Search results for: noninvasive neurally adjusted ventilatory assist
Commenced in January 2007
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Edition: International
Paper Count: 1742

Search results for: noninvasive neurally adjusted ventilatory assist

182 South African Multiple Deprivation-Concentration Index Quantiles Differentiated by Components of Success and Impediment to Tuberculosis Control Programme Using Mathematical Modelling in Rural O. R. Tambo District Health Facilities

Authors: Ntandazo Dlatu, Benjamin Longo-Mbenza, Andre Renzaho, Ruffin Appalata, Yolande Yvonne Valeria Matoumona Mavoungou, Mbenza Ben Longo, Kenneth Ekoru, Blaise Makoso, Gedeon Longo Longo

Abstract:

Background: The gap between complexities related to the integration of Tuberculosis /HIV control and evidence-based knowledge motivated the initiation of the study. Therefore, the objective of this study was to explore correlations between national TB management guidelines, multiple deprivation indexes, quantiles, components and levels of Tuberculosis control programme using mathematical modeling in rural O.R. Tambo District Health Facilities, South Africa. Methods: The study design used mixed secondary data analysis and cross-sectional analysis between 2009 and 2013 across O.R Tambo District, Eastern Cape, South Africa using univariate/ bivariate analysis, linear multiple regression models, and multivariate discriminant analysis. Health inequalities indicators and component of an impediment to the tuberculosis control programme were evaluated. Results: In total, 62 400 records for TB notification were analyzed for the period 2009-2013. There was a significant but negative between Financial Year Expenditure (r= -0.894; P= 0.041) Seropositive HIV status(r= -0.979; P= 0.004), Population Density (r = -0.881; P= 0.048) and the number of TB defaulter in all TB cases. It was shown unsuccessful control of TB management program through correlations between numbers of new PTB smear positive, TB defaulter new smear-positive, TB failure all TB, Pulmonary Tuberculosis case finding index and deprivation-concentration-dispersion index. It was shown successful TB program control through significant and negative associations between declining numbers of death in co-infection of HIV and TB, TB deaths all TB and SMIAD gradient/ deprivation-concentration-dispersion index. The multivariate linear model was summarized by unadjusted r of 96%, adjusted R2 of 95 %, Standard Error of estimate of 0.110, R2 changed of 0.959 and significance for variance change for P=0.004 to explain the prediction of TB defaulter in all TB with equation y= 8.558-0.979 x number of HIV seropositive. After adjusting for confounding factors (PTB case finding the index, TB defaulter new smear-positive, TB death in all TB, TB defaulter all TB, and TB failure in all TB). The HIV and TB death, as well as new PTB smear positive, were identified as the most important, significant, and independent indicator to discriminate most deprived deprivation index far from other deprivation quintiles 2-5 using discriminant analysis. Conclusion: Elimination of poverty such as overcrowding, lack of sanitation and environment of highest burden of HIV might end the TB threat in O.R Tambo District, Eastern Cape, South Africa. Furthermore, ongoing adequate budget comprehensive, holistic and collaborative initiative towards Sustainable Developmental Goals (SDGs) is necessary for complete elimination of TB in poor O.R Tambo District.

Keywords: tuberculosis, HIV/AIDS, success, failure, control program, health inequalities, South Africa

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181 Cognitive Linguistic Features Underlying Spelling Development in a Second Language: A Case Study of L2 Spellers in South Africa

Authors: A. Van Staden, A. Tolmie, E. Vorster

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Research confirms the multifaceted nature of spelling development and underscores the importance of both cognitive and linguistic skills that affect sound spelling development such as working and long-term memory, phonological and orthographic awareness, mental orthographic images, semantic knowledge and morphological awareness. This has clear implications for many South African English second language spellers (L2) who attempt to become proficient spellers. Since English has an opaque orthography, with irregular spelling patterns and insufficient sound/grapheme correspondences, L2 spellers can neither rely, nor draw on the phonological awareness skills of their first language (for example Sesotho and many other African languages), to assist them to spell the majority of English words. Epistemologically, this research is informed by social constructivism. In addition the researchers also hypothesized that the principles of the Overlapping Waves Theory was an appropriate lens through which to investigate whether L2 spellers could significantly improve their spelling skills via the implementation of an alternative route to spelling development, namely the orthographic route, and more specifically via the application of visual imagery. Post-test results confirmed the results of previous research that argues for the interactive nature of different cognitive and linguistic systems such as working memory and its subsystems and long-term memory, as learners were systematically guided to store visual orthographic images of words in their long-term lexicons. Moreover, the results have shown that L2 spellers in the experimental group (n = 9) significantly outperformed L2 spellers (n = 9) in the control group whose intervention involved phonological awareness (and coding) including the teaching of spelling rules. Consequently, L2 learners in the experimental group significantly improved in all the post-test measures included in this investigation, namely the four sub-tests of short-term memory; as well as two spelling measures (i.e. diagnostic and standardized measures). Against this background, the findings of this study look promising and have shown that, within a social-constructivist learning environment, learners can be systematically guided to apply higher-order thinking processes such as visual imagery to successfully store and retrieve mental images of spelling words from their output lexicons. Moreover, results from the present study could play an important role in directing research into this under-researched aspect of L2 literacy development within the South African education context.

Keywords: English second language spellers, phonological and orthographic coding, social constructivism, visual imagery as spelling strategy

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180 We Have Never Seen a Dermatologist. Prisons Telederma Project Reaching the Unreachable Through Teledermatology

Authors: Innocent Atuhe, Babra Nalwadda, Grace Mulyowa, Annabella Habinka Ejiri

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Background: Atopic Dermatitis (AD) is one of the most prevalent and growing chronic inflammatory skin diseases in African prisons. AD care is limited in African due to a lack of information about the disease amongst primary care workers, limited access to dermatologists, lack of proper training of healthcare workers, and shortage of appropriate treatments. We designed and implemented the Prisons Telederma project based on the recommendations of the International Society of Atopic Dermatitis. We aimed at; i) increase awareness and understanding of teledermatology among prison health workers and ii) improve treatment outcomes of prisoners with atopic dermatitis through increased access to and utilization of consultant dermatologists through teledermatology in Uganda prisons. Approach: We used Store-and-forward Teledermatology (SAF-TD) to increase access to dermatologist-led care for prisoners and prison staff with AD. We conducted five days of training for prison health workers using an adapted WHO training guide on recognizing neglected tropical diseases through changes on the skin together with an adapted American Academy of Dermatology (AAD) Childhood AD Basic Dermatology Curriculum designed to help trainees develop a clinical approach to the evaluation and initial management of patients with AD. This training was followed by blended e-learning, webinars facilitated by consultant Dermatologists with local knowledge of medication and local practices, apps adjusted for pigmented skin, WhatsApp group discussions, and sharing pigmented skin AD pictures and treatment via zoom meetings. We hired a team of Ugandan Senior Consultant dermatologists to draft an iconographic atlas of the main dermatoses in pigmented African skin and shared this atlas with prison health staff for use as a job aid. We had planned to use MySkinSelfie mobile phone application to take and share skin pictures of prisoners with AD with Consultant Dermatologists, who would review the pictures and prescribe appropriate treatment. Unfortunately, the National Health Service withdrew the app from the market due to technical issues. We monitored and evaluated treatment outcomes using the Patient-Oriented Eczema Measure (POEM) tool. We held four advocacy meetings to persuade relevant stakeholders to increase supplies and availability of first-line AD treatments such as emollients in prison health facilities. Results: We have the very first iconographic atlas of the main dermatoses in pigmented African skin. We increased; i) the proportion of prison health staff with adequate knowledge of AD and teledermatology from 20% to 80%; ii) the proportion of prisoners with AD reporting improvement in disease severity (POEM scores) from 25% to 35% in one year; iii) increased proportion of prisoners with AD seen by consultant dermatologist through teledermatology from 0% to 20% in one year and iv)Increased the availability of AD recommended treatments in prisons health facilities from 5% to 10% in one year. Our study contributes to the use, evaluation, and verification of the use of teledermatology to increase access to specialist dermatology services to the most hard to reach areas and vulnerable populations such as that of prisoners.

Keywords: teledermatology, prisoners, reaching, un-reachable

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179 Solar Power Generation in a Mining Town: A Case Study for Australia

Authors: Ryan Chalk, G. M. Shafiullah

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Climate change is a pertinent issue facing governments and societies around the world. The industrial revolution has resulted in a steady increase in the average global temperature. The mining and energy production industries have been significant contributors to this change prompting government to intervene by promoting low emission technology within these sectors. This paper initially reviews the energy problem in Australia and the mining sector with a focus on the energy requirements and production methods utilised in Western Australia (WA). Renewable energy in the form of utility-scale solar photovoltaics (PV) provides a solution to these problems by providing emission-free energy which can be used to supplement the existing natural gas turbines in operation at the proposed site. This research presents a custom renewable solution for the mining site considering the specific township network, local weather conditions, and seasonal load profiles. A summary of the required PV output is presented to supply slightly over 50% of the towns power requirements during the peak (summer) period, resulting in close to full coverage in the trench (winter) period. Dig Silent Power Factory Software has been used to simulate the characteristics of the existing infrastructure and produces results of integrating PV. Large scale PV penetration in the network introduce technical challenges, that includes; voltage deviation, increased harmonic distortion, increased available fault current and power factor. Results also show that cloud cover has a dramatic and unpredictable effect on the output of a PV system. The preliminary analyses conclude that mitigation strategies are needed to overcome voltage deviations, unacceptable levels of harmonics, excessive fault current and low power factor. Mitigation strategies are proposed to control these issues predominantly through the use of high quality, made for purpose inverters. Results show that use of inverters with harmonic filtering reduces the level of harmonic injections to an acceptable level according to Australian standards. Furthermore, the configuration of inverters to supply active and reactive power assist in mitigating low power factor problems. Use of FACTS devices; SVC and STATCOM also reduces the harmonics and improve the power factor of the network, and finally, energy storage helps to smooth the power supply.

Keywords: climate change, mitigation strategies, photovoltaic (PV), power quality

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178 An A-Star Approach for the Quickest Path Problem with Time Windows

Authors: Christofas Stergianos, Jason Atkin, Herve Morvan

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As air traffic increases, more airports are interested in utilizing optimization methods. Many processes happen in parallel at an airport, and complex models are needed in order to have a reliable solution that can be implemented for ground movement operations. The ground movement for aircraft in an airport, allocating a path to each aircraft to follow in order to reach their destination (e.g. runway or gate), is one process that could be optimized. The Quickest Path Problem with Time Windows (QPPTW) algorithm has been developed to provide a conflict-free routing of vehicles and has been applied to routing aircraft around an airport. It was subsequently modified to increase the accuracy for airport applications. These modifications take into consideration specific characteristics of the problem, such as: the pushback process, which considers the extra time that is needed for pushing back an aircraft and turning its engines on; stand holding where any waiting should be allocated to the stand; and runway sequencing, where the sequence of the aircraft that take off is optimized and has to be respected. QPPTW involves searching for the quickest path by expanding the search in all directions, similarly to Dijkstra’s algorithm. Finding a way to direct the expansion can potentially assist the search and achieve a better performance. We have further modified the QPPTW algorithm to use a heuristic approach in order to guide the search. This new algorithm is based on the A-star search method but estimates the remaining time (instead of distance) in order to assess how far the target is. It is important to consider the remaining time that it is needed to reach the target, so that delays that are caused by other aircraft can be part of the optimization method. All of the other characteristics are still considered and time windows are still used in order to route multiple aircraft rather than a single aircraft. In this way the quickest path is found for each aircraft while taking into account the movements of the previously routed aircraft. After running experiments using a week of real aircraft data from Zurich Airport, the new algorithm (A-star QPPTW) was found to route aircraft much more quickly, being especially fast in routing the departing aircraft where pushback delays are significant. On average A-star QPPTW could route a full day (755 to 837 aircraft movements) 56% faster than the original algorithm. In total the routing of a full week of aircraft took only 12 seconds with the new algorithm, 15 seconds faster than the original algorithm. For real time application, the algorithm needs to be very fast, and this speed increase will allow us to add additional features and complexity, allowing further integration with other processes in airports and leading to more optimized and environmentally friendly airports.

Keywords: a-star search, airport operations, ground movement optimization, routing and scheduling

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177 Company's Orientation and Human Resource Management Evolution in Technological Startup Companies

Authors: Yael Livneh, Shay Tzafrir, Ilan Meshoulam

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Technological startup companies have been recognized as bearing tremendous potential for business and economic success. However, many entrepreneurs who produce promising innovative ideas fail to implement them as successful businesses. A key argument for such failure is the entrepreneurs' lack of competence in adaptation of the relevant level of formality of human resource management (HRM). The purpose of the present research was to examine multiple antecedents and consequences of HRM formality in growing startup companies. A review of the research literature identified two central components of HRM formality: HR control and professionalism. The effect of three contextual predictors was examined. The first was an intra-organizational factor: the development level of the organization. We based on a differentiation between knowledge exploration and knowledge exploitation. At a given time, the organization chooses to focus on a specific mix of these orientations, a choice which requires an appropriate level of HRM formality, in order to efficiently overcome the challenges. It was hypothesized that the mix of orientations of knowledge exploration and knowledge exploitation would predict HRM formality. The second predictor was the personal characteristics the organization's leader. According the idea of blueprint effect of CEO's on HRM, it was hypothesized that the CEO's cognitive style would predict HRM formality. The third contextual predictor was an external organizational factor: the level of investor involvement. By using the agency theory, and based on Transaction Cost Economy, it was hypothesized that the level of investor involvement in general management and HRM would be positively related to the HRM formality. The effect of formality on trust was examined directly and indirectly by the mediation role of procedural justice. The research method included a time-lagged field study. In the first study, data was obtained using three questionnaires, each directed to a different source: CEO, HR position-holder and employees. 43 companies participated in this study. The second study was conducted approximately a year later. Data was recollected using three questionnaires by reapplying the same sample. 41 companies participated in the second study. The organizations samples included technological startup companies. Both studies included 884 respondents. The results indicated consistency between the two studies. HRM formality was predicted by the intra-organizational factor as well as the personal characteristics of the CEO, but not at all by the external organizational context. Specifically, the organizational orientations was the greatest contributor to both components of HRM formality. The cognitive style predicted formality to a lesser extent. The investor's involvement was found not to have any predictive effect on the HRM formality. The results indicated a positive contribution to trust in HRM, mainly via the mediation of procedural justice. This study contributed a new concept for technological startup company development by a mixture of organizational orientation. Practical implications indicated that the level of HRM formality should be matched to that of the company's development. This match should be challenged and adjusted periodically by referring to the organization orientation, relevant HR practices, and HR function characteristics. A relevant matching could enhance further trust and business success.

Keywords: control, formality, human resource management, organizational development, professionalism, technological startup company

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176 Dietary Intakes and Associated Demographic, Behavioural and Other Health-Related Factors in Mexican College Students

Authors: Laura E. Hall, Joel Monárrez-Espino, Luz María Tejada Tayabas

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College students are at risk of weight gain and poor dietary habits, and health behaviours established during this period have been shown to track into midlife. They may therefore be an important target group for health promotion strategies, yet there is a lack of literature regarding dietary intakes and associated factors in this group, particularly in middle-income countries such as Mexico. The aim of this exploratory research was to describe and compare reported dietary intakes among nursing and nutrition college students at two public universities in Mexico, and to explore the relationship between demographic, behavioural and other health-related factors and the risk of low diet quality. Mexican college students (n=444) majoring in nutrition or nursing at two urban universities completed questionnaires regarding dietary and health-related behaviours and risks. Dietary intake was assessed via 24-hour recall. Weight, height and abdominal circumference were measured. Descriptive statistics were reported and nutrient intakes were compared between colleges and study tracks using Student’s t tests, odds ratios and Pearson chi square tests. Two dietary quality scores were constructed to explore the relationship between demographic, behavioural and other health-related factors and the diet quality scores using binary logistic regression. Analysis was performed using SPSS statistics, with differences considered statistically significant at p<0.05. The response rate to the survey was 91%. When macronutrients were considered as a percentage of total energy, the majority of students had protein intakes within recommended ranges, however one quarter of students had carbohydrate and fat intakes exceeding recommended levels. Three quarters had fibre intakes that were below recommendations. More than half of the students reported intakes of magnesium, zinc, vitamin A, folate and vitamin E that were below estimated average requirements. Students studying nutrition reported macronutrient and micronutrient intakes that were more compliant with recommendations compared to nursing students, and students studying in central-north Mexico were more compliant than those studying in southeast Mexico. Breakfast skipping (Adjusted Odds Ratio (OR) = 5.3; 95% Confidence Interval (CI) = 1.2-22.7), risk of anxiety (OR = 2.3; CI = 1.3-4.4), and university location (OR = 1.6; CI = 1.03-2.6) were associated with a greater risk of having a low macronutrient score. Caloric intakes <1800kcal (OR = 5.8; CI = 3.5-9.7), breakfast skipping (OR = 3.7; CI = 1.4-10.3), vigorous exercise ≤1h/week (OR = 2.6; CI = 1.3-5.2), soda consumption >250mls/day (OR = 2.0; CI = 1.2-3.3), unhealthy diet perception (OR = 1.9; CI = 1.2-3.0), and university location (OR = 1.8; CI = 1.1-2.8) were significantly associated with greater odds of having a low micronutrient score. College students studying nursing and nutrition did not report ideal diets, and these students should not be overlooked in public health interventions. Differences in dietary intakes between universities and study tracks were evident, with more favourable profiles evident in nutrition compared to nursing, and North-central compared to Southeast students. Further, demographic, behavioural and other health-related factors were associated with diet quality scores, warranting further research.

Keywords: college student, diet quality, nutrient intake, young adult

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175 Mental Balance, Emotional Balance, and Stress Management: The Role of Ancient Vedic Philosophy from India

Authors: Emily Schulz

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The ancient Vedic culture from India had traditions that supported all aspects of health, including psychological health, and are relevant in the current era. These traditions have been compiled by Professor Dr. Purna, a rare Himalayan Master, into the Purna Health Management System (PHMS). The PHMS is a unique, holistic, and integrated approach to health management. It is comprised of four key factors: Health, Fitness, and Nutrition (HF&N), Life Balance (Stress Management) (LB-SM), Spiritual Growth and Development (SG&D); and Living in Harmony with the Natural Environment (LHWNE). The purpose of the PHMS is to give people the tools to take responsibility for managing their own holistic health and wellbeing. A study using a cross-sectional mixed-methods anonymous online survey was conducted during 2017-2018. Adult students of Professor Dr. Purna were invited to participate through announcements made at various events He held throughout the globe. Follow-up emails were sent with consenting language for interested parties and provided them with a link to the survey. Participation in the study was completely voluntary and no incentives were given to respond to the survey. The overall aim of the study was to investigate the effectiveness of implementation of the PHMS on practitioners' emotional balance. However, given the holistic nature of the PHMS, survey questions also inquired about participants’ physical health, stress level, ability to manage stress, and wellbeing using Likert scales. The survey also included some open-ended questions to gain an understanding of the participants’ experiences with the PHMS relative to their emotional balance. In total, 52 people out of 253 potential respondents participated in the study. Data were analyzed using nonparametric Spearman’s Rho correlation coefficient (rs) since the data were not on a normal distribution. Statistical significance was set at p < .05. Results of the study suggested that there are moderate to strong statistically significant relationships (p < .001) between participants' frequent implementation of each of the four key factors of the PHMS and self-reported mental/emotional health (HF&N rs = 0.42; LB-SM rs = 0.54; SG&D rs = 0.49; LHWNE rs = 0.45) Results also demonstrated statistically significant relationships (p < .001) between participants' frequent implementation of each of the four key factors of the PHMS and their self-reported ability to manage stress (HF&N rs = 0.44; LB-SM rs = 0.55; SG&D rs = 0.39; LHWNE rs = 0.55). Additionally, those who reported experiencing better physical health also reported better mental/emotional health (rs = 0.49, p < .001) and better ability to manage stress (rs = 0.46, p < .001). The findings of this study suggest that wisdom from the ancient Vedic culture may be useful for those working in the field of psychology and related fields who would like to assist clients in calming their mind and emotions and managing their stress levels.

Keywords: balanced emotions, balanced mind, stress management, Vedic philosophy

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174 Fly ash Contamination in Groundwater and its Implications on Local Climate Change

Authors: Rajkumar Ghosh

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Fly ash, a byproduct of coal combustion, has become a prevalent environmental concern due to its potential impact on both groundwater quality and local climate change. This study aims to provide an in-depth analysis of the various mechanisms through which fly ash contaminates groundwater, as well as the possible consequences of this contamination on local climate change. The presence of fly ash in groundwater not only poses a risk to human health but also has the potential to influence local climate change through complex interactions. Although fly ash has various applications in construction and other industries, improper disposal and lack of containment measures have led to its infiltration into groundwater systems. Through a comprehensive review of existing literature and case studies, the interactions between fly ash and groundwater systems, assess the effects on hydrology, and discuss the implications for the broader climate. This section reviews the pathways through which fly ash enters groundwater, including leaching from disposal sites, infiltration through soil, and migration from surface water bodies. The physical and chemical characteristics of fly ash that contribute to its mobility and persistence in groundwater. The introduction of fly ash into groundwater can alter its chemical composition, leading to an increase in the concentration of heavy metals, metalloids, and other potentially toxic elements. The mechanisms of contaminant transport and highlight the potential risks to human health and ecosystems. Fly ash contamination in groundwater may influence the hydrological cycle through changes in groundwater recharge, discharge, and flow dynamics. This section examines the implications of altered hydrology on local water availability, aquatic habitats, and overall ecosystem health. The presence of fly ash in groundwater may have direct and indirect effects on local climate change. The role of fly ash as a potent greenhouse gas absorber and its contribution to radiative forcing. Additionally, investigation of the possible feedback mechanisms between groundwater contamination and climate change, such as altered vegetation patterns and changes in local temperature and precipitation patterns. In this section, potential mitigation and remediation techniques to minimize fly ash contamination in groundwater are analyzed. These may include improved waste management practices, engineered barriers, groundwater remediation technologies, and sustainable fly ash utilization. This paper highlights the critical link between fly ash contamination in groundwater and its potential contribution to local climate change. It emphasizes the importance of addressing this issue promptly through a combination of preventive measures, effective management strategies, and continuous monitoring. By understanding the interconnections between fly ash contamination, groundwater quality, and local climate, towards creating a more resilient and sustainable environment for future generations. The findings of this research can assist policymakers and environmental managers in formulating sustainable strategies to mitigate fly ash contamination and minimize its contribution to climate change.

Keywords: groundwater, climate, sustainable environment, fly ash contamination

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173 The Socio-Emotional Vulnerability of Professional Rugby Union Athletes

Authors: Hannah Kuhar

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This paper delves into the attitudes of professional and semi-professional rugby union athletes in regard to socio-emotional vulnerability, or the willingness to express the full spectrum of human emotion in a social context. Like all humans, athletes of all sports regularly experience feelings of shame, powerlessness, and loneliness, and often feel unable to express such feelings due to factors including lack of situational support, absence of adequate expressive language and lack of resource. To this author’s knowledge, however, no previous research has considered the particular demographic of professional rugby union athletes, despite the sport’s immense popularity and economic contribution to global communities. Hence, this paper aims to extend previous research by exploring the experiences of professional rugby union athletes and their unwillingness and inability to express socio-emotional vulnerability. By having a better understanding of vulnerability in rugby and sports, this paper is able to contribute to the growing field of mental health and wellbeing research, particularly towards the emerging themes of resilience and belonging. Based on qualitative fieldwork conducted over a period of seven months across France and Australia, via the mechanisms of semi-structured interview and observation, this work uses the field theory framework of Pierre Bourdieu to construct an analysis of multidisciplinary thought. Approaching issues of gender, sexuality, physicality, education, and family, this paper shows that socio-emotional vulnerability is experienced by all players regardless of their background, in a variety of ways. Common themes and responses are drawn to show the universality of rugby’s pitfalls, which have previously been limited to specific demographics in isolation of their broader contexts. With the author themselves a semi-professional athlete, the provision of unique ‘insider’ access facilitates a deeper and more comprehensive understanding of first-hand athlete experiences, often unexplored within the context of the academic arena. The primary contention of this paper is to argue that by celebrating socio-emotional vulnerability, there becomes an opportunity to improve on-field team outcomes. Ultimately, players play better when they feel supported by their teammates, and this logic extends to the outcome of the team when socio-emotional team initiatives are widely embraced. The creation of such a culture requires deliberate and purposeful efforts, where player ownership and buy-in are high. Further study in this field may assist teams to better understand the elements which contribute to strong team culture and to strong results on the pitch.

Keywords: rugby, vulnerability, athletes, France, Bourdieu

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172 Reducing Falls in Memory Care through Implementation of the Stopping Elderly Accidents, Deaths, and Injuries Program

Authors: Cory B. Lord

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Falls among the elderly population has become an area of concern in healthcare today. The negative impacts of falls lead to increased morbidity, mortality, and financial burdens for both patients and healthcare systems. Falls in the United States is reported at an annual rate of 36 million in those aged 65 and older. Each year, one out of four people in this age group will suffer a fall, with 20% of these falls causing injury. The setting for this Doctor of Nursing Practice (DNP) project was a memory care unit in an assisted living community, as these facilities house cognitively impaired older adults. These communities lack fall prevention programs; therefore, the need exists to add to the body of knowledge to positively impact this population. The objective of this project was to reduce fall rates through the implementation of the Center for Disease Control and Prevention (CDC) STEADI (stopping elderly accidents, deaths, and injuries) program. The DNP project performed was a quality improvement pilot study with a pre and post-test design. This program was implemented in the memory care setting over 12 weeks. The project included an educational session for staff and a fall risk assessment with appropriate resident referrals. The three aims of the DNP project were to reduce fall rates among the elderly aged 65 and older who reside in the memory care unit, increase staff knowledge of STEADI fall prevention measures after an educational session, and assess the willingness of memory care unit staff to adopt an evidence-based a fall prevention program. The Donabedian model was used as a guiding conceptual framework for this quality improvement pilot study. The fall rate data for 12 months before the intervention was evaluated and compared to post-intervention fall rates. The educational session comprised of a pre and post-test to assess staff knowledge of the fall prevention program and the willingness of staff to adopt the fall prevention program. The overarching goal was to reduce falls in the elderly population who live in memory care units. The results of the study showed, on average that the fall rate during the implementation period of STEADI (μ=6.79) was significantly lower when compared to the prior 12 months (μ= 9.50) (p=0.02, α = 0.05). The mean staff knowledge scores improved from pretest (μ=77.74%) to post-test (μ=87.42%) (p=0.00, α= 0.05) after the education session. The results of the willingness to adopt a fall prevention program were scored at 100%. In summation, implementing the STEADI fall prevention program can assist in reducing fall rates for residents aged 65 and older who reside in a memory care setting.

Keywords: dementia, elderly, falls, STEADI

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171 A Study of Kinematical Parameters I9N Instep Kicking in Soccer

Authors: Abdolrasoul Daneshjoo

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Introduction: Soccer is a game which draws more attention in different countries especially in Brazil. Kicking among different skills in soccer and soccer players is an excellent role for the success and preference of a team. The way of point gaining in this game is passing the ball over the goal lines which are gained by shoot skill in attack time and or during the penalty kicks.Regarding the above assumption, identifying the effective factors in instep kicking in different distances shoot with maximum force and high accuracy or pass and penalty kick, may assist the coaches and players in raising qualitative level of performing the skill. Purpose: The aim of the present study was to study of a few kinematical parameters in instep kicking from 3 and 5 meter distance among the male and female elite soccer players. Methods: 24 right dominant lower limb subjects (12 males and 12 females) among Tehran elite soccer players with average and the standard deviation (22.5 ± 1.5) & (22.08± 1.31) years, height of (179.5 ± 5.81) & (164.3 ± 4.09) cm, weight of (69.66 ± 4.09) & (53.16 ± 3.51) kg, %BMI (21.06 ± .731) & (19.67 ± .709), having playing history of (4 ± .73) & (3.08 ± .66) years respectively participated in this study. They had at least two years of continuous playing experience in Tehran soccer league.For sampling player's kick; Kinemetrix Motion analysis with three cameras with 500 Hz was used. Five reflective markers were placed laterally on the kicking leg over anatomical points (the iliac crest, major trochanter, lateral epicondyle of femur, lateral malleolus, and lateral aspect of distal head of the fifth metatarsus). Instep kick was filmed, with one step approach and 30 to 45 degrees angle from stationary ball. Three kicks were filmed, one kick selected for further analyses. Using Kinemetrix 3D motion analysis software, the position of the markers was analyzed. Descriptive statistics were used to describe the mean and standard deviation, while the analysis of variance, and independent t-test (P < 0.05) were used to compare the kinematic parameters between two genders. Results and Discussion: Among the evaluated parameters, the knee acceleration, the thigh angular velocity, the angle of knee proportionately showed significant relationship with consequence of kick. While company performance on 5m in 2 genders, significant differences were observed in internal – external displacement of toe, ankle, hip and the velocity of toe, ankle and the acceleration of toe and the angular velocity of pelvic, thigh and before time contact. Significant differences showed the internal – external displacement of toe, the ankle, the knee and the hip, the iliac crest and the velocity of toe, the ankle and acceleration of ankle and angular velocity of the pelvic and the knee.

Keywords: biomechanics, kinematics, soccer, instep kick, male, female

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170 Development of a Bead Based Fully Automated Mutiplex Tool to Simultaneously Diagnose FIV, FeLV and FIP/FCoV

Authors: Andreas Latz, Daniela Heinz, Fatima Hashemi, Melek Baygül

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Introduction: Feline leukemia virus (FeLV), feline immunodeficiency virus (FIV), and feline coronavirus (FCoV) are serious infectious diseases affecting cats worldwide. Transmission of these viruses occurs primarily through close contact with infected cats (via saliva, nasal secretions, faeces, etc.). FeLV, FIV, and FCoV infections can occur in combination and are expressed in similar clinical symptoms. Diagnosis can therefore be challenging: Symptoms are variable and often non-specific. Sick cats show very similar clinical symptoms: apathy, anorexia, fever, immunodeficiency syndrome, anemia, etc. Sample volume for small companion animals for diagnostic purposes can be challenging to collect. In addition, multiplex diagnosis of diseases can contribute to an easier, cheaper, and faster workflow in the lab as well as to the better differential diagnosis of diseases. For this reason, we wanted to develop a new diagnostic tool that utilizes less sample volume, reagents, and consumables than multiplesingleplex ELISA assays Methods: The Multiplier from Dynextechonogies (USA) has been used as platform to develop a Multiplex diagnostic tool for the detection of antibodies against FIV and FCoV/FIP and antigens for FeLV. Multiplex diagnostics. The Dynex®Multiplier®is a fully automated chemiluminescence immunoassay analyzer that significantly simplifies laboratory workflow. The Multiplier®ease-of-use reduces pre-analytical steps by combining the power of efficiently multiplexing multiple assays with the simplicity of automated microplate processing. Plastic beads have been coated with antigens for FIV and FCoV/FIP, as well as antibodies for FeLV. Feline blood samples are incubated with the beads. Read out of results is performed via chemiluminescence Results: Bead coating was optimized for each individual antigen or capture antibody and then combined in the multiplex diagnostic tool. HRP: Antibody conjugates for FIV and FCoV antibodies, as well as detection antibodies for FeLV antigen, have been adjusted and mixed. 3 individual prototyple batches of the assay have been produced. We analyzed for each disease 50 well defined positive and negative samples. Results show an excellent diagnostic performance of the simultaneous detection of antibodies or antigens against these feline diseases in a fully automated system. A 100% concordance with singleplex methods like ELISA or IFA can be observed. Intra- and Inter-Assays showed a high precision of the test with CV values below 10% for each individual bead. Accelerated stability testing indicate a shelf life of at least 1 year. Conclusion: The new tool can be used for multiplex diagnostics of the most important feline infectious diseases. Only a very small sample volume is required. Fully automation results in a very convenient and fast method for diagnosing animal diseases.With its large specimen capacity to process over 576 samples per 8-hours shift and provide up to 3,456 results, very high laboratory productivity and reagent savings can be achieved.

Keywords: Multiplex, FIV, FeLV, FCoV, FIP

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169 Exploring Tweeters’ Concerns and Opinions about FIFA Arab Cup 2021: An Investigation Study

Authors: Md. Rafiul Biswas, Uzair Shah, Mohammad Alkayal, Zubair Shah, Othman Althawadi, Kamila Swart

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Background: Social media platforms play a significant role in the mediated consumption of sport, especially so for sport mega-event. The characteristics of Twitter data (e.g., user mentions, retweets, likes, #hashtag) accumulate the users in one ground and spread information widely and quickly. Analysis of Twitter data can reflect the public attitudes, behavior, and sentiment toward a specific event on a larger scale than traditional surveys. Qatar is going to be the first Arab country to host the mega sports event FIFA World Cup 2022 (Q22). Qatar has hosted the FIFA Arab Cup 2021 (FAC21) to serve as a preparation for the mega-event. Objectives: This study investigates public sentiments and experiences about FAC21 and provides an insight to enhance the public experiences for the upcoming Q22. Method: FCA21-related tweets were downloaded using Twitter Academic research API between 01 October 2021 to 18 February 2022. Tweets were divided into three different periods: before T1 (01 Oct 2021 to 29 Nov 2021), during T2 (30 Nov 2021 -18 Dec 2021), and after the FAC21 T3 (19 Dec 2021-18 Feb 2022). The collected tweets were preprocessed in several steps to prepare for analysis; (1) removed duplicate and retweets, (2) removed emojis, punctuation, and stop words (3) normalized tweets using word lemmatization. Then, rule-based classification was applied to remove irrelevant tweets. Next, the twitter-XLM-roBERTa-base model from Huggingface was applied to identify the sentiment in the tweets. Further, state-of-the-art BertTopic modeling will be applied to identify trending topics over different periods. Results: We downloaded 8,669,875 Tweets posted by 2728220 unique users in different languages. Of those, 819,813 unique English tweets were selected in this study. After splitting into three periods, 541630, 138876, and 139307 were from T1, T2, and T3, respectively. Most of the sentiments were neutral, around 60% in different periods. However, the rate of negative sentiment (23%) was high compared to positive sentiment (18%). The analysis indicates negative concerns about FAC21. Therefore, we will apply BerTopic to identify public concerns. This study will permit the investigation of people’s expectations before FAC21 (e.g., stadium, transportation, accommodation, visa, tickets, travel, and other facilities) and ascertain whether these were met. Moreover, it will highlight public expectations and concerns. The findings of this study can assist the event organizers in enhancing implementation plans for Q22. Furthermore, this study can support policymakers with aligning strategies and plans to leverage outstanding outcomes.

Keywords: FIFA Arab Cup, FIFA, Twitter, machine learning

Procedia PDF Downloads 79
168 Momentum Profits and Investor Behavior

Authors: Aditya Sharma

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Profits earned from relative strength strategy of zero-cost portfolio i.e. taking long position in winner stocks and short position in loser stocks from recent past are termed as momentum profits. In recent times, there has been lot of controversy and concern about sources of momentum profits, since the existence of these profits acts as an evidence of earning non-normal returns from publicly available information directly contradicting Efficient Market Hypothesis. Literature review reveals conflicting theories and differing evidences on sources of momentum profits. This paper aims at re-examining the sources of momentum profits in Indian capital markets. The study focuses on assessing the effect of fundamental as well as behavioral sources in order to understand the role of investor behavior in stock returns and suggest (if any) improvements to existing behavioral asset pricing models. This Paper adopts calendar time methodology to calculate momentum profits for 6 different strategies with and without skipping a month between ranking and holding period. For each J/K strategy, under this methodology, at the beginning of each month t stocks are ranked on past j month’s average returns and sorted in descending order. Stocks in upper decile are termed winners and bottom decile as losers. After ranking long and short positions are taken in winner and loser stocks respectively and both portfolios are held for next k months, in such manner that at any given point of time we have K overlapping long and short portfolios each, ranked from t-1 month to t-K month. At the end of period, returns of both long and short portfolios are calculated by taking equally weighted average across all months. Long minus short returns (LMS) are momentum profits for each strategy. Post testing for momentum profits, to study the role market risk plays in momentum profits, CAPM and Fama French three factor model adjusted LMS returns are calculated. In the final phase of studying sources, decomposing methodology has been used for breaking up the profits into unconditional means, serial correlations, and cross-serial correlations. This methodology is unbiased, can be used with the decile-based methodology and helps to test the effect of behavioral and fundamental sources altogether. From all the analysis, it was found that momentum profits do exist in Indian capital markets with market risk playing little role in defining them. Also, it was observed that though momentum profits have multiple sources (risk, serial correlations, and cross-serial correlations), cross-serial correlations plays a major role in defining these profits. The study revealed that momentum profits do have multiple sources however, cross-serial correlations i.e. the effect of returns of other stocks play a major role. This means that in addition to studying the investors` reactions to the information of the same firm it is also important to study how they react to the information of other firms. The analysis confirms that investor behavior does play an important role in stock returns and incorporating both the aspects of investors’ reactions in behavioral asset pricing models help make then better.

Keywords: investor behavior, momentum effect, sources of momentum, stock returns

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167 Motivation of Doctors and its Impact on the Quality of Working Life

Authors: E. V. Fakhrutdinova, K. R. Maksimova, P. B. Chursin

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At the present stage of the society progress the health care is an integral part of both the economic system and social, while in the second case the medicine is a major component of a number of basic and necessary social programs. Since the foundation of the health system are highly qualified health professionals, it is logical proposition that increase of doctor`s professionalism improves the effectiveness of the system as a whole. Professionalism of the doctor is a collection of many components, essential role played by such personal-psychological factors as honesty, willingness and desire to help people, and motivation. A number of researchers consider motivation as an expression of basic human needs that have passed through the “filter” which is a worldview and values learned in the process of socialization by the individual, to commit certain actions designed to achieve the expected result. From this point of view a number of researchers propose the following classification of highly skilled employee’s needs: 1. the need for confirmation the competence (setting goals that meet the professionalism and receipt of positive emotions in their decision), 2. The need for independence (the ability to make their own choices in contentious situations arising in the process carry out specialist functions), 3. The need for ownership (in the case of health care workers, to the profession and accordingly, high in the eyes of the public status of the doctor). Nevertheless, it is important to understand that in a market economy a significant motivator for physicians (both legal and natural persons) is to maximize its own profits. In the case of health professionals duality motivational structure creates an additional contrast, as in the public mind the image of the ideal physician; usually a altruistically minded person thinking is not primarily about their own benefit, and to assist others. In this context, the question of the real motivation of health workers deserves special attention. The survey conducted by the American researcher Harrison Terni for the magazine "Med Tech" in 2010 revealed the opinion of more than 200 medical students starting courses, and the primary motivation in a profession choice is "desire to help people", only 15% said that they want become a doctor, "to earn a lot". From the point of view of most of the classical theories of motivation this trend can be called positive, as intangible incentives are more effective. However, it is likely that over time the opinion of the respondents may change in the direction of mercantile motives. Thus, it is logical to assume that well-designed system of motivation of doctor`s labor should be based on motivational foundations laid during training in higher education.

Keywords: motivation, quality of working life, health system, personal-psychological factors, motivational structure

Procedia PDF Downloads 340
166 Application of Discrete-Event Simulation in Health Technology Assessment: A Cost-Effectiveness Analysis of Alzheimer’s Disease Treatment Using Real-World Evidence in Thailand

Authors: Khachen Kongpakwattana, Nathorn Chaiyakunapruk

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Background: Decision-analytic models for Alzheimer’s disease (AD) have been advanced to discrete-event simulation (DES), in which individual-level modelling of disease progression across continuous severity spectra and incorporation of key parameters such as treatment persistence into the model become feasible. This study aimed to apply the DES to perform a cost-effectiveness analysis of treatment for AD in Thailand. Methods: A dataset of Thai patients with AD, representing unique demographic and clinical characteristics, was bootstrapped to generate a baseline cohort of patients. Each patient was cloned and assigned to donepezil, galantamine, rivastigmine, memantine or no treatment. Throughout the simulation period, the model randomly assigned each patient to discrete events including hospital visits, treatment discontinuation and death. Correlated changes in cognitive and behavioral status over time were developed using patient-level data. Treatment effects were obtained from the most recent network meta-analysis. Treatment persistence, mortality and predictive equations for functional status, costs (Thai baht (THB) in 2017) and quality-adjusted life year (QALY) were derived from country-specific real-world data. The time horizon was 10 years, with a discount rate of 3% per annum. Cost-effectiveness was evaluated based on the willingness-to-pay (WTP) threshold of 160,000 THB/QALY gained (4,994 US$/QALY gained) in Thailand. Results: Under a societal perspective, only was the prescription of donepezil to AD patients with all disease-severity levels found to be cost-effective. Compared to untreated patients, although the patients receiving donepezil incurred a discounted additional costs of 2,161 THB, they experienced a discounted gain in QALY of 0.021, resulting in an incremental cost-effectiveness ratio (ICER) of 138,524 THB/QALY (4,062 US$/QALY). Besides, providing early treatment with donepezil to mild AD patients further reduced the ICER to 61,652 THB/QALY (1,808 US$/QALY). However, the dominance of donepezil appeared to wane when delayed treatment was given to a subgroup of moderate and severe AD patients [ICER: 284,388 THB/QALY (8,340 US$/QALY)]. Introduction of a treatment stopping rule when the Mini-Mental State Exam (MMSE) score goes below 10 to a mild AD cohort did not deteriorate the cost-effectiveness of donepezil at the current treatment persistence level. On the other hand, none of the AD medications was cost-effective when being considered under a healthcare perspective. Conclusions: The DES greatly enhances real-world representativeness of decision-analytic models for AD. Under a societal perspective, treatment with donepezil improves patient’s quality of life and is considered cost-effective when used to treat AD patients with all disease-severity levels in Thailand. The optimal treatment benefits are observed when donepezil is prescribed since the early course of AD. With healthcare budget constraints in Thailand, the implementation of donepezil coverage may be most likely possible when being considered starting with mild AD patients, along with the stopping rule introduced.

Keywords: Alzheimer's disease, cost-effectiveness analysis, discrete event simulation, health technology assessment

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165 Learning to Transform, Transforming to Learn: An Exploration of Teacher Professional Learning in the 4Cs (Communication, Collaboration, Creativity and Critical Reflection) in the Primary (K-6) Setting

Authors: Susan E Orlovich

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Ongoing, effective teacher professional learning is acknowledged as a critical influence on teacher practice. However, it is unclear whether the elements of effective professional learning result in transformed teacher practice in the classroom. This research project is interested in 4C teacher professional learning. The professional learning practices to assist teachers in transforming their practice to integrate the 4C capabilities seldom feature in the academic literature. The 4Cs are a shorthand way of representing the concepts of communication, collaboration, creativity, and critical reflection and refer to the capabilities needed for deeper learning, personal growth, and effective participation in society. The New South Wales curriculum review (2020) acknowledges that identifying, teaching, and assessing the 4C capabilities are areas of challenge for teachers. However, it also recognises that it is essential for teachers to build the confidence and capacity to understand, teach and assess the capabilities necessary for learners to thrive in the 21st century. This qualitative research project explores the professional learning experiences of sixteen teachers in four different primaries (K-6) settings in Sydney, Australia, who are learning to integrate, teach and assess the 4Cs. The project draws on the Theory of Practice Architecture as a framework to analyse and interpret teachers' experiences in each site. The sixteen participants in the study are teachers from four primary settings and include early career, experienced, and teachers in leadership roles (including the principal). In addition, some of the participants are also teachers who are learning within a Community of Practice (CoP) as their school setting is engaged in a 4C professional learning, Community of Practice. Qualitative and arts-informed research methods are utilised to examine the cultural-discursive, social-political, and material-economic practice arrangements of the site, explore how these arrangements may have shaped the professional learning experiences of teachers, and in turn, influence the teaching practices of the 4Cs in the setting. The research is in the data analysis stage (October 2022), with preliminary findings pending. The research objective is to investigate the elements of the professional learning experiences undertaken by teachers to teach the 4Cs in the primary setting. The lens of practice architectures theory is used to identify the influence of the practice architectures on critical praxis in each site and examine how the practice arrangements enable or constrain the teaching of 4C capabilities. This research aims to offer deep insight into the practice arrangements which may enable or constrain teacher professional learning in the 4Cs. Such insight from this study may contribute to a better understanding of the practices that enable teachers to transform their practice to achieve the integration, teaching, and assessment of the 4C capabilities.

Keywords: 4Cs, communication, collaboration, creativity, critical reflection, teacher professional learning

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164 UNHCR and the International Refugee Protection: An Analysis of Its Actions in Protecting Mozambican Refugees in Malawi

Authors: Marcia Teresa Gildo

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The United Nations High Commissioner for Refugees (UNHCR) is responsible to provide international protection and humanitarian assistance to refugees and to seek permanent solutions to their situation. To fulfil this mandate, the agency works in collaboration with its partners and governments. This paper aims to analyse the agency's actions to protect and provide assistance to Mozambican refugees in Malawi. Since July 2015, approximately 12.000 people have fled Mozambique to neighbouring Malawi due to the political-military conflict between the government of Mozambique and RENAMO (the country’s largest opposition party). This led to a series of military clashes between the two parties and the consequent flight of some Mozambicans to Malawi, in search of asylum. Most arrived from the province of Tete, in the central region of Mozambique, and, to a lesser extent, from the province of Zambezia. The asylum seekers arrived in small groups and settled in the village of Kapise in the Mwanza district of Thambani, as well as in Chikwawa and Nsanje districts in Malawi. UNHCR led an interinstitutional response action to manage the flow of Mozambican asylum seekers to Malawi. In view of these aspects and the ongoing challenge of protecting refugees and finding permanent solutions to their situation, UNHCR remains an indispensable international organization. However, there are significant gaps in the international refugee protection regime, and there have been many occasions when UNHCR has failed to fulfill its mandate. The analysis was carried out through qualitative research methods and techniques based essentially on consultation of books, newspapers and scientific articles, television and journalistic reports and interviews with the people who were involved in the process. From the data obtained, it was concluded that UNHCR worked in coordination with its partners and the government of Malawi to provide protection and emergency assistance to the refugees. However, existing funds covered only the immediate needs of refugees, more funds had to be allocated. That was made through an interinstitutional appeal. Although the funds allocated were not sufficient, they allowed the agency to protect and assist the refugees until a permanent solution was found. UNHCR also worked in coordination with the governments of Malawi and Mozambique so that a tripartite agreement was signed between the parties for the voluntary repatriation of Mozambican refugees, since security conditions were guaranteed and the refugees had expressed their willingness to return to their country of origin. UNHCR's actions to protect Mozambican refugees in Malawi have enabled humanitarian conditions to be respected and the rights of refugees to be guaranteed. Cooperation with the different actors involved in the response has allowed UNHCR to fulfil its mandate.

Keywords: assistance , cooperation, international protection, refugees

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163 Developing a Quality Mentor Program: Creating Positive Change for Students in Enabling Programs

Authors: Bianca Price, Jennifer Stokes

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Academic and social support systems are critical for students in enabling education; these support systems have the potential to enhance the student experience whilst also serving a vital role for student retention. In the context of international moves toward widening university participation, Australia has developed enabling programs designed to support underrepresented students to access to higher education. The purpose of this study is to examine the effectiveness of a mentor program based within an enabling course. This study evaluates how the mentor program supports new students to develop social networks, improve retention, and increase satisfaction with the student experience. Guided by Social Learning Theory (SLT), this study highlights the benefits that can be achieved when students engage in peer-to-peer based mentoring for both social and learning support. Whilst traditional peer mentoring programs are heavily based on face-to-face contact, the present study explores the difference between mentors who provide face-to-face mentoring, in comparison with mentoring that takes place through the virtual space, specifically via a virtual community in the shape of a Facebook group. This paper explores the differences between these two methods of mentoring within an enabling program. The first method involves traditional face-to-face mentoring that is provided by alumni students who willingly return to the learning community to provide social support and guidance for new students. The second method requires alumni mentor students to voluntarily join a Facebook group that is specifically designed for enabling students. Using this virtual space, alumni students provide advice, support and social commentary on how to be successful within an enabling program. Whilst vastly different methods, both of these mentoring approaches provide students with the support tools needed to enhance their student experience and improve transition into University. To evaluate the impact of each mode, this study uses mixed methods including a focus group with mentors, in-depth interviews, as well as engaging in netnography of the Facebook group ‘Wall’. Netnography is an innovative qualitative research method used to interpret information that is available online to better understand and identify the needs and influences that affect the users of the online space. Through examining the data, this research will reflect upon best practice for engaging students in enabling programs. Findings support the applicability of having both face-to-face and online mentoring available for students to assist enabling students to make a positive transition into University undergraduate studies.

Keywords: enabling education, mentoring, netnography, social learning theory

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162 Effect of Rapeseed Press Cake on Extrusion System Parameters and Physical Pellet Quality of Fish Feed

Authors: Anna Martin, Raffael Osen

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The demand for fish from aquaculture is constantly growing. Concurrently, due to a shortage of fishmeal caused by extensive overfishing, fishmeal substitution by plant proteins is getting increasingly important for the production of sustainable aquafeed. Several research studies evaluated the impact of plant protein meals, concentrates or isolates on fish health and fish feed quality. However, these protein raw materials often require elaborate and expensive manufacturing and their availability is limited. Rapeseed press cake (RPC) – a side product of de-oiling processes – exhibits a high potential as a plant-based fishmeal alternative in fish feed for carnivorous species due to its availability, low costs and protein content. In order to produce aquafeed with RPC, it is important to systematically assess i) inclusion levels of RPC with similar pellet qualities compared to fishmeal containing formulations and ii) how extrusion parameters can be adjusted to achieve targeted pellet qualities. However, the effect of RPC on extrusion system parameters and pellet quality has only scarcely been investigated. Therefore, the aim of this study was to evaluate the impact of feed formulation, extruder barrel temperature (90, 100, 110 °C) and screw speed (200, 300, 400 rpm) on extrusion system parameters and the physical properties of fish feed pellets. A co-rotating pilot-scale twin screw extruder was used to produce five iso-nitrogenous feed formulations: a fish meal based reference formulation including 16 g/100g fishmeal and four formulations in which fishmeal was substituted by RPC to 25, 50, 75 or 100 %. Extrusion system parameters, being product temperature, pressure at the die, specific mechanical energy (SME) and torque, were monitored while samples were taken. After drying, pellets were analyzed regarding to optical appearance, sectional and longitudinal expansion, sinking velocity, bulk density, water stability, durability and specific hardness. In our study, the addition of minor amounts of RPC already had high impact on pellet quality parameters, especially on expansion but only marginally affected extrusion system parameters. Increasing amounts of RPC reduced sectional expansion, sinking velocity, bulk density and specific hardness and increased longitudinal expansion compared to a reference formulation without RPC. Water stability and durability were almost not affected by RPC addition. Moreover, pellets with rapeseed components showed a more coarse structure than pellets containing only fishmeal. When the adjustment of barrel temperature and screw speed was investigated, it could be seen that the increase of extruder barrel temperature led to a slight decrease of SME and die pressure and an increased sectional expansion of the reference pellets but did almost not affect rapeseed containing fish feed pellets. Also changes in screw speed had little effects on the physical properties of pellets however with raised screw speed the SME and the product temperature increased. In summary, a one-to-one substitution of fishmeal with RPC without the adjustment of extrusion process parameters does not result in fish feed of a designated quality. Therefore, a deeper knowledge of raw materials and their behavior under thermal and mechanical stresses as applied during extrusion is required.

Keywords: extrusion, fish feed, press cake, rapeseed

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161 Relationship Between Brain Entropy Patterns Estimated by Resting State fMRI and Child Behaviour

Authors: Sonia Boscenco, Zihan Wang, Euclides José de Mendoça Filho, João Paulo Hoppe, Irina Pokhvisneva, Geoffrey B.C. Hall, Michael J. Meaney, Patricia Pelufo Silveira

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Entropy can be described as a measure of the number of states of a system, and when used in the context of physiological time-based signals, it serves as a measure of complexity. In functional connectivity data, entropy can account for the moment-to-moment variability that is neglected in traditional functional magnetic resonance imaging (fMRI) analyses. While brain fMRI resting state entropy has been associated with some pathological conditions like schizophrenia, no investigations have explored the association between brain entropy measures and individual differences in child behavior in healthy children. We describe a novel exploratory approach to evaluate brain fMRI resting state data in two child cohorts, and MAVAN (N=54, 4.5 years, 48% males) and GUSTO (N = 206, 4.5 years, 48% males) and its associations to child behavior, that can be used in future research in the context of child exposures and long-term health. Following rs-fMRI data pre-processing and Shannon entropy calculation across 32 network regions of interest to acquire 496 unique functional connections, partial correlation coefficient analysis adjusted for sex was performed to identify associations between entropy data and Strengths and Difficulties questionnaire in MAVAN and Child Behavior Checklist domains in GUSTO. Significance was set at p < 0.01, and we found eight significant associations in GUSTO. Negative associations were found between two frontoparietal regions and cerebellar posterior and oppositional defiant problems, (r = -0.212, p = 0.006) and (r = -0.200, p = 0.009). Positive associations were identified between somatic complaints and four default mode connections: salience insula (r = 0.202, p < 0.01), dorsal attention intraparietal sulcus (r = 0.231, p = 0.003), language inferior frontal gyrus (r = 0.207, p = 0.008) and language posterior superior temporal gyrus (r = 0.210, p = 0.008). Positive associations were also found between insula and frontoparietal connection and attention deficit / hyperactivity problems (r = 0.200, p < 0.01), and insula – default mode connection and pervasive developmental problems (r = 0.210, p = 0.007). In MAVAN, ten significant associations were identified. Two positive associations were found = with prosocial scores: the salience prefrontal cortex and dorsal attention connection (r = 0.474, p = 0.005) and the salience supramarginal gyrus and dorsal attention intraparietal sulcus (r = 0.447, p = 0.008). The insula and prefrontal connection were negatively associated with peer problems (r = -0.437, p < 0.01). Conduct problems were negatively associated with six separate connections, the left salience insula and right salience insula (r = -0.449, p = 0.008), left salience insula and right salience supramarginal gyrus (r = -0.512, p = 0.002), the default mode and visual network (r = -0.444, p = 0.009), dorsal attention and language network (r = -0.490, p = 0.003), and default mode and posterior parietal cortex (r = -0.546, p = 0.001). Entropy measures of resting state functional connectivity can be used to identify individual differences in brain function that are correlated with variation in behavioral problems in healthy children. Further studies applying this marker into the context of environmental exposures are warranted.

Keywords: child behaviour, functional connectivity, imaging, Shannon entropy

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160 Correlation between Visual Perception and Social Function in Patients with Schizophrenia

Authors: Candy Chieh Lee

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Objective: The purpose of this study is to investigate the relationship between visual perception and social function in patients with schizophrenia. The specific aims are: 1) To explore performances in visual perception and social function in patients with schizophrenia 2) to examine the correlation between visual perceptual skills and social function in patients with schizophrenia The long-term goal is to be able to provide the most adequate intervention program for promoting patients’ visual perceptual skills and social function, as well as compensatory techniques. Background: Perceptual deficits in schizophrenia have been well documented in the visual system. Clinically, a considerable portion (up to 60%) of schizophrenia patients report distorted visual experiences such as visual perception of motion, color, size, and facial expression. Visual perception is required for the successful performance of most activities of daily living, such as dressing, making a cup of tea, driving a car and reading. On the other hand, patients with schizophrenia usually exhibit psychotic symptoms such as auditory hallucination and delusions which tend to alter their perception of reality and affect their quality of interpersonal relationship and limit their participation in various social situations. Social function plays an important role in the prognosis of patients with schizophrenia; lower social functioning skills can lead to poorer prognosis. Investigations on the relationship between social functioning and perceptual ability in patients with schizophrenia are relatively new but important as the results could provide information for effective intervention on visual perception and social functioning in patients with schizophrenia. Methods: We recruited 50 participants with schizophrenia in the mental health hospital (Taipei City Hospital, Songde branch, Taipei, Taiwan) acute ward. Participants who have signed consent forms, diagnosis of schizophrenia and having no organic vision deficits were included. Participants were administered the test of visual-perceptual skills (non-motor), third edition (TVPS-3) and the personal and social performance scale (PSP) for assessing visual perceptual skill and social function. The assessments will take about 70-90 minutes to complete. Data Analysis: The IBM SPSS 21.0 will be used to perform the statistical analysis. First, descriptive statistics will be performed to describe the characteristics and performance of the participants. Lastly, Pearson correlation will be computed to examine the correlation between PSP and TVPS-3 scores. Results: Significant differences were found between the means of participants’ TVPS-3 raw scores of each subtest with the age equivalent raw score provided by the TVPS-3 manual. Significant correlations were found between all 7 subtests of TVPS-3 and PSP total score. Conclusions: The results showed that patients with schizophrenia do exhibit visual perceptual deficits and is correlated social functions. Understanding these facts of patients with schizophrenia can assist health care professionals in designing and implementing adequate rehabilitative treatment according to patients’ needs.

Keywords: occupational therapy, social function, schizophrenia, visual perception

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159 Artificial Intelligence and Governance in Relevance to Satellites in Space

Authors: Anwesha Pathak

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With the increasing number of satellites and space debris, space traffic management (STM) becomes crucial. AI can aid in STM by predicting and preventing potential collisions, optimizing satellite trajectories, and managing orbital slots. Governance frameworks need to address the integration of AI algorithms in STM to ensure safe and sustainable satellite activities. AI and governance play significant roles in the context of satellite activities in space. Artificial intelligence (AI) technologies, such as machine learning and computer vision, can be utilized to process vast amounts of data received from satellites. AI algorithms can analyse satellite imagery, detect patterns, and extract valuable information for applications like weather forecasting, urban planning, agriculture, disaster management, and environmental monitoring. AI can assist in automating and optimizing satellite operations. Autonomous decision-making systems can be developed using AI to handle routine tasks like orbit control, collision avoidance, and antenna pointing. These systems can improve efficiency, reduce human error, and enable real-time responsiveness in satellite operations. AI technologies can be leveraged to enhance the security of satellite systems. AI algorithms can analyze satellite telemetry data to detect anomalies, identify potential cyber threats, and mitigate vulnerabilities. Governance frameworks should encompass regulations and standards for securing satellite systems against cyberattacks and ensuring data privacy. AI can optimize resource allocation and utilization in satellite constellations. By analyzing user demands, traffic patterns, and satellite performance data, AI algorithms can dynamically adjust the deployment and routing of satellites to maximize coverage and minimize latency. Governance frameworks need to address fair and efficient resource allocation among satellite operators to avoid monopolistic practices. Satellite activities involve multiple countries and organizations. Governance frameworks should encourage international cooperation, information sharing, and standardization to address common challenges, ensure interoperability, and prevent conflicts. AI can facilitate cross-border collaborations by providing data analytics and decision support tools for shared satellite missions and data sharing initiatives. AI and governance are critical aspects of satellite activities in space. They enable efficient and secure operations, ensure responsible and ethical use of AI technologies, and promote international cooperation for the benefit of all stakeholders involved in the satellite industry.

Keywords: satellite, space debris, traffic, threats, cyber security.

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158 Comparison of the Yumul Faces Anxiety Scale to the Categorization Scale, the Numerical Verbal Rating Scale, and the State-Trait Anxiety Inventory for Preoperative Anxiety Evaluation

Authors: Ofelia Loani Elvir Lazo, Roya Yumul, David Chernobylsky, Omar Durra

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Background: It is crucial to detect the patient’s existing anxiety to assist patients in a perioperative setting which is to be caused by the fear associated with surgical and anesthetic complications. However, the current gold standard for assessing patient anxiety, the STAI, is problematic to use in the preoperative setting, given the duration and concentration required to complete the 40-item questionnaire. Our primary aim in the study is to investigate the correlation of the Yumul Visual Facial Anxiety Scale (VFAS) and Numerical Verbal Rating Scale (NVRS) to State-Trait Anxiety Inventory (STAI) to determine the optimal anxiety scale to use in the perioperative setting. Methods: A clinical study of patients undergoing various surgeries was conducted utilizing each of the preoperative anxiety scales. Inclusion criteria included patients undergoing elective surgeries, while exclusion criteria included patients with anesthesia contraindications, inability to comprehend instructions, impaired judgement, substance abuse history, and those pregnant or lactating. 293 patients were analyzed in terms of demographics, anxiety scale survey results, and anesthesia data via Spearman Coefficients, Chi-Squared Analysis, and Fischer’s exact test utilized for comparative analysis. Results: Statistical analysis showed that VFAS had a higher correlation to STAI than NVRS (rs=0.66, p<0.0001 vs. rs=0.64, p<0.0001). The combined VFAS-Categorization Scores showed the highest correlation with the gold standard (rs=0.72, p<0.0001). Subgroup analysis showed similar results. STAI evaluation time (247.7 ± 54.81 sec) far exceeds VFAS (7.29 ± 1.61 sec), NVRS (7.23 ± 1.60 sec), and Categorization scales (7.29 ± 1.99 sec). Patients preferred VFAS (54.4%), Categorization (11.6%), and NVRS (8.8%). Anesthesiologists preferred VFAS (63.9%), NVRS (22.1%), and Categorization Scales (14.0%). Of note, the top five causes of preoperative anxiety were determined to be waiting (56.5%), pain (42.5%), family concerns (40.5%), no information about surgery (40.1%), or anesthesia (31.6%). Conclusıons: Both VFAS and Categorization tests also take significantly less time than STAI, which is critical in the preoperative setting. Combined VFAS-Categorization Score (VCS) demonstrates the highest correlation to the gold standard, STAI. Among both patients and anesthesiologists, VFAS was the most preferred scale. This forms the basis of the Yumul Faces Anxiety Scale, designed for quick quantization and assessment in the preoperative setting while maintaining a high correlation to the golden standard. Additional studies using the formulated Yumul Faces Anxiety Scale are merited.

Keywords: numerical verbal anxiety scale, preoperative anxiety, state-trait anxiety inventory, visual facial anxiety scale

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157 An Empirical Analysis of Farmers Field Schools and Effect on Tomato Productivity in District Malakand Khyber Pakhtunkhwa-Pakistan

Authors: Mahmood Iqbal, Khalid Nawab, Tachibana Satoshi

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Farmer Field School (FFS) is constantly aims to assist farmers to determine and learn about field ecology and integrated crop management. The study was conducted to examine the change in productivity of tomato crop in the study area; to determine increase in per acre yield of the crop, and find out reduction in per acre input cost. A study of tomato crop was conducted in ten villages namely Jabban, Bijligar Colony, Palonow, Heroshah, Zara Maira, Deghar Ghar, Sidra Jour, Anar Thangi, Miangano Korona and Wartair of district Malakand. From each village 15 respondents were selected randomly on the basis of identical allocation making sample size of 150 respondents. The research was based on primary as well as secondary data. Primary data was collected from farmers while secondary data were taken from Agriculture Extension Department Dargai, District Malakand. Interview schedule was planned and each farmer was interviewed personally. The study was based on comparison of cost, yield and income of tomato before and after FFS. Paired t-test and Statistical Package for Social Sciences (SPSS) was used for analysis; outcome of the study show that integrated pest management project has brought a positive change in the attitude of farmers of the project area through FFS approach. In district Malakand 66.0% of the respondents were between the age group of 31-50 years, 11.3% of respondents had primary level of education, 12.7% of middle level, 28.7% metric level, 3.3% of intermediate level and 2.0% of graduate level of education while 42.0% of respondents were illiterate and have no education. Average land holding size of farmers was 6.47 acres, cost of seed, crop protection from insect pest and crop protection from diseases was reduced by Rs. 210.67, Rs. 2584.43 and Rs. 3044.16 respectively, the cost of fertilizers and cost of farm yard manure was increased by Rs.1548.87 and Rs. 1151.40 respectively while tomato yield was increased by 1585.03 kg/acre from 7663.87 to 9248.90 kg/acre. The role of FFS initiate by integrated pest management project through department of agriculture extension for the development of agriculture was worth mentioning. It has brought enhancement in crop yield of tomato and their income through FFS approach. On the basis of results of the research studies, integrated pest management project should spread their developmental activities for maximum participation of the complete rural masses through participatory FFS approach.

Keywords: agriculture, Farmers field schools, extension education, tomato

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156 Recognising and Managing Haematoma Following Thyroid Surgery: Simulation Teaching is Effective

Authors: Emily Moore, Dora Amos, Tracy Ellimah, Natasha Parrott

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Postoperative haematoma is a well-recognised complication of thyroid surgery with an incidence of 1-5%. Haematoma formation causes progressive airway obstruction, necessitating emergency bedside haematoma evacuation in up to ¼ of patients. ENT UK, BAETS and DAS have developed consensus guidelines to improve perioperative care, recommending that all healthcare staff interacting with patients undergoing thyroid surgery should be trained in managing post-thyroidectomy haematoma. The aim was to assess the effectiveness of a hybrid simulation model in improving clinician’s confidence in dealing with this surgical emergency. A hybrid simulation was designed, consisting of a standardised patient wearing a part-task trainer to mimic a post-thyroidectomy haematoma in a real patient. The part-task trainer was an adapted C-spine collar with layers of silicone representing the skin and strap muscles and thickened jelly representing the haematoma. Both the skin and strap muscle layers had to be opened in order to evacuate the haematoma. Boxes have been implemented into the appropriate post operative areas (recovery and surgical wards), which contain a printed algorithm designed to assist in remembering a sequence of steps for haematoma evacuation using the ‘SCOOP’ method (skin exposure, cut sutures, open skin, open muscles, pack wound) along with all the necessary equipment to open the front of the neck. Small-group teaching sessions were delivered by ENT and anaesthetic trainees to members of the multidisciplinary team normally involved in perioperative patient care, which included ENT surgeons, anaesthetists, recovery nurses, HCAs and ODPs. The DESATS acronym of signs and symptoms to recognise (difficulty swallowing, EWS score, swelling, anxiety, tachycardia, stridor) was highlighted. Then participants took part in the hybrid simulation in order to practice this ‘SCOOP’ method of haematoma evacuation. Participants were surveyed using a Likert scale to assess their level of confidence pre- and post teaching session. 30 clinicians took part. Confidence (agreed/strongly agreed) in recognition of post thyroidectomy haematoma improved from 58.6% to 96.5%. Confidence in management improved from 27.5% to 89.7%. All participants successfully decompressed the haematoma. All participants agreed/strongly agreed, that the sessions were useful for their learning. Multidisciplinary team simulation teaching is effective at significantly improving confidence in both the recognition and management of postoperative haematoma. Hybrid simulation sessions are useful and should be incorporated into training for clinicians.

Keywords: thyroid surgery, haematoma, teaching, hybrid simulation

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155 Development of Intellectual Property Information Services in Zimbabwe’s University Libraries: Assessing the Current Status and Mapping the Future Direction

Authors: Jonathan Munyoro, Takawira Machimbidza, Stephen Mutula

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The study investigates the current status of Intellectual Property (IP) information services in Zimbabwe's university libraries. Specifically, the study assesses the current IP information services offered in Zimbabwe’s university libraries, identifies challenges to the development of comprehensive IP information services in Zimbabwe’s university libraries, and suggests solutions for the development of IP information services in Zimbabwe’s university libraries. The study is born out of a realisation that research on IP information services in university libraries has received little attention, especially in developing country contexts, despite the fact that there are calls for heightened participation of university libraries in IP information services. In Zimbabwe, the launch of the National Intellectual Property Policy and Implementation Strategy 2018-2022 and the introduction of the Education 5.0 concept are set to significantly change the IP landscape in the country. Education 5.0 places more emphasis on innovation and industrialisation (in addition to teaching, community service, and research), and has the potential to shift the focus and level of IP output produced in higher and tertiary education institutions beyond copyrights and more towards commercially exploited patents, utility models, and industrial designs. The growing importance of IP commercialisation in universities creates a need for appropriate IP information services to assist students, academics, researchers, administrators, start-ups, entrepreneurs, and inventors. The critical challenge for university libraries is to reposition themselves and remain relevant in the new trajectory. Designing specialised information services to support increased IP generation and commercialisation appears to be an opportunity for university libraries to stay relevant in the knowledge economy. However, IP information services in Zimbabwe’s universities appear to be incomplete and focused mostly on assisting with research publications and copyright-related activities. Research on the existing status of IP services in university libraries in Zimbabwe is therefore necessary to help identify gaps and provide solutions in order to stimulate the growth of new forms of such services. The study employed a quantitative approach. An online questionnaire was administered to 57 academic librarians from 15 university libraries. Findings show that the current focus of the surveyed institutions is on providing scientific research support services (15); disseminating/sharing university research output (14); and copyright activities (12). More specialised IP information services such as IP education and training, patent information services, IP consulting services, IP online service platforms, and web-based IP information services are largely unavailable in Zimbabwean university libraries. Results reveal that the underlying challenge in the development of IP information services in Zimbabwe's university libraries is insufficient IP knowledge among academic librarians, which is exacerbated by inadequate IP management frameworks in university institutions. The study proposes a framework for the entrenchment of IP information services in Zimbabwe's university libraries.

Keywords: academic libraries, information services, intellectual property, IP knowledge, university libraries, Zimbabwe

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154 Feasibility of Washing/Extraction Treatment for the Remediation of Deep-Sea Mining Trailings

Authors: Kyoungrean Kim

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Importance of deep-sea mineral resources is dramatically increasing due to the depletion of land mineral resources corresponding to increasing human’s economic activities. Korea has acquired exclusive exploration licenses at four areas which are the Clarion-Clipperton Fracture Zone in the Pacific Ocean (2002), Tonga (2008), Fiji (2011) and Indian Ocean (2014). The preparation for commercial mining of Nautilus minerals (Canada) and Lockheed martin minerals (USA) is expected by 2020. The London Protocol 1996 (LP) under International Maritime Organization (IMO) and International Seabed Authority (ISA) will set environmental guidelines for deep-sea mining until 2020, to protect marine environment. In this research, the applicability of washing/extraction treatment for the remediation of deep-sea mining tailings was mainly evaluated in order to present preliminary data to develop practical remediation technology in near future. Polymetallic nodule samples were collected at the Clarion-Clipperton Fracture Zone in the Pacific Ocean, then stored at room temperature. Samples were pulverized by using jaw crusher and ball mill then, classified into 3 particle sizes (> 63 µm, 63-20 µm, < 20 µm) by using vibratory sieve shakers (Analysette 3 Pro, Fritsch, Germany) with 63 µm and 20 µm sieve. Only the particle size 63-20 µm was used as the samples for investigation considering the lower limit of ore dressing process which is tens to 100 µm. Rhamnolipid and sodium alginate as biosurfactant and aluminum sulfate which are mainly used as flocculant were used as environmentally friendly additives. Samples were adjusted to 2% liquid with deionized water then mixed with various concentrations of additives. The mixture was stirred with a magnetic bar during specific reaction times and then the liquid phase was separated by a centrifugal separator (Thermo Fisher Scientific, USA) under 4,000 rpm for 1 h. The separated liquid was filtered with a syringe and acrylic-based filter (0.45 µm). The extracted heavy metals in the filtered liquid were then determined using a UV-Vis spectrometer (DR-5000, Hach, USA) and a heat block (DBR 200, Hach, USA) followed by US EPA methods (8506, 8009, 10217 and 10220). Polymetallic nodule was mainly composed of manganese (27%), iron (8%), nickel (1.4%), cupper (1.3 %), cobalt (1.3%) and molybdenum (0.04%). Based on remediation standards of various countries, Nickel (Ni), Copper (Cu), Cadmium (Cd) and Zinc (Zn) were selected as primary target materials. Throughout this research, the use of rhamnolipid was shown to be an effective approach for removing heavy metals in samples originated from manganese nodules. Sodium alginate might also be one of the effective additives for the remediation of deep-sea mining tailings such as polymetallic nodules. Compare to the use of rhamnolipid and sodium alginate, aluminum sulfate was more effective additive at short reaction time within 4 h. Based on these results, sequencing particle separation, selective extraction/washing, advanced filtration of liquid phase, water treatment without dewatering and solidification/stabilization may be considered as candidate technologies for the remediation of deep-sea mining tailings.

Keywords: deep-sea mining tailings, heavy metals, remediation, extraction, additives

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153 Diminishing Constitutional Hyper-Rigidity by Means of Digital Technologies: A Case Study on E-Consultations in Canada

Authors: Amy Buckley

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The purpose of this article is to assess the problem of constitutional hyper-rigidity to consider how it and the associated tensions with democratic constitutionalism can be diminished by means of using digital democratic technologies. In other words, this article examines how digital technologies can assist us in ensuring fidelity to the will of the constituent power without paying the price of hyper-rigidity. In doing so, it is impossible to ignore that digital strategies can also harm democracy through, for example, manipulation, hacking, ‘fake news,’ and the like. This article considers the tension between constitutional hyper-rigidity and democratic constitutionalism and the relevant strengths and weaknesses of digital democratic strategies before undertaking a case study on Canadian e-consultations and drawing its conclusions. This article observes democratic constitutionalism through the lens of the theory of deliberative democracy to suggest that the application of digital strategies can, notwithstanding their pitfalls, improve a constituency’s amendment culture and, thus, diminish constitutional hyper-rigidity. Constitutional hyper-rigidity is not a new or underexplored concept. At a high level, a constitution can be said to be ‘hyper-rigid’ when its formal amendment procedure is so difficult to enact that it does not take place or is limited in its application. This article claims that hyper-rigidity is one problem with ordinary constitutionalism that fails to satisfy the principled requirements of democratic constitutionalism. Given the rise and development of technology that has taken place since the Digital Revolution, there has been a significant expansion in the possibility for digital democratic strategies to overcome the democratic constitutionalism failures resulting from constitutional hyper-rigidity. Typically, these strategies have included, inter alia, e- consultations, e-voting systems, and online polling forums, all of which significantly improve the ability of politicians and judges to directly obtain the opinion of constituents on any number of matters. This article expands on the application of these strategies through its Canadian e-consultation case study and presents them as a solution to poor amendment culture and, consequently, constitutional hyper-rigidity. Hyper-rigidity is a common descriptor of many written and unwritten constitutions, including the United States, Australian, and Canadian constitutions as just some examples. This article undertakes a case study on Canada, in particular, as it is a jurisdiction less commonly cited in academic literature generally concerned with hyper-rigidity and because Canada has to some extent, championed the use of e-consultations. In Part I of this article, I identify the problem, being that the consequence of constitutional hyper-rigidity is in tension with the principles of democratic constitutionalism. In Part II, I identify and explore a potential solution, the implementation of digital democratic strategies as a means of reducing constitutional hyper-rigidity. In Part III, I explore Canada’s e-consultations as a case study for assessing whether digital democratic strategies do, in fact, improve a constituency’s amendment culture thus reducing constitutional hyper-rigidity and the associated tension that arises with the principles of democratic constitutionalism. The idea is to run a case study and then assess whether I can generalise the conclusions.

Keywords: constitutional hyper-rigidity, digital democracy, deliberative democracy, democratic constitutionalism

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