Search results for: cognitive burden
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2648

Search results for: cognitive burden

608 Continuity of Place-Identity: Identifying Regional Components of Kerala Architecture through 1805-1950

Authors: Manoj K. Kumar, Deepthi Bathala

Abstract:

Man has the need to know and feel as a part of the historical continuum and it is this continuum that reinforces his identity. Architecture and the built environment contribute to this identity as established by the various identity theories exploring the relationship between the two. Architecture which is organic has been successful in maintaining a continuum of identity until the advent of globalization when the world saw a drastic shift to architecture of ‘placelessness’. The answer to the perfect synthesis of ‘universalization’ and ‘regionalism’ is an ongoing quest. However, history has established a smooth transition from vernacular to colonial to modern unlike the architecture of today. The traditional Kerala architecture has evolved from the tropical climate, geography, local needs, materials, skills and foreign influences. It is unique in contrast to the architecture of the neighboring states as a result of the geographical barriers however influenced by the architecture of the Orient due to trade relations. Through 1805 to 1950, the European influence on the architecture of Kerala resulted in the emergence of the colonial style which managed to establish a continuum of the traditional architecture. The paper focuses on the identification of the components of architecture that established the continuity of place-identity in the architecture of Kerala and examines the transition from the traditional Kerala architecture to colonial architecture during the colonial period. Visual surveys based on the principles of urban design, cognitive mapping, typology analysis followed by the strong understanding of the morphological and built environment along with the matrix method are the research tools used. The understanding of these components of continuity can be useful in creating buildings which people can relate to in the present day. South-Asia shares the history of colonialism and the understanding of these components can pave the way for further research on how to establish a regional identity in the era of globalization.

Keywords: colonial, identity, place, regional

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607 The Effects of Traditional Thai Massage Technique Delivered by Parents on Stereotypical Behaviors in Children with Autism: A Pilot Study

Authors: Chanada Aonsri, Wichai Eungpinichpong

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Stereotypical behavior is one of the learning and social skills development problems that affect children with autism. Previous studies found that traditional Thai massage (TTM) could reduce stereotypical behaviors in autistic children. However, the effects of TTM delivered by the parents of autistic children have not been explored. This pilot study investigated the effects of TTM by parents on stereotypical behaviors in children with autism. A one-group pretest-posttest design was applied for 15 children, aged 4-16 years, with their parents' permissions. They participated in the study at the Special Education program of the Special Education Center of Khon Kaen University, Thailand. After being trained in a specialized TTM for children, the parents delivered 50-minute TTM to children once a day, twice a week for eight weeks. The severity of autism and autistic behaviors were measured using the Childhood Autism Rating Scale (CARS), and the Autism Treatment Evaluation Checklist (ATEC), respectively. The functions of autonomic nervous systems were measured using Heart Rate Variability (HRV) to indicated physical and mental disorders such as stress. The data at baseline and the 8th week were analyzed using either an independent t-test or Wilcoxon signed-rank test. The study found that 16 sessions of TTM significantly improved measured data for autism in all children including the CARS (p<0.001), ATEC, speech/language/communication (p<0.001), sociability (p<0.001), sensory/cognitive awareness (p<0.001), health/physical/behavior (p < 0.001), and HRV (p<0.001). The results indicated that TTM performed by parents could be useful as an adjunct therapy for autistic children as it can reduce stereotypical behaviors and stress.

Keywords: traditional Thai massage, stereotypical behaviors, Autistic children, parent

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606 Healthcare Utilization and Costs of Specific Obesity Related Health Conditions in Alberta, Canada

Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

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Obesity-related health conditions impose a substantial economic burden on payers due to increased healthcare use. Estimates of healthcare resource use and costs associated with obesity-related comorbidities are needed to inform policies and interventions targeting these conditions. Methods: Adults living with obesity were identified (a procedure-related body mass index code for class 2/3 obesity between 2012 and 2019 in Alberta, Canada; excluding those with bariatric surgery), and outcomes were compared over 1-year (2019/2020) between those who had and did not have specific obesity-related comorbidities. The probability of using a healthcare service (based on the odds ratio of a zero [OR-zero] cost) was compared; 95% confidence intervals (CI) were reported. Logistic regression and a generalized linear model with log link and gamma distribution were used for total healthcare cost comparisons ($CDN); cost ratios and estimated cost differences (95% CI) were reported. Potential socio-demographic and clinical confounders were adjusted for, and incremental cost differences were representative of a referent case. Results: A total of 220,190 adults living with obesity were included; 44% had hypertension, 25% had osteoarthritis, 24% had type-2 diabetes, 17% had cardiovascular disease, 12% had insulin resistance, 9% had chronic back pain, and 4% of females had polycystic ovarian syndrome (PCOS). The probability of hospitalization, ED visit, and ambulatory care was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (hospitalization: 1.8-times [OR-zero: 0.57 [0.55/0.59]] / ED visit: 1.9-times [OR-zero: 0.54 [0.53/0.56]] / ambulatory care visit: 2.4-times [OR-zero: 0.41 [0.40/0.43]]), cardiovascular disease (2.7-times [OR-zero: 0.37 [0.36/0.38]] / 1.9-times [OR-zero: 0.52 [0.51/0.53]] / 2.8-times [OR-zero: 0.36 [0.35/0.36]]), osteoarthritis (2.0-times [OR-zero: 0.51 [0.50/0.53]] / 1.4-times [OR-zero: 0.74 [0.73/0.76]] / 2.5-times [OR-zero: 0.40 [0.40/0.41]]), type-2 diabetes (1.9-times [OR-zero: 0.54 [0.52/0.55]] / 1.4-times [OR-zero: 0.72 [0.70/0.73]] / 2.1-times [OR-zero: 0.47 [0.46/0.47]]), hypertension (1.8-times [OR-zero: 0.56 [0.54/0.57]] / 1.3-times [OR-zero: 0.79 [0.77/0.80]] / 2.2-times [OR-zero: 0.46 [0.45/0.47]]), PCOS (not significant / 1.2-times [OR-zero: 0.83 [0.79/0.88]] / not significant), and insulin resistance (1.1-times [OR-zero: 0.88 [0.84/0.91]] / 1.1-times [OR-zero: 0.92 [0.89/0.94]] / 1.8-times [OR-zero: 0.56 [0.54/0.57]]). After fully adjusting for potential confounders, the total healthcare cost ratio was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (1.54-times [1.51/1.56]), cardiovascular disease (1.45-times [1.43/1.47]), osteoarthritis (1.36-times [1.35/1.38]), type-2 diabetes (1.30-times [1.28/1.31]), hypertension (1.27-times [1.26/1.28]), PCOS (1.08-times [1.05/1.11]), and insulin resistance (1.03-times [1.01/1.04]). Conclusions: Adults with obesity who have specific disease-related health conditions have a higher probability of healthcare use and incur greater costs than those without specific comorbidities; incremental costs are larger when other obesity-related health conditions are not adjusted for. In a specific referent case, hypertension was costliest (44% had this condition with an additional annual cost of $715 [$678/$753]). If these findings hold for the Canadian population, hypertension in persons with obesity represents an estimated additional annual healthcare cost of $2.5 billion among adults living with obesity (based on an adult obesity rate of 26%). Results of this study can inform decision making on investment in interventions that are effective in treating obesity and its complications.

Keywords: administrative data, healthcare cost, obesity-related comorbidities, real world evidence

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605 Prevention of Corruption in Public Purchases

Authors: Anatoly Krivinsh

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The results of dissertation research "Preventing and combating corruption in public procurement" are presented in this publication. The study was conducted 2011 till 2013 in a Member State of the European Union, in the Republic of Latvia. Goal of the thesis is to explore corruption prevention and combating issues in public procurement sphere, to identify the prevalence rates, determinants and contributing factors and prevention opportunities in Latvia. In the first chapter the author analyses theoretical aspects of understanding corruption in public procurement, with particular emphasis on corruption definition problem, its nature, causes and consequences. A separate section is dedicated to the public procurement concept, mechanism and legal framework. In the first part of this work the author presents cognitive methodology of corruption in public procurement field, based on which the author has carried out an analysis of corruption situation in public procurement in Republic of Latvia. In the second chapter of the thesis, the author analyzes the problem of corruption in public procurement, including its historical aspects, typology and classification of corruption subjects involved, corruption risk elements in public procurement and their identification. During the development of the second chapter author's practical experience in public procurements was widely used. The third and fourth chapter deals with issues related to the prevention and combating corruption in public procurement, namely the operation of the concept, principles, methods and techniques, subjects in Republic of Latvia, as well as an analysis of foreign experience in preventing and combating corruption. The fifth chapter is devoted to the corruption prevention and combating perspectives and their assessment. In this chapter the author has made the evaluation of corruption prevention and combating measures efficiency in Republic of Latvia, assessment of anti-corruption legislation development stage in public procurement field in Latvia.

Keywords: prevention of corruption, public purchases, good governance, human rights

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604 Influence of Travel Time Reliability on Elderly Drivers Crash Severity

Authors: Ren Moses, Emmanuel Kidando, Eren Ozguven, Yassir Abdelrazig

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Although older drivers (defined as those of age 65 and above) are less involved with speeding, alcohol use as well as night driving, they are more vulnerable to severe crashes. The major contributing factors for severe crashes include frailty and medical complications. Several studies have evaluated the contributing factors on severity of crashes. However, few studies have established the impact of travel time reliability (TTR) on road safety. In particular, the impact of TTR on senior adults who face several challenges including hearing difficulties, decreasing of the processing skills and cognitive problems in driving is not well established. Therefore, this study focuses on determining possible impacts of TTR on the traffic safety with focus on elderly drivers. Historical travel speed data from freeway links in the study area were used to calculate travel time and the associated TTR metrics that is, planning time index, the buffer index, the standard deviation of the travel time and the probability of congestion. Four-year information on crashes occurring on these freeway links was acquired. The binary logit model estimated using the Markov Chain Monte Carlo (MCMC) sampling technique was used to evaluate variables that could be influencing elderly crash severity. Preliminary results of the analysis suggest that TTR is statistically significant in affecting the severity of a crash involving an elderly driver. The result suggests that one unit increase in the probability of congestion reduces the likelihood of the elderly severe crash by nearly 22%. These findings will enhance the understanding of TTR and its impact on the elderly crash severity.

Keywords: highway safety, travel time reliability, elderly drivers, traffic modeling

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603 Insulin Resistance in Early Postmenopausal Women Can Be Attenuated by Regular Practice of 12 Weeks of Yoga Therapy

Authors: Praveena Sinha

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Context: Diabetes is a global public health burden, particularly affecting postmenopausal women. Insulin resistance (IR) is prevalent in this population, and it is associated with an increased risk of developing type 2 diabetes. Yoga therapy is gaining attention as a complementary intervention for diabetes due to its potential to address stress psychophysiology. This study focuses on the efficacy of a 12-week yoga practice in attenuating insulin resistance in early postmenopausal women. Research Aim: The aim of this research is to investigate the effect of a 3-month long yoga practice on insulin resistance in early postmenopausal women. Methodology: The study conducted a prospective longitudinal design with 67 women within five years of menopause. Participants were divided into two groups based on their willingness to join yoga. The Yoga group (n = 37) received routine gynecological management along with an integrated yoga module, while the Non-Yoga group (n = 30) received only routine management. Insulin resistance was measured using the homeostasis model assessment of insulin resistance (HOMA-IR) method before and after the intervention. Statistical analysis was performed using GraphPad Prism Version 5 software, with statistical significance set at P < 0.05. Findings: The results indicate a significant decrease in serum fasting insulin levels and HOMA-IR measurements in the Yoga group, although the decrease did not reach statistical significance. In contrast, the Non-Yoga group showed a significant rise in serum fasting insulin levels and HOMA-IR measurements after 3 months, suggesting a detrimental effect on insulin resistance in these postmenopausal women. Theoretical Importance: This study provides evidence that a 12-week yoga practice can attenuate the increase in insulin resistance in early postmenopausal women. It highlights the potential of yoga as a preventive measure against the early onset of insulin resistance and the development of type 2 diabetes mellitus. Regular yoga practice can be a valuable tool in addressing hormonal imbalances associated with early postmenopause, leading to a decrease in morbidity and mortality related to insulin resistance and type 2 diabetes mellitus in this population. Data Collection and Analysis Procedures: Data collection involved measuring serum fasting insulin levels and calculating HOMA-IR. Statistical analysis was performed using GraphPad Prism Version 5 software, and mean values with standard error of the mean were reported. The significance level was set at P < 0.05. Question Addressed: The study aimed to address whether a 3-month long yoga practice could attenuate insulin resistance in early postmenopausal women. Conclusion: The research findings support the efficacy of a 12-week yoga practice in attenuating insulin resistance in early postmenopausal women. Regular yoga practice has the potential to prevent the early onset of insulin resistance and the development of type 2 diabetes mellitus in this population. By addressing the hormonal imbalances associated with early post menopause, yoga could significantly decrease morbidity and mortality related to insulin resistance and type 2 diabetes mellitus in these subjects.

Keywords: post menopause, insulin resistance, HOMA-IR, yoga, type 2 diabetes mellitus

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602 Efficacy of Clickers in L2 Interaction

Authors: Ryoo Hye Jin Agnes

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This study aims to investigate the efficacy of clickers in fostering L2 class interaction. In an L2 classroom, active learner-to-learner interactions and learner-to-teacher interactions play an important role in language acquisition. In light of this, introducing learning tools that promote such interactions would benefit L2 classroom by fostering interaction. This is because the anonymity of clickers allows learners to express their needs without the social risks associated with speaking up in the class. clickers therefore efficiently help learners express their level of understanding during the process of learning itself. This allows for an evaluative feedback loop where both learners and teachers understand the level of progress of the learners, better enabling classrooms to adapt to the learners’ needs. Eventually this tool promotes participation from learners. This, in turn, is believed to be effective in fostering classroom interaction, allowing learning to take place in a more comfortable yet vibrant way. This study is finalized by presenting the result of an experiment conducted to verify the effectiveness of this approach when teaching pragmatic aspect of Korean expressions with similar semantic functions. The learning achievement of learners in the experimental group was found higher than the learners’ in a control group. A survey was distributed to the learners, questioning them regarding the efficacy of clickers, and how it contributed to their learning in areas such as motivation, self-assessment, increasing participation, as well as giving feedback to teachers. Analyzing the data collected from the questionnaire given to the learners, the study presented data suggesting that this approach increased the scope of interactivity in the classroom, thus not only increasing participation but enhancing the type of classroom participation among learners. This participation in turn led to a marked improvement in their communicative abilities.

Keywords: second language acquisition, interaction, clickers, learner response system, output from learners, learner’s cognitive process

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601 Knowledge, Attitude and Beliefs Towards Polypharmacy Amongst Older People Attending Family Medicine Clinic at the Aga Khan University Hospital, Nairobi, Kenya (AKUHN) Sub-Saharan Africa-Qualitative Study

Authors: Maureen Kamau, Gulnaz Mohamoud, Adelaide Lusambili, Njeri Nyanja

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Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. These multiple chronic conditions are managed with polypharmacy. Polypharmacy has numerous adverse effects including non-adherence, poor compliance to the various medications, reduced appetite, and risk of fall. Studies on polypharmacy and ageing are few and poorly understood especially in low and middle - income countries. The aim of this study was to explore the knowledge, attitudes and beliefs of older people towards polypharmacy. A qualitative study of 15 patients aged 60 years and above, taking more than five medications per day were conducted at the Aga Khan University using Semi-structured in-depth interviews. Three interviews were pilot interviews, and data analysis was performed on 12 interviews. Data were analyzed using NVIVO 12 software. A thematic qualitative analysis was carried out guided by Braun and Clarke (2006) framework. Themes identified; - knowledge of their co-morbidities and of the medication that older persons take, sources of information about medicines, and storage of the medication, experiences and attitudes of older patients towards polypharmacy both positive and negative, older peoples beliefs and their coping mechanisms with polypharmacy. The study participants had good knowledge on their multiple co-morbidities, and on the medication they took. The patients had positive attitudes towards medication as it enhanced their health and well-being, and enabled them to perform their activities of daily living. There was a strong belief among older patients that the medications were necessary for their health. All these factors enhanced compliance to the multiple medication. However, some older patients had negative attitudes due to the pill burden, side effects of the medication, and stigma associated with being ill. Cost of healthcare was a concern, with most of the patients interviewed relying on insurance to cover the cost of their medication. Older patients had accepted that the medication they were prescribed were necessary for their health, as it enabled them to complete their activities of daily living. Some concerns about the side effects of the medication arose, and brought about the need for patient education that would ensure that the patients are aware of the medications they take, and potential side effects. The effect that the COVID 19 pandemic had in the healthcare of the older patients was evident by the number of the older patients avoided coming to the hospital during the period of the pandemic. The relationship with the primary care physician and the older patients is an important one, especially in LMICs such as Kenya, as many of the older patients trusted the doctors wholeheartedly to make the best decision about their health and about their medication. Prescription review is important to avoid the use of potentially inappropriate medication.

Keywords: polypharmacy, older patients, multiple chronic conditions, Kenya, Africa, qualitative study, indepth interviews, primary care

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600 Memory Based Reinforcement Learning with Transformers for Long Horizon Timescales and Continuous Action Spaces

Authors: Shweta Singh, Sudaman Katti

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The most well-known sequence models make use of complex recurrent neural networks in an encoder-decoder configuration. The model used in this research makes use of a transformer, which is based purely on a self-attention mechanism, without relying on recurrence at all. More specifically, encoders and decoders which make use of self-attention and operate based on a memory, are used. In this research work, results for various 3D visual and non-visual reinforcement learning tasks designed in Unity software were obtained. Convolutional neural networks, more specifically, nature CNN architecture, are used for input processing in visual tasks, and comparison with standard long short-term memory (LSTM) architecture is performed for both visual tasks based on CNNs and non-visual tasks based on coordinate inputs. This research work combines the transformer architecture with the proximal policy optimization technique used popularly in reinforcement learning for stability and better policy updates while training, especially for continuous action spaces, which are used in this research work. Certain tasks in this paper are long horizon tasks that carry on for a longer duration and require extensive use of memory-based functionalities like storage of experiences and choosing appropriate actions based on recall. The transformer, which makes use of memory and self-attention mechanism in an encoder-decoder configuration proved to have better performance when compared to LSTM in terms of exploration and rewards achieved. Such memory based architectures can be used extensively in the field of cognitive robotics and reinforcement learning.

Keywords: convolutional neural networks, reinforcement learning, self-attention, transformers, unity

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599 Weakly Solving Kalah Game Using Artificial Intelligence and Game Theory

Authors: Hiba El Assibi

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This study aims to weakly solve Kalah, a two-player board game, by developing a start-to-finish winning strategy using an optimized Minimax algorithm with Alpha-Beta Pruning. In weakly solving Kalah, our focus is on creating an optimal strategy from the game's beginning rather than analyzing every possible position. The project will explore additional enhancements like symmetry checking and code optimizations to speed up the decision-making process. This approach is expected to give insights into efficient strategy formulation in board games and potentially help create games with a fair distribution of outcomes. Furthermore, this research provides a unique perspective on human versus Artificial Intelligence decision-making in strategic games. By comparing the AI-generated optimal moves with human choices, we can explore how seemingly advantageous moves can, in the long run, be harmful, thereby offering a deeper understanding of strategic thinking and foresight in games. Moreover, this paper discusses the evaluation of our strategy against existing methods, providing insights on performance and computational efficiency. We also discuss the scalability of our approach to the game, considering different board sizes (number of pits and stones) and rules (different variations) and studying how that affects performance and complexity. The findings have potential implications for the development of AI applications in strategic game planning, enhancing our understanding of human cognitive processes in game settings, and offer insights into creating balanced and engaging game experiences.

Keywords: minimax, alpha beta pruning, transposition tables, weakly solving, game theory

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598 More Precise: Patient-Reported Outcomes after Stroke

Authors: Amber Elyse Corrigan, Alexander Smith, Anna Pennington, Ben Carter, Jonathan Hewitt

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Background and Purpose: Morbidity secondary to stroke is highly heterogeneous, but it is important to both patients and clinicians in post-stroke management and adjustment to life after stroke. The consideration of post-stroke morbidity clinically and from the patient perspective has been poorly measured. The patient-reported outcome measures (PROs) in morbidity assessment help improve this knowledge gap. The primary aim of this study was to consider the association between PRO outcomes and stroke predictors. Methods: A multicenter prospective cohort study assessed 549 stroke patients at 19 hospital sites across England and Wales during 2019. Following a stroke event, demographic, clinical, and PRO measures were collected. Prevalence of morbidity within PRO measures was calculated with associated 95% confidence intervals. Predictors of domain outcome were calculated using a multilevel generalized linear model. Associated P -values and 95% confidence intervals are reported. Results: Data were collected from 549 participants, 317 men (57.7%) and 232 women (42.3%) with ages ranging from 25 to 97 (mean 72.7). PRO morbidity was high post-stroke; 93.2% of the cohort report post-stroke PRO morbidity. Previous stroke, diabetes, and gender are associated with worse patient-reported outcomes across both the physical and cognitive domains. Conclusions: This large-scale multicenter cohort study illustrates the high proportion of morbidity in PRO measures. Further, we demonstrate key predictors of adverse outcomes (Diabetes, previous stroke, and gender) congruence with clinical predictors. The PRO has been demonstrated to be an informative and useful stroke when considering patient-reported outcomes and has wider implications for considerations of PROs in clinical management. Future longitudinal follow-up with PROs is needed to consider association of long-term morbidity.

Keywords: morbidity, patient-reported outcome, PRO, stroke

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597 Impact of Transportation on Access to Reproductive and Maternal Health Services in Northeast Cambodia: A Policy Brief

Authors: Zaman Jawahar, Anne Rouve-Khiev, Elizabeth Hoban, Joanne Williams

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Ensuring access to timely obstetric care is essential to prevent maternal deaths. Geographical barriers pose significant challenges for women accessing quality reproductive and maternal health services in rural Cambodia. This policy brief affirms the need to address the issue of transportation and cost (direct and indirect) as critical barriers to accessing reproductive and maternal health (RMH) services in four provinces in Northeast Cambodia (Kratie, Ratanak Kiri, Mondul Kiri, Stung Treng). A systemic search of the literature identified 1,116 articles, and only ten articles from low-and-middle-income countries met the inclusion criteria. The ten articles reported on transportation and cost related to accessing RMH services. In addition, research findings from Partnering to Save Lives (PSL) studies in the four provinces were included in the analysis. Thematic data analysis using the information in the ten articles and PSL research findings was conducted, and the findings are presented in this paper. The key findings are the critical barriers to accessing RMH services in the four provinces because women experience: 1) difficulties finding affordable transportation; 2) lack of available and accessible transportation; 3) greater distance and traveling time to services; 4) poor geographical terrain and; 5) higher opportunity costs. Distance and poverty pose a double burden for the women accessing RMH services making a facility-based delivery less feasible compared to home delivery. Furthermore, indirect and hidden costs associated with institutional delivery may have an impact on women’s decision to seek RMH care. Existing health financing schemes in Cambodia such as the Health Equity Fund (HEF) and the Voucher Scheme contributed to the solution but have also shown some limitations. These schemes contribute to improving access to RMH services for the poorest group, but the barrier of transportation costs remains. In conclusion, initiatives that are proven to be effective in the Cambodian context should continue or be expanded in conjunction with the HEF, and special consideration should be given to communities living in geographically remote regions and difficult to access areas. The following strategies are recommended: 1) maintain and further strengthen transportation support in the HEF scheme; 2) expand community-based initiatives such as Community Managed Health Equity Funds and Village Saving Loans Associations; 3) establish maternity waiting homes; and 4) include antenatal and postnatal care in the provision of integrated outreach services. This policy brief can be used to inform key policymakers and provide evidence that can assist them to develop strategies to increase poor women’s access to RMH services in low-income settings, taking into consideration the geographic distance and other indirect costs associated with a facility-based delivery.

Keywords: access, barriers, northeast Cambodia, reproductive and maternal health service, transportation and cost

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596 Revolutionary Wastewater Treatment Technology: An Affordable, Low-Maintenance Solution for Wastewater Recovery and Energy-Saving

Authors: Hady Hamidyan

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As the global population continues to grow, the demand for clean water and effective wastewater treatment becomes increasingly critical. By 2030, global water demand is projected to exceed supply by 40%, driven by population growth, increased water usage, and climate change. Currently, about 4.2 billion people lack access to safely managed sanitation services. The wastewater treatment sector faces numerous challenges, including the need for energy-efficient solutions, cost-effectiveness, ease of use, and low maintenance requirements. This abstract presents a groundbreaking wastewater treatment technology that addresses these challenges by offering an energy-saving approach, wastewater recovery capabilities, and a ready-made, affordable, and user-friendly package with minimal maintenance costs. The unique design of this ready-made package made it possible to eliminate the need for pumps, filters, airlift, and other common equipment. Consequently, it enables sustainable wastewater treatment management with exceptionally low energy and cost requirements, minimizing investment and maintenance expenses. The operation of these packages is based on continuous aeration, which involves injecting oxygen gas or air into the aeration chamber through a tubular diffuser with very small openings. This process supplies the necessary oxygen for aerobic bacteria. The recovered water, which amounts to almost 95% of the input, can be treated to meet specific quality standards, allowing safe reuse for irrigation, industrial processes, or even potable purposes. This not only reduces the strain on freshwater resources but also provides economic benefits by offsetting the costs associated with freshwater acquisition and wastewater discharge. The ready-made, affordable, and user-friendly nature of this technology makes it accessible to a wide range of users, including small communities, industries, and decentralized wastewater treatment systems. The system incorporates user-friendly interfaces, simplified operational procedures, and integrated automation, facilitating easy implementation and operation. Additionally, the use of durable materials, efficient equipment, and advanced monitoring systems significantly reduces maintenance requirements, resulting in low overall life-cycle costs and alleviating the burden on operators and maintenance personnel. In conclusion, the presented wastewater treatment technology offers a comprehensive solution to the challenges faced by the industry. Its energy-saving approach, combined with wastewater recovery capabilities, ensures sustainable resource management and enhances environmental stewardship. This affordable, ready-made, and low-maintenance package promotes broad adoption across various sectors and communities, contributing to a more sustainable future for water and wastewater management.

Keywords: wastewater treatment, energy saving, wastewater recovery, affordable package, low maintenance costs, sustainable resource management, environmental stewardship

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595 Grounding Chinese Language Vocabulary Teaching and Assessment in the Working Memory Research

Authors: Chan Kwong Tung

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Since Baddeley and Hitch’s seminal research in 1974 on working memory (WM), this topic has been of great interest to language educators. Although there are some variations in the definitions of WM, recent findings in WM have contributed vastly to our understanding of language learning, especially its effects on second language acquisition (SLA). For example, the phonological component of WM (PWM) and the executive component of WM (EWM) have been found to be positively correlated with language learning. This paper discusses two general, yet highly relevant WM findings that could directly affect the effectiveness of Chinese Language (CL) vocabulary teaching and learning, as well as the quality of its assessment. First, PWM is found to be critical for the long-term learning of phonological forms of new words. Second, EWM is heavily involved in interpreting the semantic characteristics of new words, which consequently affects the quality of learners’ reading comprehension. These two ideas are hardly discussed in the Chinese literature, both conceptual and empirical. While past vocabulary acquisition studies have mainly focused on the cognitive-processing approach, active processing, ‘elaborate processing’ (or lexical elaboration) and other effective learning tasks and strategies, it is high time to balance the spotlight to the WM (particularly PWM and EWM) to ensure an optimum control on the teaching and learning effectiveness of such approaches, as well as the validity of this language assessment. Given the unique phonological, orthographical and morphological properties of the CL, this discussion will shed some light on the vocabulary acquisition of this Sino-Tibetan language family member. Together, these two WM concepts could have crucial implications for the design, development, and planning of vocabularies and ultimately reading comprehension teaching and assessment in language education. Hopefully, this will raise an awareness and trigger a dialogue about the meaning of these findings for future language teaching, learning, and assessment.

Keywords: Chinese Language, working memory, vocabulary assessment, vocabulary teaching

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594 Examining the Relations among Autobiographical Memory Recall Types, Quality of Descriptions, and Emotional Arousal in Psychotherapy for Depression

Authors: Jinny Hong, Jeanne C. Watson

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Three types of autobiographical memory recall -specific, episodic, and generic- were examined in relation to the quality of descriptions and in-session levels of emotional arousal. Correlational analyses and general estimating equation were conducted to test the relationships between 1) quality of descriptions and type of memory, 2) type of memory and emotional arousal, and 3) quality of descriptions and emotional arousal. The data was transcripts drawn from an archival randomized-control study comparing cognitive-behavioral therapy and emotion-focused therapy in a 16-week treatment for depression. Autobiographical memory recall segments were identified and sorted into three categories: specific, episodic, and generic. Quality of descriptions of these segments was then operationalized and measured using the Referential Activity Scale, and each memory segment was rated on four dimensions: concreteness, specificity, clarity, and overall imagery. Clients’ level of emotional arousal for each recall was measured using the Client’s Expression Emotion Scale. Contrary to the predictions, generic memories are associated with higher emotional arousal ratings and descriptive language ratings compared to specific memories. However, a positive relationship emerged between the quality of descriptions and expressed emotional arousal, indicating that the quality of descriptions in which memories are described in sessions is more important than the type of memory recalled in predicting clients’ level of emotional arousal. The results from this study provide a clearer understanding of the role of memory recall types and use of language in activating emotional arousal in psychotherapy sessions in a depressed sample.

Keywords: autobiographical memory recall, emotional arousal, psychotherapy for depression, quality of descriptions, referential activity

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593 Setswana Speech Rhythm Development in High-Socioeconomic Status Setswana-English Bilingual Children

Authors: Boikanyego Sebina

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The present study investigates the effects of socioeconomic status (SES) and bilingualism on the Setswana speech rhythm of Batswana (citizens) children aged 6-7 years with typical development born and residing in Botswana. Botswana is a country in which there is a diglossic Setswana/English language setting, where English is the dominant high-status language in educational and public contexts. Generally, children from low SES have lower linguistic and cognitive profiles than their age-matched peers from high SES. A greater understanding of these variables would allow educators to distinguish between underdeveloped language skills in children due to impairment and environmental issues for them to successfully enroll children in language development enhancement programs specific to the child’s needs. There are 20 participants: 10 high SES private English-medium educated early sequential Setswana-English bilingual children, taught full-time in English (L2) from the age of 3 years, and for whom English has become dominant; and 10 low SES children who are educated in public schools for whom English is considered a learner language, i.e., L1 Setswana is dominant. The aim is to see whether SES and bilingualism, have had an effect on the Setswana speech rhythm of children in either group. The study primarily uses semi-spontaneous speech based on the telling of the wordless picture storybook. A questionnaire is used to elicit the language use pattern of the children and that of their parents, as well as the education level of the parents and the school the children attend. A comparison of the rhythm shows that children from high SES have a lower durational variability than those from low SES. The findings of the study are that the low durational variability by children from high SES may suggest an underdeveloped rhythm. In conclusion, the results of the present study are against the notion that children from high SES outperform those from low SES in linguistic development.

Keywords: bilingualism, Setswana English, socio-economic status, speech-rhythm

Procedia PDF Downloads 67
592 Prevalence, Antimicrobial Susceptibility Pattern and Public Health Significance for Staphylococcus aureus of Isolated From Raw Red Meat at Butchery and Abattoir House in Mekelle, Northern Ethiopia

Authors: Haftay Abraha Tadesse

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Background: Staphylococcus is a genus of worldwide distributed bacteria correlated to several infectious of different sites in human and animals. They are among the most important causes of infection that are associated with the consumption of contaminated food. Objective: The objective of this study was to determine the isolates, antimicrobial susceptibility patterns and public health significance for Staphylococcus aureus in raw meat from butchery and abattoir houses of Mekelle, Northern Ethiopia. Methodology: A cross-sectional study was conducted from April to October 2019. Sociodemographic data and public health significance were collected using predesigned questionnaire. The raw meat samples were collected aseptically in the butchery and abattoir houses and transported using ice box to Mekelle University, College of Veterinary Sciences for isolating and identification of Staphylococcus aureus. Antimicrobial susceptibility tests were determined by disc diffusion method. Data obtained were cleaned and entered in to STATA 22.0 and logistic regression model with odds ratio were calculated to assess the association of risk factors with bacterial contamination. P-value < 0.05 was considered as statistically significant. Results: In present study, 88 out of 250 (35.2%) were found to be contamination with Staphylococcus aureus. Among the raw meat specimens to be positivity rate of Staphylococcus aureus were 37.6% (n=47) and (32.8% (n=41), butchery and abattoir houses, respectively. Among the associated risk factories not using gloves reduces risk was found to (AOR=0.222; 95% CI: 0.104-0.473), Strict Separation b/n clean & dirty (AOR= 1.37; 95% CI: 0.66-2.86) and poor habit of hand washing (AOR=1.08; 95%CI: 0.35-3.35) were found to be statistically significant and ha ve associated with Staphylococcus aureus contamination. All isolates thirty sevevn of Staphyloco ccus aureus were checked displayed (100%) sensitive to doxycycline, trimethoprim, gentamicin, sulphamethoxazole, amikacin, CN, Co trimoxazole and nitrofurantoi. whereas the showed resistance of cefotaxime (100%), ampicillin (87.5%), Penicillin (75%), B (75%), and nalidixic acid (50%) from butchery houses. On the other hand, all isolates of Staphylococcus aur eu isolate 100% (n= 10) showed sensitive chloramphenicol, gentamicin and nitrofurantoin whereas the showed 100% resistance of Penicillin, B, AMX, ceftriaxone, ampicillin and cefotaxime from abattoirs houses. The overall multi drug resistance pattern for Staphylococcus aureus were 90% and 100% of butchery and abattoirs houses, respectively. Conclusion: 35.3% Staphylococcus aureus isolated were recovered from the raw meat samples collected from the butchery and abattoirs houses. More has to be done in the developed of hand washing behavior, and availability of safe water in the butchery houses to reduce burden of bacterial contamination. The results of the present finding highlight the need to implement protective measures against the levels of food contamination and alternative drug options. The development of antimicrobial resistance is nearly always as a result of repeated therapeutic and/or indiscriminate use of them. Regular antimicrobial sensitivity testing helps to select effective antibiotics and to reduce the problems of drug resistance development towards commonly used antibiotics. Key words: abattoir houses, antimicrobial resistance, butchery houses, Ethiopia,

Keywords: abattoir houses, antimicrobial resistance, butchery houses, Ethiopia, staphylococcus aureuse, MDR

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591 Learning Disability or Learning Differences: Understanding Differences Between Cultural and Linguistic Diversity, Learning Differences, and Learning Disabilities

Authors: Jolanta Jonak, Sylvia Tolczyk

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Students demonstrate various learning preferences and learning styles that range from visual, auditory to kinesthetic preferences. These learning preferences are further impacted by individual cognitive make up that characterizes itself in linguistic strengths, logical- special, inter-or intra- personal, just to name a few. Students from culturally and linguistically diverse backgrounds (CLD) have an increased risk of being misunderstood by many school systems and even medical personnel. CLD students are influenced by many factors (like acculturation and experience) that may impact their achievements and functioning levels. CLD students who develop initial or basic interpersonal communication proficiency skills in the target language are even at a higher risk for being suspected of learning disability when they are underachieving academically. Research indicates that large numbers of students arenot provided the type of education and types of supports they need in order to be successful in an academicenvironment. Multiple research findings indicate that significant numbers of school staff self-reports that they do not feel adequately prepared to work with CLD students. It is extremely important for the school staff, especially school psychologists, who often are the first experts that are consulted, to be educated about overlapping symptoms and settle differences between learning difference and disability. It is equally important for medical personnel, mainly pediatricians, psychologists, and psychiatrists, to understand the subtle differences to avoid inaccurate opinions. Having the knowledge, school staff can avoid unnecessary referrals for special education evaluations and avoid inaccurate decisions about the presence of a disability. This presentation will illustrate distinctions based on research between learning differences and disabilities, how to recognize them, and how to assess for them.

Keywords: special education, learning disability, differentiation, differences

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590 Strengthening Facility-Based Systems to Improve Access to In-Patient Care for Sick Newborns in Brong Ahafo Region, Ghana

Authors: Paulina Clara Appiah, Kofi Issah, Timothy Letsa, Kennedy Nartey, Amanua Chinbuah, Adoma Dwomo-Fokuo, Jacqeline G. Asibey

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Background: The Every Newborn Action Plan provides evidence–based interventions to end preventable deaths in high burden countries. Brong Ahafo Region is one of ten regions in Ghana with less than half of its district hospitals having sick newborn units. Facility-based neonatal care is not prioritized and under-funded, and there is also inadequate knowledge and competence to manage the sick. The aim of this intervention was to make available in–patient care for sick newborns in all 19 district hospitals through the strengthening of facility-based systems. Methods: With the development and dissemination of the National Newborn Strategy and Action Plan 2014-2018, the country was able to attract PATH which provided the region with basic resuscitation equipment, supported hospital providers’ capacity building in Helping Babies Breathe, Essential Care of Every Baby, Infection Prevention and Management and held a symposia on managing the sick newborn. Newborn advocacy was promoted through newborn champions at the facility and community levels. Hospital management was then able to mobilize resources from communities, corporate organizations and from internally generated funds; created or expanded sick newborn care units and provided essential medicines and equipment. Kangaroo Mother Care was initiated in 6 hospitals. Pediatric specialist outreach services initiated comprised telephone consultations, teaching ward rounds and participating in perinatal death audits meetings. Newborn data capture and management was improved through the provision and training on the use of standard registers provided from the national level. Results: From February 2015 to November 2017, hospitals with sick newborn units increased from 7 to 19 (37%-100%). 180 pieces each of newborn ventilation bags and masks size 0, 1 and penguin suction bulbs were distributed to the hospitals, in addition to 20 newborn mannequin sets and 90 small clinical reminder posters. 802 providers (96.9%) were trained in resuscitation, of which 96% were successfully followed up in 6 weeks, 91% in 6 months and 80% in 12 months post-training. 53 clinicians (65%) were trained and mentored to manage sick newborns. 56 specialist teaching ward rounds were conducted. Data completeness improved from 92.6% - 99.9%. Availability of essential medicines improved from 11% to 100%. Number of hospital cots increased from 116 to 248 (214%). Cot occupancy rate increased from 57.4% to 92.5%. Hospitals with phototherapy equipment increased from 0 to 12 (63%). Hospitals with incubators increased from 1 to 12 (5%-63%). Newborn deaths among admissions reduced from 6.3% to 5.4%. Conclusion: Access to in-patient care increased significantly. Newborn advocacy successfully mobilized resources required for strengthening facility –based systems.

Keywords: facility-based systems, Ghana, in-patient care, newborn advocacy

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589 Outdoor Physical Play as Critical to Early Childhood Development: Findings from Saudi Arabia

Authors: Rana S. Alghamdi

Abstract:

Play in early childhood education has been stifled across the world due to an overemphasis on academic achievement and a reduced focus on physical play and motor development. In Saudi Arabia, teachers reticent to allocate more time to play for fear of retribution from parents and administrators that children are losing academic seat time. This practice has proven to be detrimental to the social, emotional, physical, and cognitive development of children. Teachers are pressured to prioritize Arabic, math, and science while providing minimal time for physical activities. Administrators tend to push for an ever-increasing emphasis on academia in order to achieve higher test scores. However, young children often find it difficult to concentrate if they are not able to get out energy through physical play. Furthermore, many youth educators are not qualified to oversee physical activities, and many facilities are unprepared for safe, outdoor play. This results in children getting little to no outdoor activity. They are stuck in a strict academic regimen that may dampen the creativity and imagination easily fostered through cooperative play. For a stronger educational system and more well-rounded students, Saudi schools should enact policies that extend the number of required hours dedicated to outdoor and physical play. They should also offer training for unqualified teachers. This training should focus on the benefits of physical play and instruct them on how to facilitate these activities safely and effectively. School administrators must focus on providing adequate equipment and safe environments for the purpose of outdoor play and education. In doing so, they will be setting their students up for a successful future and improving their abilities in all aspects of education.

Keywords: early childhood education, play, outdoor, Saudi Arabia

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588 The Effect of Iconic and Beat Gestures on Memory Recall in Greek’s First and Second Language

Authors: Eleni Ioanna Levantinou

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Gestures play a major role in comprehension and memory recall due to the fact that aid the efficient channel of the meaning and support listeners’ comprehension and memory. In the present study, the assistance of two kinds of gestures (iconic and beat gestures) is tested in regards to memory and recall. The hypothesis investigated here is whether or not iconic and beat gestures provide assistance in memory and recall in Greek and in Greek speakers’ second language. Two groups of participants were formed, one comprising Greeks that reside in Athens and one with Greeks that reside in Copenhagen. Three kinds of stimuli were used: A video with words accompanied with iconic gestures, a video with words accompanied with beat gestures and a video with words alone. The languages used are Greek and English. The words in the English videos were spoken by a native English speaker and by a Greek speaker talking English. The reason for this is that when it comes to beat gestures that serve a meta-cognitive function and are generated according to the intonation of a language, prosody plays a major role. Thus, participants that have different influences in prosody may generate different results from rhythmic gestures. Memory recall was assessed by asking the participants to try to remember as many words as they could after viewing each video. Results show that iconic gestures provide significant assistance in memory and recall in Greek and in English whether they are produced by a native or a second language speaker. In the case of beat gestures though, the findings indicate that beat gestures may not play such a significant role in Greek language. As far as intonation is concerned, a significant difference was not found in the case of beat gestures produced by a native English speaker and by a Greek speaker talking English.

Keywords: first language, gestures, memory, second language acquisition

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587 I Look Powerful So You Will Yield to Me: The Effects of Embodied Power and the Perception of Power on Conflict Management

Authors: Fai-Ho E. Choi, Wing-Tung Au

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This study investigated the effects of embodiment on conflict management. As shown in the research literature, the physiological (i.e. bodily postures) can affect the emotional and cognitive proceedings of human beings, but little has been shown on whether such effects would have ramifications in decision-making related to other individuals. In this study, conflict is defined as when two parties have seemingly incompatible goals, and the two have to deal with each other in order to maximize one’s own gain. In a matched-gender experiment, university undergraduate students were randomly assigned to either the high power condition or the low power condition, with participants in each condition instructed to perform a fix set of bodily postures that would either embody them with a high sense of power or a low sense of power. One high-power participant would pair up with a low-power participant to engage in an integrative bargaining task and a dictator game. Participants also filled out a pre-trial questionnaire and a post-trial questionnaire measuring general sense of power, self-esteem and self-efficacy. Personality was controlled for. Results are expected to support our hypotheses that people who are embodied with power will be more unyielding in a conflict management situation, and that people who are dealing with another person embodied with power will be more yielding in a conflict management situation. As conflicts arise frequently both within and between organizations, a better understanding of how human beings function in conflicts is important. This study should provide evidence that bodily postures can influence the perceived sense of power of the parties involved and hence influence the conflict outcomes. Future research needs to be conducted to investigate further how people perceive themselves and how they perceive their opponents in conflicts, such that we can come up with a behavioral theory of conflict management.

Keywords: conflict management, embodiment, negotiation, perception

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586 A Phenomenological Approach to Computational Modeling of Analogy

Authors: José Eduardo García-Mendiola

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In this work, a phenomenological approach to computational modeling of analogy processing is carried out. The paper goes through the consideration of the structure of the analogy, based on the possibility of sustaining the genesis of its elements regarding Husserl's genetic theory of association. Among particular processes which take place in order to get analogical inferences, there is one which arises crucial for enabling efficient base cases retrieval through long-term memory, namely analogical transference grounded on familiarity. In general, it has been argued that analogical reasoning is a way by which a conscious agent tries to determine or define a certain scope of objects and relationships between them using previous knowledge of other familiar domain of objects and relations. However, looking for a complete description of analogy process, a deeper consideration of phenomenological nature is required in so far, its simulation by computational programs is aimed. Also, one would get an idea of how complex it would be to have a fully computational account of the analogy elements. In fact, familiarity is not a result of a mere chain of repetitions of objects or events but generated insofar as the object/attribute or event in question is integrable inside a certain context that is taking shape as functionalities and functional approaches or perspectives of the object are being defined. Its familiarity is generated not by the identification of its parts or objective determinations as if they were isolated from those functionalities and approaches. Rather, at the core of such a familiarity between entities of different kinds lays the way they are functionally encoded. So, and hoping to make deeper inroads towards these topics, this essay allows us to consider that cognitive-computational perspectives can visualize, from the phenomenological projection of the analogy process reviewing achievements already obtained as well as exploration of new theoretical-experimental configurations towards implementation of analogy models in specific as well as in general purpose machines.

Keywords: analogy, association, encoding, retrieval

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585 The Use of Project to Enhance Learning Domains Stated by National Qualifications Framework: TQF

Authors: Duangkamol Thitivesa

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This paper explores the use of project work in a content-based instruction in a Rajabhat University, Thailand. The use of project is to promote kinds of learning expected of student teachers as stated by Thailand Quality Framework: TQF. The kinds of learning are grouped into five domains: Ethical and moral development, knowledge, cognitive skill, interpersonal skills and responsibility, and analytical and communication skills. The content taught in class is used to lead the student teachers to relate their previously-acquired linguistic knowledge to meaningful realizations of the language system in passages of immediate relevance to their professional interests, teaching methods in particular. Two research questions are formulate to guide this study: 1) To what degree are the five domains of learning expected of student teachers after the use of project in a content class?, and 2) What is the academic achievement of the students’ writing skills, as part of the learning domains stated by TQF, against the 70% attainment target after the use of project to enhance the skill? The sample of the study comprised of 38 fourth-year English major students. The data was collected by means of a summative achievement test, student writing works, an observation checklist, and project diary. The scores in the summative achievement test were analyzed by mean score, standard deviation, and t-test. Project diary serves as students’ record of the language acquired during the project. List of structures and vocabulary noted in the diary has shown students’ ability to attend to, recognize, and focus on meaningful patterns of language forms.

Keywords: Thailand quality framework, project Work, writing skill, summative

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584 Impact of Informal Institutions on Development: Analyzing the Socio-Legal Equilibrium of Relational Contracts in India

Authors: Shubhangi Roy

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Relational Contracts (informal understandings not enforceable by law) are a common feature of most economies. However, their dominance is higher in developing countries. Such informality of economic sectors is often co-related to lower economic growth. The aim of this paper is to investigate whether informal arrangements i.e. relational contracts are a cause or symptom of lower levels of economic and/or institutional development. The methodology followed involves an initial survey of 150 test subjects in Northern India. The subjects are all members of occupations where they frequently transact ensuring uniformity in transaction volume. However, the subjects are from varied socio-economic backgrounds to ensure sufficient variance in transaction values allowing us to understand the relationship between the amount of money involved to the method of transaction used, if any. Questions asked are quantitative and qualitative with an aim to observe both the behavior and motivation behind such behavior. An overarching similarity observed during the survey across all subjects’ responses is that in an economy like India with pervasive corruption and delayed litigation, economy participants have created alternative social sanctions to deal with non-performers. In a society that functions predominantly on caste, class and gender classifications, these sanctions could, in fact, be more cumbersome for a potential rule-breaker than the legal ramifications. It, therefore, is a symptom of weak formal regulatory enforcement and dispute settlement mechanism. Additionally, the study bifurcates such informal arrangements into two separate systems - a) when it exists in addition to and augments a legal framework creating an efficient socio-legal equilibrium or; b) in conflict with the legal system in place. This categorization is an important step in regulating informal arrangements. Instead of considering the entire gamut of such arrangements as counter-development, it helps decision-makers understand when to dismantle (latter) and when to pivot around existing informal systems (former). The paper hypothesizes that those social arrangements that support the formal legal frameworks allow for cheaper enforcement of regulations with lower enforcement costs burden on the state mechanism. On the other hand, norms which contradict legal rules will undermine the formal framework. Law infringement, in presence of these norms, will have no impact on the reputation of the business or individual outside of the punishment imposed under the law. It is especially exacerbated in the Indian legal system where enforcement of penalties for non-performance of contracts is low. In such a situation, the social norm will be adhered to more strictly by the individuals rather than the legal norms. This greatly undermines the role of regulations. The paper concludes with recommendations that allow policy-makers and legal systems to encourage the former category of informal arrangements while discouraging norms that undermine legitimate policy objectives. Through this investigation, we will be able to expand our understanding of tools of market development beyond regulations. This will allow academics and policymakers to harness social norms for less disruptive and more lasting growth.

Keywords: distribution of income, emerging economies, relational contracts, sample survey, social norms

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583 Epidemiology of Healthcare-Associated Infections among Hematology/Oncology Patients: Results of a Prospective Incidence Survey in a Tunisian University Hospital

Authors: Ezzi Olfa, Bouafia Nabiha, Ammar Asma, Ben Cheikh Asma, Mahjoub Mohamed, Bannour Wadiaa, Achour Bechir, Khelif Abderrahim, Njah Mansour

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Background: In hematology/oncology, health care improvement has allowed increasingly aggressive management in diagnostic and therapeutic procedures. Nevertheless, these intensified procedures have been associated with higher risk of healthcare associated infections (HAIs). We undertook this study to estimate the burden of HAIs in the cancer patients in an onco -hematology unit in a Tunisian university hospital. Materials/Methods: A prospective, observational study, based on active surveillance for a period of 06 months from Mars through September 2016, was undertaken in the department of onco-hematology in a university hospital in Tunisia. Patients, who stayed in the unit for ≥ 48 h, were followed until hospital discharge. The Centers for Disease Control and Prevention criteria (CDC) for site-specific infections were used as standard definitions for HAIs. Results: One hundred fifty patients were included in the study. The gender distribution was 33.3% for girls and 66.6% boys. They have a mean age of 23.12 years (SD = 18.36 years). The main patient’s diagnosis is: Acute Lymphoblastic Leukemia (ALL): 48.7 %( n=73). The mean length of stay was 21 days +/- 18 days. Almost 8% of patients had an implantable port (n= 12), 34.9 % (n=52) had a lumber puncture and 42.7 % (n= 64) had a medullary puncture. Chemotherapy was instituted in 88% of patients (n=132). Eighty (53.3%) patients had neutropenia at admission. The incidence rate of HAIs was 32.66 % per patient; the incidence density was 15.73 per 1000 patient-days in the unit. Mortality rate was 9.3% (n= 14), and 50% of cases of death were caused by HAIs. The most frequent episodes of infection were: infection of skin and superficial mucosa (5.3%), pulmonary aspergillosis (4.6%), Healthcare associated pneumonia (HAP) (4%), Central venous catheter associated infection (4%), digestive infection (5%), and primary bloodstream infection (2.6%). Finally, fever of unknown origin (FUO) incidence rate was 14%. In case of skin and superficial infection (n= 8), 4 episodes were documented, and organisms implicated were Escherichia.coli, Geotricum capitatum and Proteus mirabilis. For pulmonary aspergillosis, 6 cases were diagnosed clinically and radiologically, and one was proved by positive aspergillus antigen in bronchial aspiration. Only one patient died due this infection. In HAP (6 cases), four episodes were diagnosed clinically and radiologically. No bacterial etiology was established in these cases. Two patients died due to HAP. For primary bloodstream infection (4 cases), implicated germs were Enterobacter cloacae, Geotricum capitatum, klebsiella pneumoniae, and Streptococcus pneumoniae. Conclusion: This type of prospective study is an indispensable tool for internal quality control. It is necessary to evaluate preventive measures and design control guides and strategies aimed to reduce the HAI’s rate and the morbidity and mortality associated with infection in a hematology/oncology unit.

Keywords: cohort prospective studies, healthcare associated infections, hematology oncology department, incidence

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582 Knowledge Sharing Model Based on Individual and Organizational Factors Related to Faculty Members of University

Authors: Mitra Sadoughi

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This study presents the knowledge-sharing model based on individual and organizational factors related to faculty members. To achieve this goal, individual and organizational factors were presented through qualitative research in the form of open codes, axial, and selective observations; then, the final model was obtained using structural equation model. Participants included 1,719 faculty members of the Azad Universities, Mazandaran Province, Region 3. The samples related to the qualitative survey included 25 faculty members experienced at teaching and the samples related to the quantitative survey included 326 faculty members selected by multistage cluster sampling. A 72-item questionnaire was used to measure the quantitative variables. The reliability of the questionnaire was 0.93. Its content and face validity was determined with the help of faculty members, consultants, and other experts. For the analysis of quantitative data obtained from structural model and regression, SPSS and LISREL were used. The results showed that the status of knowledge sharing is moderate in the universities. Individual factors influencing knowledge sharing included the sharing of educational materials, perception, confidence and knowledge self-efficiency, and organizational factors influencing knowledge sharing included structural social capital, cognitive social capital, social capital relations, organizational communication, organizational structure, organizational culture, IT infrastructure and systems of rewards. Finally, it was found that the contribution of individual factors on knowledge sharing was more than organizational factors; therefore, a model was presented in which contribution of individual and organizational factors were determined.

Keywords: knowledge sharing, social capital, organizational communication, knowledge self-efficiency, perception, trust, organizational culture

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581 Developing the Skills of Reading Comprehension of Learners of English as a Second Language

Authors: Indu Gamage

Abstract:

Though commonly utilized as a language improvement technique, reading has not been fully employed by both language teachers and learners to develop reading comprehension skills in English as a second language. In a Sri Lankan context, this area has to be delved deep into as the learners’ show more propensity to analyze. Reading comprehension is an area that most language teachers and learners struggle with though it appears easy. Most ESL learners engage in reading tasks without being properly aware of the objective of doing reading comprehension. It is observed that when doing reading tasks, the language learners’ concern is more on the meanings of individual words than on the overall comprehension of the given text. The passiveness with which the ESL learners engage themselves in reading comprehension makes reading a tedious task for the learner thereby giving the learner a sense of disappointment at the end. Certain reading tasks take the form of translations. The active cognitive participation of the learner in the mode of using productive strategies for predicting, employing schemata and using contextual clues seems quite less. It was hypothesized that the learners’ lack of knowledge of the productive strategies of reading was the major obstacle that makes reading comprehension a tedious task for them. This study is based on a group of 30 tertiary students who read English only as a fundamental requirement for their degree. They belonged to the Faculty of Humanities and Social Sciences of the University of Ruhuna, Sri Lanka. Almost all learners hailed from areas where English was hardly utilized in their day to day conversations. The study is carried out in the mode of a questionnaire to check their opinions on reading and a test to check whether the learners are using productive strategies of reading when doing reading comprehension tasks. The test comprised reading questions covering major productive strategies for reading. Then the results were analyzed to see the degree of their active engagement in comprehending the text. The findings depicted the validity of the hypothesis as grounds behind the difficulties related to reading comprehension.

Keywords: reading, comprehension, skills, reading strategies

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580 Risk Tolerance in Youth With Emerging Mood Disorders

Authors: Ange Weinrabe, James Tran, Ian B. Hickie

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Risk-taking behaviour is common during youth. In the time between adolescence and early adulthood, young people (aged 15-25 years) are more vulnerable to mood disorders, such as anxiety and depression. What impact does an emerging mood disorder have on decision-making in youth at critical decision points in their lives? In this article, we explore the impact of risk and ambiguity on youth decision-making in a clinical setting using a well-known economic experiment. At two time points, separated by six to eight weeks, we measured risky and ambiguous choices concurrently with findings from three psychological questionnaires, the 10-item Kessler Psychological Distress Scale (K10), the 17-item Quick Inventory of Depressive Symptomatology Adolescent Version (QIDS-A17), and the 12-item Somatic and Psychological Health Report (SPHERE-12), for young help seekers aged 16-25 (n=30, mean age 19.22 years, 19 males). When first arriving for care, we found that 50% (n=15) of participants experienced severe anxiety (K10 ≥ 30) and were severely depressed (QIDS-A17 ≥ 16). In Session 2, taking attrition rates into account (n=5), we found that 44% (n=11) remained severe across the full battery of questionnaires. When applying multiple regression analyses of the pooled sample of observations (N=55), across both sessions, we found that participants who rated severely anxious avoided making risky decisions. We suggest there is some statistically significant (although weak) (p=0.09) relation between risk and severe anxiety scores as measured by K10. Our findings may support working with novel tools with which to evaluate youth experiencing an emerging mood disorder and their cognitive capacities influencing decision-making.

Keywords: anxiety, decision-making, risk, adolescence

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579 The Effect of Loud Working Environment on Incidence of Back Pain

Authors: Marcel Duh, Jadranka Stricevic, David Halozan, Dusan Celan

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Back pain is not only the result of structural or biomechanical abnormalities of the spine but is also associated with cognitive and behavioral aspects of pain and thus represents biopsychosocial problem. Stressors are not only interpersonal conflicts, negative life events, and dangerous situations but also noise. Effects of noise on human beings are psychological (excitement, stress), sensory, and physiological. The harmful effects of noise can be seen in the 40-65 dB range and are manifested as fatigue, irritability, poor sleep and psychological discomfort of the worker. Within 65-90 dB range, body metabolism increases, oxygen consumption is higher, tachycardia and hypertension appear, and the tone of skeletal muscles increases. The purpose of the study was to determine whether the stress caused by noise at the work place increases the incidence of back pain. Measurements of noise levels were carried out in three different wards of social care institution. The measurement on each ward was repeated 3 times (total of 9 measurements) for 8 hours during the morning shift. The device was set up in the room where clients spent most of the day. The staff on the ward replied to the questionnaire consisting of closed type questions about basic demographic information and information about back pain. We find that noise levels as measured in our study had no statistically significant effect on the incidence of back pain (p = 0.90). We also find that health care workers who perceive their work as stressful, have more back pain than those who perceive their job as unstressful, but correlation is statistically insignificant (p = 0.682). With our study, we have proven findings of other authors, that noise level below 65 dB does not have a significant influence on the incidence of back pain.

Keywords: health care workers, musculoskeletal disorder, noise, sick leave

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