Search results for: critical resources
Commenced in January 2007
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Edition: International
Paper Count: 10125

Search results for: critical resources

675 Predicting Provider Service Time in Outpatient Clinics Using Artificial Intelligence-Based Models

Authors: Haya Salah, Srinivas Sharan

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Healthcare facilities use appointment systems to schedule their appointments and to manage access to their medical services. With the growing demand for outpatient care, it is now imperative to manage physician's time effectively. However, high variation in consultation duration affects the clinical scheduler's ability to estimate the appointment duration and allocate provider time appropriately. Underestimating consultation times can lead to physician's burnout, misdiagnosis, and patient dissatisfaction. On the other hand, appointment durations that are longer than required lead to doctor idle time and fewer patient visits. Therefore, a good estimation of consultation duration has the potential to improve timely access to care, resource utilization, quality of care, and patient satisfaction. Although the literature on factors influencing consultation length abound, little work has done to predict it using based data-driven approaches. Therefore, this study aims to predict consultation duration using supervised machine learning algorithms (ML), which predicts an outcome variable (e.g., consultation) based on potential features that influence the outcome. In particular, ML algorithms learn from a historical dataset without explicitly being programmed and uncover the relationship between the features and outcome variable. A subset of the data used in this study has been obtained from the electronic medical records (EMR) of four different outpatient clinics located in central Pennsylvania, USA. Also, publicly available information on doctor's characteristics such as gender and experience has been extracted from online sources. This research develops three popular ML algorithms (deep learning, random forest, gradient boosting machine) to predict the treatment time required for a patient and conducts a comparative analysis of these algorithms with respect to predictive performance. The findings of this study indicate that ML algorithms have the potential to predict the provider service time with superior accuracy. While the current approach of experience-based appointment duration estimation adopted by the clinic resulted in a mean absolute percentage error of 25.8%, the Deep learning algorithm developed in this study yielded the best performance with a MAPE of 12.24%, followed by gradient boosting machine (13.26%) and random forests (14.71%). Besides, this research also identified the critical variables affecting consultation duration to be patient type (new vs. established), doctor's experience, zip code, appointment day, and doctor's specialty. Moreover, several practical insights are obtained based on the comparative analysis of the ML algorithms. The machine learning approach presented in this study can serve as a decision support tool and could be integrated into the appointment system for effectively managing patient scheduling.

Keywords: clinical decision support system, machine learning algorithms, patient scheduling, prediction models, provider service time

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674 Negotiating Communication Options for Deaf-Disabled Children

Authors: Steven J. Singer, Julianna F. Kamenakis, Allison R. Shapiro, Kimberly M. Cacciato

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Communication and language are topics frequently studied among deaf children. However, there is limited research that focuses specifically on the communication and language experiences of Deaf-Disabled children. In this ethnography, researchers investigated the language experiences of six sets of parents with Deaf-Disabled children who chose American Sign Language (ASL) as the preferred mode of communication for their child. Specifically, the researchers were interested in the factors that influenced the parents’ decisions regarding their child’s communication options, educational placements, and social experiences. Data collection in this research included 18 hours of semi-structured interviews, 20 hours of participant observations, over 150 pages of reflexive journals and field notes, and a 2-hour focus group. The team conducted constant comparison qualitative analysis using NVivo software and an inductive coding procedure. The four researchers each read the data several times until they were able to chunk it into broad categories about communication and social influences. The team compared the various categories they developed, selecting ones that were consistent among researchers and redefining categories that differed. Continuing to use open inductive coding, the research team refined the categories until they were able to develop distinct themes. Two team members developed each theme through a process of independent coding, comparison, discussion, and resolution. The research team developed three themes: 1) early medical needs provided time for the parents to explore various communication options for their Deaf-Disabled child, 2) without intervention from medical professionals or educators, ASL emerged as a prioritized mode of communication for the family, 3) atypical gender roles affected familial communication dynamics. While managing the significant health issues of their Deaf-Disabled child at birth, families and medical professionals were so fixated on tending to the medical needs of the child that the typical pressures of determining a mode of communication were deprioritized. This allowed the families to meticulously research various methods of communication, resulting in an informed, rational, and well-considered decision to use ASL as the primary mode of communication with their Deaf-Disabled child. It was evident that having a Deaf-Disabled child meant an increased amount of labor and responsibilities for parents. This led to a shift in the roles of the family members. During the child’s development, the mother transformed from fulfilling the stereotypical roles of nurturer and administrator to that of administrator and champion. The mother facilitated medical proceedings and educational arrangements while the father became the caretaker and nurturer of their Deaf-Disabled child in addition to the traditional role of earning the family’s primary income. Ultimately, this research led to a deeper understanding of the critical role that time plays in parents’ decision-making process regarding communication methods with their Deaf-Disabled child.

Keywords: American Sign Language, deaf-disabled, ethnography, sociolinguistics

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673 Patterns and Predictors of Intended Service Use among Frail Older Adults in Urban China

Authors: Yuanyuan Fu

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Background and Purpose: Along with the change of society and economy, the traditional home function of old people has gradually weakened in the contemporary China. Acknowledging these situations, to better meet old people’s needs on formal services and improve the quality of later life, this study seeks to identify patterns of intended service use among frail old people living in the communities and examined determinants that explain heterogeneous variations in old people’s intended service use patterns. Additionally, this study also tested the relationship between culture value and intended service use patterns and the mediating role of enabling factors in terms of culture value and intended service use patterns. Methods:Participants were recruited from Haidian District, Beijing, China in 2015. The multi-stage sampling method was adopted to select sub-districts, communities and old people aged 70 years old or older. After screening, 577 old people with limitations in daily life, were successfully interviewed. After data cleaning, 550 samples were included for data analysis. This study establishes a conceptual framework based on the Anderson Model (including predisposing factors, enabling factors and need factors), and further developed it by adding culture value factors (including attitudes towards filial piety and attitudes towards social face). Using a latent class analysis (LCA), this study classifies overall patterns of old people’s formal service utilization. Fourteen types of formal services were taken into account, including housework, voluntary support, transportation, home-delivered meals, and home-delivery medical care, elderly’s canteen and day-care center/respite care and so on. Structural equation modeling (SEM) was used to examine the direct effect of culture value on service use pattern, and the mediating effect of the enabling factors. Results: The LCA classified a hierarchical structure of service use patterns: multiple intended service use (N=69, 23%), selective intended service use (N=129, 23%), and light intended service use (N=352, 64%). Through SEM, after controlling predisposing factors and need factors, the results showed the significant direct effect of culture value on older people’s intended service use patterns. Enabling factors had a partial mediation effect on the relationship between culture value and the patterns. Conclusions and Implications: Differentiation of formal services may be important for meeting frail old people’s service needs and distributing program resources by identifying target populations for intervention, which may make reference to specific interventions to better support frail old people. Additionally, culture value had a unique direct effect on the intended service use patterns of frail old people in China, enriching our theoretical understanding of sources of culture value and their impacts. The findings also highlighted the mediation effects of enabling factors on the relationship between culture value factors and intended service use patterns. This study suggests that researchers and service providers should pay more attention to the important role of culture value factors in contributing to intended service use patterns and also be more sensitive to the mediating effect of enabling factors when discussing the relationship between culture value and the patterns.

Keywords: frail old people, intended service use pattern, culture value, enabling factors, contemporary China, latent class analysis

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672 A Smart Sensor Network Approach Using Affordable River Water Level Sensors

Authors: Dian Zhang, Brendan Heery, Maria O’Neill, Ciprian Briciu-Burghina, Noel E. O’Connor, Fiona Regan

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Recent developments in sensors, wireless data communication and the cloud computing have brought the sensor web to a whole new generation. The introduction of the concept of ‘Internet of Thing (IoT)’ has brought the sensor research into a new level, which involves the developing of long lasting, low cost, environment friendly and smart sensors; new wireless data communication technologies; big data analytics algorithms and cloud based solutions that are tailored to large scale smart sensor network. The next generation of smart sensor network consists of several layers: physical layer, where all the smart sensors resident and data pre-processes occur, either on the sensor itself or field gateway; data transmission layer, where data and instructions exchanges happen; the data process layer, where meaningful information is extracted and organized from the pre-process data stream. There are many definitions of smart sensor, however, to summarize all these definitions, a smart sensor must be Intelligent and Adaptable. In future large scale sensor network, collected data are far too large for traditional applications to send, store or process. The sensor unit must be intelligent that pre-processes collected data locally on board (this process may occur on field gateway depends on the sensor network structure). In this case study, three smart sensing methods, corresponding to simple thresholding, statistical model and machine learning based MoPBAS method, are introduced and their strength and weakness are discussed as an introduction to the smart sensing concept. Data fusion, the integration of data and knowledge from multiple sources, are key components of the next generation smart sensor network. For example, in the water level monitoring system, weather forecast can be extracted from external sources and if a heavy rainfall is expected, the server can send instructions to the sensor notes to, for instance, increase the sampling rate or switch on the sleeping mode vice versa. In this paper, we describe the deployment of 11 affordable water level sensors in the Dublin catchment. The objective of this paper is to use the deployed river level sensor network at the Dodder catchment in Dublin, Ireland as a case study to give a vision of the next generation of a smart sensor network for flood monitoring to assist agencies in making decisions about deploying resources in the case of a severe flood event. Some of the deployed sensors are located alongside traditional water level sensors for validation purposes. Using the 11 deployed river level sensors in a network as a case study, a vision of the next generation of smart sensor network is proposed. Each key component of the smart sensor network is discussed, which hopefully inspires the researchers who are working in the sensor research domain.

Keywords: smart sensing, internet of things, water level sensor, flooding

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671 Geovisualisation for Defense Based on a Deep Learning Monocular Depth Reconstruction Approach

Authors: Daniel R. dos Santos, Mateus S. Maldonado, Estevão J. R. Batista

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The military commanders increasingly dependent on spatial awareness, as knowing where enemy are, understanding how war battle scenarios change over time, and visualizing these trends in ways that offer insights for decision-making. Thanks to advancements in geospatial technologies and artificial intelligence algorithms, the commanders are now able to modernize military operations on a universal scale. Thus, geovisualisation has become an essential asset in the defense sector. It has become indispensable for better decisionmaking in dynamic/temporal scenarios, operation planning and management for the war field, situational awareness, effective planning, monitoring, and others. For example, a 3D visualization of war field data contributes to intelligence analysis, evaluation of postmission outcomes, and creation of predictive models to enhance decision-making and strategic planning capabilities. However, old-school visualization methods are slow, expensive, and unscalable. Despite modern technologies in generating 3D point clouds, such as LIDAR and stereo sensors, monocular depth values based on deep learning can offer a faster and more detailed view of the environment, transforming single images into visual information for valuable insights. We propose a dedicated monocular depth reconstruction approach via deep learning techniques for 3D geovisualisation of satellite images. It introduces scalability in terrain reconstruction and data visualization. First, a dataset with more than 7,000 satellite images and associated digital elevation model (DEM) is created. It is based on high resolution optical and radar imageries collected from Planet and Copernicus, on which we fuse highresolution topographic data obtained using technologies such as LiDAR and the associated geographic coordinates. Second, we developed an imagery-DEM fusion strategy that combine feature maps from two encoder-decoder networks. One network is trained with radar and optical bands, while the other is trained with DEM features to compute dense 3D depth. Finally, we constructed a benchmark with sparse depth annotations to facilitate future research. To demonstrate the proposed method's versatility, we evaluated its performance on no annotated satellite images and implemented an enclosed environment useful for Geovisualisation applications. The algorithms were developed in Python 3.0, employing open-source computing libraries, i.e., Open3D, TensorFlow, and Pythorch3D. The proposed method provides fast and accurate decision-making with GIS for localization of troops, position of the enemy, terrain and climate conditions. This analysis enhances situational consciousness, enabling commanders to fine-tune the strategies and distribute the resources proficiently.

Keywords: depth, deep learning, geovisualisation, satellite images

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670 Fathers and Daughters: Their Relationship and Its Impact on Body Image and Mental Health

Authors: John Toussaint

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Objective: Our society is suffering from an epidemic of body image dissatisfaction, and related disorders appear to be increasing globally for children. There is much to indicate that children's body image and eating attitudes are being affected negatively by socio-cultural factors such as parents, peers and media. Most studies and theories, however, have focused extensively on the daughter-mother relationship. Very few studies have investigated the role of attachment to the father as an important factor in the development of girls’ and women’s attitudes towards themselves and their bodies. Recently, data have shown that the father’s parenting style, as well as the quality of the relationship with him is crucial for the understanding of the development and persistence of body image disorders. This presentation is based on samples of participants with self-defined body image dissatisfaction, and the self-reported measures of their fathers’ parental behaviours, emotional warmth, support, or protection. Attachment theory does offer support in exploring these relationships and it is used in this presentation to assist in understanding the relationship between the father and his daughter in relation to body image and mental health. Clinical implications are also offered in respect to work with body image, eating disorders and relational therapy. Methods: As awareness of the increasing frequency of body image concerns in children grows, so too does the need for a simple, valid and reliable measure of body image. The Children's Body Image Scale (CBIS) designed in Australia, depicts seven male and females figures from which children are to choose their perceived body type and ideal body type. This was compared with a range of international body mass index (BMI) reference standards. These measures together with individual one-on-one interviews were completed by 158 children aged 7-12 years. Results: A high frequency of body image dissatisfaction was indicated in the children's responses. 55% of girls and 41% of boys said they would like to be thinner, and wished for an ideal BMI figure below the 10th percentile. This is an unhealthy and unattainable level of body fatness for the majority of children when considered in relation to the reported secular trend of their increasing average body size. Thin children were generally ranked as best and perceived as kind, happy, academically skilled, and socially successful. Fat children were perceived as unintelligent, lazy, greedy, unpopular, and unable to play physical games. Conclusions: Body image ideals and fat stereotypes are well entrenched among children. There is much to indicate that children's body image and eating attitudes are being affected negatively by sociocultural factors such as parents, peers and media. Teachers and health professionals could promote intervention programs for children involving knowledge and acceptance of genetic influences on body type; the dangerous effects of weight loss dieting; the importance of physical activity and eating healthy; and scepticism and critical analysis of mass media messages.

Keywords: body image, father attachment, mental health, eating disorders

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669 Navigating AI in Higher Education: Exploring Graduate Students’ Perspectives on Teacher-Provided AI Guidelines

Authors: Mamunur Rashid, Jialin Yan

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The current years have witnessed a rapid evolution and integration of artificial intelligence (AI) in various fields, prominently influencing the education industry. Acknowledging this transformative wave, AI tools like ChatGPT and Grammarly have undeniably introduced perspectives and skills, enriching the educational experiences of higher education students. The prevalence of AI utilization in higher education also drives an increasing number of researchers' attention in various dimensions. Departments, offices, and professors in universities also designed and released a set of policies and guidelines on using AI effectively. In regard to this, the study targets exploring and analyzing graduate students' perspectives regarding AI guidelines set by teachers. A mixed-methods study will be mainly conducted in this study, employing in-depth interviews and focus groups to investigate and collect students' perspectives. Relevant materials, such as syllabi and course instructions, will also be analyzed through the documentary analysis to facilitate understanding of the study. Surveys will also be used for data collection and students' background statistics. The integration of both interviews and surveys will provide a comprehensive array of student perspectives across various academic disciplines. The study is anchored in the theoretical framework of self-determination theory (SDT), which emphasizes and explains the students' perspective under the AI guidelines through three core needs: autonomy, competence, and relatedness. This framework is instrumental in understanding how AI guidelines influence students' intrinsic motivation and sense of empowerment in their learning environments. Through qualitative analysis, the study reveals a sense of confusion and uncertainty among students regarding the appropriate application and ethical considerations of AI tools, indicating potential challenges in meeting their needs for competence and autonomy. The quantitative data further elucidates these findings, highlighting a significant communication gap between students and educators in the formulation and implementation of AI guidelines. The critical findings of this study mainly come from two aspects: First, the majority of graduate students are uncertain and confused about relevant AI guidelines given by teachers. Second, this study also demonstrates that the design and effectiveness of course materials, such as the syllabi and instructions, also need to adapt in regard to AI policies. It indicates that certain of the existing guidelines provided by teachers lack consideration of students' perspectives, leading to a misalignment with students' needs for autonomy, competence, and relatedness. More emphasize and efforts need to be dedicated to both teacher and student training on AI policies and ethical considerations. To conclude, in this study, graduate students' perspectives on teacher-provided AI guidelines are explored and reflected upon, calling for additional training and strategies to improve how these guidelines can be better disseminated for their effective integration and adoption. Although AI guidelines provided by teachers may be helpful and provide new insights for students, educational institutions should take a more anchoring role to foster a motivating, empowering, and student-centered learning environment. The study also provides some relevant recommendations, including guidance for students on the ethical use of AI and AI policy training for teachers in higher education.

Keywords: higher education policy, graduate students’ perspectives, higher education teacher, AI guidelines, AI in education

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668 Modeling and Design of a Solar Thermal Open Volumetric Air Receiver

Authors: Piyush Sharma, Laltu Chandra, P. S. Ghoshdastidar, Rajiv Shekhar

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Metals processing operations such as melting and heat treatment of metals are energy-intensive, requiring temperatures greater than 500oC. The desired temperature in these industrial furnaces is attained by circulating electrically-heated air. In most of these furnaces, electricity produced from captive coal-based thermal power plants is used. Solar thermal energy could be a viable heat source in these furnaces. A retrofitted solar convective furnace (SCF) concept, which uses solar thermal generated hot air, has been proposed. Critical to the success of a SCF is the design of an open volumetric air receiver (OVAR), which can heat air in excess of 800oC. The OVAR is placed on top of a tower and receives concentrated solar radiation from a heliostat field. Absorbers, mixer assembly, and the return air flow chamber (RAFC) are the major components of an OVAR. The absorber is a porous structure that transfers heat from concentrated solar radiation to ambient air, referred to as primary air. The mixer ensures uniform air temperature at the receiver exit. Flow of the relatively cooler return air in the RAFC ensures that the absorbers do not fail by overheating. In an earlier publication, the detailed design basis, fabrication, and characterization of a 2 kWth open volumetric air receiver (OVAR) based laboratory solar air tower simulator was presented. Development of an experimentally-validated, CFD based mathematical model which can ultimately be used for the design and scale-up of an OVAR has been the major objective of this investigation. In contrast to the published literature, where flow and heat transfer have been modeled primarily in a single absorber module, the present study has modeled the entire receiver assembly, including the RAFC. Flow and heat transfer calculations have been carried out in ANSYS using the LTNE model. The complex return air flow pattern in the RAFC requires complicated meshes and is computational and time intensive. Hence a simple, realistic 1-D mathematical model, which circumvents the need for carrying out detailed flow and heat transfer calculations, has also been proposed. Several important results have emerged from this investigation. Circumferential electrical heating of absorbers can mimic frontal heating by concentrated solar radiation reasonably well in testing and characterizing the performance of an OVAR. Circumferential heating, therefore, obviates the need for expensive high solar concentration simulators. Predictions suggest that the ratio of power on aperture (POA) and mass flow rate of air (MFR) is a normalizing parameter for characterizing the thermal performance of an OVAR. Increasing POA/MFR increases the maximum temperature of air, but decreases the thermal efficiency of an OVAR. Predictions of the 1-D mathematical are within 5% of ANSYS predictions and computation time is reduced from ~ 5 hours to a few seconds.

Keywords: absorbers, mixer assembly, open volumetric air receiver, return air flow chamber, solar thermal energy

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667 Development of DNDC Modelling Method for Evaluation of Carbon Dioxide Emission from Arable Soils in European Russia

Authors: Olga Sukhoveeva

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Carbon dioxide (CO2) is the main component of carbon biogeochemical cycle and one of the most important greenhouse gases (GHG). Agriculture, particularly arable soils, are one the largest sources of GHG emission for the atmosphere including CO2.Models may be used for estimation of GHG emission from agriculture if they can be adapted for different countries conditions. The only model used in officially at national level in United Kingdom and China for this purpose is DNDC (DeNitrification-DeComposition). In our research, the model DNDC is offered for estimation of GHG emission from arable soils in Russia. The aim of our research was to create the method of DNDC using for evaluation of CO2 emission in Russia based on official statistical information. The target territory was European part of Russia where many field experiments are located. At the first step of research the database on climate, soil and cropping characteristics for the target region from governmental, statistical, and literature sources were created. All-Russia Research Institute of Hydrometeorological Information – World Data Centre provides open daily data about average meteorological and climatic conditions. It must be calculated spatial average values of maximum and minimum air temperature and precipitation over the region. Spatial average values of soil characteristics (soil texture, bulk density, pH, soil organic carbon content) can be determined on the base of Union state register of soil recourses of Russia. Cropping technologies are published by agricultural research institutes and departments. We offer to define cropping system parameters (annual information about crop yields, amount and types of fertilizers and manure) on the base of the Federal State Statistics Service data. Content of carbon in plant biomass may be calculated via formulas developed and published by Ministry of Natural Resources and Environment of the Russian Federation. At the second step CO2 emission from soil in this region were calculated by DNDC. Modelling data were compared with empirical and literature data and good results were obtained, modelled values were equivalent to the measured ones. It was revealed that the DNDC model may be used to evaluate and forecast the CO2 emission from arable soils in Russia based on the official statistical information. Also, it can be used for creation of the program for decreasing GHG emission from arable soils to the atmosphere. Financial Support: fundamental scientific researching theme 0148-2014-0005 No 01201352499 ‘Solution of fundamental problems of analysis and forecast of Earth climatic system condition’ for 2014-2020; fundamental research program of Presidium of RAS No 51 ‘Climate change: causes, risks, consequences, problems of adaptation and regulation’ for 2018-2020.

Keywords: arable soils, carbon dioxide emission, DNDC model, European Russia

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666 Lived Experiences and Perspectives of Adult Survivors of Incest-Related Childhood Sexual Abuse

Authors: Varsha Puri, Sharon Hudson, Ian Kim

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Background: Incest-related childhood sexual abuse (IRCSA) is challenging to study due to the shame and secrecy experienced by its survivors. Ramifications of IRCSA worsen when it is unidentified, and interventions are not made. IRCSA perspectives are essential for future prevention and intervention strategies. However, there is limited understanding of this population’s experiences, perspectives, and long-term struggles. To date, research for IRCSA has utilized data from treatment programs and qualitative research with cohorts of 10-20 people, much of the data is from 10-40 years prior. Methods. In June 2018, an anonymous online survey was posted to multiple social media sites (e.g., Facebook IRCSA groups) and sexual abuse resource sites. Survey responses were collected for a year. The survey collected non-identifying demographics, IRCSA experiences, and outcomes data. Results: We obtained 1310 completed surveys. Demographics of all ages, racial backgrounds, financial backgrounds, and genders were obtained; the majority identified as white (81%) and female (76%). Childhood sexual abuse (CSA) started before the age of 6 in 49% and was endured for more than one year in 84% of respondents, and 39% reported ten or more years of abuse. CSA by multiple perpetrators occurred in 58%, while 8% had ten or more perpetrators. CSA by perpetrators under 21 years old was reported by 46%. Female perpetrators were reported by 28% of respondents. Fathers were the highest reported sexual abusers at 60%, and mothers were reported at 17%. Only 16% reported that at least one of their perpetrators was prosecuted for sexual abuse of a minor. Respondents confirmed that 54% of the time, they informed an adult of the abuse; only 2% agreed that “an intervention was made by the family that protected me.” A majority reported that IRCSA has negatively impacted their intimate/sexual relationships (96%) and mental health (96%). A majority reported negative impacts on biological family relationships (88%), physical health (73%), finances (59%), educational achievement (57%), and employment (56%). When asked about suffering from addiction, 85% of respondents answered yes. Prevention strategies selected most by respondents include early school education around CSA prevention (67%), removing the statute of limitations for reporting CSA (69%), and improved laws protecting IRCSA survivors (63%). Conclusion: The data document that IRCSA can be pervasive, and the dearth of intervention and support for survivors have major lasting impacts. Survivors have a unique and valuable perspective on what interventions are needed to prevent IRCSA and support survivors; their voice has long been unheard in crafting prevention and intervention policies and services. These results thus provide an important call to action from these critical stakeholders. Pediatricians should recognize that perpetrators can be pediatric patients, women, and parents. Pediatricians can advocate for more early CSA prevention education and policy changes that remove the statute of limitations for reporting CSA.

Keywords: incest, childhood sexual abuse, incest-related childhood sexual abuse, incest survivor

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665 Developing Geriatric Oral Health Network is a Public Health Necessity for Older Adults

Authors: Maryam Tabrizi, Shahrzad Aarup

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Objectives- Understanding the close association between oral health and overall health for older adults at the right time and right place, a person, focus treatment through Project ECHO telementoring. Methodology- Data from monthly ECHO telementoring sessions were provided for three years. Sessions including case presentations, overall health conditions, considering medications, organ functions limitations, including the level of cognition. Contributions- Providing the specialist level of providing care to all elderly regardless of their location and other health conditions and decreasing oral health inequity by increasing workforce via Project ECHO telementoring program worldwide. By 2030, the number of adults in the USA over the age of 65 will increase more than 60% (approx.46 million) and over 22 million (30%) of 74 million older Americans will need specialized geriatrician care. In 2025, a national shortage of medical geriatricians will be close to 27,000. Most individuals 65 and older do not receive oral health care due to lack of access, availability, or affordability. One of the main reasons is a significant shortage of Oral Health (OH) education and resources for the elderly, particularly in rural areas. Poor OH is a social stigma, a thread to quality and safety of overall health of the elderly with physical and cognitive decline. Poor OH conditions may be costly and sometimes life-threatening. Non-traumatic dental-related emergency department use in Texas alone was over $250 M in 2016. Most elderly over the age of 65 present with at least one or multiple chronic diseases such as arthritis, diabetes, heart diseases, and chronic obstructive pulmonary disease (COPD) are at higher risk to develop gum (periodontal) disease, yet they are less likely to get dental care. In addition, most older adults take both prescription and over-the-counter drugs; according to scientific studies, many of these medications cause dry mouth. Reduced saliva flow due to aging and medications may increase the risk of cavities and other oral conditions. Most dental schools have already increased geriatrics OH in their educational curriculums, but the aging population growth worldwide is faster than growing geriatrics dentists. However, without the use of advanced technology and creating a network between specialists and primary care providers, it is impossible to increase the workforce, provide equitable oral health to the elderly. Project ECHO is a guided practice model that revolutionizes health education and increases the workforce to provide best-practice specialty care and reduce health disparities. Training oral health providers for utilizing the Project ECHO model is a logical response to the shortage and increases oral health access to the elderly. Project ECHO trains general dentists & hygienists to provide specialty care services. This means more elderly can get the care they need, in the right place, at the right time, with better treatment outcomes and reduces costs.

Keywords: geriatric, oral health, project echo, chronic disease, oral health

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664 Academic Staff Development: A Lever to Address the Challenges of the 21st Century University Classroom

Authors: Severino Machingambi

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Most academics entering Higher education as lecturers in South Africa do not have qualifications in Education or teaching. This creates serious problems since they are not sufficiently equipped with pedagogical approaches and theories that inform their facilitation of learning strategies. This, arguably, is one of the reasons why higher education institutions are experiencing high student failure rate. In order to mitigate this problem, it is critical that higher education institutions devise internal academic staff development programmes to capacitate academics with pedagogical skills and competencies so as to enhance the quality of student learning. This paper reported on how the Teaching and Learning Development Centre of a university used design-based research methodology to conceptualise and implement an academic staff development programme for new academics at a university of technology. This approach revolves around the designing, testing and refining of an educational intervention. Design-based research is an important methodology for understanding how, when, and why educational innovations work in practice. The need for a professional development course for academics arose due to the fact that most academics at the university did not have teaching qualifications and many of them were employed straight from industry with little understanding of pedagogical approaches. This paper examines three key aspects of the programme namely, the preliminary phase, the teaching experiment and the retrospective analysis. The preliminary phase is the stage in which the problem identification takes place. The problem that this research sought to address relates to the unsatisfactory academic performance of the majority of the students in the institution. It was therefore hypothesized that the problem could be dealt with by professionalising new academics through engagement in an academic staff development programme. The teaching experiment phase afforded researchers and participants in the programme the opportunity to test and refine the proposed intervention and the design principles upon which it was based. The teaching experiment phase revolved around the testing of the new academics professional development programme. This phase created a platform for researchers and academics in the programme to experiment with various activities and instructional strategies such as case studies, observations, discussions and portfolio building. The teaching experiment phase was followed by the retrospective analysis stage in which the research team looked back and tried to give a trustworthy account of the teaching/learning process that had taken place. A questionnaire and focus group discussions were used to collect data from participants that helped to evaluate the programme and its implementation. One of the findings of this study was that academics joining university really need an academic induction programme that inducts them into the discourse of teaching and learning. The study also revealed that existing academics can be placed on formal study programmes in which they acquire educational qualifications with a view to equip them with useful classroom discourses. The study, therefore, concludes that new and existing academics in universities should be supported through induction programmes and placement on formal studies in teaching and learning so that they are capacitated as facilitators of learning.

Keywords: academic staff, pedagogy, programme, staff development

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663 Leadership Education for Law Enforcement Mid-Level Managers: The Mediating Role of Effectiveness of Training on Transformational and Authentic Leadership Traits

Authors: Kevin Baxter, Ron Grove, James Pitney, John Harrison, Ozlem Gumus

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The purpose of this research is to determine the mediating effect of effectiveness of the training provided by Northwestern University’s School of Police Staff and Command (SPSC), on the ability of law enforcement mid-level managers to learn transformational and authentic leadership traits. This study will also evaluate the leadership styles, of course, graduates compared to non-attendees using a static group comparison design. The Louisiana State Police pay approximately $40,000 in salary, tuition, housing, and meals for each state police lieutenant attending the 10-week program of the SPSC. This school lists the development of transformational leaders as an increasing element. Additionally, the SPSC curriculum addresses all four components of authentic leadership - self-awareness, transparency, ethical/moral, and balanced processing. Upon return to law enforcement in roles of mid-level management, there are questions as to whether or not students revert to an “autocratic” leadership style. Insufficient evidence exists to support claims for the effectiveness of management training or leadership development. Though it is widely recognized that transformational styles are beneficial to law enforcement, there is little evidence that suggests police leadership styles are changing. Police organizations continue to hold to a more transactional style (i.e., most senior police leaders remain autocrats). Additionally, research in the application of transformational, transactional, and laissez-faire leadership related to police organizations is minimal. The population of the study is law enforcement mid-level managers from various states within the United States who completed leadership training presented by the SPSC. The sample will be composed of 66 active law enforcement mid-level managers (lieutenants and captains) who have graduated from SPSC and 65 active law enforcement mid-level managers (lieutenants and captains) who have not attended SPSC. Participants will answer demographics questions, Multifactor Leadership Questionnaire, Authentic Leadership Questionnaire, and the Kirkpatrick Hybrid Evaluation Survey. Analysis from descriptive statistics, group comparison, one-way MANCOVA, and the Kirkpatrick Evaluation Model survey will be used to determine training effectiveness in the four levels of reaction, learning, behavior, and results. Independent variables are SPSC graduates (two groups: upper and lower) and no-SPSC attendees, and dependent variables are transformational and authentic leadership scores. SPSC graduates are expected to have higher MLQ scores for transformational leadership traits and higher ALQ scores for authentic leadership traits than SPSC non-attendees. We also expect the graduates to rate the efficacy of SPSC leadership training as high. This study will validate (or invalidate) the benefits, costs, and resources required for leadership development from a nationally recognized police leadership program, and it will also help fill the gap in the literature that exists between law enforcement professional development and transformational and authentic leadership styles.

Keywords: training effectiveness, transformational leadership, authentic leadership, law enforcement mid-level manager

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662 Innovative Strategies for Chest Wall Reconstruction Following Resection of Recurrent Breast Carcinoma

Authors: Sean Yao Zu Kong, Khong Yik Chew

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Introduction: We described a case report of the successful use of advanced surgical techniques in a patient with recurrent breast cancer who underwent a wide resection including the hemi-sternum, clavicle, multiple ribs, and a lobe of the lung due to tumor involvement. This extensive resection exposed critical structures, requiring a creative approach to reconstruction. To address this complex chest wall reconstruction, a free fibula flap and a 4-zone rectus abdominis musculocutaneous flap were successfully utilized. The use of a free vascularized bone flap allowed for rapid osteointegration and resistance against osteoradionecrosis after adjuvant radiation, while a four-zone tram flap allowed for reconstruction of both the chest wall and breast mound. Although limited recipient vessels made free flaps challenging, the free fibula flap served as both a bony reconstruction and vascular conduit, supercharged with the distal peroneal artery and veins of the peroneal artery from the fibula graft. Our approach highlights the potential of advanced surgical techniques to improve outcomes in complex cases of chest wall reconstruction in patients with recurrent breast cancer, which is becoming increasingly relevant as breast cancer incidence rates increases. Case presentation: This report describes a successful reconstruction of a patient with recurrent breast cancer who required extensive resection, including the anterior chest wall, clavicle, and sternoclavicular joint. Challenges arose due to the loss of accessory muscles and the non-rigid rib cage, which could lead to compromised ventilation and instability. A free fibula osteocutaneous flap and a four-zone TRAM flap with vascular supercharging were utilized to achieve long-term stability and function. The patient has since fully recovered, and during the review, both flaps remained viable, and chest mound reconstruction was satisfactory. A planned nipple/areolar reconstruction was offered pending the patient’s decision after adjuvant radiotherapy. Conclusion: In conclusion, this case report highlights the successful use of innovative surgical techniques in addressing a complex case of recurrent breast cancer requiring extensive resection and radical reconstruction. Our approach, utilized a combination of a free fibula flap and a 4-zone rectus abdominis musculocutaneous flap, demonstrates the potential for advanced techniques in chest wall reconstruction to minimize complications and ensure long-term stability and function. As the incidence of breast cancer continues to rise, it is crucial that healthcare professionals explore and utilize innovative techniques to improve patient outcomes and quality of life.

Keywords: free fibula flap, rectus abdominis musculocutaneous flap, post-adjuvant radiotherapy, reconstructive surgery, malignancy

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661 Averting a Financial Crisis through Regulation, Including Legislation

Authors: Maria Krambia-Kapardis, Andreas Kapardis

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The paper discusses regulatory and legislative measures implemented by various nations in an effort to avert another financial crisis. More specifically, to address the financial crisis, the European Commission followed the practice of other developed countries and implemented a European Economic Recovery Plan in an attempt to overhaul the regulatory and supervisory framework of the financial sector. In 2010 the Commission introduced the European Systemic Risk Board and in 2011 the European System of Financial Supervision. Some experts advocated that the type and extent of financial regulation introduced in the European crisis in the wake of the 2008 crisis has been excessive and counterproductive. In considering how different countries responded to the financial crisis, global regulators have shown a more focused commitment to combat industry misconduct and to pre-empt abusive behavior. Regulators have also increased funding and resources at their disposal; have increased regulatory fines, with an increasing trend towards action against individuals; and, finally, have focused on market abuse and market conduct issues. Financial regulation can be effected, first of all, through legislation. However, neither ex ante or ex post regulation is by itself effective in reducing systemic risk. Consequently, to avert a financial crisis, in their endeavor to achieve both economic efficiency and financial stability, governments need to balance the two approaches to financial regulation. Fiduciary duty is another means by which the behavior of actors in the financial world is constrained and, thus, regulated. Furthermore, fiduciary duties extend over and above other existing requirements set out by statute and/or common law and cover allegations of breach of fiduciary duty, negligence or fraud. Careful analysis of the etiology of the 2008 financial crisis demonstrates the great importance of corporate governance as a way of regulating boardroom behavior. In addition, the regulation of professions including accountants and auditors plays a crucial role as far as the financial management of companies is concerned. In the US, the Sarbanes-Oxley Act of 2002 established the Public Company Accounting Oversight Board in order to protect investors from financial accounting fraud. In most countries around the world, however, accounting regulation consists of a legal framework, international standards, education, and licensure. Accounting regulation is necessary because of the information asymmetry and the conflict of interest that exists between managers and users of financial information. If a holistic approach is to be taken then one cannot ignore the regulation of legislators themselves which can take the form of hard or soft legislation. The science of averting a financial crisis is yet to be perfected and this, as shown by the preceding discussion, is unlikely to be achieved in the foreseeable future as ‘disaster myopia’ may be reduced but will not be eliminated. It is easier, of course, to be wise in hindsight and regulating unreasonably risky decisions and unethical or outright criminal behavior in the financial world remains major challenges for governments, corporations, and professions alike.

Keywords: financial crisis, legislation, regulation, financial regulation

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660 Methodological Approach to the Elaboration and Implementation of the Spatial-Urban Plan for the Special Purpose Area: Case-Study of Infrastructure Corridor of Highway E-80, Section Nis-Merdare, Serbia

Authors: Nebojsa Stefanovic, Sasa Milijic, Natasa Danilovic Hristic

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Spatial plan of the special purpose area constitutes a basic tool in the planning of infrastructure corridor of a highway. The aim of the plan is to define the planning basis and provision of spatial conditions for the construction and operation of the highway, as well as for developing other infrastructure systems in the corridor. This paper presents a methodology and approach to the preparation of the Spatial Plan for the special purpose area for the infrastructure corridor of the highway E-80, Section Niš-Merdare in Serbia. The applied methodological approach is based on the combined application of the integrative and participatory method in the decision-making process on the sustainable development of the highway corridor. It was found that, for the planning and management of the infrastructure corridor, a key problem is coordination of spatial and urban planning, strategic environmental assessment and sectoral traffic planning and designing. Through the development of the plan, special attention is focused on increasing the accessibility of the local and regional surrounding, reducing the adverse impacts on the development of settlements and the economy, protection of natural resources, natural and cultural heritage, and the development of other infrastructure systems in the corridor of the highway. As a result of the applied methodology, this paper analyzes the basic features such as coverage, the concept, protected zones, service facilities and objects, the rules of development and construction, etc. Special emphasis is placed to methodology and results of the Strategic Environmental Assessment of the Spatial Plan, and to the importance of protection measures, with the special significance of air and noise protection measures. For evaluation in the Strategic Environmental Assessment, a multicriteria expert evaluation (semi-quantitative method) of planned solutions was used in relation to the set of goals and relevant indicators, based on the basic set of indicators of sustainable development. Evaluation of planned solutions encompassed the significance and size, spatial conditions and probability of the impact of planned solutions on the environment, and the defined goals of strategic assessment. The framework of the implementation of the Spatial Plan is presented, which is determined for the simultaneous elaboration of planning solutions at two levels: the strategic level of the spatial plan and detailed urban plan level. It is also analyzed the relationship of the Spatial Plan to other applicable planning documents for the planning area. The effects of this methodological approach relate to enabling integrated planning of the sustainable development of the infrastructure corridor of the highway and its surrounding area, through coordination of spatial, urban and sectoral traffic planning and design, as well as the participation of all key actors in the adoption and implementation of planned decisions. By the conclusions of the paper, it is pointed to the direction for further research, particularly in terms of harmonizing methodology of planning documentation and preparation of technical-design documentation.

Keywords: corridor, environment, highway, impact, methodology, spatial plan, urban

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659 Socio-Economic Transformation of Barpak Post-Earthquake Reconstruction

Authors: Sudikshya Bhandari, Jonathan K. London

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The earthquake of April 2015 was one of the biggest disasters in the history of Nepal. The epicenter was located near Barpak, north of the Gorkha district. Before the disaster, this settlement was a compact and homogeneous settlement manifesting its uniqueness through the social and cultural activities, and a distinct vernacular architecture. Narrow alleys with stone paved streets, buildings with slate roofs, and common spaces between the houses made this settlement socially, culturally, and environmentally cohesive. With the presence of micro hydro power plants, local economic activities enabled the local community to exist and thrive. Agriculture and animal rearing are the sources of livelihood for the majority of families, along with the booming homestays (where local people welcome guests to their home, as a business) and local shops. Most of these activities are difficult to find as the houses have been destroyed with the earthquake and the process of reconstruction has been transforming the outlook of the settlement. This study characterized the drastic transformation in Barpak post-earthquake, and analyzed the consequences of the reconstruction process. In addition, it contributes to comprehending a broader representation about unsustainability created by the lack of contextual post-disaster development. Since the research is based in a specific area, a case study approach was used. Sample houses were selected on the basis of ethnicity and house typology. Mixed methods such as key informant and semi structured interviews, focus groups, observations and photographs are used for the collection of data. The research focus is predominantly on the physical change of the house typology from vernacular to externally adopted designs. This transformation of the house entails socio-cultural changes such as social fragmentation with differences among the rich and the poor and decreases in the social connectivity within families and neighborhood. Families have found that new houses require more maintenance and resources that have increased their economic expenses. The study also found that the reconstructed houses are not thermally comfortable in the cold climate of Barpak, leading to the increased use of different sources of heating like electric heaters and more firewood. Lack of storage spaces for crops and livestock have discouraged them to pursue traditional means of livelihood and depend more on buying food from stores, ultimately making it less economical for most of the families. The transformation of space leading to the economic, social and cultural changes demonstrates the unsustainability of Barpak. Conclusions from the study suggest place based and inclusive planning and policy formations that include locals as partners, identifying the possible ways to minimize the impact and implement these recommendations into the future policy and planning scenarios.

Keywords: earthquake, Nepal, reconstruction, settlement, transformation

Procedia PDF Downloads 117
658 A Comparison of Two and Three Dimensional Motion Capture Methodologies in the Analysis of Underwater Fly Kicking Kinematics

Authors: Isobel M. Thompson, Dorian Audot, Dominic Hudson, Martin Warner, Joseph Banks

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Underwater fly kick is an essential skill in swimming, which can have a considerable impact upon overall race performance in competition, especially in sprint events. Reduced wave drags acting upon the body under the surface means that the underwater fly kick will potentially be the fastest the swimmer is travelling throughout the race. It is therefore critical to understand fly kicking techniques and determining biomechanical factors involved in the performance. Most previous studies assessing fly kick kinematics have focused on two-dimensional analysis; therefore, the three-dimensional elements of the underwater fly kick techniques are not well understood. Those studies that have investigated fly kicking techniques using three-dimensional methodologies have not reported full three-dimensional kinematics for the techniques observed, choosing to focus on one or two joints. There has not been a direct comparison completed on the results obtained using two-dimensional and three-dimensional analysis, and how these different approaches might affect the interpretation of subsequent results. The aim of this research is to quantify the differences in kinematics observed in underwater fly kicks obtained from both two and three-dimensional analyses of the same test conditions. In order to achieve this, a six-camera underwater Qualisys system was used to develop an experimental methodology suitable for assessing the kinematics of swimmer’s starts and turns. The cameras, capturing at a frequency of 100Hz, were arranged along the side of the pool spaced equally up to 20m creating a capture volume of 7m x 2m x 1.5m. Within the measurement volume, error levels were estimated at 0.8%. Prior to pool trials, participants completed a landside calibration in order to define joint center locations, as certain markers became occluded once the swimmer assumed the underwater fly kick position in the pool. Thirty-four reflective markers were placed on key anatomical landmarks, 9 of which were then removed for the pool-based trials. The fly-kick swimming conditions included in the analysis are as follows: maximum effort prone, 100m pace prone, 200m pace prone, 400m pace prone, and maximum pace supine. All trials were completed from a push start to 15m to ensure consistent kick cycles were captured. Both two-dimensional and three-dimensional kinematics are calculated from joint locations, and the results are compared. Key variables reported include kick frequency and kick amplitude, as well as full angular kinematics of the lower body. Key differences in these variables obtained from two-dimensional and three-dimensional analysis are identified. Internal rotation (up to 15º) and external rotation (up to -28º) were observed using three-dimensional methods. Abduction (5º) and adduction (15º) were also reported. These motions are not observed in the two-dimensional analysis. Results also give an indication of different techniques adopted by swimmers at various paces and orientations. The results of this research provide evidence of the strengths of both two dimensional and three dimensional motion capture methods in underwater fly kick, highlighting limitations which could affect the interpretation of results from both methods.

Keywords: swimming, underwater fly kick, performance, motion capture

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657 The Budget Impact of the DISCERN™ Diagnostic Test for Alzheimer’s Disease in the United States

Authors: Frederick Huie, Lauren Fusfeld, William Burchenal, Scott Howell, Alyssa McVey, Thomas F. Goss

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Alzheimer’s Disease (AD) is a degenerative brain disease characterized by memory loss and cognitive decline that presents a substantial economic burden for patients and health insurers in the US. This study evaluates the payer budget impact of the DISCERN™ test in the diagnosis and management of patients with symptoms of dementia evaluated for AD. DISCERN™ comprises three assays that assess critical factors related to AD that regulate memory, formation of synaptic connections among neurons, and levels of amyloid plaques and neurofibrillary tangles in the brain and can provide a quicker, more accurate diagnosis than tests in the current diagnostic pathway (CDP). An Excel-based model with a three-year horizon was developed to assess the budget impact of DISCERN™ compared with CDP in a Medicare Advantage plan with 1M beneficiaries. Model parameters were identified through a literature review and were verified through consultation with clinicians experienced in diagnosis and management of AD. The model assesses direct medical costs/savings for patients based on the following categories: •Diagnosis: costs of diagnosis using DISCERN™ and CDP. •False Negative (FN) diagnosis: incremental cost of care avoidable with a correct AD diagnosis and appropriately directed medication. •True Positive (TP) diagnosis: AD medication costs; cost from a later TP diagnosis with the CDP versus DISCERN™ in the year of diagnosis, and savings from the delay in AD progression due to appropriate AD medication in patients who are correctly diagnosed after a FN diagnosis.•False Positive (FP) diagnosis: cost of AD medication for patients who do not have AD. A one-way sensitivity analysis was conducted to assess the effect of varying key clinical and cost parameters ±10%. An additional scenario analysis was developed to evaluate the impact of individual inputs. In the base scenario, DISCERN™ is estimated to decrease costs by $4.75M over three years, equating to approximately $63.11 saved per test per year for a cohort followed over three years. While the diagnosis cost is higher with DISCERN™ than with CDP modalities, this cost is offset by the higher overall costs associated with CDP due to the longer time needed to receive a TP diagnosis and the larger number of patients who receive a FN diagnosis and progress more rapidly than if they had received appropriate AD medication. The sensitivity analysis shows that the three parameters with the greatest impact on savings are: reduced sensitivity of DISCERN™, improved sensitivity of the CDP, and a reduction in the percentage of disease progression that is avoided with appropriate AD medication. A scenario analysis in which DISCERN™ reduces the utilization for patients of computed tomography from 21% in the base case to 16%, magnetic resonance imaging from 37% to 27% and cerebrospinal fluid biomarker testing, positive emission tomography, electroencephalograms, and polysomnography testing from 4%, 5%, 10%, and 8%, respectively, in the base case to 0%, results in an overall three-year net savings of $14.5M. DISCERN™ improves the rate of accurate, definitive diagnosis of AD earlier in the disease and may generate savings for Medicare Advantage plans.

Keywords: Alzheimer’s disease, budget, dementia, diagnosis.

Procedia PDF Downloads 137
656 An Introspective look into Hotel Employees Career Satisfaction

Authors: Anastasios Zopiatis, Antonis L. Theocharous

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In the midst of a fierce war for talent, the hospitality industry is seeking new and innovative ways to enrich its image as an employer of choice and not a necessity. Historically, the industry’s professions are portrayed as ‘unattractive’ due to their repetitious nature, long and unsocial working schedules, below average remunerations, and the mental and physical demands of the job. Aligning with the industry, hospitality and tourism scholars embarked on a journey to investigate pertinent topics with the aim of enhancing our conceptual understanding of the elements that influence employees at the hospitality world of work. Topics such as job involvement, commitment, job and career satisfaction, and turnover intentions became the focal points in a multitude of relevant empirical and conceptual investigations. Nevertheless, gaps or inconsistencies in existing theories, as a result of both the volatile complexity of the relationships governing human behavior in the hospitality workplace, and the academic community’s unopposed acceptance of theoretical frameworks mainly propounded in the United States and United Kingdom years ago, necessitate our continuous vigilance. Thus, in an effort to enhance and enrich the discourse, we set out to investigate the relationship between intrinsic and extrinsic job satisfaction traits and the individual’s career satisfaction, and subsequent intention to remain in the hospitality industry. Reflecting on existing literature, a quantitative survey was developed and administered, face-to-face, to 650 individuals working as full-time employees in 4- and 5- star hotel establishments in Cyprus, whereas a multivariate statistical analysis method, namely Structural Equation Modeling (SEM), was utilized to determine whether relationships existed between constructs as a means to either accept or reject the hypothesized theory. Findings, of interest to both industry stakeholders and academic scholars, suggest that the individual’s future intention to remain within the industry is primarily associated with extrinsic job traits. Our findings revealed that positive associations exist between extrinsic job traits, and both career satisfaction and future intention. In contrast, when investigating the relationship of intrinsic traits, a positive association was revealed only with career satisfaction. Apparently, the local industry’s environmental factors of seasonality, excessive turnover, overdependence on seasonal, and part-time migrant workers, prohibit industry stakeholders in effectively investing the time and resources in the development and professional growth of their employees. Consequently intrinsic job satisfaction factors such as advancement, growth, and achievement, take backstage to the more materialistic extrinsic factors. Findings from the subsequent mediation analysis support the notion that intrinsic traits can positively influence future intentions indirectly only through career satisfaction, whereas extrinsic traits can positively impact both career satisfaction and future intention both directly and indirectly.

Keywords: career satisfaction, Cyprus, hotel employees, structural equation modeling, SEM

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655 University Curriculum Policy Processes in Chile: A Case Study

Authors: Victoria C. Valdebenito

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Located within the context of accelerating globalization in the 21st-century knowledge society, this paper focuses on one selected university in Chile at which radical curriculum policy changes have been taking place, diverging from the traditional curriculum in Chile at the undergraduate level as a section of a larger investigation. Using a ‘policy trajectory’ framework, and guided by the interpretivist approach to research, interview transcripts and institutional documents were analyzed in relation to the meso (university administration) and the micro (academics) level. Inside the case study, participants from the university administration and academic levels were selected both via snow-ball technique and purposive selection, thus they had different levels of seniority, with some participating actively in the curriculum reform processes. Guided by an interpretivist approach to research, documents and interview transcripts were analyzed to reveal major themes emerging from the data. A further ‘bigger picture’ analysis guided by critical theory was then undertaken, involving interrogation of underlying ideologies and how political and economic interests influence the cultural production of policy. The case-study university was selected because it represents a traditional and old case of university setting in the country, undergoing curriculum changes based on international trends such as the competency model and the liberal arts. Also, it is representative of a particular socioeconomic sector of the country. Access to the university was gained through email contact. Qualitative research methods were used, namely interviews and analysis of institutional documents. In all, 18 people were interviewed. The number was defined by when the saturation criterion was met. Semi-structured interview schedules were based on the four research questions about influences, policy texts, policy enactment and longer-term outcomes. Triangulation of information was used for the analysis. While there was no intention to generalize the specific findings of the case study, the results of the research were used as a focus for engagement with broader themes, often evident in global higher education policy developments. The research results were organized around major themes in three of the four contexts of the ‘policy trajectory’. Regarding the context of influences and the context of policy text production, themes relate to hegemony exercised by first world countries’ universities in the higher education field, its associated neoliberal ideology, with accountability and the discourse of continuous improvement, the local responses to those pressures, and the value of interdisciplinarity. Finally, regarding the context of policy practices and effects (enactment), themes emerged around the impacts of the curriculum changes on university staff, students, and resistance amongst academics. The research concluded with a few recommendations that potentially provide ‘food for thought’ beyond the localized settings of this study, as well as possibilities for further research.

Keywords: curriculum, global-local dynamics, higher education, policy, sociology of education

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654 Cement Matrix Obtained with Recycled Aggregates and Micro/Nanosilica Admixtures

Authors: C. Mazilu, D. P. Georgescu, A. Apostu, R. Deju

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Cement mortars and concretes are some of the most used construction materials in the world, global cement production being expected to grow to approx. 5 billion tons, until 2030. But, cement is an energy intensive material, the cement industry being responsible for cca. 7% of the world's CO2 emissions. Also, natural aggregates represent non-renewable resources, exhaustible, which must be used efficiently. A way to reduce the negative impact on the environment is the use of additional hydraulically active materials, as a partial substitute for cement in mortars and concretes and/or the use of recycled concrete aggregates (RCA) for the recovery of construction waste, according to EU Directive 2018/851. One of the most effective active hydraulic admixtures is microsilica and more recently, with the technological development on a nanometric scale, nanosilica. Studies carried out in recent years have shown that the introduction of SiO2 nanoparticles into cement matrix improves the properties, even compared to microsilica. This is due to the very small size of the nanosilica particles (<100nm) and the very large specific surface, which helps to accelerate cement hydration and acts as a nucleating agent to generate even more calcium hydrosilicate which densifies and compacts the structure. The cementitious compositions containing recycled concrete aggregates (RCA) present, in generally, inferior properties compared to those obtained with natural aggregates. Depending on the degree of replacement of natural aggregate, decreases the workability of mortars and concretes with RAC, decrease mechanical resistances and increase drying shrinkage; all being determined, in particular, by the presence to the old mortar attached to the original aggregate from the RAC, which makes its porosity high and the mixture of components to require more water for preparation. The present study aims to use micro and nanosilica for increase the performance of some mortars and concretes obtained with RCA. The research focused on two types of cementitious systems: a special mortar composition used for encapsulating Low Level radioactive Waste (LLW); a composition of structural concrete, class C30/37, with the combination of exposure classes XC4+XF1 and settlement class S4. The mortar was made with 100% recycled aggregate, 0-5 mm sort and in the case of concrete, 30% recycled aggregate was used for 4-8 and 8-16 sorts, according to EN 206, Annex E. The recycled aggregate was obtained from a specially made concrete for this study, which after 28 days was crushed with the help of a Retsch jaw crusher and further separated by sieving on granulometric sorters. The partial replacement of cement was done progressively, in the case of the mortar composition, with microsilica (3, 6, 9, 12, 15% wt.), nanosilica (0.75, 1.5, 2.25% wt.), respectively mixtures of micro and nanosilica. The optimal combination of silica, from the point of view of mechanical resistance, was later used also in the case of the concrete composition. For the chosen cementitious compositions, the influence of micro and/or nanosilica on the properties in the fresh state (workability, rheological characteristics) and hardened state (mechanical resistance, water absorption, freeze-thaw resistance, etc.) is highlighted.

Keywords: cement, recycled concrete aggregates, micro/nanosilica, durability

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653 Anti-Angiogenic and Anti-Metastatic Effect of Aqueous Fraction from Euchelus Asper Methanolic Extract

Authors: Sweta Agrawal, Sachin Chaugule, Gargi Rane, Shashank More, Madhavi Indap

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Angiogenesis and metastasis are two of the most important hallmarks of cancer. Hence, most of the cancer therapies nowadays are multi-targeted so as to reduce resistance and have better efficacy. As synthetic molecules arise with a burden of their toxicities and side-effects, more and more research is being focussed on exploiting the vast natural resources of drugs, in the form of plants and animals. Although, the idea of using marine organisms as a source of pharmaceuticals is not new, the pace at which marine drugs are being discovered, has definitely up surged! In the present study, we have assessed the anti-angiogenic and in vitro anti-metastatic activity of aqueous fraction from the extract of marine gastropod Euchelus asper. The soft body of Euchelus Asper was extracted with methanol and named EAME. Partition chromatography of EAME gave three fractions EAME I, II and III. Biochemical analysis revealed the presence of proteins in EAME III. Preliminary analysis had revealed the anti-angiogenic activity was exhibited by EAME III out of the three fractions. Hereafter, EAME III (concentration 25µg/ml-400µg/ml) was tested on chick chorioallantoic membrane (CAM) model for the detailed analysis of its potential anti-angiogenic effect. In vitro testing of the fraction (concentration 0.25µg/ml - 1µg/ml), involved cytotoxicity by SRB assay, cell cycle analysis by flow cytometry and anti-proliferative effect by scratch wound healing assay on A549 lung carcinoma cells. Apart from this, a portion of treated CAM as well as conditioned medium from treated A549 were subjected to gelatin zymography for assessment of matrix metalloproteinases MMP-2 and MMP-9 levels. Our results revealed that EAME III exhibited significant anti-angiogenic activity on CAM which was also supported by histological observations. During histological studies of CAM, it was found that EAME III caused reduction in angiogenesis by altering the extracellular matrix of the CAM membrane. In vitro analysis disclosed that EAME III exhibited moderate cytotoxic effect on A549 cells and its effect was not dose-dependent. The results of flow cytometry confirmed that EAME III caused cell cycle arrest in A549 cell line as almost all of the treated cells were found in G1 phase. Further, the migration and proliferation of A549 was significantly reduced by EAME III as observed from the scratch wound assay. Moreover, Gelatin zymography analysis revealed that EAME III caused suppression of MMP-2 in CAM membrane and reduced MMP-9 and MMP-2 expression in A549 cells. This verified that the anti-angiogenic and anti-metastatic effects of EAME III were correlated with the suppression of MMP-2 and -9. To conclude, EAME III shows dual anti-tumour action by reducing angiogenesis and exerting anti-metastatic effect on lung cancer cells, thus it has the potential to be used as an anti-cancer agent against lung carcinoma.

Keywords: angiogenesis, anti-cancer, marine drugs, matrix metalloproteinases

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652 Stakeholder-Driven Development of a One Health Platform to Prevent Non-Alimentary Zoonoses

Authors: A. F. G. Van Woezik, L. M. A. Braakman-Jansen, O. A. Kulyk, J. E. W. C. Van Gemert-Pijnen

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Background: Zoonoses pose a serious threat to public health and economies worldwide, especially as antimicrobial resistance grows and newly emerging zoonoses can cause unpredictable outbreaks. In order to prevent and control emerging and re-emerging zoonoses, collaboration between veterinary, human health and public health domains is essential. In reality however, there is a lack of cooperation between these three disciplines and uncertainties exist about their tasks and responsibilities. The objective of this ongoing research project (ZonMw funded, 2014-2018) is to develop an online education and communication One Health platform, “eZoon”, for the general public and professionals working in veterinary, human health and public health domains to support the risk communication of non-alimentary zoonoses in the Netherlands. The main focus is on education and communication in times of outbreak as well as in daily non-outbreak situations. Methods: A participatory development approach was used in which stakeholders from veterinary, human health and public health domains participated. Key stakeholders were identified using business modeling techniques previously used for the design and implementation of antibiotic stewardship interventions and consisted of a literature scan, expert recommendations, and snowball sampling. We used a stakeholder salience approach to rank stakeholders according to their power, legitimacy, and urgency. Semi-structured interviews were conducted with stakeholders (N=20) from all three disciplines to identify current problems in risk communication and stakeholder values for the One Health platform. Interviews were transcribed verbatim and coded inductively by two researchers. Results: The following key values were identified (but were not limited to): (a) need for improved awareness of veterinary and human health of each other’s fields, (b) information exchange between veterinary and human health, in particularly at a regional level; (c) legal regulations need to match with daily practice; (d) professionals and general public need to be addressed separately using tailored language and information; (e) information needs to be of value to professionals (relevant, important, accurate, and have financial or other important consequences if ignored) in order to be picked up; and (f) need for accurate information from trustworthy, centrally organised sources to inform the general public. Conclusion: By applying a participatory development approach, we gained insights from multiple perspectives into the main problems of current risk communication strategies in the Netherlands and stakeholder values. Next, we will continue the iterative development of the One Health platform by presenting key values to stakeholders for validation and ranking, which will guide further development. We will develop a communication platform with a serious game in which professionals at the regional level will be trained in shared decision making in time-critical outbreak situations, a smart Question & Answer (Q&A) system for the general public tailored towards different user profiles, and social media to inform the general public adequately during outbreaks.

Keywords: ehealth, one health, risk communication, stakeholder, zoonosis

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651 Education Delivery in Youth Justice Centres: Inside-Out Prison Exchange Program Pedagogy in an Australian Context

Authors: Tarmi A'Vard

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This paper discusses the transformative learning experience for students participating in the Inside-Out Prison Exchange Program (Inside-out) and explores the value this pedagogical approach may have in youth justice centers. Inside-Out is a semester-long university course which is unique as it takes 15 university students, with their textbook and theory-based knowledge, behind the walls to study alongside 15 incarcerated students, who have the lived experience of the criminal justice system. Inside-out is currently offered in three Victorian prisons, expanding to five in 2020. The Inside-out pedagogy which is based on transformative dialogic learning is reliant upon the participants sharing knowledge and experiences to develop an understanding and appreciation of the diversity and uniqueness of one another. Inside-out offers the class an opportunity to create its own guidelines for dialogue, which can lead to the student’s sense of equality, which is fundamental in the success of this program. Dialogue allows active participation by all parties in reconciling differences, collaborating ideas, critiquing and developing hypotheses and public policies, and encouraging self-reflection and exploration. The structure of the program incorporates the implementation of circular seating (where the students alternate between inside and outside), activities, individual reflective tasks, group work, and theory analysis. In this circle everyone is equal, this includes the educator, who serves as a facilitator more so than the traditional teacher role. A significant function of the circle is to develop a group consciousness, allowing the whole class to see itself as a collective, and no one person holds a superior role. This also encourages participants to be responsible and accountable for their behavior and contributions. Research indicates completing academic courses, like Inside-Out, contributes positively to reducing recidivism. Inside-Out’s benefits and success in many adult correctional institutions have been outlined in evaluation reports and scholarly articles. The key findings incorporate the learning experiences for the students in both an academic capability and professional practice and development. Furthermore, stereotypes and pre-determined ideas are challenged, and there is a promotion of critical thinking and evidence of self-discovery and growth. There is empirical data supporting positive outcomes of education in youth justice centers in reducing recidivism and increasing the likelihood of returning to education upon release. Hence, this research could provide the opportunity to increase young people’s engagement in education which is a known protective factor for assisting young people to move away from criminal behavior. In 2016, Tarmi completed the Inside-Out educator training in Philadelphia, Pennsylvania, and has developed an interest in exploring the pedagogy of Inside-Out, specifically targeting young offenders in a Youth Justice Centre.

Keywords: dialogic transformative learning, inside-out prison exchange program, prison education, youth justice

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650 Soybean Oil Based Phase Change Material for Thermal Energy Storage

Authors: Emre Basturk, Memet Vezir Kahraman

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In many developing countries, with the rapid economic improvements, energy shortage and environmental issues have become a serious problem. Therefore, it has become a very critical issue to improve energy usage efficiency and also protect the environment. Thermal energy storage system is an essential approach to match the thermal energy claim and supply. Thermal energy can be stored by heating, cooling or melting a material with the energy and then enhancing accessible when the procedure is reversed. The overall thermal energy storage techniques are sorted as; latent heat or sensible heat thermal energy storage technology segments. Among these methods, latent heat storage is the most effective method of collecting thermal energy. Latent heat thermal energy storage depend on the storage material, emitting or discharging heat as it undergoes a solid to liquid, solid to solid or liquid to gas phase change or vice versa. Phase change materials (PCMs) are promising materials for latent heat storage applications due to their capacities to accumulate high latent heat storage per unit volume by phase change at an almost constant temperature. Phase change materials (PCMs) are being utilized to absorb, collect and discharge thermal energy during the cycle of melting and freezing, converting from one phase to another. Phase Change Materials (PCMs) can generally be arranged into three classes: organic materials, salt hydrates and eutectics. Many kinds of organic and inorganic PCMs and their blends have been examined as latent heat storage materials. Organic PCMs are rather expensive and they have average latent heat storage per unit volume and also have low density. Most organic PCMs are combustible in nature and also have a wide range of melting point. Organic PCMs can be categorized into two major categories: non-paraffinic and paraffin materials. Paraffin materials have been extensively used, due to their high latent heat and right thermal characteristics, such as minimal super cooling, varying phase change temperature, low vapor pressure while melting, good chemical and thermal stability, and self-nucleating behavior. Ultraviolet (UV)-curing technology has been generally used because it has many advantages, such as low energy consumption , high speed, high chemical stability, room-temperature operation, low processing costs and environmental friendly. For many years, PCMs have been used for heating and cooling industrial applications including textiles, refrigerators, construction, transportation packaging for temperature-sensitive products, a few solar energy based systems, biomedical and electronic materials. In this study, UV-curable, fatty alcohol containing soybean oil based phase change materials (PCMs) were obtained and characterized. The phase transition behaviors and thermal stability of the prepared UV-cured biobased PCMs were analyzed by differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA). The heating process phase change enthalpy is measured between 30 and 68 J/g, and the freezing process phase change enthalpy is found between 18 and 70 J/g. The decomposition of UVcured PCMs started at 260 ºC and reached a maximum of 430 ºC.

Keywords: fatty alcohol, phase change material, thermal energy storage, UV curing

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649 The Challenges of Citizen Engagement in Urban Transformation: Key Learnings from Three European Cities

Authors: Idoia Landa Oregi, Itsaso Gonzalez Ochoantesana, Olatz Nicolas Buxens, Carlo Ferretti

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The impact of citizens in urban transformations has become increasingly important in the pursuit of creating citizen-centered cities. Citizens at the forefront of the urban transformation process are key to establishing resilient, sustainable, and inclusive cities that cater to the needs of all residents. Therefore, collecting data and information directly from citizens is crucial for the sustainable development of cities. Within this context, public participation becomes a pillar for acquiring the necessary information from citizens. Public participation in urban transformation processes establishes a more responsive, equitable, and resilient urban environment. This approach cultivates a sense of shared responsibility and collective progress in building cities that truly serve the well-being of all residents. However, the implementation of public participation practices often overlooks strategies to effectively engage citizens in the processes, resulting in non-successful participatory outcomes. Therefore, this research focuses on identifying and analyzing the critical aspects of citizen engagement during the same participatory urban transformation process in different European contexts: Ermua (Spain), Elva (Estonia) and Matera (Italy). The participatory neighborhood regeneration process is divided into three main stages, to turn social districts into inclusive and smart neighborhoods: (i) the strategic level, (ii) the design level, and (iii) the implementation level. In the initial stage, the focus is on diagnosing the neighborhood and creating a shared vision with the community. The second stage centers around collaboratively designing various action plans to foster inclusivity and intelligence while pushing local economic development within the district. Finally, the third stage ensures the proper co-implementation of the designed actions in the neighborhood. To this date, the presented results critically analyze the key aspects of engagement in the first stage of the methodology, the strategic plan, in the three above-mentioned contexts. It is a multifaceted study that incorporates three case studies to shed light on the various perspectives and strategies adopted by each city. The results indicate that despite of the various cultural contexts, all cities face similar barriers when seeking to enhance engagement. Accordingly, the study identifies specific challenges within the participatory approach across the three cities such as the existence of discontented citizens, communication gaps, inconsistent participation, or administration resistance. Consequently, key learnings of the process indicate that a collaborative sphere needs to be cultivated, educating both citizens and administrations in the aspects of co-governance, giving these practices the appropriate space and their own communication channels. This study is part of the DROP project, funded by the European Union, which aims to develop a citizen-centered urban renewal methodology to transform the social districts into smart and inclusive neighborhoods.

Keywords: citizen-centred cities, engagement, public participation, urban transformation

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648 Regulating the Ottomans on Turkish Television and the Making of Good Citizens

Authors: Chien Yang Erdem

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This paper takes up the proliferating historical dramas and children’s programs featuring the Ottoman-Islamic legacy on Turkish television as a locus where the processes of subjectification take place. A critical analysis of this emergent cultural phenomenon reveals an alliance of neoliberal and neoconservative political rationalities based on which the Turkish media is restructured to transform society. The existing debates have focused on how the Ottoman historical dramas manifest the Justice and Development Party’s (Adalet ve Kalkınma Partisi) neo-Ottomanist ideology and foreign policy. However, this approach tends to overlook the more complex relationship between the media, government, and society. Employing Michel Foucault’s notion of 'technologies of the self,' this paper aims to examine the governing practices that are deployed to regulate the media and to transform individual citizens into governable subjects in contemporary Turkey. First, through a brief discussion of recent development of the Turkish media towards an authoritarian model, the paper suggests that the relation between the Ottoman television drama and the political subject in question cannot be adequately examined without taking into account the force of the market. Second, by focusing on the managerial restructuring of the Turkish Television and Radio Corporation (Türkiye Radyo ve Televizyon Kurumu), the paper aims to illustrate the rationale and process through which the Turkish media sector is transformed into an integral part of the free market where the government becomes a key actor. The paper contends that this new sphere of free market is organized in a way that enables direct interference of the government and divides media practitioners and consumers into opposing categories through their own participation in the media market. On the one hand, a 'free subject' is constituted based on the premise that the market is a sphere where individuals are obliged to exercise their right to freedom (of choice, lifestyle, and expression). On the other hand, this 'free subject' is increasingly subjugated to such disciplinary practices as censorship for being on the wrong side of the government. Finally, the paper examines the relation between the restructured Turkish media market and the proliferation of Ottoman television drama in the 2010s. The study maintains that the reorganization of the media market has produced a condition where private sector is encouraged to take an active role in reviving Turkey’s Ottoman-Islamic cultural heritage and promulgating moral-religious values. Paying specific attention to the controversial case of Magnificent Century (Muhteşem Yüzyıl) in contrast with TRT’s Ottoman historical drama and children’s programs, the paper aims to identify the ways in which individual citizens are directed to conduct themselves as a virtuous citizenry. It is through the double movement between the governing practices associated with the media market and those concerning the making of a 'conservative generation' that a subject of citizenry of new Turkey is constituted.

Keywords: neoconservatism, neoliberalism, ottoman historical drama, technologies of the self, Turkish television

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647 Identification of Hub Genes in the Development of Atherosclerosis

Authors: Jie Lin, Yiwen Pan, Li Zhang, Zhangyong Xia

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Atherosclerosis is a chronic inflammatory disease characterized by the accumulation of lipids, immune cells, and extracellular matrix in the arterial walls. This pathological process can lead to the formation of plaques that can obstruct blood flow and trigger various cardiovascular diseases such as heart attack and stroke. The underlying molecular mechanisms still remain unclear, although many studies revealed the dysfunction of endothelial cells, recruitment and activation of monocytes and macrophages, and the production of pro-inflammatory cytokines and chemokines in atherosclerosis. This study aimed to identify hub genes involved in the progression of atherosclerosis and to analyze their biological function in silico, thereby enhancing our understanding of the disease’s molecular mechanisms. Through the analysis of microarray data, we examined the gene expression in media and neo-intima from plaques, as well as distant macroscopically intact tissue, across a cohort of 32 hypertensive patients. Initially, 112 differentially expressed genes (DEGs) were identified. Subsequent immune infiltration analysis indicated a predominant presence of 27 immune cell types in the atherosclerosis group, particularly noting an increase in monocytes and macrophages. In the Weighted gene co-expression network analysis (WGCNA), 10 modules with a minimum of 30 genes were defined as key modules, with blue, dark, Oliver green and sky-blue modules being the most significant. These modules corresponded respectively to monocyte, activated B cell, and activated CD4 T cell gene patterns, revealing a strong morphological-genetic correlation. From these three gene patterns (modules morphology), a total of 2509 key genes (Gene Significance >0.2, module membership>0.8) were extracted. Six hub genes (CD36, DPP4, HMOX1, PLA2G7, PLN2, and ACADL) were then identified by intersecting 2509 key genes, 102 DEGs with lipid-related genes from the Genecard database. The bio-functional analysis of six hub genes was estimated by a robust classifier with an area under the curve (AUC) of 0.873 in the ROC plot, indicating excellent efficacy in differentiating between the disease and control group. Moreover, PCA visualization demonstrated clear separation between the groups based on these six hub genes, suggesting their potential utility as classification features in predictive models. Protein-protein interaction (PPI) analysis highlighted DPP4 as the most interconnected gene. Within the constructed key gene-drug network, 462 drugs were predicted, with ursodeoxycholic acid (UDCA) being identified as a potential therapeutic agent for modulating DPP4 expression. In summary, our study identified critical hub genes implicated in the progression of atherosclerosis through comprehensive bioinformatic analyses. These findings not only advance our understanding of the disease but also pave the way for applying similar analytical frameworks and predictive models to other diseases, thereby broadening the potential for clinical applications and therapeutic discoveries.

Keywords: atherosclerosis, hub genes, drug prediction, bioinformatics

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646 From Victim to Ethical Agent: Oscar Wilde's The Ballad of Reading Gaol as Post-Traumatic Writing

Authors: Mona Salah El-Din Hassanein

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Faced with a sudden, unexpected, and overwhelming event, the individual's normal cognitive processing may cease to function, trapping the psyche in "speechless terror", while images, feelings and sensations are experienced with emotional intensity. Unable to master such situation, the individual becomes a trauma victim who will be susceptible to traumatic recollections like intrusive thoughts, flashbacks, and repetitive re-living of the primal event in a way that blurs the distinction between past and present, and forecloses the future. Trauma is timeless, repetitious, and contagious; a trauma observer could fall prey to "secondary victimhood". Central to the process of healing the psychic wounds in the aftermath of trauma is verbalizing the traumatic experience (i.e., putting it into words) – an act which provides a chance for assimilation, testimony, and reevaluation. In light of this paradigm, this paper proposes a reading of Oscar Wilde's The Ballad of Reading Gaol, written shortly after his release from prison, as a post-traumatic text which traces the disruptive effects of the traumatic experience of Wilde's imprisonment for homosexual offences and the ensuing reversal of fortune he endured. Post-traumatic writing demonstrates the process of "working through" a trauma which may lead to the possibility of ethical agency in the form of a "survivor mission". This paper draws on fundamental concepts and key insights in literary trauma theory which is characterized by interdisciplinarity, combining the perspectives of different fields like critical theory, psychology, psychiatry, psychoanalysis, history, and social studies. Of particular relevance to this paper are the concepts of "vicarious traumatization" and "survivor mission", as The Ballad of Reading Gaol was written in response to Wilde's own prison trauma and the indirect traumatization he experienced as a result of witnessing the execution of a fellow prisoner whose story forms the narrative base of the poem. The Ballad displays Wilde's sense of mission which leads him to recognize the social as well as ethical implications of personal tragedy. Through a close textual analysis of The Ballad of Reading Gaol within the framework of literary trauma theory, the paper aims to: (a) demonstrate how the poem's thematic concerns, structure and rhetorical figures reflect the structure of trauma; (b) highlight Wilde's attempts to come to terms with the effects of the cataclysmic experience which transformed him into a social outcast; and (c) show how Wilde manages to transcend the victim status and assumes the role of ethical agent to voice a critique of the Victorian penal system and the standards of morality underlying the cruelties practiced against wrong doers and to solicit social action.

Keywords: ballad of reading of reading, post-traumatic writing, trauma theory, Wilde

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