Search results for: physician employment

Authors: Pinn Tsin Isabel Yee

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With the advent of internet technologies, students are increasingly turning toward social media and cross-platform messaging apps such as WhatsApp, Line, and WeChat to support their teaching and learning processes. Although each messaging app has varying features, WhatsApp remains one of the most popular cross-platform apps that allow for fast, simple, secure messaging and free calls anytime, anywhere. With a plethora of advantages, students could easily assimilate WhatsApp as a supportive technology in their learning process. There could be peer to peer learning, and a teacher will be able to share knowledge digitally via the creation of WhatsApp groups. Content analysis techniques were utilized to analyze data collected by closed-ended question forms. Studies demonstrated that 98.8% of college students (n=80) from the Monash University foundation year agreed that the employment of WhatsApp groups was helpful as a learning tool. Approximately 71.3% disagreed that notifications and alerts from the WhatsApp group were disruptions in their studies. Students commented that they could silence the notifications and hence, it would not disturb their flow of thoughts. In fact, an overwhelming majority of students (95.0%) found it enjoyable to participate in WhatsApp groups for educational purposes. It was a common perception that some students felt pressured to post a reply in such groups, but data analysis showed that 72.5% of students did not feel pressured to comment or reply. It was good that 93.8% of students felt satisfactory if their posts were not responded to speedily, but was eventually attended to. Generally, 97.5% of students found it useful if their teachers provided their handphone numbers to be added to a WhatsApp group. If a teacher posts an explanation or a mathematical working in the group, all students would be able to view the post together, as opposed to individual students asking their teacher a similar question. On whether students preferred using Facebook as a learning tool, there was a 50-50 divide in the replies from the respondents as 51.3% of students liked WhatsApp, while 48.8% preferred Facebook as a supportive technology in teaching and learning. Taken altogether, the utilization of WhatsApp groups as a supportive technology in teaching and learning should be implemented in all classes to continuously engage our generation Y students in the ever-changing digital landscape.-

Keywords: education, learning, messaging app, technology, WhatsApp groups

Procedia PDF Downloads 139

Authors: L. Musak, J. Valachova, T. Vasicko, O. Osina

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Stainless steel is resistant to electrochemical corrosion by passivation. Welders are greatly exposed to welding fumes of toxic metals, which added to this steel. The content of chromium (Cr) is above 11.5%, Ni and Mo from 2 to 6.5%. The aim of the study was the evaluation of occupational exposure to Cr, chromosome analysis and valuation of individual susceptibility polymorphism of gene CCND1 c.870 G>A. The exposed group was consisted from 117 welders of stainless steels. The average age was 38.43 years and average exposure time 7.14 years. Smokers represented 40.17%. The control group consisted of 123 non-exposed workers with an average age of 39.74 years and time employment 16.67 years. Smokers accounted for 22.76%. Analysis of Cr in blood and urine was performed by atomic absorption spectrophotometry (AAS Varian SpectraAA 30P) with electrothermal decomposition of the sample in the graphite furnace. For the evaluation of chromosomal aberrations (CA) cytogenetic analysis of peripheral blood lymphocytes was used. Gene polymorphism was determined by PCR-RFLP reaction using appropriate primers and restriction enzymes. For statistic analysis the Mann-Whitney U-test was used. The mean Cr level in blood of exposed group was 0.095 µmol/l (0.019 min - max 0.504). No value exceeds the average normal value. The mean value Cr in urine was 7.9 µmol/mol creatinine (min 0.026 to max 19.26). The total number of CA was 1.86% in compared to 1.70% controls. (CTA-type 0.90% vs. 0.80% and CSA-type 0.96% vs. 0.90%). In the number of total CA statistical difference was observed between smokers and non-smokers of exposed group (S-1.57% vs. NS-2.04%, P<0.05). In CCND1 gene polymorphisms was observed the increasing of the total CA with wild-type allele (WT) via heterozygous to the VAR genotype (1.44% <1.82% <2.13%). A statistically higher incidence of CTA-type aberrations in variant genotypes between exposed and control groups was observed (1.22% vs. 0.59%, P <0.05). The work place is usually higher source of exposure to harmful factors. Workers need consistent and frequent health control. In assessing the risk of adverse effects of metals it is important to consider their persistence, behavior and bioavailability. Prolonged exposure to carcinogens may not manifest symptoms of poisoning, but delayed effects may occur, which resulted in a higher incidence of malignant tumors.

Keywords: CCND1, genotoxicity, polymorphism, stainless steel, welders

Procedia PDF Downloads 333

Authors: Azeb Degife

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Over the past few years, the volume of international investment in agricultural land has increased globally. In recent times, Ethiopian government uses agricultural investment as one of the most important and effective strategies for economic growth, food security and poverty reduction in rural areas. Since the mid-2000s, government has awarded millions of hectares of most fertile land to rich countries and some of the world's most wealthy people to export various kinds of crop, often in long-term leases and at bargain prices. This study focuses on the pros and cons of large-scale agriculture investment Gambella region, Ethiopia. The main results were generated both from primary and secondary data sources. Primary data are obtained through interview, direct observation and a focus group discussion (FGDs). The secondary data are obtained from published documents, reports from governmental and non-governmental institutions. The findings of the study demonstrated that agriculture investment has advantages on the socio-economic and disadvantages on socio-environmental aspects. The main benefits agriculture investments in the region are infrastructural development and generation employment for the local people. Further, the Ethiopian government also generates foreign currency from the agriculture investment opportunities. On the other hand, Gambella people are strongly tied to the land and the rivers that run through in the region. However, now large-scale agricultural investment by foreign and local investors on an industrial scale results deprives people livelihoods and natural resources of the region. Generally, the negative effects of agriculture investment include increasing food insecurity, and displacement of smallholder farmers and pastoralists. Moreover, agriculture investment has strong adverse environmental impacts on natural resources such as land, water, forests and biodiversity. Therefore, an Ethiopian government strategy needs to focus on integration approach and sustainable agricultural growth.

Keywords: agriculture investment, cons, displacement, Gambella, integration approach, pros, socio-economic, socio-environmental

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Authors: Clifford Lewis

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This paper aims to advance the conversation of an alternative view of leadership, namely ‘leadership as the management of meaning’. Here, leadership is considered as a social process of the management of meaning within an employment context, as opposed to a psychological trait, set of behaviours or relational consequence as seen in mainstream leadership research. Specifically, this study explores the relationship between intersectional identities and the management of meaning. Design: Semi-structured, one-on-one interviews were conducted with women and men of colour working in the South African private sector organisations in various leadership positions. Employing an intersectional approach using gender and race, participants were selected by using purposive and snowball sampling concurrently. Thematic and Axial coding was used to identify dominant themes. Findings: Findings suggest that, both gender and race shape how leaders manage meaning. Findings also confirm that intersectionality is an appropriate approach when studying the leadership experiences of those groups who are underrepresented in organisational leadership structures. The findings points to the need for further research into the differential effects of intersecting identities on organisational leadership experiences and that ‘leadership as the management of meaning’ is an appropriate approach for addressing this knowledge gap. Theoretical Contribution: There is a large body of literature on the complex challenges faced by women and people of colour in leadership but there is relatively little empirical work on how identity influences the management of meaning. This study contributes to the leadership literature by providing insight into how intersectional identities influence the management of meaning at work and how this impacts the leadership experiences of largely marginalised groups. Practical Implications: Understanding the leadership experiences of underrepresented groups is important because of both legal mandates and for building diverse talent for organisations and societies. Such an understanding assists practitioners in being sensitive to simplistic notions of challenges individuals might face in accessing and practicing leadership in organisations. Advancing the conversation on leadership as the management of meaning allows for a better understanding of complex challenges faced by women and people of colour and an opportunity for organisations to systematically remove unfair structural obstacles and develop their diverse leadership capacity.

Keywords: intersectionality, diversity, leadership, sensemaking

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Authors: Leijun Zhang

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Reading literacy has become a powerful tool for academic success and an essential goal of education. The ability to read is not only fundamental for pupils’ academic success but also a prerequisite for successful participation in today’s vastly expanding multi-literate textual environment. It is also important to recognize that, in many educational settings, students are expected to learn a foreign/second language for successful participation in the increasingly globalized world. Therefore, it is crucial to help learners become skilled foreign-language readers. Research indicates that students’ reading comprehension can be significantly improved through explicit instruction of multiple reading strategies. Despite the wealth of research on how to enhance learners’ reading comprehension achievement by identifying an enormous range of reading strategies and techniques for assisting students in comprehending specific texts, relatively scattered studies have centered on whether these reading comprehension strategies and techniques are used in classrooms, especially in Chinese academic settings. Given the central role of ‘the teacher’ in reading instruction, the study investigates the degree of importance that EFL teachers attach to reading comprehension strategies and their classroom employment of those strategies in secondary schools in China. It also explores the efficiency of reading strategy instruction on pupils’ reading comprehension performance. As a mix-method study, the analysis drew on data from a quantitative survey and interviews with seven teachers. The study revealed that the EFL teachers had positive attitudes toward the use of cognitive strategies despite their insufficient knowledge about and limited attention to the metacognitive strategies and supporting strategies. Regarding the selection of reading strategies for instruction, the mandated curriculum and high-stakes examinations, text features and demands, teaching preparation programs and their own EFL reading experiences were the major criteria in their responses, while few teachers took into account the learner needs in their choice of reading strategies. Although many teachers agreed upon the efficiency of reading strategy instruction in developing students’ reading comprehension competence, three challenges were identified in their implementation of the strategy instruction. The study provides some insights into reading strategy instruction in EFL contexts and proposes implications for curriculum innovation, teacher professional development, and reading instruction research.

Keywords: reading comprehension strategies, EFL reading instruction, language teacher cognition, teacher education

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Authors: Mansour Rezvani, Mohammad Mahdi Mortaheb

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This study considers the employment of foreign workforce in Kish Free Trade and Industrial Zone and aims to investigate the productivity of foreign construction labours as compared to their local counterpart. Moreover, this study compares work skills and experience of foreign and local Iranian construction workers to optimize construction working conditions. The results and findings have been effectively applied to develop a training program to optimize and promote Iranian workforce productivity and effectiveness in construction industry in comparison with foreign workforce. It is hoped that the accumulated findings contribute to decrease demand for foreign workers and skills shortages in construction sectors. Therefore, job vacancies for local residents in Kish and other looking for job people in main lands will be increased. The method of collecting data has been conducted by distributing a questionnaire and interviewing most foreign construction workers, local Iranian construction works and the project managers of five mega projects in Kish Island including Mica mall, Basak, Persian, Damoon and Sarina mall. All data have been analyzed by SPSS and Excel software. A topic-related survey was conducted through a structured questionnaire including 54 employers, 20 contractors and 13 consultants. About 56 factors were identified. After implementing the context validity test, 52 factors were stated in 52 questions based on five major groups consist of: (1) economical, (2) social and cultural, (3) individual, (4) technical, (5) organizational, environmental and legal. Based on the quantified Relative Importance Index, the ten most important factors, ten less important factors, and three most important categories were identified. To date, there is not any comprehensive study that explores the important critical factors in mega construction projects on Kish Island to identify the major problems to decrease demand for foreign workers.

Keywords: cultural characteristics, foreign worker, local construction workers, productivity, technical training

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Authors: Ali Baker, Russel Krawitz

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This paper describes a rare occurrence where a potentially fatal complication of COVID-19 infection (MIS-A) was misdiagnosed as an acute abdomen. As most patients with this syndrome present with fever and gastrointestinal symptoms, they may inadvertently fall under the care of the surgical unit. However, unusual imaging findings and a poor response to anti-microbial therapy should prompt clinicians to suspect a non-surgical etiology. More than half of MIS-A patients require ICU admission and vasopressor support. Prompt referral to a physician is key, as the cornerstone of treatment is IVIG and corticosteroid therapy. A 32 year old woman presented with right sided abdominal pain and fevers. She had also contracted COVID-19 two months earlier. Abdominal examination revealed generalised right sided tenderness. The patient had raised inflammatory markers, but other blood tests were unremarkable. CT scan revealed extensive lymphadenopathy along the ileocolic chain. The patient proved to be a diagnostic dilemma. She was reviewed by several surgical consultants and discussed with several inpatient teams. Although IV antibiotics were commenced, the right sided abdominal pain, and fevers persisted. Pan-culture returned negative. A mild cholestatic derangement developed. On day 5, the patient underwent preparation for colonoscopy to assess for a potential intraluminal etiology. The following day, the patient developed sinus tachycardia and hypotension that was refractory to fluid resuscitation. That patient was transferred to ICU and required vasopressor support. Repeat CT showed peri-portal edema and a thickened gallbladder wall. On re-examination, the patient was Murphy’s sign positive. Biliary ultrasound was equivocal for cholecystitis. The patient was planned for diagnostic laparoscopy. The following morning, a marked rise in cardiac troponin was discovered, and a follow-up echocardiogram revealed moderate to severe global systolic dysfunction. The impression was post-COVID MIS with myocardial involvement. IVIG and Methylprednisolone infusions were commenced. The patient had a great response. Vasopressor support was weaned, and the patient was discharged from ICU. The patient continued to improve clinically with oral prednisolone, and was discharged on day 17. Although MIS following COVID-19 infection is well-described syndrome in children, only recently has it come to light that it can occur in adults. The exact incidence is unknown, but it is thought to be rare. A recent systematic review found only 221 cases of MIS-A, which could be included for analysis. Symptoms vary, but the most frequent include fever, gastrointestinal, and mucocutaneous. Many patients progress to multi-organ failure and require vasopressor support. 7% succumb to the illness. The pathophysiology of MIS is only partly understood. It shares similarities with Kawasaki disease, macrophage activation syndrome, and cytokine release syndrome. Importantly, by definition, the patient must have an absence of severe respiratory symptoms. It is thought to be due to a dysregulated immune response to the virus. Potential mechanisms include reduced levels of neutralising antibodies and autoreactive antibodies that promote inflammation. Further research into MIS-A is needed. Although rare, this potentially fatal syndrome should be considered in the unwell surgical patient who has recently contracted COVID-19 and poses a diagnostic dilemma.

Keywords: acute-abdomen, MIS, COVID-19, ICU

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Authors: Cláudia Alcoforado, Anabela Ribeiro

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This paper is part of an ongoing PhD thesis. It seeks to develop a model to identify the spatial failures of the public transportation supply. In the construction of the model, it also seeks to detect the social needs arising from the disadvantage in transport. The case study is carried out for the Brazilian city of Recife. Currently, Recife has a population density of 7,039.64 inhabitants per km². Unfortunately, only 46.9% of urban households on public roads have adequate urbanization. Allied to this reality, the trend of the occupation of the poorest population is that of the peripheries, a fact that has been consolidated in Brazil and Latin America, thus burdening the families' income, since the greater the distances covered for the basic activities and consequently also the transport costs. In this way, there have been great impacts caused by the supply of public transportation to locations with low demand or lack of urban infrastructure. The model under construction uses methods such as Currie’s Gap Assessment associated with the London’s Public Transport Access Level, and the Public Transport Accessibility Index developed by Saghapour. It is intended to present the stage of the thesis with the spatial/need gaps of the neighborhoods of Recife already detected. The benefits of the geographic information system are used in this paper. It should be noted that gaps are determined from the transport supply indices. In this case, considering the presence of walking catchment areas. Still in relation to the detection of gaps, the relevant demand index is also determined. This, in turn, is calculated through indicators that reflect social needs. With the use of the smaller Brazilian geographical unit, the census sector, the model with the inclusion of population density in the study areas should present more consolidated results. Based on the results achieved, an analysis of transportation disadvantage will be carried out as a factor of social exclusion in the study area. It is anticipated that the results obtained up to the present moment, already indicate a strong trend of public transportation in areas of higher income classes, leading to the understanding that the most disadvantaged population migrates to those neighborhoods in search of employment.

Keywords: gap assessment, public transport supply, social exclusion, spatial gaps

Procedia PDF Downloads 151

Authors: N. Elgendy, N. Hussein

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The current Syrian crisis has caused unprecedented practices of global mobility. The process of forced eviction and the resettlement of refugees could be seen through the insights of the “new mobilities paradigm”. The mobility of refugees in terms of meaning and practice is a subject that calls for further studies. There is a need for the development of an approach to human mobility to understand a practice that is turning into a phenomenon in the 21^st century. This paper aims at studying, from a qualitative point of view, the process of movement within the six constituents of mobility defined as the first phase of the journey of a refugee. The second phase would include the process of settling in and re-defining the host country as new “home” to refugees. The change in the refugee state of mind and crossing the physical and mental borders from a “foreigner” to a citizen is encouraged by both the governmental policies and the local communities’ efforts to embrace these newcomers. The paper would focus on these policies of social and economic integration. The concept of integration connotes the idea that refugees would enjoy the opportunities, rights and services available to the citizens of the refugee’s new community. So, this paper examines this concept through showcasing the two hosting countries of Canada and Egypt, as they provide two contrasting situations in terms of cultural, geographical, economic and political backgrounds. The analysis would highlight the specific policies defined towards the refugees including the mass communication, media calls, and access to employment. This research is part of a qualitative research project on the process of Urban Mobility practiced by the Syrian Refugees, drawing on conversational interviews with new-settlers who have moved to the different hosting countries, from their home in Syria. It explores these immigrants’ practical and emotional relationships with the process of movement and settlement. It uses the conversational interviews as a tool to document analysis and draw relationships in an attempt to establish an understanding of the factors that contribute to the new-settlers feeling of home and integration within the new community.

Keywords: integration, mobility, policy, refugees

Procedia PDF Downloads 296

Authors: Jolanta Jonak

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Emotional wellbeing is crucial for healthy development of children, youth, and adolescence. Lack of healthy emotional development and functioning can lead to many challenges in academic, social, and physical domains. Unfortunately, mental health problems are steadily increasing over the past several years and significantly intensified during and after the Covid 19 pandemic. Some experts warn that globally, we are entering a mental health crisis pandemic. Prior to the Covid 19 pandemic in 2020, a considerable number of youth aged 6-17 experienced a mental health disorder each year, with half of all mental health conditions beginning by age 14. The most common mental health disorders in children are Attention-Deficit/Hyperactivity Disorder (ADHD), behavior problems, anxiety, and depression. In U.S. schools, youth with these diagnoses tend to be classified under the umbrella of Emotional Disability. Several concerning trends have been emerging about the mental health of U.S. high school students. These trends have been steadily increasing for the past decade, particularly having increasing numbers of high school students who experienced persistent feelings of sadness or hopelessness, seriously considered attempting suicide, made a suicide plan, and attempted suicide. The number of students who felt persistently sad or hopeless increased across every racial and ethnic group. Parents, educators, and mental health providers are key stakeholders that are responsible for actively and effectively supporting struggling youth. A commonly faced challenge is that mental wellbeing is not supported as effectively as it should be. When effective prevention is paired with enhanced treatment developed on a multidisciplinary approach, mental health and emotional wellbeing in young people can be positively enhanced. Major health organizations including the Center for Disease Control and the National Institutes of Health encourage health professionals and other stakeholders to focus on addressing emotional wellbeing and mental health of young people.

Keywords: social emotional wellbeing, disability, learning, prevention

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Authors: Joshua Adan Valdez, Shawn Gallaher

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Global climate change has impacted atmospheric temperatures contributing to rising sea levels, decreasing sea ice, and increased freshening of high latitude oceans. This freshening has contributed to increased stratification inhibiting local mixing and nutrient transport, modifying regional circulations in polar oceans. In recent years, the Western Arctic has seen an increase in freshwater volume at an average rate of 397+-116km3/year across the Beaufort Gyre. The majority of the freshwater volume resides in the Beaufort Gyre surface lens driven by anticyclonic wind forcing, sea ice melt, and Arctic river runoff, and is typically defined as water fresher than 34.8. The near-isothermal nature of Arctic seawater and non-linearities in the equation of state for near-freezing waters result in a salinity-driven pycnocline as opposed to the temperature-driven density structure seen in the lower latitudes. In this study, we investigate the relationship between freshwater content and dynamic ocean topography (DOT). In situ measurements of freshwater content are useful in providing information on the freshening rate of the Beaufort Gyre; however, their collection is costly and time-consuming. Utilizing NASA’s ICESat-2’s DOT remote sensing capabilities and Air Expendable CTD (AXCTD) data from the Seasonal Ice Zone Reconnaissance Surveys (SIZRS), a linear regression model between DOT and freshwater content is determined along the 150° west meridian. Freshwater content is calculated by integrating the volume of water between the surface and a depth with a reference salinity of ~34.8. Using this model, we compare interannual variability in freshwater content within the gyre, which could provide a future predictive capability of freshwater volume changes in the Beaufort-Chukchi Sea using non-in situ methods. Successful employment of the ICESat-2’s DOT approximation of freshwater content could potentially demonstrate the value of remote sensing tools to reduce reliance on field deployment platforms to characterize physical ocean properties.

Keywords: Cryosphere, remote sensing, Arctic oceanography, climate modeling, Ekman transport

Procedia PDF Downloads 52

Authors: Ritvik Chauhan, Vijay Kumar Baraik

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Crime is a rare event on earth surface. It is not simple but a complex event occurring in a spatio- temporal environment. Crime is one of the most serious security threats to human environments as it may result in harm to the individuals through the loss of property, physical and psychological injuries. The conventional studies done on different nature crime was mostly related to laws, psychological, social and political themes. The geographical areas are heterogeneous in their environmental conditions, associations between structural conditions, social organization which contributing specific crimes. The crime pattern analysis is made through theories in which criminal events occurs in persistent, identifiable patterns in a particular space and time. It will be the combined analysis of spatial factors and rational factors to the crime. In this study, we are analyzing the combined factors for the origin of crime against children. Children have always been vulnerable to victimization more because they are silent victims both physically and mentally to crimes and they even not realize what is happening with them. Their trusting nature and innocence always misused by criminals to perform crimes. The nature of crime against children is changed in past years like child rape, kidnapping &abduction, selling & buying of girls, foeticide, infanticide, prostitution, child marriage etc turned to more cruel and inhuman. This study will focus on understanding the space-time pattern of crime against children during the period 2001-2012. It also makes an attempt to explore and ascertain the association of crimes categorised against children, its rates with various geographical and socio-demographic factors through causal analysis using selected indicators (child sex-ratio, education, literacy rate, employment, income, etc.) obtained from the Census of India and other government sources. The outcome of study will help identifying the high crime regions with specified nature of crimes. It will also review the existing efforts and exploring the new plausible measure for tracking, monitoring and minimization of crime rate to meet the end goal of protecting the children from crimes committed against them.

Keywords: crime against children, geographic profiling, spatio-temporal analysis, hotspot

Procedia PDF Downloads 194

Authors: Djurdjica Perovic, Sanja Pekovic, Tatjana Stanovcic, Jovana Vukcevic

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Tourism development in rural areas calls for a discussion of strategies that would attract more tourists. Several scholars argue that rural areas may become more attractive to tourists by leveraging their cultural heritage. The present paper explores the development of sustainable heritage tourism practices in transitional societies of the Western Balkans, specifically targeting Montenegrin rural areas. It addresses the sustainable tourism as a shift in business paradigm, enhancing the centrality of the host community, fostering the encounters with local culture, customs and heritage and minimizing the environmental and social impact. Disseminating part of the results of the interdisciplinary KATUN project, the paper explores the diversification of economic activities related to the cultural heritage of katuns (temporary settlements in Montenegrin mountainous regions where the agricultural households stay with livestock during the summer season) through sustainable agro-tourism. It addresses the role of heritage tourism in creating more dynamic economy of under-developed mountain areas, new employment opportunities, sources of income for the local community and more balanced regional development, all based on the principle of sustainability. Based on the substantial field research (including interviews with over 50 households and tourists, as well as the number of stakeholders such as relevant Ministries, business communities and media representatives), the paper analyses the strategies employed in raising the awareness and katun-sensitivity of both national and international tourists and stimulating their interest in sustainable agriculture, rural tourism and cultural heritage of Montenegrin mountain regions. Studying the phenomena of responsible tourism and tourists’ consumerist consciousness in Montenegro through development of katuns should allow evaluating stages of sustainability and cultural heritage awareness, closely intertwined with the EU integration processes in the country. Offering deeper insight at the relationship between rural tourism, sustainable agriculture and cultural heritage, the paper aims to understand if cultural heritage of the area is valuable for agro-tourism development and in which context.

Keywords: heritage tourism, sustainable tourism, added value, Montenegro

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Authors: Catarina Seco Matos, Miguel Amaral

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The developed world is facing falling birth rates and rising life expectancies. As a result, the overall demographic structure of societies is becoming markedly older. This leads to an economic and political pressure towards the extension of individuals’ working lives. On the other hand, evidence shows that some older workers choose to stay in the labour force as employees, whereas others choose to pursue a more entrepreneurial occupational path. Thus, entrepreneurship or self-employment may be an option for socioeconomic participation of older individuals. Previous research on senior entrepreneurship is scarce and it focuses mainly on entrepreneurship determinants and individuals’ intentions. The fact that entrepreneurship is perceived as a voluntary or involuntary decision or as a positive or a negative outcome by older individuals is, to the best of our knowledge, still unexplored in the literature. In order to analyse the determinants of entrepreneurial satisfaction among older individuals, primary data were obtained from a unique questionnaire survey, which was sent to Portuguese senior entrepreneurs who have launched their company aged 50 and over (N=181). Portugal is one of the countries in the world with the with the largest ageing population and with a high proportion of older individuals who remain active after their official retirement age – which makes it an extremely relevant case study on senior entrepreneurship. Findings suggest that non pecuniary factors (rather than pecuniary) are the main driver for entrepreneurship at older ages. Specifically, results show that the will to remain active is the main motivation of older individuals to become entrepreneurs. This is line with the activity and continuity theories. Furthermore, senior entrepreneurs tend to have had an active working life (using their professional experience as a proxy) and, thus, want to keep the same lifestyle at an older age (in line with theory of continuity). Finally, results show that even though older individuals’ companies may not show the best financial performance that does not seem to affect their satisfaction with the company and with entrepreneurship in general. The present study aims at exploring, discussing and bring new research on senior entrepreneurship to the fore, rather than assuming purely deductive approach; hence, further confirmatory analyses with larger sets from different countries of data are required.

Keywords: active ageing, entrepreneurship, older entrepreneur, Portugal, satisfaction, senior entrepreneur

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Authors: Agnes Simone

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A 52-year-old male with unknown psychiatric and medical history was brought to the Psychiatric Emergency Room by ambulance directly from jail. He had been detained for three weeks for possession of a firearm while intoxicated. On initial evaluation, the patient was unable to provide a reliable history. He presented with odd jerking movements of his extremities and catatonic features, including mutism and stupor. His vital signs were stable. Patient was transferred to the medical emergency department for work-up of altered mental status. Due to suspicion for opioid overdose, the patient was given naloxone (Narcan) with no improvement. Laboratory work-up included complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, vitamin B12, folate, magnesium, rapid plasma reagin, HIV, blood alcohol level, aspirin, and Tylenol blood levels, urine drug screen, and urinalysis, which were all negative. CT head and chest X-Ray were also negative. With this negative work-up, the medical team concluded there was no organic etiology and requested inpatient psychiatric admission. Upon re-evaluation by psychiatry, it was evident that the patient continued to have an altered mental status. Of note, the medical team did not include substance withdrawal in the differential diagnosis due to stable vital signs and a negative urine drug screen. The psychiatry team decided to check California's prescription drug monitoring program (CURES) and discovered that the patient was prescribed benzodiazepine alprazolam (Xanax) 2mg BID, a sedative-hypnotic, and hydrocodone/acetaminophen 10mg/325mg (Norco) QID, an opioid. After a thorough chart review, his daughter's contact information was found, and she confirmed his benzodiazepine and opioid use, with recent escalation and misuse. It was determined that the patient was experiencing alprazolam withdrawal, given this collateral information, his current symptoms, negative urine drug screen, and recent abrupt discontinuation of medications while incarcerated. After admission to the medical unit and two doses of alprazolam 2mg, the patient's mental status, alertness, and orientation improved, but he had no memory of the events that led to his hospitalization. He was discharged with a limited supply of alprazolam and a close follow-up to arrange a taper. Accompanying this case report, a qualitative review of presentations with alprazolam withdrawal was completed. This case and the review highlights: (1) Alprazolam withdrawal can occur at low doses and within just one week of use. (2) Alprazolam withdrawal can present without any vital sign instability. (3) Alprazolam withdrawal does not respond to short-acting benzodiazepines but does respond to certain long-acting benzodiazepines due to its unique chemical structure. (4) Alprazolam withdrawal is distinct from and more severe than other benzodiazepine withdrawals. This case highlights (1) the importance of physician utilization of drug-monitoring programs. This case, in particular, relied on California's drug monitoring program. (2) The importance of obtaining collateral information, especially in cases in which the patient is unable to provide a reliable history. (3) The importance of including substance intoxication and withdrawal in the differential diagnosis even when there is a negative urine drug screen. Toxidrome of withdrawal can be delayed. (4) The importance of discussing addiction and withdrawal risks of medications with patients.

Keywords: addiction risk of benzodiazepines, alprazolam withdrawal, altered mental status, benzodiazepines, drug monitoring programs, sedative-hypnotics, substance use disorder

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Authors: Henda J Thomas, Cornelia PJ Harmse, Cecile Schultz

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Wearables are one of the technologies that will flourish within the fourth industrial revolution and digital transformation arenas, allowing employers to integrate collected data into organisational information systems. The study aimed to investigate whether wearable technology readiness can predict employees’ acceptance to wear wearables in the workplace. The factors of technology readiness predisposition that predict acceptance and positive attitudes towards wearable use in the workplace were examined. A quantitative research approach was used. The population consisted of 8 081 South African Department of Employment and Labour employees (DEL). Census sampling was used, and questionnaires to collect data were sent electronically to all 8 081 employees, 351 questionnaires were received back. The measuring instrument called the Technology Readiness and Acceptance Model (TRAM) was used in this study. Four hypotheses were formulated to investigate the relationship between readiness and acceptance of wearables in the workplace. The results found consistent predictions of technology acceptance (TA) by eagerness, optimism, and discomfort in the technology readiness (TR) scales. The TR scales of optimism and eagerness were consistent positive predictors of the TA scales, while discomfort proved to be a negative predictor for two of the three TA scales. Insecurity was found not to be a predictor of TA. It was recommended that the digital transformation policy of the DEL should be revised. Wearables in the workplace should be embraced from the viewpoint of convenience, automation, and seamless integration with the DEL information systems. The empirical contribution of this study can be seen in the fact that positive attitude emerged as a factor that extends the TRAM. In this study, positive attitude is identified as a new dimension to the TRAM not found in the original TA model and subsequent studies of the TRAM. Furthermore, this study found that Perceived Usefulness (PU) and Behavioural Intention to Use and (BIU) could not be separated but formed one factor. The methodological contribution of this study can lead to the development of a Wearable Readiness and Acceptance Model (WRAM). To the best of our knowledge, no author has yet introduced the WRAM into the body of knowledge.

Keywords: technology acceptance model, technology readiness index, technology readiness and acceptance model, wearable devices, wearable technology, fourth industrial revolution

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Authors: Burçin Saltık, Levent Genç

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In this study, it was aimed to determine a route for identification of rice cultivation areas within Thrace and Marmara regions of Turkey using remote sensing and GIS. Landsat 8 (OLI-TIRS) imageries acquired in production season of 2013 with 181/32 Path/Row number were used. Four different seasonal images were generated utilizing original bands and different transformation techniques. All images were classified individually using supervised classification techniques and Land Use Land Cover Maps (LULC) were generated with 8 classes. Areas (ha, %) of each classes were calculated. In addition, district-based rice distribution maps were developed and results of these maps were compared with Turkish Statistical Institute (TurkSTAT; TSI)’s actual rice cultivation area records. Accuracy assessments were conducted, and most accurate map was selected depending on accuracy assessment and coherency with TSI results. Additionally, rice areas on over 4° slope values were considered as mis-classified pixels and they eliminated using slope map and GIS tools. Finally, randomized rice zones were selected to obtain maximum-minimum value ranges of each date (May, June, July, August, September images separately) NDVI, LSWI, and LST images to test whether they may be used for rice area determination via raster calculator tool of ArcGIS. The most accurate classification for rice determination was obtained from seasonal LSWI LULC map, and considering TSI data and accuracy assessment results and mis-classified pixels were eliminated from this map. According to results, 83151.5 ha of rice areas exist within study area. However, this result is higher than TSI records with an area of 12702.3 ha. Use of maximum-minimum range of rice area NDVI, LSWI, and LST was tested in Meric district. It was seen that using the value ranges obtained from July imagery, gave the closest results to TSI records, and the difference was only 206.4 ha. This difference is normal due to relatively low resolution of images. Thus, employment of images with higher spectral, spatial, temporal and radiometric resolutions may provide more reliable results.

Keywords: landsat 8 (OLI-TIRS), LST, LSWI, LULC, NDVI, rice

Procedia PDF Downloads 203

Authors: Yuen Man Yan

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Peer support has been a rising prevalent mental health service in the globe. The community-based mental health services employ persons with lived experience of mental illness to be peer support workers (PSWs) to provide peer support service to those who are in the progress of recovery (PIRs). It represents the transformation of mental health service system to a recovery-oriented and person-centered care. Literatures proved the feasibility and effectiveness of the peer support service. Researchers have attempted to explore the unique good qualities of peer support service that benefit the PIRs. Empirical researches found that the strength of the relationship between those who sought for change and the change agents positively related to the outcomes in one-to-one therapies across theoretical orientations. However, there is lack of literature on investigating the relationship building between the PSWs and PIRs in the one-to-one community-based peer support service. This study aims to identify and characterise the relationship in the community-based one-to-one peer support service from the perspectives of PSWs and PIRs; and to conceptualize the components of relationship building between PSWs and PIRs in the community-based one-to-one peer support service. The study adopted the constructivist grounded theory approach. 10 pairs of the PSWs and PIRs participated in the study. Data were collected through multiple qualitative methods, including observation of the interaction and exchange of the PSWs and PIRs in the 1ₛₜ, 3ᵣ𝒹 and 9th sessions of the community-based one-to-one peer support service; and semi-structural interview with the PSWs and PIRs separately after the 3ᵣ𝒹and 9ₜₕ session of the peer support service. This presentation is going to report the preliminary findings of the study. PSWs and PIRs identified their relationship as “life alliance”. Empathy was found to be one of key components of the relationship between the PSWs and the PIRs. Unlike the empathy, as explained by Carl Roger, in which the service provider was able to put themselves into the shoes of the service recipients as if he was the service recipients, the intensity of the empathy was much greater in the relationship between PSWs and PIRs because PSWs had the lived experience of mental illness and recovery. The dimensions of the empathy in the relationship between PSWs and PIRs was found to be multiple, not only related to the mental illness but also related to various aspects in life, like family relationship, employment, interest of life, self-esteem and etc.

Keywords: person with lived experience, peer support worker, peer support service, relationship building, therapeutic alliance, community-based mental health setting

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Authors: Tasha L. Golden

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Girls in the U.S. juvenile justice system are most often arrested for truancy, drug use, or running from home, all of which are symptoms of abuse. In fact, some have called this 'The Sexual Abuse to Prison Pipeline.' Such abuse has consequences for girls' health, education, employment, and parenting, often resulting in significant health disparities. Yet when arrested, girls rarely encounter services designed to meet their unique needs. Instead, they are expected to cope with a system that was historically designed for males. In fact, even literature advocating for increased gender equity frequently fails to include girls’ voices and firsthand accounts. In response to these combined injustices, public health researchers launched a trauma-informed creative writing intervention in a southern juvenile detention facility. The program was designed to improve the health of detained girls, while also establishing innovative methods of both data collection and social justice advocacy. Girls’ poems and letters were collected and coded, adding rich qualitative data to traditional survey responses. In addition, as part of the intervention, these poems are regularly published by international literary publisher Sarabande Books—and distributed to judges, city leaders, attorneys, state representatives, and more. By utilizing a creative medium, girls generated substantial civic engagement with their concerns—thus expanding their influence and improving policy advocacy efforts. Researchers hypothesized that having access to their communities and policy makers would provide its own health benefits for incarcerated girls: cultivating self-esteem, locus of control, and a sense of leadership. This paper discusses the establishment of this intervention, examines findings from its evaluation, and includes several girls’ poems as exemplars. Grounded in social science regarding expressive writing, stigma, muted group theory, and health promotion, the paper theorizes about the application of arts-based advocacy efforts to other social justice endeavors.

Keywords: advocacy, public health, social justice, women’s health

Procedia PDF Downloads 139

Authors: Philip A. Szlosek, M. Susan Guyer, Mary G. Barnum, Elizabeth M. Mullin

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In the United States, athletic training is a healthcare profession that encompasses the prevention, examination, diagnosis, treatment, and rehabilitation of injuries and medical conditions. Athletic trainers work under the direction of or in collaboration with a physician and are recognized by the American Medical Association as allied healthcare professionals. Internationally, this profession is often known as athletic therapy. As healthcare professionals, athletic trainers must be prepared for autonomous practice immediately after graduation. However, new athletic trainers have been shown to have clinical areas of strength and weakness.To better assess professional readiness and improve the preparedness of new athletic trainers, the factors of athletic training professional readiness must be defined. Limited research exists defining the holistic aspects of professional readiness needed for athletic trainers. Confirming the factors of professional readiness in athletic training could enhance the professional preparation of athletic trainers and result in more highly prepared new professionals. The objective of this study was to further explore and confirm the factors of professional readiness in athletic training. Authors useda qualitative design based in grounded theory. Participants included athletic trainers with greater than 24 months of experience from a variety of work settings from each district of the National Athletic Trainer’s Association. Participants took the demographic questionnaire electronically using Qualtrics Survey Software (Provo UT). After completing the demographic questionnaire, 20 participants were selected to complete one-on-one interviews using GoToMeeting audiovisual web conferencing software. IBM Statistical Package for the Social Sciences (SPSS, v. 21.0) was used to calculate descriptive statistics for participant demographics. The first author transcribed all interviews verbatim and utilized a grounded theory approach during qualitative data analysis. Data were analyzed using a constant comparative analysis and open and axial coding. Trustworthiness was established using reflexivity, member checks, and peer reviews. Analysis revealed four overarching themes, including management, interpersonal relations, clinical decision-making, and confidence. Management was categorized as athletic training services not involving direct patient care and was divided into three subthemes, including administration skills, advocacy, and time management. Interpersonal Relations was categorized as the need and ability of the athletic trainer to properly interact with others. Interpersonal relations was divided into three subthemes, including personality traits, communication, and collaborative practice. Clinical decision-making was categorized as the skills and attributes required by the athletic trainer whenmaking clinical decisions related to patient care. Clinical decision-making was divided into three subthemes including clinical skills, continuing education, and reflective practice. The final theme was confidence. Participants discussed the importance of confidence regarding relationships building, clinical and administrative duties, and clinical decision-making. Overall, participants explained the value of a well-rounded athletic trainer and emphasized that athletic trainers need communication and organizational skills, the ability to collaborate, and must value self-reflection and continuing education in addition to having clinical expertise. Future research should finalize a comprehensive model of professional readiness for athletic training, develop a holistic assessment instrument for athletic training professional readiness, and explore the preparedness of new athletic trainers.

Keywords: autonomous practice, newly certified athletic trainer, preparedness for professional practice, transition to practice skills

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Authors: Ann Devitt, Mairead Brady, Markus Lamest, Stephen Gomez

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This study set out to explore the use of an online collaborative serious game for student learning in a postgraduate introductory marketing module. The simulation game aimed to bridge the theory-practice divide in marketing by allowing students to apply theory in a safe, simulated marketplace. This study addresses the following research questions: Does an online marketing simulation game engage students higher order cognitive skills? Does collaborative activity required develop students’ “soft” skills, such as communication and negotiation? What specific affordances of the online simulation promote learning? This qualitative case study took place in 2014 with 40 postgraduate students on a Business Masters Programme. The two-week intensive module combined lectures with collaborative activity on a marketing simulation game, MMX from Pearsons. The game requires student teams to compete against other teams in a marketplace and design a marketing plan to maximize key performance indicators. The data for this study comprise essays written by students after the module reflecting on their learning on the module. A thematic analysis was conducted of the essays using the following a priori theme sets: 6 levels of the cognitive domain of Blooms taxonomy; 5 principles of Cooperative Learning; affordances of simulation environments including experiential learning; motivation and engagement; goal orientation. Preliminary findings would strongly suggest that the game facilitated students identifying the value of theory in practice, in particular for future employment; enhanced their understanding of group dynamics and their role within that; and impacted very strongly, both positively and negatively on motivation. In particular the game mechanics of MMX, which hinges on the correct identification of a target consumer group, was identified as a key determinant of extrinsic and intrinsic motivation for learners. The findings also suggest that the situation of the simulation game within a broader module which required post-game reflection was valuable in identifying key learning of marketing concepts in both the positive and the negative experiences of the game.

Keywords: simulation, marketing, serious game, cooperative learning, bloom's taxonomy

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Authors: Kishor Prasad Bhatta, Suman Ghimire, Durga Prasad Joshi

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Invasive Alien Species (IAS) are considered waste forest resources in Nepal. The rapid expansion of IAS is one of the nine main drivers of forest degradation, though the extent and distribution of this species are not well known. Further, the knowledge of the impact of IAS removal on forest plant diversity is hardly known, and the possibilities of income generation from them at the grass-root communities are rarely documented. Systematic sampling of 1% with nested circular plots of 500 square meters was performed in IAS removed and non-removed area, each of 30 hectares in Udayapur Community Forest User Group (CFUG), Chitwan, central Nepal to observe whether the removal of IAS contributed to an increase in plant diversity. In addition, ten entrepreneurs of Udaypur CFUG, involved in the charcoal production, briquette making and marketing were interviewed and interacted as well as their record keeping booklets were reviewed to understand if the charcoal production contributed to their income and employment. The average annual precipitation and temperature of the study area is 2100 mm and 34 degree Celsius respectively with Shorea robusta as main tree species and Eupatorium odoratum as dominant IAS. All the interviewed households were from the ̔below-poverty-line’ category as per Community Forestry Guidelines. A higher Shannon-Weiner plant diversity index at regeneration level was observed in IAS removed areas (2.43) than in control site (1.95). Furthermore, the number of tree seedlings and saplings in the IAS harvested blocks were significantly higher (p < 0.005) compared to the unharvested one. The sale of charcoal produced through the pyrolysis of IAS in ̔ Bio-energy kilns’ contributed for an average increased income of 30.95 % (Nepalese rupees 31,000) of the involved households. Despite above factors, some operational policy hurdles related to charcoal transport and taxation existed at field level. This study suggests that plant diversity could be increased through the removal of IAS, and considerable economic benefits could be achieved if charcoal is substantially produced and utilized.

Keywords: briquette, economic benefits, pyrolysis, regeneration

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Authors: Sukruthai Sapniwat, Falan Srisuriyachai

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Polymer Flooding is one of the most well-known methods in Enhanced Oil Recovery (EOR) technology which can be implemented after either primary or secondary recovery, resulting in favorable conditions for the displacement mechanism in order to lower the residual oil in the reservoir. Polymer substances can lower the mobility ratio of the whole process by increasing the viscosity of injected water. Therefore, polymer flooding can increase volumetric sweep efficiency, which leads to a better recovery factor. Moreover, polymer adsorption onto rock surface can help decrease reservoir permeability contrast with high heterogeneity. Due to the reduction of the absolute permeability, effective permeability to water, representing flow ability of the injected fluid, is also reduced. Once polymer is adsorbed onto rock surface, polymer molecule can be desorbed when different fluids are injected. This study is performed to evaluate the effects of the adsorption and desorption process of polymer solutions to yield benefits on the oil recovery mechanism. A reservoir model is constructed by reservoir simulation program called STAR® commercialized by the Computer Modeling Group (CMG). Various polymer concentrations, starting times of polymer flooding process and polymer injection rates were evaluated with selected values of polymer desorption degrees including 0, 25, 50, 75 and 100%. The higher the value, the more adsorbed polymer molecules to return back to flowing fluid. According to the results, polymer desorption lowers polymer consumption, especially at low concentrations. Furthermore, starting time of polymer flooding and injection rate affect the oil production. The results show that waterflooding followed by earlier polymer flooding can increase the oil recovery factor while the higher injection rate also enhances the recovery. Polymer concentration is related to polymer consumption due to the two main benefits of polymer flooding control described above. Therefore, polymer slug size should be optimized based on polymer concentration. Polymer desorption causes polymer re-employment that is previously adsorbed onto rock surface, resulting in an increase of sweep efficiency in the further period of polymer flooding process. Even though waterflooding supports polymer injectivity, water cut at the producer can prematurely terminate the oil production. The injection rate decreases polymer adsorption due to decreased retention time of polymer flooding process.

Keywords: enhanced oil recovery technology, polymer adsorption and desorption, polymer flooding, reservoir simulation

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Authors: Arfan Fadli, Marini Kristina Situmeang, Mukhammad Fatkhullah, Siti Hazar Sitorus

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Merantau is one of the traditions that has been done by the Minangkabau tribe since the 15th century where it is based on socio-economic factors. In fact, that is not only limited to economic factors alone but more how to develop themselves through the experience to get the skills or education. The lack of jobs opportunity in the hometown causes the community, especially for young men to seek livelihoods in other areas. Unemployment impacts on the economy of the community that led to change in the pattern of employment from farmers to traders or new businesses in areas outside of their homeland. This is also worsened because many young people are not interested in becoming a farmer and working on the land in their village. In this context, merantau is considered to be an alternative to fulfilling livelihoods, and therefore this study examines how the merantau tradition constructed by the Minangkabau community, West Sumatera Province. The research method is done by literature review by collecting information related to the social construction of merantau tradition from various scientific publications. The results show how merantau becomes a solution of economic problems for Minangkabau society. Merantau which has now become an institutionalized tradition for the Minangkabau community where the culture of merantau occurred like a chain that can raise the people from the condition of poverty. When there are people who have successfully in merantau, they tend to bring other relatives who have not found a job to be able to trade with them. In the place of merantau, they will be disciplined to learn how to trade. Eventually, they will have new skills to trade and even make their own business. The tradition of bringing relatives to the rantau to be empowered is a unique side of merantau because it is influenced by the Matrilinear kinship system. The matrilineal kinship system in Minangkabau is the largest in the world where helping relatives are considered to be of the highest value. This system also places men as high positions where men should be encouraged to go abroad for financial success and to help their relatives in their hometown. The success of this tradition (to uplift and resolve the poverty and manpower issues) is demonstrated by the tradition of Minangkabau communities that have been successful in the area of Rantau that send money to their relatives in their homes (remittance). Merantau tradition can also be an alternative in reducing unemployment especially for young people where it is demonstrated by the culture of helping relatives to get work outside of their homeland.

Keywords: matrilineal kinship system, merantau, minangkabau community, reducing unemployment

Procedia PDF Downloads 179

Authors: L. Musak, J. Valachova, T. Vasicko, O. Osina

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Introduction: Stainless steel is resistant to electrochemical corrosion by passivation. Welders are greatly exposed to welding fumes of toxic metals, which added to this steel. The content of chromium (Cr) in steel was above 11.5%, Ni and Mo from 2 to 6.5%. The aim of the study was the evaluation of occupational exposure to Cr, chromosome analysis and valuation of individual susceptibility polymorphism of gene CCND1 c.870 G>A. Materials and Methods: The exposed group was consisted from 117 welders of stainless steels. The average age was 38.43 years and average exposure time 7.14 years. Smokers represented 40.17%. The control group consisted of 123 non-exposed workers with an average age of 39.74 years and time employment 16.67 years. Smokers accounted for 22.76%. Analysis of Cr in blood and urine was performed by atomic absorption spectrophotometry (AAS Varian SpectraAA 30P) with electrothermal decomposition of the sample in the graphite furnace. For the evaluation of chromosomal aberrations (CA) was used cytogenetic analysis of peripheral blood lymphocytes, gene polymorphism was determined by PCR-RFLP reaction using appropriate primers and restriction enzymes. For statistical analysis was used the Mann-Whitney U-test. Results: The mean Cr level in exposed group was 0.095 mmol/l (0.019 min-max 0.504). No value does exceed the average normal value. The average value Cr in urine was 7.9 mmol/mol creatinine (min 0.026 to max 19.26). The total number of CA was 1.86% in compared to 1.70% controls. (CTA-type 0.90% vs 0.80% and CSA-type 0.96% vs 0.90%). In the number of total CA was observed statistical difference between smokers and non-smokers of exposed group (S-1.57% vs. NS-2.04%, P<0.05). In CCND1 gene polymorphisms was observed the increasing of the total CA with wild-type allele (WT) via heterozygous to the VAR genotype (1.44%<1.82%<2.13%). There was observed a statistically higher incidence of CTA-type aberrations in variant genotypes between exposed and control groups (1.22% vs. 0.59%, P<0.05). Discussion and conclusions: The work place is usually higher source of exposure to harmful factors. Workers need consistently and checked frequently health control. In assessing the risk of adverse effects of metals is important to consider their persistence, behavior and bioavailability. Prolonged exposure to carcinogens may not manifest symptoms of poisoning, but delayed effects may occur, which resulted in a higher incidence of malignant tumors.

Keywords: genotoxicity, chromium, stainless steels, welders

Procedia PDF Downloads 344

Authors: Victor Kang, Sirene Bellahnid, Amy Al-Simaani

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Efficient documentation and completion of clerical tasks are pillars of efficient patient-centered care in acute settings such as the emergency department (ED). Medical scribes aid physicians with documentation, navigation of electronic health records, results gathering, and communication coordination with other healthcare teams. However, the use of medical scribes is not widespread, with some hospitals even continuing to discontinue their programs. One reason for this could be the lack of studies that have outlined concrete improvements in efficiency and patient and provider satisfaction in emergency departments before and after incorporating scribes. Methods: We conducted a review of the literature concerning the implementation of a medical scribe program and emergency department performance. For this review, a narrative synthesis accompanied by textual commentaries was chosen to present the selected papers. PubMed was searched exclusively. Initially, no date limits were set, but seeing as the electronic medical record was officially implemented in Canada in 2013, studies published after this date were preferred as they provided insight into the interplay between its implementation and scribes on quality improvement. Results: Throughput, efficiency, and cost-effectiveness were the most commonly used parameters in evaluating scribes in the Emergency Department. Important throughput metrics, specifically door-to-doctor and disposition time, were significantly decreased in emergency departments that utilized scribes. Of note, this was shown to be the case in community hospitals, where the burden of documentation and clerical tasks would fall directly upon the attending physician. Academic centers differ in that they rely heavily on residents and students; so the implementation of scribes has been shown to have limited effect on these metrics. However, unique to academic centers was the provider’s perception of incrased time for teaching was unique to academic centers. Consequently, providers express increased work satisfaction in relation to time spent with patients and in teaching. Patients, on the other hand, did not demonstrate a decrease in satisfaction in regards to the care that was provided, but there was no significant increase observed either. Of the studies we reviewed, one of the biggest limitations was the lack of significance in the data. While many individual studies reported that medical scribes in emergency rooms improved relative value units, patient satisfaction, provider satisfaction, and increased number of patients seen, there was no statistically significant improvement in the above criteria when compiled in a systematic review. There is also a clear publication bias; very few studies with negative results were published. To prove significance, data from more emergency rooms with scribe programs would need to be compiled which also includes emergency rooms who did not report noticeable benefits. Furthermore, most data sets focused only on scribes in academic centers. Conclusion: Ultimately, the literature suggests that while emergency room physicians who have access to medical scribes report higher satisfaction due to lower clerical burdens and can see more patients per shift, there is still variability in terms of patient and provider satisfaction. Whether or not this variability exists due to differences in training (in-house trainees versus contractors), population profile (adult versus pediatric), setting (academic versus community), or which shifts scribe work cannot be determined based on the studies that exist. Ultimately, more scribe programs need to be evaluated to determine whether these variables affect outcomes and prove whether scribes significantly improve emergency room efficiency.

Keywords: emergency medicine, medical scribe, scribe, documentation

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Authors: Sahar Navabakhsh, Rokia Raslan, Yair Schwartz

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Decision-making on regeneration of housing estates, whether to refurbish or re-build, has been mostly triggered by economic factors. To enable sustainable growth, it is vital that environmental and social impacts of different scenarios are also taken into account. The methodology used to include all the three sustainable development pillars is called Life Cycle Sustainability Assessment (LCSA), which comprises of Life Cycle Assessment (LCA) for the assessment of environmental impacts of buildings. Current practice of LCA is regularly conducted post design stage and by sustainability experts. Not only is undertaking an LCA at this stage less effective, but issues such as the limited scope for the definition and assessment of environmental impacts, the implication of changes in the system boundary and the alteration of each of the variable metrics, employment of different Life Cycle Impact Assessment Methods and use of various inventory data for Life Cycle Inventory Analysis can result in considerably contrasting results. Given the niche nature and scarce specialist domain of LCA of buildings, the majority of the stakeholders do not contribute to the generation or interpretation of the impact assessment, and the results can be generated and interpreted subjectively due to the mentioned uncertainties. For an effective and democratic assessment of environmental impacts, different stakeholders, and in particular the community and design team should collaborate in the process of data collection, assessment and analysis. This paper examines and evaluates a participatory approach to LCSA through the analysis of a case study of a housing estate in South West London. The study has been conducted throughout tier-based collaborative methods to collect and share data through surveys and co-design workshops with the community members and the design team as the main stakeholders. The assessment of lifecycle impacts is conducted throughout the process and has influenced the decision-making on the design of the Community Plan. The evaluation concludes better assessment transparency and outcome, alongside other socio-economic benefits of identifying and engaging the most contributive stakeholders in the process of conducting LCSA.

Keywords: life cycle assessment, participatory LCA, life cycle sustainability assessment, participatory processes, decision-making, housing estate regeneration

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Authors: Pronab Ganguly, Ahmed A. Moustafa

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Holistic management of schizophrenia involves mainstream pharmacological intervention, complimentary medicine intervention, therapeutic intervention and other psychosocial factors such as accommodation, education, job training, employment, relationship, friendship, exercise, overall well-being, smoking, substance abuse, suicide prevention, stigmatisation, recreation, entertainment, violent behaviour, arrangement of public trusteeship and guardianship, day-day-living skill, integration with community, and management of overweight due to medications and other health complications related to medications amongst others. Our review shows that there is no integrated survey by combining all these factors. An international web-based survey was conducted to evaluate the significance of all these factors and present them in a unified manner. It is believed this investigation will contribute positively towards holistic management of schizophrenia. There will be two surveys. In the pharmacological intervention survey, five popular drugs for schizophrenia will be chosen and their efficacy as well as harmful side effects will be evaluated on a scale of 0 -10. This survey will be done by psychiatrists. In the second survey, each element of therapeutic intervention and psychosocial factors will be evaluated according to their significance on a scale of 0 - 10. This survey will be done by care givers, psychologists, case managers and case workers. For the first survey, professional bodies of psychiatrists in English speaking countries will be contacted to request them to ask their members to participate in the survey. For the second survey, professional bodies of clinical psychologist and care givers in English speaking countries will be contacted to request them to ask their members to participate in the survey. Additionally, for both the surveys, relevant professionals will be contacted through personal contact networks. For both the surveys, mean, mode, median, standard deviation and net promoter score will be calculated for each factor and then presented in a statistically significant manner. Subsequently each factor will be ranked according to their statistical significance. Additionally, country specific variation will be highlighted to identify the variation pattern. The results of these surveys will identify the relative significance of each type of pharmacological intervention, each type of therapeutic intervention and each type of psychosocial factor. The determination of this relative importance will definitely contribute to the improvement in quality of life for individuals with schizophrenia.

Keywords: schizophrenia, holistic management, antipsychotics, quality of life

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Authors: Annelyn Fatima Lopez, Ermenilda Avendano, Aileen Marie Vargas, Lara Baylon, Rorilee Angeles

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BACKGROUND: The COVID-19 resulted in a public health emergency and quarantine measures which may negatively impact psychosocial and environmental aspects of vulnerable populations. OBJECTIVES: This study intended to determine the quality of life, situations and emerging concerns of parents of children with neurodevelopmental disorders during the ongoing coronavirus pandemic. METHODOLOGY: Parents of patients seen in the PCMC Neurodevelopmental Pediatrics OPD clinic were recruited to fill out questionnaires on parent and child characteristics, survey on situations and emerging concerns during the coronavirus pandemic and WHOQOL-BREF (Filipino version) for parental quality of life. RESULTS: Data from 115 respondents showed a lower score in the environmental domain. The child characteristics that are statistically comparable with the QoL scores include sex, severity of ID and ADHD while the parent characteristics that are statistically comparable with the QoL scores include educational attainment, monthly family income, father’s employment status and family structure (P-value <0.05). Most respondents reported physical distancing (82.61%) and curfew (80.87%) as measures implemented due to the pandemic. Inability to access essential services (43.48-74.48%) were further compounded by limited financial resources (51.30%) and public transport (60%). Government responses received include quarantine pass (90.43%), food allowance or relief package (86.09%), disinfection (60.87%), DSWD-SAP (42.61%) and cash distribution (41.74%). Concerns encountered include socio-environmental issues (i.e. no available transportation, effect on the ability to earn, inadequate food/medicine rations, disruptions in basic social services) and patient concerns (i.e. access to education, medical, developmental and behavioral services, nutrition and sleep). RECOMMENDATIONS: Programs and policies should be planned accordingly to provide improvement of quality of life for both parents and the child with a neurodevelopmental disorder.

Keywords: covid-19, neurodevelopmental disorder, parental quality of life, whoqol-bref

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Authors: Daijun Chen

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Affordable housing is subsidized by the government to meet the housing demand of low and middle-income urban residents in the process of urbanization and to alleviate the housing inequality caused by market-based housing reforms. It is a recognized fact that the living conditions of the insured have been improved while constructing the subsidized housing. However, the choice of affordable housing is mostly in the suburbs, where the surrounding urban functions and infrastructure are incomplete, resulting in the spatial mismatch of "jobs-housing" in affordable housing. The main reason for this problem is that the residents of affordable housing are more sensitive to the spatial location of their residence, but their selectivity and controllability to the housing location are relatively weak, which leads to higher commuting costs. Their real cost of living has not been effectively reduced. In this regard, 92 subsidized housing communities in Nanjing, China, are selected as the research sample in this paper. The residents of the affordable housing and their commuting Spatio-temporal behavior characteristics are identified based on the LBS (location-based service) data. Based on the spatial mismatch theory, spatial mismatch indicators such as commuting distance and commuting time are established to measure the spatial mismatch degree of subsidized housing in different districts of Nanjing. Furthermore, the geographically weighted regression model is used to analyze the influencing factors of the spatial mismatch of affordable housing in terms of the provision of employment opportunities, traffic accessibility and supporting service facilities by using spatial, functional and other multi-source Spatio-temporal big data. The results show that the spatial mismatch of affordable housing in Nanjing generally presents a "concentric circle" pattern of decreasing from the central urban area to the periphery. The factors affecting the spatial mismatch of affordable housing in different spatial zones are different. The main reasons are the number of enterprises within 1 km of the affordable housing district and the shortest distance to the subway station. And the low spatial mismatch is due to the diversity of services and facilities. Based on this, a spatial optimization strategy for different levels of spatial mismatch in subsidized housing is proposed. And feasible suggestions for the later site selection of subsidized housing are also provided. It hopes to avoid or mitigate the impact of "spatial mismatch," promote the "spatial adaptation" of "jobs-housing," and truly improve the overall welfare level of affordable housing residents.

Keywords: affordable housing, spatial mismatch, commuting characteristics, spatial adaptation, welfare benefits

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