Search results for: geological setting
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2276

Search results for: geological setting

596 Evaluating the Efficacy of Tasquinimod in Covid-19

Authors: Raphael Udeh, Luis García De Guadiana Romualdo, Xenia Dolje-Gore

Abstract:

Background: Quite disturbing is the huge public health impact of COVID-19: As at today [25th March 2021, the COVID-19 global burden shows over 123 million cases and over 2.7 million deaths worldwide. Rationale: Recent evidence shows calprotectin’s potential as a therapeutic target, stating that tasquinimod, from the Quinoline-3-Carboxamide family is capable of blocking the interaction between calprotectin and TLR4. Hence preventing the cytokine release syndrome, that heralds the functional exhaustion in COVID-19. Early preclinical studies showed that tasquinimod inhibit tumor growth and prevent angiogenesis/cytokine storm. Phase I – III clinical studies in prostate cancer showed it has a good safety profile with good radiologic progression free survival but no effect on overall survival. Rationale/hypothesis: Strategic endeavors have been amplified globally to assess new therapeutic interventions for COVID-19 management – thus the clinical and antiviral efficacy of tasquinimod in COVID-19 remains to be explored. Hence the primary objective of this trial will be to evaluate the efficacy of tasquinimod in the treatment of adult patients with severe COVID-19 infections. Therefore, I hypothesise that among adults with COVID19 infection, tasquinimod will reduce the severe respiratory distress associated with COVID-19 compared to placebo, over a 28-day study period. Method: The setting is in Europe. Design – a randomized, placebo-controlled, phase II double-blinded trial. Trial lasts for 28 days from randomization, Tasquinimod capsule given as 0.5mg daily 1st fortnight, then 1mg daily 2nd fortnight. I0 outcome - assessed using six-point ordinal scale alongside eight 20 outcomes. 125 participants to be enrolled, data collection at baseline and subsequent data points, and safety reporting monitored via serological profile. Significance: This work could potentially establish tasquinimod as an effective and safe therapeutic agent for COVID-19 by reducing the severe respiratory distress, related time to recovery, time on oxygen/admission. It will also drive future research – as in larger multi-centre RCT.

Keywords: Calprotectin, COVID-19, Phase II Trial, Tasquinimod

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595 Money Laundering Risk Assessment in the Banking Institutions: An Experimental Approach

Authors: Yusarina Mat-Isa, Zuraidah Mohd-Sanusi, Mohd-Nizal Haniff, Paul A. Barnes

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In view that money laundering has become eminent for banking institutions, it is an obligation for the banking institutions to adopt a risk-based approach as the integral component of the accepted policies on anti-money laundering. In doing so, those involved with the banking operations are the most critical group of personnel as these are the people who deal with the day-to-day operations of the banking institutions and are obligated to form a judgement on the level of impending risk. This requirement is extended to all relevant banking institutions staff, such as tellers and customer account representatives for them to identify suspicious customers and escalate it to the relevant authorities. Banking institutions staffs, however, face enormous challenges in identifying and distinguishing money launderers from other legitimate customers seeking genuine banking transactions. Banking institutions staffs are mostly educated and trained with the business objective in mind to serve the customers and are not trained to be “detectives with a detective’s power of observation”. Despite increasing awareness as well as trainings conducted for the banking institutions staff, their competency in assessing money laundering risk is still insufficient. Several gaps have prompted this study including the lack of behavioural perspectives in the assessment of money laundering risk in the banking institutions. Utilizing experimental approach, respondents are randomly assigned within a controlled setting with manipulated situations upon which judgement of the respondents is solicited based on various observations related to the situations. The study suggests that it is imperative that informed judgement is exercised in arriving at the decision to proceed with the banking services required by the customers. Judgement forms a basis of opinion for the banking institution staff to decide if the customers posed money laundering risk. Failure to exercise good judgement could results in losses and absorption of unnecessary risk into the banking institutions. Although the banking institutions are exposed with choices of automated solutions in assessing money laundering risk, the human factor in assessing the risk is indispensable. Individual staff in the banking institutions is the first line of defence who are responsible for screening the impending risk of any customer soliciting for banking services. At the end of the spectrum, the individual role involvement on the subject of money laundering risk assessment is not a substitute for automated solutions as human judgement is inimitable.

Keywords: banking institutions, experimental approach, money laundering, risk assessment

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594 Mural Exhibition as a Promotive Strategy to Proper Hygiene and Sanitation Practices among Children: A Case Study from Urban Slum Schools in Nairobi, Kenya

Authors: Abdulaziz Kikanga, Kellen Muchira, Styvers Kathuni, Paul Saitoti

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Background: Provision of adequate levels of water, sanitation, and hygiene in schools is a strategic objective in achieving universal primary education among children in low and middle-income countries. However, lack of proper sanitation and hygiene practices in schools, especially those in informal settlement has resulted to an increased rate of school absenteeism thereby affecting the education and health outcomes of the children in those setting. Intervention or Response: Catholic Relief Services in Kenya supports five schools in informal settlements of Nairobi by painting of key hygiene messages on school walls to promote proper hygiene and sanitation practices among the school children. The mural exhibitions depict the essence of proper hygiene practices, proper latrine use, and hand washing after visiting the latrine. The artwork is context specific and its aimed at improving the uptake of proper hygiene and sanitation practices among the school children. Review of project related documents was conducted including interviews with the school children. Thematic analysis was used to interpret the qualitative information generated. Results and Lessons Learnt: 12 school children have interviewed on proper hygiene and sanitation practices and the exercise revealed that painted murals were the best communication platforms for creating awareness on proper sanitation on issues relating to water, sanitation, and hygiene in schools. The painting mural provided a strong knowledge base for the formation of healthy habits in both the school and informal settlement. In addition, these sanitation messages on the school walls empower the children to share these practices with their siblings, parents, and other family members thereby acting as agents of change to proper hygiene and sanitation in those informal settlements. The findings revealed that by adopting proper sanitation and hygiene practices, there has been a reduction of school absenteeism due to a decrease in disease related to inadequate sanitation and hygiene in schools. Conclusion: The adoption of proper sanitation in schools entails more than just a painted mural wall. Insights revealed that to have a lasting sanitation and hygiene intervention, there is a need to invest in effective hygiene educational programming that encourages the formation of proper hygiene habits and promotes changes in behavior.

Keywords: education outcomes, informal settlement, mural exhibition, school hygiene and sanitation

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593 The Influence of Activity Selection and Travel Distance on Forest Recreation Policies

Authors: Mark Morgan, Christine Li, Shuangyu Xu, Jenny McCarty

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The National Wild and Scenic Rivers System was created by the U.S. Congress in 1968 (Public Law 90-542; 16 U.S.C. 1271 et seq.) to preserve outstanding natural, cultural, and recreational values of some U.S. rivers in a free-flowing condition for the enjoyment of present and future generations. This Act is notable for safeguarding the special character of these rivers while supporting management action that encourages public participation for co-creating river protection goals and strategies. This is not an easy task. To meet the challenges of modern ecosystem management, federal resource agencies must address many legal, environmental, economic, political, and social issues. The U.S. Forest Service manages a 44-mile section of the Eleven Point National Scenic River (EPR) in southern Missouri, mainly for outdoor recreation purposes. About half of the acreage is in private lands, while the remainder flows through the Mark Twain National Forest. Private land along the river is managed by scenic easements to ensure protection of scenic values and natural resources, without public access. A portion of the EPR lies adjacent to a 16,500-acre tract known as the Irish Wilderness. The spring-fed river has steep bluffs, deep pools, clear water, and a slow current, making it an ideal setting for outdoor enthusiasts. A 10-month visitor study was conducted at five access points along the EPR during 2019 so the US Forest Service could update their river management plan. A mail-back survey was administered to 560 on-site visitors, yielding a response rate of 53%. Although different types of visitors use the EPR, boating and fishing were the predominant forms of outdoor recreation. Some river use was from locals, but other visitors came from farther away. Formulating unbiased policies for outdoor recreation is difficult because managers must assign relative values to recreational activities and travel distance. Because policymaking is a subjective process, management decisions can affect user groups in different ways (i.e., boaters vs. fishers; proximate vs. distal visitors), as seen through a GIS analysis.

Keywords: activity selection, forest recreation, policy, travel distance

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592 Initial Palaeotsunami and Historical Tsunami in the Makran Subduction Zone of the Northwest Indian Ocean

Authors: Mohammad Mokhtari, Mehdi Masoodi, Parvaneh Faridi

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history of tsunami generating earthquakes along the Makran Subduction Zone provides evidence of the potential tsunami hazard for the whole coastal area. In comparison with other subduction zone in the world, the Makran region of southern Pakistan and southeastern Iran remains low seismicity. Also, it is one of the least studied area in the northwest of the Indian Ocean regarding tsunami studies. We present a review of studies dealing with the historical /and ongoing palaeotsunamis supported by IGCP of UNESCO in the Makran Subduction Zone. The historical tsunami presented here includes about nine tsunamis in the Makran Subduction Zone, of which over 7 tsunamis occur in the eastern Makran. Tsunami is not as common in the western Makran as in the eastern Makran, where a database of historical events exists. The historically well-documented event is related to the 1945 earthquake with a magnitude of 8.1moment magnitude and tsunami in the western and eastern Makran. There are no details as to whether a tsunami was generated by a seismic event before 1945 off western Makran. But several potentially large tsunamigenic events in the MSZ before 1945 occurred in 325 B.C., 1008, 1483, 1524, 1765, 1851, 1864, and 1897. Here we will present new findings from a historical point of view, immediately, we would like to emphasize that the area needs to be considered with higher research investigation. As mentioned above, a palaeotsunami (geological evidence) is now being planned, and here we will present the first phase result. From a risk point of view, the study shows as preliminary achievement within 20 minutes the wave reaches to Iranian as well Pakistan and Oman coastal zone with very much destructive tsunami waves capable of inundating destructive effect. It is important to note that all the coastal areas of all states surrounding the MSZ are being developed very rapidly, so any event would have a devastating effect on this region. Although several papers published about modelling, seismology, tsunami deposits in the last decades; as Makran is a forgotten subduction zone, more data such as the main crustal structure, fault location, and its related parameter are required.

Keywords: historical tsunami, Indian ocean, makran subduction zone, palaeotsunami

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591 An Integrated Approach to Syllabus Design for Business Chinese

Authors: Dongshuo Wang, Minjie Xing

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International businesses prefer to hire people who speak more than one language. With the booming of China’s market, industries and trade, business leaders are looking for people who can speak Chinese and operate successfully in a Chinese cultural context, and therefore an increasing number of tertiary students choose a Business Chinese (BC) course. As a result, BC syllabus design is urgently needed. What business knowledge should be included in China’s context? What aspects of BC culture should be included? How much Chinese language should be introduced to conduct business in China? With these research questions, this research explores a syllabus design that integrates the three aspects of subject knowledge of business in communication, business practice including the procedure of and strategies for communicating business in practice and language skills including the disciplinary and professional contexts in which linguistic choices are made. After literature review and consultancy with China-related business professionals, senior staff from business schools and representatives of students, the authors of this paper, together with language tutors drafted a syllabus based on the integrated approach to include subject knowledge, business practice and language skills. Due to the nature of this research which requires trial/test and detailed description for each correction, qualitative methods are adopted. Two in-depth focus group interviews (with 2 staff and 4 students in each group), and 18 individual interviews (8 staff and 10 students) were conducted. QDA was used for systematizing, organizing, and analysing qualitative data. It was discovered that the business knowledge related to a Chinese cultural context, including face value, networking skills, strategic plans for signing a contract, marketing, sales, and after-sale service, should be introduced through lectures and seminars; business practice could be implemented by students setting up their own companies, virtual or real; and language skills would be trained via writing business messages and presenting their companies in fairs and exhibitions. After a longitudinal study of trials and amendments for three years from 2013 to 2016, the syllabus was approved by staff and students and the university. Students appreciated the syllabus, as they could apply the subject knowledge into practice by using it in their own companies and Chinese language was used throughout the process. The syllabus is now ready to be used in universities offering BC, and the designing process can be applied to other new courses as well.

Keywords: business Chinese, syllabus design, business knowledge, language skills

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590 Leveraging xAPI in a Corporate e-Learning Environment to Facilitate the Tracking, Modelling, and Predictive Analysis of Learner Behaviour

Authors: Libor Zachoval, Daire O Broin, Oisin Cawley

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E-learning platforms, such as Blackboard have two major shortcomings: limited data capture as a result of the limitations of SCORM (Shareable Content Object Reference Model), and lack of incorporation of Artificial Intelligence (AI) and machine learning algorithms which could lead to better course adaptations. With the recent development of Experience Application Programming Interface (xAPI), a large amount of additional types of data can be captured and that opens a window of possibilities from which online education can benefit. In a corporate setting, where companies invest billions on the learning and development of their employees, some learner behaviours can be troublesome for they can hinder the knowledge development of a learner. Behaviours that hinder the knowledge development also raise ambiguity about learner’s knowledge mastery, specifically those related to gaming the system. Furthermore, a company receives little benefit from their investment if employees are passing courses without possessing the required knowledge and potential compliance risks may arise. Using xAPI and rules derived from a state-of-the-art review, we identified three learner behaviours, primarily related to guessing, in a corporate compliance course. The identified behaviours are: trying each option for a question, specifically for multiple-choice questions; selecting a single option for all the questions on the test; and continuously repeating tests upon failing as opposed to going over the learning material. These behaviours were detected on learners who repeated the test at least 4 times before passing the course. These findings suggest that gauging the mastery of a learner from multiple-choice questions test scores alone is a naive approach. Thus, next steps will consider the incorporation of additional data points, knowledge estimation models to model knowledge mastery of a learner more accurately, and analysis of the data for correlations between knowledge development and identified learner behaviours. Additional work could explore how learner behaviours could be utilised to make changes to a course. For example, course content may require modifications (certain sections of learning material may be shown to not be helpful to many learners to master the learning outcomes aimed at) or course design (such as the type and duration of feedback).

Keywords: artificial intelligence, corporate e-learning environment, knowledge maintenance, xAPI

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589 The Safety Related Functions of The Engineered Barriers of the IAEA Borehole Disposal System: The Ghana Pilot Project

Authors: Paul Essel, Eric T. Glover, Gustav Gbeddy, Yaw Adjei-Kyereme, Abdallah M. A. Dawood, Evans M. Ameho, Emmanuel A. Aberikae

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Radioactive materials mainly in the form of Sealed Radioactive Sources are being used in various sectors (medicine, agriculture, industry, research, and teaching) for the socio-economic development of Ghana. The use of these beneficial radioactive materials has resulted in an inventory of Disused Sealed Radioactive Sources (DSRS) in storage. Most of the DSRS are legacy/historic sources which cannot be returned to their manufacturer or country of origin. Though small in volume, DSRS can be intensively radioactive and create a significant safety and security liability. They need to be managed in a safe and secure manner in accordance with the fundamental safety objective. The Radioactive Waste Management Center (RWMC) of the Ghana Atomic Energy Commission (GAEC) is currently storing a significant volume of DSRS. The initial activities of the DSRS range from 7.4E+5 Bq to 6.85E+14 Bq. If not managed properly, such DSRS can represent a potential hazard to human health and the environment. Storage is an important interim step, especially for DSRS containing very short-lived radionuclides, which can decay to exemption levels within a few years. Long-term storage, however, is considered an unsustainable option for DSRS with long half-lives hence the need for a disposal facility. The GAEC intends to use the International Atomic Energy Agency’s (IAEA’s) Borehole Disposal System (BDS) to provide a safe, secure, and cost-effective disposal option to dispose of its DSRS in storage. The proposed site for implementation of the BDS is on the GAEC premises at Kwabenya. The site has been characterized to gain a general understanding in terms of its regional setting, its past evolution and likely future natural evolution over the assessment time frame. Due to the long half-lives of some of the radionuclides to be disposed of (Ra-226 with half-life of 1600 years), the engineered barriers of the system must be robust to contain these radionuclides for this long period before they decay to harmless levels. There is the need to assess the safety related functions of the engineered barriers of this disposal system.

Keywords: radionuclides, disposal, radioactive waste, engineered barrier

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588 Modal Composition and Tectonic Provenance of the Sandstones of Ecca Group, Karoo Supergroup in the Eastern Cape Province, South Africa

Authors: Christopher Baiyegunhi, Kuiwu Liu, Oswald Gwavava

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Petrography of the sandstones of Ecca Group, Karoo Supergroup in the Eastern Cape Province of South Africa have been investigated on composition, provenance and influence of weathering conditions. Petrographic studies based on quantitative analysis of the detrital minerals revealed that the sandstones are composed mostly of quartz, feldspar and lithic fragments of metamorphic and sedimentary rocks. The sandstones have an average framework composition of 24.3% quartz, 19.3% feldspar, 26.1% rock fragments, and 81.33% of the quartz grains are monocrystalline. These sandstones are generally very fine to fine grained, moderate to well sorted, and subangular to subrounded in shape. In addition, they are compositionally immature and can be classified as feldspathic wacke and lithic wacke. The absence of major petrographically distinctive compositional variations in the sandstones perhaps indicate homogeneity of their source. As a result of this, it is inferred that the transportation distance from the source area was quite short and the main mechanism of transportation was by river systems to the basin. The QFL ternary diagrams revealed dissected and transitional arc provenance pointing to an active margin and uplifted basement preserving the signature of a recycled provenance. This is an indication that the sandstones were derived from a magmatic arc provenance. Since magmatic provenance includes transitional arc and dissected arc, it also shows that the source area of the Ecca sediments had a secondary sedimentary and metasedimentary rocks from a marginal belt that developed as a result of rifting. The weathering diagrams and semi-quantitative weathering index indicate that the Ecca sandstones are mostly from a plutonic source area, with climatic conditions ranging from arid to humid. The compositional immaturity of the sandstones is suggested to be due to weathering or recycling and low relief or short transport from the source area. The detrital modal compositions of these sandstones are related to back arc to island and continental margin arc. The origin and deposition of the Ecca sandstones are due to low-moderate weathering, recycling of pre-existing rocks, erosion and transportation of debris from the orogeny of the Cape Fold Belt.

Keywords: petrography, tectonic setting, provenance, Ecca Group, Karoo Basin

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587 Medical Student's Responses to Emotional Content in Doctor-Patient Communication: To Explore Differences in Communication Training of Medical Students and Its Impact on Doctor-Patient Communication

Authors: Stephanie Yun Yu Law

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Background: This study aims to investigate into communication between trainee doctors and patients, especially how doctor’s reaction to patient’s emotional issues expressed in the consultation affect patient’s satisfaction. Objectives: Thus, there are three aims in this study, 1.) how do trainee doctors react to patients emotional cues in OSCE station? 2.) Any differences in the respond type to emotional cues between first year students and third year students? 3.) Is response type (reducing space) related to OSCE outcome (patient satisfaction and expert rating)? Methods: Fifteen OSCE stations was videotaped, in which 9 were stations with first-year students and 6 were with third-year students. OSCE outcomes were measured by Communication Assessment Tool and Examiners Checklist. Analyses: All patient’s cues/concerns and student’s reaction were coded by Verona Coding Definitions of Emotional Sequence. Descriptive data was gathered from Observer XT and logistic regression (two-level) was carried out to see if occurrence of reducing space response can be predicted by OSCE outcomes. Results: Reducing space responses from all students were slightly less than a half in total responses to patient’s cues. The mean percentage of reducing space behaviours was lower among first year students when compared to third year students. Patient’s satisfaction significantly (p<0.05) and negatively predicted reducing space behaviours. Conclusions: Most of the medical students, to some extent, did not provide adequate responses for patient’s emotional cues. But first year students did provide more space for patients to talk about their emotional issues when compared to third year students. Lastly, patients would feel less satisfied if trainee doctors use more reducing space responses in reaction to patient’s expressed emotional cues/concerns. Practical implications: Firstly, medical training programme can be tailored on teaching students how to detect and respond appropriately to emotional cues in order to improve underperformed student’s communication skills in healthcare setting. Furthermore, trainee doctor’s relationship with patients in clinical practice can also be improved by reacting appropriately to patient’s emotive cues in consultations (such as limit the use of reducing space behaviours).

Keywords: doctors-patients communication, applied clinical psychology, health psychology, healthcare professionals

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586 Effects of Renin Angiotensin Pathway Inhibition on Efficacy of Anti-PD-1/PD-L1 Treatment in Metastatic Cancer

Authors: Philip Friedlander, John Rutledge, Jason Suh

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Inhibition of programmed death-1 (PD-1) or its ligand PD-L1 confers therapeutic efficacy in a wide range of solid tumor malignancies. Primary or acquired resistance can develop through activation of immunosuppressive immune cells such as tumor-associated macrophages. The renin angiotensin system (RAS) systemically regulates fluid and sodium hemodynamics, but components are expressed on and regulate the activity of immune cells, particularly of myeloid lineage. We hypothesized that inhibition of RAS would improve the efficacy of PD-1/PD-L-1 treatment. A retrospective analysis was performed through a chart review of patients with solid metastatic malignancies treated with a PD-1/PD-L1 inhibitor between 1/2013 and 6/2019 at Valley Hospital, a community hospital in New Jersey, USA. Efficacy was determined by medical oncologist documentation of clinical benefit in visit notes and by the duration of time on immunotherapy treatment. The primary endpoint was the determination of efficacy differences in patients treated with an inhibitor of RAS ( ace inhibitor, ACEi, or angiotensin blocker, ARB) compared to patients not treated with these inhibitors. To control for broader antihypertensive effects, efficacy as a function of treatment with beta blockers was assessed. 173 patients treated with PD-1/PD-L-1 inhibitors were identified of whom 52 were also treated with an ACEi or ARB. Chi-square testing revealed a statistically significant relationship between being on an ACEi or ARB and efficacy to PD-1/PD-L-1 therapy (p=0.001). No statistically significant relationship was seen between patients taking or not taking beta blocker antihypertensives (p= 0.33). Kaplan-Meier analysis showed statistically significant improvement in the duration of therapy favoring patients concomitantly treated with ACEi or ARB compared to patients not exposed to antihypertensives and to those treated with beta blockers. Logistic regression analysis revealed that age, gender, and cancer type did not have significant effects on the odds of experiencing clinical benefit (p=0.74, p=0.75, and p=0.81, respectively). We conclude that retrospective analysis of the treatment of patients with solid metastatic tumors with anti-PD-1/PD-L1 in a community setting demonstrates greater clinical benefit in the context of concomitant ACEi or ARB inhibition, irrespective of gender or age. This data supports the development of prospective assessment through randomized clinical trials.

Keywords: angiotensin, cancer, immunotherapy, PD-1, efficacy

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585 Application of the Building Information Modeling Planning Approach to the Factory Planning

Authors: Peggy Näser

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Factory planning is a systematic, objective-oriented process for planning a factory, structured into a sequence of phases, each of which is dependent on the preceding phase and makes use of particular methods and tools, and extending from the setting of objectives to the start of production. The digital factory, on the other hand, is the generic term for a comprehensive network of digital models, methods, and tools – including simulation and 3D visualisation – integrated by a continuous data management system. Its aim is the holistic planning, evaluation and ongoing improvement of all the main structures, processes and resources of the real factory in conjunction with the product. Digital factory planning has already become established in factory planning. The application of Building Information Modeling has not yet been established in factory planning but has been used predominantly in the planning of public buildings. Furthermore, this concept is limited to the planning of the buildings and does not include the planning of equipment of the factory (machines, technical equipment) and their interfaces to the building. BIM is a cooperative method of working, in which the information and data relevant to its lifecycle are consistently recorded, managed and exchanged in a transparent communication between the involved parties on the basis of digital models of a building. Both approaches, the planning approach of Building Information Modeling and the methodical approach of the Digital Factory, are based on the use of a comprehensive data model. Therefore it is necessary to examine how the approach of Building Information Modeling can be extended in the context of factory planning in such a way that an integration of the equipment planning, as well as the building planning, can take place in a common digital model. For this, a number of different perspectives have to be investigated: the equipment perspective including the tools used to implement a comprehensive digital planning process, the communication perspective between the planners of different fields, the legal perspective, that the legal certainty in each country and the quality perspective, on which the quality criteria are defined and the planning will be evaluated. The individual perspectives are examined and illustrated in the article. An approach model for the integration of factory planning into the BIM approach, in particular for the integrated planning of equipment and buildings and the continuous digital planning is developed. For this purpose, the individual factory planning phases are detailed in the sense of the integration of the BIM approach. A comprehensive software concept is shown on the tool. In addition, the prerequisites required for this integrated planning are presented. With the help of the newly developed approach, a better coordination between equipment and buildings is to be achieved, the continuity of the digital factory planning is improved, the data quality is improved and expensive implementation errors are avoided in the implementation.

Keywords: building information modeling, digital factory, digital planning, factory planning

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584 Efficacy of Single-Dose Azithromycin Therapy for the Treatment of Chlamydia trachomatis in Patients Evaluated for Child Sexual Abuse in an Urban Health Center 2006-16

Authors: Trenton Hubbard, Kenneth Soyemi, Emily Siffermann

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Introduction: According to the American Academy of Pediatrics (AAP) there are different weight-based recommendations for the treatment of Chlamydia trachomatis (CT) in patients who are being evaluated for sexual assault. Current AAP Red Book guidelines recommend that uncomplicated C. trachomatis anogenital infection in prepubertal patients weighing less than =<45 kg be treated with oral erythromycin 50 mg/kg/day QID for 14 days with no alternative therapies, and for patients whose weight => 45 kg are Azithromycin 1 gm PO once. Our study objective was to determine the efficacy of single-dose Azithromycin therapy for the treatment of Chlamydia trachomatis in patients weighing less than 50 kg who were evaluated for child sexual abuse in an urban setting. Methods: We conducted a retrospective chart review of historical medical records (paper and electronic) patients weighing less than 50 kg who were evaluated for child sexual abuse and subsequently treated for C. trachomatis infection with Azithromycin (20 mg/kg PO once up to a maximum 1 gm) and received a Test of Cure (TOC) from 2006-2016. Qualitative variables were expressed as percentages. Quantitative variables were expressed as mean values (+/- standard deviation [SD]) if they followed a normal distribution or as median values (interquartile range[IQR]) if they did not. Wilcoxson two-sample test was used to compare means of Azithromycin Dose, mg/kg, and TOC timing between treatment responders and non-responders. Results: We reviewed records of 34 patients, average age (SD) was 5.4 (2.0) years, 33 (97%) were treated for CT and 1(3%) for both GC and CT. 25 (74%) were females. Urine PCR was the most commonly used test at evaluation and as TOC with 13 (38%) patients completing both tests. The average (SD) dose of Azithromycin at treatment was 470 (136) mg and average (SD) mg/kg dose of 20 (1.9) mg/kg for all patients. Median (IQR) timing for TOC testing was 19 (14-26) days. Of the 33 with complete data 25 (74%) had a negative TOC. When compared with treatment non-responders (TOC failures), treatment responders received higher doses (average dose (SD) received 495 (139) vs 401(110), P 0.06)); similar average (SD) weight base dosing received (20.8(2.0) vs 19.7 (1.5), P 0.15)), and earlier average (SD)TOC test timing (18.8 (5.6) vs 32 (28.6) P 0.02)). Conclusion: Azithromycin dosing appears to be efficacious in the treatment of CT post sexual assault as majority of patients responded. Although treatment responders and non-responders received similar weight based doses, there is need for additional studies to understand variances and predictors of response.

Keywords: child sexual abuse, chlmaydia trachmotis infection, single-dose azithromycin, weight less than or equal to 45 kilograms

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583 Embodied Communication - Examining Multimodal Actions in a Digital Primary School Project

Authors: Anne Öman

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Today in Sweden and in other countries, a variety of digital artefacts, such as laptops, tablets, interactive whiteboards, are being used at all school levels. From an educational perspective, digital artefacts challenge traditional teaching because they provide a range of modes for expression and communication and are not limited to the traditional medium of paper. Digital technologies offer new opportunities for representations and physical interactions with objects, which put forward the role of the body in interaction and learning. From a multimodal perspective the emphasis is on the use of multiple semiotic resources for meaning- making and the study presented here has examined the differential use of semiotic resources by pupils interacting in a digitally designed task in a primary school context. The instances analyzed in this paper come from a case study where the learning task was to create an advertising film in a film-software. The study in focus involves the analysis of a single case with the emphasis on the examination of the classroom setting. The research design used in this paper was based on a micro ethnographic perspective and the empirical material was collected through video recordings of small-group work in order to explore pupils’ communication within the group activity. The designed task described here allowed students to build, share, collaborate upon and publish the redesigned products. The analysis illustrates the variety of communicative modes such as body position, gestures, visualizations, speech and the interaction between these modes and the representations made by the pupils. The findings pointed out the importance of embodied communication during the small- group processes from a learning perspective as well as a pedagogical understanding of pupils’ representations, which were similar from a cultural literacy perspective. These findings open up for discussions with further implications for the school practice concerning the small- group processes as well as the redesigned products. Wider, the findings could point out how multimodal interactions shape the learning experience in the meaning-making processes taking into account that language in a globalized society is more than reading and writing skills.

Keywords: communicative learning, interactive learning environments, pedagogical issues, primary school education

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582 Using Immersive Study Abroad Experiences to Strengthen Preservice Teachers’ Critical Reflection Skills on Future Classroom Practices

Authors: Meredith Jones, Susan Catapano, Carol McNulty

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Study abroad experiences create unique learning opportunities for preservice teachers to strengthen their reflective thinking practices through applied learning experiences. Not only do study abroad experiences provide opportunities for students to expand their cultural sensitivity, but incorporating applied learning experiences in study abroad trips creates unique opportunities for preservice teachers to engage in critical reflection on their teaching skills. Applied learning experiences are designed to nurture learning and growth through a reflective, experiential process outside the traditional classroom setting. As students participate in applied learning experiences, they engage in critical reflection independently, with their peers, and with university faculty. Critical reflection within applied learning contexts generates, deepens, and documents learning but must be intentionally designed to be effective. Grounded in Dewey’s model of reflection, this qualitative study examines longitudinal data from various study abroad cohorts from a particular university. Reflective data was collected during the study abroad trip, and follow up data on critical reflection of teaching practices were collected six months and a year after the trip. Dewey’s model of reflection requires preservice teachers to make sense of their experiences by reflecting on theoretical knowledge, experiences, and pedagogical knowledge. Guided reflection provides preservice teachers with a framework to respond to questions and ideas critical to the applied learning outcomes. Prompts are used to engage preservice teachers in reflecting on situations they have experienced and how they can be transferred to their teaching. Findings from this study noted that students with previous field experiences, or work in the field, engaged in more critical reflection on pedagogical knowledge throughout their applied learning experience. Preservice teachers with limited experiences in the field benefited from engaging in critical reflection prompted by university faculty during the applied learning experience. However, they were able to independently engage in critical reflection once they began work in the field through university field placements, internships, or student teaching. Finally, students who participated in study abroad applied learning experiences reported their critical reflection on their teaching practices, and cultural sensitivity enhanced their teaching and relationships with children once they formally entered the teaching profession.

Keywords: applied learning experiences, critical reflection, cultural sensitivity, preservice teachers, teacher education

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581 Ecological Evaluation and Conservation Strategies of Economically Important Plants in Indian Arid Zone

Authors: Sher Mohammed, Purushottam Lal, Pawan K. Kasera

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The Thar Desert of Rajasthan covers a wide geographical area spreading between 23.3° to 30.12°, North latitude and 69.3◦ to 76◦ Eastern latitudes; having a unique spectrum of arid zone vegetation. This desert is spreading over 12 districts having a rich source of economically important/threatened plant diversity interacting and growing with adverse climatic conditions of the area. Due to variable geological, physiographic, climatic, edaphic and biotic factors, the arid zone medicinal flora exhibit a wide collection of angiosperm families. The herbal diversity of this arid region is medicinally important in household remedies among tribal communities as well as in traditional systems. The on-going increasing disturbances in natural ecosystems are due to climatic and biological, including anthropogenic factors. The unique flora and subsequently dependent faunal diversity of the desert ecosystem is losing its biotic potential. A large number of plants have no future unless immediate steps are taken to arrest the causes, leading to their biological improvement. At present the potential loss in ecological amplitude of various genera and species is making several plant species as red listed plants of arid zone vegetation such as Commmiphora wightii, Tribulus rajasthanensis, Calligonum polygonoides, Ephedra foliata, Leptadenia reticulata, Tecomella undulata, Blepharis sindica, Peganum harmala, Sarcostoma vinimale, etc. Mostly arid zone species are under serious pressure against prevailing ecosystem factors to continuation their life cycles. Genetic, molecular, cytological, biochemical, metabolic, reproductive, germination etc. are the several points where the floral diversity of the arid zone area is facing severe ecological influences. So, there is an urgent need to conserve them. There are several opportunities in the field to carry out remarkable work at particular levels to protect the native plants in their natural habitat instead of only their in vitro multiplication.

Keywords: ecology, evaluation, xerophytes, economically, threatened plants, conservation

Procedia PDF Downloads 247
580 Evaluation of Main Factors Affecting the Choice of a Freight Forwarder: A Sri Lankan Exporter’s Perspective

Authors: Ishani Maheshika

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The intermediary role performed by freight forwarders in exportation has become significant in fulfilling businesses’ supply chain needs in this dynamic world. Since the success of exporter’s business is at present, highly reliant on supply chain optimization, cost efficiency, profitability, consistent service and responsiveness, the decision of selecting the most beneficial freight forwarder has become crucial for exporters. Although there are similar foreign researches, prior researches covering Sri Lankan setting are not in existence. Moreover, results vary with time, nature of industry and business environment factors. Therefore, a study from the perspective of Sri Lankan exporters was identified as a requisite to be researched. In order to identify and prioritize key factors which have affected the exporter’s decision in selecting freight forwarders in Sri Lankan context, Sri Lankan export industry was stratified into 22 sectors based on commodity using stratified sampling technique. One exporter from each sector was then selected using judgmental sampling to have a sample of 22. Factors which were identified through a pilot survey, was organized under 6 main criteria. A questionnaire was basically developed as pairwise comparisons using 9-point semantic differential scale and comparisons were done within main criteria and subcriteria. After a pre-testing, interviews and e-mail questionnaire survey were conducted. Data were analyzed using Analytic Hierarchy Process to determine priority vectors of criteria. Customer service was found to be the most important main criterion for Sri Lankan exporters. It was followed by reliability and operational efficiency respectively. The criterion of the least importance is company background and reputation. Whereas small sized exporters pay more attention to rate, reliability is the major concern among medium and large scale exporters. Irrespective of seniority of the exporter, reliability is given the prominence. Responsiveness is the most important sub criterion among Sri Lankan exporters. Consistency of judgments with respect to main criteria was verified through consistency ratio, which was less than 10%. Being more competitive, freight forwarders should come up with customized marketing strategies based on each target group’s requirements and expectations in offering services to retain existing exporters and attract new exporters.

Keywords: analytic hierarchy process, freight forwarders, main criteria, Sri Lankan exporters, subcriteria

Procedia PDF Downloads 387
579 Women Executives: A Panacea to Incessant Sexual Assaults in Higher Institutions, Federal Polytechnic Nekede Imo State Nigeria as a Case Study

Authors: Ujunma Nnenna Egbuawa

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Rape or sexual assault is a hideous crime of violence done predominantly to women and occasionally to men. In institutions of higher learning, it’s mostly experienced within or outside the campus environment due to students who are from different backgrounds socially. These students also have been imbibed with conflicting ethical standards, thus act both morally and amoral with respect to their sexual urges. The most affected among these are the female students who live outside the campus environment that is suitable for any immoral activity. These female students that are victims of rape hardly would want to be identified and this has left them as habitual prey to the unsuspecting predators. The socio-cultural setting has also been a contributory factor to the psychological and physical damage these victims face throughout their time of study as female rape victims. This is an empirical study designed to elicit information from students of Federal Polytechnic Nekede Owerri Imo State Nigeria on whether they have been sexually assaulted or raped and how they handled it thereafter. This institution was used as a case study because the provost of this tertiary institution is a woman whose name is Dr( Mrs ) C.U Njoku who has made consented efforts to ensure these rape victims rise above the social stigma associated with it. This rector has also put in some measures to bring about a decline in cases of rape within and outside the campus environment. She also granted the researcher an oral interview on how she has been able to achieve these and the challenges she hitherto faced in the process. Three research questions and a hypothesis guided the study. Samples of 119 students were used and stratification was done for sex, age and the academic level of the students. 14 item questionnaires were used and data generated from the survey were analyzed using percentages. This workshop would engage the participants by investigating some courses that may help in declining the rate of rape cases within a campus. Also, necessary measures that would be taken to help in sensitizing the tertiary institutions in areas that can aid the healing procedures of these victims. The need also for guidance and counseling unit is also a necessity for the psychological survival of these rape victims. As a result, the participants would gain an increased awareness of the influence of rape and sexual assault on campus. There ought to be a paradigm shift in institutions of higher learning in policies, administrative decisions and introduction of courses that will uplift ethical standards in order to bring about a change both locally and globally.

Keywords: institutions, psychological, sexual assault, socio-cultural

Procedia PDF Downloads 140
578 L2 Exposure Environment, Teaching Skills, and Beliefs about Learners’ Out-of-Class Learning: A Survey on Teachers of English as a Foreign Language

Authors: Susilo Susilo

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In the process of foreign language acquisition, L2 exposure has been evidently assumed efficient for learners to help increase their proficiency. However, to get enough L2 exposure in the context of learning English as a foreign language is not as easy as that of the first language learning context. Therefore, beyond the classroom L2 exposure is helpful for EFL learners to achieve the language tasks. Alongside the rapid development of technology and media, English as a foreign language is virtually used in the social media of almost all regions, affecting the faces of Teaching English as a Foreign Language (TEFL). This different face of TEFL unavoidably intrigues teachers to treat their students differently in the classroom in order that they can put more effort in maximizing beyond-the-class learning to help improve their in-class achievements. The study aims to investigate: 1) EFL teachers’ teaching skills and beliefs about students’ out-of-class activities in different L2 exposure environments, and 2) the effect on EFL teachers’ teaching skills and beliefs about students’ out-of-class activities of different L2 exposure environments. This is a survey for 80 EFL teachers from Senior High Schools in three regions of two provinces in Indonesia. A questionnaire using a four-point Likert scale was distributed to the respondents to elicit data. The questionnaires were developed by reffering to the constructs of teaching skills (i.e. teaching preparation, teaching action, and teaching evaluation) and beliefs about out-of-class learning (i.e. setting, process and atmosphere), which have been taken from some expert definitions. The internal consistencies for those constructs were examined by using Cronbach Alpha. The data of the study were analyzed by using SPSS program, i.e. descriptive statistics and independent sample t-test. The standard for determining the significance was p < .05. The results revealed that: 1) teaching skills performed by the teachers of English as a foreign language in different exposure environments showed various focus of teaching skills, 2) the teachers showed various ways of beliefs about students’ out-of-class activities in different exposure environments, 3) there was a significant difference in the scores for NNESTs’ teaching skills in urban regions (M=34.5500, SD=4.24838) and those in rural schools (M=24.9500, SD=2.42794) conditions; t (78)=12.408, p = 0.000; and 4) there was a significant difference in the scores for NNESTs’ beliefs about students’ out-of-class activities in urban schools (M=36.9250, SD=6.17434) and those in rural regions (M=29.4250, SD=4.56793) conditions; t (78)=6.176, p = 0.000. These results suggest that different L2 exposure environments really do have effects on teachers’ teaching skills and beliefs about their students’ out-of-class learning.

Keywords: belief about EFL out-of-class learning, L2 exposure environment, teachers of English as a foreign language, teaching skills

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577 The Yield of Neuroimaging in Patients Presenting to the Emergency Department with Isolated Neuro-Ophthalmological Conditions

Authors: Dalia El Hadi, Alaa Bou Ghannam, Hala Mostafa, Hana Mansour, Ibrahim Hashim, Soubhi Tahhan, Tharwat El Zahran

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Introduction: Neuro-ophthalmological emergencies require prompt assessment and management to avoid vision or life-threatening sequelae. Some would require neuroimaging. Most commonly used are the CT and MRI of the Brain. They can be over-used when not indicated. Their yield remains dependent on multiple factors relating to the clinical scenario. Methods: A retrospective cross-sectional study was conducted by reviewing the electronic medical records of patients presenting to the Emergency Department (ED) with isolated neuro-ophthalmologic complaints. For each patient, data were collected on the clinical presentation, whether neuroimaging was performed (and which type), and the result of neuroimaging. Analysis of the performed neuroimaging was made, and its yield was determined. Results: A total of 211 patients were reviewed. The complaints or symptoms at presentation were: blurry vision, change in the visual field, transient vision loss, floaters, double vision, eye pain, eyelid droop, headache, dizziness and others such as nausea or vomiting. In the ED, a total of 126 neuroimaging procedures were performed. Ninety-four imagings (74.6%) were normal, while 32 (25.4%) had relevant abnormal findings. Only 2 symptoms were significant for abnormal imaging: blurry vision (p-value= 0.038) and visual field change (p-value= 0.014). While 4 physical exam findings had significant abnormal imaging: visual field defect (p-value= 0.016), abnormal pupil reactivity (p-value= 0.028), afferent pupillary defect (p-value= 0.018), and abnormal optic disc exam (p-value= 0.009). Conclusion: Risk indicators for abnormal neuroimaging in the setting of neuro-ophthalmological emergencies are blurred vision or changes in the visual field on history taking. While visual field irregularities, abnormal pupil reactivity with or without afferent pupillary defect, or abnormal optic discs, are risk factors related to physical testing. These findings, when present, should sway the ED physician towards neuroimaging but still individualizing each case is of utmost importance to prevent time-consuming, resource-draining, and sometimes unnecessary workup. In the end, it suggests a well-structured patient-centered algorithm to be followed by ED physicians.

Keywords: emergency department, neuro-ophthalmology, neuroimaging, risk indicators

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576 Experiences of Community Midwives Receiving Helping Baby Breathe Training Through the Low Dose High-frequency Approach in Gujrat, Pakistan

Authors: Anila Naz, Arusa Lakhani, Kiran Mubeen, Yasmeen Amarsi

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Pakistan's neonatal mortality rate has the highest proportion in the South Asian region and it is higher in the rural areas as compared to the urban areas. Poor resuscitation techniques and lack of basic newborn resuscitation skills in birth attendants, are contributing factors towards neonatal deaths. Based on the significant outcomes of the Helping Baby Breath (HBB) training, a similar training was implemented for Community Midwives (CMWs) in a low resource setting in Gujrat, Pakistan, to improve their knowledge and skills. The training evaluation was conducted and participant feedback was obtained through both qualitative and quantitative methods. The findings of the quantitative assessment of the training evaluation will be published elsewhere. This paper presents the qualitative evaluation of the training. Objective: The objective of the study was to determine the perceptions of HBB trained CMWs about the effectiveness of the HBB training, and the challenges faced in the implementation of HBB skills for newborn resuscitation, at their work settings. The qualitative descriptive design was used in this study. The purposive sampling technique was chosen to recruit midwives and key informants as participants of the training. Interviews were conducted by using a semi-structured interview guide. The study included a total of five interviews: two focus group interviews for CMWs (10 in each group), and three individual interviews of key informants. The content analysis of the qualitative data yielded three themes: the effectiveness of training, challenges, and suggestions. The findings revealed that the HBB training was effective for the CMWs in terms of its usability, regarding improvement in newborn resuscitation knowledge and skills. Moreover, it enhanced confidence and satisfaction in CMWs. However, less volume of patients was a challenge for a few CMWs with regards to practicing their skills. Due to the inadequate number of patients and less opportunities of practice for several CMWs, they required such trainings frequently, in order to maintain their competency. The CMWs also recommended that HBB training should be part of the Midwifery program curriculum. Moreover, similar trainings were also recommended for other healthcare providers working in low resource settings, including doctors and nurses.

Keywords: neonatal resuscitation technique, helping baby breathe, community midwives, training evaluation

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575 Nurses' Knowledge and Practice Regarding Care of Patients Connected to Intra-Aortic Balloon Pump at Cairo University Hospitals

Authors: Tharwat Ibrahim Rushdy, Warda Youssef Mohammed Morsy, Hanaa Ali Ahmed Elfeky

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Background: Intra-aortic balloon pump (IABP) is the first and the most commonly used mechanical circulatory support for patients with acute coronary syndromes and cardiogenic shock. Therefore, critical care nurses not only have to know how to monitor and operate the IABP, but also to provide interventions for preventing possible complications. Aim of the study: To assess nurses' knowledge and practices regarding care of patients connected to IABP at the ICUs of Cairo University Hospitals. Research design: A descriptive exploratory design was utilized. Sample: Convenience samples of 40 nurses were included in the current study. Setting: This study was carried out at the Intensive Care Units of Cairo University Hospitals. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a- Nurses' personal background sheet, b- IABP nurses' knowledge self-administered questionnaire, and c- IABP Nurses' practice observational checklist. Results: The majority of the studied sample had unsatisfactory knowledge and practice level (88% & 95%) respectively with a mean of 9.45+2.94 and 30.5+8.7, respectively. Unsatisfactory knowledge was found regarding description and physiological effects, nursing care, indications, contraindications, complications, weaning, and removal of IABP in percentage of 95%, 90%, 72.5%, and 57.5%, respectively, with a mean total knowledge score of 9.45 +2.94. In addition, unsatisfactory practice was found regarding about preparation and initiation of IABP therapy, nursing practice during therapy, weaning, and removal of IABP in percentages of (97.5%, 97.5%, and 90%), respectively. Finally, knowledge level was found to differ significantly in relation to gender (t = 2.46 at P ≤ 0.018). However, gender didn't play a role in relation to practice (t = 0.086 at P≤ 0.932). Conclusion: In spite of having vital role in assessment and management of critically ill patients, critical care nurses in the current study had in general unsatisfactory knowledge and practice regarding care of patients connected to IABP. Recommendation: updating knowledge and practice of ICU nurses through carrying out continuing educational programs about IABP; strict observation of nurses' practice when caring for patients connected to IABP and provision of guidance to correct of poor practices and replication of this study on larger probability sample selected from different geographical locations.

Keywords: knowledge, practice, intra-aortic balloon pump (IABP), ICU nurses, intensive care unit (ICU), introduction

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574 Comparative Morphometric Analysis of Yelganga-Shivbhadra and Kohilla River Sub-Basins in Aurangabad District Maharashtra India

Authors: Chandrakant Gurav, Md Babar, Ajaykumar Asode

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Morphometric analysis is the first stage of any basin analysis. By using these morphometric parameters we give indirect information about the nature and relations of stream with other streams, Geology of the area, groundwater condition and tectonic history of the basin. In the present study, Yelganga, Shivbhadra and Kohilla rivers, tributaries of the Godavari River in Aurangabad district, Maharashtra, India are considered to compare and study their morphometric characters. The linear, areal and relief morphometric aspects of the sub-basins have been assessed and evaluated in GIS environment. For this study, ArcGIS 10.1 software has been used for delineating, digitizing and generating different thematic maps. The Survey of India (SOI) toposheets maps and Shuttle Radar Topography Mission (SRTM) Digital Elevation Model (DEM) on resolution 30 m downloaded from United States Geological Survey (USGS) have been used for preparation of map and data generation. Geologically, the study area is covered by Central Deccan Volcanic Province (CDVP). It mainly consists of ‘aa’ type of basaltic lava flows of Late (upper) Cretaceous to Early (lower) Eocene age. The total geographical area of Yelganga, Shivbhadra and Kohilla river sub-basins are 185.5 sq. km., 142.6 sq. km and 122.3 sq. km. respectively The stream ordering method as suggested by the Strahler has been employed for present study and found that all the sub-basins are of 5th order streams. The average bifurcation ratio value of the sub-basins is below 5, indicates that there appears to be no strong structural control on drainage development, homogeneous nature of lithology and drainage network is in well-developed stage of erosion. The drainage density of Yelganga, Shivbhadra and Kohilla Sub-basins is 1.79 km/km2, 1.48 km/km2 and 1.89 km/km2 respectively and stream frequency is 1.94 streams/km2, 1.19 streams/km2 and 1.68 streams/km2 respectively, indicating semi-permeable sub-surface. Based on textural ratio values it indicates that the sub-basins have coarse texture. Shape parameters such as form factor ratio, circularity ratio and elongation ratio values shows that all three sub- basins are elongated in shape.

Keywords: GIS, Kohilla, morphometry, Shivbhadra, Yelganga

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573 Risk of Fatal and Non-Fatal Coronary Heart Disease and Stroke Events among Adult Patients with Hypertension: Basic Markov Model Inputs for Evaluating Cost-Effectiveness of Hypertension Treatment: Systematic Review of Cohort Studies

Authors: Mende Mensa Sorato, Majid Davari, Abbas Kebriaeezadeh, Nizal Sarrafzadegan, Tamiru Shibru, Behzad Fatemi

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Markov model, like cardiovascular disease (CVD) policy model based simulation, is being used for evaluating the cost-effectiveness of hypertension treatment. Stroke, angina, myocardial infarction (MI), cardiac arrest, and all-cause mortality were included in this model. Hypertension is a risk factor for a number of vascular and cardiac complications and CVD outcomes. Objective: This systematic review was conducted to evaluate the comprehensiveness of this model across different regions globally. Methods: We searched articles written in the English language from PubMed/Medline, Ovid/Medline, Embase, Scopus, Web of Science, and Google scholar with a systematic search query. Results: Thirteen cohort studies involving a total of 2,165,770 (1,666,554 hypertensive adult population and 499,226 adults with treatment-resistant hypertension) were included in this scoping review. Hypertension is clearly associated with coronary heart disease (CHD) and stroke mortality, unstable angina, stable angina, MI, heart failure (HF), sudden cardiac death, transient ischemic attack, ischemic stroke, subarachnoid hemorrhage, intracranial hemorrhage, peripheral arterial disease (PAD), and abdominal aortic aneurism (AAA). Association between HF and hypertension is variable across regions. Treatment resistant hypertension is associated with a higher relative risk of developing major cardiovascular events and all-cause mortality when compared with non-resistant hypertension. However, it is not included in the previous CVD policy model. Conclusion: The CVD policy model used can be used in most regions for the evaluation of the cost-effectiveness of hypertension treatment. However, hypertension is highly associated with HF in Latin America, the Caribbean, Eastern Europe, and Sub-Saharan Africa. Therefore, it is important to consider HF in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment in these regions. We do not suggest the inclusion of PAD and AAA in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment due to a lack of sufficient evidence. Researchers should consider the effect of treatment-resistant hypertension either by including it in the basic model or during setting the model assumptions.

Keywords: cardiovascular disease policy model, cost-effectiveness analysis, hypertension, systematic review, twelve major cardiovascular events

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572 Comparison of High Speed Railway Bride Foundation Design

Authors: Hussein Yousif Aziz

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This paper discussed the design and analysis of bridge foundation subjected to load of train with three codes, namely AASHTO code, British Standard BS Code 8004 (1986), and Chinese code (TB10002.5-2005).The study focused on the design and analysis of bridge’s foundation manually with the three codes and found which code is better for design and controls the problem of high settlement due to the applied loads. The results showed the Chinese codes are costly that the number of reinforcement bars in the pile cap and piles is more than those with AASHTO code and BS code with the same dimensions. Settlement of the bridge was calculated depending on the data collected from the project site. The vertical ultimate bearing capacity of single pile for three codes is also discussed. Other analyses by using the two-dimensional Plaxis program and other programs like SAP2000 14, PROKON many parameters are calculated. The maximum values of the vertical displacement are close to the calculated ones. The results indicate that the AASHTO code is economics and safer in the bearing capacity of single pile. The purpose of this project is to study out the pier on the basis of the design of the pile foundation. There is a 32m simply supported beam of box section on top of the structure. The pier of bridge is round-type. The main component of the design is to calculate pile foundation and the settlement. According to the related data, we choose 1.0m in diameter bored pile of 48m. The pile is laid out in the rectangular pile cap. The dimension of the cap is 12m 9 m. Because of the interaction factors of pile groups, the load-bearing capacity of simple pile must be checked, the punching resistance of pile cap, the shearing strength of pile cap, and the part in bending of pile cap, all of them are very important to the structure stability. Also, checking soft sub-bearing capacity is necessary under the pile foundation. This project provides a deeper analysis and comparison about pile foundation design schemes. Firstly, here are brief instructions of the construction situation about the Bridge. With the actual construction geological features and the upper load on the Bridge, this paper analyzes the bearing capacity and settlement of single pile. In the paper the Equivalent Pier Method is used to calculate and analyze settlements of the piles.

Keywords: pile foundation, settlement, bearing capacity, civil engineering

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571 Diplomacy in Times of Disaster: Management through Reputational Capital

Authors: Liza Ireni-Saban

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The 6.6 magnitude quake event that occurred in 2003 (Bam, Iran) made it impossible for the Iranian government to handle disaster relief efforts domestically. In this extreme event, the Iranian government reached out to the international community, and this created a momentum that had to be carried out by trust-building efforts on all sides, often termed ‘Disaster Diplomacy’. Indeed, the circumstances were even more critical when one considers the increasing political and economic isolation of Iran within the international community. The potential for transformative political space to be opened by disaster has been recognized by dominant international political actors. Despite the fact that Bam 2003 post-disaster relief efforts did not catalyze any diplomatic activities on all sides, it is suggested that few international aid agencies have successfully used disaster recovery to enhance their popular legitimacy and reputation among the international community. In terms of disaster diplomacy, an actor’s reputational capital may affect his ability to build coalitions and alliances to achieve international political ends, to negotiate and build understanding and trust with foreign publics. This study suggests that the post-disaster setting may benefit from using the ecology of games framework to evaluate the role of bridging actors and mediators in facilitating collaborative governance networks. Recent developments in network theory and analysis provide means of structural embeddedness to explore how reputational capital can be built through brokerage roles of actors engaged in a disaster management network. This paper then aims to structure the relations among actors that participated in the post-disaster relief efforts in the 2003 Bam earthquake (Iran) in order to assess under which conditions actors may be strategically utilized to serve as mediating organizations for future disaster events experienced by isolated nations or nations in conflict. The results indicate the strategic use of reputational capital by the Iranian Ministry of Foreign Affairs as key broker to build a successful coordinative system for reducing disaster vulnerabilities. International aid agencies rarely played brokerage roles to coordinate peripheral actors. U.S. foreign assistance (USAID), despite coordination capacities, was prevented from serving brokerage roles in the system.

Keywords: coordination, disaster diplomacy, international aid organizations, Iran

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570 Guidelines for the Management Process Development of Research Journals in Order to Develop Suan Sunandha Rajabhat University to International Standards

Authors: Araya Yordchim, Rosjana Chandhasa, Suwaree Yordchim

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This research aims to study guidelines on the development of management process for research journals in order to develop Suan Sunandha Rajabhat University to international standards. This research investigated affecting elements ranging from the format of the article, evaluation form for research article quality, the process of creating a scholarly journal, satisfaction level of those with knowledge and competency to conduct research, arisen problems, and solutions. Drawing upon the sample size of 40 persons who had knowledge and competency in conducting research and creating scholarly journal articles at an international level, the data for this research were collected using questionnaires as a tool. Through the usage of computer software, data were analyzed by using the statistics in the forms of frequency, percentage, mean, standard deviation, and multiple regression analysis. The majority of participants were civil servants with a doctorate degree, followed by civil servants with a master's degree. Among them, the suitability of the article format was rated at a good level while the evaluation form for research articles quality was assessed at a good level. Based on participants' viewpoints, the process of creating scholarly journals was at a good level, while the satisfaction of those who had knowledge and competency in conducting research was at a satisfactory level. The problems encountered were the difficulty in accessing the website. The solution to the problem was to develop a website with user-friendly accessibility, including setting up a Google scholar profile for the purpose of references counting and the articles being used for reference in real-time. Research article format influenced the level of satisfaction of those who had the knowledge and competency to conduct research with statistical significance at the 0.01 level. The research article quality assessment form (preface section, research article writing section, preparation for research article manuscripts section, and the original article evaluation form for the author) affected the satisfaction of those with knowledge and competency to conduct research with the statistical significance at the level of 0.01. The process of establishing journals had an impact on the satisfaction of those with knowledge and ability to conduct research with statistical significance at the level of .05

Keywords: guidelines, development of management, research journals, international standards

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569 Application of Groundwater Level Data Mining in Aquifer Identification

Authors: Liang Cheng Chang, Wei Ju Huang, You Cheng Chen

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Investigation and research are keys for conjunctive use of surface and groundwater resources. The hydrogeological structure is an important base for groundwater analysis and simulation. Traditionally, the hydrogeological structure is artificially determined based on geological drill logs, the structure of wells, groundwater levels, and so on. In Taiwan, groundwater observation network has been built and a large amount of groundwater-level observation data are available. The groundwater level is the state variable of the groundwater system, which reflects the system response combining hydrogeological structure, groundwater injection, and extraction. This study applies analytical tools to the observation database to develop a methodology for the identification of confined and unconfined aquifers. These tools include frequency analysis, cross-correlation analysis between rainfall and groundwater level, groundwater regression curve analysis, and decision tree. The developed methodology is then applied to groundwater layer identification of two groundwater systems: Zhuoshui River alluvial fan and Pingtung Plain. The abovementioned frequency analysis uses Fourier Transform processing time-series groundwater level observation data and analyzing daily frequency amplitude of groundwater level caused by artificial groundwater extraction. The cross-correlation analysis between rainfall and groundwater level is used to obtain the groundwater replenishment time between infiltration and the peak groundwater level during wet seasons. The groundwater regression curve, the average rate of groundwater regression, is used to analyze the internal flux in the groundwater system and the flux caused by artificial behaviors. The decision tree uses the information obtained from the above mentioned analytical tools and optimizes the best estimation of the hydrogeological structure. The developed method reaches training accuracy of 92.31% and verification accuracy 93.75% on Zhuoshui River alluvial fan and training accuracy 95.55%, and verification accuracy 100% on Pingtung Plain. This extraordinary accuracy indicates that the developed methodology is a great tool for identifying hydrogeological structures.

Keywords: aquifer identification, decision tree, groundwater, Fourier transform

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568 The Impact of Dog-Assisted Wellbeing Intervention on Student Motivation and Affective Engagement in the Primary and Secondary School Setting

Authors: Yvonne Howard

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This project currently under development is centered around current learning processes, including a thorough literature review and ongoing practical experiences gained as a deputy head in a school. These daily experiences with students engaging in animal-assisted interventions and the school therapy dog form a strong base for this research. The primary objective of this research is to comprehensively explore the impact of dog-assisted well-being interventions on student motivation and affective engagement within primary and secondary school settings. The educational domain currently encounters a significant challenge due to the lack of substantial research in this area. Despite the perceived positive outcomes of such interventions being acknowledged and shared in various settings, the evidence supporting their effectiveness in an educational context remains limited. This study aims to bridge the gap in the research and shed light on the potential benefits of dog-assisted well-being interventions in promoting student motivation and affective engagement. The significance of this topic recognizes that education is not solely confined to academic achievement but encompasses the overall well-being and emotional development of students. Over recent years, there has been a growing interest in animal-assisted interventions, particularly in healthcare settings. This interest has extended to the educational context. While the effectiveness of these interventions in these areas has been explored in other fields, the educational sector lacks comprehensive research in this regard. Through a systematic and thorough research methodology, this study seeks to contribute valuable empirical data to the field, providing evidence to support informed decision-making regarding the implementation of dog-assisted well-being interventions in schools. This research will utilize a mixed-methods design, combining qualitative and quantitative measures to assess the research objectives. The quantitative phase will include surveys and standardized scales to measure student motivation and affective engagement, while the qualitative phase will involve interviews and observations to gain in-depth insights from students, teachers, and other stakeholders. The findings will contribute evidence-based insights, best practices, and practical guidelines for schools seeking to incorporate dog-assisted interventions, ultimately enhancing student well-being and improving educational outcomes.

Keywords: therapy dog, wellbeing, engagement, motivation, AAI, intervention, school

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567 Patient Experience in a Healthcare Setting: How Patients' Encounters Make for Better Value Co-creation

Authors: Kingsley Agyapong

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Research conducted in recent years has delved into the concept of patient-perceived value within the context of co-creation, particularly in the realm of doctor-patient interactions within healthcare settings. However, existing scholarly discourse lacks exploration regarding the emergence of patient-derived value in the co-creation process, specifically within encounters involving patients and stakeholders such as doctors, nurses, pharmacists, and other healthcare professionals. This study aims to fill this gap by elucidating the perspectives of patients regarding the value they derive from their interactions with multiple stakeholders in the delivery of healthcare services. The fieldwork was conducted at a university clinic located in Ghana. Data collection procedures involved conducting 20 individual interviews with key informants on distinct value accrued from co-creation practices and interactions with stakeholders. The key informants consisted of patients receiving care at the university clinic during the Malaria Treatment Process. Three themes emerged from both the existing literature and the empirical data collected. The first theme, labeled as "patient value needs in co-creation," encapsulates elements such as communication effectiveness, interpersonal interaction quality, treatment efficacy, and enhancements to the overall quality of life experienced by patients during their interactions with healthcare professionals. The second theme, designated as "services that enhance patients' experience in value co-creation," pertains to patients' perceptions of services that contribute favourably to co-creation experiences, including initiatives related to health promotion and the provision of various in-house services that patients deem pertinent for augmenting their overall experiences. The third theme, titled "Challenges in the co-creation of patients' value," delineates obstacles encountered within the co-creation process, including health professionals' challenges in effectively following up with patients scheduled for review and prolonged waiting times for healthcare delivery. This study contributes to the patients' perceptions of value within the co-creation process during their interactions with service providers, particularly healthcare professionals. By gaining a deeper insight into this process, healthcare providers can enhance the delivery of patient-centered care, thereby leading to improved healthcare outcomes. The study further offers managerial implications derived from its findings, providing actionable insights for healthcare managers and policymakers aiming to optimize patient value creation in healthcare services. Furthermore, it suggests avenues for future research endeavors within healthcare settings.

Keywords: patient, healthcare, co-creation, malaria

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