Search results for: supporting staff
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2536

Search results for: supporting staff

616 Role of Tele-health in Expansion of Medical Care

Authors: Garima Singh, Kunal Malhotra

Abstract:

Objective: The expansion of telehealth has been instrumental in increasing access to medical services, especially for underserved and rural communities. In 2020, 14 million patients received virtual care through telemedicine and the global telemedicine market is expected to reach up to $185 million by 2023. It provides a platform and allows a patient to receive primary care as well as specialized care using technology and the comfort of their homes. Telemedicine was particularly useful during COVID-pandemic and the number of telehealth visits increased by 5000% during that time. It continues to serve as a significant resource for patients seeking care and to bridge the gap between the disease and the treatment. Method: As per APA (American Psychiatric Association), Telemedicine is the process of providing health care from a distance through technology. It is a subset of telemedicine, and can involve providing a range of services, including evaluations, therapy, patient education and medication management. It can involve direct interaction between a physician and the patient. It also encompasses supporting primary care providers with specialist consultation and expertise. It can also involve recording medical information (images, videos, etc.) and sending this to a distant site for later review. Results: In our organization, we are using telepsychiatry and serving 25 counties and approximately 1.4 million people. We provide multiple services, including inpatient, outpatient, crisis intervention, Rehab facility, autism services, case management, community treatment and multiple other modalities. With project ECHO (Extension for Community Healthcare Outcomes) it has been used to advise and assist primary care providers in treating mental health. It empowers primary care providers to treat patients in their own community by sharing knowledge. Conclusion: Telemedicine has shown to be a great medium in meeting patients’ needs and accessible mental health. It has been shown to improve access to care in both urban and rural settings by bringing care to a patient and reducing barriers like transportation, financial stress and resources. Telemedicine is also helping with reducing ER visits, integrating primary care and improving the continuity of care and follow-up. There has been substantial evidence and research about its effectiveness and its usage.

Keywords: telehealth, telemedicine, access to care, medical technology

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

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

Abstract:

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

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

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

Authors: Manuela S. Tolentino, John G. Nepomuceno

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

Keywords: inclusion, inclusive education, framework, special education

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613 House Extension Strategy in High-Density Informal Settlement: A Case Study in Kampung Cikini, Jakarta, Indonesia

Authors: Meidesta Pitria, Akiko Okabe

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In high-density informal settlement, extension area at the outside of the houses could primarily happen as a spatial modification response. House extension in high-density informal settlement is not only becoming a physical spatial modification that makes a blur zone between private and public but also supporting the growth and existence of informal economy and other daily activities in both individuals and communities. This research took a case study in an informal settlement named Kampung Cikini, a densely populated area in Central Jakarta. The aim of this study is to identify and clarify house extension as a strategy in dealing with urbanization in an informal settlement. By using the perspective and information from housewives, the analysis is based on the assumption that land ownership transformation and the activities in house extension area influence the different kinds of house extension’s spatial modification and local planning policy in relation with the implementation of house extension strategy. The data collection was done in four sites, two sites are located in outer-wide alley and another two sites are located in inner-narrow alley. In this research, data of 104 housewives in 86 houses were collected through representatives of housewives and local leader of each sites. The research was started from participatory mapping process, deep interview with local leader, and initiated collaboration with housewives community in having a celebration as communal event to cultivate together the issue. This study shows that land ownership, activities, and alley are indispensable in the decision of extension space making. The more permanency status of land ownership the more permanent and various extension could be implemented. However, in some blocks, the existence of origin house or first land owner also has a significant role in coordination and agreement in using and modifying extension space. In outer-wide alley, the existence of more various activities in front area of the houses is significantly related with the chance given by having wider alley, particularly for informal income generating activities. In the inner-narrow alley, limited space in front of the houses affects more negotiations in the community for having more shared spaces, even inside their private space.

Keywords: house extension, housewives, informal settlement, kampung, high density

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612 Demand-Side Financing for Thai Higher Education: A Reform Towards Sustainable Development

Authors: Daral Maesincee, Jompol Thongpaen

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Thus far, most of the decisions made within the walls of Thai higher education (HE) institutions have primarily been supply-oriented. With the current supply-driven, itemized HE financing systems, the nation is struggling to systemically produce high-quality manpower that serves the market’s needs, often resulting in education mismatches and unemployment – particularly in science, technology, and innovation (STI)-related fields. With the COVID-19 pandemic challenges widening the education inequality (accessibility and quality) gap, HE becomes even more unobtainable for underprivileged students, permanently leaving some out of the system. Therefore, Thai HE needs a new financing system that produces the “right people” for the “right occupations” through the “right ways,” regardless of their socioeconomic backgrounds, and encourages the creation of non-degree courses to tackle these ongoing challenges. The “Demand-Side Financing for Thai Higher Education” policy aims to do so by offering a new paradigm of HE resource allocation via two main mechanisms: i) standardized formula-based unit-cost subsidizations that is specific to each study field and ii) student loan programs that respond to the “demand signals” from the labor market and the students, that are in line with the country’s priorities. Through in-dept reviews, extensive studies, and consultations with various experts, education committees, and related agencies, i) the method of demand signal analysis is identified, ii) the unit-cost of each student in the sample study fields is approximated, iii) the method of budget analysis is formulated, iv) the interagency workflows are established, and v) a supporting information database is created to suggest the number of graduates each HE institution can potentially produce, the study fields and skillsets that are needed by the labor market, the employers’ satisfaction with the graduates, and each study field’s employment rates. By responding to the needs of all stakeholders, this policy is expected to steer Thai HE toward producing more STI-related manpower in order to uplift Thai people’s quality of life and enhance the nation’s global competitiveness. This policy is currently in the process of being considered by the National Education Transformation Committee and the Higher Education Commission.

Keywords: demand-side financing, higher education resource, human capital, higher education

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611 Assessment of Factors Influencing Adoption of Agroforestry Technologies in Halaba Special Woreda, Southern Ethiopia

Authors: Mihretu Erjabo

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Halaba special district is characterized by drought, soil erosion, high population pressure, poor livestock production, lack of feed for livestock, very deep water table, very low productivity of crops and food insufficiency. In order to address these problems, the woreda agricultural development office along with other management practices such as soil physical conservation measures agroforestry was introduced decades ago as a means to alleviate the problem. However, the level of agroforestry adoption remains low. Objective of this study was to identify the factors that influence adoption of agroforestry technologies by farmers in the district. Random sampling was employed to select two kebele administrations and respondents. Data collection was conducted by rural household questionnaire survey, participatory rural appraisal, questionnaires for local and woreda extension staff, secondary data resources and field observation. A sample of 12 key informants, 6 extension staffs, and 182 households, were used in the data collection. Chi square test used to determine significant relationships between adoption of agroforestry and 15 selected variables. Out of which eleven were found to be significant to affect farmers’ adoptiveness. These were frequency of visits of farmers (13.39%), participation in training (11.49%), farmers’ attitude towards agroforestry practices (10.61%), frequency of visits of extensionists (10.38%), participation in extension meeting (10.34%), participation in field day (10.28%), land holding size (9.29%), level of literacy (8.78%), awareness about the importance of agroforestry technology packages (7.06%), time taken from their residence to nearest extension (5.04%) and gender of respondents (3.34%). This study also identified various factors that result in low adoption rates of agroforestry including fear of competition, seedling, rainfall and labour shortage, free grazing, financial problem, expecting trees as soil degrader and long span of trees and lack of need ranking. To improve farmers’ adoption, the factors identified should be well addressed by launching a series and recurrent outreach extension program appropriate and suitable to farmers need.

Keywords: farmers attitude, farmers participation, soil degradation, technology packages

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610 University Students' Perceptions of Effective Teaching

Authors: Christine K. Ormsbee, Jeremy S. Robinson

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

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

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609 The Importance of Elders in Guiding Research and Findings for Aboriginal People Experiencing Homelessness

Authors: Alice V. Brown, Patrick Egan, Dorothy Bagshaw, Jackie Oakley, Emma Vieira, Louise Southalan, Duc Dau, Lucy Spanswick, Lindey Andrews, Mandy Wilson, Jocelyn Jones

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Western Australia has recently adopted a 10-year plan to end homelessness across its State, with sections of the plan focused particularly on the Aboriginal and Torres Strait Islander population. In 2022, we engaged with 70-90 Aboriginal people experiencing homelessness in Perth, Western Australia, through qualitative interviews and creative methods, listening to their experiences of homelessness and their views on how services, State plans, and policies could better support them. This research was driven by the Aboriginal community through a Community Ownership Group of 16 Aboriginal Elders, elected by Elders’ groups, from across the Perth metropolitan area. The Community Ownership Group met every six weeks across the 15-month project timeline to guide the research team, endorse methods chosen, and provide richer context to research findings to ensure they adequately represent the experiences of Aboriginal people. These meetings were audio-recorded when possible and documented through meeting notes, verbal and visual minutes, and film, providing insights into homelessness from the perspective of Aboriginal Elders. In this paper, we compare the views of those experiencing homelessness with the views of the Aboriginal Elders -many of whom have experienced homelessness firsthand- and literature regarding how those experiencing homelessness can be better supported. We detail the ‘survival-directed thinking’ of those we engaged with who was in the throes of homelessness, leading them to focus more on immediate solutions such as food and housing. We then compare these narratives to Elders’ views that have been more regularly focused on connection to culture and long-term plans for healing homelessness, alongside immediate outreach -views also reflected in the literature. Through these comparisons, we highlight the importance of engaging both with those currently experiencing homelessness as well as with Aboriginal Elders as important cultural caretakers and authorities. We demonstrate how these varied voices uncover both long and short-term perspectives on how homelessness can be better managed in policy and service provision. We also highlight the potential role Aboriginal Elders can play in supporting the Aboriginal homeless community and their transition into housing.

Keywords: Aboriginal and Torres strait islander peoples, aboriginal elders, homelessness, community-led research

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

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

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

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

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607 Heritage and the Sustainable Development Goals: Successful Practices and Lessons Learnt from the Uk’s Global Challenges Research Fund and Newton Research Portfolios

Authors: Francesca Giliberto

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Heritage and culture, in general, plays a central role in addressing the complexity and broad variety of global development challenges, ranging from environmental degradation and refugee and humanitarian crisis to extreme poverty, food insecurity, persisting inequalities, and unsustainable urbanisation, just to mention some examples. Nevertheless, the potential of harnessing heritage to address global challenges has remained largely under-represented and underestimated in the most recent international development agenda adopted by the United Nations in 2015 (2030 Agenda). Among the 17 sustainable development goals (SDGs) and 169 associated targets established, only target 11.4 explicitly mentions heritage, stating that efforts should be strengthened “to protect and safeguard the world’s cultural and natural heritage in order to make our cities safe, resilient, and sustainable”. However, this global target continues to reflect a rather limited approach to heritage for development. This paper will provide a critical reflection on the contribution that using (tangible and intangible) heritage in international research can make to tackling global challenges and supporting the achievement of all the SDGs. It will present key findings and insights from the heritage strand of PRAXIS, a research project from the University of Leeds, which focuses on Arts and Humanities research across 300+ projects funded through the Global Challenges Research Fund and Newton Fund. In particular, this paper will shed light on successful practices and lessons learned from 87 research projects funded through the Global Challenges Research Fund and Newton Fund portfolios in 49 countries eligible for Official Development Assistance (ODA) between 2014 and 2021. Research data were collected through a desk assessment of project data available on UKRI Gateway to Research, online surveys, and qualitative interviews with research principal investigators and partners. The findings of this research provide evidence of how heritage and heritage research can foster innovative, interdisciplinary, inclusive, and transformative sustainable development and the achievement of the SDGs in ODA countries and beyond. This paper also highlights current challenges and research gaps that still need to be overcome to rethink current approaches and transform our development models to be more integrated, human-centred, and sustainable.

Keywords: global challenges, heritage, international research, sustainable development

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

Authors: Nilanthi Ratnayake, Wen-Ling Liu

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

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

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

Authors: Asinguza P. Allan

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

Keywords: advocacy, empowerment, evidence, human resources

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

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

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

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

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

Authors: Daniel Wachira

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

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

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

Authors: Adedeji S. Adegoke, Olakunle N. Popoola

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

Keywords: consumer, marketing, organization, promotional mix

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601 Knowledge, Attitude and Associated Factors of Practice towards Post Exposure Prophylaxis of HIV Infection among Health Professionals in Yeka and Kazanchis Health Center

Authors: Semira Zeru Haileslassie

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

Keywords: HIV infection, prophylaxis, knowledge, attitude

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600 An Analytical View of Albanian and French Legislation on Access to Health Care Benefits

Authors: Oljana Hoxhaj

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

Keywords: effective service, harmonization level, innovation, reform

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599 Attitude to the Types of Organizational Change

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

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

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

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

Authors: Sreejith Jayachandran, Mojtaba Ghods, Morteza Mohammadzaheri

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

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

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597 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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596 The Interventions to Parents Caring Children with Attention Deficit/Hyperactivity Disorder in Hong Kong

Authors: Wing Chi Wong

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Globally, studying parents caring for children with attention deficit/ hyperactivity disorder (ADHD) is valuable in order to design measures in supporting those parents by health care providers and government. Such parents in Hong Kong seem to encounter detrimental stress and enormous difficulties which are exacerbated by the traditional Chinese culture, exclusion from social members and fiercely competitive educational system. However, seldom studies scrutinize this issue in Hong Kong. This article aims to review the literature regarding parents caring offsprings with ADHD in Hong Kong. Criteria were set for searching among published studies listed in various databases, including MEDLINE, CINCAHL, PsycINFO, ProQuest, Embase, Cochrane Library and Springer Link. Articles with words 'Attention Deficit Hyperactivity Disorder', 'parenting', 'parent', 'family', 'father', 'mother', 'care' in titles and abstracts were identified. Articles with all types of research designs and methods, regardless in English or Chinese, were included. They were limited to years between January 2008 and September 2018. Four relevant studies have resulted. Of them, two were exploratory studies, one was a qualitative study, and one was a survey. Samples were recruited from child psychiatric clinic, Child and Adolescent Mental Health Unit, or multiple family group therapy centres. Authors proclaimed that quality of life of those parents was usually low; particularly mothers perceived a higher stress than fathers; parenting barriers existed; conflicts were commonly raised in parent-child relationship resulting in probable maltreatment to children. Previous studies generally suggested the potential negative outcomes of parents caring children with ADHD. The types and effectiveness of interventions to those parents on relieving their tortures under Hong Kong context had not been explored and systematically evaluated. The scanty studies and existing understanding could not give a promising conclusion pertaining to the appropriate family intervention to parents living with children with ADHD. A stringent research design is necessary to establish evidence on the effectiveness of interventions for those families.

Keywords: attention deficit/ hyperactivity disorder, Hong Kong, parents, interventions

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

Authors: Olurankinse Felix

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

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

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

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

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

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

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593 The Concept of Universal Design in the Independent City Life of Disabled Individuals

Authors: Berfu Guley Goren, Ayse Lale Berkoz

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The aim of the study is to analyze the concept of universal design and accessibility to make the city which allows equality and independence for individuals. In the content of the study, literature researches and observations of samples in Istanbul, Turkey are analyzed. As a result proposals are going to be developed to create the cities which are designed for everyone. In globalization process, in cities, population have been increasing dramatically with social and economic activities. Medical developments have been effective in prolonging human life and the disability that comes with aging has also increased in parallel with the disabled population. Nowadays disability is an important phenomenon. Because approximately 1 billion people live with disabilities. The heterogeneous structure formed by the rapid gathering of individuals with different social, economic and physical characteristics in the cities creates great spatial diversity and richness in the cities with different needs brought together. Unlike the cultural and physical wealth in these places and the potential to integrate and diversify the urban people, unfortunately, the designs in practice cause the urban areas to break apart, the urbanities to tear themselves apart, to interfere with their communication and interactions. The social and physical structure of the city is important to feel belonging to the urban society. In most cities when an observation is made, obstructions for people with disabilities can be seen in urban physical structure and design. With these obstructions, people with disabilities cannot live in urban space, and they are desolated in urban life. The city, which offers equal opportunity, the relation between economic development, social justice and built environment must be planned synchronous. Isolation and stigmatization must be abolished by regulations, activities of awareness and universal urban design. Without regard to social, economical and physical features every individual has the same right, which is using the freedom of movement. Supporting freedom of movement of every individual may be ensured by universal design and its principles. So urban spaces are going to be for every individual. For equal opportunity in urban services, urban design must be the focus on every individual including people with disabilities. In built environment practices, democratic suitable spaces should be created. In this respect, urban planners, architects, political decision-makers and other relevant actors should work together and should think very versatile.

Keywords: disability, equality, universal design, urban design

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592 Inclusive Education in Early Childhood Settings: Fostering a Diverse Learning Environment

Authors: Rodrique Watong Tchounkeu

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This paper investigated the implementation and impact of inclusive education practices in early childhood settings (ages 3-6) with the overarching aim of fostering a diverse learning environment. The primary objectives were to assess the then-current state of inclusive practices, identify effective methodologies for accommodating diverse learning needs, and evaluate the outcomes of implementing inclusive education in early childhood settings. To achieve these objectives, a mixed-methods approach was employed, combining qualitative interviews with early childhood educators and parents, along with quantitative surveys distributed to a diverse sample of participants. The qualitative phase involved semi-structured interviews with 30 educators and 50 parents, selected through purposive sampling. The interviews aimed to gather insights into the challenges faced in implementing inclusive education, the strategies employed, and the perceived benefits and drawbacks. The quantitative phase included surveys administered to 300 early childhood educators across various settings, measuring their familiarity with inclusive practices, their perceived efficacy, and their willingness to adapt teaching methods. The results revealed a significant gap between the theoretical understanding and practical implementation of inclusive education in early childhood settings. While educators demonstrated a high level of theoretical knowledge, they faced challenges in effectively translating these concepts into practice. Parental perspectives highlighted the importance of collaboration between educators and parents in supporting inclusive education. The surveys indicated a positive correlation between educators' familiarity with inclusive practices and their willingness to adapt teaching methods, emphasizing the need for targeted professional development. The implications of this study suggested the necessity for comprehensive training programs for early childhood educators focused on the practical implementation of inclusive education strategies. Additionally, fostering stronger partnerships between educators and parents was crucial for creating a supportive learning environment for all children. By addressing these findings, this research contributed to the advancement of inclusive education practices in early childhood settings, ultimately leading to more inclusive and effective learning environments for diverse groups of young learners.

Keywords: inclusive education, early childhood settings, diverse learning, young learners, practical implementation, parental collaboration

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591 Large-Scale Experimental and Numerical Studies on the Temperature Response of Main Cables and Suspenders in Bridge Fires

Authors: Shaokun Ge, Bart Merci, Fubao Zhou, Gao Liu, Ya Ni

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This study investigates the thermal response of main cables and suspenders in suspension bridges subjected to vehicle fires, integrating large-scale gasoline pool fire experiments with numerical simulations. Focusing on a suspension bridge in China, the research examines the impact of wind speed, pool size, and lane position on flame dynamics and temperature distribution along the cables. The results indicate that higher wind speeds and larger pool sizes markedly increase the mass burning rate, causing flame deflection and non-uniform temperature distribution along the cables. Under a wind speed of 1.56 m/s, maximum temperatures reached approximately 960 ℃ near the base in emergency lane fires and 909 ℃ at 1.6 m height for slow lane fires, underscoring the heightened thermal risk from emergency lane fires. The study recommends a zoning strategy for cable fire protection, suggesting a 0-12.8 m protection zone with a target temperature of 1000 ℃ and a 12.8-20.8 m zone with a target temperature of 700 ℃, both with a 90-minute fire resistance. This approach, based on precise temperature distribution data from experimental and simulation results, provides a vital reference for the fire protection design of suspension bridge cables. Understanding cable temperature response during vehicle fires is crucial for developing fire protection systems, as it dictates necessary structural protection, fire resistance duration, and maximum temperatures for mitigation. Challenges of controlling environmental wind in large-scale fire tests are also addressed, along with a call for further research on fire behavior mechanisms and structural temperature response in cable-supported bridges under varying wind conditions. Conclusively, the proposed zoning strategy enhances the theoretical understanding of near-field temperature response in bridge fires, contributing significantly to the field by supporting the design of passive fire protection systems for bridge cables, safeguarding their integrity under extreme fire conditions.

Keywords: bridge fire, temperature response, large-scale experiment, numerical simulations, fire protection

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590 Influence of Long-Term Variability in Atmospheric Parameters on Ocean State over the Head Bay of Bengal

Authors: Anindita Patra, Prasad K. Bhaskaran

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The atmosphere-ocean is a dynamically linked system that influences the exchange of energy, mass, and gas at the air-sea interface. The exchange of energy takes place in the form of sensible heat, latent heat, and momentum commonly referred to as fluxes along the atmosphere-ocean boundary. The large scale features such as El Nino and Southern Oscillation (ENSO) is a classic example on the interaction mechanism that occurs along the air-sea interface that deals with the inter-annual variability of the Earth’s Climate System. Most importantly the ocean and atmosphere as a coupled system acts in tandem thereby maintaining the energy balance of the climate system, a manifestation of the coupled air-sea interaction process. The present work is an attempt to understand the long-term variability in atmospheric parameters (from surface to upper levels) and investigate their role in influencing the surface ocean variables. More specifically the influence of atmospheric circulation and its variability influencing the mean Sea Level Pressure (SLP) has been explored. The study reports on a critical examination of both ocean-atmosphere parameters during a monsoon season over the head Bay of Bengal region. A trend analysis has been carried out for several atmospheric parameters such as the air temperature, geo-potential height, and omega (vertical velocity) for different vertical levels in the atmosphere (from surface to the troposphere) covering a period from 1992 to 2012. The Reanalysis 2 dataset from the National Centers for Environmental Prediction-Department of Energy (NCEP-DOE) was used in this study. The study signifies that the variability in air temperature and omega corroborates with the variation noticed in geo-potential height. Further, the study advocates that for the lower atmosphere the geo-potential heights depict a typical east-west contrast exhibiting a zonal dipole behavior over the study domain. In addition, the study clearly brings to light that the variations over different levels in the atmosphere plays a pivotal role in supporting the observed dipole pattern as clearly evidenced from the trends in SLP, associated surface wind speed and significant wave height over the study domain.

Keywords: air temperature, geopotential height, head Bay of Bengal, long-term variability, NCEP reanalysis 2, omega, wind-waves

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

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

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

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

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588 Opto-Thermal Frequency Modulation of Phase Change Micro-Electro-Mechanical Systems

Authors: Syed A. Bukhari, Ankur Goswmai, Dale Hume, Thomas Thundat

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Here we demonstrate mechanical detection of photo-induced Insulator to metal transition (MIT) in ultra-thin vanadium dioxide (VO₂) micro strings by using < 100 µW of optical power. Highly focused laser beam heated the string locally resulting in through plane and along axial heat diffusion. Localized temperature increase can cause temperature rise > 60 ºC. The heated region of VO₂ can transform from insulating (monoclinic) to conducting (rutile) phase leading to lattice compressions and stiffness increase in the resonator. The mechanical frequency of the resonator can be tuned by changing optical power and wavelength. The first mode resonance frequency was tuned in three different ways. A decrease in frequency below a critical optical power, a large increase between 50-120 µW followed by a large decrease in frequency for optical powers greater than 120 µW. The dynamic mechanical response was studied as a function of incident optical power and gas pressure. The resonance frequency and amplitude of vibration were found to be decreased with increasing laser power from 25-38 µW and increased by1-2 % when the laser power was further increased to 52 µW. The transition in films was induced and detected by a single pump and probe source and by employing external optical sources of different wavelengths. This trend in dynamic parameters of the strings can be co-related with reversible Insulator to metal transition in VO₂ films which creates change in density of the material and hence the overall stiffness of the strings leading to changes in string dynamics. The increase in frequency at a particular optical power manifests a transition to a more ordered metallic phase which tensile stress onto the string. The decrease in frequency at higher optical powers can be correlated with poor phonon thermal conductivity of VO₂ in conducting phase. Poor thermal conductivity of VO₂ can force in-plane penetration of heat causing the underneath SiN supporting VO₂ which can result as a decrease in resonance frequency. This noninvasive, non-contact laser-based excitation and detection of Insulator to metal transition using micro strings resonators at room temperature and with laser power in few µWs is important for low power electronics, and optical switching applications.

Keywords: thermal conductivity, vanadium dioxide, MEMS, frequency tuning

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587 Enhancing the Quality of Silage Bales Produced by a Commercial Scale Silage Producer in Northern province, Sri Lanka: A Step Toward Supporting Smallholder Dairy Farmers in the Northern Province Sri Lanka

Authors: Harithas Aruchchunan

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Silage production is an essential aspect of dairy farming, used to provide high-quality feed to ruminants. However, dairy farmers in Northern Province Sri Lanka are facing multiple challenges that compromise the quality and quantity of silage produced. To tackle these challenges, promoting silage feeding has become an essential component of sustainable dairy farming practices. In this study, silage bale samples were collected from a newly started silage baling factory in Jaffna, Northern province and their quality was analysed at the Veterinary Research Institute laboratory in Kandy in March 2023. The results show the nutritional composition of three Napier grass cultivars: Super Napier, CO6, and Indian Red Napier (BH18). The main parameters analysed were dry matter, pH, lactic acid, soluble carbohydrate, ammonia nitrogen, ash, crude protein, NDF, and ADF. The results indicate that Super Napier and CO6 have higher crude protein content and lower ADF levels, making them suitable for producing high-quality silage. The pH levels of all three cultivars were safe, and the ammonia nitrogen levels were considered appropriate. However, laboratory results indicate that the quality of silage bales produced can be further enhanced. Dairy farmers should be encouraged to adopt these cultivars to achieve better yields as they are high in protein and are better suited to Northern Province's soil and climate. Therefore, it is vital to educate small-scale fodder producers, who supply the raw material to silage factories, on the best practices of cultivating these new cultivars. To improve silage bale production and quality in Northern Province Sri Lanka, we recommend increasing public awareness about silage feeding, providing education and training to dairy farmers and small-scale fodder producers on modern silage production techniques and improving the availability of raw materials for silage production. Additionally, Napier grass cultivars need to be promoted among dairy farmers for better production and quality of silage bales. Failing to improve the quality and quantity of silage bale production could not only lead to the decline of dairy farming in Northern Province Sri Lanka but also the negative impact on the economy

Keywords: silage bales, dairy farming, economic crisis, Sri Lanka

Procedia PDF Downloads 92