Search results for: institutional mission
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1544

Search results for: institutional mission

314 Effect of Simulation on Anxiety and Knowledge among Novice Nursing Students

Authors: Suja Karkada, Jayanthi Radhakrishnan, Jansi Natarajan, Gerald, Amandu Matua, Sujatha Shanmugasundaram

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Simulation-based learning is an educational strategy designed to simulate actual clinical situations in a safe environment. Globally, simulation is recognized by several landmark studies as an effective teaching-learning method. A systematic review of the literature on simulation revealed simulation as a useful strategy in creating a learning environment which contributes to knowledge, skills, safety, and confidence. However, to the best of the author's knowledge, there are no studies on assessing the anxiety of the students undergoing simulation. Hence the researchers undertook a study with the aim to evaluate the effectiveness of simulation on anxiety and knowledge among novice nursing students. This quasi-experimental study had a total sample of 69 students (35- Intervention group with simulation and 34- Control group with case scenario) consisting of all the students enrolled in the Fundamentals of Nursing Laboratory course during Spring 2016 and Fall 2016 semesters at a college of nursing in Oman. Ethical clearance was obtained from the Institutional Review Board (IRB) of the college of nursing. Informed consent was obtained from every participant. Study received the Dean’s fund for research. The data were collected regarding the demographic information, knowledge and anxiety levels before and after the use of simulation and case scenario for the procedure nasogastric tube feeding in intervention and control group respectively. The intervention was performed by four faculties who were the core team members of the course. Results were analyzed in SPSS using descriptive and inferential statistics. Majority of the students’ in intervention (82.9%) and control (89.9%) groups were equal to or below the age of 20 years, were females (71%), 76.8% of them were from rural areas and 65.2% had a GPA of more than 2.5. The selection of the samples to either the experimental or the control group was from a homogenous population (p > 0.05). There was a significant reduction of anxiety among the students of control group (t (67) = 2.418, p = 0.018) comparing to the experimental group, indicating that simulation creates anxiety among Novice nursing students. However, there was no significant difference in the mean scores of knowledge. In conclusion, the study was useful in that it will help the investigators better understand the implications of using simulation in teaching skills to novice students. Since previous studies with students indicate better knowledge acquisition; this study revealed that simulation can increase anxiety among novice students possibly it is the first time they are introduced to this method of teaching.

Keywords: anxiety, knowledge, novice students, simulation

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313 ‘Green Gait’ – The Growing Relevance of Podiatric Medicine amid Climate Change

Authors: Angela Evans, Gabriel Gijon-Nogueron, Alfonso Martinez-Nova

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Background The health sector, whose mission is protecting health, also contributes to the climate crisis, the greatest health threat of the 21st century. The carbon footprint from healthcare exceeds 5% of emissions globally, surpassing 7% in the USA and Australia. Global recognition has led to the Paris Agreement, the United Nations Sustainable Development Goals, and the World Health Organization's Climate Change Action Plan. It is agreed that the majority of health impacts stem from energy and resource consumption, as well as the production of greenhouse gases in the environment and deforestation. Many professional medical associations and healthcare providers advocate for their members to take the lead in environmental sustainability. Objectives To avail and expand ‘Green Podiatry’ via the three pillars of: Exercise ; Evidence ; Everyday changes; to highlight the benefits of physical activity and exercise for both human health and planet health. Walking and running are beneficial for health, provide low carbon transport, and have evidence-based health benefits. Podiatrists are key healthcare professionals in the physical activity space and can influence and guide their patients to increase physical activity and avert the many non-communicable diseases that are decimating public health, eg diabetes, arthritis, depression, cancer, obesity. Methods Publications, conference presentations, and pilot projects pertinent to ‘Green Podiatry’ have been activated since 2021, and a survey of podiatrist’s knowledge and awareness has been undertaken.The survey assessed attitudes towards environmental sustainability in work environment. The questions addressed commuting habits, hours of physical exercise per week, and attitudes in the clinic, such as prescribing unnecessary treatments or emphasizing sports as primary treatment. Results Teaching and Learning modules have been developed for podiatric medicine students and graduates globally. These will be availed. A pilot foot orthoses recycling project has been undertaken and will be reported, in addition to established footwear recycling. The preliminary survey found almost 90% of respondents had no knowledge of green podiatry or footwear recycling. Only 30% prescribe sports/exercise as the primary treatment for patients, and 45% do not to prescribe unnecessary treatments. Conclusions Podiatrists are in a good position to lead in the crucial area of healthcare and climate change implications. Sufficient education of podiatrists is essential for the profession to beneficially promote health and physical activity, which is beneficial for the health of all peoples and all communities.

Keywords: climate change, gait, green, healthcare, sustainability

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312 Physical Planning Strategies for Disaster Mitigation and Preparedness in Coastal Region of Andhra Pradesh, India

Authors: Thimma Reddy Pothireddy, Ramesh Srikonda

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India is prone to natural disasters such as Floods, droughts, cyclones, earthquakes and landslides frequently due to its geographical considerations. It has become a persistent phenomenon as observed in last ten decades. The recent survey indicates that about 60% of the landmass is prone to earthquakes of various intensities with reference to Richard scale, over 40 million hectares is prone to floods; about 8% of the total area is prone to cyclones and 68% of the area is vulnerable to drought. Climate change is likely to be perceived through the experience of extreme weather events. There is growing societal concern about climate change, given the potential impacts of associated natural hazards such as cyclones, flooding, earthquakes, landslides etc. The recent natural calamities such as Cyclone Hudhud had crossed the land at Northern cost of AP, Vishakapatanam on 12 Oct’2014 with a wind speed ranging between 175 – 200 kmph and the records show that the tidal waves were reached to the height of 14mts and above; and it alarms us to have critical focus on planning issues so as to find appropriate solutions. The existing condition is effective is in terms of institutional set up along with responsive management mechanism of disaster mitigation but considerations at settlement planning level to allow mitigation operations are not adequate. This paper deals to understand the response to climate change will possibly happen through adaptation to climate hazards and essential to work out an appropriate mechanism and disaster receptive settlement planning for responding to natural (and climate-related) calamities particularly to cyclones and floods. The statistics indicate that 40 million hectares flood prone (5% of area), and 1853 kmts of cyclone prone coastal length in India so it is essential and crucial to have appropriate physical planning considerations to improve preparedness and to operate mitigation measures effectively to minimize the loss and damage. Vijayawada capital region which is susceptible to cyclonic and floods has been studied with respect to trajectory analysis to work out risk vulnerability and to integrated disaster mitigation physical planning considerations.

Keywords: meta analysis, vulnerability index, physical planning, trajectories

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311 Brazilian Public Security: Governability and Constitutional Change

Authors: Gabriel Dolabella, Henrique Rangel, Stella Araújo, Carlos Bolonha, Igor de Lazari

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Public security is a common subject on the Brazilian political agenda. The seventh largest economy in the world has high crime and insecurity rates. Specialists try to explain this social picture based on poverty, inequality or public policies addressed to drug trafficking. This excerpt approaches State measures to handle that picture. Therefore, the public security - law enforcement institutions - is at the core of this paper, particularly the relationship among federal and state law enforcement agencies, mainly ruled by a system of urgency. The problems are informal changes on law enforcement management and public opinion collaboration to these changes. Whenever there were huge international events, Brazilian armed forces occupied streets to assure law enforcement - ensuring the order. This logic, considered in the long time, could impact the federal structure of the country. The post-madisonian theorists verify that urgency is often associated to delegation of powers, which is true for Brazilian law enforcement, but here there is a different delegation: States continuously delegate law enforcement powers to the federal government throughout the use of Armed Forces. Therefore, the hypothesis is: Brazil is under a political process of federalization of public security. The political framework addressed here can be explained by the disrespect of legal constraints and the failure of rule of law theoretical models. The methodology of analysis is based on general criteria. Temporally, this study investigates events from 2003, when discussions about the disarmament statute begun. Geographically, this study is limited to Brazilian borders. Materially, the analysis result from the observation of legal resources and political resources (pronouncements of government officials). The main parameters are based on post-madisonianism and federalization of public security can be assessed through credibility and popularity that allow evaluation of this political process of constitutional change. The objective is to demonstrate how the Military Forces are used in public security, not as a random fact or an isolated political event, in order to understand the political motivations and effects that stem from that use from an institutional perspective.

Keywords: public security, governability, rule of law, federalism

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310 Palliative Care Referral Behavior Among Nurse Practitioners in Hospital Medicine

Authors: Sharon Jackson White

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Purpose: Nurse practitioners (NPs) practicing within hospital medicine play a significant role in caring for patients who might benefit from palliative care (PC) services. Using the Theory of Planned Behavior, the purpose of this study was to examine the relationships among facilitators to referral, barriers to referral, self-efficacy with end-of-life discussions, history of referral, and referring to PC among NPs in hospital medicine. Hypotheses: 1) Perceived facilitators to referral will be associated with a higher history of referral and a higher number of referrals to PC. 2) Perceived barriers to referral will be associated with a lower history of referral and a lower number of referrals to PC. 3) Increased self-efficacy with end-of-life discussions will be associated with a higher history of referral and a higher number of referrals to PC. 4) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the history of referral to PC. 5) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the number of referrals to PC. Significance: Previous studies of referring patients to PC within the hospital setting care have focused on physician practices. Identifying factors that influence NPs referring hospitalized patients to PC is essential to ensure that patients have access to these important services. This study incorporates the SNRS mission of advancing nursing research through the dissemination of research findings and the promotion of nursing science. Methods: A cross-sectional, predictive correlational study was conducted. History of referral to PC, facilitators to referring to PC, barriers to referring to PC, self-efficacy in end-of-life discussions, and referral to PC were measured using the PC referral case study survey, facilitators and barriers to PC referral survey, and self-assessment with end-of-life discussions survey. Data were analyzed descriptively and with Pearson’s Correlation, Spearman’s Rho, point-biserial correlation, multiple regression, logistic regression, Chi-Square test, and the Mann-Whitney U test. Results: Only one facilitator (PC team being helpful with establishing goals of care) was significantly associated with referral to PC. Three variables were statistically significant in relation to the history of referring to PC: “Inclined to refer: PC can help decrease the length of stay in hospital”, “Most inclined to refer: Patients with serious illnesses and/or poor prognoses”, and “Giving bad news to a patient or family member”. No predictor variables contributed a significant variance in the number of referrals to PC for all three case studies. There were no statistically significant results showing a relationship between the history of referral and referral to PC. All five hypotheses were partially supported. Discussion: Findings from this study emphasize the need for further research on NPs who work in hospital settings and what factors influence their behaviors of referring to PC. Since there is an increase in NPs practicing within hospital settings, future studies should use a larger sample size and incorporate hospital medicine NPs and other types of NPs that work in hospitals.

Keywords: palliative care, nurse practitioners, hospital medicine, referral

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309 Brazilian Constitution and the Fundamental Right to Sanitation

Authors: Michely Vargas Delpupo, José Geraldo Romanello Bueno

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The right to basic sanitation, was elevated to the category of fundamental right by the Brazilian Constitution of 1988 to protect the ecologically balanced environment, ensuring social rights to health and adequate housing warranting dignity of the human person as a principle of the Brazilian Democratic State. Because of their essentiality to the Brazilian population, this article seeks to understand why universal access to basic sanitation is a goal so difficult to achieve in Brazil. Therefore, this research uses the deductive and analytical method. Given the nature of the research literature, research techniques were centered in specialized books on the subject, journals, theses and dissertations, laws, relevant law case and raising social indicators relating to the theme. The relevance of the topic stems, among other things, the fact that sanitation services are essential for a dignified life, i.e. everyone is entitled to the maintenance of the necessary existence conditions are satisfied. However, the effectiveness of this right is undermined in society, since Brazil has huge deficit in sanitation services, denying thus a worthy life to most of the population. Thus, it can be seen that the provision of water and sewage services in Brazil is still characterized by a large imbalance, since the municipalities with lower population index have greater disability in the sanitation service. The truth is that the precariousness of water and sewage services in Brazil is still very concentrated in the North and Northeast regions, limiting the effective implementation of the Law 11.445/2007 in the country. Therefore, there is urgent need for a positive service by the State in the provision of sanitation services in order to prevent and control disease, improve quality of life and productivity of individuals, besides preventing contamination of water resources. More than just social and economic necessity, there is even a an obligation of the government to implement such services. In this sense, given the current scenario, to achieve universal access to basic sanitation imposes many hurdles. These are mainly in the field of properly formulated and implemented public policies, i.e. it requires an excellent institutional organization, management services, strategic planning, social control, in order to provide answers to complex challenges.

Keywords: fundamental rights, health, sanitation, universal access

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308 The Impact of Corruption on Exports and Innovation in Small and Medium-Sized Enterprises: The Case of Tunisia

Authors: Moujib Bahri, Rahim Kallel, Ouafa Sakka

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Corruption is a phenomenon that increases uncertainty and risk of SMEs as it undermines the quality of the business environment and the easy access to public services. Our research builds on existing research on corruption's effects on economic growth at the firm level. Several papers have analyzed the effect of firms’ payments of bribes on their performance; however, only limited research has investigated the link between corruption, innovation, and exports. Drawing on principal-agent theory, we explore how corruption weakens the institutional context and makes the business environment unsound and not conducive to innovation and exports. This study employs data from The Enterprise Surveys conducted in Tunisia between March 2013 and July 2014 by the World Bank, the European Bank for Reconstruction and Development (EBRD) and the European Investment Bank (EIB). The main objective of this survey was to gain a better understanding of Tunisian firms’ perception of the environment in which they operate. Since 2011, the country's political situation has become fragile and unstable, and public services are perceived as inefficient and corrupt. We test our hypotheses on a sample of 537 Tunisian manufacturing SMEs using structural equation modeling and path analysis. We find that political instability leads to higher level of corruption, and that excessive business licensing regulations create a fertile ground for bribery. Our findings do not support the greasing hypothesis suggesting that corruption can reduce the negative effect of bureaucratic delays and the hard access of companies to public services related to innovation and exports. Instead, our results support the sanding hypothesis according to which corruption hinders innovation activities and exports. Furthermore, corruption is found to, negatively and significantly, impact firms’ ownership of quality certificates. Our results suggest that, in an environment with a high level of corruption, governments and policymakers interested in assisting SMEs with their innovation and export activities should have a better control on corruption to allow them developing those activities without being forced to bribe government officers.

Keywords: corruption, innovation, exports, SMEs

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307 A New Obesity Index Derived from Waist Circumference and Hip Circumference Well-Matched with Other Indices in Children with Obesity

Authors: Mustafa M. Donma, Orkide Donma

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Anthropometric obesity indices such as waist circumference (WC), indices derived from anthropometric measurements such as waist-to-hip ratio (WHR), and indices created from body fat mass composition such as trunk-to-leg fat ratio (TLFR) are commonly used for the evaluation of mild or severe forms of obesity. Their clinical utilities are being compared using body mass index (BMI) percentiles to classify obesity groups. The best of them is still being investigated to make a clear-cut discrimination between healthy normal individuals (N-BMI) and overweight or obese (OB) or morbid obese patients. The aim of this study is to derive a new index, which best suits the purpose for the discrimination of children with N-BMI from OB children. A total of eighty-three children participated in the study. Two groups were constituted. The first group comprised 42 children with N-BMI, and the second group was composed of 41 OB children, whose age- and sex- adjusted BMI percentile values vary between 95 and 99. The corresponding values for the first group were between 15 and 85. This classification was based upon the tables created by World Health Organization. The institutional ethics committee approved the study protocol. Informed consent forms were filled by the parents of the participants. Anthropometric measurements were taken and recorded following a detailed physical examination. Within this context, weight, height (Ht), WC, hip C (HC), neck C (NC) values were taken. Body mass index, WHR, (WC+HC)/2, WC/Ht, (WC/HC)/Ht, WC*NC were calculated. Bioelectrical impedance analysis was performed to obtain body’s fat compartments in terms of total fat, trunk fat, leg fat, arm fat masses. Trunk-to-leg fat ratio, trunk-to-appendicular fat ratio (TAFR), (trunk fat+leg fat)/2 ((TF+LF)/2) were calculated. Fat mass index (FMI) and diagnostic obesity notation model assessment-II (D2I) index values were calculated. Statistical analysis of the data was performed. Significantly increased values of (WC+HC)/2, (TF+LF)/2, D2I, and FMI were observed in OB group in comparison with those of N-BMI group. Significant correlations were calculated between BMI and WC, (WC+HC)/2, (TF+LF)/2, TLFR, TAFR, D2I as well as FMI both in N-BMI and OB groups. The same correlations were obtained for WC. (WC+HC)/2 was correlated with TLFR, TAFR, (TF+LF)/2, D2I, and FMI in N-BMI group. In OB group, the correlations were the same except those with TLFR and TAFR. These correlations were not present with WHR. Correlations were observed between TLFR and BMI, WC, (WC+HC)/2, (TF+LF)/2, D2I as well as FMI in N-BMI group. Same correlations were observed also with TAFR. In OB group, correlations between TLFR or TAFR and BMI, WC as well as (WC+HC)/2 were missing. None was noted with WHR. From these findings, it was concluded that (WC+HC)/2, but not WHR, was much more suitable as an anthropometric obesity index. The only correlation valid in both groups was that exists between (WC+HC)/2 and (TF+LF)/2. This index was suggested as a link between anthropometric and fat-based indices.

Keywords: children, hip circumference, obesity, waist circumference

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306 The Regionalism Paradox in the Fight against Human Trafficking: Indonesia and the Limits of Regional Cooperation in ASEAN

Authors: Nur Iman Subono, Meidi Kosandi

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This paper examines the role of regional cooperation in the Association of Southeast Asian Nations (ASEAN) in the fight against human trafficking for Indonesia. Many among scholars suggest that regional cooperation is necessary for combating human trafficking for its transnational and organized character as a crime against humanity. ASEAN members have been collectively active in responding transnational security issues with series of talks and collaboration agreement since early 2000s. Lately in 2015, ASEAN agreed on ASEAN Convention against Trafficking in Persons, particularly Women and Children (ACTIP) that requires each member to collaborate in information sharing and providing effective safeguard and protection of victims. Yet, the frequency of human trafficking crime occurrence remains high and tend to increase in Indonesian in 2017-2018. The objective of this paper is to examine the effectiveness and success of ACTIP implementation in the fight against human trafficking in Indonesia. Based on two years of research (2017-2018) in three provinces with the largest number of victims in Indonesia, this paper shows the tendency of persisting crime despite the implementation of regional and national anti-trafficking policies. The research was conducted by archive study, literature study, discourse analysis, and depth interviews with local government officials, police, prosecutors, victims, and traffickers. This paper argues that the relative success of ASEAN in establishing convention at the high-level meetings has not been followed with the success in its implementation in the society. Three main factors have contributed to the ineffectiveness of the agreements, i.e. (1) ASEAN institutional arrangement as a collection of sovereign states instead of supranational organization with binding authority; (2) the lack of commitment of ASEAN sovereign member-states to the agreements; and (3) the complexity and variety of the nature of the crime in each member-state. In effect, these factors have contributed to generating the regionalism paradox in ASEAN where states tend to revert to national policies instead of seeking regional collective solution.

Keywords: human trafficking, transnational security, regionalism, anti trafficking policy

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305 Leadership and Management Strategies of Sports Administrator in Asia

Authors: Mark Christian Inductivo Siwa, Jesrelle Ormoc Bontuyan

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This study was conducted in selected tertiary schools in selected universities in Asian countries such as Philippines, Thailand, and China, which are the top performing countries in Southeast Asian Games or SEA Games and Asian School Games (ASG), also known as the Youth SEA Games and Asian Games. The respondents of the study are sports administrators/directors and coaches in selected Southeast Asian countries such as Philippines, Thailand, and in Asia which is China. This study has generated a progressive sports operational model of Sports Leadership and Management in Selected Universities in Asia. This study utilized mixed-method research. It is a methodology for conducting research that involves collecting, analyzing and integrating quantitative (e.g., experiments, surveys) and qualitative (e.g., focus groups, interviews) research. This approach to research is used to provide integration for a better understanding of the research problem than either of each alone. This study particularly employed the explanatory sequential design of mixed methods, which involved two phases: the quantitative phase, which involves the collection and analysis of quantitative data, followed by the qualitative phase, which involves the collection and analysis of qualitative data. This study will prioritize the quantitative data and the findings will be followed up during the interpretation phase in the qualitative data of the study. The qualitative data help explain or build upon initial quantitative results. In phase I, the researcher began with the collection and analysis of the quantitative data. His investigation gave greater emphasis on the quantitative methods, particularly employed surveys with the coaches and sports directors of the three selected universities in Asia. In Phase II, the researcher subsequently collected and analyzed the qualitative data obtained through an interview with the sports directors to follow from or connect to the results of the quantitative phase. This study followed the data analysis spiral so that the researcher could follow – up or explain the quantitative results. The researcher engaged in the process of moving in analytic circles. Based on the school's mission and vision, the sports leadership and management consistently followed the key factors to take into account when leading the organization and managing the process in sports leadership and management when formulating objectives/goals, budget, equipment care and maintenance, facilities, training matrix, and consideration. Also, sports management demonstrates the need for development in terms of the upkeep and care of equipment as well as athlete funding. The development of goals or sports management goals, sports facilities and equipment, as well as improvements in demonstrating training and consideration, and incentives, should also include a maintenance plan. The study concluded with a progressive sports operational model that was created based on the result of the study.

Keywords: sports leadership and management, formulating objectives, budget, equipment care and maintenance, training, consideration, incentives, progressive sports operational model

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304 Shedding Light on Colorism: Exploring Stereotypes, Influential Factors, and Consequences in African American Communities

Authors: India Sanders, Jeffrey Sherman

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Colorism has been a persistent and ingrained issue in the history of the United States, with far-reaching consequences that continue to affect various aspects of daily life, institutional policies, public spaces, economic structures, and social norms. This complex problem has had a particularly profound impact on the African-American community, shaping how they are perceived and treated within society at large. The prevalence of negative stereotypes surrounding African Americans can lead to severe repercussions such as discrimination and mental health disparities. The effects of such biases can also materialize in diverse forms, impacting the well-being and livelihoods of individuals within this community. Current research has examined how people from different racial groups perceive different skin tones of Black people, looking at the cognitive processes that manifest through categorization and stereotypes. Additionally, studies observed consequences related to colorism and how it directly affects those with darker versus lighter skin tones. However, not much research has been conducted on the influence of stereotypes associated with various skin tones. In the present study, it is hypothesized that participants in Group A will rate positive stereotypes associated with lighter skin tones significantly higher than positive stereotypes associated with darker skin tones. It is also hypothesized that participants in Group B will rate negative stereotypes associated with darker skin tones significantly higher than negative stereotypes associated with lighter skin tones. For this study, a quantitative study on stereotypes of skin tone representation within the African-American community will be conducted. Participants will rate the accuracy of various visual representations within mass media of African Americans with light skin tones and dark skin tones using a Likert scale. Participants will also be provided a questionnaire further examining the perception of stereotypes and how this affects their interactions with African Americans with lighter versus darker skin tones. The purpose of this study is to investigate the impact of skin tone portrayals on African Americans, including associated stereotypes and societal perceptions. It is expected that participants will more likely associate negative stereotypes with African Americans who have darker skin tones, as this is a common and reinforced viewpoint in the cultural and social system.

Keywords: colorism, discrimination, racism, stereotype

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303 China Global Policy through the Shanghai Cooperation Organization

Authors: Enayatollah Yazdani

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In the post-Cold War era, the world is facing a new emerging global order with the rise of multiple actors in the international arena. China, as a rising global power, has great leverage in internal relations. In particular, during the last two decades, China has rapidly transformed its economy into a global leader in advanced technologies. As a rising power and as one of the two major founding members of the Shanghai Cooperation Organization (SCO), China has tried to use this regional organization, which has the potential to become an important political and security organization of the major states located in the vast Eurasian landmass, for its “go global” strategy. In fact, for Beijing, the SCO represents a new and unique cooperation model, reflecting its vision of a multipolar world order. China has used the SCO umbrella as a multilateral platform to address external threats posed by non-state actors on its vulnerable western border; to gain a strong economic and political foothold in Central Asia without putting the Sino-Russian strategic partnership at risk; and to enhance its energy security through large-scale infrastructure investment in, and trade with, the Central Asian member states. In other words, the SCO is one of the successful outcomes of Chines foreign policy in the post-Cold War era. The expansion of multilateral ties all over the world by dint of pursuing institutional strategies as SCO identifies China as a more constructive power. SCO became a new model of cooperation that was formed on the remains of collapsed Soviet system and predetermined China's geopolitical role in the region. As the fast developing effective regional mechanism, SCO now has more of an external impact on the international system and forms a new type of interaction for promoting China's grand strategy of 'peaceful rise.' This paper aims to answer this major question: How the Chinese government has manipulated the SCO for its foreign policy and global and regional influence? To answer this question, the main discussion is that with regard to the SCO capabilities and politico-economic potential, this organization has been used by China as a platform to expand influence beyond its borders.

Keywords: China, the Shanghai Cooperation Organization (SCO), Central Asia, global policy, foreign policy

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302 Beyond Inclusion: The Need for Health Equity for Women with Disabilities

Authors: Jaishree Ellis

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The United States Centers for Disease Control tells us that many women with disabilities will not receive regular health screenings, including Pap Smears and mammograms. This article was comprised and written to recognize the barriers to care, gaps in existing healthcare implementation, and viable methodologies for the provision of comprehensive and robust gynecologic care for women with disabilities. According to the World Health Organization, 15% of the world's population, or approximately 1 billion people, have disabilities, most of whom are identified as women. Women with disabilities are described as being multi-disabled, as in some places, they suffer exclusion because of their disabilities as well as their gender. The paucity of information regarding how to create a healthcare system that is inclusive of every woman, regardless of her type of disability (physical, mental, intellectual or medical), has made it challenging to establish an environment that makes it possible for individuals to access care in an equitable, respectful and comprehensive way. A review of the current literature, institutional websites within the United States and American resource guides was implemented to determine where comprehensive models of care for women with disabilities exist, as well as the modalities that are being employed to meet their healthcare needs. The many barriers to care that women with disabilities face were also extracted from various sources within the literature to provide an exhaustive list that can be tackled, one by one. Of the 637 Hospital Systems in the United States, only 7 provide website documentation of health care services that address the unique needs of women with disabilities. The presumption is that if institutions have not marketed such interventions to the community, then it is likely that they do not have a robust suite of services with which to make gynecologic care available to patients with disabilities. Through this review, 7 main barriers to comprehensive gynecologic care were identified, with more than 20 sub-categories existing within those. As with many other areas of community life, inclusion remains lacking in the delivery of healthcare for women with disabilities. There are at least 7 barriers that must be overcome in order to provide equity in the medical office, the exam room, the hospital and the operating room. While few institutions have prioritized this, those few have provided blueprints that can easily be adopted by others. However, as the general population lives longer and ages, the incidence of disabilities increases, as do the healthcare disparities surrounding them. Further compounded by this is a lack of formal education for medical providers in the United States.

Keywords: health equity, inclusion, healthcare disparities, education

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301 Ecology, Value-Form and Metabolic Rift: Conceptualizing the Environmental History of the Amazon in the Capitalist World-System (19th-20th centuries)

Authors: Santiago Silva de Andrade

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In recent decades, Marx's ecological theory of the value-form and the theory of metabolic rift have represented fundamental methodological innovations for social scientists interested in environmental transformations and their relationships with the development of the capital system. However, among Latin American environmental historians, such theoretical and methodological instruments have been used infrequently and very cautiously. This investigation aims to demonstrate how the concepts of metabolic rift and ecological value-form are important for understanding the environmental, economic and social transformations in the Amazon region between the second half of the 19th century and the end of the 20th century. Such transformations manifested themselves mainly in two dimensions: the first concerns the link between the manufacture of tropical substances for export and scientific developments in the fields of botany, chemistry and agriculture. This link was constituted as a set of social, intellectual and economic relations that condition each other, configuring an asymmetrical field of exchanges and connections between the demands of the industrialized world - personified in scientists, naturalists, businesspeople and bureaucrats - and the agencies of local social actors, such as indigenous people, riverside dwellers and quilombolas; the second dimension concerns the imperative link between the historical development of the capitalist world-system and the restructuring of the natural world, its landscapes, biomes and social relations, notably in peripheral colonial areas. The environmental effects of capitalist globalization were not only seen in the degradation of exploited environments, although this has been, until today, its most immediate and noticeable aspect. There was also, in territories subject to the logic of market accumulation, the reformulation of patterns of authority and institutional architectures, such as property systems, political jurisdictions, rights and social contracts, as a result of the expansion of commodity frontiers between the 16th and 21st centuries. . This entire set of transformations produced impacts on the ecological landscape of the Amazon. This demonstrates the need to investigate the histories of local configurations of power, spatial and ecological - with their institutions and social actors - and their role in structuring the capitalist world-system , under the lens of the ecological theory of value-form and metabolic rift.

Keywords: amazon, ecology, form-value, metabolic rift

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300 Live and Learn in Ireland: Supporting International Students

Authors: Tom Farrelly, Yvoonne Kavanagh, Tony Murphy

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In the last 20 years, Ireland has enjoyed an upsurge in the number of international students coming to avail of its well-regarded Higher Education system. While welcome, the influx of international students has posed a number of cultural, social and academic challenges for the Irish HE sector, both at institutional and individual lecturer level. Notwithstanding the challenge to the Irish HE sector, the difficulties that incoming students face needs to be acknowledged and addressed. For students who have never left their home country before the transition can be daunting even if they have not learned the customs and ways of the new country. In 2013, Ireland’s National Forum for the Advancement of Teaching and Learning in Higher Education invited submissions from interested parties to design and implement digital supports aimed at assisting students transitioning into or exiting higher education. Five colleges—the Institute of Technology, Tralee; University College Cork, Institute of Technology, Carlow; Cork Institute of Technology and Waterford Institute of Technology—collectively known as the Southern Cluster, were granted funding to research and develop digital objects to support international students' transition into the Irish higher education system. One of the key fundamentals of this project was its strong commitment to incorporating the student voice to help inform the design of the digital objects. The primary research method used to ascertain student views was the circulation of an online questionnaire using SurveyMonkey to existing international students in each of the five participant colleges. The questionnaire sought to examine the experiences and opinions of the students in relation to three main aspects of their living and studying in Ireland (hence the name of the project LiveAndLearnInIreland) (1) the academic environment (2) the social aspects of living in Ireland and (3) the practical aspects of living in Ireland. The response to the survey (n=573), revealed a number of sometimes surprising issues and themes for the digital objects to address. The research, therefore, offers insight into the types of concerns that any college, whether in Ireland or further afield, needs to take into consideration, if it is to genuinely assist what can be a difficult transition for the international student. That said, while there are a number of themes that emerged that have international implications there are other themes that have a particular resonance for the Irish HE sector.

Keywords: international, transition, support, inclusion

Procedia PDF Downloads 196
299 Long-Term Resilience Performance Assessment of Dual and Singular Water Distribution Infrastructures Using a Complex Systems Approach

Authors: Kambiz Rasoulkhani, Jeanne Cole, Sybil Sharvelle, Ali Mostafavi

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Dual water distribution systems have been proposed as solutions to enhance the sustainability and resilience of urban water systems by improving performance and decreasing energy consumption. The objective of this study was to evaluate the long-term resilience and robustness of dual water distribution systems versus singular water distribution systems under various stressors such as demand fluctuation, aging infrastructure, and funding constraints. To this end, the long-term dynamics of these infrastructure systems was captured using a simulation model that integrates institutional agency decision-making processes with physical infrastructure degradation to evaluate the long-term transformation of water infrastructure. A set of model parameters that varies for dual and singular distribution infrastructure based on the system attributes, such as pipes length and material, energy intensity, water demand, water price, average pressure and flow rate, as well as operational expenditures, were considered and input in the simulation model. Accordingly, the model was used to simulate various scenarios of demand changes, funding levels, water price growth, and renewal strategies. The long-term resilience and robustness of each distribution infrastructure were evaluated based on various performance measures including network average condition, break frequency, network leakage, and energy use. An ecologically-based resilience approach was used to examine regime shifts and tipping points in the long-term performance of the systems under different stressors. Also, Classification and Regression Tree analysis was adopted to assess the robustness of each system under various scenarios. Using data from the City of Fort Collins, the long-term resilience and robustness of the dual and singular water distribution systems were evaluated over a 100-year analysis horizon for various scenarios. The results of the analysis enabled: (i) comparison between dual and singular water distribution systems in terms of long-term performance, resilience, and robustness; (ii) identification of renewal strategies and decision factors that enhance the long-term resiliency and robustness of dual and singular water distribution systems under different stressors.

Keywords: complex systems, dual water distribution systems, long-term resilience performance, multi-agent modeling, sustainable and resilient water systems

Procedia PDF Downloads 263
298 Emergency Physician Performance for Hydronephrosis Diagnosis and Grading Compared with Radiologist Assessment in Renal Colic: The EPHyDRA Study

Authors: Sameer A. Pathan, Biswadev Mitra, Salman Mirza, Umais Momin, Zahoor Ahmed, Lubna G. Andraous, Dharmesh Shukla, Mohammed Y. Shariff, Magid M. Makki, Tinsy T. George, Saad S. Khan, Stephen H. Thomas, Peter A. Cameron

Abstract:

Study objective: Emergency physician’s (EP) ability to identify hydronephrosis on point-of-care ultrasound (POCUS) has been assessed in the past using CT scan as the reference standard. We aimed to assess EP interpretation of POCUS to identify and grade the hydronephrosis in a direct comparison with the consensus-interpretation of POCUS by radiologists, and also to compare the EP and radiologist performance using CT scan as the criterion standard. Methods: Using data from a POCUS databank, a prospective interpretation study was conducted at an urban academic emergency department. All POCUS exams were performed on patients presenting with renal colic to the ED. Institutional approval was obtained for conducting this study. All the analyses were performed using Stata MP 14.0 (Stata Corp, College Station, Texas). Results: A total of 651 patients were included, with paired sets of renal POCUS video clips and the CT scan performed at the same ED visit. Hydronephrosis was reported in 69.6% of POCUS exams by radiologists and 72.7% of CT scans (p=0.22). The κ for consensus interpretation of POCUS between the radiologists to detect hydronephrosis was 0.77 (0.72 to 0.82) and weighted κ for grading the hydronephrosis was 0.82 (0.72 to 0.90), interpreted as good to very good. Using CT scan findings as the criterion standard, Eps had an overall sensitivity of 81.1% (95% CI: 79.6% to 82.5%), specificity of 59.4% (95% CI: 56.4% to 62.5%), PPV of 84.3% (95% CI: 82.9% to 85.7%), and NPV of 53.8% (95% CI: 50.8% to 56.7%); compared to radiologist sensitivity of 85.0% (95% CI: 82.5% to 87.2%), specificity of 79.7% (95% CI: 75.1% to 83.7%), PPV of 91.8% (95% CI: 89.8% to 93.5%), and NPV of 66.5% (95% CI: 61.8% to 71.0%). Testing for a report of moderate or high degree of hydronephrosis, specificity of EP was 94.6% (95% CI: 93.7% to 95.4%) and to 99.2% (95% CI: 98.9% to 99.5%) for identifying severe hydronephrosis alone. Conclusion: EP POCUS interpretations were comparable to the radiologists for identifying moderate to severe hydronephrosis using CT scan results as the criterion standard. Among patients with moderate or high pre-test probability of ureteric calculi, as calculated by the STONE-score, the presence of moderate to severe (+LR 6.3 and –LR 0.69) or severe hydronephrosis (+LR 54.4 and –LR 0.57) was highly diagnostic of the stone disease. Low dose CT is indicated in such patients for evaluation of stone size and location.

Keywords: renal colic, point-of-care, ultrasound, bedside, emergency physician

Procedia PDF Downloads 258
297 Dividend Payout and Capital Structure: A Family Firm Perspective

Authors: Abhinav Kumar Rajverma, Arun Kumar Misra, Abhijeet Chandra

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Family involvement in business is universal across countries, with varying characteristics. Firms of developed economies have diffused ownership structure; however, that of emerging markets have concentrated ownership structure, having resemblance with that of family firms. Optimization of dividend payout and leverage are very crucial for firm’s valuation. This paper studies dividend paying behavior of National Stock Exchange listed Indian firms from financial year 2007 to 2016. The final sample consists of 422 firms and of these more than 49% (207) are family firms. Results reveal that family firms pay lower dividend and are more leveraged compared to non-family firms. This unique data set helps to understand dividend behavior and capital structure of sample firms over a long-time period and across varying family ownership concentration. Using panel regression models, this paper examines factors affecting dividend payout and capital structure and establishes a link between the two using Two-stage Least Squares regression model. Profitability shows a positive impact on dividend and negative impact on leverage, confirming signaling and pecking order theory. Further, findings support bankruptcy theory as firm size has a positive relation with dividend and leverage and volatility shows a negative relation with both dividend and leverage. Findings are also consistent with agency theory, family ownership concentration has negative relation with both dividend payments and leverage. Further, the impact of family ownership control confirms the similar finding. The study further reveals that firms with high family ownership concentration (family control) do have an impact on determining the level of private benefits. Institutional ownership is not significant for dividend payments. However, it shows significant negative relation with leverage for both family and non-family firms. Dividend payout and leverage show mixed association with each other. This paper provides evidence of how varying level of family ownership concentration and ownership control influences the dividend policy and capital structure of firms in an emerging market like India and it can have significant contribution towards understanding and formulating corporate dividend policy decisions and capital structure for emerging economies, where majority of firms exhibit behavior of family firm.

Keywords: dividend, family firms, leverage, ownership structure

Procedia PDF Downloads 252
296 Ganga Rejuvenation through Forestation and Conservation Measures in Riverscape

Authors: Ombir Singh

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In spite of the religious and cultural pre-dominance of the river Ganga in the Indian ethos, fragmentation and degradation of the river continued down the ages. Recognizing the national concern on environmental degradation of the river and its basin, Ministry of Water Resources, River Development & Ganga Rejuvenation (MoWR,RD&GR), Government of India has initiated a number of pilot schemes for the rejuvenation of river Ganga under the ‘Namami Gange’ Programme. Considering the diversity, complexity, and intricacies of forest ecosystems and pivotal multiple functions performed by them and their inter-connectedness with highly dynamic river ecosystems, forestry interventions all along the river Ganga from its origin at Gaumukh, Uttarakhand to its mouth at Ganga Sagar, West Bengal has been planned by the ministry. For that Forest Research Institute (FRI) in collaboration with National Mission for Clean Ganga (NMCG) has prepared a Detailed Project Report (DPR) on Forestry Interventions for Ganga. The Institute has adopted an extensive consultative process at the national and state levels involving various stakeholders relevant in the context of river Ganga and employed a science-based methodology including use of remote sensing and GIS technologies for geo-spatial analysis, modeling and prioritization of sites for proposed forestation and conservation interventions. Four sets of field data formats were designed to obtain the field based information for forestry interventions, mainly plantations and conservation measures along the river course. In response, five stakeholder State Forest Departments had submitted more than 8,000 data sheets to the Institute. In order to analyze a voluminous field data received from five participating states, the Institute also developed a software to collate, analyze and generation of reports on proposed sites in Ganga basin. FRI has developed potential plantation and treatment models for the proposed forestry and other conservation measures in major three types of landscape components visualized in the Ganga riverscape. These are: (i) Natural, (ii) Agriculture, and (iii) Urban Landscapes. Suggested plantation models broadly varied for the Uttarakhand Himalayas and the Ganga Plains in five participating states. Besides extensive plantations in three type of landscapes within the riverscape, various conservation measures such as soil and water conservation, riparian wildlife management, wetland management, bioremediation and bio-filtration and supporting activities such as policy and law intervention, concurrent research, monitoring and evaluation, and mass awareness campaigns have been envisioned in the DPR. The DPR also incorporates the details of the implementation mechanism, budget provisioned for different components of the project besides allocation of budget state-wise to five implementing agencies, national partner organizations and the Nodal Ministry.

Keywords: conservation, Ganga, river, water, forestry interventions

Procedia PDF Downloads 131
295 Vitamin D Levels in Relation to Thyroid Disorders

Authors: Binaya Tamang, Buddhhi Raj Pokhrel, Narayan Gautam

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Background: There may be a connection between thyroid function and vitamin D status since both bind to similar nuclear hormone receptors and have similar response regions on gene promoters. The purpose of the current study was to investigate the relationship between thyroid hormones and vitamin D levels in females who were attending a tertiary care center in western Nepal and were either hypothyroid or euthyroid. Methods: This hospital-based cross-sectional study was carried out between March 2020 and March 2021 by the Biochemistry department of the Universal College of Medical Sciences (UCMS), Bhairahawa, Province No. 5, Nepal, in cooperation with Internal medicine. Prior to the study, institutional review committee approval (UCMS/IRC/008/20) was acquired from UCMS. Women who visited the Internal Medicine OPD of UCMS and were advised to get a thyroid function test (TFT) were included in the study population. Only those who were willing to participate in the study were enrolled after the goals and advantages of the study had been explained to them. Participants who had recently used vitamin D supplements and medications that affected thyroid hormones were excluded. The participants gave their consent verbally and in writing. After getting the consent, a convenient sample technique was applied. Serum was isolated after drawing 3 ml of blood in a plain vial. Chemiluminescence assay was used to analyze vitamin D and thyroid hormones (MAGLUMI 2000). SPSS version 16.0 for Windows was used to conduct the statistical analysis. Statistical significance was defined as a P-value < 0.05. Results: Majority of the study population (n=214, 71%) had insufficient serum vitamin D levels. Among the thyroid groups, the median Vitamin D levels were significantly lower in hypothyroid (16.88 ng/ml) as compared to the euthyroid groups (25.01 ng/ml) (P<0.001). Similarly, serum Vitamin D levels were considerably lower in the obese population (16.86 ng/ml) as compared to the normal BMI group (24.90 ng/ml) (P<0.001) as well as in the vegetarian (15.43 ng.ml) than mixed diet consumer (24.89 ng/ml) (P<0.01). Even after the adjustment for these variables, the Vitamin D levels were significantly lower in the hypothyroid population than in the euthyroid group (P<0.001). Conclusion: Comparing the hypothyroid population to the euthyroid, the median serum vitamin D levels were considerably lower. We were alarmed to see that the majority of euthyroid participants also had low levels of vitamin D. Therefore if left untreated, low vitamin D levels in hypothyroid patients could worsen their health further.

Keywords: vitamin D, thyroid hormones, euthyroid, hypothyroid, Nepal

Procedia PDF Downloads 123
294 A Case Study of Low Head Hydropower Opportunities at Existing Infrastructure in South Africa

Authors: Ione Loots, Marco van Dijk, Jay Bhagwan

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Historically, South Africa had various small-scale hydropower installations in remote areas that were not incorporated in the national electricity grid. Unfortunately, in the 1960s most of these plants were decommissioned when Eskom, the national power utility, rapidly expanded its grid and capability to produce cheap, reliable, coal-fired electricity. This situation persisted until 2008, when rolling power cuts started to affect all citizens. This, together with the rising monetary and environmental cost of coal-based power generation, has sparked new interest in small-scale hydropower development, especially in remote areas or at locations (like wastewater treatment works) that could not afford to be without electricity for long periods at a time. Even though South Africa does not have the same, large-scale, hydropower potential as some other African countries, significant potential for micro- and small-scale hydropower is hidden in various places. As an example, large quantities of raw and potable water are conveyed daily under either pressurized or gravity conditions over large distances and elevations. Due to the relative water scarcity in the country, South Africa also has more than 4900 registered dams of varying capacities. However, institutional capacity and skills have not been maintained in recent years and therefore the identification of hydropower potential, as well as the development of micro- and small-scale hydropower plants has not gained significant momentum. An assessment model and decision support system for low head hydropower development has been developed to assist designers and decision makers with first-order potential analysis. As a result, various potential sites were identified and many of these sites were situated at existing infrastructure like weirs, barrages or pipelines. One reason for the specific interest in existing infrastructure is the fact that capital expenditure could be minimized and another is the reduced negative environmental impact compared to greenfield sites. This paper will explore the case study of retrofitting an unconventional and innovative hydropower plant to the outlet of a wastewater treatment works in South Africa.

Keywords: low head hydropower, retrofitting, small-scale hydropower, wastewater treatment works

Procedia PDF Downloads 220
293 Developing Cause-effect Model of Urban Resilience versus Flood in Karaj City using TOPSIS and Shannon Entropy Techniques

Authors: Mohammad Saber Eslamlou, Manouchehr Tabibian, Mahta Mirmoghtadaei

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The history of urban development and the increasing complexities of urban life have long been intertwined with different natural and man-made disasters. Sometimes, these unpleasant events have destroyed the cities forever. The growth of the urban population and the increase of social and economic resources in the cities increased the importance of developing a holistic approach to dealing with unknown urban disasters. As a result, the interest in resilience has increased in most of the scientific fields, and the urban planning literature has been enriched with the studies of the social, economic, infrastructural, and physical abilities of the cities. In this regard, different conceptual frameworks and patterns have been developed focusing on dimensions of resilience and different kinds of disasters. As the most frequent and likely natural disaster in Iran is flooding, the present study aims to develop a cause-effect model of urban resilience against flood in Karaj City. In this theoretical study, desk research and documentary studies were used to find the elements and dimensions of urban resilience. In this regard, 6 dimensions and 32 elements were found for urban resilience and a questionnaire was made by considering the requirements of TOPSIS techniques (pairwise comparison). The sample of the research consisted of 10 participants who were faculty members, academicians, board members of research centers, managers of the Ministry of Road and Urban Development, board members of New Towns Development Company, experts, and practitioners of consulting companies who had scientific and research backgrounds. The gathered data in this survey were analyzed using TOPSIS and Shannon Entropy techniques. The results show that Infrastructure/Physical, Social, Organizational/ Institutional, Structural/Physical, Economic, and Environmental dimensions are the most effective factors in urban resilience against floods in Karaj, respectively. Finally, a comprehensive model and a systematic framework of factors that affect the urban resilience of Karaj against floods was developed. This cause – effect model shows how different factors are related and influence each other, based on their connected structure and preferences.

Keywords: urban resilience, TOPSIS, Shannon entropy, cause-effect model of resilience, flood

Procedia PDF Downloads 36
292 Landing Performance Improvement Using Genetic Algorithm for Electric Vertical Take Off and Landing Aircrafts

Authors: Willian C. De Brito, Hernan D. C. Munoz, Erlan V. C. Carvalho, Helder L. C. De Oliveira

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In order to improve commute time for small distance trips and relieve large cities traffic, a new transport category has been the subject of research and new designs worldwide. The air taxi travel market promises to change the way people live and commute by using the concept of vehicles with the ability to take-off and land vertically and to provide passenger’s transport equivalent to a car, with mobility within large cities and between cities. Today’s civil air transport remains costly and accounts for 2% of the man-made CO₂ emissions. Taking advantage of this scenario, many companies have developed their own Vertical Take Off and Landing (VTOL) design, seeking to meet comfort, safety, low cost and flight time requirements in a sustainable way. Thus, the use of green power supplies, especially batteries, and fully electric power plants is the most common choice for these arising aircrafts. However, it is still a challenge finding a feasible way to handle with the use of batteries rather than conventional petroleum-based fuels. The batteries are heavy and have an energy density still below from those of gasoline, diesel or kerosene. Therefore, despite all the clear advantages, all electric aircrafts (AEA) still have low flight autonomy and high operational cost, since the batteries must be recharged or replaced. In this sense, this paper addresses a way to optimize the energy consumption in a typical mission of an aerial taxi aircraft. The approach and landing procedure was chosen to be the subject of an optimization genetic algorithm, while final programming can be adapted for take-off and flight level changes as well. A real tilt rotor aircraft with fully electric power plant data was used to fit the derived dynamic equations of motion. Although a tilt rotor design is used as a proof of concept, it is possible to change the optimization to be applied for other design concepts, even those with independent motors for hover and cruise flight phases. For a given trajectory, the best set of control variables are calculated to provide the time history response for aircraft´s attitude, rotors RPM and thrust direction (or vertical and horizontal thrust, for independent motors designs) that, if followed, results in the minimum electric power consumption through that landing path. Safety, comfort and design constraints are assumed to give representativeness to the solution. Results are highly dependent on these constraints. For the tested cases, performance improvement ranged from 5 to 10% changing initial airspeed, altitude, flight path angle, and attitude.

Keywords: air taxi travel, all electric aircraft, batteries, energy consumption, genetic algorithm, landing performance, optimization, performance improvement, tilt rotor, VTOL design

Procedia PDF Downloads 92
291 The Effects of Globalization on Health: A Case of Kenyatta National Hospital Healthcare Services

Authors: S. Ithai, A. Oloo

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The emergence of globalization has cultivated an international consensus that without economic development; it is very unlikely that a country may realize social or political development. It is equally important to note that the economic effect on social development automatically influence the country healthcare services as healthcare systems are improved and adopted. For decades and before 1980's, the colonial and the Governments of Kenya had pursued a goal to provide free healthcare services to its citizen with minimal success; but as population increased, this endeavor became almost a mirage. The challenge called for a change of strategy with introduction of cost sharing which also could not guarantee sustainability of healthcare services in the country due to increased number of poor people and poverty. An involvement of multisectral approach to provision of health individual, collaboration and adoption of all dimensions through globalization provides a ray of hope to not only economic, political and social development but also guaranteed equitable and reliable healthcare systems in Kenya and specifically referral healthcare services at KNH. With the advent of globalization, KNH has made positive strides that have guaranteed patients with reliable healthcare services. These include increased donor funding, collaboration levels, training and research as well as enhanced the hospital relations with international partners. During this period, the hospital has increased number of local doctors and nurses, enhanced transfer of skills, innovations and technologies which are driving forces to quality and efficient healthcare services. The period has also brought in challenges for the hospital which include increased competition, attraction of qualified nurses and doctors to international are some the issues that have made the hospital to spend more resources in research and development in order to stay afloat. This paper reveals the link between globalization and healthcare and its influence on institution policy choice. However, the process is not expected to take place automatically without institutional initiatives if KNH is to reap the benefits of globalization. KNH need to make use of the existing infrastructure, human resources and donor confidence, the opportunities that are indeed important in propelling KNH toward Vision 2030 and achieving the desired Millennium Development Goals (MDGs).

Keywords: globalization, Kenyatta National Hospital, native, healthcare

Procedia PDF Downloads 314
290 Sustainability in Space: Material Efficiency in Space Missions

Authors: Hamda M. Al-Ali

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From addressing fundamental questions about the history of the solar system to exploring other planets for any signs of life have always been the core of human space exploration. This triggered humans to explore whether other planets such as Mars could support human life on them. Therefore, many planned space missions to other planets have been designed and conducted to examine the feasibility of human survival on them. However, space missions are expensive and consume a large number of various resources to be successful. To overcome these problems, material efficiency shall be maximized through the use of reusable launch vehicles (RLV) rather than disposable and expendable ones. Material efficiency is defined as a way to achieve service requirements using fewer materials to reduce CO2 emissions from industrial processes. Materials such as aluminum-lithium alloys, steel, Kevlar, and reinforced carbon-carbon composites used in the manufacturing of spacecrafts could be reused in closed-loop cycles directly or by adding a protective coat. Material efficiency is a fundamental principle of a circular economy. The circular economy aims to cutback waste and reduce pollution through maximizing material efficiency so that businesses can succeed and endure. Five strategies have been proposed to improve material efficiency in the space industry, which includes waste minimization, introduce Key Performance Indicators (KPIs) to measure material efficiency, and introduce policies and legislations to improve material efficiency in the space sector. Another strategy to boost material efficiency is through maximizing resource and energy efficiency through material reusability. Furthermore, the environmental effects associated with the rapid growth in the number of space missions include black carbon emissions that lead to climate change. The levels of emissions must be tracked and tackled to ensure the safe utilization of space in the future. The aim of this research paper is to examine and suggest effective methods used to improve material efficiency in space missions so that space and Earth become more environmentally and economically sustainable. The objectives used to fulfill this aim are to identify the materials used in space missions that are suitable to be reused in closed-loop cycles considering material efficiency indicators and circular economy concepts. An explanation of how spacecraft materials could be re-used as well as propose strategies to maximize material efficiency in order to make RLVs possible so that access to space becomes affordable and reliable is provided. Also, the economic viability of the RLVs is examined to show the extent to which the use of RLVs has on the reduction of space mission costs. The environmental and economic implications of the increase in the number of space missions as a result of the use of RLVs are also discussed. These research questions are studied through detailed critical analysis of the literature, such as published reports, books, scientific articles, and journals. A combination of keywords such as material efficiency, circular economy, RLVs, and spacecraft materials were used to search for appropriate literature.

Keywords: access to space, circular economy, material efficiency, reusable launch vehicles, spacecraft materials

Procedia PDF Downloads 87
289 The Role of People in Continuing Airworthiness: A Case Study Based on the Royal Thai Air Force

Authors: B. Ratchaneepun, N.S. Bardell

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It is recognized that people are the main drivers in almost all the processes that affect airworthiness assurance. This is especially true in the area of aircraft maintenance, which is an essential part of continuing airworthiness. This work investigates what impact English language proficiency, the intersection of the military and Thai cultures, and the lack of initial and continuing human factors training have on the work performance of maintenance personnel in the Royal Thai Air Force (RTAF). A quantitative research method based on a cross-sectional survey was used to gather data about these three key aspects of “people” in a military airworthiness environment. 30 questions were developed addressing the crucial topics of English language proficiency, impact of culture, and human factors training. The officers and the non-commissioned officers (NCOs) who work for the Aeronautical Engineering Divisions in the RTAF comprised the survey participants. The survey data were analysed to support various hypotheses by using a t-test method. English competency in the RTAF is very important since all of the service manuals for Thai military aircraft are written in English. Without such competency, it is difficult for maintenance staff to perform tasks and correctly interpret the relevant maintenance manual instructions; any misunderstandings could lead to potential accidents. The survey results showed that the officers appreciated the importance of this more than the NCOs, who are the people actually doing the hands-on maintenance work. Military culture focuses on the success of a given mission, and leverages the power distance between the lower and higher ranks. In Thai society, a power distance also exists between younger and older citizens. In the RTAF, such a combination tends to inhibit a just reporting culture and hence hinders safety. The survey results confirmed this, showing that the older people and higher ranks involved with RTAF aircraft maintenance believe that the workplace has a positive safety culture and climate, whereas the younger people and lower ranks think the opposite. The final area of consideration concerned human factors training and non-technical skills training. The survey revealed that those participants who had previously attended such courses appreciated its value and were aware of its benefits in daily life. However, currently there is no regulation in the RTAF to mandate recurrent training to maintain such knowledge and skills. The findings from this work suggest that the people involved in assuring the continuing airworthiness of the RTAF would benefit from: (i) more rigorous requirements and standards in the recruitment, initial training and continuation training regarding English competence; (ii) the development of a strong safety culture that exploits the uniqueness of both the military culture and the Thai culture; and (iii) providing more initial and recurrent training in human factors and non-technical skills.

Keywords: aircraft maintenance, continuing airworthiness, military culture, people, Royal Thai Air Force

Procedia PDF Downloads 112
288 Expectations of Unvaccinated Health Workers in Greece and the Question of Trust: A Qualitative Study of Vaccine Hesitancy

Authors: Sideri Katerina, Chanania Eleni

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The reasons why people remain unvaccinated, especially health workers, are complex. In Greece, 2 percent of health workers (around 7,000) remain unvaccinated, despite the fact that for this group of people vaccination against COVID-19 is mandatory. In April 2022, the Greek health minister repeated that unvaccinated health care workers will remain suspended from their jobs ‘for as long as the pandemic lasts,’ explaining that the suspension of the workers in question was ‘entirely their choice’ and that health professionals who do not believe in vaccines ‘do not believe in their own science.’ Although policy circles around the world often link vaccine hesitancy to ignorance of science or misinformation, various recently published qualitative studies show that vaccine hesitancy is the result of a combination of factors, which include distrust towards elites and the system of innovation and distrust towards government. In a similar spirit, some commentators warn that labeling hesitancy as “anti-science” is bad politics. In this paper, we worked within the tradition of STS taking the view that people draw upon personal associations to enact and express civic concern with an issue, the enactment of public concern involves the articulation of threats to actors’ way of life, personal values, relationships, lived experiences, broader societal values and institutional structures. To this effect, we have conducted 27 in depth interviews with unvaccinated Greek health workers and we are in the process of conducting 20 more interviews. We have so far found that rather than a question of believing in ‘facts’ vaccine hesitancy reflects deep distrust towards those charged with the making of decisions and pharmaceutical companies and that emotions (rather than rational thinking) play a crucial role in the formation of attitudes and the making of decisions. We need to dig deeper so as to understand the causes of distrust towards technical government and the ways in which public(s) conceive of and want to be part in the politics of innovation. We particularly address the question of the effectiveness of mandatory vaccination of health workers and whether such top-down regulatory measures further polarize society, to finally discuss alternative regulatory approaches and governance structures.

Keywords: vaccine hesitancy, innovation, trust in vaccines, sociology of vaccines, attitude drivers towards scientific information, governance

Procedia PDF Downloads 51
287 Understanding Trauma Informed Pedagogy in On-Line Education during Turbulent Times: A Mixed Methods Study in a Canadian Social Work Context

Authors: Colleen McMillan, Alice Schmidt-Hanbidge, Beth Archer-Kuhn, Heather Boynton, Judith Hughes

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It is well known that social work students enter the profession with higher scores of adverse childhood experiences (ACE). Add to that the fact that COVID-19 has forced higher education institutions to shift to online teaching and learning, where students, faculty and field educators in social work education have reported increased stressors as well as posing challenges in developing relationships with students and being able to identify mental health challenges including those related to trauma. This multi-institutional project included three Canadian post-secondary institutions at five sites (the University of Waterloo, the University of Calgary and the University of Manitoba) and partners; Desire To Learn (D2L), The Centre for Teaching Excellence at the University of Waterloo and the Taylor Institute for Teaching and Learning. A sequential mixed method research design was used. Survey data was collected from students, faculty and field education staff from the 3 universities using the Qualtrics Insight Platform, followed by virtual focus group data with students to provide greater clarity to the quantitative data. Survey data was analyzed using SPSS software, while focus group data was transcribed verbatim and organized with N-Vivo 12. Thematic analysis used line-by-line coding and constant comparative methods within and across focus groups. The following three objectives of the study were achieved: 1) Establish a Canadian baseline on trauma informed pedagogy and student experiences of trauma informed teaching in the online higher education environment during a pandemic; 2) Identify and document educator and student experiences of online learning regarding the ability to process trauma experiences; and, 3) Transfer the findings into a trauma informed pedagogical model for Social Work as a first step toward developing a universal trauma informed teaching model. The trauma informed pedagogy model would be presented in relation to the study findings.

Keywords: trauma informed pedagogy, higher education, social work, mental health

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286 Factors of Non-Conformity Behavior and the Emergence of a Ponzi Game in the Riba-Free (Interest-Free) Banking System of Iran

Authors: Amir Hossein Ghaffari Nejad, Forouhar Ferdowsi, Reza Mashhadi

Abstract:

In the interest-free banking system of Iran, the savings of society are in the form of bank deposits, and banks using the Islamic contracts, allocate the resources to applicants for obtaining facilities and credit. In the meantime, the central bank, with the aim of introducing monetary policy, determines the maximum interest rate on bank deposits in terms of macroeconomic requirements. But in recent years, the country's economic constraints with the stagflation and the consequence of the institutional weaknesses of the financial market of Iran have resulted in massive disturbances in the balance sheet of the banking system, resulting in a period of mismatch maturity in the banks' assets and liabilities and the implementation of a Ponzi game. This issue caused determination of the interest rate in long-term bank deposit contracts to be associated with non-observance of the maximum rate set by the central bank. The result of this condition was in the allocation of new sources of equipment to meet past commitments towards the old depositors and, as a result, a significant part of the supply of equipment was leaked out of the facilitating cycle and credit crunch emerged. The purpose of this study is to identify the most important factors affecting the occurrence of non-confirmatory financial banking behavior using data from 19 public and private banks of Iran. For this purpose, the causes of this non-confirmatory behavior of banks have been investigated using the panel vector autoregression method (PVAR) for the period of 2007-2015. Granger's causality test results suggest that the return of parallel markets for bank deposits, non-performing loans and the high share of the ratio of facilities to banks' deposits are all a cause of the formation of non-confirmatory behavior. Also, according to the results of impulse response functions and variance decomposition, NPL and the ratio of facilities to deposits have the highest long-term effect and also have a high contribution to explaining the changes in banks' non-confirmatory behavior in determining the interest rate on deposits.

Keywords: non-conformity behavior, Ponzi Game, panel vector autoregression, nonperforming loans

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285 Health Care Teams during COVID-19: Roles, Challenges, Emotional State and Perceived Preparedness to the Next Pandemic

Authors: Miriam Schiff, Hadas Rosenne, Ran Nir-Paz, Shiri Shinan Altman

Abstract:

To examine (1) the level, predictors, and subjective perception of professional quality of life (PRoQL), posttraumatic growth, roles, task changes during the pandemic, and perceived preparedness for the next pandemic. These variables were added as part of an international study on social workers in healthcare stress, resilience, and perceived preparedness we took part in, along with Australia, Canada, China, Hong Kong, Singapore, and Taiwan. (2) The extent to which background variables, rate of exposure to the virus, working in COVID wards, profession, personal resilience, and resistance to organizational change predict posttraumatic growth, perceived preparedness, and PRoQL (the latter was examined among social workers only). (3) The teams' perceptions of how the pandemic impacted them at the personal, professional, and organizational levels and what assisted them. Methodologies: Mixed quantitative and qualitative methods were used. 1039 hospital healthcare workers from various professions participated in the quantitative study while 32 participated in in-depth interviews. The same methods were used in six other countries. Findings: The level of PRoQL was moderate, with higher burnout and secondary traumatization level than during routine times. Differences between countries in the level of PRoQL were found as well. Perceived preparedness for the next pandemic at the personal level was moderate and similar among the different health professions. Higher exposure to the virus was associated with lower perceived preparedness of the hospitals. Compared to other professions, doctors and nurses perceived hospitals as significantly less prepared for the next pandemic. The preparedness of the State of Israel for the next pandemic is perceived as low by all healthcare professionals. A moderate level of posttraumatic growth was found. Staff who worked at the COVID ward reported a greater level of growth. Doctors reported the lowest level of growth. The staff's resilience was high, with no differences among professions or levels of exposure. Working in the COVID ward and resilience predicted better preparedness, while resistance to organizational change predicted worse preparedness. Findings from the qualitative part of the study revealed that healthcare workers reported challenges at the personal, professional and organizational level during the different waves of the pandemic. They also report on internal and external resources they either owned or obtained during that period. Conclusion: Exposure to the COVID-19 virus is associated with secondary traumatization on one hand and personal posttraumatic growth on the other hand. Personal and professional discoveries and a sense of mission helped cope with the pandemic that was perceived as a historical event, war, or mass casualty event. Personal resilience, along with the support of colleagues, family, and direct management, were seen as significant components of coping. Hospitals should plan ahead and improve their preparedness to the next pandemic.

Keywords: covid-19, health-care, social workers, burnout, preparedness, international perspective

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