Search results for: theory of critical distances
Commenced in January 2007
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Edition: International
Paper Count: 9992

Search results for: theory of critical distances

452 Job Satisfaction among Brigadista in Nicaragua: A Lesson to Be Considered for Task-Shifting

Authors: Rashed Shah, Jeanne Koepsell, Dixmer Rivera, Eric Swedberg, David Marsh

Abstract:

Success of primary health care goals of health promotion and disease prevention may well be determined by community based health workers’ overall job satisfaction. It is also important to understand the ways community health workers perceive their jobs and the importance they give to the various factors influencing their job satisfaction, which is critical before making a decision for task-shifting and for expanding their scope of work. Although brigadistas are unpaid volunteers, they are formally recognized and receive support and supervision from the Ministry of Health in Nicaragua. Brigadistas are responsible for classifying and diagnosing illnesses, administering treatment, counseling mothers and care givers within the community, encouraging referral in case of serious illness and making follow-up visits at home. Some brigadistas provide more technically advanced services, including treatment for pneumonia, diarrhea, malaria and tuberculosis and/or distribution of contraceptives. Expanding brigadistas’ duties could threaten their heretofore ‘job satisfaction’. This study primarily aims to report on job satisfaction of brigadistas in Nicaragua before expanding the scope of their work by adding more responsibilities. The study was guided by the following research questions: 1) What aspects of their job made the brigadistas satisfied or dissatisfied? 2) What is the job satisfaction level of brigadistas in Nicaragua? This cross-sectional study was conducted during March – July 2014, to assess brigadistas’ job satisfaction, prior to deciding on inclusion of care for sick newborns and young infants (<2 months of age) to brigadistas’ existing service package of community case management for children of 2-59 months of age. Following stratified random sampling strategy, 15 brigadistas were randomly selected from each of the following four strata: [(1) females under 25 years of age, (2) females over 30 years of age, (3) males under 25 years of age, and (4) males over 30 years of age. Out of 45 completed in-person interview with eligible and available brigadistas, 20 (44.4%) were with female and 25 (55.6%) were with male respondents; the mean age (±sd) was found as 32.0 (±3.2) years. About 53% (24/45) brigadista mentioned “Training” as the most helpful for performing their job. Another 31% (14/45) mentioned that “feeling of doing good, supporting community, women and children” was helpful to perform their job well. When asked about difficulty, about 35.5% (16/45) brigadistas mentioned about “Lack of time” due to their responsibilities in family, farm, other work places, study and such time constraint made their job performance difficult. Measured on a 0-5 scale, estimated average job satisfaction was 4.2. Current trends in task-shifting and integrated program delivery require community health workers (like the brigadistas) to deliver several essential services, including maternal, newborn and child health, and family planning, and thereby increasing their responsibilities. Given the reported level of job satisfaction among brigadistas (4.2 out of 5), and the mentioned difficulty in performing their current job (as ‘Lack of Time’) in this study results, the policy makers and program managers in MOH should be cautious enough before making a decision to expand current scope of work for brigadistas in Nicaragua.

Keywords: Brigadisata, job satisfaction, Nicaragua, task-shifting

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451 Glucose Measurement in Response to Environmental and Physiological Challenges: Towards a Non-Invasive Approach to Study Stress in Fishes

Authors: Tomas Makaras, Julija Razumienė, Vidutė Gurevičienė, Gintarė Sauliutė, Milda Stankevičiūtė

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Stress responses represent animal’s natural reactions to various challenging conditions and could be used as a welfare indicator. Regardless of the wide use of glucose measurements in stress evaluation, there are some inconsistencies in its acceptance as a stress marker, especially when it comes to comparison with non-invasive cortisol measurements in the fish challenging stress. To meet the challenge and to test the reliability and applicability of glucose measurement in practice, in this study, different environmental/anthropogenic exposure scenarios were simulated to provoke chemical-induced stress in fish (14-days exposure to landfill leachate) followed by a 14-days stress recovery period and under the cumulative effect of leachate fish subsequently exposed to pathogenic oomycetes (Saprolegnia parasitica) to represent a possible infection in fish. It is endemic to all freshwater habitats worldwide and is partly responsible for the decline of natural freshwater fish populations. Brown trout (Salmo trutta fario) and sea trout (Salmo trutta trutta) juveniles were chosen because of a large amount of literature on physiological stress responses in these species was known. Glucose content in fish by applying invasive and non-invasive glucose measurement procedures in different test mediums such as fish blood, gill tissues and fish-holding water were analysed. The results indicated that the quantity of glucose released in the holding water of stressed fish increased considerably (approx. 3.5- to 8-fold) and remained substantially higher (approx. 2- to 4-fold) throughout the stress recovery period than the control level suggesting that fish did not recover from chemical-induced stress. The circulating levels of glucose in blood and gills decreased over time in fish exposed to different stressors. However, the gill glucose level in fish showed a decrease similar to the control levels measured at the same time points, which was found to be insignificant. The data analysis showed that concentrations of β-D glucose measured in gills of fish treated with S. parasitica differed significantly from the control recovery, but did not differ from the leachate recovery group showing that S. parasitica presence in water had no additive effects. In contrast, a positive correlation between blood and gills glucose were determined. Parallel trends in blood and water glucose changes suggest that water glucose measurement has much potency in predicting stress. This study demonstrated that measuring β-D-glucose in fish-holding water is not stressful as it involves no handling and manipulation of an organism and has critical technical advantages concerning current (invasive) methods, mainly using blood samples or specific tissues. The quantification of glucose could be essential for studies examining the stress physiology/aquaculture studies interested in the assessment or long-term monitoring of fish health.

Keywords: brown trout, landfill leachate, sea trout, pathogenic oomycetes, β-D-glucose

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450 Selling Electric Vehicles: Experiences from Car Salesmen in Sweden

Authors: Jens Hagman, Jenny Janhager Stier, Ellen Olausson, Anne Y. Faxer, Ana Magazinius

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Sweden has the second highest electric vehicle (plug-in hybrid and battery electric vehicle) sales per capita in Europe but in relation to sales of internal combustion engine electric vehicles sales are still minuscular (< 4%). Much research effort has been placed on various technical and user focused barriers and enablers for adoption of electric vehicles. Less effort has been placed on investigating the retail (dealership-customer) sales process of vehicles in general and electric vehicles in particular. Arguably, no one ought to be better informed about needs and desires of potential electric vehicle buyers than car salesmen, originating from their daily encounters with customers at the dealership. The aim of this paper is to explore the conditions of selling electric vehicle from a car salesmen’s perspective. This includes identifying barriers and enablers for electric vehicle sales originating from internal (dealership and brand) and external (customer, government) sources. In this interview study five car brands (manufacturers) that sell both electric and internal combustion engine vehicles have been investigated. A total of 15 semi-structured interviews have been conducted (three per brand, in rural and urban settings and at different dealerships). Initial analysis reveals several barriers and enablers, experienced by car salesmen, which influence electric vehicle sales. Examples of as reported by car salesmen identified barriers are: -Electric vehicles earn car salesmen less commission on average compared to internal combustion engine vehicles. -It takes more time to sell and deliver an electric vehicle than an internal combustion engine vehicle. -Current leasing contracts entails relatively low second-hand value estimations for electric vehicles and thus a high leasing fee, which negatively affects the attractiveness of electric vehicles for private consumers in particular. -High purchasing price discourages many consumers from considering electric vehicles. -The education and knowledge level of electric vehicles differs between car salesmen, which could affect their self-confidence in meeting well prepared and question prone electric vehicle buyers. Examples of identified enablers are: -Company car tax regulation promotes sales of electric vehicles; in particular, plug-in hybrid electric vehicles are sold extensively to companies (up to 95 % of sales). -Low operating cost of electric vehicles such as fuel and service is an advantage when understood by consumers. -The drive performance of electric vehicles (quick, silent and fun to drive) is attractive to consumers. -Environmental aspects are considered important for certain consumer groups. -Fast technological improvements, such as increased range are opening up a wider market for electric vehicles. -For one of the brands; attractive private lease campaigns have proved effective to promote sales. This paper gives insights of an important but often overlooked aspect for the diffusion of electric vehicles (and durable products in general); the interaction between car salesmen and customers at the critical acquiring moment. Extracted through interviews with multiple car salesmen. The results illuminate untapped potential for sellers (salesmen, dealerships and brands) to mitigating sales barriers and strengthening sales enablers and thus becoming a more important actor in the electric vehicle diffusion process.

Keywords: customer barriers, electric vehicle promotion, sales of electric vehicles, interviews with car salesmen

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449 Higher Education Benefits and Undocumented Students: An Explanatory Model of Policy Adoption

Authors: Jeremy Ritchey

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Undocumented immigrants in the U.S. face many challenges when looking to progress in society, especially when pursuing post-secondary education. The majority of research done on state-level policy adoption pertaining to undocumented higher-education pursuits, specifically in-state resident tuition and financial aid eligibility policies, have framed the discussion on the potential and actual impacts which implementation can and has achieved. What is missing is a model to view the social, political and demographic landscapes upon which such policies (in their various forms) find a route to legislative enactment. This research looks to address this gap in the field by investigating the correlations and significant state-level variables which can be operationalized to construct a framework for adoption of these specific policies. In the process, analysis will show that past unexamined conceptualizations of how such policies come to fruition may be limited or contradictory when compared to available data. Circling on the principles of Policy Innovation and Policy Diffusion theory, this study looks to use variables collected via Michigan State University’s Correlates of State Policy Project, a collectively and ongoing compiled database project centered around annual variables (1900-2016) collected from all 50 states relevant to policy research. Using established variable groupings (demographic, political, social capital measurements, and educational system measurements) from the time period of 2000 to 2014 (2001 being when such policies began), one can see how this data correlates with the adoption of policies related to undocumented students and in-state college tuition. After regression analysis, the results will illuminate which variables appears significant and to what effect, as to help formulate a model upon which to explain when adoption appears to occur and when it does not. Early results have shown that traditionally held conceptions on conservative and liberal identities of the state, as they relate to the likelihood of such policies being adopted, did not fall in line with the collected data. Democratic and liberally identified states were, overall, less likely to adopt pro-undocumented higher education policies than Republican and conservatively identified states and vis versa. While further analysis is needed as to improve the model’s explanatory power, preliminary findings are showing promise in widening our understanding of policy adoption factors in this realm of policies compared to the gap of such knowledge in the publications of the field as it currently exists. The model also looks to serve as an important tool for policymakers in framing such potential policies in a way that is congruent with the relevant state-level determining factors while being sensitive to the most apparent sources of potential friction. While additional variable groups and individual variables will ultimately need to be added and controlled for, this research has already begun to demonstrate how shallow or unexamined reasoning behind policy adoption in the realm of this topic needs to be addressed or else the risk is erroneous conceptions leaking into the foundation of this growing and ever important field.

Keywords: policy adoption, in-state tuition, higher education, undocumented immigrants

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448 Comparison of Artificial Neural Networks and Statistical Classifiers in Olive Sorting Using Near-Infrared Spectroscopy

Authors: İsmail Kavdır, M. Burak Büyükcan, Ferhat Kurtulmuş

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Table olive is a valuable product especially in Mediterranean countries. It is usually consumed after some fermentation process. Defects happened naturally or as a result of an impact while olives are still fresh may become more distinct after processing period. Defected olives are not desired both in table olive and olive oil industries as it will affect the final product quality and reduce market prices considerably. Therefore it is critical to sort table olives before processing or even after processing according to their quality and surface defects. However, doing manual sorting has many drawbacks such as high expenses, subjectivity, tediousness and inconsistency. Quality criterions for green olives were accepted as color and free of mechanical defects, wrinkling, surface blemishes and rotting. In this study, it was aimed to classify fresh table olives using different classifiers and NIR spectroscopy readings and also to compare the classifiers. For this purpose, green (Ayvalik variety) olives were classified based on their surface feature properties such as defect-free, with bruised defect and with fly defect using FT-NIR spectroscopy and classification algorithms such as artificial neural networks, ident and cluster. Bruker multi-purpose analyzer (MPA) FT-NIR spectrometer (Bruker Optik, GmbH, Ettlingen Germany) was used for spectral measurements. The spectrometer was equipped with InGaAs detectors (TE-InGaAs internal for reflectance and RT-InGaAs external for transmittance) and a 20-watt high intensity tungsten–halogen NIR light source. Reflectance measurements were performed with a fiber optic probe (type IN 261) which covered the wavelengths between 780–2500 nm, while transmittance measurements were performed between 800 and 1725 nm. Thirty-two scans were acquired for each reflectance spectrum in about 15.32 s while 128 scans were obtained for transmittance in about 62 s. Resolution was 8 cm⁻¹ for both spectral measurement modes. Instrument control was done using OPUS software (Bruker Optik, GmbH, Ettlingen Germany). Classification applications were performed using three classifiers; Backpropagation Neural Networks, ident and cluster classification algorithms. For these classification applications, Neural Network tool box in Matlab, ident and cluster modules in OPUS software were used. Classifications were performed considering different scenarios; two quality conditions at once (good vs bruised, good vs fly defect) and three quality conditions at once (good, bruised and fly defect). Two spectrometer readings were used in classification applications; reflectance and transmittance. Classification results obtained using artificial neural networks algorithm in discriminating good olives from bruised olives, from olives with fly defect and from the olive group including both bruised and fly defected olives with success rates respectively changing between 97 and 99%, 61 and 94% and between 58.67 and 92%. On the other hand, classification results obtained for discriminating good olives from bruised ones and also for discriminating good olives from fly defected olives using the ident method ranged between 75-97.5% and 32.5-57.5%, respectfully; results obtained for the same classification applications using the cluster method ranged between 52.5-97.5% and between 22.5-57.5%.

Keywords: artificial neural networks, statistical classifiers, NIR spectroscopy, reflectance, transmittance

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447 Legislating for Public Participation and Environmental Justice: Whether It Solves or Prevent Disputes

Authors: Deborah A. Hollingworth

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The key tenets associated with ‘environmental justice’, were first articulated in a global context in Principle 10 of the United Nations Declaration on Environment and Development at Rio de Janeiro in 1992 (the Rio Declaration). The elements can be conflated to require: public participation in decision-making; the provision of relevant information to those affected about environmental hazards issues; access to judicial and administrative proceeding; and the opportunity for redress where remedy where required. This paper examines the legislative and regulatory arrangements in place for the implementation these elements in a number of industrialised democracies, including Australia. Most have, over time made regulatory provision for these elements – even if they are not directly attributed Principle 10 or the notion of environmental justice. The paper proposes, that of these elements the most critical to the achievement of good environmental governance, is a legislated recognition and role of public participation. However, the paper considers that notwithstanding sound legislative and regulatory practices, environmental regulators frequently struggle, where there is a complex decision-making scenario or long-standing enmity between a community and industry to achieve effective engagement with the public. This study considers the dilemma confronted by environmental regulators to given meaningful effect to the principles enshrined in Principle 10 – that even when the legislative expression of Principle 10 is adhered to – does not prevent adverse outcomes. In particular, it considers, as a case study a prominent environmental incident in 2014 in Australia in which an open-cut coalmine located in the regional township of Morwell caught fire during bushfire season. The fire, which took 45 days to be extinguished had a significant and adverse impact on the community in question, but compounded a complex, and sometime antagonistic history between the mine and township. The case study exemplifies the complex factors that will often be present between industry, the public and regulatory bodies, and which confound the concept of environmental justice, and the elements of enshrined in the Principle 10 of the Rio Declaration. The study proposes that such tensions and complex examples will commonly be the reality of communities and regulators. However, to give practical effect to outcomes contemplated by Principle 10, the paper considers that regulators will may consider public intervention more broadly as including early interventions and formal opportunities for “conferencing” between industry, community and regulators. These initiatives help to develop a shared understanding and identification of issues. It is proposed that although important, options for “alternative dispute resolution” are not sufficiently preventative, as they come into play when a dispute has arise. Similarly “restorative justice” programs, while important once an incident or adverse environmental outcome has occurred, are post event and therefore necessarily limited. The paper considers the examples of how public participation at the outset – at the time of a proposal, before issues arise or eventuate to ensure, is demonstrably the most effective way for building commonality and an agreed methodology for working to resolve issues once they occur.

Keywords: environmental justice, alternative dispute resolution, domestic environmental law, international environmental law

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446 Alternative Energy and Carbon Source for Biosurfactant Production

Authors: Akram Abi, Mohammad Hossein Sarrafzadeh

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Because of their several advantages over chemical surfactants, biosurfactants have given rise to a growing interest in the past decades. Advantages such as lower toxicity, higher biodegradability, higher selectivity and applicable at extreme temperature and pH which enables them to be used in a variety of applications such as: enhanced oil recovery, environmental and pharmaceutical applications, etc. Bacillus subtilis produces a cyclic lipopeptide, called surfactin, which is one of the most powerful biosurfactants with ability to decrease surface tension of water from 72 mN/m to 27 mN/m. In addition to its biosurfactant character, surfactin exhibits interesting biological activities such as: inhibition of fibrin clot formation, lyses of erythrocytes and several bacterial spheroplasts, antiviral, anti-tumoral and antibacterial properties. Surfactin is an antibiotic substance and has been shown recently to possess anti-HIV activity. However, application of biosurfactants is limited by their high production cost. The cost can be reduced by optimizing biosurfactant production using cheap feed stock. Utilization of inexpensive substrates and unconventional carbon sources like urban or agro-industrial wastes is a promising strategy to decrease the production cost of biosurfactants. With suitable engineering optimization and microbiological modifications, these wastes can be used as substrates for large-scale production of biosurfactants. As an effort to fulfill this purpose, in this work we have tried to utilize olive oil as second carbon source and also yeast extract as second nitrogen source to investigate the effect on both biomass and biosurfactant production improvement in Bacillus subtilis cultures. Since the turbidity of the culture was affected by presence of the oil, optical density was compromised and no longer could be used as an index of growth and biomass concentration. Therefore, cell Dry Weight measurements with applying necessary tactics for removing oil drops to prevent interference with biomass weight were carried out to monitor biomass concentration during the growth of the bacterium. The surface tension and critical micelle dilutions (CMD-1, CMD-2) were considered as an indirect measurement of biosurfactant production. Distinctive and promising results were obtained in the cultures containing olive oil compared to cultures without it: more than two fold increase in biomass production (from 2 g/l to 5 g/l) and considerable reduction in surface tension, down to 40 mN/m at surprisingly early hours of culture time (only 5hr after inoculation). This early onset of biosurfactant production in this culture is specially interesting when compared to the conventional cultures at which this reduction in surface tension is not obtained until 30 hour of culture time. Reducing the production time is a very prominent result to be considered for large scale process development. Furthermore, these results can be used to develop strategies for utilization of agro-industrial wastes (such as olive oil mill residue, molasses, etc.) as cheap and easily accessible feed stocks to decrease the high costs of biosurfactant production.

Keywords: agro-industrial waste, bacillus subtilis, biosurfactant, fermentation, second carbon and nitrogen source, surfactin

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445 Effect of Rolling Shear Modulus and Geometric Make up on the Out-Of-Plane Bending Performance of Cross-Laminated Timber Panel

Authors: Md Tanvir Rahman, Mahbube Subhani, Mahmud Ashraf, Paul Kremer

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Cross-laminated timber (CLT) is made from layers of timber boards orthogonally oriented in the thickness direction, and due to this, CLT can withstand bi-axial bending in contrast with most other engineered wood products such as laminated veneer lumber (LVL) and glued laminated timber (GLT). Wood is cylindrically anisotropic in nature and is characterized by significantly lower elastic modulus and shear modulus in the planes perpendicular to the fibre direction, and is therefore classified as orthotropic material and is thus characterized by 9 elastic constants which are three elastic modulus in longitudinal direction, tangential direction and radial direction, three shear modulus in longitudinal tangential plane, longitudinal radial plane and radial tangential plane and three Poisson’s ratio. For simplification, timber materials are generally assumed to be transversely isotropic, reducing the number of elastic properties characterizing it to 5, where the longitudinal plane and radial planes are assumed to be planes of symmetry. The validity of this assumption was investigated through numerical modelling of CLT with both orthotropic mechanical properties and transversely isotropic material properties for three softwood species, which are Norway spruce, Douglas fir, Radiata pine, and three hardwood species, namely Victorian ash, Beech wood, and Aspen subjected to uniformly distributed loading under simply supported boundary condition. It was concluded that assuming the timber to be transversely isotropic results in a negligible error in the order of 1 percent. It was also observed that along with longitudinal elastic modulus, ratio of longitudinal shear modulus (GL) and rolling shear modulus (GR) has a significant effect on a deflection for CLT panels of lower span to depth ratio. For softwoods such as Norway spruce and Radiata pine, the ratio of longitudinal shear modulus, GL to rolling shear modulus GR is reported to be in the order of 12 to 15 times in literature. This results in shear flexibility in transverse layers leading to increased deflection under out-of-plane loading. The rolling shear modulus of hardwoods has been found to be significantly higher than those of softwoods, where the ratio between longitudinal shear modulus to rolling shear modulus as low as 4. This has resulted in a significant rise in research into the manufacturing of CLT from entirely from hardwood, as well as from a combination of softwood and hardwoods. The commonly used beam theory to analyze the performance of CLT panels under out-of-plane loads are the Shear analogy method, Gamma method, and k-method. The shear analogy method has been found to be the most effective method where shear deformation is significant. The effect of the ratio of longitudinal shear modulus and rolling shear modulus of cross-layer on the deflection of CLT under uniformly distributed load with respect to its length to depth ratio was investigated using shear analogy method. It was observed that shear deflection is reduced significantly as the ratio of the shear modulus of the longitudinal layer and rolling shear modulus of cross-layer decreases. This indicates that there is significant room for improvement of the bending performance of CLT through developing hybrid CLT from a mix of softwood and hardwood.

Keywords: rolling shear modulus, shear deflection, ratio of shear modulus and rolling shear modulus, timber

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444 New Findings on the Plasma Electrolytic Oxidation (PEO) of Aluminium

Authors: J. Martin, A. Nominé, T. Czerwiec, G. Henrion, T. Belmonte

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The plasma electrolytic oxidation (PEO) is a particular electrochemical process to produce protective oxide ceramic coatings on light-weight metals (Al, Mg, Ti). When applied to aluminum alloys, the resulting PEO coating exhibit improved wear and corrosion resistance because thick, hard, compact and adherent crystalline alumina layers can be achieved. Several investigations have been carried out to improve the efficiency of the PEO process and one particular way consists in tuning the suitable electrical regime. Despite the considerable interest in this process, there is still no clear understanding of the underlying discharge mechanisms that make possible metal oxidation up to hundreds of µm through the ceramic layer. A key parameter that governs the PEO process is the numerous short-lived micro-discharges (micro-plasma in liquid) that occur continuously over the processed surface when the high applied voltage exceeds the critical dielectric breakdown value of the growing ceramic layer. By using a bipolar pulsed current to supply the electrodes, we previously observed that micro-discharges are delayed with respect to the rising edge of the anodic current. Nevertheless, explanation of the origin of such phenomena is still not clear and needs more systematic investigations. The aim of the present communication is to identify the relationship that exists between this delay and the mechanisms responsible of the oxide growth. For this purpose, the delay of micro-discharges ignition is investigated as the function of various electrical parameters such as the current density (J), the current pulse frequency (F) and the anodic to cathodic charge quantity ratio (R = Qp/Qn) delivered to the electrodes. The PEO process was conducted on Al2214 aluminum alloy substrates in a solution containing potassium hydroxide [KOH] and sodium silicate diluted in deionized water. The light emitted from micro-discharges was detected by a photomultiplier and the micro-discharge parameters (number, size, life-time) were measured during the process by means of ultra-fast video imaging (125 kfr./s). SEM observations and roughness measurements were performed to characterize the morphology of the elaborated oxide coatings while XRD was carried out to evaluate the amount of corundum -Al203 phase. Results show that whatever the applied current waveform, the delay of micro-discharge appearance increases as the process goes on. Moreover, the delay is shorter when the current density J (A/dm2), the current pulse frequency F (Hz) and the ratio of charge quantity R are high. It also appears that shorter delays are associated to stronger micro-discharges (localized, long and large micro-discharges) which have a detrimental effect on the elaborated oxide layers (thin and porous). On the basis of the results, a model for the growth of the PEO oxide layers will be presented and discussed. Experimental results support that a mechanism of electrical charge accumulation at the oxide surface / electrolyte interface takes place until the dielectric breakdown occurs and thus until micro-discharges appear.

Keywords: aluminium, micro-discharges, oxidation mechanisms, plasma electrolytic oxidation

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443 Developing Thai-UK Double Degree Programmes: An Exploratory Study Identifying Challenges, Competing Interests and Risks

Authors: Joy Tweed, Jon Pike

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In Thailand, a 4.0 policy has been initiated that is designed to prepare and train an appropriate workforce to support the move to a value-based economy. One aspect of support for this policy is a project to encourage the creation of double degree programmes, specifically between Thai and UK universities. This research into the project, conducted with its key players, explores the factors that can either enable or hinder the development of such programmes. It is an area that has received little research attention to date. Key findings focus on differences in quality assurance requirements, attitudes to benefits, risks, and committed levels of institutional support, thus providing valuable input into future policy making. The Transnational Education (TNE) Development Project was initiated in 2015 by the British Council, in conjunction with the Office for Higher Education Commission (OHEC), Thailand. The purpose of the project was to facilitate opportunities for Thai Universities to partner with UK Universities so as to develop double degree programme models. In this arrangement, the student gains both a UK and a Thai qualification, spending time studying in both countries. Twenty-two partnerships were initiated via the project. Utilizing a qualitative approach, data sources included participation in TNE project workshops, peer reviews, and over 20 semi-structured interviews conducted with key informants within the participating UK and Thai universities. Interviews were recorded, transcribed, and analysed for key themes. The research has revealed that the strength of the relationship between the two partner institutions is critical. Successful partnerships are often built on previous personal contact, have senior-level involvement and are strengthened by partnership on different levels, such as research, student exchange, and other forms of mobility. The support of the British Council was regarded as a key enabler in developing these types of projects for those universities that had not been involved in TNE previously. The involvement of industry is apparent in programmes that have high scientific content but not well developed in other subject areas. Factors that hinder the development of partnership programmes include the approval processes and quality requirements of each institution. Significant differences in fee levels between Thai and UK universities provide a challenge and attempts to bridge them require goodwill on the part of the latter that may be difficult to realise. This research indicates the key factors to which attention needs to be given when developing a TNE programme. Early attention to these factors can reduce the likelihood that the partnership will fail to develop. Representatives in both partner universities need to understand their respective processes of development and approval. The research has important practical implications for policy-makers and planners involved with TNE, not only in relation to the specific TNE project but also more widely in relation to the development of TNE programmes in other countries and other subject areas. Future research will focus on assessing the success of the double degree programmes generated by the TNE Development Project from the perspective of universities, policy makers, and industry partners.

Keywords: double-degree, internationalization, partnerships, Thai-UK

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442 The Role and Challenges of Media in the Transformation of Contemporary Nigeria Democracies

Authors: Henry Okechukwu Onyeiwu

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The role of media in the transformation of contemporary Nigeria's democracies is multifaceted and profoundly impactful. As Nigeria navigates its complex socio-political landscape, media serves as both a catalyst for democratic engagement and a platform for public discourse. This paper explores the various dimensions through which media influences democracy in Nigeria, including its role in informing citizens, shaping public opinion, and providing a forum for diverse voices. The increasing penetration of social media has revolutionized the political sphere, empowering citizens to participate in governance and hold leaders accountable. However, challenges such as misinformation, censorship, and media bias continue to pose significant threats to democratic integrity. This study critically analyzes the interplay between traditional and new media, highlighting their contributions to electoral processes, civic education, and advocacy for human rights. Ultimately, the findings illustrate that while media is a crucial agent for democratic transformation, its potential can only be realized through a commitment to journalistic integrity and the promotion of media literacy among the Nigerian populace. The media plays a critical role in shaping public democracies in Nigeria, yet it faces a myriad of challenges that hinder its effectiveness. This paper examines the various obstacles confronting media broadcasting in Nigeria, which range from political interference and censorship to issues of professionalism and the proliferation of fake news. Political interference is particularly pronounced, as government entities and political actors often attempt to control narratives, compromising the independence of media outlets. This control often manifests in the form of censorship, where journalists face threats and harassment for reporting on sensitive topics related to governance, corruption, and human rights abuses. Moreover, the rapid rise of social media has introduced a dual challenge; while it offers a platform for citizen engagement and diverse viewpoints, it also facilitates the spread of misinformation and propaganda. The lack of media literacy among the populace exacerbates this issue, as citizens often struggle to discern credible information from false narratives. Additionally, economic constraints deeply affect the sustainability and independence of many broadcasting organizations. Advertisers may unduly influence content, leading to sensationalism over substantive reporting. This paper argues that for media to effectively contribute to Nigerian public democracies, there needs to be a concerted effort to address these challenges. Strengthening journalistic ethics, enhancing regulatory frameworks, and promoting media literacy among citizens are essential steps in fostering a more vibrant and accountable media landscape. Ultimately, this research underscores the necessity of a resilient media ecosystem that can truly support democratic processes, empower citizens, and hold power to account in contemporary Nigeria.

Keywords: media, democracy, socio-political, governance

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441 Influence Study of the Molar Ratio between Solvent and Initiator on the Reaction Rate of Polyether Polyols Synthesis

Authors: María José Carrero, Ana M. Borreguero, Juan F. Rodríguez, María M. Velencoso, Ángel Serrano, María Jesús Ramos

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Flame-retardants are incorporated in different materials in order to reduce the risk of fire, either by providing increased resistance to ignition, or by acting to slow down combustion and thereby delay the spread of flames. In this work, polyether polyols with fire retardant properties were synthesized due to their wide application in the polyurethanes formulation. The combustion of polyurethanes is primarily dependent on the thermal properties of the polymer, the presence of impurities and formulation residue in the polymer as well as the supply of oxygen. There are many types of flame retardants, most of them are phosphorous compounds of different nature and functionality. The addition of these compounds is the most common method for the incorporation of flame retardant properties. The employment of glycerol phosphate sodium salt as initiator for the polyol synthesis allows obtaining polyols with phosphate groups in their structure. However, some of the critical points of the use of glycerol phosphate salt are: the lower reactivity of the salt and the necessity of a solvent (dimethyl sulfoxide, DMSO). Thus, the main aim in the present work was to determine the amount of the solvent needed to get a good solubility of the initiator salt. Although the anionic polymerization mechanism of polyether formation is well known, it seems convenient to clarify the role that DMSO plays at the starting point of the polymerization process. Regarding the fact that the catalyst deprotonizes the hydroxyl groups of the initiator and as a result of this, two water molecules and glycerol phosphate alkoxide are formed. This alkoxide, together with DMSO, has to form a homogeneous mixture where the initiator (solid) and the propylene oxide (PO) are soluble enough to mutually interact. The addition rate of PO increased when the solvent/initiator ratios studied were increased, observing that it also made the initiation step shorter. Furthermore, the molecular weight of the polyol decreased when higher solvent/initiator ratios were used, what revealed that more amount of salt was activated, initiating more chains of lower length but allowing to react more phosphate molecules and to increase the percentage of phosphorous in the final polyol. However, the final phosphorous content was lower than the theoretical one because only a percentage of salt was activated. On the other hand, glycerol phosphate disodium salt was still partially insoluble in DMSO studied proportions, thus, the recovery and reuse of this part of the salt for the synthesis of new flame retardant polyols was evaluated. In the recovered salt case, the rate of addition of PO remained the same than in the commercial salt but a shorter induction period was observed, this is because the recovered salt presents a higher amount of deprotonated hydroxyl groups. Besides, according to molecular weight, polydispersity index, FT-IR spectrum and thermal stability, there were no differences between both synthesized polyols. Thus, it is possible to use the recovered glycerol phosphate disodium salt in the same way that the commercial one.

Keywords: DMSO, fire retardants, glycerol phosphate disodium salt, recovered initiator, solvent

Procedia PDF Downloads 278
440 The Importance and Necessity for Acquiring Pedagogical Skills by the Practice Tutors for the Training of the General Nurses

Authors: Maria Luiza Fulga, Georgeta Truca, Mihaela Alexandru, Andriescu Mariana, Crin Marcean

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The significance of nursing as a subject in the post-secondary healthcare curriculum is a major. We aimed to enable our students to assess the patient's risk, to establish prevention measures and to adapt to a specific learning context, in order to acquire the skills and abilities necessary for the nursing profession. In order to achieve these objectives, during the three years of study, teachers put an emphasis on acquiring communication skills, because in our country after the first cycle of hospital accreditation concluded in 2016, the National Authority for Quality of Health Management has introduced the criteria for the implementation and application of the nursing process according to the accreditation standards. According to these requirements, the nurse has to carry out the nursing assessment, based on communication as a distinct component, so that they can identify nursing diagnoses and implement the nursing plan. In this respect, we, the teachers, have refocused, by approaching various teaching strategies and preparing students for the real context of learning and applying what they learn. In the educational process, the tutors in the hospitals have an important role to play in acquiring professional skills. Students perform their activity in the hospital in accordance with the curriculum, in order to verify the practical applicability of the theoretical knowledge acquired in the school classes and also have the opportunity to acquire their skills in a real learning context. In clinical education, the student nurse learns in the middle of a guidance team which includes a practice tutor, who is a nurse that takes responsibility for the practical/clinical learning of the students in their field of activity. In achieving this objective, the tutor's abilities involve pedagogical knowledge, knowledge for the good of the individual and nursing theory, in order to be able to guide clinical practice in accordance with current requirements. The aim of this study is to find out the students’ confidence level in practice tutors in hospitals, the students’ degree of satisfaction in the pedagogical skills of the tutors and the practical applicability of the theoretical knowledge. In this study, we used as a method of investigation a student satisfaction questionnaire regarding the clinical practice in the hospital and the sample of the survey consisted of 100 students aged between 20 and 50 years, from the first, second and third year groups, with the General Nurse specialty (nurses responsible for general care), from 'Fundeni' Healthcare Post-Secondary School, Bucharest, Romania. Following the analysis of the data provided, we arrived the conclusion that the hospital tutor needs to improve his/her pedagogical skills, the knowledge of nursing diagnostics, and the implementation of the nursing plan, so that the applicability of the theoretical notions would be increased. Future plans include the pedagogical training of the medical staff, as well as updating the knowledge needed to implement the nursing process in order to meet current requirements.

Keywords: clinical training, nursing process, pedagogical skills, tutor

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439 ‘Call Before, Save Lives’: Reducing Emergency Department Visits through Effective Communication

Authors: Sandra Cardoso, Gaspar Pais, Judite Neves, Sandra Cavaca, Fernando Araújo

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In 2021, Portugal has 63 emergency department (ED) visits per 100 people annually, the highest numbers in Europe. While EDs provide a critical service, high use is indicative of inappropriate and inefficient healthcare. In Portugal, all ED have the Manchester Triage System (MTS), a clinical risk management tool to enable that patients are seen in order of clinical priority. In 2023, more than 40% of the ED visits were of non-urgent conditions (blue and green), that could be better managed in primary health care (PHC), meaning wrong use of resources and lack of health literacy. From 2017, the country has a phone line, SNS24 (Contact Centre of the National Health Service), for triage, counseling, and referral service, 24 hours/7 days a week. The pilot project ‘Call before, save lives’ was implemented in the municipalities of Póvoa de Varzim and Vila do Conde (around 150.000 residents), in May 2023, by the executive board of the Portuguese Health Service, with the support of the Shared Services of the Ministry of Health, and local authorities. This geographical area has short travel times, 99% of the population a family doctor and the region is organized in a health local unit (HLU), integrating PHC and the local hospital. The purposes of this project included to increase awareness to contact SNS 24, before going to an ED, and non-urgent conditions oriented to a family doctor, reducing ED visits. The implementation of the project involved two phases, beginning with: i) development of campaigns using local influencers (fishmonger, model, fireman) through local institutions and media; ii) provision of telephone installed on site to contact SNS24; iii) establishment of open consultation in PHC; iv) promotion of the use of SNS24; v) creation of acute consultations at the hospital for complex chronic patients; and vi) direct referral for home hospitalization by PHC. The results of this project showed an excellent level of access to SNS24, an increase in the number of users referred to ED, with great satisfaction of users and professionals. The second phase, initiated in January 2024, for access to the ED, the need for prior referral was established as an admission rule, except for certain situations, as trauma patients. If the patient refuses, their registration in the ED and subsequent screening in accordance with the MTS must be ensured. When the patient is non-urgent, shall not be observed in the ED, provided that, according to his clinical condition, is guaranteed to be referred to PHC or to consultation/day hospital, through effective scheduling of an appointment for the same or the following day. In terms of results, 8 weeks after beginning of phase 2, we assist of a decrease in self-reported patients to ED from 59% to 15%, and a reduction of around 7% of ED visits. The key for this success was an effective public campaign that increases the knowledge of the right use of the health system, and capable of changing behaviors.

Keywords: contact centre of the national health service, emergency department visits, public campaign, health literacy, SNS24

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438 A Practical Methodology for Evaluating Water, Sanitation and Hygiene Education and Training Programs

Authors: Brittany E. Coff, Tommy K. K. Ngai, Laura A. S. MacDonald

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Many organizations in the Water, Sanitation and Hygiene (WASH) sector provide education and training in order to increase the effectiveness of their WASH interventions. A key challenge for these organizations is measuring how well their education and training activities contribute to WASH improvements. It is crucial for implementers to understand the returns of their education and training activities so that they can improve and make better progress toward the desired outcomes. This paper presents information on CAWST’s development and piloting of the evaluation methodology. The Centre for Affordable Water and Sanitation Technology (CAWST) has developed a methodology for evaluating education and training activities, so that organizations can understand the effectiveness of their WASH activities and improve accordingly. CAWST developed this methodology through a series of research partnerships, followed by staged field pilots in Nepal, Peru, Ethiopia and Haiti. During the research partnerships, CAWST collaborated with universities in the UK and Canada to: review a range of available evaluation frameworks, investigate existing practices for evaluating education activities, and develop a draft methodology for evaluating education programs. The draft methodology was then piloted in three separate studies to evaluate CAWST’s, and CAWST’s partner’s, WASH education programs. Each of the pilot studies evaluated education programs in different locations, with different objectives, and at different times within the project cycles. The evaluations in Nepal and Peru were conducted in 2013 and investigated the outcomes and impacts of CAWST’s WASH education services in those countries over the past 5-10 years. In 2014, the methodology was applied to complete a rigorous evaluation of a 3-day WASH Awareness training program in Ethiopia, one year after the training had occurred. In 2015, the methodology was applied in Haiti to complete a rapid assessment of a Community Health Promotion program, which informed the development of an improved training program. After each pilot evaluation, the methodology was reviewed and improvements were made. A key concept within the methodology is that in order for training activities to lead to improved WASH practices at the community level, it is not enough for participants to acquire new knowledge and skills; they must also apply the new skills and influence the behavior of others following the training. The steps of the methodology include: development of a Theory of Change for the education program, application of the Kirkpatrick model to develop indicators, development of data collection tools, data collection, data analysis and interpretation, and use of the findings for improvement. The methodology was applied in different ways for each pilot and was found to be practical to apply and adapt to meet the needs of each case. It was useful in gathering specific information on the outcomes of the education and training activities, and in developing recommendations for program improvement. Based on the results of the pilot studies, CAWST is developing a set of support materials to enable other WASH implementers to apply the methodology. By using this methodology, more WASH organizations will be able to understand the outcomes and impacts of their training activities, leading to higher quality education programs and improved WASH outcomes.

Keywords: education and training, capacity building, evaluation, water and sanitation

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437 Design of Smart Catheter for Vascular Applications Using Optical Fiber Sensor

Authors: Lamiek Abraham, Xinli Du, Yohan Noh, Polin Hsu, Tingting Wu, Tom Logan, Ifan Yen

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In the field of minimally invasive, smart medical instruments such as catheters and guidewires are typically used at a remote distance to gain access to the diseased artery, often negotiating tortuous, complex, and diseased vessels in the process. Three optical fiber sensors with a diameter of 1.5mm each that are 120° apart from each other is proposed to be mounted into a catheter-based pump device with a diameter of 10mm. These sensors are configured to solve the challenges surgeons face during insertion through curvy major vessels such as the aortic arch. Moreover, these sensors deal with providing information on rubbing the walls and shape sensing. This study presents an experimental and mathematical models of the optical fiber sensors with 2 degrees of freedom. There are two eight gear-shaped tubes made up of 3D printed thermoplastic Polyurethane (TPU) material that are connected. The optical fiber sensors are mounted inside the first tube for protection from external light and used TPU material as a prototype for a catheter. The second tube is used as a flat reflection for the light intensity modulation-based optical fiber sensors. The first tube is attached to the linear guide for insertion and withdrawal purposes and can manually turn it 45° by manipulating the tube gear. A 3D hard material phantom was developed that mimics the aortic arch anatomy structure in which the test was carried out. During the insertion of the sensors into the 3D phantom, datasets are obtained in terms of voltage, distance, and position of the sensors. These datasets reflect the characteristics of light intensity modulation of the optical fiber sensors with a plane project of the aortic arch structure shape. Mathematical modeling of the light intensity was carried out based on the projection plane and experiment set-up. The performance of the system was evaluated in terms of its accuracy in navigating through the curvature and information on the position of the sensors by investigating 40 single insertions of the sensors into the 3D phantom. The experiment demonstrated that the sensors were effectively steered through the 3D phantom curvature and to desired target references in all 2 degrees of freedom. The performance of the sensors echoes the reflectance of light theory, where the smaller the radius of curvature, the more of the shining LED lights are reflected and received by the photodiode. A mathematical model results are in good agreement with the experiment result and the operation principle of the light intensity modulation of the optical fiber sensors. A prototype of a catheter using TPU material with three optical fiber sensors mounted inside has been developed that is capable of navigating through the different radius of curvature with 2 degrees of freedom. The proposed system supports operators with pre-scan data to make maneuverability and bendability through curvy major vessels easier, accurate, and safe. The mathematical modelling accurately fits the experiment result.

Keywords: Intensity modulated optical fiber sensor, mathematical model, plane projection, shape sensing.

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436 Implementation of a Multidisciplinary Weekly Safety Briefing in a Tertiary Paediatric Cardiothoracic Transplant Unit

Authors: Lauren Dhugga, Meena Parameswaran, David Blundell, Abbas Khushnood

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Context: A multidisciplinary weekly safety briefing was implemented at the Paediatric Cardiothoracic Unit at the Freeman Hospital in Newcastle-upon-Tyne. It is a tertiary referral centre with a quarternary cardiac paediatric intensive care unit and provides complexed care including heart and lung transplants, mechanical support and advanced heart failure assessment. Aim: The aim of this briefing is to provide a structured platform of communication, in an effort to improve efficiency, safety, and patient care. Problem: The paediatric cardiothoracic unit is made up of a vast multidisciplinary team including doctors, intensivists, anaesthetists, surgeons, specialist nurses, echocardiogram technicians, physiotherapists, psychologists, dentists, and dietitians. It provides care for children with congenital and acquired cardiac disease and is one of only two units in the UK to offer paediatric heart transplant. The complexity of cases means that there can be many teams involved in providing care to each patient, and frequent movement of children between ward, high dependency, and intensive care areas. Currently, there is no structured forum for communicating important information across the department, for example, staffing shortages, prescribing errors and significant events. Strategy: An initial survey questioning the need for better communication found 90% of respondents agreed that they could think of an incident that had occurred due to ineffective communication, and 85% felt that incident could have been avoided had there been a better form of communication. Lastly, 80% of respondents felt that a weekly 60 second safety briefing would be beneficial to improve communication within our multidisciplinary team. Based on those promising results, a weekly 60 second safety briefing was implemented to be conducted on a Monday morning. The safety briefing covered four key areas (SAFE): staffing, awareness, fix and events. This was to highlight any staffing gaps, any incident reports to be learned from, any issues that required fixing and any events including teachings for the week ahead. The teams were encouraged to email suggestions or issues to be raised for the week or to approach in person with information to add. The safety briefing was implemented using change theory. Effect: The safety briefing has been trialled over 6 weeks and has received a good buy in from staff across specialties. The aim is to embed this safety briefing into a weekly meeting using the PDSA cycle. There will be a second survey in one month to assess the efficacy of the safety briefing and to continue to improve the delivery of information. The project will be presented at the next clinical governance briefing to attract wider feedback and input from across the trust. Lessons: The briefing displays promise as a tool to improve vigilance and communication in a busy multi-disciplinary unit. We have learned about how to implement quality improvement and about the culture of our hospital - how hierarchy influences change. We demonstrate how to implement change through a grassroots process, using a junior led briefing to improve the efficiency, safety, and communication in the workplace.

Keywords: briefing, communication, safety, team

Procedia PDF Downloads 142
435 Measurement and Modelling of HIV Epidemic among High Risk Groups and Migrants in Two Districts of Maharashtra, India: An Application of Forecasting Software-Spectrum

Authors: Sukhvinder Kaur, Ashok Agarwal

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Background: For the first time in 2009, India was able to generate estimates of HIV incidence (the number of new HIV infections per year). Analysis of epidemic projections helped in revealing that the number of new annual HIV infections in India had declined by more than 50% during the last decade (GOI Ministry of Health and Family Welfare, 2010). Then, National AIDS Control Organisation (NACO) planned to scale up its efforts in generating projections through epidemiological analysis and modelling by taking recent available sources of evidence such as HIV Sentinel Surveillance (HSS), India Census data and other critical data sets. Recently, NACO generated current round of HIV estimates-2012 through globally recommended tool “Spectrum Software” and came out with the estimates for adult HIV prevalence, annual new infections, number of people living with HIV, AIDS-related deaths and treatment needs. State level prevalence and incidence projections produced were used to project consequences of the epidemic in spectrum. In presence of HIV estimates generated at state level in India by NACO, USIAD funded PIPPSE project under the leadership of NACO undertook the estimations and projections to district level using same Spectrum software. In 2011, adult HIV prevalence in one of the high prevalent States, Maharashtra was 0.42% ahead of the national average of 0.27%. Considering the heterogeneity of HIV epidemic between districts, two districts of Maharashtra – Thane and Mumbai were selected to estimate and project the number of People-Living-with-HIV/AIDS (PLHIV), HIV-prevalence among adults and annual new HIV infections till 2017. Methodology: Inputs in spectrum included demographic data from Census of India since 1980 and sample registration system, programmatic data on ‘Alive and on ART (adult and children)’,‘Mother-Baby pairs under PPTCT’ and ‘High Risk Group (HRG)-size mapping estimates’, surveillance data from various rounds of HSS, National Family Health Survey–III, Integrated Biological and Behavioural Assessment and Behavioural Sentinel Surveillance. Major Findings: Assuming current programmatic interventions in these districts, an estimated decrease of 12% points in Thane and 31% points in Mumbai among new infections in HRGs and migrants is observed from 2011 by 2017. Conclusions: Project also validated decrease in HIV new infection among one of the high risk groups-FSWs using program cohort data since 2012 to 2016. Though there is a decrease in HIV prevalence and new infections in Thane and Mumbai, further decrease is possible if appropriate programme response, strategies and interventions are envisaged for specific target groups based on this evidence. Moreover, evidence need to be validated by other estimation/modelling techniques; and evidence can be generated for other districts of the state, where HIV prevalence is high and reliable data sources are available, to understand the epidemic within the local context.

Keywords: HIV sentinel surveillance, high risk groups, projections, new infections

Procedia PDF Downloads 211
434 Measuring Enterprise Growth: Pitfalls and Implications

Authors: N. Šarlija, S. Pfeifer, M. Jeger, A. Bilandžić

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Enterprise growth is generally considered as a key driver of competitiveness, employment, economic development and social inclusion. As such, it is perceived to be a highly desirable outcome of entrepreneurship for scholars and decision makers. The huge academic debate resulted in the multitude of theoretical frameworks focused on explaining growth stages, determinants and future prospects. It has been widely accepted that enterprise growth is most likely nonlinear, temporal and related to the variety of factors which reflect the individual, firm, organizational, industry or environmental determinants of growth. However, factors that affect growth are not easily captured, instruments to measure those factors are often arbitrary, causality between variables and growth is elusive, indicating that growth is not easily modeled. Furthermore, in line with heterogeneous nature of the growth phenomenon, there is a vast number of measurement constructs assessing growth which are used interchangeably. Differences among various growth measures, at conceptual as well as at operationalization level, can hinder theory development which emphasizes the need for more empirically robust studies. In line with these highlights, the main purpose of this paper is twofold. Firstly, to compare structure and performance of three growth prediction models based on the main growth measures: Revenues, employment and assets growth. Secondly, to explore the prospects of financial indicators, set as exact, visible, standardized and accessible variables, to serve as determinants of enterprise growth. Finally, to contribute to the understanding of the implications on research results and recommendations for growth caused by different growth measures. The models include a range of financial indicators as lag determinants of the enterprises’ performances during the 2008-2013, extracted from the national register of the financial statements of SMEs in Croatia. The design and testing stage of the modeling used the logistic regression procedures. Findings confirm that growth prediction models based on different measures of growth have different set of predictors. Moreover, the relationship between particular predictors and growth measure is inconsistent, namely the same predictor positively related to one growth measure may exert negative effect on a different growth measure. Overall, financial indicators alone can serve as good proxy of growth and yield adequate predictive power of the models. The paper sheds light on both methodology and conceptual framework of enterprise growth by using a range of variables which serve as a proxy for the multitude of internal and external determinants, but are unlike them, accessible, available, exact and free of perceptual nuances in building up the model. Selection of the growth measure seems to have significant impact on the implications and recommendations related to growth. Furthermore, the paper points out to potential pitfalls of measuring and predicting growth. Overall, the results and the implications of the study are relevant for advancing academic debates on growth-related methodology, and can contribute to evidence-based decisions of policy makers.

Keywords: growth measurement constructs, logistic regression, prediction of growth potential, small and medium-sized enterprises

Procedia PDF Downloads 252
433 Neighborhood-Scape as a Methodology for Enhancing Gulf Region Cities' Quality of Life: Case of Doha, Qatar

Authors: Eman AbdelSabour

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Sustainability is increasingly being considered as a critical aspect in shaping the urban environment. It works as an invention development basis for global urban growth. Currently, different models and structures impact the means of interpreting the criteria that would be included in defining a sustainable city. There is a collective need to improve the growth path to an extremely durable path by presenting different suggestions regarding multi-scale initiatives. The global rise in urbanization has led to increased demand and pressure for better urban planning choice and scenarios for a better sustainable urban alternative. The need for an assessment tool at the urban scale was prompted due to the trend of developing increasingly sustainable urban development (SUD). The neighborhood scale is being managed by a growing research committee since it seems to be a pertinent scale through which economic, environmental, and social impacts could be addressed. Although neighborhood design is a comparatively old practice, it is in the initial years of the 21st century when environmentalists and planners started developing sustainable assessment at the neighborhood level. Through this, urban reality can be considered at a larger scale whereby themes which are beyond the size of a single building can be addressed, while it still stays small enough that concrete measures could be analyzed. The neighborhood assessment tool has a crucial role in helping neighborhood sustainability to perform approach and fulfill objectives through a set of themes and criteria. These devices are also known as neighborhood assessment tool, district assessment tool, and sustainable community rating tool. The primary focus of research has been on sustainability from the economic and environmental aspect, whereas the social, cultural issue is rarely focused. Therefore, this research is based on Doha, Qatar, the current urban conditions of the neighborhoods is discussed in this study. The research problem focuses on the spatial features in relation to the socio-cultural aspects. This study is outlined in three parts; the first section comprises of review of the latest use of wellbeing assessment methods to enhance decision process of retrofitting physical features of the neighborhood. The second section discusses the urban settlement development, regulations and the process of decision-making rule. An analysis of urban development policy with reference to neighborhood development is also discussed in this section. Moreover, it includes a historical review of the urban growth of the neighborhoods as an atom of the city system present in Doha. Last part involves developing quantified indicators regarding subjective well-being through a participatory approach. Additionally, applying GIS will be utilized as a visualizing tool for the apparent Quality of Life (QoL) that need to develop in the neighborhood area as an assessment approach. Envisaging the present QoL situation in Doha neighborhoods is a process to improve current condition neighborhood function involves many days to day activities of the residents, due to which areas are considered dynamic.

Keywords: neighborhood, subjective wellbeing, decision support tools, Doha, retrofiring

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432 Applying Napoleoni's 'Shell-State' Concept to Jihadist Organisations's Rise in Mali, Nigeria and Syria/Iraq, 2011-2015

Authors: Francesco Saverio Angiò

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The Islamic State of Iraq and the Levant / Syria (ISIL/S), Al-Qaeda in the Islamic Maghreb (AQIM) and People Committed to the Propagation of the Prophet's Teachings and Jihad, also known as ‘Boko Haram’ (BH), have fought successfully against Syria and Iraq, Mali, Nigeria’s government, respectively. According to Napoleoni, the ‘shell-state’ concept can explain the economic dimension and the financing model of the ISIL insurgency. However, she argues that AQIM and BH did not properly plan their financial model. Consequently, her idea would not be suitable to these groups. Nevertheless, AQIM and BH’s economic performances and their (short) territorialisation suggest that their financing models respond to a well-defined strategy, which they were able to adapt to new circumstances. Therefore, Napoleoni’s idea of ‘shell-state’ can be applied to the three jihadist armed groups. In the last five years, together with other similar entities, ISIL/S, AQIM and BH have been fighting against governments with insurgent tactics and terrorism acts, conquering and ruling a quasi-state; a physical space they presented as legitimate territorial entity, thanks to a puritan version of the Islamic law. In these territories, they have exploited the traditional local economic networks. In addition, they have contributed to the development of legal and illegal transnational business activities. They have also established a justice system and created an administrative structure to supply services. Napoleoni’s ‘shell-state’ can describe the evolution of ISIL/S, AQIM and BH, which has switched from an insurgency to a proto or a quasi-state entity, enjoying a significant share of power over territories and populations. Napoleoni first developed and applied the ‘Shell-state’ concept to describe the nature of groups such as the Palestine Liberation Organisation (PLO), before using it to explain the expansion of ISIL. However, her original conceptualisation emphasises on the economic dimension of the rise of the insurgency, focusing on the ‘business’ model and the insurgents’ financing management skills, which permits them to turn into an organisation. However, the idea of groups which use, coordinate and grab some territorial economic activities (at the same time, encouraging new criminal ones), can also be applied to administrative, social, infrastructural, legal and military levels of their insurgency, since they contribute to transform the insurgency to the same extent the economic dimension does. In addition, according to Napoleoni’s view, the ‘shell-state’ prism is valid to understand the ISIL/S phenomenon, because the group has carefully planned their financial steps. Napoleoni affirmed that ISIL/S carries out activities in order to promote their conversion from a group relying on external sponsors to an entity that can penetrate and condition local economies. On the contrary, ‘shell-state’ could not be applied to AQIM or BH, which are acting more like smugglers. Nevertheless, despite its failure to control territories, as ISIL has been able to do, AQIM and BH have responded strategically to their economic circumstances and have defined specific dynamics to ensure a flow of stable funds. Therefore, Napoleoni’s theory is applicable.

Keywords: shell-state, jihadist insurgency, proto or quasi-state entity economic planning, strategic financing

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431 Climate Change and Rural-Urban Migration in Brazilian Semiarid Region

Authors: Linda Márcia Mendes Delazeri, Dênis Antônio Da Cunha

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Over the past few years, the evidence that human activities have altered the concentration of greenhouse gases in the atmosphere have become stronger, indicating that this accumulation is the most likely cause of climate change observed so far. The risks associated with climate change, although uncertain, have the potential to increase social vulnerability, exacerbating existing socioeconomic challenges. Developing countries are potentially the most affected by climate change, since they have less potential to adapt and are those most dependent on agricultural activities, one of the sectors in which the major negative impacts are expected. In Brazil, specifically, it is expected that the localities which form the semiarid region are among the most affected, due to existing irregularity in rainfall and high temperatures, in addition to economic and social factors endemic to the region. Given the strategic limitations to handle the environmental shocks caused by climate change, an alternative adopted in response to these shocks is migration. Understanding the specific features of migration flows, such as duration, destination and composition is essential to understand the impacts of migration on origin and destination locations and to develop appropriate policies. Thus, this study aims to examine whether climatic factors have contributed to rural-urban migration in semiarid municipalities in the recent past and how these migration flows will be affected by future scenarios of climate change. The study was based on microeconomic theory of utility maximization, in which, to decide to leave the countryside and move on to the urban area, the individual seeks to maximize its utility. Analytically, we estimated an econometric model using the modeling of Fixed Effects and the results confirmed the expectation that climate drivers are crucial for the occurrence of the rural-urban migration. Also, other drivers of the migration process, as economic, social and demographic factors were also important. Additionally, predictions about the rural-urban migration motivated by variations in temperature and precipitation in the climate change scenarios RCP 4.5 and 8.5 were made for the periods 2016-2035 and 2046-2065, defined by the Intergovernmental Panel on Climate Change (IPCC). The results indicate that there will be increased rural-urban migration in the semiarid region in both scenarios and in both periods. In general, the results of this study reinforce the need for formulations of public policies to avoid migration for climatic reasons, such as policies that give support to the productive activities generating income in rural areas. By providing greater incentives for family agriculture and expanding sources of credit for the farmer, it will have a better position to face climate adversities and to settle in rural areas. Ultimately, if migration becomes necessary, there must be the adoption of policies that seek an organized and planned development of urban areas, considering migration as an adaptation strategy to adverse climate effects. Thus, policies that act to absorb migrants in urban areas and ensure that they have access to basic services offered to the urban population would contribute to the social costs reduction of climate variability.

Keywords: climate change, migration, rural productivity, semiarid region

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430 Ethical Decision-Making by Healthcare Professionals during Disasters: Izmir Province Case

Authors: Gulhan Sen

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Disasters could result in many deaths and injuries. In these difficult times, accessible resources are limited, demand and supply balance is distorted, and there is a need to make urgent interventions. Disproportionateness between accessible resources and intervention capacity makes triage a necessity in every stage of disaster response. Healthcare professionals, who are in charge of triage, have to evaluate swiftly and make ethical decisions about which patients need priority and urgent intervention given the limited available resources. For such critical times in disaster triage, 'doing the greatest good for the greatest number of casualties' is adopted as a code of practice. But there is no guide for healthcare professionals about ethical decision-making during disasters, and this study is expected to use as a source in the preparation of the guide. This study aimed to examine whether the qualities healthcare professionals in Izmir related to disaster triage were adequate and whether these qualities influence their capacity to make ethical decisions. The researcher used a survey developed for data collection. The survey included two parts. In part one, 14 questions solicited information about socio-demographic characteristics and knowledge levels of the respondents on ethical principles of disaster triage and allocation of scarce resources. Part two included four disaster scenarios adopted from existing literature and respondents were asked to make ethical decisions in triage based on the provided scenarios. The survey was completed by 215 healthcare professional working in Emergency-Medical Stations, National Medical Rescue Teams and Search-Rescue-Health Teams in Izmir. The data was analyzed with SPSS software. Chi-Square Test, Mann-Whitney U Test, Kruskal-Wallis Test and Linear Regression Analysis were utilized. According to results, it was determined that 51.2% of the participants had inadequate knowledge level of ethical principles of disaster triage and allocation of scarce resources. It was also found that participants did not tend to make ethical decisions on four disaster scenarios which included ethical dilemmas. They stayed in ethical dilemmas that perform cardio-pulmonary resuscitation, manage limited resources and make decisions to die. Results also showed that participants who had more experience in disaster triage teams, were more likely to make ethical decisions on disaster triage than those with little or no experience in disaster triage teams(p < 0.01). Moreover, as their knowledge level of ethical principles of disaster triage and allocation of scarce resources increased, their tendency to make ethical decisions also increased(p < 0.001). In conclusion, having inadequate knowledge level of ethical principles and being inexperienced affect their ethical decision-making during disasters. So results of this study suggest that more training on disaster triage should be provided on the areas of the pre-impact phase of disaster. In addition, ethical dimension of disaster triage should be included in the syllabi of the ethics classes in the vocational training for healthcare professionals. Drill, simulations, and board exercises can be used to improve ethical decision making abilities of healthcare professionals. Disaster scenarios where ethical dilemmas are faced should be prepared for such applied training programs.

Keywords: disaster triage, medical ethics, ethical principles of disaster triage, ethical decision-making

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429 Framework Proposal on How to Use Game-Based Learning, Collaboration and Design Challenges to Teach Mechatronics

Authors: Michael Wendland

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This paper presents a framework to teach a methodical design approach by the help of using a mixture of game-based learning, design challenges and competitions as forms of direct assessment. In today’s world, developing products is more complex than ever. Conflicting goals of product cost and quality with limited time as well as post-pandemic part shortages increase the difficulty. Common design approaches for mechatronic products mitigate some of these effects by helping the users with their methodical framework. Due to the inherent complexity of these products, the number of involved resources and the comprehensive design processes, students very rarely have enough time or motivation to experience a complete approach in one semester course. But, for students to be successful in the industrial world, it is crucial to know these methodical frameworks and to gain first-hand experience. Therefore, it is necessary to teach these design approaches in a real-world setting and keep the motivation high as well as learning to manage upcoming problems. This is achieved by using a game-based approach and a set of design challenges that are given to the students. In order to mimic industrial collaboration, they work in teams of up to six participants and are given the main development target to design a remote-controlled robot that can manipulate a specified object. By setting this clear goal without a given solution path, a constricted time-frame and limited maximal cost, the students are subjected to similar boundary conditions as in the real world. They must follow the methodical approach steps by specifying requirements, conceptualizing their ideas, drafting, designing, manufacturing and building a prototype using rapid prototyping. At the end of the course, the prototypes will be entered into a contest against the other teams. The complete design process is accompanied by theoretical input via lectures which is immediately transferred by the students to their own design problem in practical sessions. To increase motivation in these sessions, a playful learning approach has been chosen, i.e. designing the first concepts is supported by using lego construction kits. After each challenge, mandatory online quizzes help to deepen the acquired knowledge of the students and badges are awarded to those who complete a quiz, resulting in higher motivation and a level-up on a fictional leaderboard. The final contest is held in presence and involves all teams with their functional prototypes that now need to contest against each other. Prices for the best mechanical design, the most innovative approach and for the winner of the robotic contest are awarded. Each robot design gets evaluated with regards to the specified requirements and partial grades are derived from the results. This paper concludes with a critical review of the proposed framework, the game-based approach for the designed prototypes, the reality of the boundary conditions, the problems that occurred during the design and manufacturing process, the experiences and feedback of the students and the effectiveness of their collaboration as well as a discussion of the potential transfer to other educational areas.

Keywords: design challenges, game-based learning, playful learning, methodical framework, mechatronics, student assessment, constructive alignment

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428 Train Timetable Rescheduling Using Sensitivity Analysis: Application of Sobol, Based on Dynamic Multiphysics Simulation of Railway Systems

Authors: Soha Saad, Jean Bigeon, Florence Ossart, Etienne Sourdille

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Developing better solutions for train rescheduling problems has been drawing the attention of researchers for decades. Most researches in this field deal with minor incidents that affect a large number of trains due to cascading effects. They focus on timetables, rolling stock and crew duties, but do not take into account infrastructure limits. The present work addresses electric infrastructure incidents that limit the power available for train traction, and hence the transportation capacity of the railway system. Rescheduling is needed in order to optimally share the available power among the different trains. We propose a rescheduling process based on dynamic multiphysics railway simulations that include the mechanical and electrical properties of all the system components and calculate physical quantities such as the train speed profiles, voltage along the catenary lines, temperatures, etc. The optimization problem to solve has a large number of continuous and discrete variables, several output constraints due to physical limitations of the system, and a high computation cost. Our approach includes a phase of sensitivity analysis in order to analyze the behavior of the system and help the decision making process and/or more precise optimization. This approach is a quantitative method based on simulation statistics of the dynamic railway system, considering a predefined range of variation of the input parameters. Three important settings are defined. Factor prioritization detects the input variables that contribute the most to the outputs variation. Then, factor fixing allows calibrating the input variables which do not influence the outputs. Lastly, factor mapping is used to study which ranges of input values lead to model realizations that correspond to feasible solutions according to defined criteria or objectives. Generalized Sobol indexes are used for factor prioritization and factor fixing. The approach is tested in the case of a simple railway system, with a nominal traffic running on a single track line. The considered incident is the loss of a feeding power substation, which limits the power available and the train speed. Rescheduling is needed and the variables to be adjusted are the trains departure times, train speed reduction at a given position and the number of trains (cancellation of some trains if needed). The results show that the spacing between train departure times is the most critical variable, contributing to more than 50% of the variation of the model outputs. In addition, we identify the reduced range of variation of this variable which guarantees that the output constraints are respected. Optimal solutions are extracted, according to different potential objectives: minimizing the traveling time, the train delays, the traction energy, etc. Pareto front is also built.

Keywords: optimization, rescheduling, railway system, sensitivity analysis, train timetable

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427 Simulation and Thermal Evaluation of Containers Using PCM in Different Weather Conditions of Chile: Energy Savings in Lightweight Constructions

Authors: Paula Marín, Mohammad Saffari, Alvaro de Gracia, Luisa F. Cabeza, Svetlana Ushak

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Climate control represents an important issue when referring to energy consumption of buildings and associated expenses, both in installation or operation periods. The climate control of a building relies on several factors. Among them, localization, orientation, architectural elements, sources of energy used, are considered. In order to study the thermal behaviour of a building set up, the present study proposes the use of energy simulation program Energy Plus. In recent years, energy simulation programs have become important tools for evaluation of thermal/energy performance of buildings and facilities. Besides, the need to find new forms of passive conditioning in buildings for energy saving is a critical component. The use of phase change materials (PCMs) for heat storage applications has grown in importance due to its high efficiency. Therefore, the climatic conditions of Northern Chile: high solar radiation and extreme temperature fluctuations ranging from -10°C to 30°C (Calama city), low index of cloudy days during the year are appropriate to take advantage of solar energy and use passive systems in buildings. Also, the extensive mining activities in northern Chile encourage the use of large numbers of containers to harbour workers during shifts. These containers are constructed with lightweight construction systems, requiring heating during night and cooling during day, increasing the HVAC electricity consumption. The use of PCM can improve thermal comfort and reduce the energy consumption. The objective of this study was to evaluate the thermal and energy performance of containers of 2.5×2.5×2.5 m3, located in four cities of Chile: Antofagasta, Calama, Santiago, and Concepción. Lightweight envelopes, typically used in these building prototypes, were evaluated considering a container without PCM inclusion as the reference building and another container with PCM-enhanced envelopes as a test case, both of which have a door and a window in the same wall, orientated in two directions: North and South. To see the thermal response of these containers in different seasons, the simulations were performed considering a period of one year. The results show that higher energy savings for the four cities studied are obtained when the distribution of door and window in the container is in the north direction because of higher solar radiation incidence. The comparison of HVAC consumption and energy savings in % for north direction of door and window are summarised. Simulation results show that in the city of Antofagasta 47% of heating energy could be saved and in the cities of Calama and Concepción the biggest savings in terms of cooling could be achieved since PCM reduces almost all the cooling demand. Currently, based on simulation results, four containers have been constructed and sized with the same structural characteristics carried out in simulations, that are, containers with/without PCM, with door and window in one wall. Two of these containers will be placed in Antofagasta and two containers in a copper mine near to Calama, all of them will be monitored for a period of one year. The simulation results will be validated with experimental measurements and will be reported in the future.

Keywords: energy saving, lightweight construction, PCM, simulation

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426 Implementation of Project-Based Learning with Peer Assessment in Large Classes under Consideration of Faculty’s Scare Resources

Authors: Margit Kastner

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To overcome the negative consequences associated with large class sizes and to support students in developing the necessary competences (e.g., critical thinking, problem-solving, or team-work skills) a marketing course has been redesigned by implementing project-based learning with peer assessment (PBL&PA). This means that students can voluntarily take advantage of this supplementary offer and explore -in addition to attending the lecture where clicker questions are asked- a real-world problem, find a solution, and assess the results of peers while working in small collaborative groups. In order to handle this with little further effort, the process is technically supported by the university’s e-learning system in such a way that students upload their solution in form of an assignment which is then automatically distributed to peer groups who have to assess the work of three other groups. Finally, students’ work is graded automatically considering both, students’ contribution to the project and the conformity of the peer assessment. The purpose of this study is to evaluate students’ perception of PBL&PA using an online-questionnaire to collect the data. More specifically, it aims to discover students’ motivations for (not) working on a project and the benefits and problems students encounter. In addition to the survey, students’ performance was analyzed by comparing the final grades of those who participated in PBL&PA with those who did not participate. Among the 260 students who filled out the questionnaire, 47% participated in PBL&PA. Besides extrinsic motivations (bonus credits), students’ participation was often motivated by learning and social benefits. Reasons for not working on a project were connected to students’ organization and management of their studies (e.g., time constraints, no/wrong information) and teamwork concerns (e.g., missing engagement of peers, prior negative experiences). In addition, high workload and insufficient extrinsic motivation (bonus credits) were mentioned. With regards to benefits and problems students encountered during the project, students provided more positive than negative comments. Positive aspects most often stated were learning and social benefits while negative ones were mainly attached to the technical implementation. Interestingly, bonus credits were hardly named as a positive aspect meaning that intrinsic motivations have become more important when working on the project. Team aspects generated mixed feelings. In addition, students who voluntarily participated in PBL&PA were, in general, more active and utilized further course offers such as clicker questions. Examining students’ performance at the final exam revealed that students without participating in any of the offered active learning tasks performed poorest in the exam while students who used all activities were best. In conclusion, the goals of the implementation were met in terms of students’ perceived benefits and the positive impact on students’ exam performance. Since the comparison of the automatic grading with faculty grading showed valid results, it is possible to rely only on automatic grading in the future. That way, the additional workload for faculty will be within limits. Thus, the implementation of project-based learning with peer assessment can be recommended for large classes.

Keywords: automated grading, large classes, peer assessment, project-based learning

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425 The Impact of Professional Development on Teachers’ Instructional Practice

Authors: Karen Koellner, Nanette Seago, Jennifer Jacobs, Helen Garnier

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Although studies of teacher professional development (PD) are prevalent, surprisingly most have only produced incremental shifts in teachers’ learning and their impact on students. There is a critical need to understand what teachers take up and use in their classroom practice after attending PD and why we often do not see greater changes in learning and practice. This paper is based on a mixed methods efficacy study of the Learning and Teaching Geometry (LTG) video-based mathematics professional development materials. The extent to which the materials produce a beneficial impact on teachers’ mathematics knowledge, classroom practices, and their students’ knowledge in the domain of geometry through a group-randomized experimental design are considered. In this study, we examine a small group of teachers to better understand their interpretations of the workshops and their classroom uptake. The participants included 103 secondary mathematics teachers serving grades 6-12 from two states in different regions. Randomization was conducted at the school level, with 23 schools and 49 teachers assigned to the treatment group and 18 schools and 54 teachers assigned to the comparison group. The case study examination included twelve treatment teachers. PD workshops for treatment teachers began in Summer 2016. Nine full days of professional development were offered to teachers, beginning with the one-week institute (Summer 2016) and four days of PD throughout the academic year. The same facilitator-led all of the workshops, after completing a facilitator preparation process that included a multi-faceted assessment of fidelity. The overall impact of the LTG PD program was assessed from multiple sources: two teacher content assessments, two PD embedded assessments, pre-post-post videotaped classroom observations, and student assessments. Additional data was collected from the case study teachers including additional videotaped classroom observations and interviews. Repeated measures ANOVA analyses were used to detect patterns of change in the treatment teachers’ content knowledge before and after completion of the LTG PD, relative to the comparison group. No significant effects were found across the two groups of teachers on the two teacher content assessments. Teachers were rated on the quality of their mathematics instruction captured in videotaped classroom observations using the Math in Common Observation Protocol. On average, teachers who attended the LTG PD intervention improved their ability to engage students in mathematical reasoning and to provide accurate, coherent, and well-justified mathematical content. In addition, the LTG PD intervention and instruction that engaged students in mathematical practices both positively and significantly predicted greater student knowledge gains. Teacher knowledge was not a significant predictor. Twelve treatment teachers were self-selected to serve as case study teachers to provide additional videotapes in which they felt they were using something from the PD they learned and experienced. Project staff analyzed the videos, compared them to previous videos and interviewed the teachers regarding their uptake of the PD related to content knowledge, pedagogical knowledge and resources used.

Keywords: teacher learning, professional development, pedagogical content knowledge, geometry

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424 The Establishment of Primary Care Networks (England, UK) Throughout the COVID-19 Pandemic: A Qualitative Exploration of Workforce Perceptions

Authors: Jessica Raven Gates, Gemma Wilson-Menzfeld, Professor Alison Steven

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In 2019, the Primary Care system in the UK National Health Service (NHS) was subject to reform and restructuring. Primary Care Networks (PCNs) were established, which aligned with a trend towards integrated care both within the NHS and internationally. The introduction of PCNs brought groups of GP practices in a locality together, to operate as a network, build on existing services and collaborate at a larger scale. PCNs were expected to bring a range of benefits to patients and address some of the workforce pressures in the NHS, through an expanded and collaborative workforce. The early establishment of PCNs was disrupted by the emerging COVID-19 pandemic. This study, set in the context of the pandemic, aimed to explore experiences of the PCN workforce, and their perceptions of the establishment of PCNs. Specific objectives focussed on examining factors perceived as enabling or hindering the success of a PCN, the impact on day-to-day work, the approach to implementing change, and the influence of the COVID-19 pandemic upon PCN development. This study is part of a three-phase PhD project that utilized qualitative approaches and was underpinned by social constructionist philosophy. Phase 1: a systematic narrative review explored the provision of preventative healthcare services in UK primary settings and examined facilitators and barriers to delivery as experienced by the workforce. Phase 2: informed by the findings of phase 1, semi-structured interviews were conducted with fifteen participants (PCN workforce). Phase 3: follow-up interviews were conducted with original participants to examine any changes to their experiences and perceptions of PCNs. Three main themes span across phases 2 and 3 and were generated through a Framework Analysis approach: 1) working together at scale, 2) network infrastructure, and 3) PCN leadership. Findings suggest that through efforts to work together at scale and collaborate as a network, participants have broadly accepted the concept of PCNs. However, the workforce has been hampered by system design and system complexity. Operating against such barriers has led to a negative psychological impact on some PCN leaders and others in the PCN workforce. While the pandemic undeniably increased pressure on healthcare systems around the world, it also acted as a disruptor, offering a glimpse into how collaboration in primary care can work well. Through the integration of findings from all phases, a new theoretical model has been developed, which conceptualises the findings from this Ph.D. study and demonstrates how the workforce has experienced change associated with the establishment of PCNs. The model includes a contextual component of the COVID-19 pandemic and has been informed by concepts from Complex Adaptive Systems theory. This model is the original contribution to knowledge of the PhD project, alongside recommendations for practice, policy and future research. This study is significant in the realm of health services research, and while the setting for this study is the UK NHS, the findings will be of interest to an international audience as the research provides insight into how the healthcare workforce may experience imposed policy and service changes.

Keywords: health services research, qualitative research, NHS workforce, primary care

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423 A Mixed-Methods Design and Implementation Study of ‘the Attach Project’: An Attachment-Based Educational Intervention for Looked after Children in Northern Ireland

Authors: Hannah M. Russell

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‘The Attach Project’ (TAP), is an educational intervention aimed at improving educational and socio-emotional outcomes for children who are looked after. TAP is underpinned by Attachment Theory and is adapted from Dyadic Developmental Psychotherapy (DDP), which is a treatment for children and young people impacted by complex trauma and disorders of attachment. TAP has been implemented in primary schools in Northern Ireland throughout the 2018/19 academic year. During this time, a design and implementation study has been conducted to assess the promise of effectiveness for the future dissemination and ‘scaling-up’ of the programme for a larger, randomised control trial. TAP has been designed specifically for implementation in a school setting and is comprised of a whole school element and a more individualised Key Adult-Key Child pairing. This design and implementation study utilises a mixed-methods research design consisting of quantitative, qualitative, and observational measures with stakeholder input and involvement being considered an integral component. The use of quantitative measures, such as self-report questionnaires prior to and eight months following the implementation of TAP, enabled the analysis of the strengths and direction of relations between the various components of the programme, as well as the influence of implementation factors. The use of qualitative measures, incorporating semi-structured interviews and focus groups, enabled the assessment of implementation factors, identification of implementation barriers, and potential methods of addressing these issues. Observational measures facilitated the continual development and improvement of ‘TAP training’ for school staff. Preliminary findings have provided evidence of promise for the effectiveness of TAP and indicate the potential benefits of introducing this type of attachment-based intervention across other educational settings. This type of intervention could benefit not only children who are looked after but all children who may be impacted by complex trauma or disorders of attachment. Furthermore, findings from this study demonstrate that it is possible for children to form a secondary attachment relationship with a significant adult in school. However, various implementation factors which should be addressed were identified throughout the study, such as the necessity of protected time being introduced to facilitate the development of a positive Key Adult- Key Child relationship. Furthermore, additional ‘re-cap’ training is required in future dissemination of the programme, to maximise ‘attachment friendly practice’ in the whole staff team. Qualitative findings have also indicated that there is a general opinion across school staff that this type of Key Adult- Key Child pairing could be more effective if it was introduced as soon as children begin primary school. This research has provided ample evidence for the need to introduce relationally based interventions in schools, to help to ensure that children who are looked after, or who are impacted by complex trauma or disorders of attachment, can thrive in the school environment. In addition, this research has facilitated the identification of important implementation factors and barriers to implementation, which can be addressed prior to the ‘scaling-up’ of TAP for a robust, randomised controlled trial.

Keywords: attachment, complex trauma, educational interventions, implementation

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