Search results for: clinical education
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10260

Search results for: clinical education

1170 Political Economy on the Recent Labor Condition in the Philippines: A Literature Review

Authors: Lloyd B. Ranises

Abstract:

The Philippine labor force has been affected by the pandemic recently. The situation was added by the high inflation rate, which makes matter worse. Since the Philippines has a new government after the 2022 national election, the labor condition under the previous government has been passed on to the new one. To understand the labor challenges the present government faces, this study revisits the labor conditions and responses of the previous government from 2016 to 2022. Thus, this study reviews the labor force of the Philippines within the time frame. It explores the challenges in the labor market and examines government policy. This study uses secondary sources in tracing the labor conditions and government actions that addressed them. The Literatures are consolidated to see its relevance to the new government’s labor policy. This study found that the labor force had a sluggish growth earlier until 2018 and thrived on but was affected by the pandemic. By 2020, the National Capital Region’s labor force dropped, although, after which, it begins to thrive again, showing recovery. However, its composition is much more complex. Cognitive skill is high in demand that requires tertiary education. But the production of goods and services is low in the scientific workforce in addition to the mismatch between position and profession. Moreover, Philippine labor has poor female participation. In addition to these complexities, the agricultural rural areas have high underemployment, which implies surplus labor of low skill. Overseas employment, on the other, is significant to the decrease in domestic production. The major responses of the previous government, by far, have been focused on the minimum wage increase and the social services and health insurance, which are appropriate to the post-pandemic needs. Yet still, some issues are unattended. This study concludes that the previous government’s policy needs to be fleshed out substantially. It necessitates that the new administration shall consider encompassing all aspects of the Philippine labor force to sustain and strengthen the economy of the country.

Keywords: cognitive skills, minimum wage, national capital region, underemployment

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1169 Non-Time and Non-Sense: Temporalities of Addiction for Heroin Users in Scotland

Authors: Laura Roe

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This study draws on twelve months of ethnographic fieldwork conducted in 2017 with heroin and poly-substance users in Scotland and explores experiences of time and temporality as factors in continuing drug use. The research largely took place over the year in which drug-related deaths in Scotland reached a record high, and were statistically recorded as the highest in Europe. This qualitative research is therefore significant in understanding both evolving patterns of drug use and the experiential lifeworlds of those who use heroin and other substances in high doses. Methodologies included participant observation, structured and semi-structured interviews, and unstructured conversations with twenty-two regular participants. The fieldwork was conducted in two needle exchanges, a community recovery group and in the community. The initial aim of the study was to assess evolving patterns of drug preferences in order to explore a clinical and user-reported rise in the use of novel psychoactive substances (NPS), which are typically considered to be highly potent, synthetic substances, often available at a low cost. It was found, however, that while most research participants had experimented with NPS with varying intensity, those who used every day regularly consumed heroin, methadone, and alcohol with benzodiazepines such as diazepam or anticonvulsants such as gabapentin. The research found that many participants deliberately pursued the non-fatal effects of overdose, aiming to induce states of dissociation, detachment and uneven consciousness, and did so by both mixing substances and experimenting with novel modes of consumption. Temporality was significant in the decision to consume cocktails of substances, as users described wishing to sever themselves from time; entering into states of ‘non-time’ and insensibility through specific modes of intoxication. Time and temporality similarly impacted other aspects of addicted life. Periods of attempted abstinence witnessed a slowing of time’s passage that was tied to affective states of boredom and melancholy, in addition to a disruptive return of distressing and difficult memories. Abject past memories frequently dominated and disrupted the present, which otherwise could be highly immersive due to the time and energy-consuming nature of seeking drugs while in financial difficulty. There was furthermore a discordance between individual user temporalities and the strict time-based regimes of recovery services and institutional bodies, and the study aims to highlight the impact of such a disjuncture on the efficacy of treatment programs. Many participants had difficulty in adhering to set appointments or temporal frameworks due to their specific temporal situatedness. Overall, exploring increasing tendencies of heroin users in Scotland towards poly-substance use, this study draws on experiences and perceptions of time, analysing how temporality comes to bear on the ways drugs are sought and consumed, and how recovery is imagined and enacted. The study attempts to outline the experiential, intimate and subjective worlds of heroin and poly-substance users while explicating the structural and historical factors that shape them.

Keywords: addiction, poly-substance use, temporality, timelessness

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1168 A Randomized, Controlled Trial to Test Habit Formation Theory for Low Intensity Physical Exercise Promotion in Older Adults

Authors: Patrick Louie Robles, Jerry Suls, Ciaran Friel, Mark Butler, Samantha Gordon, Frank Vicari, Joan Duer-Hefele, Karina W. Davidson

Abstract:

Physical activity guidelines focus on increasing moderate-intensity activity for older adults, but adherence to recommendations remains low. This is despite the fact that scientific evidence finds increasing physical activity is positively associated with health benefits. Behavior change techniques (BCTs) have demonstrated some effectiveness in reducing sedentary behavior and promoting physical activity. This pilot study uses a personalized trials (N-of-1) design, delivered virtually, to evaluate the efficacy of using five BCTs in increasing low-intensity physical activity (by 2,000 steps of walking per day) in adults aged 45-75 years old. The 5 BCTs described in habit formation theory are goal setting, action planning, rehearsal, rehearsal in a consistent context, and self-monitoring. The study recruited health system employees in the target age range who had no mobility restrictions and expressed interest in increasing their daily activity by a minimum of 2,000 steps per day at least five days per week. Participants were sent a Fitbit Charge 4 fitness tracker with an established study account and password. Participants were recommended to wear the Fitbit device 24/7 but were required to wear it for a minimum of ten hours per day. Baseline physical activity was measured by Fitbit for two weeks. Participants then engaged remotely with a clinical research coordinator to establish a “walking plan” that included a time and day interval (e.g., between 7am -8am on Monday-Friday), a location for the walk (e.g., park), and how much time the plan would need to achieve a minimum of 2,000 steps over their baseline average step count (20 minutes). All elements of the walking plan were required to remain consistent throughout the study. In the 10-week intervention phase of the study, participants received all five BCTs in a single, time-sensitive text message. The text message was delivered 30 minutes prior to the established walk time and signaled participants to begin walking when the context (i.e., day of the week, time of day) they pre-selected is encountered. Participants were asked to log both the start and conclusion of their activity session by pressing a button on the Fitbit tracker. Within 30 minutes of the planned conclusion of the activity session, participants received a text message with a link to a secure survey. Here, they noted whether they engaged in the BCTs when prompted and completed an automaticity survey to identify how “automatic” their walking behavior had become. At the end of their trial, participants received a personalized summary of their step data over time, helping them learn more about their responses to the five BCTs. Whether the use of these 5 ‘habit formation’ BCTs in combination elicits a change in physical activity behavior among older adults will be reported. This study will inform the feasibility of a virtually-delivered N-of-1 study design to effectively promote physical activity as a component of healthy aging.

Keywords: aging, exercise, habit, walking

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1167 Determinants and Impact on Income: Special Reference to Household Level Coir Yarn Labourers

Authors: G. H. B. Dilhari, A. A. D. T. Saparamadu

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The coir is one of the by-products of the coconut and the coir industry can be identified as one of the traditional industries in Sri Lanka. Sri Lanka is one of the prominent countries for the coir production. Due to the labour insensitiveness, the labourers are the significant factor in the coir production process. The study has analyzed the determinants and its impact on income of the household level coir yarn labourers. The study was conducted in the Kumarakanda Grama Niladhari division, Galle, Sri Lanka. Simple random sampling was used to generate the sample of 100 household level coir yarn labourers and structured questionnaire, personal interviews and discussion were performed to gather the required data. The obtained data were statistically analyzed by using Statistical Package for Social Science (SPSS) software. Mann-Whitney U and Kruskal-Wallis test were carried out. The findings revealed that the household level coir yarn industry is dominated by the female workers and fewer amounts of workers have engaged this industry as the main occupation. In addition to that, elderly participation of the industry is greater than younger participation and most of them engaged as an extra income source. Level of education, the methods of engagement, satisfaction, labour’s children employment in the coir industry, support from the government, method of government support, working hours per day, employed as a main job, no of completed units per day, suffering any job related diseases and type of the diseases were related with income level of household level coir yarn labourers. The recommendations were formulated in respect to these problems including technological transformation for coir yarn production, strengthening of the raw material base and regulating the raw material supply, introduction of new technologies, markets and training programs, the establishment of the labourers association, the initiation of micro credit schemes, better consideration about the job oriented diseases.

Keywords: coir, coir yarn labourers, income, Galle

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1166 Assessment Proposal to Establish the First Geo-Park in Egypt at Abu-Roash Area, Cairo

Authors: Kholoud Abdelmaksoud, Mahmoud Emam, Wael Al-Metwaly

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Egypt is known as cradle of civilization due to its ancient history and archeological sites, but Egypt possess also a cradle of Geo-sites, which qualify it to be listed as one of the most important Geo-heritage sites all over the country. Geology and landscape in Abu-Roash area is considered as one of the most important geological places (geo-sites) inside Cairo which help us to know and understand geology and geologic processes, so the area is used mainly for geological education purposes, also the area contain an archeological sites; pyramid complex, tombs, and Coptic monastery which give the area unique importance. Abu-Roash area is located inside Cairo 9 km north of the Giza Pyramids, which make the accessibility to the area easy and safe, the geology of Abu-Roash constitutes a complex Cretaceous sedimentary succession mass with showing outstanding tectonic features (Syrian Arc system event), these features are considered as a Geo-heritage, which will be the main designation of ‘Geo-parks’ establishing. The research is dealing with the numerous geo-sites found in the area, and its geologic and archeological importance, the relation between geo-sites and archeology, also the research proposed a detailed maps for these sites depicting Geo-routes and the hazardous places surrounding Abu-Roash area. The research is proposing a new proposal not applied in Egypt before, establishing a Geo-park, to promote this unique geo-heritage from hazardous factors and anthropogenic effects, also it will offer geo-educational opportunities to the general public and to the scientific community, enhancement of Geo-tourism which will be linked easily with the Ancient Egyptian tourism, it will also provide a significant economic benefit to Abu-Roash residential area. Finally, the research recommends that The United Nations Educational, Scientific and Cultural Organizations promote conservation of geological and geo-morphological heritage to list this area for its importance under the umbrella of geo-parks.

Keywords: geo-park, geo-sites, Abu-roash, archaeological sites, geo-tourism

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1165 A Survey on Intelligent Traffic Management with Cooperative Driving in Urban Roads

Authors: B. Karabuluter, O. Karaduman

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Traffic management and traffic planning are important issues, especially in big cities. Due to the increase of personal vehicles and the physical constraints of urban roads, the problem of transportation especially in crowded cities over time is revealed. This situation reduces the living standards, and it can put human life at risk because the vehicles such as ambulance, fire department are prevented from reaching their targets. Even if the city planners take these problems into account, emergency planning and traffic management are needed to avoid cases such as traffic congestion, intersections, traffic jams caused by traffic accidents or roadworks. In this study, in smart traffic management issues, proposed solutions using intelligent vehicles acting in cooperation with urban roads are examined. Traffic management is becoming more difficult due to factors such as fatigue, carelessness, sleeplessness, social behavior patterns, and lack of education. However, autonomous vehicles, which remove the problems caused by human weaknesses by providing driving control, are increasing the success of practicing the algorithms developed in city traffic management. Such intelligent vehicles have become an important solution in urban life by using 'swarm intelligence' algorithms and cooperative driving methods to provide traffic flow, prevent traffic accidents, and increase living standards. In this study, studies conducted in this area have been dealt with in terms of traffic jam, intersections, regulation of traffic flow, signaling, prevention of traffic accidents, cooperation and communication techniques of vehicles, fleet management, transportation of emergency vehicles. From these concepts, some taxonomies were made out of the way. This work helps to develop new solutions and algorithms for cities where intelligent vehicles that can perform cooperative driving can take place, and at the same time emphasize the trend in this area.

Keywords: intelligent traffic management, cooperative driving, smart driving, urban road, swarm intelligence, connected vehicles

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1164 Effects of Live Webcast-Assisted Teaching on Physical Assessment Technique Learning of Young Nursing Majors

Authors: Huey-Yeu Yan, Ching-Ying Lee, Hung-Ru Lin

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Background: Physical assessment is a vital clinical nursing competence. The gap between conventional teaching method and the way e-generation students’ preferred could be bridged owing to the support of Internet technology, i.e. interacting with online media to manage learning works. Nursing instructors in the wake of new learning pattern of the e-generation students are challenged to actively adjust and make teaching contents and methods more versatile. Objective: The objective of this research is to explore the effects on teaching and learning with live webcast-assisted on a specific topic, Physical Assessment technique, on a designated group of young nursing majors. It’s hoped that, with a way of nursing instructing, more versatile learning resources may be provided to facilitate self-directed learning. Design: This research adopts a cross-sectional descriptive survey. The instructor demonstrated physical assessment techniques and operation procedures via live webcast broadcasted online to all students. It increased both the off-time interaction between teacher and students concerning teaching materials. Methods: A convenient sampling was used to recruit a total of 52 nursing-majors at a certain university. The nursing majors took two-hour classes of Physical Assessment per week for 18 weeks (36 hrs. in total). The instruction covered four units with live webcasting and then conducted an online anonymous survey of learning outcomes by questionnaire. The research instrument was the online questionnaire, covering three major domains—online media used, learning outcome evaluation and evaluation result. The data analysis was conducted via IBM SPSS Statistics Version 2.0. The descriptive statistics was undertaken to describe the analysis of basic data and learning outcomes. Statistical methods such as descriptive statistics, t-test, ANOVA, and Pearson’s correlation were employed in verification. Results: Results indicated the following five major findings. (1) learning motivation, about four fifth of the participants agreed the online instruction resources are very helpful in improving learning motivation and raising the learning interest. (2) learning needs, about four fifth of participants agreed it was helpful to plan self-directed practice after the instruction, and meet their needs of repetitive learning and/or practice at their leisure time. (3) learning effectiveness, about two third agreed it was helpful to reduce pre-exam anxiety, and improve their test scores. (4) course objects, about three fourth agreed that it was helpful to achieve the goal of ‘executing the complete Physical Assessment procedures with proper skills’. (5) finally, learning reflection, about all of participants agreed this experience of online instructing, learning, and practicing is beneficial to them, they recommend instructor to share with other nursing majors, and they will recommend it to fellow students too. Conclusions: Live webcasting is a low-cost, convenient, efficient and interactive resource to facilitate nursing majors’ motivation of learning, need of self-directed learning and practice, outcome of learning. When live webcasting is integrated into nursing teaching, it provides an opportunity of self-directed learning to promote learning effectiveness, as such to fulfill the teaching objective.

Keywords: innovative teaching, learning effectiveness, live webcasting, physical assessment technique

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1163 Effect of Renin Angiotensin Pathway Inhibition on the Efficacy of Anti-programmed Cell Death (PD-1/L-1) Inhibitors in Advanced Non-small Cell Lung Cancer Patients- Comparison of Single Hospital Retrospective Assessment to the Published Literature

Authors: Esther Friedlander, Philip Friedlander

Abstract:

The use of immunotherapy that inhibits programmed death-1 (PD-1) or its ligand PD-L1 confers survival benefits in patients with non-small cell lung cancer (NSCLC). However, approximately 45% of patients experience primary treatment resistance, necessitating the development of strategies to improve efficacy. While the renin-angiotensin system (RAS) has systemic hemodynamic effects, tissue-specific regulation exists along with modulation of immune activity in part through regulation of myeloid cell activity, leading to the hypothesis that RAS inhibition may improve anti-PD-1/L-1 efficacy. A retrospective analysis was conducted that included 173 advanced solid tumor cancer patients treated at Valley Hospital, a community Hospital in New Jersey, USA, who were treated with a PD-1/L-1 inhibitor in a defined time period showing a statistically significant relationship between RAS pathway inhibition (RASi through concomitant treatment with an ACE inhibitor or angiotensin receptor blocker) and positive efficacy to the immunotherapy that was independent of age, gender and cancer type. Subset analysis revealed strong numerical benefit for efficacy in both patients with squamous and nonsquamous NSCLC as determined by documented clinician assessment of efficacy and by duration of therapy. A PUBMED literature search was now conducted to identify studies assessing the effect of RAS pathway inhibition on anti-PD-1/L1 efficacy in advanced solid tumor patients and compare these findings to those seen in the Valley Hospital retrospective study with a focus on NSCLC specifically. A total of 11 articles were identified assessing the effects of RAS pathway inhibition on the efficacy of checkpoint inhibitor immunotherapy in advanced cancer patients. Of the 11 studies, 10 assessed the effect on survival of RASi in the context of treatment with anti-PD-1/PD-L1, while one assessed the effect on CTLA-4 inhibition. Eight of the studies included patients with NSCLC, while the remaining 2 were specific to genitourinary malignancies. Of the 8 studies, two were specific to NSCLC patients, with the remaining 6 studies including a range of cancer types, of which NSCLC was one. Of these 6 studies, only 2 reported specific survival data for the NSCLC subpopulation. Patient characteristics, multivariate analysis data and efficacy data seen in the 2 NSLCLC specific studies and in the 2 basket studies, which provided data on the NSCLC subpopulation, were compared to that seen in the Valley Hospital retrospective study supporting a broader effect of RASi on anti-PD-1/L1 efficacy in advanced NSLCLC with the majority of studies showing statistically significant benefit or strong statistical trends but with one study demonstrating worsened outcomes. This comparison of studies extends published findings to the community hospital setting and supports prospective assessment through randomized clinical trials of efficacy in NSCLC patients with pharmacodynamic components to determine the effect on immune cell activity in tumors and on the composition of the tumor microenvironment.

Keywords: immunotherapy, cancer, angiotensin, efficacy, PD-1, lung cancer, NSCLC

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1162 The Effect of Ethnic and Boko Haram Insurgency in the Economic Development of Cultural Heritage and Tourism Industries in Nigeria

Authors: Chinwe Juliana Abara, Dayo Keshi

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Through cultural heritage materials, nations witness significant boom in the world of art and tourism as well as attract foreign investors and tourists to the benefit of the regions and countries where they are located. There are notable heritage sites which record visits by tourists in their thousands annually. According to UNESCO the cultural heritage reflects the life of the community, its history and its identity. Its preservation helps to rebuild broken communities, re-establish their identities, and link their past with their present and future. During any form of conflict or war, a lot happen. People die, houses destroyed and every other thing in the society suffers. Wars and conflicts in various countries have claimed antiquities, heritage materials, contemporary Arts, Galleries, Museums, Archives and very important Monuments and Heritage sites. My Paper deals with the effects of insurgencies and conflicts on cultural heritage and tourism industries in Nigeria and how they can be protected and restored so as to yield the desirable economic gains. Preceding from the premise that conflict of any type puts our cultural heritage at risk; this paper also explores the practical challenges and opportunities available to us in the face of incessant ethnic and Boko Haram (western education is abomination) insurgents and their wanton destruction of lives and properties. There will be a review of relevant literature and documents on the effects of violence on heritage materials and tourism industries in Nigeria particularly and other parts of the world in generally .My paper also highlights the activities the National Council for Arts and Culture as well as other Cultural Agencies in Nigeria have employed to sensitize the stakeholders, the youth, the elderly, and the community at large on the need for peaceful co-existence so as to collectively strive to safeguard and secure our cultural heritage in the face of all these challenges for posterity and desirable economic gains.

Keywords: cultural heritage, conflict, tourism, insurgency, challenges

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1161 Concept for Knowledge out of Sri Lankan Non-State Sector: Performances of Higher Educational Institutes and Successes of Its Sector

Authors: S. Jeyarajan

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Concept of knowledge is discovered from conducted study for successive Competition in Sri Lankan Non-State Higher Educational Institutes. The Concept discovered out of collected Knowledge Management Practices from Emerald inside likewise reputed literatures and of Non-State Higher Educational sector. A test is conducted to reveal existences and its reason behind of these collected practices in Sri Lankan Non-State Higher Education Institutes. Further, unavailability of such study and uncertain on number of participants for data collection in the Sri Lankan context contributed selection of research method as qualitative method, which used attributes of Delphi Method to manage those likewise uncertainty. Data are collected under Dramaturgical Method, which contributes efficient usage of the Delphi method. Grounded theory is selected as data analysis techniques, which is conducted in intermixed discourse to manage different perspectives of data that are collected systematically through perspective and modified snowball sampling techniques. Data are then analysed using Grounded Theory Development Techniques in Intermix discourses to manage differences in Data. Consequently, Agreement in the results of Grounded theories and of finding in the Foreign Study is discovered in the analysis whereas present study conducted as Qualitative Research and The Foreign Study conducted as Quantitative Research. As such, the Present study widens the discovery in the Foreign Study. Further, having discovered reason behind of the existences, the Present result shows Concept for Knowledge from Sri Lankan Non-State sector to manage higher educational Institutes in successful manner.

Keywords: adherence of snowball sampling into perspective sampling, Delphi method in qualitative method, grounded theory development in intermix discourses of analysis, knowledge management for success of higher educational institutes

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1160 Ethnobotanical and Laboratory Investigations of Plants Used for the Treatment of Typhoid Fever in Gombe State, North-Eastern Nigeria

Authors: Abubakar Bello Usman, Alhassan Muhammad Gani, Kolo Ibrahim

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The use of botanical raw materials to produce pharmaceuticals, herbal remedies, teas, spirits, cosmetics, sweets, dietary supplements, special industrial compounds and crude materials constitute an important global resource in terms of healthcare and economy. In Nigeria and other developing countries, the indigenous knowledge on the uses of plants lies with the older generation and the traditional healers. However, these custodians are decreasing in number due to death and other unforeseen occurrences. An Ethno-botanical survey was carried out to obtain information on the ethno medical values of wide range of plants used by the people of Gombe State, North-Eastern Nigeria, in the practice of healing and cure of typhoid (enteric) fever. Oral interviews were conducted so as to consider those with low literacy level who are involved in the practice of traditional medicine and thirty four (34) informants availed themselves for the interview and were consulted. All relevant information obtained from the respondents was recorded. A recent and valid nomenclature, along with local names, family names, part of the plant(s) used, methods of preparation and administration and fifty four (54) plant species belonging to 27 families as well as 7 unidentified species that are commonly used by the people of the state in ethnomedical treatment of the ailment were tabulated. Those interviewed included traditional practitioners, local herb sellers, traditional rulers, hunters, farmers and patients. Specific questions were asked and information supplied by informants was promptly documented. Results showed that the people of Gombe State are knowledgeable on herbal medicine in the treatment of diseases and ailments. Furthermore, the aqueous leaf extracts of Senna siamea, the plant species with the highest PPK (percentage of people who have knowledge about the use of a species for treating typhoid fever) in this ethnobotanical survey, was tested for its activity against clinical isolates of Salmonella typhi using the agar well diffusion method. The aqueous extracts showed some activity (zones of inhibition 11, 9, 7.5, 3.5, 1.3 mm) at 2000, 1800, 1600, 1400, 1200 µg/ml concentrations respectively. Preliminary phytochemical studies of the aqueous leaf extracts of the plant revealed the presence of secondary metabolites such as alkaloids, saponins, tannins, flavonoids and cardiac glycosides. Though a large number of traditionally used plants for the treatment of enteric fever were identified, further scientific validation of the traditional claims of anti-typhoid properties is imperative. This would establish their candidature for any possible future research for active principles and the possible development of new cheaper and more effective anti-typhoid drugs, as well as in the conservation of this rich diversity of medicinal plants.

Keywords: antimicrobial activities, ethnobotany, gombe state, north-eastern Nigeria, phytochemical screening, senna siamea, typhoid fever

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1159 Determinants of Utilization of Information and Communication Technology by Lecturers at Kenya Medical Training College, Nairobi

Authors: Agnes Anyango Andollo, Jane Achieng Achola

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The use of Information and Communication Technologies (ICTs) has become one of the driving forces in facilitation of learning in most colleges. The ability to effectively harness the technology varies from college to college. The study objective was to determine the lecturers’, institutional attributes and policies that influence the utilization of ICT by the lecturers’. A cross sectional survey design was employed in order to empirically investigate the extent to which lecturers’ personal, institutional attributes and policies influence the utilization of ICT to facilitate learning. The target population of the study was 295 lecturers who facilitate learning at KMTC-Nairobi. Structured self-administered questionnaire was given to the lecturers. Quantitative data was scrutinized for completeness, accuracy and uniformity then coded. Data were analyzed in frequencies and percentages using Statistical Package for Social Sciences (SPSS) version 19, this was a reliable tool for quantitative data analysis. A total of 155 completed questionnaires administered were obtained from the respondents for the study that were subjected to analysis. The study found out that 93 (60%) of the respondents were male while 62 (40%) of the respondents were female. Individual’s educational level, age, gender and educational experience had the greatest impact on use of ICT. Lecturers’ own beliefs, values, ideas and thinking had moderate impact on use of ICT. And that institutional support by provision of resources for ICT related training such as internet, computers, laptops and projectors had moderate impact (p = 0.049) at 5% significant level on use of ICT. The study concluded that institutional attributes and ICT policy were keys to utilization of ICT by lecturers at KMTC Nairobi also mandatory policy on use of ICT by lecturers to facilitate learning was key. It recommended that policies should be put in place for Technical support to lecturers when in problem during utilization of ICT and also a mechanism should be put in place to make the use of ICT in teaching and learning mandatory.

Keywords: policy, computers education, medical training institutions, ICTs

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1158 Well-being of Parents of Children with Autism Spectrum Disorder or Developmental Coordination Disorder: Cross-Cultural and Cross-disorder Comparative Studies

Authors: Léa Chawki, Émilie Cappe

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Context: Nowadays, supporting parents of children with autism spectrum disorder (ASD) and helping them adjust to their child’s condition represents a core clinical and scientific necessity and is encouraged by the French National Strategy for Autism (2018). In France, ASD remains a challenging condition, causing distress, segregation and social stigma to concerned family members concerned by this handicap. The literature highlights that neurodevelopmental disorders in children, such as ASD, influence parental well-being. This impact could be different according to parents’ culture and the child’s particular disorder manifestation, such as developmental coordination disorder (DCC), for instance. Objectives: This present study aims to explore parental stress, anxiety and depressive symptoms, as well as the quality of life in parents of children with ASD or DCD, as well as the explicit individual, psychosocial and cultural factors of parental well-being. Methods: Participants will be recruited through diagnostic centers, child and specialized adolescent units, and organizations representing families with ASD and DCD. Our sample will include five groups of 150 parents: four groups of parents having children with ASD – one living in France, one in the US, one in Canada and the other in Lebanon – and one group of French parents of children with DCD. Self-evaluation measures will be filled directly by parents in order to measure parental stress, anxiety and depressive symptoms, quality of life, coping and emotional regulation strategies, internalized stigma, perceived social support, the child’s problem behaviors severity, as well as motor coordination deficits in children with ASD and DCD. A sociodemographic questionnaire will help collect additional useful data regarding participants and their children. Individual and semi-structured research interviews will be conducted to complete quantitative data by further exploring participants’ distinct experiences related to parenting a child with a neurodevelopmental disorder. An interview grid, specially designed for the needs of this study, will strengthen the comparison between the experiences of parents of children with ASD with those of parents of children with DCD. It will also help investigate cultural differences regarding parent support policies in the context of raising a child with ASD. Moreover, interviews will help clarify the link between certain research variables (behavioral differences between ASD and DCD, family leisure activities, family and children’s extracurricular life, etc.) and parental well-being. Research perspectives: Results of this study will provide a more holistic understanding of the roles of individual, psychosocial and cultural variables related to parental well-being. Thus, this study will help direct the implementation of support services offered to families of children with neurodevelopmental disorders (ASD and DCD). Also, the implications of this study are essential in order to guide families through changes related to public policies assisting neurodevelopmental disorders and other disabilities. The between-group comparison (ASD and DCD) is also expected to help clarify the origins of all the different challenges encountered by those families. Hence, it will be interesting to investigate whether complications perceived by parents are more likely to arise from child-symptom severity, or from the lack of support obtained from health and educational systems.

Keywords: Autism spectrum disorder, cross-cultural, cross-disorder, developmental coordination delay, well-being

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1157 Remedying the Scourge of Poverty as a Social Problem: The Islamic Perspective

Authors: Maryam Umar Ladan, Arshad Munir

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Poverty has always been a constant feature of society throughout history. It has existed in the lives of people and it is a fact that although the majority of people lives in poverty, the remaining minority lives in luxury. While some countries called the first World countries lives in luxury, the third World countries lives in poverty. It remains an undesirable phenomenon affecting a vast number of people across the globe despite governmental, institutional and private organizations’ interventions with measures aimed at cushioning its adverse effects. Unequal distribution of societal resources, accumulated wealth in the hands of few, lack of access to education and employment, individual responsibility among others, were highlighted as factors associated with poverty. Poverty predisposes the poor individual to malnutrition and starvation, exposure to disease, thereby resulting to violence, crimes, and experiencing lifelong problems. Evidence show that about 50 percent of the world population lives on less than 2.50 dollar a day, 90 percent of whom are from Sub-Saharan Africa and South Asia including countries where Islam is the major if not one adherent religion. As a solution to poverty, Islam prescribes a system of annual Zakat (charity). The Islamic law prescribes that every person who has a saving that reaches a certain limit should give out 2.5 percent of the total annual earning (as in income, money, farm produce) to deserving and prescribed citizens. This is to, among others; reduce the level of inequality through distribution of wealth among the Muslim Ummah (community). Furthermore, Islam encourages the rich in several places in the Qur’an to spend their wealth on poor people other than the compulsory 2.5%. Therefore, it is inarguable that the Islamic system of distribution of resources (as zakat) is the best strategy to poverty eradication. Thus, strongly recommended for desired results in poverty eradication efforts. If every rich person gives Zakat sincerely, poverty will be eradicated in the world, and not a single person will die of want of food or material things.

Keywords: Islam, charity, poverty, zakat

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1156 The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) Process: An Audit of Its Utilisation on a UK Tertiary Specialist Intensive Care Unit

Authors: Gokulan Vethanayakam, Daniel Aston

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Introduction: The ReSPECT process supports healthcare professionals when making patient-centered decisions in the event of an emergency. It has been widely adopted by the NHS in England and allows patients to express thoughts and wishes about treatments and outcomes that they consider acceptable. It includes (but is not limited to) cardiopulmonary resuscitation decisions. ReSPECT conversations should ideally occur prior to ICU admission and should be documented in the eight sections of the nationally-standardised ReSPECT form. This audit evaluated the use of ReSPECT on a busy cardiothoracic ICU in an NHS Trust where established policies advocating its use exist. Methods: This audit was a retrospective review of ReSPECT forms for a sample of high-risk patients admitted to ICU at the Royal Papworth Hospital between January 2021 and March 2022. Patients all received one of the following interventions: Veno-Venous Extra-Corporeal Membrane Oxygenation (VV-ECMO) for severe respiratory failure (retrieved via the national ECMO service); cardiac or pulmonary transplantation-related surgical procedures (including organ transplants and Ventricular Assist Device (VAD) implantation); or elective non-transplant cardiac surgery. The quality of documentation on ReSPECT forms was evaluated using national standards and a graded ranking tool devised by the authors which was used to assess narrative aspects of the forms. Quality was ranked as A (excellent) to D (poor). Results: Of 230 patients (74 VV-ECMO, 104 transplant, 52 elective non-transplant surgery), 43 (18.7%) had a ReSPECT form and only one (0.43%) patient had a ReSPECT form completed prior to ICU admission. Of the 43 forms completed, 38 (88.4%) were completed due to the commencement of End of Life (EoL) care. No non-transplant surgical patients included in the audit had a ReSPECT form. There was documentation of balance of care (section 4a), CPR status (section 4c), capacity assessment (section 5), and patient involvement in completing the form (section 6a) on all 43 forms. Of the 34 patients assessed as lacking capacity to make decisions, only 22 (64.7%) had reasons documented. Other sections were variably completed; 29 (67.4%) forms had relevant background information included to a good standard (section 2a). Clinical guidance for the patient (section 4b) was given in 25 (58.1%), of which 11 stated the rationale that underpinned it. Seven forms (16.3%) contained information in an inappropriate section. In a comparison of ReSPECT forms completed ahead of an EoL trigger with those completed when EoL care began, there was a higher number of entries in section 3 (considering patient’s values/fears) that were assessed at grades A-B in the former group (p = 0.014), suggesting higher quality. Similarly, forms from the transplant group contained higher quality information in section 3 than those from the VV-ECMO group (p = 0.0005). Conclusions: Utilisation of the ReSPECT process in high-risk patients is yet to be well-adopted in this trust. Teams who meet patients before hospital admission for transplant or high-risk surgery should be encouraged to engage with the ReSPECT process at this point in the patient's journey. VV-ECMO retrieval teams should consider ReSPECT conversations with patients’ relatives at the time of retrieval.

Keywords: audit, critical care, end of life, ICU, ReSPECT, resuscitation

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1155 Assessing P0.1 and Occlusion Pressures in Brain-Injured Patients on Pressure Support Ventilation: A Study Protocol

Authors: S. B. R. Slagmulder

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Monitoring inspiratory effort and dynamic lung stress in patients on pressure support ventilation in the ICU is important for protecting against self inflicted lung injury (P-SILI) and diaphragm dysfunction. Strategies to address the detrimental effects of respiratory drive and effort can lead to improved patient outcomes. Two non-invasive estimation methods, occlusion pressure (Pocc) and P0.1, have been proposed for achieving lung and diaphragm protective ventilation. However, their relationship and interpretation in neuro ICU patients is not well understood. P0.1 is the airway pressure measured during a 100-millisecond occlusion of the inspiratory port. It reflects the neural drive from the respiratory centers to the diaphragm and respiratory muscles, indicating the patient's respiratory drive during the initiation of each breath. Occlusion pressure, measured during a brief inspiratory pause against a closed airway, provides information about the inspiratory muscles' strength and the system's total resistance and compliance. Research Objective: Understanding the relationship between Pocc and P0.1 in brain-injured patients can provide insights into the interpretation of these values in pressure support ventilation. This knowledge can contribute to determining extubation readiness and optimizing ventilation strategies to improve patient outcomes. The central goal is to asses a study protocol for determining the relationship between Pocc and P0.1 in brain-injured patients on pressure support ventilation and their ability to predict successful extubation. Additionally, comparing these values between brain-damaged and non-brain-damaged patients may provide valuable insights. Key Areas of Inquiry: 1. How do Pocc and P0.1 values correlate within brain injury patients undergoing pressure support ventilation? 2. To what extent can Pocc and P0.1 values serve as predictive indicators for successful extubation in patients with brain injuries? 3. What differentiates the Pocc and P0.1 values between patients with brain injuries and those without? Methodology: P0.1 and occlusion pressures are standard measurements for pressure support ventilation patients, taken by attending doctors as per protocol. We utilize electronic patient records for existing data. Unpaired T-test will be conducted to compare P0.1 and Pocc values between both study groups. Associations between P0.1 and Pocc and other study variables, such as extubation, will be explored with simple regression and correlation analysis. Depending on how the data evolve, subgroup analysis will be performed for patients with and without extubation failure. Results: While it is anticipated that neuro patients may exhibit high respiratory drive, the linkage between such elevation, quantified by P0.1, and successful extubation remains unknown The analysis will focus on determining the ability of these values to predict successful extubation and their potential impact on ventilation strategies. Conclusion: Further research is pending to fully understand the potential of these indices and their impact on mechanical ventilation in different patient populations and clinical scenarios. Understanding these relationships can aid in determining extubation readiness and tailoring ventilation strategies to improve patient outcomes in this specific patient population. Additionally, it is vital to account for the influence of sedatives, neurological scores, and BMI on respiratory drive and occlusion pressures to ensure a comprehensive analysis.

Keywords: brain damage, diaphragm dysfunction, occlusion pressure, p0.1, respiratory drive

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1154 Indoor Air Quality Analysis for Renovating Building: A Case Study of Student Studio, Department of Landscape, Chiangmai, Thailand

Authors: Warangkana Juangjandee

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The rapidly increasing number of population in the limited area creates an effect on the idea of the improvement of the area to suit the environment and the needs of people. Faculty of architecture Chiang Mai University is also expanding in both variety fields of study and quality of education. In 2020, the new department will be introduced in the faculty which is Department of Landscape Architecture. With the limitation of the area in the existing building, the faculty plan to renovate some parts of its school for anticipates the number of students who will join the program in the next two years. As a result, the old wooden workshop area is selected to be renovated as student studio space. With such condition, it is necessary to study the restriction and the distinctive environment of the site prior to the improvement in order to find ways to manage the existing space due to the fact that the primary functions that have been practiced in the site, an old wooden workshop space and the new function, studio space, are too different. 72.9% of the annual times in the room are considered to be out of the thermal comfort condition with high relative humidity. This causes non-comfort condition for occupants which could promote mould growth. This study aims to analyze thermal comfort condition in the Landscape Learning Studio Area for finding the solution to improve indoor air quality and respond to local conditions. The research methodology will be in two parts: 1) field gathering data on the case study 2) analysis and finding the solution of improving indoor air quality. The result of the survey indicated that the room needs to solve non-comfort condition problem. This can be divided into two ways which are raising ventilation and indoor temperature, e.g. improving building design and stack driven ventilation, using fan for enhancing more internal ventilation.

Keywords: relative humidity, renovation, temperature, thermal comfort

Procedia PDF Downloads 195
1153 Improving English by Reading Local Literature: The Case for Thai Primary Children

Authors: Wipada Prasansaph

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The aim of this research is twofold: to develop a local literature (simplified English translation version) reading booklet for Thai primary school children (the fourth graders) and to encourage the love of reading in English by reading local literature. An excerpt from Thai literature namely Phra-apaimani, the reading requirement for Primary 4 was selected to be translated into English in simplified language with cartoon pictures to illustrate the key happenings of the story. After the first draft of the booklet development, the samples of the booklets were distributed to 3 educator experts to call for validity and comments on 1) the appropriateness of the English language, 2) the organization of the booklet, 3) the comprehension of the story, and 4) the relevance to the core curriculum of Basic Education of Thailand (B.E.2551). The IOC (Index of Item – Objective Congruence) was 0.9 indicated that the material is applicable (with some comments and suggestions). After the first amendment, the booklets were distributed to 30 fourth graders (in 3 schools – 10 in each school), 10 English teachers of Primary 4, and 10 educational supervisors for English subjects (in primary level) to call for comments on 1) the comprehension of the story 2) the organization of the booklet, and 3) the encouragement for the love of reading in English. The English reading booklet on Phra-apaimani for Thai primary children, the IOC questionnaire (with the open-ended questions) for the educator experts, and the rating scales for the students, the teachers, and the educational supervisors were used as the instruments of the research. The findings revealed that most students rated ‘positive’ level for the comprehension of the story, while the teachers and the educational supervisors rated ‘highly positive’. The 3 groups rated ‘highly positive’ for both the organization of the booklet and for the encouragement for the love of reading in English. It is recommended that there should be more production of English reading texts for children, especially the texts that children already have some background knowledge. Moreover, illustration is the most crucial part for the children’s reading texts.

Keywords: English language, reading skill, primary children, Thai literature

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1152 Swift Rising Pattern of Emerging Construction Technology Trends in the Construction Management

Authors: Gayatri Mahajan

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Modern Construction Technology (CT) includes a broad range of advanced techniques and practices that bound the recent developments in material technology, design methods, quantity surveying, facility management, services, structural analysis and design, and other management education. Adoption of recent digital transformation technology is the need of today to speed up the business and is also the basis of construction improvement. Incorporating and practicing the technologies such as cloud-based communication and collaboration solution, Mobile Apps and 5G,3D printing, BIM and Digital Twins, CAD / CAM, AR/ VR, Big Data, IoT, Wearables, Blockchain, Modular Construction, Offsite Manifesting, Prefabrication, Robotic, Drones and GPS controlled equipment expedite the progress in the Construction industry (CI). Resources used are journaled research articles, web/net surfing, books, thesis, reports/surveys, magazines, etc. The outline of the research organization for this study is framed at four distinct levels in context to conceptualization, resources, innovative and emerging trends in CI, and better methods for completion of the construction projects. The present study conducted during 2020-2022 reveals that implementing these technologies improves the level of standards, planning, security, well-being, sustainability, and economics too. Application uses, benefits, impact, advantages/disadvantages, limitations and challenges, and policies are dealt with to provide information to architects and builders for smooth completion of the project. Results explain that construction technology trends vary from 4 to 15 for CI, and eventually, it reaches 27 for Civil Engineering (CE). The perspective of the most recent innovations, trends, tools, challenges, and solutions is highly embraced in the field of construction. The incorporation of the above said technologies in the pandemic Covid -19 and post-pandemic might lead to a focus on finding out effective ways to adopt new-age technologies for CI.

Keywords: BIM, drones, GPS, mobile apps, 5G, modular construction, robotics, 3D printing

Procedia PDF Downloads 88
1151 Training for Digital Manufacturing: A Multilevel Teaching Model

Authors: Luís Rocha, Adam Gąska, Enrico Savio, Michael Marxer, Christoph Battaglia

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The changes observed in the last years in the field of manufacturing and production engineering, popularly known as "Fourth Industry Revolution", utilizes the achievements in the different areas of computer sciences, introducing new solutions at almost every stage of the production process, just to mention such concepts as mass customization, cloud computing, knowledge-based engineering, virtual reality, rapid prototyping, or virtual models of measuring systems. To effectively speed up the production process and make it more flexible, it is necessary to tighten the bonds connecting individual stages of the production process and to raise the awareness and knowledge of employees of individual sectors about the nature and specificity of work in other stages. It is important to discover and develop a suitable education method adapted to the specificities of each stage of the production process, becoming an extremely crucial issue to exploit the potential of the fourth industrial revolution properly. Because of it, the project “Train4Dim” (T4D) intends to develop complex training material for digital manufacturing, including content for design, manufacturing, and quality control, with a focus on coordinate metrology and portable measuring systems. In this paper, the authors present an approach to using an active learning methodology for digital manufacturing. T4D main objective is to develop a multi-degree (apprenticeship up to master’s degree studies) and educational approach that can be adapted to different teaching levels. It’s also described the process of creating the underneath methodology. The paper will share the steps to achieve the aims of the project (training model for digital manufacturing): 1) surveying the stakeholders, 2) Defining the learning aims, 3) producing all contents and curriculum, 4) training for tutors, and 5) Pilot courses test and improvements.

Keywords: learning, Industry 4.0, active learning, digital manufacturing

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1150 Women Entrepreneuship in Croatia: Issues and Policies

Authors: Marko Kolakovic, Mihaela Mikic, Martina Taborin

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Women entrepreneurship is often regarded as the unused economical potential in many countries, including Republic of Croatia. Although women represent a majority in the population, they are still a minority in the field of entrepreneurship and face many challenges in fulfilling their entrepreneurship potential. The reasons are often hided in historical distorted perceptions about value, credibility, competitiveness, responsibility and knowledge which women have, or can have. This is significant for at least two reasons. First, in terms of global economic crisis, the economy needs more quality, more skilled and educated people willing to face entrepreneurial challenges and create new jobs, new opportunities and higher living standards. Second, in the entrepreneurial activity, women finally have a chance to highlight their own abilities, such as knowledge, relentless work, organizational skills, communication and negotiation skills, responsibility, flexibility, etc., in order to insure their economic independence, for a better social position, and to increase confidence and faith in their own abilities. This paper empirically analyses characteristics of women entrepreneurship in Croatia and conducted policies for it improvement. An empirical research was conducted with the goal of discovering real life experiences and attitudes of Croatian women entrepreneurs. Results show that Croatian women entrepreneurs are usually highly educated, have previous work experience and operate in service sector, due to lower need for start-up capital. The biggest obstacle on their entrepreneurial path represents government bureaucracy. Although the number of women entrepreneurs is rising today and the gap between male and women entrepreneurs in Croatia, as well as women entrepreneurship levels lower than the European average, we believe that there is still a long way to reach potential and successful women entrepreneurship development. Research showed that by breaking down the barriers as access to finance, education investments, knowledge, skills and confidence development, women will be able to accomplish more significant and more efficient entrepreneurial outcome.

Keywords: Croatia, policy, SMEs, women entrepreneurial strategy, women entrepreneurship

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1149 Genetic Polymorphism and Insilico Study Epitope Block 2 MSP1 Gene of Plasmodium falciparum Isolate Endemic Jayapura

Authors: Arsyam Mawardi, Sony Suhandono, Azzania Fibriani, Fifi Fitriyah Masduki

Abstract:

Malaria is an infectious disease caused by Plasmodium sp. This disease has a high prevalence in Indonesia, especially in Jayapura. The vaccine that is currently being developed has not been effective in overcoming malaria. This is due to the high polymorphism in the Plasmodium genome especially in areas that encode Plasmodium surface proteins. Merozoite Surface Protein 1 (MSP1) Plasmodium falciparum is a surface protein that plays a role in the invasion process in human erythrocytes through the interaction of Glycophorin A protein receptors and sialic acid in erythrocytes with Reticulocyte Binding Proteins (RBP) and Duffy Adhesion Protein (DAP) ligands in merozoites. MSP1 can be targeted to be a specific antigen and predicted epitope area which will be used for the development of diagnostic and malaria vaccine therapy. MSP1 consists of 17 blocks, each block is dimorphic, and has been marked as the K1 and MAD20 alleles. Exceptions only in block 2, because it has 3 alleles, among others K1, MAD20 and RO33. These polymorphisms cause allelic variations and implicate the severity of patients infected P. falciparum. In addition, polymorphism of MSP1 in Jayapura isolates has not been reported so it is interesting to be further identified and projected as a specific antigen. Therefore, in this study, we analyzed the allele polymorphism as well as detected the MSP1 epitope antigen candidate on block 2 P. falciparum. Clinical samples of selected malaria patients followed the consecutive sampling method, examining malaria parasites with blood preparations on glass objects observed through a microscope. Plasmodium DNA was isolated from the blood of malarial positive patients. The block 2 MSP1 gene was amplified using PCR method and cloned using the pGEM-T easy vector then transformed to TOP'10 E.coli. Positive colonies selection was performed with blue-white screening. The existence of target DNA was confirmed by PCR colonies and DNA sequencing methods. Furthermore, DNA sequence analysis was done through alignment and formation of a phylogenetic tree using MEGA 6 software and insilico analysis using IEDB software to predict epitope candidate for P. falciparum. A total of 15 patient samples have been isolated from Plasmodium DNA. PCR amplification results show the target gene size about ± 1049 bp. The results of MSP1 nucleotide alignment analysis reveal that block 2 MSP1 genes derived from the sample of malarial patients were distributed in four different allele family groups, K1 (7), MAD20 (1), RO33 (0) and MSP1_Jayapura (10) alleles. The most commonly appears of the detected allele is MSP1_Jayapura single allele. There was no significant association between sex variables, age, the density of parasitemia and alel variation (Mann Whitney, U > 0.05), while symptomatic signs have a significant difference as a trigger of detectable allele variation (U < 0.05). In this research, insilico study shows that there is a new epitope antigen candidate from the MSP1_Jayapura allele and it is predicted to be recognized by B cells with 17 amino acid lengths in the amino acid sequence 187 to 203.

Keywords: epitope candidate, insilico analysis, MSP1 P. falciparum, polymorphism

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1148 Effectiveness of Simulation Resuscitation Training to Improve Self-Efficacy of Physicians and Nurses at Aga Khan University Hospital in Advanced Cardiac Life Support Courses Quasi-Experimental Study Design

Authors: Salima R. Rajwani, Tazeen Ali, Rubina Barolia, Yasmin Parpio, Nasreen Alwani, Salima B. Virani

Abstract:

Introduction: Nurses and physicians have a critical role in initiating lifesaving interventions during cardiac arrest. It is important that timely delivery of high quality Cardio Pulmonary Resuscitation (CPR) with advanced resuscitation skills and management of cardiac arrhythmias is a key dimension of code during cardiac arrest. It will decrease the chances of patient survival if the healthcare professionals are unable to initiate CPR timely. Moreover, traditional training will not prepare physicians and nurses at a competent level and their knowledge level declines over a period of time. In this regard, simulation training has been proven to be effective in promoting resuscitation skills. Simulation teaching learning strategy improves knowledge level, and skills performance during resuscitation through experiential learning without compromising patient safety in real clinical situations. The purpose of the study is to evaluate the effectiveness of simulation training in Advanced Cardiac Life Support Courses by using the selfefficacy tool. Methods: The study design is a quantitative research design and non-randomized quasi-experimental study design. The study examined the effectiveness of simulation through self-efficacy in two instructional methods; one is Medium Fidelity Simulation (MFS) and second is Traditional Training Method (TTM). The sample size was 220. Data was compiled by using the SPSS tool. The standardized simulation based training increases self-efficacy, knowledge, and skills and improves the management of patients in actual resuscitation. Results: 153 students participated in study; CG: n = 77 and EG: n = 77. The comparison was done between arms in pre and post-test. (F value was 1.69, p value is <0.195 and df was 1). There was no significant difference between arms in the pre and post-test. The interaction between arms was observed and there was no significant difference in interaction between arms in the pre and post-test. (F value was 0.298, p value is <0.586 and df is 1. However, the results showed self-efficacy scores were significantly higher within experimental group in post-test in advanced cardiac life support resuscitation courses as compared to Traditional Training Method (TTM) and had overall (p <0.0001) and F value was 143.316 (mean score was 45.01 and SD was 9.29) verses pre-test result showed (mean score was 31.15 and SD was 12.76) as compared to TTM in post-test (mean score was 29.68 and SD was 14.12) verses pre-test result showed (mean score was 42.33 and SD was 11.39). Conclusion: The standardized simulation-based training was conducted in the safe learning environment in Advanced Cardiac Life Suport Courses and physicians and nurses benefited from self-confidence, early identification of life-threatening scenarios, early initiation of CPR, and provides high-quality CPR, timely administration of medication and defibrillation, appropriate airway management, rhythm analysis and interpretation, and Return of Spontaneous Circulation (ROSC), team dynamics, debriefing, and teaching and learning strategies that will improve the patient survival in actual resuscitation.

Keywords: advanced cardiac life support, cardio pulmonary resuscitation, return of spontaneous circulation, simulation

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1147 Implementation of Real-World Learning Experiences in Teaching Courses of Medical Microbiology and Dietetics for Health Science Students

Authors: Miriam I. Jimenez-Perez, Mariana C. Orellana-Haro, Carolina Guzman-Brambila

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As part of microbiology and dietetics courses, students of medicine and nutrition analyze the main pathogenic microorganisms and perform dietary analyzes. The course of microbiology describes in a general way the main pathogens including bacteria, viruses, fungi, and parasites, as well as their interaction with the human species. We hypothesize that lack of practical application of the course causes the students not to find the value and the clinical application of it when in reality it is a matter of great importance for healthcare in our country. The courses of the medical microbiology and dietetics are mostly theoretical and only a few hours of laboratory practices. Therefore, it is necessary the incorporation of new innovative techniques that involve more practices and community fieldwork, real cases analysis and real-life situations. The purpose of this intervention was to incorporate real-world learning experiences in the instruction of medical microbiology and dietetics courses, in order to improve the learning process, understanding and the application in the field. During a period of 6 months, medicine and nutrition students worked in a community of urban poverty. We worked with 90 children between 4 and 6 years of age from low-income families with no access to medical services, to give an infectious diagnosis related to nutritional status in these children. We expect that this intervention would give a different kind of context to medical microbiology and dietetics students improving their learning process, applying their knowledge and laboratory practices to help a needed community. First, students learned basic skills in microbiology diagnosis test during laboratory sessions. Once, students acquired abilities to make biochemical probes and handle biological samples, they went to the community and took stool samples from children (with the corresponding informed consent). Students processed the samples in the laboratory, searching for enteropathogenic microorganism with RapID™ ONE system (Thermo Scientific™) and parasites using Willis and Malloy modified technique. Finally, they compared the results with the nutritional status of the children, previously measured by anthropometric indicators. The anthropometric results were interpreted by the OMS Anthro software (WHO, 2011). The microbiological result was interpreted by ERIC® Electronic RapID™ Code Compendium software and validated by a physician. The results were analyses of infectious outcomes and nutritional status. Related to fieldwork community learning experiences, our students improved their knowledge in microbiology and were capable of applying this knowledge in a real-life situation. They found this kind of learning useful when they translate theory to a real-life situation. For most of our students, this is their first contact as health caregivers with real population, and this contact is very important to help them understand the reality of many people in Mexico. In conclusion, real-world or fieldwork learning experiences empower our students to have a real and better understanding of how they can apply their knowledge in microbiology and dietetics and help a much- needed population, this is the kind of reality that many people live in our country.

Keywords: real-world learning experiences, medical microbiology, dietetics, nutritional status, infectious status.

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1146 Assessment of Environmental Implications of Rapid Population Growth on Land Use Dynamics: A Case Study of Eleme Local Government Area, Rivers State, Nigeria

Authors: Moses Obenade, Henry U. Okeke, Francis I. Okpiliya, Eugene J. Aniah

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Population growth in Eleme has been rapid over the past 75 years with its attendant pressure on the natural resources of the area. Between 1937 and 2006 the population of Eleme grew from 2,528 to 190,194 and is projected to be above 265,707 in 2016 based on an annual growth rate of 3.4%. Using the combined technologies of Geographic Information Systems (GIS), remote sensing (RS) and Demography techniques as its methodology, this paper examines the environmental implications of rapid population growth on land use dynamics in Eleme between 1986 and 2015. The study reveals that between 1986 and 2006, Built-up area and Farmland increased by 72.67 and 12.77% respectively, while light and thick vegetation recorded a decrease of -6.92 and -61.64% respectively. Water body remains fairly constant with minimal changes. Also, between 2006 and 2015 covering a period of 9 years, Built-up area further increased by 53% with an annual growth rate of 2.32 km2 gaining more land area on the detriment of other land uses. Built-up area has an annual growth rate of 2.32km2 and is expected to increase from 18.67km2 in 2006 to 41.87km2 in 2016.The observed Land used/Land cover dynamics is derived by the demographic characteristics of the Study area. Eleme has a total area of 138km2 out of which the Federal Government of Nigeria compulsorily acquired an estimated area of 59.34km2 for industrial purposes excluding acquisitions by the Rivers State Government. It is evident from the findings of this study that the carrying capacity of Eleme ecosystem is under threat due to the current population growth and land consumption rates. Therefore, measures such as use of appropriate technologies in farming techniques, waste management; investment in family planning and female empowerment, maternal health and education, afforestation programs; and amendment of Land Use Act of 1978 are recommended.

Keywords: population growth, Eleme, land use, GIS and remote sensing

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1145 Gendered Economic, Social, and Health Effects of the Mobile Health and Nutritional Services of the International Medical Corps (IMC) in Vulnerable Areas of Ethiopia

Authors: Abdela Zeinu Yasin

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The current research aimed to assess the status of IMC in providing treatment for malnourished children and programs in water, sanitation, and hygiene (WASH), food and livelihood security, and comprehensive healthcare through Mobile health and nutrition programs during the last 5 years period. We have conducted 60 in-depth interviews with women during the period from conception to a child’s birthday, health facility staff, and female community health volunteers (FCHVs), as well as 12 focus group discussions with health facility staff and other household decision-makers. We employed thematic analysis using framework matrices and analytical memorandums. The study revealed that 78% of the respondents, of whom 97% were women, have benefited from the selected vulnerable areas. The use of the clear water and sanitization program has reached the 81% of selected households. The use of a modern baby delivery system among the respondent has been 68% of the women and health facilities among the decision-makers/focal person. More than 8 in 10 participants (84%) could read and understand the health facility instructions, and the majority (82%) of women, health facility staff, and male decision-makers can also read and write bulletins and instructions. We found that decision-maker women preferred participative education, whereas health facilities and the IMC desired educational and motivational bulletins. A Mobile Health and Nutrition program intervention by the IMC is acceptable in the conditions of the Ethiopian community and has the potential to improve community health and nutrition service utilization, particularly by providing clean water and sanitization; women’s birth control, and health improvement in the vulnerable regions of the country. The current research findings shall contribute to text IMC Mobile Health and Nutritional intervention design in under-resourced settings.

Keywords: clean water, health and nutrition services, hygiene, IMC, mobile health, sanitation

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1144 Effectiveness of a Sports Nutrition Intervention for High-School Athletes: A Feasibility Study

Authors: Michael Ryan, Rosemary E. Borgerding, Kimberly L. Oliver

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The objective of this study was to assess the effectiveness of a sports nutrition intervention on body composition in high-school athletes. The study aimed to improve the food and water intake of high-school athletes, evaluate the cost-effectiveness of the intervention, and assess changes in body fat. Data were collected through observations, questionnaires, and interviews. Additionally, bioelectrical impedance analysis was performed to assess the body composition of athletes both before and after the intervention. Athletes (n=25) participated in researcher-monitored training sessions three times a week over the course of 12 weeks. During these sessions, in addition to completing their auxiliary sports training, participants were exposed to educational interventions aimed at improving their nutrition. These included discussions regarding current eating habits, nutritional guidelines for athletes, and individualized recommendations. Food was also made available to athletes for consumption before and after practice. Meals of balanced macronutrient composition were prepared and provided to athletes on four separate occasions throughout the intervention, either prior to or following a competitive event such as a tournament or game. A paired t-test was used to determine the statistical significance of the changes in body fat percentage. The results showed that there was a statistically significant difference between pre and post-intervention body fat percentage (p= .006). Cohen's d of 0.603 was calculated, indicating a moderate effect size. In conclusion, this study provides evidence that a sports nutrition intervention that combines food availability, explicit prescription, and education can be effective in improving the body composition of high-school athletes. However, it's worth noting that this study had a small sample size, and the conclusions cannot be generalized to a larger population. Further research is needed to assess the scalability of this study. This preliminary study demonstrated the feasibility of this type of nutritional intervention and laid the groundwork for a larger, more extensive study to be conducted in the future.

Keywords: bioelectrical impedance, body composition, high-school athletes, sports nutrition, sports pedagogy

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1143 Application of Discrete-Event Simulation in Health Technology Assessment: A Cost-Effectiveness Analysis of Alzheimer’s Disease Treatment Using Real-World Evidence in Thailand

Authors: Khachen Kongpakwattana, Nathorn Chaiyakunapruk

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Background: Decision-analytic models for Alzheimer’s disease (AD) have been advanced to discrete-event simulation (DES), in which individual-level modelling of disease progression across continuous severity spectra and incorporation of key parameters such as treatment persistence into the model become feasible. This study aimed to apply the DES to perform a cost-effectiveness analysis of treatment for AD in Thailand. Methods: A dataset of Thai patients with AD, representing unique demographic and clinical characteristics, was bootstrapped to generate a baseline cohort of patients. Each patient was cloned and assigned to donepezil, galantamine, rivastigmine, memantine or no treatment. Throughout the simulation period, the model randomly assigned each patient to discrete events including hospital visits, treatment discontinuation and death. Correlated changes in cognitive and behavioral status over time were developed using patient-level data. Treatment effects were obtained from the most recent network meta-analysis. Treatment persistence, mortality and predictive equations for functional status, costs (Thai baht (THB) in 2017) and quality-adjusted life year (QALY) were derived from country-specific real-world data. The time horizon was 10 years, with a discount rate of 3% per annum. Cost-effectiveness was evaluated based on the willingness-to-pay (WTP) threshold of 160,000 THB/QALY gained (4,994 US$/QALY gained) in Thailand. Results: Under a societal perspective, only was the prescription of donepezil to AD patients with all disease-severity levels found to be cost-effective. Compared to untreated patients, although the patients receiving donepezil incurred a discounted additional costs of 2,161 THB, they experienced a discounted gain in QALY of 0.021, resulting in an incremental cost-effectiveness ratio (ICER) of 138,524 THB/QALY (4,062 US$/QALY). Besides, providing early treatment with donepezil to mild AD patients further reduced the ICER to 61,652 THB/QALY (1,808 US$/QALY). However, the dominance of donepezil appeared to wane when delayed treatment was given to a subgroup of moderate and severe AD patients [ICER: 284,388 THB/QALY (8,340 US$/QALY)]. Introduction of a treatment stopping rule when the Mini-Mental State Exam (MMSE) score goes below 10 to a mild AD cohort did not deteriorate the cost-effectiveness of donepezil at the current treatment persistence level. On the other hand, none of the AD medications was cost-effective when being considered under a healthcare perspective. Conclusions: The DES greatly enhances real-world representativeness of decision-analytic models for AD. Under a societal perspective, treatment with donepezil improves patient’s quality of life and is considered cost-effective when used to treat AD patients with all disease-severity levels in Thailand. The optimal treatment benefits are observed when donepezil is prescribed since the early course of AD. With healthcare budget constraints in Thailand, the implementation of donepezil coverage may be most likely possible when being considered starting with mild AD patients, along with the stopping rule introduced.

Keywords: Alzheimer's disease, cost-effectiveness analysis, discrete event simulation, health technology assessment

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1142 Creative Skills Supported by Multidisciplinary Learning: Case Innovation Course at the Seinäjoki University of Applied Sciences

Authors: Satu Lautamäki

Abstract:

This paper presents findings from a multidisciplinary course (bachelor level) implemented at Seinäjoki University of Applied Sciences, Finland. The course aims to develop innovative thinking of students, by having projects given by companies, using design thinking methods as a tool for creativity and by integrating students into multidisciplinary teams working on the given projects. The course is obligatory for all first year bachelor students across four faculties (business and culture, food and agriculture, health care and social work, and technology). The course involves around 800 students and 30 pedagogical coaches, and it is implemented as an intensive one-week course each year. The paper discusses the pedagogy, structure and coordination of the course. Also, reflections on methods for the development of creative skills are given. Experts in contemporary, global context often work in teams, which consist of people who have different areas of expertise and represent various professional backgrounds. That is why there is a strong need for new training methods where multidisciplinary approach is at the heart of learning. Creative learning takes place when different parties bring information to the discussion and learn from each other. When students in different fields are looking for professional growth for themselves and take responsibility for the professional growth of other learners, they form a mutual learning relationship with each other. Multidisciplinary team members make decisions both individually and collectively, which helps them to understand and appreciate other disciplines. Our results show that creative and multidisciplinary project learning can develop diversity of knowledge and competences, for instance, students’ cultural knowledge, teamwork and innovation competences, time management and presentation skills as well as support a student’s personal development as an expert. It is highly recommended that higher education curricula should include various studies for students from different study fields to work in multidisciplinary teams.

Keywords: multidisciplinary learning, creative skills, innovative thinking, project-based learning

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1141 Personality, Coping, Quality of Life, and Distress in Persons with Hearing Loss: A Cross-Sectional Study of Patients Referred to an Audiological Service

Authors: Oyvind Nordvik, Peder O. L. Heggdal, Jonas Brannstrom, Flemming Vassbotn, Anne Kari Aarstad, Hans Jorgen Aarstad

Abstract:

Background: Hearing Loss (HL) is a condition that may affect people in all stages of life, but the prevalence increases with age, mostly because of age-related HL, generally referred to as presbyacusis. As human speech is related to relatively high frequencies, even a limited hearing loss at high frequencies may cause impaired speech intelligibility. Being diagnosed with, treated for and living with a chronic condition such as HL, must for many be a disabling and stressful condition that put ones coping resources to test. Stress is a natural part of life and most people will experience stressful events or periods. Chronic diseases, such as HL, are risk factor for distress in individuals, causing anxiety and lowered mood. How an individual cope with HL may be closely connected to the level of distress he or she is experiencing and to personality, which can be defined as those characteristics of a person that account for consistent patterns of feelings, thinking, and behavior. Thus, as to distress in life, such as illness or disease, available coping strategies may be more important than the challenge itself. The same line of arguments applies to level of experienced health-related quality of life (HRQoL). Aim: The aim of this study was to investigate the relationship between distress, HRQoL, reported hearing loss, personality and coping in patients with HL. Method: 158 adult (aged 18-78 years) patients with HL, referred for hearing aid (HA) fitting at Haukeland University Hospital in western Norway, participated in the study. Both first-time users, as well as patients referred for HA renewals were included. First-time users had been pre-examined by an ENT-specialist. The questionnaires were answered before the actual HA fitting procedure. The pure-tone average (PTA; frequencies 0.5, 1, 2, and 4 kHz) was determined for each ear. The Eysenck personality inventory, neuroticism and lie scales, the Theoretically Originated Measure of the Cognitive Activation Theory of Stress (TOMCATS) measuring active coping, hopelessness and helplessness, as well as distress (General Health Questionnaire (GHQ) - 12 items) and the EORTC Quality of Life Questionnaire general part were answered. In addition, we used a revised and shortened version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) as a measure of patient-reported hearing loss. Results: Significant correlations were determined between APHAB (weak), HRQoL scores (strong), distress scores (strong) on the one side and personality and choice of coping scores on the other side. As measured by stepwise regression analyses, the distress and HRQoL scores were scored secondary to the obtained personality and coping scores. The APHAB scores were as determined by regression analyses scored secondary to PTA (best ear), level of neuroticism and lie score. Conclusion: We found that reported employed coping style, distress/HRQoL and personality are closely connected to each other in this patient group. Patient-reported HL was associated to hearing level and personality. There is need for further investigations on these questions, and how these associations may influence the clinical context.

Keywords: coping, distress, hearing loss, personality

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