Search results for: analysis of quality factors
Commenced in January 2007
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Paper Count: 38806

Search results for: analysis of quality factors

29656 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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29655 A development of Innovator Teachers Training Curriculum to Create Instructional Innovation According to Active Learning Approach to Enhance learning Achievement of Private School in Phayao Province

Authors: Palita Sooksamran, Katcharin Mahawong

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This research aims to offer the development of innovator teachers training curriculum to create instructional innovation according to active learning approach to enhance learning achievement. The research and development process is carried out in 3 steps: Step 1 The study of the needs necessary to develop a training curriculum: the inquiry was conducted by a sample of teachers in private schools in Phayao province that provide basic education at the level of education. Using a questionnaire of 176 people, the sample was defined using a table of random numbers and stratified samples, using the school as a random layer. Step 2 Training curriculum development: the tools used are developed training curriculum and curriculum assessments, with nine experts checking the appropriateness of the draft curriculum. The statistic used in data analysis is the average ( ) and standard deviation (S.D.) Step 3 study on effectiveness of training curriculum: one group pretest/posttest design applied in this study. The sample consisted of 35 teachers from private schools in Phayao province. The participants volunteered to attend on their own. The results of the research showed that: 1.The essential demand index needed with the list of essential needs in descending order is the choice and create of multimedia media, videos, application for learning management at the highest level ,Developed of multimedia, video and applications for learning management and selection of innovative learning management techniques and methods of solve the problem Learning , respectively. 2. The components of the training curriculum include principles, aims, scope of content, training activities, learning materials and resources, supervision evaluation. The scope of the curriculum consists of basic knowledge about learning management innovation, active learning, lesson plan design, learning materials and resources, learning measurement and evaluation, implementation of lesson plans into classroom and supervision and motoring. The results of the evaluation of quality of the draft training curriculum at the highest level. The Experts suggestion is that the purpose of the course should be used words that convey the results. 3. The effectiveness of training curriculum 1) Cognitive outcomes of the teachers in creating innovative learning management was at a high level of relative gain score. 2) The assessment results of learning management ability according to the active learning approach to enhance learning achievement by assessing from 2 education supervisor as a whole were very high , 3) Quality of innovation learning management based on active learning approach to enhance learning achievement of the teachers, 7 instructional Innovations were evaluated as outstanding works and 26 instructional Innovations passed the standard 4) Overall learning achievement of students who learned from 35 the sample teachers was at a high level of relative gain score 5) teachers' satisfaction towards the training curriculum was at the highest level.

Keywords: training curriculum, innovator teachers, active learning approach, learning achievement

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29654 Treatment Outcome of Cutaneous Leishmaniasis and Its Associated Factors among Admitted Patients in All Africa Leprosy Rehabilitation and Training Center Hospital, Ethiopia

Authors: Kebede Mairie, Getahun Belete, Mitike Abeba

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Background: Leishmania aethiopica is a peculiar parasite causing cutaneous leishmaniasis in Ethiopia and its mainstay treatment is Sodium Stibogluconate. However, its treatment outcome in Ethiopia is not well documented. Objectives: To determine the treatment outcome of admitted cutaneous leishmaniasis patients and its associated factors in Addis Ababa, Ethiopia. Methods: A retrospective study was conducted from 1st November 2021 to 30th March 2022. Medical records of all cutaneous leishmaniasis-diagnosed and admitted patients who received parenteral sodium stibogluconate at All Africa Leprosy Rehabilitation and Training Center (ALERT) hospital, the main Leishmania treatment center in Ethiopia from July 2011 to September 2021 were reviewed. Results: A total of 827 charts of admitted cases from July 2011 to September 2021 were retrieved, but 667 (80.65%) were reviewed. Improvement in the treatment outcome was recorded in 93.36 % in the first course of SSG treatment and 96.23%, 94.62%, and 96.97% subsequently in the second, third and fourth treatment courses, respectively. Female gender and diffuse cutaneous leishmaniasis were the two predictive determinants in the treatment of cutaneous leishmaniasis. Conclusion: The study shows that parenteral sodium stibogluconate therapy treats hospitalized cutaneous leishmaniasis patients well, with female gender and diffuse cutaneous leishmaniasis having poor outcomes suggesting the need for a different approach for diffuse cutaneous leishmaniasis patients.

Keywords: cutaneous leishmaniasis, leishmania aethiopica, sodium stibogluconate, diffuse cutaneous leishmaniasis, pentostam

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29653 Tolerance of Some Warm Season Turfgrasses to Compaction under Shade and Sunlight Conditions of Riyadh, Saudi Arabia

Authors: Mohammed A. Al-Yafrsi, Fahed A. Al-Mana

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A study was conducted to evaluate the compaction-tolerance ability of some warm season turfgrasses under shade and sunlight conditions in Riyadh, Saudi Arabia. Hybrid bermudagrass (Cynodon dactylon): 'Tifway' and 'Tifsport', seashore paspalum (Paspalum vaginatum) and its cultivar 'Sea Isle 2000' were used. The study area was divided into two sections where one was exposed to sunlight and the other one was maintained under shade using green plastic grille (shade 70%). Turfgrasses were planted by sods in beds containing a mixture of sand, silt, and peat moss (4: 1: 1, v/v). The soil compaction was applied using a locally-made cylindrical roll (weighing 250 kg), passing four times over the growing turfgrasses for 3 days/week. The results revealed that compaction treatment led to a decrease in grass height, and it was the lowest (4.0 cm) for paspalum 'Sea Isle 2000' in February. At the shaded area, paspalum turfgrasses retained its high quality degree (4.0) in April, May, and June. In the sunlight area, the grass quality degree was the greatest (4.0) in 'Sea Isle 2000' and the lowest (3.0) in 'Tifsport'. Paspalum turfgrasses gave higher color degree (4) than bermuda grasses (2.5) in April, May, and June. The compaction also led to a decline in leaf area, fresh and dry weights of all grown turfgrasses. The grass density was high for paspalum turfgrasses indicating that their resistance to compaction was greater than bermudagrasses. It can be concluded that the best compaction and shade tolerant turfgrasses are 'Sea Isle 2000' and seashore paspalum.

Keywords: hybrid bermudagrass, seashore paspalum, soil compaction, shade area, sunlight condition

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29652 Cultural Background as Moderator of the Association Between Personal Bonding Social Capital and Well-Being: An Association Study in a Sample of Dutch and Turkish Older Adults in the Netherlands

Authors: Marianne Simons, Sinan Kurt, Marjolein Stefens, Kai Karos, Johan Lataster

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As cultural diversity within older populations in European countries increases, the role of cultural background should be taken account of in aging studies. Bonding social capital (BSC), containing someone’s socio-emotional resources, is recognised as an important ingredient for wellbeing in old age and found to be associated with someone’s cultural background. The current study examined the association between BSC, loneliness and wellbeing in a sample including older Turkish migrants with a collectivistic cultural background and native Dutch older adults, both living in the Netherlands, characterised by an individualistic culture. A sample of 119 Turkish migrants (64.7% male; age 65-87, M(SD)=71.13(5.04) and 124 native Dutch adults (32.3% male, age 65-94, M(SD)= 71.9(5.32) filled out either an online or printed questionnaire measuring BSC, psychological, social and emotional well-being, loneliness and relevant demographic covariates. Regression analysis - including confounders age, gender, level of education, physical health and relationship - showed positive associations between BSC and respectively emotional, social and psychological well-being and a negative association with loneliness in both samples. Moderation analyses showed that these associations were significantly stronger for the Turkish older migrants than for their native peers. Measurement invariance analysis indicated partial metric invariance for the measurement of BSC and loneliness and non-invariance for wellbeing, calling for caution comparing means between samples. The results stress the importance of BSC for wellbeing of older migrants from collectivistic cultures living in individualistic countries. Previous research, shows a trend of older migrants displaying lower levels of BSC as well as associated variables, such as education, physical health, and financial income. This calls for more research of the interplay between demographic and psychosocial factors restraining mental wellbeing of older migrant populations. Measurement invariance analyses further emphasize the importance of taking cultural background into account in positive aging studies.

Keywords: positive aging, cultural background, wellbeing, social capital, loneliness

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29651 Variability of the Snowline Altitude at Different Region in the Eastern Tibetan Plateau in Recent 20 Years

Authors: Zhen Li, Chang Liu, Ping Zhang

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These Glaciers are thought of as natural water reservoirs and are of vital importance to hydrological models and industrial production, and glacial changes act as significant indicators of climate change. The glacier snowline can be used as an indicator of the equilibrium line, which may be a key parameter to study the effect of climate change on glaciers. Using Google Earth Engine, we select optical satellite imageries and implement the Otsu thresholding method on a near-infrared band to detect snowline altitudes (SLAs) of 26 glaciers in three regions of the eastern Tibetan Plateau. Three different study regions in the eastern Tibetan Plateau have different climate regimes, which are Sepu Kangri (SK, maritime glacier), Bu’Gyai Kangri (BK, continental glacier) and west of Qiajajima (WQ, continental glacier), along a latitudinal transect from south to north. We analyzed the effects of climatic factors on the SLA changes from 1995 to 2016. SLAs are fluctuating upward, and the rising values are 100 m, 60 m, and 34 m from south to north during the 22 years. We also observed that the climatic factor that affects the variability of SLA gradually changes from precipitation to temperature from south to north. The northern continental glaciers are mainly affected by temperature, and the southern maritime glaciers affected by precipitation. Owing to the influence of primary climatic factors, continental glaciers are found to have higher SLAs on the south slope, while maritime glaciers have higher SLAs on the north slope.

Keywords: climate change, glacier, snowline altitude, tibetan plateau

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29650 Spatial Climate Changes in the Province of Macerata, Central Italy, Analyzed by GIS Software

Authors: Matteo Gentilucci, Marco Materazzi, Gilberto Pambianchi

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Climate change is an increasingly central issue in the world, because it affects many of human activities. In this context regional studies are of great importance because they sometimes differ from the general trend. This research focuses on a small area of central Italy which overlooks the Adriatic Sea, the province of Macerata. The aim is to analyze space-based climate changes, for precipitation and temperatures, in the last 3 climatological standard normals (1961-1990; 1971-2000; 1981-2010) through GIS software. The data collected from 30 weather stations for temperature and 61 rain gauges for precipitation were subject to quality controls: validation and homogenization. These data were fundamental for the spatialization of the variables (temperature and precipitation) through geostatistical techniques. To assess the best geostatistical technique for interpolation, the results of cross correlation were used. The co-kriging method with altitude as independent variable produced the best cross validation results for all time periods, among the methods analysed, with 'root mean square error standardized' close to 1, 'mean standardized error' close to 0, 'average standard error' and 'root mean square error' with similar values. The maps resulting from the analysis were compared by subtraction between rasters, producing 3 maps of annual variation and three other maps for each month of the year (1961/1990-1971/2000; 1971/2000-1981/2010; 1961/1990-1981/2010). The results show an increase in average annual temperature of about 0.1°C between 1961-1990 and 1971-2000 and 0.6 °C between 1961-1990 and 1981-2010. Instead annual precipitation shows an opposite trend, with an average difference from 1961-1990 to 1971-2000 of about 35 mm and from 1961-1990 to 1981-2010 of about 60 mm. Furthermore, the differences in the areas have been highlighted with area graphs and summarized in several tables as descriptive analysis. In fact for temperature between 1961-1990 and 1971-2000 the most areally represented frequency is 0.08°C (77.04 Km² on a total of about 2800 km²) with a kurtosis of 3.95 and a skewness of 2.19. Instead, the differences for temperatures from 1961-1990 to 1981-2010 show a most areally represented frequency of 0.83 °C, with -0.45 as kurtosis and 0.92 as skewness (36.9 km²). Therefore it can be said that distribution is more pointed for 1961/1990-1971/2000 and smoother but more intense in the growth for 1961/1990-1981/2010. In contrast, precipitation shows a very similar shape of distribution, although with different intensities, for both variations periods (first period 1961/1990-1971/2000 and second one 1961/1990-1981/2010) with similar values of kurtosis (1st = 1.93; 2nd = 1.34), skewness (1st = 1.81; 2nd = 1.62 for the second) and area of the most represented frequency (1st = 60.72 km²; 2nd = 52.80 km²). In conclusion, this methodology of analysis allows the assessment of small scale climate change for each month of the year and could be further investigated in relation to regional atmospheric dynamics.

Keywords: climate change, GIS, interpolation, co-kriging

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29649 The Impact of Two Factors on EFL Learners' Fluency

Authors: Alireza Behfar, Mohammad Mahdavi

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Nowadays, in the light of progress in the world of science, technology and communications, mastery of learning international languages is a sure and needful matter. In learning any language as a second language, progress and achieving a desirable level in speaking is indeed important for approximately all learners. In this research, we find out how preparation can influence L2 learners' oral fluency with respect to individual differences in working memory capacity. The participants consisted of sixty-one advanced L2 learners including MA students of TEFL at Isfahan University as well as instructors teaching English at Sadr Institute in Isfahan. The data collection consisted of two phases: A working memory test (reading span test) and a picture description task, with a one-month interval between the two tasks. Speaking was elicited through speech generation task in which the individuals were asked to discuss four topics emerging in two pairs. The two pairs included one simple and one complex topic and was accompanied by planning time and without any planning time respectively. Each topic was accompanied by several relevant pictures. L2 fluency was assessed based on preparation. The data were then analyzed in terms of the number of syllables, the number of silent pauses, and the mean length of pauses produced per minute. The study offers implications for strategies to improve learners’ both fluency and working memory.

Keywords: two factors, fluency, working memory capacity, preparation, L2 speech production reading span test picture description

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29648 Prediction of the Factors Influencing the Utilization of HIV Testing among Young People Aged between 17-25 Years in Saudi Arabia

Authors: Abdullah Almilaibary, Jeremy Jolley, Mark Hayter

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Background: Despite recent progress in enhancing the accessibility of HIV-related health services worldwide, opportunities to diagnose patients are often missed due to genuine barriers at different levels. The aim of the study is to explore the factors that affect the utilization of HIV testing services by young people aged 17-25 in Saudi Arabia. Methods: A non-experimental descriptive cross-sectional design was used to predict factors that influenced HIV testing among Umm- Al Qura University students aged 17-25 years. A newly developed self-completed online questionnaire was used and the study sample was drawn using a convenience sampling technique. The questionnaire consisted of 52 items divided into three scales: 12 items for HIV/AIDS-related knowledge, 3 items for risk perception, and 37 items for attitudes toward HIV testing. Five experts in the field of HIV/AIDS validated the contents of the questionnaire and agreed that the items included were related to the construct being measured. The reliability of the questionnaire was also assessed using a test/re-test strategy with 27 participants recruited from the population under study. The reliability assessment revealed that the questionnaire was consistent as Cronbach’s Alpha was 0.80 for HIV/ADS knowledge, 0.88 for risk perception and 0.78 for attitudes towards HIV testing. The data were collected between 14th of July and 14th of October 2014. Results: 394 participants completed the questionnaires: 116 (29.4%) male and 278 (70%) female. 50.5% of the participants were aged 20 to 22 years, 34.8% were 17-19 years and 14.7% were aged between 23-25 years; about 93% of the participants were single. Only 20 (6%) participants had previously been tested for HIV. The main reasons for not being tested for HIV were: exposure to HIV was considered unlikely (48%), HIV test was not offered (36%) and unawareness of HIV testing centres (16%). On HIV/AIDS-related knowledge, the male participants scored higher than the females as the mean score for males was (M = 6.4, SD = 2.4) while for females it was (M 5.7, SD 2.5). In terms of risk perception, female participants appeared to have lower levels of risk perception than male participants, with the mean score for males being (M 11.7, SD 2.5) and (M 10.5, SD 2.4) for females. The female participants showed slightly more positive attitudes towards HIV testing than male participants: the mean score for males was (M = 108.14, SD = 17.9) and was (M = 111.32, SD = 17.3) for females. Conclusions: The data reveal that misconceptions about HIV/AIDS in Saudi Arabia are still a challenge. Although the attitudes towards HIV testing were reasonably positive, the utilization of the HIV test was low. Thus, tailoring HIV/AIDS preventive strategies in Saudi Arabia should focus on the needs of young people and other high risk groups in the country.

Keywords: attitude toward hiv testing, hiv testing, hiv/aids related knowledge, risk perception

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29647 Seismic Assessment of Old Existing RC Buildings In Madinah with Masonry Infilled Using Ambient Vibration Measurements

Authors: Tarek M. Alguhane, Ayman H. Khalil, Nour M. Fayed, Ayman M. Ismail

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Early, pre-code, reinforced concrete structures present undetermined resistance to earthquakes. This situation is particularly unacceptable in the case of essential structures, such as healthcare structures and pilgrims' houses. Among these, existing old RC building in Madinah is seismically evaluated with and without infill wall and their dynamic characteristics are compared with measured values in the field using ambient vibration measurements (AVM). After, updating the mathematical models for this building with the experimental results, three dimensional pushover analysis (Nonlinear static analysis) was carried out using SAP 2000 software incorporating inelastic material properties for concrete, infill and steel. The purpose of this analysis is to evaluate the expected performance of structural systems by estimating, strength and deformation demands in design, and comparing these demands to available capacities at the performance levels of interest. The results are summarized and discussed.

Keywords: seismic assessment, pushover analysis ambient vibration, modal update

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29646 Inferring the Ecological Quality of Seagrass Beds from Using Composition and Configuration Indices

Authors: Fabrice Houngnandan, Celia Fery, Thomas Bockel, Julie Deter

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Getting water cleaner and stopping global biodiversity loss requires indices to measure changes and evaluate the achievement of objectives. The endemic and protected seagrass species Posidonia oceanica is a biological indicator used to monitor the ecological quality of marine Mediterranean waters. One ecosystem index (EBQI), two biotic indices (PREI, Bipo), and several landscape indices, which measure the composition and configuration of the P. oceanica seagrass at the population scale have been developed. While the formers are measured at monitoring sites, the landscape indices can be calculated for the entire seabed covered by this ecosystem. This present work aims to search on the link between these indices and the best scale to be used in order to maximize this link. We used data collected between 2014 to 2019 along the French Mediterranean coastline to calculate EBQI, PREI, and Bipo at 100 sites. From the P. oceanica seagrass distribution map, configuration and composition indices around these different sites in 6 different grid sizes (100 m x 100 to 1000 m x 1000 m) were determined. Correlation analyses were first used to find out the grid size presenting the strongest and most significant link between the different types of indices. Finally, several models were compared basis on various metrics to identify the one that best explains the nature of the link between these indices. Our results showed a strong and significant link between biotic indices and the best correlations between biotic and landscape indices within the 600 m x 600 m grid cells. These results showed that the use of landscape indices is possible to monitor the health of seagrass beds at a large scale.

Keywords: ecological indicators, decline, conservation, submerged aquatic vegetation

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29645 Interest Charges and Sustainability Challenges: The Case of OECD Countries

Authors: Aime Philombe Zapji Ymele

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Servicing public debt is a significant budgetary burden. In the sense that the payment of interest charges is a liability on the balance sheet of the public budget and affects fiscal policy. Interest charges can sometimes become a burden if they crowd out private activities. In order to analyse and understand the determinants of the debt burden and its impact on the sustainability of public finances, the present work focuses on OECD countries. It is noted from the literature that the factors that determine interest charges are macroeconomic (inflation, GDP growth, and interest rates) and public finances (primary balance and public debt). After analysing a panel of 33 OECD countries and using ordinary least squares (OLS), we find that public debt, inflation, and long-term interest rates are positively correlated with interest charges. An increase in any of these variables leads to an increase in debt charges. On the other hand, a growth in GDP is negatively associated with interest charges. Indeed, an increase in GDP generates enough revenue to meet the repayment of debt charges. According to the empirical analysis, we can say that, despite the large and growing debt-to-GDP ratio of major OECD countries, interest charges are not a threat to the sustainability of public finances. However, it is important for these countries to reduce the ratio of public debt to GDP because, in the face of the many challenges (health, aging population, etc.) that are looming on the horizon, an increase in interest rates could bring with it considerable burdens that would threaten the budgetary balance of these states.

Keywords: interest charges, sustainability, public debt, interest rates

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29644 Analytical Solutions for Tunnel Collapse Mechanisms in Circular Cross-Section Tunnels under Seepage and Seismic Forces

Authors: Zhenyu Yang, Qiunan Chen, Xiaocheng Huang

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Reliable prediction of tunnel collapse remains a prominent challenge in the field of civil engineering. In this study, leveraging the nonlinear Hoek-Brown failure criterion and the upper-bound theorem, an analytical solution for the collapse surface of shallowly buried circular tunnels was derived, taking into account the coupled effects of surface loads and pore water pressures. Initially, surface loads and pore water pressures were introduced as external force factors, equating the energy dissipation rate to the external force, yielding our objective function. Subsequently, the variational method was employed for optimization, and the outcomes were juxtaposed with previous research findings. Furthermore, we utilized the deduced equation set to systematically analyze the influence of various rock mass parameters on collapse shape and extent. To validate our analytical solutions, a comparison with prior studies was executed. The corroboration underscored the efficacy of our proposed methodology, offering invaluable insights for collapse risk assessment in practical engineering applications.

Keywords: tunnel roof stability, analytical solution, hoek–brown failure criterion, limit analysis

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29643 Adapting to Rural Demographic Change: Impacts, Challenges and Opportunities for Ageing Farmers in Prachin Buri Province, Thailand

Authors: Para Jansuwan, Kerstin K. Zander

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Most people in rural Thailand still depend on agriculture. The rural areas are undergoing changes in their demographic structures with an increasing older population, out migration of younger people and a shift away from work in the agricultural sector towards manufacturing and service provisioning. These changes may lead to a decline in agricultural productivity and food insecurity. Our research aims to examine perceptions of older farmers on how rural demographic change affects them, to investigate how farmers may change their agricultural practices to cope with their ageing and to explore the factors affecting these changes, including the opportunities and challenges arising from them. The data were collected through a household survey with 368 farmers in the Prachin Buri province in central Thailand, the main area for agricultural production. A series of binomial logistic regression models were applied to analyse the data. We found that most farmers suffered from age-related diseases, which compromised their working capacity. Most farmers attempted to reduce labour intense work, by either stopping farming through transferring farmland to their children (41%), stopping farming by giving the land to the others (e.g., selling, leasing out) (28%) and continuing farming with making some changes (e.g., changing crops, employing additional workers) (24%). Farmers’ health and having a potential farm successor were positively associated with the probability of stopping farming by transferring the land to the children. Farmers with a successor were also less likely to stop farming by giving the land to the others. Farmers’ age was negatively associated with the likelihood of continuing farming by making some changes. The results show that most farmers base their decisions on the hope that their children will take over the farms, and that without successor, farmers lease out or sell the land. Without successor, they also no longer invest in expansion and improvement of their farm production, especially adoption of innovative technologies that could help them to maintain their farm productivity. To improve farmers’ quality of life and sustain their farm productivity, policies are needed to support the viability of farms, the access to a pension system and the smooth and successful transfer of the land to a successor of farmers.

Keywords: rural demographic change, older farmer, stopping farming, continuing farming, health and age, farm successor, Thailand

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29642 Advanced Numerical and Analytical Methods for Assessing Concrete Sewers and Their Remaining Service Life

Authors: Amir Alani, Mojtaba Mahmoodian, Anna Romanova, Asaad Faramarzi

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Pipelines are extensively used engineering structures which convey fluid from one place to another. Most of the time, pipelines are placed underground and are encumbered by soil weight and traffic loads. Corrosion of pipe material is the most common form of pipeline deterioration and should be considered in both the strength and serviceability analysis of pipes. The study in this research focuses on concrete pipes in sewage systems (concrete sewers). This research firstly investigates how to involve the effect of corrosion as a time dependent process of deterioration in the structural and failure analysis of this type of pipe. Then three probabilistic time dependent reliability analysis methods including the first passage probability theory, the gamma distributed degradation model and the Monte Carlo simulation technique are discussed and developed. Sensitivity analysis indexes which can be used to identify the most important parameters that affect pipe failure are also discussed. The reliability analysis methods developed in this paper contribute as rational tools for decision makers with regard to the strengthening and rehabilitation of existing pipelines. The results can be used to obtain a cost-effective strategy for the management of the sewer system.

Keywords: reliability analysis, service life prediction, Monte Carlo simulation method, first passage probability theory, gamma distributed degradation model

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29641 System Dynamics Projections of Environmental Issues for Domestic Water and Wastewater Scenarios in Urban Area of India

Authors: Isha Sharawat, R. P. Dahiya, T. R. Sreekrishnan

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One of the environmental challenges in India is urban wastewater management as regulations and infrastructural development has not kept pace with the urbanization and growing population. The quality of life of people is also improving with the rapid growth of the gross domestic product. This has contributed to the enhancement in the per capita water requirement and consumption. More domestic water consumption generates more wastewater. The scarcity of potable water is making the situation quite serious, and water supply has to be regulated in most parts of the country during summer. This requires elaborate and concerted efforts to efficiently manage the water resources and supply systems. In this article, a system dynamics modelling approach is used for estimating the water demand and wastewater generation in a district headquarter city of North India. Projections are made till the year 2035. System dynamics is a software tool used for formulation of policies. On the basis of the estimates, policy scenarios are developed for sustainable development of water resources in conformity with the growing population. Mitigation option curtailing the water demand and wastewater generation include population stabilization, water reuse and recycle and water pricing. The model is validated quantitatively, and sensitivity analysis tests are carried out to examine the robustness of the model.

Keywords: system dynamics, wastewater, water pricing, water recycle

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29640 Temperament as a Success Determinant in Formative Assessment

Authors: George Fomunyam Kehdinga

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Assessment is a vital part of the educational process, and formative assessment is a way of ensuring that higher education achieves the desired effects. Different factors influence how students perform in assessments in general, and formative assessment in particular and temperament is one of such determining factors. This paper which is a qualitative case study of four universities in four different countries examines how the temperamental make up of students either empowers them to perform excellently in formative assessment or incapacitates their performance. These four universities were chosen from Cameroon, South Africa, United Kingdom and the United States of America and three students were chosen from each institution, six of which were undergraduate student and six postgraduate students. Data in this paper was generated through qualitative interviews and document analyses which was preceded by a temperament test. From the data generated, it was discovered that cholerics who are natural leaders, hence do not struggle to express themselves often perform excellently in formative assessment while sanguines on the other hand who are also extroverts like cholerics perform relatively well. Phlegmatics and melancholics performed averagely and poorly respectively in formative assessment because they are naturally prone to fear and hate such activities because they like keeping to themselves. The paper, therefore, suggest that temperament is a success determinant in formative assessment. It also proposes that lecturers need and understanding of temperaments to be able to fully administer formative assessment in the lecturer room. It also suggests that assessment should be balance in the classroom so that some students because of their temperamental make-up are not naturally disadvantaged while others are performing excellently. Lastly, the paper suggests that since formative assessment is a process of generating data, it should be contextualised or given and individualised approach so as to ensure that trustworthy data is generated.

Keywords: temperament, formative assessment, academic success, students

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29639 Integrating Multiple Types of Value in Natural Capital Accounting Systems: Environmental Value Functions

Authors: Pirta Palola, Richard Bailey, Lisa Wedding

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Societies and economies worldwide fundamentally depend on natural capital. Alarmingly, natural capital assets are quickly depreciating, posing an existential challenge for humanity. The development of robust natural capital accounting systems is essential for transitioning towards sustainable economic systems and ensuring sound management of capital assets. However, the accurate, equitable and comprehensive estimation of natural capital asset stocks and their accounting values still faces multiple challenges. In particular, the representation of socio-cultural values held by groups or communities has arguably been limited, as to date, the valuation of natural capital assets has primarily been based on monetary valuation methods and assumptions of individual rationality. People relate to and value the natural environment in multiple ways, and no single valuation method can provide a sufficiently comprehensive image of the range of values associated with the environment. Indeed, calls have been made to improve the representation of multiple types of value (instrumental, intrinsic, and relational) and diverse ontological and epistemological perspectives in environmental valuation. This study addresses this need by establishing a novel valuation framework, Environmental Value Functions (EVF), that allows for the integration of multiple types of value in natural capital accounting systems. The EVF framework is based on the estimation and application of value functions, each of which describes the relationship between the value and quantity (or quality) of an ecosystem component of interest. In this framework, values are estimated in terms of change relative to the current level instead of calculating absolute values. Furthermore, EVF was developed to also support non-marginalist conceptualizations of value: it is likely that some environmental values cannot be conceptualized in terms of marginal changes. For example, ecological resilience value may, in some cases, be best understood as a binary: it either exists (1) or is lost (0). In such cases, a logistic value function may be used as the discriminator. Uncertainty in the value function parameterization can be considered through, for example, Monte Carlo sampling analysis. The use of EVF is illustrated with two conceptual examples. For the first time, EVF offers a clear framework and concrete methodology for the representation of multiple types of value in natural capital accounting systems, simultaneously enabling 1) the complementary use and integration of multiple valuation methods (monetary and non-monetary); 2) the synthesis of information from diverse knowledge systems; 3) the recognition of value incommensurability; 4) marginalist and non-marginalist value analysis. Furthermore, with this advancement, the coupling of EVF and ecosystem modeling can offer novel insights to the study of spatial-temporal dynamics in natural capital asset values. For example, value time series can be produced, allowing for the prediction and analysis of volatility, long-term trends, and temporal trade-offs. This approach can provide essential information to help guide the transition to a sustainable economy.

Keywords: economics of biodiversity, environmental valuation, natural capital, value function

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29638 Analyzing the Relationship between the Spatial Characteristics of Cultural Structure, Activities, and the Tourism Demand

Authors: Deniz Karagöz

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This study is attempt to comprehend the relationship between the spatial characteristics of cultural structure, activities and the tourism demand in Turkey. The analysis divided into four parts. The first part consisted of a cultural structure and cultural activity (CSCA) index provided by principal component analysis. The analysis determined four distinct dimensions, namely, cultural activity/structure, accessing culture, consumption, and cultural management. The exploratory spatial data analysis employed to determine the spatial models of cultural structure and cultural activities in 81 provinces in Turkey. Global Moran I indices is used to ascertain the cultural activities and the structural clusters. Finally, the relationship between the cultural activities/cultural structure and tourism demand was analyzed. The raw/original data of the study official databases. The data on the cultural structure and activities gathered from the Turkish Statistical Institute and the data related to the tourism demand was provided by the Republic of Turkey Ministry of Culture and Tourism.

Keywords: cultural activities, cultural structure, spatial characteristics, tourism demand, Turkey

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29637 Artificial Intelligence-Generated Previews of Hyaluronic Acid-Based Treatments

Authors: Ciro Cursio, Giulia Cursio, Pio Luigi Cursio, Luigi Cursio

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Communication between practitioner and patient is of the utmost importance in aesthetic medicine: as of today, images of previous treatments are the most common tool used by doctors to describe and anticipate future results for their patients. However, using photos of other people often reduces the engagement of the prospective patient and is further limited by the number and quality of pictures available to the practitioner. Pre-existing work solves this issue in two ways: 3D scanning of the area with manual editing of the 3D model by the doctor or automatic prediction of the treatment by warping the image with hand-written parameters. The first approach requires the manual intervention of the doctor, while the second approach always generates results that aren’t always realistic. Thus, in one case, there is significant manual work required by the doctor, and in the other case, the prediction looks artificial. We propose an AI-based algorithm that autonomously generates a realistic prediction of treatment results. For the purpose of this study, we focus on hyaluronic acid treatments in the facial area. Our approach takes into account the individual characteristics of each face, and furthermore, the prediction system allows the patient to decide which area of the face she wants to modify. We show that the predictions generated by our system are realistic: first, the quality of the generated images is on par with real images; second, the prediction matches the actual results obtained after the treatment is completed. In conclusion, the proposed approach provides a valid tool for doctors to show patients what they will look like before deciding on the treatment.

Keywords: prediction, hyaluronic acid, treatment, artificial intelligence

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29636 Web-Based Decision Support Systems and Intelligent Decision-Making: A Systematic Analysis

Authors: Serhat Tüzün, Tufan Demirel

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Decision Support Systems (DSS) have been investigated by researchers and technologists for more than 35 years. This paper analyses the developments in the architecture and software of these systems, provides a systematic analysis for different Web-based DSS approaches and Intelligent Decision-making Technologies (IDT), with the suggestion for future studies. Decision Support Systems literature begins with building model-oriented DSS in the late 1960s, theory developments in the 1970s, and the implementation of financial planning systems and Group DSS in the early and mid-80s. Then it documents the origins of Executive Information Systems, online analytic processing (OLAP) and Business Intelligence. The implementation of Web-based DSS occurred in the mid-1990s. With the beginning of the new millennia, intelligence is the main focus on DSS studies. Web-based technologies are having a major impact on design, development and implementation processes for all types of DSS. Web technologies are being utilized for the development of DSS tools by leading developers of decision support technologies. Major companies are encouraging its customers to port their DSS applications, such as data mining, customer relationship management (CRM) and OLAP systems, to a web-based environment. Similarly, real-time data fed from manufacturing plants are now helping floor managers make decisions regarding production adjustment to ensure that high-quality products are produced and delivered. Web-based DSS are being employed by organizations as decision aids for employees as well as customers. A common usage of Web-based DSS has been to assist customers configure product and service according to their needs. These systems allow individual customers to design their own products by choosing from a menu of attributes, components, prices and delivery options. The Intelligent Decision-making Technologies (IDT) domain is a fast growing area of research that integrates various aspects of computer science and information systems. This includes intelligent systems, intelligent technology, intelligent agents, artificial intelligence, fuzzy logic, neural networks, machine learning, knowledge discovery, computational intelligence, data science, big data analytics, inference engines, recommender systems or engines, and a variety of related disciplines. Innovative applications that emerge using IDT often have a significant impact on decision-making processes in government, industry, business, and academia in general. This is particularly pronounced in finance, accounting, healthcare, computer networks, real-time safety monitoring and crisis response systems. Similarly, IDT is commonly used in military decision-making systems, security, marketing, stock market prediction, and robotics. Even though lots of research studies have been conducted on Decision Support Systems, a systematic analysis on the subject is still missing. Because of this necessity, this paper has been prepared to search recent articles about the DSS. The literature has been deeply reviewed and by classifying previous studies according to their preferences, taxonomy for DSS has been prepared. With the aid of the taxonomic review and the recent developments over the subject, this study aims to analyze the future trends in decision support systems.

Keywords: decision support systems, intelligent decision-making, systematic analysis, taxonomic review

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29635 Knowledge Transformation Flow (KTF) of Visually Impaired Students: The Virtual Knowledge System as a New Service Innovation

Authors: Chatcai Tangsri, Onjaree Na-Takuatoong

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This paper aims to present the key factors that support the decision to use the technology and to present the knowledge transformation flow of visually impaired students after the use of virtual knowledge system as proposed as a new service innovation to universities in Thailand. Correspondents of 27 visually impaired students are involved in this research. Total of 25 students are selected from the University that mainly conducts non-classroom teaching environment; while another 2 visually impaired students are selected from classroom teaching environment. All of them are fully involved in the study along 8 weeks duration. All correspondents are classified into 5 small groups in various conditions. The research results revealed that the involvement from knowledge facilitator can push out for the behavioral actual use of the virtual knowledge system although there is no any developed intention to use behaviors. Secondly, the situations that the visually impaired students inadequate of the knowledge sources that usually provided by assistants i.e. peers, audio files etc. In this case, they will use the virtual knowledge system for both knowledge access and knowledge transfer request. With this evidence, the need of knowledge would play a stronger role than all technology acceptance factors. Finally, this paper revealed that the knowledge transfer in the normal method that students have a chance to physically meet up is still confirmed as their preference method. In term of other aspects of technology acceptance, it will be discussed together with challenges and recommendations at the end of this paper.

Keywords: knowledge system, visually impaired students, higher education, knowledge management enable technology, synchronous/asynchronous knowledge access, synchronous/asynchronous knowledge transfer

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29634 Magnetic Field Effects on Seed Germination of Phaseolus Vulgaris, Early Seedling Growth, and Chemical Composition

Authors: Farzad Tofigh, Saeideh Najafi, Reza Heidari, Rashid Jamei

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In order to study the effects of magnetic field on the root system and growth of Phaseolus vulgaris, an experiment was conducted in 2012. The possible involvement of magnetic field (MF) pretreatment in physiological factors of Phaseolus vulgaris was investigated. Seeds were subjected to 10 days with 1.8 mT of magnetic field for 1h per day. MF pretreatment decreased the plant height, fresh and dry weight, length of root and length of shoot, Chlorophyll a, Chlorophyll b and carotenoid in 10 days old seedling. In addition, activity of enzymes such as Catalase and Guaiacol peroxidase was decreased due to MF exposure. Also, the total Protein and DPPH content of the treated by magnetic field was not significantly changed in compare to control groups, while the flavonoid, Phenol and prolin content of the treated of the treated by magnetic field was significantly changed in compare to control groups. Lateral branches of roots and secondary roots increased with MF. The results suggest that pretreatment of this MF plays important roles in changes in crop productivity. In all cases there was observed a slight stimulating effect of the factors examined. The growth dynamics were weakened. The plants were shorter. Moreover, the effect of a magnetic field on the crop of Phaseolus vulgaris and its structure was small.

Keywords: carotenoid, chlorophyll a, chlorophyll b, DPPH, enzymes, flavonoid, germination, growth, phenol, proline, protein, magnetic field

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29633 Studying the Relationship Between Washback Effects of IELTS Test on Iranian Language Teachers, Teaching Strategies and Candidates

Authors: Afsaneh Jasmine Majidi

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Language testing is an important part of language teaching experience and language learning process as it presents assessment strategies for teachers to evaluate the efficiency of teaching and for learners to examine their outcomes. However, language testing is demanding and challenging because it should provide the opportunity for proper and objective decision. In addition to all the efforts test designers put to design valid and reliable tests, there are some other determining factors which are even more complex and complicated. These factors affect the educational system, individuals, and society, and the impact of the tests vary according to the scope of the test. Seemingly, the impact of a simple classroom assessment is not the same as that of high stake tests such as International English Language Testing System (IELTS). As the importance of the test increases, it affects wider domain. Accordingly, the impacts of high stake tests are reflected not only in teaching, learning strategies but also in society. Testing experts use the term ‘washback’ or ‘impact’ to define the different effects of a test on teaching, learning, and community. This paper first looks at the theoretical background of ‘washback’ and ‘impact’ in language testing by reviewing of relevant literature in the field and then investigates washback effects of IELTS test of on Iranian IELTS teachers and students. The study found significant relationship between the washback effect of IELTS test and teaching strategies of Iranian IELTS teachers as well as performance of Iranian IELTS candidates and their community.

Keywords: high stake tests, IELTS, Iranian Candidates, language testing, test impact, washback

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29632 Advancing Our Understanding of Age-Related Changes in Executive Functions: Insights from Neuroimaging, Genetics and Cognitive Neurosciences

Authors: Yasaman Mohammadi

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Executive functions are a critical component of goal-directed behavior, encompassing a diverse set of cognitive processes such as working memory, cognitive flexibility, and inhibitory control. These functions are known to decline with age, but the precise mechanisms underlying this decline remain unclear. This paper provides an in-depth review of recent research investigating age-related changes in executive functions, drawing on insights from neuroimaging, genetics, and cognitive neuroscience. Through an interdisciplinary approach, this paper offers a nuanced understanding of the complex interplay between neural mechanisms, genetic factors, and cognitive processes that contribute to executive function decline in aging. Here, we investigate how different neuroimaging methods, like functional magnetic resonance imaging (fMRI) and positron emission tomography (PET), have helped scientists better understand the brain bases for age-related declines in executive function. Additionally, we discuss the role of genetic factors in mediating individual differences in executive functions across the lifespan, as well as the potential for cognitive interventions to mitigate age-related decline. Overall, this paper presents a comprehensive and integrative view of the current state of knowledge regarding age-related changes in executive functions. It underscores the need for continued interdisciplinary research to fully understand the complex and dynamic nature of executive function decline in aging, with the ultimate goal of developing effective interventions to promote healthy cognitive aging.

Keywords: executive functions, aging, neuroimaging, cognitive neuroscience, working memory, cognitive training

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29631 Evaluating and Supporting Student Engagement in Online Learning

Authors: Maria Hopkins

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Research on student engagement is founded on a desire to improve the quality of online instruction in both course design and delivery. A high level of student engagement is associated with a wide range of educational practices including purposeful student-faculty contact, peer to peer contact, active and collaborative learning, and positive factors such as student satisfaction, persistence, achievement, and learning. By encouraging student engagement, institutions of higher education can have a positive impact on student success that leads to retention and degree completion. The current research presents the results of an online student engagement survey which support faculty teaching practices to maximize the learning experience for online students. The ‘Indicators of Engaged Learning Online’ provide a framework that measures level of student engagement. Social constructivism and collaborative learning form the theoretical basis of the framework. Social constructivist pedagogy acknowledges the social nature of knowledge and its creation in the minds of individual learners. Some important themes that flow from social constructivism involve the importance of collaboration among instructors and students, active learning vs passive consumption of information, a learning environment that is learner and learning centered, which promotes multiple perspectives, and the use of social tools in the online environment to construct knowledge. The results of the survey indicated themes that emphasized the importance of: Interaction among peers and faculty (collaboration); Timely feedback on assignment/assessments; Faculty participation and visibility; Relevance and real-world application (in terms of assignments, activities, and assessments); and Motivation/interest (the need for faculty to motivate students especially those that may not have an interest in the coursework per se). The qualitative aspect of this student engagement study revealed what instructors did well that made students feel engaged in the course, but also what instructors did not do well, which could inform recommendations to faculty when expectations for teaching a course are reviewed. Furthermore, this research provides evidence for the connection between higher student engagement and persistence and retention in online programs, which supports our rationale for encouraging student engagement, especially in the online environment because attrition rates are higher than in the face-to-face environment.

Keywords: instructional design, learning effectiveness, online learning, student engagement

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29630 Quantitative Polymerase Chain Reaction Analysis of Phytoplankton Composition and Abundance to Assess Eutrophication: A Multi-Year Study in Twelve Large Rivers across the United States

Authors: Chiqian Zhang, Kyle D. McIntosh, Nathan Sienkiewicz, Ian Struewing, Erin A. Stelzer, Jennifer L. Graham, Jingrang Lu

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Phytoplankton plays an essential role in freshwater aquatic ecosystems and is the primary group synthesizing organic carbon and providing food sources or energy to ecosystems. Therefore, the identification and quantification of phytoplankton are important for estimating and assessing ecosystem productivity (carbon fixation), water quality, and eutrophication. Microscopy is the current gold standard for identifying and quantifying phytoplankton composition and abundance. However, microscopic analysis of phytoplankton is time-consuming, has a low sample throughput, and requires deep knowledge and rich experience in microbial morphology to implement. To improve this situation, quantitative polymerase chain reaction (qPCR) was considered for phytoplankton identification and quantification. Using qPCR to assess phytoplankton composition and abundance, however, has not been comprehensively evaluated. This study focused on: 1) conducting a comprehensive performance comparison of qPCR and microscopy techniques in identifying and quantifying phytoplankton and 2) examining the use of qPCR as a tool for assessing eutrophication. Twelve large rivers located throughout the United States were evaluated using data collected from 2017 to 2019 to understand the relation between qPCR-based phytoplankton abundance and eutrophication. This study revealed that temporal variation of phytoplankton abundance in the twelve rivers was limited within years (from late spring to late fall) and among different years (2017, 2018, and 2019). Midcontinent rivers had moderately greater phytoplankton abundance than eastern and western rivers, presumably because midcontinent rivers were more eutrophic. The study also showed that qPCR- and microscope-determined phytoplankton abundance had a significant positive linear correlation (adjusted R² 0.772, p-value < 0.001). In addition, phytoplankton abundance assessed via qPCR showed promise as an indicator of the eutrophication status of those rivers, with oligotrophic rivers having low phytoplankton abundance and eutrophic rivers having (relatively) high phytoplankton abundance. This study demonstrated that qPCR could serve as an alternative tool to traditional microscopy for phytoplankton quantification and eutrophication assessment in freshwater rivers.

Keywords: phytoplankton, eutrophication, river, qPCR, microscopy, spatiotemporal variation

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29629 Dynamic Analysis of Submerged Floating Tunnel Subjected to Hydrodynamic and Seismic Loadings

Authors: Naik Muhammad, Zahid Ullah, Dong-Ho Choi

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Submerged floating tunnel (SFT) is a new solution for the transportation infrastructure through sea straits, fjords, and inland waters, and can be a good alternative to long span suspension bridges. SFT is a massive cylindrical structure that floats at a certain depth below the water surface and subjected to extreme environmental conditions. The identification of dominant structural response of SFT becomes more important due to intended environmental conditions for the design of SFT. The time domain dynamic problem of SFT moored by vertical and inclined mooring cables/anchors is formulated. The dynamic time history analysis of SFT subjected to hydrodynamic and seismic excitations is performed. The SFT is modeled by finite element 3D beam, and the mooring cables are modeled by truss elements. Based on the dynamic time history analysis the displacements and internal forces of SFT were calculated. The response of SFT is presented for hydrodynamic and seismic excitations. The transverse internal forces of SFT were the maximum compared to vertical direction, for both hydrodynamic and seismic cases; this indicates that the cable system provides very small stiffness in transverse direction as compared to vertical direction of SFT.

Keywords: submerged floating tunnel, hydrodynamic analysis, time history analysis, seismic response

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29628 A Varicella Outbreak in a Highly Vaccinated School Population in Voluntary 2-Dose Era in Beijing, China

Authors: Chengbin Wang, Li Lu, Luodan Suo, Qinghai Wang, Fan Yang, Xu Wang, Mona Marin

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Background: Two-dose varicella vaccination has been recommended in Beijing since November 2012. We investigated a varicella outbreak in a highly vaccinated elementary school population to examine transmission patterns and risk factors for vaccine failure. Methods: A varicella case was defined as an acute generalized maculopapulovesicular rash without other apparent cause in a student attending the school from March 28 to May 17, 2015. Breakthrough varicella was defined as varicella >42 days after last vaccine dose. Vaccination information was collected from immunization records. Information on prior disease and clinical presentation was collected via survey of students’ parents. Results: Of the 1056 school students, 1028 (97.3%) reported no varicella history, of whom 364 (35.4%) had received 1-dose and 650 (63.2%) had received 2-dose varicella vaccine, for 98.6% school-wide vaccination coverage with ≥ 1 dose before the outbreak. A total of 20 cases were identified for an overall attack rate of 1.9%. The index case was in a 2-dose vaccinated student who was not isolated. The majority of cases were breakthrough (19/20, 95%) with attack rates of 7.1% (1/14), 1.6% (6/364) and 2.0% (13/650) among unvaccinated, 1-dose, and 2-dose students, respectively. Most cases had < 50 lesions (18/20, 90%). No difference was found between 1-dose and 2-dose breakthrough cases in disease severity or sociodemographic factors. Conclusion: Moderate 2-dose varicella vaccine coverage was insufficient to prevent a varicella outbreak. Two-dose breakthrough varicella is still contagious. High 2-dose varicella vaccine coverage and timely isolation of ill persons might be needed for varicella outbreak control in the 2-dose era.

Keywords: varicella, outbreak, breakthrough varicella, vaccination

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29627 Students’ Speech Anxiety in Blended Learning

Authors: Mary Jane B. Suarez

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Public speaking anxiety (PSA), also known as speech anxiety, is innumerably persistent in any traditional communication classes, especially for students who learn English as a second language. The speech anxiety intensifies when communication skills assessments have taken their toll in an online or a remote mode of learning due to the perils of the COVID-19 virus. Both teachers and students have experienced vast ambiguity on how to realize a still effective way to teach and learn speaking skills amidst the pandemic. Communication skills assessments like public speaking, oral presentations, and student reporting have defined their new meaning using Google Meet, Zoom, and other online platforms. Though using such technologies has paved for more creative ways for students to acquire and develop communication skills, the effectiveness of using such assessment tools stands in question. This mixed method study aimed to determine the factors that affected the public speaking skills of students in a communication class, to probe on the assessment gaps in assessing speaking skills of students attending online classes vis-à-vis the implementation of remote and blended modalities of learning, and to recommend ways on how to address the public speaking anxieties of students in performing a speaking task online and to bridge the assessment gaps based on the outcome of the study in order to achieve a smooth segue from online to on-ground instructions maneuvering towards a much better post-pandemic academic milieu. Using a convergent parallel design, both quantitative and qualitative data were reconciled by probing on the public speaking anxiety of students and the potential assessment gaps encountered in an online English communication class under remote and blended learning. There were four phases in applying the convergent parallel design. The first phase was the data collection, where both quantitative and qualitative data were collected using document reviews and focus group discussions. The second phase was data analysis, where quantitative data was treated using statistical testing, particularly frequency, percentage, and mean by using Microsoft Excel application and IBM Statistical Package for Social Sciences (SPSS) version 19, and qualitative data was examined using thematic analysis. The third phase was the merging of data analysis results to amalgamate varying comparisons between desired learning competencies versus the actual learning competencies of students. Finally, the fourth phase was the interpretation of merged data that led to the findings that there was a significantly high percentage of students' public speaking anxiety whenever students would deliver speaking tasks online. There were also assessment gaps identified by comparing the desired learning competencies of the formative and alternative assessments implemented and the actual speaking performances of students that showed evidence that public speaking anxiety of students was not properly identified and processed.

Keywords: blended learning, communication skills assessment, public speaking anxiety, speech anxiety

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