Search results for: shortage of junior staff
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1932

Search results for: shortage of junior staff

282 Current Status of Inclusive Education for Students with Disabilities in Punjab, Pakistan

Authors: Muhammad Shahid Shah, Akram Maqbool, Samina Ashraf

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Since start of this century, world has adopted inclusion as a trend in special education. To meet the challenges of inclusion response, the Punjab government has developed a progressive policy to implement inclusive education. The objectives of this research were to analyze the administration and implementation process by consideration on the management, student’s admission process, screening and assessment, adaptations in curriculum and instruction along with an evaluation, government and nonprofit organizations support. The sample consisted of 50 schools both public and private with a total of 3000 students, 9 percent of which (270) were students with disabilities. Among all the students with disabilities, 63 percent (170) were male and 37 percent (100) were female. The concluded remarks regarding management revealed that a large number of inclusive schools was lacking in terms of developing a certain model for inclusion, including the managerial breakup of staff, the involvement of stakeholders, and conducted frequent meetings. Many of schools are not able to restructure their school organizations due to lack of financial resources, consultations, and backup. As for as student’s admission/identification/assessment was concerned, only 12 percent schools applied a selection process regarding student admission, half of which used different procedures for disable candidates. Approximately 5 percent of inclusive schools had modified their curriculum, including a variety of standards. In terms of instruction, 25 percent of inclusive schools reported that they modified their instructional process. Only a few schools, however, provided special equipment for students with visual impairment, physical impairment, speech and hearing problems, students with mild intellectual disabilities, and autism. In a student evaluation, more than 45 percent reported that test items, administration, time allocations, and students’ reports were modified. For the primary board examination conducted by the Education Department of Government of Punjab, this number decreased dramatically. Finally, government and nonprofit organizations support in the forms of funding, coaching, and facilities were mostly provided by provincial governments and by Ghazali Education Trust.

Keywords: inclusion, identification, assessment, funding, facilities, evaluation

Procedia PDF Downloads 138
281 A Protocol for Usability of Teaching to Students with Learning Difficulties at University: An Italian Research

Authors: Tamara Zappaterra

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The Learning Difficulties have an evolutionary nature. The international research has focused its analysis on the characteristics of Learning Difficulties in childhood, but we are still far from a thorough understanding of the nature of such disorders in adolescence and adulthood. Such issues become even more urgent in the university context. Spelling, meaning, and appropriate use of the specific vocabulary of the various disciplines represent an additional challenge for the dyslexic student. This paper explores the characteristics of Learning Difficulties in adulthood and the impact with the university teaching. It presents the results of an interdisciplinary project (educational, medical and engineering area) at University of Florence. The purpose of project is to design of a protocol for usability of teaching and individual study at university level. The project, after a first reconnaissance of user needs that have been reached with the participation of the very same protagonists, is at the stage of guidelines drafting for inclusion and education, to be used by teachers, students and administrative staff. The methodologies used are a questionnaire built on purpose and a series of focus groups with users. For collecting data during the focus groups it was decided to use a method typical of the Quality Function Deployment, a tool originally used for quality management, whose versatility makes it easy to use in a number of different context. The paper presents furthermore the findings of the project, the most significant elements of the guidelines for teaching, i.e. the section for teachers, whose aim is to implement a Learning Difficulties-friendly teaching, even at the university level, in compliance with italian Law 170/2010. The Guidelines for the didactic and inclusion of Learning Difficulties students of the University of Florence are articulated around a global and systemic plan of action, meant to accompany and protect the students during their study career, even before enrolling at the University, with different declination: the logistical, relational, educational, and didactic levels have been considered. These guidelines in Italy received the endorsement of the CNUDD. It is a systemic intervention plan for Learning Difficulties students, which roused and keeps rousing the interest of all the university system, with a radical consideration on academic teaching. Since while we try to provide the best Learning Difficulties-friendly didactic in compliance with the rules, no one can be exempted from a wider consideration on the nature and the quality of university teaching offered to all students.

Keywords: didactic tools, learning difficulties, special and inclusive education, university teaching

Procedia PDF Downloads 283
280 Facilitating Career Development of Women in Science, Technology, Engineering, Mathematics and Medicine: Towards Increasing Understanding, Participation, Progression and Retention through an Intersectionality Perspective

Authors: Maria Tsouroufli, Andrea Mondokova, Subashini Suresh

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Background: The under-representation of women and consequent failure to fulfil their potential contribution to Science, Technology, Engineering, Maths, and Medicine (STEMM) subjects in the UK is an issue that the Higher Education sector is being encouraged to address. Focus: The aim of this research is to investigate the barriers, facilitators, and incentives that influence diverse groups of women who have embarked upon a related career in STEMM subjects. The project will address a number of interconnected research questions: 1. How do participants perceive the barriers, facilitators and incentives for women in terms of research, teaching and management/leadership at each stage of their development towards forging a career in STEMM? 2. How might gender intersect with ethnicity, pregnancy/maternity and academic grade in the career experiences of women in STEMM? 3. How do participants perceive the example of female role models in emulating them as a career model? 4. How do successful females in STEMM see themselves as role models and what strategies do they employ to promote their careers? 5. How does institutional culture manifest itself as a barrier or facilitator for women in STEMM subjects in the institution? Methodology and Theoretical framework: A mixed-methodology will be employed in a case study of one university. The study will draw on extant quantitative data for context and involve conducting a qualitative inquiry to discover the perceptions of staff and students around the key concepts under study (career progression, sense of belonging and tenure, role-models, personal satisfaction, perceived gender in/equality, institutional culture). The analysis will be informed by an intersectionality framework, feminist and gender theory, and organisational psychology and human resource management perspectives. Implications: Preliminary findings will be collected in 2017. Conclusions will be drawn and used to inform recruitment and retention, and the development and implementation of initiatives to enhance the experiences and outcomes of women working and studying in STEMM subjects in Higher Education.

Keywords: under-representation, women, STEMM subjects, intersectionality

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279 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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278 Construction of a Dynamic Model of Cerebral Blood Circulation for Future Integrated Control of Brain State

Authors: Tomohiko Utsuki

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Currently, brain resuscitation becomes increasingly important due to revising various clinical guidelines pertinent to emergency care. In brain resuscitation, the control of brain temperature (BT), intracranial pressure (ICP), and cerebral blood flow (CBF) is required for stabilizing physiological state of brain, and is described as the essential treatment points in many guidelines of disorder and/or disease such as brain injury, stroke, and encephalopathy. Thus, an integrated control system of BT, ICP, and CBF will greatly contribute to alleviating the burden on medical staff and improving treatment effect in brain resuscitation. In order to develop such a control system, models related to BT, ICP, and CBF are required for control simulation, because trial and error experiments using patients are not ethically allowed. A static model of cerebral blood circulation from intracranial arteries and vertebral artery to jugular veins has already constructed and verified. However, it is impossible to represent the pooling of blood in blood vessels, which is one cause of cerebral hypertension in this model. And, it is also impossible to represent the pulsing motion of blood vessels caused by blood pressure change which can have an affect on the change of cerebral tissue pressure. Thus, a dynamic model of cerebral blood circulation is constructed in consideration of the elasticity of the blood vessel and the inertia of the blood vessel wall. The constructed dynamic model was numerically analyzed using the normal data, in which each arterial blood flow in cerebral blood circulation, the distribution of blood pressure in the Circle of Willis, and the change of blood pressure along blood flow were calculated for verifying against physiological knowledge. As the result, because each calculated numerical value falling within the generally known normal range, this model has no problem in representing at least the normal physiological state of the brain. It is the next task to verify the accuracy of the present model in the case of disease or disorder. Currently, the construction of a migration model of extracellular fluid and a model of heat transfer in cerebral tissue are in progress for making them parts of an integrated model of brain physiological state, which is necessary for developing an future integrated control system of BT, ICP and CBF. The present model is applicable to constructing the integrated model representing at least the normal condition of brain physiological state by uniting with such models.

Keywords: dynamic model, cerebral blood circulation, brain resuscitation, automatic control

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277 Delivering Comprehensive Sexuality Education to Students with Disability in Special Schools in Fiji

Authors: Sera Ratu, Jane Chivers, Jessica Botfield

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Objectives: The Reproductive and Family Health Association of Fiji (RFHAF) and Family Planning Australia are working together to introduce quality comprehensive sexuality education into Special Schools - which are schools for students with disability. Sexual and reproductive health information is needed by students with disability attending Special Schools. Children with special needs go through the same changes as able-bodied children. The Fiji Disability Inclusion project is a three-year project that started in 2015. One of its objectives is to increase exposure to comprehensive sexuality education for primary and secondary school students with disability. Method: A baseline survey was undertaken with 72 students with disability; it included questions about puberty, sexual health, and relationships. 34 teachers also completed a survey about their views of sexuality education and confidence in delivering it. Consent was facilitated by running information sessions with teachers and parents. The process of gaining consent and completing the surveys was designed to be accessible to students with disability. Given the sensitive nature of reproductive and sexual health, and the potential vulnerability of young people with disability, ethical considerations were important in the design and implementation of the surveys, and ethics approval was obtained. Results: Findings from the surveys suggest that students have mixed knowledge and awareness of sexual health issues. Most teachers reported a need for their students to learn about sexuality and relationships. A positive outcome of conducting the surveys was that RFHAF staff reported they have developed skills and confidence in communicating with young people with a range of disabilities. They have a greater understanding of what students want to learn, and what teachers feel is important. Conclusions: These survey findings will assist RFHAF in developing comprehensive sexuality education programs that are relevant and accessible to students in Special Schools, and to develop an appropriate professional development program for teachers. Findings may also be applicable to other Special Schools when developing sexuality education programs. The education programs developed for students as part of this project, and the professional development programs for teachers, may be relevant to other countries.

Keywords: comprehensive sexuality education, delivery, sexual and reproductive health and rights, special schools

Procedia PDF Downloads 337
276 Development of a Nursing Care Program Based on Anthroposophic External Therapy for the Pediatric Hospital in Brazil and Germany

Authors: Karina Peron, Ricardo Ghelman, Monica Taminato, Katia R. Oliveira, Debora C. A. Rodrigues, Juliana R. C. Mumme, Olga K. M. Sunakozaua, Georg Seifert, Vicente O. Filho

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The nurse is the most available health professional for the interventions of support in the integrative approach in hospital environment, therefore a professional group key to changes in the model of care. The central components in the performance of anthroposophic nursing procedures are direct physical contact, promotion of proper rhythm, thermal regulation and the construction of a calm and empathic atmosphere, safe for patients and their caregivers. The procedures of anthroposophic external therapies (AET), basically composed of the application of compresses and the use of natural products, provide an opportunity to intensify the therapeutic results through an innovative, complementary and integrative model in the university hospital. The objective of this work is to report the implementation of a program of nursing techniques (AET) through a partnership between the Pediatric Oncology Sector of the Department of Pediatrics of the Faculty of Medicine of the University of Sao Paulo and Charite University of Berlin, with lecturers from Berlin's Integrative Hospital Havelhöhe and Witten-Herdecke Integrative Hospital, both in Germany. Intensive training activities of the Hospital's nursing staff and a survey on AET needs were developed based on the most prevalent complaints in pediatric oncology patients in the three environments of the Hospital of Pediatric Oncology: Bone Marrow Transplantation Unit, Intensive Care Unit and Division of Internal Patients. We obtained the approval of the clinical protocol of external anthroposophic therapies for nursing care by the Ethics Committee and the Academic Council of the Hospital. With this project, we highlight the key AET needs that will be part of the standard program of pediatric oncology care with appropriate scientific support. The results of the prevalent symptoms were: vomiting, nausea, pain, difficulty in starting sleep, constipation, cold extremities, mood disorder and psychomotor agitation. This project was the pioneer within the Integrative Pediatrics Program, as an innovative concept of Medicine and Integrative Health presented at scientific meetings.

Keywords: integrative health care, integrative nursing, pediatric nursing, pediatric oncology

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275 Public Health Emergency Management (PHEM) to COVID-19 Pandemic in North-Eastern Part of Thailand

Authors: Orathai Srithongtham, Ploypailin Mekathepakorn, Tossaphong Buraman, Pontida Moonpradap, Rungrueng Kitpati, Chulapon Kratet, Worayuth Nak-ai, Suwaree Charoenmukkayanan, Peeranuch Keawkanya

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The COVID-19 pandemic was effect to the health security of the Thai people. The PHEM principle was essential to the surveillance, prevention, and control of COVID-19. This study aimed to present the process of prevention and control of COVID-19 from February 29, 2021- April 30, 2022, and the factors and conditions influent the successful outcome. The study areas were three provinces. The target group was 37 people, composed of public health personnel. The data was collected in-depth, and group interviews followed the non-structure interview guide and were analyzed by content analysis. The components of COVID-19 prevention and control were found in the process of PHEM as follows; 1) Emergency Operation Center (EOC) with an incidence command system (ICS) from the district to provincial level and to propose the provincial measure, 2) Provincial Communicable Disease Committee (PCDC) to decide the provincial measure 3) The measure for surveillance, prevention, control, and treatment of COVID-19, and 4) outcomes and best practices for surveillance and control of COVID-19. The success factors of 4S and EC were as follows; Space: prepare the quarantine (HQ, LQ), Cohort Ward (CW), field hospital, and community isolation and home isolation to face with the patient and risky group, Staff network from various organization and group cover the community leader and Health Volunteer (HV), Stuff the management and sharing of the medical and non-medical equipment, System of Covid-19 respond were EOC, ICS, Joint Investigation Team (JIT) and Communicable Disease Control Unit (CDCU) for monitoring the real-time of surveillance and control of COVID-19 output, Environment management in hospital and the community with Infections Control (IC) principle, and Culture in term of social capital on “the relationship of Isan people” supported the patient provide the good care and support. The structure of PHEM, Isan’s Culture, and good preparation was a significant factor in the three provinces.

Keywords: public health, emergency management, covid-19, pandemic

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274 Implementation of Inclusive Education in DepEd-Dasmarinas: Basis for Inclusion Program Framework

Authors: Manuela S. Tolentino, John G. Nepomuceno

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The purpose of this investigation was to assess the implementation of inclusive education (IE) in 6 elementary and 5 secondary public schools in the City Schools Division of Dasmarinas. Participants in this study were 11 school heads, 73 teachers, 22 parents and 22 students (regular and with special needs) who were selected using purposive sampling. A 30-item questionnaire was used to gather data on the extent of the implementation of IE in the division while focus group discussion (FGD) was used to gather insights on what facilitate and hinder the implementation of the IE program. This study assessed the following variables: school culture and environment, inclusive education policy implementation, and curriculum design and practices. Data were analyzed using frequency count, mean and ranking. Results revealed that participants have similar assessment on the extent of the implementation of IE. School heads rated school culture and environment as highest in terms of implementation while teachers and pupils chose curriculum design and practices. On the other hand, parents felt that inclusive education policies are implemented best. School culture and environment are given high ratings. Participants perceived that the IE program in the division is making everyone feel welcome regardless of age, sex, social status, physical, mental and emotional state; students with or without disability are equally valued, and students help each. However, some aspects of the IE program implementation are given low ratings namely: partnership between staff, parents and caregivers, school’s effort to minimize discriminatory practice, and stakeholders sharing the philosophy of inclusion. As regards education policy implementation, indicators with the highest ranks were school’s effort to admit students from the locality especially students with special needs, and the implementation of the child protection policy and anti-bullying policy. The results of the FGD revealed that both school heads and teachers possessed the welcoming gesture to accommodate students with special needs. This can be linked to the increasing enrolment of SNE in the division. However, limitations of the teachers’ knowledge on handling learners, facilities and collaboration among stakeholders hinder the implementation of IE program. Based on the findings, inclusion program framework was developed for program enhancement. This will be the basis for the improvement of the program’s efficiency, the relationship between stakeholders, and formulation of solutions.

Keywords: inclusion, inclusive education, framework, special education

Procedia PDF Downloads 171
273 University Students' Perceptions of Effective Teaching

Authors: Christine K. Ormsbee, Jeremy S. Robinson

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Teacher quality is important for United States universities. It impacts student achievement, program and degree progress, and even retention. While course instructors are still the primary designers and deliverers of instruction in U.S. higher education classrooms, students have become better and more vocal consumers of instruction. They are capable of identifying what instructors do that facilitates their learning or, conversely, what instructors do that makes learning more difficult. Instructors can use students as resources as they design and implement their courses. Students have become more aware of their own learning preferences and processes and can articulate those. While it is not necessarily possible or likely that an instructor can address the widely varying differences in learning preferences represented by a large class of students, it is possible for them to employ general instructional supports that help students understand clearly the instructor's study expectations, identify critical content, efficiently commit content to memory, and develop new skills. Those learning supports include reading guides, test study guides, and other instructor-developed tasks that organize learning for students, hold them accountable for the content, and prepare them to use that material in simulated and real situations. When U.S. university teaching and learning support staff work with instructors to help them identify areas of their teaching to improve, a key part of that assistance includes talking to the instructor member's students. Students are asked to explain what the instructor does that helps them learn, what the instructor does that impedes their learning, and what they wish the instructor would do. Not surprisingly, students are very specific in what they see as helpful learning supports for them. Moreover, they also identify impediments to their success, viewing those as the instructor creating unnecessary barriers to learning. A qualitative survey was developed to provide undergraduate students the opportunity to identify instructor behaviors and/or practices that they thought helped students learn and those behaviors and practices that were perceived as hindrances to student success. That information is used to help instructors implement more student-focused learning supports that facilitate student achievement. In this session, data shared from the survey will focus on supportive instructor behaviors identified by undergraduate students in an institution located in the southwest United States and those behaviors that students perceive as creating unnecessary barriers to their academic success.

Keywords: effective teaching, pedagogy, student engagement, instructional design

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272 Nursing-Related Barriers to Children’s Pain Management at Selected Hospitals in Ghana: A Descriptive Qualitative Study

Authors: Abigail Kusi Amponsah, Evans Frimpong Kyei, John Bright Agyemang, Hanson Boakye, Joana Kyei-Dompim, Collins Kwadwo Ahoto, Evans Oduro

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Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children’s pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children’s pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children’s pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n =24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses’ inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children’s pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children’s pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain management

Keywords: Nursing-Related Barriers, Children, Pain Management, Ghana

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271 Building Student Empowerment through Live Commercial Projects: A Reflective Account of Participants

Authors: Nilanthi Ratnayake, Wen-Ling Liu

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Prior research indicates an increasing gap between the skills and capabilities of graduates in the contemporary workplace across the globe. The challenge of addressing this issue primarily lies on the hands of higher education institutes/universities. In particular, surveys of UK employers and retailers found that soft skills including communication, numeracy, teamwork, confidence, analytical ability, digital/IT skills, business sense, language, and social skills are highly valued by graduate employers, and in achieving this, there are various assessed and non-assessed learning exercises have already been embedded into the university curriculum. To this end, this research study aims to explore the reflections of postgraduate student participation in a live commercial project (i.e. designing an advertising campaign for open days, summer school etc.) implemented with the intention of offering a transformative experience by deploying this project. Qualitative research methodology has been followed in this study, collecting data from three types of target audiences; students, academics and employers via a series of personal interviews and focus group discussions. Recorded data were transcribed, entered into NVIVO, and analysed using meaning condensation and content analysis. Students reported that they had a very positive impact towards improving self-efficacy, especially in relation to soft skills and confidence in seeking employment opportunities. In addition, this project has reduced cultural barriers for international students in general communications. Academic staff and potential employers who attended on the presentation day expressed their gratitude for offering a lifelong experience for students, and indeed believed that these type of projects contribute significantly to enhance skills and capabilities of students to cater the demands of employers. In essence, key findings demonstrate that an integration of knowledge-based skills into a live commercial project facilitate individuals to make the transition from education to employment in terms of skills, abilities and work behaviours more effectively in comparison to some other activities/assuagements that are currently in place in higher education institutions/universities.

Keywords: soft skills, commercially live project, higher education, student participation

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270 Communities as a Source of Evidence: A Case of Advocating for Improved Human Resources for Health in Uganda

Authors: Asinguza P. Allan

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The Advocacy for Better Health aims to equip citizens with enabling environment and systems to effectively advocate for strong action plans to improve health services. This is because the 2020 Government target for Uganda to transform into a middle income country will be achieved if investment is made in keeping the population healthy and productive. Citizen participation as an important foundation for change has been emphasized to gather data through participatory rural appraisal and inform evidence-based advocacy for recruitment and motivation of human resources. Citizens conduct problem ranking during advocacy forums on staffing levels and health worker absenteeism. Citizens prioritised inadequate number of midwives and absenteeism. On triangulation, health worker to population ratio in Uganda remains at 0.25/1,000 which is far below the World Health Organization (WHO) threshold of 2.3/1,000. Working with IntraHealth, the project advocated for recruitment of critical skilled staff (doctors and midwives) and scale up health workers motivation strategy to reduce Uganda’s Neonatal Mortality Rate of 22/1,000 and Maternal Mortality Ratio of 320/100,000. Government has committed to increase staffing to 80% by 2018 (10 districts have passed ordinances and revived use of duty rosters to address health worker absenteeism. On the other hand, the better health advocacy debate has been elevated with need to increase health sector budget allocations from 8% to 10%. The project has learnt that building a body of evidence from citizens enhances the advocacy agenda. Communities will further monitor government commitments to reduce Neonatal Mortality Rate and Maternal Mortality Ratio. The project has learnt that interface meeting between duty bearers and the community allows for immediate feedback and the process is a strong instrument for empowerment. It facilitates monitoring and performance evaluation of services, projects and government administrative units (like district assemblies) by the community members themselves. This, in turn, makes the human resources in health to be accountable, transparent and responsive to communities where they work. This, in turn, promotes human resource performance.

Keywords: advocacy, empowerment, evidence, human resources

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269 Understanding Trauma Informed Pedagogy in On-Line Education during Turbulent Times: A Mixed Methods Study in a Canadian Social Work Context

Authors: Colleen McMillan, Alice Schmidt-Hanbidge, Beth Archer-Kuhn, Heather Boynton, Judith Hughes

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It is well known that social work students enter the profession with higher scores of adverse childhood experiences (ACE). Add to that the fact that COVID-19 has forced higher education institutions to shift to online teaching and learning, where students, faculty and field educators in social work education have reported increased stressors as well as posing challenges in developing relationships with students and being able to identify mental health challenges including those related to trauma. This multi-institutional project included three Canadian post-secondary institutions at five sites (the University of Waterloo, the University of Calgary and the University of Manitoba) and partners; Desire To Learn (D2L), The Centre for Teaching Excellence at the University of Waterloo and the Taylor Institute for Teaching and Learning. A sequential mixed method research design was used. Survey data was collected from students, faculty and field education staff from the 3 universities using the Qualtrics Insight Platform, followed by virtual focus group data with students to provide greater clarity to the quantitative data. Survey data was analyzed using SPSS software, while focus group data was transcribed verbatim and organized with N-Vivo 12. Thematic analysis used line-by-line coding and constant comparative methods within and across focus groups. The following three objectives of the study were achieved: 1) Establish a Canadian baseline on trauma informed pedagogy and student experiences of trauma informed teaching in the online higher education environment during a pandemic; 2) Identify and document educator and student experiences of online learning regarding the ability to process trauma experiences; and, 3) Transfer the findings into a trauma informed pedagogical model for Social Work as a first step toward developing a universal trauma informed teaching model. The trauma informed pedagogy model would be presented in relation to the study findings.

Keywords: trauma informed pedagogy, higher education, social work, mental health

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268 Challenges in Employment and Adjustment of Academic Expatriates Based in Higher Education Institutions in the KwaZulu-Natal Province, South Africa

Authors: Thulile Ndou

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The purpose of this study was to examine the challenges encountered in the mediation of attracting and recruiting academic expatriates who in turn encounter their own obstacles in adjusting into and settling in their host country, host academic institutions and host communities. The none-existence of literature on attraction, placement and management of academic expatriates in the South African context has been acknowledged. Moreover, Higher Education Institutions in South Africa have voiced concerns relating to delayed and prolonged recruitment and selection processes experienced in the employment process of academic expatriates. Once employed, academic expatriates should be supported and acquainted with the surroundings, the local communities as well as be assisted to establish working relations with colleagues in order to facilitate their adjustment and integration process. Hence, an employer should play a critical role in facilitating the adjustment of academic expatriates. This mixed methods study was located in four Higher Education Institutions based in the KwaZulu-Natal province, in South Africa. The explanatory sequential design approach was deployed in the study. The merits of this approach were chiefly that it employed both the quantitative and qualitative techniques of inquiry. Therefore, the study examined and interrogated its subject from a multiplicity of quantitative and qualitative vantage points, yielding a much more enriched and enriching illumination. Mixing the strengths of both the quantitative and the qualitative techniques delivered much more durable articulation and understanding of the subject. A 5-point Likert scale questionnaire was used to collect quantitative data relating to interaction adjustment, general adjustment and work adjustment from academic expatriates. One hundred and forty two (142) academic expatriates participated in the quantitative study. Qualitative data relating to employment process and support offered to academic expatriates was collected through a structured questionnaire and semi-structured interviews. A total of 48 respondents; including, line managers, human resources practitioners, and academic expatriates participated in the qualitative study. The Independent T-test, ANOVA and Descriptive Statistics were performed to analyse, interpret and make meaning of quantitative data and thematic analysis was used to analyse qualitative data. The qualitative results revealed that academic talent is sourced from outside the borders of the country because of the academic skills shortage in almost all academic disciplines especially in the disciplines associated with Science, Engineering and Accounting. However, delays in work permit application process made it difficult to finalise the recruitment and selection process on time. Furthermore, the quantitative results revealed that academic expatriates experience general and interaction adjustment challenges associated with the use of local language and understanding of local culture. However, female academic expatriates were found to be better adjusted in the two areas as compared to male academic expatriates. Moreover, significant mean differences were found between institutions suggesting that academic expatriates based in rural areas experienced adjustment challenges differently from the academic expatriates based in urban areas. The study gestured to the need for policy revisions in the area of immigration, human resources and academic administration.

Keywords: academic expatriates, recruitment and selection, interaction and general adjustment, work adjustment

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267 Factors Associated with Increase of Diabetic Foot Ulcers in Diabetic Patients in Nyahururu County Hospital

Authors: Daniel Wachira

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The study aims to determine factors contributing to increasing rates of DFU among DM patients attending clinics in Nyahururu County referral hospital, Lakipia County. The study objectives include;- To determine the demographic factors contributing to increased rates of DFU among DM patients, determining the sociocultural factors that contribute to increased rates of DFU among DM patients and determining the health facility factors contributing to increased rates of DFU among DM patients attending DM clinic at Nyahururu county referral hospital, Laikipia County. This study will adopt a descriptive cross-sectional study design. It involves the collection of data at a one-time point without follow-up. This method is fast and inexpensive, there is no loss to follow up as the data is collected at one time point and associations between variables can be determined. The study population includes all DM patients with or without DFU. The sampling technique that will be used is the probability sampling method, a simple random method of sampling will be used. The study will employ the use of questionnaires to collect the required information. Questionnaires will be a research administered questionnaires. The questionnaire developed was done in consultation with other research experts (supervisor) to ensure reliability. The questionnaire designed will be pre-tested by hand delivering them to a sample 10% of the sample size at J.M Kariuki Memorial hospital, Nyandarua county and thereafter collecting them dully filled followed by refining of errors to ensure it is valid for collection of data relevant for this study. Refining of errors on the questionnaires to ensure it was valid for collection of data relevant for this study. Data collection will begin after the approval of the project. Questionnaires will be administered only to the participants who met the selection criteria by the researcher and those who agreed to participate in the study to collect key information with regard to the objectives of the study. The study's authority will be obtained from the National Commission of Science and Technology and Innovation. Permission will also be obtained from the Nyahururu County referral hospital administration staff. The purpose of the study will be explained to the respondents in order to secure informed consent, and no names will be written on the questionnaires. All the information will be treated with maximum confidentiality by not disclosing who the respondent was and the information.

Keywords: diabetes, foot ulcer, social factors, hospital factors

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266 Promotional Mix as a Determinant of Consumer Buying Decision in the Food and Beverages Industry: A Case Study of Nigeria Bottling Company Plc., Asejire Ibadan

Authors: Adedeji S. Adegoke, Olakunle N. Popoola

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Promotion is indispensible and inestimable property of marketing through which different organizations persuade their prospective customers. The idea of passing information about a product to the consumer at outside the world is known as promotional activities. A study was determined whether there was relationship between promotional mix and consumer buying decision, that is may be customers were influenced by promotion. It was investigated to determine whether promotion can be used to influence competitors’ activities in the market and also research was conducted to determine if there was any problem encountered by Nigeria bottling company plc, in promoting its beverages products. The various forms of promotional mix available for an organization were examined and recommended the appropriate promotional mix that company can adopt to boost the company sales. The research design was depended on the primary and secondary data. The primary data were information collected from the subjects using methods of data collection, that is through the use of questionnaire, interview, direct observation, etc. The secondary data consist of information that already exists having been collected for another purpose by some researchers. These include internal and external sources. The questionnaire was designed and administered to the staff of production and marketing department of Nigeria bottling company plc., which served as the population of this study, out of which sample was drawn randomly from the population, using sample random technique. It was deduced that 90% of the respondents opined that advertising influenced competition in the market and that there was a good sale after they started advert while 10% of them were not sure. At advertising level, 85% of the respondents chose 81-100% as the increase in the percentage recorded in their sales level, while 10% of them agreed that increase in the percentage recorded in their sales was within 61-80% and 5% of them chose 45-60% as the percentage increase in their sales record. Due to unstable economic condition of the Nigeria, many business organizations adopted the promotional strategies. Apart from advertising, it was discovered through research that sales promotion served as an incentive to consumers of Nigeria bottling company plc at a time offer gifts and prizes to consumers which drastically increased their level of sales. Since advertising and sales promotion increased the level of sales, more money should be allocated for this purpose to maintain market share and thereby increase profit.

Keywords: consumer, marketing, organization, promotional mix

Procedia PDF Downloads 162
265 Knowledge, Attitude and Associated Factors of Practice towards Post Exposure Prophylaxis of HIV Infection among Health Professionals in Yeka and Kazanchis Health Center

Authors: Semira Zeru Haileslassie

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Lack of awareness and practices of PEP treatment were observed among respondents, but they had a better attitude towards PEP. To this end, a formal training for all respondents regarding PEP for HIV prior to their clinical attachments is of utmost importance. The training ought to incorporate a brief clarification with respect to the unpleasant impact of non-adherence that essentially incorporate destitute treatment result and most prominent hazard of resistance and few given as a major cause for non-compliance to PEP, common transient side-effects of PEP and its administrations ought to be cloister educated healthcare specialists to diminish its effect on adherence. Besides, the propensity of detailing needle adhere harm was destitute that needs endeavors to progress. Progressing the culture of detailing and making the detailing handle simple is very necessary. In reality, announcing such wounds as early as conceivable will educate others not to commit same issue once more and, for the most part, will empower stakeholders to intercede the issue sometime prior to it re-occur. At long last, as distant as get up and go utilize has cleared out with so numerous bothers, risk decrease is the foremost choice. With this, taking the increased significance of protective barriers so as to decrease the hazard of exposure to HIV, distinctive stakeholders (the healing center hardware supply chain director, the HIV/ Helps clinic, the clinic chief, hardware and supply quality confirmation group, and other authoritative bodies) ought to work together in co-ordination to secure the supply and guarantee the quality of those crucial protective barriers and to advance demand health laborers to continuously wear protective barriers when exposed to HIV hazard components as well as to dispose appropriately once done. At long last, we prescribe future examiners to conduct planned multicenter studies with extra goals (counting indicator investigation) for way better generalization and result. In spite of satisfactory information and favorable state of mind towards PEP for HIV in most of the respondents, this study uncovered that there were delays in starting, low utilization, and fragmented use of the prescribed PEP. So, health care staff need to progress their practice on PEP of HIV through diverse training program related to PEP of HIV.

Keywords: HIV infection, prophylaxis, knowledge, attitude

Procedia PDF Downloads 195
264 An Analytical View of Albanian and French Legislation on Access to Health Care Benefits

Authors: Oljana Hoxhaj

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The integration process of Albania into the European family carries many difficulties. In this context, the Albanian legislator is inclined to implement in the domestic legal framework models which have been successful in other countries. Our paper aims to present an analytical and comparative approach to the health system in Albania and France, mainly focusing on citizen’s access to these services. Different standards and cultures between states, in the context of an approximate model, will be the first challenge of our paper. Over the last few years, the Albanian government has undertaken concrete reforms in this sector, aiming to transform the vision on which the previous health system was structured. In this perspective, the state fulfills not only an obligation to its citizens, but also consolidates progressive steps toward alignment with European Union standards. The necessity to undertake a genuine reform in this area has come as an exigency of society, which has permanently identified problems within this sector, considering it ineffective, out of standards, and corrupt. The inclusion of health services on the Albanian government agenda reflects its will in the function of good governance, transparency, and broadening access to the provision of quality health services in the public and private sectors. The success of any initiative in the health system consists of giving priority to patient needs. Another objective that should be in the state's consideration is to create the premise to provide a comprehensive process on whose foundations partnership and broader co-operation with beneficiary entities are established in any decision-making that is directly related to their interests. Some other important and widespread impacts on the effective realization of citizens' access to the healthcare system coincide with the construction of appropriate infrastructure, increasing the professionalism and qualification of medical staff, and the allocation of a higher budget. France has one of the most effective healthcare models in Europe. That is why we have chosen to analyze this country, aiming to highlight the advantages of this system, as well as the commitment of the French state to drafting effective health policies. In the framework of the process of harmonization of the Albanian legislation with that of the European Union, through our work, we aim to identify the space to implement the whole of these legislative innovations in the Albanian legislation.

Keywords: effective service, harmonization level, innovation, reform

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263 Attitude to the Types of Organizational Change

Authors: O. Y. Yurieva, O. V. Yurieva, O. V. Kiselkina, A. V. Kamaseva

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Since the early 2000s, there are some innovative changes in the civil service in Russia due to administrative reform. Perspectives of the reform of the civil service include a fundamental change in the personnel component, increasing the level of professionalism of officials, increasing their capacity for self-organization and self-regulation. In order to achieve this, the civil service must be able to continuously change. Organizational changes have long become the subject of scientific understanding; problems of research in the field of organizational change is presented by topics focused on the study of the methodological aspects of the implementation of the changes, the specifics of changes in different types of organizations (business, government, and so on), design changes in the organization, including based on the change in organizational culture. In this case, the organizational changes in the civil service are the least studied areas; research of problems of its transformation is carried out in fragments. According to the theory of resistance of Herbert Simon, the root of the opposition and rejection of change is in the person who will resist any change, if it threatens to undermine the degree of satisfaction as a member of the organization (regardless of the reasons for this change). Thus, the condition for successful adaptation to changes in the organization is the ability of its staff to perceive innovation. As part of the problem, the study sought to identify the innovation civil servants, to determine readiness for the development of proposals for the implementation of organizational change in the public service. To identify the relationship to organizational changes case study carried out by the method of "Attitudes to organizational change" of I. Motovilina, which allowed predicting the type of resistance to changes, to reveal the contradictions and hidden results. The advantage of the method of I. Motovilina is its brevity, simplicity, the analysis of the responses to each question, the use of "overlapping" issues potentially conflicting factors. Based on the study made by the authors, it was found that respondents have a positive attitude to change more local than those that take place in reality, such as "increase opportunities for professional growth", "increase the requirements for the level of professionalism of", "the emergence of possible manifestations initiatives from below". Implemented by the authors diagnostics related to organizational changes in the public service showed the presence of specific problem areas, with roots in the lack of understanding of the importance of innovation personnel in the process of bureaucratization of innovation in public service organizations.

Keywords: innovative changes, self-organization, self-regulation, civil service

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262 Development of a Miniature and Low-Cost IoT-Based Remote Health Monitoring Device

Authors: Sreejith Jayachandran, Mojtaba Ghods, Morteza Mohammadzaheri

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The modern busy world is running behind new embedded technologies based on computers and software; meanwhile, some people forget to do their health condition and regular medical check-ups. Some of them postpone medical check-ups due to a lack of time and convenience, while others skip these regular evaluations and medical examinations due to huge medical bills and hospital expenses. Engineers and medical experts have come together to give birth to a new device in the telemonitoring system capable of monitoring, checking, and evaluating the health status of the human body remotely through the internet for the needs of all kinds of people. The remote health monitoring device is a microcontroller-based embedded unit. Various types of sensors in this device are connected to the human body, and with the help of an Arduino UNO board, the required analogue data is collected from the sensors. The microcontroller on the Arduino board processes the analogue data collected in this way into digital data and transfers that information to the cloud, and stores it there, and the processed digital data is instantly displayed through the LCD attached to the machine. By accessing the cloud storage with a username and password, the concerned person’s health care teams/doctors and other health staff can collect this data for the assessment and follow-up of that patient. Besides that, the family members/guardians can use and evaluate this data for awareness of the patient's current health status. Moreover, the system is connected to a Global Positioning System (GPS) module. In emergencies, the concerned team can position the patient or the person with this device. The setup continuously evaluates and transfers the data to the cloud, and also the user can prefix a normal value range for the evaluation. For example, the blood pressure normal value is universally prefixed between 80/120 mmHg. Similarly, the RHMS is also allowed to fix the range of values referred to as normal coefficients. This IoT-based miniature system (11×10×10) cm³ with a low weight of 500 gr only consumes 10 mW. This smart monitoring system is manufactured with 100 GBP, which can be used not only for health systems, it can be used for numerous other uses including aerospace and transportation sections.

Keywords: embedded technology, telemonitoring system, microcontroller, Arduino UNO, cloud storage, global positioning system, remote health monitoring system, alert system

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261 An Assessment of the Performance of Local Government in Ondo State Nigeria: A Capital Budgeting Approach

Authors: Olurankinse Felix

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Local governments in Ondo State Nigeria are the third tier of government saddled with the responsibility of providing governance and economic services at the grassroots. To be able to do this, the Constitution of the Federal Republic of Nigeria provided that a proportion of Federation Account be allocated to them in addition to their internally generated revenue. From the allocation and other incidental sources of revenue, the local governments are expected to provide basic infrastructures and other social amenities to better the lots of the rural dwellers. Nevertheless, local governments’ performances in terms of provision of social amenities are without questioning and quite not encouraging. Assessing the performance of local governments in this period of dearth and scarcity of resources is highly indispensable more so that the activities of local governments’ staff are bedeviled and characterized with fraud, corruption and mismanagement. Considering the direct impact of the consequences of their action on the living standard of the rural dwellers therefore calls for the need to evaluate their level of performances using capital budgeting approach. The paper being a time series study adopts the survey design. Data were obtained through secondary source mainly from the Annual financial statements and publication of approved budgets estimates covering the period of study (2008-2012). The use of ratio analysis was employed in analyzing the comparative level of performances of the local governments under study. The result of the study shows that less than 30% of the local governments were able to harness the budgetary allocation to provide amenities to the beneficiaries while majority of the local governments were involved in unethical conduct ranging from theft of fund, corruption, diversion of funds and extra-budgetary activities. Also, there is poor internally generated revenue to complement the statutory allocation and besides, the monthly withholding of larger portions of local government share by the state in the name of joint account were also seen as contributory factors. The study recommends the need for transparency and accountability in public fund management through the oversight function of the state house of assembly. Also local government should be made to be autonomous and independent of the state by jettisoning the idea of joint account.

Keywords: performance, transparency and accountability, capital budgeting, joint account, local government autonomy

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260 “Environmental-Friendly” and “People-Friendly” Project for a New North-East Italian Hospital

Authors: Emanuela Zilli, Antonella Ruffatto, Davide Bonaldo, Stefano Bevilacqua, Tommaso Caputo, Luisa Fontana, Carmelina Saraceno, Antonio Sturaroo, Teodoro Sava, Antonio Madia

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The new Hospital in Cittadella - ULSS 6 Euganea Health Trust, in the North-East of Italy (400 beds, project completion date in 2026), will partially take the place of the existing building. Interesting features have been suggested in order to project a modern, “environmental-friendly” and “people-friendly” building. Specific multidisciplinary meetings (involving stakeholders and professionals with different backgrounds) have been organized on a periodic basis in order to guarantee the appropriate implementation of logistic and organizational solutions related to eco-sustainability, integration with the context, and the concept of “design for all” and “humanization of care.” The resulting building will be composed of organic shapes determined by the external environment (sun movement, climate, landscape, pre-existing buildings, roads) and the needs of the internal environment (areas of care and diagnostic-treatment paths reorganized with experience gained during the pandemic), with extensive use of renewable energy, solar panels, a 4th-generation heating system, sanitised and maintainable surfaces. There is particular attention to the quality of the staff areas, which include areas dedicated to psycho-physical well-being (relax points, yoga gym), study rooms, and a centralized conference room. Outdoor recreational spaces and gardens for music and watercolour therapy will be included; atai-chi gym is dedicated to oncology patients. Integration in the urban and social context is emphasized through window placement toward the gardens (maternal-infant, mental health, and rehabilitation wards). Service areas such as dialysis, radiology, and labs have views of the medieval walls, the symbol of the city’s history. The new building has been designed to pursue the maximum level of eco-sustainability, harmony with the environment, and integration with the historical, urban, and social context; the concept of humanization of care has been considered in all the phases of the project management.

Keywords: environmental-friendly, humanization, eco-sustainability, new hospital

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259 A Comparative Study on the Positive and Negative of Electronic Word-of-Mouth on the SERVQUAL Scale-Take A Certain Armed Forces General Hospital in Taiwan As An Example

Authors: Po-Chun Lee, Li-Lin Liang, Ching-Yuan Huang

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Purpose: Research on electronic word-of-mouth (eWOM)& online review has been widely used in service industry management research in recent years. The SERVQUAL scale is the most commonly used method to measure service quality. Therefore, the purpose of this research is to combine electronic word of mouth & online review with the SERVQUAL scale. To explore the comparative study of positive and negative electronic word-of-mouth reviews of a certain armed force general hospital in Taiwan. Data sources: This research obtained online word-of-mouth comment data on google maps from a military hospital in Taiwan in the past ten years through Internet data mining technology. Research methods: This study uses the semantic content analysis method to classify word-of-mouth reviews according to the revised PZB SERVQUAL scale. Then carry out statistical analysis. Results of data synthesis: The results of this study disclosed that the negative reviews of this military hospital in Taiwan have been increasing year by year. Under the COVID-19 epidemic, positive word-of-mouth has a downward trend. Among the five determiners of SERVQUAL of PZB, positive word-of-mouth reviews performed best in “Assurance,” with a positive review rate of 58.89%, Followed by 43.33% of “Responsiveness.” In negative word-of-mouth reviews, “Assurance” performed the worst, with a positive rate of 70.99%, followed by responsive 29.01%. Conclusions: The important conclusions of this study disclosed that the total number of electronic word-of-mouth reviews of the military hospital has revealed positive growth in recent years, and the positive word-of-mouth growth has revealed negative growth after the epidemic of COVID-19, while the negative word-of-mouth has grown substantially. Regardless of the positive and negative comments, what patients care most about is “Assurance” of the professional attitude and skills of the medical staff, which needs to be strengthened most urgently. In addition, good “Reliability” will help build positive word-of-mouth. However, poor “Responsiveness” can easily lead to the spread of negative word-of-mouth. This study suggests that the hospital should focus on these few service-oriented quality management and audits.

Keywords: quality of medical service, electronic word-of-mouth, armed forces general hospital

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258 Prospects of Low Immune Response Transplants Based on Acellular Organ Scaffolds

Authors: Inna Kornienko, Svetlana Guryeva, Anatoly Shekhter, Elena Petersen

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Transplantation is an effective treatment option for patients suffering from different end-stage diseases. However, it is plagued by a constant shortage of donor organs and the subsequent need of a lifelong immunosuppressive therapy for the patient. Currently some researchers look towards using of pig organs to replace human organs for transplantation since the matrix derived from porcine organs is a convenient substitute for the human matrix. As an initial step to create a new ex vivo tissue engineered model, optimized protocols have been created to obtain organ-specific acellular matrices and evaluated their potential as tissue engineered scaffolds for culture of normal cells and tumor cell lines. These protocols include decellularization by perfusion in a bioreactor system and immersion-agitation on an orbital shaker with use of various detergents (SDS, Triton X-100) and freezing. Complete decellularization – in terms of residual DNA amount – is an important predictor of probability of immune rejection of materials of natural origin. However, the signs of cellular material may still remain within the matrix even after harsh decellularization protocols. In this regard, the matrices obtained from tissues of low-immunogenic pigs with α3Galactosyl-tranferase gene knock out (GalT-KO) may be a promising alternative to native animal sources. The research included a study of induced effect of frozen and fresh fragments of GalT-KO skin on healing of full-thickness plane wounds in 80 rats. Commercially available wound dressings (Ksenoderm, Hyamatrix and Alloderm) as well as allogenic skin were used as a positive control and untreated wounds were analyzed as a negative control. The results were evaluated on the 4th day after grafting, which corresponds to the time of start of normal wound epithelization. It has been shown that a non-specific immune response in models treated with GalT-Ko pig skin was milder than in all the control groups. Research has been performed to measure technical skin characteristics: stiffness and elasticity properties, corneometry, tevametry, and cutometry. These metrics enabled the evaluation of hydratation level, corneous layer husking level, as well as skin elasticity and micro- and macro-landscape. These preliminary data may contribute to development of personalized transplantable organs from GalT-Ko pigs with significantly limited potential of immune rejection. By applying growth factors to a decellularized skin sample it is possible to achieve various regenerative effects based on the particular situation. In this particular research BMP2 and Heparin-binding EGF-like growth factor have been used. Ideally, a bioengineered organ must be biocompatible, non-immunogenic and support cell growth. Porcine organs are attractive for xenotransplantation if severe immunologic concerns can be bypassed. The results indicate that genetically modified pig tissues with knock-outed α3Galactosyl-tranferase gene may be used for production of low-immunogenic matrix suitable for transplantation.

Keywords: decellularization, low-immunogenic, matrix, scaffolds, transplants

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257 European Prosecutor's Office: Chances and Threats; Brief to Polish Perspective

Authors: Katarzyna Stoklosa

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Introduction: European Public Prosecutor’s Office (EPPO) is an independent office in European Union which was established under the article 86 of the Treaty on the Functioning of the European Union by the Treaty of Lisbon following the method of enhanced cooperation. EPPO is aimed at combating crimes against the EU’s financial interest et fraud against the EU budgets on the one hand, EPPO will give a chance to effective fight with organized criminality, on the other it seems to be a threat for member-states which bound with justice the problem of sovereignty. It is a new institution that will become effective from 2020, which is why it requires prior analysis. Methodology: The author uses statistical and comparative methods by collecting and analyzing the work of current institutions such as Europol, Eurojust, as well as the future impact of EPPO on detection and prosecution of crimes. The author will also conduct questionnaire among students and academic staff involved in the perception of EU institutions and the need to create new entities dealing with inter-agency cooperation in criminal matters. Thanks to these research the author will draw up present ways of cooperation between member-states and changes in fighting with financial crimes which will grow up under new regulation. Major Finding of the Study: Analysis and research show that EPPO is an institution based on the principle of mutual recognition, which often does not work in cooperation between Member States. Distrust and problems with the recognition of judgments of other EU Member States may significantly affect the functioning of EPPO. Poland is not part of the EPPO, because arguments have been raised that the European Public Prosecutor's Office interferes too much with the Member States’ pro-active sovereignty and duplicates competences. The research and analyzes carried out by the author show that EPPO has completely new competences, for example, it may file indictments against perpetrators of financial crimes. However, according to the research carried out by the author, such competences may undermine the sovereignty and the principle of protecting the public order of the EU. Conclusion: After the analysis, it will be possible to set following thesis: EPPO is only possible way to effective fight with organized financial criminality. However in conclusion Polish doubts should not be criticized at all. Institutions as EPPO must properly respect sovereignty of member-states. Even instruments like that cannot provoke political contraventions, because there are no other ways to effective resolving of international criminality problem.

Keywords: criminal trial, economic crimes, European Public Prosecutor's Office, European Union

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256 The Investigation of Work Stress and Burnout in Nurse Anesthetists: A Cross-Sectional Study

Authors: Yen Ling Liu, Shu-Fen Wu, Chen-Fuh Lam, I-Ling Tsai, Chia-Yu Chen

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Purpose: Nurse anesthetists are confronting extraordinarily high job stress in their daily practice, deriving from the fast-track anesthesia care, risk of perioperative complications, routine rotating shifts, teaching programs and interactions with the surgical team in the operating room. This study investigated the influence of work stress on the burnout and turnover intention of nurse anesthetists in a regional general hospital in Southern Taiwan. Methods: This was a descriptive correlational study carried out in 66 full-time nurse anesthetists. Data was collected from March 2017 to June 2017 by in-person interview, and a self-administered structured questionnaire was completed by the interviewee. Outcome measurements included the Practice Environment Scale of the Nursing Work Index (PES-NWI), Maslach Burnout Inventory (MBI) and nursing staff turnover intention. Numerical data were analyzed by descriptive statistics, independent t test, or one-way ANOVA. Categorical data were compared using the chi-square test (x²). Datasets were computed with Pearson product-moment correlation and linear regression. Data were analyzed by using SPSS 20.0 software. Results: The average score for job burnout was 68.7916.67 (out of 100). The three major components of burnout, including emotional depletion (mean score of 26.32), depersonalization (mean score of 13.65), and personal(mean score of 24.48). These average scores suggested that these nurse anesthetists were at high risk of burnout and inversely correlated with turnover intention (t = -4.048, P < 0.05). Using linear regression model, emotional exhaustion and depersonalization were the two independent factors that predicted turnover intention in the nurse anesthetists (19.1% in total variance). Conclusion/Implications for Practice: The study identifies that the high risk of job burnout in the nurse anesthetists is not simply derived from physical overload, but most likely resulted from the additional emotional and psychological stress. The occurrence of job burnout may affect the quality of nursing work, and also influence family harmony, in turn, may increase the turnover rate. Multimodal approach is warranted to reduce work stress and job burnout in nurse anesthetists to enhance their willingness to contribute in anesthesia care.

Keywords: anesthesia nurses, burnout, job, turnover intention

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255 Assessment of Routine Health Information System (RHIS) Quality Assurance Practices in Tarkwa Sub-Municipal Health Directorate, Ghana

Authors: Richard Okyere Boadu, Judith Obiri-Yeboah, Kwame Adu Okyere Boadu, Nathan Kumasenu Mensah, Grace Amoh-Agyei

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Routine health information system (RHIS) quality assurance has become an important issue, not only because of its significance in promoting a high standard of patient care but also because of its impact on government budgets for the maintenance of health services. A routine health information system comprises healthcare data collection, compilation, storage, analysis, report generation, and dissemination on a routine basis in various healthcare settings. The data from RHIS give a representation of health status, health services, and health resources. The sources of RHIS data are normally individual health records, records of services delivered, and records of health resources. Using reliable information from routine health information systems is fundamental in the healthcare delivery system. Quality assurance practices are measures that are put in place to ensure the health data that are collected meet required quality standards. Routine health information system quality assurance practices ensure that data that are generated from the system are fit for use. This study considered quality assurance practices in the RHIS processes. Methods: A cross-sectional study was conducted in eight health facilities in Tarkwa Sub-Municipal Health Service in the western region of Ghana. The study involved routine quality assurance practices among the 90 health staff and management selected from facilities in Tarkwa Sub-Municipal who collected or used data routinely from 24th December 2019 to 20th January 2020. Results: Generally, Tarkwa Sub-Municipal health service appears to practice quality assurance during data collection, compilation, storage, analysis and dissemination. The results show some achievement in quality control performance in report dissemination (77.6%), data analysis (68.0%), data compilation (67.4%), report compilation (66.3%), data storage (66.3%) and collection (61.1%). Conclusions: Even though the Tarkwa Sub-Municipal Health Directorate engages in some control measures to ensure data quality, there is a need to strengthen the process to achieve the targeted percentage of performance (90.0%). There was a significant shortfall in quality assurance practices performance, especially during data collection, with respect to the expected performance.

Keywords: quality assurance practices, assessment of routine health information system quality, routine health information system, data quality

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254 Learning Curve Effect on Materials Procurement Schedule of Multiple Sister Ships

Authors: Vijaya Dixit Aasheesh Dixit

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Shipbuilding industry operates in Engineer Procure Construct (EPC) context. Product mix of a shipyard comprises of various types of ships like bulk carriers, tankers, barges, coast guard vessels, sub-marines etc. Each order is unique based on the type of ship and customized requirements, which are engineered into the product right from design stage. Thus, to execute every new project, a shipyard needs to upgrade its production expertise. As a result, over the long run, holistic learning occurs across different types of projects which contributes to the knowledge base of the shipyard. Simultaneously, in the short term, during execution of a project comprising of multiple sister ships, repetition of similar tasks leads to learning at activity level. This research aims to capture above learnings of a shipyard and incorporate learning curve effect in project scheduling and materials procurement to improve project performance. Extant literature provides support for the existence of such learnings in an organization. In shipbuilding, there are sequences of similar activities which are expected to exhibit learning curve behavior. For example, the nearly identical structural sub-blocks which are successively fabricated, erected, and outfitted with piping and electrical systems. Learning curve representation can model not only a decrease in mean completion time of an activity, but also a decrease in uncertainty of activity duration. Sister ships have similar material requirements. The same supplier base supplies materials for all the sister ships within a project. On one hand, this provides an opportunity to reduce transportation cost by batching the order quantities of multiple ships. On the other hand, it increases the inventory holding cost at shipyard and the risk of obsolescence. Further, due to learning curve effect the production scheduled of each consequent ship gets compressed. Thus, the material requirement schedule of every next ship differs from its previous ship. As more and more ships get constructed, compressed production schedules increase the possibility of batching the orders of sister ships. This work aims at integrating materials management with project scheduling of long duration projects for manufacturing of multiple sister ships. It incorporates the learning curve effect on progressively compressing material requirement schedules and addresses the above trade-off of transportation cost and inventory holding and shortage costs while satisfying budget constraints of various stages of the project. The activity durations and lead time of items are not crisp and are available in the form of probabilistic distribution. A Stochastic Mixed Integer Programming (SMIP) model is formulated which is solved using evolutionary algorithm. Its output provides ordering dates of items and degree of order batching for all types of items. Sensitivity analysis determines the threshold number of sister ships required in a project to leverage the advantage of learning curve effect in materials management decisions. This analysis will help materials managers to gain insights about the scenarios: when and to what degree is it beneficial to treat a multiple ship project as an integrated one by batching the order quantities and when and to what degree to practice distinctive procurement for individual ship.

Keywords: learning curve, materials management, shipbuilding, sister ships

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253 Fostering Creativity in Education Exploring Leadership Perspectives on Systemic Barriers to Innovative Pedagogy

Authors: David Crighton, Kelly Smith

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The ability to adopt creative pedagogical approaches is increasingly vital in today’s educational landscape. This study examines the institutional barriers that hinder educators, in the UK, from embracing such innovation, focusing specifically on the experiences and perspectives of educational leaders. Current literature primarily focuses on the challenges that academics and teachers encounter, particularly highlighting how management culture and audit processes negatively affect their ability to be creative in classrooms and lecture theatres. However, this focus leaves a gap in understanding management perspectives, which is crucial for providing a more holistic insight into the challenges encountered in educational settings. To explore this gap, we are conducting semi-structured interviews with senior leaders across various educational contexts, including universities, schools, and further education colleges. This qualitative methodology, combined with thematic analysis, aims to uncover the managerial, financial, and administrative pressures these leaders face in fostering creativity in teaching and supporting professional learning opportunities. Preliminary insights indicate that educational leaders face significant barriers, such as institutional policies, resource limitations, and external performance indicators. These challenges create a restrictive environment that stifles educators' creativity and innovation. Addressing these barriers is essential for empowering staff to adopt more creative pedagogical approaches, ultimately enhancing student engagement and learning outcomes. By alleviating these constraints, educational leaders can cultivate a culture that fosters creativity and flexibility in the classroom. These insights will inform practical recommendations to support institutional change and enhance professional learning opportunities, contributing to a more dynamic educational environment. In conclusion, this study offers a timely exploration of how leadership can influence the pedagogical landscape in a rapidly evolving educational context. The research seeks to highlight the crucial role that educational leaders play in shaping a culture of creativity and adaptability, ensuring that institutions are better equipped to respond to the challenges of contemporary education.

Keywords: educational leadership, professional learning, creative pedagogy, marketisation

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