Search results for: teams' autonomy

Authors: A. Anastasiou, K. S. Tingay

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Background: Discovering suitable datasets is an important part of health research, particularly for projects working with clinical data from patients organized in cohorts (cohort data), but with the proliferation of so many national and international initiatives, it is becoming increasingly difficult for research teams to locate real world datasets that are most relevant to their project objectives. We present a method for identifying healthcare institutes in the European Union (EU) which may hold haemato-oncology (HO) data. A key enabler of this research was the bibInsight platform, a scientometric data management and analysis system developed by the authors at Swansea University. Method: A PubMed search was conducted using HO clinical terms taken from previous work. The resulting XML file was processed using the bibInsight platform, linking affiliations to the Global Research Identifier Database (GRID). GRID is an international, standardized list of institutions, including the city and country in which the institution exists, as well as a category of the main business type, e.g., Academic, Healthcare, Government, Company. Countries were limited to the 28 current EU members, and institute type to 'Healthcare'. An article was considered valid if at least one author was affiliated with an EU-based healthcare institute. Results: The PubMed search produced 21,310 articles, consisting of 9,885 distinct affiliations with correspondence in GRID. Of these articles, 760 were from EU countries, and 390 of these were healthcare institutes. One affiliation was excluded as being a veterinary hospital. Two EU countries did not have any publications in our analysis dataset. The results were analysed by country and by individual healthcare institute. Networks both within the EU and internationally show institutional collaborations, which may suggest a willingness to share data for research purposes. Geographical mapping can ensure that data has broad population coverage. Collaborations with industry or government may exclude healthcare institutes that may have embargos or additional costs associated with data access. Conclusions: Data reuse is becoming increasingly important both for ensuring the validity of results, and economy of available resources. The ability to identify potential, specific data sources from over twenty thousand articles in less than an hour could assist in improving knowledge of, and access to, data sources. As our method has not yet specified if these healthcare institutes are holding data, or merely publishing on that topic, future work will involve text mining of data-specific concordant terms to identify numbers of participants, demographics, study methodologies, and sub-topics of interest.

Keywords: data reuse, data discovery, data linkage, journal articles, text mining

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Authors: Shierwin Agagen Cabunilas

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Countless Filipinos are reeling in dire economic inequality while many others are victims of human trafficking. Where there is extreme economic inequality, majority of the Filipinos are deprived of basic needs to have a good life, i.e., decent shelter, safe environment, food, quality education, social security, etc. The problem on human trafficking poses a scandal and threat in respect to human rights and dignity of a person on matters of sex, gender, ethnicity and race among others. The economic inequality and trafficking in persons are social pathologies that needed considerable amount of attention and visible solution both in the national and international level. However, the Philippine government seems falls short in terms of goals to lessen, if not altogether eradicate, the dire fate of many Filipinos. The lack of solidarity among Filipinos seems to further aggravate injustice and create hindrances to economic equity and protection of Filipinos from syndicated crimes, i.e., human trafficking. Indifference towards the welfare and well-being of the Filipino people trashes them into an unending cycle of marginalization and neglect. A transnational solidaristic action in response to these concerns is imperative. The subsequent sections will first discuss the notion of solidarity and the motivating factors for collective action. While solidarity has been previously thought of as stemming from and for one’s own community and people, it can be argued as a value that defies borders. Solidarity bridges peoples of diverse societies and cultures. Although there are limits to international interventions on another’s sovereignty, such as, internal political autonomy, transnational solidarity may not be an opposition to solidarity with people suffering injustices. Governments, nations and institutions can work together in securing justice. Solidarity thus is a positive political action that can best respond to issues of economic, class, racial and gender injustices. This is followed by a critical analysis of some data on Philippine economic inequality and human trafficking and link the place of transnational solidaristic arrangements. Here, the present work is interested on the normative aspect of the problem. It begins with the section on economic inequality and subsequently, human trafficking. It is argued that a transnational solidarity is vital in assisting the Philippine governing bodies and authorities to seriously execute innovative economic policies and developmental programs that are justice and egalitarian oriented. Transnational solidarity impacts a corrective measure in the economic practices, and activities of the Philippine government. Moreover, it is suggested that in order to mitigate Philippine economic inequality and human trafficking concerns it involves a (a) historical analysis of systems that brought about economic anomalies, (b) renewed and innovated economic policies, (c) mutual trust and relatively high transparency, and (d) grass-root and context-based approach. In conclusion, the findings are briefly sketched and integrated in an optimistic view that transnational solidarity is capable of influencing Philippine governing bodies towards socio-economic transformation and development of the lives of Filipinos.

Keywords: Philippines, Filipino, economic inequality, human trafficking, transnational solidarity

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Authors: Ella Abaev, Shany Segal, Miri Gabay

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Background: Choking is a blockage of airways that prevents efficient breathing and air flow to the lungs. Choking may be partial or full and is an emergency situation. Complete or prolonged choking leads to apnea, lack of oxygen in the tissues of the body and brain, and can cause death. There are three mechanisms of choking: obstruction of internal respiratory tracts by food or object aspiration, any material that blocks or covers external air passages, external pressure on the neck or trapping between objects. Children's airways are narrower than that of adults and therefore the risk of choking is greater, due to the aspiration of food and other foreign bodies into the lungs. In the Child Development Center at Safra Children’s Hospital, Tel Hashomer in Israel are treated infants, toddlers, and children aged 0-18 years with various developmental disabilities. Due to the increase in reports of ‘almost an event’ of choking in the past year and the serious consequences of choking event, it was decided to give an emphasis to the issue. Incidence and methods: The number of reports of ‘almost an event’ or a choking event was examined at the center during the years 2013-2018 and a thorough research work was conducted on the subject in order to build a prevention program. Findings: Between 2013 and 2018 the center reported about ten cases of ‘almost choking events’. In the middle of 2018 alone three cases of ‘almost an event’ were reported. Objective: Providing knowledge leads to awareness raise, change of perception, change in behavior and prevention. The center employs more than 130 staff members from various sectors so that it is the work of multi-professional teams to promote the quality and safety of the treatment. The familiarity of the staff with risk factors, prevention guidelines, identification of choking signs, and treatment are most important and significant in determining the outcome of a choking event. Conclusions and recommendations: After in-depth research work was carried out in cooperation with the Risk Management Unit on the subject of choking, which include a description of the definitions, mechanisms, risk factors, treatment methods and extensive recommendations for prevention (e.g. using treatment and stimulation accessories with standards association stamps and adjustment of the type of food and the way it is served to match to the child's age and the ability to swallow). The expected stages of development and emphasis on the population of children with special needs were taken into account. The research findings will be published by the staff and parents of the patients, professional publications, and lectures and there is an expectation to decrease the number of choking events in the next years.

Keywords: children with special needs, choking, educational system, prevention guidelines

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Authors: Judson P. LaGrone

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Simulation-based education in curricula was once a luxurious component of nursing programs but now serves as a vital element of an individual’s learning experience. A debriefing occurs after the simulation scenario or clinical experience is completed to allow the instructor(s) or trained professional(s) to act as a debriefer to guide a reflection with a purpose of acknowledging, assessing, and synthesizing the thought process, decision-making process, and actions/behaviors performed during the scenario or clinical experience. Debriefing is a vital component of the simulation process and educational experience to allow the learner(s) to progressively build upon past experiences and current scenarios within a safe and welcoming environment with a guided dialog to enhance future practice. The aim of this integrative review was to assess current practices of debriefing models in simulation-based education for health care professionals and students. The following databases were utilized for the search: CINAHL Plus, Cochrane Database of Systemic Reviews, EBSCO (ERIC), PsycINFO (Ovid), and Google Scholar. The advanced search option was useful to narrow down the search of articles (full text, Boolean operators, English language, peer-reviewed, published in the past five years). Key terms included debrief, debriefing, debriefing model, debriefing intervention, psychological debriefing, simulation, simulation-based education, simulation pedagogy, health care professional, nursing student, and learning process. Included studies focus on debriefing after clinical scenarios of nursing students, medical students, and interprofessional teams conducted between 2015 and 2020. Common themes were identified after the analysis of articles matching the search criteria. Several debriefing models are addressed in the literature with similarities of effectiveness for participants in clinical simulation-based pedagogy. Themes identified included (a) importance of debriefing in simulation-based pedagogy, (b) environment for which debriefing takes place is an important consideration, (c) individuals who should conduct the debrief, (d) length of debrief, and (e) methodology of the debrief. Debriefing models supported by theoretical frameworks and facilitated by trained staff are vital for a successful debriefing experience. Models differed from self-debriefing, facilitator-led debriefing, video-assisted debriefing, rapid cycle deliberate practice, and reflective debriefing. A reoccurring finding was centered around the emphasis of continued research for systematic tool development and analysis of the validity and effectiveness of current debriefing practices. There is a lack of consistency of debriefing models among nursing curriculum with an increasing rate of ill-prepared faculty to facilitate the debriefing phase of the simulation.

Keywords: debriefing model, debriefing intervention, health care professional, simulation-based education

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Authors: Min-Hsun Liao

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Since the outbreak of war between Russia and Ukraine in February 2022, universities around the world have extended their helping hands to welcome Ukrainian students whose academic careers have been unexpectedly interrupted. Tunghai University (THU) in Taiwan and Mykolas Romeris University (MRU) in Lithuania are among the many other universities offering short- and long-term scholarships to host Ukrainian students in the midst of the war crisis. This mixed-methods study examines the cross-cultural adjustment processes of Ukrainian students in Taiwan. The research team at MRU will also conduct a parallel study with their Ukrainian students. Both institutions are committed to gaining insights into the adjustment processes of these students through cross-institutional collaboration. Studies show that while international students come from different cultural backgrounds, the difficulties they face while studying abroad are comparable and vary in intensity. These difficulties range from learning the language of the host country, adopting cultural customs, and adapting culinary preferences to the sociocultural shock of being separated from family and friends. These problems have been the subject of numerous studies. Study findings indicate that these challenges, if not properly addressed, can lead to significant stress, despair, and failure in academics or other endeavors for international students, not to mention those who have had to leave home involuntarily and settle into a completely new environment. Among these challenges, the language of the host country is foremost. The issue of international students' adjustment, particularly language acquisition, is critical to the psychological, academic, and sociocultural well-being of individuals. Both quantitative and qualitative data will be collected: 1) the International Student Cross-cultural Adaptation Survey (ISCAS) will be distributed to all Ukrainian students in both institutions; 2) one-on-one interviews will be conducted to gain a deeper understanding of their adaptations; and 3) t-tests or ANOVA will be calculated to determine significant differences between the languages used and the adaptation patterns of Ukrainian students. The significance of this study is consistent with three SDGs, namely quality education, peace/justice, and strong institutions and partnerships for the goals. The THU and MRU research teams believe that through partnership, both institutions can benefit exponentially from sharing the data, avoiding fixed interpretation, and sharing contextual insights, which will help improve the overall quality of education for international students and promote peace/justice through strong institutions. The impact of host country language proficiency on academic and sociocultural adjustments remains inconclusive. Therefore, the outcome of the study will shed new light on the relationship between language and various adjustments. In addition, the feedback from Ukrainian students will help other host countries better serve international students who must flee their home countries for an undisturbed education.

Keywords: international students, ukrainian students, cross-cultural adaptation, host country language, acculturation theory

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Authors: Marius Nygaard, Ona Flindall

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The Palisaden student housing project was completed in August 2013 and was, with its eight floors, Norway’s tallest timber building at the time of completion. It was the first time cross-laminated-timber (CLT) was utilized at this scale in Norway. The project was the result of a concerted effort by a newly formed management company to establish CLT as a sustainable and financially competitive alternative to conventional steel and concrete systems. The introduction of CLT onto the student housing market proved so successful that by 2017 more than 4000 individual student residences will have been built using the same model of development and construction. The aim of this paper is to identify the key factors that enabled this breakthrough for CLT. It is based on an in-depth study of a series of housing projects and the role of the management company who both instigated and enabled this shift of CLT from the margin to the mainstream. Specifically, it will look at how a new building system was integrated into a marketing strategy that identified a market potential within the existing structure of the construction industry and within the economic restrictions inherent to student housing in Norway. It will show how a key player established a project model that changed both the patterns of cooperation and the information basis for decisions. Based on qualitative semi-structured interviews with managers, contractors and the interdisciplinary teams of consultants (architects, structural engineers, acoustical experts etc.) this paper will trace the introduction, expansion and evolution of CLT-based building systems in the student housing market. It will show how the project management firm’s position in the value chain enabled them to function both as a liaison between contractor and client, and between contractor and producer. A position that allowed them to improve the flow of information. This ensured that CLT was handled on equal terms to other structural solutions in the project specifications, enabling realistic pricing and risk evaluation. Secondly, this paper will describe and discuss how the project management firm established and interacted with a growing network of contractors, architects and engineers to pool expertise and broaden the knowledge base across Norway’s regional markets. Finally, it will examine the role of the client, the building typology, and the industrial and technological factors in achieving this breakthrough for CLT in the construction industry. This paper gives an in-depth view of the progression of a single case rather than a broad description of the state of the art of large-scale timber building in Norway. However, this type of study may offer insights that are important to the understanding not only of specific markets but also of how new technologies should be introduced in big and well-established industries.

Keywords: cross-laminated-timber (CLT), industry breakthrough, student housing, timber market

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Authors: K. Mellou, G. Anastopoulos, T. Zakinthinos, C. Botsi, A. Terzidis

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‘PHILOS – Emergency health response to refugee crisis’ is a programme of the Greek Ministry of Health, implemented by the Hellenic Center for Disease Control and Prevention (HCDCP). The programme is funded by the Asylum, Migration and Integration Fund (AMIF) of EU’s DG Migration and Home Affairs. With the EU Member States accepting, the last period, accelerating migration flows, Greece inevitably occupies a prominent position in the migratory map due to this geographical location. The main objectives of the programme are a) reinforcement of the capacity of the public health system and enhancement of the epidemiological surveillance in order to cover refugees/migrant population, b) provision of on-site primary health care and psychological support services, and c) strengthening of national health care system task-force. The basic methods for achieving the aforementioned goals are: a) implementation of syndromic surveillance system at camps and enhancement of public health response with the use of mobile medical units (Sub-action A), b) enhancement of health care services inside the camps via increasing human resources and implementing standard operating procedures (Sub-action B), and c) reinforcement of the national health care system (primary healthcare units, hospitals, and emergency care spots) of affected regions with personnel (Sub-action C). As a result, 58 health professionals were recruited under sub-action 2 and 10 mobile unit teams (one or two at each health region) were formed. The main actions taken so far by the mobile units are the evaluation, of syndromic surveillance, of living conditions at camps and medical services. Also, vaccination coverage of children population was assessed, and more than 600 catch-up vaccinations were performed by the end of June 2017. Mobile units supported transportation of refugees/migrants from camps to medical services reducing the load of the National Center for Emergency Care (more than 350 transportations performed). The total number of health professionals (MD, nurses, etc.) placed at camps was 104. Common practices were implemented in the recording and collection of psychological and medical history forms at the camps. Protocols regarding maternity care, gender based violence and handling of violent incidents were produced and distributed at personnel working at camps. Finally, 290 health care professionals were placed at primary healthcare units, public hospitals and the National Center for Emergency Care at affected regions. The program has, also, supported training activities inside the camps and resulted to better coordination of offered services on site.

Keywords: migrants, refugees, public health, syndromic surveillance, national health care system, primary care, emergency health response

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Authors: Ariane Plaisance, Holly O. Witteman, Patrick Michel Archambault

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Upon admission to an intensive care unit (ICU), all patients should discuss their wishes concerning life-sustaining interventions (e.g., cardiopulmonary resuscitation (CPR)). Without such discussions, interventions that prolong life at the cost of decreasing its quality may be used without appropriate guidance from patients. We employed user-centered design to adapt an existing decision aid (DA) about CPR to create a novel wiki-based DA adapted to the context of a single ICU and tailored to individual patient’s risk factors. During Phase 1, we conducted three weeks of ethnography of the decision-making context in our ICU to identify clinician and patient needs for a decision aid. During this time, we observed five dyads of intensivists and patients discussing their wishes concerning life-sustaining interventions. We also conducted semi-structured interviews with the attending intensivists in this ICU. During Phase 2, we conducted three rounds of rapid prototyping involving 15 patients and 11 other allied health professionals. We recorded discussions between intensivists and patients and used a standardized observation grid to collect patients’ comments and sociodemographic data. We applied content analysis to field notes, verbatim transcripts and the completed observation grids. Each round of observations and rapid prototyping iteratively informed the design of the next prototype. We also used the programming architecture of a wiki platform to embed the GO-FAR prediction rule programming code that we linked to a risk graphics software to better illustrate outcome risks calculated. During Phase I, we identified the need to add a section in our DA concerning invasive mechanical ventilation in addition to CPR because both life-sustaining interventions were often discussed together by physicians. During Phase II, we produced a context-adapted decision aid about CPR and mechanical ventilation that includes a values clarification section, questions about the patient’s functional autonomy prior to admission to the ICU and the functional decline that they would judge acceptable upon hospital discharge, risks and benefits of CPR and invasive mechanical ventilation, population-level statistics about CPR, a synthesis section to help patients come to a final decision and an online calculator based on the GO-FAR prediction rule. Even though the three rounds of rapid prototyping led to simplifying the information in our DA, 60% (n= 3/5) of the patients involved in the last cycle still did not understand the purpose of the DA. We also identified gaps in the discussion and documentation of patients’ preferences concerning life-sustaining interventions (e.g.,. CPR, invasive mechanical ventilation). The final version of our DA and our online wiki-based GO-FAR risk calculator using the IconArray.com risk graphics software are available online at www.wikidecision.org and are ready to be adapted to other contexts. Our results inform producers of decision aids on the use of wikis and user-centered design to develop DAs that are better adapted to users’ needs. Further work is needed on the creation of a video version of our DA. Physicians will also need the training to use our DA and to develop shared decision-making skills about goals of care.

Keywords: ethnography, intensive care units, life-sustaining therapies, user-centered design

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Authors: Thao Nguyen, Maximiliano Hyon, Sany Rajagukguk, Anna Melkonyan

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Introduction: Type 2 Diabetes is a well-established risk factor for severe SARS-CoV-2 infection. Uncontrolled hyperglycemia in patients with established or newly diagnosed diabetes is associated with poor outcomes, including increased mortality and hospital length of stay. Objectives: Our study aims to compare three different glycemic management strategies and their association with clinical outcomes in patients hospitalized for moderate to severe SARS-CoV-2 infection. Identifying optimal glycemic management strategies will improve the quality of patient care and improve their outcomes. Method: This is a retrospective observational study on patients hospitalized at Adventist Health White Memorial with severe SARS-CoV-2 infection from 11/1/2020 to 02/28/2021. The following inclusion criteria were used: positive SARS-CoV-2 PCR test, age >18 yrs old, diabetes or random glucose >200 mg/dL on admission, oxygen requirement >4L/min, and treatment with glucocorticoids. Our exclusion criteria included: ICU admission within 24 hours, discharge within five days, death within five days, and pregnancy. The patients were divided into three glycemic management groups: Group 1, managed solely by the Primary Team, Group 2, by Pharmacy; and Group 3, by Endocrinologist. Primary outcomes were average glucose on Day 5, change in glucose between Days 3 and 5, and average insulin dose on Day 5 among groups. Secondary outcomes would be upgraded to ICU, inpatient mortality, and hospital length of stay. For statistics, we used IBM® SPSS, version 28, 2022. Results: Most studied patients were Hispanic, older than 60, and obese (BMI >30). It was the first CV-19 surge with the Delta variant in an unvaccinated population. Mortality was markedly high (> 40%) with longer LOS (> 13 days) and a high ICU transfer rate (18%). Most patients had markedly elevated inflammatory markers (CRP, Ferritin, and D-Dimer). These, in combination with glucocorticoids, resulted in severe hyperglycemia that was difficult to control. Average glucose on Day 5 was not significantly different between groups primary vs. pharmacy vs. endocrine (220.5 ± 63.4 vs. 240.9 ± 71.1 vs. 208.6 ± 61.7 ; P = 0.105). Change in glucose from days 3 to 5 was not significantly different between groups but trended towards favoring the endocrinologist group (-26.6±73.6 vs. 3.8±69.5 vs. -32.2±84.1; P= 0.052). TDD insulin was not significantly different between groups but trended towards higher TDD for the endocrinologist group (34.6 ± 26.1 vs. 35.2 ± 26.4 vs. 50.5 ± 50.9; P=0.054). The endocrinologist group used significantly more preprandial insulin compared to other groups (91.7% vs. 39.1% vs. 65.9% ; P < 0.001). The pharmacy used more basal insulin than other groups (95.1% vs. 79.5% vs. 79.2; P = 0.047). There were no differences among groups in the clinical outcomes: LOS, ICU upgrade, or mortality. Multivariate regression analysis controlled for age, sex, BMI, HbA1c level, renal function, liver function, CRP, d-dimer, and ferritin showed no difference in outcomes among groups. Conclusion: Given high-risk factors in our population, despite efforts from the glycemic management teams, it’s unsurprising no differences in clinical outcomes in mortality and length of stay.

Keywords: glycemic management, strategies, hospitalized, SARS-CoV-2, outcomes

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Authors: Cath Grimley, Debra Bick, Sarah Hillman, Louise Clarke, Helen Atherton, Jo Parsons

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The problem: Women in the UK are offered influenza (flu), pertussis (whooping cough) and COVID-19 vaccinations during their pregnancy but uptake of all three vaccines is below the desired rate. These vaccines are offered during pregnancy as pregnant women are at an increased risk of hospitalisation, morbidity, and mortality from these illnesses. Exposure to these diseases during pregnancy can also have a negative impact on the unborn baby with an increased risk of serious complications both while in utero and following birth. The research aims to explore perceptions about the vaccinations offered in pregnancy both from the perspectives of pregnant women and midwives. To determine factors that influence pregnant women’s decisions about whether or not to accept the vaccines following the Covid-19 pandemic and to explore midwives’ experiences of recommending and delivering vaccines. The approach: This research follows a qualitative design involving semi-structured interviews with pregnant women and midwives in the UK. Interviews with midwives explored vaccination discussions they routinely have with pregnant women and identified some of the barriers to vaccination that pregnant women discuss with them. Interviews with pregnant women explored their views since the COVID-19 pandemic about vaccinations offered during pregnancy, and whether the pandemic has influenced perceptions of vulnerability to illness in pregnant women. Midwives were recruited via participating hospitals and midwife specific social media groups. Pregnant women were recruited via participating hospitals and community groups. All interviews were conducted remotely (using telephone or Microsoft Teams) and analysed using thematic analysis. Findings: 43 pregnant women and 16 midwives were recruited and interviewed. The findings presented here will focus on data from midwives. Topics identified included three key themes for midwives. These were 1) Delivery of vaccinations which includes the convenience of offering vaccinations while attending standard antenatal appointments and practical barriers faced in delivering these vaccinations at hospital. 2) Messages and guidance included the importance of up-to-date informational needs for midwives to deliver vaccines and that uncertainty and conflicting messages about the COVID-19 vaccine during pregnancy were a barrier to delivery. 3) Recommendations to have vaccines look at all aspects of recommendations such as how recommendations are communicated, the contents of the recommendation, the importance of the vaccine and the impact of those recommendations on whether women accept the vaccine. Implications: Findings highlight the importance for midwives to receive clear and consistent information so they can feel confident in relaying this information while recommending and delivering vaccines to pregnant women. Emphasising why vaccines are important when recommending vaccinations to pregnant women in addition to standard information on the availability and timing will add to the strength and impact of that recommendation in helping women to make informed decisions about accepting vaccines. The findings of this study will inform the development of an intervention to increase vaccination uptake amongst pregnant women.

Keywords: vaccination, pregnancy, qualitative, interviews, Covid-19, midwives

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Authors: A. Sgobba, C. Meskell

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The feasibility of on-site electricity production from solar and wind and the resulting load management for a specific manufacturing plant in Ireland are assessed. The industry sector accounts directly and indirectly for a high percentage of electricity consumption and global greenhouse gas emissions; therefore, it will play a key role in emission reduction and control. Manufacturing plants, in particular, are often located in non-residential areas since they require open spaces for production machinery, parking facilities for the employees, appropriate routes for supply and delivery, special connections to the national grid and other environmental impacts. Since they have larger spaces compared to commercial sites in urban areas, they represent an appropriate case study for evaluating the technical and economic viability of energy system integration with low power density technologies, such as solar and wind, for on-site electricity generation. The available open space surrounding the analysed manufacturing plant can be efficiently used to produce a discrete quantity of energy, instantaneously and locally consumed. Therefore, transmission and distribution losses can be reduced. The usage of storage is not required due to the high and almost constant electricity consumption profile. The energy load of the plant is identified through the analysis of gas and electricity consumption, both internally monitored and reported on the bills. These data are not often recorded and available to third parties since manufacturing companies usually keep track only of the overall energy expenditures. The solar potential is modelled for a period of 21 years based on global horizontal irradiation data; the hourly direct and diffuse radiation and the energy produced by the system at the optimum pitch angle are calculated. The model is validated using PVWatts and SAM tools. Wind speed data are available for the same period within one-hour step at a height of 10m. Since the hub of a typical wind turbine reaches a higher altitude, complementary data for a different location at 50m have been compared, and a model for the estimate of wind speed at the required height in the right location is defined. Weibull Statistical Distribution is used to evaluate the wind energy potential of the site. The results show that solar and wind energy are, as expected, generally decoupled. Based on the real case study, the percentage of load covered every hour by on-site generation (Level of Autonomy LA) and the resulting electricity bought from the grid (Expected Energy Not Supplied EENS) are calculated. The economic viability of the project is assessed through Net Present Value, and the influence the main technical and economic parameters have on NPV is presented. Since the results show that the analysed renewable sources can not provide enough electricity, the integration with a cogeneration technology is studied. Finally, the benefit to energy system integration of wind, solar and a cogeneration technology is evaluated and discussed.

Keywords: demand, energy system integration, load, manufacturing, national grid, renewable energy sources

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Authors: Diana Mitova, Krassimir Mitrev

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To prepare the current generation for the future, education systems need to change. It implies a way of learning that meets the demands of the times and the environment in which we live. Productive interaction in the educational process implies an interactive learning environment and the possibility of personal development of learners based on communication and mutual dialogue, cooperation and good partnership in decision-making. Students need not only theoretical knowledge, but transferable skills that will help them to become inventors and entrepreneurs, to implement ideas. STEM education , is now a real necessity for the modern school. Through learning in a "learning company", students master examples from classroom practice, simulate real life situations, group activities and apply basic interactive learning strategies and techniques. The learning company is the subject of this study, reduced to entrepreneurship training in STEM - technologies that encourage students to think outside the traditional box. STEM learning focuses the teacher's efforts on modeling entrepreneurial thinking and behavior in students and helping them solve problems in the world of business and entrepreneurship. Learning based on the implementation of various STEM projects in extracurricular activities, experiential learning, and an interdisciplinary approach are means by which educators better connect the local community and private businesses. Learners learn to be creative, experiment and take risks and work in teams - the leading characteristics of any innovator and future entrepreneur. This article presents some European policies on STEM and entrepreneurship education. It also shares best practices for training company training , with the integration of STEM in the learning company training environment. The main results boil down to identifying some advantages and problems in STEM entrepreneurship education. The benefits of using integrative approaches to teach STEM within a training company are identified, as well as the positive effects of project-based learning in a training company using STEM. Best practices for teaching entrepreneurship through extracurricular activities using STEM within a training company are shared. The following research methods are applied in this research paper: Theoretical and comparative analysis of principles and policies of European Union countries and Bulgaria in the field of entrepreneurship education through a training company. Experiences in entrepreneurship education through extracurricular activities with STEM application within a training company are shared. A questionnaire survey to investigate the motivation of secondary vocational school students to learn entrepreneurship through a training company and their readiness to start their own business after completing their education. Within the framework of learning through a "learning company" with the integration of STEM, the activity of the teacher-facilitator includes the methods: counseling, supervising and advising students during work. The expectation is that students acquire the key competence "initiative and entrepreneurship" and that the cooperation between the vocational education system and the business in Bulgaria is more effective.

Keywords: STEM, entrepreneurship, training company, extracurricular activities

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Authors: Alexis Polanco Jr, Tsai Lu Liu

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Research on digital assessment for deaf and hard of hearing (DHH) students is negligible. Part of this stems from the DHH assessment design existing at the intersection of the emergent disciplines of usability, accessibility, and child-computer interaction (CCI). While these disciplines have some prevailing guidelines —e.g. in user experience design (UXD), there is Jacob Nielsen’s 10 Usability Heuristics (Nielsen-10); for accessibility, there are the Web Content Accessibility Guidelines (WCAG) & the Principles of Universal Design (PUD)— this research was unable to uncover a unified set of guidelines. Given that digital assessments have lasting implications for the funding and shaping of U.S. school districts, it is vital that cross-disciplinary guidelines emerge. As a result, this research seeks to provide a framework by which these disciplines can share knowledge. The framework entails a process of asking subject-matter experts (SMEs) and design & development professionals to self-describe their fields of expertise, how their work might serve DHH students, and to expose any incongruence between their ideal process and what is permissible at their workplace. This research used two rounds of mixed methods. The first round consisted of structured interviews with SMEs in usability, accessibility, CCI, and DHH education. These practitioners were not designers by trade but were revealed to use designerly work processes. In addition to asking these SMEs about their field of expertise, work process, etc., these SMEs were asked to comment about whether they believed Nielsen-10 and/or PUD were sufficient for designing products for middle-school DHH students. This first round of interviews revealed that Nielsen-10 and PUD were, at best, a starting point for creating middle-school DHH design guidelines or, at worst insufficient. The second round of interviews followed a semi-structured interview methodology. The SMEs who were interviewed in the first round were asked open-ended follow-up questions about their semantic understanding of guidelines— going from the most general sense down to the level of design guidelines for DHH middle school students. Designers and developers who were never interviewed previously were asked the same questions that the SMEs had been asked across both rounds of interviews. In terms of the research goals: it was confirmed that the design of digital assessments for DHH students is inherently cross-disciplinary. Unexpectedly, 1) guidelines did not emerge from the interviews conducted in this study, and 2) the principles of Nielsen-10 and PUD were deemed to be less relevant than expected. Given the prevalence of Nielsen-10 in UXD curricula across academia and certificate programs, this poses a risk to the efficacy of DHH assessments designed by UX designers. Furthermore, the following findings emerged: A) deep collaboration between the disciplines of usability, accessibility, and CCI is low to non-existent; B) there are no universally agreed-upon guidelines for designing digital assessments for DHH middle school students; C) these disciplines are structured academically and professionally in such a way that practitioners may not know to reach out to other disciplines. For example, accessibility teams at large organizations do not have designers and accessibility specialists on the same team.

Keywords: deaf, hard of hearing, design, guidelines, education, assessment

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Authors: Sarah Lister, Pauline Palmer

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Research findings presented within this paper form part of a larger scale collaboration between academics at Manchester Metropolitan University and a technology company. The overarching aims of this project focus on developing a series of game-based resources to promote the teaching of aspects of mathematics through a second language (L2) in primary schools. This study explores the potential of game-based learning (GBL) as a dynamic way to engage and motivate learners, making learning fun and purposeful. The research examines the capacity of GBL resources to provide a meaningful and purposeful context for CLIL. GBL is a powerful learning environment and acts as an effective vehicle to promote the learning of mathematics through an L2. The fun element of GBL can minimise stress and anxiety associated with mathematics and L2 learning that can create barriers. GBL provides one of the few safe domains where it is acceptable for learners to fail. Games can provide a life-enhancing experience for learners, revolutionizing the routinized ways of learning through fusing learning and play. This study argues that playing games requires learners to think creatively to solve mathematical problems, using the L2 in order to progress, which can be associated with the development of higher-order thinking skills and independent learning. GBL requires learners to engage appropriate cognitive processes with increased speed of processing, sensitivity to environmental inputs, or flexibility in allocating cognitive and perceptual resources. At surface level, GBL resources provide opportunities for learners to learn to do things. Games that fuse subject content and appropriate learning objectives have the potential to make learning academic subjects more learner-centered, promote learner autonomy, easier, more enjoyable, more stimulating and engaging and therefore, more effective. Data includes observations of the children playing the games and follow up group interviews. Given that learning as a cognitive event cannot be directly observed or measured. A Cognitive Discourse Functions (CDF) construct was used to frame the research, to map the development of learners’ conceptual understanding in an L2 context and as a framework to observe the discursive interactions that occur learner to learner and between learner and teacher. Cognitively, the children were required to engage with mathematical content, concepts and language to make decisions quickly, to engage with the gameplay to reason, solve and overcome problems and learn through experimentation. The visual elements of the games supported the learning of new concepts. Children recognised the value of the games to consolidate their mathematical thinking and develop their understanding of new ideas. The games afforded them time to think and reflect. The teachers affirmed that the games provided meaningful opportunities for the learners to practise the language. The findings of this research support the view that using the game-based resources supported children’s grasp of mathematical ideas and their confidence and ability to use the L2. Engaging with the content and language through the games led to deeper learning.

Keywords: CLIL, gaming, language, mathematics

Procedia PDF Downloads 116

Authors: Hsueh Ping Peng

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End-stage renal disease most commonly occurs in the elderly population. Elderly people are approaching the end of their lives, and when facing major life-threatening situations, apart from aggressive medical treatment, they can also choose treatment methods such as hospice care to improve their quality of life. The purpose of this study was to investigate factors associated with the awareness and willingness to sign hospice and palliative care consent forms in elderly with end-stage renal disease. This study used both quantitative, cross-sectional study designs. In the quantitative section, 110 elderly patients (aged 65 or above) with end-stage renal disease receiving conventional hemodialysis were recruited as study participants from a medical center in Taipei City. Data were collected using structured questionnaires. Study tools included basic demographic data, questionnaires on the awareness and perception of hospice and palliative care, etc. After collecting the data, data analysis was conducted using SPSS 20.0 statistical software, including descriptive statistics, chi-square test, logistic regression, and other inferential statistics. The results showed that the average age of participants was 71.6 years old, more males than females, average years of dialysis was 6.1 years and most subjects rated their self-perceived health status as fair. Results of the study are summarized as follows: Elderly people with end-stage renal disease did not have sufficient knowledge and awareness about hospice and palliative care. Influencing factors included level of education, marital status, years of dialysis and age, etc. Demographic factors influencing the signing of consent forms included gender, marital status, and age, which all showed significant impacts. Factors taken into consideration when signing consent forms included awareness of hospice care, understanding the relevant definitions of hospice care, and understanding that consent may be modified or cancelled at any time; it was predicted that people who knew more about ways to receive hospice care or more related definitions were more willing to sign the consent forms. In the qualitative study section, 10 participants who signed the consent form, five male, and 5 female, between the ages of 65-90, have completed the semi-structured interviews. Analysis of the interviews revealed six themes: (1) passing away peacefully, (2) autonomy on arrangements of life and death, (3) unwillingness to increase family and social burden, (4) friends and relatives’ experience influencing the decision to give consent, (5) sharing information to facilitate the giving of consent, (6) facing each day with ease, to reflect the experience and factors of consideration for elderly with end-stage renal disease when signing consent forms. The results of this study provides the awareness, thoughts and feelings of elderly with end-stage renal disease on signing consent forms, and serve as a future reference for the dialysis unit to enhance the promotion of hospice and palliative care and related caregiving measures, thereby improving the quality of life and care for elderly people with end-stage renal disease.

Keywords: end-stage renal disease, hemodialysis, hospice and palliative care, awareness, willingness

Procedia PDF Downloads 143

Authors: Sofia Mariani, Irene Leo

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The objective of the present study is to define the mediating role of attitudes that objectify and devalue women (hostile sexism, benevolent sexism, and sexual objectification of women) in the indirect correlation between exposure to televised sports and acceptance of rape myths. A second goal is to contribute to research on the topic by defining the role of mediators in exposure to different types of sports, following the traditional gender classification of sports. Data collection was carried out by means of an online questionnaire, measuring television sport exposure, sport type, hostile sexism, benevolent sexism, and sexual objectification of women. Data analysis was carried out using IBM SPSS software. The model used was created using Ordinary Least Squares (OLS) regression path analysis. The predictor variable in the model was television sports exposure, the outcome was rape myths acceptance, and the mediators were (1) hostile sexism, (2) benevolent sexism, and (3) sexual objectification of women. Correlation analyses were carried out dividing by sport type and controlling for the participants’ gender. As seen in existing literature, television sports exposure was found to be indirectly and positively related to rape myth acceptance through the mediating role of: (1) hostile sexism, (2) benevolent sexism, and (3) sexual objectification of women. The type of sport watched influenced the role of the mediators: hostile sexism was found to be the common mediator to all sports type, exposure to traditionally considered feminine or neutral sports showed the additional mediation effect of sexual objectification of women. In line with existing literature, controlling for gender showed that the only significant mediators were hostile sexism for male participants and benevolent sexism for female participants. Given the prevalence of men among the viewers of traditionally considered masculine sports, the correlation between television sports exposure and rape myth acceptance through the mediation of hostile sexism is likely due to the gender of the participants. However, this does not apply to the viewers of traditionally considered feminine and neutral sports, as this group is balanced in terms of gender and shows a unique mediation: the correlation between television sports exposure and rape myth acceptance is mediated by both hostile sexism and sexual objectification. Given that hostile sexism is defined as hostility towards women who oppose or fail to conform to traditional gender roles, these findings confirm that sport is perceived as a non-traditional activity for women. Additionally, these results imply that the portrayal of women in traditionally considered feminine and neutral sports - which are defined as such because of their aesthetic characteristics - may have a strong component of sexual objectification of women. The present research contributes to defining the association between sports exposure and rape myth acceptance through the mediation effects of sexist attitudes and sexual objectification of women. The results of this study have practical implications, such as supporting the feminine sports teams who ask for more practical and less revealing uniforms, more similar to their male colleagues and therefore less objectifying.

Keywords: television exposure, sport, rape myths, objectification, sexism

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Authors: S. H. Babu Gurucharan, Priyanka Kaushal

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Majority of the world's population is expected to live in the Asia and Pacific region by 2050 and thus their cities will generate the maximum waste. India, being the second populous country in the world, is an ideal case study to identify a solution for Asian countries. Waste minimisation and utilisation have always been part of the Indian culture. During rapid urbanisation, our society lost the art of waste minimisation and utilisation habits. Presently, Waste is not considered as a resource, thus wasting an opportunity to tap resources. The technologies in vogue are not suited for effective treatment of large quantities of generated solid waste, without impacting the environment and the population. If not treated efficiently, Waste can become a silent killer. The article is trying to highlight the Indian municipal solid waste scenario as a key indicator of Asian waste management and recommend sustainable waste management and suggest effective solutions to treat the Solid Waste. The methods followed during the research were to analyse the solid waste data on characteristics of solid waste generated in Indian cities, then evaluate the current technologies to identify the most suitable technology in Indian conditions with minimal environmental impact, interact with the technology technical teams, then generate a technical process specific to Indian conditions and further examining the environmental impact and advantages/ disadvantages of the suggested process. The most important finding from the study was the recognition that most of the current municipal waste treatment technologies being employed, operate sub-optimally in Indian conditions. Therefore, the study using the available data, generated heat and mass balance of processes to arrive at the final technical process, which was broadly divided into Waste processing, Waste Treatment, Power Generation, through various permutations and combinations at each stage to ensure that the process is techno-commercially viable in Indian conditions. Then environmental impact was arrived through secondary sources and a comparison of environmental impact of different technologies was tabulated. The major advantages of the suggested process are the effective use of waste for resource generation both in terms of maximised power output or conversion to eco-friendly products like biofuels or chemicals using advanced technologies, minimum environmental impact and the least landfill requirement. The major drawbacks are the capital, operations and maintenance costs. The existing technologies in use in Indian municipalities have their own limitations and the shortlisted technology is far superior to other technologies in vogue. Treatment of Municipal Solid Waste with an efficient green power generation is possible through a combination of suitable environment-friendly technologies. A combination of bio-reactors and plasma-based gasification technology is most suitable for Indian Waste and in turn for Asian waste conditions.

Keywords: calorific value, gas fermentation, landfill, municipal solid waste, plasma gasification, syngas

Procedia PDF Downloads 161

Authors: Irene Kalemaki, Ioanna Garefi

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Social Innovation Education (SIE) is a new educational approach that aims to empower students to take action for a more democratic and sustainable society. Conceptually and pedagogically wise, it is situated at the intersection of Enterprise Education and Citizenship Education as it aspires to i) combine action with activism, ii) personal development with collective efficacy, iii) entrepreneurial mindsets with democratic values and iv) individual competences with collective competences. This paper abstract presents the work of the NEMESIS project, funded by H2020, that aims to design, test and validate the first consolidated approach for embedding Social Innovation Education in schools of primary and secondary education. During the academic year 2018-2019, eight schools from five European countries experimented with different approaches and methodologies to incorporate SIE in their settings. This paper reports briefly on these attempts and discusses the wider educational philosophy underlying these interventions with a particular focus on analyzing the learning outcomes and impact on students. That said, this paper doesn’t only report on the theoretical and practical underpinnings of SIE, but most importantly, it provides evidence on the impact of SIE on students. In terms of methodology, the study took place from September 2018 to July 2019 in eight schools from Greece, Spain, Portugal, France, and the UK involving directly 56 teachers, 1030 students and 69 community stakeholders. Focus groups, semi-structured interviews, classroom observations as well as students' written narratives were used to extract data on the impact of SIE on students. The overall design of the evaluation activities was informed by a realist approach, which enabled us to go beyond “what happened” and towards understanding “why it happened”. Research findings suggested that SIE can benefit students in terms of their emotional, cognitive, behavioral and agentic engagement. Specifically, the emotional engagement of students was increased because through SIE interventions; students voice was heard, valued, and acted upon. This made students feel important to their school, increasing their sense of belonging, confidence and level of autonomy. As regards cognitive engagement, both students and teachers reported positive outcomes as SIE enabled students to take ownership of their ideas to drive their projects forward and thus felt more motivated to perform in class because it felt personal, important and relevant to them. In terms of behavioral engagement, the inclusive environment and the collective relationships that were reinforced through the SIE interventions had a direct positive impact on behaviors among peers. Finally, with regard to agentic engagement, it has been observed that students became very proactive which was connected to the strong sense of ownership and enthusiasm developed during collective efforts to deliver real-life social innovations. Concluding, from a practical and policy point of view these research findings could encourage the inclusion of SIE in schools, while from a research point of view, they could contribute to the scientific discourse providing evidence and clarity on the emergent field of SIE.

Keywords: education, engagement, social innovation, students

Procedia PDF Downloads 115

Authors: Violet Petit-Steeghs, Jochem J. R. Van Roon, Jacqueline E. W. Broerse

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Last decennia the retirement age in Europe is gradually increasing. As a result, people have to continue working for a longer period of time. Health problems due to increased sedentary behavior and mental conditions like burn-out, pose a threat in fulfilling employees’ working life. In order to stimulate the ability and willingness to work in the present and future, it is important to stay vital. Vitality is regarded in literature as a sense of energy, motivation and resilience. It is assumed that by increasing their vitality, employees will stay healthier and be more satisfied with their job, leading to a more sustainable employment and less absenteeism in the future. The aim of this project is to obtain insights into the experiences and barriers of employees, and specifically office workers, with regard to their vitality. These insights are essential in order to develop appropriate measures in the future. To get more insights in the experiences of office workers on their vitality, 8 focus group discussions were organized with 6-10 office workers from 4 different employers (an university, a national construction company and a large juridical and care service organization) in the Netherlands. The discussions were transcribed and analyzed via open coding. This project is part of a larger consortium project Provita2, and conducted in collaboration with University of Technology Eindhoven. Results showed that a range of interdependent factors form a complex network that influences office workers’ vitality. These factors can be divided in three overarching groups: (1) personal (2) organizational and (3) environmental factors. Personal intrinsic factors, relating to the office worker, comprise someone’s physical health, coping style, life style, needs, and private life. Organizational factors, relating to the employer, are the workload, management style and the structure, vision and culture of the organization. Lastly, environmental factors consist of the air, light, temperature at the workplace and whether the workplace is inspiring and workable. Office workers experienced barriers to improve their own vitality due to a lack of autonomy. On the one hand, because most factors were not only intrinsic but extrinsic, like work atmosphere or the temperature in the room. On the other hand, office workers were restricted in adapting both intrinsic as well as extrinsic factors. Restrictions to for instance the flexibility of working times and the workload, can set limitations for improving vitality through personal factors like physical activity and mental relaxation. In conclusion, a large range of interdependent factors influence the vitality of office workers. Office workers are often regarded to have a responsibility to improve their vitality, but are limitedly autonomous in adapting these factors. Measures to improve vitality should therefore not only focus on increasing awareness among office workers, but also on empowering them to fulfill this responsibility. A holistic approach that takes the complex mutual dependencies between the different factors and actors (like managers, employees and HR personnel) into account is highly recommended.

Keywords: occupational health, perspectives office workers, sustainable employment, vitality at work, work & wellbeing

Procedia PDF Downloads 115

Authors: Sibawu Witness Siyepu

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This study explores the effects of instructional design using blended learning in the learning of radian measures among Engineering students. Blended learning is an education programme that combines online digital media with traditional classroom methods. It requires the physical presence of both lecturer and student in a mathematics computer laboratory. Blended learning provides element of class control over time, place, path or pace. The focus was on the use of Khan Academy to supplement traditional classroom interactions. Khan Academy is a non-profit educational organisation created by educator Salman Khan with a goal of creating an accessible place for students to learn through watching videos in a computer assisted computer. The researcher who is an also lecturer in mathematics support programme collected data through instructing students to watch Khan Academy videos on radian measures, and by supplying students with traditional classroom activities. Classroom activities entails radian measure activities extracted from the Internet. Students were given an opportunity to engage in class discussions, social interactions and collaborations. These activities necessitated students to write formative assessments tests. The purpose of formative assessments tests was to find out about the students’ understanding of radian measures, including errors and misconceptions they displayed in their calculations. Identification of errors and misconceptions serve as pointers of students’ weaknesses and strengths in their learning of radian measures. At the end of data collection, semi-structure interviews were administered to a purposefully sampled group to explore their perceptions and feedback regarding the use of blended learning approach in teaching and learning of radian measures. The study employed Algebraic Insight Framework to analyse data collected. Algebraic Insight Framework is a subset of symbol sense which allows a student to correctly enter expressions into a computer assisted systems efficiently. This study offers students opportunities to enter topics and subtopics on radian measures into a computer through the lens of Khan Academy. Khan academy demonstrates procedures followed to reach solutions of mathematical problems. The researcher performed the task of explaining mathematical concepts and facilitated the process of reinvention of rules and formulae in the learning of radian measures. Lastly, activities that reinforce students’ understanding of radian were distributed. Results showed that this study enthused the students in their learning of radian measures. Learning through videos prompted the students to ask questions which brought about clarity and sense making to the classroom discussions. Data revealed that sense making through reinvention of rules and formulae assisted the students in enhancing their learning of radian measures. This study recommends the use of Khan Academy in blended learning to be introduced as a socialisation programme to all first year students. This will prepare students that are computer illiterate to become conversant with the use of Khan Academy as a powerful tool in the learning of mathematics. Khan Academy is a key technological tool that is pivotal for the development of students’ autonomy in the learning of mathematics and that promotes collaboration with lecturers and peers.

Keywords: algebraic insight framework, blended learning, Khan Academy, radian measures

Procedia PDF Downloads 288

Authors: Leen Al Kassab, Sarah Johns, Helen Noble, Nawal Nour, Elizabeth Janiak, Sarrah Shahawy

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Introduction: Immigrant and refugee women experience disparities in sexual and reproductive health (SRH) outcomes, partially as a result of barriers to SRH literacy and to regular healthcare access and engagement. Despite the existing data highlighting growing needs for culturally relevant and structurally competent care, interventions are scarce and not well-documented. Methods: In this IRB-approved study, we used a community-based participatory research approach, with the assistance of a community advisory board, to conduct a qualitative needs assessment of SRH knowledge and service engagement with immigrant and refugee women from Africa or the Middle East and currently residing in Boston. We conducted a total of nine focus group discussions (FGDs) in partnership with medical, community, and religious centers, in six languages: Arabic, English, French, Somali, Pashtu, and Dari. A total of 44 individuals participated. We explored migrant and refugee women’s current and evolving SRH care needs and gaps, specifically related to the development of interventions and clinical best practices targeting SRH literacy, healthcare engagement, and informed decision-making. Recordings of the FGDs were transcribed verbatim and translated by interpreter services. We used open coding with multiple coders who resolved discrepancies through consensus and iteratively refined our codebook while coding data in batches using Dedoose software. Results: Participants reported immigrant adaptation experiences, discrimination, and feelings of trust, autonomy, privacy, and connectedness to family, community, and the healthcare system as factors surrounding SRH knowledge and needs. The context of previously learned SRH knowledge was commonly noted to be in schools, at menstruation, before marriage, from family members, partners, friends, and online search engines. Common themes included empowering strength drawn from religious and cultural communities, difficulties bridging educational gaps with their US- born daughters, and a desire for more SRH education from multiple sources, including family, health care providers, and religious experts & communities. Regarding further SRH education, participants’ preferences varied regarding ideal platform (virtual vs. in-person), location (in religious and community centers or not), smaller group sizes, and the involvement of men. Conclusions: Based on these results, empowering SRH initiatives should include both community and religious center-based, as well as clinic-based, interventions. Interventions should be composed of frequent educational workshops in small groups involving age-grouped women, daughters, and (sometimes) men, tailored SRH messaging, and the promotion of culturally, religiously, and linguistically competent care.

Keywords: community, immigrant, religion, sexual & reproductive health, women's health

Procedia PDF Downloads 104

Authors: Jacqueline A. G. Sachett, Cláudia S. Nogueira, Diana C. P. Lima, Jessica T. S. Oliveira, Guilherme K. M. Salazar, Lílian K. Aguiar

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The Polo Amazon Telehealth offers several tools for professionals working in Primary Health Care as a second formative opinion, teleconsulting and training between the different areas, whether medicine, dentistry, nursing, physiotherapy, among others. These activities have a monthly schedule of free access to the municipalities of Amazonas registered. With this premise, and in partnership with the University of the State of Amazonas (UEA), is promoting the practice of the triad; teaching-research-extension in order to collaborate with the enrichment and acquisition of knowledge through educational practices carried out through teleconferences. Therefore, nursing is to join efforts and inserts as a collaborator of this project running, contributing to the education and training of these professionals who are part of the health system in full Amazon. The aim of this study is to report the experience of academic of Amazonas State University nursing course, about the experience in the extension project underway in Polo Telemedicine Amazon. This was a descriptive study, the experience report type, about the experience of nursing academic UEA, by extension 'Telenursing: teleconsulting and second formative opinion for FHS professionals in the state of Amazonas' project, held in Polo Telemedicine Amazon, through an agreement with the UEA and funded by the Foundation of Amazonas Research from July / 2012 to July / 2016. Initially developed active search of members of the Family Health Strategy professionals, in order to provide training and training teams to use the virtual clinic, as well as the virtual environment is the focus of this tool design. The election period was an aggravating factor for the implementation of teleconsulting proposal, due to change of managers in each municipality, requiring the stoppage until they assume their positions. From this definition, we established the need for new training. The first video conference took place on 03.14.2013 for learning and training in the use of Virtual Learning Environment and Virtual Clinic, with the participation of municipalities of Novo Aripuanã, São Paulo de Olivença and Manacapuru. During the whole project was carried out literature about what is being done and produced at the national level about the subject. By the time the telenursing project has received twenty-five (25) consultancy requests. The consultants sent by nursing professionals, all have been answered to date. Faced with the lived experience, particularly in video conferencing, face to cause difficulties issues, such as the fluctuation in the number of participants in activities, difficulty of participants to reconcile the opening hours of the units with the schedule of video conferencing, transmission difficulties and changes schedule. It was concluded that the establishment of connection between the Telehealth points is one of the main factors for the implementation of Telenursing and that this feature is still new for nursing. However, effective training and updating, may provide to these professional category subsidies to quality health care in the Amazon.

Keywords: Amazon, teleconsulting, telehealth, telenursing

Procedia PDF Downloads 287

Authors: Euripides Antoniades

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In 1821 the Greek Revolution movement, under the political influence that arose from the French revolution, and the corresponding movements in Italy, Germany and America, requested the liberation of the nation and the establishment of an independent national state. Published topics in the British press regarding the Greek Revolution, focused on : a) the right of the Greeks to claim their freedom from Turkish domination in order to establish an independent state based on the principle of national autonomy, b) criticism regarding Turkish rule as illegal and the power of the Ottoman Sultan as arbitrary, c) the recognition of the Greek identity and its distinction from the Turkish one and d) the endorsement Greeks as the descendants of ancient Greeks. The advantage of newspaper as a media is sharing information and ideas and dealing with issues in greater depth and detail, unlike other media, such as radio or television. The London Times is a print publication that presents, in chronological or thematic order, the news, opinions or announcements about the most important events that have occurred in a place during a specified period of time. This paper employs the rich archive of The London Times archive by quoting extracts from publications of that period, to convey the British public perspective regarding the Greek Revolution from its beginning until the London Protocol of 1828. Furthermore, analyses the publications of the British newspaper in terms of the number of references to the Greek revolution, front page and editorial references as well as the size of publications on the revolution during the period 1821-1828. A combination of qualitative and quantitative content analysis was applied. An attempt was made to record Greek Revolution references along with the usage of specific words and expressions that contribute to the representation of the historical events and their exposure to the reading public. Key finds of this research reveal that a) there was a frequency of passionate daily articles concerning the events in Greece, their length, and context in The London Times, b) the British public opinion was influenced by this particular newspaper and c) the newspaper published various news about the revolution by adopting the role of animator of the Greek struggle. For instance, war events and the battles of Wallachin and Moldavia, Hydra, Crete, Psara, Mesollogi, Peloponnese were presented not only for informing the readers but for promoting the essential need for freedom and the establishment of an independent Greek state. In fact, this type of news was the main substance of the The London Times’ structure, establishing a positive image about the Greek Revolution contributing to the European diplomatic development such as the standpoint of France, - that did not wish to be detached from the conclusions regarding the English loans and the death of Alexander I of Russia and his succession by the ambitious Nicholas. These factors offered a change in the attitude of the British and Russians respectively assuming a positive approach towards Greece. The Great Powers maintained a neutral position in the Greek-Ottoman conflict, same time they engaged in Greek power increasement by offering aid.

Keywords: Greece, revolution, newspaper, the London times, London, great britain, mass media

Procedia PDF Downloads 69

Authors: Sami Alanazi

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Teamwork practices have been recognized as a significant strategy to improve patient safety, quality of care, and staff and patient satisfaction in healthcare settings, particularly within the emergency department (ED). The EDs depend heavily on teams of interdisciplinary healthcare staff to carry out their operational goals and core business of providing care to the serious illness and injured. The ED is also recognized as a high-risk area in relation to service demand and the potential for human error. Few studies have considered the perceptions and experiences of the ED staff (physicians, nurses, allied health professionals, and administration staff) about the practice of teamwork, especially in Saudi Arabia (SA), and no studies have been conducted to explore the practices of teamwork in the EDs. Aim: To explore the practices of teamwork from the perspectives and experiences of staff (physicians, nurses, allied health professionals, and administration staff) when interacting with each other in the admission areas in the ED of a public hospital in the Northern Border region of SA. Method: A qualitative case study design was utilized, drawing on two methods for the data collection, comprising of semi-structured interviews (n=22) with physicians (6), nurses (10), allied health professionals (3), and administrative members (3) working in the ED of a hospital in the Northern Border region of SA. The second method is non-participant direct observation. All data were analyzed using thematic analysis. Findings: The main themes that emerged from the analysis were as follows: the meaningful of teamwork, reasons of teamwork, the ED environmental factors, the organizational factors, the value of communication, leadership, teamwork skills in the ED, team members' behaviors, multicultural teamwork, and patients and families behaviors theme. Discussion: Working in the ED environment played a major role in affecting work performance as well as team dynamics. However, Communication, time management, fast-paced performance, multitasking, motivation, leadership, and stress management were highlighted by the participants as fundamental skills that have a major impact on team members and patients in the ED. It was found that the behaviors of the team members impacted the team dynamics as well as ED health services. Behaviors such as disputes among team members, conflict, cooperation, uncooperative members, neglect, and emotions of the members. Besides that, the behaviors of the patients and their accompanies had a direct impact on the team and the quality of the services. In addition, the differences in the cultures have separated the team members and created undesirable gaps such the gender segregation, national origin discrimination, and similarity and different in interests. Conclusion: Effective teamwork, in the context of the emergency department, was recognized as an essential element to obtain the quality of care as well as improve staff satisfaction.

Keywords: teamwork, barrier, facilitator, emergencydepartment

Procedia PDF Downloads 109

Authors: Cherng-Jye Jeng, Ming-Feng Hou, Hsing-Yuan Liu, Chuan-Feng Chang, Lih-Rong Wang, Yen-Chin Lin

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Introduction: The incidence of breast cancer has gradually increased in Taiwan, and the characteristic of younger ages impact these women in their middle age, and may also cause challenges in terms of family, work, and illness. Breasts are symbols of femininity, as well as of sex. For women, breasts are important organs for the female identity and sexual expression. Losing breasts not only affects the female role, but would also affect sexual attraction and sexual desire. Thus, women with breast cancer who have need for mastectomies experience physical incompletion, which affects women’s self-confidence, physical image, and self-orientation. Purposes: 1. To understand the physical experience of women with breast cancer. 2. To explore the issue of sexual issues on the health effects of women with breast cancer. 3. To construct a domestic sex life issue group model for domestic women with breast cancer. 4. To explore the accompaniment experiences and sexual relationship adjustments of spouses when women have breast cancer. Method: After the research plan passes IRB review, participants will be recruited at breast surgery clinic in the affiliated hospital, to screen suitable subjects for entry into the group. Between March and May 2015, two sexual health and sex life consultation groups were conducted, which were (1) 10 in postoperative groups for women with cancer; (2) 4 married couples group for postoperative women with cancer. After sharing experiences and dialogue, women can achieve mutual support and growth. Data organization and analysis underwent descriptive analysis in qualitative research, and the group process was transcribed into transcripts for overall-content and category-content analysis. Results: Ten women with breast cancer believed that participating in group can help them exchange experiences, and elevate sexual health. The main issues include: (1) after breast cancer surgery, patients generally received chemotherapy or estrogen suppressants, causing early menopause; in particular, vaginal dryness can cause pain or bleeding in intercourse, reducing their desire for sexual activity; (2) breast cancer accentuates original spousal or family and friend relationships; some people have support and care from their family, and spouses emphasize health over the appearance of breasts; however, some people do not have acceptance and support from their family, and some even hear spousal sarcasm about loss of breasts; (3) women with breast cancer have polarized expressions of optimism and pessimism in regards to their emotions, beliefs, and body image regarding cancer; this is related to the women’s original personalities, attribution of causes of cancer, and extent of worry about relapse. Conclusion: The research results can be provided as a reference to medical institutions or breast cancer volunteer teams, to pay attention to maintaining the health of women with breast cancer.

Keywords: women with breast cancer, experiences of objectifying the body, quality of sex life, sexual health

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Authors: Aliya Moreira, Blake Duffy, Sam Kosinski, Kate Heckman, Erika Steensma

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Introduction: The One Health initiative promotes recognition of the interrelatedness between people, animals, plants, and their shared environment. The field of comparative medicine studies the similarities and differences between humans and animals for the purpose of advancing medical sciences. Currently, medical school education is narrowly focused on human anatomy and physiology, but as the COVID-19 pandemic has demonstrated, a holistic understanding of health requires comprehension of the interconnection between health and the lived environment. To prepare future physicians for unique challenges from emerging zoonoses to climate change, medical students can benefit from exposure to and experience with One Health and Comparative Medicine content. Methods: In January 2020, an elective course for medical students on One Health and Comparative Medicine was created to provide medical students with the background knowledge necessary to understand the applicability of animal and environmental health in medical research and practice. The 2-week course was continued in January 2021, with didactic and experiential activities taking place virtually due to the COVID-19 pandemic. In response to student feedback, lectures were added to expand instructional content on zoonotic and wildlife diseases for the second iteration of the course. Other didactic sessions included interprofessional lectures from 20 physicians, veterinarians, public health professionals, and basic science researchers. The first two cohorts of students were surveyed regarding One Health and Comparative Medicine concepts at the beginning and conclusion of the course. Results: 16 medical students have completed the comparative medicine course thus far, with 87.5% (n=14) completing pre-and post-course evaluations. 100% of student respondents indicated little to no exposure to comparative medicine or One Health concepts during medical school. Following the course, 100% of students felt familiar or very familiar with comparative medicine and One Health concepts. To assess course efficacy, questions were evaluated on a five-point Likert scale. 100% agreed or strongly agreed that learning Comparative Medicine and One Health topics augmented their medical education. 100% agreed or strongly agreed that a course covering this content should be regularly offered to medical students. Conclusions: Data from the student evaluation surveys demonstrate that the Comparative Medicine course was successful in increasing medical student knowledge of Comparative Medicine and One Health. Results also suggest that interprofessional training in One Health and Comparative Medicine is applicable and useful for medical trainees. Future iterations of this course could capitalize on the inherently interdisciplinary nature of these topics by enrolling students from veterinary and public health schools into a longitudinal course. Such recruitment may increase the course’s value by offering multidisciplinary student teams the opportunity to conduct research projects, thereby strengthening both the individual learning experience as well as sparking future interprofessional research ventures. Overall, these efforts to educate medical students in One Health topics should be reproducible at other institutions, preparing more future physicians for the diverse challenges they will encounter in practice.

Keywords: medical education, interprofessional instruction, one health, comparative medicine

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Authors: Mikko Salminen, Simo Järvelä, Niklas Ravaja

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One of the central models of emotional intelligence (EI) is that of Mayer and Salovey’s, which includes ability to monitor own feelings and emotions and those of others, ability to discriminate different emotions, and to use this information to guide thinking and actions. There is vast amount of previous research where positive links between EI and, for example, leadership successfulness, work outcomes, work wellbeing and organizational climate have been reported. EI has also a role in the effectiveness of work teams, and the effects of EI are especially prominent in jobs requiring emotional labor. Thus, also the organizational context must be taken into account when considering the effects of EI on work outcomes. Based on previous research, it is suggested that EI can also protect managers from the negative consequences of stress. Stress may have many detrimental effects on the manager’s performance in essential work tasks. Previous studies have highlighted the effects of stress on, not only health, but also, for example, on cognitive tasks such as decision-making, which is important in managerial work. The motivation for the current study came from the notion that, unfortunately, many stressed individuals may not be aware of the circumstance; periods of stress-induced physiological arousal may be prolonged if there is not enough time for recovery. To tackle this problem, physiological stress levels of managers were collected using recording of heart rate variability (HRV). The goal was to use this data to provide the managers with feedback on their stress levels. The managers could access this feedback using a www-based learning environment. In the learning environment, in addition to the feedback on stress level and other collected data, also developmental tasks were provided. For example, those with high stress levels were sent instructions for mindfulness exercises. The current study focuses on the relation between the measured physiological stress levels and EI of the managers. In a pilot study, 33 managers from various fields wore the Firstbeat Bodyguard HRV measurement devices for three consecutive days and nights. From the collected HRV data periods (minutes) of stress and recovery were detected using dedicated software. The effects of EI on HRV-calculated stress indexes were studied using Linear Mixed Models procedure in SPSS. There was a statistically significant effect of total EI, defined as an average score of Schutte’s emotional intelligence test, on the percentage of stress minutes during the whole measurement period (p=.025). More stress minutes were detected on those managers who had lower emotional intelligence. It is suggested, that high EI provided managers with better tools to cope with stress. Managing of own emotions helps the manager in controlling possible negative emotions evoked by, e.g., critical feedback or increasing workload. High EI managers may also be more competent in detecting emotions of others, which would lead to smoother interactions and less conflicts. Given the recent trend to different quantified-self applications, it is suggested that monitoring of bio-signals would prove to be a fruitful direction to further develop new tools for managerial and leadership coaching.

Keywords: emotional intelligence, leadership, heart rate variability, personality, stress

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Authors: D. Pogliana, A. Maso, N. Milani, D. Panzin, S. Rivaroli, J. Konin

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This case aims to identify the role of movement quality during the final stage of return to sport (RTS) in a male amateur football player 13 years old after passing the acute phase of the bilateral Osgood-Schlatter disease (OSD). The patient, after a year from passing the acute phase of OSD with the abstention of physical activity, reports bilateral anterior knee pain at the beginning of the football sport activity. Interventions: After the orthopedist check, who recommended physiotherapy sessions for the correction of motor patterns and the isometric reinforcement of the muscles of the quadriceps, the rehabilitation intervention was developed in 7 weeks through 14 sessions of neuro-motor training (NMT) with a frequency of two weekly sessions and six sessions of muscle-strengthening with a frequency of one weekly session. The sessions of NMT were carried out through free body exercises (or with overloads) with visual bio-feedback with the help of two cameras (one with anterior vision and one with lateral vision of the subject) and a big touch screen. The aim of these sessions of NMT was to modify the dysfunctional motor patterns evaluated by the 2D motion analysis test. The test was carried out at the beginning and at the end of the rehabilitation course and included five movements: single-leg squat (SLS), drop jump (DJ), single-leg hop (SLH), lateral shuffle (LS), and change of direction (COD). Each of these movements was evaluated through the video analysis of dynamic valgus knee, pelvic tilt, trunk control, shock absorption, and motor strategy. A free image analysis software (Kinovea) was then used to calculate scores. Results: Baseline assessment of the subject showed a total score of 59% on the right limb and 64% on the left limb (considering an optimal score above 85%) with large deficits in shock absorption capabilities, the presence of dynamic valgus knee, and dysfunctional motor strategies defined “quadriceps dominant.” After six weeks of training, the subject achieved a total score of 80% on the right limb and 86% on the left limb, with significant improvements in shock absorption capabilities, the presence of dynamic knee valgus, and the employment of more hip-oriented motor strategies on both lower limbs. The improvements shown in dynamic knee valgus, greater hip-oriented motor strategies, and improved shock absorption identified through six weeks of the NMT program can help a teenager amateur football player to manage the anterior knee pain during sports activity. In conclusion, NMT was a good choice to help a 13 years old male amateur football player to return to performance without pain after OSD and can also be used with all this type of athletes of the other teams' sports.

Keywords: movement analysis, neuro-motor training, knee pain, movement strategies

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Authors: Munir Kassa, Mengistu Hailemariam, Meghan Obermeyer, Kefelegn Baruda, Yonas Getachew, Asnakech Dessie

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Improving the quality of sexual and reproductive health services that women receive is expected to have an impact on women’s satisfaction with the services, on their continued use and, ultimately, on their ability to achieve their fertility goals or reproductive intentions. Surprisingly, however, there is little empirical evidence of either whether this expectation is correct, or how best to improve service quality within sexual and reproductive health programs so that these impacts can be achieved. The Recent focus on quality has prompted more physicians to do quality improvement work, but often without the needed skill sets, which results in poorly conceived and ultimately unsuccessful improvement initiatives. As this renders the work unpublishable, it further impedes progress in the field of health care improvement and widens the quality chasm. Moreover, since 2014, the Center for International Reproductive Health Training (CIRHT) has worked diligently with 11 teaching hospitals across Ethiopia to increase access to contraception and abortion care services. This work has included improving pre-service training through education and curriculum development, expanding hands-on training to better learn critical techniques and counseling skills, and fostering a “team science” approach to research by encouraging scientific exploration. This is the first time this systematic approach has been applied and documented to improve access to high-quality services in Ethiopia. The purpose of this article is to report initiatives undertaken, and findings concluded by the clinical service team at CIRHT in an effort to provide a pragmatic approach to quality improvement projects. An audit containing nearly 300 questions about several aspects of patient care, including structure, process, and outcome indicators was completed by each teaching hospital’s quality improvement team. This baseline audit assisted in identifying major gaps and barriers, and each team was responsible for determining specific quality improvement aims and tasks to support change interventions using Shewart’s Cycle for Learning and Improvement (the Plan-Do-Study-Act model). To measure progress over time, quality improvement teams met biweekly and compiled monthly data for review. Also, site visits to each hospital were completed by the clinical service team to ensure monitoring and support. The results indicate that applying an evidence-based, participatory approach to quality improvement has the potential to increase the accessibility and quality of services in a short amount of time. In addition, continued ownership and on-site support are vital in promoting sustainability. This approach could be adapted and applied in similar contexts, particularly in other African countries.

Keywords: abortion, contraception, quality improvement, service provision

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Authors: Judith Sue Hwa Joo

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Guanyin (Avalokiteśvara in Sanskrit), the Bodhisattva of Mercy and Compassion, is the most widely worshipped Buddhist Divinity in Chinese societies and is also believed by more than half of Asian populations across various countries. The most overwhelming reason for the popularity of Guanyin in Chinese societies is, according to the Lotus Sutra, that Guanyin would apperceive voices of those suffering from immense afflictions and troubles, and liberate them upon crying for his/her holy name with wholeheartedness. Its pervasive social influence has spanned more than two thousand years and is still deeply affecting the lives of most Chinese people. This study aimed to investigate whether Guanyin Worship has evolved and changed in modern Chinese societies across the Taiwan Strait. Taiwan and China, albeit having the same language and culture, have been territorially divided and governed by two different political regimes for over 70 years. It would be scientifically intriguing to unveil any substantial changes in religious behaviors in the context of Guanyin Worship. A comprehensive anonymous questionnaire survey in Chinese communities was conducted from October 2017 to May 2019 across various countries, mostly in China, Taiwan, and Hong Kong areas. Since the religious survey is officially prohibited in China, the study was difficult and could only be exercised by means of snowball sampling. Demographic data (age, sex, education, religious belief) were registered and Guanyin’s salvation functions under various confronting situations were investigated. Psychological dimensions of religious belief in Guanyin were probed in terms of the worship experience, the willingness of veneration, and egoistic or altruistic ideations. A literature review on documented functional attributes was carried out in parallel for comparison analyses with traditional roles. Effective 1123 out of 1139 samples were obtained. Statistical analysis revealed that Guanyin Worship is still commonly practiced and deeply rooted in the hearts of all Chinese people regardless of gender, age, education, and residential area, even though they may not enshrine Guanyin at home nowadays. The conventional roles of Guanyin Bodhisattva are still valid and best satisfy the real interests of lifestyles in modern times. When comparing the traditional Buddhist Sutra and the documented literature, the divine power of modern Guanyin has notably empowered to recover, protect and transform fetal and infant spirits due to the sexual liberation, increased abortion rate, gender awakening and enhanced female autonomy in the reproductive decision. However, the One-Child policy may have critically impacted the trajectory of Guanyin Worship so that people in China prevail over those in Taiwan praying for aborted lives or premature deaths. Furthermore, particularly in Hong Kong and Macao, Guanyin not only serves as the sea guardian for the fishermen but also additional services a new function as the God of Wealth. The divine powers and salvation functions of Guanyin are indeed evolving and expanding to comply with the modern psychosocial, cultural and societal needs. This study sheds light on the modernization process of the two-thousand-year-old Guanyin Worship of contemporary Chinese societies.

Keywords: Buddhism, Guanyin, religious behavior, salvation function

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