Search results for: support of breastfeeding

Authors: Xiaojing Wang, Ann-Marie Ward, Tony Wall

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The problem of over-indebtedness has increased since deregulation of the banking industry in the 1980s, and now it has become a major problem for most countries in Europe, including Germany. Consumer debt issues have attracted not only the attention of academics but also government and debt counselling institutions. Overall, this research aims to contribute to the knowledge gap regarding the causes of consumer over-indebtedness in Germany and to develop predictive models for assessing consumer over-indebtedness risk at consumer level. The situation of consumer over-indebtedness is serious in Germany. The relatively high level of social welfare support in Germany suggests that consumer debt problems are caused by other factors, other than just over-spending and income volatility. Prior literature suggests that the overall stability of the economy and level of welfare support for individuals from the structural environment contributes to consumers’ debt problems. In terms of cultural influence, the conspicuous consumption theory in consumer behaviour suggests that consumers would spend more than their means to be seen as similar profiles to consumers in a higher socio-economic class. This results in consumers taking on more debt than they can afford, and eventually becoming over-indebted. Studies have also shown that financial literacy is negatively related to consumer over-indebtedness risk. Whilst prior literature has examined structural and cultural influences respectively, no study has taken a collective approach. To address this gap, a model is developed to investigate the association between consumer over-indebtedness and proxies for influences from the structural and cultural environment based on the above theories. The model also controls for consumer demographic characteristics identified as being of influence in prior literature, such as gender and age, and adverse shocks, such as divorce or bereavement in the household. Benefiting from SOEP regional data, this study is able to conduct quantitative empirical analysis to test both structural and cultural influences at a localised level. Using German Socio-Economic Panel (SOEP) study data from 2006 to 2016, this study finds that social benefits, financial literacy and the existence of conspicuous consumption all contribute to being over-indebted. Generally speaking, the risk of becoming over-indebted is high when consumers are in a low-welfare community, have little awareness of their own financial situation and always over-spend. In order to tackle the problem of over-indebtedness, countermeasures can be taken, for example, increasing consumers’ financial awareness, and the level of welfare support. By analysing causes of consumer over-indebtedness in Germany, this study also provides new insights on the nature and underlying causes of consumer debt issues in Europe.

Keywords: consumer, debt, financial literacy, socio-economic

Procedia PDF Downloads 212

Authors: Zsuzsa Szakaly

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Several constitutions have explicit or implicit eternity clauses in the European Union, their classic roles were analyzed so far, albeit there are new possibilities emerging in relation to the identity of the constitutions of the Member States. The aim of the study is to look at the practice of the Constitutional Courts of the Member States in detail regarding eternity clauses where limiting constitutional amendment has practical bearing, and to examine the influence of such practice on Europeanization. There are some states that apply explicit eternity clauses embedded in the text of the constitution, e.g., Italy, Germany, and Romania. In other states, the Constitutional Court 'unearthed' the implicit eternity clauses from the text of the basic law, e.g., Slovakia and Croatia. By using comparative analysis to examine the explicit or implicit clauses of the concerned constitutions, taking into consideration the new trends of the judicial opinions of the Member States and the fresh scientific studies, the main questions are: How to wield the double-edged sword of eternity clauses? To support European Integration or to support the sovereignty of the Member State? To help Europeanization or to act against it? Eternity clauses can easily find themselves between a rock and a hard place, the law of the European Union and the law of a Member State, with more possible interpretations. As more and more Constitutional Courts started to declare elements of their Member States’ constitutional identities, these began to interfere with the eternity clauses. Will this trend eventually work against Europeanization? As a result of the research, it can be stated that a lowest common denominator exists in the practice of European Constitutional Courts regarding eternity clauses. The chance of a European model and the possibility of this model influencing the status quo between the European Union and the Member States will be examined by looking at the answers these courts have found so far.

Keywords: constitutional court, constitutional identity, eternity clause, European Integration

Procedia PDF Downloads 141

Authors: R. Tariq, R. Lee

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Background: Additional demands placed on senior clinical teams with ongoing COVID-19 management has accelerated the need to harness the wider healthcare professional resources and upskill them to take on greater clinical responsibility safely. The UK NHS Long Term Plan (2019)¹ emphasises the importance of expanding Advanced Practitioners’ (APs) roles to take on more clinical diagnostic responsibilities to cope with increased demand. In acute settings, APs are often the first point of care for patients and require training to take on initial triage responsibilities efficiently and safely. Critically, their roles include determining which onward services the patients may require, and assessing whether they can be treated at home, avoiding unnecessary admissions to the hospital. Dem Dx is a Clinical Reasoning Platform (CRP) that claims to help frontline healthcare professionals independently assess and triage patients. It guides the clinician from presenting complaints through associated symptoms to a running list of differential diagnoses, media, national and institutional guidelines. The objective of this study was to compare the clinical referral rates and guidelines adherence registered by the HMR Urgent Community Care Team (UCCT)² and Dem Dx recommendations using retrospective cases. Methodology: 192 cases seen by the UCCT were anonymised and reassessed using Dem Dx clinical pathways. We compared the UCCT’s performance with Dem Dx regarding the appropriateness of onward referrals. We also compared the clinical assessment regarding adherence to NICE guidelines recorded on the clinical notes and the presence of suitable guidance in each case. The cases were audited by two medical doctors. Results: Dem Dx demonstrated appropriate referrals in 85% of cases, compared to 47% in the UCCT team (p<0.001). Of particular note, Dem Dx demonstrated an almost 65% (p<0.001) improvement in the efficacy and appropriateness of referrals in a highly experienced clinical team. The effectiveness of Dem Dx is in part attributable to the relevant NICE and local guidelines found within the platform's pathways and was found to be suitable in 86% of cases. Conclusion: This study highlights the potential of clinical decision support, as Dem Dx, to improve the quality of onward clinical referrals delivered by a multidisciplinary team in primary care. It demonstrated that it could support healthcare professionals in making appropriate referrals, especially those that may be overlooked by providing suitable clinical guidelines directly embedded into cases and clear referral pathways. Further evaluation in the clinical setting has been planned to confirm those assumptions in a prospective study.

Keywords: advanced practitioner, clinical reasoning, clinical decision-making, management, multidisciplinary team, referrals, triage

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Authors: Gulnaz Erkomaishvili

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Introduction: The paper assesses the impact of the COVID-19 pandemic on the activities of small and medium-sized enterprises in Georgia, identifies their problems, and analyzes the state economic policy measures. During the pandemic, entrepreneurs named the imposition of restrictions, access to financial resources, shortage of qualified personnel, high tax rates, unhealthy competition in the market, etc. as the main challenges. The Georgian government has had to take special measures to mitigate the crisis impact caused by the pandemic. For example - in 2020, they mobilized more than 1,6 billion Gel for various eventsto support entrepreneurs. Small and medium-sized entrepreneurship development strategy is presented based on the research; Corresponding conclusions are made, and recommendations are developed. Objectives: The object of research is small and medium-sized enterprises and economic-political decisions aimed at their promotion.Methodology: This paper uses general and specific methods, in particular, analysis, synthesis, induction, deduction, scientific abstraction, comparative and statistical methods, as well as experts’ evaluation. In-depth interviews with experts were conducted to determine quantitative and qualitative indicators; Publications of the National Statistics Office of Georgia are used to determine the regularity between analytical and statistical estimations. Also, theoretical and applied research of international organizations and scientist-economists are used. Contributions: The COVID-19pandemic has had a significant impact on small and medium-sized enterprises. For them, Lockdown is a major challenge. Total sales volume decreased. At the same time, the innovative capabilities of enterprises and the volume of sales in remote channels have increased. As for the assessment of state support measures by small and medium-sizedentrepreneurs, despite the existence of support programs, a large number of entrepreneurs still do not evaluate the measures taken by the state positively. Among the desirable measures to be taken by the state, which would improve the activities of small and medium-sized entrepreneurs, who negatively or largely negatively assessed the activity of the state, named: tax incentives/exemption from certain taxes at the initial stage; Need for periodic trainings/organization of digital technologies, marketing training courses to improve the qualification of employees; Logic and adequacy of criteria when awarding grants and funding; Facilitating the finding of investors; Less bureaucracy, etc.

Keywords: small and medium enterprises, small and medium entrepreneurship, economic policy for small and medium entrepreneurship development, government regulations in Georgia, COVID-19 pandemic

Procedia PDF Downloads 155

Authors: Vida Dones-Jimenez

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The main purpose of this study is to determine the preschool teachers’ technology and 21st-century skills and its relation to teachers’ performance. The participants were 94 preschool teachers and 59 school administrators from the CDAPS member schools. The data were collected by using 21st Century Skill, developed by ISSA (2009), Technology Skills of Teachers Survey (2013) and Teacher Performance Evaluation Criteria and Descriptors (200) was modified by the current researcher to suit the needs of her study and was administered personally by her. The surveys were designed to measure the participants’ 21st-century skills, technology skills and teaching performance. The result of the study indicates that the majority of the preschool teachers are the college graduate. Most of them are in the teaching profession for 0 to 10 years. It also indicated that the majority of the school administrators are masters’ degree holder. The preschool teachers are outstanding in their teaching performance as rated by the school administrators. The preschool teachers are skillful in using technology, and they are very skillful in executing the 21st-century skills in teaching. It was further determined that no significant difference between preschool teachers 21st-century skill in regards to educational attainment same as with the number of years in teaching, likewise with their technology skills. Furthermore, the study has shown that there is a very weak relationship between technology and 21st-century skills of preschool teachers, a weak relationship between technology skills and teaching performance and a very weak relationship between 21st-century skills and teaching performance were also established. The study recommends that the preschool teachers should be encouraged to enroll in master degree programs. School administrators should support the implementation of newly adopted technologies and support faculty members at various levels of use and experience. It is also recommended that regular review of the professional development plan be undertaken to upgrade 21st-century teaching and learning skills of preschool teachers.

Keywords: preschool teacher, teaching performance, technology, 21st century skills

Procedia PDF Downloads 399

Authors: Narges Ebadi, Davod Ahmadi, Hiliary Monteith, Hugo Melgar-Quinonez

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Migration cannot necessarily relieve pressure on water resources in origin communities, and male out-migration can increase the water management burden of women. However, inflows of financial remittances seem to offer possibilities of investing in improving drinking-water access. Therefore, remittances may be an important pathway for migrants to support water security. This paper explores the association between water access and the receipt of remittances in households in sub-Saharan Africa. Data from round 6 of the 'Afrobarometer' surveys in 2016 were used (n= 49,137). Descriptive, bivariate and multivariate statistical analyses were carried out in this study. Regardless of country, findings from descriptive analyses showed that approximately 80% of the respondents never received remittance, and 52% had enough clean water. Only one-fifth of the respondents had piped water supply inside the house (19.9%), and approximately 25% had access to a toilet inside the house. Bivariate analyses revealed that even though receiving remittances was significantly associated with water supply, the strength of association was very weak. However, other factors such as the area of residence (rural vs. urban), cash income frequencies, electricity access, and asset ownership were strongly associated with water access. Results from unadjusted multinomial logistic regression revealed that the probability of having no access to piped water increased among remittance recipients who received financial support at least once a month (OR=1.324) (p < 0.001). In contrast, those not receiving remittances were more likely to regularly have a water access concern (OR=1.294) (p < 0.001), and not have access to a latrine (OR=1.665) (p < 0.001). In conclusion, receiving remittances is significantly related to water access as the strength of odds ratios for socio-demographic factors was stronger.

Keywords: remittances, water access, SSA, migration

Procedia PDF Downloads 179

Authors: Jamshid Hussain, Kuen Song Lin

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Over one thousand tons of pig hair biowaste (PHB) are produced yearly in Taiwan. The improper disposal of PHB can have a negative impact on the environment, consequently contributing to the spread of diseases. The treatment of PHB has become a major environmental and economic challenge. Innovative treatments must be developed because of the heavy metal and sulfur content of PHB. Like most organic materials, PHB is composed of many organic volatiles that contain large amounts of hydrogen. Hydrogen gas can be effectively produced by the catalytic gasification of PHB using a laboratory-scale fixed-bed gasifier, employing 15 wt% NiO/Al₂O₃ catalyst at 753–913 K. The derived kinetic parameters were obtained and refined using simulation calculations. FE–SEM microphotograph showed that NiO/Al₂O₃ catalyst particles are Spherical or irregularly shaped with diameters of 10–20 nm. HR–TEM represented that the fresh Ni particles were evenly dispersed and uniform in the microstructure of Al₂O₃ support. The sizes of the NiO nanoparticles were vital in determining catalyst activity. As displayed in the pre-edge XANES spectra of the NiO/Al₂O₃ catalysts, it exhibited a non-intensive absorbance nature for the 1s to 3d transition, which is prohibited by the selection rule for an ideal octahedral symmetry. Similarly, the populace of Ni(II) and Ni(0) onto Al₂O₃ supports are proportional to the strength of the 1s to 4pxy transition, respectively. The weak shoulder at 8329–8334 eV and a strong character at 8345–8353 eV were ascribed to the 1s to 4pxy shift, which suggested the presence of NiO types onto Al₂O₃ support in PHB catalytic gasification. As determined by the XANES analyses, Ni(II)→Ni(0) reduction was mostly observed. The oxidation of PHB onto the NiO/Al₂O₃ surface may have resulted in Ni(0) and the formation of tar during the gasification process. The EXAFS spectra revealed that the Ni atoms with Ni–Ni/Ni–O bonds were found. The Ni–O bonding proved that the produced syngas were unable to reduce NiO to Ni(0) completely. The weakness of the Ni–Ni bonds may have been caused by the highly dispersed Ni in the Al₂O₃ support. The central Ni atoms have Ni–O (2.01 Å) and Ni–Ni (2.34 Å) bond distances in the fresh NiO/Al₂O₃ catalyst. The PHB was converted into hydrogen-rich syngas (CO + H₂, >89.8% dry basis). When PHB (250 kg h−1) was catalytically gasified at 753–913 K, syngas was produced at approximately 5.45 × 105 kcal h−1 of heat recovery with 76.5%–83.5% cold gas efficiency. The simulation of the pilot-scale PHB catalytic gasification demonstrated that the system could provide hydrogen (purity > 99.99%) and generate electricity for an internal combustion engine of 100 kW and a proton exchange membrane fuel cell (PEMFC) of 175 kW. A projected payback for a PHB catalytic gasification plant with a capacity of 10- or 20-TPD (ton per day) was around 3.2 or 2.5 years, respectively.

Keywords: pig hair biowaste, catalytic gasification, hydrogen production, PEMFC, resource recovery

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Authors: E. Asadollahi-Yazdi, J. Gardan, P. Lafon

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Nowadays, manufactures are encountered with production of different version of products due to quality, cost and time constraints. On the other hand, Additive Manufacturing (AM) as a production method based on CAD model disrupts the design and manufacturing cycle with new parameters. To consider these issues, the researchers utilized Design For Manufacturing (DFM) approach for AM but until now there is no integrated approach for design and manufacturing of product through the AM. So, this paper aims to provide a general methodology for managing the different production issues, as well as, support the interoperability with AM process and different Product Life Cycle Management tools. The problem is that the models of System Engineering which is used for managing complex systems cannot support the product evolution and its impact on the product life cycle. Therefore, it seems necessary to provide a general methodology for managing the product’s diversities which is created by using AM. This methodology must consider manufacture and assembly during product design as early as possible in the design stage. The latest approach of DFM, as a methodology to analyze the system comprehensively, integrates manufacturing constraints in the numerical model in upstream. So, DFM for AM is used to import the characteristics of AM into the design and manufacturing process of a hybrid product to manage the criteria coming from AM. Also, the research presents an integrated design method in order to take into account the knowledge of layers manufacturing technologies. For this purpose, the interface model based on the skin and skeleton concepts is provided, the usage and manufacturing skins are used to show the functional surface of the product. Also, the material flow and link between the skins are demonstrated by usage and manufacturing skeletons. Therefore, this integrated approach is a helpful methodology for designer and manufacturer in different decisions like material and process selection as well as, evaluation of product manufacturability.

Keywords: additive manufacturing, 3D printing, design for manufacturing, integrated design, interoperability

Procedia PDF Downloads 316

Authors: Klara Królewiak-Detsi, Anna Orylska, Anna Gorgolewska, Marta Boczkowska, Agata Graczykowska

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This study investigates the communication between students and teachers in inclusive education in Poland. Specifically, we examine the communication and interaction of students with special educational needs during online learning compared to traditional face-to-face instruction. Our research questions are (1) how children with special educational needs communicate with their teachers and peers during online learning, and (2) what strategies can improve their communication skills. We conducted five focus groups with: (1) 55 children with special educational needs, (2) 65 typically developing pupils, (3) 28 professionals (psychologists and special education therapists), (4) 16 teachers, and (5) 16 parents of children with special educational needs. Our analysis focused on primary schools and used thematic analysis according to the 6-step procedure of Braun and Clarke. Our findings reveal that children with disabilities faced more difficulties communicating and interacting with others online than in face-to-face lessons. The online tools used for education were not adapted to the needs of children with disabilities, and schools lacked clear guidelines on how to pursue inclusive education online. Based on the results, we offer recommendations for online communication training and tools that are dedicated to children with special educational needs. Additionally, our results demonstrate that typically developing pupils are better in interpersonal relations and more often and effectively use social support. Children with special educational needs had similar emotional and communication challenges compared to their typically developing peers. In conclusion, our study highlights the importance of providing adequate support for the online education of children with special educational needs in inclusive classrooms.

Keywords: Inclusive education, Special educational needs, Social skills development, Online communication

Procedia PDF Downloads 131

Authors: D. Supaporn, B. Julaluk

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The purposes of this study were to study symptom cluster, functional status and quality of life of patients with chronic obstructive pulmonary disease (COPD), and to examine factors related to and predicting symptom cluster, functional status and quality of life of COPD patients. The sample was 180 COPD patients multi-stage random sampling from 4 hospitals in the eastern region, Thailand. The research instruments were 8 questionnaires and recorded forms measuring personal and illness data, co-morbidity, physical and psychological symptom, health status perception, social support, and regimen adherence, functional status and quality of life. Spearman rank and Pearson correlation coefficient, exploratory factors analysis and standard multiple regression were used to analyzed data. The findings revealed that two symptom clusters were generated: physical symptom cluster including dyspnea, fatigue and insomnia; and, psychological symptom cluster including anxiety and depression. Scores of physical symptom cluster was at moderate level while that of psychological symptom cluster was at low level. Scores on functional status, social support and overall regimen adherence were at good level whereas scores on quality of life and health status perception were at moderate level. Disease severity was positively related to physical symptom cluster, psychological symptom cluster and quality of life, and was negatively related to functional status at a moderate level (rs = .512, .509, .588 and -.611, respectively). Co-morbidity was positively related to physical symptom cluster and psychological symptom cluster at a low level (r = .179 and .176, respectively). Regimen adherence was negatively related to quality of life and psychological symptom cluster at a low level (r=-.277 and -.309, respectively), and was positively related to functional status at a moderate level (r=.331). Health status perception was negatively related to physical symptom cluster, psychological symptom cluster and quality of life at a moderate to high level (r = -.567, -.640 and -.721, respectively) and was positively related to functional status at a high level (r = .732). Social support was positively related to functional status (r=.235) and was negatively related to quality of life at a low level (r=-.178). Physical symptom cluster was negatively related to functional status (r= -.490) and was positively related to quality of life at a moderate level (r=.566). Psychological symptom cluster was negatively related to functional status and was positively related to quality of life at a moderate level (r= -.566 and .559, respectively). Disease severity, co-morbidity and health status perception could predict 40.2% of the variance of physical symptom cluster. Disease severity, co-morbidity, regimen adherence and health status perception could predict 49.8% of the variance of psychological symptom cluster. Co-morbidity, regimen adherence and health status perception could predict 65.0% of the variance of functional status. Disease severity, health status perception and physical symptom cluster could predict 60.0% of the variance of quality of life in COPD patients. The results of this study can be used for enhancing quality of life of COPD patients.

Keywords: chronic obstructive pulmonary disease, functional status, quality of life, symptom cluster

Procedia PDF Downloads 558

Authors: Miriam Palomo-Nieto, Adrian Agricola, Rudolf Psotta, Reza Abdollahipour, Ludvik Valtr

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The importance of vision and the visual control of movement have been labeled in the literature related to motor control and many studies have demonstrated that children with low motor competence may rely more heavily on vision to perform movements than their typically developing peers. The aim of the study was to highlight the effects of different visual conditions on motor performance during walking in children with different levels of motor coordination. Participants (n = 32, mean age = 8.5 years sd. ± 0.5) were divided into two groups: typical development (TD) and low motor coordination (LMC) based on the scores of the Movement Assessment Battery for Children (MABC-2). They were asked to walk along a 10 meters walkway where the Optojump-Next instrument was installed in a portable laboratory (15 x 3 m), which allows that all participants had the same visual information. They walked in self-selected speed under four visual conditions: full vision (FV), limited vision 100 ms (LV-100), limited vision 150 ms (LV-150) and non-vision (NV). For visual occlusion participants were equipped with Plato Goggles that shut for 100 and 150 ms, respectively, within each 2 sec. Data were analyzed in a two-way mixed-effect ANOVA including 2 (TD vs. LMC) x 4 (FV, LV-100, LV-150 & NV) with repeated-measures on the last factor (p ≤.05). Results indicated that TD children walked faster and with longer normalized steps length and strides than LMC children. For TD children the percentage of the single support and swing time were higher than for low motor competence children. However, the percentage of load response and pre swing was higher in the low motor competence children rather than the TD children. These findings indicated that through walking we could be able to identify different levels of motor coordination in children. Likewise, LMC children showed shorter percentages in those parameters regarding only one leg support, supporting the idea of balance problems.

Keywords: visual information, motor performance, walking pattern, optojump

Procedia PDF Downloads 574

Authors: Nimrod Bantigue

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The Department of Education is continuously providing safe teaching-learning facilities and hazard-free environments to the learners. To achieve this goal, teachers’ awareness of DepEd’s DRRM programs and activities is extremely important; thus, this descriptive correlational quantitative study was conceptualized. This research answered four questions on the profile and level of awareness of the 153 teacher respondents of Oriental Mindoro National High School for the academic year 2018-2019. Stratified proportional sampling was employed, and both descriptive and inferential statistics were utilized to treat data. The findings revealed that the majority of the teachers at OMNHS are female and are in the age bracket of 20-40. Most are married and pursue graduate studies. They have moderate awareness of the Department of Education’s DRRM programs and activities in terms of assessment of risks activities, planning activities, implementation activities during disaster and evaluation and monitoring activities with 3.32, 3.12, 3.40 and 3.31 as computed means, respectively. Further, the result showed a significant relationship between the profile of the respondents such as age, civil status and educational attainment and the level of awareness. On the contrary, sex does not have a significant relationship with the level of awareness. The Support School DRRM program with Utilization Guide on School DRRM Manual was proposed to increase, improve and strengthen the weakest areas of awareness rated in each DRRM activity, such as assessment of risks, planning, and implementation during disasters and monitoring and evaluation.

Keywords: awareness, management, monitoring, risk reduction

Procedia PDF Downloads 219

Authors: M. Govindarajan

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One of the major developments in machine learning in the past decade is the ensemble method, which finds highly accurate classifier by combining many moderately accurate component classifiers. In this research work, new ensemble classification methods are proposed with homogeneous ensemble classifier using bagging and heterogeneous ensemble classifier using arcing and their performances are analyzed in terms of accuracy. A Classifier ensemble is designed using Radial Basis Function (RBF) and Support Vector Machine (SVM) as base classifiers. The feasibility and the benefits of the proposed approaches are demonstrated by the means of standard datasets of intrusion detection. The main originality of the proposed approach is based on three main parts: preprocessing phase, classification phase, and combining phase. A wide range of comparative experiments is conducted for standard datasets of intrusion detection. The performance of the proposed homogeneous and heterogeneous ensemble classifiers are compared to the performance of other standard homogeneous and heterogeneous ensemble methods. The standard homogeneous ensemble methods include Error correcting output codes, Dagging and heterogeneous ensemble methods include majority voting, stacking. The proposed ensemble methods provide significant improvement of accuracy compared to individual classifiers and the proposed bagged RBF and SVM performs significantly better than ECOC and Dagging and the proposed hybrid RBF-SVM performs significantly better than voting and stacking. Also heterogeneous models exhibit better results than homogeneous models for standard datasets of intrusion detection. 

Keywords: data mining, ensemble, radial basis function, support vector machine, accuracy

Procedia PDF Downloads 248

Authors: Thien Bach Nguyen, Nhu-Van Nguyen, Phi-Minh Nguyen, Minh Hien Dao

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The external store safe separation evaluation process implementing CFD and MIL-HDBK-1763 is proposed to support the evaluation and compliance of the external store safe separation with the extensive using CFD and the criteria from MIL-HDBK-1763. The criteria of safe separation are researched and investigated for the various standards and handbooks such as MIL-HDBK-1763, MIL-HDBK-244A, AGARD-AG-202 and AGARD-AG-300 to acquire the appropriate and tailored values and limits for the typical applications of external carriages and aircraft fighters. The CFD and 6DOF simulations are extensively used in ANSYS 2023 R1 Software for verification and validation of moving unstructured meshes and solvers by calibrating the position, aerodynamic forces and moments of the existing air-to-ground missile models. The verified CFD and 6DoF simulation separation process is applied and implemented for the investigation of the typical munition separation phenomena and compliance with the tailored requirements of MIL-HDBK-1763. The prediction of munition trajectory parameters under aircraft aerodynamics interference and specified rack unit consideration after munition separation is provided and complied with the tailored requirements to support the safe separation evaluation of improved and newly external store munition before the flight test performed. The proposed process demonstrates the effectiveness and reliability in providing the understanding of the complicated store separation and the reduction of flight test sorties during the improved and new munition development projects by extensively using the CFD and tailoring the existing standards.

Keywords: external store separation, MIL-HDBK-1763, CFD, moving meshes, flight test data, munition.

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Authors: Jireh Reinor L. Vitto, Mylene S. Gumarao, Levy M. Fajanilan, Sheryll Ann M. Castillo, Leonardo B. Dorado, Miriam P. Narbarte

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Human trafficking may happen to anyone. The study aimed to explore the experiences of victim witnesses of human trafficking. It utilized a qualitative phenomenological study design. Eighteen women, 15 to 46 years old, had experienced human trafficking (sex or labor trafficking), and with a filed case or not. An in-depth semi-structured, open-ended interview was employed to gather information. Guardians were also interviewed for triangulation purposes. Findings showed that the participants experienced fatigue and abuse for their physical aspect and gained negative feelings such as burdened, sad, scared (fear), stress, anger, trauma, depress and suicidal thoughts for their psychological aspect. For the spiritual aspect, the participants concluded to have enhanced spiritual life where they knew about God, became closer to God, and learned how to pray. They also faced challenges such as dysfunctional family, delinquent friends, exploitation, problems kept from the family, and poverty, which resulted in their becoming victims of human trafficking. To cope with the situation, they utilized family support, prayers, guts or courage (lakas ng loob), negotiation with their employer, and support from kababayans. Their practices and mechanisms to recover were the Blas Ople Center, rescue/entrapment operation, shelter, and embassy. After the incident, the participants shared that they earned to have thoughts of having a good life without going abroad/makabayan, knowledge of overseas Filipino workers, wise choice of friends, contentment, and value for the family.

Keywords: victim-witnesses, human trafficking, lived experiences, challenges, coping strategies

Procedia PDF Downloads 131

Authors: Bilge Kaan Tekelioglu, Mehmet Celik, Mahmut Ali Gokce, Ladine Celik, Yusuf Uzun

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A male mature barn owl (Tyto alba) was brought to Cukurova University Ceyhan Veterinary Medicine Faculty at the beginning of January 2017. The bird was found at a local state elementary school’s garden where had been terribly damaged by metal wires. On the clinical examination, the animal was in shock and atonic position at arrival and seems to have feather problems and severe injuries. The ears, eyes, claws and wounded areas were checked and no signs of viral, microbial or ecto-parasitic infection were observed. The bird has been declared by U.S. wild life Office as endangered species. At first, the owl was kept in silent, warm and darkened cabinet against shock and warmed fluid replacement was started by % 5 dextrose solution per orally. On the second day, we started per oral forced feeding with chicken flesh meat dipped into the dextrose solution. On the third day, the bird was continued to be fed with fresh meat. At the fourth day, the owl was started to be fed with chicks during the next 3 days died by natural means which has been supplied by a local breeder. At the first 3 days 1 chick per day and the following days 2 chicks per day has been given per orally. The tenth day we started flying exercises in a small and non-windowed room safely. The saved owl was kept in this room for 10 more days. Finally, the owl was released at the habitation where it had been found injured. This study has one more time proved that, if you save one, you can save more. Wild life is in danger all over the world. Every living creature has right and deserves a chance to live.

Keywords: wild life, barn owl, Tyto alba, rescue, life support, feeding

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Authors: Y. N. Shashidhara, B. S. Shakuntala

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Introduction: Nursing practice is undergoing tremendous changes and challenges. In order to meet social challenges and needs, nursing practice must be research based. Research is needed to evaluate the effectiveness of nursing treatment modalities, to determine the impact of nursing care on the health of the patients or to test the theory of nursing practice. Objective of the study to explore the attitude of staff nurses on Nursing research and its utilization Methodology: The descriptive study design was adopted and 300 staff nurses were selected by systematic random sampling technique from eight hospitals. The attitude on nursing research was assessed by validated and reliable self-administered attitude scale which consists of 40 items. Results: The overall attitude mean score 130.2 (SD 11.5) regarding attitude on Nursing research and its utilization. Some of the findings are the majority of staff nurses (51% agreed and 18.3% strongly agreed) that they have all the motivation to use research findings if they get support. Nearly 25.3 percent of staff nurses agreed and 10.7 percent strongly agreed that they do not have time to conduct research. The majority of staff nurses 53.7 percent agreed that research will help in updating Nursing profession. Nearly 32.6 percent of staff nurses agreed and 20.5 percent strongly agreed that being able to use will make them better nurses. About 45.3 percent and 17.3 percent agreed and strongly agreed that knowledge gained through experience is more useful than research. Most (40%) of nurses agreed that thy do not have the authority to change the patient care practice. The majority of staff nurses (45.7 percent agreed and 13 percent strongly agreed) feel the research will consume their personal time. Majority, 50 percent of staff nurses agreed and 16.7 percent strongly agreed that to conduct and utilize research findings requires financial support. Majority 50 percent of staff nurses agreed and 12 percent strongly agreed that physicians will cooperate and value nursing research findings. Majority 67.3 percent of staff nurses had moderate positive and 32.7 percent of staff nurses had highly positive attitude towards Nursing research and its utilization. Conclusion: With this study we understanding that, the staff nurses have positive attitude regarding nursing research. If the nurses are supported and motivated for research utilization we can improve the patient care.

Keywords: nurses, attitude, nursing research, research utilization

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Authors: Francis Zerd, Brian E. Moore, Atuganile E. Malango, Patrick W. Hosokawa, Kevin O. Lillehei, Laurence Lemery Mchome, D. Ryan Ormond

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Introduction: Since neuropathologic diagnosis in the developing world is hampered by limitations in technical infrastructure, trained laboratory personnel, and subspecialty-trained pathologists, the use of telepathology for diagnostic support, second-opinion consultations, and ongoing training holds promise as a means of addressing these challenges. This research aims to assess the utility of static teleneuropathology in improving neuropathologic diagnoses in low- and middle-income countries. Methods: Consecutive neurosurgical biopsy and resection specimens obtained at Muhimbili National Hospital in Tanzania between July 1, 2018, and June 30, 2019, were selected for retrospective, blinded static-image neuropathologic review followed by on-site review by an expert neuropathologist. Results: A total of 75 neuropathologic cases were reviewed. The agreement of static images and on-site glass diagnosis was 71% with strict criteria and 88% with less stringent criteria. This represents an overall improvement in diagnostic accuracy from 36% by general pathologists to 71% by a neuropathologist using static telepathology (or 76% to 88% with less stringent criteria). Conclusions: Telepathology offers a suitable means of providing diagnostic support, second-opinion consultations, and ongoing training to pathologists practicing in resource-limited countries. Moreover, static digital teleneuropathology is an uncomplicated, cost-effective, and reliable way to achieve these goals.

Keywords: neuropathology, resource-limited settings, static image, Tanzania, teleneuropathology

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Authors: Ahmed A. Alghamdi

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Single-walled carbon nanotubes (SWCNTs) are an outstanding material for applications in thermoelectric power generation, nanoelectronics, electrochemical energy storage, photovoltaics, and light emission. They are ultra-lightweight and possess electrical as well as thermal conductivity, flexibility, and mechanical strength. SWCNT is applicable in water treatment, brine desalination, removal of heavy metal ions associated with pollutants, and oil-water separation. Carbon nanotube (CNT) is believed to tackle the trade-off issue between permeability, selectivity, and fouling issues in membrane filtration applications. Studying these CNT structures, as well as their interconnection in nanotechnology, assists in finding the precise position to be placed for water desalination. Reverse osmosis (RO) has been used globally for desalination, resulting in purified water. Thin film composite (TFC) membranes were utilized in the RO process for desalination. The sheet thickness increases the salt rejection and decreases the water flux when CNT is utilized as a support layer to this membrane. Thus, through a temperature-induced phase separation technique (TIPS), axially aligned SWCNT (AASWCNT) is fabricated, and its use enhances the salt rejection and water flux at short reaction times with a modified procedure. An evaluation was conducted and analogized with prior works in the literature, which exhibited that the prepared TFC membrane showed a better outcome.

Keywords: single-walled carbon nanotubes, thin film composite, axially aligned swcnt, temperature induced phase separation technique, reverse osmosis

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Authors: Moujib Bahri, Ouafa Sakka, Kallel Rahim

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This study builds on the literature about the effects of corruption on economic growth at the firm level, which analyzes how the payment of bribes affect organizational performance. Traditionally, the literature distinguishes two points of view regarding the impact of corruption: grease view and sand view. The grease view is based on the idea that corruption can compensate for the negative effect of red tape on firms’ activities such as innovation and exports. Therefore, some firms will be motivated to pay some additional money to officials in order to reduce the delay related to bureaucratic procedures. On the contrary, the second point of view considers that corruption sands the wheels of the economy and distorts resource allocation because it increases agency and transaction costs and reduces the returns on the investment. We have tested the effect of corruption on innovation and export activities on a sample of 537 Tunisian manufacturing small and medium enterprises (SMEs) using structural equation modeling and path analysis. Tunisia has undergone a revolution in 2010 and since then, the country is experiencing a political instability and economic hardships. Our results 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 exports. Instead, our results support the sanding hypothesis according to which corruption hinders SMEs’ exports through its negative influence on innovation. Furthermore, our results show that the interaction between excessive bureaucratic red tape and corruption has a negative effect on exports. However, the interaction between political instability and corruption increases exports.

Keywords: corruption, exports, SMEs, economic conditions

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Authors: Fadila Hadjeris

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The study aims at investigating the functions of English-Arabic code switching in English as a foreign language classroom oral discourse and the extent to which they can contribute to the flow of classroom interaction. It also seeks to understand the views, beliefs, and perceptions of teachers and learners towards this practice. We hypothesized that code switching is a communicative strategy which facilitates classroom interaction. Due to this fact, both teachers and learners support its use. The study draws on a key body of literature in bilingualism, second language acquisition, and classroom discourse in an attempt to provide a framework for considering the research questions. It employs a combination of qualitative and quantitative research methods which include classroom observations and questionnaires. The analysis of the recordings shows that teachers’ code switching to Arabic is not only used for academic and classroom management reasons. Rather, the data display instances in which code switching is used for social reasons. The analysis of the questionnaires indicates that teachers and pupils have different attitudes towards this phenomenon. Teachers reported their deliberate switching during EFL teaching, yet the majority was against this practice. According to them, the use of the mother has detrimental effects on the acquisition and the practice of the target language. In contrast, pupils showed their preference to their teachers’ code switching because it enhances and facilitates their understanding. These findings support the fact that the shift to pupils’ mother tongue is a strategy which aids and facilitates the teaching and the learning of the target language. This, in turn, necessitates recommendations which are suggested to teachers and course designers.

Keywords: bilingualism, codeswitching, classroom interaction, classroom discourse, EFL learning/ teaching, SLA

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Authors: Hanh Thi My Nguyen

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The purpose of this research is to examine the experiences of parents of children who are deaf or hard of hearing in supporting their children to access education in Vietnam. Parents play a crucial role in supporting their children to gain full access to education. It was widely reported that parents of those children confronted a range of problems to support their children to access education. To author’s best knowledge, there has been a lack of research exploring the experiences of those parents in literature. This research examines factors affecting those parents in supporting their children to access education. To conduct the study, qualitative approach using a phenomenological research design was chosen to explore the central phenomena. Ten parents of children who were diagnosed as deaf or hard of hearing and aged 6-9 years were recruited through the support of the Association of Parents of Children with Hearing Impairment. Participants were interviewed via telephone with a mix of open and closed questions; interviews were audio recorded, transcribed and thematically analysed. The research results show that there are nine main factors that affected the parents in this study in making decisions relating to education for their children including: lack of information resources, perspectives of those parents on communication approaches, the families’ financial capacity, the psychological impact on the participants after their children’ diagnosis, the attitude of family members, attitude of school administrators, lack of local schools and qualified teachers, and current education system for the deaf in Vietnam. Apart from those factors, the lack of knowledge of the participants’ partners about deaf education and the partners’ employment are barriers to educational access and successful communication with their child.

Keywords: access to education, deaf, hard of hearing, parents experience

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Authors: Nursel Bektas

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The purpose of this study is to investigate the roles of teaching assistants (TAs) working in reception classes through practitioners’ perspectives. The study has two major purposes; firstly to explore the general roles of TAs, and secondly to identify their roles in supporting children for mathematics. A small-scale case study approach was adopted for this study. The research was carried out in two reception classes within a primary school in London. The qualitative data were gathered through observations and semi-structured interviews with four reception class practitioners, comprising two teachers and two TAs. The results show that TAs consider their role to be more like a teacher, whereas classroom teachers do not corroborate this and they generally believe that the role of TAs depends on their personal characteristics and skills. In regard to the general role of TAs, the study suggests that reception class TAs are deployed both at the classroom level to provide academic support for children’s learning and development, and at the school level they are deployed as support staff such as Midday Meal Supervisor or assistants. In terms of the pedagogical roles of TAs, it was found that TAs have a strong teaching role in literacy development, with notable autonomy if conducting their own phonics sessions without teacher direction, but a negligible influence in numeracy/ math’s. In addition, the results show that the TA role is perceived to be quite limited in planning and assessment processes. Linked to their limited roles in such processes, all participants agree that all the responsibility regarding the children’s learning and development, planning and assessment lies with the teacher. Therefore, data suggest that TAs’ roles in these areas depend on TAs’ their own initiatives.

Keywords: early years education, reception classes, roles, teaching assistants

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Authors: Varis Ransibrahmanakul, Doug Pirhalla, Scott Sheridan, Cameron Lee

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U.S. coastal areas and ecosystems are facing multiple sea level rise threats and effects: heavy rain events, cyclones, and changing wind and weather patterns all influence coastal flooding, sedimentation, and erosion along critical barrier islands and can strongly impact habitat resiliency and water quality in protected habitats. These impacts are increasing over time and have accelerated the need for new tracking techniques, models and tools of flood risk to support enhanced preparedness for coastal management and mitigation. To address this issue, NOAA National Ocean Service (NOS) evaluated new metrics from satellite altimetry AVISO/Copernicus and MODIS IR flood extents to isolate nodes atmospheric variability indicative of elevated sea level and nuisance flood events. Using de-trended time series of cross-shelf sea surface heights (SSH), we identified specific Self Organizing Maps (SOM) nodes and transitions having a strongest regional association with oceanic spatial patterns (e.g., heightened downwelling favorable wind-stress and enhanced southward coastal transport) indicative of elevated coastal sea levels. Results show the impacts of the inverted barometer effect as well as the effects of surface wind forcing; Ekman-induced transport along broad expanses of the U.S. eastern coastline. Higher sea levels and corresponding localized flooding are associated with either pattern indicative of enhanced on-shore flow, deepening cyclones, or local- scale winds, generally coupled with an increased local to regional precipitation. These findings will support an integration of satellite products and will inform seasonal outlook model development supported through NOAAs Climate Program Office and NOS office of Center for Operational Oceanographic Products and Services (CO-OPS). Overall results will prioritize ecological areas and coastal lab facilities at risk based on numbers of nuisance flood projected and inform coastal management of flood risk around low lying areas subjected to bank erosion.

Keywords: AVISO satellite altimetry SSHA, MODIS IR flood map, nuisance flood, remote sensing of flood

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Authors: Xuan Zheng

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China is home to one of the world’s largest Deaf and Hard of Hearing (DHH) populations. In the 1980s, the concept of inclusive education was introduced, giving rise to a unique “learning in regular class (随班就读)” model tailored to local contexts. China’s inclusive education for DHH students is diversifying with innovative models like special education classes at regular schools, regular classes at regular schools, resource classrooms, satellite classes, and bilingual-bimodal projects. The scope extends to preschool and higher education programs. However, the inclusive development of DHH students faces challenges. The prevailing pathological viewpoint on disabilities persists, emphasizing the necessity for favorable auditory and speech rehabilitation outcomes before DHH students can integrate into regular classes. In addition, inadequate support systems in inclusive schools result in poor academic performance and increased psychological disorders among the group, prompting a notable return to special education schools. Looking ahead, China’s inclusive education for DHH students needs a substantial shift from “learning in regular class” to “sharing equal regular education.” Particular attention should be devoted to the effective integration of DHH students who employ sign language into mainstream educational settings. It is crucial to strengthen regulatory frameworks and institutional safeguards, advance the professional development of educators specializing in inclusive education for DHH students, and consistently enhance resources tailored to this demographic. Furthermore, the establishment of a robust, multidimensional, and collaborative support network, engaging both families and educational institutions, is also a pivotal facet.

Keywords: deaf, hard of hearing, inclusive education, China

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Authors: Meral Huri, Sedef Şahin

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Post-traumatic stress disorder (PTSD) is characterized by psychiatric symptoms and triggered by a terrifying experience which may immediately effect cognitive, affective, behavioral and social skills of the individual. One of the most common noncutaneous cancer among men is prostate cancer. The incidence of psychological stress is quite common in men with prostate cancer. The aim of the study was to explore the PTSD frequency among prostate cancer and define the relationship between occupational participation, coping skills and level of perceived social support among patients with prostate cancer. Forty patients diagnosed with prostate cancer were included in the study. After dividing the patients into two groups ( study/ control) according to type of tumor, we recorded their characteristics and evaluations differences. We evaluated the demographic information form, Structured Clinical Interview for DSM-IV (SCID- I)- Clinical Version for PTSD, Multidimensional Scale of Perceived Social Support, Styles of Coping Inventory and Canadian Occupational Performance Measure (COPM) before and after 1 month from surgery. The mean age of the study group (n:18) was 65.85.6 years (range: 61-79 years). The mean age of the control group (n: 22) was a little bit higher than the study group with mean age 71.3±6.9 years (range: 60-85 years). There was no statistically significant difference between the groups for age and the other characteristics. According to the results of the study, statistically significant difference was found between the level of PTSD of study and the control group. 22% of study group showed PTSD while 13% of the control group showed PTSD (r: 0.02, p<0.001). The scores of study group and control group showed statistically significant difference in five sub-categories of Styles of Coping Inventory. Patients with prostate cancer showed decreased scores in optimistic, seeking social supports and self-confident approach, while increased scores in helpless and submissive sub-categories than the control group (p<0.001). The scores of Multidimensional Scale of Perceived Social Supports of study group and control group showed statistically significant difference. The total perceived social supports score of the study group was 71.34 ± 0.75 while it was 75.34 ± 0.64 for the control group. Total and the sub-category scores of study group were statistically significant lower than the control group. According to COPM, mean scores of occupational participation of study group for occupational performance were 4.32±2.24 and 7.01±1.52 for the control group, respectively). Mean Satisfaction scores were 3,22±2.31 and 7.45±1.74 for the study and control group, respectively. The patients with prostate cancer and benign prostate hyperplasia (BPH) did not show any statistically difference in activity performance (r:0.87) while patients with prostate cancer showed statistically lower scores than the patients with BPH in activity satisfaction (r:0.02, p<0.001).Psycho-social occupational therapy interventions might help to decrease the prevalence of PTSD by increasing associated factors such as the social support perception, using coping skills and activity participation of patients with prostate cancer.

Keywords: activity performance, occupational therapy, posttraumatic stress disorder, prostate cancer

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Authors: Xuan Dinh Vu, Elmar Csaplovics

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There has been an increasing need for methods to define priority areas for biodiversity conservation since the effectiveness of biodiversity conservation in protected areas largely depends on the availability of material resources. The identification of priority areas requires the integration of biodiversity data together with social data on human pressures and responses. However, the deficit of comprehensive data and reliable methods becomes a key challenge in zoning where the demand for conservation is most urgent and where the outcomes of conservation strategies can be maximized. In order to fill this gap, the study applied an environmental model Condition–Pressure–Response to suggest a set of criteria to identify priority areas for biodiversity conservation. Our empirical data has been compiled from 185 respondents, categorizing into three main groups: governmental administration, research institutions, and protected areas in Vietnam by using a well - designed questionnaire. Then, the Analytic Hierarchy Process (AHP) theory was used to identify the weight of all criteria. Our results have shown that priority level for biodiversity conservation could be identified by three main indicators: condition, pressure, and response with the value of the weight of 26%, 41%, and 33%, respectively. Based on the three indicators, 7 criteria and 15 sub-criteria were developed to support for defining priority areas for biodiversity conservation and zoning protected areas. In addition, our study also revealed that the groups of governmental administration and protected areas put a focus on the 'Pressure' indicator while the group of Research Institutions emphasized the importance of 'Response' indicator in the evaluation process. Our results provided recommendations to apply the developed criteria for identifying priority areas for biodiversity conservation in Vietnam.

Keywords: biodiversity conservation, condition–pressure–response model, criteria, priority areas, protected areas

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Authors: Kudzanayi Chiteka, Wellington Makondo

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The whole world is on the drive to go green owing to the negative effects of burning fossil fuels. Therefore, there is immediate need to identify and utilise alternative renewable energy sources. Among these energy sources solar energy is one of the most dominant in Zimbabwe. Solar power plants used to generate electricity are entirely dependent on solar radiation. For planning purposes, solar radiation values should be known in advance to make necessary arrangements to minimise the negative effects of the absence of solar radiation due to cloud cover and other naturally occurring phenomena. This research focused on the prediction of Global Horizontal Irradiation values for the sixth day given values for the past five days. Artificial intelligence techniques were used in this research. Three models were developed based on Support Vector Machines, Radial Basis Function, and Feed Forward Back-Propagation Artificial neural network. Results revealed that Support Vector Machines gives the best results compared to the other two with a mean absolute percentage error (MAPE) of 2%, Mean Absolute Error (MAE) of 0.05kWh/m²/day root mean square (RMS) error of 0.15kWh/m²/day and a coefficient of determination of 0.990. The other predictive models had prediction accuracies of MAPEs of 4.5% and 6% respectively for Radial Basis Function and Feed Forward Back-propagation Artificial neural network. These two models also had coefficients of determination of 0.975 and 0.970 respectively. It was found that prediction of GHI values for the future days is possible using artificial intelligence-based predictive models.

Keywords: solar energy, global horizontal irradiation, artificial intelligence, predictive models

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Authors: Muhammet Baldan, Emel Timuçin

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Molecular solubility prediction plays a crucial role in various fields, such as drug discovery, environmental science, and material science. In this study, we compare the performance of five machine learning algorithms—linear regression, support vector machines (SVM), random forests, gradient boosting machines (GBM), and neural networks—for predicting molecular solubility using the AqSolDB dataset. The dataset consists of 9981 data points with their corresponding solubility values. MACCS keys (166 bits), RDKit properties (20 properties), and structural properties(3) features are extracted for every smile representation in the dataset. A total of 189 features were used for training and testing for every molecule. Each algorithm is trained on a subset of the dataset and evaluated using metrics accuracy scores. Additionally, computational time for training and testing is recorded to assess the efficiency of each algorithm. Our results demonstrate that random forest model outperformed other algorithms in terms of predictive accuracy, achieving an 0.93 accuracy score. Gradient boosting machines and neural networks also exhibit strong performance, closely followed by support vector machines. Linear regression, while simpler in nature, demonstrates competitive performance but with slightly higher errors compared to ensemble methods. Overall, this study provides valuable insights into the performance of machine learning algorithms for molecular solubility prediction, highlighting the importance of algorithm selection in achieving accurate and efficient predictions in practical applications.

Keywords: random forest, machine learning, comparison, feature extraction

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Authors: Phenphak Horadee, Rodchares Hanrinth, Saithip Suttiruksa

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Inappropriate use of antibiotics has happened in several hospitals, Thailand. Drug use evaluation (DUE) is one strategy to overcome this difficulty. However, most community hospitals still encounter incomplete evaluation resulting overuse of antibiotics with high cost. Consequently, drug-resistant bacteria have been rising due to inappropriate antibiotic use. The aim of this study was to involve stakeholders in conceptualizing, developing, and prioritizing a feasible intervention strategy to promote and support appropriate antibiotic prescribing in a community hospital, Thailand. Study antibiotics included four antibiotics such as Meropenem, Piperacillin/tazobactam, Amoxicillin/clavulanic acid, and Vancomycin. The study was conducted for the 1-year period between March 1, 2018, and March 31, 2019, in a community hospital in the northeastern part of Thailand. Concept mapping was used in a purposive sample, including doctors (one was an administrator), pharmacists, and nurses who involving drug use evaluation of antibiotics. In-depth interviews for each participant and survey research were conducted to seek the problems for inappropriate use of antibiotics based on drug use evaluation system. Seventy-seven percent of DUE reported appropriate antibiotic prescribing, which still did not reach the goal of 80 percent appropriateness. Meropenem led other antibiotics for inappropriate prescribing. The causes of the unsuccessful DUE program were classified into three themes such as personnel, lack of public relation and communication, and unsupported policy and impractical regulations. During the first meeting, stakeholders (n = 21) expressed the generation of interventions. During the second meeting, participants who were almost the same group of people in the first meeting (n = 21) were requested to independently rate the feasibility and importance of each idea and to categorize them into relevant clusters to facilitate multidimensional scaling and hierarchical cluster analysis. The outputs of analysis included the idealist, cluster list, point map, point rating map, cluster map, and cluster rating map. All of these were distributed to participants (n = 21) during the third meeting to reach consensus on an intervention model. The final proposed intervention strategy included 29 feasible and crucial interventions in seven clusters: development of information technology system, establishing policy and taking it into the action plan, proactive public relations of the policy, action plan and workflow, in cooperation of multidisciplinary teams in drug use evaluation, work review and evaluation with performance reporting, promoting and developing professional and clinical skill for staff with training programs, and developing practical drug use evaluation guideline for antibiotics. These interventions are relevant and fit to several intervention strategies for antibiotic stewardship program in many international organizations such as participation of the multidisciplinary team, developing information technology to support antibiotic smart use, and communication. These interventions were prioritized for implementation over a 1-year period. Once the possibility of each activity or plan is set up, the proposed program could be applied and integrated into hospital policy after evaluating plans. Effectiveness of each intervention could be promoted to other community hospitals to promote and support antibiotic smart use.

Keywords: antibiotic, concept mapping, drug use evaluation, multidisciplinary teams

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