Search results for: Likert scales
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1157

Search results for: Likert scales

197 The Effect of Organizational Justice on Management by Values Perception and Intention to Leave: A Study among Nurses

Authors: Arzu K. Harmanci Seren, Burcu Alacam, Serap Altuntas, Ulku Baykal

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Organizational justice has been evaluated as a concept related to rules developed with regards to distributing gains and making decisions of distribution such as duty, goods, service, reward, punishment, fee, organizational position, opportunity or role among those working in that organization, and to social norms on which these rules are based. Studies of organizational justice are crucial for analyzing the organizational life. It is considered that organization justice will be positively influential upon organizational behaviours such as employees’ level of work satisfaction, their performance, and behaviours of organization citizenship, management by values perception, tendency towards cooperation, and towards quitting their jobs. However, when the literature related to health and nurse management is examined, authors could not reach enough findings related to the influence of nurses’ perception of organizational justice upon the perception of management and the intention of quitting in accordance with the values. For that reason, this study has been carried out with the purpose of determining the influence of nurses’ perception of organizational justice upon the perception of management and the intention of quitting in accordance with the values. The study has been carried out with 176 nurses working in a university hospital in Istanbul and a private hospital who accepted to take part in the study, and it is definitive and relation-seeking. Before the data has been collected, ethics committee approval and institutional permissions have been taken, Organizational Justice Scale, Management by Values, Intention to Leave Scale with a questionnaire including 8 questions that aims at defining the personal and professional characteristics of the nurses have been used as a means of data collection. The data collected between 1 May and 20 June 2016 have been evaluated by the researchers in a computer via definitive, relation-seeking and psychometric statistic. As a result of the study, it has been determined that most of the nurses are working in a university hospital (70.5%), that they are 30 and over (49.4%), women (91.5%), single (52.8%) and have a Bachelor’s Degree (48.3%), working in a surgery unit (17.6), have 5 year or less institutional experience (44.9%), 11 year or more professional experience. Cronbach alpha values of the scales used in this study are .94, .95 and .56. Nurses’ average scores of Organizational Justice Scale is M= 3.35±.96, Management by Values Scale is M=3.30±.74, Intention to Leave Scale is M=8.36±3.14. As a result of the analysis carried out in order to determine the influence of nurses’ perception of organizational justice upon the perception of management and the intention of quitting in accordance with the values, it has been pointed out that the Perception of Organizational Justice influenced the perception of Management by Values positively, Intention to Leave negatively.

Keywords: intention to leave, management by values, nursing, organizational justice

Procedia PDF Downloads 255
196 Conflict around the Brownfield Reconversion of the Canadian Forces Base Rockcliffe in Ottawa: A Clash of Ambitions and Visions in Canadian Urban Sustainability

Authors: Kenza Benali

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Over the past decade, a number of remarkable projects in urban brownfield reconversion emerged across Canada, including the reconversion of former military bases owned by the Canada Lands Company (CLC) into sustainable communities. However, unlike other developments, the regeneration project of the former Canadian Forces Base Rockcliffe in Ottawa – which was announced as one of the most ambitious Smart growth projects in Canada – faced serious obstacles in terms of social acceptance by the local community, particularly urban minorities composed of Francophones, Indigenous and vulnerable groups who live near or on the Base. This turn of events led to the project being postponed and even reconsidered. Through an analysis of its press coverage, this research aims to understand the causes of this urban conflict which lasted for nearly ten years. The findings reveal that the conflict is not limited to the “standard” issues common to most conflicts related to urban mega-projects in the world – e.g., proximity issues (threads to the quality of the surrounding neighbourhoods; noise, traffic, pollution, New-build gentrification) often associated with NIMBY phenomena. In this case, the local actors questioned the purpose of the project (for whom and for what types of uses is it conceived?), its local implementation (to what extent are the local history and existing environment taken into account?), and the degree of implication of the local population in the decision-making process (with whom is the project built?). Moreover, the interests of the local actors have “jumped scales” and transcend the micro-territorial level of their daily life to take on a national and even international dimension. They defined an alternative view of how this project, considered strategic by his location in the nation’s capital, should be a reference as well as an international showcase of Canadian ambition and achievement in terms of urban sustainability. This vision promoted, actually, a territorial and national identity approach - in which some cultural values are highly significant (respect of social justice, inclusivity, ethnical diversity, cultural heritage, etc.)- as a counterweight to planners’ vision which is criticized as a normative/ universalist logic that ignore the territorial peculiarities.

Keywords: smart growth, brownfield reconversion, sustainable neighborhoods, Canada Lands Company, Canadian Forces Base Rockcliffe, urban conflicts

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195 Economic and Environmental Assessment of Heat Recovery in Beer and Spirit Production

Authors: Isabel Schestak, Jan Spriet, David Styles, Prysor Williams

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Breweries and distilleries are well-known for their high water usage. The water consumption in a UK brewery to produce one litre of beer reportedly ranges from 3-9 L and in a distillery from 7-45 L to produce a litre of spirit. This includes product water such as mashing water, but also water for wort and distillate cooling and for cleaning of tanks, casks, and kegs. When cooling towers are used, cooling water can be the dominating water consumption in a brewery or distillery. Interlinked to the high water use is a substantial heating requirement for mashing, wort boiling, or distillation, typically met by fossil fuel combustion such as gasoil. Many water and waste water streams are leaving the processes hot, such as the returning cooling water or the pot ales. Therefore, several options exist to optimise water and energy efficiency of spirit production through heat recovery. Although these options are known in the sector, they are often not applied in practice due to planning efforts or financial obstacles. In this study, different possibilities and design options for heat recovery systems are explored in four breweries/distilleries in the UK and assessed from an economic but also environmental point of view. The eco-efficiency methodology, according to ISO 14045, is applied to combine both assessment criteria to determine the optimum solution for heat recovery application in practice. The economic evaluation is based on the total value added (TVA) while the Life Cycle Assessment (LCA) methodology is applied to account for the environmental impacts through the installations required for heat recovery. The four case study businesses differ in a) production scale with mashing volumes ranging from 2500 to 40,000 L, in b) terms of heating and cooling technology used, and in c) the extent to which heat recovery is/is not applied. This enables the evaluation of different cases for heat recovery based on empirical data. The analysis provides guidelines for practitioners in the brewing and distilling sector in and outside the UK for the realisation of heat recovery measures. Financial and environmental payback times are showcased for heat recovery systems in the four distilleries which are operating at different production scales. The results are expected to encourage the application of heat recovery where environmentally and economically beneficial and ultimately contribute to a reduction of the water and energy footprint in brewing and distilling businesses.

Keywords: brewery, distillery, eco-efficiency, heat recovery from process and waste water, life cycle assessment

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194 Optimizing Residential Housing Renovation Strategies at Territorial Scale: A Data Driven Approach and Insights from the French Context

Authors: Rit M., Girard R., Villot J., Thorel M.

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In a scenario of extensive residential housing renovation, stakeholders need models that support decision-making through a deep understanding of the existing building stock and accurate energy demand simulations. To address this need, we have modified an optimization model using open data that enables the study of renovation strategies at both territorial and national scales. This approach provides (1) a definition of a strategy to simplify decision trees from theoretical combinations, (2) input to decision makers on real-world renovation constraints, (3) more reliable identification of energy-saving measures (changes in technology or behaviour), and (4) discrepancies between currently planned and actually achieved strategies. The main contribution of the studies described in this document is the geographic scale: all residential buildings in the areas of interest were modeled and simulated using national data (geometries and attributes). These buildings were then renovated, when necessary, in accordance with the environmental objectives, taking into account the constraints applicable to each territory (number of renovations per year) or at the national level (renovation of thermal deficiencies (Energy Performance Certificates F&G)). This differs from traditional approaches that focus only on a few buildings or archetypes. This model can also be used to analyze the evolution of a building stock as a whole, as it can take into account both the construction of new buildings and their demolition or sale. Using specific case studies of French territories, this paper highlights a significant discrepancy between the strategies currently advocated by decision-makers and those proposed by our optimization model. This discrepancy is particularly evident in critical metrics such as the relationship between the number of renovations per year and achievable climate targets or the financial support currently available to households and the remaining costs. In addition, users are free to seek optimizations for their building stock across a range of different metrics (e.g., financial, energy, environmental, or life cycle analysis). These results are a clear call to re-evaluate existing renovation strategies and take a more nuanced and customized approach. As the climate crisis moves inexorably forward, harnessing the potential of advanced technologies and data-driven methodologies is imperative.

Keywords: residential housing renovation, MILP, energy demand simulations, data-driven methodology

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193 Integration of an Evidence-Based Medicine Curriculum into Physician Assistant Education: Teaching for Today and the Future

Authors: Martina I. Reinhold, Theresa Bacon-Baguley

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Background: Medical knowledge continuously evolves and to help health care providers to stay up-to-date, evidence-based medicine (EBM) has emerged as a model. The practice of EBM requires new skills of the health care provider, including directed literature searches, the critical evaluation of research studies, and the direct application of the findings to patient care. This paper describes the integration and evaluation of an evidence-based medicine course sequence into a Physician Assistant curriculum. This course sequence teaches students to manage and use the best clinical research evidence to competently practice medicine. A survey was developed to assess the outcomes of the EBM course sequence. Methodology: The cornerstone of the three-semester sequence of EBM are interactive small group discussions that are designed to introduce students to the most clinically applicable skills to identify, manage and use the best clinical research evidence to improve the health of their patients. During the three-semester sequence, the students are assigned each semester to participate in small group discussions that are facilitated by faculty with varying background and expertise. Prior to the start of the first EBM course in the winter semester, PA students complete a knowledge-based survey that was developed by the authors to assess the effectiveness of the course series. The survey consists of 53 Likert scale questions that address the nine objectives for the course series. At the end of the three semester course series, the same survey was given to all students in the program and the results from before, and after the sequence of EBM courses are compared. Specific attention is paid to overall performance of students in the nine course objectives. Results: We find that students from the Class of 2016 and 2017 consistently improve (as measured by percent correct responses on the survey tool) after the EBM course series (Class of 2016: Pre- 62% Post- 75%; Class of 2017: Pre- 61 % Post-70%). The biggest increase in knowledge was observed in the areas of finding and evaluating the evidence, with asking concise clinical questions (Class of 2016: Pre- 61% Post- 81%; Class of 2017: Pre- 61 % Post-75%) and searching the medical database (Class of 2016: Pre- 24% Post- 65%; Class of 2017: Pre- 35 % Post-66 %). Questions requiring students to analyze, evaluate and report on the available clinical evidence regarding diagnosis showed improvement, but to a lesser extend (Class of 2016: Pre- 56% Post- 77%; Class of 2017: Pre- 56 % Post-61%). Conclusions: Outcomes identified that students did gain skills which will allow them to apply EBM principles. In addition, the outcomes of the knowledge-based survey allowed the faculty to focus on areas needing improvement, specifically the translation of best evidence into patient care. To address this area, the clinical faculty developed case scenarios that were incorporated into the lecture and discussion sessions, allowing students to better connect the research studies with patient care. Students commented that ‘class discussion and case examples’ contributed most to their learning and that ‘it was helpful to learn how to develop research questions and how to analyze studies and their significance to a potential client’. As evident by the outcomes, the EBM courses achieved the goals of the course and were well received by the students. 

Keywords: evidence-based medicine, clinical education, assessment tool, physician assistant

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192 Usability Assessment of a Bluetooth-Enabled Resistance Exercise Band among Young Adults

Authors: Lillian M. Seo, Curtis L. Petersen, Ryan J. Halter, David Kotz, John A. Batsis

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Background: Resistance-based exercises effectively enhance muscle strength, which is especially important in older populations as it reduces the risk of disability. Our group developed a Bluetooth-enabled handle for resistance exercise bands that wirelessly transmits relative force data through low-energy Bluetooth to a local smartphone or similar device. The system has the potential to measure home-based exercise interventions, allowing health professionals to monitor compliance. Its feasibility has already been demonstrated in both clinical and field-based settings, but it remained unclear whether the system’s usability persisted upon repeated use. The current study sought to assess the usability of this system and its users’ satisfaction with repeated use by deploying the device among younger adults to gather formative information that can ultimately improve the device’s design for older adults. Methods: A usability study was conducted in which 32 participants used the above system. Participants executed 10 repetitions of four commonly performed exercises: bicep flexion, shoulder abduction, elbow extension, and triceps extension. Each completed three exercise sessions, separated by at least 24 hours to minimize muscle fatigue. At its conclusion, subjects completed an adapted version of the usefulness, satisfaction, and ease (USE) questionnaire – assessing the system across four domains: usability, satisfaction, ease of use, and ease of learning. The 20-item questionnaire examined how strongly a participant agrees with positive statements about the device on a seven-point Likert scale, with one representing ‘strongly disagree’ and seven representing ‘strongly agree.’ Participants’ data were aggregated to calculate mean response values for each question and domain, effectively assessing the device’s performance across different facets of the user experience. Summary force data were visualized using a custom web application. Finally, an optional prompt at the end of the questionnaire allowed for written comments and feedback from participants to elicit qualitative indicators of usability. Results: Of the n=32 participants, 13 (41%) were female; their mean age was 32.4 ± 11.8 years, and no participants had a physical impairment. No usability questions received a mean score < 5 of seven. The four domains’ mean scores were: usefulness 5.66 ± 0.35; satisfaction 6.23 ± 0.06; ease of use 6.25 ± 0.43; and ease of learning 6.50 ± 0.19. Representative quotes of the open-ended feedback include: ‘A non-rigid strap-style handle might be useful for some exercises,’ and, ‘Would need different bands for each exercise as they use different muscle groups with different strength levels.’ General impressions were favorable, supporting the expectation that the device would be a useful tool in exercise interventions. Conclusions: A simple usability assessment of a Bluetooth-enabled resistance exercise band supports a consistent and positive user experience among young adults. This study provides adequate formative data, assuring the next steps can be taken to continue testing and development for the target population of older adults.

Keywords: Bluetooth, exercise, mobile health, mHealth, usability

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191 Empirical Orthogonal Functions Analysis of Hydrophysical Characteristics in the Shira Lake in Southern Siberia

Authors: Olga S. Volodko, Lidiya A. Kompaniets, Ludmila V. Gavrilova

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The method of empirical orthogonal functions is the method of data analysis with a complex spatial-temporal structure. This method allows us to decompose the data into a finite number of modes determined by empirically finding the eigenfunctions of data correlation matrix. The modes have different scales and can be associated with various physical processes. The empirical orthogonal function method has been widely used for the analysis of hydrophysical characteristics, for example, the analysis of sea surface temperatures in the Western North Atlantic, ocean surface currents in the North Carolina, the study of tropical wave disturbances etc. The method used in this study has been applied to the analysis of temperature and velocity measurements in saline Lake Shira (Southern Siberia, Russia). Shira is a shallow lake with the maximum depth of 25 m. The lake Shira can be considered as a closed water site because of it has one small river providing inflow and but it has no outflows. The main factor that causes the motion of fluid is variable wind flows. In summer the lake is strongly stratified by temperature and saline. Long-term measurements of the temperatures and currents were conducted at several points during summer 2014-2015. The temperature has been measured with an accuracy of 0.1 ºC. The data were analyzed using the empirical orthogonal function method in the real version. The first empirical eigenmode accounts for 70-80 % of the energy and can be interpreted as temperature distribution with a thermocline. A thermocline is a thermal layer where the temperature decreases rapidly from the mixed upper layer of the lake to much colder deep water. The higher order modes can be interpreted as oscillations induced by internal waves. The currents measurements were recorded using Acoustic Doppler Current Profilers 600 kHz and 1200 kHz. The data were analyzed using the empirical orthogonal function method in the complex version. The first empirical eigenmode accounts for about 40 % of the energy and corresponds to the Ekman spiral occurring in the case of a stationary homogeneous fluid. Other modes describe the effects associated with the stratification of fluids. The second and next empirical eigenmodes were associated with dynamical modes. These modes were obtained for a simplified model of inhomogeneous three-level fluid at a water site with a flat bottom.

Keywords: Ekman spiral, empirical orthogonal functions, data analysis, stratified fluid, thermocline

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190 Knowledge Management Barriers: A Statistical Study of Hardware Development Engineering Teams within Restricted Environments

Authors: Nicholas S. Norbert Jr., John E. Bischoff, Christopher J. Willy

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Knowledge Management (KM) is globally recognized as a crucial element in securing competitive advantage through building and maintaining organizational memory, codifying and protecting intellectual capital and business intelligence, and providing mechanisms for collaboration and innovation. KM frameworks and approaches have been developed and defined identifying critical success factors for conducting KM within numerous industries ranging from scientific to business, and for ranges of organization scales from small groups to large enterprises. However, engineering and technical teams operating within restricted environments are subject to unique barriers and KM challenges which cannot be directly treated using the approaches and tools prescribed for other industries. This research identifies barriers in conducting KM within Hardware Development Engineering (HDE) teams and statistically compares significance to barriers upholding the four KM pillars of organization, technology, leadership, and learning for HDE teams. HDE teams suffer from restrictions in knowledge sharing (KS) due to classification of information (national security risks), customer proprietary restrictions (non-disclosure agreement execution for designs), types of knowledge, complexity of knowledge to be shared, and knowledge seeker expertise. As KM evolved leveraging information technology (IT) and web-based tools and approaches from Web 1.0 to Enterprise 2.0, KM may also seek to leverage emergent tools and analytics including expert locators and hybrid recommender systems to enable KS across barriers of the technical teams. The research will test hypothesis statistically evaluating if KM barriers for HDE teams affect the general set of expected benefits of a KM System identified through previous research. If correlations may be identified, then generalizations of success factors and approaches may also be garnered for HDE teams. Expert elicitation will be conducted using a questionnaire hosted on the internet and delivered to a panel of experts including engineering managers, principal and lead engineers, senior systems engineers, and knowledge management experts. The feedback to the questionnaire will be processed using analysis of variance (ANOVA) to identify and rank statistically significant barriers of HDE teams within the four KM pillars. Subsequently, KM approaches will be recommended for upholding the KM pillars within restricted environments of HDE teams.

Keywords: engineering management, knowledge barriers, knowledge management, knowledge sharing

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189 Prediction of the Factors Influencing the Utilization of HIV Testing among Young People Aged between 17-25 Years in Saudi Arabia

Authors: Abdullah Almilaibary, Jeremy Jolley, Mark Hayter

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Background: Despite recent progress in enhancing the accessibility of HIV-related health services worldwide, opportunities to diagnose patients are often missed due to genuine barriers at different levels. The aim of the study is to explore the factors that affect the utilization of HIV testing services by young people aged 17-25 in Saudi Arabia. Methods: A non-experimental descriptive cross-sectional design was used to predict factors that influenced HIV testing among Umm- Al Qura University students aged 17-25 years. A newly developed self-completed online questionnaire was used and the study sample was drawn using a convenience sampling technique. The questionnaire consisted of 52 items divided into three scales: 12 items for HIV/AIDS-related knowledge, 3 items for risk perception, and 37 items for attitudes toward HIV testing. Five experts in the field of HIV/AIDS validated the contents of the questionnaire and agreed that the items included were related to the construct being measured. The reliability of the questionnaire was also assessed using a test/re-test strategy with 27 participants recruited from the population under study. The reliability assessment revealed that the questionnaire was consistent as Cronbach’s Alpha was 0.80 for HIV/ADS knowledge, 0.88 for risk perception and 0.78 for attitudes towards HIV testing. The data were collected between 14th of July and 14th of October 2014. Results: 394 participants completed the questionnaires: 116 (29.4%) male and 278 (70%) female. 50.5% of the participants were aged 20 to 22 years, 34.8% were 17-19 years and 14.7% were aged between 23-25 years; about 93% of the participants were single. Only 20 (6%) participants had previously been tested for HIV. The main reasons for not being tested for HIV were: exposure to HIV was considered unlikely (48%), HIV test was not offered (36%) and unawareness of HIV testing centres (16%). On HIV/AIDS-related knowledge, the male participants scored higher than the females as the mean score for males was (M = 6.4, SD = 2.4) while for females it was (M 5.7, SD 2.5). In terms of risk perception, female participants appeared to have lower levels of risk perception than male participants, with the mean score for males being (M 11.7, SD 2.5) and (M 10.5, SD 2.4) for females. The female participants showed slightly more positive attitudes towards HIV testing than male participants: the mean score for males was (M = 108.14, SD = 17.9) and was (M = 111.32, SD = 17.3) for females. Conclusions: The data reveal that misconceptions about HIV/AIDS in Saudi Arabia are still a challenge. Although the attitudes towards HIV testing were reasonably positive, the utilization of the HIV test was low. Thus, tailoring HIV/AIDS preventive strategies in Saudi Arabia should focus on the needs of young people and other high risk groups in the country.

Keywords: attitude toward hiv testing, hiv testing, hiv/aids related knowledge, risk perception

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188 Manufacturing and Calibration of Material Standards for Optical Microscopy in Industrial Environments

Authors: Alberto Mínguez-Martínez, Jesús De Vicente Y Oliva

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It seems that we live in a world in which the trend in industrial environments is the miniaturization of systems and materials and the fabrication of parts at the micro-and nano-scale. The problem arises when manufacturers want to study the quality of their production. This characteristic is becoming crucial due to the evolution of the industry and the development of Industry 4.0. As Industry 4.0 is based on digital models of production and processes, having accurate measurements becomes capital. At this point, the metrology field plays an important role as it is a powerful tool to ensure more stable production to reduce scrap and the cost of non-conformities. The most extended measuring instruments that allow us to carry out accurate measurements at these scales are optical microscopes, whether they are traditional, confocal, focus variation microscopes, profile projectors, or any other similar measurement system. However, the accuracy of measurements is connected to the traceability of them to the SI unit of length (the meter). The fact of providing adequate traceability to 2D and 3D dimensional measurements at micro-and nano-scale in industrial environments is a problem that is being studied, and it does not have a unique answer. In addition, if commercial material standards for micro-and nano-scale are considered, we can find that there are two main problems. On the one hand, those material standards that could be considered complete and very interesting do not give traceability of dimensional measurements and, on the other hand, their calibration is very expensive. This situation implies that these kinds of standards will not succeed in industrial environments and, as a result, they will work in the absence of traceability. To solve this problem in industrial environments, it becomes necessary to have material standards that are easy to use, agile, adaptive to different forms, cheap to manufacture and, of course, traceable to the definition of meter with simple methods. By using these ‘customized standards’, it would be possible to adapt and design measuring procedures for each application and manufacturers will work with some traceability. It is important to note that, despite the fact that this traceability is clearly incomplete, this situation is preferable to working in the absence of it. Recently, it has been demonstrated the versatility and the utility of using laser technology and other AM technologies to manufacture customized material standards. In this paper, the authors propose to manufacture a customized material standard using an ultraviolet laser system and a method to calibrate it. To conclude, the results of the calibration carried out in an accredited dimensional metrology laboratory are presented.

Keywords: industrial environment, material standards, optical measuring instrument, traceability

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187 Active Learning through a Game Format: Implementation of a Nutrition Board Game in Diabetes Training for Healthcare Professionals

Authors: Li Jiuen Ong, Magdalin Cheong, Sri Rahayu, Lek Alexander, Pei Ting Tan

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Background: Previous programme evaluations from the diabetes training programme conducted in Changi General Hospital revealed that healthcare professionals (HCPs) are keen to receive advance diabetes training and education, specifically in medical, nutritional therapy. HCPs also expressed a preference for interactive activities over didactic teaching methods to enhance their learning. Since the War on Diabetes was initiated by MOH in 2016, HCPs are challenged to be actively involved in continuous education to be better equipped to reduce the growing burden of diabetes. Hence, streamlining training to incorporate an element of fun is of utmost importance. Aim: The nutrition programme incorporates game play using an interactive board game that aims to provide a more conducive and less stressful environment for learning. The board game could be adapted for training of community HCPs, health ambassadors or caregivers to cope with the increasing demand of diabetes care in the hospital and community setting. Methodology: Stages for game’s conception (Jaffe, 2001) were adopted in the development of the interactive board game ‘Sweet Score™ ’ Nutrition concepts and topics in diabetes self-management are embedded into the game elements of varying levels of difficulty (‘Easy,’ ‘Medium,’ ‘Hard’) including activities such as a) Drawing/ sculpting (Pictionary-like) b)Facts/ Knowledge (MCQs/ True or False) Word definition) c) Performing/ Charades To study the effects of game play on knowledge acquisition and perceived experiences, participants were randomised into two groups, i.e., lecture group (control) and game group (intervention), to test the difference. Results: Participants in both groups (control group, n= 14; intervention group, n= 13) attempted a pre and post workshop quiz to assess the effectiveness of knowledge acquisition. The scores were analysed using paired T-test. There was an improvement of quiz scores after attending the game play (mean difference: 4.3, SD: 2.0, P<0.001) and the lecture (mean difference: 3.4, SD: 2.1, P<0.001). However, there was no significance difference in the improvement of quiz scores between gameplay and lecture (mean difference: 0.9, 95%CI: -0.8 to 2.5, P=0.280). This suggests that gameplay may be as effective as a lecture in terms of knowledge transfer. All the13 HCPs who participated in the game rated 4 out of 5 on the likert scale for the favourable learning experience and relevance of learning to their job, whereas only 8 out of 14 HCPs in the lecture reported a high rating in both aspects. 16. Conclusion: There is no known board game currently designed for diabetes training for HCPs.Evaluative data from future training can provide insights and direction to improve the game format and cover other aspects of diabetes management such as self-care, exercise, medications and insulin management. Further testing of the board game to ensure learning objectives are met is important and can assist in the development of awell-designed digital game as an alternative training approach during the COVID-19 pandemic. Learning through gameplay increases opportunities for HCPs to bond, interact and learn through games in a relaxed social setting and potentially brings more joy to the workplace.

Keywords: active learning, game, diabetes, nutrition

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186 Environmental Related Mortality Rates through Artificial Intelligence Tools

Authors: Stamatis Zoras, Vasilis Evagelopoulos, Theodoros Staurakas

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The association between elevated air pollution levels and extreme climate conditions (temperature, particulate matter, ozone levels, etc.) and mental consequences has been, recently, the focus of significant number of studies. It varies depending on the time of the year it occurs either during the hot period or cold periods but, specifically, when extreme air pollution and weather events are observed, e.g. air pollution episodes and persistent heatwaves. It also varies spatially due to different effects of air quality and climate extremes to human health when considering metropolitan or rural areas. An air pollutant concentration and a climate extreme are taking a different form of impact if the focus area is countryside or in the urban environment. In the built environment the climate extreme effects are driven through the formed microclimate which must be studied more efficiently. Variables such as biological, age groups etc may be implicated by different environmental factors such as increased air pollution/noise levels and overheating of buildings in comparison to rural areas. Gridded air quality and climate variables derived from the land surface observations network of West Macedonia in Greece will be analysed against mortality data in a spatial format in the region of West Macedonia. Artificial intelligence (AI) tools will be used for data correction and prediction of health deterioration with climatic conditions and air pollution at local scale. This would reveal the built environment implications against the countryside. The air pollution and climatic data have been collected from meteorological stations and span the period from 2000 to 2009. These will be projected against the mortality rates data in daily, monthly, seasonal and annual grids. The grids will be operated as AI-based warning models for decision makers in order to map the health conditions in rural and urban areas to ensure improved awareness of the healthcare system by taken into account the predicted changing climate conditions. Gridded data of climate conditions, air quality levels against mortality rates will be presented by AI-analysed gridded indicators of the implicated variables. An Al-based gridded warning platform at local scales is then developed for future system awareness platform for regional level.

Keywords: air quality, artificial inteligence, climatic conditions, mortality

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185 Intersubjectivity of Forensic Handwriting Analysis

Authors: Marta Nawrocka

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In each of the legal proceedings, in which expert evidence is carried out, a major concern is the assessment of the evidential value of expert reports. Judicial institutions, while making decisions, rely heavily on the expert reports, because they usually do not possess 'special knowledge' from a certain fields of science which makes it impossible for them to verify the results presented in the processes. In handwriting studies, the standards of analysis are developed. They unify procedures used by experts in comparing signs and in constructing expert reports. However, the methods used by experts are usually of a qualitative nature. They rely on the application of knowledge and experience of expert and in effect give significant range of margin in the assessment. Moreover, the standards used by experts are still not very precise and the process of reaching the conclusions is poorly understood. The above-mentioned circumstances indicate that expert opinions in the field of handwriting analysis, for many reasons, may not be sufficiently reliable. It is assumed that this state of affairs has its source in a very low level of intersubjectivity of measuring scales and analysis procedures, which consist elements of this kind of analysis. Intersubjectivity is a feature of cognition which (in relation to methods) indicates the degree of consistency of results that different people receive using the same method. The higher the level of intersubjectivity is, the more reliable and credible the method can be considered. The aim of the conducted research was to determine the degree of intersubjectivity of the methods used by the experts from the scope of handwriting analysis. 30 experts took part in the study and each of them received two signatures, with varying degrees of readability, for analysis. Their task was to distinguish graphic characteristics in the signature, estimate the evidential value of the found characteristics and estimate the evidential value of the signature. The obtained results were compared with each other using the Alpha Krippendorff’s statistic, which numerically determines the degree of compatibility of the results (assessments) that different people receive under the same conditions using the same method. The estimation of the degree of compatibility of the experts' results for each of these tasks allowed to determine the degree of intersubjectivity of the studied method. The study showed that during the analysis, the experts identified different signature characteristics and attributed different evidential value to them. In this scope, intersubjectivity turned out to be low. In addition, it turned out that experts in various ways called and described the same characteristics, and the language used was often inconsistent and imprecise. Thus, significant differences have been noted on the basis of language and applied nomenclature. On the other hand, experts attributed a similar evidential value to the entire signature (set of characteristics), which indicates that in this range, they were relatively consistent.

Keywords: forensic sciences experts, handwriting analysis, inter-rater reliability, reliability of methods

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184 Do the Health Benefits of Oil-Led Economic Development Outweigh the Potential Health Harms from Environmental Pollution in Nigeria?

Authors: Marian Emmanuel Okon

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Introduction: The Niger Delta region of Nigeria has a vast reserve of oil and gas, which has globally positioned the nation as the sixth largest exporter of crude oil. Production rapidly rose following oil discovery. In most oil producing nations of the world, the wealth generated from oil production and export has propelled economic advancement, enabling the development of industries and other relevant infrastructures. Therefore, it can be assumed that majority of the oil resource such as Nigeria’s, has the potential to improve the health of the population via job creation and derived revenues. However, the health benefits of this economic development might be offset by the environmental consequences of oil exploitation and production. Objective: This research aims to evaluate the balance between the health benefits of oil-led economic development and harmful environmental consequences of crude oil exploitation in Nigeria. Study Design: A pathway has been designed to guide data search and this study. The model created will assess the relationship between oil-led economic development and population health development via job creation, improvement of education, development of infrastructure and other forms of development as well as through harmful environmental consequences from oil activities. Data/Emerging Findings: Diverse potentially suitable datasets which are at different geographical scales have been identified, obtained or applied for and the dataset from the World Bank has been the most thoroughly explored. This large dataset contains information that would enable the longitudinal assessment of both the health benefits and harms from oil exploitation in Nigeria as well as identify the disparities that exist between the communities, states and regions. However, these data do not extend far back enough in time to capture the start of crude oil production. Thus, it is possible that the maximum economic benefits and health harms could be missed. To deal with this shortcoming, the potential for a comparative study with countries like United Kingdom, Morocco and Cote D’ivoire has also been taken into consideration, so as to evaluate the differences between these countries as well as identify the areas of improvement in Nigeria’s environmental and health policies. Notwithstanding, these data have shown some differences in each country’s economic, environmental and health state over time as well as a corresponding summary statistics. Conclusion: In theory, the beneficial effects of oil exploitation to the health of the population may be substantial as large swaths of the ‘wider determinants’ of population heath are influenced by the wealth of a nation. However, if uncontrolled, the consequences from environmental pollution and degradation may outweigh these benefits. Thus, there is a need to address this, in order to improve environmental and population health in Nigeria.

Keywords: environmental pollution, health benefits, oil-led economic development, petroleum exploitation

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183 The Differential Impacts of Shame and Guilt on Father Involvement in Families with Special Needs Children

Authors: Lo Kai Chung

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Fathers in the family of disabled children play a crucial role in fostering child development. Previous studies addressing emotions of father involvement in rearing children with special needs have been rare. With reference to the cultural orientation and masculine idea of Chinese fathers, shame and guilt are probable causal emotions that affect fathers’ psycho-behavioral reactions and, thus, father involvement. Based on the findings of our earlier qualitative studies, the current study aims to develop and validate a multi-item scale of guilt or shame and explore their relations with and fatherhood in families with children with special needs. A model is proposed to understand the roles that shame and guilt play in affecting fathers’ involvement in their family system. The severity and type of the child’s special needs are regarded as independent variables affecting the father’s emotional responses – shame and guilt. It is hypothesized that shame and guilt, under the influence of masculinity, lead to avoidance and compensation, respectively, which subsequently decrease and increase father involvement with children with special needs. A cross-sectional online questionnaire survey of fathers with children with special needs recruited by convenience sampling was conducted. Potential participants were reached by bulk emails, related groups on the Internet and education/social services providers. Totally 537 valid sets of online questionnaires were collected from fathers of children with special needs. EFA on the items pool of shame and guilt was performed, resulting in an x-item single-factor solution and y-item single-factor solution, respectively. Further path model analysis revealed that shame and guilt, under the influence of masculinity, showed differential avoidance and compensation responses and resulted in a decrease and increase in father involvement with special needs children. Demographic and key confounding variables were controlled in the analysis. The shame and guilt scales developed show good psychometric properties. Furthermore, they showed significant differential impacts, under the influence of masculinity, on avoidance and compensation behaviours, consequently resulting in a decrease/increase in father involvement in the expected directions. The findings have important theoretical and practical implications. At the community and policy level, the findings inform the design of strategies for strengthening the role of men in families with special needs children.

Keywords: emotions, father involvement, guilt, shame, special needs

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182 Development of a Psychometric Testing Instrument Using Algorithms and Combinatorics to Yield Coupled Parameters and Multiple Geometric Arrays in Large Information Grids

Authors: Laith F. Gulli, Nicole M. Mallory

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The undertaking to develop a psychometric instrument is monumental. Understanding the relationship between variables and events is important in structural and exploratory design of psychometric instruments. Considering this, we describe a method used to group, pair and combine multiple Philosophical Assumption statements that assisted in development of a 13 item psychometric screening instrument. We abbreviated our Philosophical Assumptions (PA)s and added parameters, which were then condensed and mathematically modeled in a specific process. This model produced clusters of combinatorics which was utilized in design and development for 1) information retrieval and categorization 2) item development and 3) estimation of interactions among variables and likelihood of events. The psychometric screening instrument measured Knowledge, Assessment (education) and Beliefs (KAB) of New Addictions Research (NAR), which we called KABNAR. We obtained an overall internal consistency for the seven Likert belief items as measured by Cronbach’s α of .81 in the final study of 40 Clinicians, calculated by SPSS 14.0.1 for Windows. We constructed the instrument to begin with demographic items (degree/addictions certifications) for identification of target populations that practiced within Outpatient Substance Abuse Counseling (OSAC) settings. We then devised education items, beliefs items (seven items) and a modifiable “barrier from learning” item that consisted of six “choose any” choices. We also conceptualized a close relationship between identifying various degrees and certifications held by Outpatient Substance Abuse Therapists (OSAT) (the demographics domain) and all aspects of their education related to EB-NAR (past and present education and desired future training). We placed a descriptive (PA)1tx in both demographic and education domains to trace relationships of therapist education within these two domains. The two perceptions domains B1/b1 and B2/b2 represented different but interrelated perceptions from the therapist perspective. The belief items measured therapist perceptions concerning EB-NAR and therapist perceptions using EB-NAR during the beginning of outpatient addictions counseling. The (PA)s were written in simple words and descriptively accurate and concise. We then devised a list of parameters and appropriately matched them to each PA and devised descriptive parametric (PA)s in a domain categorized information grid. Descriptive parametric (PA)s were reduced to simple mathematical symbols. This made it easy to utilize parametric (PA)s into algorithms, combinatorics and clusters to develop larger information grids. By using matching combinatorics we took paired demographic and education domains with a subscript of 1 and matched them to the column with each B domain with subscript 1. Our algorithmic matching formed larger information grids with organized clusters in columns and rows. We repeated the process using different demographic, education and belief domains and devised multiple information grids with different parametric clusters and geometric arrays. We found benefit combining clusters by different geometric arrays, which enabled us to trace parametric variables and concepts. We were able to understand potential differences between dependent and independent variables and trace relationships of maximum likelihoods.

Keywords: psychometric, parametric, domains, grids, therapists

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181 Health Advocacy in Medical School: An American Survey on Attitudes and Engagement in Clerkships

Authors: Rachel S. Chang, Samuel P. Massion, Alan Z. Grusky, Heather A. Ridinger

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Introduction Health advocacy is defined as activities that improve access to care, utilize resources, address health disparities, and influence health policy. Advocacy is increasingly being recognized as a critical component of a physician’s role, as understanding social determinants of health and improving patient care are important aspects within the American Medical Association’s Health Systems Science framework. However, despite this growing prominence, educational interventions that address advocacy topics are limited and variable across medical school curricula. Furthermore, few recent studies have evaluated attitudes toward health advocacy among physicians-in-training in the United States. This study examines medical student attitudes towards health advocacy, along with perceived knowledge, ability, and current level of engagement with health advocacy during their clerkships. Methods This study employed a cross-sectional survey design using a single anonymous, self-report questionnaire to all second-year medical students at Vanderbilt University School of Medicine (n=96) in December 2020 during clerkship rotations. The survey had 27 items with 5-point Likert scale (15), multiple choice (11), and free response questions (1). Descriptive statistics and thematic analysis were utilized to analyze responses. The study was approved by the Vanderbilt University Institutional Review Board. Results There was an 88% response rate among second-year clerkship medical students. A majority (83%) agreed that formal training in health advocacy should be a mandatory part of the medical student curriculum Likewise, 83% of respondents felt that acting as a health advocate or patients should be part of their role as a clerkship student. However, a minority (25%) felt adequately prepared. While 72% of respondents felt able to identify a psychosocial need, 18% felt confident navigating the healthcare system and only 9% felt able to connect a patient to a psychosocial resource to fill that gap. 44% of respondents regularly contributed to conversations with their medical teams when discussing patients’ social needs, such as housing insecurity, financial insecurity, or legal needs. On average, respondents reported successfully connecting patients to psychosocial resources 1-2 times per 8-week clerkship block. Barriers to participating in health advocacy included perceived time constraints, lack of awareness of resources, lower emphasis among medical teams, and scarce involvement with social work teams. Conclusions In this single-institutional study, second-year medical students on clerkships recognize the importance of advocating for patients and support advocacy training within their medical school curriculum. However, their perceived lack of ability to navigate the healthcare system and connect patients to psychosocial resources, result in students feeling unprepared to advocate as effectively as they hoped during their clerkship rotations. Our results support the ongoing need to equip medical students with training and resources necessary for them to effectively act as advocates for patients.

Keywords: clerkships, medical students, patient advocacy, social medicine

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180 Simulation of the Visco-Elasto-Plastic Deformation Behaviour of Short Glass Fibre Reinforced Polyphthalamides

Authors: V. Keim, J. Spachtholz, J. Hammer

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The importance of fibre reinforced plastics continually increases due to the excellent mechanical properties, low material and manufacturing costs combined with significant weight reduction. Today, components are usually designed and calculated numerically by using finite element methods (FEM) to avoid expensive laboratory tests. These programs are based on material models including material specific deformation characteristics. In this research project, material models for short glass fibre reinforced plastics are presented to simulate the visco-elasto-plastic deformation behaviour. Prior to modelling specimens of the material EMS Grivory HTV-5H1, consisting of a Polyphthalamide matrix reinforced by 50wt.-% of short glass fibres, are characterized experimentally in terms of the highly time dependent deformation behaviour of the matrix material. To minimize the experimental effort, the cyclic deformation behaviour under tensile and compressive loading (R = −1) is characterized by isothermal complex low cycle fatigue (CLCF) tests. Combining cycles under two strain amplitudes and strain rates within three orders of magnitude and relaxation intervals into one experiment the visco-elastic deformation is characterized. To identify visco-plastic deformation monotonous tensile tests either displacement controlled or strain controlled (CERT) are compared. All relevant modelling parameters for this complex superposition of simultaneously varying mechanical loadings are quantified by these experiments. Subsequently, two different material models are compared with respect to their accuracy describing the visco-elasto-plastic deformation behaviour. First, based on Chaboche an extended 12 parameter model (EVP-KV2) is used to model cyclic visco-elasto-plasticity at two time scales. The parameters of the model including a total separation of elastic and plastic deformation are obtained by computational optimization using an evolutionary algorithm based on a fitness function called genetic algorithm. Second, the 12 parameter visco-elasto-plastic material model by Launay is used. In detail, the model contains a different type of a flow function based on the definition of the visco-plastic deformation as a part of the overall deformation. The accuracy of the models is verified by corresponding experimental LCF testing.

Keywords: complex low cycle fatigue, material modelling, short glass fibre reinforced polyphthalamides, visco-elasto-plastic deformation

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179 Characterization of Soil Microbial Communities from Vineyard under a Spectrum of Drought Pressures in Sensitive Area of Mediterranean Region

Authors: Gianmaria Califano, Júlio Augusto Lucena Maciel, Olfa Zarrouk, Miguel Damasio, Jose Silvestre, Ana Margarida Fortes

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Global warming, with rapid and sudden changes in meteorological conditions, is one of the major constraints to ensuring agricultural and crop resilience in the Mediterranean regions. Several strategies are being adopted to reduce the pressure of drought stress on grapevines at regional and local scales: improvements in the irrigation systems, adoption of interline cover crops, and adaptation of pruning techniques. However, still, more can be achieved if also microbial compartments associated with plants are considered in crop management. It is known that the microbial community change according to several factors such as latitude, plant variety, age, rootstock, soil composition and agricultural management system. Considering the increasing pressure of the biotic and abiotic stresses, it is of utmost necessity to also evaluate the effects of drought on the microbiome associated with the grapevine, which is a commercially important crop worldwide. In this study, we characterize the diversity and the structure of the microbial community under three long-term irrigation levels (100% ETc, 50% ETc and rain-fed) in a drought-tolerant grapevine cultivar present worldwide, Syrah. To avoid the limitations of culture-dependent methods, amplicon sequencing with target primers for bacteria and fungi was applied to the same soil samples. The use of the DNeasy PowerSoil (Qiagen) extraction kit required further optimization with the use of lytic enzymes and heating steps to improve DNA yield and quality systematically across biological treatments. Target regions (16S rRNA and ITS genes) of our samples are being sequenced with Illumina technology. With bioinformatic pipelines, it will be possible to obtain a characterization of the bacterial and fungal diversity, structure and composition. Further, the microbial communities will be assessed for their functional activity, which remains an important metric considering the strong inter-kingdom interactions existing between plants and their associated microbiome. The results of this study will lay the basis for biotechnological applications: in combination with the establishment of a bacterial library, it will be possible to explore the possibility of testing synthetic microbial communities to support plant resistance to water scarcity.

Keywords: microbiome, metabarcoding, soil, vinegrape, syrah, global warming, crop sustainability

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178 Subcontractor Development Practices and Processes: A Conceptual Model for LEED Projects

Authors: Andrea N. Ofori-Boadu

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The purpose is to develop a conceptual model of subcontractor development practices and processes that strengthen the integration of subcontractors into construction supply chain systems for improved subcontractor performance on Leadership in Energy and Environmental Design (LEED) certified building projects. The construction management of a LEED project has an important objective of meeting sustainability certification requirements. This is in addition to the typical project management objectives of cost, time, quality, and safety for traditional projects; and, therefore increases the complexity of LEED projects. Considering that construction management organizations rely heavily on subcontractors, poor performance on complex projects such as LEED projects has been largely attributed to the unsatisfactory preparation of subcontractors. Furthermore, the extensive use of unique and non-repetitive short term contracts limits the full integration of subcontractors into construction supply chains and hinders long-term cooperation and benefits that could enhance performance on construction projects. Improved subcontractor development practices are needed to better prepare and manage subcontractors, so that complex objectives can be met or exceeded. While supplier development and supply chain theories and practices for the manufacturing sector have been extensively investigated to address similar challenges, investigations in the construction sector are not that obvious. Consequently, the objective of this research is to investigate effective subcontractor development practices and processes to guide construction management organizations in their development of a strong network of high performing subcontractors. Drawing from foundational supply chain and supplier development theories in the manufacturing sector, a mixed interpretivist and empirical methodology is utilized to assess the body of knowledge within literature for conceptual model development. A self-reporting survey with five-point Likert scale items and open-ended questions is administered to 30 construction professionals to estimate their perceptions of the effectiveness of 37 practices, classified into five subcontractor development categories. Data analysis includes descriptive statistics, weighted means, and t-tests that guide the effectiveness ranking of practices and categories. The results inform the proposed three-phased LEED subcontractor development program model which focuses on preparation, development and implementation, and monitoring. Highly ranked LEED subcontractor pre-qualification, commitment, incentives, evaluation, and feedback practices are perceived as more effective, when compared to practices requiring more direct involvement and linkages between subcontractors and construction management organizations. This is attributed to unfamiliarity, conflicting interests, lack of trust, and resource sharing challenges. With strategic modifications, the recommended practices can be extended to other non-LEED complex projects. Additional research is needed to guide the development of subcontractor development programs that strengthen direct involvement between construction management organizations and their network of high performing subcontractors. Insights from this present research strengthen theoretical foundations to support future research towards more integrated construction supply chains. In the long-term, this would lead to increased performance, profits and client satisfaction.

Keywords: construction management, general contractor, supply chain, sustainable construction

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177 Sustainable Concepts Applied in the Pre-Columbian Andean Architecture in Southern Ecuador

Authors: Diego Espinoza-Piedra, David Duran

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All architectural and land use processes are framed in a cultural, social and geographical context. The present study analyzes the Andean culture before the Spanish conquest in southern Ecuador, in the province of Azuay. This area has been habited for more than 10.000 years. The Canari and the Inca cultures occupied Azuay close to the arrival of the Spanish conquers. The Inca culture was settled in the Andes Mountains. The Canari culture was established in the south of Ecuador, on the actual provinces of Azuay and Canar. In contrast with history and archeology, to the best of our knowledge, their architecture has not yet been studied in this area because of the lack of architectural structures. Consequently, the present research reviewed the land use and culture for architectonic interpretations. The two main architectural objects in these cultures were dwellings and public buildings. In the first case, housing was conceived as temporary. It had to stand as long as its inhabitants lived. Therefore, houses were built when a couple got married. The whole community started the construction through the so-called ‘minga’ or collective work. The construction materials were tree branches, reeds, agave, ground, and straw. So that when their owners aged and then died, this house was easily disarmed and overthrown. Their materials become part of the land for agriculture. Finally, this cycle was repeated indefinitely. In the second case, the buildings, which we can call public, have presented erroneous interpretations. They have been defined as temples. But according to our conclusions, they were places for temporary accommodation, storage of objects and products, and in some special cases, even astronomical observatories. These public buildings were settled along the important road system called ‘Capac-Nam’, currently declared by UNESCO as World Cultural Heritage. The buildings had different scales at regular distances. Also, they were established in special or strategic places, which constituted a system of observatories. These observatories allowed to determine the cycles or calendars (solar or lunar) necessary for the agricultural production, as well as other natural phenomena. Most of the current minimal existence of physical structures in quantity and state of conservation is at the level of foundations or pieces of walls. Therefore, this study was realized after the identification of the history and culture of the inhabitants of this Andean region.

Keywords: Andean, pre-Colombian architecture, Southern Ecuador, sustainable

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176 Scenario-Based Learning Using Virtual Optometrist Applications

Authors: J. S. M. Yang, G. E. T. Chua

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Diploma in Optometry (OPT) course is a three-year program offered by Ngee Ann Polytechnic (NP) to train students to provide primary eye care. Students are equipped with foundational conceptual knowledge and practical skills in the first three semesters before clinical modules in fourth to six semesters. In the clinical modules, students typically have difficulties in integrating the acquired knowledge and skills from the past semesters to perform general eye examinations on public patients at NP Optometry Centre (NPOC). To help the students overcome the challenge, a web-based game Virtual Optometrist (VO) was developed to help students apply their skills and knowledge through scenario-based learning. It consisted of two interfaces, Optical Practice Counter (OPC) and Optometric Consultation Room (OCR), to provide two simulated settings for authentic learning experiences. In OPC, students would recommend and provide appropriate frame and lens selection based on virtual patient’s case history. In OCR, students would diagnose and manage virtual patients with common ocular conditions. Simulated scenarios provided real-world clinical situations that required contextual application of integrated knowledge from relevant modules. The stages in OPC and OCR are of increasing complexity to align to expected students’ clinical competency as they progress to more senior semesters. This prevented gameplay fatigue as VO was used over the semesters to achieve different learning outcomes. Numerous feedback opportunities were provided to students based on their decisions to allow individualized learning to take place. The game-based learning element in VO was achieved through the scoreboard and leader board to enhance students' motivation to perform. Scores were based on the speed and accuracy of students’ responses to the questions posed in the simulated scenarios, preparing the students to perform accurately and effectively under time pressure in a realistic optometric environment. Learning analytics was generated in VO’s backend office based on students’ responses, offering real-time data on distinctive and observable learners’ behavior to monitor students’ engagement and learning progress. The backend office allowed versatility to add, edit, and delete scenarios for different intended learning outcomes. Likert Scale was used to measure students’ learning experience with VO for OPT Year 2 and 3 students. The survey results highlighted the learning benefits of implementing VO in the different modules, such as enhancing recall and reinforcement of clinical knowledge for contextual application to develop higher-order thinking skills, increasing efficiency in clinical decision-making, facilitating learning through immediate feedback and second attempts, providing exposure to common and significant ocular conditions, and training effective communication skills. The results showed that VO has been useful in reinforcing optometry students’ learning and supporting the development of higher-order thinking, increasing efficiency in clinical decision-making, and allowing students to learn from their mistakes with immediate feedback and second attempts. VO also exposed the students to diverse ocular conditions through simulated real-world clinical scenarios, which may otherwise not be encountered in NPOC, and promoted effective communication skills.

Keywords: authentic learning, game-based learning, scenario-based learning, simulated clinical scenarios

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175 Challenges in Employment and Adjustment of Academic Expatriates Based in Higher Education Institutions in the KwaZulu-Natal Province, South Africa

Authors: Thulile Ndou

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The purpose of this study was to examine the challenges encountered in the mediation of attracting and recruiting academic expatriates who in turn encounter their own obstacles in adjusting into and settling in their host country, host academic institutions and host communities. The none-existence of literature on attraction, placement and management of academic expatriates in the South African context has been acknowledged. Moreover, Higher Education Institutions in South Africa have voiced concerns relating to delayed and prolonged recruitment and selection processes experienced in the employment process of academic expatriates. Once employed, academic expatriates should be supported and acquainted with the surroundings, the local communities as well as be assisted to establish working relations with colleagues in order to facilitate their adjustment and integration process. Hence, an employer should play a critical role in facilitating the adjustment of academic expatriates. This mixed methods study was located in four Higher Education Institutions based in the KwaZulu-Natal province, in South Africa. The explanatory sequential design approach was deployed in the study. The merits of this approach were chiefly that it employed both the quantitative and qualitative techniques of inquiry. Therefore, the study examined and interrogated its subject from a multiplicity of quantitative and qualitative vantage points, yielding a much more enriched and enriching illumination. Mixing the strengths of both the quantitative and the qualitative techniques delivered much more durable articulation and understanding of the subject. A 5-point Likert scale questionnaire was used to collect quantitative data relating to interaction adjustment, general adjustment and work adjustment from academic expatriates. One hundred and forty two (142) academic expatriates participated in the quantitative study. Qualitative data relating to employment process and support offered to academic expatriates was collected through a structured questionnaire and semi-structured interviews. A total of 48 respondents; including, line managers, human resources practitioners, and academic expatriates participated in the qualitative study. The Independent T-test, ANOVA and Descriptive Statistics were performed to analyse, interpret and make meaning of quantitative data and thematic analysis was used to analyse qualitative data. The qualitative results revealed that academic talent is sourced from outside the borders of the country because of the academic skills shortage in almost all academic disciplines especially in the disciplines associated with Science, Engineering and Accounting. However, delays in work permit application process made it difficult to finalise the recruitment and selection process on time. Furthermore, the quantitative results revealed that academic expatriates experience general and interaction adjustment challenges associated with the use of local language and understanding of local culture. However, female academic expatriates were found to be better adjusted in the two areas as compared to male academic expatriates. Moreover, significant mean differences were found between institutions suggesting that academic expatriates based in rural areas experienced adjustment challenges differently from the academic expatriates based in urban areas. The study gestured to the need for policy revisions in the area of immigration, human resources and academic administration.

Keywords: academic expatriates, recruitment and selection, interaction and general adjustment, work adjustment

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174 Exploring Safety Culture in Interventional Radiology: A Cross-Sectional Survey on Team Members' Attitudes

Authors: Anna Bjällmark, Victoria Persson, Bodil Karlsson, May Bazzi

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Introduction: Interventional radiology (IR) is a continuously growing discipline that allows minimally invasive treatments of various medical conditions. The IR environment is, in several ways, comparable to the complex and accident-prone operation room (OR) environment. This implies that the IR environment may also be associated with various types of risks related to the work process and communication in the team. Patient safety is a central aspect of healthcare and involves the prevention and reduction of adverse events related to patient care. To maintain patient safety, it is crucial to build a safety culture where the staff are encouraged to report events and incidents that may have affected patient safety. It is also important to continuously evaluate the staff´s attitudes to patient safety. Despite the increasing number of IR procedures, research on the staff´s view regarding patients is lacking. Therefore, the main aim of the study was to describe and compare the IR team members' attitudes to patient safety. The secondary aim was to evaluate whether the WHO safety checklist was routinely used for IR procedures. Methods: An electronic survey was distributed to 25 interventional units in Sweden. The target population was the staff working in the IR team, i.e., physicians, radiographers, nurses, and assistant nurses. A modified version of the Safety Attitudes Questionnaire (SAQ) was used. Responses from 19 of 25 IR units (44 radiographers, 18 physicians, 5 assistant nurses, and 1 nurse) were received. The respondents rated their level of agreement for 27 items related to safety culture on a five-point Likert scale ranging from “Disagree strongly” to “Agree strongly.” Data were analyzed statistically using SPSS. The percentage of positive responses (PPR) was calculated by taking the percentage of respondents who got a scale score of 75 or higher. The respondents rated which corresponded to response options “Agree slightly” or “Agree strongly”. Thus, average scores ≥ 75% were classified as “positive” and average scores < 75% were classified as “non-positive”. Findings: The results indicated that the IR team had the highest factor scores and the highest percentages of positive responses in relation to job satisfaction (90/94%), followed by teamwork climate (85/92%). In contrast, stress recognition received the lowest ratings (54/25%). Attitudes related to these factors were relatively consistent between different professions, with only a few significant differences noted (Factor score: p=0.039 for job satisfaction, p=0.050 for working conditions. Percentage of positive responses: p=0.027 for perception of management). Radiographers tended to report slightly lower values compared to other professions for these factors (p<0.05). The respondents reported that the WHO safety checklist was not routinely used at their IR unit but acknowledged its importance for patient safety. Conclusion: This study reported high scores concerning job satisfaction and teamwork climate but lower scores concerning perception of management and stress recognition indicating that the latter are areas of improvement. Attitudes remained relatively consistent among the professions, but the radiographers reported slightly lower values in terms of job satisfaction and perception of the management. The WHO safety checklist was considered important for patient safety.

Keywords: interventional radiology, patient safety, safety attitudes questionnaire, WHO safety checklist

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173 Effect of Cognitive Rehabilitation in Pediatric Population with Acquired Brain Injury: A Pilot Study

Authors: Carolina Beltran, Carlos De Los Reyes

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Acquired brain injury (ABI) is any physical and functional injury secondary to events that affect the brain tissue. It is one of the biggest causes of disability in the world and it has a high annual incidence in the pediatric population. There are several causes of ABI such as traumatic brain injury, central nervous system infection, stroke, hypoxia, tumors and others. The consequences can be cognitive, behavioral, emotional and functional. The cognitive rehabilitation is necessary to achieve the best outcomes for pediatric people with ABI. Cognitive orientation to daily occupational performance (CO-OP) is an individualized client-centered, performance-based, problem-solving approach that focuses on the strategy used to support the acquisition of three client-chosen goals. It has demonstrated improvements in the pediatric population with other neurological disorder but not in Spanish speakers with ABI. Aim: The main objective of this study was to determine the efficacy of cognitive orientation to daily occupational performances (CO-OP) adapted to Spanish speakers, in the level of independence and behavior in a pediatric population with ABI. Methods: Case studies with measure pre/post-treatment were used in three children with ABI, sustained at least before 6 months assessment, in school, aged 8 to 16 years, age ABI after 6 years old and above average intellectual ability. Twelve sessions of CO-OP adapted to Spanish speakers were used and videotaped. The outcomes were based on cognitive, behavior and functional independence measurements such as Child Behavior Checklist (CBCL), Behavior Rating Inventory of Executive Function (BRIEF), The Vineland Adaptive Behavior Scales (VINELAND, Social Support Scale (MOS-SSS) and others neuropsychological measures. This study was approved by the ethics committee of Universidad del Norte in Colombia. Informed parental written consent was obtained for all participants. Results: children were able to identify three goals and use the global strategy ‘goal-plan-do-check’ during each session. Verbal self-instruction was used by all children. CO-OP showed a clinically significant improvement in goals regarding with independence level and behavior according to parents and teachers. Conclusion: The results indicated that CO-OP and the use of a global strategy such as ‘goal-plan-do-check’ can be used in children with ABI in order to improve their specific goals. This is a preliminary version of a big study carrying in Colombia as part of the experimental design.

Keywords: cognitive rehabilitation, acquired brain injury, pediatric population, cognitive orientation to daily occupational performance

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172 Examination of Relationship between Internet Addiction and Cyber Bullying in Adolescents

Authors: Adem Peker, Yüksel Eroğlu, İsmail Ay

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As the information and communication technologies have become embedded in everyday life of adolescents, both their possible benefits and risks to adolescents are being identified. The information and communication technologies provide opportunities for adolescents to connect with peers and to access to information. However, as with other social connections, users of information and communication devices have the potential to meet and interact with in harmful ways. One emerging example of such interaction is cyber bullying. Cyber bullying occurs when someone uses the information and communication technologies to harass or embarrass another person. Cyber bullying can take the form of malicious text messages and e-mails, spreading rumours, and excluding people from online groups. Cyber bullying has been linked to psychological problems for cyber bullies and victims. Therefore, it is important to determine how internet addiction contributes to cyber bullying. Building on this question, this study takes a closer look at the relationship between internet addiction and cyber bullying. For this purpose, in this study, based on descriptive relational model, it was hypothesized that loss of control, excessive desire to stay online, and negativity in social relationships, which are dimensions of internet addiction, would be associated positively with cyber bullying and victimization. Participants were 383 high school students (176 girls and 207 boys; mean age, 15.7 years). Internet addiction was measured by using Internet Addiction Scale. The Cyber Victim and Bullying Scale was utilized to measure cyber bullying and victimization. The scales were administered to the students in groups in the classrooms. In this study, stepwise regression analyses were utilized to examine the relationships between dimensions of internet addiction and cyber bullying and victimization. Before applying stepwise regression analysis, assumptions of regression were verified. According to stepwise regression analysis, cyber bullying was predicted by loss of control (β=.26, p<.001) and negativity in social relationships (β=.13, p<.001). These variables accounted for 9 % of the total variance, with the loss of control explaining the higher percentage (8 %). On the other hand, cyber victimization was predicted by loss of control (β=.19, p<.001) and negativity in social relationships (β=.12, p<.001). These variables altogether accounted for 8 % of the variance in cyber victimization, with the best predictor loss of control (7 % of the total variance). The results of this study demonstrated that, as expected, loss of control and negativity in social relationships predicted cyber bullying and victimization positively. However, excessive desire to stay online did not emerge a significant predictor of both cyberbullying and victimization. Consequently, this study would enhance our understanding of the predictors of cyber bullying and victimization since the results proposed that internet addiction is related with cyber bullying and victimization.

Keywords: cyber bullying, internet addiction, adolescents, regression

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171 Listening to Circles, Playing Lights: A Study of Cross-Modal Perception in Music

Authors: Roni Granot, Erica Polini

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Music is often described in terms of non-auditory adjectives such as a rising melody, a bright sound, or a zigzagged contour. Such cross modal associations have been studied with simple isolated musical parameters, but only rarely in rich musical contexts. The current study probes cross sensory associations with polarity based dimensions by means of pairings of 10 adjectives: blunt-sharp, relaxed-tense, heavy-light, low (in space)-high, low (pitch)-high, big-small, hard-soft, active-passive, bright-dark, sad-happy. 30 participants (randomly assigned to one of two groups) were asked to rate one of 27 short saxophone improvisations on a 1 to 6 scale where 1 and six correspond to the opposite pole of each dimension. The 27 improvisations included three exemplars for each of three dimensions (size, brightness, sharpness), played by three different players. Here we focus on the question of whether ratings of scales corresponding with the musical dimension were consistently rated as such (e.g. music improvised to represent a white circle rated as bright in contrast with music improvised to represent a dark circle rated as dark). Overall the average scores by dimension showed an upward trend in the equivalent verbal scale, with a low rating for small, bright and sharp musical improvisations and higher scores for large, dark and blunt improvisations. Friedman tests indicate a statistically significant difference for brightness (χ2 (2) = 19.704, p = .000) and sharpness dimensions (χ2 (2) = 15.750, p = .000), but not for size (χ2 (2) = 1.444, p = .486). Post hoc analysis with Wilcoxon signed-rank tests within the brightness dimension, show significant differences among all possible parings resulted in significant differences: the rankings of 'bright' and 'dark' (Z = -3.310, p = .001), of 'bright' and 'medium' (Z = -2.438, p = .015) and of 'dark' and 'medium' music (Z = -2.714, p = .007); but only differences between the extreme contrasts within the sharpness dimension : 'sharp' and 'blunt' music (Z = -3.147, p = .002) and between 'sharp' and 'medium' music rated on the sharpness scale (Z = - 3.054, p = .002), but not between 'medium' and 'blunt' music (Z = -.982, p = .326). In summary our study suggests a privileged link between music and the perceptual and semantic domain of brightness. In contrast, size seems to be very difficult to convey in music, whereas sharpness seems to be mapped onto the two extremes (sharp vs. blunt) rather than continuously. This is nicely reflected in the musical literature in titles and texts which stress the association between music and concepts of light or darkness rather than sharpness or size.

Keywords: audiovisual, brightness, cross-modal perception, cross-sensory correspondences, size, visual angularity

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170 Assessing the Competence of Oral Surgery Trainees: A Systematic Review

Authors: Chana Pavneet

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Background: In more recent years in dentistry, a greater emphasis has been placed on competency-based education (CBE) programmes. Undergraduate and postgraduate curriculums have been reformed to reflect these changes, and adopting a CBE approach has shown to be beneficial to trainees and places an emphasis on continuous lifelong learning. The literature is vast; however, very little work has been done specifically to the assessment of competence in dentistry and even less so in oral surgery. The majority of the literature tends to opinion pieces. Some small-scale studies have been undertaken in this area researching assessment tools which can be used to assess competence in oral surgery. However, there is a lack of general consensus on the preferable assessment methods. The aim of this review is to identify the assessment methods available and their usefulness. Methods: Electronic databases (Medline, Embase, and the Cochrane Database of systematic reviews) were searched. PRISMA guidelines were followed to identify relevant papers. Abstracts of studies were reviewed, and if they met the inclusion criteria, they were included in the review. Papers were reviewed against the critical appraisal skills programme (CASP) checklist and medical education research quality instrument (MERQSI) to assess their quality and identify any bias in a systematic manner. The validity and reliability of each assessment method or tool were assessed. Results: A number of assessment methods were identified, including self-assessment, peer assessment, and direct observation of skills by someone senior. Senior assessment tended to be the preferred method, followed by self-assessment and, finally, peer assessment. The level of training was shown to affect the preferred assessment method, with one study finding peer assessment more useful in postgraduate trainees as opposed to undergraduate trainees. Numerous tools for assessment were identified, including a checklist scale and a global rating scale. Both had their strengths and weaknesses, but the evidence was more favourable for global rating scales in terms of reliability, applicability to more clinical situations, and easier to use for examiners. Studies also looked into trainees’ opinions on assessment tools. Logbooks were not found to be significant in measuring the competence of trainees. Conclusion: There is limited literature exploring the methods and tools which assess the competence of oral surgery trainees. Current evidence shows that the most favourable assessment method and tool may differ depending on the stage of training. More research is required in this area to streamline assessment methods and tools.

Keywords: competence, oral surgery, assessment, trainees, education

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169 Moderating and Mediating Effects of Business Model Innovation Barriers during Crises: A Structural Equation Model Tested on German Chemical Start-Ups

Authors: Sarah Mueller-Saegebrecht, André Brendler

Abstract:

Business model innovation (BMI) as an intentional change of an existing business model (BM) or the design of a new BM is essential to a firm's development in dynamic markets. The relevance of BMI is also evident in the ongoing COVID-19 pandemic, in which start-ups, in particular, are affected by limited access to resources. However, first studies also show that they react faster to the pandemic than established firms. A strategy to successfully handle such threatening dynamic changes represents BMI. Entrepreneurship literature shows how and when firms should utilize BMI in times of crisis and which barriers one can expect during the BMI process. Nevertheless, research merging BMI barriers and crises is still underexplored. Specifically, further knowledge about antecedents and the effect of moderators on the BMI process is necessary for advancing BMI research. The addressed research gap of this study is two-folded: First, foundations to the subject on how different crises impact BM change intention exist, yet their analysis lacks the inclusion of barriers. Especially, entrepreneurship literature lacks knowledge about the individual perception of BMI barriers, which is essential to predict managerial reactions. Moreover, internal BMI barriers have been the focal point of current research, while external BMI barriers remain virtually understudied. Second, to date, BMI research is based on qualitative methodologies. Thus, a lack of quantitative work can specify and confirm these qualitative findings. By focusing on the crisis context, this study contributes to BMI literature by offering a first quantitative attempt to embed BMI barriers into a structural equation model. It measures managers' perception of BMI development and implementation barriers in the BMI process, asking the following research question: How does a manager's perception of BMI barriers influence BMI development and implementation in times of crisis? Two distinct research streams in economic literature explain how individuals react when perceiving a threat. "Prospect Theory" claims that managers demonstrate risk-seeking tendencies when facing a potential loss, and opposing "Threat-Rigidity Theory" suggests that managers demonstrate risk-averse behavior when facing a potential loss. This study quantitively tests which theory can best predict managers' BM reaction to a perceived crisis. Out of three in-depth interviews in the German chemical industry, 60 past BMIs were identified. The participating start-up managers gave insights into their start-up's strategic and operational functioning. After, each interviewee described crises that had already affected their BM. The participants explained how they conducted BMI to overcome these crises, which development and implementation barriers they faced, and how severe they perceived them, assessed on a 5-point Likert scale. In contrast to current research, results reveal that a higher perceived threat level of a crisis harms BM experimentation. Managers seem to conduct less BMI in times of crisis, whereby BMI development barriers dampen this relation. The structural equation model unveils a mediating role of BMI implementation barriers on the link between the intention to change a BM and the concrete BMI implementation. In conclusion, this study confirms the threat-rigidity theory.

Keywords: barrier perception, business model innovation, business model innovation barriers, crises, prospect theory, start-ups, structural equation model, threat-rigidity theory

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168 Variability of the X-Ray Sun during Descending Period of Solar Cycle 23

Authors: Zavkiddin Mirtoshev, Mirabbos Mirkamalov

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We have analyzed the time series of full disk integrated soft X-ray (SXR) and hard X-ray (HXR) emission from the solar corona during 2004 January 1 to 2009 December 31, covering the descending phase of solar cycle 23. We employed the daily X-ray index (DXI) derived from X-ray observations from the Solar X-ray Spectrometer (SOXS) mission in four different energy bands: 4-5.5; 5.5-7.5 keV (SXR) and 15-20; 20-25 keV (HXR). The application of Lomb-Scargle periodogram technique to the DXI time series observed by the Silicium detector in the energy bands reveals several short and intermediate periodicities of the X-ray corona. The DXI explicitly show the periods of 13.6 days, 26.7 days, 128.5 days, 151 days, 180 days, 220 days, 270 days, 1.24 year and 1.54 year periods in SXR as well as in HXR energy bands. Although all periods are above 70% confidence level in all energy bands, they show strong power in HXR emission in comparison to SXR emission. These periods are distinctly clear in three bands but somehow not unambiguously clear in 5.5-7.5 keV band. This might be due to the presence of Ferrum and Ferrum/Niccolum line features, which frequently vary with small scale flares like micro-flares. The regular 27-day rotation and 13.5 day period of sunspots from the invisible side of the Sun are found stronger in HXR band relative to SXR band. However, flare activity Rieger periods (150 and 180 days) and near Rieger period 220 days are very strong in HXR emission which is very much expected. On the other hand, our current study reveals strong 270 day periodicity in SXR emission which may be connected with tachocline, similar to a fundamental rotation period of the Sun. The 1.24 year and 1.54 year periodicities, represented from the present research work, are well observable in both SXR as well as in HXR channels. These long-term periodicities must also have connection with tachocline and should be regarded as a consequence of variation in rotational modulation over long time scales. The 1.24 year and 1.54 year periods are also found great importance and significance in the life formation and it evolution on the Earth, and therefore they also have great astro-biological importance. We gratefully acknowledge support by the Indian Centre for Space Science and Technology Education in Asia and the Pacific (CSSTEAP, the Centre is affiliated to the United Nations), Physical Research Laboratory (PRL) at Ahmedabad, India. This work has done under the supervision of Prof. Rajmal Jain and paper consist materials of pilot project and research part of the M. Tech program which was made during Space and Atmospheric Science Course.

Keywords: corona, flares, solar activity, X-ray emission

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