Search results for: Sustained Attention to Response Task (SART)
Commenced in January 2007
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Edition: International
Paper Count: 11424

Search results for: Sustained Attention to Response Task (SART)

534 Thulium Laser Design and Experimental Verification for NIR and MIR Nonlinear Applications in Specialty Optical Fibers

Authors: Matej Komanec, Tomas Nemecek, Dmytro Suslov, Petr Chvojka, Stanislav Zvanovec

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Nonlinear phenomena in the near- and mid-infrared region are attracting scientific attention mainly due to the supercontinuum generation possibilities and subsequent utilizations for ultra-wideband applications like e.g. absorption spectroscopy or optical coherence tomography. Thulium-based fiber lasers provide access to high-power ultrashort pump pulses in the vicinity of 2000 nm, which can be easily exploited for various nonlinear applications. The paper presents a simulation and experimental study of a pulsed thulium laser based for near-infrared (NIR) and mid-infrared (MIR) nonlinear applications in specialty optical fibers. In the first part of the paper the thulium laser is discussed. The thulium laser is based on a gain-switched seed-laser and a series of amplification stages for obtaining output peak powers in the order of kilowatts for pulses shorter than 200 ps in full-width at half-maximum. The pulsed thulium laser is first studied in a simulation software, focusing on seed-laser properties. Afterward, a pre-amplification thulium-based stage is discussed, with the focus of low-noise signal amplification, high signal gain and eliminating pulse distortions during pulse propagation in the gain medium. Following the pre-amplification stage a second gain stage is evaluated with incorporating a thulium-fiber of shorter length with increased rare-earth dopant ratio. Last a power-booster stage is analyzed, where the peak power of kilowatts should be achieved. Examples of analytical study are further validated by the experimental campaign. The simulation model is further corrected based on real components – parameters such as real insertion-losses, cross-talks, polarization dependencies, etc. are included. The second part of the paper evaluates the utilization of nonlinear phenomena, their specific features at the vicinity of 2000 nm, compared to e.g. 1550 nm, and presents supercontinuum modelling, based on the thulium laser pulsed output. Supercontinuum generation simulation is performed and provides reasonably accurate results, once fiber dispersion profile is precisely defined and fiber nonlinearity is known, furthermore input pulse shape and peak power must be known, which is assured thanks to the experimental measurement of the studied thulium pulsed laser. The supercontinuum simulation model is put in relation to designed and characterized specialty optical fibers, which are discussed in the third part of the paper. The focus is placed on silica and mainly on non-silica fibers (fluoride, chalcogenide, lead-silicate) in their conventional, microstructured or tapered variants. Parameters such as dispersion profile and nonlinearity of exploited fibers were characterized either with an accurate model, developed in COMSOL software or by direct experimental measurement to achieve even higher precision. The paper then combines all three studied topics and presents a possible application of such a thulium pulsed laser system working with specialty optical fibers.

Keywords: nonlinear phenomena, specialty optical fibers, supercontinuum generation, thulium laser

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533 Conceptualizing of Priorities in the Dynamics of Public Administration Contemporary Reforms

Authors: Larysa Novak-Kalyayeva, Aleksander Kuczabski, Orystlava Sydorchuk, Nataliia Fersman, Tatyana Zemlinskaia

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The article presents the results of the creative analysis and comparison of trends in the development of the theory of public administration during the period from the second half of the 20th to the beginning of the 21st century. The process of conceptualization of the priorities of public administration in the dynamics of reforming was held under the influence of such factors as globalization, integration, information and technological changes and human rights is examined. The priorities of the social state in the concepts of the second half of the 20th century are studied. Peculiar approaches to determining the priorities of public administration in the countries of "Soviet dictatorship" in Central and Eastern Europe in the same period are outlined. Particular attention is paid to the priorities of public administration regarding the interaction between public power and society and the development of conceptual foundations for the modern managerial process. There is a thought that the dynamics of the formation of concepts of the European governance is characterized by the sequence of priorities: from socio-economic and moral-ethical to organizational-procedural and non-hierarchical ones. The priorities of the "welfare state" were focused on the decent level of material wellbeing of population. At the same time, the conception of "minimal state" emphasized priorities of human responsibility for their own fate under the conditions of minimal state protection. Later on, the emphasis was placed on horizontal ties and redistribution of powers and competences of "effective state" with its developed procedures and limits of responsibility at all levels of government and in close cooperation with the civil society. The priorities of the contemporary period are concentrated on human rights in the concepts of "good governance" and all the following ones, which recognize the absolute priority of public administration with compliance, provision and protection of human rights. There is a proved point of view that civilizational changes taking place under the influence of information and technological imperatives also stipulate changes in priorities, redistribution of emphases and update principles of managerial concepts on the basis of publicity, transparency, departure from traditional forms of hierarchy and control in favor of interactivity and inter-sectoral interaction, decentralization and humanization of managerial processes. The necessity to permanently carry out the reorganization, by establishing the interaction between different participants of public power and social relations, to establish a balance between political forces and social interests on the basis of mutual trust and mutual understanding determines changes of social, political, economic and humanitarian paradigms of public administration and their theoretical comprehension. The further studies of theoretical foundations of modern public administration in interdisciplinary discourse in the context of ambiguous consequences of the globalizational and integrational processes of modern European state-building would be advisable. This is especially true during the period of political transformations and economic crises which are the characteristic of the contemporary Europe, especially for democratic transition countries.

Keywords: concepts of public administration, democratic transition countries, human rights, the priorities of public administration, theory of public administration

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532 A Long-Standing Methodology Quest Regarding Commentary of the Qur’an: Modern Debates on Function of Hermeneutics in the Quran Scholarship in Turkey

Authors: Merve Palanci

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This paper aims to reveal and analyze methodology debates on Qur’an Commentary in Turkish Scholarship and to make sound inductions on the current situation, with reference to the literature evolving around the credibility of Hermeneutics when the case is Qur’an commentary and methodological connotations related to it, together with the other modern approaches to the Qur’an. It is fair to say that Tafseer, constituting one of the main parts of basic Islamic sciences, has drawn great attention from both Muslim and non-Muslim scholars for a long time. And with the emplacement of an acute junction between natural sciences and social sciences in the post-enlightenment period, this interest seems to pave the way for methodology discussions that are conducted by theology spheres, occupying a noticeable slot in Tafseer literature, as well. A panoramic glance at the classical treatise in relation to the methodology of Tafseer, namely Usul al-Tafseer, leads the reader to the conclusion that these classics are intrinsically aimed at introducing the Qur’an and its early history of formation as a corpus and providing a better understanding of its content. To illustrate, the earliest methodology work extant for Qur’an commentary, al- Aql wa’l Fahm al- Qur’an by Harith al-Muhasibi covers content that deals with Qur’an’s rhetoric, its muhkam and mutashabih, and abrogation, etc. And most of the themes in question are evident to share a common ground: understanding the Scripture and producing an accurate commentary to be built on this preliminary phenomenon of understanding. The content of other renowned works in an overtone of Tafseer methodology, such as Funun al Afnan, al- Iqsir fi Ilm al- Tafseer, and other succeeding ones al- Itqan and al- Burhan is also rich in hints related to preliminary phenomena of understanding. However, these works are not eligible for being classified as full-fledged methodology manuals assuring a true understanding of the Qur’an. And Hermeneutics is believed to supply substantial data applicable to Qur’an commentary as it deals with the nature of understanding itself. Referring to the latest tendencies in Tafseer methodology, this paper envisages to centralize hermeneutical debates in modern scholarship of Qur’an commentary and the incentives that lead scholars to apply for Hermeneutics in Tafseer literature. Inspired from these incentives, the study involves three parts. In the introduction part, this paper introduces key features of classical methodology works in general terms and traces back the main methodological shifts of modern times in Qur’an commentary. To this end, revisionist Ecole, scientific Qur’an commentary ventures, and thematic Qur’an commentary are included and analysed briefly. However, historical-critical commentary on the Quran, as it bears a close relationship with hermeneutics, is handled predominantly. The second part is based on the hermeneutical nature of understanding the Scripture, revealing a timeline for the beginning of hermeneutics debates in Tafseer, and Fazlur Rahman’s(d.1988) influence will be manifested for establishing a theoretical bridge. In the following part, reactions against the application of Hermeneutics in Tafseer activity and pro-hermeneutics works will be revealed through cross-references to the prominent figures of both, and the literature in question in theology scholarship in Turkey will be explored critically.

Keywords: hermeneutics, Tafseer, methodology, Ulum al- Qur’an, modernity

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531 Higher Education in India Strength, Weakness, Opportunities and Threats

Authors: Renu Satish Nair

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Indian higher education system is the third largest in the world next to United States and China. India is experiencing a rapid growth in higher education in terms of student enrollment as well as establishment of new universities, colleges and institutes of national importance. Presently about 22 million students are being enrolled in higher education and more than 46 thousand institutions’ are functioning as centers of higher education. Indian government plays a 'command and control' role in higher education. The main governing body is University Grants Commission, which enforces its standards, advises the government, and helps coordinate between the centre and the state. Accreditation of higher learning is over seen by 12 autonomous institutions established by the University Grants Commission. The present paper is an effort to analyze the strength, weakness, opportunities and threat (SWOT Analysis) of Indian Higher education system. The higher education in India is progressing ahead by virtue of its strength which is being recognized at global level. Several institutions of India, such as Indian Institutes of Technology (IITs), Indian Institutes of Management (IIMs) and National Institutes of Technology (NITs) have been globally acclaimed for their standard of education. Three Indian universities were listed in the Times Higher Education list of the world’s top 200 universities i.e. Indian Institutes of Technology, Indian Institute of Management and Jawahar Lal Nehru University in 2005 and 2006. Six Indian Institutes of Technology and the Birla Institute of Technology and Science - Pilani were listed among the top 20 science and technology schools in Asia by the Asia Week. The school of Business situated in Hyderabad was ranked number 12 in Globe MBA ranking by the Financial Times of London in 2010 while the All India Institute of Medical Sciences has been recognized as a global leader in medical research and treatment. But at the same time, because of vast expansion, the system bears several weaknesses. The Indian higher education system in many parts of the country is in the state of disrepair. In almost half the districts in the country higher education enrollment are very low. Almost two third of total universities and 90% of colleges are rated below average on quality parameters. This can be attributed to the under prepared faculty, unwieldy governance and other obstacles to innovation and improvement that could prohibit India from meeting its national education goals. The opportunities in Indian higher education system are widely ranged. The national institutions are training their products to compete at global level and make them capable to grab opportunities worldwide. The state universities and colleges with their limited resources are giving the products that are capable enough to secure career opportunities and hold responsible positions in various government and private sectors with in the country. This is further creating opportunities for the weaker section of the society to join the main stream. There are several factors which can be defined as threats to Indian higher education system. It is a matter of great concern and needs proper attention. Some important factors are -Conservative society, particularly for women education; -Lack of transparency, -Taking higher education as a means of business

Keywords: Indian higher education system, SWOT analysis, university grants commission, Indian institutes of technology

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530 Traumatic Brain Injury Induced Lipid Profiling of Lipids in Mice Serum Using UHPLC-Q-TOF-MS

Authors: Seema Dhariwal, Kiran Maan, Ruchi Baghel, Apoorva Sharma, Poonam Rana

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Introduction: Traumatic brain injury (TBI) is defined as the temporary or permanent alteration in brain function and pathology caused by an external mechanical force. It represents the leading cause of mortality and morbidity among children and youth individuals. Various models of TBI in rodents have been developed in the laboratory to mimic the scenario of injury. Blast overpressure injury is common among civilians and military personnel, followed by accidents or explosive devices. In addition to this, the lateral Controlled cortical impact (CCI) model mimics the blunt, penetrating injury. Method: In the present study, we have developed two different mild TBI models using blast and CCI injury. In the blast model, helium gas was used to create an overpressure of 130 kPa (±5) via a shock tube, and CCI injury was induced with an impact depth of 1.5mm to create diffusive and focal injury, respectively. C57BL/6J male mice (10-12 weeks) were divided into three groups: (1) control, (2) Blast treated, (3) CCI treated, and were exposed to different injury models. Serum was collected on Day1 and day7, followed by biphasic extraction using MTBE/Methanol/Water. Prepared samples were separated on Charged Surface Hybrid (CSH) C18 column and acquired on UHPLC-Q-TOF-MS using ESI probe with inhouse optimized parameters and method. MS peak list was generated using Markerview TM. Data were normalized, Pareto-scaled, and log-transformed, followed by multivariate and univariate analysis in metaboanalyst. Result and discussion: Untargeted profiling of lipids generated extensive data features, which were annotated through LIPID MAPS® based on their m/z and were further confirmed based on their fragment pattern by LipidBlast. There is the final annotation of 269 features in the positive and 182 features in the negative mode of ionization. PCA and PLS-DA score plots showed clear segregation of injury groups to controls. Among various lipids in mild blast and CCI, five lipids (Glycerophospholipids {PC 30:2, PE O-33:3, PG 28:3;O3 and PS 36:1 } and fatty acyl { FA 21:3;O2}) were significantly altered in both injury groups at Day 1 and Day 7, and also had VIP score >1. Pathway analysis by Biopan has also shown hampered synthesis of Glycerolipids and Glycerophospholipiods, which coincides with earlier reports. It could be a direct result of alteration in the Acetylcholine signaling pathway in response to TBI. Understanding the role of a specific class of lipid metabolism, regulation and transport could be beneficial to TBI research since it could provide new targets and determine the best therapeutic intervention. This study demonstrates the potential lipid biomarkers which can be used for injury severity diagnosis and identification irrespective of injury type (diffusive or focal).

Keywords: LipidBlast, lipidomic biomarker, LIPID MAPS®, TBI

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529 Training for Search and Rescue Teams: Online Training for SAR Teams to Locate Lost Persons with Dementia Using Drones

Authors: Dalia Hanna, Alexander Ferworn

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This research provides detailed proposed training modules for the public safety teams and, specifically, SAR teams responsible for search and rescue operations related to finding lost persons with dementia. Finding a lost person alive is the goal of this training. Time matters if a lost person is to be found alive. Finding lost people living with dementia is quite challenging, as they are unaware they are lost and will not seek help. Even a small contribution to SAR operations could contribute to saving a life. SAR operations will always require expert professional and human volunteers. However, we can reduce their time, save lives, and reduce costs by providing practical training that is based on real-life scenarios. The content for the proposed training is based on the research work done by the researcher in this area. This research has demonstrated that, based on utilizing drones, the algorithmic approach could support a successful search outcome. Understanding the behavior of the lost person, learning where they may be found, predicting their survivability, and automating the search are all contributions of this work, founded in theory and demonstrated in practice. In crisis management, human behavior constitutes a vital aspect in responding to the crisis; the speed and efficiency of the response often get affected by the difficulty of the context of the operation. Therefore, training in this area plays a significant role in preparing the crisis manager to manage the emotional aspects that lead to decision-making in these critical situations. Since it is crucial to gain high-level strategic choices and the ability to apply crisis management procedures, simulation exercises become central in training crisis managers to gain the needed skills to respond critically to these events. The training will enhance the responders’ ability to make decisions and anticipate possible consequences of their actions through flexible and revolutionary reasoning in responding to the crisis efficiently and quickly. As adult learners, search and rescue teams will be approaching training and learning by taking responsibility of the learning process, appreciate flexible learning and as contributors to the teaching and learning happening during that training. These are all characteristics of adult learning theories. The learner self-reflects, gathers information, collaborates with others and is self-directed. One of the learning strategies associated with adult learning is effective elaboration. It helps learners to remember information in the long term and use it in situations where it might be appropriate. It is also a strategy that can be taught easily and used with learners of different ages. Designers must design reflective activities to improve the student’s intrapersonal awareness.

Keywords: training, OER, dementia, drones, search and rescue, adult learning, UDL, instructional design

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528 A Protocol of Procedures and Interventions to Accelerate Post-Earthquake Reconstruction

Authors: Maria Angela Bedini, Fabio Bronzini

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The Italian experiences, positive and negative, of the post-earthquake are conditioned by long times and structural bureaucratic constraints, also motivated by the attempt to contain mafia infiltration and corruption. The transition from the operational phase of the emergency to the planning phase of the reconstruction project is thus hampered by a series of inefficiencies and delays, incompatible with the need for rapid recovery of the territories in crisis. In fact, intervening in areas affected by seismic events means at the same time associating the reconstruction plan with an urban and territorial rehabilitation project based on strategies and tools in which prevention and safety play a leading role in the regeneration of territories in crisis and the return of the population. On the contrary, the earthquakes that took place in Italy have instead further deprived the territories affected of the minimum requirements for habitability, in terms of accessibility and services, accentuating the depopulation process, already underway before the earthquake. The objective of this work is to address with implementing and programmatic tools the procedures and strategies to be put in place, today and in the future, in Italy and abroad, to face the challenge of the reconstruction of activities, sociality, services, risk mitigation: a protocol of operational intentions and firm points, open to a continuous updating and implementation. The methodology followed is that of the comparison in a synthetic form between the different Italian experiences of the post-earthquake, based on facts and not on intentions, to highlight elements of excellence or, on the contrary, damage. The main results obtained can be summarized in technical comparison cards on good and bad practices. With this comparison, we intend to make a concrete contribution to the reconstruction process, certainly not only related to the reconstruction of buildings but privileging the primary social and economic needs. In this context, the recent instrument applied in Italy of the strategic urban and territorial SUM (Minimal Urban Structure) and the strategic monitoring process become dynamic tools for supporting reconstruction. The conclusions establish, by points, a protocol of interventions, the priorities for integrated socio-economic strategies, multisectoral and multicultural, and highlight the innovative aspects of 'inversion' of priorities in the reconstruction process, favoring the take-off of 'accelerator' interventions social and economic and a more updated system of coexistence with risks. In this perspective, reconstruction as a necessary response to the calamitous event can and must become a unique opportunity to raise the level of protection from risks and rehabilitation and development of the most fragile places in Italy and abroad.

Keywords: an operational protocol for reconstruction, operational priorities for coexistence with seismic risk, social and economic interventions accelerators of building reconstruction, the difficult post-earthquake reconstruction in Italy

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527 Seawater Desalination for Production of Highly Pure Water Using a Hydrophobic PTFE Membrane and Direct Contact Membrane Distillation (DCMD)

Authors: Ahmad Kayvani Fard, Yehia Manawi

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Qatar’s primary source of fresh water is through seawater desalination. Amongst the major processes that are commercially available on the market, the most common large scale techniques are Multi-Stage Flash distillation (MSF), Multi Effect distillation (MED), and Reverse Osmosis (RO). Although commonly used, these three processes are highly expensive down to high energy input requirements and high operating costs allied with maintenance and stress induced on the systems in harsh alkaline media. Beside that cost, environmental footprint of these desalination techniques are significant; from damaging marine eco-system, to huge land use, to discharge of tons of GHG and huge carbon footprint. Other less energy consuming techniques based on membrane separation are being sought to reduce both the carbon footprint and operating costs is membrane distillation (MD). Emerged in 1960s, MD is an alternative technology for water desalination attracting more attention since 1980s. MD process involves the evaporation of a hot feed, typically below boiling point of brine at standard conditions, by creating a water vapor pressure difference across the porous, hydrophobic membrane. Main advantages of MD compared to other commercially available technologies (MSF and MED) and specially RO are reduction of membrane and module stress due to absence of trans-membrane pressure, less impact of contaminant fouling on distillate due to transfer of only water vapor, utilization of low grade or waste heat from oil and gas industries to heat up the feed up to required temperature difference across the membrane, superior water quality, and relatively lower capital and operating cost. To achieve the objective of this study, state of the art flat-sheet cross-flow DCMD bench scale unit was designed, commissioned, and tested. The objective of this study is to analyze the characteristics and morphology of the membrane suitable for DCMD through SEM imaging and contact angle measurement and to study the water quality of distillate produced by DCMD bench scale unit. Comparison with available literature data is undertaken where appropriate and laboratory data is used to compare a DCMD distillate quality with that of other desalination techniques and standards. Membrane SEM analysis showed that the PTFE membrane used for the study has contact angle of 127º with highly porous surface supported with less porous and bigger pore size PP membrane. Study on the effect of feed solution (salinity) and temperature on water quality of distillate produced from ICP and IC analysis showed that with any salinity and different feed temperature (up to 70ºC) the electric conductivity of distillate is less than 5 μS/cm with 99.99% salt rejection and proved to be feasible and effective process capable of consistently producing high quality distillate from very high feed salinity solution (i.e. 100000 mg/L TDS) even with substantial quality difference compared to other desalination methods such as RO and MSF.

Keywords: membrane distillation, waste heat, seawater desalination, membrane, freshwater, direct contact membrane distillation

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526 Regional Rates of Sand Supply to the New South Wales Coast: Southeastern Australia

Authors: Marta Ribo, Ian D. Goodwin, Thomas Mortlock, Phil O’Brien

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Coastal behavior is best investigated using a sediment budget approach, based on the identification of sediment sources and sinks. Grain size distribution over the New South Wales (NSW) continental shelf has been widely characterized since the 1970’s. Coarser sediment has generally accumulated on the outer shelf, and/or nearshore zones, with the latter related to the presence of nearshore reef and bedrocks. The central part of the NSW shelf is characterized by the presence of fine sediments distributed parallel to the coastline. This study presents new grain size distribution maps along the NSW continental shelf, built using all available NSW and Commonwealth Government holdings. All available seabed bathymetric data form prior projects, single and multibeam sonar, and aerial LiDAR surveys were integrated into a single bathymetric surface for the NSW continental shelf. Grain size information was extracted from the sediment sample data collected in more than 30 studies. The information extracted from the sediment collections varied between reports. Thus, given the inconsistency of the grain size data, a common grain size classification was her defined using the phi scale. The new sediment distribution maps produced, together with new detailed seabed bathymetric data enabled us to revise the delineation of sediment compartments to more accurately reflect the true nature of sediment movement on the inner shelf and nearshore. Accordingly, nine primary mega coastal compartments were delineated along the NSW coast and shelf. The sediment compartments are bounded by prominent nearshore headlands and reefs, and major river and estuarine inlets that act as sediment sources and/or sinks. The new sediment grain size distribution was used as an input in the morphological modelling to quantify the sediment transport patterns (and indicative rates of transport), used to investigate sand supply rates and processes from the lower shoreface to the NSW coast. The rate of sand supply to the NSW coast from deep water is a major uncertainty in projecting future coastal response to sea-level rise. Offshore transport of sand is generally expected as beaches respond to rising sea levels but an onshore supply from the lower shoreface has the potential to offset some of the impacts of sea-level rise, such as coastline recession. Sediment exchange between the lower shoreface and sub-aerial beach has been modelled across the south, central, mid-north and far-north coast of NSW. Our model approach is that high-energy storm events are the primary agents of sand transport in deep water, while non-storm conditions are responsible for re-distributing sand within the beach and surf zone.

Keywords: New South Wales coast, off-shore transport, sand supply, sediment distribution maps

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525 Gender Differences In Pain Assessment: A Daily Activities Perspective

Authors: Hui-mei Huang, Huei-Jiun Cheng

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Introduction Many patients are aware of the health benefits associated with an active lifestyle, but they are often hindered from engaging in physical activity due to the presence of pain. The majority of patients experience pain, which can fluctuate over time and is influenced by various factors, including gender. Gender differences in clinical pain and pain-related conditions are widely recognized. Existing literature strongly supports the notion that men and women exhibit distinct responses to pain. Previous studies conducted in Taiwan have highlighted gender differences in pain assessment, but only a limited number of studies have investigated the gender-related factors that influence pain during daily activities. The objective of this study was to examine gender differences in pain assessment among inpatients in Taiwan and investigate whether gender and surgical procedures are factors that impact the daily activities of pain. Method In this study, a prospective and structured questionnaire survey method was utilized, employing intentional sampling to gather data from inpatients admitted to a medical center in central Taiwan. The research period covered in this study is from October 1, 2019, to June 30, 2020. In this study, participants who were hospitalized within 48 hours were requested to self-assess their pain using the Numeric Rating Scale (NRS) and indicate the impact of pain on their activities. The data were analyzed to explore the potential influence of gender and surgical procedures on daily activities affected by pain. Result A total of 722 cases were included in the study, with the mean age of the subjects is 54.38 years old (SD=16.3), and the range varied from 18 to 93 years old. Among the subjects, 48.23% (n=348) were male, and 62.3% (n=450) of them had received more than 12 years of education., and 56.9% (n=411) underwent surgery. The results indicated that regardless of whether the participants underwent surgery or not, females experienced higher perceived severe pain intensity than males (t=2.248, P < .05). However, in surgical patients, there was no significant difference in gender (t=1.75, P > .05). Regarding the impact of pain on daily activities when pain intensity reached 7 , male subjects experienced a 5-point effect on their daily activities (AUC=0.84, 95% CI 0.79-0.89, P <0.01), while female subjects experienced a 7-point effect (AUC=0.88, 95% CI 0.80-0.87, P <0.01). Discussion Some studies suggest that women experience painful stimuli as more intense than men, this difference has been observed in various types of experimental pain, including mechanical and thermal stimuli. Our study reached the same conclusion, female patients exhibited greater intensity of pain. According to the research findings, The research findings highlight the significant impact of gender on individuals' response to intense pain (NRS>7) during their daily activities, with men showing a higher pain tolerance. The higher pain tolerance often observed in men may be attributed to societal conditioning, which encourages them to conceal outward expressions of pain. Further research in this area could help provide a more comprehensive understanding of the topic in Taiwan.

Keywords: pain assessment, gender, surgery, activities of daily living

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524 Interwoven Realms: The Relationship Between Textiles, Fashion, and Architecture

Authors: Toktam mehrabani

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Textiles, fashion, and architecture, though seemingly disparate fields, share a deep and evolving relationship. This paper explores the intersection of these disciplines, examining how the tactile, structural, and aesthetic qualities of textiles have influenced both fashion and architecture over time. By investigating historical and contemporary examples, this paper seeks to unravel the ways in which textiles and fashion have not only shaped architectural design but have also acted as a bridge between functionality, art, and human experience in the built environment.Textiles have been integral to human culture since the dawn of civilization. Their presence transcends mere functionality, serving as a medium for artistic expression, cultural identity, and social commentary. Fashion, derived from textiles, has long been associated with personal identity and societal trends, while architecture reflects human needs, environmental context, and cultural values. This paper posits that the relationship between textiles, fashion, and architecture is more interconnected than often perceived, with each influencing and inspiring the other across time. Textiles in Architectural Design: From ancient draperies in temples to tapestries in castles, textiles have adorned structures, softening rigid spaces and adding layers of warmth and luxury. Fabric screens and curtains have also served functional purposes, such as controlling light, acoustics, and temperature. Fashion as Architectural Expression: Renaissance and Baroque fashion used exaggerated forms, corsetry, and layers to mirror the grandiosity of architectural styles of the time. Clothing acted as wearable architecture, with structured garments mirroring the strong lines and curves of buildings..Structural Textiles in Architecture: In the 21st century, textiles are no longer just decorative; they have become integral to architectural innovation. Materials like tensile fabrics and smart textiles are used in creating flexible, lightweight structures. Iconic examples include Frei Otto’s work with tensile membranes, seen in the Munich Olympic Stadium.Technological advancements have drastically transformed the relationship between textiles, fashion, and architecture. Digital tools like 3D printing and laser cutting allow designers in both fields to push the limits of form and structure. Smart textiles that react to environmental stimuli are being explored for use in both wearable technology and adaptable architecture, such as facades that change in response to weather conditions. Textiles, fashion, and architecture are inextricably linked through their shared exploration of form, structure, and expression. This interdisciplinary relationship continues to evolve, driven by technological advancements and a growing emphasis on sustainability. As fashion becomes more architectural in its construction and architecture more fluid in its forms, the lines between these disciplines blur, offering new possibilities for creativity and functionality in both wearable and built environments.

Keywords: textiles in architecture, fashion and architecture, textile architecture, structural textiles, wearable architecture, architectural fashion

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523 Negative Perceptions of Ageing Predicts Greater Dysfunctional Sleep Related Cognition Among Adults Aged 60+

Authors: Serena Salvi

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Ageistic stereotypes and practices have become a normal and therefore pervasive phenomenon in various aspects of everyday life. Over the past years, renewed awareness towards self-directed age stereotyping in older adults has given rise to a line of research focused on the potential role of attitudes towards ageing on seniors’ health and functioning. This set of studies has showed how a negative internalisation of ageistic stereotypes would discourage older adults in seeking medical advice, in addition to be associated to negative subjective health evaluation. An important dimension of mental health that is often affected in older adults is represented by sleep quality. Self-reported sleep quality among older adults has shown to be often unreliable when compared to their objective sleep measures. Investigations focused on self-reported sleep quality among older adults have suggested how this portion of the population would tend to accept disrupted sleep if believed to be up to standard for their age. On the other hand, unrealistic expectations, and dysfunctional beliefs towards sleep in ageing, might prompt older adults to report sleep disruption even in the absence of objective disrupted sleep. Objective of this study is to examine an association between personal attitudes towards ageing in adults aged 60+ and dysfunctional sleep related cognition. More in detail, this study aims to investigate a potential association between personal attitudes towards ageing, sleep locus of control and dysfunctional beliefs towards sleep among this portion of the population. Data in this study were statistically analysed in SPSS software. Participants were recruited through the online participants recruitment system Prolific. Inclusion of attention check questions throughout the questionnaire and consistency of responses were looked at. Prior to the commencement of this study, Ethical Approval was granted (ref. 39396). Descriptive statistics were used to determine the frequency, mean, and SDs of the variables. Pearson coefficient was used for interval variables, independent T-test for comparing means between two independent groups, analysis of variance (ANOVA) test for comparing the means in several independent groups, and hierarchical linear regression models for predicting criterion variables based on predictor variables. In this study self-perceptions of ageing were assessed using APQ-B’s subscales, while dysfunctional sleep related cognition was operationalised using the SLOC and the DBAS16 scales. Of the final subscales taken in consideration in the brief version of the APQ questionnaire, Emotional Representations (ER), Control Positive (PC) and Control and Consequences Negative (NC) have shown to be of particularly relevance for the remits of this study. Regression analysis show how an increase in the APQ-B subscale Emotional Representations (ER) predicts an increase in dysfunctional beliefs and attitudes towards sleep in this sample, after controlling for subjective sleep quality, level of depression and chronological age. A second regression analysis showed that APQ-B subscales Control Positive (PC) and Control and Consequences Negative (NC) were significant predictors in the change of variance of SLOC, after controlling for subjective sleep quality, level of depression and dysfunctional beliefs about sleep.

Keywords: sleep-related cognition, perceptions of aging, older adults, sleep quality

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522 Effect of Non-Thermal Plasma, Chitosan and Polymyxin B on Quorum Sensing Activity and Biofilm of Pseudomonas aeruginosa

Authors: Alena Cejkova, Martina Paldrychova, Jana Michailidu, Olga Matatkova, Jan Masak

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Increasing the resistance of pathogenic microorganisms to many antibiotics is a serious threat to the treatment of infectious diseases and cleaning medical instruments. It should be added that the resistance of microbial populations growing in biofilms is often up to 1000 times higher compared to planktonic cells. Biofilm formation in a number of microorganisms is largely influenced by the quorum sensing regulatory mechanism. Finding external factors such as natural substances or physical processes that can interfere effectively with quorum sensing signal molecules should reduce the ability of the cell population to form biofilm and increase the effectiveness of antibiotics. The present work is devoted to the effect of chitosan as a representative of natural substances with anti-biofilm activity and non- thermal plasma (NTP) alone or in combination with polymyxin B on biofilm formation of Pseudomonas aeruginosa. Particular attention was paid to the influence of these agents on the level of quorum sensing signal molecules (acyl-homoserine lactones) during planktonic and biofilm cultivations. Opportunistic pathogenic strains of Pseudomonas aeruginosa (DBM 3081, DBM 3777, ATCC 10145, ATCC 15442) were used as model microorganisms. Cultivations of planktonic and biofilm populations in 96-well microtiter plates on horizontal shaker were used for determination of antibiotic and anti-biofilm activity of chitosan and polymyxin B. Biofilm-growing cells on titanium alloy, which is used for preparation of joint replacement, were exposed to non-thermal plasma generated by cometary corona with a metallic grid for 15 and 30 minutes. Cultivation followed in fresh LB medium with or without chitosan or polymyxin B for next 24 h. Biofilms were quantified by crystal violet assay. Metabolic activity of the cells in biofilm was measured using MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) colorimetric test based on the reduction of MTT into formazan by the dehydrogenase system of living cells. Activity of N-acyl homoserine lactones (AHLs) compounds involved in the regulation of biofilm formation was determined using Agrobacterium tumefaciens strain harboring a traG::lacZ/traR reporter gene responsive to AHLs. The experiments showed that both chitosan and non-thermal plasma reduce the AHLs level and thus the biofilm formation and stability. The effectiveness of both agents was somewhat strain dependent. During the eradication of P. aeruginosa DBM 3081 biofilm on titanium alloy induced by chitosan (45 mg / l) there was an 80% decrease in AHLs. Applying chitosan or NTP on the P. aeruginosa DBM 3777 biofilm did not cause a significant decrease in AHLs, however, in combination with both (chitosan 55 mg / l and NTP 30 min), resulted in a 70% decrease in AHLs. Combined application of NTP and polymyxin B allowed reduce antibiotic concentration to achieve the same level of AHLs inhibition in P. aeruginosa ATCC 15442. The results shown that non-thermal plasma and chitosan have considerable potential for the eradication of highly resistant P. aeruginosa biofilms, for example on medical instruments or joint implants.

Keywords: anti-biofilm activity, chitosan, non-thermal plasma, opportunistic pathogens

Procedia PDF Downloads 200
521 Barriers to Entry: The Pitfall of Charter School Accountability

Authors: Ian Kingsbury

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The rapid expansion of charter schools (public schools that receive government but do not face the same regulations as traditional public schools) over the preceding two decades has raised concerns over the potential for graft and fraud. These concerns are largely justified: Incidents of financial crime and mismanagement are not unheard of, and the charter sector has become a darling of hedge fund managers. In response, several states have strengthened their charter school regulatory regimes. Imposing regulations and attempting to increase accountability seem like sensible measures, and perhaps they are necessary. However, increased regulation may come at the cost of imposing barriers to entry. Specifically, increased regulation often entails evidence for a high likelihood of fiscal solvency. That should theoretically entail access to capital in the short-term, which may systematically preclude Black or Hispanic applicants from opening charter schools. Moreover, increased regulation necessarily entails more red tape. The institutional wherewithal and the number of hours required to complete an application to open a charter school might favor those who have partnered with an education service provider, specifically a charter management organization (CMO) or education management organization (EMO). These potential barriers to entry pose a significant policy concern. Just as policymakers hope to increase the share of minority teachers and principals, they should sensibly care whether individuals who open charter schools look like the students in that school. Moreover, they might be concerned if successful applications in states with stringent regulations are overwhelmingly affiliated with education service providers. One of the original missions of charter schools was to serve as a laboratory of innovation. Approving only those applications affiliated with education service providers (and in effect establishing a parallel network of schools rather than a diverse marketplace of schools) undermines that mission. Data and methods: The analysis examines more than 2,000 charter school applications from 15 states. It compares the outcomes of applications from states with a strong regulatory environment (those with high scores) from NACSA-the National Association of Charter School Authorizers- to applications from states with a weak regulatory environment (those with a low NACSA score). If the hypothesis is correct, applicants not affiliated with an ESP are more likely to be rejected in high-regulation states compared to those affiliated with an ESP, and minority candidates not affiliated with an education service provider (ESP) are particularly likely to be rejected. Initial returns indicate that the hypothesis holds. More applications in low NASCA-scoring Arizona come from individuals not associated with an ESP, and those individuals are as likely to be accepted as those affiliated with an ESP. On the other hand, applicants in high-NACSA scoring Indiana and Ohio are more than 20 percentage points more likely to be accepted if they are affiliated with an ESP, and the effect is particularly pronounced for minority candidates. These findings should spur policymakers to consider the drawbacks of charter school accountability and consider accountability regimes that do not impose barriers to entry.

Keywords: accountability, barriers to entry, charter schools, choice

Procedia PDF Downloads 159
520 Feasibility and Acceptability of Modified Mindfulness-Based Stress Reduction for Health Care Workers in Acute Stress during the COVID-19 Pandemic

Authors: Susan Evans, Janna Gordon-Elliott, Katarzyna Wyka, Virginia Mutch

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During the rise of the COVID-19 pandemic, healthcare workers needed an intervention that could address their profound acute stress. Mindfulness-based stress reduction (MBSR) is a program that has long established effectiveness for mental and physical health outcomes. In recent years, MBSR has been modified such that the duration of both class time and number of sessions has been abbreviated, and its delivery has been adapted for online dissemination, thus increasing the likelihood that individuals who could most benefit from the program would do so. We sought to investigate whether a brief, online version of MBSR could be feasible and acceptable for health care workers (HCW) in acute stress in response to the COVID-19 pandemic. Participants were recruited via an email sent to all hospital employees, which spans residents, physicians, nurses, housekeeping, lab technicians, administrators, and others. Participating HCW were asked about their previous experience with mindfulness and asked to commit to a minimum of 3 sessions. They were then provided with four weekly 1-hour sessions online that included the major mindfulness exercises taught during traditional MBSR programs (i.e., body scan, sitting meditation, mindful eating, and yoga). Participants were provided with supporting slides, videos, demonstrations and asked to track their practice. Hospital staff enrolled in the program; by the end of the first day of recruitment, 40 had applied; by the start date, about 100 were enrolled, and n attended a minimum of 3 sessions, supporting feasibility. Hospital staff also participated and practiced the mindfulness exercises (n=42), thus supporting acceptability. Participants reported that the program was logical, successful, and worth recommending both before starting the program and after completing it (M= 22.02 and M=21.76, respectively, possible range 0-27). There was a slight decline in the belief in improvement in health and well-being due to the program (ES=.37, p=.021). Secondary hypotheses regarding participants’ self-reported stress and levels of mindfulness were also supported, such that participants reported improvements in perceived stress (ES=.45, p=.006), compassion satisfaction, burnout, and secondary traumatic stress (ES=.41, ES=.31, ES=.35, respectively, p<.05). Participants reported significant improvements in the describing facet of mindfulness (ES=.49, p=.004), while all other facets (observing, acting with awareness, nonjudging of inner experience, nonreactivity to inner experience) remained unchanged pre- to post-program. Results from this study suggest that an abridged, online version of MBSR is feasible and accessible to health care workers in acute stress and provides benefits expected from traditional MBSR programs. The lack of a randomized control group limits generalizability. We intend to provide a structure, framework, and lessons learned to hospital administrators and clinical staff seeking to support their employees in acute stress.

Keywords: acute stress, health care workers, mindfulness, online interventions

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519 Designing Sustainable and Energy-Efficient Urban Network: A Passive Architectural Approach with Solar Integration and Urban Building Energy Modeling (UBEM) Tools

Authors: A. Maghoul, A. Rostampouryasouri, MR. Maghami

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The development of an urban design and power network planning has been gaining momentum in recent years. The integration of renewable energy with urban design has been widely regarded as an increasingly important solution leading to climate change and energy security. Through the use of passive strategies and solar integration with Urban Building Energy Modeling (UBEM) tools, architects and designers can create high-quality designs that meet the needs of clients and stakeholders. To determine the most effective ways of combining renewable energy with urban development, we analyze the relationship between urban form and renewable energy production. The procedure involved in this practice include passive solar gain (in building design and urban design), solar integration, location strategy, and 3D models with a case study conducted in Tehran, Iran. The study emphasizes the importance of spatial and temporal considerations in the development of sector coupling strategies for solar power establishment in arid and semi-arid regions. The substation considered in the research consists of two parallel transformers, 13 lines, and 38 connection points. Each urban load connection point is equipped with 500 kW of solar PV capacity and 1 kWh of battery Energy Storage (BES) to store excess power generated from solar, injecting it into the urban network during peak periods. The simulations and analyses have occurred in EnergyPlus software. Passive solar gain involves maximizing the amount of sunlight that enters a building to reduce the need for artificial lighting and heating. Solar integration involves integrating solar photovoltaic (PV) power into smart grids to reduce emissions and increase energy efficiency. Location strategy is crucial to maximize the utilization of solar PV in an urban distribution feeder. Additionally, 3D models are made in Revit, and they are keys component of decision-making in areas including climate change mitigation, urban planning, and infrastructure. we applied these strategies in this research, and the results show that it is possible to create sustainable and energy-efficient urban environments. Furthermore, demand response programs can be used in conjunction with solar integration to optimize energy usage and reduce the strain on the power grid. This study highlights the influence of ancient Persian architecture on Iran's urban planning system, as well as the potential for reducing pollutants in building construction. Additionally, the paper explores the advances in eco-city planning and development and the emerging practices and strategies for integrating sustainability goals.

Keywords: energy-efficient urban planning, sustainable architecture, solar energy, sustainable urban design

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518 Community Resilience in Response to the Population Growth in Al-Thahabiah Neighborhood

Authors: Layla Mujahed

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Amman, the capital of Jordan, is the main political, economic, social and cultural center of Jordan and beyond. The city faces multitude demographic challenges related to the unstable political situation in the surrounded countries. It has regional and local migrants who left their homes to find better life in the capital. This resulted with random and unequaled population distribution. Some districts have high population and pressure on the infrastructure and services more than other districts.Government works to resolve this challenge in compliance with 100 Cities Resilience Framework (CRF). Amman participated in this framework as a member in December 2014 to work in achieving the four goals: health and welfare, infrastructure and utilities, economy and education as well as administration and government.  Previous research studies lack in studying Amman resilient work in neighborhood scale and the population growth as resilient challenge. For that, this study focuses on Al-Thahabiah neighborhood in Shafa Badran district in Amman. This paper studies the reasons and drivers behind this population growth during the selected period in this area then provide strategies to improve the resilient work in neighborhood scale. The methodology comprises of primary and secondary data. The primary data consist of interviews with chief officer in the executive part in Great Amman Municipality and resilient officer. The secondary data consist of papers, journals, newspaper, articles and book’s reading. The other part of data consists of maps and statistical data which describe the infrastructural and social situation in the neighborhood and district level during the studying period. Based upon those data, more detailed information will be found, e.g., the centralizing position of population and the provided infrastructure for them. This will help to provide these services and infrastructure to other neighborhoods and enhance population distribution. This study develops an analytical framework to assess urban demographical time series in accordance with the criteria of CRF to make accurate detailed projections on the requirements for the future development in the neighborhood scale and organize the human requirements for affordable quality housing, employment, transportation, health and education in this neighborhood to improve the social relations between its inhabitants and the community. This study highlights on the localization of resilient work in neighborhood scale and spread the resilient knowledge related to the shortage of its research in Jordan. Studying the resilient work from population growth challenge perspective helps improve the facilities provide to the inhabitants and improve their quality of life.

Keywords: city resilience framework, demography, population growth, stakeholders, urban resilience

Procedia PDF Downloads 179
517 Impact of Climate Change on Crop Production: Climate Resilient Agriculture Is the Need of the Hour

Authors: Deepak Loura

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Climate change is considered one of the major environmental problems of the 21st century and a lasting change in the statistical distribution of weather patterns over periods ranging from decades to millions of years. Agriculture and climate change are internally correlated with each other in various aspects, as the threat of varying global climate has greatly driven the attention of scientists, as these variations are imparting a negative impact on global crop production and compromising food security worldwide. The fast pace of development and industrialization and indiscriminate destruction of the natural environment, more so in the last century, have altered the concentration of atmospheric gases that lead to global warming. Carbon dioxide (CO₂), methane (CH₄), and nitrous oxide (NO) are important biogenic greenhouse gases (GHGs) from the agricultural sector contributing to global warming and their concentration is increasing alarmingly. Agricultural productivity can be affected by climate change in 2 ways: first, directly, by affecting plant growth development and yield due to changes in rainfall/precipitation and temperature and/or CO₂ levels, and second, indirectly, there may be considerable impact on agricultural land use due to snow melt, availability of irrigation, frequency and intensity of inter- and intra-seasonal droughts and floods, soil organic matter transformations, soil erosion, distribution and frequency of infestation by insect pests, diseases or weeds, the decline in arable areas (due to submergence of coastal lands), and availability of energy. An increase in atmospheric CO₂ promotes the growth and productivity of C3 plants. On the other hand, an increase in temperature, can reduce crop duration, increase crop respiration rates, affect the equilibrium between crops and pests, hasten nutrient mineralization in soils, decrease fertilizer- use efficiencies, and increase evapotranspiration among others. All these could considerably affect crop yield in long run. Climate resilient agriculture consisting of adaptation, mitigation, and other agriculture practices can potentially enhance the capacity of the system to withstand climate-related disturbances by resisting damage and recovering quickly. Climate resilient agriculture turns the climate change threats that have to be tackled into new business opportunities for the sector in different regions and therefore provides a triple win: mitigation, adaptation, and economic growth. Improving the soil organic carbon stock of soil is integral to any strategy towards adapting to and mitigating the abrupt climate change, advancing food security, and improving the environment. Soil carbon sequestration is one of the major mitigation strategies to achieve climate-resilient agriculture. Climate-smart agriculture is the only way to lower the negative impact of climate variations on crop adaptation before it might affect global crop production drastically. To cope with these extreme changes, future development needs to make adjustments in technology, management practices, and legislation. Adaptation and mitigation are twin approaches to bringing resilience to climate change in agriculture.

Keywords: climate change, global warming, crop production, climate resilient agriculture

Procedia PDF Downloads 74
516 The Role of Law in the Transformation of Collective Identities in Nigeria

Authors: Henry Okechukwu Onyeiwu

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Nigeria, with its rich tapestry of ethnicities, cultures, and religions, serves as a critical case study in understanding how law influences and shapes collective identities. This abstract delves into the historical context of legal systems in Nigeria, examining the colonial legacies that have influenced contemporary laws and how these laws interact with traditional practices and beliefs. This study examines the critical role of law in shaping and transforming collective identities in Nigeria, a nation characterized by its rich tapestry of ethnicities, cultures, and religions. The legal framework in Nigeria has evolved in response to historical, social, and political dynamics, influencing the way communities perceive themselves and interact with one another. This research highlights the interplay between law and collective identity, exploring how legal instruments, such as constitutions, statutes, and judicial rulings, have contributed to the formation, negotiation, and reformation of group identities over time. Moreover, contemporary legal debates surrounding issues such as citizenship, resource allocation, and communal conflicts further illustrate the law's role in identity formation. The legal recognition of different ethnic groups fosters a sense of belonging and collective identity among these groups, yet it simultaneously raises questions about inclusivity and equality. Laws concerning indigenous rights and affirmative action are essential in this discourse, as they reflect the necessity of balancing majority rule with minority rights—a challenge that Nigeria continues to navigate. By employing a multidisciplinary approach that integrates legal studies, sociology, and anthropology, the study analyses key historical milestones, such as colonial legal legacies, post-independence constitutional developments, and ongoing debates surrounding federalism and ethnic rights. It also investigates how laws affect social cohesion and conflict among Nigeria's diverse ethnic groups, as well as the role of law in promoting inclusivity and recognizing minority rights. Case studies are utilized to illustrate practical examples of legal transformations and their impact on collective identities in various Nigerian contexts, including land rights, religious freedoms, and ethnic representation in government. The findings reveal that while the law has the potential to unify disparate groups under a national identity, it can also exacerbate divisions when applied inequitably or favouring particular groups over others. Ultimately, this study aims to shed light on the dual nature of law as both a tool for transformation and a potential source of conflict in the evolution of collective identities in Nigeria. By understanding these dynamics, policymakers and legal practitioners can develop strategies to foster unity and respect for diversity in a complex societal landscape.

Keywords: law, collective identity, Nigeria, ethnicity, conflict, inclusion, legal framework, transformation

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515 Scale up of Isoniazid Preventive Therapy: A Quality Management Approach in Nairobi County, Kenya

Authors: E. Omanya, E. Mueni, G. Makau, M. Kariuki

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HIV infection is the strongest risk factor for a person to develop TB. Isoniazid preventive therapy (IPT) for People Living with HIV (PLWHIV) not only reduces the individual patients’ risk of developing active TB but mitigates cross infection. In Kenya, IPT for six months was recommended through the National TB, Leprosy and Lung Disease Program to treat latent TB. In spite of this recommendation by the national government, uptake of IPT among PLHIV remained low in Kenya by the end of 2015. The USAID/Kenya and East Africa Afya Jijini project, which supports 42 TBHIV health facilities in Nairobi County, began addressing low uptake of IPT through Quality Improvement (QI) teams set up at the facility level. Quality is characterized by WHO as one of the four main connectors between health systems building blocks and health systems outputs. Afya Jijini implements the Kenya Quality Model for Health, which involves QI teams being formed at the county, sub-county and facility levels. The teams review facility performance to identify gaps in service delivery and use QI tools to monitor and improve performance. Afya Jijini supported the formation of these teams in 42 facilities and built the teams’ capacity to review data and use QI principles to identify and address performance gaps. When the QI teams began working on improving IPT uptake among PLHIV, uptake was at 31.8%. The teams first conducted a root cause analysis using cause and effect diagrams, which help the teams to brainstorm on and to identify barriers to IPT uptake among PLHIV at the facility level. This is a participatory process where program staff provides technical support to the QI teams in problem identification and problem-solving. The gaps identified were inadequate knowledge and skills on the use of IPT among health care workers, lack of awareness of IPT by patients, inadequate monitoring and evaluation tools, and poor quantification and forecasting of IPT commodities. In response, Afya Jijini trained over 300 health care workers on the administration of IPT, supported patient education, supported quantification and forecasting of IPT commodities, and provided IPT data collection tools to help facilities monitor their performance. The facility QI teams conducted monthly meetings to monitor progress on implementation of IPT and took corrective action when necessary. IPT uptake improved from 31.8% to 61.2% during the second year of the Afya Jijini project and improved to 80.1% during the third year of the project’s support. Use of QI teams and root cause analysis to identify and address service delivery gaps, in addition to targeted program interventions and continual performance reviews, can be successful in increasing TB related service delivery uptake at health facilities.

Keywords: isoniazid, quality, health care workers, people leaving with HIV

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514 COVID-19’s Impact on the Use of Media, Educational Performance, and Learning in Children and Adolescents with ADHD Who Engaged in Virtual Learning

Authors: Christina Largent, Tazley Hobbs

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Objective: A literature review was performed to examine the existing research on COVID-19 lockdown as it relates to ADHD child/adolescent individuals, media use, and impact on educational performance/learning. It was surmised that with the COVID-19 shut-down and transition to remote learning, a less structured learning environment, increased screen time, in addition to potential difficulty accessing school resources would impair ADHD individuals’ performance and learning. A resulting increase in the number of youths diagnosed and treated for ADHD would be expected. As of yet, there has been little to no published data on the incidence of ADHD as it relates to COVID-19 outside of reports from several nonprofit agencies such as CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder ), who reported an increased number of calls to their helpline, The New York based Child Mind Institute, who reported an increased number of appointments to discuss medications, and research released from Athenahealth showing an increase in the number of patients receiving new diagnosis of ADHD and new prescriptions for ADHD medications. Methods: A literature search for articles published between 2020 and 2021 from Pubmed, Google Scholar, PsychInfo, was performed. Search phrases and keywords included “covid, adhd, child, impact, remote learning, media, screen”. Results: Studies primarily utilized parental reports, with very few from the perspective of the ADHD individuals themselves. Most findings thus far show that with the COVID-19 quarantine and transition to online learning, ADHD individuals’ experienced decreased ability to keep focused or adhere to the daily routine, as well as increased inattention-related problems, such as careless mistakes or lack of completion in homework, which in turn translated into overall more difficulty with remote learning. To add further injury, one study showed (just on evaluation of two different sites within the US) that school based services for these individuals decreased with the shift to online-learning. Increased screen time, television, social media, and gaming were noted amongst ADHD individuals. One study further differentiated the degree of digital media, identifying individuals with “problematic “ or “non-problematic” use. ADHD children with problematic digital media use suffered from more severe core symptoms of ADHD, negative emotions, executive function deficits, damage to family environment, pressure from life events, and a lower motivation to learn. Conclusions and Future Considerations: Studies found not only was online learning difficult for ADHD individuals but it, in addition to greater use of digital media, was associated with worsening ADHD symptoms impairing schoolwork, in addition to secondary findings of worsening mood and behavior. Currently, data on the number of new ADHD cases, in addition to data on the prescription and usage of stimulants during COVID-19, has not been well documented or studied; this would be well-warranted out of concern for over diagnosing or over-prescribing our youth. It would also be well-worth studying how reversible or long-lasting these negative impacts may be.

Keywords: COVID-19, remote learning, media use, ADHD, child, adolescent

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513 Implementing the WHO Air Quality Guideline for PM2.5 Worldwide can Prevent Millions of Premature Deaths Per Year

Authors: Despina Giannadaki, Jos Lelieveld, Andrea Pozzer, John Evans

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Outdoor air pollution by fine particles ranks among the top ten global health risk factors that can lead to premature mortality. Epidemiological cohort studies, mainly conducted in United States and Europe, have shown that the long-term exposure to PM2.5 (particles with an aerodynamic diameter less than 2.5μm) is associated with increased mortality from cardiovascular, respiratory diseases and lung cancer. Fine particulates can cause health impacts even at very low concentrations. Previously, no concentration level has been defined below which health damage can be fully prevented. The World Health Organization ambient air quality guidelines suggest an annual mean PM2.5 concentration limit of 10μg/m3. Populations in large parts of the world, especially in East and Southeast Asia, and in the Middle East, are exposed to high levels of fine particulate pollution that by far exceeds the World Health Organization guidelines. The aim of this work is to evaluate the implementation of recent air quality standards for PM2.5 in the EU, the US and other countries worldwide and estimate what measures will be needed to substantially reduce premature mortality. We investigated premature mortality attributed to fine particulate matter (PM2.5) under adults ≥ 30yrs and children < 5yrs, applying a high-resolution global atmospheric chemistry model combined with epidemiological concentration-response functions. The latter are based on the methodology of the Global Burden of Disease for 2010, assuming a ‘safe’ annual mean PM2.5 threshold of 7.3μg/m3. We estimate the global premature mortality by PM2.5 at 3.15 million/year in 2010. China is the leading country with about 1.33 million, followed by India with 575 thousand and Pakistan with 105 thousand. For the European Union (EU) we estimate 173 thousand and the United States (US) 52 thousand in 2010. Based on sensitivity calculations we tested the gains from PM2.5 control by applying the air quality guidelines (AQG) and standards of the World Health Organization (WHO), the EU, the US and other countries. To estimate potential reductions in mortality rates we take into consideration the deaths that cannot be avoided after the implementation of PM2.5 upper limits, due to the contribution of natural sources to total PM2.5 and therefore to mortality (mainly airborne desert dust). The annual mean EU limit of 25μg/m3 would reduce global premature mortality by 18%, while within the EU the effect is negligible, indicating that the standard is largely met and that stricter limits are needed. The new US standard of 12μg/m3 would reduce premature mortality by 46% worldwide, 4% in the US and 20% in the EU. Implementing the AQG by the WHO of 10μg/m3 would reduce global premature mortality by 54%, 76% in China and 59% in India. In the EU and US, the mortality would be reduced by 36% and 14%, respectively. Hence, following the WHO guideline will prevent 1.7 million premature deaths per year. Sensitivity calculations indicate that even small changes at the lower PM2.5 standards can have major impacts on global mortality rates.

Keywords: air quality guidelines, outdoor air pollution, particulate matter, premature mortality

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512 Analysing the Stability of Electrical Grid for Increased Renewable Energy Penetration by Focussing on LI-Ion Battery Storage Technology

Authors: Hemendra Singh Rathod

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Frequency is, among other factors, one of the governing parameters for maintaining electrical grid stability. The quality of an electrical transmission and supply system is mainly described by the stability of the grid frequency. Over the past few decades, energy generation by intermittent sustainable sources like wind and solar has seen a significant increase globally. Consequently, controlling the associated deviations in grid frequency within safe limits has been gaining momentum so that the balance between demand and supply can be maintained. Lithium-ion battery energy storage system (Li-Ion BESS) has been a promising technology to tackle the challenges associated with grid instability. BESS is, therefore, an effective response to the ongoing debate whether it is feasible to have an electrical grid constantly functioning on a hundred percent renewable power in the near future. In recent years, large-scale manufacturing and capital investment into battery production processes have made the Li-ion battery systems cost-effective and increasingly efficient. The Li-ion systems require very low maintenance and are also independent of geographical constraints while being easily scalable. The paper highlights the use of stationary and moving BESS for balancing electrical energy, thereby maintaining grid frequency at a rapid rate. Moving BESS technology, as implemented in the selected railway network in Germany, is here considered as an exemplary concept for demonstrating the same functionality in the electrical grid system. Further, using certain applications of Li-ion batteries, such as self-consumption of wind and solar parks or their ancillary services, wind and solar energy storage during low demand, black start, island operation, residential home storage, etc. offers a solution to effectively integrate the renewables and support Europe’s future smart grid. EMT software tool DIgSILENT PowerFactory has been utilised to model an electrical transmission system with 100% renewable energy penetration. The stability of such a transmission system has been evaluated together with BESS within a defined frequency band. The transmission system operators (TSO) have the superordinate responsibility for system stability and must also coordinate with the other European transmission system operators. Frequency control is implemented by TSO by maintaining a balance between electricity generation and consumption. Li-ion battery systems are here seen as flexible, controllable loads and flexible, controllable generation for balancing energy pools. Thus using Li-ion battery storage solution, frequency-dependent load shedding, i.e., automatic gradual disconnection of loads from the grid, and frequency-dependent electricity generation, i.e., automatic gradual connection of BESS to the grid, is used as a perfect security measure to maintain grid stability in any case scenario. The paper emphasizes the use of stationary and moving Li-ion battery storage for meeting the demands of maintaining grid frequency and stability for near future operations.

Keywords: frequency control, grid stability, li-ion battery storage, smart grid

Procedia PDF Downloads 150
511 Inclusive Early Childhood Education and the Development of Children with Learning Disabilities in Ghana: Cultural-Historical Analysis

Authors: D. K. Kumador, E. A. Muthivhi

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Historically, reforms in early childhood education in Ghana have focused narrowly on structural and pedagogical aspects with little attention paid to the broader sociocultural framework within which schooling and child development systems interact. This preliminary study investigates inclusive early childhood education within rapidly changing Ghanaian socio-cultural context, and its consequences for the development of children with learning disabilities. The study addresses an important topic, which is largely under-researched outside of Europe, North America, and Australasia. While inclusive education has been widely accepted globally at the level of policy, its implementation is uneven, as is shown in numerous studies across an array of countries and education systems. Despite this burgeoning area of research internationally, there have been far fewer studies conducted in African settings and fewer still that use cultural-historical activity theory as an investigative approach. More so, specific literature on the subject in the Ghanaian context is non-existent and, as such, coming to a deeper understanding of the sociocultural practices that shape, and possibly impede, inclusive early childhood education in an African country, Ghana, is a worthwhile research endeavour. Using cultural-historical activity theory as a methodological framework, this study employed classroom observations, and in-depth interviews and focus group discussions of preschool teachers in three kindergarten centres in the Greater Accra Region of Ghana to qualitatively explore inclusive early childhood education and the development of children with learning disabilities. The findings showed that literature from Ghana rarely discusses child informed consent as an on-going process that must be articulated throughout the research process from data collection to analysis, reporting and dissemination. Further, the study showed that the introduction and implementation of inclusive education framework – with its concomitant revisions in the curriculum, policies, and school rules, as well as enhanced community and parent involvement – into existing schooling practices, generated contradictions in inclusive teachers’ approaches to teaching and learning, and classroom management. Generally, contradictions in the understanding and acceptability of approaches to teaching and learning occur when a new way of doing things is incorporated into existing practices. These contradictions are thought to be a source of change and development. Thus, they guide teachers to unlearn outmoded practices, relearn or learn new approaches that are beneficial to the development of all children. Nonetheless, the findings of the current study showed that preschool teachers’ belief systems and perceptions of disabilities mediated the outcomes of such contradictions. Also, that was evidenced in the way they engaged children with learning disabilities compared to their typically developing counterparts, showing disregard for what was prescribed by new policies and school rules. The findings have implications for research with young children and the development outcomes of children with learning disabilities in inclusive early childhood education settings.

Keywords: CHAT, classroom management, cultural-historical activity theory, ghana, inclusive early childhood education, schooling practices, young children with learning disabilities

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510 Apple in the Big Tech Oligopoly: An Analysis of Disruptive Innovation Trends and Their Influence on the Capacity of Conserving a Positive Social Impact as Primary Purpose

Authors: E. Loffi Borghese

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In this comprehensive study, we delve into the intricate dynamics of the big tech oligopoly, focusing particularly on Apple as a case study. The core objective is to scrutinize the evolving relationship between a firm's commitment to positive social impact as its primary purpose and its resilience in the face of disruptive innovations within the big tech market. Our exploration begins with a theoretical framework, emphasizing the significance of distinguishing between corporate social responsibility and social impact as a primary purpose. Drawing on insights from Drumwright and Bartkus and Glassman, we underscore the transformative potential when a firm aligns its core business with a social mission, transcending mere side activities. Examining successful firms, such as Apple, we adopt Sinek's perspective on inspirational leadership and the "golden circle." This framework sheds light on why some organizations, like Apple, succeed in making positive social impact their primary purpose. Apple's early-stage life cycle is dissected, revealing a profound commitment to challenging the status quo and promoting simpler alternatives that resonate with its users' lives. The study then navigates through industry life cycles, drawing on Klepper's stages and Christensen's disruptive innovations. Apple's dominance in the big tech oligopoly is contrasted with companies like Harley Davidson and Polaroid, illustrating the consequences of failing to adapt to disruptive innovations. The data and methods employed encompass a qualitative approach, leveraging sources like ECB, Forbes, World in Data, and scientific articles. A secondary data analysis probes Apple's market evolution within the big tech oligopoly, emphasizing the shifts in market context and innovation trends that demand strategic adaptations. The subsequent sections scrutinize Apple's present innovation strategies, highlighting its diversified product portfolio and intensified focus on big data. We examine the implications of these shifts on Apple's capacity to maintain positive social impact as its primary purpose, pondering potential consequences on its brand perception. The study culminates in a reflection on the broader implications of the big tech oligopoly's dominance. It contemplates the diminishing competitiveness in the market and the potential sidelining of positive social impact as a competitive advantage. The expansion of tech firms into diverse sectors raises concerns about negative societal impacts, prompting a call for increased regulatory attention and awareness. In conclusion, this research serves as a catalyst for heightened awareness and discussion on the intricate interplay between firms' social impact goals, disruptive innovations, and the broader societal implications within the evolving landscape of the big tech oligopoly. Despite limitations, this study aims to stimulate further research, urging a conscious and responsible approach to shaping the future economic system.

Keywords: innovation trends, market dynamics, social impact, tech oligopoly

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509 Mastopexy with the "Dermoglandular Autоaugmentation" Method. Increased Stability of the Result. Personalized Technique

Authors: Maksim Barsakov

Abstract:

Introduction. In modern plastic surgery, there are a large number of breast lift techniques.Due to the spreading information about the "side effects" of silicone implants, interest in implant-free mastopexy is increasing year after year. However, despite the variety of techniques, patients sometimes do not get full satisfaction from the results of mastopexy because of the unexpressed filling of the upper pole, extended anchoring postoperative scars and sometimes because of obtaining an aesthetically unattractive breast shape. The stability of the result after mastopexy depends on many factors, including postoperative rehabilitation. Stability of weight and hormonal background, stretchability of tissues. The high recurrence rate of ptosis and short-term aesthetic effect of mastopexy indicate the urgency of improving surgical techniques and increasing the stabilization of breast tissue. Purpose of the study. To develop and introduce into practice a technique of mastopexy based on the use of a modified Ribeiro flap, as well as elements of tissue movement and fixation designed to increase the stability of postoperative mastopexy. In addition, to give indications for the application of this surgical technique. Materials and Methods. it operated on 103 patients aged 18 to 53 years from 2019 to 2023 according to the reported method. These were patients with primary mastopexy, secondary mastopexy, and also patient with implant removal and one-stage mastopexy. The patients were followed up for 12 months to assess the stability of the result. Results and their discussion. Observing the patients, we noted greater stability of the breast shape and upper pole filling compared to the conventional classical methods. We did not have to resort to anchoring scars. In 90 percent of cases, a inverted T-shape scar was used. In 10 percent, the J-scar was used. The quantitative distribution of complications identified among the operated patients is as follows: worsened healing of the junction of vertical and horizontal sutures at the period of 1-1.5 months after surgery - 15 patients; at treatment with ointment method healing was observed in 7-30 days; permanent loss of NAC sensitivity - 0 patients; vascular disorders in the area of NAC/areola necrosis - 0 patients; marginal necrosis of the areola-2 patients. independent healing within 3-4 weeks without aesthetic defects. Aesthetically unacceptable mature scars-3 patients; partial liponecrosis of the autoflap unilaterally - 1 patient. recurrence of ptosis - 1 patient (after weight loss of 12 kg). In the late postoperative period, 2 patients became pregnant, gave birth, and no lactation problems were observed. Conclusion. Thus, in the world of plastic surgery methods of breast lift continue to improve, which is especially relevant in modern times, due to the increased attention to this operation. The author's proposed method of mastopexy with glandular autoflap allows obtaining in most cases a stable result, a fuller breast shape, avoiding the presence of extended anchoring scars, and also preserves the possibility of lactation. The author of this article has obtained a patent for invention for this method of mastopexy.

Keywords: mastopexy, mammoplasty, autoflap, personal technique

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508 COVID-19 Laws and Policy: The Use of Policy Surveillance For Better Legal Preparedness

Authors: Francesca Nardi, Kashish Aneja, Katherine Ginsbach

Abstract:

The COVID-19 pandemic has demonstrated both a need for evidence-based and rights-based public health policy and how challenging it can be to make effective decisions with limited information, evidence, and data. The O’Neill Institute, in conjunction with several partners, has been working since the beginning of the pandemic to collect, analyze, and distribute critical data on public health policies enacted in response to COVID-19 around the world in the COVID-19 Law Lab. Well-designed laws and policies can help build strong health systems, implement necessary measures to combat viral transmission, enforce actions that promote public health and safety for everyone, and on the individual level have a direct impact on health outcomes. Poorly designed laws and policies, on the other hand, can fail to achieve the intended results and/or obstruct the realization of fundamental human rights, further disease spread, or cause unintended collateral harms. When done properly, laws can provide the foundation that brings clarity to complexity, embrace nuance, and identifies gaps of uncertainty. However, laws can also shape the societal factors that make disease possible. Law is inseparable from the rest of society, and COVID-19 has exposed just how much laws and policies intersects all facets of society. In the COVID-19 context, evidence-based and well-informed law and policy decisions—made at the right time and in the right place—can and have meant the difference between life or death for many. Having a solid evidentiary base of legal information can promote the understanding of what works well and where, and it can drive resources and action to where they are needed most. We know that legal mechanisms can enable nations to reduce inequities and prepare for emerging threats, like novel pathogens that result in deadly disease outbreaks or antibiotic resistance. The collection and analysis of data on these legal mechanisms is a critical step towards ensuring that legal interventions and legal landscapes are effectively incorporated into more traditional kinds of health science data analyses. The COVID-19 Law Labs see a unique opportunity to collect and analyze this kind of non-traditional data to inform policy using laws and policies from across the globe and across diseases. This global view is critical to assessing the efficacy of policies in a wide range of cultural, economic, and demographic circumstances. The COVID-19 Law Lab is not just a collection of legal texts relating to COVID-19; it is a dataset of concise and actionable legal information that can be used by health researchers, social scientists, academics, human rights advocates, law and policymakers, government decision-makers, and others for cross-disciplinary quantitative and qualitative analysis to identify best practices from this outbreak, and previous ones, to be better prepared for potential future public health events.

Keywords: public health law, surveillance, policy, legal, data

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507 Numerical Investigation of the Boundary Conditions at Liquid-Liquid Interfaces in the Presence of Surfactants

Authors: Bamikole J. Adeyemi, Prashant Jadhawar, Lateef Akanji

Abstract:

Liquid-liquid interfacial flow is an important process that has applications across many spheres. One such applications are residual oil mobilization, where crude oil and low salinity water are emulsified due to lowered interfacial tension under the condition of low shear rates. The amphiphilic components (asphaltenes and resins) in crude oil are considered to assemble at the interface between the two immiscible liquids. To justify emulsification, drag and snap-off suppression as the main effects of low salinity water, mobilization of residual oil is visualized as thickening and slip of the wetting phase at the brine/crude oil interface which results in the squeezing and drag of the non-wetting phase to the pressure sinks. Meanwhile, defining the boundary conditions for such a system can be very challenging since the interfacial dynamics do not only depend on interfacial tension but also the flow rate. Hence, understanding the flow boundary condition at the brine/crude oil interface is an important step towards defining the influence of low salinity water composition on residual oil mobilization. This work presents a numerical evaluation of three slip boundary conditions that may apply at liquid-liquid interfaces. A mathematical model was developed to describe the evolution of a viscoelastic interfacial thin liquid film. The base model is developed by the asymptotic expansion of the full Navier-Stokes equations for fluid motion due to gradients of surface tension. This model was upscaled to describe the dynamics of the film surface deformation. Subsequently, Jeffrey’s model was integrated into the formulations to account for viscoelastic stress within a long wave approximation of the Navier-Stokes equations. To study the fluid response to a prescribed disturbance, a linear stability analysis (LSA) was performed. The dispersion relation and the corresponding characteristic equation for the growth rate were obtained. Three slip (slip, 1; locking, -1; and no-slip, 0) boundary conditions were examined using the resulted characteristic equation. Also, the dynamics of the evolved interfacial thin liquid film were numerically evaluated by considering the influence of the boundary conditions. The linear stability analysis shows that the boundary conditions of such systems are greatly impacted by the presence of amphiphilic molecules when three different values of interfacial tension were tested. The results for slip and locking conditions are consistent with the fundamental solution representation of the diffusion equation where there is film decay. The interfacial films at both boundary conditions respond to exposure time in a similar manner with increasing growth rate which resulted in the formation of more droplets with time. Contrarily, no-slip boundary condition yielded an unbounded growth and it is not affected by interfacial tension.

Keywords: boundary conditions, liquid-liquid interfaces, low salinity water, residual oil mobilization

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506 Teaching Timber: The Role of the Architectural Student and Studio Course within an Interdisciplinary Research Project

Authors: Catherine Sunter, Marius Nygaard, Lars Hamran, Børre Skodvin, Ute Groba

Abstract:

Globally, the construction and operation of buildings contribute up to 30% of annual green house gas emissions. In addition, the building sector is responsible for approximately a third of global waste. In this context, the utilization of renewable resources in buildings, especially materials that store carbon, will play a significant role in the growing city. These are two reasons for introducing wood as a building material with a growing relevance. A third is the potential economic value in countries with a forest industry that is not currently used to capacity. In 2013, a four-year interdisciplinary research project titled “Wood Be Better” was created, with the principle goal to produce and publicise knowledge that would facilitate increased use of wood in buildings in urban areas. The research team consisted of architects, engineers, wood technologists and mycologists, both from research institutions and industrial organisations. Five structured work packages were included in the initial research proposal. Work package 2 was titled “Design-based research” and proposed using architecture master courses as laboratories for systematic architectural exploration. The aim was twofold: to provide students with an interdisciplinary team of experts from consultancies and producers, as well as teachers and researchers, that could offer the latest information on wood technologies; whilst at the same time having the studio course test the effects of the use of wood on the functional, technical and tectonic quality within different architectural projects on an urban scale, providing results that could be fed back into the research material. The aim of this article is to examine the successes and failures of this pedagogical approach in an architecture school, as well as the opportunities for greater integration between academic research projects, industry experts and studio courses in the future. This will be done through a set of qualitative interviews with researchers, teaching staff and students of the studio courses held each semester since spring 2013. These will investigate the value of the various experts of the course; the different themes of each course; the response to the urban scale, architectural form and construction detail; the effect of working with the goals of a research project; and the value of the studio projects to the research. In addition, six sample projects will be presented as case studies. These will show how the projects related to the research and could be collected and further analysed, innovative solutions that were developed during the course, different architectural expressions that were enabled by timber, and how projects were used as an interdisciplinary testing ground for integrated architectural and engineering solutions between the participating institutions. The conclusion will reflect on the original intentions of the studio courses, the opportunities and challenges faced by students, researchers and teachers, the educational implications, and on the transparent and inclusive discourse between the architectural researcher, the architecture student and the interdisciplinary experts.

Keywords: architecture, interdisciplinary, research, studio, students, wood

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

Authors: Martina I. Reinhold, Theresa Bacon-Baguley

Abstract:

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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