Search results for: specialized support services
983 Learning in Multicultural Workspaces: A Case of Aged Care
Authors: Robert John Godby
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To be responsive now and in the future, workplaces must address the demands of multicultural teams as they become more common elements of the global labor force. This is especially the case for aged care due to the aging population, industry growth and migrant recruitment. This research identifies influences on and improvements for learning in these environments. Its unique contribution is to illuminate how culturally diverse workplaces can work and learn together more effectively. A mixed-methods approach was used to gather data about this topic in two phases. Firstly, the research methods included a survey of 102 aged care workers around Australia from two multi-site aged care organisations. The questionnaire elicited both quantitative and qualitative data about worker characteristics and perspectives on working and learning in aged care. Secondly, a case study of one aged care worksite was formulated drawing on worksite information and interviews with workers. A review of the literature suggests that learning in multicultural work environments is influenced by three main factors: 1) the individual workers themselves, 2) their interaction with each other and 3) the environment in which they work. There are various accounts of these three factors, how they are manifested and how they lead to a change in workers’ disposition, knowledge, or expertise when confronted with new circumstances. The study has found that a key individual factor influencing learning is cultural background. Their unique view of the world was shown to affect their approach to both their work and co-working. Interactional factors suggest that the high requirement for collaboration in aged care positively supports learning in this context; however, it can be hindered by cultural bias and spoken accent. The study also found that environmental factors, such as disruptions caused by the pandemic, were another key influence. For example, the need to wear face masks hindered the communication needed for workplace learning. This was especially challenging due to the diverse language backgrounds and abilities within the teams. Potential improvements for learning in multicultural aged care work environments were identified. These include more frequent and structured inter-peer learning (e.g. buddying), communication training (e.g. English language usage for both native and non-native speaking workers) and support for cross-cultural habitude (e.g. recognizing and adapting to cultural differences). Workplace learning in cross-cultural aged care environments is an area that is not extensively dealt with in the literature. This study addresses this gap and holds the potential to contribute practical insights to aged care and other diverse industries.Keywords: cross-cultural learning, learning in aged care, migrant learning, workplace learning
Procedia PDF Downloads 159982 NHS Tayside Plastic Surgery Induction Cheat Sheet and Video
Authors: Paul Holmes, Mike N. G.
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Foundation-year doctors face increased stress, pressure and uncertainty when starting new rotations throughout their first years of work. This research questionnaire resulted in an induction cheat sheet and induction video that enhanced the Junior doctor's understanding of how to work effectively within the plastic surgery department at NHS Tayside. The objectives and goals were to improve the transition between cohorts of junior doctors in ward 26 at Ninewells Hospital. Before this quality improvement project, the induction pack was 74 pages long and over eight years old. With the support of consultant Mike Ng a new up-to-date induction was created. This involved a questionnaire and cheat sheet being developed. The questionnaire covered clerking, venipuncture, ward pharmacy, theatres, admissions, specialties on the ward, the cardiac arrest trolley, clinical emergencies, discharges and escalation. This audit has three completed cycles between August 2022 and August 2023. The cheat sheet developed a concise two-page A4 document designed for doctors to be able to reference easily and understand the essentials. The document format is a table containing ward layout; specialty; location; physician associate, shift patterns; ward rounds; handover location and time; hours coverage; senior escalation; nights; daytime duties, meetings/MDTs/board meetings, important bleeps and codes; department guidelines; boarders; referrals and patient stream; pharmacy; absences; rota coordinator; annual leave; top tips. The induction video is a 10-minute in-depth explanation of all aspects of the ward. The video explores in more depth the contents of the cheat sheet. This alternative visual format familiarizes the junior doctor with all aspects of the ward. These were provided to all foundation year 1 and 2 doctors on ward 26 at Ninewells Hospital at NHS Tayside Scotland. This work has since been adopted by the General Surgery Department, which extends to six further wards and has improved the effective handing over of the junior doctor’s role between cohorts. There is potential to further expand the cheat sheet to other departments as the concise document takes around 30 minutes to complete by a doctor who is currently on that ward. The time spent filling out the form provides vital information to the incoming junior doctors, which has a significant possibility to improve patient care.Keywords: induction, junior doctor, handover, plastic surgery
Procedia PDF Downloads 85981 Navigating the Integration of AI in High School Assessment: Strategic Implementation and Ethical Practice
Authors: Loren Clarke, Katie Reed
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The integration of artificial intelligence (AI) in high school education assessment offers transformative potential, providing more personalized, timely, and accurate evaluations of student performance. However, the successful adoption of AI-driven assessment systems requires robust change management strategies to navigate the complexities and resistance that often accompany such technological shifts. This presentation explores effective methods for implementing AI in high school assessment, emphasizing the need for strategic planning and stakeholder engagement. Focusing on a case study of a Victorian high school, it will examine the practical steps taken to integrate AI into teaching and learning. This school has developed innovative processes to support academic integrity and foster authentic cogeneration with AI, ensuring that the technology is used ethically and effectively. By creating comprehensive professional development programs for teachers and maintaining transparent communication with students and parents, the school has successfully aligned AI technologies with their existing curricula and assessment frameworks. The session will highlight how AI has enhanced both formative and summative assessments, providing real-time feedback that supports differentiated instruction and fosters a more personalized learning experience. Participants will learn about best practices for managing the integration of AI in high school settings while maintaining a focus on equity and student-centered learning. This presentation aims to equip high school educators with the insights and tools needed to effectively manage the integration of AI in assessment, ultimately improving educational outcomes and preparing students for future success. Methodologies: The research is a case study of a Victorian high school to examine AI integration in assessments, focusing on practical implementation steps, ethical practices, and change management strategies to enhance personalized learning and assessment. Outcomes: This research explores AI integration in high school assessments, focusing on personalized evaluations, ethical use, and change management. A Victorian school case study highlights best practices to enhance assessments and improve student outcomes. Main Contributions: This research contributes by outlining effective AI integration in assessments, showcasing a Victorian school's implementation, and providing best practices for ethical use, change management, and enhancing personalized learning outcomes.Keywords: artificial intelligence, assessment, curriculum design, teaching and learning, ai in education
Procedia PDF Downloads 22980 The Impact of Riparian Alien Plant Removal on Aquatic Invertebrate Communities in the Upper Reaches of Luvuvhu River Catchment, Limpopo Province
Authors: Rifilwe Victor Modiba, Stefan Hendric Foord
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Alien invasive plants (IAP’s) have considerable negative impacts on freshwater habitats and South Africa has implemented an innovative Work for Water (WfW) programme for the systematic removal of these plants aimed at, amongst other objectives, restoring biodiversity and ecosystem services in these threatened habitats. These restoration processes are expensive and have to be evidence-based. In this study in-stream macroinvertebrate and adult Odonata assemblages were used as indicators of restoration success by quantifying the response of biodiversity metrics for these two groups to the removal of IAP’s in a strategic water resource of South Africa that is extensively invaded by invasive alien plants (IAP’s). The study consisted of a replicated design that included 45 sampling units, viz. 15 invaded, 15 uninvaded and 15 cleared sites stratified across the upper reaches of six sub-catchments of the Luvuvhu river catchment, Limpopo Province. Cleared sites were only considered if they received at least two WfW treatments in the last 3 years. The Benthic macroinvertebrate and adult Odonate assemblages in each of these sampling were surveyed from between November and March, 2013/2014 and 2014/2015 respectively. Generalized Linear Models (GLM) with a log link function and Poisson error distribution were done for metrics (invaded, cleared, and uninvaded) whose residuals were not normally distributed or had unequal variance and for abundance. RDA was done for EPTO genera (Ephemeroptera, Plecoptera, Trichoptera and Odonata) and adult Odonata species abundance. GLM was done to for the abundance of Genera and Odonates that had the association with the RDA environmental factors. Sixty four benthic macroinvertebrate families, 57 EPTO genera, and 45 adult Odonata species were recorded across all 45 sampling units. There was no significant difference between the SASS5 total score, ASPT, and family richness of the three invasion classes. Although clearing only had a weak positive effect on the adult Odonate species richness it had a positive impact on DBI scores. These differences were mainly the result of significantly larger DBI scores in the cleared sites as compared to the invaded sites. Results suggest that water quality is positively impacted by repeated clearing pointing to the importance of follow up procedures after initial clearing. Adult Odonate diversity as measured by richness, endemicity, threat and distribution respond positively to all forms of the clearing. The clearing had a significant impact on Odonate assemblage structure but did not affect EPTO structure. Variation partitioning showed that 21.8% of the variation in EPTO assemblage can be explained by spatial and environmental variables, 16% of the variation in Odonate structure was explained by spatial and environmental variables. The response of the diversity metrics to clearing increased in significance at finer taxonomic resolutions, particularly of adult Odonates whose metrics significantly improved with clearing and whose structure responded to both invasion and clearing. The study recommends the use of DBI for surveying river health when hydraulic biotopes are poor.Keywords: DBI, evidence-based conservation, EPTO, macroinvetebrates
Procedia PDF Downloads 186979 Designing of Food Products with Seasoned Plant Components Assigned for Obese and Diabetic Individuals
Authors: A. Gramza-Michałowska, J. Skręty, M. Antczak, J. Kobus-Cisowska, D. Kmiecik, J. Korczak, Kulczyński Bartosz
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Background: Modern consumer highly appreciates the correlation between eating habits and health. Intensified research showed many proofs confirming that food besides its basic nutritional function, possess also significant prophylactic and therapeutic potential. Preventive potential of selected food is commonly used as improvement factor of patients life standard. World Health Organization indicates that diabetes (Diabetes mellitus) and obesity are two of the most common and dangerous diseases. Diet therapy is an element of diabetes education program and a part of healing process, allowing maintaining and remaining the optimal metabolic state of the system. It must be remembered that diabetes treatment should be individualized to each patient. One of highly recommended vegetable for diabetes is asparagus (Asparagus officinalis L.), low calories common plant, growing in European countries. Objective: To propose the technology of unsweetened muesli production with addition of new components, we investigated the effects of selected vegetable addition on antioxidative capacity and consumer’s acceptance of muesli as representative of breakfast product. Methods: Muesli was formulated from a composition of oat flakes, flaxseed, bran, carrots, broccoli and asparagus. Basic composition of muesli was evaluated as content of protein, lipids, fatty acid composition, ash, selected minerals and caloricity. Antioxidant capacity of muesli was evaluated with use radical scavenging methods (DPPH, ABTS), ORAC value and PCL - photochemiluminescence antiradical potential. Proposed muesli as new product was also characterized with sensory analysis, which included color, scent, taste, consistency and overall acceptance of a product. Results: Results showed that addition of freeze-dried asparagus into muesli allowed to lower the fat content and caloricity of a product according to the base product. No significant loss in antioxidant potential was evaluated, also the sensory value of a product was not negative. Conclusion: Designed muesli would be an answer for obese people looking for healthy snack during the daytime. Results showed that product with asparagus addition would be accepted by the consumers and because of its antidiabetic potential could be a n important factor in prevention of diabetes or obesity. Financial support by the UE Project no PO IG 01.01.00.00-061/09Keywords: muesli, vegetables, asparagus, antioxidant potential, lipids
Procedia PDF Downloads 317978 Architecture for Hearing Impaired: A Study on Conducive Learning Environments for Deaf Children with Reference to Sri Lanka
Authors: Champa Gunawardana, Anishka Hettiarachchi
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Conducive Architecture for learning environments is an area of interest for many scholars around the world. Loss of sense of hearing leads to the assumption that deaf students are visual learners. Comprehending favorable non-hearing attributes of architecture can lead to effective, rich and friendly learning environments for hearing impaired. The objective of the current qualitative investigation is to explore the nature and parameters of a sense of place of deaf children to support optimal learning. The investigation was conducted with hearing-impaired children (age: between 8-19, Gender: 15 male and 15 female) of Yashodhara deaf and blind school at Balangoda, Sri Lanka. A sensory ethnography study was adopted to identify the nature of perception and the parameters of most preferred and least preferred spaces of the learning environment. The common perceptions behind most preferred places in the learning environment were found as being calm and quiet, sense of freedom, volumes characterized by openness and spaciousness, sense of safety, wide spaces, privacy and belongingness, less crowded, undisturbed, availability of natural light and ventilation, sense of comfort and the view of green colour in the surroundings. On the other hand, the least preferred spaces were found to be perceived as dark, gloomy, warm, crowded, lack of freedom, smells (bad), unsafe and having glare. Perception of space by deaf considering the hierarchy of sensory modalities involved was identified as; light - color perception (34 %), sight - visual perception (32%), touch - haptic perception (26%), smell - olfactory perception (7%) and sound – auditory perception (1%) respectively. Sense of freedom (32%) and sense of comfort (23%) were the predominant psychological parameters leading to an optimal sense of place perceived by hearing impaired. Privacy (16%), rhythm (14%), belonging (9%) and safety (6%) were found as secondary factors. Open and wide flowing spaces without visual barriers, transparent doors and windows or open port holes to ease their communication, comfortable volumes, naturally ventilated spaces, natural lighting or diffused artificial lighting conditions without glare, sloping walkways, wider stairways, walkways and corridors with ample distance for signing were identified as positive characteristics of the learning environment investigated.Keywords: deaf, visual learning environment, perception, sensory ethnography
Procedia PDF Downloads 230977 Children and Communities Benefit from Mother-Tongue Based Multi-Lingual Education
Authors: Binay Pattanayak
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Multilingual state, Jharkhand is home to more than 19 tribal and regional languages. These are used by more than 33 communities in the state. The state has declared 12 of these languages as official languages of the state. However, schools in the state do not recognize any of these community languages even in early grades! Children, who speak in their mother tongues at home, local market and playground, find it very difficult to understand their teacher and textbooks in school. They fail to acquire basic literacy and numeracy skills in early grades. Out of frustration due to lack of comprehension, the majority of children leave school. Jharkhand sees the highest dropout in early grades in India. To address this, the state under the guidance of the author designed a mother tongue based pre-school education programme named Bhasha Puliya and bilingual picture dictionaries in 9 tribal and regional mother tongues of children. This contributed significantly to children’s school readiness in the school. Followed by this, the state designed a mother-tongue based multilingual education programme (MTB-MLE) for multilingual context. The author guided textbook development in 5 tribal (Santhali, Mundari, Ho, Kurukh and Kharia) and two regional (Odia and Bangla) languages. Teachers and community members were trained for MTB-MLE in around 1,000 schools of the concerned language pockets. Community resource groups were constituted along with their academic calendars in each school to promote story-telling, singing, painting, dancing, riddles, etc. with community support. This, on the one hand, created rich learning environments for children. On the other hand, the communities have discovered a great potential in the process of developing a wide variety of learning materials for children in own mother-tongue using their local stories, songs, riddles, paintings, idioms, skits, etc. as a process of their literary, cultural and technical enrichment. The majority of children are acquiring strong early grade reading skills (basic literacy and numeracy) in grades I-II thereby getting well prepared for higher studies. In a phased manner they are learning Hindi and English after 4-5 years of MTB-MLE using the foundational language learning skills. Community members have started designing new books, audio-visual learning materials in their mother-tongues seeing a great potential for their cultural and technological rejuvenation.Keywords: community resource groups, MTB-MLE, multilingual, socio-linguistic survey, learning
Procedia PDF Downloads 198976 The Ongoing Impact of Secondary Stressors on Businesses in Northern Ireland Affected by Flood Events
Authors: Jill Stephenson, Marie Vaganay, Robert Cameron, Caoimhe McGurk, Neil Hewitt
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Purpose: The key aim of the research was to identify the secondary stressors experienced by businesses affected by single or repeated flooding and to determine to what extent businesses were affected by these stressors, along with any resulting impact on health. Additionally, the research aimed to establish the likelihood of businesses being re-exposed to the secondary stressors through assessing awareness of flood risk, implementation of property protection measures and level of community resilience. Design/methodology/approach: The chosen research method involved the distribution of a questionnaire survey to businesses affected by either single or repeated flood events. The questionnaire included the Impact of Event Scale (a 15-item self-report measure which assesses subjective distress caused by traumatic events). Findings: 55 completed questionnaires were returned by flood impacted businesses. 89% of the businesses had sustained internal flooding while 11% had experienced external flooding. The results established that the key secondary stressors experienced by businesses, in order of priority, were: flood damage, fear of reoccurring flooding, prevention of access to the premise/closure, loss of income, repair works, length of closure and insurance issues. There was a lack of preparedness for potential future floods and consequent vulnerability to the emergence of secondary stressors among flood affected businesses, as flood resistance or flood resilience measures had only been implemented by 11% and 13% respectively. In relation to the psychological repercussions, the Impact of Event scores suggested that potential prevalence of post-traumatic stress disorder (PTSD) was noted among 8 out of 55 respondents (l5%). Originality/value: The results improve understanding of the enduring repercussions of flood events on businesses, indicating that not only residents may be susceptible to the detrimental health impacts of flood events and single flood events may be just as likely as reoccurring flooding to contribute to ongoing stress. Lack of financial resources is a possible explanation for the lack of implementation of property protection measures among businesses, despite 49% experiencing flooding on multiple occasions. Therefore it is recommended that policymakers should consider potential sources of financial support or grants towards flood defences for flood impacted businesses. Any form of assistance should be made available to businesses at the earliest opportunity as there was no significant association between the time of the last flood event and the likelihood of experiencing PTSD symptoms.Keywords: flood event, flood resilience, flood resistance, PTSD, secondary stressors
Procedia PDF Downloads 430975 An Efficient and Low Cost Protocol for Rapid and Mass in vitro Propagation of Hyssopus officinalis L.
Authors: Ira V. Stancheva, Ely G. Zayova, Maria P. Geneva, Marieta G. Hristozkova, Lyudmila I. Dimitrova, Maria I. Petrova
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The study describes a highly efficient and low-cost protocol for rapid and mass in vitro propagation of medicinal and aromatic plant species (Hyssopus officinalis L., Lamiaceae). Hyssop is an important aromatic herb used for its medicinal values because of its antioxidant, anti-inflammatory and antimicrobial properties. The protocol for large-scale multiplication of this aromatic plant was developed using young stem tips explants. The explants were sterilized with 0.04% mercuric chloride (HgCl₂) solution for 20 minutes and washing three times with sterile distilled water in 15 minutes. The cultural media was full and half strength Murashige and Skoog medium containing indole-3-butyric acid. Full and ½ Murashige and Skoog media without auxin were used as controls. For each variant 20 glass tubes with two plants were used. In each tube two tip and nodal explants were inoculated. Maximum shoot and root number were obtained on ½ Murashige and Skoog medium supplemented with 0.1 mg L-1 indole-3-butyric acid at the same time after four weeks of culture. The number of shoots per explant and shoot height were considered. The data on rooting percentage, the number of roots per plant and root length were collected after the same cultural period. The highest percentage of survival 85% for this medicinal plant was recorded in mixture of soil, sand and perlite (2:1:1 v/v/v). This mixture was most suitable for acclimatization of all propagated plants. Ex vitro acclimatization was carried out at 24±1 °C and 70% relative humidity under 16 h illuminations (50 μmol m⁻²s⁻¹). After adaptation period, the all plants were transferred to the field. The plants flowered within three months after transplantation. Phenotypic variations in the acclimatized plants were not observed. An average of 90% of the acclimatized plants survived after transferring into the field. All the in vitro propagated plants displayed normal development under the field conditions. Developed in vitro techniques could provide a promising alternative tool for large-scale propagation that increases the number of homologous plants for field cultivation. Acknowledgments: This study was conducted with financial support from National Science Fund at the Bulgarian Ministry of Education and Science, Project DN06/7 17.12.16.Keywords: Hyssopus officinalis L., in vitro culture, micro propagation, acclimatization
Procedia PDF Downloads 312974 Exploring the Cultural Values of Nursing Personnel Utilizing Hofstede's Cultural Dimensions
Authors: Ma Chu Jui
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Culture plays a pivotal role in shaping societal responses to change and fostering adaptability. In the realm of healthcare provision, hospitals serve as dynamic settings molded by the cultural consciousness of healthcare professionals. This intricate interplay extends to their expectations of leadership, communication styles, and attitudes towards patient care. Recognizing the cultural inclinations of healthcare professionals becomes imperative in navigating this complex landscape. This study will utilize Hofstede's Value Survey Module 2013 (VSM 2013) as a comprehensive analytical tool. The targeted participants for this research are in-service nursing professionals with a tenure of at least three months, specifically employed in the nursing department of an Eastern hospital. This quantitative approach seeks to quantify diverse cultural tendencies among the targeted nursing professionals, elucidating not only abstract cultural concepts but also revealing their cultural inclinations across different dimensions. The study anticipates gathering between 400 to 500 responses, ensuring a robust dataset for a comprehensive analysis. The focused approach on nursing professionals within the Eastern hospital setting enhances the relevance and specificity of the cultural insights obtained. The research aims to contribute valuable knowledge to the understanding of cultural tendencies among in-service nursing personnel in the nursing department of this specific Eastern hospital. The VSM 2013 will be initially distributed to this specific group to collect responses, aiming to calculate scores on each of Hofstede's six cultural dimensions—Power Distance Index (PDI), Individualism vs. Collectivism (IDV), Uncertainty Avoidance Index (UAI), Masculinity vs. Femininity (MAS), Long-Term Orientation vs. Short-Term Normative Orientation (LTO), and Indulgence vs. Restraint (IVR). the study unveils a significant correlation between different cultural dimensions and healthcare professionals' tendencies in understanding leadership expectations through PDI, grasping behavioral patterns via IDV, acknowledging risk acceptance through UAI, and understanding their long-term and short-term behaviors through LTO. These tendencies extend to communication styles and attitudes towards patient care. These findings provide valuable insights into the nuanced interconnections between cultural factors and healthcare practices. Through a detailed analysis of the varying levels of these cultural dimensions, we gain a comprehensive understanding of the predominant inclinations among the majority of healthcare professionals. This nuanced perspective adds depth to our comprehension of how cultural values shape their approach to leadership, communication, and patient care, contributing to a more holistic understanding of the healthcare landscape. A profound comprehension of the cultural paradigms embraced by healthcare professionals holds transformative potential. Beyond a mere understanding, it acts as a catalyst for elevating the caliber of healthcare services. This heightened awareness fosters cohesive collaboration among healthcare teams, paving the way for the establishment of a unified healthcare ethos. By cultivating shared values, our study envisions a healthcare environment characterized by enhanced quality, improved teamwork, and ultimately, a more favorable and patient-centric healthcare landscape. In essence, our research underscores the critical role of cultural awareness in shaping the future of healthcare delivery.Keywords: hofstede's cultural, cultural dimensions, cultural values in healthcare, cultural awareness in nursing
Procedia PDF Downloads 65973 Risks and Values in Adult Safeguarding: An Examination of How Social Workers Screen Safeguarding Referrals from Residential Homes
Authors: Jeremy Dixon
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Safeguarding adults forms a core part of social work practice. The Government in England and Wales has made efforts to standardise practices through The Care Act 2014. The Act states that local authorities have duties to make inquiries in cases where an adult with care or support needs is experiencing or at risk of abuse and is unable to protect themselves from abuse or neglect. Despite the importance given to safeguarding adults within law there remains little research about how social workers conduct such decisions on the ground. This presentation reports on findings from a pilot research study conducted within two social work teams in a Local Authority in England. The objective of the project was to find out how social workers interpreted safeguarding duties as laid out by The Care Act 2014 with a particular focus on how workers assessed and managed risk. Ethnographic research methods were used throughout the project. This paper focusses specifically on decisions made by workers in the assessment team. The paper reports on qualitative observation and interviews with five workers within this team. Drawing on governmentality theory, this paper analyses the techniques used by workers to manage risk from a distance. A high proportion of safeguarding referrals came from care workers or managers in residential care homes. Social workers conducting safeguarding assessments were aware that they had a duty to work in partnership with these agencies. However, their duty to safeguard adults also meant that they needed to view them as potential abusers. In making judgments about when it was proportionate to refer for a safeguarding assessment workers drew on a number of common beliefs about residential care workers which were then tested in conversations with them. Social workers held the belief that residential homes acted defensively, leading them to report any accident or danger. Social workers therefore encouraged residential workers to consider whether statutory criteria had been met and to use their own procedures to manage risk. In addition social workers carried out an assessment of the workers’ motives; specifically whether they were using safeguarding procedures as a shortcut for avoiding other assessments or as a means of accessing extra resources. Where potential abuse was identified social workers encouraged residential homes to use disciplinary policies as a means of isolating and managing risk. The study has implications for understanding risk within social work practice. It shows that whilst social workers use law to govern individuals, these laws are interpreted against cultural values. Additionally they also draw on assumptions about the culture of others.Keywords: adult safeguarding, governmentality, risk, risk assessment
Procedia PDF Downloads 289972 South African Breast Cancer Mutation Spectrum: Pitfalls to Copy Number Variation Detection Using Internationally Designed Multiplex Ligation-Dependent Probe Amplification and Next Generation Sequencing Panels
Authors: Jaco Oosthuizen, Nerina C. Van Der Merwe
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The National Health Laboratory Services in Bloemfontien has been the diagnostic testing facility for 1830 patients for familial breast cancer since 1997. From the cohort, 540 were comprehensively screened using High-Resolution Melting Analysis or Next Generation Sequencing for the presence of point mutations and/or indels. Approximately 90% of these patients stil remain undiagnosed as they are BRCA1/2 negative. Multiplex ligation-dependent probe amplification was initially added to screen for copy number variation detection, but with the introduction of next generation sequencing in 2017, was substituted and is currently used as a confirmation assay. The aim was to investigate the viability of utilizing internationally designed copy number variation detection assays based on mostly European/Caucasian genomic data for use within a South African context. The multiplex ligation-dependent probe amplification technique is based on the hybridization and subsequent ligation of multiple probes to a targeted exon. The ligated probes are amplified using conventional polymerase chain reaction, followed by fragment analysis by means of capillary electrophoresis. The experimental design of the assay was performed according to the guidelines of MRC-Holland. For BRCA1 (P002-D1) and BRCA2 (P045-B3), both multiplex assays were validated, and results were confirmed using a secondary probe set for each gene. The next generation sequencing technique is based on target amplification via multiplex polymerase chain reaction, where after the amplicons are sequenced parallel on a semiconductor chip. Amplified read counts are visualized as relative copy numbers to determine the median of the absolute values of all pairwise differences. Various experimental parameters such as DNA quality, quantity, and signal intensity or read depth were verified using positive and negative patients previously tested internationally. DNA quality and quantity proved to be the critical factors during the verification of both assays. The quantity influenced the relative copy number frequency directly whereas the quality of the DNA and its salt concentration influenced denaturation consistency in both assays. Multiplex ligation-dependent probe amplification produced false positives due to ligation failure when ligation was inhibited due to a variant present within the ligation site. Next generation sequencing produced false positives due to read dropout when primer sequences did not meet optimal multiplex binding kinetics due to population variants in the primer binding site. The analytical sensitivity and specificity for the South African population have been proven. Verification resulted in repeatable reactions with regards to the detection of relative copy number differences. Both multiplex ligation-dependent probe amplification and next generation sequencing multiplex panels need to be optimized to accommodate South African polymorphisms present within the genetically diverse ethnic groups to reduce the false copy number variation positive rate and increase performance efficiency.Keywords: familial breast cancer, multiplex ligation-dependent probe amplification, next generation sequencing, South Africa
Procedia PDF Downloads 231971 Internal Family Systems Parts-Work: A Revolutionary Approach to Reducing Suicide Lethality
Authors: Bill D. Geis
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Even with significantly increased spending, suicide rates continue to climb—with alarming increases among traditionally low-risk groups. This has caused clinicians and researchers to call for a complete rethinking of all assumptions about suicide prevention, assessment, and intervention. A form of therapy--Internal Family Systems Therapy--affords tremendous promise in sustained diminishment of lethal suicide risk. Though a form of therapy that is most familiar to trauma therapists, Internal Family Systems Therapy, involving direct work with suicidal parts, is a promising therapy for meaningful and sustained reduction in suicide deaths. Developed by Richard Schwartz, Internal Family Systems Therapy proposes that we are all influenced greatly by internal parts, frozen by development adversities, and these often-contradictory parts contribute invisibly to mood, distress, and behavior. In making research videos of patients from our database and discussing their suicide attempts, it is clear that many persons who attempt suicide are in altered states at the time of their attempt and influenced by factors other than conscious intent. Suicide intervention using this therapy involves direct work with suicidal parts and other interacting parts that generate distress and despair. Internal Family Systems theory posits that deep experiences of pain, fear, aloneness, and distress are defended by a range of different parts that attempt to contain these experiences of pain through various internal activities that unwittingly push forward inhibition, fear, self-doubt, hopelessness, desires to cut and engage in destructive behavior, addictive behavior, and even suicidal actions. These suicidal parts are often created (and “frozen”) at young ages, and these very young parts do not understand the consequences of this influence. Experience suggests that suicidal parts can create impulsive risk behind the scenes when pain is high and emotional support reduced—with significant crisis potential. This understanding of latent suicide risk is consistent with many of our video accounts of serious suicidal acts—compiled in a database of 1104 subjects. Since 2016, consent has been obtained and records kept of 23 highly suicidal patients, with initial Intention-to-Die ratings (0= no intent, 10 = conviction to die) between 5 and 10. In 67% of these cases using IFST parts-work intervention, these highly suicidal patients’ risk was reduced to 0-1, and 83% of cases were reduced to 4 or lower. There were no suicide deaths. Case illustrations will be offered.Keywords: suicide, internal family systems therapy, crisis management, suicide prevention
Procedia PDF Downloads 42970 Real Estate Trend Prediction with Artificial Intelligence Techniques
Authors: Sophia Liang Zhou
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For investors, businesses, consumers, and governments, an accurate assessment of future housing prices is crucial to critical decisions in resource allocation, policy formation, and investment strategies. Previous studies are contradictory about macroeconomic determinants of housing price and largely focused on one or two areas using point prediction. This study aims to develop data-driven models to accurately predict future housing market trends in different markets. This work studied five different metropolitan areas representing different market trends and compared three-time lagging situations: no lag, 6-month lag, and 12-month lag. Linear regression (LR), random forest (RF), and artificial neural network (ANN) were employed to model the real estate price using datasets with S&P/Case-Shiller home price index and 12 demographic and macroeconomic features, such as gross domestic product (GDP), resident population, personal income, etc. in five metropolitan areas: Boston, Dallas, New York, Chicago, and San Francisco. The data from March 2005 to December 2018 were collected from the Federal Reserve Bank, FBI, and Freddie Mac. In the original data, some factors are monthly, some quarterly, and some yearly. Thus, two methods to compensate missing values, backfill or interpolation, were compared. The models were evaluated by accuracy, mean absolute error, and root mean square error. The LR and ANN models outperformed the RF model due to RF’s inherent limitations. Both ANN and LR methods generated predictive models with high accuracy ( > 95%). It was found that personal income, GDP, population, and measures of debt consistently appeared as the most important factors. It also showed that technique to compensate missing values in the dataset and implementation of time lag can have a significant influence on the model performance and require further investigation. The best performing models varied for each area, but the backfilled 12-month lag LR models and the interpolated no lag ANN models showed the best stable performance overall, with accuracies > 95% for each city. This study reveals the influence of input variables in different markets. It also provides evidence to support future studies to identify the optimal time lag and data imputing methods for establishing accurate predictive models.Keywords: linear regression, random forest, artificial neural network, real estate price prediction
Procedia PDF Downloads 103969 [Keynote Talk]: Monitoring of Ultrafine Particle Number and Size Distribution at One Urban Background Site in Leicester
Authors: Sarkawt M. Hama, Paul S. Monks, Rebecca L. Cordell
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Within the Joaquin project, ultrafine particles (UFP) are continuously measured at one urban background site in Leicester. The main aims are to examine the temporal and seasonal variations in UFP number concentration and size distribution in an urban environment, and to try to assess the added value of continuous UFP measurements. In addition, relations of UFP with more commonly monitored pollutants such as black carbon (BC), nitrogen oxides (NOX), particulate matter (PM2.5), and the lung deposited surface area(LDSA) were evaluated. The effects of meteorological conditions, particularly wind speed and direction, and also temperature on the observed distribution of ultrafine particles will be detailed. The study presents the results from an experimental investigation into the particle number concentration size distribution of UFP, BC, and NOX with measurements taken at the Automatic Urban and Rural Network (AURN) monitoring site in Leicester. The monitoring was performed as part of the EU project JOAQUIN (Joint Air Quality Initiative) supported by the INTERREG IVB NWE program. The total number concentrations (TNC) were measured by a water-based condensation particle counter (W-CPC) (TSI model 3783), the particle number concentrations (PNC) and size distributions were measured by an ultrafine particle monitor (UFP TSI model 3031), the BC by MAAP (Thermo-5012), the NOX by NO-NO2-NOx monitor (Thermos Scientific 42i), and a Nanoparticle Surface Area Monitor (NSAM, TSI 3550) was used to measure the LDSA (reported as μm2 cm−3) corresponding to the alveolar region of the lung between November 2013 and November 2015. The average concentrations of particle number concentrations were observed in summer with lower absolute values of PNC than in winter might be related mainly to particles directly emitted by traffic and to the more favorable conditions of atmospheric dispersion. Results showed a traffic-related diurnal variation of UFP, BC, NOX and LDSA with clear morning and evening rush hour peaks on weekdays, only an evening peak at the weekends. Correlation coefficients were calculated between UFP and other pollutants (BC and NOX). The highest correlation between them was found in winter months. Overall, the results support the notion that local traffic emissions were a major contributor of the atmospheric particles pollution and a clear seasonal pattern was found, with higher values during the cold season.Keywords: size distribution, traffic emissions, UFP, urban area
Procedia PDF Downloads 330968 Bank Internal Controls and Credit Risk in Europe: A Quantitative Measurement Approach
Authors: Ellis Kofi Akwaa-Sekyi, Jordi Moreno Gené
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Managerial actions which negatively profile banks and impair corporate reputation are addressed through effective internal control systems. Disregard for acceptable standards and procedures for granting credit have affected bank loan portfolios and could be cited for the crises in some European countries. The study intends to determine the effectiveness of internal control systems, investigate whether perceived agency problems exist on the part of board members and to establish the relationship between internal controls and credit risk among listed banks in the European Union. Drawing theoretical support from the behavioural compliance and agency theories, about seventeen internal control variables (drawn from the revised COSO framework), bank-specific, country, stock market and macro-economic variables will be involved in the study. A purely quantitative approach will be employed to model internal control variables covering the control environment, risk management, control activities, information and communication and monitoring. Panel data from 2005-2014 on listed banks from 28 European Union countries will be used for the study. Hypotheses will be tested and the Generalized Least Squares (GLS) regression will be run to establish the relationship between dependent and independent variables. The Hausman test will be used to select whether random or fixed effect model will be used. It is expected that listed banks will have sound internal control systems but their effectiveness cannot be confirmed. A perceived agency problem on the part of the board of directors is expected to be confirmed. The study expects significant effect of internal controls on credit risk. The study will uncover another perspective of internal controls as not only an operational risk issue but credit risk too. Banks will be cautious that observing effective internal control systems is an ethical and socially responsible act since the collapse (crisis) of financial institutions as a result of excessive default is a major contagion. This study deviates from the usual primary data approach to measuring internal control variables and rather models internal control variables in a quantitative approach for the panel data. Thus a grey area in approaching the revised COSO framework for internal controls is opened for further research. Most bank failures and crises could be averted if effective internal control systems are religiously adhered to.Keywords: agency theory, credit risk, internal controls, revised COSO framework
Procedia PDF Downloads 317967 Generation Z: Insights into Travel Behavior
Authors: Joao Ferreira Do Rosario, Nuno Gustavo, Ana Machado, Lurdes Calisto, Luisa Carvalho, Georgette Andraz
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Currently, tourism small and medium enterprises (TSMEs) face serious economic and financial problems, making recovery efforts difficult. How the pandemic will affect tourists' behavior is still to be known. Will tourists be even more cautious regarding their choices or, on the contrary, will they be more adventurers with an enormous desire to travel in search of the lost freedom? Tourists may become even more demanding when traveling, more austere, or less concerned and eager to socialize. Adjusting to this "new tourist" is an added challenge for tourism service providers. Generation Z made up of individuals born in 1995 and following years, currently tends to assume a particular role and meaning in the present and future economic and social context, considering that we are facing the youngest workforce as well as tomorrow's consumers. This generation is distinguished from others as it is the first generation to combine a high level of education and technological knowledge and to fully experience the digital world. These young people are framed by a new value system that can explain new behaviours and consumption, namely, in the context of tourism. All these considerations point to the importance of investigating this target group as it is essential to understand how these individuals perceive, understand, act, and can be involved in a new environment built around a society regulated by new priorities and challenges of a sustainable nature. This leads not only to a focus on short-term market choices but mainly to predict future choices from a longer-term perspective. Together with the social background of a person, values are considered a stable antecedent of behavior and might therefore predict not just immediate, but also future choices. Furthermore, the meaning attributed to travel has a general connotation and goes beyond a specific travel choice or experience. In other words, values and travel's meaning form a chain of influences on the present and future travel behavior. This study explores the social background and values of Generation Z travelers vs the meaning these tourists give to travel. The aim is to discover in their present behavior cues to predict travel choices so that the future of tourism can be secured. This study also provides data for predicting the tourism choices of youngsters in the more immediate future. Methodologically, a quantitative approach was adopted based on the collection of data through a survey. Since academic research on Generation Z of tourists is still scarce, it is expected to contribute to deepening scientific knowledge in this area. Furthermore, it is expected that this research will support tourism professionals in defining differentiated marketing strategies and adapted to the requirements of this target, in a new time.Keywords: Generation Z, travel behavior, travel meaning, Generation Z Values
Procedia PDF Downloads 224966 Temporal Delays along the Neurosurgical Care Continuum for Traumatic Brain Injury Patients in Mulago Hospital in Kampala Uganda
Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo N. Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund
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Background: While delays to care exist in resource rich settings, greater delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of traumatic brain injury (TBI) in Sub Saharan Africa (SSA). While many LMICs have government subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold. First, due to a lack of a functional CT scanner at the tertiary hospital, patients need to arrange their own transportation to the nearby private facility for CT scans. Second, self-financing for the private CT scans ranges from $80 - $130, which is near the average monthly income in Kampala. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified ‘three delays’ framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury
Procedia PDF Downloads 347965 Post-Traumatic Stress Disorder and Problem Alcohol Use in Women: Systematic Analysis
Authors: Neringa Bagdonaite
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Study Aims: The current study aimed to systematically analyse various research done in the area of female post-traumatic stress disorder (PTSD) and alcohol abuse, and to critically review these results on the basis of theoretical models as well as answer following questions: (I) What is the reciprocal relationship between PTSD and problem alcohol use among females; (II) What are the moderating/mediating factors of this relationship? Methods: The computer bibliographic databases Ebsco, Scopus, Springer, Web of Science, Medline, Science Direct were used to search for scientific articles. Systematic analyses sample consisted of peer-reviewed, English written articles addressing mixed gender and female PTSD and alcohol abuse issues from Jan 2012 to May 2017. Results: Total of 1011 articles were found in scientific databases related to searched keywords of which 29 met the selection criteria and were analysed. The results of longitudinal studies indicate that (I) various trauma, especially interpersonal trauma exposure in childhood is linked with increased risk of revictimization in later life and problem alcohol use; (II) revictimization in adolescence or adulthood, rather than victimization in childhood has a greater impact on the onset and progression of problematic alcohol use in adulthood. Cross-sectional and epidemiological studies also support significant relationships between female PTSD and problem alcohol use. Regards to the negative impact of alcohol use on PTSD symptoms results are yet controversial; some evidence suggests that alcohol does not exacerbate symptoms of PTSD over time, while others argue that problem alcohol use worsens PTSD symptoms and is linked to chronicity of both disorders, especially among women with previous alcohol use problems. Analysis of moderating/mediating factors of PTSD and problem alcohol use revealed, that higher motives/expectancies, specifically distress coping motives for alcohol use significantly moderates the relationship between PTSD and problematic alcohol use. Whereas negative affective states mediate relationship between symptoms of PTSD and alcohol use, but only among woman with alcohol use problems already developed. Conclusions: Interpersonal trauma experience, especially in childhood and its reappearance in lifetime is linked with PTSD symptoms and problem drinking among women. Moreover, problem alcohol use can be both a cause and a consequence of trauma and PTSD, and if used for coping it, increases the likelihood of chronicity of both disorders. In order to effectively treat both disorders, it’s worthwhile taking into account this dynamic interplay of women's PTSD symptoms and problem drinking.Keywords: female, trauma, post-traumatic stress disorder, problem alcohol use, systemic analysis
Procedia PDF Downloads 183964 Use of Geoinformatics and Mathematical Equations to Assess Erosion and Soil Fertility in Cassava Growing Areas in Maha Sarakham Province, Thailand
Authors: Sasirin Srisomkiew, Sireewan Ratsadornasai, Tanomkwan Tipvong, Isariya Meesing
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Cassava is an important food source in the tropics and has recently gained attention as a potential source of biofuel that can replace limited fossil fuel sources. As a result, the demand for cassava production to support industries both within the country and abroad has increased. In Thailand, most farmers prefer to grow cassava in sandy and sandy loam areas where the soil has low natural fertility. Cassava is a tuber plant that has large roots to store food, resulting in the absorption of large amounts of nutrients from the soil, such as nitrogen, phosphorus, and potassium. Therefore, planting cassava in the same area for a long period causes soil erosion and decreases soil fertility. The loss of soil fertility affects the economy, society, and food and energy security of the country. Therefore, it is necessary to know the level of soil fertility and the amount of nutrients in the soil. To address this problem, this study applies geo-informatics technology and mathematical equations to assess erosion and soil fertility and to analyze factors affecting the amount of cassava production in Maha Sarakham Province. The results show that the area for cassava cultivation has increased in every district of Maha Sarakham Province between 2015-2022, with the total area increasing to 180,922 rai or 5.47% of the province’s total area during this period. Furthermore, it was found that it is possible to assess areas with soil erosion problems that had a moderate level of erosion in areas with high erosion rates ranging from 5-15 T/rai/year. Soil fertility assessment and information obtained from the soil nutrient map for 2015–2023 reveal that farmers in the area have improved the soil by adding chemical fertilizers along with organic fertilizers, such as manure and green manure, to increase the amount of nutrients in the soil. This is because the soil resources of Maha Sarakham Province mostly have relatively low agricultural potential due to the soil texture being sand and sandy loam. In this scenario, the ability to absorb nutrients is low, and the soil holds little water, so it is naturally low in fertility. Moreover, agricultural soil problems were found, including the presence of saline soil, sandy soil, and acidic soil, which is a serious restriction on land use because it affects the release of nutrients into the soil. The results of this study may be used as a guideline for managing soil resources and improving soil quality to prevent soil degradation problems that may occur in the future.Keywords: Cassava, geoinformatics, soil erosion, soil fertility, land use change
Procedia PDF Downloads 52963 Deployment of Armed Soldiers in European Cities as a Source of Insecurity among Czech Population
Authors: Blanka Havlickova
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In the last ten years, there are growing numbers of troops with machine guns serving on streets of European cities. We can see them around government buildings, major transport hubs, synagogues, galleries and main tourist landmarks. As the main purpose of armed soldier’s presence in European cities authorities declare the prevention of terrorist attacks and psychological support for tourists and domestic population. The main objective of the following study is to find out whether the deployment of armed soldiers in European cities has a calming and reassuring effect on Czech citizens (if the presence at armed soldiers make the Czech population feel more secure) or rather becomes a stress factor (the presence of soldiers standing guard in full military fatigues recalls serious criminality and terrorist attacks which are reflected in the fears and insecurity of Czech population). The initial hypothesis of this study is connected with the priming theory, the idea that when we are exposed to an image (armed soldier), it makes us unconsciously focus on a topic connected with this image (terrorism). This paper is based on a quantitative public survey, which was carried out in the form of electronic questioning among the citizens of the Czech Republic. Respondents answered 14 questions about two European cities – London and Paris. Besides general questions investigating the respondents' awareness of these cities, some of the questions focused on the fear that the respondents had when picturing themselves leaving next Monday for the given city (London or Paris). The questions asking about respondent´s travel fears and concerns were accompanied by different photos. When answering the question about fear some respondents have been presented with a photo of Westminster Palace and the Eiffel with ordinary citizens while other respondents have been presented with a picture of the Westminster Palace, the and Eiffel's tower not only with ordinary citizens, but also with one soldier holding a machine gun. The main goal of this paper is to analyse and compare data about concerns for these two groups of respondents (presented with different pictures) and find out if and how an armed soldier with a machine gun in front of the Westminster Palace or the Eiffel Tower affects the public's concerns about visiting the site. In other words, the aim of this paper is to confirm or rebut the hypothesis that the look at a soldier with a machine gun in front of the Eiffel Tower or the Westminster Palace automatically triggers the association with a terrorist attack leading to an increase in fear and insecurity among Czech population.Keywords: terrorism, security measures, priming, risk perception
Procedia PDF Downloads 250962 Development of a Bi-National Thyroid Cancer Clinical Quality Registry
Authors: Liane J. Ioannou, Jonathan Serpell, Joanne Dean, Cino Bendinelli, Jenny Gough, Dean Lisewski, Julie Miller, Win Meyer-Rochow, Stan Sidhu, Duncan Topliss, David Walters, John Zalcberg, Susannah Ahern
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Background: The occurrence of thyroid cancer is increasing throughout the developed world, including Australia and New Zealand, and since the 1990s has become the fastest increasing malignancy. Following the success of a number of institutional databases that monitor outcomes after thyroid surgery, the Australian and New Zealand Endocrine Surgeons (ANZES) agreed to auspice the development of a bi-national thyroid cancer registry. Objectives: To establish a bi-national population-based clinical quality registry with the aim of monitoring and improving the quality of care provided to patients diagnosed with thyroid cancer in Australia and New Zealand. Patients and Methods: The Australian and New Zealand Thyroid Cancer Registry (ANZTCR) captures clinical data for all patients, over the age of 18 years, diagnosed with thyroid cancer, confirmed by histopathology report, that have been diagnosed, assessed or treated at a contributing hospital. Data is collected by endocrine surgeons using a web-based interface, REDCap, primarily via direct data entry. Results: A multi-disciplinary Steering Committee was formed, and with operational support from Monash University the ANZTCR was established in early 2017. The pilot phase of the registry is currently operating in Victoria, New South Wales, Queensland, Western Australia and South Australia, with over 30 sites expected to come on board across Australia and New Zealand in 2018. A modified-Delphi process was undertaken to determine the key quality indicators to be reported by the registry, and a minimum dataset was developed comprising information regarding thyroid cancer diagnosis, pathology, surgery, and 30-day follow up. Conclusion: There are very few established thyroid cancer registries internationally, yet clinical quality registries have shown valuable outcomes and patient benefits in other cancers. The establishment of the ANZTCR provides the opportunity for Australia and New Zealand to further understand the current practice in the treatment of thyroid cancer and reasons for variation in outcomes. The engagement of endocrine surgeons in supporting this initiative is crucial. While the pilot registry has a focus on early clinical outcomes, it is anticipated that future collection of longer-term outcome data particularly for patients with the poor prognostic disease will add significant further value to the registry.Keywords: thyroid cancer, clinical registry, population health, quality improvement
Procedia PDF Downloads 193961 School Refusal Behaviours: The Roles of Adolescent and Parental Factors
Authors: Junwen Chen, Celina Feleppa, Tingyue Sun, Satoko Sasagawa, Michael Smithson
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School refusal behaviours refer to behaviours to avoid school attendance, chronic lateness in arriving at school, or regular early dismissal. Poor attendance in schools is highly correlated with anxiety, depression, suicide attempts, delinquency, violence, and substance use and abuse. Poor attendance is also a strong indicator of lower achievement in school, as well as problematic social-emotional development. Long-term consequences of school refusal behaviours include fewer opportunities for higher education, employment, and social difficulties, and high risks of later psychiatric illness. Given its negative impacts on youth educational outcomes and well-being, a thorough understanding of factors that are involved in the development of this phenomenon is warranted for developing effective management approaches. This study investigated parental and adolescent factors that may contribute to school refusal behaviours by specifically focusing on the role of parental and adolescents’ anxiety and depression, emotion dysregulation, and parental rearing style. Findings are expected to inform the identification of both parental and adolescents’ factors that may contribute to school refusal behaviours. This knowledge will enable novel and effective approaches that incorporate these factors to managing school refusal behaviours in adolescents, which in turn improve their school and daily functioning. Results are important for an integrative understanding of school refusal behaviours. Furthermore, findings will also provide information for policymakers to weigh the benefits of interventions targeting school refusal behaviours in adolescents. One-hundred-and-six adolescents aged 12-18 years (mean age = 14.79 years old, SD = 1.78, males = 44) and their parents (mean age = 47.49 years old, SD = 5.61, males = 27) completed an online questionnaire measuring both parental and adolescents’ anxiety, depression, emotion dysregulation, parental rearing styles, and adolescents’ school refusal behaviours. Adolescents with school refusal behaviours reported greater anxiety and depression, with their parents showing greater emotion dysregulation. Parental emotion dysregulation and adolescents’ anxiety and depression predicted school refusal behaviours independently. To date, only limited studies have investigated the interplay between parental and youth factors in relation to youth school refusal behaviours. Although parental emotion dysregulation has been investigated in relation to youth emotion dysregulation, little is known about its role in the context of school refusal. This study is one of the very few that investigated both parental and adolescent factors in relation to school refusal behaviours in adolescents. The findings support the theoretical models that emphasise the role of youth and parental psychopathology in school refusal behaviours. Future management of school refusal behaviours should target adolescents’ anxiety and depression while incorporating training for parental emotion regulation skills.Keywords: adolescents, school refusal behaviors, parental factors, anxiety and depression, emotion dysregulation
Procedia PDF Downloads 128960 Adverse Childhood Experience of Domestic Violence and Domestic Mental Health Leading to Youth Violence: An Analysis of Selected Boroughs in London
Authors: Sandra Smart-Akande, Chaminda Hewage, Imtiaz Khan, Thanuja Mallikarachchi
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According to UK police-recorded data, there has been a substantial increase in knife-related crime and youth violence in the UK since 2014 particularly in the London boroughs. These crime rates are disproportionally distributed across London with the majority of these crimes occurring in the highly deprived areas of London and among young people aged 11 to 24 with large discrepancies across ethnicity, age, gender and borough of residence. Comprehensive studies and literature have identified risk factors associated with a knife carrying among youth to be Adverse Childhood Experience (ACEs), poor mental health, school or social exclusion, drug dealing, drug using, victim of violent crime, bullying, peer pressure or gang involvement, just to mention a few. ACEs are potentially traumatic events that occur in childhood, this can be experiences or stressful events in the early life of a child and can lead to an increased risk of damaging health or social outcomes in the latter life of the individual. Research has shown that children or youths involved in youth violence have had childhood experience characterised by disproportionate adverse childhood experiences and substantial literature link ACEs to be associated with criminal or delinquent behavior. ACEs are commonly grouped by researchers into: Abuse (Physical, Verbal, Sexual), Neglect (Physical, Emotional) and Household adversities (Mental Illness, Incarcerated relative, Domestic violence, Parental Separation or Bereavement). To the author's best knowledge, no study to date has investigated how household mental health (mental health of a parent or mental health of a child) and domestic violence (domestic violence on a parent or domestic violence on a child) is related to knife homicides across the local authorities areas of London. This study seeks to address the gap by examining a large sample of data from the London Metropolitan Police Force and Characteristics of Children in Need data from the UK Department for Education. The aim of this review is to identify and synthesise evidence from data and a range of literature to identify the relationship between adverse childhood experiences and youth violence in the UK. Understanding the link between ACEs and future outcomes can support preventative action.Keywords: adverse childhood experiences, domestic violence, mental health, youth violence, prediction analysis, London knife crime
Procedia PDF Downloads 120959 Impact of Natural and Artificial Disasters, Lackadaisical and Semantic Approach in Risk Management, and Mitigation Implication for Sustainable Goals in Nigeria, from 2009 to 2022
Authors: Wisdom Robert Duruji, Moses Kanayochukwu Ifoh, Efeoghene Edward Esiemunobo
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This study examines the impact of natural and artificial disasters, lackadaisical and semantic approach in risk management, and mitigation implication for sustainable development goals in Nigeria, from 2009 to 2022. The study utilizes a range of research methods to achieve its objectives. These include literature review, website knowledge, Google search, news media information, academic journals, field-work and on-site observations. These diverse methods allow for a comprehensive analysis on the impact and the implications being study. The study finds that paradigm shift from remediating seismic, flooding, environmental pollution and degradation natural disasters by Nigeria Emergency Management Agency (NEMA), to political and charity organization; has plunged risk reduction strategies to embezzling opportunities. However, this lackadaisical and semantic approach in natural disaster mitigation, invariably replicates artificial disasters in Nigeria through: Boko Haram terrorist organization, Fulani herdsmen and farmers conflicts, political violence, kidnapping for ransom, ethnic conflicts, Religious dichotomy, insurgency, secession protagonists, unknown-gun-men, and banditry. This study also, finds that some Africans still engage in self-imposed slavery through human trafficking, by nefariously stow-away to Europe; through Libya, Sahara desert and Mediterranean sea; in search for job opportunities, due to ineptitude in governance by their leaders; a perilous journey that enhanced artificial disasters in Nigeria. That artificial disaster fatality in Nigeria increased from about 5,655 in 2009 to 114,318 in 2018; and to 157,643 in 2022. However, financial and material loss of about $9.29 billion was incurred in Nigeria due to natural disaster, while about $70.59 billion was accrued due to artificial disaster; from 2009 to 2018. Although disaster risk mitigation and politics can synergistically support sustainable development goals; however, they are different entities, and need for distinct separations in Nigeria, as in reality and perception. This study concluded that referendum should be conducted in Nigeria, to ascertain its current status as a nation. Therefore it is recommended that Nigerian governments should refine its naturally endowed crude oil locally; to end fuel subsidy scam, corruption and poverty in Nigeria!Keywords: corruption, crude oil, environmental risk analysis, Nigeria, referendum, terrorism
Procedia PDF Downloads 44958 Talking to Ex-Islamic State Fighters inside Iraqi Prisons: An Arab Woman’s Perspective on Radicalization and Deradicalization
Authors: Suha Hassen
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This research aims to untangle the complexity of conducting face-to-face interviews with 80 ex-Islamic State fighters, encompassing three groups: local Iraqis, Arabs from the Middle East, and international fighters from around the globe. Each interview lasted approximately two hours and was conducted in both Arabic and English, focusing on the motivations behind joining the Islamic State and the pathways and mechanisms facilitating their involvement. The phenomenon of individuals joining violent Islamist extremist and jihadist organizations is multifaceted, drawing substantial attention within terrorism and security studies. Organizations such as the Islamic State, Hezbollah, Hamas, and Al-Qaeda pose formidable threats to international peace and stability, employing various terrorist tactics for radicalization and recruitment. However, significant gaps remain in current studies, including a lack of firsthand accounts, an inadequate understanding of original narratives (religious and linguistic) due to abstraction and misinterpretation of motivations, and a lack of Arab women's perspectives from the region. This study addresses these gaps by exploring the cultural, religious, and historical complexities that shape the narratives of ex-ISIS fighters. The paper will showcase three distinct cases: one French prisoner, one Moroccan fighter, and a local Iraqi, illustrating the diverse motivations and experiences that contribute to joining and leaving extremist groups. The findings provide valuable insights into the nuanced dynamics of radicalization, emphasizing the need for gender-sensitive approaches in counter-terrorism strategies and deradicalization programs. Importantly, this research has practical implications for counter-narrative policies and early-stage prevention of radicalization. By understanding the narratives used by ex-fighters, policymakers can develop targeted counter-narratives that disrupt recruitment efforts. Additionally, insights into the mechanisms of radicalization can inform early intervention programs, helping to identify and support at-risk individuals before they become entrenched in extremist ideologies. Ultimately, this research enhances our understanding of the individual experiences of ex-ISIS fighters and calls for a reevaluation of the narratives surrounding women’s roles in extremism and recovery.Keywords: Arab women in extremism, counter-narrative policy, ex-ISIS fighters in Iraq, radicalization
Procedia PDF Downloads 23957 The Residential Subdivision under the Influence of the Unfinished Densification, Case Study for Subdivisions in Setif, Algeria
Authors: Lacheheb Dhia Eddine Zakaria, Ballout Amor
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Today, it is necessary to be thrifty for its planet, on one hand the space being a rare, nonrenewable resource, and on the other hand the ecological, economic and social cost of the urban sprawl. It is commonly asserted that the promotion of a more compact and dense city has a positive effect in terms of public costs of investment, functioning and costs for the citizens and the users of the city. It is clear that the modes urban development management have to evolve profoundly, in particular towards a densification favourable to the raising of the urban quality through an ideal urban density on the scale of the individual housing estate. The lot as an individual housing estate was adopted as an alternative development model to the collective housing, thought in an anthropocentric perspective to emerge as a quality model where the density plays an important role, by being included in operations of a global coherence, in an optimal organization without forgetting the main importance of the deadlines of construction and the finalization of the works. The image of eternal construction site inflicted to our cities explains the renewed interest for the application of the regulatory framework and the completion of these limited operations without global coherence, which are summed up in our case to a ground cut in plots of land, sold then built independently without being finished, and support the relevance of the essential question of the improvement of the outside aspect bound to the appearance which can be revealed as a so important factor for a better use and a better acceptance of its housing environment, that the ratio of a number of houses on a plot of land or the number of square meters by house. To demonstrate the impact of the completion degree of the subdivision dwellings, roads system and urban public utilities on the density or the densification and therefore on the urban quality, we studied two residential subdivisions, the private subdivision Sellam and the subdivision El Imane with a common situation, and a different land surface, density and cutting, being occupied by various social classes, with different needs and different household average size. The approach of this work is based on the typo morphological analysis to reveal the differences in the degrees of completions of the subdivision’s built environment and on the investigation, by a household’s survey, to demonstrate importance of the degree of completion and to reveal the conditions of qualitative densification favourable and convenient to a better subdivision’s appropriation.Keywords: subdivision, degree of completion, densification, urban quality
Procedia PDF Downloads 372956 Creating Renewable Energy Investment Portfolio in Turkey between 2018-2023: An Approach on Multi-Objective Linear Programming Method
Authors: Berker Bayazit, Gulgun Kayakutlu
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The World Energy Outlook shows that energy markets will substantially change within a few forthcoming decades. First, determined action plans according to COP21 and aim of CO₂ emission reduction have already impact on policies of countries. Secondly, swiftly changed technological developments in the field of renewable energy will be influential upon medium and long-term energy generation and consumption behaviors of countries. Furthermore, share of electricity on global energy consumption is to be expected as high as 40 percent in 2040. Electrical vehicles, heat pumps, new electronical devices and digital improvements will be outstanding technologies and innovations will be the testimony of the market modifications. In order to meet highly increasing electricity demand caused by technologies, countries have to make new investments in the field of electricity production, transmission and distribution. Specifically, electricity generation mix becomes vital for both prevention of CO₂ emission and reduction of power prices. Majority of the research and development investments are made in the field of electricity generation. Hence, the prime source diversity and source planning of electricity generation are crucial for improving the wealth of citizen life. Approaches considering the CO₂ emission and total cost of generation, are necessary but not sufficient to evaluate and construct the product mix. On the other hand, employment and positive contribution to macroeconomic values are important factors that have to be taken into consideration. This study aims to constitute new investments in renewable energies (solar, wind, geothermal, biogas and hydropower) between 2018-2023 under 4 different goals. Therefore, a multi-objective programming model is proposed to optimize the goals of minimizing the CO₂ emission, investment amount and electricity sales price while maximizing the total employment and positive contribution to current deficit. In order to avoid the user preference among the goals, Dinkelbach’s algorithm and Guzel’s approach have been combined. The achievements are discussed with comparison to the current policies. Our study shows that new policies like huge capacity allotment might be discussible although obligation for local production is positive. The improvements in grid infrastructure and re-design support for the biogas and geothermal can be recommended.Keywords: energy generation policies, multi-objective linear programming, portfolio planning, renewable energy
Procedia PDF Downloads 244955 Effect of Institutional Structure on Project Managers Performance in Construction Projects: A Case Study in Nigeria
Authors: Ebuka Valentine Iroha, Tsunemi Watanabe, Satoshi Tsuchiya
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Project management practices play an important role in construction project performance and are one of project managers' essential key performance indicators. Previous studies have explored the poor performance of the construction industry, with project delays and cost overruns identified to contribute largely to numerous abandoned projects. These challenges are attributed to insufficient project management practices and a lack of utilization of project managers. The actual causes of inadequate project management practices and underutilization of project managers have been rarely discussed. This study tends to bridge the gap by identifying and assessing the actual causes of insufficient project management practices and underutilization of project managers. This study differs from past studies investigating the causes of poor performance by using institutional analysis methods to identify and analyze the factors influencing project management practices and proper utilization of project managers. Based on a comprehensive literature review, this study identified some factors embedded in the construction industry that influence the institutional environment and weaken the laws and regulations. These factors were used as the basis for semi-structured interview questions to investigate their impacts on project management practices and project managers. The data collected were coded into a four-level framework for institutional analysis. This method was used to analyze the interrelationships between the identified embedded factors, institutional laws and regulations, and construction organizations to understand how these influences result in the underutilization of project managers. The study found that the underutilization of project managers consists of two subsystems, including underutilization and lowering commitment. The first subsystem, corruption, political influence, religious and tribal discrimination, and organizational culture, were found to affect the institutional structure. These embedded factors weaken the industry’s governance mechanism, forcing project managers to prioritize corrupt practices over project demands. The ineffectiveness of the existing laws and regulations worsens the situation, supporting unfair working conditions and contributing to the underperformance of project managers. This situation leads to the development of the second subsystem, which is characterized by a lack of opportunities for career development and minimal incentives within construction organizations. The findings provide significant potential for addressing systemic challenges in the construction industry, particularly the underutilization of project managers and enhancing organizational support measures to improve project management practices and mitigate the adverse effects of corruption.Keywords: construction industry, project management, poor performance, embedded factors, project managers underutilization
Procedia PDF Downloads 39954 On-Site Coaching on Freshly-Graduated Nurses to Improves Quality of Clinical Handover and to Avoid Clinical Error
Authors: Sau Kam Adeline Chan
Abstract:
World Health Organization had listed ‘Communication during Patient Care Handovers’ as one of its highest 5 patient safety initiatives. Clinical handover means transfer of accountability and responsibility of clinical information from one health professional to another. The main goal of clinical handover is to convey patient’s current condition and treatment plan accurately. Ineffective communication at point of care is globally regarded as the main cause of the sentinel event. Situation, Background, Assessment and Recommendation (SBAR), a communication tool, is extensively regarded as an effective communication tool in healthcare setting. Nonetheless, just by scenario-based program in nursing school or attending workshops on SBAR would not be enough for freshly graduated nurses to apply it competently in a complex clinical practice. To what extend and in-depth of information should be conveyed during handover process is not easy to learn. As such, on-site coaching is essential to upgrade their expertise on the usage of SBAR and ultimately to avoid any clinical error. On-site coaching for all freshly graduated nurses on the usage of SBAR in clinical handover was commenced in August 2014. During the preceptorship period, freshly graduated nurses were coached by the preceptor. After that, they were gradually assigned to take care of a group of patients independently. Nurse leaders would join in their shift handover process at patient’s bedside. Feedback and support were given to them accordingly. Discrepancies on their clinical handover process were shared with them and documented for further improvement work. Owing to the constraint of manpower in nurse leader, about coaching for 30 times were provided to a nurse in a year. Staff satisfaction survey was conducted to gauge their feelings about the coaching and look into areas for further improvement. Number of clinical error avoided was documented as well. The nurses reported that there was a significant improvement particularly in their confidence and knowledge in clinical handover process. In addition, the sense of empowerment was developed when liaising with senior and experienced nurses. Their proficiency in applying SBAR was enhanced and they become more alert to the critical criteria of an effective clinical handover. Most importantly, accuracy of transferring patient’s condition was improved and repetition of information was avoided. Clinical errors were prevented and quality patient care was ensured. Using SBAR as a communication tool looks simple. The tool only provides a framework to guide the handover process. Nevertheless, without on-site training, loophole on clinical handover still exists, patient’s safety will be affected and clinical error still happens.Keywords: freshly graduated nurse, competency of clinical handover, quality, clinical error
Procedia PDF Downloads 148