural competence (i.e., connection to the curriculum, authentic relationships, reflective thinking, effective communication, and sensitivity to students’ culture); and (c) coaching of classroom teachers using an adapted version of the Classroom Check-Up, which intends to increase teachers’ use of effective classroom management and culturally-responsive strategies using research-based motivational interviewing and data-informed problem-solving approaches. This paper presents findings from a randomized controlled trial (RCT) testing the impact of Double Check, on office discipline referrals (disaggregated by race) and independently observed and self-reported culturally-responsive practices and classroom behavior management. The RCT included 12 elementary and middle schools; 159 classroom teachers were randomized either to receive coaching or serve as comparisons. Specifically, multilevel analyses indicated that teacher self-reported culturally responsive behavior management improved over the course of the school year for teachers who received the coaching and professional development. However, the average annual office discipline referrals issued to black students were reduced among teachers who were randomly assigned to receive coaching relative to comparison teachers. Similarly, observations conducted by trained external raters indicated significantly more teacher proactive behavior management and anticipation of student problems, higher student compliance, less student non-compliance, and less socially disruptive behaviors in classrooms led by coached teachers than classrooms led teachers randomly assigned to the non-coached condition. These findings indicated promising effects of the Double Check model on a range of teacher and student outcomes, including disproportionality in office discipline referrals among Black students. These results also suggest that the Double Check model is one of only a few systematic approaches to promoting culturally-responsive behavior management which has been rigorously tested and shown to be associated with improvements in either student or staff outcomes indicated significant reductions in discipline problems and improvements in behavior management. Implications of these findings are considered within the broader context of globalization and demographic shifts, and their impacts on schools. These issues are particularly timely, given growing concerns about immigration policies in the U.S. and abroad.

Keywords: ethnically and culturally diverse students, student engagement, school-based prevention, academic achievement

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