Search results for: personal and social challenges
3321 Ambient Notifications and the Interruption Effect
Authors: Trapond Hiransalee
Abstract:
The technology of mobile devices has changed our daily lives. Since smartphone have become a multi-functional device, many people spend unnecessary time on them, and could be interrupted by inappropriate notifications such as unimportant messages from social media. Notifications from smartphone could draw people’s attention and distract them from their priorities and current tasks. This research investigated that if the users were notified by their surroundings instead of smartphone, would it create less distraction and keep their focus on the present task. The experiment was a simulation of a lamp and door notification. Notifications related to work will be embedded in the lamp such as an email from a colleague. A notification that is useful when going outside such as weather information, traffic information, and schedule reminder will be embedded in the door. The experiment was conducted by sending notifications to the participant while he or she was working on a primary task and the working performance was measured. The results show that the lamp notification had fewer interruption effects than the smartphone. For the door notification, it was simulated in order to gain opinions and insights on ambient notifications from participants. Many participants agreed that the ambient notifications are useful and being informed by them could lessen the usage of their smartphone. The results and insights from this research could be used to guide the design process of ambient notifications.Keywords: HCI, interaction, interaction design, usability testing
Procedia PDF Downloads 4053320 The Assessment of the Comparative Efficiency of Reforms through the Integral Index of Transformation
Authors: Samson Davoyan, Ashot Davoyan, Ani Khachatryan
Abstract:
The indexes (Global Competitiveness Index, Economic Freedom Index, Human Development Index, etc.) developed by different international and non-government organizations in time and space express the quantitative and qualitative features of different fields of various reforms implemented in different countries. The main objective of our research is to develop new methodology that we will use to create integral index based on many indexes and that will include many areas of reforms. To achieve our aim we have used econometric methods (regression model for panel data method). The basis of our methodology is the development of the new integral index based on quantitative assessment of the change of two main parameters: the score of the countries by different indexes and the change of the ranks of countries for following two periods of time. As a result of the usage of methods for analyzes we have defined the indexes that are used to create the new integral index and the scales for each of them. Analyzing quantitatively and qualitatively analysis through the integral index for more than 100 countries for 2009-2014, we have defined comparative efficiency that helps to conclude in which directions countries have implemented reforms more effectively compared to others and in which direction reforms have implemented less efficiently.Keywords: development, rank, reforms, comparative, index, economic, corruption, social, program
Procedia PDF Downloads 3263319 A 3D Model of the Sustainable Management of the Natural Environment in National Parks
Authors: Paolo Russu
Abstract:
This paper investigates the economic and ecological dynamics that emerge in Protected Areas (PAs) as a result of interactions between visitors to the area and the animals that live there. We suppose that the PAs contain two species whose interactions are determined by the Lotka-Volterra equations system. Visitors' decisions to visit PAs are influenced by the entrance cost required to enter the park as well as the chance of witnessing the species that live there. Visitors have contradictory effects on the species and thus on the sustainability of the protected areas: on the one hand, an increase in the number of tourists damages the natural habitat of the areas and thus the species living there; on the other hand, it increases the total amount of entrance fees that the managing body of the PAs can use to perform defensive expenditures that protect the species from extinction. For a given set of parameter values, the existence of saddle-node bifurcation, Hopf bifurcation, homoclinic orbits, and a Bogdanov–Takens bifurcation of codimension two has been investigated. The system displays periodic doubling and chaotic solutions, as demonstrated by numerical examples. Pontryagin's Maximum Principle was utilized to develop an optimal admission charge policy that maximized both social gain and ecosystem conservation.Keywords: environmental preferences, singularities point, dynamical system, chaos
Procedia PDF Downloads 973318 Comprehensive Literature Review of the Humanistic Burden of Clostridium (Clostridiodes) difficile Infection
Authors: Caroline Seo, Jennifer Stephens, Kirstin H. Heinrich
Abstract:
Background: Clostridiodes (formerly Clostridium) difficile infection (CDI) is an anaerobic, spore-forming bacterium with manifestations including diarrhea, pseudomembranous colitis and toxic megacolon. Despite general understanding that CDI may be associated with marked burden on patients’ health, there has been limited information available on the humanistic burden of CDI. The objective of this literature review was to summarize the published data on the humanistic burden of CDI globally, in order to better inform future research efforts and increase awareness of the patient perspective in this disease. Methods: A comprehensive literature review of the past 15 years (2002-2017) was conducted using MEDLINE, Embase and Cumulative Index of Nursing and Allied Health Literature. Additional searches were conducted from conference proceedings (2015-2017). Articles selected were studies specifically designed to examine the humanistic burden of illness associated with adult patients with CDI. Results: Of 3,325 articles or abstracts identified, 33 remained after screening and full text review. Sixty percent (60%) were published in 2016 or 2017. Data from the United States or Western Europe were most common. Data from Brazil, Canada, China and Spain also exist. Thirteen (13) studies used validated patient-reported outcomes instruments, mostly EQ-5D utility and SF-36 generic instruments. Three (3) studies used CDI-specific instruments (CDiff32, CDI-DaySyms). The burden of CDI impacts patients in multiple health-related quality of life (HRQOL) domains. SF-36 domains with the largest decrements compared to other GI diarrheal diseases (IBS-D and Crohn’s) were role physical, physical functioning, vitality, social functioning, and role emotional. Reported EQ-5D utilities for CDI ranged from 0.35-0.42 compared to 0.65 in Crohn’s and 0.72 in IBS-D. The majority of papers addressed physical functioning and mental health domains (67% for both). Across various studies patients reported weakness, lack of appetite, sleep disturbance, functional dependence, and decreased activities of daily lives due to the continuous diarrhea. Due to lack of control over this infection, CDI also impacts the psychological and emotional quality of life of the patients. Patients reported feelings of fear, anxiety, frustration, depression, and embarrassment. Additionally, the type of disease (primary vs. recurrent) may impact mental health. One study indicated that there is a decrement in SF-36 mental scores in patients with recurrent CDI, in comparison to patients with primary CDI. Other domains highlighted by these studies include pain (27%), social isolation (27%), vitality and fatigue (24%), self-care (9%), and caregiver burden (0%). Two studies addressed work productivity, with 1 of these studies reporting that CDI patients had the highest work productivity and activity impairment scores among the gastrointestinal diseases. No study specifically included caregiver self-report. However, 3 studies did provide mention of patients’ worry on how their diagnosis of CDI would impact family, caregivers, and/or friends. Conclusions: Despite being a serious public health issue there has been a paucity of research on the HRQOL among those with CDI. While progress is being made, gaps exist in understanding the burden on patients, caregivers, and families. Future research is warranted to aid understanding of the CDI patient perspective.Keywords: burden, Clostridiodes, difficile, humanistic, infection
Procedia PDF Downloads 1363317 Multi-Class Text Classification Using Ensembles of Classifiers
Authors: Syed Basit Ali Shah Bukhari, Yan Qiang, Saad Abdul Rauf, Syed Saqlaina Bukhari
Abstract:
Text Classification is the methodology to classify any given text into the respective category from a given set of categories. It is highly important and vital to use proper set of pre-processing , feature selection and classification techniques to achieve this purpose. In this paper we have used different ensemble techniques along with variance in feature selection parameters to see the change in overall accuracy of the result and also on some other individual class based features which include precision value of each individual category of the text. After subjecting our data through pre-processing and feature selection techniques , different individual classifiers were tested first and after that classifiers were combined to form ensembles to increase their accuracy. Later we also studied the impact of decreasing the classification categories on over all accuracy of data. Text classification is highly used in sentiment analysis on social media sites such as twitter for realizing people’s opinions about any cause or it is also used to analyze customer’s reviews about certain products or services. Opinion mining is a vital task in data mining and text categorization is a back-bone to opinion mining.Keywords: Natural Language Processing, Ensemble Classifier, Bagging Classifier, AdaBoost
Procedia PDF Downloads 2323316 Team Teaching versus Traditional Pedagogical Method
Authors: L. M. H. Mustonen, S. A. Heikkilä
Abstract:
The focus of the paper is to describe team teaching as a HAMK’s pedagogical method, and its impacts to the teachers work. Background: Traditionally it is thought that teaching is a job where one mostly works alone. More and more teachers feel that their work is getting more stressful. Solutions to these problems have been sought in Häme University of Applied sciences’ (From now on referred to as HAMK). HAMK has made a strategic change to move to the group oriented working of teachers. Instead of isolated study courses, there are now larger 15 credits study modules. Implementation: As examples of the method, two cases are presented: technical project module and summer studies module, which was integrated into the EU development project called Energy Efficiency with Precise Control. In autumn 2017, technical project will be implemented third time. There are at least three teachers involved in it and it is the first module of the new students. Main focus is to learn the basic skills of project working. From communicational viewpoint, they learn the basics of written and oral reporting and the basics of video reporting skills. According to our quality control system, the need for the development is evaluated in the end of the module. There are always some differences in each implementation but the basics are the same. The other case summer studies 2017 is new and part of a larger EU project. For the first time, we took a larger group of first to third year students from different study programmes to the summer studies. The students learned professional skills and also skills from different fields of study, international cooperation, and communication skills. Benefits and challenges: After three years, it is possible to consider what the changes mean in the everyday work of the teachers - and of course – what it means to students and the learning process. The perspective is HAMK’s electrical and automation study programme: At first, the change always means more work. The routines born after many years and the course material used for years may not be valid anymore. Teachers are teaching in modules simultaneously and often with some subjects overlapping. Finding the time to plan the modules together is often difficult. The essential benefit is that the learning outcomes have improved. This can be seen in the feedback given by both the teachers and the students. Conclusions: A new type of working environment is being born. A team of teachers designs a module that matches the objectives and ponders the answers to such questions as what are the knowledge-based targets of the module? Which pedagogical solutions will achieve the desired results? At what point do multiple teachers instruct the class together? How is the module evaluated? How can the module be developed further for the next execution? The team discusses openly and finds the solutions. Collegiate responsibility and support are always present. These are strengthening factors of the new communal university teaching culture. They are also strong sources of pleasure of work.Keywords: pedagogical development, summer studies, team teaching, well-being at work
Procedia PDF Downloads 1093315 Multi-Labeled Aromatic Medicinal Plant Image Classification Using Deep Learning
Authors: Tsega Asresa, Getahun Tigistu, Melaku Bayih
Abstract:
Computer vision is a subfield of artificial intelligence that allows computers and systems to extract meaning from digital images and video. It is used in a wide range of fields of study, including self-driving cars, video surveillance, medical diagnosis, manufacturing, law, agriculture, quality control, health care, facial recognition, and military applications. Aromatic medicinal plants are botanical raw materials used in cosmetics, medicines, health foods, essential oils, decoration, cleaning, and other natural health products for therapeutic and Aromatic culinary purposes. These plants and their products not only serve as a valuable source of income for farmers and entrepreneurs but also going to export for valuable foreign currency exchange. In Ethiopia, there is a lack of technologies for the classification and identification of Aromatic medicinal plant parts and disease type cured by aromatic medicinal plants. Farmers, industry personnel, academicians, and pharmacists find it difficult to identify plant parts and disease types cured by plants before ingredient extraction in the laboratory. Manual plant identification is a time-consuming, labor-intensive, and lengthy process. To alleviate these challenges, few studies have been conducted in the area to address these issues. One way to overcome these problems is to develop a deep learning model for efficient identification of Aromatic medicinal plant parts with their corresponding disease type. The objective of the proposed study is to identify the aromatic medicinal plant parts and their disease type classification using computer vision technology. Therefore, this research initiated a model for the classification of aromatic medicinal plant parts and their disease type by exploring computer vision technology. Morphological characteristics are still the most important tools for the identification of plants. Leaves are the most widely used parts of plants besides roots, flowers, fruits, and latex. For this study, the researcher used RGB leaf images with a size of 128x128 x3. In this study, the researchers trained five cutting-edge models: convolutional neural network, Inception V3, Residual Neural Network, Mobile Network, and Visual Geometry Group. Those models were chosen after a comprehensive review of the best-performing models. The 80/20 percentage split is used to evaluate the model, and classification metrics are used to compare models. The pre-trained Inception V3 model outperforms well, with training and validation accuracy of 99.8% and 98.7%, respectively.Keywords: aromatic medicinal plant, computer vision, convolutional neural network, deep learning, plant classification, residual neural network
Procedia PDF Downloads 1873314 Impact of Web 2.0 on Digital Divide in Azad Jammu and Kashmir
Authors: Sana Shokat, Rabia Riaz, Raja Shoaib Hussain, Saba Shabir
Abstract:
Digital divide is usually measured in terms of gap between those who can efficiently use new technological tools, such as Internet, and those who cannot. It is also hypothesized that web 2.0 tools motivate people to use technology i.e. Social networking sites can play an important role in bridging digital gap. This study was to determine the presence of digital divide in urban and rural areas of district Muzaffrabad, Azad Jammu & Kashmir taking internet usage as the key element. A cross-sectional community based survey was conducted involving 384 respondents from city Muzaffrabad and village Garhi Doppta. The existence of digital divide was accessed on the basis of the questionnaires given. Chi- square test was used to find the association of different demographic and ICT related factors with internet usage. Age based and area based divide still exist among the targeted population but gender based digital divide is vanishing from the intended area of study. Outcomes of the survey also revealed that web 2.0-based web sites are also becoming popular and attracting people to use internet. Trend of using internet and communication technologies can be increased by solving the highlighted problems.Keywords: Azad Jammu and Kashmir, digital divide, ICT, information and communication technology, Web2.0
Procedia PDF Downloads 3673313 Examining Smallholder Farmers’ Perceptions of Climate Change and Barriers to Strategic Adaptation in Todee District, Liberia
Authors: Joe Dorbor Wuokolo
Abstract:
Thousands of smallholder farmers in Todee District, Montserrado county, are currently vulnerable to the negative impact of climate change. The district, which is the agricultural hot spot for the county, is faced with unfavorable changes in the daily temperature due to climate change. Farmers in the district have observed a dramatic change in the ratio of rainfall to sunshine, which has caused a chilling effect on their crop yields. However, there is a lack of documentation regarding how farmers perceive and respond to these changes and challenges. A study was conducted in the region to examine the perceptions of smallholder farmers regarding the negative impact of climate change, the adaptation strategies practice, and the barriers that hinder the process of advancing adaptation strategy. On purpose, a sample of 41 respondents from five towns was selected, including five town chiefs, five youth leaders, five women leaders, and sixteen community members. Women and youth leaders were specifically chosen to provide gender balance and enhance the quality of the investigation. Additionally, to validate the barriers farmers face during adaptation to climate change, this study interviewed eight experts from local and international organizations and government ministries and agencies involved in climate change and agricultural programs on what they perceived as the major barrier in both local and national level that impede farmers adaptation to climate change impact. SPSS was used to code the data, and descriptive statistics were used to analyze the data. The weighted average index (WAI) was used to rank adaptation strategies and the perceived importance of adaptation practices among farmers. On a scale from 0 to 3, 0 indicates the least important technique, and 3 indicates the most effective technique. In addition, the Problem Confrontation Index (PCI) was used to rank the barriers that prevented farmers from implementing adaptation measures. According to the findings, approximately 60% of all respondents considered the use of irrigation systems to be the most effective adaptation strategy, with drought-resistant varieties making up 30% of the total. Additionally, 80% of respondents placed a high value on drought-resistant varieties, while 63% percent placed it on irrigation practices. In addition, 78% of farmers ranked and indicated that unpredictability of the weather is the most significant barrier to their adaptation strategies, followed by the high cost of farm inputs and lack of access to financing facilities. 80% of respondents believe that the long-term changes in precipitation (rainfall) and temperature (hotness) are accelerating. This suggests that decision-makers should adopt policies and increase the capacity of smallholder farmers to adapt to the negative impact of climate change in order to ensure sustainable food production.Keywords: adaptation strategies, climate change, farmers’ perception, smallholder farmers
Procedia PDF Downloads 823312 Pavement Roughness Prediction Systems: A Bump Integrator Approach
Authors: Manish Pal, Rumi Sutradhar
Abstract:
Pavement surface unevenness plays a pivotal role on roughness index of road which affects on riding comfort ability. Comfort ability refers to the degree of protection offered to vehicle occupants from uneven elements in the road surface. So, it is preferable to have a lower roughness index value for a better riding quality of road users. Roughness is generally defined as an expression of irregularities in the pavement surface which can be measured using different equipment like MERLIN, Bump integrator, Profilometer etc. Among them Bump Integrator is quite simple and less time consuming in case of long road sections. A case study is conducted on low volume roads in West District in Tripura to determine roughness index (RI) using Bump Integrator at the standard speed of 32 km/h. But it becomes too tough to maintain the requisite standard speed throughout the road section. The speed of Bump Integrator (BI) has to lower or higher in some distinctive situations. So, it becomes necessary to convert these roughness index values of other speeds to the standard speed of 32 km/h. This paper highlights on that roughness index conversional model. Using SPSS (Statistical Package of Social Sciences) software a generalized equation is derived among the RI value at standard speed of 32 km/h and RI value at other speed conditions.Keywords: bump integrator, pavement distresses, roughness index, SPSS
Procedia PDF Downloads 2473311 A Peer-Produced Community of Learning: The Case of Second-Year Algerian Masters Students at a Distance
Authors: Nihad Alem
Abstract:
Nowadays, distance learning (DL) is widely perceived as a reformed type of education that takes advantage of technology to give more appealing opportunities especially for learners whose life conditions impede their attendance to regular classrooms however, creating interactional environment for students to expand their learning community and alleviate the feeling of loneliness and isolation should receive more attention when designing a distance learning course. This research aims to explore whether the audio/video peer learning can offer pedagogical add-ons to the Algerian distance learners and what are the pros and cons of its application as an educational experience in a synchronous environment mediated by Skype. Data were collected using video recordings of six sessions, reflective logs, and in-depth semi-structured interviews and will be analyzed by qualitatively identifying and measuring the three constitutional elements of the educational experience of peer learning namely the social presence, the cognitive presence, and the facilitation presence using a modified community of inquiry coding template. The findings from this study will provide recommendations for effective peer learning educational experience using the facilitation presence concept.Keywords: audio/visual peer learning, community of inquiry, distance learning, facilitation presence
Procedia PDF Downloads 1513310 Perception of Health Care Providers: A Need to Introduce Screening of Maternal Mental Health at Primary Health Care in Nepal
Authors: Manisha Singh, Padam Simkhada
Abstract:
Background: Although mental health policy has been adapted in Nepal since 1997, the implementation of the policy framework is yet to happen. The fact that mental health services are largely concentrated in urban areas more specific to treatment only provides a clear picture of the scarcity of mental health services in the country. The shreds of evidence from around the world, along with WHO’s (World Health Organization) Mental Health Gap Action Program (mhGAP) suggest that effective mental health services can be provided from Primary Health Care (PHC) centers through community-based programs without having to place a specialized health worker. However, the country is still facing the same challenges to date with very few psychiatrists and psychologists, but they are largely based in cities. Objectives: The main objectives of this study are; (a) to understand the perception of health workers at PHC on maternal mental health, and (b) to assess the availability of the mental health services at PHC to address maternal mental health. Methods: This study used a qualitative approach where an in-depth interview was conducted with the health workers at the primary level. “Mayadevi” rural municipality in Rupendehi District that comprised of 13 small villages, was chosen as the study site. A total 8 health institutions which covered all 13 sites were included where either the health post in- charge or health worker working in maternal and child health care was interviewed for the study. All the health posts in the study area were included in the study. The interviews were conducted in Nepali; later, they were translated in English, transcribed, and triangulated. NViVO was used for the analysis. Results: The findings show that most of the health workers understood what maternal mental health was and deemed it as a public health issue. They could explain the symptoms and knew what medication to prescribe if need be. However, the majority of them failed to name the screening tools in place for maternal mental health. Moreover, they hadn’t even seen one. None of the health care centers had any provision for screening mental health status. However, one of the centers prescribed medication when the patients displayed symptoms of depression. But they believed there were a significant number of hidden cases in the community due to the stigma around mental health and being a woman with mental health problem makes the situation even difficult. Nonetheless, the health workers understood the importance of having screening tools and acknowledged the need of training and support in order to provide the services from PHC. Conclusion: Community health workers can identify cases with mental health problems and prevent them from deteriorating further. But there is a need for robust training and support to build the capacity of the health workers. The screening tools on mental health needs to be encouraged to be used in the PHC levels. Furthermore, community-based culture-sensitive programs need to be initiated and implemented to mitigate the stigma related issues around mental health.Keywords: maternal mental health, health care providers, screening, Nepal
Procedia PDF Downloads 1273309 Sustainable Development Variables to Assess Transport Infrastructure in Remote Destinations
Authors: Dimitrios J. Dimitriou, Maria F. Sartzetaki
Abstract:
The assessment variables of the accessibility and the sustainability of access infrastructure for remote regions may vary significant by location and a wide range of factors may affect the decision process. In this paper, the environmental disturbance implications of transportation system to key demand and supply variables impact the economic system in remote destination are descripted. According to a systemic approach, the key sustainability variables deals with decision making process that have to be included in strategic plan for the critical transport infrastructure development and their relationship to regional socioeconomic system are presented. The application deals with the development of railway in remote destinations, where the traditional CBA not include the external cost generated by the environmental impacts that may have a range of diverse impacts on transport infrastructure and services. The analysis output provides key messages to decision and policy makers towards sustainable development of transport infrastructure, especially for remote destinations where accessibility is a key factor of regional economic development and social stability. The key conclusion could be essential useful for relevant applications in remote regions in the same latitude.Keywords: sustainable development in remote regions, transport infrastructure, strategic planning, sustainability variables
Procedia PDF Downloads 3553308 Collaboration and Automatic Tutoring as a Learning Strategy: A Case Study in Programming Courses
Authors: Luis H. Gonzalez-Guerra, Armandina J. Leal-Flores
Abstract:
Students attending classrooms nowadays are habituated to use digital devices all the time and for multiple things. They have been familiar with digital technology throughout their lives so they have developed skills that should be naturally adopted as part of their study strategies. New learning styles require taking in consideration the use of models that support and promote student motivation for learning and development of their creative thinking skills. To achieve student learning in programming courses, different strategies are used. One of them is a collaboration between students, which is a tool which faculty can take advantage of when teaching these kinds of courses. Moreover, cooperation is an essential skill that society should reinforce in order to promote a healthy social environment and cohabitation. Nevertheless, students will still require support and advice to get a complete and correct programming solution to successfully address and solve the problems given throughout the course. This paper present a model where collaboration between students is associated with an automatic tutoring platform providing an excellent approach for the individual learning in collaborative activities in programming courses, and also motivates students to increase their knowledge regarding the topics covered in the classroom.Keywords: automatic tutoring, collaboration learning, creative thinking, motivation
Procedia PDF Downloads 2723307 Convectory Policing-Reconciling Historic and Contemporary Models of Police Service Delivery
Authors: Mark Jackson
Abstract:
Description: This paper is based on an theoretical analysis of the efficacy of the dominant model of policing in western jurisdictions. Those results are then compared with a similar analysis of a traditional reactive model. It is found that neither model provides for optimal delivery of services. Instead optimal service can be achieved by a synchronous hybrid model, termed the Convectory Policing approach. Methodology and Findings: For over three decades problem oriented policing (PO) has been the dominant model for western police agencies. Initially based on the work of Goldstein during the 1970s the problem oriented framework has spawned endless variants and approaches, most of which embrace a problem solving rather than a reactive approach to policing. This has included the Area Policing Concept (APC) applied in many smaller jurisdictions in the USA, the Scaled Response Policing Model (SRPM) currently under trial in Western Australia and the Proactive Pre-Response Approach (PPRA) which has also seen some success. All of these, in some way or another, are largely based on a model that eschews a traditional reactive model of policing. Convectory Policing (CP) is an alternative model which challenges the underpinning assumptions which have seen proliferation of the PO approach in the last three decades and commences by questioning the economics on which PO is based. It is argued that in essence, the PO relies on an unstated, and often unrecognised assumption that resources will be available to meet demand for policing services, while at the same time maintaining the capacity to deploy staff to develop solutions to the problems which were ultimately manifested in those same calls for service. The CP model relies on the observations from a numerous western jurisdictions to challenge the validity of that underpinning assumption, particularly in fiscally tight environment. In deploying staff to pursue and develop solutions to underpinning problems, there is clearly an opportunity cost. Those same staff cannot be allocated to alternative duties while engaged in a problem solution role. At the same time, resources in use responding to calls for service are unavailable, while committed to that role, to pursue solutions to the problems giving rise to those same calls for service. The two approaches, reactive and PO are therefore dichotomous. One cannot be optimised while the other is being pursued. Convectory Policing is a pragmatic response to the schism between the competing traditional and contemporary models. If it is not possible to serve either model with any real rigour, it becomes necessary to taper an approach to deliver specific outcomes against which success or otherwise might be measured. CP proposes that a structured roster-driven approach to calls for service, combined with the application of what is termed a resource-effect response capacity has the potential to resolve the inherent conflict between traditional and models of policing and the expectations of the community in terms of community policing based problem solving models.Keywords: policing, reactive, proactive, models, efficacy
Procedia PDF Downloads 4833306 Coupling Random Demand and Route Selection in the Transportation Network Design Problem
Authors: Shabnam Najafi, Metin Turkay
Abstract:
Network design problem (NDP) is used to determine the set of optimal values for certain pre-specified decision variables such as capacity expansion of nodes and links by optimizing various system performance measures including safety, congestion, and accessibility. The designed transportation network should improve objective functions defined for the system by considering the route choice behaviors of network users at the same time. The NDP studies mostly investigated the random demand and route selection constraints separately due to computational challenges. In this work, we consider both random demand and route selection constraints simultaneously. This work presents a nonlinear stochastic model for land use and road network design problem to address the development of different functional zones in urban areas by considering both cost function and air pollution. This model minimizes cost function and air pollution simultaneously with random demand and stochastic route selection constraint that aims to optimize network performance via road capacity expansion. The Bureau of Public Roads (BPR) link impedance function is used to determine the travel time function in each link. We consider a city with origin and destination nodes which can be residential or employment or both. There are set of existing paths between origin-destination (O-D) pairs. Case of increasing employed population is analyzed to determine amount of roads and origin zones simultaneously. Minimizing travel and expansion cost of routes and origin zones in one side and minimizing CO emission in the other side is considered in this analysis at the same time. In this work demand between O-D pairs is random and also the network flow pattern is subject to stochastic user equilibrium, specifically logit route choice model. Considering both demand and route choice, random is more applicable to design urban network programs. Epsilon-constraint is one of the methods to solve both linear and nonlinear multi-objective problems. In this work epsilon-constraint method is used to solve the problem. The problem was solved by keeping first objective (cost function) as the objective function of the problem and second objective as a constraint that should be less than an epsilon, where epsilon is an upper bound of the emission function. The value of epsilon should change from the worst to the best value of the emission function to generate the family of solutions representing Pareto set. A numerical example with 2 origin zones and 2 destination zones and 7 links is solved by GAMS and the set of Pareto points is obtained. There are 15 efficient solutions. According to these solutions as cost function value increases, emission function value decreases and vice versa.Keywords: epsilon-constraint, multi-objective, network design, stochastic
Procedia PDF Downloads 6473305 Promoting Stem Education and a Cosmic Perspective by Using 21st Century Science of Learning
Authors: Rohan Roberts
Abstract:
The purpose of this project was to collaborate with a group of high-functioning, more-able students (aged 15-18) to promote STEM Education and a love for science by bringing a cosmic perspective into the classroom and high school environment. This was done using 21st century science of learning, a focus on the latest research on Neuroeducation, and modern pedagogical methods based on Howard Gardner's theory of Multiple Intelligences, Bill Lucas’ theory of New Smarts, and Sir Ken Robinson’s recommendations on encouraging creativity. The result was an increased sense of passion, excitement, and wonder about science in general, and about the marvels of space and the universe in particular. In addition to numerous unique and innovative science-based initiatives, clubs, workshops, and science trips, this project also saw a marked rise in student-teacher collaboration in science learning and in student engagement with the general public through the press, social media, and community-based initiatives. This paper also outlines the practical impact that bringing a cosmic perspective into the classroom has had on the lives, interests, and future career prospects of the students involved in this endeavour.Keywords: cosmic perspective, gifted and talented, neuro-education, STEM education
Procedia PDF Downloads 3343304 Drug Delivery Cationic Nano-Containers Based on Pseudo-Proteins
Authors: Sophio Kobauri, Temur Kantaria, Nina Kulikova, David Tugushi, Ramaz Katsarava
Abstract:
The elaboration of effective drug delivery vehicles is still topical nowadays since targeted drug delivery is one of the most important challenges of the modern nanomedicine. The last decade has witnessed enormous research focused on synthetic cationic polymers (CPs) due to their flexible properties, in particular as non-viral gene delivery systems, facile synthesis, robustness, not oncogenic and proven gene delivery efficiency. However, the toxicity is still an obstacle to the application in pharmacotherapy. For overcoming the problem, creation of new cationic compounds including the polymeric nano-size particles – nano-containers (NCs) loading with different pharmaceuticals and biologicals is still relevant. In this regard, a variety of NCs-based drug delivery systems have been developed. We have found that amino acid-based biodegradable polymers called as pseudo-proteins (PPs), which can be cleared from the body after the fulfillment of their function are highly suitable for designing pharmaceutical NCs. Among them, one of the most promising are NCs made of biodegradable Cationic PPs (CPPs). For preparing new cationic NCs (CNCs), we used CPPs composed of positively charged amino acid L-arginine (R). The CNCs were fabricated by two approaches using: (1) R-based homo-CPPs; (2) Blends of R-based CPPs with regular (neutral) PPs. According to the first approach NCs we prepared from CPPs 8R3 (composed of R, sebacic acid and 1,3-propanediol) and 8R6 (composed of R, sebacic acid and 1,6-hexanediol). The NCs prepared from these CPPs were 72-101 nm in size with zeta potential within +30 ÷ +35 mV at a concentration 6 mg/mL. According to the second approach, CPPs 8R6 was blended in organic phase with neutral PPs 8L6 (composed of leucine, sebacic acid and 1,6-hexanediol). The NCs prepared from the blends were 130-140 nm in size with zeta potential within +20 ÷ +28 mV depending on 8R6/8L6 ratio. The stability studies of fabricated NCs showed that no substantial change of the particle size and distribution and no big particles’ formation is observed after three months storage. In vitro biocompatibility study of the obtained NPs with four different stable cell lines: A549 (human), U-937 (human), RAW264.7 (murine), Hepa 1-6 (murine) showed both type cathionic NCs are biocompatible. The obtained data allow concluding that the obtained CNCs are promising for the application as biodegradable drug delivery vehicles. This work was supported by the joint grant from the Science and Technology Center in Ukraine and Shota Rustaveli National Science Foundation of Georgia #6298 'New biodegradable cationic polymers composed of arginine and spermine-versatile biomaterials for various biomedical applications'.Keywords: biodegradable polymers, cationic pseudo-proteins, nano-containers, drug delivery vehicles
Procedia PDF Downloads 1553303 The Language of Hip-Hop and Rap in Tunisia: Symbol of Cultural Change in Post-Arab Spring Tunisia
Authors: Zouhir Gabsi
Abstract:
The Arab Spring has had noticeable effects on Tunisia in socio-economic, political, and cultural terms. Few have predicted that the music of hip-hop and rap could engage with the socio-political situation in Tunisia, especially after the downfall of Ben Ali’s regime. Having survived as underground music since the year 2000, the genre of hip-hop and rap remains an aberration from the folkloric tradition. By adhering to the socio-economic reality of the Tunisian street, rappers attempt to claim authenticity mainly in both thematic and language uses, and by usurping the power of ‘space’ from the regime’s control. With the songs’ fast-paced rhythms, catchy phrases, puns, vulgarisms, and linguistic innovations using metaphors, hip-hop, and rap have struck a chord with Tunisia’s youth. Tunisia’s new social reality has allowed Tunisian rappers to express dissent and voice people’s despair over the socio-economic and political situation. This paper argues that rap artists use language as a vehicle to claim the authenticity of their message. It also explores how the performative nature of the language of hip-hop and rap interacts with the Tunisian culture and argues the power of music in the context of political and socio-economic grievances in post-Arab Spring Tunisia.Keywords: Arab Spring, hip-hop, eevolution, Tunisia, Tunisian Arabic
Procedia PDF Downloads 1523302 Planning a European Policy for Increasing Graduate Population: The Conditions That Count
Authors: Alice Civera, Mattia Cattaneo, Michele Meoli, Stefano Paleari
Abstract:
Despite the fact that more equal access to higher education has been an objective public policy for several decades, little is known about the effectiveness of alternative means for achieving such goal. Indeed, nowadays, high level of graduate population can be observed both in countries with the high and low level of fees, or high and low level of public expenditure in higher education. This paper surveys the extant literature providing some background on the economic concepts of the higher education market, and reviews key determinants of demand and supply. A theoretical model of aggregate demand and supply of higher education is derived, with the aim to facilitate the understanding of the challenges in today’s higher education systems, as well as the opportunities for development. The model is validated on some exemplary case studies describing the different relationship between the level of public investment and levels of graduate population and helps to derive general implications. In addition, using a two-stage least squares model, we build a macroeconomic model of supply and demand for European higher education. The model allows interpreting policies shifting either the supply or the demand for higher education, and allows taking into consideration contextual conditions with the aim of comparing divergent policies under a common framework. Results show that the same policy objective (i.e., increasing graduate population) can be obtained by shifting either the demand function (i.e., by strengthening student aid) or the supply function (i.e., by directly supporting higher education institutions). Under this theoretical perspective, the level of tuition fees is irrelevant, and empirically we can observe high levels of graduate population in both countries with high (i.e., the UK) or low (i.e., Germany) levels of tuition fees. In practice, this model provides a conceptual framework to help better understanding what are the external conditions that need to be considered, when planning a policy for increasing graduate population. Extrapolating a policy from results in different countries, under this perspective, is a poor solution when contingent factors are not addressed. The second implication of this conceptual framework is that policies addressing the supply or the demand function needs to address different contingencies. In other words, a government aiming at increasing graduate population needs to implement complementary policies, designing them according to the side of the market that is interested. For example, a ‘supply-driven’ intervention, through the direct financial support of higher education institutions, needs to address the issue of institutions’ moral hazard, by creating incentives to supply higher education services in efficient conditions. By contrast, a ‘demand-driven’ policy, providing student aids, need to tackle the students’ moral hazard, by creating an incentive to responsible behavior.Keywords: graduates, higher education, higher education policies, tuition fees
Procedia PDF Downloads 1663301 Management Problems in a Patient With Long-term Undiagnosed Permanent Hypoparathyroidism
Authors: Babarina Maria, Andropova Margarita
Abstract:
Introduction: Hypoparathyroidism (HypoPT) is a rare endocrine disorder with an estimated prevalence of 0.25 per 1000 individuals. The most common cause of HypoPT is the loss of active parathyroid tissue following thyroid or parathyroid surgery. Sometimes permanent postoperative HypoPT occures, manifested by hypocalcemia in combination with low levels of PTH during 6 months or more after surgery. Cognitive impairments in patients with hypocalcemia due to chronic HypoPT are observed, and this can lead to problems and challenges in everyday living: memory loss and impaired concentration, that may be the cause of poor compliance. Clinical case: Patient K., 66 years old, underwent thyroidectomy in 2013 (at the age of 55) because of papillary thyroid cancer T1NxMx, histopathology findings confirmed the diagnosis. 5 years after the surgery, she was followed up on an outpatient basis, TSH levelsonly were monitored, and the dose of levothyroxine was adjusted. In 2018 due to, increasing complaints include tingling and cramps in the arms and legs, memory loss, sleep disorder, fatigue, anxiety, hair loss, muscle pain, tachycardia, positive Chvostek, and Trousseau signs were diagnosed during examination, also in blood analyses: total Ca 1.86 mmol/l (2.15-2.55), Ca++ 0.96 mmol/l (1.12-1.3), P 1.55 mmol/l (0.74-1.52), Mg 0.79 mmol/l (0.66-1.07) - chronic postoperative HypoPT was diagnosed. Therapy was initiated: alfacalcidol 0.5 mcg per day, calcium carbonate 2000 mg per day, cholecalciferol 1000 IU per day, magnesium orotate 3000 mg per day. During the case follow-up, hypocalcemia, hyperphosphatemia persisted, hypercalciuria15.7 mmol/day (2.5-6.5) was diagnosed. Dietary recommendations were given because of the high content of phosphorus rich foods, and therapy was adjusted: the dose of alfacalcidol was increased to 2.5 mcg per day, and the dose of calcium carbonate was reduced to 1500 mg per day. As part of the screening for complications of hypoPT, data for cataracts, Fahr syndrome, nephrocalcinosis, and kidney stone disease were not obtained. However, HypoPT compensation was not achieved, and therefore hydrochlorothiazide 25 mg was initiated, the dose of alfacalcidol was increased to 3 mcg per day, calcium carbonate to 3000 mg per day, magnesium orotate and cholecalciferol were continued at the same doses. Therapeutic goals were achieved: calcium phosphate product <4.4 mmol2/l2, there were no episodes of hypercalcemia, twenty-four-hour urinary calcium excretion was significantly reduced. Conclusion: Timely prescription, careful explanation of drugs usage rules, and monitoring and maintaining blood and urine parameters within the target contribute to the prevention of HypoPT complications development and life-threatening events.Keywords: hypoparathyroidism, hypocalcemia, hyperphosphatemia, hypercalciuria
Procedia PDF Downloads 1083300 Digital Literacy Transformation and Implications in Institutions of Higher Learning in Kenya
Authors: Emily Cherono Sawe, Elisha Ondieki Makori
Abstract:
Knowledge and digital economies have brought challenges and potential opportunities for universities to innovate and improve the quality of learning. Disruption technologies and information dynamics continue to transform and change the landscape in teaching, scholarship, and research activities across universities. Digital literacy is a fundamental and imperative element in higher education and training, as witnessed during the new norm. COVID-19 caused unprecedented disruption in universities, where teaching and learning depended on digital innovations and applications. Academic services and activities were provided online, including library information services. Information professionals were forced to adopt various digital platforms in order to provide information services to patrons. University libraries’ roles in fulfilling educational responsibilities continue to evolve in response to changes in pedagogy, technology, economy, society, policies, and strategies of parent institutions. Libraries are currently undergoing considerable transformational change as a result of the inclusion of a digital environment. Academic libraries have been at the forefront of providing online learning resources and online information services, as well as supporting students and staff to develop digital literacy skills via online courses, tutorials, and workshops. Digital literacy transformation and information staff are crucial elements reminiscent of the prioritization of skills and knowledge for lifelong learning. The purpose of this baseline research is to assess the implications of digital literacy transformation in institutions of higher learning in Kenya and share appropriate strategies to leverage and sustain teaching and research. Objectives include examining the leverage and preparedness of the digital literacy environment in streamlining learning in the universities, exploring and benchmarking imperative digital competence for information professionals, establishing the perception of information professionals towards digital literacy skills, and determining lessons, best practices, and strategies to accelerate digital literacy transformation for effective research and learning in the universities. The study will adopt a descriptive research design using questionnaires and document analysis as the instruments for data collection. The targeted population is librarians and information professionals, as well as academics in public and private universities teaching information literacy programmes. Data and information are to be collected through an online structured questionnaire and digital face-to-face interviews. Findings and results will provide promising lessons together with best practices and strategies to transform and change digital literacies in university libraries in Kenya.Keywords: digital literacy, digital innovations, information professionals, librarians, higher education, university libraries, digital information literacy
Procedia PDF Downloads 963299 Confirmatory Factor Analysis of Smartphone Addiction Inventory (SPAI) in the Yemeni Environment
Authors: Mohammed Al-Khadher
Abstract:
Currently, we are witnessing rapid advancements in the field of information and communications technology, forcing us, as psychologists, to combat the psychological and social effects of such developments. It also drives us to continually look for the development and preparation of measurement tools compatible with the changes brought about by the digital revolution. In this context, the current study aimed to identify the factor analysis of the Smartphone Addiction Inventory (SPAI) in the Republic of Yemen. The sample consisted of (1920) university students (1136 males and 784 females) who answered the inventory, and the data was analyzed using the statistical software (AMOS V25). The factor analysis results showed a goodness-of-fit of the data five-factor model with excellent indicators, as RMSEA-(.052), CFI-(.910), GFI-(.931), AGFI-(.915), TLI-(.897), NFI-(.895), RFI-(.880), and RMR-(.032). All within the ideal range to prove the model's fit of the scale’s factor analysis. The confirmatory factor analysis results showed factor loading in (4) items on (Time Spent), (4) items on (Compulsivity), (8) items on (Daily Life Interference), (5) items on (Craving), and (3) items on (Sleep interference); and all standard values of factor loading were statistically significant at the significance level (>.001).Keywords: smartphone addiction inventory (SPAI), confirmatory factor analysis (CFA), yemeni students, people at risk of smartphone addiction
Procedia PDF Downloads 953298 Perspective and Challenge of Tidal Power in Bangladesh
Authors: Md. Alamgir Hossain, Md. Zakir Hossain, Md. Atiqur Rahman
Abstract:
Tidal power can play a vital role in integrating as new source of renewable energy to the off-grid power connection in isolated areas, namely Sandwip, in Bangladesh. It can reduce the present energy crisis and improve the social, environmental and economic perspective of Bangladesh. Tidal energy is becoming popular around the world due to its own facilities. The development of any country largely depends on energy sector improvement. Lack of energy sector is because of hampering progress of any country development, and the energy sector will be stable by only depend on sustainable energy sources. Renewable energy having environmental friendly is the only sustainable solution of secure energy system. Bangladesh has a huge potential of tidal power at different locations, but effective measures on this issue have not been considered sincerely. This paper summarizes the current energy scenario, and Bangladesh can produce power approximately 53.19 MW across the country to reduce the growing energy demand utilizing tidal energy as well as it is shown that Sandwip is highly potential place to produce tidal power, which is estimated approximately 16.49 MW by investing only US $10.37 million. Besides this, cost management for tidal power plant has been also discussed.Keywords: sustainable energy, tidal power, cost analysis, power demand, gas crisis
Procedia PDF Downloads 4943297 The Taiwan Environmental Impact Assessment Act Contributes to the Water Resources Saving
Authors: Feng-Ming Fan, Xiu-Hui Wen
Abstract:
Shortage of water resources is a crucial problem to be solved in Taiwan. However, lack of effective and mandatory regulation on water recovery and recycling leads to no effective water resource controls currently. Although existing legislation sets standards regarding water recovery, implementation and enforcement of legislation are facing challenges. In order to break through the dilemma, this study aims to find enforcement tools, improve inspection skills, develop an inspection system, to achieve sustainable development of precious water resources. The Taiwan Environmental Impact Assessment Act (EIA Act) was announced on 1994. The aim of EIA Act is to protect the environment by preventing and mitigating the adverse impact of development activity on the environment. During the EIA process, we can set standards that require enterprises to reach a certain percentage of water recycling based on different case characteristics, to promote sewage source reduction and water saving benefits. Next, we have to inspect how the enterprises handle their waste water and perform water recovery based on environmental assessment commitments, for the purpose of reviewing and measuring the implementation efficiency of water recycling and reuse, an eco-friendly measure. We invited leading experts in related fields to provide lecture on water recycling, strengthen law enforcement officials’ inspection knowledge, and write inspection reference manual to be used as basis of enforcement. Then we finalized the manual by reaching mutual agreement between the experts and relevant agencies. We then inspected 65 high-tech companies whose daily water consumption is over 1,000 tons individually, located at 3 science parks, set up by Ministry of Science and Technology. Great achievement on water recycling was achieved at an amount of 400 million tons per year, equivalent to 2.5 months water usage for general public in Taiwan. The amount is equal to 710 billion bottles of 600 ml cola, 170 thousand international standard swimming pools of 2,500 tons, irrigation water applied to 40 thousand hectares of rice fields, or 1.7 Taipei Feitsui Reservoir of reservoir storage. This study demonstrated promoting effects of environmental impact assessment commitments on water recycling, and therefore water resource sustainable development. It also confirms the value of EIA Act for environmental protection. Economic development should go hand in hand with environmental protection, and it’s a mainstream. It clearly shows the EIA regulation can minimize harmful effects caused by development activity to the environment, as well as pursuit water resources sustainable development.Keywords: the environmental impact assessment act, water recycling environmental assessment commitment, water resource sustainable development, water recycling, water reuse
Procedia PDF Downloads 2473296 Establishment of Aquaculture Cooperative for Sustainable Local People Economic Welfare in Jatiluhur, West Java, Indonesia
Authors: Aisyah Nurfitria, Alifa Rahmadia Putri, Andini Lestari, Kartika Sukmatullahi Hasanah, Mutiara Mayang Oktavia
Abstract:
The research aims to describe and analyze the background and condition of Jatiluhur Dam, West Java, Indonesia. The Jatiluhur Dam as known as the biggest dam in West Java has huge fisheries resource, which is supposed to assure the local people appropriateness of living. Unfortunately based on this field research, the local people are living a life in under poverty line. This study focuses on increasing local people economic welfare through “Aquaculture Cooperative” implementation. Empower and diversify income of local people is the purpose of this study. In the same way, this study also focuses on the sustainable local people’s livelihoods. In order to obtain the sustainability of them, recovering the fisheries of Jatiluhur Dam is the part of “Aquaculture Cooperative” program. Method that is used in this research is a qualitative approach by literature review and in-depth interview through direct observation as data collecting techniques. Factors such as social and economic condition are also considered in order to know how “Aquaculture Cooperative” able to accepted by local people.Keywords: aquaculture cooperative, economic welfare, Jatiluhur fisheries, West Java
Procedia PDF Downloads 4473295 An Evaluative Approach for Successful Implementation of Lean and Green Manufacturing in Indian SMEs
Authors: Satya S. N. Narayana, P. Parthiban, T. Niranjan, N. Kannan
Abstract:
Enterprises adopt methodologies to increase their business performance and to stay competent in the volatile global market. Lean manufacturing is one such manufacturing paradigm which focuses on reduction of cost by elimination of wastes or non-value added activities. With increased awareness about social responsibility and the necessary to meet the terms of the environmental policy, green manufacturing is becoming increasingly important for industries. Large plants have more resources, have started implementing lean and green practices and they are getting good results. Small and medium scale enterprises (SMEs) are facing problems in implementing lean and green concept. This paper aims to identify the key issues for implementation of lean and green concept in Indian SMEs. The key factors identified based on literature review and expert opinions are grouped into different levels by Modified Interpretive Structural Modeling (MISM) to explore the importance among the factors to implement lean and green manufacturing. Finally, Fuzzy Analytic Network Process (FANP) method has been used to determine the extent to which the main principles of lean and green manufacturing have been carried out in the six Indian medium scale manufacturing industries.Keywords: lean manufacturing, green manufacturing, MISM, FANP
Procedia PDF Downloads 5433294 Influences of Emerging Beauty Industry for Men on Construction of Masculinities of Male Students of Dhaka City
Authors: Abu Saleh Mohammad Sowad
Abstract:
Back in history, muscular and strong male body has always been used to promulgate masculinity; for physically representing supreme manliness there were not many other options. This idealized male figure was proliferated mainly for spreading the notion of male superiority in relation to power and to give a strong base to the social construction of masculinity. This study targets to disclose the perception about the attributes masculinities among the male students of Dhaka city regarding male beautification. It is an attempt to unveil young men’s perspectives regarding their masculinities and beauty. Till the very recent past, beauty was always seen as sole feminine trait in Bangladeshi society. From history we can see men have always been assumed as the ambassador of roughness but in recent time the emergence of fashion-conscious men can be seen, who are slowly occupying a handsome position in the society. Concerning study attempts to bring out the way in which such changing trend of male beauty is perceived among the male students of Dhaka city. What could be the ideologies of these young men who are being involved with it? What is influencing them to be part of such arena which, to a great extent, is still considered as female domain? Is their perception about construction of masculinity is shifting from the so called idealized masculinity? The study tries to find out the answers.Keywords: masculinity, male beauty, Bangladesh, identity, body
Procedia PDF Downloads 4743293 The Impact of Bayh-Dole Act on Knowledge Transfer in the States and a Study on Applicability in Turkey
Authors: Murat Sengoz, Mustafa Kemal Topcu
Abstract:
This study aims to contribute to efforts of Turkey to increase research and development to overcome mid-income level trap by discussing regulations on patenting and licensing. Knowledge and technology transfer from universities to business world is attached great significance to increase innovation. Through literature survey, it is observed that the States accomplished to boost the economy and increase welfare by the Bayh-Dole Act enacted in 1980. Thus, this good practice is imitated by other nations to make technological developments. The Act allows universities to acquire patent right in research programs funded by government to increase technology transfer from universities whilst motivating real sector to use research pools in the universities. An act similar with Bayh-Dole could be beneficial to Turkey since efforts in Turkey are to promote research, development and innovation. Towards this end, the impact of Bayh-Dole Act on the patent system for universities in the Sates is deliberately examined, applicability in Turkey is discussed. However, it is conceded that success rate of applying Bayh-Dole Act in Turkey would be low once Turkey mainly differs from the States regarding social, economic and cultural traits.Keywords: Bayh-Dole Act, knowledge transfer, license, patent, spin-off
Procedia PDF Downloads 2823292 Menopause Hormone Therapy: An Insight into Knowledge and Attitudes of Obstetricians and Gynecologists in Singapore
Authors: Tan Hui Ying Renee, Stella Rizalina Sasha, Farah Safdar Husain
Abstract:
Introduction: Menopause Hormone Therapy (MHT) is an effective drug indicated for the treatment of menopausal symptoms and as replacement therapy in women who undergo premature menopause. In 2020, less than 8.8% of perimenopausal Singaporean women are on hormonal therapy, as compared to the Western population, where up to 50% may be on MHT. Factors associated with MHT utilization have been studied from patient characteristics, but the impact of locally prescribing physicians resulting in low MHT utilization has yet to be evaluated. The aim of the study is to determine the level of knowledge physicians in the Obstetrics and Gynaecology specialty have and their attitudes toward MHT. We believe that knowledge of MHT is lacking and that negative attitudes towards MHT may influence its use and undermine the benefits MHT may have for women. This paper is a part of a larger study on Singaporean physicians’ knowledge and attitudes towards MHT. Methods: This is a cross-sectional study intended to assess the knowledge and attitudes of physicians toward Menopausal Hormone Therapy. An anonymous questionnaire was disseminated via institutional internal circulations to optimize reach to physicians who may prescribe MHT, particularly in the fields of Gynaecology, Family Medicine and Endocrinology. Responses were completed voluntarily. Physicians had the option for each question to declare that they were ‘unsure’ or that the question was ‘beyond their expertise’. 21 knowledge questions tested factual recall on indications, contraindications, and risks of MHT. The remaining 6 questions were clinical scenarios crafted with the intention of testing specific principles related to the use of MHT. These questions received face validation from experts in the field. 198 responses were collected, 79 of which were from physicians in the Obstetrics and Gynaecology specialty. The data will be statistically analyzed to investigate areas that can be improved to increase the overall benefits of MHT for the Singaporean population. Results: Preliminary results show that the prevailing factors that limit Singaporean gynecologists and obstetricians from prescribing MHT are a lack of knowledge of MHT and a lack of confidence in prescribing MHT. Risks and indications of MHT were not well known by many physicians, with the majority of the questions having more than 25% incorrect and ‘unsure’ as their reply. The clinical scenario questions revealed significant shortcomings in knowledge on how to navigate real-life challenges in MHT use, with 2 of 6 questions with more than 50% incorrect or ‘beyond their expertise’ as their reply. The portion of the questionnaire that investigated the attitudes of physicians showed that though a large majority believed MHT to be an effective drug, only 40.5% were confident in prescribing it. Conclusion: Physicians in the Obstetrics and Gynaecology specialty lack knowledge and confidence in MHT. Therefore, it is imperative to formulate solutions on both the individual and institutional levels to fill these gaps and ensure that MHT is used appropriately and prescribed to the patients who need it.Keywords: menopause, menopause hormone therapy, physician factors, obstetrics and gynecology, menopausal symptoms, Singapore
Procedia PDF Downloads 39