Search results for: implement
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1547

Search results for: implement

437 Evaluation of the Effect of Milk Recording Intervals on the Accuracy of an Empirical Model Fitted to Dairy Sheep Lactations

Authors: L. Guevara, Glória L. S., Corea E. E, A. Ramírez-Zamora M., Salinas-Martinez J. A., Angeles-Hernandez J. C.

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Mathematical models are useful for identifying the characteristics of sheep lactation curves to develop and implement improved strategies. However, the accuracy of these models is influenced by factors such as the recording regime, mainly the intervals between test day records (TDR). The current study aimed to evaluate the effect of different TDR intervals on the goodness of fit of the Wood model (WM) applied to dairy sheep lactations. A total of 4,494 weekly TDRs from 156 lactations of dairy crossbred sheep were analyzed. Three new databases were generated from the original weekly TDR data (7D), comprising intervals of 14(14D), 21(21D), and 28(28D) days. The parameters of WM were estimated using the “minpack.lm” package in the R software. The shape of the lactation curve (typical and atypical) was defined based on the WM parameters. The goodness of fit was evaluated using the mean square of prediction error (MSPE), Root of MSPE (RMSPE), Akaike´s Information Criterion (AIC), Bayesian´s Information Criterion (BIC), and the coefficient of correlation (r) between the actual and estimated total milk yield (TMY). WM showed an adequate estimate of TMY regardless of the TDR interval (P=0.21) and shape of the lactation curve (P=0.42). However, we found higher values of r for typical curves compared to atypical curves (0.9vs.0.74), with the highest values for the 28D interval (r=0.95). In the same way, we observed an overestimated peak yield (0.92vs.6.6 l) and underestimated time of peak yield (21.5vs.1.46) in atypical curves. The best values of RMSPE were observed for the 28D interval in both lactation curve shapes. The significant lowest values of AIC (P=0.001) and BIC (P=0.001) were shown by the 7D interval for typical and atypical curves. These results represent the first approach to define the adequate interval to record the regime of dairy sheep in Latin America and showed a better fitting for the Wood model using a 7D interval. However, it is possible to obtain good estimates of TMY using a 28D interval, which reduces the sampling frequency and would save additional costs to dairy sheep producers.

Keywords: gamma incomplete, ewes, shape curves, modeling

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436 The Development of the First Inter-Agency Residential Rehabilitation Service for Gambling Disorder with Complex Clinical Needs

Authors: Dragos Dragomir-Stanciu, Leon Marsh

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Background As a response to the gaps identified in recent research in the provision of residential care to address co-occurring health needs, including mental health problems and complexities Gamble Aware has facilitated the possibility to provide a new service which would extend the NGTS provision of residential rehabilitation for gambling disorder with complex and co-morbid presentation. Gordon Moody, together with Adferiad have been successful in securing the tender for this service and this presentation aims to introduce FOLD, the resulting model of treatment developed for the delivery of the service. Setting As a partnership, we have come together to coproduce a model which allows us to share our clinical and industry knowledge and build on our reputations as trusted treatment providers. The presentation will outline our expertise share in development of a unified approach to recovery-oriented models of care, clinical governance, risk assessment and management and aftercare and continuous recovery. We will also introduce our innovative specialist referral portal which will offer referring partners the ability to include the service user in planning their own recovery journey. Outcomes Our collaboration has resulted in the development of the FOLD model which includes three agile and flexible treatment packages aimed at offering the most enhanced and comprehensive treatment in UK, to date, for those most affected by gambling harm. The paper will offer insight into each treatment package and all recovery model stages involved, as well as into the partnership work with NGST providers, local mental health and social care providers and lived experience organisation that will enable us to offer support to more 100 people a year who would otherwise get “lost in the system”. Conclusion FOLD offers a great opportunity to develop, implement and evaluate a new, much needed, whole-person and whole-system approach to counter gambling related harms.

Keywords: gambling treatment, partnership working, integrated care pathways, NGTS, complex needs

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435 A Brief Trauma Treatment Program for Survivors of Trauma: A Single-Case Design

Authors: Duane Booysen, Ashraf Kagee

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There is a high prevalence of violent crime and trauma exposure in South African society. Considering the prevalence of continuous violent crimes and traumatization in South Africa, the public mental health sector is required to combat the burgeoning effect of traumatic stress in South Africa. Trauma counselors, especially, provide important mental health services at primary health care to persons affected by traumatic events. Therefore, the evaluation and implementation of evidence-based trauma therapies is essential at a primary health care level in treating traumatic stress. A single-case design was used to evaluate the treatment effect of a Brief Trauma Treatment Programme treating persons who present with symptoms of posttraumatic stress disorder at a primary care trauma centre in Cape Town, South Africa. The sample consisted of six adult participants who presented with symptoms of posttraumatic stress and were assessed at baseline, during treatment, post-intervention and at 3-month follow. All participants received six sessions of trauma therapy. Assessment measures included the posttraumatic stress disorder symptom scale interviews for Diagnostic and Statistical Manual fifth edition (DSM5), the posttraumatic disorder checklist for DSM5, Beck Depression Inventory and Beck Anxiety Inventory. Results demonstrate that participants had noticeable reduced symptoms for traumatic stress, anxiety and depression despite living in contexts of violent crime and trauma. In conclusion, the article critically reflects on the need to evaluate and implement evidence-based treatments for the South African context, and how evidence-based treatments are used in developing socio-economic and cultural diverse contexts with continuous levels of violence and traumatization.

Keywords: psychological interventions, public mental health, traumatic stress, single-case design

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434 A Preliminary Kinematic Comparison of Vive and Vicon Systems for the Accurate Tracking of Lumbar Motion

Authors: Yaghoubi N., Moore Z., Van Der Veen S. M., Pidcoe P. E., Thomas J. S., Dexheimer B.

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Optoelectronic 3D motion capture systems, such as the Vicon kinematic system, are widely utilized in biomedical research to track joint motion. These systems are considered powerful and accurate measurement tools with <2 mm average error. However, these systems are costly and may be difficult to implement and utilize in a clinical setting. 3D virtual reality (VR) is gaining popularity as an affordable and accessible tool to investigate motor control and perception in a controlled, immersive environment. The HTC Vive VR system includes puck-style trackers that seamlessly integrate into its VR environments. These affordable, wireless, lightweight trackers may be more feasible for clinical kinematic data collection. However, the accuracy of HTC Vive Trackers (3.0), when compared to optoelectronic 3D motion capture systems, remains unclear. In this preliminary study, we compared the HTC Vive Tracker system to a Vicon kinematic system in a simulated lumbar flexion task. A 6-DOF robot arm (SCORBOT ER VII, Eshed Robotec/RoboGroup, Rosh Ha’Ayin, Israel) completed various reaching movements to mimic increasing levels of hip flexion (15°, 30°, 45°). Light reflective markers, along with one HTC Vive Tracker (3.0), were placed on the rigid segment separating the elbow and shoulder of the robot. We compared position measures simultaneously collected from both systems. Our preliminary analysis shows no significant differences between the Vicon motion capture system and the HTC Vive tracker in the Z axis, regardless of hip flexion. In the X axis, we found no significant differences between the two systems at 15 degrees of hip flexion but minimal differences at 30 and 45 degrees, ranging from .047 cm ± .02 SE (p = .03) at 30 degrees hip flexion to .194 cm ± .024 SE (p < .0001) at 45 degrees of hip flexion. In the Y axis, we found a minimal difference for 15 degrees of hip flexion only (.743 cm ± .275 SE; p = .007). This preliminary analysis shows that the HTC Vive Tracker may be an appropriate, affordable option for gross motor motion capture when the Vicon system is not available, such as in clinical settings. Further research is needed to compare these two motion capture systems in different body poses and for different body segments.

Keywords: lumbar, vivetracker, viconsystem, 3dmotion, ROM

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433 Fijian Women’s Role in Disaster Risk Management: Climate Change

Authors: Priyatma Singh, Manpreet Kaur

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Climate change is progressively being identified as a global crisis and this has immediate repercussions for Fiji Islands due to its geographical location being prone to natural disasters. In the Pacific, it is common to find significant differences between men and women, in terms of their roles and responsibilities. In the pursuit of prudent preparedness before disasters, Fijian women’s engagement is constrained due to socially constructed roles and expectation of women here in Fiji. This vulnerability is aggravated by viewing women as victims, rather than as key people who have vital information of their society, economy, and environment, as well as useful skills, which, when recognized and used, can be effective in disaster risk reduction. The focus of this study on disaster management is to outline ways in which Fijian women can be actively engaged in disaster risk management, articulating in decision-making, negating the perceived ideology of women’s constricted roles in Fiji and unveiling social constraints that limit women’s access to practical disaster management strategic plan. This paper outlines the importance of gender mainstreaming in disaster risk reduction and the ways of mainstreaming gender based on a literature review. It analyses theoretical study of academic literature as well as papers and reports produced by various national and international institutions and explores ways to better inform and engage women for climate change per ser disaster management in Fiji. The empowerment of women is believed to be a critical element in constructing disaster resilience as women are often considered to be the designers of community resilience at the local level. Gender mainstreaming as a way of bringing a gender perspective into climate related disasters can be applied to distinguish the varying needs and capacities of women, and integrate them into climate change adaptation strategies. This study will advocate women articulation in disaster risk management, thus giving equal standing to females in Fiji and also identify the gaps and inform national and local Disaster Risk Management authorities to implement processes that enhance gender equality and women’s empowerment towards a more equitable and effective disaster practice.

Keywords: disaster risk management, climate change, gender mainstreaming, women empowerment

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432 Usage of Visual Tools for Light Exploring with Children in the Geographical Istria Region Kindergartens in Republic of Croatia and Republic of Slovenia

Authors: Urianni Merlin, Đeni Zuliani Blašković

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Inspired by the Reggio Pedagogy approach that explores light from physical, mathematical, artistic, and natural perspectives, emphasizes the value of visual tools in light exploring that opens up a wide area of experiential discovery and knowledge, especially if used in kindergartens with children. While there is some literature evidence of visual tool usage for light exploring in kindergartens in the Republic of Slovenia, in the Republic of Croatia there are few researches, and those published are focused at shadow exploring, exploring of physical characteristics and teatrical play of light and shadow. The objectives of this research are to assess how much visual tools are used for light exploring by preschool teachers from geographical Istria kindergartens as part of the activities offered to children and if the usage of the visual tool for light exploring it’s different regarding the work environment (Slovenian and Croatian Istria kindergartens; city vs. village kindergartens; preschool teachers age and length of service). One hundred one preschool teachers from Croatian Istria Region and 70 preschool teachers from Slovenian Istria Region responded to a self-made questionnaire regarding visual tool usage habits in their work. As predicted, results show significant differences in visual tool usage regarding preschool teachers' work environment, length of service, and age. Preschool teachers from Slovenian Istria that work in kindergartens located in the city that have from 15 to 19 years of service and are more than 30 years of age use significantly more visual tools for light exploring. The results highlight the differences in visual tools usage for light exploring in the small Istria peninsula that can be attributed to different University art curricula in Slovenia and Croatia or lifelong education offered in Slovenia that is more open to Italian reggio pedagogy influence and are further used by older preschool teachers with more service experience. Considering the small number of researches, this research significantly contributes to science and motivates preschool teachers and scientists to implement the use of light tools in the preschool and university curriculum, especially in Croatia.

Keywords: activities with light, light exploring, preschool children, visual tools

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431 Internet Health: A Cross-Sectional Survey Exploring Identified Risks and Online Safety Measures in Parent and Children with Neurodevelopmental Disorders

Authors: Abdirahim Mohamed, Sarita Rana Chhetri, Michael Sleath, Nadia Saleem

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Rationale: Internet usage has been very much integrated into our daily lives. Internet usage within a neurodevelopmental disorder population is also on the increase. Nevertheless, there is very little empirical research on how this population virtually protect themselves; along with how their parents can keep them safe online. This topic was an ever-growing concern to the parents within our services and in many cases would add to the stresses and mental health of parents. This ignited an idea within our team to conduct research to explore the perceived online risks within this population and how they keep themselves safe. In conjunction, we also explored how parents and caregivers monitor and safeguard their young people to the potential threats online. Our hypothesis was that the perceived risks will heavily outnumber the safeguarding measures implemented by this population. Method: Within the Coventry and Warwickshire NHS Partnership Trust Child and Adolescent Mental Health Service (CAMHS), we distributed qualitative questionnaires to all the clinical bases (N=80). Questions explored topics such as daily internet usage, safeguarding measures, and perceived threats. The researchers requested for all CAMHS clinicians to identify participants. Participants in this study were accessing CAMHS for neurodevelopmental specific interventions. Results: The data were analysed using both Excel and SPSS. Within SPSS, a MANOVA was conducted and found a significant difference between safeguarding measures and perceived online risks within responses (p ≤ 0.5). This supports our hypothesis that participants in this population are well versed in the safeguarding issues of the internet; however, struggle to implement appropriate preventative measures. Data were also screened using Excel and found that all parents and carers stated they 'monitored their child’s internet use'. Conclusion: Data suggest that parents/carers may require more specific intervention to equip them with preventative measures due to the clear discrepancy between perceived risks and safeguarding measures. More research may also need to be conducted around this area to determine appropriate methodology to explore this topic further.

Keywords: Internet, health , how safe are we , internet health check

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430 Higher Education Leadership and Creating Sites of Institutional Belonging: A Global Case Study

Authors: Lisa M. Coleman

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The focus on disability, LGBTQ+, and internationalization has certainly been the subject of much research and programmatic across higher education. Many universities have entered into global partnerships with varying success and challenges across the various areas, including laws and policies. Attentiveness to the specific nuances of global inclusion, diversity, equity, belonging, and access (GIDBEA) and the leadership to support these efforts is crucial to the development of longstanding success across the programs. There have been a number of shifts related to diversification across student and alumni bodies. These shifts include but are not limited to how people identify gender, race, and sexuality (and the intersections across such identities), as well as trends across emerging and diverse disability communities. NYU is the most international campus in the United States, with the most campuses and sites outside of its county of origin and the most international students and exchange programs than any other university. As a result, the ongoing work related to GIDEBA is at the center of much of the leadership, administrative, and research efforts. Climate assessment work across NYU’s diverse global campus landscape will serve as the foundation to exemplify best practices related to data collection and dissemination, community and stakeholder engagement, and effective implementation of innovative strategies to close gap areas as identified. The data (quantitative and qualitative) and related research findings represent data collected from close to 22,000 stakeholders across the NYU campuses. The case study centers on specific methodological considerations, data integrity, stakeholder engagement from across student-faculty, staff, and alumni constituencies, and tactics to advance specific GIDBEA initiatives related to navigating shifting landscapes. Design thinking, incubation, and co-creation strategies have been employed to expand, leverage, actualize, and implement GIDBEA strategies that are – concrete, measurable, differentiated, and specific to global sites and regions and emerging trends.

Keywords: disability, LGBTQ+, DEI, research, case studies

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429 Women Entrepreneurship in Poland and Its Impact on the Country’s Economic Development

Authors: Sabina Klimek

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In general, entrepreneurs are viewed as agents of change whose goal is to ensure that resources are efficiently utilized. They are very important in the global economy; they create wealth and provide jobs. At the same time, many policymakers say that women entrepreneurs are a ‘special group’ worthy of their own research and policies. The status of Polish women has been changing as well, even though, to a large extent, it is still defined by the double role that women are expected to fill according to the dominant stereotypical model of family life. However, in the past decade, Polish women’s economic activities have experienced rapid growth and today are at a high level. In the article, the author presents the results of a survey conducted among women entrepreneurs in Poland concerning the functioning of their enterprises, motivation in setting up a company, and barriers that hinder them in business. The questionnaire (300 questionnaires were provided) and case studies carried out by the author have proven that female entrepreneurs in Poland are characterized by commonalities. Mostly they run small or micro-enterprises, operate in larger cities, are well-educated, and run service companies. Their main motivation to run their own business is mostly indicated by their need for independence. However, one of their biggest barriers and hesitations is the apprehension of non-payment. Entrepreneurs want to develop their companies, go to foreign markets and implement new solutions. They are not afraid of the future; they are only trying to create it. Detailed hypothesis, which reads as follows. The author additionally conducted a macroeconomic analysis calculating what part of GDP in Poland is produced by female entrepreneurs. The results of the study presented in this article prove that female entrepreneurship in Poland has a stable impact on the economy of the country, and women entrepreneurs produce over 13% of the national GDP. After years of growth in the number of female entrepreneurs in Poland, there has been a period of stabilization. However, there has also been a reduction in the number of self-employed people as well as the number of women in total employment. In the article, the author analyses the reasons for decreasing number of self-employed women and the total employment of women in Poland and provides suggestions for steps and incentives that should be made in order to encourage female entrepreneurship to grow in the country.

Keywords: women entrepreneurship, women in business, women entrepreneurship in Poland, Poland, GDP of Poland

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428 Adopting a Stakeholder Perspective to Profile Successful Sustainable Circular Business Approaches: A Single Case Study

Authors: Charleen von Kolpinski, Karina Cagarman, Alina Blaute

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The circular economy concept is often framed by politicians, scientists and practitioners as being the solution to sustainability problems of our times. However, the focus of these discussions and publications is very often set on environmental and economic aspects. In contrast, the social dimension of sustainability has been neglected and only a few recent and mostly conceptual studies targeted the inclusion of social aspects and the SDGs into circular economy research. All stakeholders of this new circular system have to be included to represent a truly sustainable solution to all the environmental, economic and social challenges caused by the linear economic system. Hence, this empirical research aims to analyse, next to the environmental and economic dimension, also explicitly the social dimension of a sustainable circular business model. This inductive and explorative approach applies the single case study method. A multi-stakeholder view is adopted to shed light on social aspects of the circular business model. Different stakeholder views, tensions between stakeholders and conflicts of interest are detected. In semi-structured interviews with different stakeholders of the company, this study compares the different stakeholder views to profile the success factors of its business model in terms of sustainability implementation and to detect its shortcomings. These findings result in the development of propositions which cover different social aspects of sustainable circular business model implementation. This study is an answer to calls for future empirical research about the social dimension of the circular economy and contributes to sustainable business model thinking in entrepreneurial contexts of the circular economy. It helps identifying all relevant stakeholders and their needs to successfully and inclusively implement a sustainable circular business model. The method of a single case study has some limitations by nature as it only covers one enterprise with its special business model. Therefore, more empirical studies are needed to research sustainable circular business models from multiple stakeholder perspectives, in different countries and industries. Future research can build upon the developed propositions of this study and develop hypotheses to be tested.

Keywords: circular economy, single case study, social dimension, sustainable circular business model

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427 From Poverty to Progress: A Comparative Analysis of Mongolia with PEER Countries

Authors: Yude Wu

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Mongolia, grappling with significant socio-economic challenges, faces pressing issues of inequality and poverty, as evidenced by a high Gini coefficient and the highest poverty rate among the top 20 largest Asian countries. Despite government efforts, Mongolia's poverty rate experienced only a slight reduction from 29.6 percent in 2016 to 27.8 percent in 2020. PEER countries, such as South Africa, Botswana, Kazakhstan, and Peru, share characteristics with Mongolia, including reliance on the mining industry and classification as lower middle-income countries. Successful transitions of these countries to upper middle-income status between 1994 and the 2010s provide valuable insights. Drawing on secondary analyses of existing research and PEER country profiles, the study evaluates past policies, identifies gaps in current approaches, and proposes recommendations to combat poverty sustainably. The hypothesis includes a reliance on the mining industry and a transition from lower to upper middle-income status. Policies from these countries, such as the GEAR policy in South Africa and economic diversification in Botswana, offer insights into Mongolia's development. This essay aims to illuminate the multidimensional nature of underdevelopment in Mongolia through a secondary analysis of existing research and PEER country profiles, evaluating past policies, identifying gaps in current approaches, and providing recommendations for sustainable progress. Drawing inspiration from PEER countries, Mongolia can implement policies such as economic diversification to reduce vulnerability and create stable job opportunities. Emphasis on infrastructure, human capital, and strategic partnerships for Foreign Direct Investment (FDI) aligns with successful strategies implemented by PEER countries, providing a roadmap for Mongolia's development objectives.

Keywords: inequality, PEER countries, comparative analysis, nomadic animal husbandry, sustainable growth

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426 Designing and Implementing a Tourist-Guide Web Service Based on Volunteer Geographic Information Using Open-Source Technologies

Authors: Javad Sadidi, Ehsan Babaei, Hani Rezayan

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The advent of web 2.0 gives a possibility to scale down the costs of data collection and mapping, specifically if the process is done by volunteers. Every volunteer can be thought of as a free and ubiquitous sensor to collect spatial, descriptive as well as multimedia data for tourist services. The lack of large-scale information, such as real-time climate and weather conditions, population density, and other related data, can be considered one of the important challenges in developing countries for tourists to make the best decision in terms of time and place of travel. The current research aims to design and implement a spatiotemporal web map service using volunteer-submitted data. The service acts as a tourist-guide service in which tourists can search interested places based on their requested time for travel. To design the service, three tiers of architecture, including data, logical processing, and presentation tiers, have been utilized. For implementing the service, open-source software programs, client and server-side programming languages (such as OpenLayers2, AJAX, and PHP), Geoserver as a map server, and Web Feature Service (WFS) standards have been used. The result is two distinct browser-based services, one for sending spatial, descriptive, and multimedia volunteer data and another one for tourists and local officials. Local official confirms the veracity of the volunteer-submitted information. In the tourist interface, a spatiotemporal search engine has been designed to enable tourists to find a tourist place based on province, city, and location at a specific time of interest. Implementing the tourist-guide service by this methodology causes the following: the current tourists participate in a free data collection and sharing process for future tourists, a real-time data sharing and accessing for all, avoiding a blind selection of travel destination and significantly, decreases the cost of providing such services.

Keywords: VGI, tourism, spatiotemporal, browser-based, web mapping

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425 Improving the Management of Delirium of Surgical Inpatients

Authors: Shammael Selorfia

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The Quality improvement project aimed to improve junior doctors and nurses’ knowledge and confidence in diagnosing and managing delirium on inpatient surgical wards in a tertiary hospital. The study aimed to develop a standardised assessment and management checklist for all staff working with patients who were presenting with signs of delirium. The aim of the study was to increase confidence of staff at dealing with delirium and improve the quality of referrals that were being sent to the Mental Health Liaison team over a 6-month period. A significant proportion of time was being spent by the Mental Health Liaison triage nurses on referrals for delirium. Data showed 28% of all delirium referrals from surgical teams were being closed at triage reflecting a poor standard of quality of those referrals. A qualitative survey of junior doctors in 6 surgical specialties in a UK tertiary hospital was conducted. These specialties include general surgery, vascular, plastic, urology, neurosurgery, and orthopaedics. The standardised checklist was distributed to all surgical wards. A comparison was made between the Mental health team caseload of delirium before intervention was compared and after. A Qualitative survey at end of 3-month cycle and compare overall caseload on Mental Health Liaison team to pre-QIP data with aim to improve quality of referrals and reduce workload on Mental Health Liaison team. At the end of the project cycle, we demonstrated an improvement in the quality of referrals with a decrease in the percentage of referrals being closed at triage by 8%. Our surveys also indicated an increase in the knowledge of official trust delirium guidelines and confidence at managing the patients. This project highlights that a new approach to delirium using multi-component interventions is needed, where the diagnosis of delirium is shared amongst medical and nursing staff, and everyone plays role in management. The key is improving awareness of delirium and encouraging the use of recognized diagnostic tools and official guidelines. Recommendations were made to the trust on how to implement a long-lasting change.

Keywords: delirium, surgery, quality, improvement

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424 Decommissioning of Nuclear Power Plants: The Current Position and Requirements

Authors: A. Stifi, S. Gentes

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Undoubtedly from construction's perspective, the use of explosives will remove a large facility such as a 40-storey building , that took almost 3 to 4 years for construction, in few minutes. Usually, the reconstruction or decommissioning, the last phase of life cycle of any facility, is considered to be the shortest. However, this is proved to be wrong in the case of nuclear power plant. Statistics says that in the last 30 years, the construction of a nuclear power plant took an average time of 6 years whereas it is estimated that decommissioning of such plants may take even a decade or more. This paper is all about the decommissioning phase of a nuclear power plant which needs to be given more attention and encouragement from the research institutes as well as the nuclear industry. Currently, there are 437 nuclear power reactors in operation and 70 reactors in construction. With around 139 nuclear facilities already been shut down and are in different decommissioning stages and approximately 347 nuclear reactors will be in decommissioning phase in the next 20 years (assuming the operation time of a reactor as 40 years), This fact raises the following two questions (1) How far is the nuclear and construction Industry ready to face the challenges of decommissioning project? (2) What is required for a safety and reliable decommissioning project delivery? The decommissioning of nuclear facilities across the global have severe time and budget overruns. Largely the decommissioning processes are being executed by the force of manual labour where the change in regulations is respectively observed. In term of research and development, some research projects and activities are being carried out in this area, but the requirement seems to be much more. The near future of decommissioning shall be better through a sustainable development strategy where all stakeholders agree to implement innovative technologies especially for dismantling and decontamination processes and to deliever a reliable and safety decommissioning. The scope of technology transfer from other industries shall be explored. For example, remotery operated robotic technologies used in automobile and production industry to reduce time and improve effecincy and saftey shall be tried here. However, the innovative technologies are highly requested but they are alone not enough, the implementation of creative and innovative management methodologies should be also investigated and applied. Lean Management with it main concept "elimination of waste within process", is a suitable example here. Thus, the cooperation between international organisations and related industries and the knowledge-sharing may serve as a key factor for the successful decommissioning projects.

Keywords: decommissioning of nuclear facilities, innovative technology, innovative management, sustainable development

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423 Customer Relationship Management: An Essential Tool for Librarians

Authors: Pushkar Lal Sharma, Sanjana Singh, Umesh Kumar Sahu

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This paper helps to understand the need of Customer Relationship Management in Libraries and why Librarians should implement the marketing concept of Customer Relationship Management in their libraries. As like any industry, libraries too face growing challenges to continuously meet customer expectations, and attract and retain users in light of overflowing competition. The ability to understand customers, build relationships and market diverse services is essential when considering ways to expand service offerings and improve Return on Investment. Since Library is service oriented Enterprise, hence the Customer/User/ Reader/Patron are the most important element of Library & Information System to whom and for whom library offers various services. How to provide better and most efficient services to its users is the main concern of every Library & Information centre in the present era. The basic difference between Business Enterprise and Library Information System is that ‘in Business System ‘the efficiency is measured in terms of ’profit’ or ‘monetary gains’; whereas in a Library & Information System, the efficiency is measured in terms of ‘services’ and therefore the goals that are set in Business Enterprise are’ profit oriented’ whereas goals set in the Library & Information Centre are ‘Service-oriented’. With the explosion of information and advancement of technology readers have so many choices to get information rather than visiting a library. Everything is available at the click of a mouse, library customers have become more knowledgeable and demanding in an era marked by abundance of information resources and services. With this explosion of information in every field of knowledge and choice in selection of service, satisfying user has become a challenge now a day for libraries. Accordingly, Libraries have to build good relationship with its users by adopting Customer relationship Management. CRM refers to the methods and tools which help an organization to manage its relationship with its customers in an organized way. The Customer Relationship Management (CRM) combines business strategy and technology to identify, acquire and retain good customer relationship. The goal of CRM is to optimize management of customer information needs & interests and increase customer satisfaction and loyalty. Implementing CRM in Libraries can improve customer data and process management, customer loyalty, retention and satisfaction.

Keywords: customer relationship management, CRM, CRM tools, customer satisfaction

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422 Impact of Revenue Reform on Vulnerable Communities

Authors: Pauliasi Tony Fakahau

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This paper provides an overview of the impact of the revenue reform programme on vulnerable communities in the Kingdom of Tonga. Economic turmoil and mismanagement during the late 1990s forced the government to seek technical and financial assistance from the Asian Development Bank to undertake a comprehensive Economic and Public Sector Reform (EPSR) programme. The EPSR is a Western model recommended by donor agencies as the solution to Tonga’s economic challenges. The EPSR programme included public sector reform, private sector growth, and revenue generation. Tax reform was the main tool for revenue generation, which set out to strengthen tax compliance and administration as well as implement a value-added consumption tax. The EPSR is based on Western values and ideology but failed to recognise that Tongan cultural values are important to the local community. Two participant groups were interviewed. Participant group one consisted of 51 people representing vulnerable communities. Participant group two consisted of six people from the government and business sector who were from the elite of Tongan society. The Kakala Research Methodology provided the framework for the research, and the Talanoa Research Method was used to conduct semi-structured interviews in the homes of the first group and in the workplaces of the second group. The research found a heavy burden of the consumption tax on the purchasing power of participant group one (vulnerable participants), having an impact on nearly every financial transaction they made. Participant group ones’ main financial priorities were kavenga fakalotu (obligations to the church), kavenga fakafāmili (obligations to the family) and kavenga fakafonua (obligations to cultural events for the village, nobility, and royalty). The findings identified inequalities of the revenue reform, especially from consumption tax, for vulnerable people and communities compared to the elite of society. The research concluded that government and donor agencies need ameliorating policies to reduce the burden of tax on vulnerable groups more susceptible to the impact of revenue reform.

Keywords: tax reform, tonga vulnerable community revenue, revenue reform, public sector reform

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421 Research on the Effectiveness of Online Guided Case Teaching in Problem-Based Learning: A Preschool Special Education Course

Authors: Chen-Ya Juan

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Problem-Based Learning uses vague questions to guide student thinking and enhance their self-learning and collaboration. Most teachers implement PBL in a physical classroom, where teachers can monitor and evaluate students’ learning progress and guide them to search resources for answers. However, the prevalence of the Covid-19 in the world had changed from physical teaching to distance teaching. This instruction used many cases and applied Problem-Based Learning combined on the distance teaching via the internet for college students. This study involved an experimental group with PBL and a control group without PBL. The teacher divided all students in PBL class into eight groups, and 7~8 students in each group. The teacher assigned different cases for each group of the PBL class. Three stages of instruction were developed, including background knowledge of Learning, case analysis, and solving problems for each case. This study used a quantitative research method, a two-sample t-test, to find a significant difference in groups with PBL and without PBL. Findings indicated that PBL incased the average score of special education knowledge. The average score was improved by 20.46% in the PBL group and 15.4% without PBL. Results didn’t show significant differences (0.589>0.05) in special education professional knowledge. However, the feedback of the PBL students implied learning more about the application, problem-solving skills, and critical thinking. PBL students were more likely to apply professional knowledge on the actual case, find questions, resources, and answers. Most of them understood the importance of collaboration, working as a team, and communicating with other team members. The suggestions of this study included that (a) different web-based teaching instruments influenced student’s Learning; (b) it is difficult to monitor online PBL progress; (c) online PBL should be implemented flexible and multi-oriented; (d) although PBL did not show a significant difference on the group with PBL and without PBL, it did increase student’s problem-solving skills and critical thinking.

Keywords: problem-based learning, college students, distance learning, case analysis, problem-solving

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420 Community Involvement and Willingness To Pay for Municipal Solid Waste Management Activities in Rapid Urbanized Region: A Case Study of Mnadani and Madukani Wards-Dodoma Urban

Authors: Isabela Thomas Mkude

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This research was done to assess how the community is involved in waste management activities and their willingness to pay for services. Mnadani and Madukani are among the old wards in Dodoma urban. These two areas are similar and face numerous environmental problems, poor solid waste management practices being among them. People realize problems because they live with them daily but the study advice that the only way to stay off problems is to find appropriate measures. The findings recognized some problems that led to poor community involvement solid waste management the study areas. Lack of community education on how to deal with solid wastes, poor responsibility of ward leaders in issues concerning the environment and in active participation of communities in environmental meeting are among other major problems found during the research. The research also revealed that there is low willingness to pay for waste collection among communities and financial problems that make environmental committee inactive; that leading to a poor disposal and unavailable collection facilities in urban area. Although the municipal improves disposal activities by increasing amount of waste to be disposed off by 11% in three years, the amount of waste that collected is also increasing by 41% each day. It is advised that some corrective measures need to be put in place so that the communities are well involved in managing solid wastes as the best way to attain achievement in keeping the urban free from solid waste. Environmental education dissemination to the communities is needed so that they become responsible and dedicated citizen on the environment. There should be some incentives from government to the wards local government and CBOs so that they can practically implement solid waste management programs and to attract formation of more groups and motivate the present groups. Capacity building programs to the ward leaders need to be given priority so that leaders are well organized and able to plan, coordinate and cooperate with various governmental institutions, and NGOs responsible for development and environmental management.

Keywords: solid waste, waste management, public involvement, rapid urbanized region

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419 Risk Management Approach for a Secure and Performant Integration of Automated Drug Dispensing Systems in Hospitals

Authors: Hind Bouami, Patrick Millot

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Medication dispensing system is a life-critical system whose failure may result in preventable adverse events leading to longer patient stays in hospitals or patient death. Automation has led to great improvements in life-critical systems as it increased safety, efficiency, and comfort. However, critical risks related to medical organization complexity and automated solutions integration can threaten drug dispensing security and performance. Knowledge about the system’s complexity aspects and human machine parameters to control for automated equipment’s security and performance will help operators to secure their automation process and to optimize their system’s reliability. In this context, this study aims to document the operator’s situation awareness about automation risks and parameters involved in automation security and performance. Our risk management approach has been deployed in the North Luxembourg hospital center’s pharmacy, which is equipped with automated drug dispensing systems since 2009. With more than 4 million euros of gains generated, North Luxembourg hospital center’s success story was enabled by the management commitment, pharmacy’s involvement in the implementation and improvement of the automation project, and the close collaboration between the pharmacy and Sinteco’s firm to implement the necessary innovation and organizational actions for automated solutions integration security and performance. An analysis of the actions implemented by the hospital and the parameters involved in automated equipment’s integration security and performance has been made. The parameters to control for automated equipment’s integration security and performance are human aspects (6.25%), technical aspects (50%), and human-machine interaction (43.75%). The implementation of an anthropocentric analysis system before automation would have prevented and optimized the control of risks related to automation.

Keywords: Automated drug delivery systems, Hospitals, Human-centered automated system, Risk management

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418 Imposing Personal Liability on Shareholder's/Partner's in a Corporate Entity; Implementation of UK’s Personal Liability Institutions in Georgian Corporate Law: Content and Outcomes

Authors: Gvantsa Magradze

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The paper examines the grounds for the imposition of a personal liability on shareholder/partner, mainly under Georgian and UK law’s comparative analysis. The general emphasis was made on personal responsibility grounds adaptation in practice and presents the analyze of court decisions. On this base, reader will be capable to find a difference between the dogmatic and practical grounds for imposition personal liability. The first chapter presents the general information about discussed issue and notion of personal liability. The second chapter is devoted to an explanation the concept – ‘the head of the corporation’ to make it clear who is the subject of responsibility in the article and not to remain individuals beyond the attention, who do not hold the position of director but are participating in governing activities and, therefore, have to have fiduciury duties. After short comparative analysis of personal responsibility, the Georgian Corporate law reality is further discussed. Here, the problem of determining personal liability is a problematic issue, thus a separate chapter is devoted to the issue, which explains the grounds for personal liability imposition in details. Within the paper is discussed the content and the purpose of personal liability institutions under UK’s corporate law and an attempt to implement them, and especially ‘Alter Ego’ doctrine in Georgian corporate Law reality and the outcomes of the experiment. For the research purposes will be examined national case law in regard to personal liability imposition, as well as UK’s experience in that regard. Comparative analyze will make it clear, wherein the Georgian statute, are gaps and how to fill them up. The articles major finding as stated, is that Georgian Corporate law does not provide any legally consolidated grounds for personal liability imposition, which in fact, leads to unfaithful, unlawful actions on partners’/shareholders’ behalf. In order to make business market fair, advancement of a national statute is inevitable, and for that, the experience sharing from developed countries is an irreplaceable gift. Overall, the article analyses, how discussed amendments might influence case law and if such amendments were made years ago, how the judgments could look like (before and after amendments).

Keywords: alter ego doctrine, case law, corporate law, good faith, personal liability

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417 Risk Factors Associated with Dengue Fever Outbreak in Diredawa Administration City, Ethiopia, October 2015: A Case Control Study

Authors: Luna Degife, Desalegn Belay, Yoseph Worku, Tigist Tesfaye, Assefa Tufa, Abyot Bekele, Zegeye Hailemariam, Abay Hagos

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Half of the world’s population is at risk of Dengue Fever (DF), a highly under-recognized and underreported mosquito-borne viral disease with high prevalence in the tropical and subtropical regions. Globally, an estimated 50 to 200 million cases and 20, 000 DF deaths occur annually as per the world health organization report. In Ethiopia, the first outbreak occurred in 2013 in Diredawa administration city. Afterward, three outbreaks have been reported from the eastern part of the country. We received a report of the fifth DF outbreak for Ethiopia and the second for Diredawa city on October 4, 2015. We conducted the investigation to confirm the outbreak, identify the risk factors for the repeatedly occurrence of the disease and implement control measures. We conducted un- matched case-control study and defined a suspected DF case as any person with fever of 2-7 days and 2 or more of the following: a headache, arthralgia, myalgia, rash, or bleeding from any part of the body. Controls were residents of Diredawa city without DF symptoms. We interviewed 70 Cases and 140 controls from all health facilities in Diredawa city from October 7 to 15; 2015. Epi Info version 7.1.5.0 was used to analyze the data and multivariable logistic regression was conducted to assess risk factors for DF. Sixty-nine blood samples were collected for Laboratory confirmation.The mean age for cases was 23.7±9.5 standard deviation (SD) and for controls 31.2±13 SD. Close contact with DF patient (Adjusted odds ratio (AOR)=5.36, 95% confidence interval(CI): 2.75-10.44), nonuse of long-lasting insecticidal nets (AOR=2.74, 95% CI: 1.06-7.08) and availability of stagnant water in the village (AOR=3.61, 95% CI:1.31-9.93) were independent risk factors associated with higher rates of the disease. Forty-two samples were tested positive. Endemicity of DF is becoming a concern for Diredawa city after the first outbreak. Therefore, effective vector control activities need to be part of long-term preventive measures.

Keywords: dengue fever, Diredawa, outbreak, risk factors, second

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416 Overcoming Barriers to Improve HIV Education and Public Health Outcomes in the Democratic Republic of Congo

Authors: Danielle A. Walker, Kyle L. Johnson, Tara B. Thomas, Sandor Dorgo, Jacen S. Moore

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Approximately 37 million people worldwide are infected with the Human Immunodeficiency Virus (HIV), with the majority located in sub-Saharan Africa. The relationship existing between HIV incidence and socioeconomic inequity confirms the critical need for programs promoting HIV education, prevention and treatment access. This literature review analyzed 36 sources with a specific focus on the Democratic Republic of Congo, whose critically low socioeconomic status and education rate have resulted in a drastically high HIV rates. Relationships between HIV testing and treatment and barriers to care were explored. Cultural and religious considerations were found to be vital when creating and implementing HIV education and testing programs. Partnerships encouraging active support from community-based spiritual leaders to implement HIV educational programs were also key mechanisms to reach communities and individuals. Gender roles were highlighted as a key component for implementation of effective community trust-building and successful HIV education programs. The efficacy of added support by hospitals and clinics in rural areas to facilitate access to HIV testing and care for people living with HIV/AIDS (PLWHA) was discussed. This review highlighted the need for healthcare providers to provide a network of continued education for PLWHA in clinical settings during disclosure and throughout the course of treatment to increase retention in care and promote medication adherence for viral load suppression. Implementation of culturally sensitive models that rely on community familiarity with HIV educators such as ‘train-the-trainer’ were also proposed as efficacious tools for educating rural communities about HIV. Further research is needed to promote community partnerships for HIV education, understand the cultural context of gender roles as barriers to care, and empower local health care providers to be successful within the HIV Continuum of Care.

Keywords: cultural sensitivity, Democratic Republic of the Congo, education, HIV

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415 Integration of Design Management in the Product Development Process in SME's

Authors: Vitor Carneiro, Augusto Barata Da Rocha, Barbara Rangel, Jorge Lino Alves

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In the European Union countries, Small and Medium-Sized Enterprises (SME’s) have an important contribution to economic activity and to the Gross Domestic Product (GDP). The implementation of design practices in SME’s is often a difficult task due to resources limitations. Unlike large companies, their product development and innovation processes frequentlylack adequate planning and systematic procedures. Design management interest has grown exponentially in recent years, but as it is a recent topic there is an absence of systematic methodologies to implement design management in SME’s with little or no design experience. This work presents a contribution to improve and optimize the process of design integration and management in SME’s. A review analysis is presented to select relevant articles on the subject, review and classify the main published contributions. Based on the selected articles content it was possible to identify five main themes related to the subject under analysis: Design Function Organization, Design Management Integration, Design Management Capabilities, Managing Design Projects, and Tools and Methods. Design management is discussed from different perspectives depending on the focus on which it is placed, whether in a design or management perspective, leading to different visions and definitions: from a more upstream strand at the intersection of design and the organization's strategic management (strategic design management) to a more downstream strand related to project management and design process (design management operational). The review analysis of the selected articles allowed the identification of a high level of complexity of connections and parameters in the design management during the product development process in the context of SME’s. Within each group of the five main themes, several sub-themes, directly or indirectly related, should be considered.Sub-connections also occur between sub-themes of different themes creating a complex and intricate web of connections. This complexity of connections is often the main obstacle to conduct design management and product development efficiently. This work proposes a formulation of a systematic methodological approach to optimize the integrated project and the management and control of the product development process among SME's. The implementation of this formulation will improve the integration of design management in the product development and innovation process in SME’s.

Keywords: design management, product development, product innovation, SME’s.

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414 Characteristics of Children Heart Rhythm Regulation with Acute Respiratory Diseases

Authors: D. F. Zeynalov, T. V. Kartseva, O. V. Sorokin

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Currently, approaches to assess cardiointervalography are based on the calculation of data variance intervals RR. However, they do not allow the evaluation of features related to a period of the cardiac cycle, so how electromechanical phenomena during cardiac subphase are characterized by differently directed changes. Therefore, we have proposed a method of subphase analysis of the cardiac cycle, developed in the department of hominal physiology Novosibirsk State Medical University to identify the features of the dispersion subphase of the cardiac cycle. In the present paper we have examined the 5-minute intervals cardiointervalography (CIG) to isolate RR-, QT-, ST-ranges in healthy children and children with acute respiratory diseases (ARD) in comparison. It is known that primary school-aged children suffer at ARD 5-7 times per year. Consequently, it is one of the most relevant problems in pediatrics. It is known that the spectral indices and indices of temporal analysis of heart rate variability are highly sensitive to the degree of intoxication during immunological process. We believe that the use of subphase analysis of heart rate will allow more thoroughly evaluate responsiveness of the child organism during the course of ARD. The study involved 60 primary school-aged children (30 boys and 30 girls). In order to assess heart rhythm regulation, the record CIG was used on the "VNS-Micro" device of Neurosoft Company (Ivanovo) for 5 minutes in the supine position and 5 minutes during active orthostatic test. Subphase analysis of variance QT-interval and ST-segment was performed on the "KardioBOS" software Biokvant Company (Novosibirsk). In assessing the CIG in the supine position and in during orthostasis of children with acute respiratory diseases only RR-intervals are observed typical trend of general biological reactions through pressosensitive compensation mechanisms to lower blood pressure, but compared with healthy children the severity of the changes is different, of sick children are more pronounced indicators of heart rate regulation. But analysis CIG RR-intervals and analysis subphase ST-segment have yielded conflicting trends, which may be explained by the different nature of the intra- and extracardiac influences on regulatory mechanisms that implement the various phases of the cardiac cycle.

Keywords: acute respiratory diseases, cardiointervalography, subphase analysis, cardiac cycle

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413 An Empirical Study of Performance Management System: Implementation of Performance Management Cycle to Achieve High-Performance Culture at Pertamina Company, Indonesia

Authors: Arif Budiman

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Any organization or company that wishes to achieve vision, mission, and goals of the organization is required to implement a performance management system or known as the Performance Management System (PMS) in every part of the whole organization. PMS is a tool to help visualize the direction and work program of the organization to achieve the goal. The challenge is PMS should not stop merely as a visualization tool to achieve the vision and mission of the organization, but PMS should also be able to create a high-performance culture that is inherent in each individual of the organization. Establishment of a culture within an organization requires the support of top leaders and also requires a system or governance that encourages every individual in the organization to be involved in any work program of the organization. Keywords of creating a high-performance culture are the formation of communication pattern involving the whole individual, either vertically or horizontally, and performed consistently and persistently by all individuals in each line of the organization. PT Pertamina (Persero) as the state-owned national energy company holds a system to internalize the culture of high performance through a system called Performance Management System Cycle (PMS Cycle). This system has 7 stages of the cycle, those are: (1) defining vision, mission and strategic plan of the company, (2) defining key performance indicator of each line and the individual (‘expectation setting conversation’), (3) defining performance target and performance agreement, (4) monitoring performance on a monthly regular basis (‘pulse check’), (5) implementing performance dialogue between leaders and staffs periodically every 3 months (‘performance dialogue’), (6) defining rewards and consequences based on the achievement of the performance of each line and the individual, and (7) calculating the final performance value achieved by each line and individual from one period of the current year. Perform PMS is a continual communication running throughout the year, that is why any three performance discussion that should be performed, include expectation setting conversations, pulse check and performance dialogue. In addition, another significant point and necessary undertaken to complete the assessment of individual performance assessment is soft competencies through 360-degree assessment by leaders, staffs, and peers.

Keywords: 360-degree assessment, expectation setting conversation, performance management system cycle, performance dialogue, pulse check

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412 The Restrictions of the Householder’s ‘Double Two-Thirds Principles’ in Decision-Making for Elevators Addition to Existing Condominium

Authors: Haifeng Shi, Kun Song, Yili Zhao

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In China, with the extensive promotion of the ‘aging in place’ pension policy as the background, most of the elders will choose to remain in their current homes and communities, finding out of preference or necessity that they will need to remodel their homes to fit their changing needs. This generation elder born in the 1960s to 1970s almost live in the same form of housing-condominium built from 1982 to 2012. Based on the survey of existing multi-family housing, especially in Tianjin, it is found that the current ‘double two-thirds principles’ is becoming the threshold for modification to existing house, particularly in the project of elevators addition to existing condominium (built from 1982 to 2016 without elevators below 6 floors according to the previous building code). Firstly, this article concludes the local policies of elevator addition nationwide, most of which has determined the importance and necessity of the community-based self-organization principle in the operation of the elevator addition. Secondly, by comparing the three existing community management systems (owners' congress, property management system and community committee) in instances, find that the community-based ‘two-thirds’ principle is not conducive to implement for multi-owned property renovation in the community or common accessibility modification in the building. However, analysis the property and other community management related laws, pointing out the shortcomings of the existing community-based ‘two-thirds’ decision-making norms. The analyzation showed that the unit-based and ‘100% principle’ method is more capable of common accessibility in the condominium in China. Differing from existing laws, the unit-based principle will be effective for the process of decision-making and ‘100% principle’ will protect closely profit-related householders for condominium modification in the multi-owned area. These three aspects of the analysis suggest that the establishment of the unit-based self-organization mechanism is a preferred and inevitable method to solve the problem of elevators addition to the existing condominium in China.

Keywords: aging in place, condominium, modification, multi own

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411 A Conceptual Model of Preparing School Counseling Students as Related Service Providers in the Transition Process

Authors: LaRon A. Scott, Donna M. Gibson

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Data indicate that counselor education programs in the United States do not prepare their students adequately to serve students with disabilities nor provide counseling as a related service. There is a need to train more school counselors to provide related services to students with disabilities, for many reasons, but specifically, school counselors are participating in Individualized Education Programs (IEP) and transition planning meetings for students with disabilities where important academic, mental health and post-secondary education decisions are made. While school counselors input is perceived very important to the process, they may not have the knowledge or training in this area to feel confident in offering required input in these meetings. Using a conceptual research design, a model that can be used to prepare school counseling students as related service providers and effective supports to address transition for students with disabilities was developed as a component of this research. The authors developed the Collaborative Model of Preparing School Counseling Students as Related Service Providers to Students with Disabilities, based on a conceptual framework that involves an integration of Social Cognitive Career Theory (SCCT) and evidenced-based practices based on Self-Determination Theory (SDT) to provide related and transition services and planning with students with disabilities. The authors’ conclude that with five overarching competencies, (1) knowledge and understanding of disabilities, (2) knowledge and expertise in group counseling to students with disabilities, (3), knowledge and experience in specific related service components, (4) knowledge and experience in evidence-based counseling interventions, (5) knowledge and experiencing in evidenced-based transition and career planning services, that school counselors can enter the field with the necessary expertise to adequately serve all students. Other examples and strategies are suggested, and recommendations for preparation programs seeking to integrate a model to prepare school counselors to implement evidenced-based transition strategies in supporting students with disabilities are included

Keywords: transition education, social cognitive career theory, self-determination, counseling

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410 Assessing the Impact of the Rome II Regulation's General Rule on Cross-Border Road Traffic Accidents: A Critique of Recent Case Law

Authors: Emma Roberts

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The Rome II Regulation has established a uniform regime of conflict of law rules across the European Union (except for Denmark) which determines the law applicable in non-contractual obligations disputes. It marks a significant development towards the Europeanization of private international law and aims to provide the most appropriate connecting factors to achieve both legal certainty and justice in individual cases. Many non-contractual obligations are recognised to present such distinct factors that, to achieve these aims, a special rule is provided for determining the applicable law in cases in respect of product liability and environmental torts, for example. Throughout the legislative process, the European Parliament sought to establish a separate rule for road traffic accidents, recognising that these cases too present such novel situations that a blanket application of a lex loci damni approach would not provide an appropriate answer. Such attempts were rejected and, as a result, cases arising out of road traffic accidents are subject to the Regulation’s general lex loci damni rule along with its escape clause and limited exception. This paper offers a critique of the Regulation’s response to cross-border road traffic accident cases. In England and Wales, there have been few cases that have applied the Regulation’s provisions to date, but significantly the majority of such cases are in respect of road traffic accidents. This paper examines the decisions in those cases and challenges the legislators’ decision not to provide a special rule for such incidences. Owing to the diversity in compensation systems globally, applying the Regulation’s general rule to cases of road traffic accidents – given the breadth of matters that are to be subject to the lex cause – cannot ensure an outcome that provides ‘justice in individual cases’ as is assured by the Regulation's recitals. Not only does this paper suggest that the absence of a special rule for road traffic accidents means that the Regulation fails to achieve one of its principal aims, but it further makes out a compelling case for the legislative body of the European Union to implement a corrective instrument.

Keywords: accidents abroad, applicable law, cross-border torts, non-contractual obligations, road traffic accidents

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409 Family and Community Care for the Elderly: An Implementation Research in Local Community, Thailand

Authors: Sumattana Glangkarn, Vorapoj Promasatayaprot

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Background: Proportion of population ageing in Thailand has been increased rapidly in the past decades according to living longer and the fertility rates have decreased. The most important challenge related to this situation is to consider how to improve quality and years of healthy of life. This study aimed to implement the older persons’ long term care (LTC) system for elderly care by family and community. Method: The Consolidated Framework for Implementation Research (CFIR) was employed for guiding and evaluating an implementation process in ageing care. The CFIR composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Results: most elderly participants were couples, educating primary school and living with children and grandchildren. More than half of them had chronic diseases such as diabetes mellitus and hypertension. Factor analysis revealed factors related to health care of older participants which consisted of exercise, diet, accidental prevention, relaxation, self-care capacity, joyfulness, family relationship, and personal hygiene. A pre-implementation phase showed intervention characteristics included facilities and services of the LTC policy from the Ministry of Public Health. The complexities of the LTC and relative advantages were explained. Community leaders, public health volunteers, care givers and health professionals had participated in the LTC activities. Outer and inner settings consisted of context of community, culture, and readiness. Characteristics of the individuals related to knowledge, self-efficacy, perceptions, and believes. The process consisted of planning, acting, observing, and reflecting. The implementation outcomes and service outcomes had been evaluated during-implementation phase. Conclusion: the participation of caregivers, community leaders, public health volunteers, and health professionals had supported the LTC services. Thus, family and community care could improve quality of life of the ageing.

Keywords: ageing, CFIR, long term care, implementation

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408 Dosimetry in Interventional Radiology Examinations for Occupational Exposure Monitoring

Authors: Ava Zarif Sanayei, Sedigheh Sina

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Interventional radiology (IR) uses imaging guidance, including X-rays and CT scans, to deliver therapy precisely. Most IR procedures are performed under local anesthesia and start with a small needle being inserted through the skin, which may be called pinhole surgery or image-guided surgery. There is increasing concern about radiation exposure during interventional radiology procedures due to procedure complexity. The basic aim of optimizing radiation protection as outlined in ICRP 139, is to strike a balance between image quality and radiation dose while maximizing benefits, ensuring that diagnostic interpretation is satisfactory. This study aims to estimate the equivalent doses to the main trunk of the body for the Interventional radiologist and Superintendent using LiF: Mg, Ti (TLD-100) chips at the IR department of a hospital in Shiraz, Iran. In the initial stage, the dosimeters were calibrated with the use of various phantoms. Afterward, a group of dosimeters was prepared, following which they were used for three months. To measure the personal equivalent dose to the body, three TLD chips were put in a tissue-equivalent batch and used under a protective lead apron. After the completion of the duration, TLDs were read out by a TLD reader. The results revealed that these individuals received equivalent doses of 387.39 and 145.11 µSv, respectively. The findings of this investigation revealed that the total radiation exposure to the staff was less than the annual limit of occupational exposure. However, it's imperative to implement appropriate radiation protection measures. Although the dose received by the interventional radiologist is a bit noticeable, it may be due to the reason for using conventional equipment with over-couch x-ray tubes for interventional procedures. It is therefore important to use dedicated equipment and protective means such as glasses and screens whenever compatible with the intervention when they are available or have them fitted to equipment if they are not present. Based on the results, the placement of staff in an appropriate location led to increasing the dose to the radiologist. Manufacturing and installation of moveable lead curtains with a thickness of 0.25 millimeters can effectively minimize the radiation dose to the body. Providing adequate training on radiation safety principles, particularly for technologists, can be an optimal approach to further decreasing exposure.

Keywords: interventional radiology, personal monitoring, radiation protection, thermoluminescence dosimetry

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