Search results for: illness perception
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2537

Search results for: illness perception

1007 Uptake of Off-Site Construction: Benefit and Future Application

Authors: Faisal Alazzaz, Andrew Whyte

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Off-site construction methods have played an important role in the construction sector in the past few decades. It is increasingly becoming a major alternative technique and strategic direction compared to traditional in-situ method. It produces a significant amount of value for the construction industry and the economy more generally. To date, an impressive number of studies have been lunched on the perceived perception of off-site construction. However, it seems that a quantifying benefit on the offsite construction area is lacking. Therefore, this paper examines the recent research literature on the benefits of off- site construction and provides future direction. In the beginning, this paper provides a brief history and current value of the off-site construction followed by a detailed discussion on the benefit of off-site construction. These benefits include but not limited to time saving, quality improvement, relieving skills shortages, cost reduction and productivity improvement. Toward this end, off-site construction should learn from other productive industry similar to services or manufacturing industry by applying operational management tools and techniques with extensive focus on employee empowerment will shed the light on future uptake of Off-site construction. This study is of value in providing scholars have a clear picture of perceived benefit of off-site construction research and give an opportunities for future uptake of off-site method.

Keywords: building projects, employer empowerment, off-site construction benefits, productivity

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1006 Sports Fans and Non-Interested Public Recognition of the Problems of Sports in Egypt through Caricature

Authors: Alaaeldin Hamdy Ahmed Mohammed

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Introduction: This study examines sports’ fans and non-interested public perception and recognition of the problems that have negative impacts upon the Egyptian sports, particularly football, through caricatures. Eight caricature paintings were designed to express eight problems affecting the Egyptian sports and its development. These paintings were distributed on two groups of the fans and the non-interested public. Methods: The study was limited to eight caricatures representing the eight issues which are: the impact of stopping the sports activity on athletes, the effect of clubs’ disagreement, fanaticism between the members of the ultras of different clubs, the negative impact of the mingling of politics into sports, the negative role of the clubs affects the professionalism of the promising players, the conflict between the national organization responsible for sports, the breaking in of the fans to the playgrounds, the impact of the lack of planning on the national team. The Results: The results showed that both sports fans and those who are not interested in sports recognized the problems that the caricatures refer to and criticizes exaggeration although the rate was higher for the fans. These caricatures contributed also in their recognition of the danger of the negative impact of these problems on the Egyptian sports, particularly football which is the most common at the Egyptian sports fans. Discussion: This finding echoes the conclusion that caricatures are distinctive in the adults’ facial stimuli that are either systematically exaggerated recognition of them.

Keywords: caricature, fans, football, sports

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1005 International Conference on Comparative Religion and Mythology

Authors: Mara Varelaki

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In response to the challenge of the environmental crisis the discipline of environmental ethics examines the relation of human beings towards the environment and the value of the non-human constituents of the surrounding world. In the face of this crisis, assumptions regarding human and nature relations ought to be traced and reexamined because they can cause difficulties in diagnosing problematic attitudes towards the environment and non-human animals. This paper presents the claims that European and the Judea-Christian cosmogonic myths place the human figure in the core of the creation of the cosmos, thus verifying a hierarchical structure where humans occupy the top, and they establish a perception of nature as a non-human other. By doing so, these narratives provide some justification to the notion of the human-nature dichotomy and the human domination over other life forms and ecosystems. These anthropocentric assumptions evolved into what Hilde Lindemann terms master narratives and their influence extents to ecocentric ethical theories which attempt, and often fail, to shed the anthropocentrism of the western ethical tradition. The goal of this paper is (1) to trace the anthropocentric assumptions embedded in western thought and (2) articulate how they maintain their grip on our contemporary understanding of the human relation to and position within the environment, thus showing the need for a method of detecting and bracketing anthropocentric assumptions in social narratives and ethical frameworks.

Keywords: cosmogonies, anthropocentrism, human/nature dichotomy, master narratives, ecocentrism

Procedia PDF Downloads 103
1004 Evaluation of a Personalized Online Decision Aid for Colorectal Cancer Screening: A Randomized Controlled Trial

Authors: Linda P. M. Pluymen, Mariska M. G. Leeflang, I. Stegeman, Henock G. Yebyo, Anne E. M. Brabers, Patrick M. Bossuyt, E. Dekker, Anke J. Woudstra, Mirjam P. Fransen

Abstract:

Weighing the benefits and harms of colorectal cancer screening can be difficult for individuals. An existing online decision aid was expanded with a benefit-harm analysis to help people make an informed decision about participating in colorectal cancer screening. In a randomized controlled trial, we investigated whether those in the intervention group who used the decision aid with benefit-harm analysis were more certain about their decision than those in the control group who used the decision aid without benefit-harm analysis. Participants were 623 (39% of those invited) men and women aged 45 until 75 years old. Analyses were performed in those 386 participants (62%) who reported to have completed the entire decision aid. No statistically significant differences were observed between intervention and control group in decisional conflict score (mean difference 2.4, 95% CI -0.9, 5.6), clarity of values (mean difference 1.0, 95% CI -4.4, 6.6), deliberation score (mean difference 0.5, 95% CI -0.6, 1.7), anxiety score (mean difference 0.0, 95% CI -0.3, 0.3) and risk perception score (mean difference 0.1, -0.1, 0.3). Adding a benefit-harm analysis to an online decision aid did not improve informed decision making about participating in colorectal cancer screening.

Keywords: benefit-harm analysis, decision aid, informed decision making, personalized decision making

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1003 Combination of Artificial Neural Network Model and Geographic Information System for Prediction Water Quality

Authors: Sirilak Areerachakul

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Water quality has initiated serious management efforts in many countries. Artificial Neural Network (ANN) models are developed as forecasting tools in predicting water quality trend based on historical data. This study endeavors to automatically classify water quality. The water quality classes are evaluated using 6 factor indices. These factors are pH value (pH), Dissolved Oxygen (DO), Biochemical Oxygen Demand (BOD), Nitrate Nitrogen (NO3N), Ammonia Nitrogen (NH3N) and Total Coliform (T-Coliform). The methodology involves applying data mining techniques using multilayer perceptron (MLP) neural network models. The data consisted of 11 sites of Saen Saep canal in Bangkok, Thailand. The data is obtained from the Department of Drainage and Sewerage Bangkok Metropolitan Administration during 2007-2011. The results of multilayer perceptron neural network exhibit a high accuracy multilayer perception rate at 94.23% in classifying the water quality of Saen Saep canal in Bangkok. Subsequently, this encouraging result could be combined with GIS data improves the classification accuracy significantly.

Keywords: artificial neural network, geographic information system, water quality, computer science

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1002 Rejuvenating Cultural Energy: Forging Pathways to Alternative Ecological and Development Paradigms

Authors: Aldrin R. Logdat

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The insights and wisdom of the Alangan Mangyans offer valuable guidance for developing alternative ecological and development frameworks. Their reverence for the sacredness of the land, rooted in their traditional cosmology, guides their harmonious relationship with nature. Through their practice of swidden farming, ecosystem preservation takes precedence as they carefully manage agricultural activities and allow for forest regeneration. This approach aligns with natural processes, reflecting their profound understanding of the natural world. Similar to early advocates like Aldo Leopold, the emphasis is on shifting our perception of land from a commodity to a community. The indigenous wisdom of the Alangan Mangyans provides practical and sustainable approaches to preserving the interdependence of the biotic community and ecosystems. By integrating their cultural heritage, we can transcend the prevailing anthropocentric mindset and foster a meaningful and sustainable connection with nature. The revitalization of cultural energy and the embrace of alternative frameworks require learning from indigenous peoples like the Alangan Mangyans, where reverence for the land and the recognition of the interconnectedness between humanity and nature are prioritized. This paves the way for a future where harmony with nature and the well-being of the Earth community prevail.

Keywords: Alangan Mangyans, ecological frameworks, sacredness of the land, cultural energy

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1001 Impact of COVID-19 Disease on Reproductive Health in Women

Authors: Mikailzade Parvin, Gurbanova Jamila, Alizade Samaya, Hasanova Afat

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It is known that in March 2020, the World Health Organization (WHO) declared a global pandemic of the 2019 coronovirus disease COVID-19, caused by the severe acute respiratory syndrome coronovirus (SARS-CoV-2). In this period, ensuring the safety of pregnancy and childbirth has become one of the necessary issues. The measures taken in this direction naturally consisted of strengthening and improving preventive measures among pregnant women. It should be noted that the lethality of SARS-CoV-2 infection among women reached 25%. The relevance of studying the effect of COVID-19 on reproductive health in women is due to its wide spread worldwide, severe clinical course, and the occurrence of numerous complications or lethality. It is of urgent importance to study the impact of the mentioned coronavirus infection on the health of pregnant women and the serious complications caused by it.Taking these into account, 230 pregnant women infected with the COVID-19 virus infection were registered. The average age of the pregnant women included in the study was: 29.24±6.0. The diagnosis of corona virus infection was made on the basis of polymerase chain reaction (PCR), serological tests (IgG, IgM). In 57.4% of cases, bilateral pneumonia was recorded in pregnant women and confirmed on the basis of radiological (RH) examination. RH examination revealed pneumonia with infiltrate in the lungs. Among clinical symptoms in pregnant women infected with COVID-19 virus infection: in 86 (37.4%) cases, symptoms such as high fever (t-39.0oC), shortness of breath, fatigue, and hypoxia were noted in pregnant women. A decrease in SpO2 to a minimal level was recorded. Laboratory-instrumental examinations were carried out. The obtained results showed: the average limit of D-dimer was 0.8±0.5; prothrombin time 13.2±1.1 seconds; INR 0.98±0.08, prothrombin index 104.3±19.5%, EHS - 34.8±13.6 mm/s. It should be noted that respiratory distress syndrome (RDS), premature birth, malformed and extremely malformed newborns, asphyxia or hypoxia have been reported in infants born to pregnant women infected with the coronavirus disease.Thus, from the obtained indicators, it is known that pregnant women infected with the virus have a high risk of serious illness and death for both themselves and their babies. It has been proven that the majority of babies born to SARS-CoV-2 positive mothers have a negative impact on their health.

Keywords: Covid 19, reproductive health, preqnancy, premature birth

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1000 Language Development in Rare Diseases: Angelman Syndrome vs Prader-Willi Syndrome

Authors: Sara Canas Pedrosa, Esther Moraleda SepuLveda

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Angelman Syndrome (AS) and Prader-Willi Syndrome (PWS) are considered rare genetic disorders that share the same chromosomal region: 15q11.2-q13. This is why both share some common characteristics, such as, delay in language development. However, there is still little research that specifically focuses on the linguistic profile in these populations. Therefore, the objective of this study was to know the characteristics of oral and written language that Angelman Syndrome and Prader-Willi Syndrome present from the point of view of parents. The sample consisted of 36 families (with children between 6 and 17 years old), of which 23 had children with AS and 13 had children with PWS. All of them answered the Language Assessment Scale of the standardized test CELF-4, Spanish Clinical Evaluation of Language Fundamentals-4 (Wiig, Secord & Semel, 2006). The scale is made up of 40 items that assesses the perception of parents in areas such as: difficulty of listening, speaking, reading and writing. The results indicate that the majority of parents manifest problems in almost all the sub-areas related to oral language and written language, taking into account that many do not achieve a literacy level, with similar results in comparison with both syndromes. These data support the importance of working on oral language delay and its relationship with the subsequent learning of literacy throughout its development.

Keywords: Angelman Syndrome , development, language, Prader-Willi Syndrome

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999 Digital Privacy Legislation Awareness

Authors: Henry Foulds, Magda Huisman, Gunther R. Drevin

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Privacy is regarded as a fundamental human right and it is clear that the study of digital privacy is an important field. Digital privacy is influenced by new and constantly evolving technologies and this continuous change makes it hard to create legislation to protect people’s privacy from being exploited by misuse of these technologies.

This study aims to benefit digital privacy legislation efforts by evaluating the awareness and perceived importance of digital privacy legislation among computer science students. The chosen fixed variables for the population are study year and gamer classification.

The use of location based services in mobile applications and games are a concern for digital privacy. For this reason the study focused on computer science students as they have a high likelihood to use and develop this type of software. Surveys were used to evaluate awareness and perceived importance of digital privacy legislation.

The results of the study show that privacy legislation and awareness of privacy legislation are important to people. The perception of the importance of privacy legislation increases with academic experience. Awareness of privacy legislation increases from non-gamers to pro gamers. 

Keywords: digital privacy, legislation awareness, gaming, privacy legislation

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998 Risky Driving Behavior among Bus Driver in Jakarta

Authors: Ratri A. Benedictus, Felicia M. Yolanda

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Public transport is a crucial issue for capital city in developing country, such as Jakarta. Inadequate number and low quality of public transport services resulting personal vehicles as the main option. As a result, traffic jams are getting worse in Jakarta. The low quality of public transport, particularly buses, compounded by the risk behavior of the driver. Traffic accidents involving public bus in Jakarta were often the case, even result in fatality. The purpose of this study is to get a description of risk behavior among the public bus drivers in Jakarta. 132 bus drivers become respondent of this study. Risky Driving Behavior scale of Dorn were used. Data were analyzed using descriptive statistics. 51.5% of respondents felt often showing risky behavior while on driving. The highest type of risky driving behavior is still using the unsafe bus (62%). Followed by trespass the bus line (30%), over speed (21%), violate the road signs (15%) and driving with unhealthy physical condition (4%). Results of this study suggested that high understanding of the bus drivers on their risk behaviors have not lead to the emergence of safe driving behavior. Therefore, together with technical engineering and instrumentation work intervention over this issue, psychological aspects also need to be considered, such as: risk perception, safety attitude,safety culture, locus of control and Fatalism.

Keywords: bus driver, psychological factors, public transportation, risky driving behavior

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997 Pharmaceutical Innovation in Jordan: KAP Analysis

Authors: Abdel Qader Al Bawab, Mohannad Odeh, Rami Amer

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Recently, there has been an increasing interest in innovative business development. Nevertheless, in the pharmacy practice field, there seems to be a gap in perceptions, attitudes, and knowledge about innovation between practicing pharmacists and academia. This study explores this gap and aspects of pharmaceutical innovation in Jordan, comparing pharmacists and last-year pharmacy students. A validated (r2 = 0.74) and reliable (Pearson’s r = 0.88) online questionnaire was designed to assess and compare knowledge, attitude, and perceptions about pharmaceutical innovation. A total of 397 participants (215 pharmacy students and 182 pharmaceutical professionals) responded. Compared with 50% of the pharmacists, only 32.1% of the students claimed that they knew the differences between pharmaceutical innovation, discovery, invention, and entrepreneurship [x2 (2) = 14.238, p = 0.001; Cramer’s V = 0.189]. Pharmacists demonstrated a higher level of trust in the innovative website design for their institution compared with students (25.3% vs. 16.3%, p < 0.001, Cramer’s V = 0.327). However, 60% of the students did not know the innovative design standards for websites, while the corresponding percentage was 37% for the pharmacists (p < 0.001; Cramer’s V = 0.327). The majority of the students were interested in pharmaceutical innovation (81.9%). Unfortunately, 76.3% never studied innovation in their pharmacy curricula. Similarly, most pharmacists (76.4%) considered adopting innovation, but only 30% had a concrete plan. For the field where pharmacists aim to innovate in the next 5 years, new pharmaceutical services were the dominant field (34.6%). Despite a positive attitude and perception, pharmacists and pharmacy students expressed poor knowledge about innovation. Policies to enhance awareness about innovation and professional educational tools should be implemented.

Keywords: pharmacy, innovation, knowledge, attitude, practice

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996 Exploring the Dualistic Nature of Design: Integrative Perspectives and Methodological Approaches in Design Research

Authors: Joni Agung Sudarmanto

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The concept of design has historically been elusive and characterized by its fluidity, leading to divergent viewpoints on its fundamental nature. Guy Julier views design as inherent in material culture, while Sanders sees it as a collective endeavor focusing on the outcome. Design's dualistic nature, procedural and outcome-oriented, spans various domains, including objects, individuals, and the environment. This comprehensive view of design challenges the notion that design practice is distinct from research, highlighting their shared exploratory nature. The article explores methodological techniques in design research and the three prevalent approaches: "into design," "through design," and "for design." The contradictory meanings of design arise from its etymology and its duality as both process and result, leading to its integrative nature across objects, humans, and the environment. The parallels between design and research activities, underscoring their exploratory and knowledge-generating nature, are situated within creative research, challenging the perception of design practice as separate from research endeavors. The "into design" approach encourages interdisciplinary collaboration, enriching design research with diverse perspectives. The "through design" approach bridges theory and practice, producing more practical outcomes. The "for design" approach supports specific design solutions, providing designers with valuable guidance.

Keywords: dualistic nature of design, integrative perspectives, methodological approaches, design research

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995 Being Reticent for Healing – Singularity and Non-Verbalization in Indigenous Medical Practices in Sri Lanka

Authors: Ayami Umemura

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The purpose of this paper is to examine the meaning of verbalization in clinical practice using the keywords silence and singularity. A patient's experience of illness and treatment is singular, irreplaceable, and irreproducible and ultimately cannot be compared with that of others. In his book Difference and Repetition, Gilles Deleuze positioned irreplaceable singularity as the opposite concept of particularity as a generalizable and substitutable property and matched the former with universality. He also said that singularity could not be represented because of its irreplaceable nature. Representation or verbalization is a procedure that converts an irreplaceable, idiosyncratic reality into something that can be substituted. Considering the act of verbalizing medical diagnosis based on this, it can be said that diagnosis is the practice of decontextualizing and generalizing the suffering embedded in the patient's irreplaceable life history as a disease. This paper examines the above with the key concept of the practice of "non-verbalization" in traditional medical practices in Sri Lanka. In the practice of Sri Lankan traditional medicine and the inheritance of medical knowledge and care techniques, there is a tendency to avoid verbalizing specific matters or stating them aloud. Specifically, the following should be avoided. The healer informs the patient of the name of the disease, mentions the name of the herb used in front of the patient, explains the patient's condition to the healer, and referring the names of poisonous animals, such as poisonous snakes that have been damaged. And so on. Furthermore, when passing on medical knowledge and skills, it is also possible to avoid verbalizing knowledge of medicinal herbs and medical treatment methods and explaining them verbally. In addition to the local belief that the soul of language in Sri Lanka is deeply involved in this background, Sri Lankan traditional medicine has a unique view of the human body and personality that is rooted in the singularity that appears in the relationship with the movement of celestial bodies and the supernatural realm. It can be pointed out that it is premised on the view. In other words, the “silence” in Sri Lankan indigenous medicine is the reason for emphasizing specificity. Furthermore, we can say that "non-verbalization" is a practice aimed at healing. Based on these discussions, this paper will focus on the unique relationships between practitioners and patients that become invisible due to verbalization, which is overlooked by clinical medicine, where informed consent, ensuring transparency, and audit culture is dominant. We will examine the experience of treatment and aim to relativize clinical medicine, which is based on audit cultures.

Keywords: audit cultures, indigenous medicine, singularity, verbalization

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994 Soueif’s 'The Returning' and 'The Nativity': A Portrait of the Other as Others

Authors: Samira Brahimi

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Throughout Aisha, her first collection of short stories, Ahdaf Soueif draws a multilayered picture of the Other as others, picturing a series of encounters of her protagonist with this very Other as a set of binary elements. The current essay includes a comparative study between two narratives, namely The Returning and The Nativity. The Other is portrayed as a male/female binary in The Returning and as 'The Foreigner' in an exotic land vs. the local in The Nativity. The analysis is to focus on Aisha, the main female character, who figures as conforming to the portrait of the stereotyped Arab Muslim woman as a sex-subject, submissive, and maudlin character, confining her vision of the Other to the boundaries of her cocooned self, epitomizing a self-centered vision of the world. This reduced vision results in the possibility of viewing the Other as a hindrance to her attaining a clarified and centrifugal representation of the latter, herself, and the outside world. The encounters could also be considered as the character's opportunity for a less stigmatized perception of the elements set forth. The main queries to be probed are: what are the different perceptions of the Other by the author in the narratives set forth? How does the protagonist's encounter with the Other(s) impede her ability to understand the Other, herself, and the world around her? Or how does this encounter allow her an enlightened vision of the aforementioned elements to forge a new start? The possibility of imagining a dialogic relation between different perceptions of the Other opens up new perspectives for adopting magnified representations of the later, oneself, and the world, dilating one's imagination.

Keywords: dialogic, female, foreigner, local, male, other, others

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993 Prevalence of Foodborne Pathogens in Pig and Cattle Carcass Samples Collected from Korean Slaughterhouses

Authors: Kichan Lee, Kwang-Ho Choi, Mi-Hye Hwang, Young Min Son, Bang-Hun Hyun, Byeong Yeal Jung

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Recently, worldwide food safety authorities have been strengthening food hygiene in order to curb foodborne illness outbreaks. The hygiene status of Korean slaughterhouses has been monitored annually by Animal and Plant Quarantine Agency and provincial governments through foodborne pathogens investigation using slaughtered pig and cattle meats. This study presented the prevalence of food-borne pathogens from 2014 to 2016 in Korean slaughterhouses. Sampling, microbiological examinations, and analysis of results were performed in accordance with ‘Processing Standards and Ingredient Specifications for Livestock Products’. In total, swab samples from 337 pig carcasses (100 samples in 2014, 135 samples in 2015, 102 samples in 2016) and 319 cattle carcasses (100 samples in 2014, 119 samples in 2015, 100 samples in 2016) from twenty slaughterhouses were examined for Listeria monocytogenes, Campylobacter jejuni, Campylobacter coli, Salmonella spp., Staphylococcus aureus, Clostridium perfringens, Yersinia enterocolitica, Escherichia coli O157:H7 and non-O157 enterohemorrhagic E. coli (EHEC, serotypes O26, O45, O103, O104, O111, O121, O128 and O145) as foodborne pathogens. The samples were analyzed using cultural and PCR-based methods. Foodborne pathogens were isolated in 78 (23.1%) out of 337 pig samples. In 2014, S. aureus (n=17) was predominant, followed by Y. enterocolitica (n=7), C. perfringens (n=2) and L. monocytogenes (n=2). In 2015, C. coli (n=14) was the most prevalent, followed by L. monocytogenes (n=4), S. aureus (n=3), and C. perfringens (n=2). In 2016, S. aureus (n=16) was the most prevalent, followed by C. coli (n=13), L. monocytogenes (n=2) and C. perfringens (n=1). In case of cattle carcasses, foodborne bacteria were detected in 41 (12.9%) out of 319 samples. In 2014, S. aureus (n=16) was the most prevalent, followed by Y. enterocolitica (n=3), C. perfringens (n=3) and L. monocytogenes (n=2). In 2015, L. monocytogenes was isolated from 4 samples, S. aureus from three, C. perfringens, Y. enterocolitica and Salmonella spp. from one, respectively. In 2016, L. monocytogenes (n=6) was the most prevalent, followed by C. perfringens (n=3) C. jejuni (n=1), respectively. It was found that 10 carcass samples (4 cattle and 6 pigs) were contaminated with two bacterial pathogen tested. Interestingly, foodborne pathogens were more detected from pig carcasses than cattle carcasses. Although S. aureus was predominantly detected in this study, other foodborne pathogens were also isolated in slaughtered meats. Results of this study alerted the risk of foodborne pathogen infection for humans from slaughtered meats. Therefore, the authors insisted that it was important to enhance hygiene level of slaughterhouses according to Hazard Analysis and Critical Control Point.

Keywords: carcass, cattle, foodborne, Korea, pathogen, pig

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992 Medical Ethics in the Hospital: Towards Quality Ethics Consultation

Authors: Dina Siniora, Jasia Baig

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During the past few decades, the healthcare system has undergone profound changes in their healthcare decision-making competencies and moral aptitudes due to the vast advancement in technology, clinical skills, and scientific knowledge. Healthcare decision-making deals with morally contentious dilemmas ranging from illness, life and death judgments that require sensitivity and awareness towards the patient’s preferences while taking into consideration medicine’s abilities and boundaries. As the ever-evolving field of medicine continues to become more scientifically and morally multifarious; physicians and the hospital administrators increasingly rely on ethics committees to resolve problems that arise in everyday patient care. The role and latitude of responsibilities of ethics committees which includes being dispute intermediaries, moral analysts, policy educators, counselors, advocates, and reviewers; suggest the importance and effectiveness of a fully integrated committee. Despite achievements on Integrated Ethics and progress in standards and competencies, there is an imminent necessity for further improvement in quality within ethics consultation services in areas of credentialing, professionalism and standards of quality, as well as the quality of healthcare throughout the system. These concerns can be resolved first by collecting data about particular quality gaps and comprehend the level to which ethics committees are consistent with newly published ASBH quality standards. Policymakers should pursue improvement strategies that target both academic bioethics community and major stakeholders at hospitals, who directly influence ethics committees. This broader approach oriented towards education and intervention outcome in conjunction with preventive ethics to address disparities in quality on a systematic level. Adopting tools for improving competencies and processes within ethics consultation by implementing a credentialing process, upholding normative significance for the ASBH core competencies, advocating for professional Code of Ethics, and further clarifying the internal structures will improve productivity, patient satisfaction, and institutional integrity. This cannot be systemically achieved without a written certification exam for HCEC practitioners, credentialing and privileging HCEC practitioners at the hospital level, and accrediting HCEC services at the institutional level.

Keywords: ethics consultation, hospital, medical ethics, quality

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991 Coping with Climate Change in Agriculture: Perception of Farmers in Oman

Authors: B. S. Choudri

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Introduction: Climate change is a major threat to rural livelihoods and to food security in the developing world, including Oman. The aim of this study is to provide a basis for policymakers and researchers in order to understand the impacts of climate change on agriculture and developing adaptation strategies in Oman. Methodology: The data was collected from different agricultural areas across the country with the help of a questionnaire survey among farmers, discussion with community, and observations at the field level. Results: The analysis of data collected from different areas within the country shows a shift in the sowing period of major crops and increased temperatures over recent years. Farmer community is adopting through diversification of crops, use of heat-tolerant species, and improved measures of soil and water conservation. Agriculture has been the main livelihood for most of the farmer communities in rural areas in the country. Conclusions: In order to reduce the effects of climate change at the local and farmer communities, risk reduction would be important along with an in-depth analysis of the vulnerability. Therefore, capacity building of local farmers and providing them with scientific knowledge, mainstreaming adaptation into development activities would be essential with additional funding and subsidies.

Keywords: agriculture, climate change, vulnerability, adaptation

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990 Stochastic Modeling for Parameters of Modified Car-Following Model in Area-Based Traffic Flow

Authors: N. C. Sarkar, A. Bhaskar, Z. Zheng

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The driving behavior in area-based (i.e., non-lane based) traffic is induced by the presence of other individuals in the choice space from the driver’s visual perception area. The driving behavior of a subject vehicle is constrained by the potential leaders and leaders are frequently changed over time. This paper is to determine a stochastic model for a parameter of modified intelligent driver model (MIDM) in area-based traffic (as in developing countries). The parametric and non-parametric distributions are presented to fit the parameters of MIDM. The goodness of fit for each parameter is measured in two different ways such as graphically and statistically. The quantile-quantile (Q-Q) plot is used for a graphical representation of a theoretical distribution to model a parameter and the Kolmogorov-Smirnov (K-S) test is used for a statistical measure of fitness for a parameter with a theoretical distribution. The distributions are performed on a set of estimated parameters of MIDM. The parameters are estimated on the real vehicle trajectory data from India. The fitness of each parameter with a stochastic model is well represented. The results support the applicability of the proposed modeling for parameters of MIDM in area-based traffic flow simulation.

Keywords: area-based traffic, car-following model, micro-simulation, stochastic modeling

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989 Applying Neural Networks for Solving Record Linkage Problem via Fuzzy Description Logics

Authors: Mikheil Kalmakhelidze

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Record linkage (RL) problem has become more and more important in recent years due to the growing interest towards big data analysis. The problem can be formulated in a very simple way: Given two entries a and b of a database, decide whether they represent the same object or not. There are two classical deterministic and probabilistic ways of solving the RL problem. Using simple Bayes classifier in many cases produces useful results but sometimes they show to be poor. In recent years several successful approaches have been made towards solving specific RL problems by neural network algorithms including single layer perception, multilayer back propagation network etc. In our work, we model the RL problem for specific dataset of student applications in fuzzy description logic (FDL) where linkage of specific pair (a,b) depends on the truth value of corresponding formula A(a,b) in a canonical FDL model. As a main result, we build neural network for deciding truth value of FDL formulas in a canonical model and thus link RL problem to machine learning. We apply the approach to dataset with 10000 entries and also compare to classical RL solving approaches. The results show to be more accurate than standard probabilistic approach.

Keywords: description logic, fuzzy logic, neural networks, record linkage

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988 A Multicenter Assessment on Psychological Well-Being Status among Medical Residents in the United Arab Emirates

Authors: Mahera Abdulrahman

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Objective: Healthcare transformation from traditional to modern in the country recently prompted the need to address career choices, accreditation perception and satisfaction among medical residents. However, a concerted nationwide study to understand and address burnout in the medical residency program has not been conducted in the UAE and the region. Methods: A nationwide, multicenter, cross-sectional study was designed to evaluate professional burnout and depression among medical residents in order to address the gap. Results: Our results indicate that 75.5% (216/286) of UAE medical residents had moderate to high emotional exhaustion, 84% (249/298) had high depersonalization, and 74% (216/291) had a low sense of personal accomplishment. In aggregate, 70% (212/302) of medical residents were considered to be experiencing at least one symptom of burnout based on a high emotional exhaustion score or a high depersonalization score. Depression ranging from 6-22%, depending on the specialty was also striking given the fact the Arab culture lays high emphasis on family bonding. Interestingly 83% (40/48) of medical residents who had high scores for depression also reported burnout. Conclusion: Our data indicate that burnout and depression among medical residents is epidemic. There is an immediate need to address burnout through effective interventions at both the individual and institutional levels. It is imperative to reconfigure the approach to medical training for the well-being of the next generation of physicians in the Arab world.

Keywords: mental health, Gulf, Arab, residency training, burnout, depression

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987 Casusation and Criminal Responsibility

Authors: László Schmidt

Abstract:

“Post hoc ergo propter hoc” means after it, therefore because of it. In other words: If event Y followed event X, then event Y must have been caused by event X. The question of causation has long been a central theme in philosophical thought, and many different theories have been put forward. However, causality is an essentially contested concept (ECC), as it has no universally accepted definition and is used differently in everyday, scientific, and legal thinking. In the field of law, the question of causality arises mainly in the context of establishing legal liability: in criminal law and in the rules of civil law on liability for damages arising either from breach of contract or from tort. In the study some philosophical theories of causality will be presented and how these theories correlate with legal causality. It’s quite interesting when philosophical abstractions meet the pragmatic demands of jurisprudence. In Hungarian criminal judicial practice the principle of equivalence of conditions is the generally accepted and applicable standard of causation, where all necessary conditions are considered equivalent and thus a cause. The idea is that without the trigger, the subsequent outcome would not have occurred; all the conditions that led to the subsequent outcome are equivalent. In the case where the trigger that led to the result is accompanied by an additional intervening cause, including an accidental one, independent of the perpetrator, the causal link is not broken, but at most the causal link becomes looser. The importance of the intervening causes in the outcome should be given due weight in the imposition of the sentence. According to court practice if the conduct of the offender sets in motion the causal process which led to the result, it does not exclude his criminal liability and does not interrupt the causal process if other factors, such as the victim's illness, may have contributed to it. The concausa does not break the chain of causation, i.e. the existence of a causal link establish the criminal liability of the offender. Courts also adjudicates that if an act is a cause of the result if the act cannot be omitted without the result being omitted. This essentially assumes a hypothetical elimination procedure, i.e. the act must be omitted in thought and then examined to see whether the result would still occur or whether it would be omitted. On the substantive side, the essential condition for establishing the offence is that the result must be demonstrably connected with the activity committed. The provision on the assessment of the facts beyond reasonable doubt must also apply to the causal link: that is to say, the uncertainty of the causal link between the conduct and the result of the offence precludes the perpetrator from being held liable for the result. Sometimes, however, the courts do not specify in the reasons for their judgments what standard of causation they apply, i.e. on what basis they establish the existence of (legal) causation.

Keywords: causation, Hungarian criminal law, responsibility, philosophy of law

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986 Developing and Validating an Instrument for Measuring Mobile Government Adoption in Saudi Arabia

Authors: Sultan Alotaibi, Dmitri Roussinov

Abstract:

Many governments recently started to change the ways of providing their services by allowing their citizens to access services from anywhere without the need of visiting the location of the service provider. Mobile government (M-government) is one of the techniques that fulfill that goal. It has been adopted by many governments. M-government can be defined as an implementation of Electronic Government (E-Government) by using mobile technology with the aim of improving service delivery to citizens, businesses and all government agencies. There have been several research projects developing models to understand the behavior of individuals towards the adoption of m-government. This paper proposes a model for adoption of m-government services in Saudi Arabia by extending Technology Acceptance Model (TAM) by introducing external factors. This paper also reports on the development of a survey instrument designed to measure user perception of mobile government acceptance. A survey instrument has been developed by using existing scales from prior instruments and a pilot study has been conducted by distributing the survey to 33 participants. As a result, a survey instrument has been refined to retain 43 items. The results also showed that the reliabilities of all the scales in the survey instrument are above the levels acceptable in current academic research, thus the instruments developed by us are capable of analyzing the factors in M-government adoption.

Keywords: TAM, m-government, e-government, model, acceptance, mobile government

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985 Coping in Your Profession: An Exploratory Analysis of Healthcare Students’ Perceptions of Burnout

Authors: Heather Clark, Jon Kelly

Abstract:

Burnout among healthcare professionals has been elevated to a high level of concern. The descriptions of the healthcare workplace often include language such as, stressful, long hours, rotating shifts, weekends and holidays, and exhausting. New graduate healthcare professionals are being sent into the workplace with little to no coping skills, knowledge of signs and symptoms of burnout, or resources that are available. The authors of this study created a university course entitled 'coping in your profession' that enrolled registered nurses, licensed practical nurses, EMTs, nurse assistants, and medical assistants. The course addresses burnout, self-analysis, incivility, coping mechanisms, and organizational responsibilities for employee well-being. The students were surveyed using QualtricsXM that included a pre-course and post-course analysis. Pre-course results showed high levels of individual experiences with burnout and limited knowledge of resources to combat burnout. Post-course results included personal growth and that students’ perception of burnout can be prevented at both the individual and the organization levels. Students also indicated that few to no resources to combat burnout existed at their place of employment. Addressing burnout at the educational level helps prepare graduates with the knowledge and tools to combat burnout at the individual and organization level.

Keywords: burnout, coping, healthcare workers, incivility, resilience

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984 Innovations in the Implementation of Preventive Strategies and Measuring Their Effectiveness Towards the Prevention of Harmful Incidents to People with Mental Disabilities who Receive Home and Community Based Services

Authors: Carlos V. Gonzalez

Abstract:

Background: Providers of in-home and community based services strive for the elimination of preventable harm to the people under their care as well as to the employees who support them. Traditional models of safety and protection from harm have assumed that the absence of incidents of harm is a good indicator of safe practices. However, this model creates an illusion of safety that is easily shaken by sudden and inadvertent harmful events. As an alternative, we have developed and implemented an evidence-based resilient model of safety known as C.O.P.E. (Caring, Observing, Predicting and Evaluating). Within this model, safety is not defined by the absence of harmful incidents, but by the presence of continuous monitoring, anticipation, learning, and rapid response to events that may lead to harm. Objective: The objective was to evaluate the effectiveness of the C.O.P.E. model for the reduction of harm to individuals with mental disabilities who receive home and community based services. Methods: Over the course of 2 years we counted the number of incidents of harm and near misses. We trained employees on strategies to eliminate incidents before they fully escalated. We trained employees to track different levels of patient status within a scale from 0 to 10. Additionally, we provided direct support professionals and supervisors with customized smart phone applications to track and notify the team of changes in that status every 30 minutes. Finally, the information that we collected was saved in a private computer network that analyzes and graphs the outcome of each incident. Result and conclusions: The use of the COPE model resulted in: A reduction in incidents of harm. A reduction the use of restraints and other physical interventions. An increase in Direct Support Professional’s ability to detect and respond to health problems. Improvement in employee alertness by decreasing sleeping on duty. Improvement in caring and positive interaction between Direct Support Professionals and the person who is supported. Developing a method to globally measure and assess the effectiveness of prevention from harm plans. Future applications of the COPE model for the reduction of harm to people who receive home and community based services are discussed.

Keywords: harm, patients, resilience, safety, mental illness, disability

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983 Improving the Detection of Depression in Sri Lanka: Cross-Sectional Study Evaluating the Efficacy of a 2-Question Screen for Depression

Authors: Prasad Urvashi, Wynn Yezarni, Williams Shehan, Ravindran Arun

Abstract:

Introduction: Primary health services are often the first point of contact that patients with mental illness have with the healthcare system. A number of tools have been developed to increase detection of depression in the context of primary care. However, one challenge amongst many includes utilizing these tools within the limited primary care consultation timeframe. Therefore, short questionnaires that screen for depression that are just as effective as more comprehensive diagnostic tools may be beneficial in improving detection rates of patients visiting a primary care setting. Objective: To develop and determine the sensitivity and specificity of a 2-Question Questionnaire (2-QQ) to screen for depression in in a suburban primary care clinic in Ragama, Sri Lanka. The purpose is to develop a short screening tool for depression that is culturally adapted in order to increase the detection of depression in the Sri Lankan patient population. Methods: This was a cross-sectional study involving two steps. Step one: verbal administration of 2-QQ to patients by their primary care physician. Step two: completion of the Peradeniya Depression Scale, a validated diagnostic tool for depression, the patient after their consultation with the primary care physician. The results from the PDS were then correlated to the results from the 2-QQ for each patient to determine sensitivity and specificity of the 2-QQ. Results: A score of 1/+ on the 2-QQ was most sensitive but least specific. Thus, setting the threshold at this level is effective for correctly identifying depressed patients, but also inaccurately captures patients who are not depressed. A score of 6 on the 2-QQ was most specific but least sensitive. Setting the threshold at this level is effective for correctly identifying patients without depression, but not very effective at capturing patients with depression. Discussion: In the context of primary care, it may be worthwhile setting the 2-QQ screen at a lower threshold for positivity (such as a score of 1 or above). This would generate a high test sensitivity and thus capture the majority of patients that have depression. On the other hand, by setting a low threshold for positivity, patients who do not have depression but score higher than 1 on the 2-QQ will also be falsely identified as testing positive for depression. However, the benefits of identifying patients who present with depression may outweigh the harms of falsely identifying a non-depressed patient. It is our hope that the 2-QQ will serve as a quick primary screen for depression in the primary care setting and serve as a catalyst to identify and treat individuals with depression.

Keywords: depression, primary care, screening tool, Sri Lanka

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982 Relatively High Heart-Rate Variability Predicts Greater Survival Chances in Patients with Covid-19

Authors: Yori Gidron, Maartje Mol, Norbert Foudraine, Frits Van Osch, Joop Van Den Bergh, Moshe Farchi, Maud Straus

Abstract:

Background: The worldwide pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-COV2), which began in 2019, also known as Covid-19, has infected over 136 million people and tragically took the lives of over 2.9 million people worldwide. Many of the complications and deaths are predicted by the inflammatory “cytokine storm.” One way to progress in the prevention of death is by finding a predictive and protective factor that inhibits inflammation, on the one hand, and which also increases anti-viral immunity on the other hand. The vagal nerve does precisely both actions. This study examined whether vagal nerve activity, indexed by heart-rate variability (HRV), predicts survival in patients with Covid-19. Method: We performed a pseudo-prospective study, where we retroactively obtained ECGs of 271 Covid-19 patients arriving at a large regional hospital in The Netherlands. HRV was indexed by the standard deviation of the intervals between normal heartbeats (SDNN). We examined patients’ survival at 3 weeks and took into account multiple confounders and known prognostic factors (e.g., age, heart disease, diabetes, hypertension). Results: Patients’ mean age was 68 (range: 25-95) and nearly 22% of the patients had died by 3 weeks. Their mean SDNN (17.47msec) was far below the norm (50msec). Importantly, relatively higher HRV significantly predicted a higher chance of survival, after statistically controlling for patients’ age, cardiac diseases, hypertension and diabetes (relative risk, H.R, and 95% confidence interval (95%CI): H.R = 0.49, 95%CI: 0.26 – 0.95, p < 0.05). However, since HRV declines rapidly with age and since age is a profound predictor in Covid-19, we split the sample by median age (40). Subsequently, we found that higher HRV significantly predicted greater survival in patients older than 70 (H.R = 0.35, 95%CI: 0.16 – 0.78, p = 0.01), but HRV did not predict survival in patients below age 70 years (H.R = 1.11, 95%CI: 0.37 – 3.28, p > 0.05). Conclusions: To the best of our knowledge, this is the first study showing that higher vagal nerve activity, as indexed by HRV, is an independent predictor of higher chances for survival in Covid-19. The results are in line with the protective role of the vagal nerve in diseases and extend this to a severe infectious illness. Studies should replicate these findings and then test in controlled trials whether activating the vagus nerve may prevent mortality in Covid-19.

Keywords: Covid-19, heart-rate Variability, prognosis, survival, vagal nerve

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981 Governance and Public Policy: The Perception of Civil Society Participation in Brazil and South Africa

Authors: Paulino V. Tavares, Ana L. Romao

Abstract:

Public governance, in general, is essential to qualify and educate, pedagogically, the decision-making process of the government in relation to the management of resources and the provision of public services, with transparency and active participation of individuals and citizens for the development of a more democratic environment, besides stimulating control and social empowerment, aiming at the development of the collectivity. In this context, the participation of society in the elaboration, execution, and control of public policies is prominent to strengthen public governance itself. With this, using a multidimensional approach with the application of two questionnaires to a universe of twenty Counselors of the Courts of Auditors (Brazil), twenty professionals of public administration (Brazil), twenty Government/Provincial Counselors (South Africa), and twenty South African professionals of public administration, the preliminary results indicate that the participation of civil society, for both countries, is very low in the elaboration, execution, and control of public policies. At the same time, about 70% of the answers obtained indicate, on average, three possible paths to increase the participation of civil society. With this, it is delineated that developing new horizons to strengthen both public policies how social participation is necessary, but, for both, it is important that governments and civil society, in their respective countries, have an awareness of the effective importance of this interaction.

Keywords: Brazil, civil society, participation, South Africa

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980 Exploratory Study of the Influencing Factors for Hotels' Competitors

Authors: Asma Ameur, Dhafer Malouche

Abstract:

Hotel competitiveness research is an essential phase of the marketing strategy for any hotel. Certainly, knowing the hotels' competitors helps the hotelier to grasp its position in the market and the citizen to make the right choice in picking a hotel. Thus, competitiveness is an important indicator that can be influenced by various factors. In fact, the issue of competitiveness, this ability to cope with competition, remains a difficult and complex concept to define and to exploit. Therefore, the purpose of this article is to make an exploratory study to calculate a competitiveness indicator for hotels. Further on, this paper makes it possible to determine the criteria of direct or indirect effect on the image and the perception of a hotel. The actual research is used to look into the right model for hotel ‘competitiveness. For this reason, we exploit different theoretical contributions in the field of machine learning. Thus, we use some statistical techniques such as the Principal Component Analysis (PCA) to reduce the dimensions, as well as other techniques of statistical modeling. This paper presents a survey covering of the techniques and methods in hotel competitiveness research. Furthermore, this study allows us to deduct the significant variables that influence the determination of hotel’s competitors. Lastly, the discussed experiences in this article found that the hotel competitors are influenced by several factors with different rates.

Keywords: competitiveness, e-reputation, hotels' competitors, online hotel’ review, principal component analysis, statistical modeling

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979 Evaluating Thailand’s Cosmetic Surgery Tourism by Taiwanese Female Tourists

Authors: Wen-Yu Chen, Chia-Yuan Hsu, Sasinee Vongsrikul

Abstract:

The present study is to explore the perception of Taiwanese females towards medical tourism in Thailand for the development of applicable marketing strategy, integrating travel motivation and cosmetic surgery trend to attract potential medical tourists from Taiwan. Since previous studies relevant to this research issue are limited, qualitative study is firstly employed by using one focus group interview and in-depth interviews with Taiwanese females. Moreover, the present research collected questionnaires from 290 Taiwanese females to provide greater understanding of research results. The top three factors that affect Taiwanese females’ decision for not going to Thailand for medical tourism are “physicians and nurses cannot speak Chinese”, “low quality of the cosmetic surgery product that I want to do”, and “the county does not have laws to protect medical tourists’ right”. The finding of the empirical part would suggest the area in medical tourism industry which Thailand should promote and emphasizes in order to increase its presence as a hub for cosmetic surgery and attract Taiwanese female market. Therefore, the study contributes to the potential development of marketing strategy for medical tourism, specifically in the area of cosmetic surgery in Thailand while targeting Taiwan market.

Keywords: Thailand, Taiwanese female tourists, medical tourism, cosmetic surgery

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978 Hopes of out of School Children with Disabilities for Educational Inclusion

Authors: Afaf Manzoor, Abdul Hameed

Abstract:

Hopes to attend school is the most effective means to overcome the burden of disability and become a self-reliant, productive citizen. The objectives of the study were to develop a valid and reliable scale to measure hopes of out of school children with disabilities and find an association between hopes and various demographic factors such as type of disability, gender, socio-economic status, and locale, etc. Child Hope theory by Snyder (2003) was used as a framework to develop a measure for the hopes of children. According to this theory, hope is defined as a set of cognition that includes self- perception which establish routes to achieve desired goals (pathways) and motivation for achieving the goals (agency). By applying this theory, inclusion hope scale was developed and validated. The data were collected from 361 out of school children with disabilities living in three districts (Lahore, Sheikupura, Kasur) of Lahore Division by using the cluster sampling technique. Findings of the study indicated that children with intellectual challenges were more hopeless as compared to other types of disabilities. Similarly, children living in urban areas have better hopes for inclusion in school. However, no gender disparity was found in terms of being hopeful to attend schools. The study also includes recommendations to improve hopes for educational inclusion among out of school children with disabilities.

Keywords: out of school children, disability, hopes, inclusion

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