Search results for: Tourist Satisfaction
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2037

Search results for: Tourist Satisfaction

87 Multisensory Science, Technology, Engineering and Mathematics Learning: Combined Hands-on and Virtual Science for Distance Learners of Food Chemistry

Authors: Paulomi Polly Burey, Mark Lynch

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It has been shown that laboratory activities can help cement understanding of theoretical concepts, but it is difficult to deliver such an activity to an online cohort and issues such as occupational health and safety in the students’ learning environment need to be considered. Chemistry, in particular, is one of the sciences where practical experience is beneficial for learning, however typical university experiments may not be suitable for the learning environment of a distance learner. Food provides an ideal medium for demonstrating chemical concepts, and along with a few simple physical and virtual tools provided by educators, analytical chemistry can be experienced by distance learners. Food chemistry experiments were designed to be carried out in a home-based environment that 1) Had sufficient scientific rigour and skill-building to reinforce theoretical concepts; 2) Were safe for use at home by university students and 3) Had the potential to enhance student learning by linking simple hands-on laboratory activities with high-level virtual science. Two main components of the resources were developed, a home laboratory experiment component, and a virtual laboratory component. For the home laboratory component, students were provided with laboratory kits, as well as a list of supplementary inexpensive chemical items that they could purchase from hardware stores and supermarkets. The experiments used were typical proximate analyses of food, as well as experiments focused on techniques such as spectrophotometry and chromatography. Written instructions for each experiment coupled with video laboratory demonstrations were used to train students on appropriate laboratory technique. Data that students collected in their home laboratory environment was collated across the class through shared documents, so that the group could carry out statistical analysis and experience a full laboratory experience from their own home. For the virtual laboratory component, students were able to view a laboratory safety induction and advised on good characteristics of a home laboratory space prior to carrying out their experiments. Following on from this activity, students observed laboratory demonstrations of the experimental series they would carry out in their learning environment. Finally, students were embedded in a virtual laboratory environment to experience complex chemical analyses with equipment that would be too costly and sensitive to be housed in their learning environment. To investigate the impact of the intervention, students were surveyed before and after the laboratory series to evaluate engagement and satisfaction with the course. Students were also assessed on their understanding of theoretical chemical concepts before and after the laboratory series to determine the impact on their learning. At the end of the intervention, focus groups were run to determine which aspects helped and hindered learning. It was found that the physical experiments helped students to understand laboratory technique, as well as methodology interpretation, particularly if they had not been in such a laboratory environment before. The virtual learning environment aided learning as it could be utilized for longer than a typical physical laboratory class, thus allowing further time on understanding techniques.

Keywords: chemistry, food science, future pedagogy, STEM education

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86 Consumer Cognitive Models of Vaccine Attitudes: Behavioral Informed Strategies Promoting Vaccination Policy in Greece

Authors: Halkiopoulos Constantinos, Koutsopoulou Ioanna, Gkintoni Evgenia, Antonopoulou Hera

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Immunization appears to be an essential part of health care service in times of pandemics such as covid-19 and aims not only to protect the health of the population but also the health and sustainability of the economies of the countries affected. It is reported that more than 3.44 billion doses have been administered so far, which accounts for 45 doses for 100 people. Vaccination programs in various countries have been promoted and accepted by people differently and therefore they proceeded in different ways and speed; most countries directing them towards people with vulnerable chronic or recent health statuses. Large scale restriction measures or lockdown, personal protection measures such as masks and gloves and a decrease in leisure and sports activities were also implemented around the world as part of the protection health strategies against the covid-19 pandemic. This research aims to present an analysis based on variations on people’s attitudes towards vaccination based on demographic, social and epidemiological characteristics, and health status on the one hand and perception of health, health satisfaction, pain, and quality of life on the other hand. 1500 Greek e-consumers participated in the research, mainly through social media who took part in an online-based survey voluntarily. The questionnaires included demographic, social and medical characteristics of the participants, and questions asking people’s willingness to be vaccinated and their opinion on whether there should be a vaccine against covid-19. Other stressor factors were also reported in the questionnaires and participants’ loss of someone close due to covid-19, or staying at home quarantine due to being infected from covid-19. WHOQUOL-BREF and GLOBAL PSYCHOTRAUMA SCREEN- GPS were used with kind permission from WHO and from the International Society for Traumatic Stress Studies in this study. Attitudes towards vaccination varied significantly related to aging, level of education, health status and consumer behavior. Health professionals’ attitudes also varied in relation to age, level of education, profession, health status and consumer needs. Vaccines have been the most common technological aid of human civilization so far in the fight against viruses. The results of this study can be used for health managers and digital marketers of pharmaceutical companies and also other staff involved in vaccination programs and for designing health policy immunization strategies during pandemics in order to achieve positive attitudes towards vaccination and larger populations being vaccinated in shorter periods of time after the break out of pandemic. Health staff needs to be trained, aided and supervised to go through with vaccination programs and to be protected through vaccination programs themselves. Feedback in each country’s vaccination program, short backs, deficiencies and delays should be addressed and worked out.

Keywords: consumer behavior, cognitive models, vaccination policy, pandemic, Covid-19, Greece

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85 Evaluating Impact of Teacher Professional Development Program on Students’ Learning

Authors: S. C. Lin, W. W. Cheng, M. S. Wu

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This study attempted to investigate the connection between teacher professional development program and students’ Learning. This study took Readers’ Theater Teaching Program (RTTP) for professional development as an example to inquiry how participants apply their new knowledge and skills learned from RTTP to their teaching practice and how the impact influence students learning. The goals of the RTTP included: 1) to enhance teachers RT content knowledge; 2) to implement RT instruction in teachers’ classrooms in response to their professional development. 2) to improve students’ ability of reading fluency in professional development teachers’ classrooms. This study was a two-year project. The researchers applied mixed methods to conduct this study including qualitative inquiry and one-group pretest-posttest experimental design. In the first year, this study focused on designing and implementing RTTP and evaluating participants’ satisfaction of RTTP, what they learned and how they applied it to design their English reading curriculum. In the second year, the study adopted quasi-experimental design approach and evaluated how participants RT instruction influenced their students’ learning, including English knowledge, skill, and attitudes. The participants in this study composed two junior high school English teachers and their students. Data were collected from a number of different sources including teaching observation, semi-structured interviews, teaching diary, teachers’ professional development portfolio, Pre/post RT content knowledge tests, teacher survey, and students’ reading fluency tests. To analyze the data, both qualitative and quantitative data analysis were used. Qualitative data analysis included three stages: organizing data, coding data, and analyzing and interpreting data. Quantitative data analysis included descriptive analysis. The results indicated that average percentage of correct on pre-tests in RT content knowledge assessment was 40.75% with two teachers ranging in prior knowledge from 35% to 46% in specific RT content. Post-test RT content scores ranged from 70% to 82% correct with an average score of 76.50%. That gives teachers an average gain of 35.75% in overall content knowledge as measured by these pre/post exams. Teachers’ pre-test scores were lowest in script writing and highest in performing. Script writing was also the content area that showed the highest gains in content knowledge. Moreover, participants hold a positive attitude toward RTTP. They recommended that the approach of professional learning community, which was applied in RTTP was benefit to their professional development. Participants also applied the new skills and knowledge which they learned from RTTP to their practices. The evidences from this study indicated that RT English instruction significantly influenced students’ reading fluency and classroom climate. The result indicated that all of the experimental group students had a big progress in reading fluency after RT instruction. The study also found out several obstacles. Suggestions were also made.

Keywords: teacher’s professional development, program evaluation, readers’ theater, english reading instruction, english reading fluency

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84 Screens Design and Application for Sustainable Buildings

Authors: Fida Isam Abdulhafiz

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Traditional vernacular architecture in the United Arab Emirates constituted namely of adobe houses with a limited number of openings in their facades. The thick mud and rubble walls and wooden window screens protected its inhabitants from the harsh desert climate and provided them with privacy and fulfilled their comfort zone needs to an extent. However, with the rise of the immediate post petroleum era reinforced concrete villas with glass and steel technology has replaced traditional vernacular dwellings. And more load was put on the mechanical cooling systems to ensure the satisfaction of today’s more demanding doweling inhabitants. However, In the early 21at century professionals started to pay more attention to the carbon footprint caused by the built constructions. In addition, many studies and innovative approaches are now dedicated to lower the impact of the existing operating buildings on their surrounding environments. The UAE government agencies started to regulate that aim to revive sustainable and environmental design through Local and international building codes and urban design policies such as Estidama and LEED. The focus in this paper is on the reduction of the emissions resulting from the use of energy sources in the cooling and heating systems, and that would be through using innovative screen designs and façade solutions to provide a green footprint and aesthetic architectural icons. Screens are one of the popular innovative techniques that can be added in the design process or used in existing building as a renovation techniques to develop a passive green buildings. Preparing future architects to understand the importance of environmental design was attempted through physical modelling of window screens as an educational means to combine theory with a hands on teaching approach. Designing screens proved to be a popular technique that helped them understand the importance of sustainable design and passive cooling. After creating models of prototype screens, several tests were conducted to calculate the amount of Sun, light and wind that goes through the screens affecting the heat load and light entering the building. Theory further explored concepts of green buildings and material that produce low carbon emissions. This paper highlights the importance of hands on experience for student architects and how physical modelling helped rise eco awareness in Design studio. The paper will study different types of façade screens and shading devices developed by Architecture students and explains the production of diverse patterns for traditional screens by student architects based on sustainable design concept that works properly with the climate requirements in the Middle East region.

Keywords: building’s screens modeling, façade design, sustainable architecture, sustainable dwellings, sustainable education

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83 A Work-Individual-Family Inquiry on Mental Health and Family Responsibility of Dealers Employed in Macau Gaming Industry

Authors: Tak Mau Simon Chan

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While there is growing reflection of the adverse impacts instigated by the flourishing gaming industry on the physical health and job satisfaction of those who work in Macau casinos, there is also a critical void in our understanding of the mental health of croupiers and how casino employment interacts with the family system. From a systemic approach, it would be most effective to examine the ‘dealer issues’ collectively and offer assistance to both the individual dealer and the family system of dealers. Therefore, with the use of a mixed method study design, the levels of anxiety, depression and sleeping quality of a sample of 1124 dealers who are working in Macau casinos have been measured in the present study, and 113 dealers have been interviewed about the impacts of casino employment on their family life. This study presents some very important findings. First, the quantitative study indicates that gender is a significant predictor of depression and anxiety levels, whilst lower income means less quality sleep. The Pearson’s correlation coefficients show that as the Zung Self-rating Anxiety Scale (ZSAS) scores increase, the Zung Self-rating Depression Scale (ZSDS) and Pittsburgh Sleep Quality Index (PSQI) scores will also simultaneously increase. Higher income, therefore, might partly explain for the reason why mothers choose to work in the gaming industry even with shift work involved and a stressful work environment. Second, the findings from the qualitative study show that aside from the positive impacts on family finances, the shift work and job stress to some degree negatively affect family responsibilities and relationships. There are resultant family issues, including missed family activities, and reduced parental care and guidance, marital intimacy, and communication with family members. Despite the mixed views on the gender role differences, the respondents generally agree that female dealers have more family and child-minding responsibilities at home, and thus it is more difficult for them to balance work and family. Consequently, they may be more vulnerable to stress at work. Thirdly, there are interrelationships between work and family, which are based on a systemic inquiry that incorporates work- individual- family. Poor physical and psychological health due to shift work or a harmful work environment could affect not just work performance, but also life at home. Therefore, a few practice points about 1) work-family conflicts in Macau; 2) families-in- transition in Macau; and 3) gender and class sensitivity in Macau; are provided for social workers and family practitioners who will greatly benefit these families, especially whose family members are working in the gaming industry in Macau. It is concluded that in addressing the cultural phenomenon of “dealer’s complex” in Macau, a systemic approach is recommended that addresses both personal psychological needs and family issue of dealers.

Keywords: family, work stress, mental health, Macau, dealers, gaming industry

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82 A development of Innovator Teachers Training Curriculum to Create Instructional Innovation According to Active Learning Approach to Enhance learning Achievement of Private School in Phayao Province

Authors: Palita Sooksamran, Katcharin Mahawong

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This research aims to offer the development of innovator teachers training curriculum to create instructional innovation according to active learning approach to enhance learning achievement. The research and development process is carried out in 3 steps: Step 1 The study of the needs necessary to develop a training curriculum: the inquiry was conducted by a sample of teachers in private schools in Phayao province that provide basic education at the level of education. Using a questionnaire of 176 people, the sample was defined using a table of random numbers and stratified samples, using the school as a random layer. Step 2 Training curriculum development: the tools used are developed training curriculum and curriculum assessments, with nine experts checking the appropriateness of the draft curriculum. The statistic used in data analysis is the average ( ) and standard deviation (S.D.) Step 3 study on effectiveness of training curriculum: one group pretest/posttest design applied in this study. The sample consisted of 35 teachers from private schools in Phayao province. The participants volunteered to attend on their own. The results of the research showed that: 1.The essential demand index needed with the list of essential needs in descending order is the choice and create of multimedia media, videos, application for learning management at the highest level ,Developed of multimedia, video and applications for learning management and selection of innovative learning management techniques and methods of solve the problem Learning , respectively. 2. The components of the training curriculum include principles, aims, scope of content, training activities, learning materials and resources, supervision evaluation. The scope of the curriculum consists of basic knowledge about learning management innovation, active learning, lesson plan design, learning materials and resources, learning measurement and evaluation, implementation of lesson plans into classroom and supervision and motoring. The results of the evaluation of quality of the draft training curriculum at the highest level. The Experts suggestion is that the purpose of the course should be used words that convey the results. 3. The effectiveness of training curriculum 1) Cognitive outcomes of the teachers in creating innovative learning management was at a high level of relative gain score. 2) The assessment results of learning management ability according to the active learning approach to enhance learning achievement by assessing from 2 education supervisor as a whole were very high , 3) Quality of innovation learning management based on active learning approach to enhance learning achievement of the teachers, 7 instructional Innovations were evaluated as outstanding works and 26 instructional Innovations passed the standard 4) Overall learning achievement of students who learned from 35 the sample teachers was at a high level of relative gain score 5) teachers' satisfaction towards the training curriculum was at the highest level.

Keywords: training curriculum, innovator teachers, active learning approach, learning achievement

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81 User Experience Evaluation on the Usage of Commuter Line Train Ticket Vending Machine

Authors: Faishal Muhammad, Erlinda Muslim, Nadia Faradilla, Sayidul Fikri

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To deal with the increase of mass transportation needs problem, PT. Kereta Commuter Jabodetabek (KCJ) implements Commuter Vending Machine (C-VIM) as the solution. For that background, C-VIM is implemented as a substitute to the conventional ticket windows with the purposes to make transaction process more efficient and to introduce self-service technology to the commuter line user. However, this implementation causing problems and long queues when the user is not accustomed to using the machine. The objective of this research is to evaluate user experience after using the commuter vending machine. The goal is to analyze the existing user experience problem and to achieve a better user experience design. The evaluation method is done by giving task scenario according to the features offered by the machine. The features are daily insured ticket sales, ticket refund, and multi-trip card top up. There 20 peoples that separated into two groups of respondents involved in this research, which consist of 5 males and 5 females each group. The experienced and inexperienced user to prove that there is a significant difference between both groups in the measurement. The user experience is measured by both quantitative and qualitative measurement. The quantitative measurement includes the user performance metrics such as task success, time on task, error, efficiency, and learnability. The qualitative measurement includes system usability scale questionnaire (SUS), questionnaire for user interface satisfaction (QUIS), and retrospective think aloud (RTA). Usability performance metrics shows that 4 out of 5 indicators are significantly different in both group. This shows that the inexperienced group is having a problem when using the C-VIM. Conventional ticket windows also show a better usability performance metrics compared to the C-VIM. From the data processing, the experienced group give the SUS score of 62 with the acceptability scale of 'marginal low', grade scale of “D”, and the adjective ratings of 'good' while the inexperienced group gives the SUS score of 51 with the acceptability scale of 'marginal low', grade scale of 'F', and the adjective ratings of 'ok'. This shows that both groups give a low score on the system usability scale. The QUIS score of the experienced group is 69,18 and the inexperienced group is 64,20. This shows the average QUIS score below 70 which indicate a problem with the user interface. RTA was done to obtain user experience issue when using C-VIM through interview protocols. The issue obtained then sorted using pareto concept and diagram. The solution of this research is interface redesign using activity relationship chart. This method resulted in a better interface with an average SUS score of 72,25, with the acceptable scale of 'acceptable', grade scale of 'B', and the adjective ratings of 'excellent'. From the time on task indicator of performance metrics also shows a significant better time by using the new interface design. Result in this study shows that C-VIM not yet have a good performance and user experience.

Keywords: activity relationship chart, commuter line vending machine, system usability scale, usability performance metrics, user experience evaluation

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80 Thinking Lean in ICU: A Time Motion Study Quantifying ICU Nurses’ Multitasking Time Allocation

Authors: Fatma Refaat Ahmed, Sally Mohamed Farghaly

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Context: Intensive care unit (ICU) nurses often face pressure and constraints in their work, leading to the rationing of care when demands exceed available time and resources. Observations suggest that ICU nurses are frequently distracted from their core nursing roles by non-core tasks. This study aims to provide evidence on ICU nurses' multitasking activities and explore the association between nurses' personal and clinical characteristics and their time allocation. Research Aim: The aim of this study is to quantify the time spent by ICU nurses on multitasking activities and investigate the relationship between their personal and clinical characteristics and time allocation. Methodology: A self-observation form utilizing the "Diary" recording method was used to record the number of tasks performed by ICU nurses and the time allocated to each task category. Nurses also reported on the distractions encountered during their nursing activities. A convenience sample of 60 ICU nurses participated in the study, with each nurse observed for one nursing shift (6 hours), amounting to a total of 360 hours. The study was conducted in two ICUs within a university teaching hospital in Alexandria, Egypt. Findings: The results showed that ICU nurses completed 2,730 direct patient-related tasks and 1,037 indirect tasks during the 360-hour observation period. Nurses spent an average of 33.65 minutes on ventilator care-related tasks, 14.88 minutes on tube care-related tasks, and 10.77 minutes on inpatient care-related tasks. Additionally, nurses spent an average of 17.70 minutes on indirect care tasks per hour. The study identified correlations between nursing time and nurses' personal and clinical characteristics. Theoretical Importance: This study contributes to the existing research on ICU nurses' multitasking activities and their relationship with personal and clinical characteristics. The findings shed light on the significant time spent by ICU nurses on direct care for mechanically ventilated patients and the distractions that require attention from ICU managers. Data Collection: Data were collected using self-observation forms completed by participating ICU nurses. The forms recorded the number of tasks performed, the time allocated to each task category, and any distractions encountered during nursing activities. Analysis Procedures: The collected data were analyzed to quantify the time spent on different tasks by ICU nurses. Correlations were also examined between nursing time and nurses' personal and clinical characteristics. Question Addressed: This study addressed the question of how ICU nurses allocate their time across multitasking activities and whether there is an association between nurses' personal and clinical characteristics and time allocation. Conclusion: The findings of this study emphasize the need for a lean evaluation of ICU nurses' activities to identify and address potential gaps in patient care and distractions. Implementing lean techniques can improve efficiency, safety, clinical outcomes, and satisfaction for both patients and nurses, ultimately enhancing the quality of care and organizational performance in the ICU setting.

Keywords: motion study, ICU nurse, lean, nursing time, multitasking activities

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79 Blister Formation Mechanisms in Hot Rolling

Authors: Rebecca Dewfall, Mark Coleman, Vladimir Basabe

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Oxide scale growth is an inevitable byproduct of the high temperature processing of steel. Blister is a phenomenon that occurs due to oxide growth, where high temperatures result in the swelling of surface scale, producing a bubble-like feature. Blisters can subsequently become embedded in the steel substrate during hot rolling in the finishing mill. This rolled in scale defect causes havoc within industry, not only with wear on machinery but loss of customer satisfaction, poor surface finish, loss of material, and profit. Even though blister is a highly prevalent issue, there is still much that is not known or understood. The classic iron oxidation system is a complex multiphase system formed of wustite, magnetite, and hematite, producing multi-layered scales. Each phase will have independent properties such as thermal coefficients, growth rate, and mechanical properties, etc. Furthermore, each additional alloying element will have different affinities for oxygen and different mobilities in the oxide phases so that oxide morphologies are specific to alloy chemistry. Therefore, blister regimes can be unique to each steel grade resulting in a diverse range of formation mechanisms. Laboratory conditions were selected to simulate industrial hot rolling with temperature ranges approximate to the formation of secondary and tertiary scales in the finishing mills. Samples with composition: 0.15Wt% C, 0.1Wt% Si, 0.86Wt% Mn, 0.036Wt% Al, and 0.028Wt% Cr, were oxidised in a thermo-gravimetric analyser (TGA), with an air velocity of 10litresmin-1, at temperaturesof 800°C, 850°C, 900°C, 1000°C, 1100°C, and 1200°C respectively. Samples were held at temperature in an argon atmosphere for 10minutes, then oxidised in air for 600s, 60s, 30s, 15s, and 4s, respectively. Oxide morphology and Blisters were characterised using EBSD, WDX, nanoindentation, FIB, and FEG-SEM imaging. Blister was found to have both a nucleation and growth process. During nucleation, the scale detaches from the substrate and blisters after a very short period, roughly 10s. The steel substrate is then exposed inside of the blister and further oxidised in the reducing atmosphere of the blister, however, the atmosphere within the blister is highly dependent upon the porosity of the blister crown. The blister crown was found to be consistently between 35-40um for all heating regimes, which supports the theory that the blister inflates, and the oxide then subsequently grows underneath. Upon heating, two modes of blistering were identified. In Mode 1 it was ascertained that the stresses produced by oxide growth will increase with increasing oxide thickness. Therefore, in Mode 1 the incubation time for blister formation is shortened by increasing temperature. In Mode 2 increase in temperature will result in oxide with a high ductility and high oxide porosity. The high oxide ductility and/or porosity accommodates for the intrinsic stresses from oxide growth. Thus Mode 2 is the inverse of Mode 1, and incubation time is increased with temperature. A new phenomenon was reported whereby blister formed exclusively through cooling at elevated temperatures above mode 2.

Keywords: FEG-SEM, nucleation, oxide morphology, surface defect

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78 Mood Symptom Severity in Service Members with Posttraumatic Stress Symptoms after Service Dog Training

Authors: Tiffany Riggleman, Andrea Schultheis, Kalyn Jannace, Jerika Taylor, Michelle Nordstrom, Paul F. Pasquina

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Introduction: Posttraumatic Stress (PTS) and Posttraumatic Stress Disorder (PTSD) remain significant problems for military and veteran communities. Symptoms of PTSD often include poor sleep, intrusive thoughts, difficulty concentrating, and trouble with emotional regulation. Unfortunately, despite its high prevalence, service members diagnosed with PTSD often do not seek help, usually because of the perceived stigma surrounding behavioral health care. To help address these challenges, non-pharmacological, therapeutic approaches are being developed to help improve care and enhance compliance. The Service Dog Training Program (SDTP), which involves teaching patients how to train puppies to become mobility service dogs, has been successfully implemented into PTS/PTSD care programs with anecdotal reports of improved outcomes. This study was designed to assess the biopsychosocial effects of SDTP from military beneficiaries with PTS symptoms. Methods: Individuals between the ages of 18 and 65 with PTS symptom were recruited to participate in this prospective study. Each subject completes 4 weeks of baseline testing, followed by 6 weeks of active service dog training (twice per week for one hour sessions) with a professional service dog trainer. Outcome measures included the Posttraumatic Stress Checklist for the DSM-5 (PCL-5), Generalized Anxiety Disorder questionnaire-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), social support/interaction, anthropometrics, blood/serum biomarkers, and qualitative interviews. Preliminary analysis of 17 participants examined mean scores on the GAD-7, PCL-5, and PHQ-9, pre- and post-SDTP, and changes were assessed using Wilcoxon Signed-Rank tests. Results: Post-SDTP, there was a statistically significant mean decrease in PCL-5 scores of 13.5 on an 80-point scale (p=0.03) and a significant mean decrease of 2.2 in PHQ-9 scores on a 27 point scale (p=0.04), suggestive of decreased PTSD and depression symptoms. While there was a decrease in mean GAD-7 scores post-SDTP, the difference was not significant (p=0.20). Recurring themes among results from the qualitative interviews include decreased pain, forgetting about stressors, improved sense of calm, increased confidence, improved communication, and establishing a connection with the service dog. Conclusion: Preliminary results of the first 17 participants in this study suggest that individuals who received SDTP had a statistically significant decrease in PTS symptom, as measured by the PCL-5 and PHQ-9. This ongoing study seeks to enroll a total of 156 military beneficiaries with PTS symptoms. Future analyses will include additional psychological outcomes, pain scores, blood/serum biomarkers, and other measures of the social aspects of PTSD, such as relationship satisfaction and sleep hygiene.

Keywords: post-concussive syndrome, posttraumatic stress, service dog, service dog training program, traumatic brain injury

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77 Implementing Quality Improvement Projects to Enhance Contraception and Abortion Care Service Provision and Pre-Service Training of Health Care Providers

Authors: Munir Kassa, Mengistu Hailemariam, Meghan Obermeyer, Kefelegn Baruda, Yonas Getachew, Asnakech Dessie

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Improving the quality of sexual and reproductive health services that women receive is expected to have an impact on women’s satisfaction with the services, on their continued use and, ultimately, on their ability to achieve their fertility goals or reproductive intentions. Surprisingly, however, there is little empirical evidence of either whether this expectation is correct, or how best to improve service quality within sexual and reproductive health programs so that these impacts can be achieved. The Recent focus on quality has prompted more physicians to do quality improvement work, but often without the needed skill sets, which results in poorly conceived and ultimately unsuccessful improvement initiatives. As this renders the work unpublishable, it further impedes progress in the field of health care improvement and widens the quality chasm. Moreover, since 2014, the Center for International Reproductive Health Training (CIRHT) has worked diligently with 11 teaching hospitals across Ethiopia to increase access to contraception and abortion care services. This work has included improving pre-service training through education and curriculum development, expanding hands-on training to better learn critical techniques and counseling skills, and fostering a “team science” approach to research by encouraging scientific exploration. This is the first time this systematic approach has been applied and documented to improve access to high-quality services in Ethiopia. The purpose of this article is to report initiatives undertaken, and findings concluded by the clinical service team at CIRHT in an effort to provide a pragmatic approach to quality improvement projects. An audit containing nearly 300 questions about several aspects of patient care, including structure, process, and outcome indicators was completed by each teaching hospital’s quality improvement team. This baseline audit assisted in identifying major gaps and barriers, and each team was responsible for determining specific quality improvement aims and tasks to support change interventions using Shewart’s Cycle for Learning and Improvement (the Plan-Do-Study-Act model). To measure progress over time, quality improvement teams met biweekly and compiled monthly data for review. Also, site visits to each hospital were completed by the clinical service team to ensure monitoring and support. The results indicate that applying an evidence-based, participatory approach to quality improvement has the potential to increase the accessibility and quality of services in a short amount of time. In addition, continued ownership and on-site support are vital in promoting sustainability. This approach could be adapted and applied in similar contexts, particularly in other African countries.

Keywords: abortion, contraception, quality improvement, service provision

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76 Application of IoTs Based Multi-Level Air Quality Sensing for Advancing Environmental Monitoring in Pingtung County

Authors: Men An Pan, Hong Ren Chen, Chih Heng Shih, Hsing Yuan Yen

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Pingtung County is located in the southernmost region of Taiwan. During the winter season, pollutants due to insufficient dispersion caused by the downwash of the northeast monsoon lead to the poor air quality of the County. Through the implementation of various control methods, including the application of permits of air pollution, fee collection of air pollution, control oil fume of catering sectors, smoke detection of diesel vehicles, regular inspection of locomotives, and subsidies for low-polluting vehicles. Moreover, to further mitigate the air pollution, additional alternative controlling strategies are also carried out, such as construction site control, prohibition of open-air agricultural waste burning, improvement of river dust, and strengthening of road cleaning operations. The combined efforts have significantly reduced air pollutants in the County. However, in order to effectively and promptly monitor the ambient air quality, the County has subsequently deployed micro-sensors, with a total of 400 IoTs (Internet of Things) micro-sensors for PM2.5 and VOC detection and 3 air quality monitoring stations of the Environmental Protection Agency (EPA), covering 33 townships of the County. The covered area has more than 1,300 listed factories and 5 major industrial parks; thus forming an Internet of Things (IoTs) based multi-level air quality monitoring system. The results demonstrate that the IoTs multi-level air quality sensors combined with other strategies such as “sand and gravel dredging area technology monitoring”, “banning open burning”, “intelligent management of construction sites”, “real-time notification of activation response”, “nighthawk early bird plan with micro-sensors”, “unmanned aircraft (UAV) combined with land and air to monitor abnormal emissions”, and “animal husbandry odour detection service” etc. The satisfaction improvement rate of air control, through a 2021 public survey, reached a high percentage of 81%, an increase of 46% as compared to 2018. For the air pollution complaints for the whole year of 2021, the total number was 4213 in contrast to 7088 in 2020, a reduction rate reached almost 41%. Because of the spatial-temporal features of the air quality monitoring IoTs system by the application of microsensors, the system does assist and strengthen the effectiveness of the existing air quality monitoring network of the EPA and can provide real-time control of the air quality. Therefore, the hot spots and potential pollution locations can be timely determined for law enforcement. Hence, remarkable results were obtained for the two years. That is, both reduction of public complaints and better air quality are successfully achieved through the implementation of the present IoTs system for real-time air quality monitoring throughout Pingtung County.

Keywords: IoT, PM, air quality sensor, air pollution, environmental monitoring

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75 Predicting Provider Service Time in Outpatient Clinics Using Artificial Intelligence-Based Models

Authors: Haya Salah, Srinivas Sharan

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Healthcare facilities use appointment systems to schedule their appointments and to manage access to their medical services. With the growing demand for outpatient care, it is now imperative to manage physician's time effectively. However, high variation in consultation duration affects the clinical scheduler's ability to estimate the appointment duration and allocate provider time appropriately. Underestimating consultation times can lead to physician's burnout, misdiagnosis, and patient dissatisfaction. On the other hand, appointment durations that are longer than required lead to doctor idle time and fewer patient visits. Therefore, a good estimation of consultation duration has the potential to improve timely access to care, resource utilization, quality of care, and patient satisfaction. Although the literature on factors influencing consultation length abound, little work has done to predict it using based data-driven approaches. Therefore, this study aims to predict consultation duration using supervised machine learning algorithms (ML), which predicts an outcome variable (e.g., consultation) based on potential features that influence the outcome. In particular, ML algorithms learn from a historical dataset without explicitly being programmed and uncover the relationship between the features and outcome variable. A subset of the data used in this study has been obtained from the electronic medical records (EMR) of four different outpatient clinics located in central Pennsylvania, USA. Also, publicly available information on doctor's characteristics such as gender and experience has been extracted from online sources. This research develops three popular ML algorithms (deep learning, random forest, gradient boosting machine) to predict the treatment time required for a patient and conducts a comparative analysis of these algorithms with respect to predictive performance. The findings of this study indicate that ML algorithms have the potential to predict the provider service time with superior accuracy. While the current approach of experience-based appointment duration estimation adopted by the clinic resulted in a mean absolute percentage error of 25.8%, the Deep learning algorithm developed in this study yielded the best performance with a MAPE of 12.24%, followed by gradient boosting machine (13.26%) and random forests (14.71%). Besides, this research also identified the critical variables affecting consultation duration to be patient type (new vs. established), doctor's experience, zip code, appointment day, and doctor's specialty. Moreover, several practical insights are obtained based on the comparative analysis of the ML algorithms. The machine learning approach presented in this study can serve as a decision support tool and could be integrated into the appointment system for effectively managing patient scheduling.

Keywords: clinical decision support system, machine learning algorithms, patient scheduling, prediction models, provider service time

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74 Midterm Clinical and Functional Outcomes After Treatment with Ponseti Method for Idiopathic Clubfeet: A Prospective Cohort Study

Authors: Neeraj Vij, Amber Brennan, Jenni Winters, Hadi Salehi, Hamy Temkit, Emily Andrisevic, Mohan V. Belthur

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Idiopathic clubfoot is a common lower extremity deformity with an incidence of 1:500. The Ponseti Method is well known as the gold standard of treatment. However, there is limited functional data demonstrating correction of the clubfoot after treatment with the Ponseti method. The purpose of this study was to study the clinical and functional outcomes after the Ponseti method with the Clubfoot Disease-Specific Instrument (CDS) and pedobarography. This IRB-approved prospective study included patients aged 3-18 who were treated for idiopathic clubfoot with the Ponseti method between January 2008 and December 2018. Age-matched controls were identified through siblings of clubfoot patients and other community members. Treatment details were collected through a chart review of the included patients. Laboratory assessment included a physical exam, gait analysis, and pedobarography. The Pediatric Outcomes Data Collection Instrument and the Clubfoot Disease-Specific Instrument were also obtained on clubfoot patients (CF). The Wilcoxson rank-sum test was used to study differences between the CF patients and the typically developing (TD) patients. Statistical significance was set at p < 0.05. There were a total of 37 enrolled patients in our study. 21 were priorly treated for CF and 16 were TD. 94% of the CF patients had bilateral involvement. The age at the start of treatment was 29 days, the average total number of casts was seven to eight, and the average total number of casts after Achilles tenotomy was one. The reoccurrence rate was 25%, tenotomy was required in 94% of patients, and ≥1 tenotomy was required in 25% of patients. There were no significant differences between step length, step width, stride length, force-time integral, maximum peak pressure, foot progression angles, stance phase time, single-limb support time, double limb support time, and gait cycle time between children treated with the Ponseti method and typically developing children. The average post-treatment Pirani and Dimeglio scores were 5.50±0.58 and 15.29±1.58, respectively. The average post-treatment PODCI subscores were: Upper Extremity: 90.28, Transfers: 94.6, Sports: 86.81, Pain: 86.20, Happiness: 89.52, Global: 88.6. The average post-treatment Clubfoot Disease-Specific Instrument scores subscores were: Satisfaction: 73.93, Function: 80.32, Overall: 78.41. The Ponseti Method has a very high success rate and remains to be the gold standard in the treatment of idiopathic clubfoot. Timely management leads to good outcomes and a low need for repeated Achilles tenotomy. Children treated with the Ponseti method demonstrate good functional outcomes as measured through pedobarography. Pedobarography may have clinical utility in studying congenital foot deformities. Objective measures for hours of brace wear could represent an improvement in clubfoot care.

Keywords: functional outcomes, pediatric deformity, patient-reported outcomes, talipes equinovarus

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73 Nursing Education in the Pandemic Time: Case Study

Authors: Jaana Sepp, Ulvi Kõrgemaa, Kristi Puusepp, Õie Tähtla

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COVID-19 was officially recognized as a pandemic in late 2019 by the WHO, and it has led to changes in the education sector. Educational institutions were closed, and most schools adopted distance learning. Estonia is known as a digitally well-developed country. Based on that, in the pandemic time, nursing education continued, and new technological solutions were implemented. To provide nursing education, special focus was paid on quality and flexibility. The aim of this paper is to present administrative, digital, and technological solutions which support Estonian nursing educators to continue the study process in the pandemic time and to develop a sustainable solution for nursing education for the future. This paper includes the authors’ analysis of the documents and decisions implemented in the institutions through the pandemic time. It is a case study of Estonian nursing educators. Results of the analysis show that the implementation of distance learning principles challenges the development of innovative strategies and technics for the assessment of student performance and educational outcomes and implement new strategies to encourage student engagement in the virtual classroom. Additionally, hospital internships were canceled, and the simulation approach was deeply implemented as a new opportunity to develop and assess students’ practical skills. There are many other technical and administrative changes that have also been carried out, such as students’ support and assessment systems, the designing and conducting of hybrid and blended studies, etc. All services were redesigned and made more available, individual, and flexible. Hence, the feedback system was changed, the information was collected in parallel with educational activities. Experiences of nursing education during the pandemic time are widely presented in scientific literature. However, to conclude our study, authors have found evidence that solutions implemented in Estonian nursing education allowed the students to graduate within the nominal study period without any decline in education quality. Operative information system and flexibility provided the minimum distance between the students, support, and academic staff, and likewise, the changes were implemented quickly and efficiently. Institution memberships were updated with the appropriate information, and it positively affected their satisfaction, motivation, and commitment. We recommend that the feedback process and the system should be permanently changed in the future to place all members in the same information area, redefine the hospital internship process, implement hybrid learning, as well as to improve the communication system between stakeholders inside and outside the organization. The main limitation of this study relates to the size of Estonia. Nursing education is provided by two institutions only, and similarly, the number of students is low. The result could be generated to the institutions with a similar size and administrative system. In the future, the relationship between nurses’ performance and organizational outcomes should be deeply investigated and influences of the pandemic time education analyzed at workplaces.

Keywords: hybrid learning, nursing education, nursing, COVID-19

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72 The Efficiency Analysis in the Health Sector: Marmara Region

Authors: Hale Kirer Silva Lecuna, Beyza Aydin

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Health is one of the main components of human capital and sustainable development, and it is very important for economic growth. Health economics, which is an indisputable part of the science of economics, has five stages in general. These are health and development, financing of health services, economic regulation in the health, allocation of resources and efficiency of health services. A well-developed and efficient health sector plays a major role by increasing the level of development of countries. The most crucial pillars of the health sector are the hospitals that are divided into public and private. The main purpose of the hospitals is to provide more efficient services. Therefore the aim is to meet patients’ satisfaction by increasing the service quality. Health-related studies in Turkey date back to the Ottoman and Seljuk Empires. In the near past, Turkey applied 'Health Sector Transformation Programs' under different titles between 2003 and 2010. Our aim in this paper is to measure how effective these transformation programs are for the health sector, to see how much they can increase the efficiency of hospitals over the years, to see the return of investments, to make comments and suggestions on the results, and to provide a new reference for the literature. Within this framework, the public and private hospitals in Balıkesir, Bilecik, Bursa, Çanakkale, Edirne, Istanbul, Kirklareli, Kocaeli, Sakarya, Tekirdağ, Yalova will be examined by using Data Envelopment Analysis (DEA) for the years between 2000 and 2019. DEA is a linear programming-based technique, which gives relatively good results in multivariate studies. DEA basically estimates an efficiency frontier and make a comparison. Constant returns to scale and variable returns to scale are two most commonly used DEA methods. Both models are divided into two as input and output-oriented. To analyze the data, the number of personnel, number of specialist physicians, number of practitioners, number of beds, number of examinations will be used as input variables; and the number of surgeries, in-patient ratio, and crude mortality rate as output variables. 11 hospitals belonging to the Marmara region were included in the study. It is seen that these hospitals worked effectively only in 7 provinces (Balıkesir, Bilecik, Bursa, Edirne, İstanbul, Kırklareli, Yalova) for the year 2001 when no transformation program was implemented. After the transformation program was implemented, for example, in 2014 and 2016, 10 hospitals (Balıkesir, Bilecik, Bursa, Çanakkale, Edirne, İstanbul, Kocaeli, Kırklareli, Tekirdağ, Yalova) were found to be effective. In 2015, ineffective results were observed for Sakarya, Tekirdağ and Yalova. However, since these values are closer to 1 after the transformation program, we can say that the transformation program has positive effects. For Sakarya alone, no effective results have been achieved in any year. When we look at the results in general, it shows that the transformation program has a positive effect on the effectiveness of hospitals.

Keywords: data envelopment analysis, efficiency, health sector, Marmara region

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71 An Unusual Manifestation of Spirituality: Kamppi Chapel of Helsinki

Authors: Emine Umran Topcu

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In both urban design and architecture, the primary goal is considered to be looking for ways in which people feel and think about space and place. Humans, in general, see a place as security and space as freedom and feel attached to place and long for space. Contemporary urban design manifests itself by addressing basic physical and psychological human needs. Not much attention is paid to transcendence. There seems to be a gap in the hierarchy of human needs. Usually, social aspects of public space are addressed through urban design. More personal and intimately scaled needs of an individual are neglected. How does built form contribute to an individual’s growth, contemplation, and exploration? In other words, a greater meaning in the immediate environment. Architects love to talk about meaning, poetics, attachment and other ethereal aspects of space that are not visible attributes of places. This paper aims at describing spirituality through built form with a personal experience of Kamppi Chapel of Helsinki. Experience covers various modes through which a person unfolds or constructs reality. Perception, sensation, emotion, and thought can be counted as for these modes. To experience is to get to know. What can be known is a construct of experience. Feelings and thoughts about space and place are very complex in human beings. They grow out of life experiences. The author had the chance of visiting Kamppi Chapel in April 2017, out of which the experience grew. The Kamppi Chapel is located on the South side of the busy Narinnka Square in central Helsinki. It offers a place to quiet down and compose oneself in a most lively urban space. With its curved wooden facade, the small building looks more like a museum than a chapel. It can be called a museum for contemplation. With its gently shaped interior, it embraces visitors and shields them from the hustle bustle of the city outside. Places of worship in all faiths signify sacred power. The author, having origins in a part of the world where domes and minarets dominate the cityscape, was impressed by the size and the architectural visibility of the Chapel. Anyone born and trained in such a tradition shares the inherent values and psychological mechanisms of spirituality, sacredness and the modest realities of their environment. Spirituality in all cultural traditions has not been analyzed and reinterpreted in new conceptual frameworks. Fundamentalists may reject this positivist attitude, but Kamppi Chapel as it stands does not look like it has a say like “I’m a model to be followed”. It just faces the task of representing a religious facility in an urban setting largely shaped by modern urban planning, which seems to the author as looking for a new definition of individual status. The quest between the established and the new is the demand for modern efficiency versus dogmatic rigidity. The architecture here has played a very promising and rewarding role for spirituality. The designers have been the translators for human desire for better life and aesthetic environment for an optimal satisfaction of local citizens and the visitors alike.

Keywords: architecture, Kamppi Chapel, spirituality, urban

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70 Training in Communicational Skills in Students of Medicine: Differences in Bilingualism

Authors: Naiara Ozamiz Etcebarria, Sonia Ruiz De Azua Garcia, Agurtzane Ortiz Jauregi, Virginia Guillen Cañas

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Introduction: The most relevant competencies of a health professional are an adequate communication capacity, which will influence the satisfaction of professionals and patients, therapeutic compliance, conflict prevention, clinical outcomes´ improvement and efficiency of health services. The ability of Active listening , empathy, assertiveness and social skills, are important abilities to develop in all professions in which there is a relationship with other people. In the field of health, it is even more important to have adequate qualities so that the treatment with the patient will be adequate and satisfactory. We conducted a research with students of third year in the Degree of Medicine with the objectives: - to know how the active listening, empathy, assertiveness and social skills of students are. - to know if there are differences according to different demographic variables, such as sex, language, age, number of siblings and interest in the subject. Material and Methods: The students of the Third year in the Degree of Medicine (N = 212) participated voluntarily. Sociodemographic data were collected. Descriptive and comparative analysis of the averages of the students with respect to active listening, empathy, assertiveness and social skills were performed. Once the questionnaires were collected, they were entered into the SPSS 21 database. Four communicational aspects were evaluated: The active listening questionnaire, the TECA empathy questionnaire, the ACDA questionnaire and the EHS questionnaire Social Skills Scale. The active listening questionnaire assesses these factors: Listening without interruption and less contradiction, Listening with 100% attention, Listening beyond words, Listening encouraging the other to go deeper. The TECA questionnaire of cognitive and affective empathy evaluates: Adoption of perspectives, Emotional Comprehension, Emphasizing stress, Empathic joy. The EHS questionnaire Social Skills Scale: Self-expression in social situations, Defending one's own rights as a consumer, Expressing anger or dissatisfaction, Refusing to do and cutting interactions off, Making requests, Initiating positive interactions with the other sex. The ACDA questionnaire Assertiveness Assessment Scale evaluates self-assertiveness and heteroaservitivity. Applicability: To train these skills is so important for clinical practice of medical students and these capabilities that can be measured in a longitudinal way time. Ethical-legal aspects: The data were anonymous. The study was approved by the Ethics Committee. Results: The students of the Third year in the Degree of Medicine (34.4% Basque speakers and 65.6% Spanish speakers) with average age 20.93, (27.8% men and 72.2% women). There are no differences in social skills between men and women. The Basque speaker students of are more heteroactive (ACDA) than Spanish students. Active listening has a high correlation with social skills, especially with self-expression in social situations. Listening without interruption has a high correlation with self-expression in social situations and initiating positive interactions with the opposite sex. Adoption of perspectives presents a high correlation with auto- assertiveness. Emotional understanding presents a high correlation with positive interactions with the opposite sex. Empathic joy correlates with self-assertiveness, self-expression in social situations, and initiating positive interactions with the opposite sex.

Keywords: active listening, assertiveness, communicational skills, empathy, students of medicine

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69 Investigating the Impact of Individual Risk-Willingness and Group-Interaction Effects on Business Model Innovation Decisions

Authors: Sarah Müller-Sägebrecht

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Today’s volatile environment challenges executives to make the right strategic decisions to gain sustainable success. Entrepreneurship scholars postulate mainly positive effects of environmental changes on entrepreneurship behavior, such as developing new business opportunities, promoting ingenuity, and the satisfaction of resource voids. A strategic solution approach to overcome threatening environmental changes and catch new business opportunities is business model innovation (BMI). Although this research stream has gained further importance in the last decade, BMI research is still insufficient. Especially BMI barriers, such as inefficient strategic decision-making processes, need to be identified. Strategic decisions strongly impact organizational future and are, therefore, usually made in groups. Although groups draw on a more extensive information base than single individuals, group-interaction effects can influence the decision-making process - in a favorable but also unfavorable way. Decisions are characterized by uncertainty and risk, whereby their intensity is perceived individually differently. Individual risk-willingness influences which option humans choose. The special nature of strategic decisions, such as in BMI processes, is that these decisions are not made individually but in groups due to their high organizational scope. These groups consist of different personalities whose individual risk-willingness can vary considerably. It is known from group decision theory that these individuals influence each other, observable in different group-interaction effects. The following research questions arise: i) Which impact has the individual risk-willingness on BMI decisions? And ii) how do group interaction effects impact BMI decisions? After conducting 26 in-depth interviews with executives from the manufacturing industry, the applied Gioia methodology reveals the following results: i) Risk-averse decision-makers have an increased need to be guided by facts. The more information available to them, the lower they perceive uncertainty and the more willing they are to pursue a specific decision option. However, the results also show that social interaction does not change the individual risk-willingness in the decision-making process. ii) Generally, it could be observed that during BMI decisions, group interaction is primarily beneficial to increase the group’s information base for making good decisions, less than for social interaction. Further, decision-makers mainly focus on information available to all decision-makers in the team but less on personal knowledge. This work contributes to strategic decision-making literature twofold. First, it gives insights into how group-interaction effects influence an organization’s strategic BMI decision-making. Second, it enriches risk-management research by highlighting how individual risk-willingness impacts organizational strategic decision-making. To date, it was known in BMI research that risk aversion would be an internal BMI barrier. However, with this study, it becomes clear that it is not risk aversion that inhibits BMI. Instead, the lack of information prevents risk-averse decision-makers from choosing a riskier option. Simultaneously, results show that risk-averse decision-makers are not easily carried away by the higher risk-willingness of their team members. Instead, they use social interaction to gather missing information. Therefore, executives need to provide sufficient information to all decision-makers to catch promising business opportunities.

Keywords: business model innovation, decision-making, group biases, group decisions, group-interaction effects, risk-willingness

Procedia PDF Downloads 96
68 Process of Production of an Artisanal Brewery in a City in the North of the State of Mato Grosso, Brazil

Authors: Ana Paula S. Horodenski, Priscila Pelegrini, Salli Baggenstoss

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The brewing industry with artisanal concepts seeks to serve a specific market, with diversified production that has been gaining ground in the national environment, also in the Amazon region. This growth is due to the more demanding consumer, with a diversified taste that wants to try new types of beer, enjoying products with new aromas, flavors, as a differential of what is so widely spread through the big industrial brands. Thus, through qualitative research methods, the study aimed to investigate how is the process of managing the production of a craft brewery in a city in the northern State of Mato Grosso (BRAZIL), providing knowledge of production processes and strategies in the industry. With the efficient use of resources, it is possible to obtain the necessary quality and provide better performance and differentiation of the company, besides analyzing the best management model. The research is descriptive with a qualitative approach through a case study. For the data collection, a semi-structured interview was elaborated, composed of the areas: microbrewery characterization, artisan beer production process, and the company supply chain management. Also, production processes were observed during technical visits. With the study, it was verified that the artisan brewery researched develops preventive maintenance strategies with the inputs, machines, and equipment, so that the quality of the product and the production process are achieved. It was observed that the distance from the supplying centers makes the management of processes and the supply chain be carried out with a longer planning time so that the delivery of the final product is satisfactory. The production process of the brewery is composed of machines and equipment that allows the control and quality of the product, which the manager states that for the productive capacity of the industry and its consumer market, the available equipment meets the demand. This study also contributes to highlight one of the challenges for the development of small breweries in front of the market giants, that is, the legislation, which fits the microbreweries as producers of alcoholic beverages. This makes the micro and small business segment to be taxed as a major, who has advantages in purchasing large batches of raw materials and tax incentives because they are large employers and tax pickers. It was possible to observe that the supply chain management system relies on spreadsheets and notes that are done manually, which could be simplified with a computer program to streamline procedures and reduce risks and failures of the manual process. In relation to the control of waste and effluents affected by the industry is outsourced and meets the needs. Finally, the results showed that the industry uses preventive maintenance as a productive strategy, which allows better conditions for the production and quality of artisanal beer. The quality is directly related to the satisfaction of the final consumer, being prized and performed throughout the production process, with the selection of better inputs, the effectiveness of the production processes and the relationship with the commercial partners.

Keywords: artisanal brewery, production management, production processes, supply chain

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67 Drivers of the Performance of Members of a Social Incubator Considering the Values of Work: A Qualitative Study with Social Entrepreneurs

Authors: Leticia Lengler, Vania Estivalete, Vivian Flores Costa, Tais De Andrade, Lisiane Fellini Faller

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Social entrepreneurship has emerged and driven a new development perspective, and as the literature mentions, it is based on innovation, and mainly, on the creation of social value, rather than personal wealth and shareholders. In this field of study, one of the focuses of discussion refers to the distinct characteristics of the individuals responsible for socially directed initiatives, named as social entrepreneurs. To contribute to this perspective, the present study aims to identify the values related to work that guide the performance of social entrepreneurs, members of enterprises that have developed themselves within a social incubator at a federal institution of higher education in Brazil. Each person's value system is present in different facets of his life, manifesting himself in his choices and in the way he conducts the relationship with other people in society. Especially the values of work, the focus of this research, play a significant role in organizational studies, since they are considered one of the important guiding principles of the behavior of individuals in the work environment. Regarding the method of the study, a descriptive and qualitative research was carried out. In the data collection, 24 entrepreneurs, members of five different enterprises belonging to the social incubator, were interviewed. The research instrument consisted of three open questions, which could be answered with the support of a "disc of values", an artifact organized to clearly demonstrate the values of the work to the respondents. The analysis of the interviews took into account the categories defined a priori, based on the model proposed by previous authors who validated these constructs within their research contexts, contemplating the following dimensions: Self-determination and stimulation; Safety; Conformity; Universalism and benevolence; Achievement; and Power. It should be noted that, in order to provide a better understanding of the interviewees, in the "disc of values" used in the research, these dimensions were represented by the objectives that define them, being respectively: Challenge; Financial independence; Commitment; Welfare of others; Personal success; And Power. Some preliminary results show that, as guiding principles of the investigation, priority is given to work values related to Self-determination and stimulation, Conformity and Universalism and benevolence. Such findings point to the importance given by these individuals to independent thinking and acting, as well as to novelty and constant challenge. Still, they demonstrate the appreciation of commitment to their enterprise, the people who make it and the quality of their work. They also point to the relevance of the possibility of contributing to the greater social good, that is, of the search for the well-being of close people and of society, as it is implied in models of social entrepreneurship coming from literature. With a lower degree of priority, the values denominated Safety and Realization, as the financial question at work and the search for satisfaction and personal success, through the use of socially recognized skills were mentioned aspects with little emphasis by social entrepreneurs. The Power value was not considered as guiding principle of the work for the respondents.

Keywords: qualitative study, social entrepreneur, social incubator, values of work

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66 Social Media Governance in UK Higher Education Institutions

Authors: Rebecca Lees, Deborah Anderson

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Whilst the majority of research into social media in education focuses on the applications for teaching and learning environments, this study looks at how such activities can be managed by investigating the current state of social media regulation within UK higher education. Social media has pervaded almost all aspects of higher education; from marketing, recruitment and alumni relations to both distance and classroom-based learning and teaching activities. In terms of who uses it and how it is used, social media is growing at an unprecedented rate, particularly amongst the target market for higher education. Whilst the platform presents opportunities not found in more traditional methods of communication and interaction, such as speed and reach, it also carries substantial risks that come with inappropriate use, lack of control and issues of privacy. Typically, organisations rely on the concept of a social contract to guide employee behaviour to conform to the expectations of that organisation. Yet, where academia and social media intersect applying the notion of a social contract to enforce governance may be problematic; firstly considering the emphasis on treating students as customers with a growing focus on the use and collection of satisfaction metrics; and secondly regarding the notion of academic’s freedom of speech, opinion and discussion, which is a long-held tradition of learning instruction. Therefore the need for sound governance procedures to support expectations over online behaviour is vital, especially when the speed and breadth of adoption of social media activities has in the past outrun organisations’ abilities to manage it. An analysis of the current level of governance was conducted by gathering relevant policies, guidelines and best practice documentation available online via internet search and institutional requests. The documents were then subjected to a content analysis in the second phase of this study to determine the approach taken by institutions to apply such governance. Documentation was separated according to audience, i.e.: applicable to staff, students or all users. Given many of these included guests and visitors to the institution within their scope being easily accessible was considered important. Yet, within the UK only about half of all education institutions had explicit social media governance documentation available online without requiring member access or considerable searching. Where they existed, the majority focused solely on employee activities and tended to be policy based rather than rooted in guidelines or best practices, or held a fallback position of governing online behaviour via implicit instructions within IT and computer regulations. Explicit instructions over expected online behaviours is therefore lacking within UK HE. Given the number of educational practices that now include significant online components, it is imperative that education organisations keep up to date with the progress of social media use. Initial results from the second phase of this study which analyses the content of the governance documentation suggests they require reading levels at or above the target audience, with some considerable variability in length and layout. Further analysis will add to this growing field of investigating social media governance within higher education.

Keywords: governance, higher education, policy, social media

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65 The Influence of Leadership Styles on Organizational Performance and Innovation: Empirical Study in Information Technology Sector in Spain

Authors: Richard Mababu Mukiur

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Leadership is an important drive that plays a key role in the success and development of organizations, particularly in the current context of digital transformation, highly competitivity and globalization. Leaders are persons that hold a dominant and privileged position within an organization, field, or sector of activities and are able to manage, motivate and exercise a high degree of influence over other in order to achieve the institutional goals. They achieve commitment and engagement of others to embrace change, and to make good decisions. Leadership studies in higher education institutions have examined how effective leaders hold their organizations, and also to find approaches which fit best in the organizations context for its better management, transformation and improvement. Moreover, recent studies have highlighted the impact of leadership styles on organizational performance and innovation capacities, since some styles give better results than others. Effective leadership is part of learning process that take place through day-to-day tasks, responsibilities, and experiences that influence the organizational performance, innovation and engagement of employees. The adoption of appropriate leadership styles can improve organization results and encourage learning process, team skills and performance, and employees' motivation and engagement. In the case of case of Information Technology sector, leadership styles are particularly crucial since this sector is leading relevant changes and transformations in the knowledge society. In this context, the main objective of this study is to analyze managers leadership styles with their relation to organizational performance and innovation that may be mediated by learning organization process and demographic variables. Therefore, it was hypothesized that the transformational and transactional leadership will be the main style adopted in Information Technology sector and will influence organizational performance and innovation capacity. A sample of 540 participants from Information technology sector has been determined in order to achieve the objective of this study. The Multifactor Leadership Questionnaire was administered as the principal instrument, Scale of innovation and Learning Organization Questionnaire. Correlations and multiple regression analysis have been used as the main techniques of data analysis. The findings indicate that leadership styles have a relevant impact on organizational performance and innovation capacity. The transformational and transactional leadership are predominant styles in Information technology sector. The effective leadership style tend to be characterized by the capacity of generating and sharing knowledge that improve organization performance and innovation capacity. Managers are adopting and adapting their leadership styles that respond to the new organizational, social and cultural challenges and realities of contemporary society. Managers who encourage innovation, foster learning process, share experience are useful to the organization since they contribute to its development and transformation. Learning process capacity and demographic variables (age, gender, and job tenure) mediate the relationship between leadership styles, innovation capacity and organizational performance. The transformational and transactional leadership tend to enhance the organizational performance due to their significant impact on team-building, employees' engagement and satisfaction. Some practical implications and future lines of research have been proposed.

Keywords: leadership styles, tranformational leadership, organisational performance, organisational innovation

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64 ‘Call Before, Save Lives’: Reducing Emergency Department Visits through Effective Communication

Authors: Sandra Cardoso, Gaspar Pais, Judite Neves, Sandra Cavaca, Fernando Araújo

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In 2021, Portugal has 63 emergency department (ED) visits per 100 people annually, the highest numbers in Europe. While EDs provide a critical service, high use is indicative of inappropriate and inefficient healthcare. In Portugal, all ED have the Manchester Triage System (MTS), a clinical risk management tool to enable that patients are seen in order of clinical priority. In 2023, more than 40% of the ED visits were of non-urgent conditions (blue and green), that could be better managed in primary health care (PHC), meaning wrong use of resources and lack of health literacy. From 2017, the country has a phone line, SNS24 (Contact Centre of the National Health Service), for triage, counseling, and referral service, 24 hours/7 days a week. The pilot project ‘Call before, save lives’ was implemented in the municipalities of Póvoa de Varzim and Vila do Conde (around 150.000 residents), in May 2023, by the executive board of the Portuguese Health Service, with the support of the Shared Services of the Ministry of Health, and local authorities. This geographical area has short travel times, 99% of the population a family doctor and the region is organized in a health local unit (HLU), integrating PHC and the local hospital. The purposes of this project included to increase awareness to contact SNS 24, before going to an ED, and non-urgent conditions oriented to a family doctor, reducing ED visits. The implementation of the project involved two phases, beginning with: i) development of campaigns using local influencers (fishmonger, model, fireman) through local institutions and media; ii) provision of telephone installed on site to contact SNS24; iii) establishment of open consultation in PHC; iv) promotion of the use of SNS24; v) creation of acute consultations at the hospital for complex chronic patients; and vi) direct referral for home hospitalization by PHC. The results of this project showed an excellent level of access to SNS24, an increase in the number of users referred to ED, with great satisfaction of users and professionals. The second phase, initiated in January 2024, for access to the ED, the need for prior referral was established as an admission rule, except for certain situations, as trauma patients. If the patient refuses, their registration in the ED and subsequent screening in accordance with the MTS must be ensured. When the patient is non-urgent, shall not be observed in the ED, provided that, according to his clinical condition, is guaranteed to be referred to PHC or to consultation/day hospital, through effective scheduling of an appointment for the same or the following day. In terms of results, 8 weeks after beginning of phase 2, we assist of a decrease in self-reported patients to ED from 59% to 15%, and a reduction of around 7% of ED visits. The key for this success was an effective public campaign that increases the knowledge of the right use of the health system, and capable of changing behaviors.

Keywords: contact centre of the national health service, emergency department visits, public campaign, health literacy, SNS24

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63 Revisionist Powers Seeking for Status within the System by Adopting a Compresence of Cooperative and Competitive Strategies

Authors: Mirele Plenishti

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Revisionist powers are sometimes associated to revolutionary and status quo powers, this because along the line representing the level of satisfaction–dissatisfaction with the system, revisionist powers are located in between status quo and revolutionary powers. In particular, the case of revisionist powers seeking for social status adjustments (while having status quo intentions) can, in the first option, be refuted due to the disbelief that dissatisfaction could coexist with status quo intentions – this entailing the possibility to trigger a spiral effect by over-counter-reacting. In the second option, revisionist powers can be underestimated as a real threat, this entailing a potential inadequate reaction. The necessity to well manage international change entails the need to understand better how revisionist powers seek for changes in status, within the system. The complexity of this case is heightened by the propensity of both IR scholars and practitioners to infer states' aims and intentions – towards the system – by looking at their behaviours. This has resulted in the tendency to consider cooperative international behaviours as symptomatic of status quo intentions, and vice versa: status quo intentions as manifested through positive/cooperative behaviours. Similarly, assertive/competitive international behaviours are considered as symptomatic (and vice versa, as manifestations) of revolutionary intentions. Therefore, within complex and composite foreign policies, scholars who disbelieve the existence of revisionist powers with status quo intentions, tend to highlight the negative/competitive elements; while more optimist scholars tend to focus on conforming/cooperative behaviours. Both perspectives, while understanding relevant components of the complex international interaction, still miss a composite overview. In order to closely investigate the strategies adopted by (status quo aiming) revisionist states, and by drawing on sociological studies on peer relations, focused on children's behaviour, one could expect that the compresence of both positive (compliant/cooperative) and negative (competitive/assertive) behaviours, is deliberate, and functional to seeking social status adjustments. Indeed, at the end of 90s, peer relation studies focused on children's behaviour, discerned between the concept of social acceptance (that refers to the degree of social preference assigned to the child– how much is s/he liked) and popularity (which refers to the social status assigned to the child within the group). By building on this distinction, it was possible to identify a link relating social acceptance to prosocial (compliant/cooperative) behaviours and strategies, and popularity to both prosocial and antisocial (aggressive/assertive) behaviours and strategies. Since then, antisocial behaviours ceased to be considered as a proof of social maladjustment and were finally identified as socially recognized strategies adopted in function of the achievement of popularity. Drawing on these results, one can hypothesize that also international status seekers perform both positive (conforming/compliant/cooperative) and negative (assertive/aggressive/competitive) behaviours. Therefore, the link between aims and behaviours loses its strength, since cooperative and competitive behaviours are both means for status seeking strategies that aim at status quo intentions. By carrying out a historical investigation of Italy's foreign policy during fascism, the intent is to closely look at this compresence of behaviours, in order to better qualify its components and their relations.

Keywords: compresence of cooperative and competitive behaviours and strategies, revisionist powers, status quo intentions, status seeking

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62 Antiinflammatory and Wound Healing Activity of Sedum Essential Oils Growing in Kazakhstan

Authors: Dmitriy Yu. Korulkin, Raissa A. Muzychkina

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The last decade the growth of severe and disseminated forms of inflammatory diseases is observed in Kazakhstan, in particular, septic shock, which progresses on 3-15% of patients with infectious complications of postnatal period. In terms of the rate of occurrence septic shock takes third place after hemorrhagic and cardiovascular shock, in terms of lethality it takes first place. The structure of obstetric sepsis has significantly changed. Currently the first place is taken by postabortive sepsis (40%) that is connected with usage of imperfect methods of artificial termination of pregnancy in late periods (intraamnial injection of sodium chloride, glucose). The second place is taken by postnatal sepsis (32%); the last place is taken by septic complications of caesarean section (28%). In this connection, search for and assessment of effectiveness of new medicines for treatment of postoperative infectious complications, having biostimulating effect and speeding up regeneration processes, is very promising and topical. Essential oil was obtained by the method hydrodistillation air-dry aerial part of Sedum L. plants using Clevenger apparatus. Pilot batch of plant medicinal product based on Sedum essential oils was produced by Chimpharm JSC, Santo Member of Polpharma Group (Kazakhstan). During clinical test of the plant medicinal product based on Sedum L. essential oils 37 female patients at the age from 35 to 57 with clinical signs of complicated postoperative processes and 12 new mothers with clinical signs of inflammatory process on sutures on anterior abdominal wall after caesarean section and partial disruption of surgical suture line on perineum were examined. Medicine usage methods - surgical wound treatment 2 times a day, treatment with other medicines of local action was not performed. Before and after treatment general clinical test, determination of immune status, bacterioscopic test of wound fluid was performed to all women, medical history data was taken into account, wound cleansing and healing time, full granulations, side effects and complications, satisfaction with the used medicine was assessed. On female patients with inflammatory infiltration and partial disruption of surgical suture line anesthetic wound healing effect of plant medicinal product based on Sedum L. essential oils was observed as early as on the second day after beginning of using it, wound cleansing took place, as a rule, within the first row days. Hyperemia in the area of suture line also was not observed for 2-3-d day of usage of medicine, good constant course was observed. The absence of clinical effect on this group of patients was not registered. The represented data give evidence of that clinical effect was accompanied with normalization of changed laboratory findings. No allergic responses or side effects were observed during usage of the plant medicinal products based on Sedum L. essential oils.

Keywords: antiinflammatory, bioactive substances, essential oils, isolation, sedum L., wound healing

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61 Identity and Mental Adaptation of Deaf and Hard-of-Hearing Students

Authors: N. F. Mikhailova, M. E. Fattakhova, M. A. Mironova, E. V. Vyacheslavova

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For the mental and social adaptation of the deaf and hard-of-hearing people, cultural and social aspects - the formation of identity (acculturation) and educational conditions – are highly significant. We studied 137 deaf and hard-of-hearing students in different educational situations. We used these methods: Big Five (Costa & McCrae, 1997), TRF (Becker, 1989), WCQ (Lazarus & Folkman, 1988), self-esteem, and coping strategies (Jambor & Elliott, 2005), self-stigma scale (Mikhailov, 2008). Type of self-identification of students depended on the degree of deafness, type of education, method of communication in the family: large hearing loss, education in schools for deaf, and gesture communication increased the likelihood of a 'deaf' acculturation. Less hearing loss, inclusive education in public school or school for the hearing-impaired, mixed communication in the family contributed to the formation of 'hearing' acculturation. The choice of specific coping depended on the degree of deafness: a large hearing loss increased coping 'withdrawal into the deaf world' and decreased 'bicultural skills' coping. People with mild hearing loss tended to cover-up it. In the context of ongoing discussion, we researched personality characteristics in deaf and hard on-hearing students, coping and other deafness associated factors depending on their acculturation type. Students who identified themselves with the 'hearing world' had a high self-esteem, a higher level of extraversion, self-awareness, personal resources, willingness to cooperate, better psychological health, emotional stability, higher ability to empathy, a greater satiety of life with feelings and sense and high sense of self-worth. They also actively used strategies, problem-solving, acceptance of responsibility, positive revaluation. Student who limited themselves within the culture of deaf people had more severe hearing loss and accordingly had more communication barriers. Lack of use or seldom use of coping strategies by these students point at decreased level of stress in their life. Their self-esteem have not been challenged in the specific social environment of the students with the same severity of defect, and thus this environment provided sense of comfort (we can assume that from the high scores on psychological health, personality resources, and emotional stability). Students with bicultural acculturation had higher level of psychological resources - they used Positive Reappraisal coping more often and had a higher level of psychological health. Lack of belonging to certain culture (marginality) leads to personality disintegration, social and psychological disadaptation: deaf and hard-of-hearing students with marginal identification had a lower self-estimation level, worse psychological health and personal resources, lower level of extroversion, self-confidence and life satisfaction. They, in fact, become 'risk group' (many of them dropped out of universities, divorced, and one even ended up in the ranks of ISIS). All these data argue the importance of cultural 'anchor' for people with hearing deprivation. Supported by the RFBR No 19-013-00406.

Keywords: acculturation, coping, deafness, marginality

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60 Ethnic Identity as an Asset: Linking Ethnic Identity, Perceived Social Support, and Mental Health among Indigenous Adults in Taiwan

Authors: A.H.Y. Lai, C. Teyra

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In Taiwan, there are 16 official indigenous groups, accounting for 2.3% of the total population. Like other indigenous populations worldwide, indigenous peoples in Taiwan have poorer mental health because of their history of oppression and colonisation. Amid the negative narratives, the ethnic identity of cultural minorities is their unique psychological and cultural asset. Moreover, positive socialisation is found to be related to strong ethnic identity. Based on Phinney’s theory on ethnic identity development and social support theory, this study adopted a strength-based approach conceptualising ethnic identity as the central organising principle that linked perceived social support and mental health among indigenous adults in Taiwan. Aims. Overall aim is to examine the effect of ethnic identity and social support on mental health. Specific aims were to examine : (1) the association between ethnic identity and mental health; (2) the association between perceived social support and mental health ; (3) the indirect effect of ethnic identity linking perceived social support and mental health. Methods. Participants were indigenous adults in Taiwan (n=200; mean age=29.51; Female=31%, Male=61%, Others=8%). A cross-sectional quantitative design was implemented using data collected in the year 2020. Respondent-driven sampling was used. Standardised measurements were: Ethnic Identity Scale(6-item); Social Support Questionnaire-SF(6 items); Patient Health Questionnaire(9-item); and Generalised Anxiety Disorder(7-item). Covariates were age, gender and economic satisfaction. A four-stage structural equation modelling (SEM) with robust maximin likelihood estimation was employed using Mplus8.0. Step 1: A measurement model was built and tested using confirmatory factor analysis (CFA). Step 2: Factor covariates were re-specified as direct effects in the SEM. Covariates were added. The direct effects of (1) ethnic identity and social support on depression and anxiety and (2) social support on ethnic identity were tested. The indirect effect of ethnic identity was examined with the bootstrapping technique. Results. The CFA model showed satisfactory fit statistics: x^2(df)=869.69(608), p<.05; Comparative ft index (CFI)/ Tucker-Lewis fit index (TLI)=0.95/0.94; root mean square error of approximation (RMSEA)=0.05; Standardized Root Mean Squared Residual (SRMR)=0.05. Ethnic identity is represented by two latent factors: ethnic identity-commitment and ethnic identity-exploration. Depression, anxiety and social support are single-factor latent variables. For the SEM, model fit statistics were: x^2(df)=779.26(527), p<.05; CFI/TLI=0.94/0.93; RMSEA=0.05; SRMR=0.05. Ethnic identity-commitment (b=-0.30) and social support (b=-0.33) had direct negative effects on depression, but ethnic identity-exploration did not. Ethnic identity-commitment (b=-0.43) and social support (b=-0.31) had direct negative effects on anxiety, while identity-exploration (b=0.24) demonstrated a positive effect. Social support had direct positive effects on ethnic identity-exploration (b=0.26) and ethnic identity-commitment (b=0.31). Mediation analysis demonstrated the indirect effect of ethnic identity-commitment linking social support and depression (b=0.22). Implications: Results underscore the role of social support in preventing depression via ethnic identity commitment among indigenous adults in Taiwan. Adopting the strength-based approach, mental health practitioners can mobilise indigenous peoples’ commitment to their group to promote their well-being.

Keywords: ethnic identity, indigenous population, mental health, perceived social support

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59 An Exploratory Factor and Cluster Analysis of the Willingness to Pay for Last Mile Delivery

Authors: Maximilian Engelhardt, Stephan Seeck

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The COVID-19 pandemic is accelerating the already growing field of e-commerce. The resulting urban freight transport volume leads to traffic and negative environmental impact. Furthermore, the service level of parcel logistics service provider is lacking far behind the expectations of consumer. These challenges can be solved by radically reorganize the urban last mile distribution structure: parcels could be consolidated in a micro hub within the inner city and delivered within time windows by cargo bike. This approach leads to a significant improvement of consumer satisfaction with their overall delivery experience. However, this approach also leads to significantly increased costs per parcel. While there is a relevant share of online shoppers that are willing to pay for such a delivery service there are no deeper insights about this target group available in the literature. Being aware of the importance of knowing target groups for businesses, the aim of this paper is to elaborate the most important factors that determine the willingness to pay for sustainable and service-oriented parcel delivery (factor analysis) and to derive customer segments (cluster analysis). In order to answer those questions, a data set is analyzed using quantitative methods of multivariate statistics. The data set was generated via an online survey in September and October 2020 within the five largest cities in Germany (n = 1.071). The data set contains socio-demographic, living-related and value-related variables, e.g. age, income, city, living situation and willingness to pay. In a prior work of the author, the data was analyzed applying descriptive and inference statistical methods that only provided limited insights regarding the above-mentioned research questions. The analysis in an exploratory way using factor and cluster analysis promise deeper insights of relevant influencing factors and segments for user behavior of the mentioned parcel delivery concept. The analysis model is built and implemented with help of the statistical software language R. The data analysis is currently performed and will be completed in December 2021. It is expected that the results will show the most relevant factors that are determining user behavior of sustainable and service-oriented parcel deliveries (e.g. age, current service experience, willingness to pay) and give deeper insights in characteristics that describe the segments that are more or less willing to pay for a better parcel delivery service. Based on the expected results, relevant implications and conclusions can be derived for startups that are about to change the way parcels are delivered: more customer-orientated by time window-delivery and parcel consolidation, more environmental-friendly by cargo bike. The results will give detailed insights regarding their target groups of parcel recipients. Further research can be conducted by exploring alternative revenue models (beyond the parcel recipient) that could compensate the additional costs, e.g. online-shops that increase their service-level or municipalities that reduce traffic on their streets.

Keywords: customer segmentation, e-commerce, last mile delivery, parcel service, urban logistics, willingness-to-pay

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58 Exploring the Influence of Maternal Self-Discrepancy on Psychological Well-Being: A Study of Middle-Aged Japanese Mothers

Authors: Chooi Fong Lee

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Maternal psychological well-being has been investigated from various aspects, such as social support, employment status. However, a perspective from self-discrepancy theory has not been employed. Moreover, most were focused on young mothers. Less is understanding the middle-aged mother’s psychological well-being. This research examined the influence of maternal self-discrepancy between actual and ideal self on maternal role achievement, state anxiety, trait anxiety, and subjective well-being among Japanese middle-aged mothers across their employment status. A pilot study with 20 Japanese mother participants (aged 40-55, 9 regular-employed, 8 non-regular-employed, and 3 homemakers) was conducted to assess the viability of survey questionnaires (Maternal Role Achievement Scale, State-Trait Anxiety Inventory, Subjective Well-being Scale, and Self-report questionnaire). The self-report questionnaire prompted participants to list up to 3 ideal selves they aspired to be and rate the extent to which their actual selves deviated from their ideal selves on a 7-point scale (1= not at all; 4 = medium; 7 = extremely). Self-discrepancy scores were calculated by subtracting participants’ degree ratings from a 7-point scale, summing them up, and then dividing the total by 3. The final sample consisted of 241 participants, 97 regular-employed, 87 non-regular employed, and 57 homemaker mothers. We ensured participants were randomly selected to mitigate bias. The results show that regular-employed mothers tend to exhibit lower self-discrepancy scores compared to non-regular employed and homemaker mothers. Moreover, the discrepancy between actual and ideal self negatively correlated with maternal role achievement, state anxiety, and subjective well-being, while positively correlated with trait anxiety. Trait anxiety arises when one feels they did not meet their ideal self, as evidenced by higher levels in homemaker mothers, who experience lower state anxiety. Conversely, regular-employed mothers exhibit higher state anxiety but lower trait anxiety, suggesting satisfaction in their professional pursuits despite balancing work and family responsibilities. Full-time maternal roles contribute to lower state anxiety but higher trait anxiety among homemaker mothers due to a lack of personal identity achievement. Non-regular employed mothers show similarities to homemaker mothers. In self-reports, regular-employed mothers highlight support and devotion to their children’s development, while non-regular-employed mothers seek life fulfillment through part-time work alongside child-rearing duties. Homemaker mothers emphasize qualities like sociability, and communication skills, potentially influencing their self-discrepancy scores. Furthermore, the hierarchical multiple regression analysis revealed that the discrepancy between actual and ideal self significantly predicts subjective well-being. In conclusion, the findings offer valuable insights into the impact of maternal self-discrepancy on psychological well-being among middle-aged Japanese mothers across different employment statuses. Understanding these dynamics becomes crucial as contemporary women increasingly pursue higher education and depart from traditional motherhood norms. Working toward one ideal self might contribute to a mother psychological well-being. Acknowledgment: This project was made possible with funding support from the Japan ICU Foundation.

Keywords: maternal employment, maternal role, self-discrepancy, state-trait anxiety, subjective well-being

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