Search results for: education of civil protection staff
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11182

Search results for: education of civil protection staff

172 The Saudi Arabia 2030 Strategy: Translation Reception and Translator Readiness

Authors: Budur Alsulami

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One of the aims of the recently implemented Saudi Arabia Vision 2030 strategy is focused on strengthening education, entertainment, and tourism to attract international visitors to the country. To promote and increase the tourism sector, tourism translation can serve the tourism industry by translating various materials that promote the country’s tourism such as brochures, catalogues, and websites. In order to achieve the goal of enhancing tourism in Saudi Arabia, promotional texts related to tourism and Saudi culture will need to be translated into English and addressed to non-Arabic-speaking potential tourists. This research aims to measure student readiness to be professional translators who can introduce and promote Saudi Arabia to non-Arabic-speaking tourists. The study will also evaluate students' abilities to promote and convey Saudi culture to non-Arabic tourists by translating tourism texts. Translating tourism materials demands considerable effort and specific translation skills to capture tourists' interest and encourage visits. Numerous scholars have explored challenges in translating tourism promotional materials, focusing on translation methods, cultural issues, course design, and necessary knowledge for tourism translation. Based on these insights, experts recommend that translators prioritize audience expectations, cultural appropriateness, and linguistic conventions while revising course syllabi to include practical skills. This research aims to assess students' readiness to become professional translators aligned with Vision 2030 tourism goals. To accomplish this, in the first stage of the project, twenty students from two Saudi Arabian Universities who have completed at least two years of Translation Studies were invited to translate two tourism texts of 300 words each. These tourism texts contain information about famous tourist sights and traditional food in Saudi Arabia and contained cultural terms and heritage information. The students then completed a questionnaire about the challenges of the text and the process of their translation, and then participated in a semi-structured interview. In the second stage of the project, the students’ translations will be evaluated by a qualified National Accreditation Authority of Translators and Interpreters (NAATI) examiner applying the NAATI rubrics. Finally, these translations will be read and assessed by fifteen to twenty native and near-native readers of English, who will evaluate the quality of the translations based on their understanding and perception of these texts. Results analysed to date suggest that a number of student translators faced challenges such as choosing a suitable translation method, omitting some key terms or words during the translation process, and managing their time, all of which may indicate a lack of practice in translating texts of this nature and lack of awareness regarding translation strategies most suitable for the genre.

Keywords: Saudi Arabia Vision 2030, translation, tourism, reader reception, culture, heritage, translator training/competencies

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171 Utilizing Quick Response (QR) Codes and Uniform Resource Locator (URL) links in Printed Discharge Instructions for Chronic Pain Patients

Authors: Jawad Arshad

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Back and neck pain result in more than 3 million Emergency Department (ED) visits per year. Approximately 10-20% of patients with acute low back pain will continue to have moderate to severe pain after 3 months and 30% will develop chronic functional impairment. Strategies for analgesia for musculoskeletal pain upon ED discharge have been shown to be highly variable and provider dependent. The American College of Physicians, United Kingdom and Danish treatment guidelines all recommend exercise as the first line treatment for low back pain present >12 weeks and as an adjunctive treatment to education and encouraging continued mobility in acute low back pain. URL links and QR codes were embedded in Epic’s Electronic Medical Record (EMR) for seamless integration into discharge instructions. To our knowledge, this is the first time QR codes have been embedded and used as an adjunct to computer generated discharge instructions into an EMR nationwide. Materials and Methods: Eleven two-minute physical therapy (PT) videos treating a variety of common painful musculoskeletal conditions were prepared in collaboration between the Pain Management and Physical Therapy departments of a large academic center. The videos were hosted and made available on Vimeo for free public access. Dynamic QR codes and URL links were created for each video and integrated into the EPIC Electronic Medical Record discharge instructions. Both data from physician prescribed PT videos and results of public searches are included. As the case report is devoid of patient identifiable information, it is exempt from IRB review requirements as per IRB policy. Results/Case Report: From 2/6/2021 to 5/19/21, the videos were prescribed on Epic a total of 76 times, the dynamic QR codes were scanned a total of 84 times. Low back (n=32) followed by neck (n=8), shoulder (n=7) and radicular low back pain (n=7) were the most common painful complaints prescribed a PT video. The videos were played on Vimeo 790 times with 83% (n=656) being unique views and 17% returning users. Shoulder pain (n=489) followed by neck (n=36) and low back pain (n=37) were the most commonly played videos. Discussion: Patients are viewing their physical therapy videos via QR codes provided by their physicians. The large number of public views of the physical therapy videos are either from patients sharing the link/QR code or patients not affiliated with our institution are searching for videos to treat their painful complaints. The data suggests there is a need for reputable home PT videos to treat commonly encountered painful complaints with 17% of viewers returning for repeat view. The shoulder pain video was played significantly more than the others despite not being given to patients more frequently, which raised suspicion it may have received increased traffic via an outside affiliate, website or influencer. When eliminating shoulder pain from the data, individuals watched 67% of the entire video on average, indicating high engagement.

Keywords: pain, EMR, emergency medicine, discharge

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170 Characteristics of Female Offenders: Using Childhood Victimization Model for Treatment

Authors: Jane E. Hill

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Sexual, physical, or emotional abuses are behaviors used by one person in a relationship or within a family unit to control the other person. Physical abuse can consist of, but not limited to hitting, pushing, and shoving. Sexual abuse is unwanted or forced sexual activity on a person without their consent. Abusive behaviors include intimidation, manipulation, humiliation, isolation, frightening, terrorizing, coercing, threatening, blaming, hurting, injuring, or wounding another individual. Although emotional, psychological and financial abuses are not criminal behaviors, they are forms of abuse and can leave emotional scars on their victim. The purpose of this literature review research was to examine characteristics of female offenders, past abuse, and pathways to offending. The question that guided this research: does past abuse influence recidivism? The theoretical foundation used was relational theory by Jean Baker Miller. One common feature of female offenders is abuse (sexual, physical, or verbal). Abuse can cause mental illnesses and substance abuse. The abuse does not directly affect the women's recidivism. However, results indicated the psychological and maladaptive behaviors as a result of the abuse did contribute to indirect pathways to continue offending. The female offenders’ symptoms of ongoing depression, anxiety, and engaging in substance abuse (self medicating) did lead to the women's incarceration. Using the childhood victimization model as the treatment approach for women's mental illness and substance abuse disorders that were a result from history of child abuse have shown success. With that in mind, if issues surrounding early victimization are not addressed, then the women offenders may not recover from their mental illness or addiction and are at a higher risk of reoffending. However, if the women are not emotionally ready to engage in the treatment process, then it should not be forced onto them because it may cause harm (targeting prior traumatic experiences). Social capital is family support and sources that assist in helping the individual with education, employment opportunities that can lead to success. Human capital refers to internal knowledge, skills, and capacities that help the individual act in new and appropriate ways. The lack of human and social capital is common among female offenders, which leads to extreme poverty and economic marginalization, more often in frequent numbers than men. In addition, the changes in welfare reform have exacerbated women’s difficulties in gaining adequate-paying jobs to support themselves and their children that have contributed to female offenders reoffending. With that in mind, one way to lower the risk factor of female offenders from reoffending is to provide them with educational and vocational training, enhance their self-efficacy, and teach them appropriate coping skills and life skills. Furthermore, it is important to strengthen family bonds and support. Having a supportive family relationship was a statistically significant protective factor for women offenders.

Keywords: characteristics, childhood victimization model, female offenders, treatment

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169 Gender Bias and the Role It Plays in Student Evaluation of Instructors

Authors: B. Garfolo, L. Kelpsh, R. Roak, R. Kuck

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Often, student ratings of instructors play a significant role in the career path of an instructor in higher education. So then, how does a student view the effectiveness of instructor teaching? This question has been address by literally thousands of studies found in the literature. Yet, why does this question still persist? A literature review reveals that while it is true that student evaluations of instructors can be biased, there is still a considerable amount of work that needs to be done in understanding why. As student evaluations of instructors can be used in a variety of settings (formative or summative) it is critical to understand the nature of the bias. The authors believe that not only is some bias possible in student evaluations, it should be expected for the simple reason that a student evaluation is a human activity and as such, relies upon perception and interpersonal judgment. As such, student ratings are affected by the same factors that can potentially affect any rater’s judgment, such as stereotypes based on gender, culture, race, etc. Previous study findings suggest that student evaluations of teacher effectiveness differ between male and female raters. However, even though studies have shown that instructor gender does play an important role in influencing student ratings, the exact nature and extent of that role remains the subject of debate. Researchers, in their attempt to define good teaching, have looked for differences in student evaluations based on a variety of characteristics such as course type, class size, ability level of the student and grading practices in addition to instructor and student characteristics (gender, age, etc.) with inconsistent results. If a student evaluation represents more than an instructor’s teaching ability, for example, a physical characteristic such as gender, then this information must be taken into account if the evaluation is to have meaning with respect to instructor assessment. While the authors concede that it is difficult or nearly impossible to separate gender from student perception of teaching practices in person, it is, however, possible to shield an instructor’s gender identity with respect to an online teaching experience. The online teaching modality presents itself as a unique opportunity to experiment directly with gender identity. The analysis of the differences of online behavior of individuals when they perceive that they are interacting with a male or female could provide a wealth of data on how gender influences student perceptions of teaching effectiveness. Given the importance of the role student ratings play in hiring, retention, promotion, tenure, and salary deliberations in academic careers, this question warrants further attention as it is important to be aware of possible bias in student evaluations if they are to be used at all with respect to any academic considerations. For experimental purposes, the author’s constructed and online class where each instructors operate under two different gender identities. In this study, each instructor taught multiple sections of the same class using both a male identity and a female identity. The study examined student evaluations of teaching based on certain student and instructor characteristics in order to determine if and where male and female students might differ in their ratings of instructors based on instructor gender. Additionally, the authors examined if there are differences between undergraduate and graduate students' ratings with respect to the experimental criteria.

Keywords: gender bias, ethics, student evaluations, student perceptions, online instruction

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168 The Association between Attachment Styles, Satisfaction of Life, Alexithymia, and Psychological Resilience: The Mediational Role of Self-Esteem

Authors: Zahide Tepeli Temiz, Itir Tari Comert

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Attachment patterns based on early emotional interactions between infant and primary caregiver continue to be influential in adult life, in terms of mental health and behaviors of individuals. Several studies reveal that infant-caregiver relationships have impressed the affect regulation, coping with stressful and negative situations, general satisfaction of life, and self image in adulthood, besides the attachment styles. The present study aims to examine the relationships between university students’ attachment style and their self-esteem, alexithymic features, satisfaction of life, and level of resilience. In line with this aim, the hypothesis of the prediction of attachment styles (anxious and avoidant) over life satisfaction, self-esteem, alexithymia, and psychological resilience was tested. Additionally, in this study Structural Equational Modeling was conducted to investigate the mediational role of self-esteem in the relationship between attachment styles and alexithymia, life satisfaction, and resilience. This model was examined with path analysis. The sample of the research consists of 425 university students who take education from several region of Turkey. The participants who sign the informed consent completed the Demographic Information Form, Experiences in Close Relationships-Revised, Rosenberg Self-Esteem Scale, The Satisfaction with Life Scale, Toronto Alexithymia Scale, and Resilience Scale for Adults. According to results, anxious, and avoidant dimensions of insecure attachment predicted the self-esteem score and alexithymia in positive direction. On the other hand, these dimensions of attachment predicted life satisfaction in negative direction. The results of linear regression analysis indicated that anxious and avoidant attachment styles didn’t predict the resilience. This result doesn’t support the theory and research indicating the relationship between attachment style and psychological resilience. The results of path analysis revealed the mediational role self esteem in the relation between anxious, and avoidant attachment styles and life satisfaction. In addition, SEM analysis indicated the indirect effect of attachment styles over alexithymia and resilience besides their direct effect. These findings support the hypothesis of this research relation to mediating role of self-esteem. Attachment theorists suggest that early attachment experiences, including supportive and responsive family interactions, have an effect on resilience to harmful situations in adult life, ability to identify, describe, and regulate emotions and also general satisfaction with life. Several studies examining the relationship between attachment styles and life satisfaction, alexithymia, and psychological resilience draw attention to mediational role of self-esteem. Results of this study support the theory of attachment patterns with the mediation of self-image influence the emotional, cognitive, and behavioral regulation of person throughout the adulthood. Therefore, it is thought that any intervention intended for recovery in attachment relationship will increase the self-esteem, life satisfaction, and resilience level, on the one side, decrease the alexithymic features, on the other side.

Keywords: alexithymia, anxious attachment, avoidant attachment, life satisfaction, path analysis, resilience, self-esteem, structural equation

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167 Community Music in Puerto Rico

Authors: Francisco Luis Reyes

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The multiple-case study explores the intricacies of three Puerto Rican Community Music (CM) initiatives. This research concentrates on the teaching and learning dynamics of three of the nation’s traditional musical genres, Plena, Bomba, and Música Jíbara, which have survived for centuries through oral transmission and enculturation in community settings. Accordingly, this research focuses on how music education is carried out in Puerto Rican CM initiatives that foster and preserve the country’s traditional music. This study examines the CM initiatives of La Junta, in Santurce (Plena), Taller Tambuyé in Rio Piedras (Bomba), and Decimanía (Música Jíbara), an initiative that stems from the municipality of Hatillo. In terms of procedure, 45–60-minute semi-structured interviews were conducted with organizers and administrators of the CM initiatives to gain insight into the educational philosophy of each project. Following this, a second series of 45–60-minute semi-structured interviews were undertaken with CM educators to collect data on their musical development, teaching practices, and relationship with learners. Subsequently, four weeks were spent observing/participating in each of the three CM initiatives. In addition to participant observations in these projects, five CM learners from each locale were recruited for two one-on-one semi-structured interviews at the beginning and end of the data collection period. The initial interview centered on the participants’ rationale for joining the CM initiative whereas the exit interview focused on participants’ experience within it. Alumni from each of the CM initiatives partook in 45–60-minute semi-structured interviews to investigate their understanding of what it means to be a member of each musical community. Finally, observations and documentation of additional activities hosted/promoted by each initiative, such as festivals, concerts, social gatherings, and workshops, were undertaken. These three initiatives were chosen because of their robust and dynamic practices in fostering the musical expressions of Puerto Rico. Data collection consisted of participant observation, narrative inquiry, historical research, philosophical inquiry, and semi-structured interviews. Data analysis for this research involved relying on theoretical propositions, which entails comparing the results—from each case and as a collective— to the arguments that led to the basis of the research (e.g., literature review, research questions, hypothesis). Comparisons to the theoretical propositions were made through pattern matching, which requires comparing predicted patterns from the literature review to findings from each case. Said process led to the development of an analytic outlook of each CM case and a cross-case synthesis. The purpose of employing said data analysis methodology is to present robust findings about CM practices in Puerto Rico and elucidate similarities and differences between the cases that comprise this research and the relevant literature. Furthermore, through the use of Sound Links’ Nine Domains of Community Music, comparisons to other community projects are made in order to point out parallels and highlight particularities in Puerto Rico.

Keywords: community music, Puerto Rico, music learning, traditional music

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166 Introduction of Dams Impacts on Downstream Wetlands: Case Study in Ahwar Delta in Yemen

Authors: Afrah Saad Mohsen Al-Mahfadi

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The construction of dams can provide various ecosystem services, but it can also lead to ecological changes such as habitat loss and coastal degradation. Yemen faces multiple risks, including water crises and inadequate environmental policies, which are particularly detrimental to coastal zones like the Ahwar Delta in Abyan. This study aims to examine the impacts of dam construction on downstream wetlands and propose sustainable management approaches. Research Aim: The main objective of this study is to assess the different impacts of dam construction on downstream wetlands, specifically focusing on the Ahwar Delta in Yemen. Methodology: The study utilizes a literature review approach to gather relevant information on dam impacts and adaptation measures. Interviews with decision-making stakeholders and local community members are conducted to gain insights into the specific challenges faced in the Ahwar Delta. Additionally, sensing data, such as Arc-GIS and precipitation data from 1981 to 2020, are analyzed to examine changes in hydrological dynamics. Questions Addressed: This study addresses the following questions: What are the impacts of dam construction on downstream wetlands in the Ahwar delta? How can environmental management planning activities be implemented to minimize these impacts? Findings: The results indicate several future issues arising from dam construction in the coastal areas, including land loss due to rising sea levels and increased salinity in drinking water wells. Climate change has led to a decrease in rainfall rates, impacting vegetation and increasing sedimentation and erosion. Downstream areas with dams exhibit lower sediment levels and slower flowing habitats compared to those without dams. Theoretical Importance: The findings of this study provide valuable insights into the ecological impacts of dam construction on downstream wetlands. Understanding these dynamics can inform decision-makers about the need for adaptation measures and their potential benefits in improving coastal biodiversity under dam impacts. Data Collection and Analysis Procedures: The study collects data through a literature review, interviews, and sensing technology. The literature review helps identify relevant studies on dam impacts and adaptation measures. Interviews with stakeholders and local community members provide firsthand information on the specific challenges faced in the Ahwar Delta. Sensing data, such as Arc-GIS and precipitation data, are analyzed to understand changes in hydrological dynamics over time. Conclusion: The study concludes that while the situation can worsen due to dam construction, practical adaptation measures can help mitigate the impacts. Recommendations include improving water management, developing integrated coastal zone planning, raising awareness among stakeholders, improving health and education, and implementing emergency projects to combat climate change.

Keywords: dam impact, delta wetland, hydrology, Yemen

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165 Contrastive Analysis of Parameters Registered in Training Rowers and the Impact on the Olympic Performance

Authors: Gheorghe Braniste

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The management of the training process in sports is closely related to the awareness of the close connection between performance and the morphological, functional and psychological characteristics of the athlete's body. Achieving high results in Olympic sports is influenced, on the one hand, by the genetically determined characteristics of the body and, on the other hand, by the morphological, functional and motor abilities of the athlete. Taking into account the importance of properly understanding the evolutionary specificity of athletes to assess their competitive potential, this study provides a comparative analysis of the parameters that characterize the growth and development of the level of adaptation of sweeping rowers, considering the growth interval between 12 and 20 years. The study established that, in the multi-annual training process, the bodies of the targeted athletes register significant adaptive changes while analyzing parameters of the morphological, functional, psychomotor and sports-technical spheres. As a result of the influence of physical efforts, both specific and non-specific, there is an increase in the adaptability of the body, its transfer to a much higher level of functionality within the parameters, useful and economical adaptive reactions influenced by environmental factors, be they internal or external. The research was carried out for 7 years, on a group of 28 athletes, following their evolution and recording the specific parameters of each age stage. In order to determine the level of physical, morpho-functional, psychomotor development and technical training of rowers, the screening data were applied at the State University of Physical Education and Sports in the Republic of Moldova. During the research, measurements were made on the waist, in the standing and sitting position, arm span, weight, circumference and chest perimeter, vital capacity of the lungs, with the subsequent determination of the vital index (tolerance level to oxygen deficiency in venous blood in Stange and Genchi breath-taking tests that characterize the level of oxygen saturation, absolute and relative strength of the hand and back, calculation of body mass and morphological maturity indices (Kettle index), body surface area (body gait), psychomotor tests (Romberg test), test-tepping 10 s., reaction to a moving object, visual and auditory-motor reaction, recording of technical parameters of rowing on a competitive distance of 200 m. At the end of the study it was found that highly performance is sports is to be associated on the one hand with the genetically determined characteristics of the body and, on the other hand, with favorable adaptive reactions and energy saving, as well as morphofunctional changes influenced by internal and external environmental factors. The importance of the results obtained at the end of the study was positively reflected in obtaining the maximum level of training of athletes in order to demonstrate performance in large-scale competitions and mostly in the Olympic Games.

Keywords: olympics, parameters, performance, peak

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164 Effects of a Cluster Grouping of Gifted and Twice Exceptional Students on Academic Motivation, Socio-emotional Adjustment, and Life Satisfaction

Authors: Line Massé, Claire Baudry, Claudia Verret, Marie-France Nadeau, Anne Brault-Labbé

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Little research has been conducted on educational services adapted for twice exceptional students. Within an action research, a cluster grouping was set up in an elementary school in Quebec, bringing together gifted or doubly exceptional (2E) students (n = 11) and students not identified as gifted (n = 8) within a multilevel class (3ᵣ𝒹 and 4ₜₕ years). 2E students had either attention deficit hyperactivity disorder (n = 8, including 3 with specific learning disability) or autism spectrum disorder (n = 2). Differentiated instructions strategies were implemented, including the possibility of progressing at their own pace of learning, independent study or research projects, flexible accommodation, tutoring with older students and the development of socio-emotional learning. A specialized educator also supported the teacher in the class for behavioural and socio-affective aspects. Objectives: The study aimed to assess the impacts of the grouping on all students, their academic motivation, and their socio-emotional adaptation. Method: A mixed method was used, combining a qualitative approach with a quantitative approach. Semi-directed interviews were conducted with students (N = 18, 4 girls and 14 boys aged 8 to 9) and one of their parents (N = 18) at the end of the school year. Parents and students completed two questionnaires at the beginning and end of the school year: the Behavior Assessment System for Children-3, children or parents versions (BASC-3, Reynolds and Kampus, 2015) and the Academic Motivation in Education (Vallerand et al., 1993). Parents also completed the Multidimensional Student Life Satisfaction Scale (Huebner, 1994, adapted by Fenouillet et al., 2014) comprising three domains (school, friendships, and motivation). Mixed thematic analyzes were carried out on the data from the interviews using the N'Vivo software. Related-samples Wilcoxon rank-sums tests were conducted for the data from the questionnaires. Results: Different themes emerge from the students' comments, including a positive impact on school motivation or attitude toward school, improved school results, reduction of their behavioural difficulties and improvement of their social relations. These remarks were more frequent among 2E students. Most 2E students also noted an improvement in their academic performance. Most parents reported improvements in attitudes toward school and reductions in disruptive behaviours in the classroom. Some parents also observed changes in behaviours at home or in the socio-emotional well-being of their children, here again, particularly parents of 2E children. Analysis of questionnaires revealed significant differences at the end of the school year, more specifically pertaining to extrinsic motivation identified, problems of conduct, attention, emotional self-control, executive functioning, negative emotions, functional deficiencies, and satisfaction regarding friendships. These results indicate that this approach could benefit not only gifted and doubly exceptional students but also students not identified as gifted.

Keywords: Cluster grouping, elementary school, giftedness, mixed methods, twice exceptional students

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163 Engineering Economic Analysis of Implementing a Materials Recovery Facility in Jamaica: A Green Industry Approach towards a Sustainable Developing Economy

Authors: Damian Graham, Ashleigh H. Hall, Damani R. Sulph, Michael A. James, Shawn B. Vassell

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This paper assesses the design and feasibility of a Materials Recovery Facility (MRF) in Jamaica as a possible green industry approach to the nation’s economic and solid waste management problems. Jamaica is a developing nation that is vulnerable to climate change that can affect its blue economy and tourism on which it is heavily reliant. Jamaica’s National Solid Waste Management Authority (NSWMA) collects only a fraction of all the solid waste produced annually which is then transported to dumpsites. The remainder is either burnt by the population or disposed of illegally. These practices negatively impact the environment, threaten the sustainability of economic growth from blue economy and tourism and its waste management system is predominantly a cost centre. The implementation of an MRF could boost the manufacturing sector, contribute to economic growth, and be a catalyst in creating a green industry with multiple downstream value chains with supply chain linkages. Globally, there is a trend to reuse and recycle that created an international market for recycled solid waste. MRFs enable the efficient sorting of solid waste into desired recoverable materials thus providing a gateway for entrance to the international trading of recycled waste. Research into the current state and effort to improve waste management in Jamaica in contrast with the similar and more advanced territories are outlined. The study explores the concept of green industrialization and its applicability to vulnerable small state economies like Jamaica. The study highlights the possible contributions and benefits derived from MRFs as a seeding factory that can anchor the reverse and forward logistics of other green industries as part of a logistic-cantered economy. Further, the study showcases an engineering economic analysis that assesses the viability of the implementation of an MRF in Jamaica. This research outlines the potential cost of constructing and operating an MRF and provides a realistic cash flow estimate to establish a baseline for profitability. The approach considers quantitative and qualitative data, assumptions, and modelling using industrial engineering tools and techniques that are outlined. Techniques of facility planning, system analysis and operations research with a focus on linear programming techniques are expressed. Approaches to overcome some implementation challenges including policy, technology and public education are detailed. The results of this study present a reasonable judgment of the prospects of incorporating an MRF to improve Jamaica’s solid waste management and contribute to socioeconomic and environmental benefits and an alternate pathway for economic sustainability.

Keywords: engineering-economic analysis, facility design, green industry, MRF, manufacturing, plant layout, solid-waste management, sustainability, waste disposal

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162 Knowledge, Attitude and Beliefs Towards Polypharmacy Amongst Older People Attending Family Medicine Clinic at the Aga Khan University Hospital, Nairobi, Kenya (AKUHN) Sub-Saharan Africa-Qualitative Study

Authors: Maureen Kamau, Gulnaz Mohamoud, Adelaide Lusambili, Njeri Nyanja

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Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. These multiple chronic conditions are managed with polypharmacy. Polypharmacy has numerous adverse effects including non-adherence, poor compliance to the various medications, reduced appetite, and risk of fall. Studies on polypharmacy and ageing are few and poorly understood especially in low and middle - income countries. The aim of this study was to explore the knowledge, attitudes and beliefs of older people towards polypharmacy. A qualitative study of 15 patients aged 60 years and above, taking more than five medications per day were conducted at the Aga Khan University using Semi-structured in-depth interviews. Three interviews were pilot interviews, and data analysis was performed on 12 interviews. Data were analyzed using NVIVO 12 software. A thematic qualitative analysis was carried out guided by Braun and Clarke (2006) framework. Themes identified; - knowledge of their co-morbidities and of the medication that older persons take, sources of information about medicines, and storage of the medication, experiences and attitudes of older patients towards polypharmacy both positive and negative, older peoples beliefs and their coping mechanisms with polypharmacy. The study participants had good knowledge on their multiple co-morbidities, and on the medication they took. The patients had positive attitudes towards medication as it enhanced their health and well-being, and enabled them to perform their activities of daily living. There was a strong belief among older patients that the medications were necessary for their health. All these factors enhanced compliance to the multiple medication. However, some older patients had negative attitudes due to the pill burden, side effects of the medication, and stigma associated with being ill. Cost of healthcare was a concern, with most of the patients interviewed relying on insurance to cover the cost of their medication. Older patients had accepted that the medication they were prescribed were necessary for their health, as it enabled them to complete their activities of daily living. Some concerns about the side effects of the medication arose, and brought about the need for patient education that would ensure that the patients are aware of the medications they take, and potential side effects. The effect that the COVID 19 pandemic had in the healthcare of the older patients was evident by the number of the older patients avoided coming to the hospital during the period of the pandemic. The relationship with the primary care physician and the older patients is an important one, especially in LMICs such as Kenya, as many of the older patients trusted the doctors wholeheartedly to make the best decision about their health and about their medication. Prescription review is important to avoid the use of potentially inappropriate medication.

Keywords: polypharmacy, older patients, multiple chronic conditions, Kenya, Africa, qualitative study, indepth interviews, primary care

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161 Black Womens Healthcare Policy Reform: Navigating their Sexual and Reproductive Care Needs

Authors: Renata Hall

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This presentation seeks to highlight an arts-based, Black feminist, and community based participatory approach to exploring the strengths and pleasures, concerns and barriers, and wants and needs of diverse Black women in navigating formal and informal sexual and reproductive healthcare continuums. Recognizing the ongoing intersectional discrimination that Black women face interpersonally and systemically in community and healthcare spaces that service needs such as, early and unwanted pregnancy, sexually transmitted infection (STI) treatment and testing, human immune-deficiency virus (HIV) treatment and testing, pre and post-natal care, gynecology and obstetrics, sex education, sexual violence and assault reporting and support, gender affirming spaces and more, this presentation unveils the community and embodied pathways to caring for the sexual self through cultural practices, advocacy and peer support. The presentation will be grounded in the arts and lived experience of 8 Black women, aiming to highlight the sexual and reproductive subjectivities of Black women, through the application and discussion of Black feminist arts-based methodology and praxis. The presentation not only seeks to illuminate methods and grammars of Blackness but so too, invite practitioners to engage in cultural and community-based methods to care. There are many themes of the conference covered in this presentation; feminist methodologies revealing narratives community and inclusion, how the utilization of technology, social media and cultural forces can drive community feminist activism and self-advocacy, how feminist methodologies can uncover opportunities for anti-racist praxis, and lastly enhancing collaboration in research. Specifically revealing how Black feminist thought and associated methods can be enhanced through community based participatory action (CBPAR) research approaches such as, photovoice, this presentation reveals the systemic histories and modern-day experiences of Black women when accessing sexual and reproductive care whilst also uncovering embodied and community-based strengths that produce grassroots, digital, and self-advocacy within healthcare systems. The ways in which the arts, digital age, cultural influences, and lived experiences can come to the fore in collaborative data collection and analysis with research participants, will be the crux of my presentation, bridging to how both Black feminist, CBPAR, and arts-based methods can create tangible, anti-racist and racially reflexive implications for the healthcare and community sector seeking to pedestal Black women's strengths and resilience's and corroborate with their lived experiences. This conversation will center around 3 of the 9 themes derived from my dissertation research, which focuses on the strengths of Black women's community care, culturally informed self-care practices, and communication and vocal pathways to strengthen their sexual and reproductive self-concept and navigational skills in the face of intersectional discrimination in care continuums.

Keywords: sexual and reproductive healthcare, black feminisms, black feminist research, antiracist healthcare policy, antiracist healthcare delivery, arts based research, photovoice

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160 Correlates of Comprehensive HIV/AIDS Knowledge and Acceptance Attitude Towards People Living with HIV/AIDS: A Cross-Sectional Study among Unmarried Young Women in Uganda

Authors: Tesfaldet Mekonnen Estifanos, Chen Hui, Afewerki Weldezgi

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Background: Youth in general and young females in particular, remain at the center of the HIV/AIDS epidemic. Sexual risk-taking among young unmarried women is relatively high and are the most vulnerable and highly exposed to HIV/AIDS. Improvements in the status of HIV/AIDS knowledge and acceptance attitude towards people living with HIV (PLWHIV) plays a great role in averting the incidence of HIV/AIDS. Thus, the aim of the study was to explore the level and correlates of HIV/AIDS knowledge and accepting attitude toward PLWHIV. Methods: A cross-sectional study was conducted using data from the Uganda Demographic Health Survey 2016 (UDHS-2016). National level representative household surveys using a multistage cluster probability sampling method, face to face interviews with standard questionnaires were performed. Unmarried women aged 15-24 years with a sample size of 2019 were selected from the total sample of 8674 women aged 15-49 years and were analyzed using SPSS version 23. Independent variables such as age, religion, educational level, residence, and wealth index were included. Two binary outcome variables (comprehensive HIV/AIDS knowledge and acceptance attitude toward PLWHIV) were utilized. We used the chi-square test as well as multivariate regression analysis to explore correlations of explanatory variables with the outcome variables. The results were reported by odds ratios (OR) with 95% confidence interval (95% CI), taking a p-value less than 0.05 as significant. Results: Almost all (99.3%) of the unmarried women aged 15-24 years were aware of HIV/AIDS, but only 51.2% had adequate comprehensive knowledge on HIV/AIDS. Only 69.4% knew both methods: using a condom every time had sex, and having only one faithful uninfected partner can prevent HIV/AIDS transmission. About 66.6% of the unmarried women reject at least two common local misconceptions about HIV/AIDS. Moreover, an alarmingly few (20.3%) of the respondents had a positive acceptance attitude to PLWHIV. On multivariate analysis, age (20-24 years), living in urban, being educated and wealthier, were predictors of having adequate comprehensive HIV/AIDS knowledge. On the other hand, research participants with adequate comprehensive knowledge about HIV/AIDS were highly likely (OR, 1.94 95% CI, 1.52-2.46) to have a positive acceptance attitude to PLWHIV than those with inadequate knowledge. Respondents with no education, Muslim, and Pentecostal religion were emerged less likely to have a positive acceptance attitude to PLWHIV. Conclusion: This study found out the highly accepted level of awareness, but the knowledge and positive acceptance attitude are not encouraging. Thus, expanding access to comprehensive sexuality and strengthening educational campaigns on HIV/AIDS in communities, health facilities, and schools is needed with a greater focus on disadvantaged women having low educational level, poor socioeconomic status, and those residing in rural areas. Sexual risk behaviors among the most affected people - young women have also a role in the spread of HIV/AIDS. Hence, further research assessing the significant contributing factors for sexual risk-taking might have a positive impact on the fight against HIV/AIDS.

Keywords: acceptance attitude, HIV/AIDS, knowledge, unmarried women

Procedia PDF Downloads 155
159 Play, Practice and Perform: The Pathway to Becoming and Belonging as an Engineer

Authors: Rick Evans

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Despite over 40 years of research into why women choose not to enroll or leave undergraduate engineering programs, along with the subsequent and serious efforts to attract more women, women receiving bachelor's degrees in engineering in the US have remained disappointingly low. We know that even despite their struggles to become more welcoming and inclusive, engineering programs remain gendered, raced and classed. However, our research team has found that women who participate and indeed thrive in undergraduate engineering project teams do so in numbers that far exceed their participation in undergraduate programs. We believe part of the answer lies in the ways that project teams facilitate experiential learning, specifically providing opportunities for members to play, practice and perform. We employ a multi-case study method and assume a feminist, activist and interpretive perspective. We seek to generate concrete and context-dependent knowledge in order to explore potentially new variables and hypotheses. Our focus is to learn from those select women who are thriving. For this oral or e-poster presentation, we will focus on the results of the second of our semi-structured interviews – the learning journey interview. During this interview, we ask participants to tell us the story/ies of their participation in project teams. Our results suggest these women find joy in their experience of developing and applying engineering expertise. They experience this joy and develop their expertise in the highly patterned progression of play, practice and performance. Play is a purposeful activity in which someone enters an imaginary world, a world not yet real to them. However, this imaginary world is still very much connected to the real world, in this case, a particular kind of engineering, in that the ways of engaging are already established, codified and rule-governed. As such, these women are novices motivated to join a community of actors. Practice, better understood as practices, a count noun, is an embodied, materially interconnected collection of actions organized around the shared understandings of that community of actors. Those shared understandings reveal a social order – a particular field of engineering. No longer novices, these women begin to develop and display their emergent identities as engineers. Perform is activity meant either to demonstrate competence and/or to enable, even teach play and practice to others. As performers, these women participants become models for others. They direct play and practice, contextualizing both within a field of engineering and the specific aims of the project team community. By playing, practicing and performing engineering, women claim their identities as engineers and, equally important, have those identities acknowledged by team members. If we hope to transform our gendered, raced, classed institutions, we need to learn more about women who thrive within those institutions. We need to learn more about their processes of becoming and belonging as engineers. Our research presentation begins with a description of project teams and our multi-case study method. We then offer detailed descriptions of play, practice, and performance using the voices of women in project teams.

Keywords: engineering education, gender, identity, project teams

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158 Drivers of the Performance of Members of a Social Incubator Considering the Values of Work: A Qualitative Study with Social Entrepreneurs

Authors: Leticia Lengler, Vania Estivalete, Vivian Flores Costa, Tais De Andrade, Lisiane Fellini Faller

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Social entrepreneurship has emerged and driven a new development perspective, and as the literature mentions, it is based on innovation, and mainly, on the creation of social value, rather than personal wealth and shareholders. In this field of study, one of the focuses of discussion refers to the distinct characteristics of the individuals responsible for socially directed initiatives, named as social entrepreneurs. To contribute to this perspective, the present study aims to identify the values related to work that guide the performance of social entrepreneurs, members of enterprises that have developed themselves within a social incubator at a federal institution of higher education in Brazil. Each person's value system is present in different facets of his life, manifesting himself in his choices and in the way he conducts the relationship with other people in society. Especially the values of work, the focus of this research, play a significant role in organizational studies, since they are considered one of the important guiding principles of the behavior of individuals in the work environment. Regarding the method of the study, a descriptive and qualitative research was carried out. In the data collection, 24 entrepreneurs, members of five different enterprises belonging to the social incubator, were interviewed. The research instrument consisted of three open questions, which could be answered with the support of a "disc of values", an artifact organized to clearly demonstrate the values of the work to the respondents. The analysis of the interviews took into account the categories defined a priori, based on the model proposed by previous authors who validated these constructs within their research contexts, contemplating the following dimensions: Self-determination and stimulation; Safety; Conformity; Universalism and benevolence; Achievement; and Power. It should be noted that, in order to provide a better understanding of the interviewees, in the "disc of values" used in the research, these dimensions were represented by the objectives that define them, being respectively: Challenge; Financial independence; Commitment; Welfare of others; Personal success; And Power. Some preliminary results show that, as guiding principles of the investigation, priority is given to work values related to Self-determination and stimulation, Conformity and Universalism and benevolence. Such findings point to the importance given by these individuals to independent thinking and acting, as well as to novelty and constant challenge. Still, they demonstrate the appreciation of commitment to their enterprise, the people who make it and the quality of their work. They also point to the relevance of the possibility of contributing to the greater social good, that is, of the search for the well-being of close people and of society, as it is implied in models of social entrepreneurship coming from literature. With a lower degree of priority, the values denominated Safety and Realization, as the financial question at work and the search for satisfaction and personal success, through the use of socially recognized skills were mentioned aspects with little emphasis by social entrepreneurs. The Power value was not considered as guiding principle of the work for the respondents.

Keywords: qualitative study, social entrepreneur, social incubator, values of work

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157 Solutions for Food-Safe 3D Printing

Authors: Geremew Geidare Kailo, Igor Gáspár, András Koris, Ivana Pajčin, Flóra Vitális, Vanja Vlajkov

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Three-dimension (3D) printing, a very popular additive manufacturing technology, has recently undergone rapid growth and replaced the use of conventional technology from prototyping to producing end-user parts and products. The 3D Printing technology involves a digital manufacturing machine that produces three-dimensional objects according to designs created by the user via 3D modeling or computer-aided design/manufacturing (CAD/CAM) software. The most popular 3D printing system is Fused Deposition Modeling (FDM) or also called Fused Filament Fabrication (FFF). A 3D-printed object is considered food safe if it can have direct contact with the food without any toxic effects, even after cleaning, storing, and reusing the object. This work analyzes the processing timeline of the filament (material for 3D printing) from unboxing to the extrusion through the nozzle. It is an important task to analyze the growth of bacteria on the 3D printed surface and in gaps between the layers. By default, the 3D-printed object is not food safe after longer usage and direct contact with food (even though they use food-safe filaments), but there are solutions for this problem. The aim of this work was to evaluate the 3D-printed object from different perspectives of food safety. Firstly, testing antimicrobial 3D printing filaments from a food safety aspect since the 3D Printed object in the food industry may have direct contact with the food. Therefore, the main purpose of the work is to reduce the microbial load on the surface of a 3D-printed part. Coating with epoxy resin was investigated, too, to see its effect on mechanical strength, thermal resistance, surface smoothness and food safety (cleanability). Another aim of this study was to test new temperature-resistant filaments and the effect of high temperature on 3D printed materials to see if they can be cleaned with boiling or similar hi-temp treatment. This work proved that all three mentioned methods could improve the food safety of the 3D printed object, but the size of this effect variates. The best result we got was with coating with epoxy resin, and the object was cleanable like any other injection molded plastic object with a smooth surface. Very good results we got by boiling the objects, and it is good to see that nowadays, more and more special filaments have a food-safe certificate and can withstand boiling temperatures too. Using antibacterial filaments reduced bacterial colonies to 1/5, but the biggest advantage of this method is that it doesn’t require any post-processing. The object is ready out of the 3D printer. Acknowledgements: The research was supported by the Hungarian and Serbian bilateral scientific and technological cooperation project funded by the Hungarian National Office for Research, Development and Innovation (NKFI, 2019-2.1.11-TÉT-2020-00249) and the Ministry of Education, Science and Technological Development of the Republic of Serbia. The authors acknowledge the Hungarian University of Agriculture and Life Sciences’s Doctoral School of Food Science for the support in this study

Keywords: food safety, 3D printing, filaments, microbial, temperature

Procedia PDF Downloads 143
156 Selling Electric Vehicles: Experiences from Car Salesmen in Sweden

Authors: Jens Hagman, Jenny Janhager Stier, Ellen Olausson, Anne Y. Faxer, Ana Magazinius

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Sweden has the second highest electric vehicle (plug-in hybrid and battery electric vehicle) sales per capita in Europe but in relation to sales of internal combustion engine electric vehicles sales are still minuscular (< 4%). Much research effort has been placed on various technical and user focused barriers and enablers for adoption of electric vehicles. Less effort has been placed on investigating the retail (dealership-customer) sales process of vehicles in general and electric vehicles in particular. Arguably, no one ought to be better informed about needs and desires of potential electric vehicle buyers than car salesmen, originating from their daily encounters with customers at the dealership. The aim of this paper is to explore the conditions of selling electric vehicle from a car salesmen’s perspective. This includes identifying barriers and enablers for electric vehicle sales originating from internal (dealership and brand) and external (customer, government) sources. In this interview study five car brands (manufacturers) that sell both electric and internal combustion engine vehicles have been investigated. A total of 15 semi-structured interviews have been conducted (three per brand, in rural and urban settings and at different dealerships). Initial analysis reveals several barriers and enablers, experienced by car salesmen, which influence electric vehicle sales. Examples of as reported by car salesmen identified barriers are: -Electric vehicles earn car salesmen less commission on average compared to internal combustion engine vehicles. -It takes more time to sell and deliver an electric vehicle than an internal combustion engine vehicle. -Current leasing contracts entails relatively low second-hand value estimations for electric vehicles and thus a high leasing fee, which negatively affects the attractiveness of electric vehicles for private consumers in particular. -High purchasing price discourages many consumers from considering electric vehicles. -The education and knowledge level of electric vehicles differs between car salesmen, which could affect their self-confidence in meeting well prepared and question prone electric vehicle buyers. Examples of identified enablers are: -Company car tax regulation promotes sales of electric vehicles; in particular, plug-in hybrid electric vehicles are sold extensively to companies (up to 95 % of sales). -Low operating cost of electric vehicles such as fuel and service is an advantage when understood by consumers. -The drive performance of electric vehicles (quick, silent and fun to drive) is attractive to consumers. -Environmental aspects are considered important for certain consumer groups. -Fast technological improvements, such as increased range are opening up a wider market for electric vehicles. -For one of the brands; attractive private lease campaigns have proved effective to promote sales. This paper gives insights of an important but often overlooked aspect for the diffusion of electric vehicles (and durable products in general); the interaction between car salesmen and customers at the critical acquiring moment. Extracted through interviews with multiple car salesmen. The results illuminate untapped potential for sellers (salesmen, dealerships and brands) to mitigating sales barriers and strengthening sales enablers and thus becoming a more important actor in the electric vehicle diffusion process.

Keywords: customer barriers, electric vehicle promotion, sales of electric vehicles, interviews with car salesmen

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155 Maritime English Communication Training for Japanese VTS Operators in the Congested Area Including the Narrow Channel of Akashi Strait

Authors: Kenji Tanaka, Kazumi Sugita, Yuto Mizushima

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This paper introduces a noteworthy form of English communication training for the officers and operators of the Osaka-Bay Marine Traffic Information Service (Osaka MARTIS) of the Japan Coast Guard working in the congested area at the Akashi Strait in Hyogo Prefecture, Japan. The authors of this paper, Marine Technical College’s (MTC) English language instructors, have been holding about forty lectures and exercises in basic and normal Maritime English (ME) for several groups of MARTIS personnel at Osaka MARTIS annually since they started the training in 2005. Trainees are expected to be qualified Maritime Third-Class Radio Operators who are responsible for providing safety information to a daily average of seven to eight hundred vessels that pass through the Akashi Strait, one of Japan’s narrowest channels. As of 2022, the instructors are conducting 55 remote lessons at MARTIS. One lesson is 90 minutes long. All 26 trainees are given oral and written assessments. The trainees need to pass the examination to become qualified operators every year, requiring them to train and maintain their linguistic levels even during the pandemic of Corona Virus Disease-19 (COVID-19). The vessel traffic information provided by Osaka MARTIS in Maritime English language is essential to the work involving the use of very high frequency (VHF) communication between MARTIS and vessels in the area. ME is the common language mainly used on board merchant, fishing, and recreational vessels, normally at sea. ME was edited and recommended by the International Maritime Organization in the 1970s, was revised in 2002, and has undergone continual revision. The vessel’s circumstances are much more serious at the strait than those at the open sea, so these vessels need ME to receive guidance from the center when passing through the narrow strait. The imminent and challenging situations at the strait necessitate that textbooks’ contents include the basics of the phrase book for seafarers as well as specific and additional navigational information, pronunciation exercises, notes on keywords and phrases, explanations about collocations, sample sentences, and explanations about the differences between synonyms especially those focusing on terminologies necessary for passing through the strait. Additionally, short Japanese-English translation quizzes about these topics, as well as prescribed readings about the maritime sector, are include in the textbook. All of these exercises have been trained in the remote education system since the outbreak of COVID-19. According to the guidelines of ME edited in 2009, the lowest level necessary for seafarers is B1 (lower individual users) of The Common European Framework of Reference for Languages: Learning, Teaching, Assessment (CEFR). Therefore, this vocational ME language training at Osaka MARTIS aims for its trainees to communicate at levels higher than B1. A noteworthy proof of improvement from this training is that most of the trainees have become qualified marine radio communication officers.

Keywords: akashi strait, B1 of CEFR, maritime english communication training, osaka martis

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154 Effectiveness of Prehabilitation on Improving Emotional and Clinical Recovery of Patients Undergoing Open Heart Surgeries

Authors: Fatma Ahmed, Heba Mostafa, Bassem Ramdan, Azza El-Soussi

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Background: World Health Organization stated that by 2020 cardiac disease will be the number one cause of death worldwide and estimates that 25 million people per year will suffer from heart disease. Cardiac surgery is considered an effective treatment for severe forms of cardiovascular diseases that cannot be treated by medical treatment or cardiac interventions. In spite of the benefits of cardiac surgery, it is considered a major stressful experience for patients who are candidate for surgery. Prehabilitation can decrease incidences of postoperative complications as it prepares patients for surgical stress through enhancing their defenses to meet the demands of surgery. When patients anticipate the postoperative sequence of events, they will prepare themselves to act certain behaviors, identify their roles and actively participate in their own recovery, therefore, anxiety levels are decreased and functional capacity is enhanced. Prehabilitation programs can comprise interventions that include physical exercise, psychological prehabilitation, nutritional optimization and risk factor modification. Physical exercises are associated with improvements in the functioning of the various physiological systems, reflected in increased functional capacity, improved cardiac and respiratory functions and make patients fit for surgical intervention. Prehabilitation programs should also prepare patients psychologically in order to cope with stress, anxiety and depression associated with postoperative pain, fatigue, limited ability to perform the usual activities of daily living through acting in a healthy manner. Notwithstanding the benefits of psychological preparations, there are limited studies which investigated the effect of psychological prehabilitation to confirm its effect on psychological, quality of life and physiological outcomes of patients who had undergone cardiac surgery. Aim of the study: The study aims to determine the effect of prehabilitation interventions on outcomes of patients undergoing cardiac surgeries. Methods: Quasi experimental study design was used to conduct this study. Sixty eligible and consenting patients were recruited and divided into two groups: control and intervention group (30 participants in each). One tool namely emotional, physiological, clinical, cognitive and functional capacity outcomes of prehabilitation intervention assessment tool was utilized to collect the data of this study. Results: Data analysis showed significant improvement in patients' emotional state, physiological and clinical outcomes (P < 0.000) with the use of prehabilitation interventions. Conclusions: Cardiac prehabilitation in the form of providing information about surgery, circulation exercise, deep breathing exercise, incentive spirometer training and nutritional education implemented daily by patients scheduled for elective open heart surgery one week before surgery have been shown to improve patients' emotional state, physiological and clinical outcomes.

Keywords: emotional recovery, clinical recovery, coronary artery bypass grafting patients, prehabilitation

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153 The Interrelation of Institutional Care and Successful Aging

Authors: Naphaporn Sapsopha

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Aging population has been growing rapidly in Thailand due to several factors – namely, the declining size of the average Thai family, changing family structure, higher survival rates of women, and job migration patterns – there are fewer working-age citizens who are able to care for and support their aging family members. When a family can no longer provide for their elders, the responsibility shifts to the government. Many non-profit institutional care facilities for older adults have already been established, but having such institutions are not enough. In addition to the provisions that a reliable shelter can provide, older adults also need efficient social services, physical wellness, and mental health, all of which are crucial for successful aging. Yet, to date, there is no consensus or a well-accepted definition of what constitutes successful aging. The issue is further complicated by cultural expectations, and the gendered experience of the older adults. These issues need to be better understood to promote effective care and wellness. This qualitative research investigates the relationship between institutional care and successful aging among the institutionalized Thai older adults at a non-profit facility in Bangkok, Thailand. Specifically, it examines: a) How do institutionalized older adults define successful aging?, b) What factors do they believe contribute to successful aging?, and c) Do their beliefs vary by gender? Data was collected using a phenomenological research approach that included focus groups and in-depth interviews using open-ended questions, conducted on 10 institutionalized older adults (5 men and 5 women) ages 60 or over. Interview transcripts were coded and analyzed using grounded theory methodology. The participants aged between 70-91 years old, and they varied in terms of gender, education, occupation, and life background. The results revealed that Thai institutionalized older adults viewed successful aging as a result of multiple interrelated factors: maintaining physical health, good mental and cognitive abilities. Remarkably, the participants identified as successful aging include independence for self-care and financial support, adhering to moral principles and religious practice, seeing the success of their loved ones, and making social contributions to their community. In addition, three primary themes were identified as a coping strategy to age successfully: self-acceptance by being sufficient and satisfied with all aspects of life, preparedness and adaptation for every stage of life, and self-esteem by maintaining their self. These beliefs are shared across gender and age differences. However, participants highlighted the importance of the interrelationship among these attributes similar to the need for a secure environment, the thoughtfulness and social support of institutional care in order to maintain positive attitude and well-being. With highly increased Thai aging population, many of these older adults will find themselves living in the institutional care; therefore, it is important to intensively understand how older adults viewed successful aging, what constituted successful aging and what could be done to promote it. Interventions to enhance successful aging may include meaningful practice and along with an effective coping strategy in order to lead a better quality of life those living in institutional care.

Keywords: institutional care, older adults, self-acceptant, successful aging

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152 The Influence of Leadership Styles on Organizational Performance and Innovation: Empirical Study in Information Technology Sector in Spain

Authors: Richard Mababu Mukiur

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Leadership is an important drive that plays a key role in the success and development of organizations, particularly in the current context of digital transformation, highly competitivity and globalization. Leaders are persons that hold a dominant and privileged position within an organization, field, or sector of activities and are able to manage, motivate and exercise a high degree of influence over other in order to achieve the institutional goals. They achieve commitment and engagement of others to embrace change, and to make good decisions. Leadership studies in higher education institutions have examined how effective leaders hold their organizations, and also to find approaches which fit best in the organizations context for its better management, transformation and improvement. Moreover, recent studies have highlighted the impact of leadership styles on organizational performance and innovation capacities, since some styles give better results than others. Effective leadership is part of learning process that take place through day-to-day tasks, responsibilities, and experiences that influence the organizational performance, innovation and engagement of employees. The adoption of appropriate leadership styles can improve organization results and encourage learning process, team skills and performance, and employees' motivation and engagement. In the case of case of Information Technology sector, leadership styles are particularly crucial since this sector is leading relevant changes and transformations in the knowledge society. In this context, the main objective of this study is to analyze managers leadership styles with their relation to organizational performance and innovation that may be mediated by learning organization process and demographic variables. Therefore, it was hypothesized that the transformational and transactional leadership will be the main style adopted in Information Technology sector and will influence organizational performance and innovation capacity. A sample of 540 participants from Information technology sector has been determined in order to achieve the objective of this study. The Multifactor Leadership Questionnaire was administered as the principal instrument, Scale of innovation and Learning Organization Questionnaire. Correlations and multiple regression analysis have been used as the main techniques of data analysis. The findings indicate that leadership styles have a relevant impact on organizational performance and innovation capacity. The transformational and transactional leadership are predominant styles in Information technology sector. The effective leadership style tend to be characterized by the capacity of generating and sharing knowledge that improve organization performance and innovation capacity. Managers are adopting and adapting their leadership styles that respond to the new organizational, social and cultural challenges and realities of contemporary society. Managers who encourage innovation, foster learning process, share experience are useful to the organization since they contribute to its development and transformation. Learning process capacity and demographic variables (age, gender, and job tenure) mediate the relationship between leadership styles, innovation capacity and organizational performance. The transformational and transactional leadership tend to enhance the organizational performance due to their significant impact on team-building, employees' engagement and satisfaction. Some practical implications and future lines of research have been proposed.

Keywords: leadership styles, tranformational leadership, organisational performance, organisational innovation

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151 The Role and Challenges of Media in the Transformation of Contemporary Nigeria Democracies

Authors: Henry Okechukwu Onyeiwu

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The role of media in the transformation of contemporary Nigeria's democracies is multifaceted and profoundly impactful. As Nigeria navigates its complex socio-political landscape, media serves as both a catalyst for democratic engagement and a platform for public discourse. This paper explores the various dimensions through which media influences democracy in Nigeria, including its role in informing citizens, shaping public opinion, and providing a forum for diverse voices. The increasing penetration of social media has revolutionized the political sphere, empowering citizens to participate in governance and hold leaders accountable. However, challenges such as misinformation, censorship, and media bias continue to pose significant threats to democratic integrity. This study critically analyzes the interplay between traditional and new media, highlighting their contributions to electoral processes, civic education, and advocacy for human rights. Ultimately, the findings illustrate that while media is a crucial agent for democratic transformation, its potential can only be realized through a commitment to journalistic integrity and the promotion of media literacy among the Nigerian populace. The media plays a critical role in shaping public democracies in Nigeria, yet it faces a myriad of challenges that hinder its effectiveness. This paper examines the various obstacles confronting media broadcasting in Nigeria, which range from political interference and censorship to issues of professionalism and the proliferation of fake news. Political interference is particularly pronounced, as government entities and political actors often attempt to control narratives, compromising the independence of media outlets. This control often manifests in the form of censorship, where journalists face threats and harassment for reporting on sensitive topics related to governance, corruption, and human rights abuses. Moreover, the rapid rise of social media has introduced a dual challenge; while it offers a platform for citizen engagement and diverse viewpoints, it also facilitates the spread of misinformation and propaganda. The lack of media literacy among the populace exacerbates this issue, as citizens often struggle to discern credible information from false narratives. Additionally, economic constraints deeply affect the sustainability and independence of many broadcasting organizations. Advertisers may unduly influence content, leading to sensationalism over substantive reporting. This paper argues that for media to effectively contribute to Nigerian public democracies, there needs to be a concerted effort to address these challenges. Strengthening journalistic ethics, enhancing regulatory frameworks, and promoting media literacy among citizens are essential steps in fostering a more vibrant and accountable media landscape. Ultimately, this research underscores the necessity of a resilient media ecosystem that can truly support democratic processes, empower citizens, and hold power to account in contemporary Nigeria.

Keywords: media, democracy, socio-political, governance

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150 Identification of ω-3 Fatty Acids Using GC-MS Analysis in Extruded Spelt Product

Authors: Jelena Filipovic, Marija Bodroza-Solarov, Milenko Kosutic, Nebojsa Novkovic, Vladimir Filipovic, Vesna Vucurovic

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Spelt wheat is suitable raw material for extruded products such as pasta, special types of bread and other products of altered nutritional characteristics compared to conventional wheat products. During the process of extrusion, spelt is exposed to high temperature and high pressure, during which raw material is also mechanically treated by shear forces. Spelt wheat is growing without the use of pesticides in harsh ecological conditions and in marginal areas of cultivation. So it can be used for organic and health safe food. Pasta is the most popular foodstuff; its consumption has been observed to rise. Pasta quality depends mainly on the properties of flour raw materials, especially protein content and its quality but starch properties are of a lesser importance. Pasta is characterized by significant amounts of complex carbohydrates, low sodium, total fat fiber, minerals, and essential fatty acids and its nutritional value can be improved with additional functional component. Over the past few decades, wheat pasta has been successfully formulated using different ingredients in pasta to cater health-conscious consumers who prefer having a product rich in protein, healthy lipids and other health benefits. Flaxseed flour is used in the production of bakery and pasta products that have properties of functional foods. However, it should be taken into account that food products retain the technological and sensory quality despite the added flax seed. Flaxseed contains important substances in its composition such as vitamins and minerals elements, and it is also an excellent source of fiber and one of the best sources of ω-3 fatty acids and lignin. In this paper, the quality and identification of spelt extruded product with the addition of flax seed, which is positively contributing to the nutritive and technology changes of the product, is investigated. ω-3 fatty acids are polyunsaturated essential fatty acids, and they must be taken with food to satisfy the recommended daily intake. Flaxseed flour is added in the quantity of 10/100 g of sample and 20/100 g of sample on farina. It is shown that the presence of ω-3 fatty acids in pasta can be clearly distinguished from other fatty acids by gas chromatography with mass spectrometry. Addition of flax seed flour influence chemical content of pasta. The addition of flax seed flour in spelt pasta in the quantities of 20g/100 g significantly increases the share of ω-3 fatty acids, which results in improved ratio of ω-6/ω-3 1:2.4 and completely satisfies minimum daily needs of ω-3 essential fatty acids (3.8 g/100 g) recommended by FDA. Flex flour influenced the pasta quality by increasing of hardness (2377.8 ± 13.3; 2874.5 ± 7.4; 3076.3 ± 5.9) and work of shear (102.6 ± 11.4; 150.8 ± 11.3; 165.0 ± 18.9) and increasing of adhesiveness (11.8 ± 20.6; 9.,98 ± 0.12; 7.1 ± 12.5) of the final product. Presented data point at good indicators of technological quality of spelt pasta with flax seed and that GC-MS analysis can be used in the quality control for flax seed identification. Acknowledgment: The research was financed by the Ministry of Education and Science of the Republic of Serbia (Project No. III 46005).

Keywords: GC-MS analysis, ω-3 fatty acids, flex seed, spelt wheat, daily needs

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149 Perception Differences in Children Learning to Golf with Traditional versus Modified (Scaled) Equipment

Authors: Lindsey D. Sams, Dean R. Gorman, Cathy D. Lirgg, Steve W. Dittmore, Jack C. Kern

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Golf is a lifetime sport that provides numerous physical and psychological benefits. The game has struggled with attrition and retention within minority groups and this has exposed the lack of a modified introduction to the game that is uniformly accessible and developmentally appropriate. Factors that have been related to sport participatory behaviors include perceived competence, enjoyment and intention. The purpose of this study was to examine self-reported perception differences in competence and enjoyment between learners using modified and traditional equipment as well as the potential effects these factors could have on intent for future participation. For this study, SNAG Golf was chosen to serve as the scaled equipment used by the modified equipment group. The participants in this study were 99 children (24 traditional equipment users/ 75 modified equipment users) located across the U.S. with ages ranging from 7 to 12 years (2nd-5th grade). Utilizing a convenience sampling method, data was obtained on a voluntary basis through surveys measuring children’s golf participation and self-perceptions concerning perceived competence, enjoyment and intention to continue participation. The scales used for perceived competence and enjoyment included Susan Harter’s Self-Perception Profile for Children (SPPC) along with the Physical Activity Enjoyment Scale (PACES). Analysis revealed no significant differences for enjoyment, perceived competence or intention between children learning with traditional golf equipment and modified golf equipment. This was true even though traditional equipment users reported significantly higher experience levels than that of modified users. Intention was regressed on the enjoyment and perceived competence variables. Congruent with current literature, enjoyment was a strong predictor of intention to continue participation, for both groups. Modified equipment users demonstrated significantly lower experience levels but reported similar levels of competence, enjoyment and intent to continue participation as reported by the more experienced, and potentially more skilled, traditional users. The ability to immediately generate these positive affects suggests the potential adoption of a more effective way to learn golf and a method that is conducive to participatory behaviors related to attrition and retention. These implications in turn, highlight an equipment candidate ideal for inception into physical education programs where new learners are introduced to various sports in safe and developmentally appropriate environments. A major goal of this study was to provide foundational research that instigates the further examination of golf’s introductory teaching methodologies, as there is a lack of its presence in current literature. Future research recommendations range from improvements in the current research design to expansive approaches related to the topic, such as progressive skill development, knowledge of the game’s tactical and strategic concepts, playing ability and teaching effectiveness when utilizing modified versus traditional equipment.

Keywords: adaptive sports, enjoyment, golf participation, modified equipment, perceived competence, SNAG golf

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148 The Lacuna in Understanding of Forensic Science amongst Law Practitioners in India

Authors: Poulomi Bhadra, Manjushree Palit, Sanjeev P. Sahni

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Forensic science uses all branches of science for criminal investigation and trial and has increasingly emerged as an important tool in the administration of justice. However, the growth and development of this field in India has not been as rapid or widespread as compared to the more developed Western countries. For successful administration of justice, it is important that all agencies involved in law enforcement adopt an inter-professional approach towards forensic science, which is presently lacking. In light of the alarmingly high average acquittal rate in India, this study aims to examine the lack of understanding and appreciation of the importance and scope of forensic evidence and expert opinions amongst law professionals such as lawyers and judges. Based on a study of trial court cases from Delhi and surrounding areas, the study underline the areas in forensics where the criminal justice system has noticeably erred. Using this information, the authors examine the extent of forensic understanding amongst legal professionals and attempt to conclusively identify the areas in which they need further appraisal. A cross-sectional study done using a structured questionnaire was conducted amongst law professionals across age, gender, type and years of experience in court, to determine their understanding of DNA, fingerprints and other interdisciplinary scientific materials used as forensic evidence. In our study, we understand the levels of understanding amongst lawyers with regards to DNA and fingerprint evidence, and how it affects trial outcomes. We also aim to understand the factors that prevent credible and advanced awareness amongst legal personnel, amongst others. The survey identified the areas in modern and advanced forensics, such as forensic entomology, anthropology, cybercrime etc., in which Indian legal professionals are yet to attain a functional understanding. It also brings to light, what is commonly termed as the ‘CSI-effect’ in the Western courtrooms, and provides scope to study the existence of this phenomenon and its effects on the Indian courts and their judgements. This study highlighted the prevalence of unchallenged expert testimony presented by the prosecution in criminal trials and impressed upon the judicial system the need for independent analysis and evaluation of the scientist’s data and/or testimony by the defense. Overall, this study aims to define a clearer and rigid understanding of why legal professionals should have basic understanding of the interdisciplinary nature of forensic sciences. Based on the aforementioned findings, the author suggests various measures by which judges and lawyers might obtain an extensive knowledge of the advances and promising potentialities of forensic science. This includes promoting a forensic curriculum in legal studies at Bachelor’s and Master’s level as well as in mid-career professional courses. Formation of forensic-legal consultancies, in consultation with the Department of Justice, will not only assist in training police, military and law personnel but will also encourage legal research in this field. These suggestions also aim to bridge the communication gap that presently exists between law practitioners, forensic scientists and the general community’s awareness of the criminal justice system.

Keywords: forensic science, Indian legal professionals, interdisciplinary awareness, legal education

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147 Psychosocial Challenges of Multi-Drug Resistant Tuberculosis (MDR-TB) Patients at St. Peter TB Specialized Hospital in Addis Ababa

Authors: Tamrat Girma Biru

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Multidrug-resistant tuberculosis (MDR-TB) is defined as resistant to at least Refampicin and Isoniazed: the most two power full TB drugs. It is a leading cause of high rates of morbidity and mortality, and increasing psychosocial challenges to patients, especially when co-infected with Human Immunodeficiency Virus (HIV). Ethiopia faces the highest rates of MDR-TB infection in the world. Objectives: The main objective of this study was to identify the psychosocial challenges of MDR-TB patients, to investigate the extent of the psychosocial challenges on (self-esteem, depression, and stigma) that MDR-TB patients encounter, to examine whether there is a sex difference in experiencing psychosocial challenges and assess the counseling needs of MDR-TB patients. Methodology: A cross-sectional study was conducted at St. Peter TB Specialized Hospital, Addis Ababa on 40 patients (25 males and 15 females) who are hospitalized for treatment. The patients were identified by using purposive sampling and made fill a questionnaire measuring their level of self-esteem, depression and stigma. Besides, data were collected from 16 participants, 28 care providers and 8 guardians, using semi-structured interview. The obtained data were analyzed using SPSS statistical program, descriptive statistics, independent t-test, and qualitative description. Results and Discussion: The results of the study showed that the majority (80%) of the respondents had suffered psychological challenges and social discriminations. Thus, the significance of MDR-TB and its association with HIV/AIDS problems is considered. Besides the psychosocial challenges, various aggravating factors such as length of treatment, drug burden and insecurity in economy together highly challenges the life of patients. In addition, 60% of participants showed low level of self-esteem. The patients also reported that they experienced high self-stigma and stigma by other members of the society. The majority of the participants (75%) showed moderate and severe level of depression. In terms of sex there is no difference between the mean scores of males and females in the level of depression and stigmatization by others and by themselves. But females showed lower level of self-esteem than males. The analysis of the t-test also shows that there were no statistically significant sex difference on the level of depression and stigma. Based on the qualitative data MDR-TB patients face various challenges in their life sphere such as: Psychological (depression, low self value, lowliness, anxiety), social (stigma, isolation from social relations, self-stigmatization,) and medical (drug side effect, drug toxicity, drug burden, treatment length, hospital stays). Recommendations: Based on the findings of this study possible recommendations were forwarded: develop and extend MDR-TB disease awareness creation through by media (printing and electronic), school net TB clubs, and door to door community education. Strengthen psychological wellbeing and social relationship of MDR-TB patients using proper and consistent psychosocial support and counseling. Responsible bodies like Ministry of Health (MOH) and its stakeholders and Non Governmental Organizations (NGOs) need to assess the challenges of patients and take measures on this pressing issue.

Keywords: psychosocial challenges, counseling, multi-drug resistant tuberculosis (MDR-TB), tuberculosis therapy

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146 The Impact of Developing an Educational Unit in the Light of Twenty-First Century Skills in Developing Language Skills for Non-Arabic Speakers: A Proposed Program for Application to Students of Educational Series in Regular Schools

Authors: Erfan Abdeldaim Mohamed Ahmed Abdalla

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The era of the knowledge explosion in which we live requires us to develop educational curricula quantitatively and qualitatively to adapt to the twenty-first-century skills of critical thinking, problem-solving, communication, cooperation, creativity, and innovation. The process of developing the curriculum is as significant as building it; in fact, the development of curricula may be more difficult than building them. And curriculum development includes analyzing needs, setting goals, designing the content and educational materials, creating language programs, developing teachers, applying for programmes in schools, monitoring and feedback, and then evaluating the language programme resulting from these processes. When we look back at the history of language teaching during the twentieth century, we find that developing the delivery method is the most crucial aspect of change in language teaching doctrines. The concept of delivery method in teaching is a systematic set of teaching practices based on a specific theory of language acquisition. This is a key consideration, as the process of development must include all the curriculum elements in its comprehensive sense: linguistically and non-linguistically. The various Arabic curricula provide the student with a set of units, each unit consisting of a set of linguistic elements. These elements are often not logically arranged, and more importantly, they neglect essential points and highlight other less important ones. Moreover, the educational curricula entail a great deal of monotony in the presentation of content, which makes it hard for the teacher to select adequate content; so that the teacher often navigates among diverse references to prepare a lesson and hardly finds the suitable one. Similarly, the student often gets bored when learning the Arabic language and fails to fulfill considerable progress in it. Therefore, the problem is not related to the lack of curricula, but the problem is the development of the curriculum with all its linguistic and non-linguistic elements in accordance with contemporary challenges and standards for teaching foreign languages. The Arabic library suffers from a lack of references for curriculum development. In this paper, the researcher investigates the elements of development, such as the teacher, content, methods, objectives, evaluation, and activities. Hence, a set of general guidelines in the field of educational development were reached. The paper highlights the need to identify weaknesses in educational curricula, decide the twenty-first-century skills that must be employed in Arabic education curricula, and the employment of foreign language teaching standards in current Arabic Curricula. The researcher assumes that the series of teaching Arabic to speakers of other languages in regular schools do not address the skills of the twenty-first century, which is what the researcher tries to apply in the proposed unit. The experimental method is the method of this study. It is based on two groups: experimental and control. The development of an educational unit will help build suitable educational series for students of the Arabic language in regular schools, in which twenty-first-century skills and standards for teaching foreign languages will be addressed and be more useful and attractive to students.

Keywords: curriculum, development, Arabic language, non-native, skills

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145 Timely Palliative Screening and Interventions in Oncology

Authors: Jaci Marie Mastrandrea, Rosario Haro

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Background: The National Comprehensive Cancer Network (NCCN) recommends that healthcare institutions have established processes for integrating palliative care (PC) into cancer treatment and that all cancer patients be screened for PC needs upon initial diagnosis as well as throughout the entire continuum of care (National Comprehensive Cancer Network, 2021). Early PC screening and intervention is directly associated with improved patient outcomes. The Sky Lakes Cancer Treatment Center (SLCTC) is an institution that has access to PC services yet does not have protocols in place for identifying patients with palliative needs or a standardized referral process. The aim of this quality improvement project was to improve early access to PC services by establishing a standardized screening and referral process for outpatient oncology patients. Method: The sample population included all adult patients with an oncology diagnosis who presented to the SLCTC for treatment during the project timeline. The “Palliative and Supportive Needs Assessment'' (PSNA) screening tool was developed from validated, evidence-based PC referral criteria. The tool was initially implemented using paper forms, and data was collected over a period of eight weeks. Patients were screened by nurses on the SLCTC oncology treatment team. Nurses responsible for screening patients received an educational inservice prior to implementation. Patients with a PSNA score of three or higher received an educational handout on the topic of PC and education about PC and symptom management. A score of five or higher indicates that PC referral is strongly recommended, and the patient’s EHR is flagged for the oncology provider to review orders for PC referral. The PSNA tool was approved by Sky Lakes administration for full integration into Epic-Beacon. The project lead collaborated with the Sky Lakes’ information systems team and representatives from Epic on the tool’s aesthetic and functionality within the Epic system. SLCTC nurses and physicians were educated on how to document the PSNA within Epic and where to view results. Results: Prior to the implementation of the PSNA screening tool, the SLCTC had zero referrals to PC in the past year, excluding referrals to hospice. Data was collected from the completed screening assessments of 100 patients under active treatment at the SLCTC. Seventy-three percent of patients met criteria for PC referral with a score greater than or equal to three. Of those patients who met referral criteria, 53.4% (39 patients) were referred for a palliative and supportive care consultation. Patients that were not referred to PC upon meeting criteria were flagged in EPIC for re-screening within one to three months. Patients with lung cancer, chronic hematologic malignancies, breast cancer, and gastrointestinal malignancy most frequently met the criteria for PC referral and scored highest overall on the scale of 0-12. Conclusion: The implementation of a standardized PC screening tool at the SLCTC significantly increased awareness of PC needs among cancer patients in the outpatient setting. Additionally, data derived from this quality improvement project supports the national recommendation for PC to be an integral component of cancer treatment across the entire continuum of care.

Keywords: oncology, palliative and supportive care, symptom management, outpatient oncology, palliative screening tool

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144 Monitoring and Evaluation of Master Science Trainee Educational Students to their Practicum in Teaching Physics for Improving and Creating Attitude Skills for Sustainable Developing Upper Secondary Students in Thailand

Authors: T. Santiboon, S. Tongbu, P. S. Saihong

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This study focuses on investigating students' perceptions of their physics classroom learning environments of their individualizations and their interactions with the instructional practicum in teaching physics of the master science trainee educational students for improving and creating attitude skills’ sustainable development toward physics for upper secondary educational students in Thailand. Associations between these perceptions and students' attitudes toward physics were also determined. The learning environment perceptions were obtained using the 35-item Physics Laboratory Environment Inventory (PLEI) modified from the original Science Laboratory Environment Inventory. The 25-item Individualized Classroom Environment Questionnaire (ICEQ) was assessed those dimensions which distinguish individualized physics classrooms from convention on individualized open and inquiry-based education Teacher-student interactions were assessed with the 48-item Questionnaires on Teacher Interaction (QTI). Both these questionnaires have an Actual Form (assesses the class as it actually is) and a Preferred Form (asks the students what they would prefer their class to be like - the ideal situation). Students’ creating attitude skills’ sustainable development toward physics were assessed with the Test Of Physics-Related Attitude (TOPRA) modified from the original Test Of Science-Related Attitude (TOSRA) The questionnaires were administered in three phases with the Custer Random Sampling technique to a sample consisted of 989 students in 28 physics classes from 10 schools at the grade 10, 11, and 12 levels in the Secondary Educational Service Area 26 (Maha Sarakham Province) and Area 27 (Roi-Et). Statistically significant differences were found between the students' perceptions of actual-1, actual-2 and preferred environments of their physics laboratory and distinguish individualized classrooms, and teacher interpersonal behaviors with their improving and creating attitudes skills’ sustainable development to their physics classes also were found. Predictions of the monitoring and evaluation of master science trainee educational students of their practicum in teaching physics; students’ skills developments of their physics achievements’ sustainable for the set of actual and preferred environments as a whole and physics related attitudes also were correlated. The R2 values indicate that 58%, 67%, and 84% of the variances in students’ attitudes to their actuale-1, actual-2 and preferred for the PLEI; 42%,science trainee educational students of their practicum in teaching physics; students’ skill developments of their physics achievements’ sustainable for the set of actual and preferred environments as a whole and physics related attitudes also were correlated. The R2 values indicate that 58%, 67%, and 84% of the variances in students’ attitudes to their actuale-1, actual-2 and preferred for the PLEI; 42%, 63%, and 72% for the ICEQ, and 38%, 59%, and 68% for the QTI in physics environment classes were attributable to their perceptions of their actual and preferred physics environments and their developing creative science skills’ sustainable toward physics, consequently. Based on all the findings, suggestions for improving the physics laboratory and individualized classes and teacher interpersonal behaviors with students' perceptions are provided of their improving and creating attitude skills’ sustainable development by the master science trainee educational students ’ instructional administrations.

Keywords: promotion, instructional model, qualitative method, reflective thinking, trainee teacher student

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143 Promoting Compassionate Communication in a Multidisciplinary Fellowship: Results from a Pilot Evaluation

Authors: Evonne Kaplan-Liss, Val Lantz-Gefroh

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Arts and humanities are often incorporated into medical education to help deepen understanding of the human condition and the ability to communicate from a place of compassion. However, a gap remains in our knowledge of compassionate communication training for postgraduate medical professionals (as opposed to students and residents); how training opportunities include and impact the artists themselves, and how train-the-trainer models can support learners to become teachers. In this report, the authors present results from a pilot evaluation of the UC San Diego Health: Sanford Compassionate Communication Fellowship, a 60-hour experiential program that uses theater, narrative reflection, poetry, literature, and journalism techniques to train a multidisciplinary cohort of medical professionals and artists in compassionate communication. In the culminating project, fellows design and implement their own projects as teachers of compassionate communication in their respective workplaces. Qualitative methods, including field notes and 30-minute Zoom interviews with each fellow, were used to evaluate the impact of the fellowship. The cohort included both artists (n=2) and physicians representing a range of specialties (n=7), such as occupational medicine, palliative care, and pediatrics. The authors coded the data using thematic analysis for evidence of how the multidisciplinary nature of the fellowship impacted the fellows’ experiences. The findings show that the multidisciplinary cohort contributed to a greater appreciation of compassionate communication in general. Fellows expressed that the ability to witness how those in different fields approached compassionate communication enhanced their learning and helped them see how compassion can be expressed in various contexts, which was both “exhilarating” and “humbling.” One physician expressed that the fellowship has been “really helpful to broaden my perspective on the value of good communication.” Fellows shared how what they learned in the fellowship translated to increased compassionate communication, not only in their professional roles but in their personal lives as well. A second finding was the development of a supportive community. Because each fellow brought their own experiences and expertise, there was a sense of genuine ability to contribute as well as a desire to learn from others. A “brave space” was created by the fellowship facilitators and the inclusion of arts-based activities: a space that invited vulnerability and welcomed fellows to make their own meaning without prescribing any one answer or right way to approach compassionate communication. This brave space contributed to a strong connection among the fellows and reports of increased well-being, as well as multiple collaborations post-fellowship to carry forward compassionate communication training at their places of work. Results show initial evidence of the value of a multidisciplinary fellowship for promoting compassionate communication for both artists and physicians. The next steps include maintaining the supportive fellowship community and collaborations with a post-fellowship affiliate faculty program; scaling up the fellowship with non-physicians (e.g., nurses and physician assistants); and collecting data from family members, colleagues, and patients to understand how the fellowship may be creating a ripple effect outside of the fellowship through fellows’ compassionate communication.

Keywords: compassionate communication, communication in healthcare, multidisciplinary learning, arts in medicine

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