Search results for: criminal evidence
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4204

Search results for: criminal evidence

3274 Calculating All Dark Energy and Dark Matter Effects through Dynamic Gravity Theory

Authors: Sean Michael Kinney

Abstract:

In 1666, Newton created the Law of Universal Gravitation. And in 1915, Einstein improved it to incorporate factors such as time dilation and gravitational lensing. But currently, there is a problem with this “universal” law. The math doesn’t work outside the confines of our solar system. And something is missing; any evidence of what gravity actually is and how it manifests. This paper explores the notion that gravity must obey the law of conservation of energy as all other forces in this universe have been shown to do. Explaining exactly what gravity is and how it manifests itself. And looking at many different implications that would be created are explained. And finally, use the math of Dynamic gravity to calculate Dark Energy and Dark Matter effects to explain all observations without the need for exotic measures.

Keywords: dynamic gravity, gravity, dark matter, dark energy

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3273 Molecular Epidemiology of Egyptian Biomphalaria Snail: The Identification of Species, Diagnostic of the Parasite in Snails and Host Parasite Relationship

Authors: Hanaa M. Abu El Einin, Ahmed T. Sharaf El- Din

Abstract:

Biomphalaria snails play an integral role in the transmission of Schistosoma mansoni, the causative agent for human schistosomiasis. Two species of Biomphalaria were reported from Egypt, Biomphalaria alexandrina and Biomphalaria glabrata, and later on a hybrid of B. alexandrina and B. glabrata was reported in streams at Nile Delta. All were known to be excellent hosts of S. mansoni. Host-parasite relationship can be viewed in terms of snail susceptibility and parasite infectivity. The objective of this study will highlight the progress that has been made in using molecular approaches to describe the correct identification of snail species that participating in transmission of schistosomiasis, rapid diagnose of infection in addition to susceptibility and resistance type. Snails were identified using of molecular methods involving Randomly Amplified Polymorphic DNA (RAPD), Polymerase Chain Reaction, Restriction Fragment Length Polymorphisms (PCR-RFLP) and Species - specific- PCR. Molecular approaches to diagnose parasite in snails from Egypt: Nested PCR assay and small subunit (SSU) rRNA gene. Also RAPD PCR for study susceptible and resistance phenotype. The results showed that RAPD- PCR, PCR-RFLP and species-specific-PCR techniques were confirmed that: no evidence for the presence of B. glabrata in Egypt, All Biomphalaria snails collected identified as B. alexandrina snail i-e B alexandrinia is a common and no evidence for hybridization with B. glabrata. The adopted specific nested PCR assay revealed much higher sensitivity which enables the detection of S. mansoni infected snails down to 3 days post infection. Nested PCR method for detection of infected snails using S. mansoni fructose -1,6- bisphosphate aldolase (SMALDO) primer, these primers are specific only for S. mansoni and not cross reactive with other schistosomes or molluscan aldolases Nested PCR for such gene is sensitive enough to detect one cercariae. Genetic variations between B. alexandrina strains that are susceptible and resistant to Schistosoma infec¬tion using a RAPD-PCR showed that 39.8% of the examined snails collected from the field were resistant, while 60.2% of these snails showed high infection rates. In conclusion the genetics of the intermediate host plays a more important role in the epidemiological control of schistosomiasis.

Keywords: biomphalaria, molecular differentiation, parasite detection, schistosomiasis

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3272 Understanding Consumption Planning Behaviors

Authors: Gaosheng Ju

Abstract:

Our empirical evidence supports a model of consumption planning behaviors with the following two characteristics. First, households formulate a rational consumption target based on their desired target, displaying a diminishing sensitivity to the discrepancy between them. Second, the established target is a reference point for their planned consumption. The diminishing sensitivity leads to opposite reactions in higher and lower quantiles of both consumption targets and consumption growth to changes in economic conditions. This phenomenon accounts for the perplexingly low correlation between consumption and other macroeconomic variables. Furthermore, the opposing movements of consumption targets offer new insights into consumption-based asset pricing.

Keywords: consumption planning, reference point, diminishing sensitivity, quantile regression, asset pricing puzzles

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3271 Conception of Increasing the Efficiency of Excavation Shoring by Prestressing Diaphragm Walls

Authors: Mateusz Frydrych

Abstract:

The construction of diaphragm walls as excavation shoring as well as part of deep foundations is widely used in geotechnical engineering. Today's design challenges lie in the optimal dimensioning of the cross-section, which is demanded by technological considerations. Also in force is the issue of optimization and sustainable use of construction materials, including reduction of carbon footprint, which is currently a relevant challenge for the construction industry. The author presents the concept of an approach to achieving increased efficiency of diaphragm wall excavation shoring by using structural compression technology. The author proposes to implement prestressed tendons in a non-linear manner in the reinforcement cage. As a result bending moment is reduced, which translates into a reduction in the amount of steel needed in the section, a reduction in displacements, and a reduction in the scratching of the casing, including the achievement of better tightness. This task is rarely seen and has not yet been described in a scientific way in the literature. The author has developed a dynamic numerical model that allows the dimensioning of the cross-section of a prestressed shear wall, as well as the study of casing displacements and cross-sectional forces in any defined computational situation. Numerical software from the Sofistik - open source development environment - was used for the study, and models were validated in Plaxis software . This is an interesting idea that allows for optimizing the execution of construction works and reducing the required resources by using fewer materials and saving time. The author presents the possibilities of a prestressed diaphragm wall, among others, using. The example of a diaphragm wall working as a cantilever at the height of two underground floors without additional strutting or stability protection by using ground anchors. This makes the execution of the work more criminal for the contractor and, as a result, cheaper for the investor.

Keywords: prestressed diaphragm wall, Plaxis, Sofistik, innovation, FEM, optimisation

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3270 The Co-Existence of Multidominance and Movement in the Syntax of Chinese Bi-Comparatives

Authors: Yaqing Hu

Abstract:

This paper puts forward a syntactic analysis involving multidominance and rightward movement in Chinese bi-comparatives, as in 'Yuehan bi Mali gao (John is taller than Mary).' It is argued here that the predicate of comparison is a shared constituent in two small clauses, namely one for the target and one for the standard; and then it moves rightward to form a degree phrase with the comparative morpheme. This proposal comes from four aspects. First, the example above can also be expressed in this way, 'A: Yuehan he Mali, shui gao? (John and Mary, who is taller?) B: Yuehan gao./Yuehan geng gao. (John is taller).' This shows that the gradable adjective is predicated of the target. In addition, according to a constraint on Chinese bi-comparatives, namely the target and the standard must be arguments of the predicate simultaneously, it is not unreasonable to assume that the gradable adjective may also be predicated of the standard. Second, subcomparatives are totally disallowed in Chinese, as in '*zhe-zhang zhuozi bi zhe-zhang yizi kuan chang. (This table is longer than this chair is wide.)' In order to save it from ungrammaticality, the target and the standard should be compared along the same dimension denoted by the gradable adjective. It may follow that in Chinese comparatives, having equal roles in the same eventuality, the target and the standard bear the same thematic relationship with the predicate of comparison. Third, verb-copy can appear in Chinese bi-comparatives, as in 'Yuehan qi ma bi Mali qi ma qi de kuai. (John rides horses faster than Mary does.)' The predicate qi seems to form a small clause with both the target and the standard. This might be supporting evidence that both the target and the standard share the predicate of comparison. Fourth, Chinese comparatives do have comparative morphemes, as in 'Yuehan bi Mali geng gao. (John is taller than Mary)', which is semantically equivalent to the first example above. Thus, it follows that one feature of Chinese comparative morphemes is that they can remain overt or covert in the syntax, which will not affect semantics. This further shows that comparative morphemes in bi-comparatives may not be able to saturate the degree argument denoted by the predicate of comparison due to its optionality in the structure. These four aspects present a challenge to the Direct Analysis used in Chinese comparatives since this approach would presume that the target and the standard somehow show independency with the predicate in the syntax. Meanwhile, this study also rejects the previous analysis of multidomiance in bi-comparatives in which the degree phrase comprised of the comparative morpheme and the gradable adjective may be shared by the standard when the comparative morpheme is covert. This syntactic analysis proposed in this study will therefore offer a different perspective of how to treat degree phrase in Chinese comparatives and may offer evidence to argue whether there is degree phrase movement in bi-comparatives as in its English counterparts.

Keywords: Chinese comparatives, degree phrase, movement, multidominance, syntactic analysis

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3269 Mental Health Impacts of COVID-19 on Diverse Youth and Families in Canada

Authors: Lucksini Raveendran

Abstract:

Introduction: This mixed-methods study focuses on the experiences of ethnocultural youth and families in Canada, identifying key barriers and opportunities to inform service programming and policies that can better meet their mental health needs during the COVID-19 pandemic and beyond. Methods: Mental Health Commission of Canada's Headstrong initiative administered the youth survey (April – June 2020) and family survey (June – August 2020) with a total sample size of 137 and 481 respondents, respectively. Thematic analysis was conducted to identify key challenges faced, coping strategies used, and help-seeking behaviours. A similar approach was also applied to the family survey data, but instead, a representative sample was collated to analyze geographically variable and ethnically diverse subgroups. Results and analysis: Multiple challenges have impacted families, including increased feelings of loneliness and distress from border travel restrictions, especially among those navigating pregnancy alone or managing children with developmental needs, which is often understudied. Also, marginalized groups were disproportionately affected by inequitable access to communication technologies, further deepening the digital divide. Some reported living in congregated homes with regular conflicts, thus leading to increased anxiety and exposure to violence. For many families, urbanicity and ethnicity played a key role in how families reported coping with feelings of uncertainty while managing work commitments, navigating community resources, fulfilling care responsibilities, and homeschooling children of all ages. Despite these challenges, there was evidence of post-traumatic growth and building community resiliency. Conclusions and implications for policy, practice, or additional research: There is a need to foster opportunities to promote and sustain mental health, wellness, and resilience for families through social connections. Also, intersectionality must be embedded in the collection, analysis, and application of data to improve equitable access to evidence-based and recovery-oriented mental health supports among diverse families in Canada. Lastly, address future research on the long-term COVID-19 impacts of travel border restrictions on family wellness.

Keywords: mental health, youth mental health, family wellness, health equity

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3268 The Illegal Architecture of Apartheid in Palestine

Authors: Hala Barakat

Abstract:

Architecture plays a crucial role in the colonization and organization of spaces, as well as the preservation of cultures and history. As a result of 70 years of occupation, Palestinian land, culture, and history are endangered today. The government of Israel has used architecture to strangulate Palestinians out and seize their land. The occupation has managed to fragment the West Bank and cause sensible scars on the landscape by creating obstacles, barriers, watchtowers, checkpoints, walls, apartheid roads, border devices, and illegal settlements to unjustly claim land from its indigenous population. The apartheid architecture has divided the Palestinian social and urban fabric into pieces, similarly to the Bantustans. The architectural techniques and methods used by the occupation are evidence of prejudice, and while the illegal settlements remain to be condemned by the United Nations, little is being done to officially end this apartheid. Illegal settlements range in scale from individual units to established cities and house more than 60,000 Israeli settlers that immigrated from all over Europe and the United States. Often architecture by Israel is being directed towards expressing ideologies and serving as evidence of its political agenda. More than 78% of what was granted to Palestine after the development of the Green Line in 1948 is under Israeli occupation today. This project aims to map the illegal architecture as a criticism of governmental agendas in the West Bank and Historic Palestinian land. The paper will also discuss the resistance to the newly developed plan for the last Arab village in Jerusalem, Lifta. The illegal architecture has isolated Palestinians from each other and installed obstacles to control their movement. The architecture of occupation has no ethical or humane logic but rather entirely political, administrative, and it should not be left for the silenced architecture to tell the story. Architecture is not being used as a connecting device but rather a way to implement political injustice and spatial oppression. By narrating stories of the architecture of occupation, we can highlight the spatial injustice of the complex apartheid infrastructure. The Israeli government has managed to intoxicate architecture to serve as a divider between cultural groups, allowing the unlawful and unethical architecture to define its culture and values. As architects and designers, the roles we play in the development of illegal settlements must align with the spatial ethics we practice. Most importantly, our profession is not performing architecturally when we design a house with a particular roof color to ensure it would not be mistaken with a Palestinian house and be attacked accidentally.

Keywords: apartheid, illegal architecture, occupation, politics

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3267 Mental Health Stigma: Barriers to Treatment and Participation in Mental Health Care among University Students in Kenya

Authors: Scholastic Nangila Adeli, Francisca Mbutitia Ngithi

Abstract:

Stigma is commonly associated with mental health patients and may act as a barrier to individuals who may seek or engage in treatment services. Stigmatization among university students is common whether they know someone with a mental health problem, or have a good knowledge and experience of mental health issues. The objective of this study was to establish the various barriers that prevent university students who have mental health challenges from seeking treatment and care. The study was a descriptive in nature where 320 respondents helped to establish the barriers to treatment or participation in mental health care among university students. A questionnaire was used to help establish the barriers and attitude towards mental illness among the respondents. Results from this study revealed that mental illnesses are common among university students and they are manifested in different forms like; anxiety and panic attacks, mood and eating disorders, Impulse control leading to gambling, alcohol and drug addictions, anger and depression leading to loneliness. Mental stigma (both social and self) was the major barrier with 62% of the respondents stating that social stigma was worse than self-stigma. This is because of the social discrimination towards the victim of mental challenges. On issues of attitude, 71% of the respondents said that they can never admit that they have a mental issue and would rather secretly seek clinical or psychological help for fear of being discriminated or excluded by peers. This view is informed by the societal belief that people with mental health challenges were dangerous (associating them with criminal behavior) and hard to socialize with or help. From the findings of this study, it is concluded that mental health problems are real among university students in Kenya and it is important for the university environment to minimize or eradicate stigma within the social circles. Stigma can be minimized or eradicated by creating awareness among university students and fostering social inclusion so that the students who have mental health challenges can experience a sense of belonging and acceptance hence build their self-esteem.

Keywords: disorders, impulse control, mental health problems, stigma

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3266 Mass Media and Tobacco in Bangladesh: An Investigation on the Role of Mass Media in the Light of Tobacco Control

Authors: Tahsina Sadeque Kapil Ahmed

Abstract:

Context: The tobacco epidemic is one of the biggest public health threats the world has ever faced. Tobacco use is a widespread phenomenon in Bangladesh, and that causes numerous deaths and disabilities in a year. The studies conducted elsewhere have strengthened the evidence that mass media campaigns conducted in the context of comprehensive tobacco control programs can promote quitting and reduce smoking, as well as smokeless tobacco prevalence. Awareness building campaigns in mass-media against tobacco use should be prioritized more, and this paper will be an initiative towards enhancing mass-media’s role in controlling tobacco in Bangladesh. Objective: the main objective of this study is to investigate the role of mass-media in controlling tobacco in Bangladesh. Methods: This is a qualitative study and both primary, as well as secondary data were used where information gathered through the Key Informant Interviews (KIIs) and media contents. The employees of media houses (five national papers, two online news portals and six TV channels) were selected as study respondent. Media Content Analysis is used through the broad range of ‘texts’ from transcripts of interviews and discussions along with the materials like reports, footages, advertisements, talk-shows, articles etc. Results: The study result documented several opinions of discussants where Mass media was found to play a strong role in support of the amended tobacco control law and its implication that could be created public support against tobacco farming, exposing to companies’ tactics and other tobacco control activities. The study results also revealed that in controlling tobacco supply and demand effectively, media has been assisting the government and anti-tobacco activities productively. Majority of the Key Informants opined spontaneously on tobacco control program publicity, organizational interference, and influence of other activities on media. They also emphasized role of media for activities of anti-tobacco organizations, awareness building actions, popularization of tobacco control law and its amendment. Conclusion and Recommendation: The study shows evidence that mass media coverage of tobacco control issues is influencing the context of comprehensive tobacco control programs. To reduce tobacco consumption, along with strict enforcement efforts, media should be used to assist with the implementation of the tobacco control law. A sustained nationwide campaign to educate the masses against the dangers of smoking and smokeless tobacco is needed, and media can play an important role in creating further awareness about the dangers associated with tobacco consumption.

Keywords: Bangladesh media, mass media, role of media, tobacco control

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3265 Isotopic Evidence (He, Ne, Ar) for Deep Fluid in the Caucasus Continental Collision Zone

Authors: Larisa Liamina, Vasily Lavrushin, Salvatore Inguaggiato

Abstract:

This study presents and summarizes the results of researching the isotopic signature of helium in the deep fluid eastern part of the Southern slope of the Greater Caucasus and the Lesser Caucasus (Azerbaijan and Armenia) for the period from 2010 to 2016. The results of isotope ratios of 3He/4He in 59 samples of the gas phase of geothermal fluids and mud volcanoes are presented. New data have been obtained not only on the isotopic ratios of helium, but also neon and argon. The R/Ra ratio was analyzed along the Ankara-Sevan ophiolite structure. The patterns of lateral variations of the 3He/4He ratio of different geological structural elements of the studied region are revealed.

Keywords: isotopes helium, deep fluids, tectonic structures, Caucasus

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3264 Existence of Systemic Risk in Turkish Banking Sector: An Evidence from Return Distributions

Authors: İlhami Karahanoglu, Oguz Ceylan

Abstract:

As its well-known definitions; systemic risk refers to whole economic system down-turn movement even collapse together in very severe cases. In fact, it points out the contagion effects of the defaults. Such a risk is can be depicted with the famous Chinese game of falling domino stones. During and after the Bear & Sterns and Lehman Brothers cases, it was well understood that there is a very strong effect of systemic risk in financial services sector. In this study, we concentrate on the existence of systemic risk in Turkish Banking Sector based upon the Halkbank Case during the end month of 2013; there was a political turmoil in Turkey in which the close relatives of the upper politicians were involved in illegal trading activities. In that operation, the CEO of Halkbank was also arrested and in investigation, Halkbank was considered as part of such illegal actions. That operation had an impact on Halkbanks stock value. The Halkbank stock value during that time interval decreased remarkably, the distributional profile of stock return changed and became more volatile as well as more skewed. In this study, the daily returns of 5 leading banks in Turkish banking sector were used to obtain 48 return distributions (for each month, 90-days-back stock value returns are used) of 5 banks for the period 12/2011-12/2013 (pre operation period) and 12/2013-12/2015 (post operation period). When those distributions are compared with timely manner, interestingly; the distribution of the 5 other leading banks in Turkey, public or private, had also distribution profiles which was different from the past 2011-2013 period just like Halkbank. Those 5 big banks, whose stock values are monitored with sub index in Istanbul stock exchange (BIST) as BN10, had more skewed distribution just following the Halkbank stock return movement during the post operation period, with lover mean value and as well higher volatility. In addition, the correlation between the stock value return distributions of the leading banks after Halkbank case, where the returns are more skewed to the left, increased (which is measured in monthly base before and after the operation). The dependence between those banks was stronger under the case where the stock values were falling compared with the normal market condition. Such distributional effect of stock returns between the leading banks in Turkey, which is valid for down sub-market (financial/banking sector) condition, can be evaluated as an evidence for the existence of contagious effect and systemic risk.

Keywords: financial risk, systemic risk, banking sector, return distribution, dependency structure

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3263 Mining Diagnostic Investigation Process

Authors: Sohail Imran, Tariq Mahmood

Abstract:

In complex healthcare diagnostic investigation process, medical practitioners have to focus on ways to standardize their processes to perform high quality care and optimize the time and costs. Process mining techniques can be applied to extract process related knowledge from data without considering causal and dynamic dependencies in business domain and processes. The application of process mining is effective in diagnostic investigation. It is very helpful where a treatment gives no dispositive evidence favoring it. In this paper, we applied process mining to discover important process flow of diagnostic investigation for hepatitis patients. This approach has some benefits which can enhance the quality and efficiency of diagnostic investigation processes.

Keywords: process mining, healthcare, diagnostic investigation process, process flow

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3262 Patterns of Eosinophilia in Cardiac Patients and its Association with Endomyocardial Disease Presenting to Tertiary Care Hospital in Peshawar

Authors: Rashid Azeem

Abstract:

Introduction: Eosinophilia, which can be categorized as mild, moderate, and severe form on the basis of increasing eosinophil counts, might be responsible for a wide range of cardiac manifestations, varying from a simple myocarditis to a severe state like endomyocardial fibrosis. Eosinophils are involved in the pathogenesis of a variety of cardiovascular disorder like Loffler endocarditis, eosinophilic granulomatosis with polyangitis (EGPH), and hyper eosinophilic (HES). Among them HES carries and incidence rate b/w 48% and 75% and is the main causes of cardiac motility and mobility due to eosinophilia involvement. Aims and objectives: The aim of this study is to determine the frequency of eosinophilia in cardiac patients and to ascertain the evidence of endomyocardial diseases in eosinophilic patients in a cardiology institution Material and Methods: This cross sectional analytical study was conducted in hematology Department of Peshawar institute of Cardiology after approval from hospital ethical and research committee. All 70 patients were subjected to detailed history and clinical examination. Investigation like CBC, Chest X-ray, ECG, Echo, Angiography findings were used to monitor patient’s clinical status. Data is analyzed using SPSS version 25 and MS Excel. Results: Out of 70 patients in our study, a total of 66 patients(94 %) shows evidence of cardiac manifestations. In our study, we have observed a number of abnormal ECG patterns in cardiac patients presenting with eosinophilia, like T wave changes, loss of R wave, sinus bradycardia with LVH strain, and ST wave abnormality. abnormal echocardiographic findings were observed in our patients, like valvular abnormalities (in 45.7%), RWMA abnormalities (in 2.8%), isolated ventricular dysfunction (in 21.4%), and in 10% patients, normal echocardiography. We further noted abnormal coronary angiography findings in cardiac patients with eosinophilia ranging from single vessel to multi vessel occlusions. Conclusions: Eosinophils are involved in the pathogenesis of a variety of cardiovascular disorders which can be detected by various diagnostic means, and the severity of the disease increases with time and with increasing eosinophil count ranging from simple myocarditis to a fatal condition like endomyocardial fibrosis. Thus, increased eosinophilic count as a laboratory parameter in cardiac patients may be a sign of endomyocardial damage which will further help cardiologist to intervene more aggressively then routine approach to a cardiac patient.

Keywords: eosinophilia, endomyocardial fibrosis, cardiac, hypereosinophilic syndrome

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3261 Measuring the Effect of a Music Therapy Intervention in a Neonatal Intensive Care Unit in Spain

Authors: Pablo González Álvarez, Anna Vinaixa Vergés, Paula Sol Ventura, Paula Fernández, Mercè Redorta, Gemma Ginovart Galiana, Maria Méndez Hernández

Abstract:

Context: The use of music therapy is gaining popularity worldwide, and it has shown positive effects in neonatology. Hospital Germans Trias i Pujol has recently established a music therapy unit and initiated a project in their neonatal intensive care unit (NICU). Research Aim: The aim of this study is to measure the effect of a music therapy intervention in the NICU of Hospital Germans Trias i Pujol in Spain. Methodology: The study will be an observational analytical case-control study. All newborns admitted to the neonatology unit, both term and preterm, and their parents will be offered a session of music therapy. Data will be collected from families who receive at least two music therapy sessions. Maternal and paternal anxiety levels will be measured through a pre- and post-intervention test. Findings: The study aims to demonstrate the benefits and acceptance of music therapy by patients, parents, and healthcare workers in the neonatal unit. The findings are expected to show a reduction in maternal and paternal anxiety levels following the music therapy sessions. Theoretical Importance: This study contributes to the growing body of literature on the effectiveness of music therapy in neonatal care. It will provide evidence of the acceptance and potential benefits of music therapy in reducing anxiety levels in both parents and babies in the NICU setting. Data Collection: Data will be collected from families who receive at least two music therapy sessions. This will include pre- and post-intervention test results to measure anxiety levels. Analysis Procedures: The collected data will be analyzed using appropriate statistical methods to determine the impact of music therapy on reducing anxiety levels in parents. Questions Addressed: - What is the effect of music therapy on maternal anxiety levels? - What is the effect of music therapy on paternal anxiety levels? - What is the acceptability and perceived benefits of music therapy among patients and healthcare workers in the NICU? Conclusion: The study aims to provide evidence supporting the value of music therapy in the neonatal intensive care unit. It seeks to demonstrate the positive effect of music therapy on reducing anxiety levels among parents.

Keywords: neonatology, music therapy, neonatal intensive care unit, babies, parents

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3260 Gender Equality: A Constitutional Myth When Featured with Domestic Violence

Authors: Suja S. Nayar, Mayuri Pandya

Abstract:

The foundation of legal system of any nation is its constitution and the strive to achieve equality amongst different classes prevailing in the social system. The most traditional form of inequality that is prevailing in the society is the gender inequality. The existence of inequality on the basis of gender prevails since the ancient era which has with the passing time merely continued and aggravated to a great extent. The founding fathers of our constitution were well aware of the then prevailing situation and being concerned about the future if this inequality continued to prevail, and in such view, the provisions of Article 14, 15, 38 and 44 of our Constitution were enacted with specific intent for the upliftment of women. The strive for equality is the rule of law embodied with the principle of foreseeability which is necessitated in the stability of justice system of any nation, and when it comes to equality, the first form of equality we need to achieve is gender equality. Time and again various initiatives have been announced and attempted to achieve the objective of gender equality, but analysis of the ground reality always have yielded disappointing results. The research that is proposed to be undertaken intends to cover all the above issues concerning the failures ineffective implementation of the gender-specific laws especially the provisions concerning the protection provided under Domestic Violence Act. The researchers will analyze the judgment of last five years' judgments of Supreme Court of India. In Hiral P. Harsora and ors. v Kusum Narottamdas Harsora and Ors. the Hon'ble Supreme Court recently deleting the words 'adult male' from the definition of respondent disclosed it is intent and understanding that domestic violence is being caused by a female on female also and not only restricted to males on females only. The procedure as prescribed under the act for claiming reliefs though is as per the criminal mandate, but the reliefs are of civil nature and so same needs to deal emphatically which now makes it a lengthier process. The pros and cons of such pronouncements are being weighed on the balance of constitution and social equality that is strived by the entire women fraternity.

Keywords: domestic, violence, constitution, gender, equality, women

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3259 Ownership Concentration and Payout Policy: Evidence from France

Authors: Asma Bentaifa

Abstract:

This paper investigates the effect of ownership concentration and especially the presence of controlling shareholders on the firm’s payout decisions. Using a sample of 870 French companies during 2007 to 2012, we find that the share of dividends in total payout is negatively correlated with the size of cash flow held by controlling shareholder, and positively related to the divergence between voting rights and cash flow rights of largest shareholders. We also document that controlled firms tend to prefer dividends over repurchases to mitigate conflicts between controlling shareholders and minority shareholders related to the presence of control enhancing devices.

Keywords: ownership, payout policy, dividend, minority expropriation

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3258 An Infinite Mixture Model for Modelling Stutter Ratio in Forensic Data Analysis

Authors: M. A. C. S. Sampath Fernando, James M. Curran, Renate Meyer

Abstract:

Forensic DNA analysis has received much attention over the last three decades, due to its incredible usefulness in human identification. The statistical interpretation of DNA evidence is recognised as one of the most mature fields in forensic science. Peak heights in an Electropherogram (EPG) are approximately proportional to the amount of template DNA in the original sample being tested. A stutter is a minor peak in an EPG, which is not masking as an allele of a potential contributor, and considered as an artefact that is presumed to be arisen due to miscopying or slippage during the PCR. Stutter peaks are mostly analysed in terms of stutter ratio that is calculated relative to the corresponding parent allele height. Analysis of mixture profiles has always been problematic in evidence interpretation, especially with the presence of PCR artefacts like stutters. Unlike binary and semi-continuous models; continuous models assign a probability (as a continuous weight) for each possible genotype combination, and significantly enhances the use of continuous peak height information resulting in more efficient reliable interpretations. Therefore, the presence of a sound methodology to distinguish between stutters and real alleles is essential for the accuracy of the interpretation. Sensibly, any such method has to be able to focus on modelling stutter peaks. Bayesian nonparametric methods provide increased flexibility in applied statistical modelling. Mixture models are frequently employed as fundamental data analysis tools in clustering and classification of data and assume unidentified heterogeneous sources for data. In model-based clustering, each unknown source is reflected by a cluster, and the clusters are modelled using parametric models. Specifying the number of components in finite mixture models, however, is practically difficult even though the calculations are relatively simple. Infinite mixture models, in contrast, do not require the user to specify the number of components. Instead, a Dirichlet process, which is an infinite-dimensional generalization of the Dirichlet distribution, is used to deal with the problem of a number of components. Chinese restaurant process (CRP), Stick-breaking process and Pólya urn scheme are frequently used as Dirichlet priors in Bayesian mixture models. In this study, we illustrate an infinite mixture of simple linear regression models for modelling stutter ratio and introduce some modifications to overcome weaknesses associated with CRP.

Keywords: Chinese restaurant process, Dirichlet prior, infinite mixture model, PCR stutter

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3257 An Exploratory Research on Awareness towards Human Rights among Public Representatives of Bihar, India

Authors: Saba Farheen, Uday Shankar

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Background- Attaining equality among all humans and eliminating all forms of discrimination against them are fundamental human rights. These rights are based on the belief that all human beings are born free with equal dignity, esteem, and honour. In India, more than 30 percent politicians are having criminal background. They are also illiterate, which obstacle them in governing the system. They do not know the basic human rights. Because of this, they cannot decide what to do for the sake of the nation. Bihar is the third largest populated state of India and is characterized by corrupt politicians and poor literacy rate. If the politicians can aware about the human rights, then they will show positive attitude towards these. Aim- The main goal of the present research was to study the subjects’ knowledge or awareness towards their human rights. It was an attempt to identify social-psychological conditions that inhibit or facilitate awareness among public representatives towards their human rights in the special context of Bihar, India. Thus the main variable awareness towards human rights has been treated as the main dependent variable. The other two variables-socio economic status and Educational status, have been treated as independent variables. Method- The subjects were 400 public representatives in the age group of 35 to 50 years. They were from High socio economic status (N=150), Middle socio economic status (N=150), and Low socio economic status (N=100). The subjects were either educated (N=200) or Uneducated (N=200). The subjects were selected randomly from the different districts of Bihar, India. “Human Rights Awareness Scale” by Dr. Iftekhar Hossain, Dr. Saba Farheen, and Dr. Uday Shankar was applied in this study. Results- Results have shown that the public representatives have very low level of awareness towards the human rights. Also, the subjects from Middle SES have highest awareness in comparison with subjects of High and Low SES. Uneducated public representatives have less awareness than the educated one about human rights. Conclusion- Conclusively, it can be stated that human rights awareness among the public representatives of India is very low, and it is being affected by their Socio economic status and literacy level.

Keywords: human rights, awareness, public representatives, bihar, India

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3256 Safer Staff: A Survey of Staff Experiences of Violence and Aggression at Work in Coventry and Warwickshire Partnership National Health Service Trust

Authors: Rupinder Kaler, Faith Ndebele, Nadia Saleem, Hafsa Sheikh

Abstract:

Background: Workplace related violence and aggression seems to be considered an acceptable occupational hazard for staff in mental health services. There is literature evidence that healthcare workers in mental health settings are at higher risk from aggression from patients. Aggressive behaviours pose a physical and psychological threat to the psychiatric staff and can result in stress, burnout, sickness, and exhaustion. Further evidence informs that health professionals are the most exposed to psychological disorders such as anxiety, depression and post-traumatic stress disorder. Fear that results from working in a dangerous environment and exhaustion can have a damaging impact on patient care and healthcare relationship. Aim: The aim of this study is to investigate the prevalence and impact of aggressive behaviour on staff working at Coventry and Warwickshire Partnership Trust. Methodology: The study methodology included carrying out a manual, anonymised, multi-disciplinary cross-sectional survey questionnaire across all clinical and non-clinical staff at CWPT from both inpatient and community settings. Findings: The unsurprising finding was that of higher prevalence of aggressive behaviours in in-patients in comparison to community staff. Conclusion: There is a high rate of verbal and physical aggression at work and this has a negative impact on the staff emotional and physical well- being. There is also a higher reliance on colleagues for support on an informal basis than formal organisational support systems. Recommendations: A workforce that is well and functioning is the biggest resource for an organisation. Staff safety during working hours is everyone's responsibility and sits with both individual staff members and the organisation. Post-incident organisational support needs to be consolidated, and hands-on, timely support offered to help maintain emotionally well staff on CWPT. The authors recommend development of preventative and practical protocols for aggression with patient and carer involvement. Post-incident organisational support needs to be consolidated, and hands-on, timely support offered to help maintain emotionally well staff on CWPT.

Keywords: safer staff, survey of staff experiences, violence and aggression, mental health

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3255 A Fresh Approach to Learn Evidence-Based Practice, a Prospective Interventional Study

Authors: Ebtehal Qulisy, Geoffrey Dougherty, Kholoud Hothan, Mylene Dandavino

Abstract:

Background: For more than 200 years, journal clubs (JCs) have been used to teach the fundamentals of critical appraisal and evidence-based practice (EBP). However, JCs curricula face important challenges, including poor sustainability, insufficient time to prepare for and conduct the activities, and lack of trainee skills and self-efficacy with critical appraisal. Andragogy principles and modern technology could help EBP be taught in more relevant, modern, and interactive ways. Method: We propose a fresh educational activity to teach EBP. Educational sessions are designed to encourage collaborative and experiential learning and do not require advanced preparation by the participants. Each session lasts 60 minutes and is adaptable to in-person, virtual, or hybrid contexts. Sessions are structured around a worksheet and include three educational objectives: “1. Identify a Clinical Conundrum”, “2. Compare and Contrast Current Guidelines”, and “3. Choose a Recent Journal Article”. Sessions begin with a short presentation by a facilitator of a clinical scenario highlighting a “grey-zone” in pediatrics. Trainees are placed in groups of two to four (based on the participants’ number) of varied training levels. The first task requires the identification of a clinical conundrum (a situation where there is no clear answer but only a reasonable solution) related to the scenario. For the second task, trainees must identify two or three clinical guidelines. The last task requires trainees to find a journal article published in the last year that reports an update regarding the scenario’s topic. Participants are allowed to use their electronic devices throughout the session. Our university provides full-text access to major journals, which facilitated this exercise. Results: Participants were a convenience sample of trainees in the inpatient services at the Montréal Children’s Hospital, McGill University. Sessions were conducted as a part of an existing weekly academic activity and facilitated by pediatricians with experience in critical appraisal. There were 28 participants in 4 sessions held during Spring 2022. Time was allocated at the end of each session to collect participants’ feedback via a self-administered online survey. There were 22 responses, were 41%(n=9) pediatric residents, 22.7%(n=5) family medicine residents, 31.8%(n=7) medical students, and 4.5%(n=1) nurse practitioner. Four respondents participated in more than one session. The “Satisfied” rates were 94.7% for session format, 100% for topic selection, 89.5% for time allocation, and 84.3% for worksheet structure. 60% of participants felt that including the sessions during the clinical ward rotation was “Feasible.” As per self-efficacy, participants reported being “Confident” for the tasks as follows: 89.5% for the ability to identify a relevant conundrum, 94.8% for the compare and contrast task, and 84.2% for the identification of a published update. The perceived effectiveness to learn EBP was reported as “Agreed” by all participants. All participants would recommend this session for further teaching. Conclusion: We developed a modern approach to teach EBP, enjoyed by all levels of participants, who also felt it was a useful learning experience. Our approach addresses known JCs challenges by being relevant to clinical care, fostering active engagement but not requiring any preparation, using available technology, and being adaptable to hybrid contexts.

Keywords: medical education, journal clubs, post-graduate teaching, andragogy, experiential learning, evidence-based practice

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3254 A Report on the Elearning Programme of the Irish College of General Practitioners Which Can Address Continuing Education Needs of Primary Care Physicians

Authors: Nicholas P. Fenlon, Aisling Lavelle, David Mclean, Margaret O'riordan

Abstract:

Background: The case for continuing professional development has been well made, and was formalized in Ireland in recent years through the enactment of the Medical Practitioner’s Act, which requires registered medical practitioners to complete a minimum of 50 hours CPD each year. The ICGP, who have been providing CPD opportunities to its members for many years, have responded to this need by developing a series of evidence-based, high-quality, multimedia modules across a range of clinical and non-clinical areas. (More traditional education opportunities are still being provided by the college also). Overview of Programme: The first module was released in September 2011, since when the eLearning program has grown steadily, and there are currently almost 20 modules available, with a further 5 in production. Each module contains three to six 10-minute video lessons, which use a combination of graphics, images, text, voice-over and clinical clips. These are supported by supplementary videos of expert pieces-to-camera, Q&As with content experts, clinical scenarios, external links and relevant documentation and other resources. Successful completion of MCQs will result in a Certificate of Completion, which can be printed or stored in Professional Competence portfolio. The Medical Practitioner’s Act requires doctors to gather CPD credits across 8 domains of practice, and various eLearning modules have been developed to address each. For instance, modules with a strong clinical content would include Management of Hypertension, Management of COPD, and Management of Asthma. Other modules focus on health promotion such as Promoting Smoking Cessation, Promoting Physical Activity, and Addressing Childhood Obesity. Modules where communication skills are keys include modules on Suicide Prevention and Management of Depression. Other modules, currently in development include non-clinical topics around risk management, including Confidentiality, Consent etc. Each module is developed by a core group, which includes where possible, a GP with a special interest in the area, and a content expert(s). The college works closely with a medical education consultant and a production company in developing and producing the modules. Modules can be accessed (with password) through the ICGP website and are available free to all ICGP members. Summary of Evaluation: There are over 1700 registered users to date (over 55% of College membership). The program was evaluated using an online survey in 2013 (N = 144/950 – 12%) and results were very positive overall but provided material for the further improvement of the program also. Future Plans: While knowledge can be imparted well through eLearning, skills and attitudes are more difficult to influence through an online environment. The college is now developing a series of linked workshops, which will lead to ICGP Professional Competence Awards. The first pilot workshop is scheduled for February 2015 and is Cardiology-themed. Participants will be required to complete the following 4 modules in advance of attending – Management of Hypertension, Management of Heart Failure, Promoting Smoking Cessation, and Promoting Physical Activity. The workshop will be case-based and interactive, addressing ECG Interpretation in General Practice. Conclusions: The ICGP have responded to members needs for high-quality evidence-based education delivered in a way that suits GPs.

Keywords: CPD opportunities, evidence-based, high quality, multimedia modules across a range of clinical and non-clinical areas, medical practitioner’s act

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3253 Effective Use of Visuals in Teaching Mathematics

Authors: Gohar Marikyan

Abstract:

This article is about investigating how to effectively use visuals in teaching introductory mathematics. The analysis showed the use of visuals in teaching introductory mathematics can be an effective tool for enhancing students’ learning and engagement in mathematics. The use of visuals was particularly effective for teaching concepts of numbers, operations with whole numbers, and properties of operations. The analysis also provides strong evidence that the effectiveness of visuals varied depending on the way the visuals are used. Furthermore, the analysis revealed that the use of visuals in mathematics instruction had a positive impact on student’s attitudes toward mathematics, with students showing higher levels of motivation and enjoyment in mathematics classes.

Keywords: analytical thinking skills, instructional strategies with visuals, introductory mathematics, student engagement and motivation

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3252 Answering the Call for Empirical Evidence: Burnout, Context and Remote Work

Authors: Clif P. Lewis, Ise-Lu Möller

Abstract:

The COVID-19 pandemic has had a profound impact on employment. The ‘future of work’ is now the ‘present of work’. Changes in the social context within which organisations are embedded necessitated drastic changes in how we work. Through the leveraging of technology and changes in mindset, we have seen exciting innovations in the world of work. This global shift in the context of employment offers a unique opportunity to examine a key unresolved issue in the study of Burnout, namely contextual antecedents. This study answers the call for deeper empirical insight into the contexts within which Burnout occur. We explore the emergence of Burnout within a remote work context by using survey data that incorporates the latest global work trends into the Areas of Worklife framework.

Keywords: burnout, remote work, pandemic, wellness

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3251 Comparisons between Student Leaning Achievements and Their Problem Solving Skills on Stoichiometry Issue with the Think-Pair-Share Model and Stem Education Method

Authors: P. Thachitasing, N. Jansawang, W. Rakrai, T. Santiboon

Abstract:

The aim of this study is to investigate of the comparing the instructional design models between the Think-Pair-Share and Conventional Learning (5E Inquiry Model) Processes to enhance students’ learning achievements and their problem solving skills on stoichiometry issue for concerning the 2-instructional method with a sample consisted of 80 students in 2 classes at the 11th grade level in Chaturaphak Phiman Ratchadaphisek School. Students’ different learning outcomes in chemistry classes with the cluster random sampling technique were used. Instructional Methods designed with the 40-experimenl student group by Think-Pair-Share process and the 40-controlling student group by the conventional learning (5E Inquiry Model) method. These learning different groups were obtained using the 5 instruments; the 5-lesson instructional plans of Think-Pair-Share and STEM Education Method, students’ learning achievements and their problem solving skills were assessed with the pretest and posttest techniques, students’ outcomes of their instructional the Think-Pair-Share (TPSM) and the STEM Education Methods were compared. Statistically significant was differences with the paired t-test and F-test between posttest and pretest technique of the whole students in chemistry classes were found, significantly. Associations between student learning outcomes in chemistry and two methods of their learning to students’ learning achievements and their problem solving skills also were found. The use of two methods for this study is revealed that the students perceive their learning achievements to their problem solving skills to be differently learning achievements in different groups are guiding practical improvements in chemistry classrooms to assist teacher in implementing effective approaches for improving instructional methods. Students’ learning achievements of mean average scores to their controlling group with the Think-Pair-Share Model (TPSM) are lower than experimental student group for the STEM education method, evidence significantly. The E1/E2 process were revealed evidence of 82.56/80.44, and 83.02/81.65 which results based on criteria are higher than of 80/80 standard level with the IOC, consequently. The predictive efficiency (R2) values indicate that 61% and 67% and indicate that 63% and 67% of the variances in chemistry classes to their learning achievements on posttest in chemistry classes of the variances in students’ problem solving skills to their learning achievements to their chemistry classrooms on Stoichiometry issue with the posttest were attributable to their different learning outcomes for the TPSM and STEMe instructional methods.

Keywords: comparisons, students’ learning achievements, think-pare-share model (TPSM), stem education, problem solving skills, chemistry classes, stoichiometry issue

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3250 Getting What You Paid For: Using Mutual Fund Governance to Predict the Activeness of Mutual Funds

Authors: Matthew Morey, Aron Gottesman

Abstract:

This paper examines the relationship between mutual fund governance and the activeness of equity mutual funds. Using a fund’s corporate culture as a proxy for its governance and controlling for other variables, we find that funds with the better governance are significantly more active than other funds. Further, we find the probability of finding a highly active fund increases significantly as the governance of the fund improves. We also find some evidence that the probability of finding a closet index fund increases as the governance of the fund declines. These results demonstrate that mutual fund governance should be considered carefully when making mutual fund investment decisions.

Keywords: active, share, mutual funds, economics

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3249 Corporate Social Media: Understanding the Impact of Service Quality and Social Value on Customer Behavior

Authors: Regina Connolly, Murray Scott, William DeLone

Abstract:

Social media are revolutionary technologies that are transforming the way we communicate, the way we collaborate and the way we influence. Companies are making major investments in platforms such as Facebook and Twitter because they realize that social media are an influential force on customer perceptions and behavior. However, to date there is little guidance on what constitutes an effective deployment of social media and there is no empirical evidence that social medial investments are yielding positive returns. This research develops and validates the components of an effective corporate social media platform in order to examine the impact of effective social media on customer intentions and behavior.

Keywords: service quality, social value, social media, IS success, Web 2.0, customer behaviour

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3248 The Role of the Child's Previous Inventory in Verb Overgeneralization in Spanish Child Language: A Case Study

Authors: Mary Rosa Espinosa-Ochoa

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The study of overgeneralization in inflectional morphology provides evidence for understanding how a child's mind works when applying linguistic patterns in a novel way. High-frequency inflectional forms in the input cause inappropriate use in contexts related to lower-frequency forms. Children learn verbs as lexical items and new forms develop only gradually, around their second year: most of the utterances that children produce are closely related to what they have previously produced. Spanish has a complex verbal system that inflects for person, mood, and tense. Approximately 200 verbs are irregular, and bare roots always require an inflected form, which represents a challenge for the memory. The aim of this research is to investigate i) what kinds of overgeneralization errors children make in verb production, ii) to what extent these errors are related to verb forms previously produced, and iii) whether the overgeneralized verb components are also frequent in children’s linguistic inventory. It consists of a high-density longitudinal study of a middle-class girl (1;11,24-2;02,24) from Mexico City, whose utterances were recorded almost daily for three months to compile a unique corpus in the Spanish language. Of the 358 types of inflected verbs produced by the child, 9.11% are overgeneralizations. Not only are inflected forms (verbal and pronominal clitics) overgeneralized, but also verbal roots. Each of the forms can be traced to previous utterances, and they show that the child is detecting morphological patterns. Neither verbal roots nor inflected forms are associated with high frequency patterns in her own speech. For example, the child alternates the bare roots of an irregular verb, cáye-te* and cáiga-te* (“fall down”), to express the imperative of the verb cá-e-te (fall down.IMPERATIVE-PRONOMINAL.CLITIC), although cay-ó (PAST.PERF.3SG) is the most frequent form of her previous complete inventory, and the combined frequency of caer (INF), cae (PRES.INDICATIVE.3SG), and caes (PRES.INDICATIVE.2SG) is the same as that of as caiga (PRES.SUBJ.1SG and 3SG). These results provide evidence that a) two forms of the same verb compete in the child’s memory, and b) although the child uses her own inventory to create new forms, these forms are not necessarily frequent in her memory storage, which means that her mind is more sensitive to external stimuli. Language acquisition is a developing process, given the sensitivity of the human mind to linguistic interaction with the outside world.

Keywords: inflection, morphology, child language acquisition, Spanish

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3247 Enforcement against Illegal Logging: Issues and Challenges

Authors: Muhammad Nur Haniff Mohd Noor, Rokiah Kadir, Suriyani Muhamad

Abstract:

Sustainable forest management and forest protection can be hampered by illegal logging. Illegal logging is not uncommon in many wood-producing countries. Hence, law enforcement, especially in timber-producing countries, is crucial in ensuring compliance with forestry related regulations, as well as confirming that all parties obey the rules and regulations prescribed by the authorities. However, enforcement officers are encountering various challenges and difficulties which have undermined the enforcement capacity and efficiency. The appropriate policy responses for these issues are important to resolve the problems in the long term and empowering enforcement capacity to meet future challenges of forest law enforcement. This paper is written according to extensive review of the articles and publications by The International Criminal Police Organization (INTERPOL), The International Tropical Timber Organization (ITTO), Chatham House and The Food and Agriculture Organization of the United Nations (FAO). Subsequently, various books and journal articles are reviewed to gain further insight towards enforcement issues and challenges. This paper identifies several issues which consist of (1) insufficient enforcement capacity and resources (2) lack of coordination between various enforcement agencies, (3) corruption in the government and private sectors and (4) unclear legal frameworks related to the forestry sector. Next, this paper discusses appropriate policy responses to address each enforcement challenges according to various publications. This includes specific reports concerning forest law enforcement published by international forestry-related organizations. Therefore, lack of resources, inadequate synchronization between agencies, corruption, and legal issues present challenges to enforcement officers in their daily routines. Recommendations regarding proper policy responses to overcome the issues are of great importance in assisting forest authorities in prioritizing their resources appropriately.

Keywords: corruption, enforcement challenges, enforcement capacity, forest law enforcement, insufficient agency coordination, legislative ambiguity

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3246 Metanotes and Foreign Language Learning: A Case of Iranian EFL Learners

Authors: Nahıd Naderı Anarı, Mojdeh Shafıee

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Languaging has been identified as a contributor to language learning. Compared to oral languaging, written languaging seems to have been less explored. In order to fill this gap, this paper examined the effect of ‘metanotes’, namely metatalk in a written modality to identify whether written languaging actually facilitates language learning. Participants were instructed to take metanotes as they performed a translation task. The effect of metanotes was then analyzed by comparing the results of these participants’ pretest and posttest with those of participants who performed the same task without taking metanotes. The statistical tests showed no evidence of the expected role of metanotes in foreign language learning.

Keywords: EFL learners, foreign language learning, language teaching, metanotes

Procedia PDF Downloads 441
3245 Implementation of Enhanced Recovery after Cesarean Section at Koidu Government Hospital, Sierra Leone 2024. A Quality Improvement Project.

Authors: Hailemariam Getachew, John Sandi, Isata Dumbuya, Patricia Efe.Azikiwe, Evaline Nginge, Moses Mugisha, Eseoghene Dase, Foday Mandaray, Grace Moore

Abstract:

Enhanced recovery after cesarean section (ERAC) is a standardized peri- operative care program that comprises the multidisciplinary team's collective efforts working in collaboration throughout the peri-operative period with the principal goal to improve quality of surgical care, decrease surgical related complications, and increasing patient satisfaction. Objective: The main objective of this project is to improve the implementation of enhanced recovery after cesarean section at Koidu Government hospital. Identified gap: Even though the hospital is providing comprehensive maternal and child care service, there are gaps in the implementation of ERAC. According to our survey, we found that there is low (13.3%) utilization of WHO surgical safety checklist, only limited (15.9%) patients get opioid free analgesia, pain was not recorded as a vital sign, there is no standardized checklist for hand over to and from Post Anesthesia care Unit(PACU). Furthermore, there is inconsistent evidence based post-operative care and there is no local consensus protocol and guideline as well. Implementation plan: we aimed at designing standardized protocol, checklist and guideline, provide training, build staff capacity, document pain as vital sign, perform regional analgesia, and provide evidence based post-operative care, monitoring and evaluation. Result: Data from 389 cesarean mothers showed that, Utilization of the WHO surgical safety check list found to be 95%, and pain assessment and documentation was done for all surgical patients. Oral feeding, ambulation and catheter removal was performed as per the ERAC standard for all patients. Postoperative complications drastically decreased from 13.6% to 8.1%. While, the rate of readmission was kept below 1%. Furthermore, the duration of hospital stay decreased from 4.64 days to 3.12 days. Conclusion The successful implementation of ERAC protocols demonstrates through this Quality Improvement Project that, the effectiveness of the protocols in improving recovery and patient outcome following cesarean section.

Keywords: cesarean delivery, enhanced recovery, quality improvement, patient outcome

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