Search results for: Alzheimer’s related quality of life
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 22854

Search results for: Alzheimer’s related quality of life

21924 Use of Life Cycle Data for State-Oriented Maintenance

Authors: Maximilian Winkens, Matthias Goerke

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The state-oriented maintenance enables the preventive intervention before the failure of a component and guarantees avoidance of expensive breakdowns. Because the timing of the maintenance is defined by the component’s state, the remaining service life can be exhausted to the limit. The basic requirement for the state-oriented maintenance is the ability to define the component’s state. New potential for this is offered by gentelligent components. They are developed at the Corporative Research Centre 653 of the German Research Foundation (DFG). Because of their sensory ability they enable the registration of stresses during the component’s use. The data is gathered and evaluated. The methodology developed determines the current state of the gentelligent component based on the gathered data. This article presents this methodology as well as current research. The main focus of the current scientific work is to improve the quality of the state determination based on the life-cycle data analysis. The methodology developed until now evaluates the data of the usage phase and based on it predicts the timing of the gentelligent component’s failure. The real failure timing though, deviate from the predicted one because the effects from the production phase aren’t considered. The goal of the current research is to develop a methodology for state determination which considers both production and usage data.

Keywords: state-oriented maintenance, life-cycle data, gentelligent component, preventive intervention

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21923 Three-Stage Mining Metals Supply Chain Coordination and Product Quality Improvement with Revenue Sharing Contract

Authors: Hamed Homaei, Iraj Mahdavi, Ali Tajdin

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One of the main concerns of miners is to increase the quality level of their products because the mining metals price depends on their quality level; however, increasing the quality level of these products has different costs at different levels of the supply chain. These costs usually increase after extractor level. This paper studies the coordination issue of a decentralized three-level supply chain with one supplier (extractor), one mineral processor and one manufacturer in which the increasing product quality level cost at the processor level is higher than the supplier and at the level of the manufacturer is more than the processor. We identify the optimal product quality level for each supply chain member by designing a revenue sharing contract. Finally, numerical examples show that the designed contract not only increases the final product quality level but also provides a win-win condition for all supply chain members and increases the whole supply chain profit.

Keywords: three-stage supply chain, product quality improvement, channel coordination, revenue sharing

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21922 2D Hexagonal Cellular Automata: The Complexity of Forms

Authors: Vural Erdogan

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We created two-dimensional hexagonal cellular automata to obtain complexity by using simple rules same as Conway’s game of life. Considering the game of life rules, Wolfram's works about life-like structures and John von Neumann's self-replication, self-maintenance, self-reproduction problems, we developed 2-states and 3-states hexagonal growing algorithms that reach large populations through random initial states. Unlike the game of life, we used six neighbourhoods cellular automata instead of eight or four neighbourhoods. First simulations explained that whether we are able to obtain sort of oscillators, blinkers, and gliders. Inspired by Wolfram's 1D cellular automata complexity and life-like structures, we simulated 2D synchronous, discrete, deterministic cellular automata to reach life-like forms with 2-states cells. The life-like formations and the oscillators have been explained how they contribute to initiating self-maintenance together with self-reproduction and self-replication. After comparing simulation results, we decided to develop the algorithm for another step. Appending a new state to the same algorithm, which we used for reaching life-like structures, led us to experiment new branching and fractal forms. All these studies tried to demonstrate that complex life forms might come from uncomplicated rules.

Keywords: hexagonal cellular automata, self-replication, self-reproduction, self- maintenance

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21921 Cognitive Fusion and Obstacles to Valued Living: Beyond Pain-Specific Events in Chronic Pain

Authors: Sergio A. Carvalho, Jose Pinto-Gouveia, David Gillanders, Paula Castilho

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The role of psychological processes has long been recognized as crucial factors in depressive symptoms in chronic pain (CP). Although some studies have explored the negative impact of being entangled with internal experiences (e.g., thoughts, emotions, physical sensations) – cognitive fusion, it is not extensively explored 1) whether these are pain-related or rather general difficult experiences, and 2) how they relate to experiencing obstacles in committing to valued actions. The current study followed a cross-sectional design in a sample of 231 participants with CP, in which a mediational model was tested through path analyses in AMOS software. The model presented a very good model fit (Χ²/DF = 1.161; CFI = .999; TLI = .996; RMSEA = .026, PCLOSE = .550.), and results showed that pain intensity was not directly related to depressive symptoms (β = .055; p = .239) but was mediated by cognitive fusion with both general and pain-related internal experiences (β = .181, 95%CI [.097; .271]; p = .015). Additionally, results showed that only general cognitive fusion (but not pain-specific fusion) was associated with experiencing obstacles to living a meaningful life, which mediated its impact on depressive symptoms (β = .197, 95%CI [.102; .307]; p = .001). Overall, this study adds on current literature by suggesting that psychological interventions to pain management should not be focused only on management of pain-related experiences, but also on developing more effective ways of relating to overall internal experiences.

Keywords: cognitive fusion, chronic pain, depressive symptoms, valued living

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21920 Quantifying Stakeholders’ Values of Technical and Vocational Education and Training Provision in Nigeria

Authors: Lidimma Benjamin, Nimmyel Gwakzing, Wuyep Nanyi

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Technical and Vocational Education and Training (TVET) has many stakeholders, each with their own values and interests. This study will focus on the diversity of the values and interests within and across groups of stakeholders by quantifying the value that stakeholders attached to several quality attributes of TVET, and also find out to what extent TVET stakeholders differ in their values. The quality of TVET therefore, depends on how well it aligns with the values and interests of these stakeholders. The five stakeholders are parents, students, teachers, policy makers, and work place training supervisors. The 9 attributes are employer appreciation of students, graduation rate, obtained computer skills of students, mentoring hours in workplace learning/Students Industrial Work Experience Scheme (SIWES), challenge, structure, students’ appreciation of teachers, schooling hours, and attention to civic education. 346 respondents (comprising Parents, Students, Teachers, Policy Makers, and Workplace Training Supervisors) were repeatedly asked to rank a set of 4 programs, each with a specific value on the nine quality indicators. Conjoint analysis was used to obtain the values that the stakeholders assigned to the 9 attributes when evaluating the quality of TVET programs. Rank-ordered logistic regression was the statistical/tool used for ranking the respondents values assign to the attributes. The similarities and diversity in values and interests of the different stakeholders will be of use by both Nigerian government and TVET colleges, to improve the overall quality of education and the match between vocational programs and their stakeholders simultaneous evaluation and combination of information in product attributes. Such approach models the decision environment by confronting a respondent with choices that are close to real-life choices. Therefore, it is more realistically than traditional survey methods.

Keywords: TVET, vignette study, conjoint analysis, quality perception, educational stakeholders

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21919 Optimization of Monitoring Networks for Air Quality Management in Urban Hotspots

Authors: Vethathirri Ramanujam Srinivasan, S. M. Shiva Nagendra

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Air quality management in urban areas is a serious concern in both developed and developing countries. In this regard, more number of air quality monitoring stations are planned to mitigate air pollution in urban areas. In India, Central Pollution Control Board has set up 574 air quality monitoring stations across the country and proposed to set up another 500 stations in the next few years. The number of monitoring stations for each city has been decided based on population data. The setting up of ambient air quality monitoring stations and their operation and maintenance are highly expensive. Therefore, there is a need to optimize monitoring networks for air quality management. The present paper discusses the various methods such as Indian Standards (IS) method, US EPA method and European Union (EU) method to arrive at the minimum number of air quality monitoring stations. In addition, optimization of rain-gauge method and Inverse Distance Weighted (IDW) method using Geographical Information System (GIS) are also explored in the present work for the design of air quality network in Chennai city. In summary, additionally 18 stations are required for Chennai city, and the potential monitoring locations with their corresponding land use patterns are ranked and identified from the 1km x 1km sized grids.

Keywords: air quality monitoring network, inverse distance weighted method, population based method, spatial variation

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21918 The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) Process: An Audit of Its Utilisation on a UK Tertiary Specialist Intensive Care Unit

Authors: Gokulan Vethanayakam, Daniel Aston

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

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

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21917 Determination the Effects of Physico-Chemical Parameters on Groundwater Status by Water Quality Index

Authors: Samaneh Abolli, Mahdi Ahmadi Nasab, Kamyar Yaghmaeian, Mahmood Alimohammadi

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The quality of drinking water, in addition to the presence of physicochemical parameters, depends on the type and geographical location of water sources. In this study, groundwater quality was investigated by sampling total dissolved solids (TDS), electrical conductivity (EC), total hardness (TH), Cl, Ca²⁺, and Mg²⁺ parameters in 13 sites, and 40 water samples were sent to the laboratory. Electrometric, titration, and spectrophotometer methods were used. In the next step, the water quality index (WQI) was used to investigate the impact and weight of each parameter in the groundwater. The results showed that only the mean of magnesium ion (40.88 mg/l) was lower than the guidelines of World Health Organization (WHO). Interpreting the WQI based on the WHO guidelines showed that the statuses of 21, 11, and 7 samples were very poor, poor, and average quality, respectively, and one sample had excellent quality. Among the studied parameters, the means of EC (2,087.49 mS/cm) and Cl (1,015.87 mg/l) exceeded the global and national limits. Classifying water quality of TH was very hard (87.5%), hard (7.5%), and moderate (5%), respectively. Based on the geographical distribution, the drinking water index in sites 4 and 11 did not have acceptable quality. Chloride ion was identified as the responsible pollutant and the most important ion for raising the index. The outputs of statistical tests and Spearman correlation had significant and direct correlation (p < 0.05, r > 0.7) between TDS, EC, and chloride, EC and chloride, as well as TH, Ca²⁺, and Mg²⁺.

Keywords: water quality index, groundwater, chloride, GIS, Garmsar

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21916 Taylor’s Law and Relationship between Life Expectancy at Birth and Variance in Age at Death in Period Life Table

Authors: David A. Swanson, Lucky M. Tedrow

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Taylor’s Law is a widely observed empirical pattern that relates variances to means in sets of non-negative measurements via an approximate power function, which has found application to human mortality. This study adds to this research by showing that Taylor’s Law leads to a model that reasonably describes the relationship between life expectancy at birth (e0, which also is equal to mean age at death in a life table) and variance at age of death in seven World Bank regional life tables measured at two points in time, 1970 and 2000. Using as a benchmark a non-random sample of four Japanese female life tables covering the period from 1950 to 2004, the study finds that the simple linear model provides reasonably accurate estimates of variance in age at death in a life table from e0, where the latter range from 60.9 to 85.59 years. Employing 2017 life tables from the Human Mortality Database, the simple linear model is used to provide estimates of variance at age in death for six countries, three of which have high e0 values and three of which have lower e0 values. The paper provides a substantive interpretation of Taylor’s Law relative to e0 and concludes by arguing that reasonably accurate estimates of variance in age at death in a period life table can be calculated using this approach, which also can be used where e0 itself is estimated rather than generated through the construction of a life table, a useful feature of the model.

Keywords: empirical pattern, mean age at death in a life table, mean age of a stationary population, stationary population

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21915 Hope for Technological Entrepreneurship in Developing Countries: Perceived Motivations, Intentions and Decisions in Africa

Authors: Umugwaneza Francoise, Ntamazeze Janviere, Donghong Ding

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Entrepreneurship has been considered by majority people from developing world as “no other option” kind of career. Consequently, for a long time entrepreneurship in developing countries has been mainly practiced by people who have low or not at all formal education. Even today, to some extent, much of the actions taken by governments, donors and some societies have tendency to consider entrepreneurship as an instrument to lift up the most vulnerable population including uneducated women, school drop outers, people with disabilities and other groups who live with some sort of vulnerability. However, there is a shortage of knowledge based and know-how entrepreneurship in developing countries. Although, the entrepreneurship done with formal educated people would contribute indispensably and sustain the development, the low numbers of formal educated people become entrepreneurs in developing countries. Empirically, this paper investigated the influential factors affecting the entrepreneurial motivation, intentions and decision among African scientists and engineers postgraduate from china universities since 1995 to 2014. Results revealed that 39% are entrepreneurs, 43% work for private sectors and 18% work for governments. Only 6% of respondents are in technological entrepreneurship related to their field of graduation. Study location, mentors or research supervisors and life style are the major factors influenced their decisions to become entrepreneurs whereas complex financial systems and political instability pushed some to employments. Interestingly, significant number of entrepreneurs did not have any entrepreneurial intentions. This paper concludes with suggestions to policy makers and investors in order to encouraging technological entrepreneurs which will provide more opportunities, create jobs and improve people’s quality of life.

Keywords: technological entrepreneurship, entrepreneurial motivation, entrepreneurship decision making, entrepreneurship intentions, formal education

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21914 Dissatisfaction as a Cause of Social Uprisings: An Empirical Analysis Utilizing the Social Uprisings Composite Indicator

Authors: Sondos Shaheen

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This paper employs a newly constructed composite indicator of social uprisings (SUCI) to analyze the causes of their occurrence. This empirical study is based on an unbalanced panel of 45 countries over the period of 1982–2007. The paper’s contribution to the literature is distinguishing between the causes of violent and nonviolent uprisings. The analysis shows that that certain variables have a significant impact on both violent and nonviolent uprisings in terms of relative SUCI values, for example, ethnic fractionalization and mountainous terrain. Nevertheless, differences between the causes of violent and nonviolent uprisings can be found. For example, life dissatisfaction is related to nonviolent social uprisings, but when life dissatisfaction is accompanied by democratic dissatisfaction, violent social uprisings are more likely.

Keywords: social uprisings, relative deprivation, dissatisfaction, mobilization, anti-government movements, causes

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21913 Quality Business Ethics: A Case Study

Authors: Fotis Vouzas

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This paper is an attempt to investigate the Business Ethics link to Quality Management. Business Ethics as a management practice is well rooted in many organizations, but its contribution to quality management implementation programs and practices is not well documented. The ISO 9000 and the Business Excellence frameworks and Awards seem to provide a basis for the implementation of a TQM philosophy contributing to efficiency, enhanced performance and sustainability. The author examines a series of Corporate Ethics initiatives and investigates the relationship to Total Quality Management in an MNC operating in Greece. The data gathering was carried out through extensive and in-depth interviews with several multiple informants, i.e., the plant manager, the production manager, and the personnel manager, using a semi-structured questionnaire with open-ended questions.

Keywords: total quality management, business ethics, Greece, ISO 9000

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21912 Introducing a Proper Total Quality Management Model for Libraries

Authors: Alireza Shahraki, Kaveh Keshmiry Zadeh

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Total quality management in libraries is of particular importance because high-quality libraries can facilitate the sustained development process in countries. This study has been conducted to examine the feasibility of implementation of total quality management in libraries of Sistan and Baluchestan and to provide an appropriate model for this concern. All of the officials and employees of Sistan and Baluchestan libraries (23 individuals) constitute the population of the study. Data gathering tool is a questionnaire that is designated based on ISO9000. The data extracted from questionnaires were analyzed using SPSS software. Results indicate that the highest degree of conformance to the 8 principles of ISO9000 is attributed to the principle of 'users' (69.9%) and the lowest degree is associated with 'decision making based on facts' (39.1%). Moreover, a significant relationship was observed among the items (1 and 3), (2 and 5), (2 and 7), (3 and 5), (4 and 5), (4 and 7), (4 and 8), (5 and 7), and (7 and 8). According to the research findings, it can generally be said that it is not eligible now to utilize TQM in libraries of Sistan and Baluchestan.

Keywords: quality management, total quality, university libraries, libraries management

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21911 Music Listening in Dementia: Current Developments and the Potential for Automated Systems in the Home: Scoping Review and Discussion

Authors: Alexander Street, Nina Wollersberger, Paul Fernie, Leonardo Muller, Ming Hung HSU, Helen Odell-Miller, Jorg Fachner, Patrizia Di Campli San Vito, Stephen Brewster, Hari Shaji, Satvik Venkatesh, Paolo Itaborai, Nicolas Farina, Alexis Kirke, Sube Banerjee, Eduardo Reck Miranda

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Escalating neuropsychiatric symptoms (NPS) in people with dementia may lead to earlier care home admission. Music listening has been reported to stimulate cognitive function, potentially reducing agitation in this population. We present a scoping review, reporting on current developments and discussing the potential for music listening with related technology in managing agitation in dementia care. Of two searches for music listening studies, one focused on older people or people living with dementia where music listening interventions, including technology, were delivered in participants’ homes or in institutions to address neuropsychiatric symptoms, quality of life and independence. The second included any population focusing on the use of music technology for health and wellbeing. In search one 70/251 full texts were included. The majority reported either statistical significance (6, 8.5%), significance (17, 24.2%) or improvements (26, 37.1%). Agitation was specifically reported in 36 (51.4%). The second search included 51/99 full texts, reporting improvement (28, 54.9%), significance (11, 21.5%), statistical significance (1, 1.9%) and no difference compared to the control (6, 11.7%). The majority in the first focused on mood and agitation, and the second on mood and psychophysiological responses. Five studies used AI or machine learning systems to select music, all involving healthy controls and reporting benefits. Most studies in both reviews were not conducted in a home environment (review 1 = 12; 17.1%; review 2 = 11; 21.5%). Preferred music listening may help manage NPS in the care home settings. Based on these and other data extracted in the review, a reasonable progression would be to co-design and test music listening systems and protocols for NPS in all settings, including people’s homes. Machine learning and automated technology for music selection and arousal adjustment, driven by live biodata, have not been explored in dementia care. Such approaches may help deliver the right music at the appropriate time in the required dosage, reducing the use of medication and improving quality of life.

Keywords: music listening, dementia, agitation, scoping review, technology

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21910 The Impact of Information and Communication Technology on Learning Quality and Conceptual Change in Moroccan High School Students

Authors: Azzeddine Atibi, Khadija El Kababi, Salim Ahmed, Mohamed Radid

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Teaching and learning occupy a significant position globally, as the sustainable development of all sectors is intrinsically linked to the improvement of the educational system. The COVID-19 pandemic demonstrated that the integration of Information and Communication Technology (ICT) in the learning process is not optional but essential, and that proficiency in computer tools is an asset that will enhance pedagogy and ensure the continuity of learning under any circumstances. The objective of our study is to evaluate the impact of introducing computer tools on the quality of learning and the realization of conceptual change in learners. To this end, a learning situation was meticulously prepared, targeting first-year baccalaureate students in experimental sciences at a public high school, "Khadija Oum Almouminin," focusing on the chapter on glycemia regulation in the Moroccan Life and Earth Sciences (LES) curriculum. The learning situation was implemented with a pilot group that utilized computer tools and a control group that studied the same chapter without using ICT. The analysis and comparison of the results allowed us to verify the research question posed and to propose perspectives to ensure conceptual change in learners.

Keywords: information and communication technology, conceptual change, continuity of learning, life and earth sciences, glycemia regulation

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21909 Quality Assurance as an Educational Development Tool: Case from the European Higher Education

Authors: Maha Mourad

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Higher education in any competitive European economy should serve the new information society by increasing the supply of good quality education services and by creating good international brands in the international higher education market. Hence, continuous risk management techniques through higher educational reforms programs became one of the top priorities within the European Union to control the quality of higher education. Risk is higher education is studies by several researchers who agreed that the risk in higher education has a direct influence on continuity of quality education and research contribution. The focus of this research is to highlights the Internal Quality Assurance (IQA) activities in the Polish higher education system as a risk management tool used to control the quality of education. This paper presents a qualitative empirical analysis in 5 different universities in Poland. In addition, it aims to help in finding global practical and create benchmark for policy makers concerning the risk management techniques based on the Polish experience.

Keywords: education development, quality assurance, sustainability, european higher education

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21908 Predictors of Childhood Trauma and Dissociation in University Students

Authors: Erdinc Ozturk, Gizem Akcan

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The aim of this study was to determine some psychosocial variables that predict childhood trauma and dissociation in university students. These psychosocial variables were perceived social support, relationship status, gender and life satisfaction. 250 (125 males, 125 females) university students (bachelor, master and postgraduate degree) were enrolled in this study. They were chosen from universities in Istanbul at the education year of 2016-2017. Dissociative Experiences Scale (DES), Childhood Trauma Questionnaire (CTQ), Multidimensional Perceived Social Support Scale, Life Satisfaction Scale and Relationship Scales Questionnaire were used to assess related variables. Demographic information form was given to students in order to have their demographic information. Frequency distribution, multiple linear regression, and t-test analysis were used for statistical analysis. As together, perceived social support, relationship status and life satisfaction were found to have predictive value on trauma among university students. However, as together, these psychosocial variables did not have predictive value on dissociation. Only, trauma and relationship status had significant predictive value on dissociation. Moreover, there was significant difference between males and females in terms of trauma; however, dissociation scores of participants were not significantly different in terms of gender.

Keywords: childhood trauma, dissociation, perceived social support, relationship status, life satisfaction

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21907 The Problems of Women over 65 with Incontinence Diagnosis: A Case Study in Turkey

Authors: Birsel Canan Demirbag, Kıymet Yesilcicek Calik, Hacer Kobya Bulut

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Objective: This study was conducted to evaluate the problems of women over 65 with incontinence diagnosis. Methods: This descriptive study was conducted with women over 65 with incontinence diagnosis in four Family Health Centers in a city in Eastern Black Sea region between November 1, and December 20, 2015. 203, 107, 178, 180 women over 65 were registered in these centers and 262 had incontinence diagnosis at least once and had an ongoing complaint. 177 women were volunteers for the study. During home visits and using face-to-face survey methodology, participants were given socio-demographic characteristics survey, Sandvik severity scale, Incontinence Quality of Life Scale, Urogenital Distress Inventory and a questionnaire including challenges experienced due to incontinence developed by the researcher. Data were analyzed with SPSS program using percentages, numbers, Chi-square, Man-Whitney U and t test with 95% confidence interval and a significance level p <0.05. Findings: 67 ± 1.4 was the mean age, 2.05 ± 0.04 was parity, 44.5 ± 2.12 was menopause age, 66.3% were primary school graduates, 45.7% had deceased spouse, 44.4% lived in a large family, 67.2% had their own room, 77.8% had income, 89.2% could meet self- care, 73.2% had a diagnosis of mixed incontinence, 87.5% suffered for 6-20 years % 78.2 had diuretics, antidepressants and heart medicines, 20.5% had urinary fecal cases, 80.5% had bladder training at least once, 90.1% didn’t have bladder diary calendar/control training programs, 31.1% had hysterectomy for prolapse, 97.1'i% was treated with lower urinary tract infection at least once, 66.3% saw a doctor to get drug in the last three months, 76.2 could not go out alone, 99.2 % had at least one chronic disease, 87.6 % had constipation complain, 2.9% had chronic cough., 45.1% fell due to a sudden rise for toilet. Incontinence Impact Questionnaire Average score was (QOL) 54.3 ± 21.1, Sandvik score was 12.1 ± 2.5, Urogenital Distress Inventory was 47.7 ± 9.2. Difficulties experienced due to incontinence were 99.5% feeling of unhappiness, 67.1% constant feeling of urine smell due to failing to change briefs frequently, % 87.2 move away from social life, 89.7 unable to use pad, 99.2% feeling of disturbing households / other individuals, 87.5% feel dizziness/fall due to sudden rise, 87.4% feeling of others’ imperceptions about the situation, % 94.3 insomnia, 78.2 lack of assistance, 84.7% couldn’t afford urine protection briefs. Results: With this study, it was found out that there were a lot of unsolved issues at individual and community level affecting the life quality of women with incontinence. In accordance with this common problem in women, to facilitate daily life it is obvious that regular home care training programs at institutional level in our country will be effective.

Keywords: health problems, incontinence, incontinence quality of life questionnaire, old age, urinary urogenital distress inventory, Sandviken severity, women

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21906 Quality as an Approach to Organizational Change and Its Role in the Reorganization of Enterprises: Case of Four Moroccan Small and Medium-Sized Enterprises

Authors: A. Boudiaf

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The purpose of this paper is to analyze and apprehend, through four case studies, the interest of the project of the implementation of the quality management system (QMS) at four Moroccan small and medium-sized enterprises (SMEs). This project could generate significant organizational change to improve the functioning of the organization. In fact, quality is becoming a necessity in the current business world. It is considered to be a major component in companies’ competitive strategies. It should be noted that quality management is characterized by a set of methods and techniques that can be used to solve malfunctions and reorganize companies. It is useful to point out that the choice of the adoption of the quality approach could be influenced by the circumstances of the business context, it could also be derived from its strategic vision; this means that this choice can be characterized as either a strategic aspect or a reactive aspect. This would probably have a major impact on the functioning of the QMS and also on the perception of the quality issue by company managers and their employees.

Keywords: business context, organizational change, quality, reorganization

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21905 Buddhism: Its Socio-Economic Relevance in the Present Changing World

Authors: Bandana Bhattacharya

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‘Buddhism’, as such signifies the ‘ism’ that is based on Buddha’s life and teachings or that is concerned with the gospel of Buddha as recorded in the literature available in Pali, Sanskrit, Buddhist Sanskrit, Prakrit and even in the other non-Indian languages wherein it has been described a very abstruse, complex and lofty philosophy of life or ‘the way of life’ preached by Him (Buddha). It has another side too, i.e., the applicability of the tenets of Buddha according to the needs of the present society, where human life and outlook has been totally changed. Applied Buddhism signifies the applicability of the Buddha’s noble tenets. Along with the theological exposition and textual criticism of the Buddha’s discourses, it has now become almost obligatory for the Buddhist scholars to re-interpret Buddhism from modern perspectives. Basically Applied Buddhism defined a ‘way of life’ which may transform the higher quality of life or essence of life due to changed circumstances, places and time. Nowadays, if we observe the present situation of the world, we will find the current problems such as health, economic, politic, global warming, population explosion, pollution of all types including cultural scarcity essential commodities and indiscriminate use of human, natural and water resources are becoming more and more pronounced day by day, under such a backdrop of world situation. Applied Buddhism rather Buddhism may be the only instrument left now for mankind to address all such human achievements, lapses, and problems. Buddha’s doctrine is itself called ‘akālika, timeless’. On the eve of the Mahāparinibbāṇa at Kusinara, the Blessed One allows His disciples to change, modify and alter His minor teachings according to the needs of the future, although He has made some utterances, which would eternally remain fresh. Hence Buddhism has been able to occupy a prominent place in modern life, because of its timeless applicability, emanating from a set of eternal values. The logical and scientific outlook of Buddha may be traced in His very first sermon named the Dhammacakkapavattana-Sutta where He suggested to avoid the two extremes, namely, constantly attachment to sensual pleasures (Kāmasukhallikānuyoga) and devotion to self-mortification that is painful as well as unprofitable and asked to adopt Majjhimapaṭipadā, ‘Middle path’, which is very much applicable even today in every spheres of human life; and the absence of which is the root cause of all problems event at present. This paper will be a humble attempt to highlight the relevance of Buddhism in the present society.

Keywords: applied Buddhism, ecology, self-awareness, value

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21904 Trauma Informed Healthy Lifestyle Program for Young Adults

Authors: Alicia Carranza, Hildemar Dos Santos, W. Lawrence Beeson, R. Patti Herring, Kimberly R. Freeman, Adam Arechiga

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Early exposure to trauma can impact health-related behaviors later in life, which poses a considerable challenge for young adults transitioning into independence when they are lacking the necessary skills and support to live a healthy life. The study will be a non-experimental, mixed methods pre- and post-test (where subjects will serve as their own controls) to determine the impact of an eight-week trauma-informed healthy lifestyle program on self-efficacy for adopting health-promoting behaviors and health outcomes among young adults. Forty-two adults, ages 18-24 who are living in Orange County, CA will be recruited to participate in the eight-week trauma-informed healthy living program. Baseline and post-intervention assessments will be conducted to assess changes in self-efficacy for nutrition and physical exercise, sleep quality and quantity, body mass index (kg/m2), and coping skills used by comparing pre- to post-intervention. Some of the planned activities include cooking demonstrations, mindful eating activities and media literacy using Instagram. Frequencies analyses, paired t-test, and multiple regression will be used to determine if there was a change in coping skills. The results of this study can serve to assess the potential for mitigating the effects of Adverse Childhood Experiences (ACEs), or other toxic stress, experienced during adolescence across the lifespan. Young adults who learn how to cope with stress in a healthy way and engage in a healthy lifestyle can be better prepared to role model that behavior to their children.

Keywords: nutrition, healthy lifestyle, trauma-informed, stress management

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21903 Elements of a Culture of Quality in the Implementation of Quality Assurance Systems of Countries in the European Higher Education Area

Authors: Laura Mion

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The implementation of quality management systems in higher education in different countries is determined by national regulatory choices and supranational indications (such as the European Standard Guidelines for Quality Assurance). The effective functioning and transformative capacity of these quality management systems largely depend on the organizational context in which they are applied and, more specifically, on the culture of quality developed in single universities or in single countries. The University's concept of quality culture integrates the structural dimension of QA (quality management manuals, process definitions, tools) with the value dimension of an organization (principles, skills, and attitudes). Within the EHEA (European Higher Education Area), countries such as Portugal, the Netherlands, the UK, and Norway demonstrate a greater integration of QA principles in the various organizational levels and areas of competence of university institutions or have greater experience in implementation or scientific and political debate on the matter. Therefore, the study, through an integrative literature review, of the quality management systems of these countries is aimed at determining a framework of the culture of quality, helpful in defining the elements which, both in structural-organizational terms and in terms of values and skills and attitudes, have proved to be factors of success in the effective implementation of quality assurance systems in universities and in the countries considered in the research. In order for a QA system to effectively aim for continuous improvement in a complex and dynamic context such as the university one, it must embrace a holistic vision of quality from an integrative perspective, focusing on the objective of transforming the reality being evaluated.

Keywords: higher education, quality assurance, quality culture, Portugal, Norway, Netherlands, United Kingdom

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21902 Meaningfulness of Right to Life in Holy Quran

Authors: Masoud Raei, Mohammadmahdi Sadeghi

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The right to life as the most essential right in human rights issues and in the first group has devoted a special place to itself. Attention to this right and its domain and its reflection in civil rights is one of the most important axis of the rights to life issues. Issues discussed concerning this matter in public law with regard to its status in human rights are the determination of government’s duty toward identification; application and guarantee of this right. The constitutions of countries have chosen different approaches towards the identification of this right and also its limits and boundaries, determining the territory of governments for citizens. The reason for such a difference is the question arising in this regard. It is claimed that without the determination of meaningfulness of the right to life, it is not possible to provide a clear response to this question. The goal of this paper is to justify its theoretical framework from the view of meaningfulness of right to life relying on Quranic verses with a conceptual approach towards the right to life so that the relationship between government and citizens with regard to right to life is determined. Through a comparative study, it is possible to attain significant differences between the teachings of the Holy Quran and human rights documents. The method of this paper is a descriptive-analytic approach relying on interpretation books on Holy Quran.

Keywords: meaningfulness, objectivism, separatism, right to life

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21901 Breaking the Silence and Rewriting the Script

Authors: Carlette Groome

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This paper examined the role of drama in the lives of four women. The researcher concluded that drama can be an avenue of healing and could be an effective means of social work intervention in the communities as well as female empowerment. The participants in the study were able to, through the dramatic process; re-write their life’s scripts by resolving paradoxes and conflicts related to the themes unearthed. The research conducted examined the role of drama in the lives of four women living in volatile communities in Jamaica, who were each exposed to violence in one, or multiple, forms. The women were trained by Sistren Theatre Collective in the use of drama for education (edutainment), and were actresses in Sistren's street theatre drama group. Using their own personal and collective experiences, they used drama to raise social consciousness at the community level, about violence and other issues affecting women. The study employed a narrative case study approach and was grounded in a constructivist paradigm. This paradigm was coupled with a basic interpretive qualitative method and the concept of the reflective practitioner provided the foundation for the analysis. Through individual conversations with the women, themes of abuse, resilience, self- esteem, and empowerment arose sharply. The women explored drama and understood it to be instrumental in healing different aspects of their lives. Also, through the dramatic process; they were able to re-write their life’s scripts by resolving paradoxes and conflicts related to the themes unearthed.

Keywords: women, drama, healing, community

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21900 Decision-Making, Expectations and Life Project in Dependent Adults Due to Disability

Authors: Julia Córdoba

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People are not completely autonomous, as we live in society; therefore, people could be defined as relationally dependent. The lack, decrease or loss of physical, psychological and/or social interdependence due to a disability situation is known as dependence. This is related to the need for help from another person in order to carry out activities of daily living. This population group lives with major social limitations that significantly reduce their participation and autonomy. They have high levels of stigma and invisibility from private environments (family and close networks), as well as from the public order (environment, community). The importance of this study lies in the fact that the lack of support and adjustments leads to what authors call the circle of exclusion. This circle describes how not accessing services - due to the difficulties caused by the disability situation impacts biological, social and psychological levels. This situation produces higher levels of exclusion and vulnerability. This study will focus on the process of autonomy and dependence of adults with disability from the model of disability proposed by the International Classification of Functioning, Health and Disability (ICF). The objectives are: i) to write down the relationship between autonomy and dependence based on socio-health variables and ii) to determine the relationship between the situation of autonomy and dependence and the expectations and interests of the participants. We propose a study that will use a survey technique through a previously validated virtual questionnaire. The data obtained will be analyzed using quantitative and qualitative methods for the details of the profiles obtained. No less than 200 questionnaires will be administered to people between 18 and 64 years of age who self-identify as having some degree of dependency due to disability. For the analysis of the results, the two main variables of autonomy and dependence will be considered. Socio-demographic variables such as age, gender identity, area of residence and family composition will be used. In relation to the biological dimension of the situation, the diagnosis, if any, and the type of disability will be asked. For the description of these profiles of autonomy and dependence, the following variables will be used: self-perception, decision-making, interests, expectations and life project, care of their health condition, support and social network, and labor and educational inclusion. The relationship between the target population and the variables collected provides several guidelines that could form the basis for the analysis of other research of interest in terms of self-perception, autonomy and dependence. The areas and situations where people state that they have greater possibilities to decide and have a say will be obtained. It will identify social (networks and support, educational background), demographic (age, gender identity and residence) and health-related variables (diagnosis and type of disability, quality of care) that may have a greater relationship with situations of dependency or autonomy. It will be studied whether the level of autonomy and/or dependence has an impact on the type of expectations and interests of the people surveyed.

Keywords: life project, disability, inclusion, autonomy

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21899 Life Cycle Assessment of Rare Earth Metals Production: Hotspot Analysis of Didymium Electrolysis Process

Authors: Sandra H. Fukurozaki, Andre L. N. Silva, Joao B. F. Neto, Fernando J. G. Landgraf

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Nowadays, the rare earth (RE) metals play an important role in emerging technologies that are crucial for the decarbonisation of the energy sector. Their unique properties have led to increasing clean energy applications, such as wind turbine generators, and hybrid and electric vehicles. Despite the substantial media coverage that has recently surrounded the mining and processing of rare earth metals, very little quantitative information is available concerning their subsequent life stages, especially related to the metallic production of didymium (Nd-Pr) in fluoride molten salt system. Here we investigate a gate to gate scale life cycle assessment (LCA) of the didymium electrolysis based on three different scenarios of operational conditions. The product system is modeled with SimaPro Analyst 8.0.2 software, and IMPACT 2002+ was applied as an impact assessment tool. In order to develop a life cycle inventories built in software databases, patents, and other published sources together with energy/mass balance were utilized. Analysis indicates that from the 14 midpoint impact categories evaluated, the global warming potential (GWP) is the main contributors to the total environmental burden, ranging from 2.7E2 to 3.2E2 kg CO2eq/kg Nd-Pr. At the damage step assessment, the results suggest that slight changes in materials flows associated with enhancement of current efficiency (between 2.5% and 5%), could lead a reduction up to 12% and 15% of human health and climate change damage, respectively. Additionally, this paper highlights the knowledge gaps and future research efforts needing to understand the environmental impacts of Nd-Pr electrolysis process from the life cycle perspective.

Keywords: didymium electrolysis, environmental impacts, life cycle assessment, rare earth metals

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21898 Cultural Adjustment Problems in Academic and Social Life Experienced by Indonesian Postgraduate Students Studying in London

Authors: Erizal Lugman

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An increasing number of students from Indonesia study in universities in the UK. Because of the substantial cultural differences between the Western and Indonesian cultures, this study investigates the issues in academic and social life experienced by Indonesian postgraduate students, with a sample of 11 Indonesian postgraduate students (8 male, 3 female) studying in London during the cultural adjustment stage. This research made use of a semi-structured interview and was analyzed qualitatively using thematic content analysis to reveal key areas of concern in the academic setting, social life, and language-related issues. The findings confirm that the most challenging aspects experienced by the participants are the use of academic English in academic situations and the students’ lack of critical thinking. Nine out of 11 students agreed that they had problems with writing essays during the cultural adjustment stage. Because of the collectivist culture in Indonesia, making friends with locals was the most concerning issue in the participants’ sociocultural adjustment, followed by difficulty in finding places to pray, looking for Halal food and using the Western toilet system The findings suggest recommendations that the students must be more aware of the cultural differences between Indonesian and Western cultures, including in the academic setting and social life. Also, the lecturers should pay more attention to their speech in the British accent which is sometimes difficult to understand.

Keywords: academic adjustment, cultural adjustment, indonesian culture, intercultural communication

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21897 Institutional Quality and Tax Compliance: A Cross-Country Regression Evidence

Authors: Debi Konukcu Onal, Tarkan Cavusoglu

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In modern societies, the costs of public goods and services are shared through taxes paid by citizens. However, taxation has always been a frictional issue, as tax obligations are perceived to be a financial burden for taxpayers rather than being merit that fulfills the redistribution, regulation and stabilization functions of the welfare state. The tax compliance literature evolves into discussing why people still pay taxes in systems with low costs of legal enforcement. Related empirical and theoretical works show that a wide range of socially oriented behavioral factors can stimulate voluntary compliance and subversive effects as well. These behavioral motivations are argued to be driven by self-enforcing rules of informal institutions, either independently or through interactions with legal orders set by formal institutions. The main focus of this study is to investigate empirically whether institutional particularities have a significant role in explaining the cross-country differences in the tax noncompliance levels. A part of the controversy about the driving forces behind tax noncompliance may be attributed to the lack of empirical evidence. Thus, this study aims to fill this gap through regression estimates, which help to trace the link between institutional quality and noncompliance on a cross-country basis. Tax evasion estimates of Buehn and Schneider is used as the proxy measure for the tax noncompliance levels. Institutional quality is quantified by three different indicators (percentile ranks of Worldwide Governance Indicators, ratings of the International Country Risk Guide, and the country ratings of the Freedom in the World). Robust Least Squares and Threshold Regression estimates based on the sample of the Organization for Economic Co-operation and Development (OECD) countries imply that tax compliance increases with institutional quality. Moreover, a threshold-based asymmetry is detected in the effect of institutional quality on tax noncompliance. That is, the negative effects of tax burdens on compliance are found to be more pronounced in countries with institutional quality below a certain threshold. These findings are robust to all alternative indicators of institutional quality, supporting the significant interaction of societal values with the individual taxpayer decisions.

Keywords: institutional quality, OECD economies, tax compliance, tax evasion

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21896 The Phenomenology in the Music of Debussy through Inspiration of Western and Oriental Culture

Authors: Yu-Shun Elisa Pong

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Music aesthetics related to phenomenology is rarely discussed and still in the ascendant while multi-dimensional discourses of philosophy were emerged to be an important trend in the 20th century. In the present study, a basic theory of phenomenology from Edmund Husserl (1859-1938) is revealed and discussed followed by the introduction of intentionality concepts, eidetic reduction, horizon, world, and inter-subjectivity issues. Further, phenomenology of music and general art was brought to attention by the introduction of Roman Ingarden’s The Work of Music and the Problems of its Identity (1933) and Mikel Dufrenne’s The Phenomenology of Aesthetic Experience (1953). Finally, Debussy’s music will be analyzed and discussed from the perspective of phenomenology. Phenomenology is not so much a methodology or analytics rather than a common belief. That is, as much as possible to describe in detail the different human experience, relative to the object of purpose. Such idea has been practiced in various guises for centuries, only till the early 20th century Phenomenology was better refined through the works of Husserl, Heidegger, Sartre, Merleau-Ponty and others. Debussy was born in an age when the Western society began to accept the multi-cultural baptism. With his unusual sensitivity to the oriental culture, Debussy has presented considerable inspiration, absorption, and echo in his music works. In fact, his relationship with nature is far from echoing the idea of Chinese ancient literati and nature. Although he is not the first composer to associate music with human and nature, the unique quality and impact of his works enable him to become a significant figure in music aesthetics. Debussy’s music tried to develop a quality analogous of nature, and more importantly, based on vivid life experience and artistic transformation to achieve the realm of pure art. Such idea that life experience comes before artwork, either clear or vague, simple or complex, was later presented abstractly in his late works is still an interesting subject worth further discussion. Debussy’s music has existed for more than or close to a century. It has received musicology researcher’s attention as much as other important works in the history of Western music. Among the pluralistic discussion about Debussy’s art and ideas, phenomenological aesthetics has enlightened new ideas and view angles to relook his great works and even gave some previous arguments legitimacy. Overall, this article provides a new insight of Debussy’s music from phenomenological exploration and it is believed phenomenology would be an important pathway in the research of the music aesthetics.

Keywords: Debussy's music, music esthetics, oriental culture, phenomenology

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21895 Barriers for Appropriate Palliative Symptom Management: A Qualitative Research in Kazakhstan, a Medium-Income Transitional-Economy Country

Authors: Ibragim Issabekov, Byron Crape, Lyazzat Toleubekova

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Background: Palliative care substantially improves the quality of life of terminally-ill patients. Symptom control is one of the keystones in the management of patients in palliative care settings, lowering distress as well as improving the quality of life of patients with end-stage diseases. The most common symptoms causing significant distress for patients are pain, nausea and vomiting, increased respiratory secretions and mental health issues like depression. Aims are: 1. to identify best practices in symptom management in palliative patients in accordance with internationally approved guidelines and compare aforementioned with actual practices in Kazakhstan; to evaluate the criteria for assessing symptoms in terminally-ill patients, 2. to review the availability and utilization of pharmaceutical agents for pain control, management of excessive respiratory secretions, nausea, and vomiting, and delirium and 3. to develop recommendations for the systematic approach to end-of-life symptom management in Kazakhstan. Methods: The use of qualitative research methods together with systematic literature review have been employed to provide a rigorous research process to evaluate current approaches for symptom management of palliative patients in Kazakhstan. Qualitative methods include in-depth semi-structured interviews of the healthcare professionals involved in palliative care provision. Results: Obstacles were found in appropriate provision of palliative care. Inadequate education and training to manage severe symptoms, poorly defined laws and regulations for palliative care provision, and a lack of algorithms and guidelines for care were major barriers in the effective provision of palliative care. Conclusion: Assessment of palliative care in this medium-income transitional-economy country is one of the first steps in the initiation of integration of palliative care into the existing health system. Achieving this requires identifying obstacles and resolving these issues.

Keywords: end-of-life care, middle income country, palliative care, symptom control

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