Search results for: consumer review
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5684

Search results for: consumer review

4424 Themes in Aesthetic Perceptions of Restorative Urban Landscapes

Authors: Rachel Bechtold, Catherine Shoulders, Donald Johnson, Jennie Popp, Elena Garcia, Lisa Wood

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Creating successfully restored urban landscapes involves both the sound design of natural resources and the incorporation of human perceptions of landscape. Moving forward with an invested interest from society is a challenge for the efficacy of reclaimed landscape design. In particular, urban areas present a dynamic environment wherein society and nature compete for resources and space. This review is meant to examine how perceptions of urban community members, the stakeholders for the plant species that share their environment, are reflected in aesthetic considerations. Findings from this literature review include themes of (1) aesthetic perceptions of stakeholders in rehabilitated landscapes and (2) the importance of organizing indicators of aesthetic perception for future design decisions. Recommendations include addressing the gap in research on aesthetic perceptions of reclaimed urban landscapes and addressing the lack of a consistent and widely accepted framework for these interdisciplinary studies. With knowledge of stakeholder perceptions, improved aesthetic and ecologic designs can more seamlessly merge into reclaimed urban landscapes.

Keywords: phytoremediation, urban landscape design, aesthetic perception, landscape ecology, phytorestoration, landscape reclamation, rehabilitation

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4423 Gait Analysis in Total Knee Arthroplasty

Authors: Neeraj Vij, Christian Leber, Kenneth Schmidt

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Introduction: Total knee arthroplasty is a common procedure. It is well known that the biomechanics of the knee do not fully return to their normal state. Motion analysis has been used to study the biomechanics of the knee after total knee arthroplasty. The purpose of this scoping review is to summarize the current use of gait analysis in total knee arthroplasty and to identify the preoperative motion analysis parameters for which a systematic review aimed at determining the reliability and validity may be warranted. Materials and Methods: This IRB-exempt scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist strictly. Five search engines were searched for a total of 279 articles. Articles underwent a title and abstract screening process followed by full-text screening. Included articles were placed in the following sections: the role of gait analysis as a research tool for operative decisions, other research applications for motion analysis in total knee arthroplasty, gait analysis as a tool in predicting radiologic outcomes, gait analysis as a tool in predicting clinical outcomes. Results: Eleven articles studied gait analysis as a research tool in studying operative decisions. Motion analysis is currently used to study surgical approaches, surgical techniques, and implant choice. Five articles studied other research applications for motion analysis in total knee arthroplasty. Other research applications for motion analysis currently include studying the role of the unicompartmental knee arthroplasty and novel physical therapy protocols aimed at optimizing post-operative care. Two articles studied motion analysis as a tool for predicting radiographic outcomes. Preoperative gait analysis has identified parameters than can predict postoperative tibial component migration. 15 articles studied motion analysis in conjunction with clinical scores. Conclusions: There is a broad range of applications within the research domain of total knee arthroplasty. The potential application is likely larger. However, the current literature is limited by vague definitions of ‘gait analysis’ or ‘motion analysis’ and a limited number of articles with preoperative and postoperative functional and clinical measures. Knee adduction moment, knee adduction impulse, total knee range of motion, varus angle, cadence, stride length, and velocity have the potential for integration into composite clinical scores. A systematic review aimed at determining the validity, reliability, sensitivities, and specificities of these variables is warranted.

Keywords: motion analysis, joint replacement, patient-reported outcomes, knee surgery

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4422 Effectiveness of Traditional Chinese Medicine in the Treatment of Eczema: A Systematic Review and Meta-Analysis Based on Eczema Area and Severity Index Score

Authors: Oliver Chunho Ma, Tszying Chang

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Background: Traditional Chinese Medicine (TCM) has been widely used in the treatment of eczema. However, there is currently a lack of comprehensive research on the overall effectiveness of TCM in treating eczema, particularly using the Eczema Area and Severity Index (EASI) score as an evaluation tool. Meta-analysis can integrate the results of multiple studies to provide more convincing evidence. Objective: To conduct a systematic review and meta-analysis based on the EASI score to evaluate the overall effectiveness of TCM in the treatment of eczema. Specifically, the study will review and analyze published clinical studies that investigate TCM treatments for eczema and use the EASI score as an outcome measure, comparing the differences in improving the severity of eczema between TCM and other treatment modalities, such as conventional Western medicine treatments. Methods: Relevant studies, including randomized controlled trials (RCTs) and non-randomized controlled trials, that involve TCM treatment for eczema and use the EASI score as an outcome measure will be searched in medical literature databases such as PubMed, CNKI, etc. Relevant data will be extracted from the selected studies, including study design, sample size, treatment methods, improvement in EASI score, etc. The methodological quality and risk of bias of the included studies will be assessed using appropriate evaluation tools (such as the Cochrane Handbook). The results of the selected studies will be statistically analyzed, including pooling effect sizes (such as standardized mean differences, relative risks, etc.), subgroup analysis (e.g., different TCM syndromes, different treatment modalities), and sensitivity analysis (e.g., excluding low-quality studies). Based on the results of the statistical analysis and quality assessment, the overall effectiveness of TCM in improving the severity of eczema will be interpreted. Expected outcomes: By integrating the results of multiple studies, we expect to provide more convincing evidence regarding the specific effects of TCM in improving the severity of eczema. Additionally, subgroup analysis and sensitivity analysis can further elucidate whether the effectiveness of TCM treatment is influenced by different factors. Besides, we will compare the results of the meta-analysis with the clinical data from our clinic. For both the clinical data and the meta-analysis results, we will perform descriptive statistics such as means, standard deviations, percentages, etc. and compare the differences between the two using statistical tests such as independent samples t-test or non-parametric tests to assess the statistical differences between them.

Keywords: Eczema, traditional Chinese medicine, EASI, systematic review, meta-analysis

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4421 The Application of International Law in Terms of Earthlife Africa Johannesburg and Another v Minister of Energy and Others 65662/16 (2017) Case

Authors: M. van der Bank

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This study involves a legal analysis of the case Earthlife Africa Johannesburg v Minister of Environmental Affairs and Others. The case considered the impact of the Thabametsi Power Project if it operated to the expected year 2060 on the global climate and ever-changing climate, in South Africa. This judgment highlights the significance, place and principles of climate change and where climate change impacts the South African environmental law which has its founding principles in the Constitution of the Republic of South Africa, 1996. This paper seeks to examine the advances for climate change regulation and application in terms of international law, in South Africa, through a qualitative study involving comparative national and international case law. A literature review study was conducted to compare and contrast the various aspects of law in order to support the argument undertaken. The paper presents a detailed discussion of the current legislation and the position as it currently stands with reference to international law and interpretation. The relevant protections as outlined in the National Environmental Management Act will be discussed. It then proceeds to outline the potential liability of the Minister in the interpretation and application of international law.

Keywords: climate change; environment, environmental review, international law; and principles

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4420 Exploring Strategies Used by Victims of Intimate Partner Violence to Increase Sense of Safety: A Systematic Review and Quantitative Study

Authors: Thomas Nally, Jane Ireland, Roxanne Khan, Philip Birch

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Intimate Partner Violence (IPV), a significant societal problem, affects individuals worldwide. However, the strategies victims use to keep safe are under-researched. IPV is significantly under-reported, and services often are not able to be accessed by all victims. Thus they are likely to use their own strategies to manage their victimization before being able to seek support. Two studies were completed to understand these strategies. A systematic review of the literature and study completed with professionals who work with victims was undertaken to understand this area. In study one, a systematic review of the literature (n=61 papers), were analyzed using Thematic Analysis. The results indicated that victims use a large array of behaviors to increase their sense of safety and coping with emotions but also experience significant barriers to help-seeking. In study 2, sixty-nine professionals completed a measure exploring the likelihood and effectiveness of various victim strategies regarding increasing their sense of safety. Strategies included in the measure were obtained from those identified in study 1. Findings indicated that professionals perceived victims of IPV to be more likely to employ safety strategies and coping behaviors that may be ineffective but not help-seeking behaviors. Further, the responses were analyzed using Cluster Analysis. Safety strategies resulted in five clusters; perpetrator-directed strategies, prevention strategies, cognitive reappraisal, safety planning and avoidance strategies. Help-Seeking resulted in six clusters; information or practical support, abuse-related support, emotional support, secondary support and informal support. Finally, coping resulted in four clusters; emotional coping, self-directed coping, thought recording/change and cognitive coping. Both studies indicate that victims may use a variety of strategies to manage their safety besides seeking help. Professionals working with victims, using a strength-based approach, should understand what is used and is effective for victims who are unable to leave the relationships or access external support.

Keywords: intimate partner violence, help-seeking, professional support, victims, victim coping, victim safety

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4419 Data Protection and Regulation Compliance on Handling Physical Child Abuse Scenarios- A Scoping Review

Authors: Ana Mafalda Silva, Rebeca Fontes, Ana Paula Vaz, Carla Carreira, Ana Corte-Real

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Decades of research on the topic of interpersonal violence against minors highlight five main conclusions: 1) it causes harmful effects on children's development and health; 2) it is prevalent; 3) it violates children's rights; 4) it can be prevented and 5) parents are the main aggressors. The child abuse scenario is identified through clinical observation, administrative data and self-reports. The most used instruments are self-reports; however, there are no valid and reliable self-report instruments for minors, which consist of a retrospective interpretation of the situation by the victim already in her adult phase and/or by her parents. Clinical observation and collection of information, namely from the orofacial region, are essential in the early identification of these situations. The management of medical data, such as personal data, must comply with the General Data Protection Regulation (GDPR), in Europe, and with the General Law of Data Protection (LGPD), in Brazil. This review aims to answer the question: In a situation of medical assistance to minors, in the suspicion of interpersonal violence, due to mistreatment, is it necessary for the guardians to provide consent in the registration and sharing of personal data, namely medical ones. A scoping review was carried out based on a search by the Web of Science and Pubmed search engines. Four papers and two documents from the grey literature were selected. As found, the process of identifying and signaling child abuse by the health professional, and the necessary early intervention in defense of the minor as a victim of abuse, comply with the guidelines expressed in the GDPR and LGPD. This way, the notification in maltreatment scenarios by health professionals should be a priority and there shouldn’t be the fear or anxiety of legal repercussions that stands in the way of collecting and treating the data necessary for the signaling procedure that safeguards and promotes the welfare of children living with abuse.

Keywords: child abuse, disease notifications, ethics, healthcare assistance

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4418 The Efficacy of Mindfulness-Based Interventions on Occupational Stress and Burnout among K-12 Educators: A Review of the Literature

Authors: Kailen Krame

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This paper presents a review of the literature on the efficacy of mindfulness-based interventions for reducing occupational stress and burnout among K-12 educators. An in-depth discussion of the incidence and impact of teacher stress and burnout is provided, as a wealth of literature indicates that this issue is of growing concern and has important implications not only for individual educators but also for students and the school as an organization. Given the evidence of a link between teacher wellbeing and student outcomes, this topic is worth further investigation in order to better understand sources of stress and burnout and propose adequate coping strategies for today’s educators. As a potential solution to teacher stress and burnout, mindfulness-based interventions are reviewed in-depth, and an overview of the history, diverse application, and effects of mindfulness practice are provided. Relevant outcomes of educator mindfulness training presented in the literature include increased emotional regulation, self-efficacy, and personal wellbeing, among several others. Lastly, additional implications and benefits of educator mindfulness training are explored, limitations of the current research are reviewed, and apparent best practices are proposed.

Keywords: educator burnout, emotional regulation, mindfulness, self-efficacy, stress-reduction

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4417 Digital Economy as an Alternative for Post-Pandemic Recovery in Latin America: A Literature Review

Authors: Armijos-Orellana Ana, González-Calle María, Maldonado-Matute Juan, Guerrero-Maxi Pedro

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Nowadays, the digital economy represents a fundamental element to guarantee economic and social development, whose importance increased significantly with the arrival of the COVID-19 pandemic. However, despite the benefits it offers, it can also be detrimental to those developing countries characterized by a wide digital divide. It is for this reason that the objective of this research was to identify and describe the main characteristics, benefits, and obstacles of the digital economy for Latin American countries. Through a bibliographic review, using the analytical-synthetic method in the period 1995-2021, it was determined that the digital economy could give way to structural changes, reduce inequality, and promote processes of social inclusion, as well as promote the construction and participatory development of organizational structures and institutional capacities in Latin American countries. However, the results showed that the digital economy is still incipient in the region and at least three factors are needed to establish it: joint work between academia, the business sector and the State, greater emphasis on learning and application of digital transformation and the creation of policies that encourage the creation of digital organizations.

Keywords: developing countries, digital divide, digital economy, digital literacy, digital transformation

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4416 Understanding the Role of Social Entrepreneurship in Building Mobility of a Service Transportation Models

Authors: Liam Fassam, Pouria Liravi, Jacquie Bridgman

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Introduction: The way we travel is rapidly changing, car ownership and use are declining among young people and those residents in urban areas. Also, the increasing role and popularity of sharing economy companies like Uber highlight a movement towards consuming transportation solutions as a service [Mobility of a Service]. This research looks to bridge the knowledge gap that exists between city mobility, smart cities, sharing economy and social entrepreneurship business models. Understanding of this subject is crucial for smart city design, as access to affordable transport has been identified as a contributing factor to social isolation leading to issues around health and wellbeing. Methodology: To explore the current fit vis-a-vis transportation business models and social impact this research undertook a comparative analysis between a systematic literature review and a Delphi study. The systematic literature review was undertaken to gain an appreciation of the current academic thinking on ‘social entrepreneurship and smart city mobility’. The second phase of the research initiated a Delphi study across a group of 22 participants to review future opinion on ‘how social entrepreneurship can assist city mobility sharing models?’. The Delphi delivered an initial 220 results, which once cross-checked for duplication resulted in 130. These 130 answers were sent back to participants to score importance against a 5-point LIKERT scale, enabling a top 10 listing of areas for shared user transports in society to be gleaned. One further round (4) identified no change in the coefficient of variant thus no further rounds were required. Findings: Initial results of the literature review returned 1,021 journals using the search criteria ‘social entrepreneurship and smart city mobility’. Filtering allied to ‘peer review’, ‘date’, ‘region’ and ‘Chartered associated of business school’ ranking proffered a resultant journal list of 75. Of these, 58 focused on smart city design, 9 on social enterprise in cityscapes, 6 relating to smart city network design and 3 on social impact, with no journals purporting the need for social entrepreneurship to be allied to city mobility. The future inclusion factors from the Delphi expert panel indicated that smart cities needed to include shared economy models in their strategies. Furthermore, social isolation born by costs of infrastructure needed addressing through holistic A-political social enterprise models, and a better understanding of social benefit measurement is needed. Conclusion: In investigating the collaboration between key public transportation stakeholders, a theoretical model of social enterprise transportation models that positively impact upon the smart city needs of reduced transport poverty and social isolation was formed. As such, the research has identified how a revised business model of Mobility of a Service allied to a social entrepreneurship can deliver impactful measured social benefits associated to smart city design existent research.

Keywords: social enterprise, collaborative transportation, new models of ownership, transport social impact

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4415 Overview of Research Contexts about XR Technologies in Architectural Practice

Authors: Adeline Stals

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The transformation of architectural design practices has been underway for almost forty years due to the development and democratization of computer technology. New and more efficient tools are constantly being proposed to architects, amplifying a technological wave that sometimes stimulates them, sometimes overwhelms them, depending essentially on their digital culture and the context (socio-economic, structural, organizational) in which they work on a daily basis. Our focus is on VR, AR, and MR technologies dedicated to architecture. The commercialization of affordable headsets like the Oculus Rift, the HTC Vive or more low-tech like the Google CardBoard, makes it more accessible to benefit from these technologies. In that regard, researchers report the growing interest of these tools for architects, given the new perspectives they open up in terms of workflow, representation, collaboration, and client’s involvement. However, studies rarely mention the consequences of the sample studied on results. Our research provides an overview of VR, AR, and MR researches among a corpus of papers selected from conferences and journals. A closer look at the sample of these research projects highlights the necessity to take into consideration the context of studies in order to develop tools truly dedicated to the real practices of specific architect profiles. This literature review formalizes milestones for future challenges to address. The methodology applied is based on a systematic review of two sources of publications. The first one is the Cumincad database, which regroups publications from conferences exclusively about digital in architecture. Additionally, the second part of the corpus is based on journal publications. Journals have been selected considering their ranking on Scimago. Among the journals in the predefined category ‘architecture’ and in Quartile 1 for 2018 (last update when consulted), we have retained the ones related to the architectural design process: Design Studies, CoDesign, Architectural Science Review, Frontiers of Architectural Research and Archnet-IJAR. Beside those journals, IJAC, not classified in the ‘architecture’ category, is selected by the author for its adequacy with architecture and computing. For all requests, the search terms were ‘virtual reality’, ‘augmented reality’, and ‘mixed reality’ in title and/or keywords for papers published between 2015 and 2019 (included). This frame time is defined considering the fast evolution of these technologies in the past few years. Accordingly, the systematic review covers 202 publications. The literature review on studies about XR technologies establishes the state of the art of the current situation. It highlights that studies are mostly based on experimental contexts with controlled conditions (pedagogical, e.g.) or on practices established in large architectural offices of international renown. However, few studies focus on the strategies and practices developed by offices of smaller size, which represent the largest part of the market. Indeed, a European survey studying the architectural profession in Europe in 2018 reveals that 99% of offices are composed of less than ten people, and 71% of only one person. The study also showed that the number of medium-sized offices is continuously decreasing in favour of smaller structures. In doing so, a frontier seems to remain between the worlds of research and practice, especially for the majority of small architectural practices having a modest use of technology. This paper constitutes a reference for the next step of the research and for further worldwide researches by facilitating their contextualization.

Keywords: architectural design, literature review, SME, XR technologies

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4414 Biosynthesis and Metabolism of Anthraquinone Derivatives

Authors: Dmitry Yu. Korulkin, Raissa A. Muzychkina

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In review the generalized data about biosynthetic routs formation anthraquinone molecules in natural cells. The basic possibilities of various ways of biosynthesis of different quinoid substances are shown.

Keywords: anthraquinones, biochemical evolution, biosynthesis, metabolism

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4413 Constraints Women Academician's Participation at Administrative Positions in Higher Education of Developing Countries

Authors: Bahieh Mohajeri, Mohamad Sharif Mustaf, Mahani Mokhtar

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Purpose: This paper attempts to set the stage for the exploration of female participation in administrative positions within non-western countries by reviewing the studies on female in administrative positions within non-western countries and suggesting guidelines for future studies in this area in developing countries. Methodology: The paper is based on a systematic review of papers that have been published in journals. Findings: The review focuses on constraints to female’s participation in higher education of developing countries (e.g. strong family responsibility, low levels of women faculty members, social values and gendered cultural factors). Practical Implications: Further guidelines for future examination of this field of study are suggested (e.g. adopting a different theoretical view).Value: The article is an initial attempt to gather knowledge about constraints of female administrators in higher education of developing countries. The subject has received less attention in studies on administration and gender. In addition, the article provides suggestions for future studies in order to understand women administrators’ experiences in different educational and cultural settings.

Keywords: administrative position, female administrator, developing countries, participation

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4412 Examining Statistical Monitoring Approach against Traditional Monitoring Techniques in Detecting Data Anomalies during Conduct of Clinical Trials

Authors: Sheikh Omar Sillah

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Introduction: Monitoring is an important means of ensuring the smooth implementation and quality of clinical trials. For many years, traditional site monitoring approaches have been critical in detecting data errors but not optimal in identifying fabricated and implanted data as well as non-random data distributions that may significantly invalidate study results. The objective of this paper was to provide recommendations based on best statistical monitoring practices for detecting data-integrity issues suggestive of fabrication and implantation early in the study conduct to allow implementation of meaningful corrective and preventive actions. Methodology: Electronic bibliographic databases (Medline, Embase, PubMed, Scopus, and Web of Science) were used for the literature search, and both qualitative and quantitative studies were sought. Search results were uploaded into Eppi-Reviewer Software, and only publications written in the English language from 2012 were included in the review. Gray literature not considered to present reproducible methods was excluded. Results: A total of 18 peer-reviewed publications were included in the review. The publications demonstrated that traditional site monitoring techniques are not efficient in detecting data anomalies. By specifying project-specific parameters such as laboratory reference range values, visit schedules, etc., with appropriate interactive data monitoring, statistical monitoring can offer early signals of data anomalies to study teams. The review further revealed that statistical monitoring is useful to identify unusual data patterns that might be revealing issues that could impact data integrity or may potentially impact study participants' safety. However, subjective measures may not be good candidates for statistical monitoring. Conclusion: The statistical monitoring approach requires a combination of education, training, and experience sufficient to implement its principles in detecting data anomalies for the statistical aspects of a clinical trial.

Keywords: statistical monitoring, data anomalies, clinical trials, traditional monitoring

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4411 A Review on Bioremediation of Waste Effluent Associated with Pulp and Paper Industry

Authors: Adamu Muhammed Tukur

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Pulp and paper industry is one of the fastest growing industries due to an increased demand in paper products. For it to satisfy this ever increasing demand, it adopts new technological innovations some of which are proved to affect our environment negatively. Global consumption of paper has increased by 400% in the last four decades and this suggests that more research is required to assess the impact of industrial effluents to our environment and public health. Paper products are generally biodegradable, however, the processes involved in its production which involve the use of mainly bleaching agents and other non-biodegradable substances pose serious problem to the environment. There are more than 250 chemicals released in paper mill waste and some are xenobiotics. Different methods such as physical and chemical methods can be adopted for the remediation of the effluents but are proved to be costly and not safe to the environment. On the other hand, biological method is shown to be less costly and environmentally friendly. Microorganisms and their enzymes have shown a promising future for bioremediation of effluents related to paper mill. Many studies prove that one of the major pollutants in the paper mill effluent is phenol especially its chlorinated derivatives. Pentachlorophenol is extremely hazardous to living cells and therefore need to be removed from the environment. Microorganisms including bacteria and fungi have the potential to degrade phenolic compounds e.g. Bacillus stearothermiphilus, Pseudomonas putida, Coricus versicolor, Sphingomonas chlorophenolica, Fusarium sp, Bacillus subtilis and P. aeroginosa. Enzymes used for the degradation include phenol hydrooxylase, polyphenoloxylase, laccase, peroxidase among others. Lignin is another important pollutant and is resistant to microbial degradation but it has been proved that certain bacteria and fungi like can degrade it. Among the fungi white-rot fungi like Fomes lividus and Trametes vesicolor are the most important bioremediators. This review focused on use of microorganism to reduce or eradicate pollutants released from the paper industry. It can serve as a review for further research to be conducted especially in the field of Biotechnology.

Keywords: bioremediation, pulp and paper, pentachlorophenol, environment

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4410 A Systematic Review of Forest School for Early Childhood Education in China: Lessons Learned from European Studies from a Perspective of Ecological System

Authors: Xiaoying Zhang

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Forest school – an outdoor educational experience that is undertaken in an outdoor environment with trees – becomes an emerging field of early childhood education recently. In China, the benefits of natural outdoor education to children and young people’s wellness have raised attention. Although different types of outdoor-based activities have been involved in some pre-school of China, few study and practice have been conducted in terms of the notion of forest school. To comprehend the impact of forest school for children and young people, this study aims to systematically review articles on the topic of forest school in preschool education from an ecological perspective, i.e. from individual level (e.g., behavior and mental health) to microsystem level (e.g., the relationship between teachers and children) to ecosystem level. Based on PRISMA framework flow, using the key words of “Forest School” and “Early Childhood Education” for searching in Web-of-science database, a total of 33 articles were identified. Sample participants of 13 studies were not preschool children, five studies were not on forest school theme, and two literature review articles were excluded for further analysis. Finally, 13 articles were eligible for thematic analysis. According to Bronfenbrenner's ecological systems theory, there are some fingdings, on the individual level, current forest school studies are concerned about the children behavioral experience in forest school, how these experience may relate to their achievement or to develop children’s wellbeing/wellness, and how this type of learning experience may enhance children’s self-awareness on risk and safety issues. On the microsystem/mesosystem level, this review indicated that pedagogical development for forest school, risk perception from teachers and parents, social development between peers, and adult’s role in the participation of forest school were concerned, explored and discussed most frequently. On the macrosystem, the conceptualization of forest school is the key theme. Different forms of presentation in various countries with diverse cultures could provide various models of forest school education. However, there was no study investigating forest school on an ecosystem level. As for the potential benefits of physical health and mental wellness that results from forest school, it informs us to reflect the system of preschool education from the ecological perspective for Chinese children. For instance, most Chinese kindergartens ignored the significance of natural outdoor activities for children. Preschool education in China is strongly oriented by primary school system, which means pre-school children are expected to be trained as primary school students to do different subjects, such as math. Hardly any kindergarteners provide the opportunities for children and young people to take risks in a natural environment like forest school does. However, merely copying forest school model for a Chinese preschool education system will be less effective. This review of different level concerns could inform us that the localization the idea of forest school to adapt to a Chinese political, educational and cultural background. More detailed results and profound discussions will be presented in the full paper.

Keywords: early childhood education, ecological system, education development prospects in China, forest school

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4409 Implementation and Use of Person-Centered Care in Europe: A Literature Review

Authors: Kristina Rosengren, Petra Brannefors, Eric Carlstrom

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Background: Implementation and use of person-centered care (PCC) is increasing worldwide, and why the current study intends to increase knowledge regarding how PCC is used in different European countries. Purpose: To describe the extent of person-centred care in 23 European countries in relation to use specific countries healthcare system (Beveridge, Bismarck, Mixed/OOP). Methods: The study was conducted by literature review inspired by Spice, both scientific empirical studies (Cinahl, Medline, Scopus) as well as grey literature (Google) were used. Totally 1194 documents were included divided into Cinahl n=139, Medline n=245, Scopus n=493 and Google n=317. Data were analysed with descriptive (percentage, range) regarding content and scope of PCC/country according to content and scope of PCC in each country, grouped into the healthcare system (Beveridge, Bismarck, Mixed/OOP) and geographic placement. Results: PCC were most common in UK (England, Scotland, Wales, North Ireland), n=481, 40.3%, Sweden (n=231, 19.3%), The Netherlands (n=80, 6.7%), Ireland (n=79, 6.6%) and Norway (n=61, 5.1%); and less common in Poland (0.6%), Hungary (0.5%), Greece (0.4%), Latvia (0.4%) and Serbia (0%). Beveridge healthcare system (12/23=0.5217, 52.2%) show 85 percent of documents with advantage of scientific literature valued 2.92 (n=999, 0.55-4.07), compare to advantage of grey literature in Bismarck (10/23=0.4347, 43.5%) with 15 percentage valued 2.35 (n=190, 0-3.27) followed by Mixed/OOP (1/23=4%) with 0.4 valued 2.25. Conclusions: Seven out of 10 countries with Beveridge health system used PCC compare to less-used PCC in countries with the Bismarck system. Research, as well as national regulations regarding PCC, are important tools to motivate the advantage of PCC in clinical practice. Moreover, implementation of PCC needs a systematic approach, from national (politicians), regional (guideline) and local (specific healthcare settings) levels visualized by decision-making as law, mission, policies, and routines in clinical practice to establish a well-integrated phenomenon in Europe.

Keywords: Beveridge, Bismarck, Europe, evidence-based, literature review, person-centered care

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4408 Systematic Review of Current Best Practice in the Diagnosis and Treatment of Obsessive Compulsive Disorder

Authors: Zahra R. Almansoor

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Background: Selective serotonin reuptake inhibitors (SSRI’s) and cognitive behavioural therapy (CBT) are the main treatment methods used for patients with obsessive compulsive disorder (OCD) under the National Institute of Health and Care Excellence (NICE) guidelines. Yet many patients are left with residual symptoms or remit, so several other therapeutic approaches have been explored. Objective: The objective was to systematically review the available literature regarding the treatment efficacy of current and potential approaches and diagnostic strategies. Method: First, studies were examined concerning diagnosis, prognosis, and influencing factors. Then, one reviewer conducted a systematic search of six databases using stringent search terms. Results of studies exploring the efficacy of treatment interventions were analysed and compared separately for adults and children. This review was limited to randomised controlled trials (RCT’s) conducted from 2016 onwards, and an improved Y-BOCS (Yale- Brown obsessive compulsive scale) score was the primary outcome measure. Results: Technology-based interventions including internet-based cognitive behavioural therapy (iCBT) were deemed as potentially effective. Discrepancy remains about the benefits of SSRI use past one year, but potential medication adjuncts include amantadine. Treatments such as association splitting and family and mindfulness strategies also have future potential. Conclusion: A range of potential therapies exist, either as treatment adjuncts to current interventions or as sole therapies. To further improve efficacy, it may be necessary to remodel the current NICE stepped-care model, especially regarding the potential use of lower intensity, cheaper treatments, including iCBT. Although many interventions show promise, further research is warranted to confirm this.

Keywords: family and group treatment, mindfulness strategies, novel treatment approaches, standard treatment, technology-based interventions

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4407 Relationships between Actors within Business Ecosystems That Adopt Circular Strategies: A Systematic Literature Review

Authors: Sophia Barquete, Adriana H. Trevisan, Janaina Mascarenhas

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The circular economy (CE) aims at the cycling of resources through restorative and regenerative strategies. To achieve circularity, coordination of several actors who have different responsibilities is necessary. The interaction among multiple actors allows the connection between the CE and business ecosystem research fields. Although fundamental, the relationships between actors within an ecosystem to foster circularity are not deeply explored in the literature. The objective of this study was to identify the possibilities of cooperation, competition, or even coopetition among the members of business ecosystems that adopt circular strategies. In particular, the motivations that make these actors interact to achieve a circular economy were investigated. A systematic literature review was adopted to select business ecosystem cases that adopt circular strategies. As a result, several motivations were identified for actors to engage in relationships within ecosystems, such as sharing knowledge and infrastructure, developing products with a circular design, promoting reverse logistics, among others. The results suggest that partnerships between actors are, in fact, important for the implementation of circular strategies. In order to achieve a complete and circular solution, actors must be able to clearly understand their roles and relationships within the network so that they can establish new partnerships or reframe those already established.

Keywords: business ecosystem, circular economy, cooperation, coopetition, competition

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4406 Factors Affecting Treatment Resilience in Patients with Oesophago-Gastric Cancers Undergoing Palliative Chemotherapy: A Literature Review

Authors: Kiran Datta, Daniella Holland-Hart, Anthony Byrne

Abstract:

Introduction: Oesophago-gastric (OG) cancers are the fifth commonest in the UK, accounting for over 12,000 deaths each year. Most patients will present at later stages of the disease, with only 21% of patients with stage 4 disease surviving longer than a year. As a result, many patients are unsuitable for curative surgery and instead receive palliative treatment to improve prognosis and symptom burden. However, palliative chemotherapy can result in significant toxicity: almost half of the patients are unable to complete their chemotherapy regimen, with this proportion rising significantly in older and frailer patients. In addition, clinical trials often exclude older and frailer patients due to strict inclusion criteria, meaning there is limited evidence to guide which patients are most likely to benefit from palliative chemotherapy. Inappropriate chemotherapy administration is at odds with the goals of palliative treatment and care, which are to improve quality of life, and this also represents a significant resource expenditure. This literature review aimed to examine and appraise evidence regarding treatment resilience in order to guide clinicians in identifying the most suitable candidates for palliative chemotherapy. Factors influencing treatment resilience were assessed, as measured by completion rates, dose reductions, and toxicities. Methods: This literature review was conducted using rapid review methodology, utilising modified systematic methods. A literature search was performed across the MEDLINE, EMBASE, and Cochrane Library databases, with results limited to papers within the last 15 years and available in English. Key inclusion criteria included: 1) participants with either oesophageal, gastro-oesophageal junction, or gastric cancers; 2) patients treated with palliative chemotherapy; 3) available data evaluating the association between baseline participant characteristics and treatment resilience. Results: Of the 2326 papers returned, 11 reports of 10 studies were included in this review after excluding duplicates and irrelevant papers. Treatment resilience factors that were assessed included: age, performance status, frailty, inflammatory markers, and sarcopenia. Age was generally a poor predictor for how well patients would tolerate chemotherapy, while poor performance status was a better indicator of the need for dose reduction and treatment non-completion. Frailty was assessed across one cohort using multiple screening tools and was an effective marker of the risk of toxicity and the requirement for dose reduction. Inflammatory markers included lymphopenia and the Glasgow Prognostic Score, which assessed inflammation and hypoalbuminaemia. Although quick to obtain and interpret, these findings appeared less reliable due to the inclusion of patients treated with palliative radiotherapy. Sarcopenia and body composition were often associated with chemotherapy toxicity but not the rate of regimen completion. Conclusion: This review demonstrates that there are numerous measures that can estimate the ability of patients with oesophago-gastric cancer to tolerate palliative chemotherapy, and these should be incorporated into clinical assessments to promote personalised decision-making around treatment. Age should not be a barrier to receiving chemotherapy and older and frailer patients should be included in future clinical trials to better represent typical patients with oesophago-gastric cancers. Decisions regarding palliative treatment should be guided by these factors identified as well as patient preference.

Keywords: frailty, oesophago-gastric cancer, palliative chemotherapy, treatment resilience

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4405 Astronomy in the Education Area: A Narrative Review

Authors: Isabella Lima Leite de Freitas

Abstract:

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

Keywords: astronomy, education area, teaching, review

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4404 A Review of Farmer Participation in Information and Communication Technology through Mobile Banking and Mobile Marketing in Rural Agricultural Systems

Authors: J. Cadby, K. Miyazawa

Abstract:

Information and Communication Technology (ICT) has been widely adopted into the agricultural landscape with advancements of mobile connectivity and data accessibility. In developed nations, mobile-technology is well integrated into marketing transactions, and also plays a crucial role in making data-driven decisions on-farm. In developing nations, mobile banking and access to agricultural extension services allow for informed decision-making and smoother transactions. In addition, the availability of updated and readily available market and climate data provides a negotiation platform, reducing economic risks for farmers worldwide. The total usage of mobile technology has risen over the past 20 years, and almost three-quarters of the world’s population subscribes to mobile technology. This study reviewed mobile technology integration into agricultural systems in developing and developed nations. Data from secondary sources were collected and investigated. The objectives of the study include a review of the success of mobile banking transactions in developing nations, and a review of application and SMS based services for direct marketing in both developed and developing nations. Rural farmers in developing countries with access to diverse m-banking options experienced increased access to farm investment resources with the use of mobile banking technology. Rural farmers involved in perishable crop production were also more likely to benefit from mobile platform sales participation. ICT programs reached through mobile application and SMS increased access to agricultural extension materials and marketing tools for demographics that faced literacy-challenges and isolated markets. As mobile technology becomes more ubiquitous in the global agricultural system, training and market opportunities to facilitate mobile usage in developing agricultural systems are necessary. Digital skills training programs are necessary in order to improve equal global adoption of ICT in agriculture.

Keywords: market participation, mobile banking, mobile technology, rural farming

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4403 Implementing a Screening Tool to Assist with Palliative Care Consultation in Adult Non-ICU Patients

Authors: Cassey Younghans

Abstract:

Background: Current health care trends demonstrate that there is an increasing number of patients being hospitalized with complex comorbidities. These complex needs require advanced therapies, and treatment goals often focus on doing everything possible to prolong life rather than focusing on the individual patient’s quality of life which is the goal of palliative care efforts. Patients benefit from palliative care in the early stages of the illness rather than after the disease progressed or the state of acuity has advanced. The clinical problem identified was that palliative care was not being implemented early enough in the disease process with patients who had complex medical conditions and who would benefit from the philosophy and skills of palliative care professionals. Purpose: The purpose of this quality improvement study was to increase the number of palliative care screenings and consults completed on adults after being admitted to one Non-ICU and Non-COVID hospital unit. Methods: A retrospective chart review assessing for possible missed opportunities to introduce palliation was performed for patients with six primary diagnoses, including heart failure, liver failure, end stage renal disease, chronic obstructive pulmonary disease, cerebrovascular accident, and cancer in a population of adults over the ago of 19 on one medical-surgical unit over a three-month period prior to the intervention. An educational session with the nurses on the benefits of palliative care was conducted by the researcher, and a screening tool was implemented. The expected outcome was to have an increase in early palliative care consultation with patients with complex comorbid conditions and a decrease in missed opportunities for the implementation of palliative care. Another retrospective chart review was completed following completion of the three month piloting of the tool. Results: During the retrospective chart review, 46 patients were admitted to the medical-surgical floor with the primary diagnoses identified in the inclusion criteria. Six patients had palliative care consults completed during that time. Twenty-two palliative care screening tools were completed during the intervention period. Of those, 15 of the patients scored a 7 or higher, suggesting that a palliative care consultation was warranted. The final retrospective chart review identified that 4 palliative consults were implemented during that time of the 31 patients who were admitted over the three month time frame. Conclusion: Educating nurses and implementing a palliative care screening upon admission can be of great value in providing early identification of patients who might benefit from palliative care. Recommendations – It is recommended that this screening tool should be used to help identify the patents of whom would benefit from a palliative care consult, and nurses would be able to initiated a palliative care consultation themselves.

Keywords: palliative care, screening, early, palliative care consult

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4402 Strengths and Challenges to Embrace Attention Deficit/Hyperactivity Disorder (ADHD) in Employment: A Systematic Review

Authors: Adèle Hotte-Meunier, Lisa Sarraf, Alan Bougeard, Félicia Bernier, Chloé Voyer, Jiaxuan Deng, Stéphanie El Asmar, Alina Stamate, Marc Corbière, Patrizia Villotti, Geneviève Sauvé

Abstract:

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with psychosocial, educational and occupational functioning. Although often conceptualized as a developmental disorder of childhood, 65% of children with ADHD continue to meet full or partial diagnostic criteria for ADHD in adulthood and an estimated 4% of the workforce has a diagnosis of ADHD. Methods: A systematic review was conducted to understand the experiences of people living with ADHD in the workplace. Articles reporting employment outcomes for people living with were identified by a search in eight databases on four separate occasions from June 27, 2022, to June 21, 2023. A risk of bias assessment for each study was performed using the Mixed Methods Appraisal Tool (MMAT). Results: A total of 79 studies were included in this systematic review (nADHD: 68, 216). Results were synthesized into three broad overarching categories: challenges, strengths and adaptations at work. Further, nine themes were included: ADHD symptoms at work, workplace performance, job satisfaction, interpersonal relationships at work, maladaptive work thoughts and behaviors, personal strengths, embracing ADHD, person-environment fit and accommodations and support. Sex differences were highlighted as a tenth subtheme. ADHD confers both strengths and limitations related to employment. Discussion: Workers with ADHD can not only adapt but thrive in employment with the right person-environment fit, accommodations and support. Many challenges related to ADHD can be managed or remodeled as assets in a workplace environment that fosters acceptance, flexible working practices and openness to neurodiversity.

Keywords: neurodivergence, occupation, workplace, person-environment fit

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4401 The Assessment of Forest Wood Biomass Potential in Terms of Sustainable Development

Authors: Julija Konstantinavičienė, Vlada Vitunskienė

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The role of sustainable biomass, including wood biomass, is becoming more important because of European Green Deal. The New EU Forest strategy is a flagship element of the European Green Deal and a key action on the EU biodiversity strategy for 2030. The first measure of this strategy is promoting sustainable forest management, including encouraging the sustainable use of wood-based resources. The first aim of this research was to develop and present a new approach to the concept of forest wood biomass potential in terms of sustainable development, distinguishing theoretical, technical and sustainable potential and detailing its constraints. The second aim was to prepare the methodology outline of sustainable forest wood biomass potential assessment and empirically check this methodology, considering economic, social and ecological constraints. The basic methodologies of the research: the review of research (with a combination of semi-systematic and integrative review methodologies), rapid assessment method and statistical data analysis. The developed methodology of assessment of forest wood potential in terms of sustainable development can be used in Lithuania and in other countries and will let us compare this potential a different time and spatial levels. The application of the methodology will be able to serve the development of new national strategies for the wood sector.

Keywords: assessment, constraints, forest wood biomass, methodology, potential, sustainability

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4400 The Common Location and the Intensity of Surface Electrical Stimulation on the Thorax and Abdomen Areas: A Systematic Review

Authors: Vu Hoang Thu Huong

Abstract:

Background: Surface electrical stimulation (SES) is a popular non-invasive approach that offers a wide range of treatments for many diseases of physical therapy. It involves applying electrical stimulation to the skin via surface electrodes to stimulate nerve fibers. SES was regularly used to treat the back and upper or lower extremities, but it was rarely used to treat the chest and abdomen. SES on the thorax and abdomen should be administered with more attention because crucial organs are under those areas (i.e., heart, lungs, liver, etc.). In these areas, safety precautions are suggested, and some SES applications might even be a contraindication. The fact that physical therapists have less experience with SES in these situations can also be attributed to these. Although a few earlier studies applied it to these settings and discovered hopeful results, none of them highlight the relationship between the intensity of SES and its depth of impact for safety considerations. Objective: To assure feasibility when using SES in these areas, the purpose of this study is to summarize the common location and intensity of those areas that have been conducted in previous studies. Method: A thorough systematic review was conducted to determine the common surface electrode position for the thorax and abdomen areas. The studies with the randomized controlled design were systematically searched using inclusion and exclusion criteria through nine electronic databases, including Pubmed, Scopus, etc., between 1975 and Dec 2021. Results: Thirty-three studies with over 1800 participants and 4 types of SES (TENS, IFC, NMES, and FES) with various categories of department hospitals were found. Following an anterior, lateral, and posterior observation, the particular SES positions found that it concentrated on 6 regions (the thoracic, abdomen, upper lateral, lower lateral, upper back, and lower back regions), and its intensity for each region was also summarized. Conclusion: This systematic review figured out the popular locations of SES in the thorax and abdominal areas as well as a summarized maximum of intensity that was found in previous studies with outstanding outcomes.

Keywords: surface electrical stimulation, electrical stimulation, thoracic, abdomen, abdominal.

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4399 Urban Flood Risk Mapping–a Review

Authors: Sherly M. A., Subhankar Karmakar, Terence Chan, Christian Rau

Abstract:

Floods are one of the most frequent natural disasters, causing widespread devastation, economic damage and threat to human lives. Hydrologic impacts of climate change and intensification of urbanization are two root causes of increased flood occurrences, and recent research trends are oriented towards understanding these aspects. Due to rapid urbanization, population of cities across the world has increased exponentially leading to improperly planned developments. Climate change due to natural and anthropogenic activities on our environment has resulted in spatiotemporal changes in rainfall patterns. The combined effect of both aggravates the vulnerability of urban populations to floods. In this context, an efficient and effective flood risk management with its core component as flood risk mapping is essential in prevention and mitigation of flood disasters. Urban flood risk mapping involves zoning of an urban region based on its flood risk, which depicts the spatiotemporal pattern of frequency and severity of hazards, exposure to hazards, and degree of vulnerability of the population in terms of socio-economic, environmental and infrastructural aspects. Although vulnerability is a key component of risk, its assessment and mapping is often less advanced than hazard mapping and quantification. A synergic effort from technical experts and social scientists is vital for the effectiveness of flood risk management programs. Despite an increasing volume of quality research conducted on urban flood risk, a comprehensive multidisciplinary approach towards flood risk mapping still remains neglected due to which many of the input parameters and definitions of flood risk concepts are imprecise. Thus, the objectives of this review are to introduce and precisely define the relevant input parameters, concepts and terms in urban flood risk mapping, along with its methodology, current status and limitations. The review also aims at providing thought-provoking insights to potential future researchers and flood management professionals.

Keywords: flood risk, flood hazard, flood vulnerability, flood modeling, urban flooding, urban flood risk mapping

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4398 Barriers to Access among Indigenous Women Seeking Prenatal Care: A Literature Review

Authors: Zarish Jawad, Nikita Chugh, Karina Dadar

Abstract:

Introduction: This paper aims to identify barriers indigenous women face in accessing prenatal care in Canada. It explores the differences in prenatal care received between indigenous and non-indigenous women. The objective is to look at changes or programs in Canada's healthcare system to reduce barriers to accessing safe prenatal care for indigenous women. Methods: A literature search of 12 papers was conducted using the following databases: PubMed, Medline, OVID, Google Scholar, and ScienceDirect. The studies included were written in English only, including indigenous females between the age of 19-35, and review articles were excluded. Participants in the studies examined did not have any severe underlying medical conditions for the duration of the study, and study designs included in the review are prospective cohort, cross-sectional, case report, and case-control studies. Results: Among all the barriers Indigenous women face in accessing prenatal care, the three most significant barriers Indigenous women face include a lack of culturally safe prenatal care, lack of services in the Indigenous community, proximity of prenatal facilities to Indigenous communities and costs of transportation. Discussion: The study found three significant barriers indigenous women face in accessing prenatal care in Canada; the geographical distribution of healthcare facilities, distrust between patients and healthcare professionals, and cultural sensitivity. Some of the suggested solutions include building more birthing and prenatal care facilities in rural areas for indigenous women, educating healthcare professionals on culturally sensitive healthcare, and involving indigenous people in the decision-making process to reduce distrust and power imbalances. Conclusion: The involvement of indigenous women and community leaders is important in making decisions regarding the implementation of effective healthcare and prenatal programs for indigenous women. However, further research is required to understand the effectiveness of the solutions and the barriers that make prenatal care less accessible for indigenous women in Canada.

Keywords: indigenous, maternal health, prenatal care, barriers

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4397 Effectiveness of Electronic Learning for Continuing Interprofessional Education on Behavior Change of Healthcare Professionals: A Scoping Review

Authors: Kailin K. Zhang, Anne W. Thompson

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Electronic learning for continuing professional education (CPE) and interprofessional education (IPE) in healthcare have been shown to improve learners’ satisfaction, attitudes, and performance. Yet, their impact on behavior change in healthcare professionals through continuing interprofessional education (CIPE) is less known. A scoping review of 32 articles from 2010 to 2020 was conducted using the Arksey and O’Malley framework across all healthcare settings. It focused on evaluating the effectiveness of CIPE on behavior change of healthcare professionals, as well as identifying course features of electronic CIPE programs facilitating behavior change. Eight different types of electronic learning methods, including online programs, tele-education, and social media, were identified as interventions. More than 35,542 healthcare professionals participated in the interventions. Electronic learning for CIPE led to positive behavior outcomes in 30 out of 32 studies, especially through a change in patient care practices. The most successful programs provided interactive and authentic learning experiences tailored to learners’ needs while promoting the direct application of what was learned in their clinical settings. Future research should include monitoring of sustained behavior changes and their resultant patient outcomes.

Keywords: behavior change, continuing interprofessional education, distance learning, electronic learning

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4396 Development of Mechanisms of Value Creation and Risk Management Organization in the Conditions of Transformation of the Economy of Russia

Authors: Mikhail V. Khachaturyan, Inga A. Koryagina, Eugenia V. Klicheva

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In modern conditions, scientific judgment of problems in developing mechanisms of value creation and risk management acquires special relevance. Formation of economic knowledge has resulted in the constant analysis of consumer behavior for all players from national and world markets. Effective mechanisms development of the demand analysis, crucial for consumer's characteristics of future production, and the risks connected with the development of this production are the main objectives of control systems in modern conditions. The modern period of economic development is characterized by a high level of globalization of business and rigidity of competition. At the same time, the considerable share of new products and services costs has a non-material intellectual nature. The most successful in Russia is the contemporary development of small innovative firms. Such firms, through their unique technologies and new approaches to process management, which form the basis of their intellectual capital, can show flexibility and succeed in the market. As a rule, such enterprises should have very variable structure excluding the tough scheme of submission and demanding essentially new incentives for inclusion of personnel in innovative activity. Realization of similar structures, as well as a new approach to management, can be constructed based on value-oriented management which is directed to gradual change of consciousness of personnel and formation from groups of adherents included in the solution of the general innovative tasks. At the same time, valuable changes can gradually capture not only innovative firm staff, but also the structure of its corporate partners. Introduction of new technologies is the significant factor contributing to the development of new valuable imperatives and acceleration of the changing values systems of the organization. It relates to the fact that new technologies change the internal environment of the organization in a way that the old system of values becomes inefficient in new conditions. Introduction of new technologies often demands change in the structure of employee’s interaction and training in their new principles of work. During the introduction of new technologies and the accompanying change in the value system, the structure of the management of the values of the organization is changing. This is due to the need to attract more staff to justify and consolidate the new value system and bring their view into the motivational potential of the new value system of the organization.

Keywords: value, risk, creation, problems, organization

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4395 Palliative Care and Persons with Intellectual Disabilities

Authors: Miriam Colleran, Barbara Sheehy-Skeffington

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Background: To explore if there are unique features in the palliative care needs of patients with intellectual disability that may impact on planning for resource and service provision for them. Aim: The purpose of this practice review is to assess the indications for, numbers of and outcomes of care for adults with intellectual disabilities referred to a specialist palliative care service over a twoyear period. Service utilization aspects considered included the frequency of home visits by a specialist palliative care doctor or clinical nurse specialist and the number of hospice admissions that occurred for the patients. Method: A retrospective review was carried out of persons 18 years and older with intellectual disabilities referred to a specialist palliative care service over a 5-year period from 30.11.3018 to 29.11.2023. A manual review was carried out of the register using key terms, namely, known residential care and community dwelling places of service providers for persons with intellectual disabilities in the area and registered diagnoses in addition to the patients known to the clinicians who had intellectual disabilities. Results: 25 referrals were made to the specialist palliative care service of 23 persons with intellectual disabilities during that time. However, this may be an underestimate. 15 women and 8 men were referred with an age range of 19 to 86 years of age. The majority had a diagnosis of Down’s syndrome or Trisomy 21. 5 patients referred did not have home visits from the specialist palliative care team. A range of 2 to 48 phone calls per person occurred by the specialist palliative care team regarding this cohort of patients. The outcomes for the patients included discharge and death. The majority of patients that died, did so in the community. One person however died in hospital. Another person died in a hospice out of area. Conclusion: Providing specialist palliative care for adults with intellectual disabilities is an important element of palliative care. The dominance of the community as the place of death for these patients and the limited number of patients dying in either hospice or hospital are noteworthy. Further research is necessary and education to inform, support, and empower specialist palliative care professionals in optimizing palliative and end-of-life care for persons with intellectual disabilities and to inform service development and provision.

Keywords: about intellectual disability, palliative care

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