Search results for: occupational settings

Authors: Jonathan D. Recchi

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Introduction: Workplace violence is a major concern for nurses throughout the United States and is a rising occupational health hazard that has been exacerbated by both the Covid-19 pandemic and increasing patient and family member incivility. De-escalation training has been found to be an evidence-based tool for emergency department nurses to help avoid or mitigate high-risk situations that could lead to workplace violence. Many healthcare organizations either do not provide de-escalation training to their staff or only provide it sparingly, such as during new employee orientation. There is limited research in the literature on the psychological benefits of de-escalation training. Purpose: The purpose of this study is to determine if there are psychological and organizational advantages to providing emergency department nurses with de-escalation training. Equipping emergency department nurses with skills that are essential to de-escalate violent or potentially violent patients may help prevent physical, mental, and/or psychological damage to the nurse because of violence and/or threatening acts. The hypothesis is that providing de-scalation training to emergency department nurses will lead to increased nurse confidence in dealing with aggressive patients, increased resiliency, increased professional quality of life, and increased intention to stay with their current organization. This study aims to show that organizations would benefit from providing de-escalation training to all nurses operating in high-risk areas on a regular basis. Significance: Showing psychological benefits to providing evidence-based de-escalation training can provide healthcare organizations with the ability to retain a more resilient and prepared workforce. Method: This study uses a pre-experimental cross-sectional pre-/post-test design using a convenience sample of emergency department registered nurses employed across Jefferson Health Northeast (Jefferson Torresdale, Jefferson Bucks, and Jefferson Frankford. Inclusion criteria include registered nurses who work full or part-time, with 51% or more of their clinical time spent in direct clinical care. Excluded from participation are registered nurses in orientation, per-diem nurses, temporary and/or travel nurses, nurses who spend less than 51% of their time in direct patient care, and nurses who have received de-escalation training within the past two years. This study uses the Connor-Davidson Resilience Scale 10 (CD-RISC-10), the Clinician Confidence in Coping with Patient Aggression Scale, the Press Ganey Intention To Stay question, and the Professional Quality of Life Scale. Results: A Paired t-Test will be used to analyze the mean scores of the three scales and one question pre and post-intervention to determine if there is a statistically significant difference in RN resiliency, confidence in coping with patient aggression, intention to stay, and professional quality of life. Discussion and Conclusions: Upon completion, the outcomes of this intervention will show the importance of providing evidence-based de-escalation training to all nurses operating within the emergency department.

Keywords: de-escalation, nursing, emergency department, workplace violence

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Authors: Jacqueline Kunzelman, Val Anderson, Robert Johnson, Nicholas Anderson, Rebecca Bates

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In an effort to protect honeybees from colony collapse disorder, beekeepers are filing for government permits to use natural lands as summer pasture for honeybees under the multiple-use management regime in the United States. Utilizing natural landscapes in high mountain ranges may help strengthen honeybee colonies, as this natural setting is generally void of chemical pollutants and pesticides that are found in agricultural and urban settings. However, the introduction of a competitive species could greatly impact the native species occupying these natural landscapes. While honeybees and butterflies have different life histories, behavior, and foraging strategies, they compete for the same nectar resources. Few, if any, studies have focused on the potential population effects of commercial honeybees on native butterfly abundance and diversity. This study attempts to observe this impact using a paired before-after control-impact (BACI) design. Over the course of two years, malaise trap samples were collected every week during the months of the flowering season in two similar areas separated by 11 kilometers. Each area contained nine malaise trap sites for replication. In the first year, samples were taken to analyze and establish trends within the pollinating communities. In the second year, honeybees were introduced to only one of the two areas, and a change in trends between the two areas was assessed. Contrary to the original hypothesis, the resulting observation was an overall significant increase in the mean butterfly abundance in the impact areas after honeybees were introduced, while control areas remained relatively stable. This overall increase in abundance over the season can be attributed to an increase in butterflies during the first and second periods of the data collection when populations were near their peak. Several potential theories are 1) Honeybees are deterring a natural predator/competitor of butterflies that previously limited population growth. 2) Honeybees are consuming resources regularly used by butterflies, which may extend the foraging time and consequent capture rates of butterflies. 3) Environmental factors such as number of rainy days were inconsistent between control and impact areas, biasing capture rates. This ongoing research will help determine the suitability of high mountain ranges for the summer pasturing of honeybees and the population impacts on many different pollinators.

Keywords: butterfly, competition, honeybee, pollinator

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Authors: Mengestie Mulugeta Belay, Serebe Abay Gebrie, Biruk Lambbiso Wamisho, Amare Worku

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Background: Low back pain (LBP) related to nursing profession, is a very common public health problem throughout the world. Various risk factors have been implicated in the etiology and LBP is assumed to be of multi-factorial origin as individual, work-related and psychosocial factors can contribute to its development. Objectives: To determine the prevalence and to identify risk factors of LBP among nurses working in Addis Ababa City Public Hospitals, Ethiopia, in the year 2015. Settings: Addis Ababa University, Black-Lion (‘Tikur Anbessa’) Hospital-BLH, is the country’s highest tertiary level referral and teaching Hospital. The three departments in connection with this study: Radiology, Pathology and Orthopedics, run undergraduate and residency programs and receive referred patients from all over the country. Methods: A cross-sectional study with internal comparison was conducted throughout the period October-December, 2015. Sample was chosen by simple random sampling technique by taken the lists of nurses from human resource departments as a sampling frame. A well-structured, pre-tested and self-administered questionnaire was used to collect quantifiable information. The questionnaire included socio-demographic, back pain features, consequences of back pain, work-related and psychosocial factors. The collected data was entered into EpiInfo version 3.5.4 and was analyzed by SPSS. A probability level of 0.05 or less and 95% confidence level was used to indicate statistical significance. Ethical clearance was obtained from all respected administrative bodies, Hospitals and study participants. Results: The study included 395 nurses and gave a response rate of 91.9%. The mean age was 30.6 (±8.4) years. Majority of the respondents were female (285, 72.2%). Nearly half of the participants (n=181, 45.8% (95% CI (40.8%- 50.6%))) were complained low back pain. There was statistical significant association between low back pain and working shift, physical activities at work; sleep disturbance and felt little pleasure by doing things. Conclusion: A high prevalence of low back pain was found among nurses working in Addis Ababa Public Hospitals. Recognition and preventive measures like providing resting periods should be taken to reduce the risk of low back pain in nurses working in Public hospitals.

Keywords: low back pain, risk factors, nurses, public hospitals

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Authors: Rohit Vashistha, Amit Kumar Gupta, G. P. Ravishankar, Mahesh P. Padwale

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Accurate thrust measurement is required for aircraft during takeoff and after ski-jump. In a developmental aircraft, takeoff from ship is extremely critical and thrust produced by the engine should be known to the pilot before takeoff so that if thrust produced is not sufficient then take-off can be aborted and accident can be avoided. After ski-jump, thrust produced by engine is required because the horizontal speed of aircraft is less than the normal takeoff speed. Engine should be able to produce enough thrust to provide nominal horizontal takeoff speed to the airframe within prescribed time limit. The contemporary low bypass gas turbine engines generally have three mounts where the two side mounts transfer the engine thrust to the airframe. The third mount only takes the weight component. It does not take any thrust component. In the present method of thrust estimation, the strain gauging of the two side mounts is carried out. The strain produced at various power settings is used to estimate the thrust produced by the engine. The quarter Wheatstone bridge is used to acquire the strain data. The engine mount assembly is subjected to Universal Test Machine for determination of equivalent elasticity of assembly. This elasticity value is used in the analytical approach for estimation of engine thrust. The estimated thrust is compared with the test bed load cell thrust data. The experimental strain data is also compared with strain data obtained from FEM analysis. Experimental setup: The strain gauge is mounted on the tapered portion of the engine mount sleeve. Two strain gauges are mounted on diametrically opposite locations. Both of the strain gauges on the sleeve were in the horizontal plane. In this way, these strain gauges were not taking any strain due to the weight of the engine (except negligible strain due to material's poison's ratio) or the hoop's stress. Only the third mount strain gauge will show strain when engine is not running i.e. strain due to weight of engine. When engine starts running, all the load will be taken by the side mounts. The strain gauge on the forward side of the sleeve was showing a compressive strain and the strain gauge on the rear side of the sleeve shows a tensile strain. Results and conclusion: the analytical calculation shows that the hoop stresses dominate the bending stress. The estimated thrust by strain gauge shows good accuracy at higher power setting as compared to lower power setting. The accuracy of estimated thrust at max power setting is 99.7% whereas at lower power setting is 78%.

Keywords: engine mounts, finite elements analysis, strain gauge, stress

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Authors: A. S. V. Carvalho, J. Luis, L. S. O. Pires, J. M. Oliveira

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Additive manufacturing technologies (AM) experienced a remarkable growth in the latest years due to the development and diffusion of a wide range of three-dimensional (3D) printing techniques. Nowadays we can find techniques available for non-industrial users, like fused filament fabrication, but techniques like 3D printing, polyjet, selective laser sintering and stereolithography are mainly spread in the industry. Robocasting (R3D) shows a great potential due to its ability to shape materials with a wide range of viscosity. Industrial porcelain compositions showing different rheological behaviour can be prepared and used as candidate materials to be processed by R3D. The use of this AM technique in industry is very residual. In this work, a specific porcelain composition with suitable rheological properties will be processed by R3D, and a systematic study of the printing parameters tuning will be shown. The porcelain composition was formulated based on an industrial spray dried porcelain powder. The powder particle size and morphology was analysed. The powders were mixed with water and an organic binder on a ball mill at 200 rpm/min for 24 hours. The batch viscosity was adjusted by the addition of an acid solution and mixed again. The paste density, viscosity, zeta potential, particle size distribution and pH were determined. In a R3D system, different speed and pressure settings were studied to access their impact on the fabrication of porcelain models. These models were dried at 80 °C, during 24 hours and sintered in air at 1350 °C for 2 hours. The stability of the models, its walls and surface quality were studied and their physical properties were accessed. The microstructure and layer adhesion were observed by SEM. The studied processing parameters have a high impact on the models quality. Moreover, they have a high impact on the stacking of the filaments. The adequate tuning of the parameters has a huge influence on the final properties of the porcelain models. This work contributes to a better assimilation of AM technologies in ceramic industry. Acknowledgments: The RoboCer3D project – project of additive rapid manufacturing through 3D printing ceramic material (POCI-01-0247-FEDER-003350) financed by Compete 2020, PT 2020, European Regional Development Fund – FEDER through the International and Competitive Operational Program (POCI) under the PT2020 partnership agreement.

Keywords: additive manufacturing, porcelain, robocasting, R3D

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Authors: Danielle G. Saique

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Introduction: Promoting Gender Equality, Equity and Empowerment of Women (GEE&EW) can be attained by practicing thereby exercising Sexual and Reproductive Health and Rights (SRHR). Gender Inequality is manifested thru Violence Against Women (VAW). Objectives: This study presents causes, prevalence, effects of Gender Inequality for not practicing and violating SRHR. This proposes Action Plan by promoting, integrating SRHR in the “holistic approach” of Social Work education, practice and service-delivery in any work-set-ups. Limitations: VAW cases showed victim and violator are known, related and living together. Cases transpired at home, reported, investigated in the police and filed in the legal court of law for the year 2013. Methods: Data from blotters, reports, filed cases, case studies gathered by the Social Worker (SWr). Qualitative analysis identified cause, prevalence of VAW related in violating SRHR. SWr serves innovative interventions in any work settings by applying SRHR background, skills in educating, counseling client-victims. Results: 65 VAW cases on non-negotiation or refusal of practicing SRHR. Non-acceptance of Family Planning yielded unwanted, unplanned pregnancies, abandoned children, battered women. Neglected pre-post natal maternal care caused complications or death. Rape, incest led trauma or death. Unsafe, unprotected sex transmitted STDs. Conclusions: Non-availing SRHR from health facilities, from Medical Health SWr concluded to non-practicing or violating rights to life, health care, protection, rights to information, education, rights to plan family, rights from torture, ill-treatment. VAW brings undesirable effects to the well-being, wellness and humaneness of the victim. Recommendations: The innovative intervention services on SRHR of a SWr and the findings, results in violating SRHR are recommendations in Action Planning by adding “The SRHR Concepts” in Social Work thereby preventing VAW; empowering women’s rights to development, gender equality, equity liberty, security, freedom; resilience and involvement in promoting, practicing, exercising SRHR at home. Recommended therefore to duplicate this innovative practice and experience on SRHR as implemented by the SWr in any work setting.

Keywords: women development, promoting gender equality, equity, empowerment of women

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Authors: A. Tamimi, S. Greatrex-White, A. Narayanasamy

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Background: Spirituality has been increasingly acknowledged in the nursing literature as an important element of holistic patient care. To date there have been numerous studies investigating the meaning of spirituality in Western cultures. Spirituality in Middle Eastern countries however remains under-researched. We will present a study which aimed to address this gap. Aim: The study aimed to explore how spirituality manifests in the lives of Jordanian End Stage Renal Failure (ESRF) patients. Methodology and Method: A hermeneutic phenomenological approach was adopted informed by the philosophy of Martin Heidegger. Participants (n=27) were recruited from four different dialysis units: in a public hospital, a private hospital, an educational hospital and a refugee’s hospital in Jordan. Data was collected through in-depth unstructured interviews. Data Analysis: Analysis was guided by the tenets of hermeneutic phenomenology namely: gaining immediate sense of what was said both during and after each interview, transcribing data verbatim, translating interviews into the English language, intensive reading and re-reading, seeking meaning units by line to line coding, developing situated structures (how spirituality was manifest in each text), developing a general structure from the individual situated structures (how the phenomenon ‘spirituality’ comes into being). Findings: Three major themes emerged from analysis: Religion, Relationships and Desperation. We will argue that a ‘secular’ concept of spirituality had no meaning for the participants in the study. Spirituality is fundamentally part of religion and vice versa. Discussion: The findings may have consequences for the use of spirituality in multi-cultural settings in Western countries. Additionally, findings highlighted an important emphasis on the practice of spirituality, often underestimated in previous literature for Arab-Muslim Jordanian patients. Conclusion: The study findings contribute to the existing gap in knowledge regarding how Arab-Muslim Jordanian ESRF patients experience spirituality during their illness. It provides valuable insights into the importance of spirituality for this patient group and suggests how nurses, educators and policy makers might help address ESRF patients’ spiritual needs and provide appropriate spiritual care. We suggest the findings may have relevance beyond the Jordanian context in educating nurses’ on the importance of appreciating the religious dimension of spirituality.

Keywords: spirituality, nursing, muslim, Jordan

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Authors: A. Schuchter, M. Promegger

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The outbreak of the COVID-19 pandemic has shown us that online education is so much more than just a cool feature for teachers – it is an essential part of modern teaching. In online math teaching, it is common to use tools to share screens, compute and calculate mathematical examples, while the students can watch the process. On the other hand, flipped classroom models are on the rise, with their focus on how students can gather knowledge by watching videos and on the teacher’s use of technological tools for information transfer. This paper proposes a co-educational teaching approach for coding and engineering subjects with the help of drone-building to spark interest in technology and create a platform for knowledge transfer. The project combines aspects from mathematics (matrices, vectors, shaders, trigonometry), physics (force, pressure and rotation) and coding (computational thinking, block-based programming, JavaScript and Python) and makes use of collaborative-shared 3D Modeling with clara.io, where students create mathematics knowhow. The instructor follows a problem-based learning approach and encourages their students to find solutions in their own time and in their own way, which will help them develop new skills intuitively and boost logically structured thinking. The collaborative aspect of working in groups will help the students develop communication skills as well as structural and computational thinking. Students are not just listeners as in traditional classroom settings, but play an active part in creating content together by compiling a Handbook of Knowledge (called “open book”) with examples and solutions. Before students start calculating, they have to write down all their ideas and working steps in full sentences so other students can easily follow their train of thought. Therefore, students will learn to formulate goals, solve problems, and create a ready-to use product with the help of “reverse engineering”, cross-referencing and creative thinking. The work on drones gives the students the opportunity to create a real-life application with a practical purpose, while going through all stages of product development.

Keywords: flipped classroom, co-creational education, coding, making, drones, co-education, ARCS-model, problem-based learning

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Authors: Josiane N. Muller, Allan K. R. Galardo, Tatiane A. Barbosa, Evan P. Ferro, Wellington M. Dos Santos, Ana Paula S. A. Correa, Edinaldo C. Rego, Jose B. P. Lima

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The susceptibility status of an insect population to any larvicide depends on several factors such includes genetic constitution, environmental conditions and others. The mosquito Aedes aegypti is the primary vector of three important viral diseases, Zika, Dengue, and Chikungunya. The frequent outbreaks of those diseases in different parts of Brazil demonstrate the importance of testing the susceptibility of vectors in different environments. Since the control of this mosquito leads to the control of disease, alternatives for vector control that value the different Brazilian environmental conditions are needed for effective actions. The aim of this study was to evaluate a new commercial formulation of Bacillus thuringiensis israelenses (DengueTech: Brazilian innovative technology) in the Brazilian Legal Amazon considering the climate conditions. Semi-field tests were conducted in the Institute of Scientific and Technological Research of the State of Amapa in two different environments, one in a shaded area and the other exposed to sunlight. The mosquito larvae were exposed to larvicide concentration and a control; each group was tested in three containers of 40 liters each. To assess persistence 50 third instar larvae of Aedes aegypti laboratory lineages (Rockefeller) and 50 larvae of Aedes aegypti collected in the municipality of Macapa, Brazil’s Amapa state, were added weekly and after 24 hours the mortality was assessed. In total 16 tests were performed, where 12 were done with replacement of water (1/5 of the volume, three times per week). The effectiveness of the product was determined through mortality of ≥ 80%, as recommend by the World Health Organization. The results demonstrated that high-water temperatures (26-35 °C) on the containers influenced the residual time of the product, where the maximum effect achieved was 21 days in the shaded area; and no effectiveness of 60 days was found in any of the tests, as expected according to the larvicide company. The test with and without water replacement did not present significant differences in the mortality rate. Considering the different environments and climate, these results stimulate the need to test larvicide and its effectiveness in specific environmental settings in order to identify the parameters required for better results. Thus, we see the importance of semi-field researches considering the local climate conditions for a successful control of Aedes aegypti.

Keywords: Aedes aegypti, bioassay, larvicida, vector control

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Authors: Violet Petit-Steeghs, Jochem J. R. Van Roon, Jacqueline E. W. Broerse

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Last decennia the retirement age in Europe is gradually increasing. As a result, people have to continue working for a longer period of time. Health problems due to increased sedentary behavior and mental conditions like burn-out, pose a threat in fulfilling employees’ working life. In order to stimulate the ability and willingness to work in the present and future, it is important to stay vital. Vitality is regarded in literature as a sense of energy, motivation and resilience. It is assumed that by increasing their vitality, employees will stay healthier and be more satisfied with their job, leading to a more sustainable employment and less absenteeism in the future. The aim of this project is to obtain insights into the experiences and barriers of employees, and specifically office workers, with regard to their vitality. These insights are essential in order to develop appropriate measures in the future. To get more insights in the experiences of office workers on their vitality, 8 focus group discussions were organized with 6-10 office workers from 4 different employers (an university, a national construction company and a large juridical and care service organization) in the Netherlands. The discussions were transcribed and analyzed via open coding. This project is part of a larger consortium project Provita2, and conducted in collaboration with University of Technology Eindhoven. Results showed that a range of interdependent factors form a complex network that influences office workers’ vitality. These factors can be divided in three overarching groups: (1) personal (2) organizational and (3) environmental factors. Personal intrinsic factors, relating to the office worker, comprise someone’s physical health, coping style, life style, needs, and private life. Organizational factors, relating to the employer, are the workload, management style and the structure, vision and culture of the organization. Lastly, environmental factors consist of the air, light, temperature at the workplace and whether the workplace is inspiring and workable. Office workers experienced barriers to improve their own vitality due to a lack of autonomy. On the one hand, because most factors were not only intrinsic but extrinsic, like work atmosphere or the temperature in the room. On the other hand, office workers were restricted in adapting both intrinsic as well as extrinsic factors. Restrictions to for instance the flexibility of working times and the workload, can set limitations for improving vitality through personal factors like physical activity and mental relaxation. In conclusion, a large range of interdependent factors influence the vitality of office workers. Office workers are often regarded to have a responsibility to improve their vitality, but are limitedly autonomous in adapting these factors. Measures to improve vitality should therefore not only focus on increasing awareness among office workers, but also on empowering them to fulfill this responsibility. A holistic approach that takes the complex mutual dependencies between the different factors and actors (like managers, employees and HR personnel) into account is highly recommended.

Keywords: occupational health, perspectives office workers, sustainable employment, vitality at work, work & wellbeing

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Authors: Jacqueline M. Dias, Amina A Khowaja

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Clinical education is one of the most important components of a nursing curriculum as it develops the students’ cognitive, psychomotor and affective skills. Clinical teaching ensures the integration of knowledge into practice. As the numbers of students increase in the field of nursing coupled with the faculty shortage, clinical preceptors are the best choice to ensure student learning in the clinical settings. The clinical preceptor role has been introduced in the undergraduate nursing programme. In Pakistan, this role emerged due to a faculty shortage. Initially, two clinical preceptors were hired. This study will explore clinical preceptors views and experiences of precepting Bachelor of Science in Nursing (BScN) students in an undergraduate program. A case study design was used. As case studies explore a single unit of study such as a person or very small number of subjects; the two clinical preceptors were fundamental to the study and served as a single case. Qualitative data were obtained through an iterative process using in depth interviews and written accounts from reflective journals that were kept by the clinical preceptors. The findings revealed that the clinical preceptors were dedicated to their roles and responsibilities. Another, key finding was that clinical preceptors’ prior knowledge and clinical experience were valuable assets to perform their role effectively. The clinical preceptors found their new role innovative and challenging; it was stressful at the same time. Findings also revealed that in the clinical agencies there were unclear expectations and role ambiguity. Furthermore, clinical preceptors had difficulty integrating theory into practice in the clinical area and they had difficulty in giving feedback to the students. Although this study is localized to one university, generalizations can be drawn from the results. The key findings indicate that the role of a clinical preceptor is demanding and stressful. Clinical preceptors need preparation prior to precepting students on clinicals. Also, institutional support is fundamental for their acceptance. This paper focuses on the views and experiences of clinical preceptors undertaking a newly established role and resonates with the literature. The following recommendations are drawn to strengthen the role of the clinical preceptors: A structured program for clinical preceptors is needed along with mentorship. Clinical preceptors should be provided with formal training in teaching and learning with emphasis on clinical teaching and giving feedback to students. Additionally, for improving integration of theory into practice, clinical modules should be provided ahead of the clinical. In spite of all the challenges, ten more clinical preceptors have been hired as the faculty shortage continues to persist.

Keywords: baccalaureate nursing education, clinical education, clinical preceptors, nursing curriculum

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Authors: Sigal Portnoy, Yael Kaufman-Cohen, Yafa Levanon

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Introduction: Rehabilitation following wrist fractures often includes exercising flexion-extension movements with a dynamic splint. However, during daily activities, we combine most of our wrist movements with radial and ulnar deviations. Also, the multi-plane wrist motion, named the ‘dart throw motion’ (DTM), was found to be a more stable motion in healthy individuals, in term of the motion of the proximal carpal bones, compared with sagittal wrist motion. The aim of this study was therefore to explore the pathomechanics of the wrist in a common multi-plane movement pattern (DTM) and design a novel splint for rehabilitation following distal radius fractures. Methods: First, a multi-axis electro-goniometer was used to quantify the plane angle of motion of the dominant and non-dominant wrists during various activities, e.g. drinking from a glass of water and answering a phone in 43 healthy individuals. The following protocols were then implemented with a population following distal radius fracture. Two dynamic scans were performed, one of the sagittal wrist motion and DTM, in a 3T magnetic resonance imaging (MRI) device, bilaterally. The scaphoid and lunate carpal bones, as well as the surface of the distal radius, were manually-segmented in SolidWorks and the angles of motion of the scaphoid and lunate bones were calculated. Subsequently, a patient-specific splint was designed using 3D scans of the hand. The brace design comprises of a proximal attachment to the arm and a distal envelope of the palm. An axle with two wheels is attached to the proximal part. Two wires attach the proximal part with the medial-palmar and lateral-ventral aspects of the distal part: when the wrist extends, the first wire is released and the second wire is strained towards the radius. The opposite occurs when the wrist flexes. The splint was attached to the wrist using Velcro and constrained the wrist movement to the desired calculated multi-plane of motion. Results: No significant differences were found between the multi-plane angles of the dominant and non-dominant wrists. The most common daily activities occurred at a plane angle of approximately 20° to 45° from the sagittal plane and the MRI studies show individual angles of the plane of motion. The printed splint fitted the wrist of the subjects and constricted movement to the desired multi-plane of motion. Hooks were inserted on each part to allow the addition of springs or rubber bands for resistance training towards muscle strengthening in the rehabilitation setting. Conclusions: It has been hypothesized that activation of the wrist in a multi-plane movement pattern following distal radius fractures will accelerate the recovery of the patient. Our results show that this motion can be determined from either the dominant or non-dominant wrists. The design of the patient-specific dynamic splint is the first step towards assessing whether splinting to induce combined movement is beneficial to the rehabilitation process, compared to conventional treatment. The evaluation of the clinical benefits of this method, compared to conventional rehabilitation methods following wrist fracture, are a part of a PhD work, currently conducted by an occupational therapist.

Keywords: distal radius fracture, rehabilitation, dynamic magnetic resonance imaging, dart throw motion

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Authors: Mirka Januszkiewicz

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The Regional Municipality of Durham is the upper level of a two-tier municipal and regional structure comprised of eight lower-tier municipalities. With a population of 655,000 in both urban and rural settings, the Region is approximately 2,537 square kilometers neighboring the City of Toronto, Ontario Canada to the east. The Region has been focused on diverting waste from disposal since the development of its Long Term Waste Management Strategy Plan for 2000-2020. With a 54 percent solid waste diversion rate, the focus now is on achieving 70 percent diversion on the path to zero waste using local waste management options whenever feasible. The Region has an Integrated Waste Management System that consists of a weekly curbside collection of recyclable printed paper and packaging and source separated organics; a seasonal collection of leaf and yard waste; a bi-weekly collection of residual garbage; and twice annual collection of intact, sealed household batteries. The Region also maintains three Waste Management Facilities for residential drop-off of household hazardous waste, polystyrene, construction and demolition debris and electronics. Special collection events are scheduled in the spring, summer and fall months for reusable items, household hazardous waste, and electronics. The Region is in the final commissioning stages of an energy from the waste facility for residual waste disposal that will recover energy from non-recyclable wastes. This facility is state of the art and is equipped for installation of carbon capture technology in the future. Despite all of these diversion programs and efforts, there is still room for improvement. Recent residential waste studies revealed that over 50% of the residual waste placed at the curb that is destined for incineration could be recycled. To move towards a zero waste community, the Region is looking to more advanced technologies for extracting the maximum recycling value from residential waste. Plans are underway to develop a pre-sort facility to remove organics and recyclables from the residual waste stream, including the growing multi-residential sector. Organics would then be treated anaerobically to generate biogas and fertilizer products for beneficial use within the Region. This project could increase the Region’s diversion rate beyond 70 percent and enhance the Region’s climate change mitigation goals. Zero waste is an ambitious goal in a changing regulatory and economic environment. Decision makers must be willing to consider new and emerging technologies and embrace change to succeed.

Keywords: municipal waste, residential, waste diversion, zero waste

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Authors: Yijie Wang, Tianyue Wang

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In the past two decades, there has been a great ‘piano lesson frenzy’ among Chinese middle-class families, with a large number of parents adding piano training to children’s extra-curriculum lists. Superficially, the frenzy reflects a rather ‘leisurely’ attitude: parents typically claim that pianos lessons are ‘just for fun’ and will hopefully render children’s life more exciting. However, a closer scrutiny reveals that there is great social-status anxiety hidden beneath this ‘leisurely’ surface. Based on pre-interviews of six Chinese middle-class parents who have enthusiastically signed their children up for piano lessons, several tentative analysis are made: 1. Owing to a series of historical and social factors, the Chinese middle-class have yet to establish their cultural norms in the past few decades, resulting in great confusion concerning how to cultivate cultural tastes in their offspring. And partly due to the fact that the middle-class status of the past Chinese generation is mostly self-acquired rather than inherited, parents are much less confident about their cultural resources—which require long-time accumulation—than material ones. Both factors combine to lead to a sort of blind, overcompensating enthusiasm in culture-related education, and the piano frenzy is but a demonstration. 2. The piano has been chosen to be the object of the frenzy partly because of its inherent characteristics as well as socially-constructed ones. Costly, large in size, imported from another culture and so forth, the piano has acquired the meaning of being exclusive, high-end and exotic, which renders it a token of top-tier status among Chinese people, and piano lessons for offspring have therefore become parents’ paths towards a kind of ‘symbolic elevation’. A child playing piano is an exhibition as well as psychological assurance of the families’ middle-class status. 3. A closer look at children’s piano training process reveals that there is much more anxiety than leisurely elements involved. Despite parents’ claim that ‘piano is mainly for kids to have fun,’ the whole process is evidently of a rather ‘ascetic’ nature, with the demands of diligence and senses of time urgency throughout, and techniques rather than flair or styles are emphasized. This either means that the apparent ‘piano-for-fun’ stance is unauthentic and is only other motives in disguise, or that the Chinese middle-class parents are not yet capable of shaking off the sense of anxiety even if they sincerely intend to. 4. When viewed in relation to Chinese formal school system as well as the job market at large, it can be said that by signing children up for piano lessons, parents are consciously or unconsciously seeking to prepare for, or reduce the risks of, their children’s future social mobility. In face of possible failures in the highly-crucial, highly-competitive formal school system, piano-playing as an extra-curriculum activity may be conveniently transferred into an alternative career path. Besides, in contemporary China, as the occupational structure goes through change, and the school-related certificates decline in value, aspects such as a person’s overall deportment, which can be gained or proved by piano-learning, have been gaining in significance.

Keywords: extra-curriculum activities, middle class, piano lesson frenzy, status anxiety

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Authors: Belyihun Muchie

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This study investigates the low English oral communication skills of 5 second-year English major students at Debark University. It aims to identify the key factors contributing to their weaknesses and propose effective interventions to improve their spoken English proficiency. Mixed-methods research will be employed, utilizing observations, questionnaires, and semi-structured interviews to gather data from the participants. To clearly identify these factors, structured and informal observations will be employed; the former will be used to identify their fluency, pronunciation, vocabulary use, and grammar accuracy, and the later will be suited to observe the natural interactions and communication patterns of learners in the classroom setting. The questionnaires will assess their self-perceptions of their skills, perceived barriers to fluency, and preferred learning styles. Interviews will also delve deeper into their experiences and explore specific obstacles faced in oral communication. Data analysis will involve both quantitative and qualitative responses. The structured observation and questionnaire will be analyzed quantitatively, whereas the informal observation and interview transcripts will be analyzed thematically. Findings will be used to identify the major causes of low oral communication skills, such as limited vocabulary, grammatical errors, pronunciation difficulties, or lack of confidence. They are also helpful to develop targeted solutions addressing these causes, such as intensive pronunciation practice, conversation simulations, personalized feedback, or anxiety-reduction techniques. Finally, the findings will guide designing an intervention plan for implementation during the action research phase. The study's outcomes are expected to provide valuable insights into the challenges faced by English major students in developing oral communication skills, contribute to the development of evidence-based interventions for improving spoken English proficiency in similar contexts, and offer practical recommendations for English language instructors and curriculum developers to enhance student learning outcomes. By addressing the specific needs of these students and implementing tailored interventions, this research aims to bridge the gap between theoretical knowledge and practical speaking ability, equipping them with the confidence and skills to flourish in English communication settings.

Keywords: oral communication skills, mixed-methods, evidence-based interventions, spoken English proficiency

Procedia PDF Downloads 26

Authors: Germans Natuhwera, Peter Ellis, Acuda Wilson, Anne Merriman, Martha Rabwoni

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Objective: The aim of the study was to diagnose the socio-economic burden and impact of a diagnosis of cervical cancer (CC) in rural women in the context of low-resourced country Uganda, using a phenomenological enquiry. Methods: This was a multi-site phenomenological inquiry, conducted at three hospice settings; Mobile Hospice Mbarara in southwestern, Little Hospice Hoima in Western, and Hospice Africa Uganda Kampala in central Uganda. A purposive sample of women with a histologically confirmed diagnosis of CC was recruited. Data was collected using open-ended audio-recorded interviews conducted in the native languages of participants. Interviews were transcribed verbatim in English, and Braun and Clarke’s (2019) framework of thematic analysis was used. Results: 13 women with a mean age of 49.2 and age range 29-71 participated in the study. All participants were of low socioeconomic status. The majority (84.6%) had advanced disease at diagnosis. A fuller reading of transcripts produced four major themes clustered under; (1) socioeconomic characteristics of women, (2) impact of CC on women’s relationships, (3) disrupted and impaired activities of daily living (ADLs), and (4) economic disruptions. Conclusions: A diagnosis of CC introduces significant socio-economic disruptions in a woman’s and her family’s life. CC causes disability, impairs the woman and her family’s productivity hence exacerbating levels of poverty in the home. High and expensive out-of-pocket expenditure on treatment, investigations, and transport costs further compound the socio-economic burden. Decentralizing cancer care services to regional centers, scaling up screening services, subsidizing costs of cancer care services, or making cervical cancer care treatment free of charge, strengthening monitoring mechanisms in public facilities to curb the vice of healthcare workers soliciting bribes from patients, increased mass awareness campaigns about cancer, training more healthcare professionals in cancer investigation and management, and palliative care, and introducing an introductory course on gynecologic cancers into all health training institutions are recommended.

Keywords: activities of daily living, cervical cancer, out-of-pocket, expenditure, phenomenology, socioeconomic

Procedia PDF Downloads 180

Authors: J. Satya Eswari, J. Sekhar Babub, Meena Murmu, Govardhan Bhat

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Electrical Discharge Machining (EDM) is an unconventional manufacturing process based on removal of material from a part by means of a series of repeated electrical sparks created by electric pulse generators at short intervals between a electrode tool and the part to be machined emmersed in dielectric fluid. In this paper, a study will be performed on the influence of the factors of peak current, pulse on time, interval time and power supply voltage. The output responses measured were material removal rate (MRR) and surface roughness. Finally, the parameters were optimized for maximum MRR with the desired surface roughness. RSM involves establishing mathematical relations between the design variables and the resulting responses and optimizing the process conditions. RSM is not free from problems when it is applied to multi-factor and multi-response situations. Design of experiments (DOE) technique to select the optimum machining conditions for machining AISI 4140 using EDM. The purpose of this paper is to determine the optimal factors of the electro-discharge machining (EDM) process investigate feasibility of design of experiment techniques. The work pieces used were rectangular plates of AISI 4140 grade steel alloy. The study of optimized settings of key machining factors like pulse on time, gap voltage, flushing pressure, input current and duty cycle on the material removal, surface roughness is been carried out using central composite design. The objective is to maximize the Material removal rate (MRR). Central composite design data is used to develop second order polynomial models with interaction terms. The insignificant coefficients’ are eliminated with these models by using student t test and F test for the goodness of fit. CCD is first used to establish the determine the optimal factors of the electro-discharge machining (EDM) for maximizing the MRR. The responses are further treated through a objective function to establish the same set of key machining factors to satisfy the optimization problem of the electro-discharge machining (EDM) process. The results demonstrate the better performance of CCD data based RSM for optimizing the electro-discharge machining (EDM) process.

Keywords: electric discharge machining (EDM), modeling, optimization, CCRD

Procedia PDF Downloads 319

Authors: Liu Chyong-Ru, Wang Yao-Chin, Huang Wen-Shiung, Tang Wan-Ching

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Although gamification has been concerned and applied in the tourism industry, limited literature could be found in tourism academy. Therefore, to contribute knowledge in festival gamification, it becomes essential to start by establishing a Festival Gamification Scale (FGS). This study defines festival gamification as the extent of a festival to involve game elements and game mechanisms. Based on self-determination theory, this study developed an FGS. Through the multi-study method, in study one, five FGS dimensions were sorted through literature review, followed by twelve in-depth interviews. A total of 296 statements were extracted from interviews and were later narrowed down to 33 items under six dimensions. In study two, 226 survey responses were collected from a cycling festival for exploratory factor analysis, resulting in twenty items under five dimensions. In study three, 253 survey responses were obtained from a marathon festival for confirmatory factor analysis, resulting in the final sixteen items under five dimensions. Then, results of criterion-related validity confirmed the positive effects of these five dimensions on flow experience. In study four, for examining the model extension of the developed five-dimensional 16-item FGS, which includes dimensions of relatedness, mastery, competence, fun, and narratives, cross-validation analysis was performed using 219 survey responses from a religious festival. For the tourism academy, the FGS could further be applied in other sub-fields such as destinations, theme parks, cruise trips, or resorts. The FGS serves as a starting point for examining the mechanism of festival gamification in changing tourists’ attitudes and behaviors. Future studies could work on follow-up studies of FGS by testing outcomes of festival gamification or examining moderating effects of enhancing outcomes of festival gamification. On the other hand, although the FGS has been tested in cycling, marathon, and religious festivals, the research settings are all in Taiwan. Cultural differences of FGS is another further direction for contributing knowledge in festival gamification. This study also contributes to several valuable practical implications. First, this FGS could be utilized in tourist surveys for evaluating the extent of gamification of a festival. Based on the results of the performance assessment by FGS, festival management organizations and festival planners could learn the relative scores among dimensions of FGS, and plan for future improvement of gamifying the festival. Second, the FGS could be applied in positioning a gamified festival. Festival management organizations and festival planners could firstly consider the features and types of their festival, and then gamify their festival based on investing resources in key FGS dimensions.

Keywords: festival gamification, festival tourism, scale development, self-determination theory

Procedia PDF Downloads 128

Authors: Salima Bijapuri, Shweta Bhatbolan, Sejalben Patel

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Ergonomics concerns the fitting of the environment and the equipment to the worker. Ergonomic principles can be employed in different dimensions of the industrial sector. Participation of all the stakeholders is the key to the formulation of a multifaceted and comprehensive approach to lessen the burden of occupational hazards. Taking responsibility for one’s own work activities by acquiring sufficient knowledge and potential to influence the practices and outcomes is the basis of participatory ergonomics and even hastens the process to identify workplace hazards. The study was aimed to check how participatory ergonomics can be effective in the management of work-related musculoskeletal disorders. Method: A mega kitchen was identified in a twin city of Karnataka, India. Consent was taken, and the screening of workers was done using observation methods. Kitchen work was structured to include different tasks, which included preparation, cooking, distributing, and serving food, packing food to be delivered to schools, dishwashing, cleaning and maintenance of kitchen and equipment, and receiving and storing raw material. Total 100 workers attended the education session on participatory ergonomics and its role in implementing the correct ergonomic practices, thus preventing WRMSDs. Demographic details and baseline data on related musculoskeletal pain and discomfort were collected using the Nordic pain questionnaire and VAS score pre- and post-study. Monthly visits were made, and the education sessions were reiterated on each visit, thus reminding, correcting, and problem-solving of each worker. After 9 months with a total of 4 such education session, the post education data was collected. The software SPSS 20 was used to analyse the collected data. Results: The majority of them (78%), depending on the availability and feasibility, participated in the intervention workshops were arranged four times. The average age of the participants was 39 years. The percentage of female participants was 79.49%, and 20.51% of participants comprised of males. The Nordic Musculoskeletal Questionnaire (NMQ) showed that knee pain was the most commonly reported complaint (62%) from the last 12 months with a mean VAS of 6.27, followed by low back pain. Post intervention, the mean VAS Score was reduced significantly to 2.38. The comparison of pre-post scores was made using Wilcoxon matched pairs test. Upon enquiring, it was found that, the participants learned the importance of applying ergonomics at their workplace which inturn was beneficial for them to handle any problems arising at their workplace on their own with self confidence. Conclusion: The participatory ergonomics proved effective with workers of mega kitchen, and it is a feasible and practical approach. The advantage of the given study area was that it had a sophisticated and ergonomically designed workstation; thus it was the lack of education and practical knowledge to use these stations was of utmost need. There was a significant reduction in VAS scores with the implementation of changes in the working style, and the knowledge of ergonomics helped to decrease physical load and improve musculoskeletal health.

Keywords: ergonomic awareness session, mega kitchen, participatory ergonomics, work related musculoskeletal disorders

Procedia PDF Downloads 115

Authors: Benjamin Mugisha Bugingo

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Healthcare staffhas been considered as asignificant pillar to the health care system. However, the contest of human resources for health in terms of the turnover of health workers in Uganda has been more distinct in the latest years. The objective of the paper, therefore, were to investigate the influence Role Human resource management functions in on employeeperformance of professional health workers in public district hospitals in Kampala. The study objectives were: to establish the effect of performance management function, financialincentives, non-financial incentives, participation, and involvement in the decision-making on the employee performance of professional health workers in public district hospitals in Kampala. The study was devised in the social exchange theory and the equity theory. This study adopted a descriptive research design using quantitative approaches. The study used a cross-sectional research design with a mixed-methods approach. With a population of 402 individuals, the study considered a sample of 252 respondents, including doctors, nurses, midwives, pharmacists, and dentists from 3 district hospitals. The study instruments entailed a questionnaire as a quantitative data collection tool and interviews and focus group discussions as qualitative data gathering tools. To analyze quantitative data, descriptive statistics were used to assess the perceived status of Human resource management functions and the magnitude of intentions to stay, and inferential statistics were used to show the effect of predictors on the outcome variable by plotting a multiple linear regression. Qualitative data were analyzed in themes and reported in narrative and verbatim quotes and were used to complement descriptive findings for a better understanding of the magnitude of the study variables. The findings of this study showed a significant and positive effect of performance management function, financialincentives, non-financial incentives, and participation and involvement in decision-making on employee performance of professional health workers in public district hospitals in Kampala. This study is expected to be a major contributor for the improvement of the health system in the country and other similar settings as it has provided the insights for strategic orientation in the area of human resources for health, especially for enhanced employee performance in relation with the integrated human resource management approach

Keywords: human resource functions, employee performance, employee wellness, profecial workers

Procedia PDF Downloads 67

Authors: Sharib Ahmed, Mansoor Rafi, Kamran Ali Awan, Faraz Khaskhali, Amir Maqbool, Altaf Hashmi

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Medical linear accelerators (LINAC’s) used in radiotherapy treatments produce undesired neutrons when they are operated at energies above 8 MeV, both in electron and photon configuration. Neutrons are produced by high-energy photons and electrons through electronuclear (e, n) a photonuclear giant dipole resonance (GDR) reactions. These reactions occurs when incoming photon or electron incident through the various materials of target, flattening filter, collimators, and other shielding components in LINAC’s structure. These neutrons may reach directly to the patient, or they may interact with the surrounding materials until they become thermalized. A work has been set up to study the effect of different parameter on the production of neutron around the room by photonuclear reactions induced by photons above ~8 MeV. One of the commercial available neutron detector (Ludlum Model 42-31H Neutron Detector) is used for the detection of thermal and fast neutrons (0.025 eV to approximately 12 MeV) inside and outside of the treatment room. Measurements were performed for different field sizes at 100 cm source to surface distance (SSD) of detector, at different distances from the isocenter and at the place of primary and secondary walls. Other measurements were performed at door and treatment console for the potential radiation safety concerns of the therapists who must walk in and out of the room for the treatments. Exposures have taken place from Elekta Synergy® linear accelerators for two different energies (10 MV and 18 MV) for a given 200 MU’s and dose rate of 600 MU per minute. Results indicates that neutron doses at 100 cm SSD depend on accelerator characteristics means jaw settings as jaws are made of high atomic number material so provides significant interaction of photons to produce neutrons, while doses at the place of larger distance from isocenter are strongly influenced by the treatment room geometry and backscattering from the walls cause a greater doses as compare to dose at 100 cm distance from isocenter. In the treatment room the ambient dose equivalent due to photons produced during decay of activation nuclei varies from 4.22 mSv.h−1 to 13.2 mSv.h−1 (at isocenter),6.21 mSv.h−1 to 29.2 mSv.h−1 (primary wall) and 8.73 mSv.h−1 to 37.2 mSv.h−1 (secondary wall) for 10 and 18 MV respectively. The ambient dose equivalent for neutrons at door is 5 μSv.h−1 to 2 μSv.h−1 while at treatment console room it is 2 μSv.h−1 to 0 μSv.h−1 for 10 and 18 MV respectively which shows that a 2 m thick and 5m longer concrete maze provides sufficient shielding for neutron at door as well as at treatment console for 10 and 18 MV photons.

Keywords: equivalent doses, neutron contamination, neutron detector, photon energy

Procedia PDF Downloads 430

Authors: Narendra Akhadkar, Silvestre Cano, Christophe Gourru

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Injection-molded parts are widely used in power system protection products. One of the biggest challenges in an injection molding process is shrinkage and warpage of the molded parts. All these geometrical variations may have an adverse effect on the quality of the product, functionality, cost, and time-to-market. The situation becomes more challenging in the case of intricate shapes and in mass production using multi-cavity tools. To control the effects of shrinkage and warpage, it is very important to correctly find out the input parameters that could affect the product performance. With the advances in the computer-aided engineering (CAE), different tools are available to simulate the injection molding process. For our case study, we used the MoldFlow insight tool. Our aim is to predict the spread of the functional dimensions and geometrical variations on the part due to variations in the input parameters such as material viscosity, packing pressure, mold temperature, melt temperature, and injection speed. The input parameters may vary during batch production or due to variations in the machine process settings. To perform the accurate product assembly variation simulation, the first step is to perform an individual part variation simulation to render realistic tolerance ranges. In this article, we present a method to simulate part variations coming from the input parameters variation during batch production. The method is based on computer simulations and experimental validation using the full factorial design of experiments (DoE). The robustness of the simulation model is verified through input parameter wise sensitivity analysis study performed using simulations and experiments; all the results show a very good correlation in the material flow direction. There exists a non-linear interaction between material and the input process variables. It is observed that the parameters such as packing pressure, material, and mold temperature play an important role in spread on functional dimensions and geometrical variations. This method will allow us in the future to develop accurate/realistic virtual prototypes based on trusted simulated process variation and, therefore, increase the product quality and potentially decrease the time to market.

Keywords: correlation, molding process, tolerance, sensitivity analysis, variation simulation

Procedia PDF Downloads 154

Authors: M. J. Ponnambalam

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Physics Outreach in Jamaica has nearly tripled the number of students doing Introductory Calculus-based Physics at the University of the West Indies (UWI, Mona) within 5 years, and thus has shown the importance of Physics Teaching & Learning in Informal Settings. In 1899, the first president of the American Physical Society called Physics, “the science above all sciences.” Sure enough, exactly one hundred years later, Time magazine proclaims Albert Einstein, “Person of the Century.” Unfortunately, Physics seems to be losing that glow in this century. Many countries, big and small, are finding it difficult to attract bright young minds to pursue Physics. At UWI, Mona, the number of students in first year Physics dropped to an all-time low of 81 in 2006, from more than 200 in the nineteen eighties, spelling disaster for the Physics Department! The author of this paper launched an aggressive Physics Outreach that same year, aimed at conveying to the students and the general public the following messages: i) Physics is an exciting intellectual enterprise, full of fun and delight. ii) Physics is very helpful in understanding how things like TV, CD player, car, computer, X-ray, CT scan, MRI, etc. work. iii) The critical and analytical thinking developed in the study of Physics is of inestimable value in almost any field. iv) Physics is the core subject for Science and Technology, and hence of national development. Science Literacy is a ‘must’ for any nation in the 21st century. Hence, the Physics Outreach aims at reaching out to every person, through every possible means. The Outreach work is split into the following target groups: i) Universities, ii) High Schools iii) Middle Schools, iv) Primary Schools, v) General Public, and vi) Physics teachers in High Schools. The programmes, tools and best practices are adjusted to suit each target group. The feedback from each group is highly positive. e.g. In February 2014, the author conducted in 3 Primary Schools the Interactive Show on ‘Science Is Fun’ to stimulate 290 students’ interest in Science – with lively and interesting demonstrations and experiments in a highly interactive way, using dramatization, story-telling and dancing. The feedback: 47% found the Show ‘Exciting’ and 51% found it ‘Interesting’ – totaling an impressive 98%. When asked to describe the Show in their own words, the leading 4 responses were: ‘Fun’ (26%), ‘Interesting’ (20%), ‘Exciting’ (14%) and ‘Educational’ (10%) – confirming that ‘fun’ & ‘education’ can go together. The success of Physics Outreach in Jamaica verifies the following words of Chodos, Associate Executive Officer of the American Physical Society: “If we could get members to go to K-12 schools and levitate a magnet or something, we really think these efforts would bring great rewards.”

Keywords: physics education, physics popularization, UWI, Jamaica

Procedia PDF Downloads 372

Authors: G. Natuhwera, M. Rabwoni, P. Ellis, A. Merriman

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Aims: Health workers are likely to document patients’ care inaccurately, especially when using new and revised case tools, and this could negatively impact patient care. This study set out to; (1) assess nurses’ and clinicians’ documentation practices when using a new patients’ continuation case sheet (PCCS) and (2) explore nurses’ and clinicians’ experiences regarding documentation of patients’ information in the new PCCS. The purpose of introducing the PCCS was to improve continuity of care for patients attending clinics at which they were unlikely to see the same clinician or nurse consistently. Methods: This was a mixed methods study. The cross-sectional inquiry retrospectively reviewed 100 case notes of active patients on hospice and palliative care program. Data was collected using a structured questionnaire with constructs formulated from the new PCCS under study. The qualitative element was face-to-face audio-recorded, open-ended interviews with a purposive sample of one palliative care clinician, and four palliative care nurse specialists. Thematic analysis was used. Results: Missing patients’ biogeographic information was prevalent at 5-10%. Spiritual and psychosocial issues were not documented in 42.6%, and vital signs in 49.2%. Poorest documentation practices were observed in past medical history part of the PCCS at 40-63%. Four themes emerged from interviews with clinicians and nurses-; (1) what remains unclear and challenges, (2) comparing the past with the present, (3) experiential thoughts, and (4) transition and adapting to change. Conclusions: The PCCS seems to be a comprehensive and simple tool to be used to document patients’ information at subsequent visits. The comprehensiveness and utility of the PCCS does paper to be limited by the failure to train staff in its use prior to introducing. The authors find the PCCS comprehensive and suitable to capture patients’ information and recommend it can be adopted and used in other palliative and hospice care settings, if suitable introductory training accompanies its introduction. Otherwise, the reliability and validity of patients’ information collected by this PCCS can be significantly reduced if some sections therein are unclear to the clinicians/nurses. The study identified clinicians- and nurses-related pitfalls in documentation of patients’ care. Clinicians and nurses need to prioritize accurate and complete documentation of patient care in the PCCS for quality care provision. This study should be extended to other sites using similar tools to ensure representative and generalizable findings.

Keywords: documentation, information case sheet, palliative care, quality improvement

Procedia PDF Downloads 120

Authors: Hanwei Gao, Louis Jezequel, Eric Cabrol, Bernard Vitry

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The chassis system is composed of complex elements that take up all the loads from the tire-ground contact area and thus it plays an important role in numerous specifications such as durability, comfort, crash, etc. During the development of new vehicle projects in Renault, durability validation is always the main focus while deployment of comfort comes later in the project. Therefore, sometimes design choices have to be reconsidered because of the natural incompatibility between these two specifications. Besides, robustness is also an important point of concern as it is related to manufacturing costs as well as the performance after the ageing of components like shock absorbers. In this paper an approach is proposed aiming to realize a multi-objective optimization between chassis endurance and comfort while taking the random factors into consideration. The adaptive-sparse polynomial chaos expansion method (PCE) with Chebyshev polynomial series has been applied to predict responses’ uncertainty intervals of a system according to its uncertain-but-bounded parameters. The approach can be divided into three steps. First an initial design of experiments is realized to build the response surfaces which represent statistically a black-box system. Secondly within several iterations an optimum set is proposed and validated which will form a Pareto front. At the same time the robustness of each response, served as additional objectives, is calculated from the pre-defined parameter intervals and the response surfaces obtained in the first step. Finally an inverse strategy is carried out to determine the parameters’ tolerance combination with a maximally acceptable degradation of the responses in terms of manufacturing costs. A quarter car model has been tested as an example by applying the road excitations from the actual road measurements for both endurance and comfort calculations. One indicator based on the Basquin’s law is defined to compare the global chassis durability of different parameter settings. Another indicator related to comfort is obtained from the vertical acceleration of the sprung mass. An optimum set with best robustness has been finally obtained and the reference tests prove a good robustness prediction of Chebyshev PCE method. This example demonstrates the effectiveness and reliability of the approach, in particular its ability to save computational costs for a complex system.

Keywords: chassis durability, Chebyshev polynomials, multi-objective optimization, polynomial chaos expansion, ride comfort, robust design

Procedia PDF Downloads 133

Authors: Mohamed Dakki, Genevieve Robin, Marie Suet, Abdeljebbar Qninba, Mohamed A. El Agbani, Asmâa Ouassou, Rhimou El Hamoumi, Hichem Azafzaf, Sami Rebah, Claudia Feltrup-Azafzaf, Nafouel Hamouda, Wed a.L. Ibrahim, Hosni H. Asran, Amr A. Elhady, Haitham Ibrahim, Khaled Etayeb, Essam Bouras, Almokhtar Saied, Ashrof Glidan, Bakar M. Habib, Mohamed S. Sayoud, Nadjiba Bendjedda, Laura Dami, Clemence Deschamps, Elie Gaget, Jean-Yves Mondain-Monval, Pierre Defos Du Rau

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In biodiversity monitoring, large datasets are becoming more and more widely available and are increasingly used globally to estimate species trends and con- servation status. These large-scale datasets challenge existing statistical analysis methods, many of which are not adapted to their size, incompleteness and heterogeneity. The development of scalable methods to impute missing data in incomplete large-scale monitoring datasets is crucial to balance sampling in time or space and thus better inform conservation policies. We developed a new method based on penalized Poisson models to impute and analyse incomplete monitoring data in a large-scale framework. The method al- lows parameterization of (a) space and time factors, (b) the main effects of predic- tor covariates, as well as (c) space–time interactions. It also benefits from robust statistical and computational capability in large-scale settings. The method was tested extensively on both simulated and real-life waterbird data, with the findings revealing that it outperforms six existing methods in terms of missing data imputation errors. Applying the method to 16 waterbird species, we estimated their long-term trends for the first time at the entire North African scale, a region where monitoring data suffer from many gaps in space and time series. This new approach opens promising perspectives to increase the accuracy of species-abundance trend estimations. We made it freely available in the r package ‘lori’ (https://CRAN.R-project.org/package=lori) and recommend its use for large- scale count data, particularly in citizen science monitoring programmes.

Keywords: biodiversity monitoring, high-dimensional statistics, incomplete count data, missing data imputation, waterbird trends in North-Africa

Procedia PDF Downloads 124

Authors: Mei Li, Victor Meddalena

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Background: Newfoundland and Labrador (NL) has rapidly aging population and is characterized by its vast geography with high proportion of dispersed rural communities when compared to other provinces in Canada. Structural, demographic and geographic factors have created big gaps for rural residents across NL with respect to accessing various health and social services. While the barriers are well documented for patients’ access to cancer care in rural and remote areas, challenges faced by family caregivers are not fully recognized. Caregiving burden coupled with challenges associated with relocation and frequent travels create situations where caregivers are vulnerable physically, emotionally, financially and socially. This study examines the experiences of family caregivers living in rural NL through a social justice lens. It is expected to identify the gaps existing in social policy and support for rural family caregivers. It will make a novel contribution to the literature in this regard. Methods: Design: This qualitative study adopted the hermeneutic phenomenology to best describe and interpret rural-based family caregivers’ living experiences and explore the meaning, impact, and the influence of both individual experience and contextual factors shaping these experiences. Data Collection: In-depth interviews with key informants were conducted with 12 participants from various rural communities in NL. A case study was also used to explore an individual’s experience in complex social units consisting of multiple variables of in-depth understanding of the reality. Data Analysis: Thematic analysis guided by the Voice-Centred Relational (VCR) method was employed to explore the relationships and contexts of participants. Emerging Themes: Six major emerging themes were identified, namely, overwhelming caregiving burden on rural family caregivers, long existing financial hardship, separation from family and community, low level of social support and self-reliance coping strategies, and social vulnerability and isolation. Conclusion: Understanding the lived experiences of rural-based family caregivers is critical to inform the policy makers the gap of health and social service in NL. The findings of this study also have implications for family caregivers who are vulnerable in other similar contexts. This study adds innovative insights for policy making and service provision in this regard.

Keywords: family caregivers, policy, relocation, rural

Procedia PDF Downloads 117

Authors: Jasmin Cowin, Amany Alkhayat

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This paper will concentrate on a comparative analysis of both the advantages and limitations of using digital learning resources (DLRs). DLRs covered will be Virtual Reality (VR), Mobile Learning (M-learning) and Computer-Assisted Language Learning (CALL) together with their subset, Mobile Assisted Language Learning (MALL) in language education. In addition, best practices for language teaching and the application of established language teaching methodologies such as Communicative Language Teaching (CLT), the audio-lingual method, or community language learning will be explored. Education has changed dramatically since the eruption of the pandemic. Traditional face-to-face education was disrupted on a global scale. The rise of distance learning brought new digital tools to the forefront, especially web conferencing tools, digital storytelling apps, test authoring tools, and VR platforms. Language educators raced to vet, learn, and implement multiple technology resources suited for language acquisition. Yet, questions remain on how to harness new technologies, digital tools, and their ubiquitous availability while using established methods and methodologies in language learning paired with best teaching practices. In M-learning language, learners employ portable computing devices such as smartphones or tablets. CALL is a language teaching approach using computers and other technologies through presenting, reinforcing, and assessing language materials to be learned or to create environments where teachers and learners can meaningfully interact. In VR, a computer-generated simulation enables learner interaction with a 3D environment via screen, smartphone, or a head mounted display. Research supports that VR for language learning is effective in terms of exploration, communication, engagement, and motivation. Students are able to relate through role play activities, interact with 3D objects and activities such as field trips. VR lends itself to group language exercises in the classroom with target language practice in an immersive, virtual environment. Students, teachers, schools, language institutes, and institutions benefit from specialized support to help them acquire second language proficiency and content knowledge that builds on their cultural and linguistic assets. Through the purposeful application of different language methodologies and teaching approaches, language learners can not only make cultural and linguistic connections in DLRs but also practice grammar drills, play memory games or flourish in authentic settings.

Keywords: language teaching methodologies, computer-assisted language learning, mobile learning, virtual reality

Procedia PDF Downloads 213

Authors: Lucrezia Crescenzi-Lanna, Silvia Cataldi, Williams Contreras, Valerio Pieri

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According to the European Commission, gender-based violence (GBV) is a violation of human rights and a form of discrimination against women in five areas: physical violence, sexual violence, psychological violence, mistreatment of women, and economic violence (henceforth EV). The TESORO project "Treatment, ExpoSition, and ORigin of economic viOlence: An innovation and internationalization project between Italy and Spain" focuses on this last dimension of gender-based violence, the least studied and the one that has received least media coverage. In Spain, 12% (2,350,684) of women over fifteen years of age have suffered economic violence from their partner or ex-partner during their lives. In Italy, another country participating in the project, many women who are welcomed in refuges and who report cases of psychological violence (79%) and/or physical violence (61%) are also victims of economic violence (34%), according to the D.i.Re. Thermometer: "Donne in Rete contro la Violenza", the association that brings together more than eighty refuges against violence in Italy. At the social level, this form of violence is incorporated into practices of inequality that manifest themselves in both the daily management of couples and families and the workplace and institutional settings. As for the mechanisms related to EV, the literature argues that it is a complex and multidimensional phenomenon that has socioeconomic and cultural roots. EV manifests itself through various strategies, which represent forms of power and control aimed at preventing women's financial independence. To analyse the issue of EV we use a multidisciplinary approach and a mixed design that includes: 1) a questionnaire administered to a stratified sample of more than a thousand Italian and Spanish citizens to study the cultural and socio-relational mechanisms and the origin of EV in family and couple contexts; and 2) interviews with those running refuges as part of the struggle against gender violence, to understand how mechanisms and educational activities in the field of economic violence are manifested in the respective region and are supportive of women. The decision to use this strategy responds to the need to combine an exploratory perspective with an explanatory one in order to understand some of the relevant concepts related to the complex phenomena of EV and the interventions dedicated to its prevention. The data will be finalized in June 2022 and presented at the ICWS conference. Among TESORO’s contributions, its collection of qualitative and quantitative data on EV in Italy and Spain stands out, deepening its origin, prevention, and treatment beyond its incidence, which has already been studied in the Macro-Survey on Violence against Women.

Keywords: gender-based violence, economic violence, economic harm, gender inequality, workplace and family contexts

Procedia PDF Downloads 78

Authors: Phenias Nsabimana, Jérôme W. Some, Hilda Vasanthakaalam, Stefaan De Henauw, Souheila Abbeddou

Abstract:

Tools for the dietary assessment in adults are limited in low- and middle-income settings. The objective of this study was to develop and validate a semi-quantitative food frequency questionnaire (FFQ) against the multiple pass-24 h recall tool for use in urban and rural Rwanda. A total of 212 adults (154 females and 58 males), 18-49 aged, including 105 urban and 107 rural residents, from the four regions of Rwanda, were recruited in the present study. A multiple-pass 24- H recall technique was used to collect dietary data in both urban and rural areas in four different rounds, on different days (one weekday and one weekend day), separated by a period of three months, from November 2020 to October 2021. The details of all the foods and beverages consumed over the 24h period of the day prior to the interview day were collected during face-to-face interviews. A list of foods, beverages, and commonly consumed recipes was developed by the study researchers and ten research assistants from the different regions of Rwanda. Non-standard recipes were collected when the information was available. A single semi-quantitative FFQ was also developed in the same group discussion prior to the beginning of the data collection. The FFQ was collected at the beginning and the end of the data collection period. Data were collected digitally. The amount of energy and macro-nutrients contributed by each food, recipe, and beverage will be computed based on nutrient composition reported in food composition tables and weight consumed. Median energy and nutrient contents of different food intakes from FFQ and 24-hour recalls and median differences (24-hour recall –FFQ) will be calculated. Kappa, Spearman, Wilcoxon, and Bland-Altman plot statistics will be conducted to evaluate the correlation between estimated nutrient and energy intake found by the two methods. Differences will be tested for their significance and all analyses will be done with STATA 11. Data collection was completed in November 2021. Data cleaning is ongoing and the data analysis is expected to be completed by July 2022. A developed and validated semi-quantitative FFQ will be available for use in dietary assessment. The developed FFQ will help researchers to collect reliable data that will support policy makers to plan for proper dietary change intervention in Rwanda.

Keywords: food frequency questionnaire, reproducibility, 24-H recall questionnaire, validation

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