Search results for: wisdom comprehensive intervention
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5449

Search results for: wisdom comprehensive intervention

4339 Impact of Chess Intervention on Cognitive Functioning of Children

Authors: Ebenezer Joseph

Abstract:

Chess is a useful tool to enhance general and specific cognitive functioning in children. The present study aims to assess the impact of chess on cognitive in children and to measure the differential impact of socio-demographic factors like age and gender of the child on the effectiveness of the chess intervention.This research study used an experimental design to study the impact of the Training in Chess on the intelligence of children. The Pre-test Post-test Control Group Design was utilized. The research design involved two groups of children: an experimental group and a control group. The experimental group consisted of children who participated in the one-year Chess Training Intervention, while the control group participated in extra-curricular activities in school. The main independent variable was training in chess. Other independent variables were gender and age of the child. The dependent variable was the cognitive functioning of the child (as measured by IQ, working memory index, processing speed index, perceptual reasoning index, verbal comprehension index, numerical reasoning, verbal reasoning, non-verbal reasoning, social intelligence, language, conceptual thinking, memory, visual motor and creativity). The sample consisted of 200 children studying in Government and Private schools. Random sampling was utilized. The sample included both boys and girls falling in the age range 6 to 16 years. The experimental group consisted of 100 children (50 from Government schools and 50 from Private schools) with an equal representation of boys and girls. The control group similarly consisted of 100 children. The dependent variables were assessed using Binet-Kamat Test of Intelligence, Wechsler Intelligence Scale for Children - IV (India) and Wallach Kogan Creativity Test. The training methodology comprised Winning Moves Chess Learning Program - Episodes 1–22, lectures with the demonstration board, on-the-board playing and training, chess exercise through workbooks (Chess school 1A, Chess school 2, and tactics) and working with chess software. Further students games were mapped using chess software and the brain patterns of the child were understood. They were taught the ideas behind chess openings and exposure to classical games were also given. The children participated in mock as well as regular tournaments. Preliminary analysis carried out using independent t tests with 50 children indicates that chess training has led to significant increases in the intelligent quotient. Children in the experimental group have shown significant increases in composite scores like working memory and perceptual reasoning. Chess training has significantly enhanced the total creativity scores, line drawing and pattern meaning subscale scores. Systematically learning chess as part of school activities appears to have a broad spectrum of positive outcomes.

Keywords: chess, intelligence, creativity, children

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4338 A Self-Directed Home Yoga Program for Women with Breast Cancer during Chemotherapy

Authors: Hiroko Komatsu, Kaori Yagasaki

Abstract:

Background: Cancer-related cognitive impairment is a common problem seen in cancer patients undergoing chemotherapy. Physical activity may show beneficial effects on the cognitive function in such patients. Therefore, we have developed a self-directed home yoga program for cancer patients with cognitive symptoms during chemotherapy. This program involves a DVD presenting a combination of yoga courses based on patient preferences to be practiced at home. This study was performed to examine the feasibility of this program. In addition, we also examined changes in cognitive function and quality of life (QOL) in these patients participating in the program. Methods: This prospective feasibility study was conducted in a 500-bed general hospital in Tokyo, Japan. The study population consisted of breast cancer patients undergoing chemotherapy as the initial therapy. This feasibility study used a convenience sample with estimation of recruitment rate in a single facility with the availability of trained nurses and physicians to ensure safe yoga intervention. The aim of the intervention program was to improve cognitive function by means of both physical and mental activation via yoga, consisting of physical practice, breathing exercises, and meditation. Information on the yoga program was provided as a booklet, with an instructor-guided group yoga class during the orientation, and a self-directed home yoga program on DVD with yoga logs. Results: The recruitment rate was 44.7%, and the study population consisted of 18 women with a mean age of 43.9 years. This study showed high rates of retention, adherence, and acceptability of the yoga program. Improvements were only observed in the cognitive aspects of fatigue, and there were serious adverse events during the program. Conclusion: The self-directed home yoga program discussed here was both feasible and safe for breast cancer patients showing cognitive symptoms during chemotherapy. The patients also rated the program as useful, interesting, and satisfactory. Participation in the program was associated with improvements in cognitive fatigue but not cognitive function.

Keywords: yoga, cognition, breast cancer, chemotherapy, quality of life

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4337 Mediation Analysis of the Efficacy of the Nimotuzumab-Cisplatin-Radiation (NCR) Improve Overall Survival (OS): A HPV Negative Oropharyngeal Cancer Patient (HPVNOCP) Cohort

Authors: Akshay Patil

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Objective: Mediation analysis identifies causal pathways by testing the relationships between the NCR, the OS, and an intermediate variable that mediates the relationship between the Nimotuzumab-cisplatin-radiation (NCR) and OS. Introduction: In randomized controlled trials, the primary interest is in the mechanisms by which an intervention exerts its effects on the outcomes. Clinicians are often interested in how the intervention works (or why it does not work) through hypothesized causal mechanisms. In this work, we highlight the value of understanding causal mechanisms in randomized trial by applying causal mediation analysis in a randomized trial in oncology. Methods: Data was obtained from a phase III randomized trial (Subgroup of HPVNOCP). NCR is reported to significantly improve the OS of patients locally advanced head and neck cancer patients undergoing definitive chemoradiation. Here, based on trial data, the mediating effect of NCR on patient overall survival was systematically quantified through progression-free survival(PFS), disease free survival (DFS), Loco-regional failure (LRF), and the disease control rate (DCR), Overall response rate (ORR). Effects of potential mediators on the HR for OS with NCR versus cisplatin-radiation (CR) were analyzed by Cox regression models. Statistical analyses were performed using R software Version 3.6.3 (The R Foundation for Statistical Computing) Results: Effects of potential mediator PFS was an association between NCR treatment and OS, with an indirect-effect (IE) 0.76(0.62 – 0.95), which mediated 60.69% of the treatment effect. Taking into account baseline confounders, the overall adjusted hazard ratio of death was 0.64 (95% CI: 0.43 – 0.96; P=0.03). The DFS was also a significant mediator and had an IE 0.77 (95% CI; 0.62-0.93), 58% mediated). Smaller mediation effects (maximum 27%) were observed for LRF with IE 0.88(0.74 – 1.06). Both DCR and ORR mediated 10% and 15%, respectively, of the effect of NCR vs. CR on the OS with IE 0.65 (95% CI; 0.81 – 1.08) and 0.94(95% CI; 0.79 – 1.04). Conclusion: Our findings suggest that PFS and DFS were the most important mediators of the OS with nimotuzumab to weekly cisplatin-radiation in HPVNOCP.

Keywords: mediation analysis, cancer data, survival, NCR, HPV negative oropharyngeal

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4336 Evaluation of the Impact of Telematics Use on Young Drivers’ Driving Behaviour: A Naturalistic Driving Study

Authors: WonSun Chen, James Boylan, Erwin Muharemovic, Denny Meyer

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In Australia, drivers aged between 18 and 24 remained at high risk of road fatality over the last decade. Despite the successful implementation of the Graduated Licensing System (GLS) that supports young drivers in their early phases of driving, the road fatality statistics for these drivers remains high. In response to these statistics, studies conducted in Australia prior to the start of the COVID-19 pandemic have demonstrated the benefits of using telematics devices for improving driving behaviour, However, the impact of COVID-19 lockdown on young drivers’ driving behaviour has emerged as a global concern. Therefore, this naturalistic study aimed to evaluate and compare the driving behaviour(such as acceleration, braking, speeding, etc.) of young drivers with the adoption of in-vehicle telematics devices. Forty-two drivers aged between 18 and 30 and residing in the Australian state of Victoria participated in this study during the period of May to October 2022. All participants drove with the telematics devices during the first 30-day. At the start of the second 30-day, twenty-one participants were randomised to an intervention group where they were provided with an additional telematics ray device that provided visual feedback to the drivers, especially when they committed to aggressive driving behaviour. The remaining twenty-one participants remined their driving journeys without the extra telematics ray device (control group). Such trustworthy data enabled the assessment of changes in the driving behaviour of these young drivers using a machine learning approach in Python. Results are expected to show participants from the intervention group will show improvements in their driving behaviour compared to those from the control group.Furthermore, the telematics data enable the assessment and quantification of such improvements in driving behaviour. The findings from this study are anticipated to shed some light in guiding the development of customised campaigns and interventions to further address the high road fatality among young drivers in Australia.

Keywords: driving behaviour, naturalistic study, telematics data, young drivers

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4335 Exploring the Intrinsic Ecology and Suitable Density of Historic Districts Through a Comparative Analysis of Ancient and Modern Ecological Smart Practices

Authors: HU Changjuan, Gong Cong, Long Hao

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Although urban ecological policies and the public's aspiration for livable environments have expedited the pace of ecological revitalization, historic districts that have evolved through natural ecological processes often become obsolete and less habitable amid rapid urbanization. This raises a critical question about historic districts inherently incapable of being ecological and livable. The thriving concept of ‘intrinsic ecology,’ characterized by its ability to transform city-district systems into healthy ecosystems with diverse environments, stable functions, and rapid restoration capabilities, holds potential for guiding the integration of ancient and modern ecological wisdom while supporting the dynamic involvement of cultures. This study explores the intrinsic ecology of historic districts from three aspects: 1) Population Density: By comparing the population density before urban population expansion to the present day, determine the reasonable population density for historic districts. 2) Building Density: Using the ‘Space-mate’ tool for comparative analysis, form a spatial matrix to explore the intrinsic ecology of building density in Chinese historic districts. 3) Green Capacity Ratio: By using ecological districts as control samples, conduct dual comparative analyses (related comparison and upgraded comparison) to determine the intrinsic ecological advantages of the two-dimensional and three-dimensional green volume in historic districts. The study inform a density optimization strategy that supports cultural, social, natural, and economic ecology, contributing to the creation of eco-historic districts.

Keywords: eco-historic districts, intrinsic ecology, suitable density, green capacity ratio.

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4334 The Importance of Development Evaluation to Preterm Children in Remote Area

Authors: Chung-Yuan Wang, Min Hsu, Bo-Ya Juan, Hsiv Ching Lin, Hsveh Min Lin, Hsiu-Fang Yeh

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The success of Taiwan's National Health Insurance (NHI) system attracts widespread praise from the international society. However, the availability of medical care in a emote area is limited. Without the convenient public transportation system and mature social welfare policy, these people are difficult to regain their health and prevent disability. Preterm children have more risk to get development delay. Preterm children in a remote area have the human right to get rehabilitation resources as those in the city area. Therefore, the aim of this study was to show the importance of development screening to preterm children in a remote area and a tract the government to notice the issue. In Pingtung, children who are suspected development delay would be suggested to take a skillful screening evaluation in our hospital. Those preterm children (within 1-year-old) visited our pediatric clinic would also be referred to take the development evaluation. After the physiatrist’s systemic evaluation, the subjects would be scheduled to take the development evaluation. Gross motor, fine motor, speech comprehension/expression and mental study were included. The evaluation was in-charged by a physical therapist, occupational therapy, speech therapist and pediatric psychologist. The tools were Peabody developmental scale, Bayley Scales of Infant and Toddler Development (Bayley-III) and Wechsler Preschool & Primary Scale of Intelligence-Revised (WPPSI-R). In 2013, 459 children received the service in our hospital. Among these children, fifty-seven were noted with preterm baby history (gestation within 37 weeks). Thirty-six of these preterm children, who had never receive development evaluation, were included in this study. Thirty-six subjects (twenty-six male and ten female) were included. Nineteen subjects were found development delay. Six subjects were found suspected development delay. In gross motor, six subjects were development delay and eight were suspected development delay. In fine motor, five subjects were development delay and three were suspected development delay. In speech, sixteen subjects were development delay and six were suspected development delay. In our study, through the provision of development evaluation service, 72.2% preterm baby were found their development delay or suspected delay. They need further early intervention rehabilitation service. We made their parents realize that when development delay was recognized at the early stage, they are often reversible. No only the patients but also their families were improved their health status. The number of the subjects was limited in our study. Further study might be needed. Compared with 770 physical therapist (PT) and 370 occupational therapy (OT) in Taipei, there are only 108 PT and 54 OT in Pingtung. Further, there are much fewer therapists working on the field of pediatric rehabilitation. Living healthy is a human's right, no matter where does he live. For those development delay children in remote area, particularly preterm children, early detection, and early intervention rehabilitation service could play an important role in decreasing their disability and improving their quality of life. Through this study, we suggest the government to add more national resources on the development evaluation to preterm children in a remote area.

Keywords: development, early intervention, preterm children, rehabilitation

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4333 Promoting Incubation Support to Youth Led Enterprises: A Case Study from Bangladesh to Eradicate Hazardous Child Labour through Microfinance

Authors: Md Maruf Hossain Koli

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The issue of child labor is enormous and cannot be ignored in Bangladesh. The problem of child exploitation is a socio-economic reality of Bangladesh. This paper will indicate the causes, consequences, and possibilities of using microfinance as remedies of hazardous child labor in Bangladesh. Poverty is one of the main reasons for children to become child laborers. It is an indication of economic vulnerability, inadequate law, and enforcement system and cultural and social inequities along with the inaccessible and low-quality educational system. An attempt will be made in this paper to explore and analyze child labor scenario in Bangladesh and will explain holistic intervention of BRAC, the largest nongovernmental organization in the world to address child labor through promoting incubation support to youth-led enterprises. A combination of research methods were used to write this paper. These include non-reactive observation in the form of literature review, desk studies as well as reactive observation like site visits and, semi-structured interviews. Hazardous Child labor is a multi-dimensional and complex issue. This paper was guided by the answer following research questions to better understand the current context of hazardous child labor in Bangladesh, especially in Dhaka city. The author attempted to figure out why child labor should be considered as a development issue? Further, it also encountered why child labor in Bangladesh is not being reduced at an expected pace? And finally what could be a sustainable solution to eradicate this situation. One of the most challenging characteristics of child labor is that it interrupts a child’s education and cognitive development hence limiting the building of human capital and fostering intergenerational reproduction of poverty and social exclusion. Children who are working full-time and do not attend school, cannot develop the necessary skills. This leads them and their future generation to remain in poor socio-economic condition as they do not get a better paying job. The vicious cycle of poverty will be reproduced and will slow down sustainable development. The outcome of the research suggests that most of the parents send their children to work to help them to increase family income. In addition, most of the youth engaged in hazardous work want to get training, mentoring and easy access to finance to start their own business. The intervention of BRAC that includes classroom and on the job training, tailored mentoring, health support, access to microfinance and insurance help them to establish startup. This intervention is working in developing business and management capacity through public-private partnerships and technical consulting. Supporting entrepreneurs, improving working conditions with micro, small and medium enterprises and strengthening value chains focusing on youth and children engaged with hazardous child labor.

Keywords: child labour, enterprise development, microfinance, youth entrepreneurship

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4332 The Effectiveness of Using Dramatic Conventions as the Teaching Strategy on Self-Efficacy for Children With Autism Spectrum Disorder

Authors: Tso Sheng-Yang, Wang Tien-Ni

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Introduction and Purpose: Previous researchers have documented children with ASD (Autism Spectrum Disorders) prefer to escaping internal privates and external privates when they face tough conditions they can’t control or they don’t like.Especially, when children with ASD need to learn challenging tasks, such us Chinese language, their inappropriate behaviors will occur apparently. Recently, researchers apply positive behavior support strategies for children with ASD to enhance their self-efficacy and therefore to reduce their adverse behaviors. Thus, the purpose of this research was to design a series of lecture based on art therapy and to evaluate its effectiveness on the child’s self-efficacy. Method: This research was the single-case design study that recruited a high school boy with ASD. Whole research can be separated into three conditions. First, baseline condition, before the class started and ended, the researcher collected participant’s competencies of self-efficacy every session. In intervention condition, the research used dramatic conventions to teach the child in Chinese language twice a week.When the data was stable across three documents, the period entered to the maintenance condition. In maintenance condition, the researcher only collected the score of self-efficacynot to do other interventions five times a month to represent the effectiveness of maintenance.The time and frequency of data collection among three conditions are identical. Concerning art therapy, the common approach, e.g., music, drama, or painting is to use art medium as independent variable. Due to visual cues of art medium, the ASD can be easily to gain joint attention with teachers. Besides, the ASD have difficulties in understanding abstract objectives Thus, using the drama convention is helpful for the ASD to construct the environment and understand the context of Classical Chinese. By real operation, it can improve the ASD to understand the context and construct prior knowledge. Result: Bassd on the 10-points Likert scale and research, we product following results. (a) In baseline condition, the average score of self-efficacyis 1.12 points, rangedfrom 1 to 2 points, and the level change is 0 point. (b)In intervention condition, the average score of self-efficacy is 7.66 points rangedfrom 7 to 9 points, and the level change is 1 point. (c)In maintenance condition, the average score of self-efficacy is 6.66 points rangedfrom 6 to 7 points, and the level change is 1 point. Concerning immediacy of change, between baseline and intervention conditions, the difference is 5 points. No overlaps were found between these two conditions. Conclusion: According to the result, we find that it is effective that using dramatic conventions a s teaching strategies to teach children with ASD. The result presents the score of self-efficacyimmediately enhances when the dramatic conventions commences. Thus, we suggest the teacher can use this approach and adjust, based on the student’s trait, to teach the ASD on difficult task.

Keywords: dramatic conventions, autism spectrum disorder, slef-efficacy, teaching strategy

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4331 The Role of Non-Governmental Organizations in Combating Human Trafficking in South India: An Overview

Authors: Kumudini Achchi

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India, being known for its rich cultural values has given a special place to women who are also been victims of humiliation, torture, and exploitation. The major share of Human Trafficking goes to sex trafficking which is recognised as world’s second most huge social evil. The original form of sex trafficking in India is prostitution with and without religious sanction. Today the situation of such women reached as an issue of human rights where they rights are denied severely. This situation demanded intervention to protect them from the exploitative situation. NGO are the proactive initiatives which offer support to the exploited women in sex trade. To understand the intervention programs of NGOs in South India, a study was conducted covering four states and a union territory considering 32 NGOs based on their preparedness to participate in the research study. Descriptive and diagnostic research design was adopted along with interview schedule as a tool for collecting data. The study reveals that these NGOs believes in the possibility of mainstreaming commercially sexually exploited women and found adopted seven different programs in the process such as rescue, rehabilitation, reintegration, prevention, developmental, advocacy and research. Each area involves different programs to reach and prepare the exploited women towards mainstreamed society which has been discussed in the paper. Implementation of these programs is not an easy task for the organizations rather they are facing hardships in the areas such as social, legal, financial, political which are hindering the successful operations. Rescue, advocacy, and research are the least adopted areas by the NGOs because of lack of support as well as knowledge in the area. Rehabilitation stands as the most adopted area in implementation. The paper further deals with the challenges in the implementation of the programs as well as the remedial measures in social work point of view having Indian cultural background.

Keywords: NGOs, commercially sexually exploited women, programmes, South India

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4330 Exploring Gender-Based Violence in Indigenous Communities in Argentina and Costa Rica: A Review of the Current Literature

Authors: Jocelyn Jones

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The objective of this literature review is to provide an assessment of the current literature concerning gender-based violence (GBV) within indigenous communities in Argentina and Costa Rica, and various public intervention strategies that have been implemented to counter the increasing rates of violence within these populations. The review will address some of the unique challenges and contextual factors influencing the prevalence and response to such violence, including the enduring impact of colonialism on familial structures, community dynamics, and the perpetuation of violence. Drawing on indigenous feminist perspectives, the paper critically assesses the intersectionality of gender, ethnicity, and socio-economic status in shaping the experiences of indigenous women, men, and gender-diverse individuals. In comparing the two nations, the literature review identifies commonalities and divergences in policy frameworks, legal responses, and grassroots initiatives aimed at addressing GBV. Regarding the assessment of the efficacy of existing interventions, the paper will consider the role of cultural revitalization, community engagement, and collaborative efforts between indigenous communities and external agencies in the development of future policies. Moreover, the review will highlight the importance of decolonizing methodologies in research and intervention strategies, and the need to emphasise culturally sensitive approaches that respect and integrate indigenous worldviews and traditional knowledge systems. Additionally, the paper will explore the potential impact of colonial legacies, resource extraction, and land dispossession on exacerbating vulnerabilities to GBV within indigenous communities. The aim of this paper is to contribute to a more in-depth understanding of GBV in indigenous contexts in order to promote cross-cultural learning and inform future research. Ultimately, this review will demonstrate the necessity of adopting a holistic and context-specific approach to address gender-based violence in indigenous communities.

Keywords: gender based violence, indigenous, colonialism, literature review

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4329 The Effectiveness of Zinc Supplementation in Taste Disorder Treatment: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Authors: Boshra Mozaffar, Arash Ardavani, Iskandar Idris

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Food taste and flavor affect food choice and acceptance, which are essential to maintain good health and quality of life. Reduced circulating zinc levels have been shown to adversely affect taste which can result in reduced appetite, weight loss and psychological problems, but the efficacy of Zinc supplementation to treat disorders of taste remains unclear. In this systematic review and meta-analysis, we aimed to examine the efficacy of zinc supplementation in the treatment of taste disorders. We searched four electronic bibliographical databases; Ovid MEDLINE, Ovid Embase, Ovid AMAD and PubMed. Article bibliographies were also searched, which yielded additional relevant studies. To facilitate the collection and identification of all available and relevant articles published before 7 December 2020, there were no restrictions on the publication date. We performed a systematic review and meta-analysis according to the PRISMA Statement. This review was registered at PROSPERO and given the identification number CRD42021228461. In total, we included 12 randomized controlled trials with 938 subjects. Intervention includes zinc (sulfate, gluconate, picolinate, polaprezinc and acetate); the pooled results of the meta-analysis indicate that improvements in taste disorder occurred more frequently in the intervention group compared to the control group (RR = 1.8; 95% CI:1.27 -2.57, p=0.009). The doses are equivalent to 17 mg- 86.7 mg of elemental zin for three to six months. Zinc supplementation is an effective treatment for taste disorders in patients with zinc deficiency or idiopathic taste disorders when given in high doses ranging from 68–86.7 mg/d for up to three months. However, we did not find sufficient evidence to determine the effectiveness of zinc supplementation in patients with taste disorders induced by chronic renal failure.

Keywords: taste change, taste disorder, zinc, zinc sulfate or Zn, deficiency, supplementation.

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4328 Astronomy in the Education Area: A Narrative Review

Authors: Isabella Lima Leite de Freitas

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The importance of astronomy for humanity is unquestionable. Despite being a robust science, capable of bringing new discoveries every day and quickly increasing the ability of researchers to understand the universe more deeply, scientific research in this area can also help in various applications outside the domain of astronomy. The objective of this study was to review and conduct a descriptive analysis of published studies that presented the importance of astronomy in the area of education. A narrative review of the literature has been performed, considering the articles published in the last five years. As astronomy involves the study of physics, chemistry, biology, mathematics and technology, one of the studies evaluated presented astronomy as the gateway to science, demonstrating the presence of astronomy in 52 school curricula in 37 countries, with celestial movement the dominant content area. Another intervention study, evaluating individuals aged 4-5 years, demonstrated that the attribution of personal characteristics to cosmic bodies, in addition to the use of comprehensive astronomy concepts, favored the learning of science in preschool-age children, considering the use of practical activities of accompaniment and free drawing. Aiming to measure scientific literacy, another study developed in Turkey, motivated the authorities of this country to change the teaching materials and curriculum of secondary schools after the term “astronomy” appeared as one of the most attractive subjects for young people aged 15 to 24. There are also reports in the literature of the use of pedagogical tools, such as the representation of the Solar System on a human scale, where students can walk along the orbits of the planets while studying the laws of dynamics. The use of this tool favored the teaching of the relationship between distance, duration and speed over the period of the planets, in addition to improving the motivation and well-being of students aged 14-16. An important impact of astronomy on education was demonstrated in the study that evaluated the participation of high school students in the Astronomical Olympiads and the International Astronomy Olympiad. The study concluded that these Olympics have considerable influence on students who pursue a career in teaching or research later on, many of whom are in the area of astronomy itself. In addition, the literature indicates that the teaching of astronomy in the digital age has facilitated the availability of data for researchers, but also for the general population. This fact can increase even more the curiosity that the astronomy area has always instilled in people and promote the dissemination of knowledge on an expanded scale. Currently, astronomy has been considered an important ally in strengthening the school curricula of children, adolescents and young adults. This has been used as teaching tools, in addition to being extremely useful for scientific literacy, being increasingly used in the area of education.

Keywords: astronomy, education area, teaching, review

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4327 Nutrition Intervention for Spinal Cord Injury in Critical Care

Authors: Dina Muharib

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Specific metabolic challenges are present following spinal cord injury. The acute stage is characterized by a reduction in metabolic activity, as well as a negative nitrogen balance that cannot be corrected, even with aggressive nutritional support. Metabolic demands need to be accurately monitored to avoid overfeeding. Enteral feeding is the optimal route following SCI. When oral feeding is not possible, nasogastric, followed by nasojejunal, then by percutaneous endoscopic gastrostomy, if necessary, is suggested.

Keywords: SCI, energy, protein, nutrition assessment, eneral feeding, nitrogen balance

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4326 Exploring the Role of Media Activity Theory as a Conceptual Basis for Advancing Journalism Education: A Comprehensive Analysis of Its Impact on News Production and Consumption in the Digital Age

Authors: Shohnaza Uzokova Beknazarovna

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This research study provides a comprehensive exploration of the Theory of Media Activity and its relevance as a conceptual framework for journalism education. The author offers a thorough review of existing literature on media activity theory, emphasizing its potential to enhance the understanding of the evolving media landscape and its implications for journalism practice. Through a combination of theoretical analysis and practical examples, the paper elucidates the ways in which the Theory of Media Activity can inform and enrich journalism education, particularly in relation to the interactive and participatory nature of contemporary media. The author presents a compelling argument for the integration of media activity theory into journalism curricula, emphasizing its capacity to equip students with a nuanced understanding of the reciprocal relationship between media producers and consumers. Furthermore, the paper discusses the implications of technological advancements on media production and consumption, highlighting the need for journalism educators to prepare students to navigate and contribute to the future of journalism in a rapidly changing media environment. Overall, this research paper offers valuable insights into the potential benefits of embracing the Theory of Media Activity as a foundational framework for journalism education. Its thorough analysis and practical implications make it a valuable resource for educators, researchers, and practitioners seeking to enhance journalism pedagogy in response to the dynamic nature of contemporary media.

Keywords: theory of media activity, journalism education, media landscape, media production, media consumption, interactive media, participatory media, technological advancements, media producers, media consumers, journalism practice, contemporary media environment, journalism pedagogy, media theory, media studies

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4325 Pros and Cons of Nanoparticles on Health

Authors: Amber Shahi, Ayesha Tazeen, Abdus Samad, Shama Parveen

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Nanoparticles (NPs) are tiny particles. According to the International Organization for Standardization, the size range of NPs is in the nanometer range (1-100 nm). They show distinct properties that are not shown by larger particles of the same material. NPs are currently being used in different fields due to their unique physicochemical nature. NPs are a boon for medical sciences, environmental sciences, electronics, and textile industries. However, there is growing concern about their potential adverse effects on human health. This poster presents a comprehensive review of the current literature on the pros and cons of NPs on human health. The poster will discuss the various types of interactions of NPs with biological systems. There are a number of beneficial uses of NPs in the field of health and environmental welfare. NPs are very useful in disease diagnosis, antimicrobial action, and the treatment of diseases like Alzheimer’s. They can also cross the blood-brain barrier, making them capable of treating brain diseases. Additionally, NPs can target specific tumors and be used for cancer treatment. To treat environmental health, NPs also act as catalytic converters to reduce pollution from the environment. On the other hand, NPs also have some negative impacts on the human body, such as being cytotoxic and genotoxic. They can also affect the reproductive system, such as the testis and ovary, and sexual behavior. The poster will further discuss the routes of exposure of NPs. The poster will conclude with a discussion of the current regulations and guidelines on the use of NPs in various applications. It will highlight the need for further research and the development of standardized toxicity testing methods to ensure the safe use of NPs in various applications. When using NPs in diagnosis and treatment, we should also take into consideration their safe concentration in the body. Overall, this poster aims to provide a comprehensive overview of the pros and cons of NPs on human health and to promote awareness and understanding of the potential risks and benefits associated with their use.

Keywords: disease diagnosis, human health, nanoparticles, toxicity testing

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4324 Bariatric Surgery Referral as an Alternative to Fundoplication in Obese Patients Presenting with GORD: A Retrospective Hospital-Based Cohort Study

Authors: T. Arkle, D. Pournaras, S. Lam, B. Kumar

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Introduction: Fundoplication is widely recognised as the best surgical option for gastro-oesophageal reflux disease (GORD) in the general population. However, there is controversy surrounding the use of conventional fundoplication in obese patients. Whilst the intra-operative failure of fundoplication, including wrap disruption, is reportedly higher in obese individuals, the more significant issue surrounds symptom recurrence post-surgery. Could a bariatric procedure be considered in obese patients for weight management, to treat the GORD, and to also reduce the risk of recurrence? Roux-en-Y gastric bypass, a widely performed bariatric procedure, has been shown to be highly successful both in controlling GORD symptoms and in weight management in obese patients. Furthermore, NICE has published clear guidelines on eligibility for bariatric surgery, with the main criteria being type 3 obesity or type 2 obesity with the presence of significant co-morbidities that would improve with weight loss. This study aims to identify the proportion of patients who undergo conventional fundoplication for GORD and/or hiatus hernia, which would have been eligible for bariatric surgery referral according to NICE guidelines. Methods: All patients who underwent fundoplication procedures for GORD and/or hiatus hernia repair at a single NHS foundation trust over a 10-year period will be identified using the Trust’s health records database. Pre-operative patient records will be used to find BMI and the presence of significant co-morbidities at the time of consideration for surgery. This information will be compared to NICE guidelines to determine potential eligibility for the bariatric surgical referral at the time of initial surgical intervention. Results: A total of 321 patients underwent fundoplication procedures between January 2011 and December 2020; 133 (41.4%) had available data for BMI or to allow BMI to be estimated. Of those 133, 40 patients (30%) had a BMI greater than 30kg/m², and 7 (5.3%) had BMI >35kg/m². One patient (0.75%) had a BMI >40 and would therefore be automatically eligible according to NICE guidelines. 4 further patients had significant co-morbidities, such as hypertension and osteoarthritis, which likely be improved by weight management surgery and therefore also indicated eligibility for referral. Overall, 3.75% (5/133) of patients undergoing conventional fundoplication procedures would have been eligible for bariatric surgical referral, these patients were all female, and the average age was 60.4 years. Conclusions: Based on this Trust’s experience, around 4% of obese patients undergoing fundoplication would have been eligible for bariatric surgical intervention. Based on current evidence, in class 2/3 obese patients, there is likely to have been a notable proportion with recurrent disease, potentially requiring further intervention. These patient’s may have benefitted more through undergoing bariatric surgery, for example a Roux-en-Y gastric bypass, addressing both their obesity and GORD. Use of patient written notes to obtain BMI data for the 188 patients with missing BMI data and further analysis to determine outcomes following fundoplication in all patients, assessing for incidence of recurrent disease, will be undertaken to strengthen conclusions.

Keywords: bariatric surgery, GORD, Nissen fundoplication, nice guidelines

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4323 Improving Pneumatic Artificial Muscle Performance Using Surrogate Model: Roles of Operating Pressure and Tube Diameter

Authors: Van-Thanh Ho, Jaiyoung Ryu

Abstract:

In soft robotics, the optimization of fluid dynamics through pneumatic methods plays a pivotal role in enhancing operational efficiency and reducing energy loss. This is particularly crucial when replacing conventional techniques such as cable-driven electromechanical systems. The pneumatic model employed in this study represents a sophisticated framework designed to efficiently channel pressure from a high-pressure reservoir to various muscle locations on the robot's body. This intricate network involves a branching system of tubes. The study introduces a comprehensive pneumatic model, encompassing the components of a reservoir, tubes, and Pneumatically Actuated Muscles (PAM). The development of this model is rooted in the principles of shock tube theory. Notably, the study leverages experimental data to enhance the understanding of the interplay between the PAM structure and the surrounding fluid. This improved interactive approach involves the use of morphing motion, guided by a contraction function. The study's findings demonstrate a high degree of accuracy in predicting pressure distribution within the PAM. The model's predictive capabilities ensure that the error in comparison to experimental data remains below a threshold of 10%. Additionally, the research employs a machine learning model, specifically a surrogate model based on the Kriging method, to assess and quantify uncertainty factors related to the initial reservoir pressure and tube diameter. This comprehensive approach enhances our understanding of pneumatic soft robotics and its potential for improved operational efficiency.

Keywords: pneumatic artificial muscles, pressure drop, morhing motion, branched network, surrogate model

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4322 Process of Analysis, Evaluation and Verification of the 'Real' Redevelopment of the Public Open Space at the Neighborhood’s Stairs: Case Study of Serres, Greece

Authors: Ioanna Skoufali

Abstract:

The present study is directed towards adaptation to climate change closely related to the phenomenon of the urban heat island (UHI). This issue is widespread and common to different urban realities, but particularly in Mediterranean cities that are characterized by dense urban. The attention of this work of redevelopment of the open space is focused on mitigation techniques aiming to solve local problems such as microclimatic parameters and the conditions of thermal comfort in summer, related to urban morphology. This quantitative analysis, evaluation, and verification survey involves the methodological elaboration applied in a real study case by Serres, through the experimental support of the ENVImet Pro V4.1 and BioMet software developed: i) in two phases concerning the anteoperam (phase a1 # 2013) and the post-operam (phase a2 # 2016); ii) in scenario A (+ 25% of green # 2017). The first study tends to identify the main intervention strategies, namely: the application of cool pavements, the increase of green surfaces, the creation of water surface and external fans; moreover, it obtains the minimum results achieved by the National Program 'Bioclimatic improvement project for public open space', EPPERAA (ESPA 2007-2013) related to the four environmental parameters illustrated below: the TAir = 1.5 o C, the TSurface = 6.5 o C, CDH = 30% and PET = 20%. In addition, the second study proposes a greater potential for improvement than postoperam intervention by increasing the vegetation within the district towards the SW/SE. The final objective of this in-depth design is to be transferable in homogeneous cases of urban regeneration processes with obvious effects on the efficiency of microclimatic mitigation and thermal comfort.

Keywords: cool pavements, microclimate parameters (TAir, Tsurface, Tmrt, CDH), mitigation strategies, outdoor thermal comfort (PET & UTCI)

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4321 Aggression Related Trauma and Coping among University Students, Exploring Emotional Intelligence Applications on Coping with Aggression Related Trauma

Authors: Asanka Bulathwatta

Abstract:

This Study tries to figure out the role of emotional Intelligence for developing coping strategies among adolescents who face traumatic events. Late adolescence students who have enrolled into the University education (Bachelor students/first-year students) would be selected as the sample. University education is an important stage of students’ academic life. Therefore, all students need to develop their competencies to attain the goal of passing examinations and also to developing their wisdom related to the scientific knowledge they gathered through their academic life. Study to be conducted in a cross-cultural manner and it will be taking place in Germany and Sri Lanka. The sample will be consisting of 200 students from each country. Late adolescence is a critical period of the human being as it is foot step in their life which acquiring the emotional and social qualities in their social life. There are many adolescents who have affected by aggression related traumatic events during their lifespan but have not been identified or treated. More specifically, there are numerous burning issues within the first year of the university students namely, ragging done by seniors to juniors, bulling, invalidation and issues raise based on attitudes changes and orientation issues. Those factors can be traumatic for both their academic and day to day lifestyle. Identifying the students who are with emotional damages and their resiliency afterward the aggression related traumas and effective rehabilitation from the traumatic events is immensely needed in order to facilitate university students for their academic achievements and social life within the University education. Research findings in Germany show that students shows more interpersonal traumas, life-threatening illnesses and death of someone related are common in German sample.

Keywords: emotional intelligence, agression, trauma, coping

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4320 A Qualitative Study into the Success and Challenges in Embedding Evidence-Based Research Methods in Operational Policing Interventions

Authors: Ahmed Kadry, Gwyn Dodd

Abstract:

There has been a growing call globally for police forces to embed evidence-based policing research methods into police interventions in order to better understand and evaluate their impact. This research study highlights the success and challenges that police forces may encounter when trying to embed evidence-based research methods within their organisation. 10 in-depth qualitative interviews were conducted with police officers and staff at Greater Manchester Police (GMP) who were tasked with integrating evidence-based research methods into their operational interventions. The findings of the study indicate that with adequate resources and individual expertise, evidence-based research methods can be applied to operational work, including the testing of initiatives with strict controls in order to fully evaluate the impact of an intervention. However, the findings also indicate that this may only be possible where an operational intervention is heavily resourced with police officers and staff who have a strong understanding of evidence-based policing research methods, attained for example through their own graduate studies. In addition, the findings reveal that ample planning time was needed to trial operational interventions that would require strict parameters for what would be tested and how it would be evaluated. In contrast, interviewees underscored that operational interventions with the need for a speedy implementation were less likely to have evidence-based research methods applied. The study contributes to the wider literature on evidence-based policing by providing considerations for police forces globally wishing to apply evidence-based research methods to more of their operational work in order to understand their impact. The study also provides considerations for academics who work closely with police forces in assisting them to embed evidence-based policing. This includes how academics can provide their expertise to police decision makers wanting to underpin their work through evidence-based research methods, such as providing guidance on how to evaluate the impact of their work with varying research methods that they may otherwise be unaware of.  

Keywords: evidence based policing, evidence-based practice, operational policing, organisational change

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4319 Long-Term Effects of Psychosocial Interventions for Adolescents on Depression and Anxiety: A Systematic Review and Meta-Analysis

Authors: Denis Duagi, Ben Carter, Maria Farrelly, Stephen Lisk, June S. L. Brown

Abstract:

Background: Adolescence represents a distinctive phase of development, and variables linked to this developmental period could affect the efficiency of prevention and treatment for depression and anxiety, as well as the long-term prognosis. The objectives of this study were to investigate the long-term effectiveness of psychosocial interventions for adolescents on depression and anxiety symptoms and to assess the influence of different intervention parameters on the long-term effects. Methods: Searches were carried out on the 11ᵗʰ of August 2022 using five databases (Cochrane Library, Embase, Medline, PsychInfo, Web of Science), as well as trial registers. Randomized controlled trials of psychosocial interventions targeting specifically adolescents were included if they assessed outcomes at 1-year post-intervention or more. The Cochrane risk of bias-2 quality assessment tool was used. The primary outcome was depression, and studies were pooled using a standardised mean difference, with an associated 95% confidence interval, p-value, and I². The study protocol was pre-registered (CRD42022348668). Findings: A total of 57 reports (n= 46,678 participants) were included in the review. Psychosocial interventions led to small reductions in depressive symptoms, with a standardised mean difference (SMD) at 1-year of -0.08 (95%CI -0.20, -0.03, p=0.002, I²=72%), 18-months SMD=-0.12, 95% CI -0.22, -0.01, p=0.03, I²=63%) and 2-years SMD=-0.12 (95% CI -0.20, -0.03, p=0.01, I²=68%). Sub-group analyses indicated that targeted interventions produced stronger effects, particularly when delivered by trained mental health professionals (K=18, SMD=-0.24, 95% CI -0.38, -0.10, p=0.001, I²=60%). No effects were detected for anxiety at any assessment. Conclusion: Psychosocial interventions specifically targeting adolescents were shown to have small but positive effects on depression symptoms but not anxiety symptoms, which were sustained for up to 2 years. These findings highlight the potential population-level preventive effects if such psychosocial interventions become widely implemented in accessible settings such as schools.

Keywords: psychosocial, adolescent, interventions, depression, anxiety, meta-analysis, randomized controlled trial

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4318 Cross Cultural Adaptation and Content Validation of the Assessment Instrument Preschooler Awareness of Stuttering Survey

Authors: Catarina Belchior, Catarina Martins, Sara Mendes, Ana Rita S. Valente, Elsa Marta Soares

Abstract:

Introduction: The negative feelings and attitudes that a person who stutters can develop are extremely relevant when considering assessment and intervention in Speech and Language Therapy. This relates to the fact that the person who stutters can experience feelings such as shame, fear and negative beliefs when communicating. Considering the complexity and importance of integrating diverse aspects in stuttering intervention, it is central to identify those emotions as early as possible. Therefore, this research aimed to achieve the translation, adaptation to European Portuguese and to analyze the content validation of the Preschooler Awareness Stuttering Survey (Abbiati, Guitar & Hutchins, 2015), an instrument that allows the assessment of the impact of stuttering on preschool children who stutter considering feelings and attitudes. Methodology: Cross-sectional descriptive qualitative research. The following methodological procedures were followed: translation, back-translation, panel of experts and pilot study. This abstract describes the results of the first three phases of this process. The translation was accomplished by two Speech Language Therapists (SLT). Both professionals have more than five years of experience and are users of English language. One of them has a broad experience in the field of stuttering. Back-translation was conducted by two bilingual individuals without experience in health or any knowledge about the instrument. The panel of experts was composed by 3 different SLT, experts in the field of stuttering. Results and Discussion: In the translation and back-translation process it was possible to verify differences in semantic and idiomatic equivalences of several concepts and expressions, as well as the need to include new information to enhance the understanding of the application of the instrument. The meeting between the two translators and the researchers allowed the achievement of a consensus version that was used in back-translation. Considering adaptation and content validation, the main change made by the experts was the conceptual equivalence of the questions and answers of the instrument's sheets. Considering that in the translated consensus version the questions began with various nouns such as 'is' or 'the cow' and that the answers did not contain the adverb 'much' as in the original instrument, the panel agreed that it would be more appropriate if the questions all started with 'how' and that all the answers should present the adverb 'much'. This decision was made to ensure that the translate instrument would be similar to the original and so that the results obtained could be comparable between the original and the translated instrument. There was also elaborated one semantic equivalence between concepts. The panel of experts found that all other items and specificities of the instrument were adequate, concluding the adequacy of the instrument considering its objectives and its intended target population. Conclusion: This research aspires to diversify the existing validated resources in this scope, adding a new instrument that allows the assessment of preschool children who stutter. Consequently, it is hoped that this instrument will provide a real and reliable assessment that can lead to an appropriate therapeutic intervention according to the characteristics and needs of each child.

Keywords: stuttering, assessment, feelings and attitudes, speech language therapy

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4317 Strategic Alliances and Creative Synergy within European Union: A Theoretical Perspective

Authors: Maha Tichetti, Barzi Redouane, Selim Kanat

Abstract:

In the European Union (EU), where economic, political, and cultural ties converge, strategic alliances play a pivotal role in shaping the collaborative landscape. This paper embarks on a journey into the EuroSphere, offering a comprehensive analysis review that unravels the dynamics of these alliances within the European context. The focus is specifically directed towards understanding their profound impact on creative synergy and innovation among teams. In our analysis, we provide theoretical explanations for key terms such as "creative synergy" and "strategic alliances." We outline various types of competitive strategies, delve into the motivations prompting the formation of strategic alliances, and critically examine the success and failure factors in these kinds of collaboration. Additionally, we explore the goals achievable through strategic alliances, especially in the context of external growth. A central focus of this paper focus on how strategic alliances can significantly impact creative synergy within the European landscape. Through a theoretical lens, we explore the interplay between collaborative strategies and the enhancement of creative thinking within teams engaged in strategic alliances. The article goes beyond theoretical frameworks to present a tangible example of a strategic alliance emerging in the European market. This case study illuminates how such alliances have empowered European companies to enhance their competitive positions on the global stage while concurrently fostering creative synergy among their teams. This comprehensive review not only contributes to the theoretical understanding of strategic alliances and creative synergy but also offers practical insights for businesses navigating the collaborative landscape within the EuroSphere. As we unravel the complexities of these alliances, we uncover valuable lessons and opportunities for future research, providing a roadmap for those seeking to harness the full potential of strategic collaborations in the dynamic European context.

Keywords: European Union, strategic alliances, creative synergy, competitiveness

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4316 Working with Interpreters: Using Role Play to Teach Social Work Students

Authors: Yuet Wah Echo Yeung

Abstract:

Working with people from minority ethnic groups, refugees and asylum seeking communities who have limited proficiency in the language of the host country often presents a major challenge for social workers. Because of language differences, social workers need to work with interpreters to ensure accurate information is collected for their assessment and intervention. Drawing from social learning theory, this paper discusses how role play was used as an experiential learning exercise in a training session to help social work students develop skills when working with interpreters. Social learning theory posits that learning is a cognitive process that takes place in a social context when people observe, imitate and model others’ behaviours. The roleplay also helped students understand the role of the interpreter and the challenges they may face when they rely on interpreters to communicate with service users and their family. The first part of the session involved role play. A tutor played the role of social worker and deliberately behaved in an unprofessional manner and used inappropriate body language when working alongside the interpreter during a home visit. The purpose of the roleplay is not to provide a positive role model for students to ‘imitate’ social worker’s behaviours. Rather it aims to active and provoke internal thinking process and encourages students to critically consider the impacts of poor practice on relationship building and the intervention process. Having critically reflected on the implications for poor practice, students were then asked to play the role of social worker and demonstrate what good practice should look like. At the end of the session, students remarked that they learnt a lot by observing the good and bad example; it showed them what not to do. The exercise served to remind students how practitioners can easily slip into bad habits and of the importance of respect for the cultural difference when working with people from different cultural backgrounds.

Keywords: role play, social learning theory, social work practice, working with interpreters

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4315 Theoretical Evaluation of Minimum Superheat, Energy and Exergy in a High-Temperature Heat Pump System Operating with Low GWP Refrigerants

Authors: Adam Y. Sulaiman, Donal F. Cotter, Ming J. Huang, Neil J. Hewitt

Abstract:

Suitable low global warming potential (GWP) refrigerants that conform to F-gas regulations are required to extend the operational envelope of high-temperature heat pumps (HTHPs) used for industrial waste heat recovery processes. The thermophysical properties and characteristics of these working fluids need to be assessed to provide a comprehensive understanding of operational effectiveness in HTHP applications. This paper presents the results of a theoretical simulation to investigate a range of low-GWP refrigerants and their suitability to supersede refrigerants HFC-245fa and HFC-365mfc. A steady-state thermodynamic model of a single-stage HTHP with an internal heat exchanger (IHX) was developed to assess system cycle characteristics at temperature ranges between 50 to 80 °C heat source and 90 to 150 °C heat sink. A practical approach to maximize the operational efficiency was examined to determine the effects of regulating minimum superheat within the process and subsequent influence on energetic and exergetic efficiencies. A comprehensive map of minimum superheat across the HTHP operating variables were used to assess specific tipping points in performance at 30 and 70 K temperature lifts. Based on initial results, the refrigerants HCFO-1233zd(E) and HFO-1336mzz(Z) were found to be closely aligned matches for refrigerants HFC-245fa and HFC-365mfc. The overall results show effective performance for HCFO-1233zd(E) occurs between 5-7 K minimum superheat, and HFO-1336mzz(Z) between 18-21 K dependant on temperature lift. This work provides a method to optimize refrigerant selection based on operational indicators to maximize overall HTHPs system performance.

Keywords: high-temperature heat pump, minimum superheat, energy & exergy efficiency, low GWP refrigerants

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4314 Sustainable Project Management: Driving the Construction Industry Towards Sustainable Developmental Goals

Authors: Francis Kwesi Bondinuba, Seidu Abdullah, Mewomo Cecilia, Opoku Alex

Abstract:

Purpose: The purpose of this research is to develop a framework for understanding how sustainable project management contributes to the construction industry's pursuit of sustainable development goals. Study design/methodology/approach: The study employed a theoretical methodology to review existing theories and models that support Sustainable Project Management (SPM) in the construction industry. Additionally, a comprehensive review of current literature on SPM is conducted to provide a thorough understanding of this study. Findings: Sustainable Project Management (SPM) practices, including stakeholder engagement and collaboration, resource efficiency, waste management, risk management, and resilience, play a crucial role in achieving the Sustainable Development Goals (SDGs) within the construction industry. Conclusion: Adopting Sustainable Project Management (SPM) practices in the Ghanaian construction industry enhances social inclusivity by engaging communities and creating job opportunities. The adoption of these practices faces significant challenges, including a lack of awareness and understanding, insufficient regulatory frameworks, financial constraints, and a shortage of skilled professionals. Recommendation: There should be a comprehensive approach to project planning and execution that includes stakeholders such as local communities, government bodies, and environmental organisations, the use of green building materials and technologies, and the implementation of effective waste management strategies, all of which will ensure the achievement of SDGs in Ghana's construction industry. Originality/value: This paper adds to the current literature by offering the various theories and models in Sustainable Project Management (SPM) and a detailed review of how Sustainable Project Management (SPM) contribute to the achievement of the Sustainable Development Goals (SDGs) in the Ghanaian Construction Industry.

Keywords: sustainable development, sustainable development goals, construction industry, ghana, sustainable project management

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4313 Comparative Study of Analgesic Efficacy of Ultrasound Guided Femoral Nerve Block Versus Intravenous Fentanyl Injection in Fracture Femur Patients at Emergency Department

Authors: Asmaa Hamdy, Israa Nassar, Tarek Aly

Abstract:

Introduction: Femoral fractures are the most common presentation in the Emergency Department (ED), and they can present as isolated injuries or as part of a polytrauma situation. To provide optimum pain management care to these patients, practitioners must be well prepared and current with utilizing modern evidence-based knowledge and practices. Management of pain associated with fracture femur in the emergency department has a critical role in the satisfaction of patients and preventing further complications. This study aimed to evaluate the analgesic efficacy of ultrasound-guided femoral nerve block compared with intravenous fentanyl in fractures of the femur in patients presented to the Emergency Department. Patients and Methods: Fifty patients with femur fractures were divided into two groups: Group A: In this group (twenty-five patients) were given intravenous fentanyl 2 micro-grams/kg and re-assessed for pain by Visual Analogue Score (VAS). Group B: In this group (twenty-five patients) underwent ultrasonography-guided femoral nerve block and were re-assessed for pain by VAS. Results: VAS score on the movement of the fractured limb between group A and group B at a 10-minute post-intervention period shows P= 0.043, and hence the difference is significant. VAS score on the movement of the fractured limb between group A and group B during a 10-minute post-intervention period showed a significant difference. Seventeen patients in group A had major PID with a percentage of 63% VS 10 patients in group B with a percentage of 37%. conclusion: both femoral nerve block and intravenous fentanyl are effective in relieving pain in patients with femur fractures. But femoral nerve block provides better and more intense analgesia and major pain intensity difference in less time. Moreover, the use of FNB had fewer side effects and more Hemodynamics stability compared to opioids.

Keywords: femur fracture, nerve block, fentanyl, ultrasound guided

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4312 Reducing Inequalities for the Uptake of Long-Term Reversible Contraceptive Methods through Special Family Planning Camps: A High Impact Service Delivery Model of Family Planning Practices

Authors: Ghulam Mustafa Halepota, Zaib Dahar

Abstract:

Background: Low acceptance of FP services, particularly in hard to reach areas where geographic, economic, or social barriers limit-service uptake. Moreover, limited resources appeared to be a reflection of dismal contraceptive use in Pakistan. People’s Primary Health Care Initiative (PPHI) is a Public Private Partnership Program of Government of Sindh which aims to improve maternal child health through accessible family planning services in far flung areas. In 2015 PPHI launched special family planning camps to have achieved a rapid improvement in CPR. On quarterly basis, these camps focus on Long Acting Reversible Contraceptives (LARC). These camps are arranged at 250 BHU Plus (24/7 MCHCs). The Organization manages 1140 primary health care facilities all over Sindh province and focuses on maternal, newborn and child health which includes antenatal care, labor/delivery, postnatal care, family planning, immunization, nutrition, BEmONC, CEmONC, diagnostic laboratories, ambulance services. Under the FPRH program, the organization launched special family planning camps in far flung areas to achieve a rapid improvement in CPR-committed to FP 2020 goal. Objective: To assess the performance of special FP camps for the improvement of long acting reversible contraceptive in hard to reach areas. Methodology: Outreach camps are organized on quarterly basis in 250 BHUs and maternal and child health centers (available-24/7). Using observational study design, the study reports 2 years data of special FP camps conducted in 23 various districts of Sindh during April 2015-April 2017. These special camps served a range of modern contraceptive methods including IUCDs, implants, condoms, pills, and injections. Moreover, 125 male medical officers are trained across Sindh in LARC and 554 female have been trained in implants and IUCD insertions. MSI Impact calculator was used to determine health and demographic impact of services. Results: This intervention has brought exceptional results, and the response has been overwhelming in time. Total 2048 special camps during 2015 till April 2017 have been carried out. 231796 MWRAs visited camps 91% opted modern FP, of which 45% opted Implants, 6% selected IUCDs from LARC (long term reversible contraceptive) from short term, 17% opted injectable 18% choose pills, and 12% used condoms. This intervention created a high contraceptive impact in rural Sindh an estimated 125048 FP users have been created, of this 111846 LARC users and 13498 are SARC users, through this intervention an estimated 55774 unintended pregnancies, 36299 live births, 9394, 80 maternal deaths, 926 and 6077 unsafe abortion have been averted. Moreover, the intervention created an economic impact and saved 2,409,563 direct health expenditure on each woman with reproductive age. Conclusion: Special FP Camps along with routine services is an effective and acceptable model for increase in provision of long-acting and permanent methods in hard to reach areas. This innovative approach by PHHI-Sindh has also been adopted in other provinces of Pakistan.

Keywords: inequalities, special camps, family planning services, hard to reach areas

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4311 Monitoring and Evaluation in Community-Based Tourism: An Analysis and Model

Authors: Ivan Gunass Govender, Andrea Giampiccoli

Abstract:

A developmental state should use community engagement to facilitate socio-economic development for disadvantaged groups and individual members of society through empowerment, social justice, sustainability, and self-reliance. In this regard, community-based tourism (CBT) as a growing market should be an indigenous effort aided by external facilitation. Since this form of tourism presents its own preconditions, characteristics, and challenges, it could be guided by higher education institutions engagement. In particular, the facilitation should not only serve to assist the community members to reach their own goals; but rather also focus on learning through knowledge creation and sharing with the engagement of higher education institutions. While the increased relevance of CBT has produced various CBT manuals (or handbooks/guidelines) documents aimed to ‘teach’ and assist various entities in CBT development, this research aims to analyse the current monitoring & evaluation (M&E) manuals and thereafter, propose an M&E model for CBT. It is important to mention that all too often effective monitoring is seldom carried out thus risking the long-term sustainability and improvement of the CBT ventures. Therefore, the proposed model will also consider some inputs external to the tourism field, but in relation to local economic development (LED) matters from the previously proposed development monitoring and evaluation system framework. M&E should be seen as fundamental components of any CBT initiative, and the whole CBT intervention should be evaluated. In this context, M&E in CBT should go beyond strict ‘numerical’ economic matters and should be understood in a holistic development. In addition, M&E in CBT should not consider issues in various ‘compartments’ such as tourists, tourism attractions, CBT owners/participants, and stakeholder engagement but as interdependent components of a macro-ecosystem. Finally, the external facilitation process should be structured in a way to promote community self-reliance in both the intervention and the M&E process. The research will attempt to propose an M&E model for CBT so as to enhance the CBT possibilities of long-term growth and success through effective collaborations with key stakeholders.

Keywords: community-based tourism, community-engagement, monitoring and evaluation, stakeholders

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4310 Research on the Updating Strategy of Public Space in Small Towns in Zhejiang Province under the Background of New-Style Urbanization

Authors: Chen Yao, Wang Ke

Abstract:

Small towns are the most basic administrative institutions in our country, which are connected with cities and rural areas. Small towns play an important role in promoting local urban and rural economic development, providing the main public services and maintaining social stability in social governance. With the vigorous development of small towns and the transformation of industrial structure, the changes of social structure, spatial structure, and lifestyle are lagging behind, causing that the spatial form and landscape style do not belong to both cities and rural areas, and seriously affecting the quality of people’s life space and environment. The rural economy in Zhejiang Province has started, the society and the population are also developing in relative stability. In September 2016, Zhejiang Province set out the 'Technical Guidelines for Comprehensive Environmental Remediation of Small Towns in Zhejiang Province,' so as to comprehensively implement the small town comprehensive environmental remediation with the main content of strengthening the plan and design leading, regulating environmental sanitation, urban order and town appearance. In November 2016, Huzhou City started the comprehensive environmental improvement of small towns, strived to use three years to significantly improve the 115 small towns, as well as to create a number of high quality, distinctive and beautiful towns with features of 'clean and livable, rational layout, industrial development, poetry and painting style'. This paper takes Meixi Town, Zhangwu Town and Sanchuan Village in Huzhou City as the empirical cases, analyzes the small town public space by applying the relative theory of actor-network and space syntax. This paper also analyzes the spatial composition in actor and social structure elements, as well as explores the relationship of actor’s spatial practice and public open space by combining with actor-network theory. This paper introduces the relevant theories and methods of spatial syntax, carries out research analysis and design planning analysis of small town spaces from the perspective of quantitative analysis. And then, this paper proposes the effective updating strategy for the existing problems in public space. Through the planning and design in the building level, the dissonant factors produced by various spatial combination of factors and between landscape design and urban texture during small town development will be solved, inhabitant quality of life will be promoted, and town development vitality will be increased.

Keywords: small towns, urbanization, public space, updating

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