Search results for: individual patient data
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 29098

Search results for: individual patient data

14338 Capacities of Early Childhood Education Professionals for the Prevention of Social Exclusion of Children

Authors: Dejana Bouillet, Vlatka Domović

Abstract:

Both policymakers and researchers recognize that participating in early childhood education and care (ECEC) is useful for all children, especially for those who are exposed to the high risk of social exclusion. Social exclusion of children is understood as a multidimensional construct including economic, social, cultural, health, and other aspects of disadvantage and deprivation, which individually or combined can have an unfavorable effect on the current life and development of a child, as well as on the child’s development and on disadvantaged life chances in adult life. ECEC institutions should be able to promote educational approaches that portray developmental, cultural, language, and other diversity amongst children. However, little is known about the ways in which Croatian ECEC institutions recognize and respect the diversity of children and their families and how they respond to their educational needs. That is why this paper is dedicated to the analysis of the capacities of ECEC professionals to respond to the demands of educational needs of this very diverse group of children and their families. The results obtained in the frame of the project “Models of response to educational needs of children at risk of social exclusion in ECEC institutions,” funded by the Croatian Science Foundation, will be presented. The research methodology arises from explanations of educational processes and risks of social exclusion as a complex and heterogeneous phenomenon. The preliminary results of the qualitative data analysis of educational practices regarding capacities to identify and appropriately respond to the requirements of children at risk of social exclusion will be presented. The data have been collected by interviewing educational staff in 10 Croatian ECEC institutions (n = 10). The questions in the interviews were related to various aspects of inclusive institutional policy, culture, and practices. According to the analysis, it is possible to conclude that Croatian ECEC professionals are still faced with great challenges in the process of implementation of inclusive policies, culture, and practices. There are several baselines of this conclusion. The interviewed educational professionals are not familiar enough with the whole complexity and diversity of needs of children at risk of social exclusion, and the ECEC institutions do not have enough resources to provide all interventions that these children and their families need.

Keywords: children at risk of social exclusion, ECEC professionals, inclusive policies, culture and practices, quallitative analysis

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14337 Powering Profits: A Dynamic Approach to Sales Marketing and Electronics

Authors: Muhammad Awais Kiani, Maryam Kiani

Abstract:

This abstract explores the confluence of these two domains and highlights the key factors driving success in sales marketing for electronics. The abstract begins by digging into the ever-evolving landscape of consumer electronics, emphasizing how technological advancements and the growth of smart devices have revolutionized the way people interact with electronics. This paradigm shift has created tremendous opportunities for sales and marketing professionals to engage with consumers on various platforms and channels. Next, the abstract discusses the pivotal role of effective sales marketing strategies in the electronics industry. It highlights the importance of understanding consumer behavior, market trends, and competitive landscapes and how this knowledge enables businesses to tailor their marketing efforts to specific target audiences. Furthermore, the abstract explores the significance of leveraging digital marketing techniques, such as social media advertising, search engine optimization, and influencer partnerships, to establish brand identity and drive sales in the electronics market. It emphasizes the power of storytelling and creating captivating content to engage with tech-savvy consumers. Additionally, the abstract emphasizes the role of customer relationship management (CRM) systems and data analytics in optimizing sales marketing efforts. It highlights the importance of leveraging customer insights and analyzing data to personalize marketing campaigns, enhance customer experience, and ultimately drive sales growth. Lastly, the abstract concludes by underlining the importance of adapting to the ever-changing landscape of the electronics industry. It encourages businesses to embrace innovation, stay informed about emerging technologies, and continuously evolve their sales marketing strategies to meet the evolving needs and expectations of consumers. Overall, this abstract sheds light on the captivating realm of sales marketing in the electronics industry, emphasizing the need for creativity, adaptability, and a deep understanding of consumers to succeed in this rapidly evolving market.

Keywords: marketing industry, electronics, sales impact, e-commerce

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14336 Design and Development of a Safety Equipment and Accessory for Bicycle Users

Authors: Francine Siy, Stephen Buñi

Abstract:

Safety plays a significant role in everyone’s life on a day-to-day basis. We wish ourselves and our loved ones their safety as we all venture out on our daily commute. The road is undeniably dangerous and unpredictable, with abundant traffic collisions and pedestrians experiencing various injuries. For bicycle users, the risk of accidents is even more exacerbated, and injuries may be severe. Even when cyclists try their best to be safe and protected, the possibility of encountering danger is always there. Despite being equipped with protective gear, safety is never guaranteed. Cyclists often settle for helmets and standard reflector vests to establish a presence on the road. There are different types of vests available, depending on the profession. However, traditional reflector vests, mostly seen on construction workers and traffic enforcers, were not designed for riders and their protection from injuries. With insufficient protection for riders, they need access to ergonomically designed equipment and accessories that suit the riders and cater to their needs. This research aimed to offer a protective vest with safety features for riders that is comfortable, effective, durable, and intuitive. This sheds light and addresses the safety of the biker population, which continuously grows through the years. The product was designed and developed by gathering data and using the cognitive mapping method to ensure that all qualitative and quantitative data were considered in this study to improve other existing products that do not have the proper design considerations. It is known that available equipment for cyclists is often sold separately or lacks the safety features for cyclists traversing open roads. Each safety feature like the headlights, reflectors, signal or rear lights, zipper pouch, body camera attachment, and wireless remote control all play a particular role in helping cyclists embark on their daily commute. These features aid in illumination, visibility, easy maneuvering, convenience, and security, allowing cyclists to go for a safer ride that is of use throughout the day. The product is designed and produced effectively and inexpensively without sacrificing the quality and purpose of its usage.

Keywords: bicycle accessory, protective gear, safety, transport, visibility

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14335 Radiofrequency and Near-Infrared Responsive Core-Shell Multifunctional Nanostructures Using Lipid Templates for Cancer Theranostics

Authors: Animesh Pan, Geoffrey D. Bothun

Abstract:

With the development of nanotechnology, research in multifunctional delivery systems has a new pace and dimension. An incipient challenge is to design an all-in-one delivery system that can be used for multiple purposes, including tumor targeting therapy, radio-frequency (RF-), near-infrared (NIR-), light-, or pH-induced controlled release, photothermal therapy (PTT), photodynamic therapy (PDT), and medical diagnosis. In this regard, various inorganic nanoparticles (NPs) are known to show great potential as the 'functional components' because of their fascinating and tunable physicochemical properties and the possibility of multiple theranostic modalities from individual NPs. Magnetic, luminescent, and plasmonic properties are the three most extensively studied and, more importantly biomedically exploitable properties of inorganic NPs. Although successful attempts of combining any two of them above mentioned functionalities have been made, integrating them in one system has remained challenge. Keeping those in mind, controlled designs of complex colloidal nanoparticle system are one of the most significant challenges in nanoscience and nanotechnology. Therefore, systematic and planned studies providing better revelation are demanded. We report a multifunctional delivery platform-based liposome loaded with drug, iron-oxide magnetic nanoparticles (MNPs), and a gold shell on the surface of liposomes, were synthesized using a lipid with polyelectrolyte (layersomes) templating technique. MNPs and the anti-cancer drug doxorubicin (DOX) were co-encapsulated inside liposomes composed by zwitterionic phophatidylcholine and anionic phosphatidylglycerol using reverse phase evaporation (REV) method. The liposomes were coated with positively charge polyelectrolyte (poly-L-lysine) to enrich the interface with gold anion, exposed to a reducing agent to form a gold nanoshell, and then capped with thio-terminated polyethylene glycol (SH-PEG2000). The core-shell nanostructures were characterized by different techniques like; UV-Vis/NIR scanning spectrophotometer, dynamic light scattering (DLS), transmission electron microscope (TEM). This multifunctional system achieves a variety of functions, such as radiofrequency (RF)-triggered release, chemo-hyperthermia, and NIR laser-triggered for photothermal therapy. Herein, we highlight some of the remaining major design challenges in combination with preliminary studies assessing therapeutic objectives. We demonstrate an efficient loading and delivery system to significant cell death of human cancer cells (A549) with therapeutic capabilities. Coupled with RF and NIR excitation to the doxorubicin-loaded core-shell nanostructure helped in securing targeted and controlled drug release to the cancer cells. The present core-shell multifunctional system with their multimodal imaging and therapeutic capabilities would be eminent candidates for cancer theranostics.

Keywords: cancer thernostics, multifunctional nanostructure, photothermal therapy, radiofrequency targeting

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14334 Observation of Critical Sliding Velocity

Authors: Visar Baxhuku, Halil Demolli, Alishukri Shkodra

Abstract:

This paper presents the monitoring of vehicle movement, namely the developing of speed of vehicles during movement in a certain twist. The basic geometry data of twist are measured with the purpose of calculating the slide in border speed. During the research, measuring developed speed of passenger vehicles for the real conditions of the road surface, dry road with average damage, was realised. After setting values, the analysis was done in function security of movement in twist.

Keywords: critical sliding velocity, moving velocity, curve, passenger vehicles

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14333 Road Accident Blackspot Analysis: Development of Decision Criteria for Accident Blackspot Safety Strategies

Authors: Tania Viju, Bimal P., Naseer M. A.

Abstract:

This study aims to develop a conceptual framework for the decision support system (DSS), that helps the decision-makers to dynamically choose appropriate safety measures for each identified accident blackspot. An accident blackspot is a segment of road where the frequency of accident occurrence is disproportionately greater than other sections on roadways. According to a report by the World Bank, India accounts for the highest, that is, eleven percent of the global death in road accidents with just one percent of the world’s vehicles. Hence in 2015, the Ministry of Road Transport and Highways of India gave prime importance to the rectification of accident blackspots. To enhance road traffic safety and reduce the traffic accident rate, effectively identifying and rectifying accident blackspots is of great importance. This study helps to understand and evaluate the existing methods in accident blackspot identification and prediction that are used around the world and their application in Indian roadways. The decision support system, with the help of IoT, ICT and smart systems, acts as a management and planning tool for the government for employing efficient and cost-effective rectification strategies. In order to develop a decision criterion, several factors in terms of quantitative as well as qualitative data that influence the safety conditions of the road are analyzed. Factors include past accident severity data, occurrence time, light, weather and road conditions, visibility, driver conditions, junction type, land use, road markings and signs, road geometry, etc. The framework conceptualizes decision-making by classifying blackspot stretches based on factors like accident occurrence time, different climatic and road conditions and suggesting mitigation measures based on these identified factors. The decision support system will help the public administration dynamically manage and plan the necessary safety interventions required to enhance the safety of the road network.

Keywords: decision support system, dynamic management, road accident blackspots, road safety

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14332 Health Outcomes from Multidrug-Resistant Salmonella in High-Income Countries: A Systematic Review and Meta-Analysis

Authors: Andrea Parisi, Samantha Vilkins, Luis Furuya-Kanamori, John A. Crump, Benjamin P. Howden, Darren Gray, Kathryn Glass, Martyn Kirk

Abstract:

Objectives: Salmonella is a leading cause of foodborne enterocolitis worldwide. Nontyphoidal Salmonella (NTS) infections that are Multi-Drug Resistant (MDR) (non-susceptible to ≥1 agent in ≥3 antimicrobial categories) may result in more severe outcomes, although these effects have not been systematically examined. We conducted a systematic review and meta-analysis to examine impacts of MDR NTS on health in high-income settings. Methods: We systematically reviewed the literature from scientific databases, including PubMed, Scopus and grey literature sources, using PRISMA guidelines. We searched for data from case-control studies, cohorts, outbreaks, reports and theses, imposing no language restriction. We included only publications from January 1990 to September 2016 from high income countries as classified by World Bank. We extracted data from papers on duration of illness, hospitalisation rates, morbidity and mortality for MDR and non-MDR NTS strains. Results: After removing duplicates, the initial search revealed 4258 articles. After further screening, we identified 16 eligible studies for the systematic review, and 9 of these were included in meta-analysis. NTS serotypes differed among the reported studies but serotype Typhimurium, Enteritidis, Newport and Heidelberg were among the most often reported as MDR pathogens. Salmonella infections that were MDR were associated with excess bloodstream infections (OR 1.63; 95%CI 1.18-2.26), excess hospitalisations (OR 2.77; 95%CI 1.47-5.21) and higher mortality (OR 3.54; 95%CI 1.10-11.40). Conclusions: MDR NTS infections are a serious public health concern. With the emergence of MDR Salmonella strains in the high-income countries, it is crucial to restrict the use of antimicrobials both in animals and humans, and intervene to prevent foodborne infections.

Keywords: Antimicrobial Resistance, Bloodstream Infection, Health Outcomes, Hospitalisation, Invasive Disease, Multi-Drug Resistance (MDR), Mortality, Nontyphoidal Salmonella

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14331 Between Hope and Despair: Exploring Experiences and Belonging of Return Migrants and Their Children in Albania

Authors: Elida Cena

Abstract:

Return migration is receiving increased attention as the phenomenon challenges assumptions of natural ‘homecomings’. This talk outlines preliminary findings from an ongoing PhD study which explores return migration of Albanian migrants (aged 30-50 years) and their children (aged 7-18 years). Participants (n=51) were purposively recruited from two Albanian cities with divergent social and economic conditions, and the majority had returned from Greece following the recent economic downturn in that country. Qualitative data were collected through in-depth interviews with respondents aged 13 years and above, and were augmented with focus groups and family case studies. Data collection for case studies was aided by photo elicitation, interviews and participatory techniques (drawing) were employed for children aged 7-12 years. Through a multidisciplinary perspective, findings will uncover experiences of migrants and children upon return, the quest to identify with the originating country and create a sense of belongingness. Narrative analysis reveals that the abrupt return was associated with ambivalent feelings and disillusionment about their (re)settlement for both younger and older participants. Faced with unexpected realities and lack of opportunities, particularly for the children of migrants, Albania is viewed as a ‘transit country’, a temporary solution to escape the crisis in the destination country and move to a more developed western country. Adult return migrants articulate lack of employment and insecurity for the future. Apart from school difficulties, children experience isolation and social exclusion, marked by stigmatized labelling from other peers which exacerbates their belonging. Such mobilities have had deeper effects in complicating family relationships as influenced by many disintegration factors. Feelings of alienation and being emigrant for the second time were common in participants' accounts. Findings concerning the difficulties of individuals (re)connecting with their ethnic background and the impact on their identities are discussed in relation to the literature on return migration and identification.

Keywords: return migration, belonging, identity, disintegration, integration

Procedia PDF Downloads 356
14330 The Role of Hypothalamus Mediators in Energy Imbalance

Authors: Maftunakhon Latipova, Feruza Khaydarova

Abstract:

Obesity is considered a chronic metabolic disease that occurs at any age. Regulation of body weight in the body is carried out through complex interaction of a complex of interrelated systems that control the body's energy system. Energy imbalance is the cause of obesity and overweight, in which the supply of energy from food exceeds the energy needs of the body. Obesity is closely related to impaired appetite regulation, and a hypothalamus is a key place for neural regulation of food consumption. The nucleus of the hypothalamus is connected and interdependent on receiving, integrating and sending hunger signals to regulate appetite. Purpose of the study: to identify markers of food behavior. Materials and methods: The screening was carried out to identify eating disorders in 200 men and women aged 18 to 35 years with overweight and obesity and to check the effects of Orexin A and Neuropeptide Y markers. A questionnaire and questionnaires were conducted with over 200 people aged 18 to 35 years. Questionnaires were for eating disorders and hidden depression (on the Zang scale). Anthropometry is measured by OT, OB, BMI, Weight, and Height. Based on the results of the collected data, 3 groups were divided: People with obesity, People with overweight, Control Group of Healthy People. Results: Of the 200 analysed persons, 86% had eating disorders. Of these, 60% of eating disorders were associated with childhood. According to the Zang test result: Normal condition was about 37%, mild depressive disorder 20%, moderate depressive disorder 25% and 18% of people suffered from severe depressive disorder without knowing it. One group of people with obesity had eating disorders and moderate and severe depressive disorder, and group 2 was overweight with mild depressive disorder. According to laboratory data, the first group had the lowest concentration of Orexin A and Neuropeptide U in blood serum. Conclusions: Being overweight and obese are the first signal of many diseases, and prevention and detection of these disorders will prevent various diseases, including type 2 diabetes. Obesity etiology is associated with eating disorders and signal transmission of the orexinorghetic system of the hypothalamus.

Keywords: obesity, endocrinology, hypothalamus, overweight

Procedia PDF Downloads 64
14329 The Impact of Gold Mining on Disability: Experiences from the Obuasi Municipal Area

Authors: Mavis Yaa Konadu Agyemang

Abstract:

Despite provisions to uphold and safeguard the rights of persons with disability in Ghana, there is evidence that they still encounter several challenges which limit their full and effective involvement in mainstream society, including the gold mining sector. The study sought to explore how persons with physical disability (PWPDs) experience gold mining in the Obuasi Municipal Area. A qualitative research design was used to discover and understand the experiences of PWPDs regarding mining. The purposive sampling technique was used to select five key informants for the study with the age range of (24-52 years) while snowball sampling aided the selection of 16 persons with various forms of physical disability with the age range of (24-60 years). In-depth interviews were used to gather data. The interviews lasted from forty-five minutes to an hour. In relation to the setting, the interviews of thirteen (13) of the participants with disability were done in their houses, two (2) were done on the phone, and one (1) was done in the office. Whereas the interviews of the five (5) key informants were all done in their offices. Data were analyzed using Creswell’s (2009) concept of thematic analysis. The findings suggest that even though land degradation affected everyone in the area, persons with mobility and visual impairment experienced many difficulties trekking the undulating land for long distances in search of arable land. Also, although mining activities are mostly labour-intensive, PWPDs were not employed even in areas where they could work. Further, the cost of items, in general, was high, affecting PWPDs more due to their economic immobility and paying for other sources of water due to land degradation and water pollution. The study also discovered that the peculiar conditions of PWPDs were not factored into compensation payments, and neither were females with physical disability engaged in compensation negotiations. Also, although some of the infrastructure provided by the gold mining companies in the area was physically accessible to some extent, it was not accessible in terms of information delivery. There is a need to educate the public on the effects of mining on PWPDs, their needs as well as disability issues in general. The Minerals and Mining Act (703) should be amended to include provisions that would consider the peculiar needs of PWPDs in compensation payment.

Keywords: mining, resettlement, compensation, environmental, social, disability

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14328 Prevalence and Risk Factors of Low Back Disorder among Waste Collection Workers: A Systematic Review

Authors: Benedicta Asante, Catherine Trask, Brenna Bath

Abstract:

Background: Waste Collection Workers’ (WCWs) activities contribute greatly to the recycling sector and are an important component of the waste management industry. As the recycling sector evolves, there is the increase in reports of injuries, particularly for common and debilitating musculoskeletal disorders such as low back disorder (LBD). WCWs are likely exposed to diverse work-related hazards that could contribute to LBD. However, there is currently no summary of the state of knowledge on the prevalence and risk factors of LBD within this workforce. Method: A comprehensive search was conducted in Ovid Medline, EMBASE, and Global Health e-publications with search term categories ‘low back disorder’ and ‘waste collection workers’. Two reviewers screened articles at title, abstract, and full-text stages. Data were extracted on study design, sampling strategy, socio-demographics, geographical region, and exposure definition, the definition of LBD, response rate, statistical techniques, LBD prevalence and risk factors. The risk of bias was assessed with a standardized tool. Results: The search of three databases generated 79 studies. Thirty-two studies met the study inclusion criteria for both title and abstract; only thirteen full-text articles met the study criteria and underwent data extraction. The majority of articles reported a 12-month prevalence of LBD between 16-74%. Although none of the included studies quantified relationships between risk factors and LBD, the suggested risk factors for LBD among WCWs included: awkward posture; lifting; pulling; pushing; repetitive motions; work duration; and physical loads. Conclusion: LBD is a major occupational health issue among WCWs. In light of these risks and future growth in this industry, further research should focus on the investigation of risk factors, with more focus on ergonomic exposure assessment, and LBD prevention efforts.

Keywords: low back pain, scavenger, waste pickers, waste collection workers

Procedia PDF Downloads 246
14327 Present Status, Driving Forces and Pattern Optimization of Territory in Hubei Province, China

Authors: Tingke Wu, Man Yuan

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“National Territorial Planning (2016-2030)” was issued by the State Council of China in 2017. As an important initiative of putting it into effect, territorial planning at provincial level makes overall arrangement of territorial development, resources and environment protection, comprehensive renovation and security system construction. Hubei province, as the pivot of the “Rise of Central China” national strategy, is now confronted with great opportunities and challenges in territorial development, protection, and renovation. Territorial spatial pattern experiences long time evolution, influenced by multiple internal and external driving forces. It is not clear what are the main causes of its formation and what are effective ways of optimizing it. By analyzing land use data in 2016, this paper reveals present status of territory in Hubei. Combined with economic and social data and construction information, driving forces of territorial spatial pattern are then analyzed. Research demonstrates that the three types of territorial space aggregate distinctively. The four aspects of driving forces include natural background which sets the stage for main functions, population and economic factors which generate agglomeration effect, transportation infrastructure construction which leads to axial expansion and significant provincial strategies which encourage the established path. On this basis, targeted strategies for optimizing territory spatial pattern are then put forward. Hierarchical protection pattern should be established based on development intensity control as respect for nature. By optimizing the layout of population and industry and improving the transportation network, polycentric network-based development pattern could be established. These findings provide basis for Hubei Territorial Planning, and reference for future territorial planning in other provinces.

Keywords: driving forces, Hubei, optimizing strategies, spatial pattern, territory

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14326 Carbon Nanotubes Functionalization via Ullmann-Type Reactions Yielding C-C, C-O and C-N Bonds

Authors: Anna Kolanowska, Anna Kuziel, Sławomir Boncel

Abstract:

Carbon nanotubes (CNTs) represent a combination of lightness and nanoscopic size with high tensile strength, excellent thermal and electrical conductivity. By now, CNTs have been used as a support in heterogeneous catalysis (CuCl anchored to pre-functionalized CNTs) in the Ullmann-type coupling with aryl halides toward formation of C-N and C-O bonds. The results indicated that the stability of the catalyst was much improved and the elaborated catalytic system was efficient and recyclable. However, CNTs have not been considered as the substrate itself in the Ullmann-type reactions. But if successful, this functionalization would open new areas of CNT chemistry leading to enhanced in-solvent/matrix nanotube individualization. The copper-catalyzed Ullmann-type reaction is an attractive method for the formation of carbon-heteroatom and carbon-carbon bonds in organic synthesis. This condensation reaction is usually conducted at temperature as high as 200 oC, often in the presence of stoichiometric amounts of copper reagent and with activated aryl halides. However, a small amount of organic additive (e.g. diamines, amino acids, diols, 1,10-phenanthroline) can be applied in order to increase the solubility and stability of copper catalyst, and at the same time to allow performing the reaction under mild conditions. The copper (pre-)catalyst is prepared by in situ mixing of copper salt and the appropriate chelator. Our research is focused on the application of Ullmann-type reaction for the covalent functionalization of CNTs. Firstly, CNTs were chlorinated by using iodine trichloride (ICl3) in carbon tetrachloride (CCl4). This method involves formation of several chemical species (ICl, Cl2 and I2Cl6), but the most reactive is the dimer. The fact (that the dimer is the main individual in CCl4) is the reason for high reactivity and possibly high functionalization levels of CNTs. This method, indeed, yielded a notable amount of chlorine onto the MWCNT surface. The next step was the reaction of CNT-Cl with three substrates: aniline, iodobenzene and phenol for the formation C-N, C-C and C-O bonds, respectively, in the presence of 1,10-phenanthroline and cesium carbonate (Cs2CO3) as a base. As the CNT substrates, two multi-wall CNT (MWCNT) types were used: commercially available Nanocyl NC7000™ (9.6 nm diameter, 1.5 µm length, 90% purity) and thicker MWCNTs (in-house) synthesized in our laboratory using catalytic chemical vapour deposition (c-CVD). In-house CNTs had diameter ranging between 60-70 nm and length up to 300 µm. Since classical Ullmann reaction was found as suffering from poor yields, we have investigated the effect of various solvents (toluene, acetonitrile, dimethyl sulfoxide and N,N-dimethylformamide) on the coupling of substrates. Owing to the fact that the aryl halides show the reactivity order of I>Br>Cl>F, we have also investigated the effect of iodine presence on CNT surface on reaction yield. In this case, in first step we have used iodine monochloride instead of iodine trichloride. Finally, we have used the optimized reaction conditions with p-bromophenol and 1,2,4-trihydroxybenzene for the control of CNT dispersion.

Keywords: carbon nanotubes, coupling reaction, functionalization, Ullmann reaction

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14325 Older Adults’ Coping during a Pandemic

Authors: Aditya Jayadas

Abstract:

During a pandemic like the one we are in with COVID-19, older adults, especially those who live in a senior retirement facility, experience even bigger challenges as they are often dependent on other individuals for care. Many older adults are dependent on caregivers to assist with their instrumented activities of daily living (IADL). With travel restrictions imposed during a pandemic, there is a critical need to ensure that older adults who are homebound continue to be able to participate in physical exercise, cognitive exercise, and social interaction programs. The objective of this study was to better understand the challenges that older adults faced during the pandemic and what they were doing specifically to cope with the pandemic physically, mentally, and through social interaction. A focus group was conducted with ten older adults (age: 82.70 ± 7.81 years; nine female and one male) who resided in a senior retirement facility. During the course of one hour, seven open-ended questions were posed to the participants: a) What has changed in your life since the start of the pandemic, b) What has been most challenging for you, c) What are you doing to take care of yourself, d) Are you doing anything specifically as it relates to your physical health, e) Are you doing anything specifically as it relates to your mental health, f) What did you do for social interaction during the pandemic, g) Is there anything else you would like to share as it relates to your experience during the pandemic. The focus group session was audio-taped, and verbatim transcripts were created to evaluate the responses of the participants. The transcript consisted of 4,698 words and 293 lines of text. The data was analyzed using content analysis. The unit of analysis was the text from the audio recordings that were transcribed. From the review of the transcribed text, themes and sub-themes were identified, along with salient quotes under each sub-theme. The major themes that emerged from the data were: having a routine, engaging in activities, attending exercise classes, use of technology, family, community, and prayer. The quotes under the sub-themes provided compelling evidence of how older adults coped during the pandemic while addressing the challenges they faced and developing strategies to address their physical and mental health while interacting with others. Lessons learned from this focus group can be used to develop specific physical exercise, cognitive exercise, and social interaction programs that benefit the health and well-being of older adults.

Keywords: cognitive exercise, pandemic, physical exercise, social interaction

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14324 A User-Side Analysis of the Public-Private Partnership: The Case of the New Bundang Subway Line in South Korea

Authors: Saiful Islam, Deuk Jong Bae

Abstract:

The purpose of this study is to examine citizen satisfaction and competitiveness of a Public Private Partnership project. The study focuses on PPP in the transport sector and investigates the New Bundang Subway Line (NBL) in South Korea as the object of a case study. Most PPP studies are dominated by the study of public and private sector interests, which are classified in to three major areas comprising of policy, finance, and management. This study will explore the user perspective by assessing customer satisfaction upon NBL cost and service quality, also the competitiveness of NBL compared to other alternative transport modes which serve the Jeongja – Gangnam trip or vice versa. The regular Bundang Subway Line, New Bundang Subway Line, bus and private vehicle are selected as the alternative transport modes. The study analysed customer satisfaction of NBL and citizen’s preference of alternative transport modes based on a survey in Bundang district, South Korea. Respondents were residents and employees who live or work in Bundang city, and were divided into the following areas Pangyo, Jeongjae – Sunae, Migeun – Ori – Jukjeon, and Imae – Yatap – Songnam. The survey was conducted in January 2015 for two weeks, and 753 responses were gathered. By applying the Hedonic Utility approach, the factors which affect the frequency of using NBL were found to be overall customer satisfaction, convenience of access, and the socio economic demographic of the individual. In addition, by applying the Analytic Hierarchy Process (AHP) method, criteria factors influencing the decision to select alternative transport modes were identified. Those factors, along with the author judgement of alternative transport modes, and their associated criteria and sub-criteria produced a priority list of user preferences regarding their alternative transport mode options. The study found that overall the regular Bundang Subway Line (BL), which was built and operated under a conventional procurement method was selected as the most preferable transport mode due to its cost competitiveness. However, on the sub-criteria level analysis, the NBL has competitiveness on service quality, particularly on journey time. By conducting a sensitivity analysis, the NBL can become the first choice of transport by increasing the NBL’s degree of weight associated with cost by 0,05. This means the NBL would need to reduce either it’s fare cost or transfer fee, or combine those two cost components to reduce the total of the current cost by 25%. In addition, the competitiveness of NBL also could be obtained by increasing NBL convenience through escalating access convenience such as constructing an additional station or providing more access modes. Although these convenience improvements would require a few extra minutes of journey time, the user found this to be acceptable. The findings and policy suggestions can contribute to the next phase of NBL development, showing that consideration should be given to the citizen’s voice. The case study results also contribute to the literature of PPP projects specifically from a user side perspective.

Keywords: public private partnership, customer satisfaction, public transport, new Bundang subway line

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14323 Characterization of Bio-Inspired Thermoelastoplastic Composites Filled with Modified Cellulose Fibers

Authors: S. Cichosz, A. Masek

Abstract:

A new cellulose hybrid modification approach, which is undoubtedly a scientific novelty, is introduced. The study reports the properties of cellulose (Arbocel UFC100 – Ultra Fine Cellulose) and characterizes cellulose filled polymer composites based on an ethylene-norbornene copolymer (TOPAS Elastomer E-140). Moreover, the approach of physicochemical two-stage cellulose treatment is introduced: solvent exchange (to ethanol or hexane) and further chemical modification with maleic anhydride (MA). Furthermore, the impact of the drying process on cellulose properties was investigated. Suitable measurements were carried out to characterize cellulose fibers: spectroscopic investigation (Fourier Transform Infrared Spektrofotometer-FTIR, Near InfraRed spectroscopy-NIR), thermal analysis (Differential scanning calorimetry, Thermal gravimetric analysis ) and Karl Fischer titration. It should be emphasized that for all UFC100 treatments carried out, a decrease in moisture content was evidenced. FT-IR reveals a drop in absorption band intensity at 3334 cm-1, the peak is associated with both –OH moieties and water. Similar results were obtained with Karl Fischer titration. Based on the results obtained, it may be claimed that the employment of ethanol contributes greatly to the lowering of cellulose water absorption ability (decrease of moisture content to approximately 1.65%). Additionally, regarding polymer composite properties, crucial data has been obtained from the mechanical and thermal analysis. The highest material performance was noted in the case of the composite sample that contained cellulose modified with MA after a solvent exchange with ethanol. This specimen exhibited sufficient tensile strength, which is almost the same as that of the neat polymer matrix – in the region of 40 MPa. Moreover, both the Payne effect and filler efficiency factor, calculated based on dynamic mechanical analysis (DMA), reveal the possibility of the filler having a reinforcing nature. What is also interesting is that, according to the Payne effect results, fibers dried before the further chemical modification are assumed to allow more regular filler structure development in the polymer matrix (Payne effect maximum at 1.60 MPa), compared with those not dried (Payne effect in the range 0.84-1.26 MPa). Furthermore, taking into consideration the data gathered from DSC and TGA, higher thermal stability is obtained in case of the materials filled with fibers that were dried before the carried out treatments (degradation activation energy in the region of 195 kJ/mol) in comparison with the polymer composite samples filled with unmodified cellulose (degradation activation energy of approximately 180 kJ/mol). To author’s best knowledge this work results in the introduction of a novel, new filler hybrid treatment approach. Moreover, valuable data regarding the properties of composites filled with cellulose fibers of various moisture contents have been provided. It should be emphasized that plant fiber-based polymer bio-materials described in this research might contribute significantly to polymer waste minimization because they are more readily degraded.

Keywords: cellulose fibers, solvent exchange, moisture content, ethylene-norbornene copolymer

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14322 Geomechanical Numerical Modeling of Well Wall in Drilling with Finite Difference Method

Authors: Marzieh Zarei

Abstract:

Well instability is one of the most fundamental challenges faced by the oil and gas industry. Well wall stability analysis is a gap to be filled in the oil industry. The collection of static data such as well logging leads to the construction of a geomechanical numerical model, which will help in assessing the probable risks in future drilling. In this paper, geomechanical model was designed, and mechanical properties of the rock was determined at all points of the model. It was found the safe mud window was determined and the minimum and maximum mud pressures were determined in the ranges of 70-60 MPa and 110-100 MPa, respectively.

Keywords: geomechanics, numerical model, well stability, in-situ stress, underbalanced drilling

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14321 Insight into the Physical Ageing of Poly(Butylene Succinate)

Authors: I. Georgousopoulou, S. Vouyiouka, C. Papaspyrides

Abstract:

The hydrolytic degradation of poly(butylene succinate) (PBS) was investigated when exposed to different humidity-temperature environments. To this direction different PBS grades were submitted to hydrolysis runs. Results indicated that the increment of hydrolysis temperature and relative humidity induced significant decrease in the molecular weight and thermal properties of the bioplastic. Τhe derived data can be considered to construct degradation kinetics based on carboxyl content variation versus time.

Keywords: hydrolytic degradation, physical ageing, poly(butylene succinate), polyester

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14320 Cultivating Students’ Competences through Social Innovation Education

Authors: Ioanna Garefi, Irene Kalemaki

Abstract:

Education is not solely about preparing young people for the world of work but also about equipping them with competences that will enable them to become socially proactive, empowered, responsible, and engaged citizens who will collectively contribute to and benefit from an inclusive and sustainable future. Hence, progress assessment towards competence development is an ongoing process where continuous efforts are needed. This paper abstract presents the work of the H2020 NEMESIS project that aims to investigate, experiment and co-create together with schools a model for introducing and embedding social innovation education (SIE henceforth) in European primary and secondary schools. All in all, during the 2018-2019 academic year, 8 schools from 5 European countries involving 56 teachers, 1030 students, and 80 external stakeholders, experimented with different methodologies for embedding SIE in their contexts. This paper captures briefly the impact of these efforts towards the cultivation and progression of students’ social innovation (SI henceforth) competences. As part of the model, 14 SI competences, whose progress was evaluated, have been introduced falling under 3 interrelated categories: competences for identifying opportunities for social and collective value creation, competences for developing collaborations and building meaningful relations and competences for taking action both on an individual and collective level. Methodologically wise, the evaluation strategy employed was informed by a realist approach, enabling the researchers to go beyond synthesizing 'what happened' and towards understanding 'why it happened', delving into ‘what works, for whom and in what circumstances’. The reason for choosing such an approach was because it goes beyond attempting to answer the basic yes or no question of evaluation and focus on an ‘explanatory quest’ tracing the limits of when and where intervention is effective. A rich mix of sources of evidence have been employed, from focus groups with 80 people from the 5 EU countries to an online survey to 206 students, classroom observations, students’ narratives granting them with the opportunity to freely express their opinions, short stories letting students express their feelings through their imagination and also, drawings so that younger children can express their perception of reality. All these evidences offered insights on the impact of SIE on the development of students’ competences. Research findings showed that students progressed in all 14 SI competences through their involvement in the different activities. This positive progression is attributed to the model’s three core principles: 1) the student-centered approach, rendering students active and self-determined producers of their own learning, 2) the co-creation process fostering intergenerational interactions, empowering thus students by making their voices heard and valued and also, 3) the transformative social action whereby through their projects, students are able to witness the impact they are bringing about with their actions. Concluding, these initial findings, together with the forthcoming evaluation research to a pool of 30 schools around Europe, have the potential to raise the dynamics of the under-investigated field of SIE and encourage its embeddedness in more schools around Europe.

Keywords: competence development, education, social innovation, students

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14319 Concept of Tourist Village on Kampung Karaton of Karaton Kasunanan Surakarta, Central Java, Indonesia

Authors: Naniek Widayati Priyomarsono

Abstract:

Introduction: In beginning of Karaton formation, namely, era of Javanese kingdom town had the power region outside castle town (called as Mancanegara), settlement of karaton can function as “the space-between” and “space-defense”, besides it was one of components from governmental structure and karaton power at that time (internal servant/abdi dalem and sentana dalem). Upon the Independence of Indonesia in 1945 “Kingdom-City” converted its political status into part of democratic town managed by statutes based on the classification. The latter affects local culture hierarchy alteration due to the physical development and events. Dynamics of social economy activities in Kampung Karaton surrounded by buildings of Complex of Karaton Kasunanan ini, have impact on the urban system disturbed into the región. Also cultural region image fades away with the weak visual access from existant cultural artefacts. That development lacks of giving appreciation to the established region image providing identity of Karaton Kasunanan particularly and identity of Surakarta city in general. Method used is strategy of grounded theory research (research providing strong base of a theory). Research is focused on actors active and passive relevantly getting involved in change process of Karaton settlement. Data accumulated is “Investigation Focus” oriented on actors affecting that change either internal or external. Investigation results are coupled with field observation data, documentation, literature study, thus it takes accurate findings. Findings: Karaton village has potential products as attraction, possessing human resource support, strong motivation from society still living in that settlement, possessing facilities and means supports, tourism event-supporting facilities, cultural art institution, available fields or development area. Data analyzed: To get the expected result it takes restoration in social cultural development direction, and economy, with ways of: Doing social cultural development strategy, economy, and politics. To-do steps are program socialization of Karaton village as Tourism Village, economical development of local society, regeneration pattern, filtering, and selection of tourism development, integrated planning system development, development with persuasive approach, regulation, market mechanism, social cultural event sector development, political development for region activity sector. Summary: In case the restoration is done by getting society involved as subject of that settlement (active participation in the field), managed and packed interestingly and naturally with tourism-supporting facilities development, village of Karaton Kasunanan Surakarta is ready to receive visit of domestic and foreign tourists.

Keywords: karaton village, finding, restoration, economy, Indonesia

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14318 Exploring the Facets of Sexuality among Older Adults

Authors: Vivienne Cloude C. Bersabe, Nuelle Anne Castro, Christy P. Gonzales, Nathalie Ann D. Ocbo, Araceli Chuwaley C. Padcayan, Michelle Gaile Lianne S. Peralta, Cecile A. Perez, Eiden Mae A. Roque, Frances Bea S. Sabaten, Korina Louise A. Saculles, Jada Kristen O. Taska, Jose Reinhard C. Laoingco, Don Leonardo N. Dacumos

Abstract:

The rationale of the study: Since discussion about sexuality is considered taboo in the Filipino culture, provision of quality holistic care often lacks sexuality aspect. This research was conducted to highlight the need for nurses to incorporate sexuality in their care of older adults. Research Objectives: To measure the levels of older adults’ sexual desire, sexual behavior, and sexual intimacy and relate them to sex, living arrangement, educational level, and presence of chronic illness, whether with or without treatment. Methods: This study is of quantitative descriptive design that utilized purposive sampling. 400 older adults of Baguio City participated. The study used a 30 point researcher-made questionnaire, one-on-one interview and focused group discussion to gather data. Data were treated using weighted mean, t-test, F-test, and Scheffe's test. Results and Conclusions: The overall findings revealed that Filipino older adults have a low level of sexuality expressed by the participants’ sexual desire, behavior, and intimacy. Males have significantly higher level of sexual desire, behavior, and intimacy. Living arrangement does not seem to influence the level of sexuality in all its 3 facets. Sexual desire was significantly higher among those with tertiary education and without chronic illness. Recommendation: It is recommended that nurses carry out their assessment of clients to include the exploration of their sexuality especially the older adults. A similar study may be done to explore other variables like demographic location, i.e., rural or urban setting; socio-cultural factors; and functional performance status. It is also recommended that a similar study may be done exploring the different facets of sexuality among homosexual older persons.

Keywords: geriatrics, older adults, Philippines, sexuality

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14317 Innovation in "Low-Tech" Industries: Portuguese Footwear Industry

Authors: Antonio Marques, Graça Guedes

Abstract:

The Portuguese footwear industry had in the last five years a remarkable performance in the exportation values, the trade balance and others economic indicators. After a long period of difficulties and with a strong reduction of companies and employees since 1994 until 2009, the Portuguese footwear industry changed the strategy and is now a success case between the international players of footwear. Only the Italian industry sells footwear with a higher value than the Portuguese and the distance between them is decreasing year by year. This paper analyses how the Portuguese footwear companies innovate and make innovation, according the classification proposed by the Oslo Manual. Also analyses the strategy follow in the innovation process, as suggested by Freeman and Soete, and shows the linkage between the type of innovation and the strategy of innovation. The research methodology was qualitative and the strategy for data collection was the case study. The qualitative data will be analyzed with the MAXQDA software. The economic results of the footwear companies studied shows differences between all of them and these differences are related with the innovation strategy adopted. The companies focused in product and marketing innovation, oriented to their target market, have higher ratios “turnover per worker” than the companies focused in process innovation. However, all the footwear companies in this “low-tech” industry create value and contribute to a positive foreign trade of 1.310 million euros in 2013. The growth strategies implemented has the participation of the sectorial organizations in several innovative projects. And it’s obvious that cooperation between all of them is a critical element to the performance achieved by the companies and the innovation observed. Can conclude that the Portuguese footwear sector has in the last years an excellent performance (economic results, exportation values, trade balance, brands and international image) and his performance is strongly related with the strategy in innovation followed, the type of innovation and the networks in the cluster. A simplified model, called “Ace of Diamonds”, is proposed by the authors and explains the way how this performance was reached by the seven companies that participate in the study (two of them are the leaders in the setor), and if this model can be used in others traditional and “low-tech” industries.

Keywords: footwear, innovation, “low-tech” industry, Oslo manual

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14316 Influence of Emotional Intelligence on Educational Supervision and Leadership Style in Saudi Arabia

Authors: Jawaher Bakheet Almudarra

Abstract:

An Educational Supervisor assists teachers to develop their competence and skills in teaching, solving educational problems, and to improve the teaching methods to suit the educational process. They evaluate their teachers and write reports based on their assessments. In 1957, the Saudi Ministry of Education instituted Educational Supervision to facilitate effective management of schools, however, there have been concerns that the Educational Supervision has not been effective in executing its mandate. Studies depicted that Educational supervision has not been effective because it has been marred by poor and autocratic leadership practices such as stringent inspection, commanding and judging. Therefore, there is need to consider some of the ways in which school outcomes can be enhanced through the improvement of Educational supervision practices. Emotional intelligence is a relatively new concept that can be integrated into the Saudi education system that is yet to be examined in-depth and embraced particularly in the realm of educational leadership. Its recognition and adoption may improve leadership practices among Educational supervisors. This study employed a qualitative interpretive approach that will focus on decoding, describing and interpreting the connection between emotional intelligence and leadership. The study also took into account the social constructions that include consciousness, language and shared meanings. The data collection took place in the Office of Educational Supervisors in Riyadh and involved 4 Educational supervisors and 20 teachers from both genders- male and female. The data collection process encompasses three methods namely; qualitative emotional intelligence self-assessment questionnaires, reflective semi-structured interviews, and open workshops. The questionnaires would explore whether the Educational supervisors understand the meaning of emotional intelligence and its significance in enhancing the quality of education system in Saudi Arabia. Subsequently, reflective semi-structured interviews were carried out with the Educational supervisors to explore the connection between their leadership styles and the way they conceptualise their emotionality. The open workshops will include discussions on emotional aspects of Educational supervisors’ practices and how Educational supervisors make use of the emotional intelligence discourse in their leadership and supervisory relationships.

Keywords: directors of educational supervision, emotional intelligence, educational leadership, education management

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14315 Valuing Social Sustainability in Agriculture: An Approach Based on Social Outputs’ Shadow Prices

Authors: Amer Ait Sidhoum

Abstract:

Interest in sustainability has gained ground among practitioners, academics and policy-makers due to growing stakeholders’ awareness of environmental and social concerns. This is particularly true for agriculture. However, relatively little research has been conducted on the quantification of social sustainability and the contribution of social issues to the agricultural production efficiency. This research's main objective is to propose a method for evaluating prices of social outputs, more precisely shadow prices, by allowing for the stochastic nature of agricultural production that is to say for production uncertainty. In this article, the assessment of social outputs’ shadow prices is conducted within the methodological framework of nonparametric Data Envelopment Analysis (DEA). An output-oriented directional distance function (DDF) is implemented to represent the technology of a sample of Catalan arable crop farms and derive the efficiency scores the overall production technology of our sample is assumed to be the intersection of two different sub-technologies. The first sub-technology models the production of random desirable agricultural outputs, while the second sub-technology reflects the social outcomes from agricultural activities. Once a nonparametric production technology has been represented, the DDF primal approach can be used for efficiency measurement, while shadow prices are drawn from the dual representation of the DDF. Computing shadow prices is a method to assign an economic value to non-marketed social outcomes. Our research uses cross sectional, farm-level data collected in 2015 from a sample of 180 Catalan arable crop farms specialized in the production of cereals, oilseeds and protein (COP) crops. Our results suggest that our sample farms show high performance scores, from 85% for the bad state of nature to 88% for the normal and ideal crop growing conditions. This suggests that farm performance is increasing with an improvement in crop growth conditions. Results also show that average shadow prices of desirable state-contingent output and social outcomes for efficient and inefficient farms are positive, suggesting that the production of desirable marketable outputs and of non-marketable outputs makes a positive contribution to the farm production efficiency. Results also indicate that social outputs’ shadow prices are contingent upon the growing conditions. The shadow prices follow an upward trend as crop-growing conditions improve. This finding suggests that these efficient farms prefer to allocate more resources in the production of desirable outputs than of social outcomes. To our knowledge, this study represents the first attempt to compute shadow prices of social outcomes while accounting for the stochastic nature of the production technology. Our findings suggest that the decision-making process of the efficient farms in dealing with social issues are stochastic and strongly dependent on the growth conditions. This implies that policy-makers should adjust their instruments according to the stochastic environmental conditions. An optimal redistribution of rural development support, by increasing the public payment with the improvement in crop growth conditions, would likely enhance the effectiveness of public policies.

Keywords: data envelopment analysis, shadow prices, social sustainability, sustainable farming

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14314 Label Survey in Romania: A Study on How Consumers Use Food Labeling

Authors: Gabriela Iordachescu, Mariana Cretu Stuparu, Mirela Praisler, Camelia Busila, Doina Voinescu, Camelia Vizireanu

Abstract:

The aim of the study was to evaluate the consumers’ degree of confidence in food labeling, how they use and understand the label and respectively food labeling elements. The label is a bridge between producers, suppliers, and consumers. It has to offer enough information in terms of public health and food safety, statement of ingredients, nutritional information, warnings and advisory statements, producing date and shelf-life, instructions for storage and preparation (if required). The survey was conducted on 500 consumers group in Romania, aged 15+, males and females, from urban and rural areas and with different graduation levels. The questionnaire was distributed face to face and online. It had single or multiple choices questions and label images for the efficiency and best understanding of the question. The law 1169/2011 applied to food products from 13 of December 2016 improved and adapted the requirements for labeling in a clear manner. The questions were divided on following topics: interest and general trust in labeling, use and understanding of label elements, understanding of the ingredient list and safety information, nutrition information, advisory statements, serving sizes, best before/use by meanings, intelligent labeling, and demographic data. Three choice selection exercises were also included. In this case, the consumers had to choose between two similar products and evaluate which label element is most important in product choice. The data were analysed using MINITAB 17 and PCA analysis. Most of the respondents trust the food label, taking into account some elements especially when they buy the first time the product. They usually check the sugar content and type of sugar, saturated fat and use the mandatory label elements and nutrition information panel. Also, the consumers pay attention to advisory statements, especially if one of the items is relevant to them or the family. Intelligent labeling is a challenging option. In addition, the paper underlines that the consumer is more careful and selective with the food consumption and the label is the main helper for these.

Keywords: consumers, food safety information, labeling, labeling nutritional information

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14313 Moderating Effects of Family Ownership on the Relationship between Corporate Governance Mechanisms and Financial Performance of Publicly Listed Companies in Nigeria

Authors: Ndagi Salihu

Abstract:

Corporate governance mechanisms are the control measures for ensuring that all the interests groups are equally represented and management are working towards wealth creation in the interest of all. Therefore, there are many empirical studies during the last three decades on corporate governance and firm performance. However, little is known about the effects of family ownership on the relationship between corporate governance and firm performance, especially in the developing economy like Nigeria. This limit our understanding of the unique governance dynamics of family ownership with regards firm performance. This study examined the impact of family ownership on the relationship between governance mechanisms and financial performance of publicly listed companies in Nigeria. The study adopted quantitative research methodology using correlational ex-post factor design and secondary data from annual reports and accounts of a sample of 23 listed companies for a period of 5 years (2014-2018). The explanatory variables are the board size, board composition, board financial expertise, and board audit committee attributes. Financial performance is proxy by Return on Assets (ROA) and Return on Equity (ROE). Multiple panel regression technique of data analysis was employed in the analysis, and the study found that family ownership has a significant positive effect on the relationships between corporate governance mechanisms and financial performance of publicly listed firms in Nigeria. This finding is the same for both the ROA and ROE. However, the findings indicate that board size, board financial expertise, and board audit committee attributes have a significant positive impact on the ROA and ROE of the sample firms after the moderation. Moreover, board composition has significant positive effect on financial performance of the sample listed firms in terms of ROA and ROE. The study concludes that the use of family ownership in the control of firms in Nigeria could improve performance by reducing the opportunistic actions managers as well as agency problems. The study recommends that publicly listed companies in Nigeria should allow significant family ownership of equities and participation in management.

Keywords: profitability, board characteristics, agency theory, stakeholders

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14312 Bridging the Gap between Teaching and Learning: A 3-S (Strength, Stamina, Speed) Model for Medical Education

Authors: Mangala. Sadasivan, Mary Hughes, Bryan Kelly

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Medical Education must focus on bridging the gap between teaching and learning when training pre-clinical year students in skills needed to keep up with medical knowledge and to meet the demands of health care in the future. The authors were interested in showing that a 3-S Model (building strength, developing stamina, and increasing speed) using a bridged curriculum design helps connect teaching and learning and improves students’ retention of basic science and clinical knowledge. The authors designed three learning modules using the 3-S Model within a systems course in a pre-clerkship medical curriculum. Each module focused on a bridge (concept map) designed by the instructor for specific content delivered to students in the course. This with-in-subjects design study included 304 registered MSU osteopathic medical students (3 campuses) ranked by quintile based on previous coursework. The instructors used the bridge to create self-directed learning exercises (building strength) to help students master basic science content. Students were video coached on how to complete assignments, and given pre-tests and post-tests designed to give them control to assess and identify gaps in learning and strengthen connections. The instructor who designed the modules also used video lectures to help students master clinical concepts and link them (building stamina) to previously learned material connected to the bridge. Boardstyle practice questions relevant to the modules were used to help students improve access (increasing speed) to stored content. Unit Examinations covering the content within modules and materials covered by other instructors teaching within the units served as outcome measures in this study. This data was then compared to each student’s performance on a final comprehensive exam and their COMLEX medical board examinations taken some time after the course. The authors used mean comparisons to evaluate students’ performances on module items (using 3-S Model) to non-module items on unit exams, final course exam and COMLEX medical board examination. The data shows that on average, students performed significantly better on module items compared to non-module items on exams 1 and 2. The module 3 exam was canceled due to a university shut down. The difference in mean scores (module verses non-module) items disappeared on the final comprehensive exam which was rescheduled once the university resumed session. Based on Quintile designation, the mean scores were higher for module items than non-module items and the difference in scores between items for Quintiles 1 and 2 were significantly better on exam 1 and the gap widened for all Quintile groups on exam 2 and disappeared in exam 3. Based on COMLEX performance, all students on average as a group, whether they Passed or Failed, performed better on Module items than non-module items in all three exams. The gap between scores of module items for students who passed COMLEX to those who failed was greater on Exam 1 (14.3) than on Exam 2 (7.5) and Exam 3 (10.2). Data shows the 3-S Model using a bridge effectively connects teaching and learning

Keywords: bridging gap, medical education, teaching and learning, model of learning

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14311 The Practice of Low Flow Anesthesia to Reduce Carbon Footprints Sustainability Project

Authors: Ahmed Eid, Amita Gupta

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Abstract: Background: Background Medical gases are estimated to contribute to 5% of the carbon footprints produced by hospitals, Desflurane has the largest impact, but all increase significantly when used with N2O admixture. Climate Change Act 2008, we must reduce our carbon emission by 80% of the 1990 baseline by 2050.NHS carbon emissions have reduced by 18.5% (2007-2017). The NHS Long Term Plan has outlined measures to achieve this objective, including a 2% reduction by transforming anaesthetic practices. FGF is an important variable that determines the utilization of inhalational agents and can be tightly controlled by the anaesthetist. Aims and Objectives Environmental safety, Identification of areas of high N20 and different anaesthetic agents used across the St Helier operating theatres and consider improvising on the current practice. Methods: Data was collected from St Helier operating theatres and retrieved daily from Care Station 650 anaesthetic machines. 60 cases were included in the sample. Collected data (average flow rate, amount and type of agent used, duration of surgery, type of surgery, duration, and the total amount of Air, O2 and N2O used. AAGBI impact anaesthesia calculator was used to identify the amount of CO2 produced and also the cost per hour for every pt. Communication via reminder emails to staff emphasized the significance of low-flow anaesthesia and departmental meeting presentations aimed at heightening awareness of LFA, Distribution of AAGBI calculator QR codes in all theatres enables the calculation of volatile anaesthetic consumption and CO2e post each case, facilitating informed environmental impact assessment. Results: A significant reduction in the flow rate use in the 2nd sample was observed, flow rate usage between 0-1L was 60% which means a great reduction of the consumption of volatile anaesthetics and also Co2e. By using LFA we can save money but most importantly we can make our lives much greener and save the planet.

Keywords: low flow anesthesia, sustainability project, N₂0, Co2e

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14310 Air Pollutants Exposure and Blood High Sensitivity C-Reactive Protein Concentrations in Healthy Pregnant Women

Authors: Gwo-Hwa Wan, Tai-Ho Hung, Fen-Fang Chung, Wan-Ying Lee, Hui-Ching Yang

Abstract:

Air pollutant exposure results in elevated concentrations of oxidative stress and inflammatory biomarkers in general populations. Increased concentrations of inflammatory biomarkers in pregnant women would be associated with preterm labor and low birth weight. To our best knowledge, the associations between air pollutants exposure and inflammation in pregnant women and fetuses are unknown, as well as their effects on fetal growth. This study aimed to evaluate the influences of outdoor air pollutants in northern Taiwan areas on the inflammatory biomarker (high sensitivity C-reactive protein, hs-CRP) concentration in the blood of healthy pregnant women and how the biomarker impacts fetal growth. In this study, 38 healthy pregnant women who are in their first trimester and live in northern Taiwan area were recruited from the Taipei Chang Gung Memorial Hospital. Personal characteristics and prenatal examination data (e.g., blood pressure) were obtained from recruited subjects. The concentrations of inflammatory mediators, hs-CRP, in the blood of healthy pregnant women were analyzed. Additionally, hourly data of air pollutants (PM10, SO2, NO2, O3, CO) concentrations were obtained from air quality monitoring stations in Taipei area, established by the Taiwan Environmental Protection Administration. The definition of lag 0 and lag 01 are the exposure to air pollutants on the day of blood withdrawal, and the average exposure to air pollutants one day before and on the day of blood withdrawal, respectively. The statistical analyses were conducted using SPSS software version 22.0 (SPSS, Inc., Chicago, IL, USA). This analytical result indicates that the healthy pregnant women aged between 28 and 42 years old. The body mass index before pregnancy averaged 21.51 (sd = 2.51) kg/m2. Around 90% of the pregnant women had never smoking habit, and 28.95% of them had allergic diseases. Approximately around 84% and 5.26% of the pregnant women worked at indoor and outdoor environments, respectively. The mean hematocrit level of the pregnant women was 37.10%, and the hemoglobin levels were ranged between 10.1 and 14.7 g/dL with 12.47 g/dL of mean value. The blood hs-CRP concentrations of healthy pregnant women in the first trimester ranged between 0.32 and 32.5 mg/L with 2.83 (sd = 5.69) mg/L of mean value. The blood hs-CRP concentrations were positively associated with ozone concentrations at lag 0-14 (r = 0.481, p = 0.017) in healthy pregnant women. Significant lag effects were identified in ozone at lag 0-14 with a positive excess concentration of blood hs-CRP.

Keywords: air pollutant, hs-CRP, pregnant woman, ozone, first trimester

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14309 Promoting Effective Institutional Governance in Cameroon Higher Education: A Governance Equalizer Perspective

Authors: Jean Patrick Mve

Abstract:

The increasing quest for efficiency, accountability, and transparency has led to the implementation of massive governance reforms among higher education systems worldwide. This is causing many changes in the governance of higher education institutions. Governments over the world are trying to adopt business-like organizational strategies to enhance the performance of higher education institutions. This study explores the changes that have taken place in the Cameroonian higher education sector. It also attempts to draw a picture of the likely future of higher education governance and the actions to be taken for the promotion of institutional effectiveness among higher education institutions. The “governance equalizer” is used as an analytical tool to this end. It covers the five dimensions of the New Public Management (NPM), namely: state regulation, stakeholder guidance, academic self-governance, managerial self-governance, and competition. Qualitative data are used, including semi-structured interviews with key informants at the organizational level and other academic stakeholders, documents and archival data from the university and from the ministry of higher education. It has been found that state regulation among higher education institutions in Cameroon is excessively high, causing the institutional autonomy to be very low, especially at the level of financial management, staffing and promotion, and other internal administrative affairs; at the level of stakeholder guidance there is a higher degree of stakeholders consideration in the academic and research activities among universities, though the government’s interest to keep its hands in most management activities is still high; academic self-governance is also very weak as the assignment of academics is done more on the basis of political considerations than competence; there is no real managerial self-governance among higher education institutions due to the lack of institutional capacity and insufficient autonomy at the level of decision making; there is a plan to promote competition among universities but a real competitive environment is not yet put into place. The study concludes that the government’s policy should make state control more relaxed and concentrate on steering and supervision. As well, real institutional autonomy, professional competence building for top management and stakeholder participation should be considered to guarantee competition and institutional effectiveness.

Keywords: Cameroon higher education, effective institutional governance, governance equalizer, institutional autonomy, institutional effectiveness

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