Search results for: ecosystem services
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4604

Search results for: ecosystem services

2684 Analyzing the Water Quality of Settling Pond after Revegetation at Ex-Mining Area

Authors: Iis Diatin, Yani Hadiroseyani, Muhammad Mujahid, Ahmad Teduh, Juang R. Matangaran

Abstract:

One of silica quarry managed by a mining company is located at Sukabumi District of West Java Province Indonesia with an area of approximately 70 hectares. Since 2013 this company stopped the mining activities. The company tries to restore the ecosystem post-mining with rehabilitation activities such as reclamation and revegetation of their ex-mining area. After three years planting the area the trees grown well. Not only planting some tree species but also some cover crop has covered the soil surface. There are two settling ponds located in the middle of the ex-mining area. Those settling pond were built in order to prevent the effect of acid mine drainage. Acid mine drainage (AMD) or the acidic water is created when sulphide minerals are exposed to air and water and through a natural chemical reaction produce sulphuric acid. AMD is the main pollutant at the open pit mining. The objective of the research was to analyze the effect of revegetation on water quality change at the settling pond. The physical and chemical of water quality parameter were measured and analysed at site and at the laboratory. Physical parameter such as temperature, turbidity and total organic matter were analyse. Also heavy metal and some other chemical parameter such as dissolved oxygen, alkalinity, pH, total ammonia nitrogen, nitrate and nitrite were analysed. The result showed that the acidity of first settling pond was higher than that of the second settling pond. Both settling pond water’s contained heavy metal. The turbidity and total organic matter were the parameter of water quality which become better after revegetation.

Keywords: acid mine drainage, ex-mining area, revegetation, settling pond, water quality

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2683 Publish/Subscribe Scientific Workflow Interoperability Framework (PS-SWIF) Architecture and Design

Authors: Ahmed Alqaoud

Abstract:

This paper describes Publish/Subscribe Scientific Workflow Interoperability Framework (PS-SWIF) architecture and its components that collectively provide interoperability between heterogeneous scientific workflow systems. Requirements to achieve interoperability are identified. This paper also provides a detailed investigation and design of models and solutions for system requirements, and considers how workflow interoperability models provided by Workflow Management Coalition (WfMC) can be achieved using the PS-SWIF system.

Keywords: publish/subscribe, scientific workflow, web services, workflow interoperability

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2682 Development of mHealth Information in Community Based on Geographical Information: A Case Study from Saraphi District, Chiang Mai, Thailand

Authors: Waraporn Boonchieng, Ekkarat Boonchieng, Wilawan Senaratana, Jaras Singkaew

Abstract:

Geographical information system (GIS) is a designated system widely used for collecting and analyzing geographical data. Since the introduction of ultra-mobile, 'smart' devices, investigators, clinicians, and even the general public have had powerful new tools for collecting, uploading and accessing information in the field. Epidemiology paired with GIS will increase the efficacy of preventive health care services. The objective of this study is to apply GPS location services that are available on the common mobile device with district health systems, storing data on our private cloud system. The mobile application has been developed for use on iOS, Android, and web-based platforms. The system consists of two parts of district health information, including recorded resident data forms and individual health recorded data forms, which were developed and approved by opinion sharing and public hearing. The application's graphical user interface was developed using HTML5 and PHP with MySQL as a database management system (DBMS). The reporting module of the developed software displays data in a variety of views, from traditional tables to various types of high-resolution, layered graphics, incorporating map location information with street views from Google Maps. Multi-extension exporting is also supported, utilizing standard platforms such as PDF, PNG, JPG, and XLS. The data were collected in the database beginning in March 2013, by district health volunteers and district youth volunteers who had completed the application training program. District health information consisted of patients’ household coordinates, individual health data, social and economic information. This was combined with Google Street View data, collected in March 2014. Studied groups consisted of 16,085 (67.87%) and 47,811 (59.87%) of the total 23,701 households and 79,855 people were collected by the system respectively, in Saraphi district, Chiang Mai Province. The report generated from the system has had a major benefit directly to the Saraphi District Hospital. Healthcare providers are able to use the basic health data to provide a specific home health care service and also to create health promotion activities according to medical needs of the people in the community.

Keywords: health, public health, GIS, geographic information system

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2681 A Study of the Relationship between Habitat Patch Metrics and Landscape Connectivity with Reference to Colombo Wetlands Sri Lanka

Authors: H. E. M. W. G. M. K. Ekanayake, J. Dharmasena

Abstract:

Natural Landscape fragmentation and habitat loss are emerging issues in Sri Lanka, which is due to rapid urban development and inadequate concern of managing Landscape connectivity. Urban Wetlands are the most vulnerable ecosystem effects from the fragmentation. Therefore, management of landscape connectivity with proper analysis and understanding has become a most important measure for urban wetland habitats. This study aimed to introduce spatial planning strategy to identify and locate landscape developments appropriately in order to restore landscape connectivity. Therefore, the study focuses on understanding the relationship between habitat patch metrics and landscape connectivity with reference to Colombo wetlands. Geographic Information Systems (GIS) was used to measure the wetland patch metrics; Patch area, Total edge, Perimeter-area ratio, Core area index and Inter-patch distances. Further, GIS-enabled least-cost path tool was used to measure the Landscape connectivity and calculate the number of species flow paths per wetland patch. According to the research findings; increasing the patch area, maintaining a mean perimeter-area ratio and core area index also reducing the inter-patch distances could enhance the landscape connectivity. Further, this study introduces three patch typologies; ‘active patches,' ‘open patches’ and ‘closed patches’ that severs to landscape connectivity in different levels. In the end, the study proposes a strategy for Landscape Architects to select most suitable locations to implement ecological based landscape developments with adjacent to the existing urban habitat in order to enhance habitat patch metrics and to restore the landscape connectivity.

Keywords: landscape fragmentation, urban wetlands, landscape connectivity, patch metrics

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2680 Doped and Co-doped ZnO Based Nanoparticles and their Photocatalytic and Gas Sensing Property

Authors: Neha Verma, Manik Rakhra

Abstract:

Statement of the Problem: Nowadays, a tremendous increase in population and advanced industrialization augment the problems related to air and water pollutions. Growing industries promoting environmental danger, which is an alarming threat to the ecosystem. For safeguard, the environment, detection of perilous gases and release of colored wastewater is required for eutrophication pollution. Researchers around the globe are trying their best efforts to save the environment. For this remediation advanced oxidation process is used for potential applications. ZnO is an important semiconductor photocatalyst with high photocatalytic and gas sensing activities. For efficient photocatalytic and gas sensing properties, it is necessary to prepare a doped/co-doped ZnO compound to decrease the electron-hole recombination rates. However, lanthanide doped and co-doped metal oxide is seldom studied for photocatalytic and gas sensing applications. The purpose of this study is to describe the best photocatalyst for the photodegradation of dyes and gas sensing properties. Methodology & Theoretical Orientation: Economical framework has to be used for the synthesis of ZnO. In the depth literature survey, a simple combustion method is utilized for gas sensing and photocatalytic activities. Findings: Rare earth doped and co-doped ZnO nanoparticles were the best photocatalysts for photodegradation of organic dyes and different gas sensing applications by varying various factors such as pH, aging time, and different concentrations of doping and codoping metals in ZnO. Complete degradation of dye was observed only in min. Gas sensing nanodevice showed a better response and quick recovery time for doped/co-doped ZnO. Conclusion & Significance: In order to prevent air and water pollution, well crystalline ZnO nanoparticles were synthesized by rapid and economic method, which is used as photocatalyst for photodegradation of organic dyes and gas sensing applications to sense the release of hazardous gases from the environment.

Keywords: ZnO, photocatalyst, photodegradation of dye, gas sensor

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2679 Sample Hospital Buildings as Modern Health Facilities in Early Republican Turkey

Authors: Mehmet Sener, Emre Kishali

Abstract:

The establishment of republic brought radical changes related to the modernization of life in early republican Turkey considering the revolutions in socio-economical, cultural and political aspects. These changes also had many influences on the formation of city planning and architectural medium that the arrangements related with health facility production had an important place amongst them. While the health services were witnessing great transformations with all its sides, socio-cultural and architectural framework of these facilities necessitated the adaption of new conceptual approaches which led to the construction new hospital buildings by the republican state with a name ‘Sample Hospital’. In this period, the state constructed sample hospitals in some cities (Adana, Ankara, Erzurum, İstanbul, Konya, Sivas and Trabzon) for the aim of being a good example for further hospitals sheltering all the characteristics of a contemporary health complex for that day. In this study, these six hospitals will firstly be elucidated considering their historical evaluations and current situations. Then, being one of the most significant modern heritages of republican history, the ways to provide the interrelationship of these complexes with the rapidly evolving current world will be discussed by proposing solutions or approaches coming from the fields of city planning, architectural preservation, engineering and architectural history together with an awareness of the socio-economic conditions, health services and architectural medium of Turkey. These hospitals are complexes composed of building ensembles which have functional relationships with each other. So, some strategies will be proposed for the preservation, renovation, and refurbishment of these complexes with an awareness of the possibility of the conflict between conservation practices and today’s health facility standards. Accordingly, the addition or removal of some elements in the complex or the suggestion of some architectural changes for the modernization of these health facilities will be investigated considering the requirements of the contemporary architectural design of health facilities. Since these hospitals are highly complex structures and have vastly changing design and construction standards, they cannot be used without adopting necessary architectural and technological interventions. So, the adaptive re-use of these buildings instead of demolition or the preservation of their overall characteristics becomes inevitable for the sustaining of these health facility heritages in Turkey. In this context, a multidisciplinary analysis will be made in this study on ‘Sample Hospital’ concept and buildings existing in Turkish modern architectural history within the framework of the adaptive reuse of these health complexes.

Keywords: adaptive re-use, conservation, early republican Turkey, sample hospital

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2678 Embracing Inclusive Education: The Issues, Challenges, Dilemmas and Future Plans for Inclusive Secondary Schools in Jakarta, Indonesia

Authors: Rinda Kurnia

Abstract:

Despite the differences and additional needs in the learning process, every individual has the right to receive educational services in order to enhance her/his abilities and potentials. This notion underlies the principle of inclusive education system, something many countries in the world are striving for since the UNESCO Salamanca Statement in 1994. This paper will consider different views that many theorists have published of the term inclusive, the issues, challenges, and dilemmas encountered during the practice, as well as some possible ways forward. It is being described, criticized and analyzed using the standpoint of a shadow teacher in an inclusive secondary school in Jakarta, Indonesia.

Keywords: inclusive education, inclusive education challenges, inclusive education dilemmas, inclusive education future plans, inclusive education issues

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2677 Evaluate Existing Mental Health Intervention Programs Tailored for International Students in China

Authors: Nargiza Nuralieva

Abstract:

This meta-analysis investigates the effectiveness of mental health interventions tailored for international students in China, with a specific focus on Uzbek students and Silk Road scholarship recipients. The comprehensive literature review synthesizes existing studies, papers, and reports, evaluating the outcomes, limitations, and cultural considerations of these programs. Data selection targets mental health programs for international students, honing in on a subset analysis related to Uzbek students and Silk Road scholarship recipients. The analysis encompasses diverse outcome measures, such as reported stress levels, utilization rates of mental health services, academic performance, and more. Results reveal a consistent and statistically significant reduction in reported stress levels, emphasizing the positive impact of these interventions. Utilization rates of mental health services witness a significant increase, highlighting the accessibility and effectiveness of support. Retention rates show marked improvement, though academic performance yields mixed findings, prompting nuanced exploration. Psychological well-being, quality of life, and overall well-being exhibit substantial enhancements, aligning with the overarching goal of holistic student development. Positive outcomes are observed in increased help-seeking behavior, positive correlations with social support, and significant reductions in anxiety levels. Cultural adaptation and satisfaction with interventions both indicate positive outcomes, underscoring the effectiveness of culturally sensitive mental health support. The findings emphasize the importance of tailored mental health interventions for international students, providing novel insights into the specific needs of Uzbek students and Silk Road scholarship recipients. This research contributes to a nuanced understanding of the multifaceted impact of mental health programs on diverse student populations, offering valuable implications for the design and refinement of future interventions. As educational institutions continue to globalize, addressing the mental health needs of international students remains pivotal for fostering inclusive and supportive learning environments.

Keywords: international students, mental health interventions, cross-cultural support, silk road scholarship, meta-analysis

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2676 Promoting Diversity and Equity through Interdisciplinary Leadership Training

Authors: Sharon Milberger, Jane Turner, Denise White-Perkins

Abstract:

Michigan shares the overall U.S. national need for more highly qualified professionals who have knowledge and experience in the use of evidence-based practices to meet the special health care needs of children, adolescents, and adults with neurodevelopmental disabilities including autism spectrum disorder (DD/ASD). The Michigan Leadership Education in Neurodevelopmental Disabilities (MI-LEND) program is a consortium of six universities that spans the state of Michigan and serves more than 181,800 undergraduate, graduate, and professional students. The purpose of the MI LEND program is to improve the health of infants, children and adolescents with disabilities in Michigan by training individuals from different disciplines to assume leadership roles in their respective fields and work across disciplines. The MI-LEND program integrates “L.I.F.E.” perspectives into all training components. L.I.F.E. is an acronym for Leadership, Interdisciplinary, Family-Centered and Equity perspectives. This paper will describe how L.I.F.E. perspectives are embedded into all aspects of the MI-LEND training program including the application process, didactic training, community and clinical experiences, discussions, journaling and projects. Specific curriculum components will be described including content from a training module dedicated to Equity. Upon completion of the Equity module, trainees are expected to be able to: 1) Use a population health framework to identify key social determinants impacting families and children; 2) Explain how addressing bias and providing culturally appropriate linguistic care/services can influence patient/client health and wellbeing; and 3) Describe the impact of policy and structural/institutional factors influencing care and services for children with DD/ASD and their families. Each trainee completes two self-assessments: the Cultural and Linguistic Competence Health Practitioner Assessment and the other assessing social attitudes/implicit bias. Trainees also conduct interviews with a family with a child with DD/ASD. In addition, interdisciplinary Equity-related group activities are incorporated into face-to-face training sessions. Each MI-LEND trainee has multiple ongoing opportunities for self-reflection through discussion and journaling and completion of a L.I.F.E. project as a culminating component of the program. The poster will also discuss the challenges related to teaching and measuring successful outcomes related to diversity/equity perspectives.

Keywords: disability, diversity, equity, training

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2675 A Qualitative Exploration of the Sexual and Reproductive Health Practices of Adolescent Mothers from Indigenous Populations in Ratanak Kiri Province, Cambodia

Authors: Bridget J. Kenny, Elizabeth Hoban, Jo Williams

Abstract:

Adolescent pregnancy presents a significant public health challenge for Cambodia. Despite declines in the overall fertility rate, the adolescent fertility rate is increasing. Adolescent pregnancy is particularly problematic in the Northeast provinces of Ratanak Kiri and Mondul Kiri where 34 percent of girls aged between 15 and 19 have begun childbearing; this is almost three times Cambodia’s national average of 12 percent. Language, cultural and geographic barriers have restricted qualitative exploration of the sexual and reproductive health (SRH) challenges that face indigenous adolescents in Northeast Cambodia. The current study sought to address this gap by exploring the SRH practices of adolescent mothers from indigenous populations in Ratanak Kiri Province. Twenty-two adolescent mothers, aged between 15 and 19, were recruited from seven indigenous villages in Ratanak Kiri Province and asked to participate in a combined body mapping exercise and semi-structured interview. Participants were given a large piece of paper (59.4 x 84.1 cm) with the outline of a female body and asked to draw the female reproductive organs onto the ‘body map’. Participants were encouraged to explain what they had drawn with the purpose of evoking conversation about their reproductive bodies. Adolescent mothers were then invited to participate in a semi-structured interview to further expand on topics of SRH. The qualitative approach offered an excellent avenue to explore the unique SRH challenges that face indigenous adolescents in rural Cambodia. In particular, the use of visual data collection methods reduced the language and cultural barriers that have previously restricted or prevented qualitative exploration of this population group. Thematic analysis yielded six major themes: (1) understanding of the female reproductive body, (2) contraceptive knowledge, (3) contraceptive use, (4) barriers to contraceptive use, (5) sexual practices, (6) contact with healthcare facilities. Participants could name several modern contraceptive methods and knew where they could access family planning services. However, adolescent mothers explained that they gained this knowledge during antenatal care visits and consequently participants had limited SRH knowledge, including contraceptive awareness, at the time of sexual initiation. Fear of the perceived side effects of modern contraception, including infertility, provided an additional barrier to contraceptive use for indigenous adolescents. Participants did not cite cost or geographic isolation as barriers to accessing SRH services. Child marriage and early sexual initiation were also identified as important factors contributing to the high prevalence of adolescent pregnancy in this population group. The findings support the Ministry of Education, Youth and Sports' (MoEYS) recent introduction of SRH education into the primary and secondary school curriculum but suggest indigenous girls in rural Cambodia require additional sources of SRH information. Results indicate adolescent girls’ first point of contact with healthcare facilities occurs after they become pregnant. Promotion of an effective continuum of care by increasing access to healthcare services during the pre-pregnancy period is suggested as a means of providing adolescents girls with an additional avenue to acquire SRH information.

Keywords: adolescent pregnancy, contraceptive use, family planning, sexual and reproductive health

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2674 The Role of Nurses and Midwives’ Self-Government in Postgraduate Education in Poland

Authors: Tomasz Holecki, Hanna Dobrowolska

Abstract:

In the Polish health care system, nurses and midwives are obliged to regularly update their professional knowledge. It is all regulated by the Law on the nurse and midwife’s profession and the code of ethics. The professional self-governing body (County Chamber of Nurses and Midwives) is obliged to organize ongoing training for them so that maintaining accessibility and availability to the high quality of educational services could be possible at all levels of post-graduate education. The aim of this study is an analysis of post-graduate education organized by the County Chamber of Nurses and Midwives in the city of Katowice, Poland, as a professional self-governing body operating in the area of Silesian province inhabited by almost 5 million citizens which bring together more than 30 thousand professionally active nurses and midwives. In the years 2000-2017, the self-government of nurses and midwives trained over 50,000 people. The education and supervision system over the labour of nurses and midwives establishes exercising control by a self-governing body. In practice, this means that conducting activities aimed at creating legal regulations and organizational conditions, as well as the practical implementation of courses, belongs to the professional self-government of nurses and midwives. The most of specialization courses that were provided from their own funds came from membership fees. The biggest group was participants of specializations in the fields of cardiac, anesthesia, and preventive nursing. The smallest group of people participated in such specializations as neonatal, emergency, and obstetrics nursing. The most popular specialist courses were in the fields of the electrocardiogram and cardiopulmonary resuscitation, whereas the least popular were the ones in the fields of protective vaccinations of neonates. So-called 'soft training-courses' in the fields of improvement of social skills and management were also provided. The research shows that a vast majority of nurses and midwives are interested in raising their professional qualifications. Specialist courses and selected fields of qualification courses received the most concrete attention. In light of conducted research, one can assert that cooperation inside the community of nurses and midwives provides access to high-quality education and training services regularly used by a wide circle of them. The presented results exemplify a level of real interest in specialist and qualification training-courses and also show sources of financing them.

Keywords: nurses and midwives, ongoing training, postgraduate education, specialist training-courses

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2673 An Android Geofencing App for Autonomous Remote Switch Control

Authors: Jamie Wong, Daisy Sang, Chang-Shyh Peng

Abstract:

Geofence is a virtual fence defined by a preset physical radius around a target location. Geofencing App provides location-based services which define the actionable operations upon the crossing of a geofence. Geofencing requires continual location tracking, which can consume noticeable amount of battery power. Additionally, location updates need to be frequent and accurate or order so that actions can be triggered within an expected time window after the mobile user navigate through the geofence. In this paper, we build an Android mobile geofencing Application to remotely and autonomously control a power switch.

Keywords: location based service, geofence, autonomous, remote switch

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2672 The People's Tribunal: Empowerment by Survivors for Survivors of Child Abuse

Authors: Alan Collins

Abstract:

This study explains how The People’s Tribunal empowered survivors of child abuse. It examines how People’s tribunals can be effective mean of empowerment; the challenges of empowerment – expectation v. reality; the findings and how they reflect other inquiry findings; and the importance of listening and learning from survivors. UKCSAPT “The People’s Tribunal” was established by survivors of child sex abuse and members of civil society to investigate historic cases of institutional sex abuse. The independent inquiry, led by a panel of four judges, listened to evidence spanning four decades from survivors and experts. A common theme throughout these accounts showed that a series of institutional failures prevented abuse from being reported; and that there are clear links between children being rendered vulnerable by these failures and predatory abuse on an organised scale. It made a series of recommendations including the establishment of a permanent and open forum for victims to share experiences and give evidence, better links between mental health services and police investigations, and training for police and judiciary professionals on the effects of undisclosed sexual abuse. The main findings of the UKCSAPT report were:-There are clear links between children rendered vulnerable by institutional failures and predatory abuse on an organised scale, even if these links often remain obscure. -UK governmental institutions have failed to provide survivors with meaningful opportunities for either healing or justice. -The vital mental health needs of survivors are not being met and this undermines both their psychological recovery and access to justice. -Police and other authorities often lack the training to understand the complex reasons for the inability of survivors to immediately disclose a history of abuse. -Without far-reaching changes in institutional culture and practices, the sexual abuse of children will continue to be a significant scourge in the UK. The report also outlined a series of recommendations for improving reporting and mental health provision, and access to justice for victims were made, including: -A permanent, government-funded popular tribunal should be established to enable survivors to come forward and tell their stories. -Survivors giving evidence should be assigned an advocate to assist their access to justice. -Mental health services should be linked to police investigations to help victims disclose abuse. -Victims who fear reprisals should be provided with a channel though which to give evidence anonymously.

Keywords: empowerment, survivors, sexual, abuse

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2671 Crop Leaf Area Index (LAI) Inversion and Scale Effect Analysis from Unmanned Aerial Vehicle (UAV)-Based Hyperspectral Data

Authors: Xiaohua Zhu, Lingling Ma, Yongguang Zhao

Abstract:

Leaf Area Index (LAI) is a key structural characteristic of crops and plays a significant role in precision agricultural management and farmland ecosystem modeling. However, LAI retrieved from different resolution data contain a scaling bias due to the spatial heterogeneity and model non-linearity, that is, there is scale effect during multi-scale LAI estimate. In this article, a typical farmland in semi-arid regions of Chinese Inner Mongolia is taken as the study area, based on the combination of PROSPECT model and SAIL model, a multiple dimensional Look-Up-Table (LUT) is generated for multiple crops LAI estimation from unmanned aerial vehicle (UAV) hyperspectral data. Based on Taylor expansion method and computational geometry model, a scale transfer model considering both difference between inter- and intra-class is constructed for scale effect analysis of LAI inversion over inhomogeneous surface. The results indicate that, (1) the LUT method based on classification and parameter sensitive analysis is useful for LAI retrieval of corn, potato, sunflower and melon on the typical farmland, with correlation coefficient R2 of 0.82 and root mean square error RMSE of 0.43m2/m-2. (2) The scale effect of LAI is becoming obvious with the decrease of image resolution, and maximum scale bias is more than 45%. (3) The scale effect of inter-classes is higher than that of intra-class, which can be corrected efficiently by the scale transfer model established based Taylor expansion and Computational geometry. After corrected, the maximum scale bias can be reduced to 1.2%.

Keywords: leaf area index (LAI), scale effect, UAV-based hyperspectral data, look-up-table (LUT), remote sensing

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2670 Three or Four Tonics and a Wave: The Trajectory of Health Insurance Regulation in Brazil

Authors: João Boaventura Branco De Matos

Abstract:

Currently, in Brazil, there is a considerable collection of publications on the supplementary health sector, but the vast majority is limited to retrospective examination of the sector. The present contribution starts from the diagnosis of an overwhelming change in the role of the State and its institutions, as well as an accelerated and no less forceful change in the way of producing goods and services, resulting in a clash between these different waves (state and market). This shock produces unique energy, capable of imposing major changes in the most varied sectors. Based on this diagnosis, there was an opportunity to offer the perspective and propositional study of regulatory measures relevant to the best conduct and performance of this sector in the future.

Keywords: private health regulation, state and market, forecasts in Brazilian regulation, political economy

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2669 Effect of Women`s Autonomy on Unmet Need for Contraception and Family Size in India

Authors: Anshita Sharma

Abstract:

India is one of the countries to initiate family planning with intention to control the growing population by reducing fertility. In effort to this, India had introduced the National family planning programme in 1952. The level of unmet need in India shows a reducing trend with increasing effectiveness of family planning services as in NFHS-1 the unmet need for limiting, spacing and total was 46 percent, 14 percent & 9 percent, respectively. The demand for spacing has reduced to at 8 percent, 8 percent for limiting and total unmet need was 16 percent in NFHS-2. The total unmet need has reduced to 13 percent in NFHS-3 for all currently married women and the demand for limiting and spacing is 7 percent and 6 percent respectively. The level of unmet need in India shows a reducing trend with increasing effectiveness of family planning services. Despite the progress, there is chunk of women who are deprived of controlling unintended and unwanted pregnancies. The present paper examines the socio-cultural and economic and demographic correlates of unmet need for contraception in India. It also examines the effect of women’s autonomy and unmet need for contraception on family size among different socio-economic groups of population. It uses data from national family health survey-3 carried out in 2005-06 and employs bi-variate techniques and multivariate techniques for analysis. The multiple regression analysis has done to seek the level and direction of relationship among various socio-economic and demographic factors. The result reveals that women with higher level of education and economic status have low level of unmet need for family planning. Women living in non-nuclear family have high unmet need for spacing and women living in nuclear family have high unmet need for limiting and family size is slightly higher of women of nuclear family. In India, the level of autonomy varies at different life point; usually women with higher age enjoy higher autonomy than their junior female member in the family. The finding shows that women with higher autonomy have large family size counter to women with low autonomy have low family size. Unmet need for family planning decrease with women’s increasing exposure to mass- media. The demographic factors like experience of child loss are directly related to family size. Women who experience higher child loss have low unmet need for spacing and limiting. Thus, It is established with the help that women’s autonomy status play substantial role in fulfilling demand of contraception for limiting and spacing which affect the family size.

Keywords: family size, socio-economic correlates, unmet need for limiting, unmet need for spacing, women`s autonomy

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2668 Microclimate Variations in Rio de Janeiro Related to Massive Public Transportation

Authors: Marco E. O. Jardim, Frederico A. M. Souza, Valeria M. Bastos, Myrian C. A. Costa, Nelson F. F. Ebecken

Abstract:

Urban public transportation in Rio de Janeiro is based on bus lines, powered by diesel, and four limited metro lines that support only some neighborhoods. This work presents an infrastructure built to better understand microclimate variations related to massive urban transportation in some specific areas of the city. The use of sensor nodes with small analytics capacity provides environmental information to population or public services. The analyses of data collected from a few small sensors positioned near some heavy traffic streets show the harmful impact due to poor bus route plan.

Keywords: big data, IoT, public transportation, public health system

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2667 Building Learning Organization: Case Study of Transforming a Banking Company with 21st Century Creative Services Company

Authors: Zeynep Aykul Yavuz

Abstract:

Misconception about design is about making a product pretty. However, the holistic approaches such as design thinking or human-centered design could take the design from making things nice to things inspired by real people and work with real-world limitations. Design thinking helps companies to understand not only problem area but also opportunities. It can be used by any people from any background which provide a space for companies where employees from different departments work together to solve the same problem. While demanding skills changing year to year into the market, previous technical skills are commons anymore. The frontier companies in the sectors look for interactive methods to solve problems. Moreover, the recruiter aims to understand the candidate’s design thinking skills (. The study includes a case study where a 21st century creative services company “ATÖLYE” offers innovation transformation with design thinking to a banking company. Both companies are located in İstanbul in Turkey. The banking company contacted with the ATÖLYE in January 2018 because they heard design thinking in different markets and how it transformed the way of working. The transformation process had 3 phases which were basic training of teams while getting coaching from ATÖLYE’s employees, coaching training with graduates of basic training, facilitator training. Employees built new skills while solving the banking company’s strategic problems. ATÖLYE offered experiential learning which helped employees’ making sense of new skills and knowledge. One day workshops were organized to create awareness about the practice of design thinking. In addition to these, a community of practice was built to create an environment to make reflections and discuss good practice. Not only graduates from the training program but also other employees from the company participated in the community gatherings. ATÖLYE did not train some employees in the company. Rather than that, its aim was to build a contemporary organization for the company. This provided a sustainable system in terms of human resources and motivation. At the beginning of 2020, employees from the first cohort in the basic training who took coaching training and facilitator training have started to design training for different groups in the company. They have considered what could be better in their training experience and designed new ones according to that, so they have been using design thinking to design the design training. This is one of the outcomes which shows the impact of all process clearly.

Keywords: design thinking, learning community, professional development, training, organizational transformation

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2666 Self-Inflicted Major Trauma: Inpatient Mental Health Management and Patient Outcomes

Authors: M. Walmsley, S. Elmatarri, S. Mannion

Abstract:

Introduction: Self-inflicted injury is a recognised cause of major trauma in adults and is an independent indicator of a reduced functional outcome compared to non-intentional major trauma. There is little literature available on the inpatient mental health (MH) management of this vulnerable group. A retrospective review was conducted of inpatient MH management of major trauma patients admitted to a UK regional Major Trauma Centre (MTC). Their outcomes were compared to all major trauma patients. This group of patients required multiple MH interventions whilst on the Major Trauma Ward (MTW) and a had worse functional outcome compared to non-intentional trauma. Method: The national TARN (Trauma Audit and Research Network) database was used to identify patients admitted to a regional MTC over a 2-year period from June 2018 to July 2020. Patients with an ISS (Injury Severity Score) of greater than 15 with a mechanism of either self-harm or high-risk behavior were included for further analysis. Inpatient medical notes were reviewed for MH interventions on the MTW. Further outcomes, including mortality, length of stay (LOS) and Glasgow Outcome Score (GOS) were compared with all major trauma patients for the same time period. Results: A total of 60 patients were identified in the time period and of those, 27 spent time on the MTW. A total of 23 (85%) had a prior MH diagnosis, with 11 (41%) under the care of secondary MH services. Adequate inpatient records for review were available for 24 patients. During their inpatient stay, 8 (33%) were reviewed on the ward by the inpatient MH team. There were 10 interventions required for 6 (25%) patients on the MTW including, sections under the Mental Health Act, transfer to specialist MH facility, pharmacological sedation and security being called to the MTW. When compared to all major trauma patients, those admitted due to self-harm or high-risk behavior had a statistically significantly higher ISS (31.43 vs 24.22, p=0.0001) and LOS (23.51d vs 16.06d, p=0.002). Functional outcomes using the GOS were reduced in this group of patients, GOS 5 (low disability) (51.66% vs. 61.01%) and they additionally had a higher level of mortality, GOS 1 (15.00% vs 11.67%). Discussion: Intentional self-harm is a recognised cause of major trauma in adults and this patient group sustains more severe injuries, requiring a longer hospital stay with worse outcomes compared to all major trauma patients. Inpatient MH interventions are required for a significant proportion of these patients and therefore, there needs to be a close relationship with MH services. There is limited available evidence for how this patient group is best managed as an inpatient to aid their recovery and further work is needed on how outcomes in this vulnerable group can be improved.

Keywords: adult major trauma, attempted suicide, self-inflicted major trauma, inpatient management

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2665 From Past to Present Awareness about Complementary Therapies

Authors: Olcay Çam, Ayşegül Bilge, Merve Uğuryol, Hacer Demirkol

Abstract:

Complementary and alternative medicine are important for human health. It has stood out that from past to present people have resorted to particularly Turkish bath houses, cupping therapy, mud bath, hirudotheraphy and healing waters for the purpose of recovering from diseases and refresh their souls. Now, methods such as herbal treatments, massage, aromatherapy, prayer, meditation, yoga and thermal springs have been recently observed to be the most frequently used complementary therapies in Turkey. These methods are not known by people exactly. As a result, complementary therapies are applied along with the modern therapies in Turkey, we are considered to be effective in maintaining and improving individuals’ health.

Keywords: complementary therapy, health, health services, modern therapies

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2664 An Action Toolkit for Health Care Services Driving Disability Inclusion in Universal Health Coverage

Authors: Jill Hanass-Hancock, Bradley Carpenter, Samantha Willan, Kristin Dunkle

Abstract:

Access to quality health care for persons with disabilities is the litmus test in our strive toward universal health coverage. Persons with disabilities experience a variety of health disparities related to increased health risks, greater socioeconomic challenges, and persistent ableism in the provision of health care. In low- and middle-income countries, the support needed to address the diverse needs of persons with disabilities and close the gaps in inclusive and accessible health care can appear overwhelming to staff with little knowledge and tools available. An action-orientated disability inclusion toolkit for health facilities was developed through consensus-building consultations and field testing in South Africa. The co-creation of the toolkit followed a bottom-up approach with healthcare staff and persons with disabilities in two developmental cycles. In cycle one, a disability facility assessment tool was developed to increase awareness of disability accessibility and service delivery gaps in primary healthcare services in a simple and action-orientated way. In cycle two, an intervention menu was created, enabling staff to respond to identified gaps and improve accessibility and inclusion. Each cycle followed five distinct steps of development: a review of needs and existing tools, design of the draft tool, consensus discussion to adapt the tool, pilot-testing and adaptation of the tool, and identification of the next steps. The continued consultations, adaptations, and field-testing allowed the team to discuss and test several adaptations while co-creating a meaningful and feasible toolkit with healthcare staff and persons with disabilities. This approach led to a simplified tool design with ‘key elements’ needed to achieve universal health coverage: universal design of health facilities, reasonable accommodation, health care worker training, and care pathway linkages. The toolkit was adapted for paper or digital data entry, produces automated, instant facility reports, and has easy-to-use training guides and online modules. The cyclic approach enabled the team to respond to emerging needs. The pilot testing of the facility assessment tool revealed that healthcare workers took significant actions to change their facilities after an assessment. However, staff needed information on how to improve disability accessibility and inclusion, where to acquire accredited training, and how to improve disability data collection, referrals, and follow-up. Hence, intervention options were needed for each ‘key element’. In consultation with representatives from the health and disability sectors, tangible and feasible solutions/interventions were identified. This process included the development of immediate/low-cost and long-term solutions. The approach gained buy-in from both sectors, who called for including the toolkit in the standard quality assessments for South Africa’s health care services. Furthermore, the process identified tangible solutions for each ‘key element’ and highlighted where research and development are urgently needed. The cyclic and consultative approach enabled the development of a feasible facility assessment tool and a complementary intervention menu, moving facilities toward universal health coverage for and persons with disabilities in low- or better-resourced contexts while identifying gaps in the availability of interventions.

Keywords: public health, disability, accessibility, inclusive health care, universal health coverage

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2663 Design and Implementation of an Image Based System to Enhance the Security of ATM

Authors: Seyed Nima Tayarani Bathaie

Abstract:

In this paper, an image-receiving system was designed and implemented through optimization of object detection algorithms using Haar features. This optimized algorithm served as face and eye detection separately. Then, cascading them led to a clear image of the user. Utilization of this feature brought about higher security by preventing fraud. This attribute results from the fact that services will be given to the user on condition that a clear image of his face has already been captured which would exclude the inappropriate person. In order to expedite processing and eliminating unnecessary ones, the input image was compressed, a motion detection function was included in the program, and detection window size was confined.

Keywords: face detection algorithm, Haar features, security of ATM

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2662 Designing an Editorialization Environment for Repeatable Self-Correcting Exercises

Authors: M. Kobylanski, D. Buskulic, P.-H. Duron, D. Revuz, F. Ruggieri, E. Sandier, C. Tijus

Abstract:

In order to design a cooperative e-learning platform, we observed teams of Teacher [T], Computer Scientist [CS] and exerciser's programmer-designer [ED] cooperating for the conception of a self-correcting exercise, but without the use of such a device in order to catch the kind of interactions a useful platform might provide. To do so, we first run a task analysis on how T, CS and ED should be cooperating in order to achieve, at best, the task of creating and implementing self-directed, self-paced, repeatable self-correcting exercises (RSE) in the context of open educational resources. The formalization of the whole process was based on the “objectives, activities and evaluations” theory of educational task analysis. Second, using the resulting frame as a “how-to-do it” guide, we run a series of three contrasted Hackathon of RSE-production to collect data about the cooperative process that could be later used to design the collaborative e-learning platform. Third, we used two complementary methods to collect, to code and to analyze the adequate survey data: the directional flow of interaction among T-CS-ED experts holding a functional role, and the Means-End Problem Solving analysis. Fourth, we listed the set of derived recommendations useful for the design of the exerciser as a cooperative e-learning platform. Final recommendations underline the necessity of building (i) an ecosystem that allows to sustain teams of T-CS-ED experts, (ii) a data safety platform although offering accessibility and open discussion about the production of exercises with their resources and (iii) a good architecture allowing the inheritance of parts of the coding of any exercise already in the data base as well as fast implementation of new kinds of exercises along with their associated learning activities.

Keywords: editorialization, open educational resources, pedagogical alignment, produsage, repeatable self-correcting exercises, team roles

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2661 Prediction of the Factors Influencing the Utilization of HIV Testing among Young People Aged between 17-25 Years in Saudi Arabia

Authors: Abdullah Almilaibary, Jeremy Jolley, Mark Hayter

Abstract:

Background: Despite recent progress in enhancing the accessibility of HIV-related health services worldwide, opportunities to diagnose patients are often missed due to genuine barriers at different levels. The aim of the study is to explore the factors that affect the utilization of HIV testing services by young people aged 17-25 in Saudi Arabia. Methods: A non-experimental descriptive cross-sectional design was used to predict factors that influenced HIV testing among Umm- Al Qura University students aged 17-25 years. A newly developed self-completed online questionnaire was used and the study sample was drawn using a convenience sampling technique. The questionnaire consisted of 52 items divided into three scales: 12 items for HIV/AIDS-related knowledge, 3 items for risk perception, and 37 items for attitudes toward HIV testing. Five experts in the field of HIV/AIDS validated the contents of the questionnaire and agreed that the items included were related to the construct being measured. The reliability of the questionnaire was also assessed using a test/re-test strategy with 27 participants recruited from the population under study. The reliability assessment revealed that the questionnaire was consistent as Cronbach’s Alpha was 0.80 for HIV/ADS knowledge, 0.88 for risk perception and 0.78 for attitudes towards HIV testing. The data were collected between 14th of July and 14th of October 2014. Results: 394 participants completed the questionnaires: 116 (29.4%) male and 278 (70%) female. 50.5% of the participants were aged 20 to 22 years, 34.8% were 17-19 years and 14.7% were aged between 23-25 years; about 93% of the participants were single. Only 20 (6%) participants had previously been tested for HIV. The main reasons for not being tested for HIV were: exposure to HIV was considered unlikely (48%), HIV test was not offered (36%) and unawareness of HIV testing centres (16%). On HIV/AIDS-related knowledge, the male participants scored higher than the females as the mean score for males was (M = 6.4, SD = 2.4) while for females it was (M 5.7, SD 2.5). In terms of risk perception, female participants appeared to have lower levels of risk perception than male participants, with the mean score for males being (M 11.7, SD 2.5) and (M 10.5, SD 2.4) for females. The female participants showed slightly more positive attitudes towards HIV testing than male participants: the mean score for males was (M = 108.14, SD = 17.9) and was (M = 111.32, SD = 17.3) for females. Conclusions: The data reveal that misconceptions about HIV/AIDS in Saudi Arabia are still a challenge. Although the attitudes towards HIV testing were reasonably positive, the utilization of the HIV test was low. Thus, tailoring HIV/AIDS preventive strategies in Saudi Arabia should focus on the needs of young people and other high risk groups in the country.

Keywords: attitude toward hiv testing, hiv testing, hiv/aids related knowledge, risk perception

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2660 Grassland Phenology in Different Eco-Geographic Regions over the Tibetan Plateau

Authors: Jiahua Zhang, Qing Chang, Fengmei Yao

Abstract:

Studying on the response of vegetation phenology to climate change at different temporal and spatial scales is important for understanding and predicting future terrestrial ecosystem dynamics andthe adaptation of ecosystems to global change. In this study, the Moderate Resolution Imaging Spectroradiometer (MODIS) Normalized Difference Vegetation Index (NDVI) dataset and climate data were used to analyze the dynamics of grassland phenology as well as their correlation with climatic factors in different eco-geographic regions and elevation units across the Tibetan Plateau. The results showed that during 2003–2012, the start of the grassland greening season (SOS) appeared later while the end of the growing season (EOS) appeared earlier following the plateau’s precipitation and heat gradients from southeast to northwest. The multi-year mean value of SOS showed differences between various eco-geographic regions and was significantly impacted by average elevation and regional average precipitation during spring. Regional mean differences for EOS were mainly regulated by mean temperature during autumn. Changes in trends of SOS in the central and eastern eco-geographic regions were coupled to the mean temperature during spring, advancing by about 7d/°C. However, in the two southwestern eco-geographic regions, SOS was delayed significantly due to the impact of spring precipitation. The results also showed that the SOS occurred later with increasing elevation, as expected, with a delay rate of 0.66 d/100m. For 2003–2012, SOS showed an advancing trend in low-elevation areas, but a delayed trend in high-elevation areas, while EOS was delayed in low-elevation areas, but advanced in high-elevation areas. Grassland SOS and EOS changes may be influenced by a variety of other environmental factors in each eco-geographic region.

Keywords: grassland, phenology, MODIS, eco-geographic regions, elevation, climatic factors, Tibetan Plateau

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2659 Assigning Moral Positions Caused by Environmental Degradation in San Buenaventura Public Housing Complex in Ixtapaluca, State of Mexico, Mexico

Authors: Ángel O. Aldape, José M. Bustos, José G. Guízar

Abstract:

Building companies providing public housing in Mexico, such as INFONAVIT, Casas GEO, Casas ARA, among others, provide low-interest home loans for thousands of Mexican families and individuals to buy a home. However, once this goal is achieved, these companies are not responsible for the care and maintenance of green areas and waste collection services because, technically, it is the local municipalities’ responsibility to provide these services to the community. However, this does not always occur with local municipalities. To study this problem, the San Buenaventura public housing complex was selected. This housing complex is located in the municipality of Ixtapaluca, State of Mexico (Estado de Mexico), Mexico. To our best knowledge, there are currently no formal studies about San Buenaventura that can offer effective options and/or better ways of sorting and disposing households’ wastes, as well as improving local green areas (community gardens and parks). Only a few web-blogs and periodical reports have addressed these serious problems that directly affect the social and psychological well-being of residents. The main goal of this research project aims to improve our understanding towards the existing ontological elements that emerge from residents’ discourses (in the form of informal talks and gossip) and discover the socio-physical elements that they use to assign moral positions onto others or onto themselves. The theoretical framework used in this study is based on two constructionist theories: positioning theory and site ontology. The first theory offered the opportunity to explore the rights, duties, and obligations assigned to a social role (or moral position) of the participants. The second theory provided a constructionist philosophical base that includes various socio-physical elements that are considered to assign personal or community meanings to particular contexts. Both theories contributed to defining personal dispositions and/or attitudes to carry out concrete social action or practice. The theoretical framework was guided by a relativistic ontology that allowed the researcher to better interpret the reality of the participants of this study. A descriptive-interpretative methodology was used, and two qualitative methods were arranged based on the theoretical framework proposed as follows: a semi-structured focus group interview, and direct observations. The semi-structured focus group was carried out with four residents of San Buenaventura and covert observations of public spaces and houses were carried out. These were analysed and interpreted by the researcher and assisted by NVivo software. The results suggest that the participants assigned moral traits of responsibility to other residents regarding the problem of the neglect of the green areas and waste pollution. The results suggest that all participants agreed to assign moral traits to other residents making them liable for the environmental degradation and the decay of green areas. They neither assigned any moral duty nor responsible moral traits onto themselves towards environmental protection or destruction. Overall, the participants in this study pointed out that external ontological elements such as the local government, infrastructure or cleaning services were not main cause of these environmental problems but rather the general lack of moral duty and disposition of other residents.

Keywords: conversation, environment, housing, moral, ontology, position, public, site, talks

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2658 The Tourism in the Regional Development of South Caucasus

Authors: Giorgi Sulashvili, Vladimer Kekenadze, Olga Khutsishvili, Bela Khotenashvili, Tsiuri Phkhakadze, Besarion Tsikhelashvili

Abstract:

The article dealt with the South Caucasus is a complex economic policy, which consists of strands: The process of deepening economic integration in the South Caucasus region; deepening economic integration with the EU in the framework of "Neighbourhood policy with Europe" and in line with the Maastricht criteria; the development of bilateral trade and economic relations with many countries of the world community; the development of sufficient conditions for the integration of the South Caucasus region in the world to enter the market. According to the author, to determine the place of Georgia in the regional policy of the South Caucasus, it is necessary to consider two views about Georgia: The first is the view of Georgia, as a part of global economic and political processes and the second look at Georgia, as a country located in the geo-economic and geopolitical space of the South Caucasus. Such approaches reveal the place of Georgia in two dimensions; in the global and regional economies. In the countries of South Caucasus, the tourism has been developing fast and has a great social and economic importance. Tourism influences deeply on the social and economic growth of the regions of the country. Tourism development formulates thousand new jobs, fixes the positions of small and middle businesses, ensures the development of the education and culture of the population. In the countries of South Caucasus, the Tourist Industry can be specified as the intersectoral complex, which consists of travel transport and it’s technical service network, tourist enterprises which are specialized in various types, wide network services. Tourists have a chance to enjoy all of these services. At the transitional stage of shifting to the market economy, tourism is among the priorities in the development of the national economy of our country. It is true that the Georgian tourism faces a range of problems at present, but its recognition and the necessity for its development may be considered as a fact. Besides, we would underline that the revitalization of the Georgian tourism is not only the question of time. This area can bring a lot of benefits as to private firms, as to specific countries. It also has many negative effects were conducted fundamental research and studies to consider both, positive and negative impacts of tourism. In the future such decisions will be taken that will bring, the maximum benefit at minimum cost, in order for tourism to take its place in Georgia it is necessary to understand the role of the tourism sector in the economic structure.

Keywords: transitional stage, national economy, Georgian tourism, positive and negative impacts

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2657 Assessment on Rumen Microbial Diversity of Bali Cattle Using 16S rRNA Sequencing

Authors: Asmuddin Natsir, A. Mujnisa, Syahriani Syahrir, Marhamah Nadir, Nurul Purnomo

Abstract:

Bacteria, protozoa, Archaea, and fungi are the dominant microorganisms found in the rumen ecosystem that has an important role in converting feed ingredients into components that can be digested and utilized by the livestock host. This study was conducted to assess the diversity of rumen bacteria of bali cattle raised under traditional farming condition. Three adult bali cattle were used in this experiment. The rumen fluid samples from the three experimental animals were obtained by the Stomach Tube method before the morning feeding. The results of study indicated that the Illumina sequencing was successful in identifying 301,589 sequences, averaging 100,533 sequences, from three rumen fluid samples of three cattle. Furthermore, based on the SILVA taxonomic database, there were 19 kinds of phyla that had been successfully identified. Of the 19 phyla, there were only two dominant groups across the three samples, namely Bacteroidetes and Firmicutes, with an average percentage of 83.68% and 13.43%, respectively. Other groups such as Synergistetes, Spirochaetae, Planctomycetes can also be identified but in relatively small percentage. At the genus level, there were 157 sequences obtained from all three samples. Of this number, the most dominant group was Prevotella 1 with a percentage of 71.82% followed by 6.94% of Christencenellaceae R-7 group. Other groups such as Prevotellaceae UCG-001, Ruminococcaceae NK4A214 group, Sphaerochaeta, Ruminococcus 2, Rikenellaceae RC9 gut group, Quinella were also identified but with very low percentages. The sequencing results were able to detect the presence of 3.06% and 3.92% respectively for uncultured rumen bacterium and uncultured bacterium. In conclusion, the results of this experiment can provide an opportunity for a better understanding of the rumen bacterial diversity of the bali cattle raised under traditional farming condition and insight regarding the uncultured rumen bacterium and uncultured bacterium that need to be further explored.

Keywords: 16S rRNA sequencing, bali cattle, rumen microbial diversity, uncultured rumen bacterium

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2656 The Implementation of a Nurse-Driven Palliative Care Trigger Tool

Authors: Sawyer Spurry

Abstract:

Problem: Palliative care providers at an academic medical center in Maryland stated medical intensive care unit (MICU) patients are often referred late in their hospital stay. The MICU has performed well below the hospital quality performance metric of 80% of patients who expire with expected outcomes should have received a palliative care consult within 48 hours of admission. Purpose: The purpose of this quality improvement (QI) project is to increase palliative care utilization in the MICU through the implementation of a Nurse-Driven PalliativeTriggerTool to prompt the need for specialty palliative care consult. Methods: MICU nursing staff and providers received education concerning the implications of underused palliative care services and the literature data supporting the use of nurse-driven palliative care tools as a means of increasing utilization of palliative care. A MICU population specific criteria of palliative triggers (Palliative Care Trigger Tool) was formulated by the QI implementation team, palliative care team, and patient care services department. Nursing staff were asked to assess patients daily for the presence of palliative triggers using the Palliative Care Trigger Tool and present findings during bedside rounds. MICU providers were asked to consult palliative medicinegiven the presence of palliative triggers; following interdisciplinary rounds. Rates of palliative consult, given the presence of triggers, were collected via electronic medical record e-data pull, de-identified, and recorded in the data collection tool. Preliminary Results: Over 140 MICU registered nurses were educated on the palliative trigger initiative along with 8 nurse practitioners, 4 intensivists, 2 pulmonary critical care fellows, and 2 palliative medicine physicians. Over 200 patients were admitted to the MICU and screened for palliative triggers during the 15-week implementation period. Primary outcomes showed an increase in palliative care consult rates to those patients presenting with triggers, a decreased mean time from admission to palliative consult, and increased recognition of unmet palliative care needs by MICU nurses and providers. Conclusions: Anticipatory findings of this QI project would suggest a positive correlation between utilizing palliative care trigger criteria and decreased time to palliative care consult. The direct outcomes of effective palliative care results in decreased length of stay, healthcare costs, and moral distress, as well as improved symptom management and quality of life (QOL).

Keywords: palliative care, nursing, quality improvement, trigger tool

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2655 A Study on the Effect of the Work-Family Conflict on Work Engagement: A Mediated Moderation Model of Emotional Exhaustion and Positive Psychology Capital

Authors: Sungeun Hyun, Sooin Lee, Gyewan Moon

Abstract:

Work-Family Conflict has been an active research area for the past decades. Work-Family Conflict harms individuals and organizations, it is ultimately expected to bring the cost of losses to the company in the long run. WFC has mainly focused on effects of organizational effectiveness and job attitude such as Job Satisfaction, Organizational Commitment, and Turnover Intention variables. This study is different from consequence variable with previous research. For this purpose, we selected the positive job attitude 'Work Engagement' as a consequence of WFC. This research has its primary research purpose in identifying the negative effects of the Work-Family Conflict, and started out from the recognition of the problem that the research on the direct relationship on the influence of the WFC on Work Engagement is lacking. Based on the COR(Conservation of resource theory) and JD-R(Job Demand- Resource model), the empirical study model to examine the negative effects of WFC with Emotional Exhaustion as the link between WFC and Work Engagement was suggested and validated. Also, it was analyzed how much Positive Psychological Capital may buffer the negative effects arising from WFC within this relationship, and the Mediated Moderation model controlling the indirect effect influencing the Work Engagement by the Positive Psychological Capital mediated by the WFC and Emotional Exhaustion was verified. Data was collected by using questionnaires distributed to 500 employees engaged manufacturing, services, finance, IT industry, education services, and other sectors, of which 389 were used in the statistical analysis. The data are analyzed by statistical package, SPSS 21.0, SPSS macro and AMOS 21.0. The hierarchical regression analysis, SPSS PROCESS macro and Bootstrapping method for hypothesis testing were conducted. Results showed that all hypotheses are supported. First, WFC showed a negative effect on Work Engagement. Specifically, WIF appeared to be on more negative effects than FIW. Second, Emotional exhaustion found to mediate the relationship between WFC and Work Engagement. Third, Positive Psychological Capital showed to moderate the relationship between WFC and Emotional Exhaustion. Fourth, the effect of mediated moderation through the integration verification, Positive Psychological Capital demonstrated to buffer the relationship among WFC, Emotional Exhastion, and Work Engagement. Also, WIF showed a more negative effects than FIW through verification of all hypotheses. Finally, we discussed the theoretical and practical implications on research and management of the WFC, and proposed limitations and future research directions of research.

Keywords: emotional exhaustion, positive psychological capital, work engagement, work-family conflict

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