Search results for: expectation setting conversation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2386

Search results for: expectation setting conversation

796 The Construction and Representation of Muslim Identity in Bollywood Commercial Films

Authors: Abonti Mehtaz

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The utmost controversial issue that Bollywood movies deal with is religious conflicts and the representation of Islam and or Muslims. The main objective of this paper is to examine that, how Muslim identity is constructed in Bollywood commercial films through the representation of Muslims and/or Islam. Two hypotheses are developed for this study, i.e., (1) Bollywood commercial films often portray the stereotypical image of Muslims. (2) The portrayal of Muslims and Islam in Bollywood commercial films is often negative. (3) Bollywood commercial films frequently construct a wrong and fake identity of Muslims through an inappropriate representation of Muslims and Islam. This study employs qualitative research techniques. To examine the hypotheses of this paper, 10 Bollywood commercial films produced in between 2000-2018 are selected purposively such as Fiza (2000), Gadar: Ek Prem Katha (2001), Company (2002), Aamir (2008), Kurbaan (2009), Anwar (2010), My name is Khan (2010), Raanjhanaa (2013), Omerta (2017) and Pari (2018). By conducting textual analyses of the above mentioned Bollywood commercial films, this paper focuses on different approaches of Muslim identity and their construction as well as representation in Bollywood commercial films in the light of scholarly work in film and cultural studies. Though 10 Bollywood commercial films are selected for contextual analysis, other Bollywood films by other directors are also mentioned in order to establish the hypotheses of this study. Framing theory is used to analyze the media contents. Findings of this study show that all hypotheses are accepted. Bollywood commercial films continually represent Islam and Muslims in incorrect ways and by doing so Bollywood commercial films construct a fallacious Muslim identity. Though the sample size of contents can be considered as a limitation of this study, the findings of the study reveal that how Bollywood commercial film is setting agenda to manipulate the image of Muslims and Islam not only in India but all over the world.

Keywords: Bollywood commercial films, Muslim identity, misrepresentation, representation, stereotypical

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795 Relationship between Pain, Social Support and Socio-Economic Indicators in Individuals with Spinal Cord Injury

Authors: Zahra Khazaeipour, Ehsan Ahmadipour, Vafa Rahimi-Movaghar, Fereshteh Ahmadipour

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Research Objectives: Chronic pain is one of the common problems associated with spinal cord injuries (SCI), which causes many complications. Therefore, this study intended to evaluate the relationship between pain and demographic, injury characteristics, socio-economic and social support in individuals with spinal cord Injury in Iran. Design: Descriptive cross-sectional study. Setting: Brain and Spinal Cord Injury Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran, between 2012 and 2013. Participants: The participants were 140 individuals with SCI, 101 (72%) men and 39 (28%) women, with mean age of 29.4 ±7.9 years. Main Outcome Measure: The Persian version of the Brief Pain Inventory (BPI) was used to measure the pain, and the Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure social support. Results: About 50.7% complained about having pain, which 79.3% had bilateral pain. The most common locations of pain were lower limbs and back. The most quality of pain was described as aching (41.4%), and tingling (32.9%). Patients with a medium level of education had the least pain compared to high and low level of education. SCI individuals with good economic situation reported higher frequency of having pain. There was no significant relationship between pain and social support. There was positive correlation between pain and impairment of mood, normal work, relations with other people and lack of sleep (P < 0.001). Conclusion: These findings revealed the importance of socioeconomic factors such as economic situation and educational level in understanding chronic pain in people with SCI and provide further support for the bio-psychosocial model. Hence, multidisciplinary evaluations and treatment strategies are advocated, including biomedical, psychological, and psycho-social interventions.

Keywords: pain, social support, socio-economic indicators, spinal cord injury

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794 Socio-Economic Setting and Implications to Climate Change Impacts in Eastern Cape Province, South Africa

Authors: Kenneth Nhundu, Leocadia Zhou, Farhad Aghdasi, Voster Muchenje

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Climate change poses increased risks to rural communities that rely on natural resources, such as forests, cropland and rangeland, waterways, and open spaces Because of their connection to the land and the potential for climate change to impact natural resources and disrupt ecosystems and seasons, rural livelihoods and well-being are disproportionately vulnerable to climate change. Climate change has the potential to affect the environment in a number of ways that place increased stress on everyone, but disproportionately on the most vulnerable populations, including the young, the old, those with chronic illness, and the poor. The communities in the study area are predominantly rural, resource-based and are generally surrounded by public or private lands that are dominated by natural resources, including forests, rangelands, and agriculture. The livelihoods of these communities are tied to natural resources. Therefore, targeted strategies to cope will be required. This paper assessed the household socio-economic characteristics and their implications to household vulnerability to climate change impacts in the rural Eastern Cape Province, South Africa. The results indicate that the rural communities are climate-vulnerable populations as they have a large proportion of people who are less economically or physically capable of adapting to climate change. The study therefore recommends that at each level, the needs, knowledge, and voices of vulnerable populations, including indigenous peoples and resource-based communities, deserve consideration and incorporation so that climate change policy (1) ensures that all people are supported and able to act, (2) provides as robust a strategy as possible to address a rapidly changing environment, and (3) enhances equity and justice.

Keywords: climate change, vulnerable, socio-economic, livelihoods

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793 Biases in Macroprudential Supervision and Their Legal Implications

Authors: Anat Keller

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Given that macro-prudential supervision is a relatively new policy area and its empirical and analytical research are still in their infancy, its theoretical foundations are also lagging behind. This paper contributes to the developing discussion on effective legal and institutional macroprudential supervision frameworks. In the first part of the paper, it is argued that effectiveness as a key benchmark poses some challenges in the context of macroprudential supervision such as the difficulty in proving causality between supervisory actions and the achievement of the supervisor’s mission. The paper suggests that effectiveness in the macroprudential context should, therefore, be assessed at the supervisory decision-making process (to be differentiated from the supervisory outcomes). The second part of the essay examines whether insights from behavioural economics can point to biases in the macroprudential decision-making process. These biases include, inter alia, preference bias, groupthink bias and inaction bias. It is argued that these biases are exacerbated in the multilateral setting of the macroprudential supervision framework in the EU. The paper then examines how legal and institutional frameworks should be designed to acknowledge and perhaps contain these identified biases. The paper suggests that the effectiveness of macroprudential policy will largely depend on the existence of clear and robust transparency and accountability arrangements. Accountability arrangements can be used as a vehicle for identifying and addressing potential biases in the macro-prudential framework, in particular, inaction bias. Inclusiveness of the public in the supervisory process in the form of transparency and awareness of the logic behind policy decisions may assist in minimising their potential unpopularity thus promoting their effectiveness. Furthermore, a governance structure which facilitates coordination of the macroprudential supervisor with other policymakers and incorporates outside perspectives and opinions could ‘break-down’ groupthink bias as well as inaction bias.

Keywords: behavioural economics and biases, effectiveness of macroprudential supervision, legal and institutional macroprudential frameworks, macroprudential decision-making process

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792 A Study of Teachers’ View on Modern Methods of Teaching Regarding the Quality of Instruction in Shiraz High Schools

Authors: Nasrin Badrkhani

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Teaching is an interaction between the teacher, student, and the concept being taught, especially within the classroom setting. As society increasingly values thoughtful and creative individuals, there is a growing need to adopt modern, active teaching methods. These methods should engage students in activities that foster problem-solving, creativity, cooperation, and scientific thinking skills. Modern teaching methods emphasize student involvement, gradual and continuous learning (process-centered approaches), and holistic evaluation of students' abilities and talents. A shift from teacher-centered to student-centered teaching is crucial. Among these modern methods are group work, role-playing, group discussions, and activities that engage students in evaluating societal values. This research employs a survey and a 38-question Likert scale questionnaire to explore teachers' perspectives on the impact of modern teaching methods on the quality of education. The study also examines the relationship between these perspectives and variables such as gender, major, and teaching experience. The statistical population consists of high school teachers in Shiraz, Iran, with sampling done using the Morgan table. Discriminant analysis was used for the initial analysis of the questions, and Cronbach's Alpha test was employed for the final examination. SPSS Software was used for statistical analysis, including T-tests and one-way ANOVA. The results indicate that teachers in this city generally have positive attitudes towards the use of modern teaching methods, except when it comes to engaging in judgments concerning societal values. There is no significant difference in viewpoints based on gender or educational background. The findings are consistent with similar studies conducted both within Iran and internationally.

Keywords: learning, modern methods, student, teacher, teaching

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791 The Comparison of Forward Head Posture Measurements between Dominant and Non-Dominant Sides in Male Football Players and Non-Athletes

Authors: Mohamed Gomaa Mohamed

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Background and purpose: Ideal posture involves a minimal amount of stress or strain on various body segments which are aligned and worked in harmony to protect the body from injury or progressive deformity. One of most common faulty posture encountered in clinical setting is forward head posture (FHP) that was considered one of the main predictors for neck pain. Furthermore, FHP may predispose to thoracic outlet syndrome, temporomandibular joint dysfunction, shoulder pain and headache. The large financial burden related to neck disorders management raises the need to improve the quality of assessment and rehabilitation of FHP. So, the purpose of the study is to compare between measurements of FHP as indicated with craniovertebral (CVA) and gaze angles assessed from dominant and non-dominant sides in football players who extensively use their dominant side and non-athletic subjects. Participants: Twenty-four subjects were divided into 12 football players and 12 non-athletic subjects. Methods: CVA and gaze angles were assessed through photogrammetric method. Photos were taken from dominant and non-dominant sides of the subjects while assuming standing position. Paired t-test was used to assess angles differences between dominant and non-dominant sides of the subjects. Since there were no statistical differences between CVA and gaze angles measured from dominant and non-dominant sides in each group, we pooled data together to become 24 measurements for each group (12 from dominant and 12 from non-dominant). Independent t-test was used to assess angles differences between football players and non-athletic subjects. Results: No significant differences were found between CVA and gaze angles measured from dominant and non-dominant sides of both groups (P>0.05). Also, there were no significant differences between CVA and gaze angles measured from football players and non-athletic subjects (P>0.05). Conclusion: FHP can be assessed from dominant or non-dominant sides interchangeably either in football players or non-athletic subjects. Furthermore, playing football has no impact on measurements of FHP when compared to non-athletic subjects.

Keywords: dominant side, forward head posture, football players, non-dominant side

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790 An Analysis of the Affect of Climate Change on Humanitarian Law: The Way Forward

Authors: Anjali Kanagali, Astha Sinha

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Climate change is the greatest threat being faced by mankind in the 21st century. It no longer is merely an environmental, scientific or economic issue but is a humanitarian issue as well. Paris Agreement put great pressure on the businesses to reduce carbon emissions and mitigate the impact of climate change. However, the already increased climate variability and extreme weather are aggravating emergency humanitarian needs. According to the Intergovernmental Panel on Climate Change (IPCC), if efficient policy changes are not made in time to combat the climate change issues, the situation will deteriorate with an estimated global temperature rise of 4 degrees. The existing international network of Humanitarian system is not adequately structured to handle the projected natural disasters and climate change crisis. The 2030 Agenda which embraces the 17 Sustainable Development Goals (SGDs) discussed the relationship between the climate change and humanitarian assistance. The Humanitarian law aims to protect, amongst other things, ‘internally displaced persons’ which includes people displaced due to natural hazard related disasters engulfing the hazards of climate change. ‘Legal protection’ of displaced people to protect their rights is becoming a pressing need in such times. In this paper, attempts will be made to analyze the causes of the displacement, identify areas where the effect of the climate change is most likely to occur and to examine the character of forced displacement triggering population movement. We shall discuss the pressure on the Humanitarian system and assistance due to climate change issues and the need for vesting powers to the local communities or local government players to deal with the climate changes. We shall also discuss the possibility of setting up a new framework where non-state actors could be set up for climate change impact and its governance.

Keywords: humanitarian assistance to climate change, humanitarian crisis, internally displaced person, legal framework for climate migrants, non-state actors

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789 The Psychology of Cross-Cultural Communication: A Socio-Linguistics Perspective

Authors: Tangyie Evani, Edmond Biloa, Emmanuel Nforbi, Lem Lilian Atanga, Kom Beatrice

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The dynamics of languages in contact necessitates a close study of how its users negotiate meanings from shared values in the process of cross-cultural communication. A transverse analysis of the situation demonstrates the existence of complex efforts on connecting cultural knowledge to cross-linguistic competencies within a widening range of communicative exchanges. This paper sets to examine the psychology of cross-cultural communication in a multi-linguistic setting like Cameroon where many local and international languages are in close contact. The paper equally analyses the pertinence of existing macro sociological concepts as fundamental knowledge traits in literal and idiomatic cross semantic mapping. From this point, the article presents a path model of connecting sociolinguistics to the increasing adoption of a widening range of communicative genre piloted by the on-going globalisation trends with its high-speed information technology machinery. By applying a cross cultural analysis frame, the paper will be contributing to a better understanding of the fundamental changes in the nature and goals of cross-cultural knowledge in pragmatics of communication and cultural acceptability’s. It emphasises on the point that, in an era of increasing global interchange, a comprehensive inclusive global culture through bridging gaps in cross-cultural communication would have significant potentials to contribute to achieving global social development goals, if inadequacies in language constructs are adjusted to create avenues that intertwine with sociocultural beliefs, ensuring that meaningful and context bound sociolinguistic values are observed within the global arena of communication.

Keywords: cross-cultural communication, customary language, literalisms, primary meaning, subclasses, transubstantiation

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788 Performance Evaluation and Kinetics of Artocarpus heterophyllus Seed for the Purification of Paint Industrial Wastewater by Coagulation-Flocculation Process

Authors: Ifeoma Maryjane Iloamaeke, Kelvin Obazie, Mmesoma Offornze, Chiamaka Marysilvia Ifeaghalu, Cecilia Aduaka, Ugomma Chibuzo Onyeije, Claudine Ifunanaya Ogu, Ngozi Anastesia Okonkwo

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This work investigated the effects of pH, settling time, and coagulant dosages on the removal of color, turbidity, and heavy metals from paint industrial wastewater using the seed of Artocarpus heterophyllus (AH) by the coagulation-flocculation process. The paint effluent was physicochemically characterized, while AH coagulant was instrumentally characterized by Scanning Electron Microscope (SEM), Fourier Transform Infrared (FTIR), and X-ray diffraction (XRD). A Jar test experiment was used for the coagulation-flocculation process. The result showed that paint effluent was polluted with color, turbidity (36000 NTU), mercury (1.392 mg/L), lead (0.252 mg/L), arsenic (1.236 mg/L), TSS (63.40mg/L), and COD (121.70 mg/L). The maximum color removal efficiency was 94.33% at the dosage of 0.2 g/L, pH 2 at a constant time of 50 mins, and 74.67% at constant pH 2, coagulant dosage of 0.2 g/L and 50 mins. The highest turbidity removal efficiency was 99.94% at 0.2 g/L and 50 mins at constant pH 2 and 96.66% at pH 2 and 0.2 g/L at constant time of 50 mins. The mercury removal efficiency of 99.29% was achieved at the optimal condition of 0.8 g/L coagulant dosage, pH 8, and constant time of 50 mins and 99.57% at coagulant dosage of 0.8 g/L, time of 50 mins constant pH 8. The highest lead removal efficiency was 99.76% at a coagulant dosage of 10 g/L, time of 40 mins at constant pH 10, and 96.53% at pH 10, coagulant dosage of 10 g/L and constant time of 40 mins. For arsenic, the removal efficiency is 75.24 % at 0.8 g/L coagulant dosage, time of 40 mins, and constant pH of 8. XRD imaging before treatment showed that Artocarpus heterophyllus coagulant was crystalline and changed to amorphous after treatment. The SEM and FTIR results of the AH coagulant and sludge suggested there were changes in the surface morphology and functional groups before and after treatment. The reaction kinetics were modeled best in the second order.

Keywords: Artocarpus heterophyllus, coagulation-flocculation, coagulant dosages, setting time, paint effluent

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787 Investigating the Role of Algerian Middle School Teachers in Enhancing Academic Self-Regulation: A Key towards Teaching How to Learn

Authors: Houda Zouar, Hanane Sarnou

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In the 21st, century the concept of learners' autonomy is crucial. The concept of self-regulated learning has come forward as a result of enabling learners to direct their learning with autonomy towards academic goals achievement. Academic self-regulation is defined as the process by which learners systematically plan, monitor and asses their learning to achieve their academic established goals. In the field of English as a foreign language, teachers emphasise the role of learners’ autonomy to foster the process of English language learning. Consequently, academic self-regulation is considered as a vehicle to enhance autonomy among English language learners. However, not all learners can be equally self-regulators if not well assisted, mainly those novice pupils of basic education. For this matter, understanding the role of teachers in fostering academic self- regulation must be among the preliminary objectives in searching and developing this area. The present research work targets the role of the Algerian middle school teachers in enhancing academic self-regulation and teaching pupils how to learn, besides their role as models in the trajectory of teaching their pupils to become self-regulators. Despite the considerable endeavours in the field of educational setting on Self-Regulated Learning, the literature of the Algerian context indicates confined endeavours to undertake and divulge this notion. To go deeper into this study, a mixed method approach was employed to confirm our hypothesis. For data collection, teachers were observed and addressed by a questionnaire on their role in enhancing academic self- regulation among their pupils. The result of the research indicates that the attempts of middle school Algerian teachers are implicit and limited. This study emphasises the need to prepare English language teachers with the necessary skills to promote autonomous and self-regulator English learners.

Keywords: Algeria, English as a foreign language, middle school, self-regulation, Teachers' role

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786 The Use of Respiratory Index of Severity in Children (RISC) for Predicting Clinical Outcomes for 3 Months-59 Months Old Patients Hospitalized with Community-Acquired Pneumonia in Visayas Community Medical Center, Cebu City from January 2013 - June 2

Authors: Karl Owen L. Suan, Juliet Marie S. Lambayan, Floramay P. Salo-Curato

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Objective: To predict the outcome among patients admitted with community-acquired pneumonia (ages 3 months to 59 months old) admitted in Visayas Community Medical Center using the Respiratory Index of Severity in Children (RISC). Design: A cross-sectional study design was used. Setting: The study was done in Visayas Community Medical Center, which is a private tertiary level in Cebu City from January-June 2013. Patients/Participants: A total of 72 patients were initially enrolled in the study. However, 1 patient transferred to another institution, thus 71 patients were included in this study. Within 24 hours from admission, patients were assigned a RISC score. Statistical Analysis: Cohen’s kappa coefficient was used for inter-rater agreement for categorical data. This study used frequency and percentage distribution for qualitative data. Mean, standard deviation and range were used for quantitative data. To determine the relationship of each RISC score parameter and the total RISC score with the outcome, a Mann Whitney U Test and 2x2 Fischer Exact test for testing associations were used. A p value less of than 0.05 alpha was considered significant. Results: There was a statistical significance between RISC score and clinical outcome. RISC score of greater than 4 was correlated with intubation and/or mortality. Conclusion: The RISC scoring system is a simple combination of clinical parameters and a reliable tool that will help stratify patients aged 3 months to 59 months in predicting clinical outcome.

Keywords: RISC, clinical outcome, community-acquired pneumonia, patients

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785 Intercultural Education and Changing Paradigms of Education: A Research Survey

Authors: Shalini Misra

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The means and methods of education have been changing fast since the invention of internet. Both, ancient and modern education emphasized on the holistic development of students. But, a significant change has been observed in the 21st century learners. Online classes, intercultural and interdisciplinary education which were exceptions in the past, are setting new trends in the field of education. In the modern era, intercultural and interpersonal skills are of immense importance, not only for students but for everyone. It sets a platform for better understanding and deeper learning by ensuring the active participation and involvement of students belonging to different social and cultural backgrounds in various academic and non-academic pursuits. On October 31, 2015, on the occasion of 140th birth anniversary of Sardar Vallabhbhai Patel, Hon’ble Prime Minister of India, Narendra Modi announced a wonderful initiative, ‘Ek Bharat Shreshtha Bharat’ i.e. ‘One India Best India’ commonly known as ‘EBSB’. The program highlighted India’s rich culture and traditions. The objective of the program was to foster a better understanding and healthy relationship among Indian States. Under this program, a variety of subjects were covered like ‘Arts, Culture and Language’ .It was claimed to be a successful cultural exchange where students from diverse communities shared their thoughts and experiences with one another. Under this online cultural exchange program, the state of Uttarakhand was paired with the state of Karnataka in the year 2022. The present paper proposes to undertake a survey of a total of thirty secondary level students of Uttarakhand and the partner state Karnataka, who participated in this program with a purpose of learning and embracing new ideas and culture thus promoting intercultural education. It aims to study and examine the role of intercultural education in shifting and establishing new paradigms of education.

Keywords: education, intercultural, interpersonal, traditions, understanding

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784 Flourishing in Marriage among Arab Couples in Israel: The Impact of Capitalization Support and Accommodation on Positive and Negative Affect

Authors: Niveen Hassan-Abbas, Tammie Ronen-Rosenbaum

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Background and purpose: 'Flourishing in marriage' is a concept refers to married individuals’ high positivity ratio regarding their marriage, namely greater reported positive than negative emotions. The study proposes a different approach to marriage which emphasizes the place of the individual himself as largely responsible for his personal flourishing within marriage. Accordingly, the individual's desire to preserve and strengthen his marriage largely determines the marital behavior in a way that will contribute to his marriage success (Actor Effect), regardless the contribution of his or her partner to his marriage success (Partner Effect). Another assumption was that flourishing in marriage could be achieved by two separate processes, where capitalization support increases the positive marriage's evaluations and accommodation decreases the negative one. A theoretical model was constructed, whereby individuals who were committed to their marriage were hypothesized as employing self-control skills by way of two dynamic processes. First, individual’s higher degree of 'capitalization supportive responses' - supportive responses to the partner's sharing of positive personal experiences - was hypothesized as increasing one’s positive evaluations of marriage and thereby one’s positivity ratio. Second, individual’s higher degree of 'accommodation' responses - the ability during conflict situations to control the impulse to respond destructively and instead to respond constructively - was hypothesized as decreasing one’s negative evaluations of marriage and thereby increasing one’s positivity ratio. Methods: Participants were 156 heterosexual Arab couples from different regions of Israel. The mean period of marriage was 10.19 (SD=7.83), ages were 31.53 years for women (SD=8.12) and 36.80 years for men (SD=8.07). Years of education were 13.87 for women (SD=2.84) and 13.23 years for men (SD=3.45). Each participant completed seven questionnaires: socio-demographic, self-control skills, commitment, capitalization support, accommodation, marital quality, positive and negative affect. Using statistical analyses adapted to dyadic research design, firstly descriptive statistics were calculated and preliminary tests were performed. Next, dyadic model based on the Actor-Partner Interdependence Model (APIM) were tested using structural equation modeling (SEM). Results: The assumption according to which flourishing in marriage can be achieved by two processes was confirmed. All of the Actor Effect hypotheses were confirmed. Participants with higher self-control used more capitalization support and accommodation responses. Among husbands, unlike wives, these correlations were stronger when the individual's commitment level was higher. More capitalization supportive responses were found to increase positive evaluations of marriage, and greater spousal accommodation was found to decrease negative evaluations of marriage. High positive evaluations and low negative evaluations were found to increase positivity ratio. Not according to expectation, four partner effect paths were found significant. Conclusions and Implications: The present findings coincide with the positive psychology approach that emphasizes human strengths. The uniqueness of this study is its proposal that individuals are largely responsible for their personal flourishing in marriage. This study demonstrated that marital flourishing can be achieved by two processes, where capitalization increases the positive and accommodation decreases the negative. Practical implications include the need to construct interventions that enhance self-control skills for employment of capitalizing responsiveness and accommodation processes.

Keywords: accommodation, capitalization support, commitment, flourishing in marriage, positivity ratio, self-control skills

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783 Immature Palm Tree Detection Using Morphological Filter for Palm Counting with High Resolution Satellite Image

Authors: Nur Nadhirah Rusyda Rosnan, Nursuhaili Najwa Masrol, Nurul Fatiha MD Nor, Mohammad Zafrullah Mohammad Salim, Sim Choon Cheak

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Accurate inventories of oil palm planted areas are crucial for plantation management as this would impact the overall economy and production of oil. One of the technological advancements in the oil palm industry is semi-automated palm counting, which is replacing conventional manual palm counting via digitizing aerial imagery. Most of the semi-automated palm counting method that has been developed was limited to mature palms due to their ideal canopy size represented by satellite image. Therefore, immature palms were often left out since the size of the canopy is barely visible from satellite images. In this paper, an approach using a morphological filter and high-resolution satellite image is proposed to detect immature palm trees. This approach makes it possible to count the number of immature oil palm trees. The method begins with an erosion filter with an appropriate window size of 3m onto the high-resolution satellite image. The eroded image was further segmented using watershed segmentation to delineate immature palm tree regions. Then, local minimum detection was used because it is hypothesized that immature oil palm trees are located at the local minimum within an oil palm field setting in a grayscale image. The detection points generated from the local minimum are displaced to the center of the immature oil palm region and thinned. Only one detection point is left that represents a tree. The performance of the proposed method was evaluated on three subsets with slopes ranging from 0 to 20° and different planting designs, i.e., straight and terrace. The proposed method was able to achieve up to more than 90% accuracy when compared with the ground truth, with an overall F-measure score of up to 0.91.

Keywords: immature palm count, oil palm, precision agriculture, remote sensing

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782 Antibacterial Activity of Copper Nanoparticles on Vancomycin Resistant Staphylococcus Aureus in Vitro and Animal Models

Authors: Sina Gharevali

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Staphylococcus aureus is one of the most important factors for nosocomial infections and infections acquired in a hospital setting role as is. Drug-resistant bacteria methicillin, which in 1961 was reported in many parts of the world, Made the role as the last drug, vancomycin, in the treatment of infections caused by the Staphylococcus aureus chain be taken into consideration. The aim of this study was to evaluate the antimicrobial effects of copper nanoparticles and compared it with antibiotics on Staphylococcus aureus resistant to vancomycin in vitro and animal model. In this study, this test was performed, and the most effective antibiotic for vancomycin-resistant Staphylococcus aureus was determined by disk diffusion method. After various concentrations of copper nanoparticles and antibiotics were prepared and vancomycin resistant Staphylococcus aureus bacteria with serial dilution method for determining antibiotic ciprofloxacin. Minimum Inhibitory Concentration and Minimum Bactericidal Concentrationcopper nanoparticles was performed. The agar dilution method for bacterial growth in different concentrations of copper nanoparticles and antibiotics ciprofloxacin was performed. The agar dilution method for bacterial growth in different concentrations of copper nanoparticles and antibiotics ciprofloxacin was performed. Then the broth dilution method for the antibiotic ciprofloxacin, nano-particles, and nano-particles of copper and copper-established antibiotic synergy MIC and MBC were obtained. MBC was obtained from the experimental animal model test method, and the results were compared. The results showed that copper nanoparticles compared with the antibiotic ciprofloxacin in vitro and animal model more effective in inhibiting the growth of Staphylococcus aureus resistant to vancomycin and ciprofloxacin and extent of the impact of the Synthetic effect of lower copper nanoparticles. Which can then be used to treat clinical research as a candidate.

Keywords: nanoparticles, copper, staphylococcus, aureus

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781 Risk Factors Associated with Obesity Among Adults in Tshikota, Makhado Municipality, Limpopo Province, South Africa

Authors: Ndou Rembuluwani Moddy, Daniel Ter Goon, Takalani Grace Tshitangano, Lindelani Fhumudzani Mushaphi

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Obesity is a global public health problem. The study aimed to determine the risk factors associated with and the consequences of obesity among residents of Tshikota, Makhado Municipality, Limpopo Province, South Africa. A cross-sectional study involving 318 randomly selected adults aged 18-45 years residing at Tshikota, Makhado Local Municipality, South Africa. Sociodemographic information includes age, gender, educational level, occupation, behavioral lifestyle, environmental, psychological, and family history. Anthropometric, blood pressure, and blood glucose measurements followed standard procedure. The prevalence of obesity and overweight was 35.5% and 28.6%, respectively. About 75.2% of obese do not engage in physical activity. Most participants (63.5%) take meals three times a day, and 19.2% do not skip breakfast. Most participants do not have access to fruits and vegetables. Participants who were pre-hypertensive were 92(28.9%) and 32(10.1%) were in Stage 1 hypertension. Of the participants with Class 1 obesity, 40.9% were pre-hypertensive, and 15.2% were in Stage 1 hypertension. In Class 2 obesity, 37.8% were pre-hypertensive, and 26.7% were in Stage 1 hypertension. There was a significant difference between BMI and blood pressure among participants (p=0.00). About 6.1% of the participants in Class 1 obesity were at high risk, and 3.0% were at very high risk of glucose levels. Regarding cholesterol levels, 65 (20.4%) were at borderline, and 17(5.3%) were at high risk. There was no significant difference in BMI and cholesterol levels among participants (p= 0.20). The prevalence of obesity and overweight was high among residents of this setting. Age, marital and educational status, and employment were significantly associated with obesity. An obesity awareness campaign is crucial, and the availability of supermarkets and full-service grocery stores would provide accessibility to healthy food such as fruits and vegetables.

Keywords: obesity, overweight, risk factors, adults.

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780 The Role of Leader, Member Exchange on Psychological Capital, Mediated by Person-Organisational Fit

Authors: Sonja Grobler

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Background: Leadership and specifically Leader, member exchange has a definite impact on employee behaviour and attitudes, and specifically their state of psychological capital. The interactionist construct of person-organisational fit (P-O fit), consisting of a combination of supplementary fit (indirect fit or value congruence) and complementary fit (direct or person-job fit, as well as needs-supply fit) may, however, impact on the relationship between LMX and psychological capital. The unique permutations of these relationships are important not only for conceptualisation purposes but also for intervention design to enhance the employees’ psychological capital; this would contribute to positive employee behaviour and attitudes. Aim: The purpose of this study was to determine whether a relationship exists between Leader, Member Exchange (LMX) and psychological capital, with possible mediation by P-O fit. Setting: The research was conducted with ± 60 employees from each of 43 private sectors and four public sector organisations in South Africa. Method: This study utilised a positivist methodology based on an empirical approach while using a cross-sectional design and quantitative analysis. The sample is relatively representative (in terms of race, gender, and the South African work force), as it consisted of 60 employees from each of the 43 South African organisations that participated in the study, with 2 486 respondents in total. Results: Significant, positive relationships were found between LMX, P-O fit, and psychological capital. Additionally, it was found that P-O fit partially mediates the relationship between ethical leadership and supervisory trust, confirming the proposed model. Conclusion: A strong, positive relationship exists between LMX (consisting of Affect, Loyalty, Contribution, and Professional Respect) and psychological capital (consisting of Self-efficacy, Hope, Resilience and Optimism) which is partially mediated by P-O fit (consisting of supplementary fit and complementary fit).

Keywords: leader and member exchange, person-organisational fit, psychological capital, positive psychology, interactionist approach

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779 From Mobility to Complexity: French Language Use among Algerian Doctoral Postgraduates in Scotland

Authors: Hadjer Chellia

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The study explores the phenomenon of second language use in a migratory setting and uses the case of Algerian international students in Scotland, United Kingdom. The linguistic history of Algeria reveals that French language has a high status among the Algerians’ verbal repertoires and Algerian English students consider it as a language of prestige. With mobility of some of these students towards Scotland -in the guise of internationalization of higher education, mobility and exchange programs, the transition was deemed to bring more complexity to their pre-migratory linguistic repertoires and resulted into their French language- being endangered and threatened by a potential shift to English. The study employed semi-structured interviews among six Ph.D. ethnically related students, and the main aim behind that is to explore their current experiences with regards to French language use and to provide an account of the factors which assist in shifting to English as a second language instead. The six participants identified in interviews were further invited to focus group sessions based on an in-group interaction fashion to discuss different topics using heritage languages. This latter was opted for as part of the methodology as a means to observe their real linguistic practice and to investigate the link between behaviors and previous perceptions. The findings detect a variety of social, individual and socio-psychological factors that would contribute in refining the concept of language shift among newly established émigré communities with short stay vis a vis the linguistic outcomes of immigrants with long stay, across generational basis that was –to some extent-the focus of previous research on language shift. The results further reveal a mismatch between students' perceptions and observed behaviors. The research is then largely relevant to international students’ sociolinguistic experience of study abroad.

Keywords: complexity, mobility, potential shift, sociolinguistic experience

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778 Solid Health Care Waste Management Practice in Ethiopia

Authors: Yeshanew Ayele Tiruneh, L. M. Modiba, S. M. Zuma

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Introduction- Healthcare waste is any waste generated by health care facilities, considered potentially hazardous to health. Solid health care waste is categorised into infectious and non-infectious wastes. Infectious waste is material suspected to contain pathogens. The non-infectious waste includes wastes that have not been in contact with infectious agents, hazardous chemicals, or radioactive substances. The purpose is to assess solid health care waste (SHCW) management practice toward developing guidelines. The setting is all health facilities found in Hossaena town. A mixed-method study design used. For the qualitative part, small purposeful samples were considered and large samples for the quantitative phase. Both samples were taken from the same population. Result - 17(3.1%) of health facility workers have hand washing facilities. 392 (72.6%) of the participants agree on the availability of one or more of personal protective equipment (PPE) in the facility ‘’the reason for the absence of some of the PPEs like boots, goggles, and shortage of disposable gloves are owing to cost inflation from time to time and sometimes absent from the market’’. The observational finding shows that colour coded waste bins are available at 23 (9.6%) of the rooms. Majority of the sharp container used in the health facility are reusable in the contrary to the health care waste management standards and most of them are plastic buckets and easily cleanable. All of the health facility infectious waste are collected transported and deposed daily. Regarding the preventive vaccination nearly half of the the fahealth facility workers wer vaccinated for Hep B virus. Conclusion- Hand washing facilities, personal protective equipment’s and preventive vaccinations are not easily available for health workers. Solid waste segregation practices are poor and these practices showed that SWMP is below the acceptable level.

Keywords: health care waste, waste management, disposal, private health facilities

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777 Mapping of Risks and Opportunities for Adolescents Girls’ Sexual and Reproductive Health in Peri-Urban Setting in Mwanza, Tanzania

Authors: Soori Nnko, Zaina Mchome, John Dusabe, Angela Obasi

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In sub-Saharan Africa, adolescent girls living in urban and periurban settings are among the groups at increased risk of getting sexually transmitted infections. One of the challenges to improve uptake of sexual and reproductive health (SRH) services among adolescents is linked to little appreciation about their vulnerability and the knowledge on availability of the SRH services. Objective: This study assesses adolescents’ perceptions on risks for SRH problems and the availability of services to prevent against SRH problems. Methodology: The study was conducted in March 2011 in Mwanza region, Tanzania. Data collection techniques included 18 Participatory Group Discussions and 17 In-depth Interviews with adolescents and young mothers aged 15-20 years. Results: Adolescents indicated that risk places included their homes, bushes, commercial centers, roadsides as well as school settings. Risk for having unprotected sex varied depending on where you are, and the time of the day. For example, collection of firewood in the bushes or water from the wells exposed girls to men who forced or lured them to have sex. The girls reported to encounter motorcyclists who offered the ride in exchange for sex. Girls also knew myriads places to seek SRH services, including public and private clinics, drug shops and traditional healers. Despite being aware of risky environment, and places to seek the services, access to SRH services were limited due to the stigma and negative attitude of community regarding adolescents’ utilization of SRH services. Conclusion: Adolescents are exposed to various risky environments, yet due to social stigma they have difficult to access the available SRH services.

Keywords: adolescent girls, sexual and reproductive health, AIDS, risk, opportunities, interventions, sub Saharan africa

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776 The Role of Cultural Expectations in Emotion Regulation among Nepali Adolescents

Authors: Martha Berg, Megan Ramaiya, Andi Schmidt, Susanna Sharma, Brandon Kohrt

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Nepali adolescents report tension and negative emotion due to perceived expectations of both academic and social achievement. These societal goals, which are internalized through early-life socialization, drive the development of self-regulatory processes such as emotion regulation. Emotion dysregulation is linked with adverse psychological outcomes such as depression, self-harm, and suicide, which are public health concerns for organizations working with Nepali adolescents. This study examined the relation among socialization, internalized cultural goals, and emotion regulation to inform interventions for reducing depression and suicide in this population. Participants included 102 students in grades 7 through 9 in a post-earthquake school setting in rural Kathmandu valley. All participants completed a tablet-based battery of quantitative measures, comprising transculturally adapted assessments of emotion regulation, depression, and self-harm/suicide ideation and behavior. Qualitative measures included two focus groups and semi-structured interviews with 22 students and 3 parents. A notable proportion of the sample reported depression symptoms in the past 2 weeks (68%), lifetime self-harm ideation (28%), and lifetime suicide attempts (13%). Students who lived with their nuclear family reported lower levels of difficulty than those who lived with more distant relatives (z=2.16, p=.03), which suggests a link between family environment and adolescent emotion regulation, potentially mediated by socialization and internalization of cultural goals. These findings call for further research into the aspects of nuclear versus extended family environments that shape the development of emotion regulation.

Keywords: adolescent mental health, emotion regulation, Nepal, socialization

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775 Role of Endotherapy vs Surgery in the Management of Traumatic Pancreatic Injury: A Tertiary Center Experience

Authors: Thinakar Mani Balusamy, Ratnakar S. Kini, Bharat Narasimhan, Venkateswaran A. R, Pugazhendi Thangavelu, Mohammed Ali, Prem Kumar K., Kani Sheikh M., Sibi Thooran Karmegam, Radhakrishnan N., Mohammed Noufal

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Introduction: Pancreatic injury remains a complicated condition requiring an individualized case by case approach to management. In this study, we aim to analyze the varied presentations and treatment outcomes of traumatic pancreatic injury in a tertiary care center. Methods: All consecutive patients hospitalized at our center with traumatic pancreatic injury between 2013 and 2017 were included. The American Association for Surgery of Trauma (AAST) classification was used to stratify patients into five grades of severity. Outcome parameters were then analyzed based on the treatment modality employed. Results: Of the 35 patients analyzed, 26 had an underlying blunt trauma with the remaining nine presenting due to penetrating injury. Overall in-hospital mortality was 28%. 19 of these patients underwent exploratory laparotomy with the remaining 16 managed nonoperatively. Nine patients had a severe injury ( > grade 3) – of which four underwent endotherapy, three had stents placed and one underwent an endoscopic pseudocyst drainage. Among those managed nonoperatively, three underwent a radiological drainage procedure. Conclusion: Mortality rates were clearly higher in patients managed operatively. This is likely a result of significantly higher degrees of major associated non-pancreatic injuries and not just a reflection of surgical morbidity. Despite this, surgical management remains the mainstay of therapy, especially in higher grades of pancreatic injury. However we would like to emphasize that endoscopic intervention definitely remains the preferred treatment modality when the clinical setting permits. This is especially applicable in cases of main pancreatic duct injury with ascites as well as pseudocysts.

Keywords: endotherapy, non-operative management, surgery, traumatic pancreatic injury

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774 Changing Pedagogy from Segregation to Inclusion: A Phenomenological Case Study of Ten Special Educators

Authors: Monique Somma

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As special education service delivery models are shifting in order to better meet the academic and social rights of students with exceptionalities, teaching practices must also align with these goals. This phenomenological case study explored the change experiences of special education teachers who have transitioned from teaching in a self-contained special education class to an inclusive class setting. Ten special educators who had recently changed their teaching roles to inclusive classrooms, completed surveys and participated in a focus group. Of the original ten educators, five chose to participate further in individual interviews. Data collected from the three methods was examined and compared for common themes. Emergent themes included, support and training, attitudes and perceptions, inclusive practice, growth and change, and teaching practice. The overall findings indicated that despite their special education training, these educators were challenged by their own beliefs and expectations, the attitudes of others and systematic barriers in the education system. They were equally surprised by the overall social and academic performance of students with exceptionalities in inclusive classes, as well as, the social and academic growth and development of the other students in the class. Over the course of their careers, they all identified an overall personal pedagogical shift, to some degree or another, which they contributed to the successful experiences of inclusion they had. They also recognized that collaborating with others was essential for inclusion to be successful. The findings from this study suggest several implications for professional development and training needs specific to special education teachers moving into inclusive settings. Maximizing the skills of teachers with special education experience in a Professional Learning Community (PLC) and mentorship opportunities would be beneficial to all staffs working toward creating inclusive classrooms and schools.

Keywords: attitudes and perceptions, inclusion of students with exceptionalities, special education teachers, teacher change

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773 Assessing the Impact of Industry 4.0 Implementation on Carbon Neutrality in industries

Authors: Sepinoud Hamedi

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The ponder points to observationally look at the impact of carbon-neutrality approaches on the key assets required for Industry 4.0 driven savvy fabricating and how these assets can give a economical competitive advantage. The hypothetical system is coordinates with the regulation hypothesis and the resource-based see (RBV). The observational strategy is utilized for collecting information through studies and assist covariance-based auxiliary condition modeling is utilized to test the theories. Discoveries demonstrate that carbon–neutral-based government arrangements have a more grounded impact on unmistakable assets and human aptitudes than intangible assets related to Industry 4.0 driven shrewd fabricating. Moment, carbon–neutral arrangement arrangement with the firm’s maintainability destinations plays a directing impact on the relationship between carbon–neutral-based government arrangements and assets (substantial, intangible assets and human abilities) for Industry 4.0 driven shrewd fabricating. Finally, the three assets (substantial, intangible assets and human abilities) for Industry 4.0 driven savvy fabricating play a basic part in creating firms’ carbon–neutral capability and assist improving operational execution. Administrative suggestions incorporate venture in progressed advanced innovations, creating a solid mentality among workers and supply chain partners, and planning preparing programs for upgrading shrewd fabricating execution to create carbon-neutrality capability. This think about proposes a crossover hypothesis within the setting of carbon nonpartisanship by coordination institutional theory and RBV. Typically the primary think about that looks at the impact of carbon neutrality-based government arrangements on crucial Industry 4.0-driven savvy fabricating assets and the circuitous impact on carbon nonpartisanship capability and operational execution.

Keywords: carbon, industry 4.0, neutrality, RBV, nonpartisanship

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772 Trainees' Perception of Virtual Learning Skills in Setting up the Simulator Welding Technology

Authors: Mohd Afif Md Nasir, Mohd Faizal Amin Nur, Jamaluddin Hasim, Abd Samad Hasan Basari, Mohd Halim Sahelan

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This study is aimed to investigate the suitability of Computer-Based Training (CBT) as one of the approaches in skills competency development at the Centre of Instructor and Advanced Skills Training (CIAST) Shah Alam Selangor and National Youth Skills Institute (NYSI) Pagoh Muar Johor. This study has also examined the perception among trainees toward Virtual Learning Environment (VLE) as to realize the development of skills in Welding Technology. The significance of the study is to create a computer-based skills development approach in welding technology among new trainees in CIAST and IKBN as well as to cultivate the element of general skills among them. This study is also important in elevating the number of individual knowledge workers (K-Workers) working in manufacturing industry in order to achieve the national vision which is to be an industrial nation in the year 2020. The design is a survey of research which using questionnaires as the instruments and is conducted towards 136 trainees from CIAST and IKBN. Data from the questionnaires is proceeding in a Statistical Package for Social Science (SPSS) in order to find the frequency, mean and chi-square testing. The findings of the study show the welding technology skills have developed in the trainees as a result of the application of the Virtual Reality simulator at a high level (mean=3.90) and the respondents agreed the skills could be embedded through the application of the Virtual Reality simulator (78.01%). The Study also found that there is a significant difference between trainee skill characteristics through the application of the Virtual Reality simulator (p<0.05). Thereby, the Virtual Reality simulator is suitable to be used in the development of welding skills among trainees through the skills training institute.

Keywords: computer-based training, virtual learning environment, welding technology, virtual reality simulator, virtual learning environment

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771 Challenges and Opportunities for Facilitating Telemedicine Services Through Information and Communication Technologies (ICT) in Ethiopia

Authors: Wegene Demeke

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Background: The demand for healthcare services is growing in developing and developed countries. Information and communication technology is used to facilitate healthcare services. In the case of developing countries, implementing telemedicine is aimed at providing healthcare for people living in remote areas where health service is not accessible. The implementations of telemedicine in developing countries are unsuccessful. For example, the recent study indicates that 90% of telemedicine projects are abandoned or failed in developing countries. Several researchers reported the technological challenges as the main factor for the non-adoption of telemedicine. However, this research reports the health professionals’ perspectives arising from technical, social and organizational factors that are considered as key elements for the setting and running of telemedicine in Ethiopia. The importance and significance of telemedicine for healthcare is growing. For example, the use of telemedicine in the current pandemic situation becomes an essential strategic element in providing healthcare services in developed countries. Method: Qualitative and quantitative exploratory research methods used to collect data to find factors affecting the adoption of Information and communication technologies for telemedicine use. The survey was distributed using emails and Google forms. The email addresses were collected from personal contact and publicly available websites in Ethiopia. The thematic analysis used to build the barriers and facilitators factors for establishing telemedicine services. A survey questionnaire with open-and-close questions was used to collect data from 175 health professionals. Outcome: The result of this research will contribute to building the key barriers and facilitators factors of telemedicine from the health professional perspectives in developing countries. The thematic analysis provides barriers and facilitators factors arising from technical, organizational, and social sources.

Keywords: telemedicine, ICT, developing country, Ethiopia, health service

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770 Digital Content Strategy (DCS) Detailed Review of the Key Content Components

Authors: Oksana Razina, Shakeel Ahmad, Jessie Qun Ren, Olufemi Isiaq

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The modern life of businesses is categorically reliant on their established position online, where digital (and particularly website) content plays a significant role as the first point of information. Digital content, therefore, becomes essential – from making the first impression to the building and development of client relationships. Despite a number of valuable papers suggesting a strategic approach when dealing with digital data, other sources often do not view or accept the approach to digital content as a holistic or continuous process. Associations are frequently made with merely a one-off marketing campaign or similar. The challenge is to establish an agreed definition for the notion of Digital Content Strategy, which currently does not exist, as DCS is viewed from an excessive number of different angles. A strategic approach to content, nonetheless, is required, both practically and contextually. The researchers, therefore, aimed at attempting to identify the key content components comprising a digital content strategy to ensure all the aspects were covered and strategically applied – from the company’s understanding of the content value to the ability to display flexibility of content and advances in technology. This conceptual project evaluated existing literature on the topic of Digital Content Strategy (DCS) and related aspects, using the PRISMA Systematic Review Method, Document Analysis, Inclusion and Exclusion Criteria, Scoping Review, Snow-Balling Technique and Thematic Analysis. The data was collected from academic and statistical sources, government and relevant trade publications. Based on the suggestions from academics and trading sources related to the issues discussed, the researchers revealed the key actions for content creation and attempted to define the notion of DCS. The major finding of the study presented Key Content Components of Digital Content Strategy and can be considered for implementation in a business retail setting.

Keywords: digital content strategy, key content components, websites, digital marketing strategy

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769 Paleogene Syn-Rift Play Identification in Palembang Sub-Basin, South Sumatera, Indonesia

Authors: Perdana Rakhmana Putra, Hansen Wijaya, Sri Budiyani, Muhamad Natsir, Alexis badai Samudra

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The Palembang Sub-Basin (PSB) located in southern part of South Sumatera basin (SSB) consist of half-graben complex trending N-S to NW-SE. These geometries are believe as an impact of strike-slip regime developed in Eocene-Oligocene. Generally, most of the wells in this area produced hydrocarbon from late stage of syn-rift sequences called Lower Talang Akar (LTAF) and post-rift sequences called Batu Raja Formation (BRF) and drilled to proved hydrocarbon on structural trap; three-way dip anticline, four-way dip anticline, dissected anticline, and stratigraphy trap; carbonate build-up and stratigraphic pinch out. Only a few wells reached the deeper syn-rift sequences called Lahat Formation (LAF) and Lemat Formation (LEF). The new interpretation of subsurface data was done by the tectonostratigraphy concept and focusing on syn-rift sequence. Base on seismic characteristic on basin centre, it divided into four sequences: pre-rift sequence, rift initiation, maximum rift and late rift. These sequences believed as a new exploration target on PSB mature basin. This paper will demonstrate the paleo depositional setting during Paleogene and exploration play concept of syn-rift sequence in PSB. The main play for this area consists of stratigraphic and structure play, where the stratigraphic play is Eocene-Oligocene sediment consist of LAF sandstone, LEF-Benakat formation, and LAF with pinch-out geometry. The pinch-out, lenses geometry and on-lap features can be seen on the seismic reflector and formed at the time of the syn-rift sequence. The structural play is dominated by a 3 Way Dip play related to reverse fault trap.

Keywords: syn-rift, tectono-stratigraphy, exploration play, basin center play, south sumatera basin

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768 The Adoption of Leagility in Healthcare Services

Authors: Ana L. Martins, Luis Orfão

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Healthcare systems have been subject to various research efforts aiming at process improvement under a lean approach. Another perspective, agility, has also been used, though in a lower scale, in order to analyse the ability of different hospital services to adapt to demand uncertainties. Both perspectives have a common denominator, the improvement of effectiveness and efficiency of the services in a healthcare setting context. Mixing the two approached allows, on one hand, to streamline the processes, and on the other hand the required flexibility to deal with demand uncertainty in terms of both volume and variety. The present research aims to analyse the impacts of the combination of both perspectives in the effectiveness and efficiency of an hospital service. The adopted methodology is based on a case study approach applied to the process of the ambulatory surgery service of Hospital de Lamego. Data was collected from direct observations, formal interviews and informal conversations. The analyzed process was selected according to three criteria: relevance of the process to the hospital, presence of human resources, and presence of waste. The customer of the process was identified as well as his perception of value. The process was mapped using flow chart, on a process modeling perspective, as well as through the use of Value Stream Mapping (VSM) and Process Activity Mapping. The Spaghetti Diagram was also used to assess flow intensity. The use of the lean tools enabled the identification of three main types of waste: movement, resource inefficiencies and process inefficiencies. From the use of the lean tools improvement suggestions were produced. The results point out that leagility cannot be applied to the process, but the application of lean and agility in specific areas of the process would bring benefits in both efficiency and effectiveness, and contribute to value creation if improvements are introduced in hospital’s human resources and facilities management.

Keywords: case study, healthcare systems, leagility, lean management

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767 Improving Infant Vaccination Rates Through Expanded Access to Care

Authors: Aidan Jacobsen, Morgan Motia, David Sam, Jonathan Mudge

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Background: The Centers for Disease Control (CDC) lists vaccine requirements for children under two years old to correlate with development markers. CDC lists the coverage by age 24 months to be at least 90% nationally and 84% for Rhode Island Blackstone Valley Community Health Center (BVCHC) in Central Falls, Rhode Island, currently has a completed vaccination rate of 51% for children by the age of 24 months. Current barriers to care for up to date well child vaccinations include lack of transportation, parental work, childcare, and other social stressors. Objective: Increase the vaccination rate of children under the age of 24 months at BVCHC. Conduct a literature review to identify the common barriers preventing children under 24 months from receiving vaccinations. Reduce the barriers to expand access to vaccination care for infants Methods: Setting: Blackstone Valley Community Health Center, Pawtucket, RI Participants: (n=41), Patients between the age of 20-24 months, not up to date with the CDC vaccination recommendations and without a future appointment. QI Intervention: Patients were contacted via phone and offered an appointment during extra Saturday clinic hours in order to receive up to date vaccine care. A Saturday vaccine clinic was established specifically for patients in need of vaccines and having identified barriers to care. Conclusions: Expanding clinic hours and targeting non vaccine up –to-date patients can increase the current standard of childhood immunizations at BVCHC. Overcoming barriers preventing childhood immunization can improve access to providing up to date vaccinations. Other barriers still deter from reaching the national standard of immunizations rates.

Keywords: vaccinations, well child care, barriers to care, social determinants of health

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