Search results for: reading support

Authors: Suresh Hettiarachchi, Conrad Wasko, Ashish Sharma

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The ever changing and expanding urban landscape increases the stress on urban systems to support and maintain safe and functional living spaces. Flooding presents one of the more serious threats to this safety, putting a larger number of people in harm’s way in congested urban settings. Climate change is adding to this stress by creating a dichotomy in the urban flood response. On the one hand, climate change is causing storms to intensify, resulting in more destructive, rarer floods, while on the other hand, longer dry periods are decreasing the severity of more frequent, less intense floods. This variability is creating a need to be more agile and innovative in how we design for and manage urban flooding. Here, we argue that to cope with this challenge climate change brings, we need to move towards urban flood management through resilience rather than flood prevention. We also argue that dealing with the larger variation in flood response to climate change means that we need to look at flooding from all aspects rather than the single-dimensional focus of flood depths and extents. In essence, we need to rethink how we manage flooding in the urban space. This change in our thought process and approach to flood management requires a practical way to assess and quantify resilience that is built into the urban landscape so that informed decision-making can support the required changes in planning and infrastructure design. Towards that end, we propose a Simple Urban Flood Resilience Index (SUFRI) based on a robust definition of resilience as a tool to assess flood resilience. The application of a simple resilience index such as the SUFRI can provide a practical tool that considers urban flood management in a multi-dimensional way and can present solutions that were not previously considered. When such an index is grounded on a clear and relevant definition of resilience, it can be a reliable and defensible way to assess and assist the process of adapting to the increasing challenges in urban flood management with climate change.

Keywords: urban flood resilience, climate change, flood management, flood modelling

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Authors: Szu-Mei Hsiao

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Many nurses have concerns about the difficulties of providing spiritual care for ethnic-Chinese patients and family members within their cultural context. This is due to a lack of knowledge and training. Most family caregivers are female. There has been little research exploring the potential impact of Chinese cultural values on the spiritual distress of couple dyadic participants in Taiwan. This study explores the spiritual issues of Taiwanese women coping with their husband’s advanced cancer during palliative care to death. Qualitative multiple case studies were used. Data was collected through participant observation and in-depth face-to-face interviews. Transcribed interview data was analyzed by using qualitative content analysis. Three couples were recruited from a community-based rural hospital in Taiwan where the husbands were hospitalized in a medical ward. Four spiritual distress themes emerged from the analysis: (1) A personal conflict in trying to come to terms with love and forgiveness; the inability to forgive their husband’s mistakes; and, lack of their family’s love and support. (2) A feeling of hopelessness due to advanced cancer, such as a feeling of disappointment in their destiny and karma, including expressing doubt on survival. (3) A feeling of uncertainty in facing death peacefully, such as fear of facing the unknown world; and, (4) A feeling of doubt causing them to question the meaning and values in their lives. This research has shown that caregivers needed family support, friends, social welfare, and the help of their religion to meet their spiritual needs in coping within the final stages of life and death. The findings of this study could assist health professionals to detect the spiritual distress of ethnic-Chinese patients and caregivers in the context of their cultural or religious background as early as possible.

Keywords: advanced cancer, Buddhism, Confucianism, Taoism, qualitative research, spiritual distress

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Authors: Nasreen Abdulmannan

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Fetal abnormalities are categorized as a structural abnormality, non-structural abnormality, or a combination of both. Fetal structural abnormalities (FSA) include, but are not limited, to Down syndrome, congenital diaphragmatic hernia, and cleft lip and palate. These abnormalities can be detected in the first weeks of pregnancy, which is almost around 9 - 20 weeks gestational. Etiological factors for FSA are unknown; however, transmitted genetic risk can be one of these factors. Consanguineous marriage often referred to as inbreeding, represents a significant risk factor for FSA due to the increased likelihood of deleterious genetic traits shared by both biological parents. In a country such as the Kingdom of Saudi Arabia (KSA), consanguineous marriage is high, which creates a significant risk of children being born with congenital abnormalities. Historically, the practice of consanguinity occurred commonly among European royalty. For example, Great Britain’s Queen Victoria married her German first cousin, Prince Albert of Coburg. Although a distant blood relationship, the United Kingdom’s Queen Elizabeth II married her cousin, Prince Philip of Greece and Denmark—both of them direct descendants of Queen Victoria. In Middle Eastern countries, a high incidence of consanguineous unions still exists, including in the KSA. Previous studies indicated that a significant gap exists in understanding the lived experiences of Saudi women dealing with an FSA-complicated pregnancy. Eleven participants were interviewed using a semi-structured interview format for this qualitative phenomenological study investigating the lived experiences of pregnant Saudi women carrying a child with FSA. This study explored the gaps in current literature regarding the lived experiences of pregnant Saudi women whose pregnancies were complicated by FSA. In addition, the researcher acquired knowledge about the available support and resources as well as the Saudi cultural perspective on FSA. This research explored the lived experiences of pregnant Saudi women utilizing Giorgi’s (2009) approach to data collection and data management. Findings for this study cover five major themes: (1) initial maternal reaction to the FSA diagnosis per ultrasound screening; (2) strengthening of the maternal relationship with God; (3) maternal concern for their child’s future; (4) feeling supported by their loved ones; and (5) lack of healthcare provider support and guidance. Future research in the KSA is needed to explore the network support for these mothers. This study recommended further clinical nursing research, nursing education, clinical practice, and healthcare policy/procedures to provide opportunities for improvement in nursing care and increase awareness in KSA society.

Keywords: fetal structural abnormalities, psychological distress, health provider, health care

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Authors: Cherng-Jye Jeng, Ming-Feng Hou, Hsing-Yuan Liu, Chuan-Feng Chang, Lih-Rong Wang, Yen-Chin Lin

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Introduction: The incidence of breast cancer has gradually increased in Taiwan, and the characteristic of younger ages impact these women in their middle age, and may also cause challenges in terms of family, work, and illness. Breasts are symbols of femininity, as well as of sex. For women, breasts are important organs for the female identity and sexual expression. Losing breasts not only affects the female role, but would also affect sexual attraction and sexual desire. Thus, women with breast cancer who have need for mastectomies experience physical incompletion, which affects women’s self-confidence, physical image, and self-orientation. Purposes: 1. To understand the physical experience of women with breast cancer. 2. To explore the issue of sexual issues on the health effects of women with breast cancer. 3. To construct a domestic sex life issue group model for domestic women with breast cancer. 4. To explore the accompaniment experiences and sexual relationship adjustments of spouses when women have breast cancer. Method: After the research plan passes IRB review, participants will be recruited at breast surgery clinic in the affiliated hospital, to screen suitable subjects for entry into the group. Between March and May 2015, two sexual health and sex life consultation groups were conducted, which were (1) 10 in postoperative groups for women with cancer; (2) 4 married couples group for postoperative women with cancer. After sharing experiences and dialogue, women can achieve mutual support and growth. Data organization and analysis underwent descriptive analysis in qualitative research, and the group process was transcribed into transcripts for overall-content and category-content analysis. Results: Ten women with breast cancer believed that participating in group can help them exchange experiences, and elevate sexual health. The main issues include: (1) after breast cancer surgery, patients generally received chemotherapy or estrogen suppressants, causing early menopause; in particular, vaginal dryness can cause pain or bleeding in intercourse, reducing their desire for sexual activity; (2) breast cancer accentuates original spousal or family and friend relationships; some people have support and care from their family, and spouses emphasize health over the appearance of breasts; however, some people do not have acceptance and support from their family, and some even hear spousal sarcasm about loss of breasts; (3) women with breast cancer have polarized expressions of optimism and pessimism in regards to their emotions, beliefs, and body image regarding cancer; this is related to the women’s original personalities, attribution of causes of cancer, and extent of worry about relapse. Conclusion: The research results can be provided as a reference to medical institutions or breast cancer volunteer teams, to pay attention to maintaining the health of women with breast cancer.

Keywords: women with breast cancer, experiences of objectifying the body, quality of sex life, sexual health

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Authors: Chun-Ming Huang, Yi-Jun Liu, Yi-Jie Hsieh, Jin-Ju Chue, Wei-Lin Lai, Chun-Yu Chen, Chih-Chyau Yang, Chien-Ming Wu

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The market of wearable devices has been growing rapidly in two years. The integration of sensors and wearable devices has become the trend of the next technology products. Thus, the academics and industries are eager to cultivate talented persons in sensing technology. Currently, academic and industries have more and more demands on the integrations of versatile sensors and applications, especially for the teams who focus on the development of sensor circuit architectures. These teams tape-out many MEMs sensors chips through the chip fabrication service from National Chip Implementation Center (CIC). However, most of these teams are only able to focus on the circuit design of MEMs sensors; they lack the key support of further system demonstration. This paper follows the CIC’s main mission of promoting the chip/system advanced design technology and aims to establish the environments of the modularized sensing system platform and the system design flow with the measurement and calibration technology. These developed environments are used to support these research teams and help academically advanced sensor designs to perform the system demonstration. Thus, the research groups can promote and transfer their advanced sensor designs to industrial and further derive the industrial economic values. In this paper, the modularized sensing platform is proposed to enable the system demonstration for advanced sensor chip design. The environment of sensor measurement and calibration is established for academic to achieve an accurate sensor result. Two reference sensor designs cooperated with the modularized sensing platform are given to show the sensing system integration and demonstration. These developed environments and platforms are currently provided to academics in Taiwan, and so that the academics can obtain a better environment to perform the system demonstration and improve the research and teaching quality.

Keywords: modularized sensing platform, sensor design and calibration, sensor system, sensor system design flow

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Authors: Melissa Houston

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Political pressures, financial restraints, and recent legislation has led to administrators’ at academic institutions to rely upon online education as a viable means for delivering education to students anytime and anywhere. Administrators at academic institutions have utilized online education as a way to ensure that academic continuity takes place while campuses are physically closed or are recovering from damages during and after disaster. There is a gap in the research as to how to best train faculty for academic continuity during and after disasters occur. The lack of available research regarding how faculty members at academic institutions prepared themselves prior to a disaster served as a major rationale for this study. The problem that was addressed in this phenomenological study was to identify the training needed by faculty to provide academic continuity during and after times of disaster. The purpose of the phenomenological study was to provide further knowledge and understanding of the training needed by faculty to provide academic continuity after a disaster. Data collection from this study will help human resource professionals as well as administrators of academic institutions to better prepare faculty to provide academic continuity in the future. Participants were recruited on LinkedIn and were qualified as having been faculty who taught traditional courses during or after a disaster. Faculty members were asked a series of open-ended questions to gain understanding of their experiences of how they acquired training for themselves for academic continuity during and after a disaster. The findings from this study showed that faculty members identified assistance needed including professional development in the form of training and support, communication, and technological resources in order to provide academic continuity. The first conclusion from this study was that academic institutions need to support their students, staff and faculty with disaster training and the resources needed to provide academic continuity during and after disasters. The second conclusion from this study is that while disasters and other academic institution incidents are occurring more frequently, limited funding and the push for online education has created limited resources for academic institutions. The need to create partnerships and consortiums with other academic institutions and communities is crucial for the success and sustainability of academic institutions. Through these partnerships and consortiums academic institutions can share resources, knowledge, and training.

Keywords: training, faculty, disaster, academic continuity

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Authors: Edward Shizha, Edward Makwarimba

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Newcomer and refugee youth feel excluded in the education system in Canada, and the formal education environment does not fully cater for their learning needs. The objective of this study was to build knowledge and understanding of the educational needs and experiences of these youth in Canada and how available afterschool programs can most effectively support their learning needs and academic outcomes. The Employment and Social Development Canada (ESDC), which funded this research, enables and empowers students to advance their educational experience through targeted investments in services that are delivered by youth-serving organizations outside the formal education system through afterschool initiatives. A literature review and a provincial/territorial internet scan were conducted to determine the availability of services and programs that serve the educational needs and academic outcomes of newcomer youth in 10 provinces and 3 territories in Canada. The goal was to identify intersectional factors (e.g., gender, sexuality, culture, social class, race, etc.) that influence educational outcomes of newcomer/refugee students and to recommend ways the ESDC could complement settlement services to enhance students’ educational success. First, data was collected through a literature search of various databases, including PubMed, Web of Science, Scopus, Google docs, ACADEMIA, and grey literature, including government documents, to inform our analysis. Second, a provincial/territorial internet scan was conducted using a template that was created by ESDC staff with the input of the researchers. The objective of the web-search scan was to identify afterschool programs, projects, and initiatives offered to newcomer/refugee youth by service provider organizations. The method for the scan included both qualitative and quantitative data gathering. Both the literature review and the provincial/territorial scan revealed that there are gender disparities in educational outcomes of newcomer and refugee youth. High school completion rates by gender show that boys are at higher risk of not graduating than girls and that girls are more likely than boys to have at least a high school diploma and more likely to proceed to postsecondary education. Findings from literature reveal that afterschool programs are required for refugee youth who experience mental health challenges and miss out on significant periods of schooling, which affect attendance, participation, and graduation from high school. However, some refugee youth use their resilience and ambition to succeed in their educational outcomes. Another finding showed that some immigrant/refugee students, through ethnic organizations and familial affiliation, maintain aspects of their cultural values, parental expectations and ambitious expectations for their own careers to succeed in both high school and postsecondary education. The study found a significant combination of afterschool programs that include academic support, scholarships, bursaries, homework support, career readiness, internships, mentorship, tutoring, non-clinical counselling, mental health and social well-being support, language skills, volunteering opportunities, community connections, peer networking, culturally relevant services etc. These programs assist newcomer youth to develop self-confidence and prepare for academic success and future career development. The study concluded that advantages of afterschool programs are greatest for youth at risk for poor educational outcomes, such as Latino and Black youth, including 2SLGBTQI+ immigrant youth.

Keywords: afterschool programs, educational outcomes, newcomer youth, refugee youth, youth-serving organizations

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Authors: G. H. B. Dilhari, A. A. D. T. Saparamadu

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The coir is one of the by-products of the coconut and the coir industry can be identified as one of the traditional industries in Sri Lanka. Sri Lanka is one of the prominent countries for the coir production. Due to the labour insensitiveness, the labourers are the significant factor in the coir production process. The study has analyzed the determinants and its impact on income of the household level coir yarn labourers. The study was conducted in the Kumarakanda Grama Niladhari division, Galle, Sri Lanka. Simple random sampling was used to generate the sample of 100 household level coir yarn labourers and structured questionnaire, personal interviews and discussion were performed to gather the required data. The obtained data were statistically analyzed by using Statistical Package for Social Science (SPSS) software. Mann-Whitney U and Kruskal-Wallis test were carried out. The findings revealed that the household level coir yarn industry is dominated by the female workers and fewer amounts of workers have engaged this industry as the main occupation. In addition to that, elderly participation of the industry is greater than younger participation and most of them engaged as an extra income source. Level of education, the methods of engagement, satisfaction, labour’s children employment in the coir industry, support from the government, method of government support, working hours per day, employed as a main job, no of completed units per day, suffering any job related diseases and type of the diseases were related with income level of household level coir yarn labourers. The recommendations were formulated in respect to these problems including technological transformation for coir yarn production, strengthening of the raw material base and regulating the raw material supply, introduction of new technologies, markets and training programs, the establishment of the labourers association, the initiation of micro credit schemes, better consideration about the job oriented diseases.

Keywords: coir, coir yarn labourers, income, Galle

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Authors: Anishur Rahman, Maria Areias, Diogo Simões, Ana Figeuiredo, Filipa Figueiredo, João Nunes

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The circular economy (CE) has gained increased awareness among academics, businesses, and decision-makers as it stimulates resource circularity in the production and consumption systems. A large epistemological study has explored the principles of CE, but scant attention eagerly focused on analysing how CE is evaluated, consented to, and enforced using economic metabolism data and business intelligent framework. Economic metabolism involves the ongoing exchange of materials and energy within and across socio-economic systems and requires the assessment of vast amounts of data to provide quantitative analysis related to effective resource management. Limited concern, the present work has focused on the regional flows pilot region from Portugal. By addressing this gap, this study aims to promote eco-innovation and sustainability in the regions of Intermunicipal Communities Região de Coimbra, Viseu Dão Lafões and Beiras e Serra da Estrela, using this data to find precise synergies in terms of material flows and give companies a competitive advantage in form of valuable waste destinations, access to new resources and new markets, cost reduction and risk sharing benefits. In our work, emphasis on applying artificial intelligence (AI) and, more specifically, on implementing state-of-the-art deep learning algorithms is placed, contributing to construction a business intelligent approach. With the emergence of new approaches generally highlighted under the sub-heading of AI and machine learning (ML), the methods for statistical analysis of complex and uncertain production systems are facing significant changes. Therefore, various definitions of AI and its differences from traditional statistics are presented, and furthermore, ML is introduced to identify its place in data science and the differences in topics such as big data analytics and in production problems that using AI and ML are identified. A lifecycle-based approach is then taken to analyse the use of different methods in each phase to identify the most useful technologies and unifying attributes of AI in manufacturing. Most of macroeconomic metabolisms models are mainly direct to contexts of large metropolis, neglecting rural territories, so within this project, a dynamic decision support model coupled with artificial intelligence tools and information platforms will be developed, focused on the reality of these transition zones between the rural and urban. Thus, a real decision support tool is under development, which will surpass the scientific developments carried out to date and will allow to overcome imitations related to the availability and reliability of data.

Keywords: circular economy, artificial intelligence, economic metabolisms, machine learning

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Authors: Shazia Salam

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This paper focuses on studying the literary reactions of selected Muslim women writers to the event of Partition of India in the north western region. It aims to explore how Muslim women experienced the Partition and how that experience was articulated through their writing. There is a serious dearth of research on the experience of Muslim women who had to witness the momentous event of the subcontinent. Since scholars have often questioned the silence around the historiography related to the experiences of Muslim women, this paper aims to explore if literature could provide insights that may be less readily available in other modes of narration. Using literature as an archival source, it aims to delve into the arenas of history that have been cloistered and closed. Muslim women have been silent about their experiences of Partition which at the cost of essentializing could be attributed to patriarchal constraints, and taboos, on speaking of intimate matters. These silences have consigned the question of their experience to a realm of anonymity. The lack of ethnographic research has in a way been compensated in the realm of literature, mainly poetry and fiction. Besides reportage, literature remains an important source of social history about Partition and how Muslim women lived through it. Where traditional history fails to record moments of rupture and dislocation, literature serves the crucial purpose. The central premise in this paper is that there is a need to revise the history of partition owing to the gaps in historiography. It looks into if literature can serve as a ground for developing new approaches to history since the question of the representation always confronts us--between what a text represents and how it represents it since imagination of the writer plays a great role in the construction of any text. With this approach as an entry point, this paper aims to unpack the questions of representation, the coalescing of history /literature and the gendered nature of partition history. It concludes that the gaps in the narratives of Partition and the memory of Partition can be addressed by way of suing literary as a source to fill in the cracks and fissures.

Keywords: gender, history, literature, partition

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Authors: Dayei Oh, Feeza Vasudeva, Narges Azizi Fard

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Drawing on the Foucauldian conception of episteme, epistemic communities refer to a community in which members share common frames of epistemic reference, delineating the proper construction of social realities for their members. One of the most cited definitions of epistemic communities is a group of professionals possessing acknowledged expertise and proficiency in a specific field, influencing policymaking and governance. More recently, the advancement of the Internet has changed the way society produces, disseminates, and consumes knowledge. Against this backdrop, this literature review explores the ways in which online epistemic communities are studied in communication scholarship between 2002 and 2022. Examining 92 peer-reviewed journal articles from the Web of Science database, three research objectives have been addressed: (1) geographical contexts, platforms, and methods that are studied in communication research, (2) different types of epistemic communities, and (3) prevailing themes and concepts that are related to the research of the chosen epistemic communities. This research demonstrates increasing scholarly attention towards the lay public as prominent online epistemic communities along with more conventional epistemic communities such as academia and journalists, hinting at how the Internet provides epistemic capacities for negotiating the boundaries of epistemic authority and competencies between experts and lay people. Through qualitative reading of these papers, the findings show that communication research tends to approach epistemic communities of the political left and right asymmetrically: The right-wing epistemic communities are studied in connection with mis/disinformation, conspiracy theories, populist rejection of authoritative epistemologies, whereas the left-wing communities are studied as emancipatory epistemic struggles and activism against Western, colonial, white, and male-centric knowledge systems. This points to a grave need for communication and multidisciplinary scholarship to investigate such uncharted characters of right- and left-wing epistemic communities.

Keywords: communication research, internet, knowledge, online epistemic communities

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Authors: Lorenzo Buti

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This paper investigates the nature of democratic action through a critical reading of Claude Lefort’s notion of the democratic ‘regime’. Lefort provides one of the most innovative accounts of the essential features of a democratic regime. According to him, democracy is a political regime that acknowledges the indeterminacy of a society and stages it as a contestation between competing political actors. As such, democracy provides the symbolic markers of society’s openness towards the future. However, despite their democratic features, the recent decades in late capitalist societies attest to a sense of the future becoming fixed and predetermined. This suggests that Lefort’s conception of democracy harbours a misunderstanding of the character and experience of democratic action. This paper examines this underlying tension in Lefort’s work. It claims that Lefort underestimates how a democratic regime, next to its symbolic function, also takes a materially constituted form with its particular dynamics of power relations. Lefort’s systematic dismissal of this material dimension for democratic action can lead to the contemporary paradoxical situation where democracy’s symbolic markers are upheld (free elections, public debate, dynamic between government and opposition in parliament,…) but the room for political decision-making is constrained due to a myriad of material constraints (e.g., market pressures, institutional inertias). The paper draws out the implications for the notion of democratic action. Contra Lefort, it argues that democratic action necessarily targets the material conditions that impede the capacity for decision-making on the basis of equality and liberty. This analysis shapes our understanding of democratic action in two ways. First, democratic action takes an asymmetrical, insurgent form, as a contestation of material power relations from below. Second, it reveals an ambivalent position vis-à-vis the political regime: democratic action is symbolically made possible by the democratic dispositive, but it contests the constituted form that the democratic regime takes.

Keywords: Claude Lefort, democratic action, material constitution, political regime

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Authors: Agnes Anyango Andollo, Jane Achieng Achola

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The use of Information and Communication Technologies (ICTs) has become one of the driving forces in facilitation of learning in most colleges. The ability to effectively harness the technology varies from college to college. The study objective was to determine the lecturers’, institutional attributes and policies that influence the utilization of ICT by the lecturers’. A cross sectional survey design was employed in order to empirically investigate the extent to which lecturers’ personal, institutional attributes and policies influence the utilization of ICT to facilitate learning. The target population of the study was 295 lecturers who facilitate learning at KMTC-Nairobi. Structured self-administered questionnaire was given to the lecturers. Quantitative data was scrutinized for completeness, accuracy and uniformity then coded. Data were analyzed in frequencies and percentages using Statistical Package for Social Sciences (SPSS) version 19, this was a reliable tool for quantitative data analysis. A total of 155 completed questionnaires administered were obtained from the respondents for the study that were subjected to analysis. The study found out that 93 (60%) of the respondents were male while 62 (40%) of the respondents were female. Individual’s educational level, age, gender and educational experience had the greatest impact on use of ICT. Lecturers’ own beliefs, values, ideas and thinking had moderate impact on use of ICT. And that institutional support by provision of resources for ICT related training such as internet, computers, laptops and projectors had moderate impact (p = 0.049) at 5% significant level on use of ICT. The study concluded that institutional attributes and ICT policy were keys to utilization of ICT by lecturers at KMTC Nairobi also mandatory policy on use of ICT by lecturers to facilitate learning was key. It recommended that policies should be put in place for Technical support to lecturers when in problem during utilization of ICT and also a mechanism should be put in place to make the use of ICT in teaching and learning mandatory.

Keywords: policy, computers education, medical training institutions, ICTs

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Authors: M. Caporale

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French Curricula across the US have recently suffered low enrollment and have experienced difficulties with retention, thus resulting in fewer students minoring and majoring in French and enrolling in upper-level classes. Successful undergraduate programs offer French courses with a strong cultural and interdisciplinary or multidisciplinary component. The World Language Curriculum in liberal arts colleges in America needs to take into account the cultural aspects of the language and encourage students to think critically about the country or countries they are studying. Limiting the critical inquiry to language or literature narrowly defined provides and incomplete and stagnant picture of France and the Francophone world in today's global community. This essay discusses the creation and implementation of a hybrid interdisciplinary L1/L2 course titled "Topics in Francophone Cinema" (subtitle "Francophone Women on Screen and Behind the Camera"). Content-based interdisciplinary courses undoubtedly increase the profile of French and Francophone cultural Studies by introducing students of other disciplines to fundamental questions relating to the French and Francophone cultures (in this case, women's rights in the Francophone world). At the same time, this study determines that through targeted reading and writing assignments, sustained aural exposure to L2 through film,and student participation in a one-credit supplementary weekly practicum (creative film writing workshop), significant advances in L2 competence are achieved with students' oral and written production levels evolving from Advanced Low to Advanced-mid, as defined by the ACFL guidelines. Use of differentiated assessment methods for L1/L2 and student learning outcomes for both groups will also be addressed.

Keywords: interdisciplinary, Francophone cultural studies, language competency, content-based

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Authors: Baha Eddine Aissou, Aichouche Belhadj Aissa

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Light detection and ranging (LiDAR) is an active remote sensing technology used for several applications. Airborne LiDAR is becoming an important technology for the acquisition of a highly accurate dense point cloud. A classification of airborne laser scanning (ALS) point cloud is a very important task that still remains a real challenge for many scientists. Support vector machine (SVM) is one of the most used statistical learning algorithms based on kernels. SVM is a non-parametric method, and it is recommended to be used in cases where the data distribution cannot be well modeled by a standard parametric probability density function. Using a kernel, it performs a robust non-linear classification of samples. Often, the data are rarely linearly separable. SVMs are able to map the data into a higher-dimensional space to become linearly separable, which allows performing all the computations in the original space. This is one of the main reasons that SVMs are well suited for high-dimensional classification problems. Only a few training samples, called support vectors, are required. SVM has also shown its potential to cope with uncertainty in data caused by noise and fluctuation, and it is computationally efficient as compared to several other methods. Such properties are particularly suited for remote sensing classification problems and explain their recent adoption. In this poster, the SVM classification of ALS LiDAR data is proposed. Firstly, connected component analysis is applied for clustering the point cloud. Secondly, the resulting clusters are incorporated in the SVM classifier. Radial basic function (RFB) kernel is used due to the few numbers of parameters (C and γ) that needs to be chosen, which decreases the computation time. In order to optimize the classification rates, the parameters selection is explored. It consists to find the parameters (C and γ) leading to the best overall accuracy using grid search and 5-fold cross-validation. The exploited LiDAR point cloud is provided by the German Society for Photogrammetry, Remote Sensing, and Geoinformation. The ALS data used is characterized by a low density (4-6 points/m²) and is covering an urban area located in residential parts of the city Vaihingen in southern Germany. The class ground and three other classes belonging to roof superstructures are considered, i.e., a total of 4 classes. The training and test sets are selected randomly several times. The obtained results demonstrated that a parameters selection can orient the selection in a restricted interval of (C and γ) that can be further explored but does not systematically lead to the optimal rates. The SVM classifier with hyper-parameters is compared with the most used classifiers in literature for LiDAR data, random forest, AdaBoost, and decision tree. The comparison showed the superiority of the SVM classifier using parameters selection for LiDAR data compared to other classifiers.

Keywords: classification, airborne LiDAR, parameters selection, support vector machine

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Authors: Jay Xiong, Li Lin

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This paper introduces a new software engineering paradigm based on complexity science, called NSE (Nonlinear Software Engineering paradigm). The purpose of establishing NSE is to help software development organizations double their productivity, half their cost, and increase the quality of their products in several orders of magnitude simultaneously. NSE complies with the essential principles of complexity science. NSE brings revolutionary changes to almost all aspects in software engineering. NSE has been fully implemented with its support platform Panorama++.

Keywords: complexity science, software development, software engineering, software maintenance

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Authors: Ł. Morawiński, C. Jasiński, M. Jurkiewicz, S. Bou Habib, M. Bondyra

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With the development of optics, electronics, and computers, vision systems are increasingly used in various areas of life, science, and industry. Vision systems have a huge number of applications. They can be used in quality control, object detection, data reading, e.g., QR-code, etc. A large part of them is used for measurement purposes. Some of them make it possible to obtain a 3D reconstruction of the tested objects or measurement areas. 3D reconstruction algorithms are mostly based on creating depth maps from data that can be acquired from active or passive methods. Due to the specific appliance in airfield technology, only passive methods are applicable because of other existing systems working on the site, which can be blinded on most spectral levels. Furthermore, reconstruction is required to work long distances ranging from hundreds of meters to tens of kilometers with low loss of accuracy even with harsh conditions such as fog, rain, or snow. In response to those requirements, HRESS (Heliport REmote Safeguard System) was developed; which main part is a rotational head with a two-camera stereovision rig gathering images around the head in 360 degrees along with stereovision 3D reconstruction and point cloud combination. The sub-pixel analysis introduced in the HRESS system makes it possible to obtain an increased distance measurement resolution and accuracy of about 3% for distances over one kilometer. Ultimately, this leads to more accurate and reliable measurement data in the form of a point cloud. Moreover, the program algorithm introduces operations enabling the filtering of erroneously collected data in the point cloud. All activities from the programming, mechanical and optical side are aimed at obtaining the most accurate 3D reconstruction of the environment in the measurement area.

Keywords: airfield monitoring, artificial intelligence, stereovision, 3D reconstruction

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Authors: Suphap Sikkhaphan, Muwanga Zake, Johnnie Wycliffe Frank

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The purposes of the study included a) investigating the authentic and transformational leadership model of the directors of tambon health promoting hospitals b) evaluating the relation between the authentic and transformation leadership of the directors of tambon health promoting hospitals and the effectiveness of their hospitals and c) assessing the invariance test of the authentic and transformation leadership of the directors of tambon health promoting hospitals. All 400 southern tambon health promoting hospital directors were enrolled into the study. Half were males (200), and another half were females (200). They were sampled via a stratified method. A research tool was a questionnaire paper containing 4 different sections. The Alpha-Cronbach’s Coefficient was equally to .98. Descriptive analysis was used for demographic data, and inferential statistics was used for the relation and invariance tests of authentic and transformational leadership of the directors of tambon health promoting hospitals. The findings revealed overall the authentic and transformation leadership model of the directors of tambon health promoting hospitals has the relation to the effectiveness of the hospitals. Only the factor of “strong community support” was statistically significantly related to the authentic leadership (p < .05). However, there were four latent variables statistically related to the transformational leadership including, competency and work climate, management system, network cooperation, and strong community support (p = .01). Regarding the relation between the authentic and transformation leadership of the directors of tambon health promoting hospitals and the effectiveness of their hospitals, four casual variables of authentic leadership were not related to those latent variables. In contrast, all four latent variables of transformational leadership has statistically significantly related to the effectiveness of tambon health promoting hospitals (p = .001). Furthermore, only management system variable was significantly related to those casual variables of the authentic leadership (p < .05). Regarding the invariance test, the result found no statistical significance of the authentic and transformational leadership model of the directors of tambon health promoting hospitals, especially between male and female genders (p > .05).

Keywords: authentic leadership, transformational leadership, tambon health promoting hospital

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Authors: Sanela Slavkovic, Congor Nad, Spela Golubovic

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Background: The diagnosis of multiple sclerosis (MS) is a major life challenge and has repercussions on all aspects of the daily functioning of those attained by it – personal activities, social participation, and quality of life. Regular follow-up of only the neurological status is not informative enough so that it could provide data on the sort of support and rehabilitation that is required. Objective: The aim of this study was to establish the current level of functioning of persons attained by MS and the factors that influence it. Methods: The study was conducted in Serbia, on a sample of 108 persons with relapse-remitting form of MS, aged 20 to 53 (mean 39.86 years; SD 8.20 years). All participants were fully ambulatory. Methods applied in the study include Expanded Disability Status Scale-EDSS and World Health Organization Disability Assessment Schedule, WHODAS 2.0 (36-item version, self-administered). Results: Participants were found to experience the most problems in the domains of Participation, Mobility, Life activities and Cognition. The least difficulties were found in the domain of Self-care. Symptom duration was the only control variable with a significant partial contribution to the prediction of the WHODAS scale score (β=0.30, p < 0.05). The total EDSS score correlated with the total WHODAS 2.0 score (r=0.34, p=0.00). Statistically significant differences in the domain of EDSS 0-5.5 were found within categories (0-1.5; 2-3.5; 4-5.5). The more pronounced a participant’s EDSS score was, although not indicative of large changes in the neurological status, the more apparent the changes in the functional domain, i.e. in all areas covered by WHODAS 2.0. Pyramidal (β=0.34, p < 0.05) and Bowel and bladder (β=0.24, p < 0.05) functional systems were found to have a significant partial contribution to the prediction of the WHODAS score. Conclusion: Measuring functioning and disability is important in the follow-up of persons suffering from MS in order to plan rehabilitation and define areas in which additional support is needed.

Keywords: disability, functionality, multiple sclerosis, rehabilitation

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Authors: Brian Kwok

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Hong Kong is well-known for its name as "the Pearl of the Orient", due to its spectacular night-view with vast amount of decorative neon lights on the streets. Neon signs are first used as the pervasive media of communication for all kinds of commercial advertising, ranging from movie theatres to nightclubs and department stores, and later appropriated by artists as medium of artwork. As a well-established visual language, it displays texts in bilingual format due to British's colonial influence, which are sometimes arranged in an opposite reading order. Research on neon signs as a visual representation is rare but significant because they are part of people’s collective memories of the unique cityscapes which associate the shifting values of people's daily lives and culture identity. Nevertheless, with the current policy to remove abandoned neon signs, their total number dramatically declines recently. The Buildings Department found an estimation of 120,000 unauthorized signboards (including neon signs) in Hong Kong in 2013, and the removal of such is at a rate of estimated 1,600 per year since 2006. In other words, the vernacular cultural values and historical continuity of neon signs will gradually be vanished if no immediate action is taken in documenting them for the purpose of research and cultural preservation. Therefore, the Hong Kong Neon Signs Archive project was established in June of 2015, and over 100 neon signs are photo-documented so far. By content analysis, this project will explore the two components of neon signs – the use of visual languages and vernacular tacit knowledge of neon makers. It attempts to answer these questions about Hong Kong's neon signs: 'What are the ways in which visual representations are used to produce our cityscapes and streetscapes?'; 'What are the visual languages and conventions of usage in different business types?'; 'What the intact knowledge are applied when producing these visual forms of neon signs?'

Keywords: cityscapes, neon signs, tacit knowledge, visual representation

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Authors: C. Patrascioiu, V. Matei, N. Nicolae

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The paper describes the experiments and the kinetic parameters calculus of the gasoil hydrofining. They are presented experimental results of gasoil hidrofining using Mo and promoted with Ni on aluminum support catalyst. The authors have adapted a kinetic model gasoil hydrofining. Using this proposed kinetic model and the experimental data they have calculated the parameters of the model. The numerical calculus is based on minimizing the difference between the experimental sulf concentration and kinetic model estimation.

Keywords: hydrofining, kinetic, modeling, optimization

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Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Shu-I Chin, Wen-Ju Yang, Wan Ming-Shang, Chien-Ying Wang

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Background: Upon recovery from critical condition, patients are normally transferred from the intensive care units (ICUs) to the general wards. However, transferring patients to a new environment causes stressful experiences for both patients and their families. Therefore, there is a necessity to communicate with the patients and their families to reduce psychological stress and unplanned return. Methods: This study was performed in the general ICUs from January 1, 2021, to December 31, 2021, in Taipei Veteran General Hospital. The patients who were evaluated by doctors and liaison nurses transferred to the general wards were selected as the research objects and ranked by the Critical Care Transition Program (CCTP). The plan was applied to 40 patients in a study group and usual care support for a control group of 40 patients. The psychological condition of patients was evaluated by a migration stress scale and a hospital anxiety and depression scale. In addition, the rate of return to ICU was also measured. Results: A total of 63 patients out of 80 (78.8%) experienced moderate to severe degrees of anxiety, and 42 patients (52.6%) experienced moderate to severe degrees of depression before being transferred. The difference between anxiety and depression changed more after the transfer; moreover, when a transition program was applied, it was lower than without a transition program. The return to ICU rate in the study group was lower than in the usual transition group, with an adjusted odds ratio of 0.21 (95% confidence interval: 0.05-0.888, P=0.034). Conclusion: Our study found that the transfer program could reduce the anxiety and depression of patients and the associated stress on their families during the transition from ICU. Before being transferred out of ICU, the healthcare providers need to assess the needs of patients to set the goals of the care plan and perform patient-centered decision-making with multidisciplinary support.

Keywords: ICU, critical care transition program, healthcare, transition program

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Authors: Abhijit Dasgupta

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This paper explores the everyday lives of the Christians residing in a Bengali Christian neighborhood in Kolkata, termed here as the larger Christian para (para meaning neighborhood in Bengali). Through ethnography and reading of secondary sources, the paper discerns how various Christians across denominations – Protestants, Catholics and Pentecostals implicate the role of bishwas (faith and belief) in their interpersonal neighborhood relations. The paper attempts to capture the role of bishwas in producing, transforming and revising the meaning of 'neighbourhood' and 'neighbours' and puts forward the argument of the neighbourhood as a theological product. By interrogating and interpreting bishwas through everyday theological discussions and reflections, the paper examines and analyses the ways everyday theology becomes an essential source of power and knowledge for the Bengali Christians in reimagining their neighbourhood compared to the nearby Hindu neighbourhoods. Borrowing literature from everyday theology, faith and belief, the paper reads and analyses various interpretations of theological knowledge across denominations to probe the prominence of bishwas within the Christian community and its role in creating a difference in their place of dwelling. The paper argues that the meaning of neighbourhood is revisited through prayers, sermons and biblical verses. At the same time, the divisions and fissures are seen among Protestants and Catholics and also among native Bengali Protestants and non-native Protestant pastors, which informs us about the complexity of theology in constituting everyday life. Thus, the paper addresses theology's role in creating an ethical Christian neighbourhood amidst everyday tensions and hostilities of diverse religious persuasions. At the same time, it looks into the processes through which multiple theological knowledge leads to schism and interdenominational hostilities. By attempting to answer these questions, the paper brings out Christians' negotiation with the neighbourhood.

Keywords: anthropology, bishwas, christianity, neighbourhood, theology

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Authors: Rosemary Saunders, Courtney Glass, Karla Seaman, Karen Gullick, Julie Andrew, Anne Wilkinson, Ashwini Davray

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Current literature demonstrates that most Australians receive end-of-life care in a hospital setting, despite most hoping to die within their own home. The necessity for high quality end-of-life care has been emphasised by the Australian Commission on Safety and Quality in Health Care and the National Safety and Quality in Health Services Standards depict the requirement for comprehensive care at the end of life (Action 5.20), reinforcing the obligation for continual organisational assessment to determine if these standards are suitably achieved. Limited research exploring clinical staff perspectives of end-of-life care delivery has been conducted within an Australian private health context. This study aimed to investigate clinical staff member perceptions of end-of-life care delivery at a private hospital in Western Australia. The study comprised of a multi-faceted mixed-methods methodology, part of a larger study. Data was obtained from clinical staff utilising surveys and focus groups. A total of 133 questionnaires were completed by clinical staff, including registered nurses (61.4%), enrolled nurses (22.7%), allied health professionals (9.9%), non-palliative care consultants (3.8%) and junior doctors (2.2%). A total of 14.7% of respondents were palliative care ward staff members. Additionally, seven staff focus groups were conducted with physicians (n=3), nurses (n=26) and allied health professionals including social workers (n=1), dietitians (n=2), physiotherapists (n=5) and speech pathologists (n=3). Key findings from the surveys highlighted that the majority of staff agreed it was part of their role to talk to doctors about the care of patients who they thought may be dying, and recognised the importance of communication, appropriate training and support for clinical staff to provide quality end-of-life care. Thematic analysis of the qualitative data generated three key themes: creating the setting which highlighted the importance of adequate resourcing and conducive physical environments for end-of-life care and to support staff and families; planning and care delivery which emphasised the necessity for collaboration between staff, families and patients to develop care plans and treatment directives; and collaborating in end-of-life care, with effective communication and teamwork leading to achievable care delivery expectations. These findings contribute to health professionals better understanding of end-of-life care provision and the importance of collaborating with patients and families in care delivery. It is crucial that health care providers implement strategies to overcome gaps in care, so quality end-of-life care is provided. Findings from this study have been translated into practice, with the development and implementation of resources, training opportunities, support networks and guidelines for the delivery of quality end-of-life care.

Keywords: clinical staff, end-of-life care, mixed-methods, private hospital.

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Authors: Yvonne A. Unrau

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Social work education is a competency-based curriculum that relies mostly on cognitive frameworks and problem-solving models. Absent from the curriculum is knowledge and skills that draw from an embodiment perspective, especially somatic practice methods. Embodiment broadly encompasses the understanding that biological, political, historical, and social factors impact human development via changes to the nervous system. In the past 20 years, research has well-established that unresolved traumatic events, especially during childhood, negatively impacts long-term health and well-being. Furthermore, traumatic stress compromises cognitive processing and activates reflexive action such as ‘fight’ or ‘flight,’ which are the focus of somatic methods. The main objective of this paper is to show how embodiment perspectives and somatic methods can enhance social work practice overall. Using an exploratory approach, the author shares a decade-long journey that involved creating an education-support program for college students who exited the state foster care system. Personal experience, program outcomes and case study narratives revealed that ‘classical’ social work methods were insufficient to fully address the complex needs of college students who were living with complex traumatic stressors. The paper chronicles select case study scenarios and key program development milestones over a 10-year period to show the benefit of incorporating embodiment perspectives in social work practice. The lessons reveal that there is an immediate need for social work curriculum to include embodiment perspectives so that social workers may be equipped to respond competently to their many clients who live with unresolved trauma.

Keywords: social work practice, social work curriculum, embodiment, traumatic stress

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Authors: Sylvia Huang

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Contemporary Buddhist music has been emerged at the new forms of large-scale public Buddhist ritual ceremonies that may involve up to 10,000 participants at a time. Since 2007, the Buddha’s Birthday ceremony (Sanskrit, Vesak) by the Buddhist Tzu Chi Foundation has being held at major cities in Taiwan and many affiliated Tzu Chi offices around the world. Analysis of this modern and technologically-dependent ceremony sheds new light on the significance of music in contemporary Buddhist ritual, and also on recently enhanced and increasingly intimate connections between music and Buddhism. Through extensive ethnographic research of ten years (2007-2017), the research explores how the form of contemporary Buddhist music relates to the role of music in participants’ experience of the ritual and the way in which they construct meaning. The theoretical approach draws on both ethnomusicology and Buddhist teachings, Dharma. As soundscape is defined as the entire sonic energy produced by a landscape, the concept of soundscape is utilised to examine the contemporary ritual music in the Tzu Chi Vesak ceremony. The analysis opens new territory in exploring how analysis of Buddhist music can benefit from incorporating Buddhist philosophy within the methodological approach. Main findings are: 1) music becomes a method for Buddhist understanding through a focus in particular on how the ceremonial program is followed by music, and 2) participants engage with each other and entrain with music in the Vesak ceremony. As Buddhist sounding, such as scripture reading, liturgical chanting, and ceremonial music singing, is a sonic epistemological knowing of the conditions in which Buddhism is practiced, experienced, and transmigrated, the research concludes by showing that studies of Buddhist music have the potential to reveal distinctively Buddhist concepts, meaning, and values. Certain principles of Buddhist philosophy are adopted within ethnomusicological analysis to further enhance understandings of the crucial function of music within such a ritual context. Finally, the contemporary Buddhist music performance in the ceremony is possessed as a means of direct access to the spiritual experience in Buddhism.

Keywords: buddhist music, Taiwan, soundscape, Vesak ceremony

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Authors: Ramuel Spirituel Mattathiah A. San Juan, Neil Ambasing

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Background: Reversal of vision metamorphopsia is a transient form of metamorphopsia described as an upside-down alteration of the visual field in the coronal plane. Patients would describe objects, such as cups, upside down, but the tea would not spill, and people would walk on their heads. It is extremely rare as a stable finding, lasting days or weeks. We report a case wherein this type of metamorphopsia occurred only in written words and lasted for six months. Objective: To the best of our knowledge, we report the first rare occurrence of reversal of vision metamorphopsia described as inverted words as the sole initial presentation of an underlying stroke. Case Presentation: We report a 59-year-old male with poorly controlled hypertension and diabetes mellitus who presented with a 3-day history of difficulty reading, described as the words were turned upside down as if the words were inverted horizontally then with the progression of deficits such as right homonymous hemianopia and achromatopsia, prosopagnosia. Cranial magnetic resonance imaging (MRI) revealed an acute infarct on the left posterior cerebral artery territory. Follow-up after six months revealed improvement of the visual field cut but with the persistence of the higher cortical function deficits. Conclusion: We report the first rare occurrence of metamorphopsia described as purely inverted words as the sole initial presentation of an underlying stroke. The differential diagnoses of a patient presenting with text reversal metamorphopsia should include stroke in the occipitotemporal areas. It further expands the landscape of metamorphopsias due to its exclusivity to written words and prolonged duration. Knowing these clinical features will help identify the lesion locus and improve subsequent stroke care, especially in time-bound management like intravenous thrombolysis.

Keywords: rare presentation, text reversal metamorphopsia, ischemic stroke, stroke

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Authors: William Gallagher, Harriet Bothwell, Lowri Evans, Kevin Jones

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Background: Worldwide, a third of adult deaths are caused by cardiovascular disease, a high proportion occurring in the developing world. Contributing to these poor outcomes are suboptimal assessments, treatments and monitoring of the acutely unwell patient. Successful training in trauma and neonates is recognised in the developing world but there is little literature supporting adult resuscitation. As far as the authors are aware no literature has been published on resuscitation training in Uganda since 2000 when a resuscitation training officer ran sessions in neonatal and paediatric resuscitation. The aim of this project was to offer training in Basic Life Support ( BLS) to staff and healthcare students based at Villa Maria Hospital in the Kalungu District, Central Uganda. This project was undertaken as a student selected component (SSC) offered by Swindon Academy, based at the Great Western Hospital, to medical students in their fourth year of the undergraduate programme. Methods: Semi-structured, informal interviews and focus groups were conducted with different clinicians in the hospital. These interviews were designed to focus on the level of training and understanding of BLS. A training session was devised which focused on BLS (excluding the use of an automatic external defribrillator) involving pre and post-training questionnaires and clinical assessments. Three training sessions were run for different cohorts: a pilot session for 5 Ugandan medical students, a second session for a group of 8 nursing and midwifery students and finally, a third was devised for physicians. The data collected was analysed in excel. Paired T-Tests determined statistical significance between pre and post-test scores and confidence before and after the sessions. Average clinical skill assessment scores were converted to percentages based on the area of BLS being assessed. Results: 27 participants were included in the analysis. 14 received ‘small group training’ whilst 13 received’ large group training’ 88% of all participants had received some form of resuscitation training. Of these, 46% had received theory training, 27% practical training and only 15% received both. 12% had received no training. On average, all participants demonstrated a significant increase of 5.3 in self-assessed confidence (p <0.05). On average, all participants thought the session was very useful. Analysis of qualitative date from clinician interviews in ongoing but identified themes identified include rescue breaths being considered the most important aspect resuscitation and doubts of a ‘good’ outcome from resuscitation. Conclusions: The results of this small study reflect the need for regular formal training in BLS in low resource settings. The active engagement and positive opinions concerning the utility of the training are promising as well as the evidence of improvement in knowledge.

Keywords: basic life support, education, resuscitation, sub-Saharan Africa, training, Uganda

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Authors: M. Hirani, M. Devine, O. Obisesan, C. Bryant

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Introduction: The use of four or more implants to support a fixed prosthesis in the edentulous mandible is well documented, with high levels of clinical outcomes recorded. Despite this, the use of three implant-supported fixed prostheses offers the potential to deliver a more cost-effective method of oral rehabilitation in the lower arch, an important consideration given that edentulism is most prevalent in low-income subpopulations. The purpose of this study aimed to evaluate the implant and prosthetic survival rate, changes in marginal bone level, and patient satisfaction associated with a three-implant-supported fixed prosthesis for rehabilitation of the edentulous mandible over a follow-up period of at least one year. Methods: A comprehensive literature search was performed to evaluate studies that met the selection criteria. The information extracted included the study design and population, participant demographics, observation period, loading protocol, and the number of implants placed together with the required outcome measures. Mean values and standard deviations (SD) were calculated using SPSS® (IBM Corporation, New York, USA), and the level of statistical significance across all comparative studies described was set at P < 0.05. Results: The eligible studies included a total of 1968 implants that were placed in 652 patients. The subjects ranged in age from 33-89 years, with a mean of 63.2 years. The mean cumulative implant and prosthetic survival rates were 95.5% and 96.2%, respectively, over a mean follow-up period of 3.25 years. The mean marginal bone loss recorded was 1.04 mm, and high patient satisfaction rates were reported across the studies. Conclusion: Current evidence suggests that a three implant-supported fixed prosthesis for the edentulous mandible is a successful treatment strategy presenting high implant and prosthetic survival rates over the short-to-medium term. Further well-designed controlled clinical trials are required to evaluate longer-term outcomes, with supplemental data correlating implant dimensions and prosthetic design.

Keywords: implants, mandible, fixed, prosthesis

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Authors: F. Christie, M. Staber

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Malnutrition is a predictor of poor clinical outcome in the elderly. Up to 60% of hip fracture patients are clinically malnourished on admission. This study assessed the perioperative nutritional state of patients admitted with a proximal femoral fracture and examined if adequate nutritional support was achieved. Methods: Prospective, the observational audit of 30 patients, admitted with a proximal femoral fracture, over a one-month period. We recorded: patient demographics; surgical delay; nutritional state on admission; documentation of Malnutrition Universal Screening Tool (MUST) score; dietician input and daily calorie intake through food charts. The nutritional state was re-assessed weekly and at discharge. The outcome was measured by the length of hospital stay and thirty-day mortality. Results: Mean age 87, M:F 1:2 and all patients were ASA three or four. Five patients (17%) had a prolonged ( >24 hours) fasting period. All patients had a MUST score completed on admission, 27% were underweight and 30% were high risk for malnutrition. Twenty-six patients (87%) were appropriately assessed for dietician referral. Thirteen patients had food charts; on average, hospital meals provided 1500kcal daily. No patient achieved > 75% of the provided calories with 69% of patients achieving 50% or less. Only three patients were started on nutritional supplements. Twenty-three patients (77%) lost weight, averaging 6% weight loss during admission. Mean length of stay (LOS) was 23 days and 30-day mortality 9%. Four patients (13%) gained weight, their mean LOS was 17 days and 30-day mortality 0%. Discussion: Malnutrition in the elderly originates in the community. Following major trauma it’s difficult to reverse nutritional deficits in hospitals. It’s therefore concerning that no high-risk patient achieved their recommended calorie intake. Perioperative optimisation needs to include early nutritional intervention, early anaesthetic review and adjusted anaesthetic techniques to support feeding.

Keywords: trauma, nutrition, neck of femur fracture

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