Search results for: culturally targeted intervention
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3956

Search results for: culturally targeted intervention

2786 Use of Ing-Formed and Derived Verbal Nominalization in American English: A Survey Applied to Native American English Speakers

Authors: Yujia Sun

Abstract:

Research on nominalizations in English can be traced back to at least the 1960s and even centered in the field nowadays. At the very beginning, the discussion was about the relationship between verbs and nouns, but then it moved to the distinct senses embodied in different forms of nominals, namely, various types of nominalizations. This paper tries to address the issue that how speakers perceive different forms of verbal nouns, and what might influence their perceptions. The data are collected through a self-designed questionnaire targeted at native speakers of American English, and the employment of the Corpus of Contemporary American English (COCA). The results show that semantic differences between different forms of nominals do play a role in people’s preference to certain form than another. But it still awaits more explorations to see how the frequency of usage is interrelates to this issue.

Keywords: corpus of contemporary American English, derived nominalization, frequency of usage, ing-formed nominalization

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2785 Dream Work: Examining the Effectiveness of Dream Interpretation in Gaining Psychological Insight into Young Adults in Korea

Authors: Ahn Christine Myunghee, Sim Wonjin, Cho Kristina, Ahn Mira, Hong Yeju, Kwok Jihae, Lim Sooyeon, Park Hansol

Abstract:

With a sharp increase in the prevalence rate for mental health issues in Korea, there is a need for specific and effective intervention strategies in counseling and psychotherapy for use with Korean clients. With the cultural emphasis on restraining emotional expression and not disclosing personal and familial problems to outsiders, clients often find it difficult to discuss their emotional issues even to therapists. Exploring a client’s internal psychological processes bypassing this culture-specific mode of therapeutic communication often becomes a challenge in the therapeutic setting. Given this socio-cultural context, the purpose of the current study was to investigate the effectiveness of using dream work to individuals in Korea. The current study conducted one 60-90 minute dream session and analyzed the dream content of 39 Korean young adults to evaluate the effectiveness of the Hill dream model in accessing the intra-psychic materials, determining essential emotional themes, and learning how the individuals interpreted the contents of their dreams. The transcribed data, which included a total of 39 sessions from 39 volunteer university students, were analyzed by the Consensus Qualitative Research (CQR) approach in terms of domains and core ideas. Self-report measures on Dream Salience, Gains from Dream Interpretations and the Session Evaluation Scale were administered before and after each of their dream sessions. The results indicated that dream work appears to be an effective way to understand unconscious motivations, thoughts, and feelings related to a person’s sense of self, and also how these people relate to other people. Current findings need to be replicated with clients referred for counseling and psychotherapy to determine if the dream work is an appropriate and useful intervention in counseling settings. Limitations of the current study and suggestions for future follow-ups are included in the discussion.

Keywords: dream work, dream interpretation, Korean, young adults, CQR

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2784 Improved Food Security and Alleviation of Cyanide Intoxication through Commercialization and Utilization of Cassava Starch by Tanzania Industries

Authors: Mariam Mtunguja, Henry Laswai, Yasinta Muzanilla, Joseph Ndunguru

Abstract:

Starchy tuberous roots of cassava provide food for people but also find application in various industries. Recently there has been the focus of concentrated research efforts to fully exploit its potential as a sustainable multipurpose crop. High starch yield is the important trait for commercial cassava production for the starch industries. Furthermore, cyanide present in cassava root poses a health challenge in the use of cassava for food. Farming communities where cassava is a staple food, prefer bitter (high cyanogenic) varieties as protection from predators and thieves. As a result, food insecure farmers prefer growing bitter cassava. This has led to cyanide intoxication to this farming communities. Cassava farmers can benefit from marketing cassava to starch producers thereby improving their income and food security. This will decrease dependency on cassava as staple food as a result of increased income and be able to afford other food sources. To achieve this, adequate information is required on the right cassava cultivars and appropriate harvesting period so as to maximize cassava production and profitability. This study aimed at identifying suitable cassava cultivars and optimum time of harvest to maximize starch production. Six commonly grown cultivars were identified and planted in a complete random block design and further analysis was done to assess variation in physicochemical characteristics, starch yield and cyanogenic potentials across three environments. The analysis showed that there is a difference in physicochemical characteristics between landraces (p ≤ 0.05), and can be targeted to different industrial applications. Among landraces, dry matter (30-39%), amylose (11-19%), starch (74-80%) and reducing sugars content (1-3%) varied when expressed on a dry weight basis (p ≤ 0.05); however, only one of the six genotypes differed in crystallinity and mean starch granule particle size, while glucan chain distribution and granule morphology were the same. In contrast, the starch functionality features measured: swelling power, solubility, syneresis, and digestibility differed (p ≤ 0.05). This was supported by Partial least square discriminant analysis (PLS-DA), which highlighted the divergence among the cassavas based on starch functionality, permitting suggestions for the targeted uses of these starches in diverse industries. The study also illustrated genotypic difference in starch yield and cyanogenic potential. Among landraces, Kiroba showed potential for maximum starch yield (12.8 t ha-1) followed by Msenene (12.3 t ha-1) and third was Kilusungu (10.2 t ha-1). The cyanide content of cassava landraces was between 15 and 800 ppm across all trial sites. GGE biplot analysis further confirmed that Kiroba was a superior cultivar in terms of starch yield. Kilusungu had the highest cyanide content and average starch yield, therefore it can also be suitable for use in starch production.

Keywords: cyanogen, cassava starch, food security, starch yield

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2783 Emotion Regulation Mediates the Relationship between Affective Disposition and Depression

Authors: Valentina Colonnello, Paolo Maria Russo

Abstract:

Studies indicate a link between individual differences in affective disposition and depression, as well as between emotion dysregulation and depression. However, the specific role of emotion dysregulation domains in mediating the relationship between affective disposition and depression remains largely unexplored. In three cross-sectional quantitative studies (total n = 1350), we explored the extent to which specific emotion regulation difficulties mediate the relationship between personal distress disposition (Study 1), separation distress as a primary emotional trait (Study 2), and an insecure, anxious attachment style (Study 3) and depression. Across all studies, we found that the relationship between affective disposition and depression was mediated by difficulties in accessing adaptive emotion regulation strategies. These findings underscore the potential for modifiable abilities that could be targeted through preventive interventions.

Keywords: emotions, mental health, individual traits, personality

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2782 Clinical Applications of Amide Proton Transfer Magnetic Resonance Imaging: Detection of Brain Tumor Proliferative Activity

Authors: Fumihiro Imai, Shinichi Watanabe, Shingo Maeda, Haruna Imai, Hiroki Niimi

Abstract:

It is important to know the growth rate of brain tumors before surgery because it influences treatment planning, including not only surgical resection strategy but also adjuvant therapy after surgery. Amide proton transfer (APT) imaging is an emerging molecular magnetic resonance imaging (MRI) technique based on chemical exchange saturation transfer without the administration of a contrast medium. The underlying assumption in APT imaging of tumors is that there is a close relationship between the proliferative activity of the tumor and mobile protein synthesis. We aimed to evaluate the diagnostic performance of APT imaging of pre-and post-treatment brain tumors. Ten patients with brain tumor underwent conventional and APT-weighted sequences on a 3.0 Tesla MRI before clinical intervention. The maximum and the minimum APT-weighted signals (APTWmax and APTWmin) in each solid tumor region were obtained and compared before and after a clinical intervention. All surgical specimens were examined for histopathological diagnosis. Eight of ten patients underwent adjuvant therapy after surgery. Histopathological diagnosis was glioma in 7 patients (WHO grade 2 in 2 patients, WHO grade 3 in 3 patients, and WHO grade 4 in 2 patients), meningioma WHO grade 1 in 2 patients, and primary lymphoma of the brain in 1 patient. High-grade gliomas showed significantly higher APTW signals than that low-grade gliomas. APTWmax in one huge parasagittal meningioma infiltrating into the skull bone was higher than that in glioma WHO grade 4. On the other hand, APTWmax in another convexity meningioma was the same as that in glioma WHO grade 3. Diagnosis of primary lymphoma of the brain was possible with APT imaging before pathological confirmation. APTW signals in residual tumors decreased dramatically within one year after adjuvant therapy in all patients. APT imaging demonstrated excellent diagnostic performance for the planning of surgery and adjuvant therapy of brain tumors.

Keywords: amides, magnetic resonance imaging, brain tumors, cell proliferation

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2781 Applying Computer Simulation Methods to a Molecular Understanding of Flaviviruses Proteins towards Differential Serological Diagnostics and Therapeutic Intervention

Authors: Sergio Alejandro Cuevas, Catherine Etchebest, Fernando Luis Barroso Da Silva

Abstract:

The flavivirus genus has several organisms responsible for generating various diseases in humans. Special in Brazil, Zika (ZIKV), Dengue (DENV) and Yellow Fever (YFV) viruses have raised great health concerns due to the high number of cases affecting the area during the last years. Diagnostic is still a difficult issue since the clinical symptoms are highly similar. The understanding of their common structural/dynamical and biomolecular interactions features and differences might suggest alternative strategies towards differential serological diagnostics and therapeutic intervention. Due to their immunogenicity, the primary focus of this study was on the ZIKV, DENV and YFV non-structural proteins 1 (NS1) protein. By means of computational studies, we calculated the main physical chemical properties of this protein from different strains that are directly responsible for the biomolecular interactions and, therefore, can be related to the differential infectivity of the strains. We also mapped the electrostatic differences at both the sequence and structural levels for the strains from Uganda to Brazil that could suggest possible molecular mechanisms for the increase of the virulence of ZIKV. It is interesting to note that despite the small changes in the protein sequence due to the high sequence identity among the studied strains, the electrostatic properties are strongly impacted by the pH which also impact on their biomolecular interactions with partners and, consequently, the molecular viral biology. African and Asian strains are distinguishable. Exploring the interfaces used by NS1 to self-associate in different oligomeric states, and to interact with membranes and the antibody, we could map the strategy used by the ZIKV during its evolutionary process. This indicates possible molecular mechanisms that can explain the different immunological response. By the comparison with the known antibody structure available for the West Nile virus, we demonstrated that the antibody would have difficulties to neutralize the NS1 from the Brazilian strain. The present study also opens up perspectives to computationally design high specificity antibodies.

Keywords: zika, biomolecular interactions, electrostatic interactions, molecular mechanisms

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2780 Effectiveness of Project Grit in Building Resilience among At-Risk Adolescents: A Case Study

Authors: Narash Narasimman, Calvin Leong Jia Jun, Raksha Karthik, Paul Englert

Abstract:

Background: Project Grit, a 12-week youth resilience program implemented by Impart and Spartans Boxing Club, aimed to help at-risk adolescents develop resilience through psychoeducation and mental health techniques for dealing with everyday stressors and adversity. The programme consists of two parts-1.5 hours of group therapy followed by 1 hour of boxing. Due to the novelty of the study, 6 male participants, aged 13 to 18, were recruited to participate in the study. Aim: This case study aims to examine the effectiveness of Project Grit in building resilience among at-risk adolescents. Methods: A case study design was employed to capture the complexity and uniqueness of the intervention, without oversimplifying or generalizing it. A 15-year-old male participant with a history of behavioural challenges, delinquency and gang involvement was selected for the study. Teacher, parent and child versions of the Strengths and Difficulties Questionnaire (SDQ) were administered to the facilitators, parents and participants respectively before and after the programme. Relevant themes from the qualitative interviews will be discussed. Results: Scores from all raters revealed improvements in most domains of the SDQ. Total difficulties scores across all raters improved from “very high” to “close to average”. High interrater reliability was observed (κ= .81). The participant reported learning methods to effectively deal with his everyday concerns using healthy coping strategies, developing a supportive social network, and building on his self efficacy. Themes from the subject’s report concurred with the improvement in SDQ scores. Conclusions: The findings suggest that Project Grit is a promising intervention for promoting resilience among at-risk adolescents. The teleological behaviourism framework and the combination of sports engagement and future orientation may be particularly effective in fostering resilience among this population. Further studies need to be conducted with a larger sample size to further validate the effectiveness of Project Grit.

Keywords: resilience, project grit, adolescents, at-risk, boxing, future orientation

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2779 Opportunities and Challenges: Tracing the Evolution of India's First State-led Curriculum-based Media Literacy Intervention

Authors: Ayush Aditya

Abstract:

In today's digitised world, the extent of an individual’s social involvement is largely determined by their interaction over the internet. The Internet has emerged as a primary source of information consumption and a reliable medium for receiving updates on everyday activities. Owing to this change in the information consumption pattern, the internet has also emerged as a hotbed of misinformation. Experts are of the view that media literacy has emerged as one of the most effective strategies for addressing the issue of misinformation. This paper aims to study the evolution of the Kerala government's media literacy policy, its implementation strategy, challenges and opportunities. The objective of this paper is to create a conceptual framework containing details of the implementation strategy based on the Kerala model. Extensive secondary research of literature, newspaper articles, and other online sources was carried out to locate the timeline of this policy. This was followed by semi-structured interview discussions with government officials from Kerala to trace the origin and evolution of this policy. Preliminary findings based on the collected data suggest that this policy is a case of policy by chance, as the officer who headed this policy during the state level implementation was the one who has already piloted a media literacy program in a district called Kannur as the district collector. Through this paper, an attempt is made to trace the history of the media literacy policy starting from the Kannur intervention in 2018, which was started to address the issue of vaccine hesitancy around measles rubella(MR) vaccination. If not for the vaccine hesitancy, this program would not have been rolled out in Kannur. Interviews with government officials suggest that when authorities decided to take up this initiative in 2020, a huge amount of misinformation emerging during the COVID-19 pandemic was the trigger. There was misinformation regarding government orders, healthcare facilities, vaccination, and lockdown regulations, which affected everyone, unlike the case of Kannur, where it was only a certain age group of kids. As a solution to this problem, the state government decided to create a media literacy curriculum to be taught in all government schools of the state starting from standard 8 till graduation. This was a tricky task, as a new course had to be immediately introduced in the school curriculum amid all the disruptions in the education system caused by the pandemic. It was revealed during the interview that in the case of the state-wide implementation, every step involved multiple checks and balances, unlike the earlier program where stakeholders were roped-in as and when the need emerged. On the pedagogy, while the training during the pilot could be managed through PowerPoint presentation, designing a state-wide curriculum involved multiple iterations and expert approvals. The reason for this is COVID-19 related misinformation has lost its significance. In the next phase of the research, an attempt will be made to compare other aspects of the pilot implementation with the state-wide implementation.

Keywords: media literacy, digital media literacy, curriculum based media literacy intervention, misinformation

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2778 Food Supply Chain Optimization: Achieving Cost Effectiveness Using Predictive Analytics

Authors: Jayant Kumar, Aarcha Jayachandran Sasikala, Barry Adrian Shepherd

Abstract:

Public Distribution System is a flagship welfare programme of the Government of India with both historical and political significance. Targeted at lower sections of society,it is one of the largest supply chain networks in the world. There has been several studies by academics and planning commission about the effectiveness of the system. Our study focuses on applying predictive analytics to aid the central body to keep track of the problem of breach of service level agreement between the two echelons of food supply chain. Each shop breach is leading to a potential additional inventory carrying cost. Thus, through this study, we aim to show that aided with such analytics, the network can be made more cost effective. The methods we illustrate in this study are applicable to other commercial supply chains as well.

Keywords: PDS, analytics, cost effectiveness, Karnataka, inventory cost, service level JEL classification: C53

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2777 Systemic Family therapy in the Queensland Foster Care System: The implementation of Integrative Practice as a Purposeful Intervention Implemented with Complex ‘Family’ Systems

Authors: Rachel Jones

Abstract:

Systemic Family therapy in the Queensland Foster Care System is the implementation of Integrative Practice as a purposeful intervention implemented with complex ‘family’ systems (by expanding the traditional concept of family to include all relevant stakeholders for a child) and is shown to improve the overall wellbeing of children (with developmental delays and trauma) in Queensland out of home care contexts. The importance of purposeful integrative practice in the field of systemic family therapy has been highlighted in achieving change in complex family systems. Essentially, it is the purposeful use of multiple interventions designed to meet the myriad of competing needs apparent for a child (with developmental delays resulting from early traumatic experiences - both in utero and in their early years) and their family. In the out-of-home care context, integrative practice is particularly useful to promote positive change for the child and what is an extended concept of whom constitutes their family. Traditionally, a child’s family may have included biological and foster care family members, but when this concept is extended to include all their relevant stakeholders (including biological family, foster carers, residential care workers, child safety, school representatives, Health and Allied Health staff, police and youth justice staff), the use of integrative family therapy can produce positive change for the child in their overall wellbeing, development, risk profile, social and emotional functioning, mental health symptoms and relationships across domains. By tailoring therapeutic interventions that draw on systemic family therapies from the first and second-order schools of family therapy, neurobiology, solution focussed, trauma-informed, play and art therapy, and narrative interventions, disability/behavioural interventions, clinicians can promote change by mixing therapeutic modalities with the individual and their stakeholders. This presentation will unpack the implementation of systemic family therapy using this integrative approach to formulation and treatment for a child in out-of-home care in Queensland (experiencing developmental delays resulting from trauma). It considers the need for intervention for the individual and in the context of the environment and relationships. By reviewing a case example, this study aims to highlight the simultaneous and successful use of pharmacological interventions, psychoeducational programs for carers and school staff, parenting programs, cognitive-behavioural and trauma-informed interventions, traditional disability approaches, play therapy, mapping genograms and meaning-making, and using family and dyadic sessions for the system associated with the foster child. These elements of integrative systemic family practice have seen success in the reduction of symptoms and improved overall well-being of foster children and their stakeholders. Accordingly, a model for best practice using this integrative systemic approach is presented for this population group and preliminary findings for this approach over four years of local data have been reviewed.

Keywords: systemic family therapy, treating families of children with delays, trauma and attachment in families systems, improving practice and functioning of children and families

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2776 The Effect of Intimate Partner Violence Prevention Program on Knowledge and Attitude of Victims

Authors: Marzieh Nojomi, Azadeh Mottaghi, Arghavan Haj-Sheykholeslami, Narjes Khalili, Arash Tehrani Banihashemi

Abstract:

Background and objectives: Domestic violence is a global problem with severe consequences throughout the life of the victims. Iran’s Ministry of Health has launched an intimate partner violence (IPV) prevention program, integrated in the primary health care services since 2016. The present study is a part of this national program’s evaluation. In this section, we aimed to examine spousal abuse victims’ knowledge and attitude towards domestic violence before and after receivingthese services. Methods: To assess the knowledge and attitudes of victims, a questionnaire designed by Ahmadzadand colleagues in 2013 was used. This questionnaire includes 15 questions regarding knowledge in the fields of definition, epidemiology, and effects on children, outcomes, and prevention of domestic violence. To assess the attitudes, this questionnaire has 10 questions regarding the attitudes toward the causes, effects, and legal or protective support services of domestic violence. To assess the satisfaction and the effect of the program on prevention or reduction of spousal violence episodes, two more questions were also added. Since domestic violence prevalence differs in different parts of the country, we chose nine areas with the highest, the lowest, and moderate prevalence of IPVfor the study. The link to final electronic version of the questionnaire was sent to the randomly selected public rural or urban health centers in the nine chosen areas. Since the study had to be completed in one month, we used newly identified victims as pre-intervention group and people who had at least received one related service from the program (like psychiatric consultation, education about safety measures, supporting organizations and etc.) during the previous year, as our post- intervention group. Results: A hundred and ninety-two newly identified IPV victims and 267 victims who had at least received one related program service during the previous year entered the study. All of the victims were female. Basic characteristics of the two groups, including age, education, occupation, addiction, spouses’ age, spouses’ addiction, duration of the current marriage, and number of children, were not statistically different. In knowledge questions, post- intervention group had statistically better scores in the fields of domestic violence outcomes and its effects on children; however, in the remaining areas, the scores of both groups were similar. The only significant difference in the attitude across the two groups was in the field of legal or protective support services. From the 267 women who had ever received a service from the program, 91.8% were satisfied with the services, and 74% reported a decrease in the number of violent episodes. Conclusion: National IPV prevention program integrated in the primary health care services in Iran is effective in improving the knowledge of victims about domestic violence outcomes and its effects on children. Improving the attitude and knowledge of domestic violence victims about its causes and preventive measures needs more effective interventions. This program can reduce the number of IPV episodes between the spouses, and satisfaction among the service users is high.

Keywords: intimate partner violence, assessment, health services, efficacy

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2775 Contribution of Women to Post-Colonial Education and Leadership

Authors: Naziema Begum Jappie

Abstract:

This paper explores the relationship between educational transformation and gender equity in higher education. It draws on various policies and experiences and investigates the paradox of increased female leadership in higher education and the persistence of gender discrimination in the sphere of work. The paper will also address specific aspects of culture and education in post-colonial South Africa. Traditional features of past education systems were not isolated, they became an essential component of the education system, post-democracy. This is currently contested through the call for decolonizing the education system. The debates and discussions seek to rectify the post-colonial education structure within which women suffered triple oppression. Using feminist critical policy analysis and post-colonial theory, the paper examines how transformation over the past two decades has impacted on gender equity and how educational reform is itself gendered. It considers the nature of gender restructuring and key developments in gender equity policy. The social inequality in education is highlighted throughout this discussion. Through an analysis of research and interviews, this paper argues that gender can no longer be privileged when identifying and responding to educational and workplace inequality. In conclusion, the paper discusses the important assumptions that support how social and educational change deliver equity and how social justice may inform equity policy and practice in a culturally diverse educational framework.

Keywords: culture, educational leadership, gender inequality in the workplace, policy implementation

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2774 Energizing Value Added Farming in Agriculture Economic Aspects towards Sustaining Crop Yield, Quality and Food Safety of Small-Scale Cocoa Farmer in Indonesia

Authors: Burmansyah Muhammad, Supriyoto Supriyoto

Abstract:

Crop yield, quality and food safety are three important components that all estate and food crops must put into consideration to lifting the economic value. These measurements should be evaluated because marketplace demand is simultaneously changing and farmers must adapt quickly to remain competitive. The increase in economic value could be done by producing high quality product that aligns with harvest collector preferences. The purpose of this study is to examine the causal effects of value added farming in agriculture economic aspects towards crop yield, quality and food security. This research is using descriptive survey research by employing data from small-scale cocoa farmers listed to off-taker company, located on Sulawesi area of Indonesia. The questionnaire was obtained from 650 cocoa farmers, selected randomly. Major findings of the study indicate that 78% of respondents agree that agriculture inputs have positive effect on crop yield, quality and food safety. The study recommended that cocoa stakeholders should ensure access to agriculture inputs in first priority and then followed by ensuring access to cocoa supply chain trader and micro-financing. Value Added Farming refers to lifting the economic value of a commodity through particular intervention. Regarding access to agriculture inputs, one of significant intervention is fertilization and plant nutrition management, both organic and inorganic fertilizer. Small-scale cocoa farmers can get access to fertilizer intervention through establishment of demo farm. Ordinary demo farm needs large area, selective requirements, lots of field resources and centralization impact. On the contrary, satellite demo farm is developing to wide-spread the impact of agriculture economic aspects and also the involvement in number of farmers. In Sulawesi Project, we develop leveling strata of small-scale demo farm with group of farmers and local cooperative. With this methodology, all of listed small-scale farmers can get access to agriculture input, micro-financing and how to deliver quality output. PT Pupuk Kaltim is member firm of holding company PT Pupuk Indonesia, private company belongs to the government of Indonesia. The company listed as Indonesia's largest producer of urea fertilizers, besides ammonia, Compound Fertilizer (NPK) and biological fertilizers. To achieve strategic objectives, the company has distinguished award such as SNI Platinum, SGS Award IFA Protect and Sustain Stewardship and Gold Rank of Environment Friendly Company. This achievement has become the strategic foundation for our company to energize value added farming in sustaining food security program. Moreover, to ensure cocoa sustainability farming the company has developed partnership with international companies and Non-Government Organization (NGO).

Keywords: fertilizer and plant nutrition management, good agriculture practices, agriculture economic aspects, value-added farming

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2773 Higher Education Quality Culture: Case Study: Georgia

Authors: Pikria Vardosanidze

Abstract:

This presentation entitled ”Higher Education Quality Culture – Case Study: Georgia”is concerned with an urgent and crucial issue. Located at the crossroads of Europe and Asia, Georgia is a transnational, post-soviet country. And it is conditioned the peculiarity of our education system. Higher education in Georgia has an extensive history and a challenging period of development consisting of several phases, especially noteworthy of which are 1918 and 1991, marking there storation of Georgia’s independence. Georgia joined the Bologna Process in 2005. Given its geopolitical location, Georgian culture has developed, and still pursues the path of development against the background of the Western and Eastern cultures. Furthermore, socio-politically and culturally, it represents part of Europe. It is of particular interest how post-Soviet states develop in terms of education. What is the path to the European integration for Georgia as a post-Soviet country? How developed is the higher education quality culture in Georgia? And, what should be done in the future? It is important to answer these questions. The research carried out in the field of education is characterized by a certain specificity as does the post-colonial research. The field of education contributes to the development of democratic society as well as to the European integration, the Eastern Partnership and so on. What is crucial for the educational system, apart from transparency and democratization, is the improvement of the quality of education which is one of the most powerful tools dictating the need for a doctoral research as such. As for the research method, the comparative method of research, and the qualitative research are applied.

Keywords: internationalization, higher education, policies, Georgia

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2772 A Realist Review of Interventions Targeting Maternal Health in Low- and Middle-income Countries

Authors: Julie Mariam Abraham, G. J. Melendez-Torres

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Background. Maternal mortality is disproportionately higher in low- and middle- income countries (LMICs) compared to other parts of the world. At the current pace of progress, the Sustainable Development Goals for maternal mortality rate will not be achieved by 2030. A variety of factors influence the increased risk of maternal complications in LMICs. These are exacerbated by socio-economic and political factors, including poverty, illiteracy, and gender inequality. This paper aims to use realist synthesis to identify the contexts, mechanisms, and outcomes (CMOs) of maternal health interventions conducted in LMICs to inform evidence-based practice for future maternal health interventions. Methods. In May 2022, we searched four electronic databases for systematic reviews of maternal health interventions in LMICs published in the last five years. We used open and axial coding of CMOs to develop an explanatory framework for intervention effectiveness. Results. After eligibility screening and full-text analysis, 44 papers were included. The intervention strategies and measured outcomes varied within reviews. Healthcare system level contextual factors were the most frequently reported, and infrastructural capacity was the most reported context. The most prevalent mechanism was increased knowledge and awareness. Discussion. Health system infrastructure must be considered in interventions to ensure effective implementation and sustainability. Healthcare-seeking behaviours are embedded within social and cultural norms, environmental conditions, family influences, and provider attitudes. Therefore, effective engagement with communities and families is important to create new norms surrounding pregnancy and delivery. Future research should explore community mobilisation and involvement to enable tailored interventions with optimal contextual fit.

Keywords: maternal mortality, service delivery and organisation, realist synthesis, sustainable development goals, overview of reviews

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2771 Plants and Microorganisms for Phytoremediation of Soils Polluted with Organochlorine Pesticides

Authors: Maritsa Kurashvili, George Adamia, Tamar Ananiashvili, Lia Amiranasvili, Tamar Varazi, Marina Pruidze, Marlen Gordeziani, Gia Khatisashvili

Abstract:

The goal of presented work is the development phytoremediation method targeted to cleaning environment polluted with organochlorine pesticides, based on joint application of plants and microorganisms. For this aim the selection of plants and microorganisms with corresponding capabilities towards three organochlorine pesticides (Lindane, DDT and PCP) has been carried out. The tolerance of plants to tested pesticides and induction degree of plant detoxification enzymes by these compounds have been used as main criteria for estimating the applicability of plants in proposed technology. Obtained results show that alfalfa, maize and soybean among tested six plant species have highest tolerance to pesticides. As a result of screening, more than 30 strains from genera Pseudomonas have been selected. As a result of GC analysis of incubation area, 11 active cultures for investigated pesticides are carefully chosen.

Keywords: DDT, Lindane, organochlorine pesticides, PCP, phytoremediation

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2770 A Study on Awareness and Attitude of First-Year Medical Students on Epilepsy in University of Khartoum 2020-2021

Authors: Mohammed E. Ibrahim, Baraa A. Taha, Kamil M. A. Shabban

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Background: Epilepsy is a common but widely misunderstood illness. Consequently, patients with epilepsy suffer from considerable stigmatization in society. This social stigma and discrimination often cause more suffering for the patients than the disease itself. Since very few studies have explored the misperceptions about epilepsy among university students in Sudan, it is not possible to provide focused intervention aimed at eliminating this discrimination. Methods: A cross-sectional study was applied among the first-year medical students at the University of Khartoum between December (2020) and February (2021). A 29-item standardized questionnaire was self-administered by 198 students (out of 320) who agreed to participate in this study. Google form was the tool used to collect the data. The data were analyzed using the Statistical Package for Social Science software version 26. Result: Overall, the results indicate a negative trend in knowledge and attitude toward epilepsy. The vast majority of the respondents (84.8%) have read or heard about epilepsy, while 43.9% had seen someone with epilepsy. Only 7.5% of the participants reported that epilepsy is contagious, whereas 43.4% of them think that epilepsy is a psychological disorder. About 62.2% of students think head/birth trauma is a cause of epilepsy. On the other side, about 15.7% and 5.1% believed that evil spirits and punishment from god can also be a possible cause of epilepsy; we found these false beliefs are more common in participants from rural areas (p-value < 0.05). In regard to attitude, 19.7% of students thought that it is inappropriate for a patient with epilepsy to have a child. This attitude correlates with the mother’s education as the percentage is higher for those who have lower mother’s education (through secondary school education and below) (p < 0.05). The majority of Our participant knew that some people with epilepsy need life-long drug treatment; this belief was found to be more common in females than their counterparts(p < 0.05). . Finally, most of the respondents (93.9%) thought that a child with epilepsy Can be successful in a normal class. This belief is four-time as common in participants whose mothers have higher education (through university education and above) compared with corresponding respondents (p < 0.05). Conclusion: This study concludes that students' knowledge about epilepsy is limited and requires immediate intervention through educational campaigns to develop a well-informed and tolerant community.

Keywords: epilepsy, awareness, attitude, university students, Sudan

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2769 Systematic Review of Dietary Fiber Characteristics Relevant to Appetite and Energy Intake Outcomes in Clinical Intervention Trials of Healthy Humans

Authors: K. S. Poutanen, P. Dussort, A. Erkner, S. Fiszman, K. Karnik, M. Kristensen, C. F. M. Marsaux, S. Miquel-Kergoat, S. Pentikäinen, P. Putz, R. E. Steinert, J. Slavin, D. J. Mela

Abstract:

Dietary fiber (DF) intake has been associated with lower body weight or less weight gain. These effects are generally attributed to putative effects of DF on appetite. Many intervention studies have tested the effect of DFs on appetite-related measures, with inconsistent results. However, DF includes a wide category of different compounds with diverse chemical and physical characteristics, and correspondingly diverse effects in human digestion. Thus, inconsistent results between DF consumption and appetite are not surprising. The specific contribution of different compounds with varying physico-chemical properties to appetite control and the mediating mechanisms are not well characterized. This systematic review aimed to assess the influence of specific DF characteristics, including viscosity, gel forming capacity, fermentability, and molecular weight, on appetite-related outcomes in healthy humans. Medline and FSTA databases were searched for controlled human intervention trials, testing the effects of well-characterized DFs on subjective satiety/appetite or energy intake outcomes. Studies were included only if they reported: 1) fiber name and origin, and 2) data on viscosity, gelling properties, fermentability, or molecular weight of the DF materials tested. The search generated 3001 unique records, 322 of which were selected for further consideration from title and abstract screening. Of these, 149 were excluded due to insufficient fiber characterization and 124 for other reasons (not original article, not randomized controlled trial, or no appetite related outcome), leaving 49 papers meeting all the inclusion criteria, most of which reported results from acute testing (<1 day). The eligible 49 papers described 90 comparisons of DFs in foods, beverages or supplements. DF-containing material of interest was efficacious for at least one appetite-related outcome in 51/90 comparisons. Gel-forming DF sources were most consistently efficacious but there were no clear associations between viscosity, MW or fermentability and appetite-related outcomes. A considerable number of papers had to be excluded from the review due to shortcomings in fiber characterization. To build understanding about the impact of DF on satiety/appetite specifically there should be clear hypotheses about the mechanisms behind the proposed beneficial effect of DF material on appetite, and sufficient data about the DF properties relevant for the hypothesized mechanisms to justify clinical testing. The hypothesized mechanisms should also guide the decision about relevant duration of exposure in studies, i.e. are the effects expected to occur during acute time frame (related to stomach emptying, digestion rate, etc.) or develop from sustained exposure (gut fermentation mediated mechanisms). More consistent measurement methods and reporting of fiber specifications and characterization are needed to establish reliable structure-function relationships for DF and health outcomes.

Keywords: appetite, dietary fiber, physico-chemical properties, satiety

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2768 Understanding Cyber Terrorism from Motivational Perspectives: A Qualitative Data Analysis

Authors: Yunos Zahri, Ariffin Aswami

Abstract:

Cyber terrorism represents the convergence of two worlds: virtual and physical. The virtual world is a place in which computer programs function and data move, whereas the physical world is where people live and function. The merging of these two domains is the interface being targeted in the incidence of cyber terrorism. To better understand why cyber terrorism acts are committed, this study presents the context of cyber terrorism from motivational perspectives. Motivational forces behind cyber terrorism can be social, political, ideological and economic. In this research, data are analyzed using a qualitative method. A semi-structured interview with purposive sampling was used for data collection. With the growing interconnectedness between critical infrastructures and Information & Communication Technology (ICT), selecting targets that facilitate maximum disruption can significantly influence terrorists. This work provides a baseline for defining the concept of cyber terrorism from motivational perspectives.

Keywords: cyber terrorism, terrorism, motivation, qualitative analysis

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2767 The Human Rights of Women in Brazilian Territory: A Literature Review of the Axes of the National Human Rights Program III

Authors: Ana Luiza Casasanta Garcia, Maria Del Carmen Cortizo

Abstract:

From the classic contractualist and early declarations of modern rights, discussions on policies for the protection and promotion of human rights were highlighted in an attempt to ensure the realization of human dignity and its values, which are (re) negotiated according to the needs evidenced in each historical and contextual moment. Aiming at guaranteeing human rights to Brazilian citizens, created in 2009 and updated in 2010, the Third National Human Rights Program (PNDH III) in force highlights guidelines and recommendations to guarantee human rights, among them, to guarantee the rights of women in Brazil. Based on this document, this article aims to locate historically and culturally the understanding of human rights related to the rights of women in Brazilian territory, from the analysis of the guiding axes of women's rights of the PNDH III. In methodological terms, the qualitative approach and documentary research were used to analyze the data according to the critical discourse analysis. As a result, it has been found that the process of building and maintaining the guarantee of women's human rights needs a reformulation that also shows a social revolution. This is justified by the fact that even with the provision in the PNDH III that, in order to guarantee the rights of women, it is necessary, for example, to adapt the Penal Code to the decriminalization of abortion and the professionalization of prostitution, these points are still very controversial and are not put into practice by the State. Finally, the importance of the critique of politics and the current system of production of understandings in favor of this social transformation is emphasized.

Keywords: human rights of women, social transformation, national human rights program III, public politics

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2766 Heritage Preservation and Cultural Tourism; The 'Pueblos Mágicos' Program and Its Role in Preserving Traditional Architecture in Mexico

Authors: Claudia Rodríguez Espinosa, Erika Elizabeth Pérez Múzquiz

Abstract:

The Pueblos Mágicos federal program tries to preserve the traditional environment of small towns (under 20,000 inhabitants), through economic investments, legislation, and legal aid. To access the program, it’s important to cover 8 requirements; one of them is the fourth, which considers ‘Promotion of symbolic and differentiated touristic attractions, such as architecture, emblematic buildings, festivities and traditions, artisan production, traditional cuisine, and touristic services that guarantee their commercialization along with assistantship and security services’. With this objective in mind, the Federal government of Mexico had developed local programs to protect emblematic public buildings in each of the 83 towns included in the Pueblos Mágicos program that involved federal and local administrations as well as local civil associations, like Adopte una Obra de Arte. In this paper, we present 3 different intervention cases: first the restoration project (now concluded) of the 16th century monastery of Santa María Magdalena in Cuitzeo, an enormous building which took 6 years to be completely restored. Second case, the public spaces intervention in Pátzcuaro, included the Plaza Grande or Vasco de Quiroga square, and the access to the arts and crafts house known as Casa de los once patios or eleven backyards house. The third case is the recovery project of the 16th century atrium of the Tzintzuntzan monastery that included the original olive trees brought by Franciscans monks to this town in the middle 1500’s. This paper tries to present successful preservation projects in 3 different scales: building, urban spaces and landscape; and in 3 different towns with the objective to preserve public architecture, public spaces and cultural traditions. Learn from foreign experiences, different ways to manage preservation projects focused on public architecture and public spaces.

Keywords: cultural tourism, heritage preservation, traditional architecture, public policies

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2765 Evolution of Minangkabau ‘Induk’ House and its influence on the Architecture

Authors: Noor Hayati Binti Ismail, Mastor Bin Surat, Raja Nafida Binti Raja Shahminan, Shahrul Kamil Bin Yunus

Abstract:

This study is to look the changes, development and evolution taking place in the Minangkabau house. Minangkabau traditional house is a part of the assets of Indonesia's culture and history. In addition to custom house, traditional Minangkabau building also serves as a place to live within the context of human habitats but has slowly through the changes. Luhak Nan Tigo of Luhak Tanah Datar, Agam And Luhak 50 Kota are holding the Minangkabau. ‘Induk’ house is the sole home, Main house or an older home for a gathering place doing activities together. The 'Genius Loci' refers to the unique aspects of the history, the value of a place, culturally and socially. Main house has the aspect of Minangkabau is a house occupied by custom rules that practice matrilineal kinship system and tendency to move out from the community. The study involves several villages and traditional houses at Padang, Bukit Tinggi, Kampar Kiri in Indonesia and Rembau, kuala Pilah, tampin in Negeri Sembilan has been selected to serve as a research field. These factors were the occurrence of evolution Minangkabau house from the ‘induk’, kampar and Negeri Sembilan. In this regard, the identity and uniqueness of the house increasingly difficult to sustain as well as lack of clarity can be understood by the people of the present generation.

Keywords: evolution, Genius loci, ‘Induk’ house, matrilineal kinship

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2764 Mining Multicity Urban Data for Sustainable Population Relocation

Authors: Xu Du, Aparna S. Varde

Abstract:

In this research, we propose to conduct diagnostic and predictive analysis about the key factors and consequences of urban population relocation. To achieve this goal, urban simulation models extract the urban development trends as land use change patterns from a variety of data sources. The results are treated as part of urban big data with other information such as population change and economic conditions. Multiple data mining methods are deployed on this data to analyze nonlinear relationships between parameters. The result determines the driving force of population relocation with respect to urban sprawl and urban sustainability and their related parameters. Experiments so far reveal that data mining methods discover useful knowledge from the multicity urban data. This work sets the stage for developing a comprehensive urban simulation model for catering to specific questions by targeted users. It contributes towards achieving sustainability as a whole.

Keywords: data mining, environmental modeling, sustainability, urban planning

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2763 PlayTrain: A Research and Intervention Project for Early Childhood Teacher Education

Authors: Dalila Lino, Maria Joao Hortas, Carla Rocha, Clarisse Nunes, Natalia Vieira, Marina Fuertes, Kátia Sa

Abstract:

The value of play is recognized worldwide and is considered a fundamental right of all children, as defined in Article 31 of the United Nations Children’s Rights. It is consensual among the scientific community that play, and toys are of vital importance for children’s learning and development. Play promotes the acquisition of language, enhances creativity and improves social, affective, emotional, cognitive and motor development of young children. Young children ages 0 to 6 who have had many opportunities to get involved in play show greater competence to adapt to new and unexpected situations and more easily overcome the pain and suffering caused by traumatic situations. The PlayTrain Project aims to understand the places/spaces of play in the education of children from 0 to 6 years and promoting the training of preschool teachers to become capable of developing practices that enhance children’s agency, experimentation in the physical and social world and the development of imagination and creativity. This project follows the Design-Based-Research (DBR) and has two dimensions: research and intervention. The participants are 120 students from the Master in Pre-school Education of the Higher School of Education, Polytechnic Institute of Lisbon enrolled in the academic year 2018/2019. The development of workshops focused on the role of play and toys for young children’s learning promotes the participants reflection and the development of skills and knowledge to construct developmentally appropriated practices in early childhood education. Data was collected through an online questionnaire and focal groups. Results show that the PlayTrain Project contribute to the development of a body of knowledge about the role of play for early childhood education. It was possible to identify the needs of preschool teacher education and to enhance the discussion among the scientific and academic community about the importance of deepening the role of play and toys in the study plans of the masters in pre-school education.

Keywords: children's learning, early childhood education, play, teacher education, toys

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2762 Knowledge of the Doctors Regarding International Patient Safety Goal

Authors: Fatima Saeed, Abdullah Mudassar

Abstract:

Introduction: Patient safety remains a global priority in the ever-evolving healthcare landscape. At the forefront of this endeavor are the International Patient Safety Goals (IPSGs), a standardized framework designed to mitigate risks and elevate the quality of care. Doctors, positioned as primary caregivers, wield a pivotal role in upholding and adhering to IPSGs, underscoring the critical significance of their knowledge and understanding of these goals. This research embarks on a comprehensive exploration into the depth of Doctors ' comprehension of IPSGs, aiming to unearth potential gaps and provide insights for targeted educational interventions. Established by influential healthcare bodies, including the World Health Organization (WHO), IPSGs represent a universally applicable set of objectives spanning crucial domains such as medication safety, infection control, surgical site safety, and patient identification. Adherence to these goals has exhibited substantial reductions in adverse events, fostering an overall enhancement in the quality of care. This study operates on the fundamental premise that an informed Doctors workforce is indispensable for effectively implementing IPSGs. A nuanced understanding of these goals empowers Doctors to identify potential risks, advocate for necessary changes, and actively contribute to a safety-centric culture within healthcare institutions. Despite the acknowledged importance of IPSGs, there is a growing concern that nurses may need more knowledge to integrate these goals into their practice seamlessly. Methodology: A Comprehensive research methodology covering study design, setting, duration, sample size determination, sampling technique, and data analysis. It introduces the philosophical framework guiding the research and details material, methods, and the analysis framework. The descriptive quantitative cross-sectional study in teaching care hospitals utilized convenient sampling over six months. Data collection involved written informed consent and questionnaires, analyzed with SPSS version 23, presenting results graphically and descriptively. The chapter ensures a clear understanding of the study's design, execution, and analytical processes. Result: The survey results reveal a substantial distribution across hospitals, with 34.52% in MTIKTH and 65.48% in HMC MTI. There is a notable prevalence of patient safety incidents, emphasizing the significance of adherence to IPSGs. Positive trends are observed, including 77.0% affirming the "time-out" procedure, 81.6% acknowledging effective healthcare provider communication, and high recognition (82.7%) of the purpose of IPSGs to improve patient safety. While the survey reflects a good understanding of IPSGs, areas for improvement are identified, suggesting opportunities for targeted interventions. Discussion: The study underscores the need for tailored care approaches and highlights the bio-socio-cultural context of 'contagion,' suggesting areas for further research amid antimicrobial resistance. Shifting the focus to patient safety practices, the survey chapter provides a detailed overview of results, emphasizing workplace distribution, patient safety incidents, and positive reflections on IPSGs. The findings indicate a positive trend in patient safety practices with areas for improvement, emphasizing the ongoing need for reinforcing safety protocols and cultivating a safety-centric culture in healthcare. Conclusion: In summary, the survey indicates a positive trend in patient safety practices with a good understanding of IPSGs among participants. However, identifying areas for potential improvement suggests opportunities for targeted interventions to enhance patient safety further. Ongoing efforts to reinforce adherence to safety protocols, address identified gaps, and foster a safety culture will contribute to continuous improvements in patient care and outcomes.

Keywords: infection control, international patient safety, patient safety practices, proper medication

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2761 A Conflict of Relations in Toni Morrison’s New World Fiction

Authors: Rajeswar Pal

Abstract:

Toni Morrison’s novels belong to present day relations of Africans with the White peoples and tangible man-woman relations. Her literary criticism can be seen as a contribution to the debate over the revision of the canon that dominated much of the scholarship of the 1980s and 1990s. New Criticism began to give way to theories of cultural studies, feminist scholarship, postcolonial revisions and investigations of race and ethnicity. Morrison is concerned with the definition of the American literature whether it reflects an eternal, universal or transcending paradigm – a paradigm that separates it clearly and unequivocally Chicano or African-American or Asian-American or Native American literature. She sees evidence on an incursion of third world or so-called minority literature into a Eurocentric stronghold, which threatens power structures and leads to an upheaval of existing norms. We see women more aligned, cross-culturally, with nature; however, the very critical distinction is that within a white world, the alignment seems to lead towards individuation for women yet separation from white male culture, and within a black world the alignment leads towards individuation and connection to a ownership of a racial consciousness. Whether externally or internally, the characters of Morrison are marked with a sense of incompleteness and mutual conflict, which drives them towards some force of wholeness. Present study fucusses to elucidate and enunciate the man-woman relations and an individual cataclysmic conflict in their minds.

Keywords: tangible, postcolonial, ethnicity, paradigm, upheaval, alignment, elucidate, cataclysmic

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2760 Applying an Automatic Speech Intelligent System to the Health Care of Patients Undergoing Long-Term Hemodialysis

Authors: Kuo-Kai Lin, Po-Lun Chang

Abstract:

Research Background and Purpose: Following the development of the Internet and multimedia, the Internet and information technology have become crucial avenues of modern communication and knowledge acquisition. The advantages of using mobile devices for learning include making learning borderless and accessible. Mobile learning has become a trend in disease management and health promotion in recent years. End-stage renal disease (ESRD) is an irreversible chronic disease, and patients who do not receive kidney transplants can only rely on hemodialysis or peritoneal dialysis to survive. Due to the complexities in caregiving for patients with ESRD that stem from their advanced age and other comorbidities, the patients’ incapacity of self-care leads to an increase in the need to rely on their families or primary caregivers, although whether the primary caregivers adequately understand and implement patient care is a topic of concern. Therefore, this study explored whether primary caregivers’ health care provisions can be improved through the intervention of an automatic speech intelligent system, thereby improving the objective health outcomes of patients undergoing long-term dialysis. Method: This study developed an automatic speech intelligent system with healthcare functions such as health information voice prompt, two-way feedback, real-time push notification, and health information delivery. Convenience sampling was adopted to recruit eligible patients from a hemodialysis center at a regional teaching hospital as research participants. A one-group pretest-posttest design was adopted. Descriptive and inferential statistics were calculated from the demographic information collected from questionnaires answered by patients and primary caregivers, and from a medical record review, a health care scale (recorded six months before and after the implementation of intervention measures), a subjective health assessment, and a report of objective physiological indicators. The changes in health care behaviors, subjective health status, and physiological indicators before and after the intervention of the proposed automatic speech intelligent system were then compared. Conclusion and Discussion: The preliminary automatic speech intelligent system developed in this study was tested with 20 pretest patients at the recruitment location, and their health care capacity scores improved from 59.1 to 72.8; comparisons through a nonparametric test indicated a significant difference (p < .01). The average score for their subjective health assessment rose from 2.8 to 3.3. A survey of their objective physiological indicators discovered that the compliance rate for the blood potassium level was the most significant indicator; its average compliance rate increased from 81% to 94%. The results demonstrated that this automatic speech intelligent system yielded a higher efficacy for chronic disease care than did conventional health education delivered by nurses. Therefore, future efforts will continue to increase the number of recruited patients and to refine the intelligent system. Future improvements to the intelligent system can be expected to enhance its effectiveness even further.

Keywords: automatic speech intelligent system for health care, primary caregiver, long-term hemodialysis, health care capabilities, health outcomes

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2759 A Comparative Psychological Interventional Study of Nicotine Dependence in Schizophrenic Patients

Authors: S. Madhusudhan, G. V. Vaniprabha

Abstract:

Worldwide statistics have shown that smoking contributes significantly to mortality, with nicotine, being more addictive. Smoking causes more than 7,00,000 deaths/year in India. Compared to the general population, the prevalence of smoking is found to be much higher among people with psychotic disorders and, more so in schizophrenia. Schizophrenic patients who smoke tend to have higher frequency of heavy smoking, with rates ranging from 60% to as high as 80%. Hence, smokers with psychiatric disorders suffer higher rates of morbidity and mortality secondary to smoking related illnesses.

Keywords: brief intervention, nicotine dependence, schizophrenia

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2758 A Systematic Review of Pedometer-or Accelerometer-Based Interventions for Increasing Physical Activity in Low Socioeconomic Groups

Authors: Shaun G. Abbott, Rebecca C. Reynolds, James B. Etter, John B. F. de Wit

Abstract:

The benefits of physical activity (PA) on health are well documented. Low socioeconomic status (SES) is associated with poor health, with PA a suggested mediator. Pedometers and accelerometers offer an effective behavior change tool to increase PA levels. While the role of pedometer and accelerometer use in increasing PA is recognized in many populations, little is known in low-SES groups. We are aiming to assess the effectiveness of pedometer- and accelerometer-based interventions for increasing PA step count and improving subsequent health outcomes among low-SES groups of high-income countries. Medline, Embase, PsycINFO, CENTRAL and SportDiscus databases were searched to identify articles published before 10th July, 2015; using search terms developed from previous systematic reviews. Inclusion criteria are: low-SES participants classified by income, geography, education, occupation or ethnicity; study duration minimum 4 weeks; an intervention and control group; wearing of an unsealed pedometer or accelerometer to objectively measure PA as step counts per day for the duration of the study. We retrieved 2,142 articles from our database searches, after removal of duplicates. Two investigators independently reviewed titles and abstracts of these articles (50% each) and a combined 20% sample were reviewed to account for inter-assessor variation. We are currently verifying the full texts of 430 articles. Included studies will be critically appraised for risk of bias using guidelines suggested by the Cochrane Public Health Group. Two investigators will extract data concerning the intervention; study design; comparators; steps per day; participants; context and presence or absence of obesity and/or chronic disease. Heterogeneity amongst studies is anticipated, thus a narrative synthesis of data will be conducted with the simplification of selected results into percentage increases from baseline to allow for between-study comparison. Results will be presented at the conference in December if selected.

Keywords: accelerometer, pedometer, physical activity, socioeconomic, step count

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2757 Improving the Weekend Handover in General Surgery: A Quality Improvement Project

Authors: Michael Ward, Eliana Kalakouti, Andrew Alabi

Abstract:

Aim: The handover process is recognized as a vulnerable step in the patient care pathway where errors are likely to occur. As such, it is a major preventable cause of patient harm due to human factors of poor communication and systematic error. The aim of this study was to audit the general surgery department’s weekend handover process compared to the recommended criteria for safe handover as set out by the Royal College of Surgeons (RCS). Method: A retrospective audit of the General Surgery department’s Friday patient lists and patient medical notes used for weekend handover in a London-based District General Hospital (DGH). Medical notes were analyzed against RCS's suggested criteria for handover. A standardized paper weekend handover proforma was then developed in accordance with guidelines and circulated in the department. A post-intervention audit was then conducted using the same methods for cycle 1. For cycle 2, we introduced an electronic weekend handover tool along with Electronic Patient Records (EPR). After a one-month period, a second post-intervention audit was conducted. Results: Following cycle 1, the paper weekend handover proforma was only used in 23% of patient notes. However, when it was used, 100% of them had a plan for the weekend, diagnosis and location but only 40% documented potential discharge status and 40% ceiling of care status. Qualitative feedback was that it was time-consuming to fill out. Better results were achieved following cycle 2, with 100% of patient notes having the electronic proforma. Results improved with every patient having documented ceiling of care, discharge status and location. Only 55% of patients had a past surgical history; however, this was still an increase when compared to paper proforma (45%). When comparing electronic versus paper proforma, there was an increase in documentation in every domain of the handover outlined by RCS with an average relative increase of 1.72 times (p<0.05). Qualitative feedback was that the autofill function made it easy to use and simple to view. Conclusion: These results demonstrate that the implementation of an electronic autofill handover proforma significantly improved handover compliance with RCS guidelines, thereby improving the transmission of information from week-day to weekend teams.

Keywords: surgery, handover, proforma, electronic handover, weekend, general surgery

Procedia PDF Downloads 159