Search results for: Systematic Literature Review
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9868

Search results for: Systematic Literature Review

838 We Have Never Seen a Dermatologist. Prisons Telederma Project Reaching the Unreachable Through Teledermatology

Authors: Innocent Atuhe, Babra Nalwadda, Grace Mulyowa, Annabella Habinka Ejiri

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Background: Atopic Dermatitis (AD) is one of the most prevalent and growing chronic inflammatory skin diseases in African prisons. AD care is limited in African due to a lack of information about the disease amongst primary care workers, limited access to dermatologists, lack of proper training of healthcare workers, and shortage of appropriate treatments. We designed and implemented the Prisons Telederma project based on the recommendations of the International Society of Atopic Dermatitis. We aimed at; i) increase awareness and understanding of teledermatology among prison health workers and ii) improve treatment outcomes of prisoners with atopic dermatitis through increased access to and utilization of consultant dermatologists through teledermatology in Uganda prisons. Approach: We used Store-and-forward Teledermatology (SAF-TD) to increase access to dermatologist-led care for prisoners and prison staff with AD. We conducted five days of training for prison health workers using an adapted WHO training guide on recognizing neglected tropical diseases through changes on the skin together with an adapted American Academy of Dermatology (AAD) Childhood AD Basic Dermatology Curriculum designed to help trainees develop a clinical approach to the evaluation and initial management of patients with AD. This training was followed by blended e-learning, webinars facilitated by consultant Dermatologists with local knowledge of medication and local practices, apps adjusted for pigmented skin, WhatsApp group discussions, and sharing pigmented skin AD pictures and treatment via zoom meetings. We hired a team of Ugandan Senior Consultant dermatologists to draft an iconographic atlas of the main dermatoses in pigmented African skin and shared this atlas with prison health staff for use as a job aid. We had planned to use MySkinSelfie mobile phone application to take and share skin pictures of prisoners with AD with Consultant Dermatologists, who would review the pictures and prescribe appropriate treatment. Unfortunately, the National Health Service withdrew the app from the market due to technical issues. We monitored and evaluated treatment outcomes using the Patient-Oriented Eczema Measure (POEM) tool. We held four advocacy meetings to persuade relevant stakeholders to increase supplies and availability of first-line AD treatments such as emollients in prison health facilities. Results: We have the very first iconographic atlas of the main dermatoses in pigmented African skin. We increased; i) the proportion of prison health staff with adequate knowledge of AD and teledermatology from 20% to 80%; ii) the proportion of prisoners with AD reporting improvement in disease severity (POEM scores) from 25% to 35% in one year; iii) increased proportion of prisoners with AD seen by consultant dermatologist through teledermatology from 0% to 20% in one year and iv)Increased the availability of AD recommended treatments in prisons health facilities from 5% to 10% in one year. Our study contributes to the use, evaluation, and verification of the use of teledermatology to increase access to specialist dermatology services to the most hard to reach areas and vulnerable populations such as that of prisoners.

Keywords: teledermatology, prisoners, reaching, un-reachable

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837 Sustainable Treatment of Vegetable Oil Industry Wastewaters by Xanthomonas campestris

Authors: Bojana Ž. Bajić, Siniša N. Dodić, Vladimir S. Puškaš, Jelena M. Dodić

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Increasing industrialization as a response to the demands of the consumer society greatly exploits resources and generates large amounts of waste effluents in addition to the desired product. This means it is a priority to implement technologies with the maximum utilization of raw materials and energy, minimum generation of waste effluents and/or their recycling (secondary use). Considering the process conditions and the nature of the raw materials used by the vegetable oil industry, its wastewaters can be used as substrates for the biotechnological production which requires large amounts of water. This way the waste effluents of one branch of industry become raw materials for another branch which produces a new product while reducing wastewater pollution and thereby reducing negative environmental impacts. Vegetable oil production generates wastewaters during the process of rinsing oils and fats which contain mainly fatty acid pollutants. The vegetable oil industry generates large amounts of waste effluents, especially in the processes of degumming, deacidification, deodorization and neutralization. Wastewaters from the vegetable oil industry are generated during the whole year in significant amounts, based on the capacity of the vegetable oil production. There are no known alternative applications for these wastewaters as raw materials for the production of marketable products. Since the literature has no data on the potential negative impact of fatty acids on the metabolism of the bacterium Xanthomonas campestris, these wastewaters were considered as potential raw materials for the biotechnological production of xanthan. In this research, vegetable oil industry wastewaters were used as the basis for the cultivation media for xanthan production with Xanthomonas campestris ATCC 13951. Examining the process of biosynthesis of xanthan on vegetable oil industry wastewaters as the basis for the cultivation media was performed to obtain insight into the possibility of its use in the aforementioned biotechnological process. Additionally, it was important to experimentally determine the absence of substances that have an inhibitory effect on the metabolism of the production microorganism. Xanthan content, rheological parameters of the cultivation media, carbon conversion into xanthan and conversions of the most significant nutrients for biosynthesis (carbon, nitrogen and phosphorus sources) were determined as indicators of the success of biosynthesis. The obtained results show that biotechnological production of the biopolymer xanthan by bacterium Xanthomonas campestris on vegetable oil industry wastewaters based cultivation media simultaneously provides preservation of the environment and economic benefits which is a sustainable solution to the problem of wastewater treatment.

Keywords: biotechnology, sustainable bioprocess, vegetable oil industry wastewaters, Xanthomonas campestris

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836 Analysis of the Statistical Characterization of Significant Wave Data Exceedances for Designing Offshore Structures

Authors: Rui Teixeira, Alan O’Connor, Maria Nogal

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The statistical theory of extreme events is progressively a topic of growing interest in all the fields of science and engineering. The changes currently experienced by the world, economic and environmental, emphasized the importance of dealing with extreme occurrences with improved accuracy. When it comes to the design of offshore structures, particularly offshore wind turbines, the importance of efficiently characterizing extreme events is of major relevance. Extreme events are commonly characterized by extreme values theory. As an alternative, the accurate modeling of the tails of statistical distributions and the characterization of the low occurrence events can be achieved with the application of the Peak-Over-Threshold (POT) methodology. The POT methodology allows for a more refined fit of the statistical distribution by truncating the data with a minimum value of a predefined threshold u. For mathematically approximating the tail of the empirical statistical distribution the Generalised Pareto is widely used. Although, in the case of the exceedances of significant wave data (H_s) the 2 parameters Weibull and the Exponential distribution, which is a specific case of the Generalised Pareto distribution, are frequently used as an alternative. The Generalized Pareto, despite the existence of practical cases where it is applied, is not completely recognized as the adequate solution to model exceedances over a certain threshold u. References that set the Generalised Pareto distribution as a secondary solution in the case of significant wave data can be identified in the literature. In this framework, the current study intends to tackle the discussion of the application of statistical models to characterize exceedances of wave data. Comparison of the application of the Generalised Pareto, the 2 parameters Weibull and the Exponential distribution are presented for different values of the threshold u. Real wave data obtained in four buoys along the Irish coast was used in the comparative analysis. Results show that the application of the statistical distributions to characterize significant wave data needs to be addressed carefully and in each particular case one of the statistical models mentioned fits better the data than the others. Depending on the value of the threshold u different results are obtained. Other variables of the fit, as the number of points and the estimation of the model parameters, are analyzed and the respective conclusions were drawn. Some guidelines on the application of the POT method are presented. Modeling the tail of the distributions shows to be, for the present case, a highly non-linear task and, due to its growing importance, should be addressed carefully for an efficient estimation of very low occurrence events.

Keywords: extreme events, offshore structures, peak-over-threshold, significant wave data

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835 Health and Greenhouse Gas Emission Implications of Reducing Meat Intakes in Hong Kong

Authors: Cynthia Sau Chun Yip, Richard Fielding

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High meat and especially red meat intakes are significantly and positively associated with a multiple burden of diseases and also high greenhouse gas (GHG) emissions. This study investigated population meat intake patterns in Hong Kong. It quantified the burden of disease and GHG emission outcomes by modeling to adjust Hong Kong population meat intakes to recommended healthy levels. It compared age- and sex-specific population meat, fruit and vegetable intakes obtained from a population survey among adults aged 20 years and over in Hong Kong in 2005-2007, against intake recommendations suggested in the Modelling System to Inform the Revision of the Australian Guide to Healthy Eating (AGHE-2011-MS) technical document. This study found that meat and meat alternatives, especially red meat intakes among Hong Kong males aged 20+ years and over are significantly higher than recommended. Red meat intakes among females aged 50-69 years and other meat and alternatives intakes among aged 20-59 years are also higher than recommended. Taking the 2005-07 age- and sex-specific population meat intake as baselines, three counterfactual scenarios of adjusting Hong Kong adult population meat intakes to AGHE-2011-MS and Pre-2011 AGHE recommendations by the year 2030 were established. Consequent energy intake gaps were substituted with additional legume, fruit and vegetable intakes. To quantify the consequent GHG emission outcomes associated with Hong Kong meat intakes, Cradle-to-ready-to-eat lifecycle assessment emission outcome modelling was used. Comparative risk assessment of burden of disease model was used to quantify the health outcomes. This study found adjusting meat intakes to recommended levels could reduce Hong Kong GHG emission by 17%-44% when compared against baseline meat intake emissions, and prevent 2,519 to 7,012 premature deaths in males and 53 to 1,342 in females, as well as multiple burden of diseases when compared to the baseline meat intake scenario. Comparing lump sum meat intake reduction and outcome measures across the entire population, and using emission factors, and relative risks from individual studies in previous co-benefit studies, this study used age- and sex-specific input and output measures, emission factors and relative risks obtained from high quality meta-analysis and meta-review respectively, and has taken government dietary recommendations into account. Hence evaluations in this study are of better quality and more reflective of real life practices. Further to previous co-benefit studies, this study pinpointed age- and sex-specific population and meat-type-specific intervention points and leverages. When compared with similar studies in Australia, this study also showed that intervention points and leverages among populations in different geographic and cultural background could be different, and that globalization also globalizes meat consumption emission effects. More regional and cultural specific evaluations are recommended to promote more sustainable meat consumption and enhance global food security.

Keywords: burden of diseases, greenhouse gas emissions, Hong Kong diet, sustainable meat consumption

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834 Analysis of Eco-Efficiency and the Determinants of Family Agriculture in Southeast Spain

Authors: Emilio Galdeano-Gómez, Ángeles Godoy-Durán, Juan C. Pérez-Mesa, Laura Piedra-Muñoz

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Eco-efficiency is receiving ever-increasing interest as an indicator of sustainability, as it links environmental and economic performances in productive activities. In agriculture, these indicators and their determinants prove relevant due to the close relationships in this activity between the use of natural resources, which is generally limited, and the provision of basic goods to society. In this context, various analyses have focused on eco-efficiency by considering individual family farms as the basic production unit. However, not only must the measure of efficiency be taken into account, but also the existence of a series of factors which constitute socio-economic, political-institutional, and environmental determinants. Said factors have been studied to a lesser extent in the literature. The present work analyzes eco-efficiency at a micro level, focusing on small-scale family farms as the main decision-making units in horticulture in southeast Spain, a sector which represents about 30% of the fresh vegetables produced in the country and about 20% of those consumed in Europe. The objectives of this study are a) to obtain a series of eco-efficiency indicators by estimating several pressure ratios and economic value added in farming, b) to analyze the influence of specific social, economic and environmental variables on the aforementioned eco-efficiency indicators. The present work applies the method of Data Envelopment Analysis (DEA), which calculates different combinations of environmental pressures (water usage, phytosanitary contamination, waste management, etc.) and aggregate economic value. In a second stage, an analysis is conducted on the influence of the socio-economic and environmental characteristics of family farms on the eco-efficiency indicators, as endogeneous variables, through the use of truncated regression and bootstrapping techniques, following Simar-Wilson methodology. The results reveal considerable inefficiency in aspects such as waste management, while there is relatively little inefficiency in water usage and nitrogen balance. On the other hand, characteristics, such as product specialization, the adoption of quality certifications and belonging to a cooperative do have a positive impact on eco-efficiency. These results are deemed to be of interest to agri-food systems structured on small-scale producers, and they may prove useful to policy-makers as regards managing public environmental programs in agriculture.

Keywords: data envelopment analysis, eco-efficiency, family farms, horticulture, socioeconomic features

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833 Evaluating Social Sustainability in Historical City Center in Turkey: Case Study of Bursa

Authors: Şeyda Akçalı

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This study explores the concept of social sustainability and its characteristics in terms of neighborhood (mahalle) which is a social phenomenon in Turkish urban life. As social sustainability indicators that moving away traditional themes toward multi-dimensional measures, the solutions for urban strategies may be achieved through learning lessons from historical precedents. It considers the inherent values of traditional urban forms contribute to the evolution of the city as well as the social functions of it. The study aims to measure non-tangible issues in order to evaluate social sustainability in historic urban environments and how they could contribute to the current urban planning strategies. The concept of neighborhood (mahalle) refers to a way of living that represents the organization of Turkish social and communal life rather than defining an administrative unit for the city. The distinctive physical and social features of neighborhood illustrate the link between social sustainability and historic urban environment. Instead of having a nostalgic view of past, it identifies both the failures and successes and extract lessons of traditional urban environments and adopt them to modern context. First, the study determines the aspects of social sustainability which are issued as the key themes in the literature. Then, it develops a model by describing the social features of mahalle which show consistency within the social sustainability agenda. The model is used to analyze the performance of traditional housing area in the historical city center of Bursa, Turkey whether it meets the residents’ social needs and contribute collective functioning of the community. Through a questionnaire survey exercised in the historic neighborhoods, the residents are evaluated according to social sustainability criteria of neighborhood. The results derived from the factor analysis indicate that social aspects of neighborhood are social infrastructure, identity, attachment, neighborliness, safety and wellbeing. Qualitative evaluation shows the relationship between key aspects of social sustainability and demographic and socio-economic factors. The outcomes support that inherent values of neighborhood retain its importance for the sustainability of community although there must be some local arrangements for few factors with great attention not to compromise the others. The concept of neighborhood should be considered as a potential tool to support social sustainability in national political agenda and urban policies. The performance of underlying factors in historic urban environment proposes a basis for both examining and improving traditional urban areas and how it may contribute to the overall city.

Keywords: historical city center, mahalle, neighborhood, social sustainability, traditional urban environment, Turkey

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832 Using Structured Analysis and Design Technique Method for Unmanned Aerial Vehicle Components

Authors: Najeh Lakhoua

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Introduction: Scientific developments and techniques for the systemic approach generate several names to the systemic approach: systems analysis, systems analysis, structural analysis. The main purpose of these reflections is to find a multi-disciplinary approach which organizes knowledge, creates universal language design and controls complex sets. In fact, system analysis is structured sequentially by steps: the observation of the system by various observers in various aspects, the analysis of interactions and regulatory chains, the modeling that takes into account the evolution of the system, the simulation and the real tests in order to obtain the consensus. Thus the system approach allows two types of analysis according to the structure and the function of the system. The purpose of this paper is to present an application of system analysis of Unmanned Aerial Vehicle (UAV) components in order to represent the architecture of this system. Method: There are various analysis methods which are proposed, in the literature, in to carry out actions of global analysis and different points of view as SADT method (Structured Analysis and Design Technique), Petri Network. The methodology adopted in order to contribute to the system analysis of an Unmanned Aerial Vehicle has been proposed in this paper and it is based on the use of SADT. In fact, we present a functional analysis based on the SADT method of UAV components Body, power supply and platform, computing, sensors, actuators, software, loop principles, flight controls and communications). Results: In this part, we present the application of SADT method for the functional analysis of the UAV components. This SADT model will be composed exclusively of actigrams. It starts with the main function ‘To analysis of the UAV components’. Then, this function is broken into sub-functions and this process is developed until the last decomposition level has been reached (levels A1, A2, A3 and A4). Recall that SADT techniques are semi-formal; however, for the same subject, different correct models can be built without having to know with certitude which model is the good or, at least, the best. In fact, this kind of model allows users a sufficient freedom in its construction and so the subjective factor introduces a supplementary dimension for its validation. That is why the validation step on the whole necessitates the confrontation of different points of views. Conclusion: In this paper, we presented an application of system analysis of Unmanned Aerial Vehicle components. In fact, this application of system analysis is based on SADT method (Structured Analysis Design Technique). This functional analysis proved the useful use of SADT method and its ability of describing complex dynamic systems.

Keywords: system analysis, unmanned aerial vehicle, functional analysis, architecture

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831 A Case Study on Experiences of Clinical Preceptors in the Undergraduate Nursing Program

Authors: Jacqueline M. Dias, Amina A Khowaja

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Clinical education is one of the most important components of a nursing curriculum as it develops the students’ cognitive, psychomotor and affective skills. Clinical teaching ensures the integration of knowledge into practice. As the numbers of students increase in the field of nursing coupled with the faculty shortage, clinical preceptors are the best choice to ensure student learning in the clinical settings. The clinical preceptor role has been introduced in the undergraduate nursing programme. In Pakistan, this role emerged due to a faculty shortage. Initially, two clinical preceptors were hired. This study will explore clinical preceptors views and experiences of precepting Bachelor of Science in Nursing (BScN) students in an undergraduate program. A case study design was used. As case studies explore a single unit of study such as a person or very small number of subjects; the two clinical preceptors were fundamental to the study and served as a single case. Qualitative data were obtained through an iterative process using in depth interviews and written accounts from reflective journals that were kept by the clinical preceptors. The findings revealed that the clinical preceptors were dedicated to their roles and responsibilities. Another, key finding was that clinical preceptors’ prior knowledge and clinical experience were valuable assets to perform their role effectively. The clinical preceptors found their new role innovative and challenging; it was stressful at the same time. Findings also revealed that in the clinical agencies there were unclear expectations and role ambiguity. Furthermore, clinical preceptors had difficulty integrating theory into practice in the clinical area and they had difficulty in giving feedback to the students. Although this study is localized to one university, generalizations can be drawn from the results. The key findings indicate that the role of a clinical preceptor is demanding and stressful. Clinical preceptors need preparation prior to precepting students on clinicals. Also, institutional support is fundamental for their acceptance. This paper focuses on the views and experiences of clinical preceptors undertaking a newly established role and resonates with the literature. The following recommendations are drawn to strengthen the role of the clinical preceptors: A structured program for clinical preceptors is needed along with mentorship. Clinical preceptors should be provided with formal training in teaching and learning with emphasis on clinical teaching and giving feedback to students. Additionally, for improving integration of theory into practice, clinical modules should be provided ahead of the clinical. In spite of all the challenges, ten more clinical preceptors have been hired as the faculty shortage continues to persist.

Keywords: baccalaureate nursing education, clinical education, clinical preceptors, nursing curriculum

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830 A Sociolinguistic Study of the Outcomes of Arabic-French Contact in the Algerian Dialect Tlemcen Speech Community as a Case Study

Authors: R. Rahmoun-Mrabet

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It is acknowledged that our style of speaking changes according to a wide range of variables such as gender, setting, the age of both the addresser and the addressee, the conversation topic, and the aim of the interaction. These differences in style are noticeable in monolingual and multilingual speech communities. Yet, they are more observable in speech communities where two or more codes coexist. The linguistic situation in Algeria reflects a state of bilingualism because of the coexistence of Arabic and French. Nevertheless, like all Arab countries, it is characterized by diglossia i.e. the concomitance of Modern Standard Arabic (MSA) and Algerian Arabic (AA), the former standing for the ‘high variety’ and the latter for the ‘low variety’. The two varieties are derived from the same source but are used to fulfil distinct functions that is, MSA is used in the domains of religion, literature, education and formal settings. AA, on the other hand, is used in informal settings, in everyday speech. French has strongly affected the Algerian language and culture because of the historical background of Algeria, thus, what can easily be noticed in Algeria is that everyday speech is characterized by code-switching from dialectal Arabic and French or by the use of borrowings. Tamazight is also very present in many regions of Algeria and is the mother tongue of many Algerians. Yet, it is not used in the west of Algeria, where the study has been conducted. The present work, which was directed in the speech community of Tlemcen-Algeria, aims at depicting some of the outcomes of the contact of Arabic with French such as code-switching, borrowing and interference. The question that has been asked is whether Algerians are aware of their use of borrowings or not. Three steps are followed in this research; the first one is to depict the sociolinguistic situation in Algeria and to describe the linguistic characteristics of the dialect of Tlemcen, which are specific to this city. The second one is concerned with data collection. Data have been collected from 57 informants who were given questionnaires and who have then been classified according to their age, gender and level of education. Information has also been collected through observation, and note taking. The third step is devoted to analysis. The results obtained reveal that most Algerians are aware of their use of borrowings. The present work clarifies how words are borrowed from French, and then adapted to Arabic. It also illustrates the way in which singular words inflect into plural. The results expose the main characteristics of borrowing as opposed to code-switching. The study also clarifies how interference occurs at the level of nouns, verbs and adjectives.

Keywords: bilingualism, borrowing, code-switching, interference, language contact

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829 Teaching Ethnic Relations in Social Work Education: A Study of Teachers' Strategies and Experiences in Sweden

Authors: Helene Jacobson Pettersson, Linda Lill

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Demographic changes and globalization in society provide new opportunities for social work and social work education in Sweden. There has been an ambition to include these aspects into the Swedish social work education. However, the Swedish welfare state standard continued to be as affectionate as invisible starting point in discussions about people’s way of life and social problems. The aim of this study is to explore content given to ethnic relations in social work in the social work education in Sweden. Our standpoint is that the subject can be understood both from individual and structural levels, it changes over time, varies in different steering documents and differs from the perspectives of teachers and students. Our question is what content is given to ethnic relations in social work by the teachers in their strategies and teaching material. The study brings together research in the interface between education science, social work and research of international migration and ethnic relations. The presented narratives are from longer interviews with a total of 17 university teachers who teach in social work program at four different universities in Sweden. The universities have in different ways a curriculum that involves the theme of ethnic relations in social work, and the interviewed teachers are teaching and grading social workers on specific courses related to ethnic relations at undergraduate and graduate levels. Overall assesses these 17 teachers a large number of students during a semester. The questions were concerned on how the teachers handle ethnic relations in education in social work. The particular focus during the interviews has been the teacher's understanding of the documented learning objectives and content of literature and how this has implications for their teaching. What emerges is the teachers' own stories about the educational work and how they relate to the content of teaching, as well as the teaching strategies they use to promote the theme of ethnic relations in social work education. The analysis of this kind of pedagogy is that the teaching ends up at an individual level with a particular focus on the professional encounter with individuals. We can see the shortage of a critical analysis of the construction of social problems. The conclusion is that individual circumstance precedes theoretical perspective on social problems related to migration, transnational relations, globalization and social. This result has problematic implications from the perspective of sustainability in terms of ethnic diversity and integration in society. Thus these aspects have most relevance for social workers’ professional acting in social support and empowerment related activities, in supporting the social status and human rights and equality for immigrants.

Keywords: ethnic relations in Swedish social work education, teaching content, teaching strategies, educating for change, human rights and equality

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828 Groundwater Potential Mapping using Frequency Ratio and Shannon’s Entropy Models in Lesser Himalaya Zone, Nepal

Authors: Yagya Murti Aryal, Bipin Adhikari, Pradeep Gyawali

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The Lesser Himalaya zone of Nepal consists of thrusting and folding belts, which play an important role in the sustainable management of groundwater in the Himalayan regions. The study area is located in the Dolakha and Ramechhap Districts of Bagmati Province, Nepal. Geologically, these districts are situated in the Lesser Himalayas and partly encompass the Higher Himalayan rock sequence, which includes low-grade to high-grade metamorphic rocks. Following the Gorkha Earthquake in 2015, numerous springs dried up, and many others are currently experiencing depletion due to the distortion of the natural groundwater flow. The primary objective of this study is to identify potential groundwater areas and determine suitable sites for artificial groundwater recharge. Two distinct statistical approaches were used to develop models: The Frequency Ratio (FR) and Shannon Entropy (SE) methods. The study utilized both primary and secondary datasets and incorporated significant role and controlling factors derived from field works and literature reviews. Field data collection involved spring inventory, soil analysis, lithology assessment, and hydro-geomorphology study. Additionally, slope, aspect, drainage density, and lineament density were extracted from a Digital Elevation Model (DEM) using GIS and transformed into thematic layers. For training and validation, 114 springs were divided into a 70/30 ratio, with an equal number of non-spring pixels. After assigning weights to each class based on the two proposed models, a groundwater potential map was generated using GIS, classifying the area into five levels: very low, low, moderate, high, and very high. The model's outcome reveals that over 41% of the area falls into the low and very low potential categories, while only 30% of the area demonstrates a high probability of groundwater potential. To evaluate model performance, accuracy was assessed using the Area under the Curve (AUC). The success rate AUC values for the FR and SE methods were determined to be 78.73% and 77.09%, respectively. Additionally, the prediction rate AUC values for the FR and SE methods were calculated as 76.31% and 74.08%. The results indicate that the FR model exhibits greater prediction capability compared to the SE model in this case study.

Keywords: groundwater potential mapping, frequency ratio, Shannon’s Entropy, Lesser Himalaya Zone, sustainable groundwater management

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827 The Impact of ESG Factors on Performance Measures in European Business

Authors: Raquel Pérez Estébanez

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This research proposal seeks to delve into the intricate relationship between performance indicators and sustainability metrics within the realm of corporate entities. As businesses grapple with the imperative of sustainable practices, understanding how traditional performance metrics intersect with sustainability indicators becomes paramount. This study endeavours to unravel the dynamics of this relationship, aiming to illuminate ways in which these two sets of metrics can be harmoniously integrated to offer a comprehensive evaluation of a company's success while considering its environmental and societal impact. The integration of performance measures and sustainability metrics has become a focal point in contemporary business literature as companies strive to balance economic success with environmental and social responsibility. Performance indicators traditionally focus on financial metrics such as return on assets, return on equity and profitability. Sustainability metrics, on the other hand, encompass environmental, social, and governance (ESG) factors. The challenge lies in aligning these diverse metrics for a comprehensive assessment. Researches indicates a growing trend among corporations to incorporate sustainability metrics into their performance evaluations. However, challenges persist, with companies often struggling to integrate non-financial indicators seamlessly. The works of GRI (Global Reporting Initiative) and SASB (Sustainability Accounting Standards Board) propose frameworks for harmonizing financial and sustainability reporting. These frameworks emphasize the need for companies to disclose material sustainability information alongside traditional financial metrics. Several studies suggest that integrating sustainability metrics positively influences decision-making. Companies considering sustainability factors in decision-making exhibit improved long-term performance and risk management. Other researches highlights the increasing importance of sustainability metrics in shaping stakeholder perceptions. Investors, in particular, are placing greater emphasis on companies' environmental and social performance when making investment decisions. Industry-specific studies underscore the need for customized approaches to integration due to sector-specific challenges and opportunities. This suggests that a one-size-fits-all solution may not be applicable across diverse industries. While progress is evident, challenges persist, necessitating further research to refine integration frameworks, address industry-specific nuances, and assess the long-term impact on organizational performance and societal contributions.

Keywords: ESG, ROE, ROA, performance measures

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826 Positioning Mama Mkubwa Indigenous Model into Social Work Practice through Alternative Child Care in Tanzania: Ubuntu Perspective

Authors: Johnas Buhori, Meinrad Haule Lembuka

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Introduction: Social work expands its boundary to accommodate indigenous knowledge and practice for better competence and services. In Tanzania, Mama Mkubwa Mkubwa (MMM) (Mother’s elder sister) is an indigenous practice of alternative child care that represents other traditional practices across African societies known as Ubuntu practice. Ubuntu is African Humanism with values and approaches that are connected to the social work. MMM focuses on using the elder sister of a deceased mother or father, a trusted elder woman from the extended family or indigenous community to provide alternative care to an orphan or vulnerable child. In Ubuntu's perspective, it takes a whole village or community to raise a child, meaning that every person in the community is responsible for child care. Methodology: A desk review method guided by Ubuntu theory was applied to enrich the study. Findings: MMM resembles the Ubuntu ideal of traditional child protection of those in need as part of alternative child care throughout Tanzanian history. Social work practice, along with other formal alternative child care, was introduced in Tanzania during the colonial era in 1940s and socio-economic problems of 1980s affected the country’s formal social welfare system, and suddenly HIV/AIDS pandemic triggered the vulnerability of children and hampered the capacity of the formal sector to provide social welfare services, including alternative child care. For decades, AIDS has contributed to an influx of orphans and vulnerable children that facilitated the re-emerging of traditional alternative child care at the community level, including MMM. MMM strongly practiced in regions where the AIDS pandemic affected the community, like Njombe, Coastal region, Kagera, etc. Despite of existing challenges, MMM remained to be the remarkably alternative child care practiced in both rural and urban communities integrated with social welfare services. Tanzania envisions a traditional mechanism of family or community environment for alternative child care with the notion that sometimes institutionalization care fails to offer children all they need to become productive members of society, and later, it becomes difficult to reconnect in the society. Implications to Social Work: MMM is compatible with social work by using strengths perspectives; MMM reflects Ubuntu's perspective on the ground of humane social work, using humane methods to achieve human goals. MMM further demonstrates the connectedness of those who care and those cared for and the inextricable link between them as Ubuntu-inspired models of social work that view children from family, community, environmental, and spiritual perspectives. Conclusion: Social work and MMM are compatible at the micro and mezzo levels; thus, application of MMM can be applied in social work practice beyond Tanzania when properly designed and integrated into other systems. When MMM is applied in social work, alternative care has the potential to support not only children but also empower families and communities. Since MMM is a community-owned and voluntary base, it can relieve the government, social workers, and other formal sectors from the annual burden of cost in the provision of institutionalized alternative child care.

Keywords: ubuntu, indigenous social work, african social work, ubuntu social work, child protection, child alternative care

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825 (Mis) Communication across the Borders: Politics, Media, and Public Opinion in Turkey

Authors: Banu Baybars Hawks

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To date, academic attention in social sciences remains inadequate with regard to research and analysis of public opinion in Turkey. Most of the existing research has assessed the public opinion during political election periods. Therefore, it is of great interest to find out what the public thinks about current issues in Turkey, and how to interpret the results to be able to reveal whether they may have any reflections on social, political, and cultural structure of the country. Accordingly, the current study seeks to fill the gap in the social sciences literature in English regarding Turkey’s social and political stand which may be perceived to be very different by other nations. Without timely feedback from public surveys, various programs for improving different services and institutions functioning in the country might not achieve their expected goal, nor can decisions about which programs to implement be made rationally. Additionally, the information gathered may not only yield important insights into public’s opinion regarding current agenda in Turkey, but also into the correlates shaping public policies. Agenda-setting studies including agenda-building, agenda melding, reversed agenda-setting and information diffusion studies will be used to explain the roles of factors and actors in the formation of public opinion in Turkey. Knowing the importance of public agenda in the agenda setting and building process, this paper aims to reveal the social and political tendencies of the Turkish public. For that purpose, a survey will be carried out in December of 2014 to determine the social and political trends in Turkey for that same year. The subjects for the study, which utilize a questionairre in one-on-one interviews, will include 1,000 individuals aged 18 years and older from 26 cities representing general population. A stratified random sampling frame will be used. The topics covered by the survey include: The most important current problem in Turkey; the Economy; Terror; Approaches to the Kurdish Issue; Evaluations of the Government and Opposition Parties; Evaluations of Institutional Efficiency; Foreign Policy; the Judicial System/Constitution; Democracy and the Media; and, Social Relations/Life in Turkey. Since the beginning of the 21st century, Turkey has been undergoing a rapid transformation. The reflections of the changes can be seen in all areas from economics to politics. It is my hope that findings of this study may shed light on the important aspects of institutions, variables setting the agenda, and formation process of public opinion in Turkey.

Keywords: public opinion, media, agenda setting, information diffusion, government, freedom, Turkey

Procedia PDF Downloads 449
824 Applying an Automatic Speech Intelligent System to the Health Care of Patients Undergoing Long-Term Hemodialysis

Authors: Kuo-Kai Lin, Po-Lun Chang

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Research Background and Purpose: Following the development of the Internet and multimedia, the Internet and information technology have become crucial avenues of modern communication and knowledge acquisition. The advantages of using mobile devices for learning include making learning borderless and accessible. Mobile learning has become a trend in disease management and health promotion in recent years. End-stage renal disease (ESRD) is an irreversible chronic disease, and patients who do not receive kidney transplants can only rely on hemodialysis or peritoneal dialysis to survive. Due to the complexities in caregiving for patients with ESRD that stem from their advanced age and other comorbidities, the patients’ incapacity of self-care leads to an increase in the need to rely on their families or primary caregivers, although whether the primary caregivers adequately understand and implement patient care is a topic of concern. Therefore, this study explored whether primary caregivers’ health care provisions can be improved through the intervention of an automatic speech intelligent system, thereby improving the objective health outcomes of patients undergoing long-term dialysis. Method: This study developed an automatic speech intelligent system with healthcare functions such as health information voice prompt, two-way feedback, real-time push notification, and health information delivery. Convenience sampling was adopted to recruit eligible patients from a hemodialysis center at a regional teaching hospital as research participants. A one-group pretest-posttest design was adopted. Descriptive and inferential statistics were calculated from the demographic information collected from questionnaires answered by patients and primary caregivers, and from a medical record review, a health care scale (recorded six months before and after the implementation of intervention measures), a subjective health assessment, and a report of objective physiological indicators. The changes in health care behaviors, subjective health status, and physiological indicators before and after the intervention of the proposed automatic speech intelligent system were then compared. Conclusion and Discussion: The preliminary automatic speech intelligent system developed in this study was tested with 20 pretest patients at the recruitment location, and their health care capacity scores improved from 59.1 to 72.8; comparisons through a nonparametric test indicated a significant difference (p < .01). The average score for their subjective health assessment rose from 2.8 to 3.3. A survey of their objective physiological indicators discovered that the compliance rate for the blood potassium level was the most significant indicator; its average compliance rate increased from 81% to 94%. The results demonstrated that this automatic speech intelligent system yielded a higher efficacy for chronic disease care than did conventional health education delivered by nurses. Therefore, future efforts will continue to increase the number of recruited patients and to refine the intelligent system. Future improvements to the intelligent system can be expected to enhance its effectiveness even further.

Keywords: automatic speech intelligent system for health care, primary caregiver, long-term hemodialysis, health care capabilities, health outcomes

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823 Implementing Peer Mediated Interventions with Visual Supports for Social Skills Development in a School-Based Work Setting with Secondary Students with Autism

Authors: Karen Eastman

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More youths and young adults with autism spectrum disorder (ASD) have been entering the workforce in recent years. Historically, students with ASD struggle after leaving high school and experience lower rates of employment, with social skills continuing to be the most problematic area of concern. Special education teachers may find it challenging to identify effective combinations of evidence-based practices (EBPs) and supports to best guide these students. One EBP, Peer Mediated Instruction and Intervention (PMII) has been well documented in the literature as being effective for younger students with autism but not researched as much with older students and adults, particularly in work settings. A need to combine PMII with other EBPs has been identified as a way to achieve a greater positive impact rather than any practice alone. A multiple baseline across skills design was used in this research project with two participants in different settings. PMII was combined with Visual Supports, with typical peers being trained in both practices. PMII is an evidence-based practice used to address social concerns by training peers without disabilities as to how they can provide feedback to and support, the student with ASD with social interactions in structured settings. The peers without disabilities were the instructors, while the adults facilitated the social situations and provided support to both the peers and students with ASD when needed. Because many individuals with ASD learn best with visual input, rather than using only the spoken word (verbal directions and feedback), Visual Supports were used in conjunction with PMII. Visual Supports can include written words, pictures, symbols, videos, or objects. In this project, the Visual Supports used were written social scripts, videos, Stop and Think signs, written reminder cards, a school map, and a pictorial task analysis of work tasks. Variables that may affect intervention outcomes in this project included attendance at school and school-based work settings for both the students with ASD and the peers without disabilities and behaviors and responses from others in the settings. Qualitative data was also collected from observations and surveys with peers about the process and their role. Data indicated that the students with ASD responded more positively to redirection and support from their peers than to teachers and staff and showed an increase in positive interactions with others. Those surveyed indicated a positive attitude toward and response to the use of peer interventions with visual supports.

Keywords: autism, social skills, vocational training, peer interventions

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822 Equity, Bonds, Institutional Debt and Economic Growth: Evidence from South Africa

Authors: Ashenafi Beyene Fanta, Daniel Makina

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Economic theory predicts that finance promotes economic growth. Although the finance-growth link is among the most researched areas in financial economics, our understanding of the link between the two is still incomplete. This is caused by, among others, wrong econometric specifications, using weak proxies of financial development, and inability to address the endogeneity problem. Studies on the finance growth link in South Africa consistently report economic growth driving financial development. Early studies found that economic growth drives financial development in South Africa, and recent studies have confirmed this using different econometric models. However, the monetary aggregate (i.e. M2) utilized used in these studies is considered a weak proxy for financial development. Furthermore, the fact that the models employed do not address the endogeneity problem in the finance-growth link casts doubt on the validity of the conclusions. For this reason, the current study examines the finance growth link in South Africa using data for the period 1990 to 2011 by employing a generalized method of moments (GMM) technique that is capable of addressing endogeneity, simultaneity and omitted variable bias problems. Unlike previous cross country and country case studies that have also used the same technique, our contribution is that we account for the development of bond markets and non-bank financial institutions rather than being limited to stock market and banking sector development. We find that bond market development affects economic growth in South Africa, and no similar effect is observed for the bank and non-bank financial intermediaries and the stock market. Our findings show that examination of individual elements of the financial system is important in understanding the unique effect of each on growth. The observation that bond markets rather than private credit and stock market development promotes economic growth in South Africa induces an intriguing question as to what unique roles bond markets play that the intermediaries and equity markets are unable to play. Crucially, our results support observations in the literature that using appropriate measures of financial development is critical for policy advice. They also support the suggestion that individual elements of the financial system need to be studied separately to consider their unique roles in advancing economic growth. We believe that our understanding of the channels through which bond market contribute to growth would be a fertile ground for future research.

Keywords: bond market, finance, financial sector, growth

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821 Friction and Wear Characteristics of Diamond Nanoparticles Mixed with Copper Oxide in Poly Alpha Olefin

Authors: Ankush Raina, Ankush Anand

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Plyometric training is a form of specialised strength training that uses fast muscular contractions to improve power and speed in sports conditioning by coaches and athletes. Despite its useful role in sports conditioning programme, the information about plyometric training on the athletes cardiovascular health especially Electrocardiogram (ECG) has not been established in the literature. The purpose of the study was to determine the effects of lower and upper body plyometric training on ECG of athletes. The study was guided by three null hypotheses. Quasi–experimental research design was adopted for the study. Seventy-two university male athletes constituted the population of the study. Thirty male athletes aged 18 to 24 years volunteered to participate in the study, but only twenty-three completed the study. The volunteered athletes were apparently healthy, physically active and free of any lower and upper extremity bone injuries for past one year and they had no medical or orthopedic injuries that may affect their participation in the study. Ten subjects were purposively assigned to one of the three groups: lower body plyometric training (LBPT), upper body plyometric training (UBPT), and control (C). Training consisted of six plyometric exercises: lower (ankle hops, squat jumps, tuck jumps) and upper body plyometric training (push-ups, medicine ball-chest throws and side throws) with moderate intensity. The general data were collated and analysed using Statistical Package for Social Science (SPSS version 22.0). The research questions were answered using mean and standard deviation, while paired samples t-test was also used to test for the hypotheses. The results revealed that athletes who were trained using LBPT had reduced ECG parameters better than those in the control group. The results also revealed that athletes who were trained using both LBPT and UBPT indicated lack of significant differences following ten weeks plyometric training than those in the control group in the ECG parameters except in Q wave, R wave and S wave (QRS) complex. Based on the findings of the study, it was recommended among others that coaches should include both LBPT and UBPT as part of athletes’ overall training programme from primary to tertiary institution to optimise performance as well as reduce the risk of cardiovascular diseases and promotes good healthy lifestyle.

Keywords: boundary lubrication, copper oxide, friction, nano diamond

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820 Synthesis, Physicochemical Characterization and Study of the Antimicrobial Activity of Chlorobutanol

Authors: N. Hadhoum, B. Guerfi, T. M. Sider, Z. Yassa, T. Djerboua, M. Boursouti, M. Mamou, F. Z. Hadjadj Aoul, L. R. Mekacher

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Introduction and objectives: Chlorobutanol is a raw material, mainly used as an antiseptic and antimicrobial preservative in injectable and ophthalmic preparations. The main objective of our study was the synthesis and evaluation of the antimicrobial activity of chlorobutanol hemihydrates. Material and methods: Chlorobutanol was synthesized according to the nucleophilic addition reaction of chloroform to acetone, identified by an infrared absorption using Spectrum One FTIR spectrometer, melting point, Scanning electron microscopy and colorimetric reactions. The dosage of carvedilol active substance was carried out by assaying the degradation products of chlorobutanol in a basic solution. The chlorobutanol obtained was subjected to bacteriological tests in order to study its antimicrobial activity. The antibacterial activity was evaluated against strains such as Escherichia coli (ATCC 25 922), Staphylococcus aureus (ATCC 25 923) and Pseudomonas aeroginosa (ATCC = American type culture collection). The antifungal activity was evaluated against human pathogenic fungal strains, such as Candida albicans and Aspergillus niger provided by the parasitology laboratory of the Hospital of Tizi-Ouzou, Algeria. Results and discussion: Chlorobutanol was obtained in an acceptable yield. The characterization tests of the product obtained showed a white and crystalline appearance (confirmed by scanning electron microscopy), solubilities (in water, ethanol and glycerol), and a melting temperature in accordance with the requirements of the European pharmacopoeia. The colorimetric reactions were directed towards the presence of a trihalogenated carbon and an alcohol function. The spectral identification (IR) showed the presence of characteristic chlorobutanol peaks and confirmed the structure of the latter. The microbiological study revealed an antimicrobial effect on all strains tested (Sataphylococcus aureus (MIC = 1250 µg/ml), E. coli (MIC = 1250 µg/ml), Pseudomonas aeroginosa (MIC = 1250 µg/ml), Candida albicans (MIC =2500 µg/ml), Aspergillus niger (MIC =2500 µg/ml)) with MIC values close to literature data. Conclusion: Thus, on the whole, the synthesized chlorobutanol satisfied the requirements of the European Pharmacopoeia, and possesses antibacterial and antifungal activity; nevertheless, it is necessary to insist on the purification step of the product in order to eliminate the maximum impurities.

Keywords: antimicrobial agent, bacterial and fungal strains, chlorobutanol, MIC, minimum inhibitory concentration

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819 Islam in Europe as a Social Movement: The Case of the Islamic Civil Society in France and Its Contribution in the Defense of Muslims’ Cultural Rights

Authors: Enrico Maria la Forgia

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Since the 80ies, in specific situations, France’s Muslims have enacted political actions to reply to attacks on their identity or assimilation attempts, using their religious affiliation as a resource for the organization and expression of collective claims. Indeed, despite Islam's internal sectarian and ethnic differences, religion may be politicized when minorities’ social and cultural rights are under attack. French Civil Society organizations, in this specific case with an Islamic background (ICSO - Islamic Civil Society Organizations), play an essential role in defending Muslims’ social and cultural rights. As a matter of fact, Civil Society organized on an ethnic or religious base is a way to strengthen minoritarian communities and their role as political actors, especially in multicultural contexts. Since the first 1983’s “Marche des Beurs” (slang word referring to French citizens with foreign origins), which involved many Muslims, the development of ICSO contributed to the strenghtening of Islam in France, here meant as a Social Movement aiming to constitute a French version of Islam, defending minorities’ cultural and religious rights, and change the perception of Islam itself in national society. However, since a visible and stigmatized minority, ICSO do not relate only to protests as a strategy to achieve their goals: on several occasions, pressure on authorities through personal networks and connections, or the introduction into public debates of bargaining through the exploitation of national or international crisis, might appear as more successfully - public discourses on minorities and Islam are generally considered favorable conditions to advance requests for cultural legitimation. The proposed abstract, based on a literary review and theoretical/methodological reflection on the state of knowledge on the topic, aims to open a new branch of studies and analysis of Civil Society and Social Movements in Europe, focusing on the French Islamic community as a political actor relating on ICSO to pressure society, local, and national authorities to improve Muslims' rights. The opted methodology relies on a qualitative approach based on ethnography and face-to-face interviews addressing heads and middle-high level activists from ICSO, in an attempt to individuate the strategies enacted by ICSO for mobilizing Muslims and build relations with, on one hand, local and national authorities; into the other, with actors belonging to the Civil Society/political sphere. The theoretical framework, instead, relies on the main Social Movements Theories (resources mobilization, political opportunity structure, and contentious/non-contentious movements), aiming to individuate eventual gaps in the analysis of Islamic Social Movements and Civil Society in minoritarian contexts.

Keywords: Islam, islamophobia, civil society, social movements, sociology, qualitative methodology, Islamic activism in social movement theory, political change, Islam as social movement, religious movements, protest and politics, France, Islamic civil society

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818 The Diverse Experiences of Men Living with Disabilities Participating in Violence Prevention Interventions in Africa and Asia: Men as Victims; Men as Perpetrators

Authors: Ingrid van der Heijden, Kristen Dunkle, Rachel Jewkes

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Background: Emerging literature on prevalence shows that men with disabilities are four more times likely than men without disabilities to experience sexual violence during their lifetime. However, compared to women with disabilities, men with disabilities still have lesser experiences of violence. While empirical evidence on the prevalence of victimization of men with disabilities is emerging, there is scarcer evidence highlighting disabled men’s perpetration of different forms of violence, particularly intimate partner violence. We can assume that men are likely to be both perpetrators and victims of violence, making more complex the causes and risks of violence. Gender norms and disability stigma play important roles in men’s experiences of violence. Men may be stigmatized because of their inability to attain hegemonic masculine ideals of strength, control over women and sexual conquest, which makes them more susceptible to emotional, physical and sexual abuse. Little to no evidence exists of men with disabilities’ experiences of perpetration of intimate partner violence, family violence or community violence. So far studies on male victimization do not succeed to offer contextual evidence that would highlight why and how men with disabilities perpetrate and/or are victims of sexual or other forms of violence. Objective: The overall aim to highlight men with disabilities’ experiences of both victimization and perpetration, and how living up to normative and hegemonic ideals of masculinity and ‘ability’ shape their experiences. It will include: identifying how gender and impairments intersect and shape their experiences of violence; identifying the contexts of and risks for violence; identifying the impacts and consequences of violence on their lives (including mental health impacts), and identifying obstacles and enablers to support and interventions to prevent violence. Methodology: In-depth qualitative interviews with 20 men with disabilities participating in interventions conducted by the What Works Global Programme for violence prevention (DIFD) in Africa and Asia. Men with a range of disabilities will be invited to share their lifetime experiences of violence. Implications for Practice: The data from this study will be used to start thinking about strategies to include men with disabilities in violence prevention strategies for both men and women. Limitations: Because men will be participating in interventions, it is assumed that they will not have severe impairments that hamper their cognitive or physical ability to participate in the intervention activities - and therefore will be able to participate in the in-depth interviews. Of course, this is a limitation of the study as it does not include those men with severe disabilities – measured by the World Health Organization’s International Classification of Functioning - who may be more vulnerable and at higher risk of experiencing violence, and who are less likely to be able to access services and interventions.

Keywords: gender, men with disabilities, perpetration of violence, victimization

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817 Mindful Self-Compassion Training to Alleviate Work Stress and Fatigue in Community Workers: A Mixed Method Evaluation

Authors: Catherine Begin, Jeanne Berthod, Manon Truchon

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In Quebec, there are more than 8,000 community organizations throughout the province, representing more than 72,000 jobs. Working in a community setting involves several particularities (e.g., contact with the suffering of users, feelings of powerlessness, institutional pressure, unstable funding, etc.), which can put workers at risk of fatigue, burnout, and psychological distress. A 2007 study shows that 52% of community workers surveyed have a high psychological distress index. The Ricochet project, founded in 2019, is an initiative aimed at providing various care and services to community workers in the Quebec City region, with a global health approach. Within this program, mindful self-compassion training (MSC) is offered at a low cost. MSC is one of the effective strategies proposed in the literature to help prevent and reduce burnout. Self-compassion is the recognition that suffering, failure, and inadequacies are inherent in the human experience and that everyone, including oneself, deserves compassion. MSC training targets several behavioral, cognitive, and emotional learnings (e.g., motivating oneself with caring, better managing difficult emotions, promoting resilience, etc.). A mixed-method evaluation was conducted with the participants in order to explore the effects of the training on community workers in the Quebec City region. The participants were community workers (management or caregiver). 15 participants completed satisfaction and perceived impact surveys, and 30 participated in structured interviews. Quantitative results showed that participants were generally completely satisfied or satisfied with the training (94%) and perceived that the training allowed them to develop new strategies for dealing with stress (87%). Participants perceived effects on their mood (93%), their contact with others (80%), and their stress level (67%). Some of the barriers raised were scheduling constraints, length of training, and guilt about taking time for oneself. The qualitative results show that individuals experienced long-term benefits, as they were able to apply the tools they received during the training in their daily lives. Some barriers were noted, such as difficulty in getting away from work or problems with the employer, which prevented enrollment. Overall, the results of this evaluation support the use of MSC (mindful self-compassion) training among community workers. Future research could support this evaluation by using a rigorous design and developing innovative ways to overcome the barriers raised.

Keywords: mindful self-compassion, community workers, work stres, burnout, wellbeing at work

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816 The Decision-Making Process of the Central Banks of Brazil and India in Regional Integration: A Comparative Analysis of MERCOSUR and SAARC (2003-2014)

Authors: Andre Sanches Siqueira Campos

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Central banks can play a significant role in promoting regional economic and monetary integration by strengthening the payment and settlement systems. However, close coordination and cooperation require facilitating the implementation of reforms at domestic and cross-border levels in order to benchmark with international standards and commitments to the liberal order. This situation reflects the normative power of the regulatory globalization dimension of strong states, which may drive or constrain regional integration. In the MERCOSUR and SAARC regions, central banks have set financial initiatives that could facilitate South America and South Asia regions to move towards convergence integration and facilitate trade and investments connectivities. This is qualitative method research based on a combination of the Process-Tracing method with Qualitative Comparative Analysis (QCA). This research approaches multiple forms of data based on central banks, regional organisations, national governments, and financial institutions supported by existing literature. The aim of this research is to analyze the decision-making process of the Central Bank of Brazil (BCB) and the Reserve Bank of India (RBI) towards regional financial cooperation by identifying connectivity instruments that foster, gridlock, or redefine cooperation. The BCB and The RBI manage the monetary policy of the largest economies of those regions, which makes regional cooperation a relevant framework to understand how they provide an effective institutional arrangement for regional organisations to achieve some of their key policies and economic objectives. The preliminary conclusion is that both BCB and RBI demonstrate a reluctance to deepen regional cooperation because of the existing economic, political, and institutional asymmetries. Deepening regional cooperation is constrained by the interests of central banks in protecting their economies from risks of instability due to different degrees of development between countries in their regions and international financial crises that have impacted the international system in the 21st century. Reluctant regional integration also provides autonomy for national development and political ground for the contestation of Global Financial Governance by Brazil and India.

Keywords: Brazil, central banks, decision-making process, global financial governance, India, MERCOSUR, connectivity, payment system, regional cooperation, SAARC

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

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

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

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

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814 Examining Employee Social Intrapreneurial Behaviour (ESIB) in Kuwait: Pilot Study

Authors: Ardita Malaj, Ahmad R. Alsaber, Bedour Alboloushi, Anwaar Alkandari

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Organizations worldwide, particularly in Kuwait, are concerned with implementing a progressive workplace culture and fostering social innovation behaviours. The main aim of this research is to examine and establish a thorough comprehension of the relationship between an inventive organizational culture, employee intrapreneurial behaviour, authentic leadership, employee job satisfaction, and employee job commitment in the manufacturing sector of Kuwait, which is a developed economy. Literature reviews analyse the core concepts and their related areas by scrutinizing their definitions, dimensions, and importance to uncover any deficiencies in existing research. The examination of relevant research uncovered major gaps in understanding. This study examines the reliability and validity of a newly developed questionnaire designed to identify the appropriate applications for a large-scale investigation. A preliminary investigation was carried out, determining a sample size of 36 respondents selected randomly from a pool of 223 samples. SPSS was utilized to calculate the percentages of the demographic characteristics for the participants, assess the credibility of the measurements, evaluate the internal consistency, validate all agreements, and determine Pearson's correlation. The study's results indicated that the majority of participants were male (66.7%), aged between 35 and 44 (38.9%), and possessed a bachelor's degree (58.3%). Approximately 94.4% of the participants were employed full-time. 72.2% of the participants are employed in the electrical, computer, and ICT sector, whilst 8.3% work in the metal industry. Out of all the departments, the human resource department had the highest level of engagement, making up 13.9% of the total. Most participants (36.1%) possessed intermediate or advanced levels of experience, whilst 21% were classified as entry-level. Furthermore, 8.3% of individuals were categorized as first-level management, 22.2% were categorized as middle management, and 16.7% were categorized as executive or senior management. Around 19.4% of the participants have over a decade of professional experience. The Pearson's correlation coefficient for all 5 components varies between 0.4009 to 0.7183. The results indicate that all elements of the questionnaire were effectively verified, with a Cronbach alpha factor predominantly exceeding 0.6, which is the criterion commonly accepted by researchers. Therefore, the work on the larger scope of testing and analysis could continue.

Keywords: pilot study, ESIB, innovative organizational culture, Kuwait, validation

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813 The Clinical Effectiveness of Off-The-Shelf Foot Orthoses on the Dynamics of Gait in Patients with Early Rheumatoid Arthritis

Authors: Vicki Cameron

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Background: Rheumatoid Arthritis (RA) typically effects the feet and about 20% of patients present initially with foot and ankle symptoms. Custom moulded foot orthoses (FO) in the management of foot and ankle problems in RA is well documented in the literature. Off-the-shelf FO are thought to provide an effective alternative to custom moulded FO in patients with RA, however they are not evidence based. Objectives: To determine the effects of off-the-shelf FO on; 1. quality of life (QOL) 2. walking speed 4. peak plantar pressure in the forefoot (PPPft) Methods: Thirty-five patients (six male and 29 female) participated in the study from 11/2006 to 07/2008. The age of the patients ranged from 26 to 80 years (mean 52.4 years; standard deviation [SD] 13.3 years). A repeated measures design was used, with patients presenting at baseline, three months and six months. Patients were tested walking barefoot, shod and shod with FO. The type of orthoses used was the Slimflex Plastic ® (Algeos). The Leeds Foot Impact Scale (LFIS) was used to investigate QOL. The Vicon 612 motion analysis system was used to determine the effect of FO on walking speed. The F-scan walkway and in-shoe systems provided information of the effect on PPPft. Ethical approval was obtained on 07/2006. Data was analysed using SPSS version 15.0. Results/Discussion: The LFIS data was analysed with a repeated measures ANOVA. There was a significant improvement in the LFIS score with the use of the FO over the six months (p<0.01). A significant increase in walking speed with the orthoses was observed (p<0.01). Peak plantar pressure in the forefoot was reduced with the FO, as shown by a non-parametric Friedman’s test (chi-square = 55.314, df=2, p<0.05). Conclusion: The results show that off-the-shelf FO are effective in managing foot problems in patients with RA. Patients reported an improved QOL with the orthoses, and further objective measurements were quantified to provide a rationale for this change. Patients demonstrated an increased walking speed, which has been shown to be associated with reduced pain. The FO decreased PPPft which have been reported as a site of pain and ulceration in patients with RA. Salient Clinical Points: Off-the-shelf FO offer an effective alternative to custom moulded FO, and can be dispensed at the chair side. This is crucial in the management of foot problems associated with RA as early intervention is advocated due to the chronic and progressive nature of the disease.

Keywords: podiatry, rheumatoid arthritis, foot orthoses, gait analysis

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812 Connectomic Correlates of Cerebral Microhemorrhages in Mild Traumatic Brain Injury Victims with Neural and Cognitive Deficits

Authors: Kenneth A. Rostowsky, Alexander S. Maher, Nahian F. Chowdhury, Andrei Irimia

Abstract:

The clinical significance of cerebral microbleeds (CMBs) due to mild traumatic brain injury (mTBI) remains unclear. Here we use magnetic resonance imaging (MRI), diffusion tensor imaging (DTI) and connectomic analysis to investigate the statistical association between mTBI-related CMBs, post-TBI changes to the human connectome and neurological/cognitive deficits. This study was undertaken in agreement with US federal law (45 CFR 46) and was approved by the Institutional Review Board (IRB) of the University of Southern California (USC). Two groups, one consisting of 26 (13 females) mTBI victims and another comprising 26 (13 females) healthy control (HC) volunteers were recruited through IRB-approved procedures. The acute Glasgow Coma Scale (GCS) score was available for each mTBI victim (mean µ = 13.2; standard deviation σ = 0.4). Each HC volunteer was assigned a GCS of 15 to indicate the absence of head trauma at the time of enrollment in our study. Volunteers in the HC and mTBI groups were matched according to their sex and age (HC: µ = 67.2 years, σ = 5.62 years; mTBI: µ = 66.8 years, σ = 5.93 years). MRI [including T1- and T2-weighted volumes, gradient recalled echo (GRE)/susceptibility weighted imaging (SWI)] and gradient echo (GE) DWI volumes were acquired using the same MRI scanner type (Trio TIM, Siemens Corp.). Skull-stripping and eddy current correction were implemented. DWI volumes were processed in TrackVis (http://trackvis.org) and 3D Slicer (http://www.slicer.org). Tensors were fit to DWI data to perform DTI, and tractography streamlines were then reconstructed using deterministic tractography. A voxel classifier was used to identify image features as CMB candidates using Microbleed Anatomic Rating Scale (MARS) guidelines. For each peri-lesional DTI streamline bundle, the null hypothesis was formulated as the statement that there was no neurological or cognitive deficit associated with between-scan differences in the mean FA of DTI streamlines within each bundle. The statistical significance of each hypothesis test was calculated at the α = 0.05 level, subject to the family-wise error rate (FWER) correction for multiple comparisons. Results: In HC volunteers, the along-track analysis failed to identify statistically significant differences in the mean FA of DTI streamline bundles. In the mTBI group, significant differences in the mean FA of peri-lesional streamline bundles were found in 21 out of 26 volunteers. In those volunteers where significant differences had been found, these differences were associated with an average of ~47% of all identified CMBs (σ = 21%). In 12 out of the 21 volunteers exhibiting significant FA changes, cognitive functions (memory acquisition and retrieval, top-down control of attention, planning, judgment, cognitive aspects of decision-making) were found to have deteriorated over the six months following injury (r = -0.32, p < 0.001). Our preliminary results suggest that acute post-TBI CMBs may be associated with cognitive decline in some mTBI patients. Future research should attempt to identify mTBI patients at high risk for cognitive sequelae.

Keywords: traumatic brain injury, magnetic resonance imaging, diffusion tensor imaging, connectomics

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811 The Effects of Inferior Tilt Fixation on a Glenoid Components in Reverse Shoulder-Arthroplasty

Authors: Soo Min Kim, Soo-Won Chae, Soung-Yon Kim, Haea Lee, Ju Yong Kang, Juneyong Lee, Seung-Ho Han

Abstract:

Reverse total shoulder arthroplasty (RTSA) has become an effective treatment option for cuff tear arthropathy and massive, irreparable rotator cuff tears and indications for its use are expanding. Numerous methods for optimal fixation of the glenoid component have been suggested, such as inferior overhang, inferior tilt, to maximize initial fixation and prevent glenoid component loosening. The inferior tilt fixation of a glenoid component has been suggested, which is expected to decrease scapular notching and to improve the stability of a glenoid component fixation in reverse total shoulder arthroplasty. Inferior tilt fixation of the glenoid component has been suggested, which can improve stability and, because it provides the most uniform compressive forces and imparts the least amount of tensile forces and micromotion, reduce the likelihood of mechanical failure. Another study reported that glenoid component inferior tilt improved impingement-free range of motion as well as minimized the scapular notching. Several authors have shown that inferior tilt of a glenoid component reduces scapular notching. However, controversy still exists regarding its importance in the literature. In this study the influence of inferior tilt fixation on the primary stability of a glenoid component has been investigated. Finite element models were constructed from cadaveric scapulae and glenoid components were implanted with neutral and 10° inferior tilts. Most previous biomechanical studies regarding the effect of glenoid component inferior tilt used a solid rigid polyurethane foam or sawbones block, not cadaveric scapulae, to evaluate the stability of the RTSA. Relative micromotions at the bone-glenoid component interface, and the distribution of bone stresses under the glenoid component and around the screws were analyzed and compared between neutral and 10° inferior tilt groups. Contact area between bone and screws and cut surface area of the cancellous bone exposed after reaming of the glenoid have also been investigated because of the fact that cancellous and cortical bone thickness vary depending on the resection level of the inferior glenoid bone. The greater relative micromotion of the bone-glenoid component interface occurred in the 10° inferior tilt group than in the neutral tilt group, especially at the inferior area of the bone-glenoid component interface. Bone stresses under the glenoid component and around the screws were also higher in the 10° inferior tilt group than in the neutral tilt group, especially at the inferior third of the glenoid bone surface under the glenoid component and inferior scapula. Thus inferior tilt fixation of the glenoid component may adversely affect the primary stability and longevity of the reverse total shoulder arthroplasty.

Keywords: finite element analysis, glenoid component, inferior tilt, reverse total shoulder arthroplasty

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810 Automatic Identification of Pectoral Muscle

Authors: Ana L. M. Pavan, Guilherme Giacomini, Allan F. F. Alves, Marcela De Oliveira, Fernando A. B. Neto, Maria E. D. Rosa, Andre P. Trindade, Diana R. De Pina

Abstract:

Mammography is a worldwide image modality used to diagnose breast cancer, even in asymptomatic women. Due to its large availability, mammograms can be used to measure breast density and to predict cancer development. Women with increased mammographic density have a four- to sixfold increase in their risk of developing breast cancer. Therefore, studies have been made to accurately quantify mammographic breast density. In clinical routine, radiologists perform image evaluations through BIRADS (Breast Imaging Reporting and Data System) assessment. However, this method has inter and intraindividual variability. An automatic objective method to measure breast density could relieve radiologist’s workload by providing a first aid opinion. However, pectoral muscle is a high density tissue, with similar characteristics of fibroglandular tissues. It is consequently hard to automatically quantify mammographic breast density. Therefore, a pre-processing is needed to segment the pectoral muscle which may erroneously be quantified as fibroglandular tissue. The aim of this work was to develop an automatic algorithm to segment and extract pectoral muscle in digital mammograms. The database consisted of thirty medio-lateral oblique incidence digital mammography from São Paulo Medical School. This study was developed with ethical approval from the authors’ institutions and national review panels under protocol number 3720-2010. An algorithm was developed, in Matlab® platform, for the pre-processing of images. The algorithm uses image processing tools to automatically segment and extract the pectoral muscle of mammograms. Firstly, it was applied thresholding technique to remove non-biological information from image. Then, the Hough transform is applied, to find the limit of the pectoral muscle, followed by active contour method. Seed of active contour is applied in the limit of pectoral muscle found by Hough transform. An experienced radiologist also manually performed the pectoral muscle segmentation. Both methods, manual and automatic, were compared using the Jaccard index and Bland-Altman statistics. The comparison between manual and the developed automatic method presented a Jaccard similarity coefficient greater than 90% for all analyzed images, showing the efficiency and accuracy of segmentation of the proposed method. The Bland-Altman statistics compared both methods in relation to area (mm²) of segmented pectoral muscle. The statistic showed data within the 95% confidence interval, enhancing the accuracy of segmentation compared to the manual method. Thus, the method proved to be accurate and robust, segmenting rapidly and freely from intra and inter-observer variability. It is concluded that the proposed method may be used reliably to segment pectoral muscle in digital mammography in clinical routine. The segmentation of the pectoral muscle is very important for further quantifications of fibroglandular tissue volume present in the breast.

Keywords: active contour, fibroglandular tissue, hough transform, pectoral muscle

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809 Best Practice for Post-Operative Surgical Site Infection Prevention

Authors: Scott Cavinder

Abstract:

Surgical site infections (SSI) are a known complication to any surgical procedure and are one of the most common nosocomial infections. Globally it is estimated 300 million surgical procedures take place annually, with an incidence of SSI’s estimated to be 11 of 100 surgical patients developing an infection within 30 days after surgery. The specific purpose of the project is to address the PICOT (Problem, Intervention, Comparison, Outcome, Time) question: In patients who have undergone cardiothoracic or vascular surgery (P), does implementation of a post-operative care bundle based on current EBP (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period (T)? Synthesis of Supporting Evidence: A literature search of five databases, including citation chasing, was performed, which yielded fourteen pieces of evidence ranging from high to good quality. Four common themes were identified for the prevention of SSI’s including use and removal of surgical dressings; use of topical antibiotics and antiseptics; implementation of evidence-based care bundles, and implementation of surveillance through auditing and feedback. The Iowa Model was selected as the framework to help guide this project as it is a multiphase change process which encourages clinicians to recognize opportunities for improvement in healthcare practice. Practice/Implementation: The process for this project will include recruiting postsurgical participants who have undergone cardiovascular or thoracic surgery prior to discharge at a Northwest Indiana Hospital. The patients will receive education, verbal instruction, and return demonstration. The patients will be followed for 12 weeks, and wounds assessed utilizing the National Healthcare Safety Network//Centers for Disease Control (NHSN/CDC) assessment tool and compared to the SSI rate of 2021. Key stakeholders will include two cardiovascular surgeons, four physician assistants, two advance practice nurses, medical assistant and patients. Method of Evaluation: Chi Square analysis will be utilized to establish statistical significance and similarities between the two groups. Main Results/Outcomes: The proposed outcome is the prevention of SSIs in the post-op cardiothoracic and vascular patient. Implication/Recommendation(s): Implementation of standardized post operative care bundles in the prevention of SSI in cardiovascular and thoracic surgical patients.

Keywords: cardiovascular, evidence based practice, infection, post-operative, prevention, thoracic, surgery

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