Search results for: Chinese Football Association
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3291

Search results for: Chinese Football Association

981 Effects of Lung Protection Ventilation Strategies on Postoperative Pulmonary Complications After Noncardiac Surgery: A Network Meta-Analysis of Randomized Controlled Trials

Authors: Ran An, Dang Wang

Abstract:

Background: Mechanical ventilation has been confirmed to increase the incidence of postoperative pulmonary complications (PPCs), and several studies have shown that low tidal volumes combined with positive end-expiratory pressure (PEEP) and recruitment manoeuvres (RM) reduce the incidence of PPCs. However, the optimal lung-protective ventilatory strategy remains unclear. Methods: Multiple databases were searched for randomized controlled trials (RCTs) published prior to October 2023. The association between individual PEEP (iPEEP) or other forms of lung-protective ventilation and the incidence of PPCs was evaluated by Bayesian network meta-analysis. Results: We included 58 studies (11610 patients) in this meta-analysis. The network meta-analysis showed that low ventilation (LVt) combined with iPEEP and RM was associated with significantly lower incidences of PPCs [HVt: OR=0.38 95CrI (0.19, 0.75), LVt: OR=0.33, 95% CrI (0.12, 0.82)], postoperative atelectasis, and pneumonia than was HVt or LVt. In abdominal surgery, LVT combined with iPEEP or medium-to-high PEEP and RM were associated with significantly lower incidences of PPCs, postoperative atelectasis, and pneumonia. LVt combined with iPEEP and RM was ranked the highest, which was based on SUCRA scores. Conclusion: LVt combined with iPEEP and RM decreased the incidences of PPCs, postoperative atelectasis, and pneumonia in noncardiac surgery patients. iPEEP-guided ventilation was the optimal lung protection ventilation strategy. The quality of evidence was moderate.

Keywords: protection ventilation strategies, postoperative pulmonary complications, network meta-analysis, noncardiac surgery

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980 Availability of Safety Measures and Knowledge Towards Hazardous Waste Management among Workers in Scientific Laboratories of Two Universities in Lebanon

Authors: Inaam Nasrallah, Pascale Salameh, Abbas El-Outa, Assem Alkak, Rihab Nasr, Wafa Toufic Bawab

Abstract:

Background: Hazardous Waste Management(HWM). is critical to human health outcomes and environmental protection. This study evaluated the knowledge regarding safety measures to be applied when collecting and storing waste in scientific laboratories of two universities in Lebanon.Method: A survey-based observational study was conducted in scientific laboratories of the public university and that of a private university, where a total of 309 participants were recruited.Result: The mean total knowledge score on safety measures of HWM was 9.02±4.34 (maximum attainable score, 13). Significant association (p<0.05) was found between knowledge score and job function, years of experience, educational level, professional status, work schedule, and training on proper HWM. Participants had adequate perceptions regarding the impact of HWM on health and the environment. Linear regression modeling revealed that knowledge score was significantly higher among bachelor level lab workers compared to those with doctoral degrees (p=0.043), full-time schedule workers versus part-timers (p=0.03), and among public university participants as compared to those of the private university (p<0.001).Conclusion: This study showed good knowledge concerning HWM in the scientific laboratoriesof the studied universities in Lebanon and a good awareness of the HWM on health and the environment. It highlights the importance of culture, attitude, and practice on proper HWM in the academic scientific laboratory.

Keywords: hasardous waste, safety measures, waste management, knwoledge score, scientific laboratory workers

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979 The Use of Corpora in Improving Modal Verb Treatment in English as Foreign Language Textbooks

Authors: Lexi Li, Vanessa H. K. Pang

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This study aims to demonstrate how native and learner corpora can be used to enhance modal verb treatment in EFL textbooks in mainland China. It contributes to a corpus-informed and learner-centered design of grammar presentation in EFL textbooks that enhances the authenticity and appropriateness of textbook language for target learners. The linguistic focus is will, would, can, could, may, might, shall, should, must. The native corpus is the spoken component of BNC2014 (hereafter BNCS2014). The spoken part is chosen because pedagogical purpose of the textbooks is communication-oriented. Using the standard query option of CQPweb, 5% of each of the nine modals was sampled from BNCS2014. The learner corpus is the POS-tagged Ten-thousand English Compositions of Chinese Learners (TECCL). All the essays under the 'secondary school' section were selected. A series of five secondary coursebooks comprise the textbook corpus. All the data in both the learner and the textbook corpora are retrieved through the concordance functions of WordSmith Tools (version, 5.0). Data analysis was divided into two parts. The first part compared the patterns of modal verbs in the textbook corpus and BNC2014 with respect to distributional features, semantic functions, and co-occurring constructions to examine whether the textbooks reflect the authentic use of English. Secondly, the learner corpus was analyzed in terms of the use (distributional features, semantic functions, and co-occurring constructions) and the misuse (syntactic errors, e.g., she can sings*.) of the nine modal verbs to uncover potential difficulties that confront learners. The analysis of distribution indicates several discrepancies between the textbook corpus and BNCS2014. The first four most frequent modal verbs in BNCS2014 are can, would, will, could, while can, will, should, could are the top four in the textbooks. Most strikingly, there is an unusually high proportion of can (41.1%) in the textbooks. The results on different meanings shows that will, would and must are the most problematic. For example, for will, the textbooks contain 20% more occurrences of 'volition' and 20% less of 'prediction' than those in BNCS2014. Regarding co-occurring structures, the textbooks over-represented the structure 'modal +do' across the nine modal verbs. Another major finding is that the structure of 'modal +have done' that frequently co-occur with could, would, should, and must is underused in textbooks. Besides, these four modal verbs are the most difficult for learners, as the error analysis shows. This study demonstrates how the synergy of native and learner corpora can be harnessed to improve EFL textbook presentation of modal verbs in a way that textbooks can provide not only authentic language used in natural discourse but also appropriate design tailed for the needs of target learners.

Keywords: English as Foreign Language, EFL textbooks, learner corpus, modal verbs, native corpus

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978 Thinking in a Foreign Language Overcomes the Developmental Reversal in Risky Decision-Making: The Foreign Language Effect in Risky Decision-Making

Authors: Rendong Cai, Bei Peng, Yanping Dong

Abstract:

In risk decision making, individuals are found to be susceptible to 'frames': people tend to be risk averse when the choice is described in terms of potential 'gains' (gain frame), whereas they tend to be risk seeking when the same choice is described in terms of potential 'losses' (loss frame); this effect is termed the framing effect. The framing effect has been well documented and some studies even find a developmental reversal in the framing effect: The more experience an individual has in a certain field, the easier for him to be influenced by the frame relevant to the field, resulting in greater decision inconsistency. Recent studies reported that using a foreign language can reduce the framing effect. However, it is not clear whether foreign language use can overcome the developmental reversal in the framing effect. The present study investigated three potential factors that may influence the developmental reversal in the framing effect: specialized knowledge of the participants, the language in which the problem is presented, and the types of problems. The present study examined the decision making behavior of 188 Chinese-English bilinguals who majored in Finance, with a group of 277 English majors as the control group. They were asked to solve a financial problem (experimental condition) and a life problem (control condition). Each problem was presented in one of the following four versions: native language-gain frame, foreign language-gain frame, native language-loss frame, and foreign language-loss frame. Results revealed that for the life problem, under the native condition, both groups were affected by the frame; but under the foreign condition, this framing effect disappeared for the financial majors. This confirmed that foreign language use modulates framing effects in general decision making, which served as an effective baseline. For the financial problem, under the native condition, only the financial major was observed to be influenced by the frame, which was a developmental reversal; under the foreign condition, however, this framing effect disappeared. The results provide further empirical evidence for the universal of the developmental reversal in risky decision making. More importantly, the results suggest that using a foreign language can overcome such reversal, which has implications for the reduction of decision biases in professionals. The findings also shed new light on the complex interaction between general decision-making and bilingualism.

Keywords: the foreign language effect, developmental reversals, the framing effect, bilingualism

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977 Magnetic Resonance Imaging for Assessment of the Quadriceps Tendon Cross-Sectional Area as an Adjunctive Diagnostic Parameter in Patients with Patellofemoral Pain Syndrome

Authors: Jae Ni Jang, SoYoon Park, Sukhee Park, Yumin Song, Jae Won Kim, Keum Nae Kang, Young Uk Kim

Abstract:

Objectives: Patellofemoral pain syndrome (PFPS) is a common clinical condition characterized by anterior knee pain. Here, we investigated the quadriceps tendon cross-sectional area (QTCSA) as a novel predictor for the diagnosis of PFPS. By examining the association between the QTCSA and PFPS, we aimed to provide a more valuable diagnostic parameter and more equivocal assessment of the diagnostic potential of PFPS by comparing the QTCSA with the quadriceps tendon thickness (QTT), a traditional measure of quadriceps tendon hypertrophy. Patients and Methods: This retrospective study included 30 patients with PFPS and 30 healthy participants who underwent knee magnetic resonance imaging. T1-weighted turbo spin echo transverse magnetic resonance images were obtained. The QTCSA was measured on the axial-angled phases of the images by drawing outlines, and the QTT was measured at the most hypertrophied quadriceps tendon. Results: The average QTT and QTCSA for patients with PFPS (6.33±0.80 mm and 155.77±36.60 mm², respectively) were significantly greater than those for healthy participants (5.77±0.36 mm and 111.90±24.10 mm2, respectively; both P<0.001). We used a receiver operating characteristic curve to confirm the sensitivities and specificities for both the QTT and QTCSA as predictors of PFPS. The optimal diagnostic cutoff value for QTT was 5.98 mm, with a sensitivity of 66.7%, a specificity of 70.0%, and an area under the curve of 0.75 (0.62–0.88). The optimal diagnostic cutoff value for QTCSA was 121.04 mm², with a sensitivity of 73.3%, a specificity of 70.0%, and an area under the curve of 0.83 (0.74–0.93). Conclusion: The QTCSA was found to be a more reliable diagnostic indicator for PFPS than QTT.

Keywords: patellofemoral pain syndrome, quadriceps muscle, hypertrophy, magnetic resonance imaging

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976 The Impact of COVID-19 on the Mental Health of Residents of Saudi Arabia

Authors: Khaleel Alyahya, Faizah Alotaibi

Abstract:

The coronavirus disease 19 (COVID-19) pandemic has caused an increase in general fear and anxiety around the globe. With the public health measures, including lockdown and travel restrictions, the COVID-19 period further resulted in a sudden increase in the vulnerability of people too ill mental health. This becomes greater among individuals who have a history of mental illness or are undergoing treatment and do not have easy access to medication and medical consultations. The study aims to measure the impact of COVID-19 and the degree of distress with the DASS scale on the mental health of residents living in Saudi Arabia. The study is a quantitative, observational, and cross-sectional conducted in Saudi Arabia to measure the impact of COVID-19 on the mental health of both citizens and residents of Saudi Arabia during pandemics. The study ran from February 2021 to June 2021, and a validated questionnaire was used. The targeted population of the study was Saudi citizens and non-Saudi residents. A sample size of 800 participants was calculated with a single proportion formula at 95% level of significance and 5% allowable error. The result revealed that participants who were always doing exercise experienced the lowest level of depression, anxiety, and stress. The highest prevalence of severe and extremely severe depression was among participants who sometimes do exercise at 53.2% for each. Similar results were obtained for anxiety and stress, where the extremely severe form was reported by those who sometimes did exercise at 54.8% and 72.2%, respectively. There was an inverse association between physical activity levels and levels of depression, anxiety, and stress during the COVID-19. Similarly, the levels of depression, anxiety, and stress differed significantly according to the exercise frequency during COVID-19.

Keywords: mental, COVID-19, pandemic, lockdown, depression, anxiety, stress

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975 Relationships of Driver Drowsiness and Sleep-Disordered Breathing Syndrome

Authors: Cheng-Yu Tsai, Wen-Te Liu, Yin-Tzu Lin, Chen-Chen Lo, Kang Lo

Abstract:

Background: Driving drowsiness related to inadequate or disordered sleep accounts for a major percentage of traffic accidents. Sleep-disordered breathing (SDB) syndrome is a common respiratory disorder during sleep. However, the effects of SDB syndrome on driving fatigue remain unclear. Objective: This study aims to investigate the relationship between SDB pattern and driving drowsiness. Methodologies: The physical condition while driving was obtained from the questionnaires to classify the state of driving fatigue. SDB syndrome was quantified as the polysomnography, and the air flow pattern was collected by the thermistor and nasal pressure cannula. To evaluate the desaturation, the mean hourly number of greater than 3% dips in oxygen saturation was sentenced by reregistered technologist during examination in a hospital in New Taipei City (Taiwan). The independent T-test was used to investigate the correlations between sleep disorders related index and driving drowsiness. Results: There were 880 subjects recruited in this study, who had been done polysomnography for evaluating severity for obstructive sleep apnea syndrome (OSAS) as well as completed the driver condition questionnaire. Four-hundred-eighty-four subjects (55%) were classified as fatigue group, and 396 subjects (45%) were served as the control group. Significantly higher values of snoring index (242.14 ± 205.51 /hours) were observed in the fatigue group (p < 0.01). The value of respiratory disturbance index (RDI) (31.82 ± 19.34 /hours) in fatigue group were significantly higher than the control group (p < 0.01). Conclusion: We observe the considerable association between SDB syndrome and driving drowsiness. To promote traffic safety, SDB syndrome should be controlled and alleviated.

Keywords: driving drowsiness, sleep-disordered breathing syndrome, snoring index, respiratory disturbance index.

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974 Genetic Polymorphism in the Vitamin D Receptor Gene and 25-Hydroxyvitamin D Serum Levels in East Indian Women with Polycystic Ovary Syndrome

Authors: Dipanshu Sur, Ratnabali Chakravorty

Abstract:

Background: Polycystic ovary syndrome (PCOS) is the most common metabolic abnormality such as changes in lipid profile, diabetes, hypertension and metabolic syndrome occurring in young women of reproductive age. Low vitamin D levels were found to be associated with the development of obesity and insulin resistance in women with PCOS. Variants on vitamin D receptor (VDR) gene have also been related to metabolic comorbidities in general population. Aim: The aim of this case-control study was to investigate whether the VDR gene polymorphisms are associated with susceptibility to PCOS. Methods: Women with PCOS and a control group, all aged 16-40 years, were enrolled. Genotyping of VDR Fok-I (rs2228570), VDR Apa-I (rs7975232) as well as GC (rs2282679), DHCR7 (rs12785878) SNPs between groups were determined by using direct sequencing. Serum 25-hydroxyvitamin D [25(OH)] levels were measured by ELISA. Results: Mean serum 25(OH)D in the PCOS and control samples were 19.08±7 and 23.27±6.03 (p=0.048) which were significantly lower in PCOS patients compared with controls. CC genotype of the VDR Apa-I SNP was same frequent in PCOS (25.6%) and controls (25.6%) (OR: 0.9995; 95%CI: 0.528 to 1.8921; p= 0.9987). The CC genotype was also significantly associated with both lower E2 (p=0.031) and Androstenedione levels (p=0.062). We observed a significant association of GC polymorphism with 25(OH)D levels. PCOS women carrying the GG genotype (in GC genes) had significantly higher risk for vitamin D deficiency than women carrying the TT genotype. Conclusions: In conclusion, data from this study indicate that vitamin D levels are lower, and vitamin D deficiency more frequent, in PCOS than in controls. The present findings suggest that the Apa-I, Fok-I polymorphism of the VDR gene is associated with PCOS and seems to modulate ovarian steroid secretion. Further studies are needed to better clarify the biological mechanisms by which the polymorphism influences PCOS risk.

Keywords: vitamin D receptor, polymorphism, vitamin D, polycystic ovary syndrome

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973 Cultural Disposition and Implicit Dehumanization of Sexualized Females by Women

Authors: Hong Im Shin

Abstract:

Previous research demonstrated that self-objectification (women view themselves as objects for use) is related to system-justification. Three studies investigated whether cultural disposition as its system-justifying function could have an impact on self-objectification and dehumanization of sexualized women and men. Study 1 (N = 91) employed a survey methodology to examine the relationship between cultural disposition (collectivism vs. individualism), trait of system-justification, and self-objectification. The results showed that the higher tendency of collectivism was related to stronger system-justification and self-objectification. Study 2 (N = 60 females) introduced a single category implicit association task (SC-IAT) to assess the extent to which sexually objectified women were associated with uniquely human attributes (i.e., culture) compared to animal-related attributes (i.e., nature). According to results, female participants associated sexually objectified female targets less with human attributes compared to animal-related attributes. Study 3 (N = 46) investigated whether priming to individualism or collectivism was associated to system justification and sexual objectification of men and women with the use of a recognition task involving upright and inverted pictures of sexualized women and men. The results indicated that the female participants primed to individualism showed an inversion effect for sexualized women and men (person-like recognition), whereas there was no inversion effect for sexualized women in the priming condition of collectivism (object-like recognition). This implies that cultural disposition plays a mediating role for rationalizing the gender status, implicit dehumanization of sexualized females and self-objectification. Future research directions are discussed.

Keywords: cultural disposition, dehumanization, implicit test, self-objectification

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972 A Systematic Review and Meta-Analysis in Slow Gait Speed and Its Association with Worse Postoperative Outcomes in Cardiac Surgery

Authors: Vignesh Ratnaraj, Jaewon Chang

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Background: Frailty is associated with poorer outcomes in cardiac surgery, but the heterogeneity in frailty assessment tools makes it difficult to ascertain its true impact in cardiac surgery. Slow gait speed is a simple, validated, and reliable marker of frailty. We performed a systematic review and meta-analysis to examine the effect of slow gait speed on postoperative cardiac surgical patients. Methods: PubMED, MEDLINE, and EMBASE databases were searched from January 2000 to August 2021 for studies comparing slow gait speed and “normal” gait speed. The primary outcome was in-hospital mortality. Secondary outcomes were composite mortality and major morbidity, AKI, stroke, deep sternal wound infection, prolonged ventilation, discharge to a healthcare facility, and ICU length of stay. Results: There were seven eligible studies with 36,697 patients. Slow gait speed was associated with an increased likelihood of in-hospital mortality (risk ratio [RR]: 2.32; 95% confidence interval [CI]: 1.87–2.87). Additionally, they were more likely to suffer from composite mortality and major morbidity (RR: 1.52; 95% CI: 1.38–1.66), AKI (RR: 2.81; 95% CI: 1.44–5.49), deep sternal wound infection (RR: 1.77; 95% CI: 1.59–1.98), prolonged ventilation >24 h (RR: 1.97; 95% CI: 1.48–2.63), reoperation (RR: 1.38; 95% CI: 1.05–1.82), institutional discharge (RR: 2.08; 95% CI: 1.61–2.69), and longer ICU length of stay (MD: 21.69; 95% CI: 17.32–26.05). Conclusion: Slow gait speed is associated with poorer outcomes in cardiac surgery. Frail patients are twofold more likely to die during hospital admission than non-frail counterparts and are at an increased risk of developing various perioperative complications.

Keywords: cardiac surgery, gait speed, recovery, frailty

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971 Effects of Planned Pre-laboratory Discussion on Physics Students’ Acquisition of Science Process Skills in Kontagora, Niger State

Authors: Akano Benedict Ubawuike

Abstract:

This study investigated the effects of pre-laboratory discussion on physics students’ acquisition of science process skills. The study design was quasi-experimental and purposive sampling technique was applied in selecting two schools in Kontagora Town for the research based on the availability of a good physics laboratory. Intact classes already grouped by the school for the sake of small laboratory space and equipment, comprising Thirty (30) students, 15 for experimental group in School A and 15 for control in school B were the subjects for the research. The instrument used for data collection was the lesson prepared for pre – practical discussion and researcher made Science Process Skill Test (SPST ) and two (2) research questions, and two (2) research hypotheses were developed to guide the study. The data collected were analyzed using means and t-Test statistics at 0.05 level of significance. The study revealed that pre-laboratory discussion was found to be more efficacious in enhancing students’ acquisition of science process skills. It also revealed that gender, had no significant effect on students’ acquisition of science process skills. Based on the findings, it was recommended among others that teachers should encourage students to develop interest in practical activities by engaging them in pre-laboratory discussion and providing instructional materials that will challenge them to be actively involved during practical lessons. It is also recommended that Ministries of Education and professional organizations like Science Teachers' Association of Nigeria (STAN) should organize workshops, seminars and conferences for physics teachers and Physics concepts should be taught with practical activity so that the students will do science instead of learning about science.

Keywords: physics, laboratory, discussion, students, acquisition, science process skills

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970 Relationship and Associated Factors of Breastfeeding Self-efficacy among Postpartum Couples in Malawi: A Cross-sectional Study

Authors: Roselyn Chipojola, Shu-yu Kuo

Abstract:

Background: Breastfeeding self-efficacy in both mothers and fathers play a crucial role in improving exclusive breastfeeding rates. However, less is known on the relationship and predictors of paternal and maternal breastfeeding self-efficacy. This study aimed to examine the relationship and associated factors of breastfeeding self-efficacy (BSE) among mothers and fathers in Malawi. Methods: A cross-sectional study was conducted on 180 pairs of postpartum mothers and fathers at a tertiary maternity facility in central Malawi. BSE was measured using the Breastfeeding Self-Efficacy Scale Short-Form. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale. A structured questionnaire was used to collect demographic and health variables. Data were analyzed using multivariable logistic regression and multinomial logistic regression. Results: A higher score of self-efficacy was found in mothers (mean=55.7, Standard Deviation (SD) =6.5) compared to fathers (mean=50.2, SD=11.9). A significant association between paternal and maternal breastfeeding self-efficacy was found (r= 0. 32). Age, employment status, mode of birth was significantly related to maternal and paternal BSE, respectively. Older age and caesarean section delivery were significant factors of combined BSE scores in couples. A higher BSE score in either the mother or her partner predicted higher exclusive breastfeeding rates. BSE scores were lower when couples’ depressive symptoms were high. Conclusion: BSE are highly correlated between Malawian mothers and fathers, with a relatively higher score in maternal BSE. Importantly, a high BSE in couples predicted higher odds of exclusive breastfeeding, which highlights the need to include both mothers and fathers in future breastfeeding promotion strategies.

Keywords: paternal, maternal, exclusive breastfeeding, breastfeeding self‑efficacy, malawi

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969 Finite Element Approach to Evaluate Time Dependent Shear Behavior of Connections in Hybrid Steel-PC Girder under Sustained Loading

Authors: Mohammad Najmol Haque, Takeshi Maki, Jun Sasaki

Abstract:

Headed stud shear connections are widely used in the junction or embedded zone of hybrid girder to achieve whole composite action with continuity that can sustain steel-concrete interfacial tensile and shear forces. In Japan, Japan Road Association (JRA) specifications are used for hybrid girder design that utilizes very low level of stud capacity than those of American Institute of Steel Construction (AISC) specifications, Japan Society of Civil Engineers (JSCE) specifications and EURO code. As low design shear strength is considered in design of connections, the time dependent shear behavior due to sustained external loading is not considered, even not fully studied. In this study, a finite element approach was used to evaluate the time dependent shear behavior for headed studs used as connections at the junction. This study clarified, how the sustained loading distinctively impacted on changing the interfacial shear of connections with time which was sensitive to lodging history, positions of flanges, neighboring studs, position of prestress bar and reinforcing bar, concrete strength, etc. and also identified a shear influence area. Stud strength was also confirmed through pushout tests. The outcome obtained from the study may provide an important basis and reference data in designing connections of hybrid girders with enhanced stud capacity with due consideration of their long-term shear behavior.

Keywords: finite element, hybrid girder, shear connections, sustained loading, time dependent behavior

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968 An Evaluation of Neuropsychiatric Manifestations in Systemic Lupus Erythematosus Patients in Saudi Arabia and Their Associated Factors

Authors: Yousef M. Alammari, Mahmoud A. Gaddoury, Reem A. Almohaini, Sara A. Alharbi, Lena S. Alsaleem, Lujain H. Allowaihiq, Maha H. Alrashid, Abdullah H. Alghamdi, Abdullah A. Alaryni

Abstract:

Objective: The goal of this study was to establish the prevalence of neuropsychiatric symptoms in systemic lupus erythematosus (NPSLE) patients in Saudi Arabia and the variables that are linked to it. Methods: During June 2021, this cross-sectional study was carried out among SLE patients in Saudi Arabia. The Saudi Rheumatism Association exploited social media platforms to provide a self-administered online questionnaire to SLE patients. All data analyses were performed using the Statistical Packages for Social Sciences (SPSS) version 26. Results: Two hundred and five SLE patients participated in the study (females 91.3 % vs. males 8.7 %). In addition, 13.5 % of patients had a family history of SLE, and 26% had SLE for one to three years. Alteration or loss of sensation (53.4%), Fear (52.4%), and headache (48.1%) were the most prevalent signs of neuropsychiatric symptoms in systemic lupus erythematosus (NPSLE) patients. The prevalence of patients with NPSLE was 40%. In a multivariate regression model, fear, altered sensations, cerebrovascular illness, sleep disruption, and diminished interest in routine activities were identified as independent risk variables for NPSLE. Conclusion: Nearly half of SLE patients demonstrated NP manifestations, with significant symptoms including fear, alteration of sensation, cerebrovascular disease, sleep disturbance, and reduced interest in normal activities. To detect the pathophysiology of NPSLE, it is necessary to understand the relationship between neuropsychiatric morbidity and other relevant rheumatic disorders in the SLE population.

Keywords: neuropsychiatric, systemic lupus erythematosus, NPSLE, prevalence, SLE patients

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967 Networks in the Tourism Sector in Brazil: Proposal of a Management Model Applied to Tourism Clusters

Authors: Gysele Lima Ricci, Jose Miguel Rodriguez Anton

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Companies in the tourism sector need to achieve competitive advantages for their survival in the market. In this way, the models based on association, cooperation, complementarity, distribution, exchange and mutual assistance arise as a possibility of organizational development, taking as reference the concept of networks. Many companies seek to partner in local networks as clusters to act together and associate. The main objective of the present research is to identify the specificities of management and the practices of cooperation in the tourist destination of São Paulo - Brazil, and to propose a new management model with possible cluster of tourism. The empirical analysis was carried out in three phases. As a first phase, a research was made by the companies, associations and tourism organizations existing in São Paulo, analyzing the characteristics of their business. In the second phase, the management specificities and cooperation practice used in the tourist destination. And in the third phase, identifying the possible strengths and weaknesses that potential or potential tourist cluster could have, proposing the development of the management model of the same adapted to the needs of the companies, associations and organizations. As a main result, it has been identified that companies, associations and organizations could be looking for synergies with each other and collaborate through a Hiperred organizational structure, in which they share their knowledge, try to make the most of the collaboration and to benefit from three concepts: flexibility, learning and collaboration. Finally, it is concluded that, the proposed tourism cluster management model is viable for the development of tourism destinations because it makes it possible to strategically address agents which are responsible for public policies, as well as public and private companies and organizations in their strategies competitiveness and cooperation.

Keywords: cluster, management model, networks, tourism sector

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966 Feasibility Study of MongoDB and Radio Frequency Identification Technology in Asset Tracking System

Authors: Mohd Noah A. Rahman, Afzaal H. Seyal, Sharul T. Tajuddin, Hartiny Md Azmi

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Taking into consideration the real time situation specifically the higher academic institutions, small, medium to large companies, public to private sectors and the remaining sectors, do experience the inventory or asset shrinkages due to theft, loss or even inventory tracking errors. This happening is due to a zero or poor security systems and measures being taken and implemented in their organizations. Henceforth, implementing the Radio Frequency Identification (RFID) technology into any manual or existing web-based system or web application can simply deter and will eventually solve certain major issues to serve better data retrieval and data access. Having said, this manual or existing system can be enhanced into a mobile-based system or application. In addition to that, the availability of internet connections can aid better services of the system. Such involvement of various technologies resulting various privileges to individuals or organizations in terms of accessibility, availability, mobility, efficiency, effectiveness, real-time information and also security. This paper will look deeper into the integration of mobile devices with RFID technologies with the purpose of asset tracking and control. Next, it is to be followed by the development and utilization of MongoDB as the main database to store data and its association with RFID technology. Finally, the development of a web based system which can be viewed in a mobile based formation with the aid of Hypertext Preprocessor (PHP), MongoDB, Hyper-Text Markup Language 5 (HTML5), Android, JavaScript and AJAX programming language.

Keywords: RFID, asset tracking system, MongoDB, NoSQL

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965 Understanding the Coping Experience of Mothers with Childhood Trauma Histories: A Qualitative Study

Authors: Chan Yan Nok

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The present study is a qualitative study based on the coping experiences of six Hong Kong Chinese mothers who had childhood trauma from their first-person perspective. Expanding the perspective beyond the dominant discourse of “inter-generation transmission of trauma”, this study explores the experiences and meanings of child trauma embedded in their narratives through the process of thematic analysis and narrative analysis. The interviewees painted a nuanced picture of their process of coping and trauma resolution. First, acknowledgement; second, feel safe and start to tell the story of trauma; third, feel the feelings and expression of emotions; fourth, clarifying and coping with the impacts of trauma; fifth, integration and transformation; and sixth, using their new understanding of experience to have a better life. It was seen that there was no “end” within the process of trauma resolution. Instead, this is an ongoing process with positive healing trajectory. Analysis of the stories of the mothers revealed recurrent themes around continuous self-reflective awareness in the process of trauma coping. Rather than being necessarily negative and detrimental, childhood trauma could highlight the meanings of being a mother and reveal opportunities for continuous personal growth and self-enhancement. Utilizing the sense of inadequacy as a core driver in the trauma recovery process while developing a heightened awareness of the unfinished business embedded in their “automatic pattern” of behaviors, emotions, and thoughts can help these mothers become more flexible to formulate new methods in facing future predicaments. Future social work and parent education practices should help mothers deal with unresolved trauma, make sense of their impacts of childhood trauma and discover the growth embedded in the past traumatic experience. They should be facilitated in “acknowledging the reality of the trauma”, including understanding their complicated emotions arising from the traumatic experiences and voicing their struggles. In addition, helping these mothers to be aware of short-term and long-term trauma impacts (i.e., secondary responses to the trauma) and explore their effective coping strategies in “overcoming secondary responses to the trauma” are crucial for their future positive adjustment and transformation. Through affirming their coping abilities and lessons learnt from past experiences, mothers can reduce feelings of shame and powerlessness and enhance their parental capacity.

Keywords: childhood trauma, coping, mothers, self-awareness, self-reflection, trauma resolution

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964 Detecting Anomalous Matches: An Empirical Study from National Basketball Association

Authors: Jacky Liu, Dulani Jayasuriya, Ryan Elmore

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Match fixing and anomalous sports events have increasingly threatened the integrity of professional sports, prompting concerns about existing detection methods. This study addresses prior research limitations in match fixing detection, improving the identification of potential fraudulent matches by incorporating advanced anomaly detection techniques. We develop a novel method to identify anomalous matches and player performances by examining series of matches, such as playoffs. Additionally, we investigate bettors' potential profits when avoiding anomaly matches and explore factors behind unusual player performances. Our literature review covers match fixing detection, match outcome forecasting models, and anomaly detection methods, underscoring current limitations and proposing a new sports anomaly detection method. Our findings reveal anomalous series in the 2022 NBA playoffs, with the Phoenix Suns vs Dallas Mavericks series having the lowest natural occurrence probability. We identify abnormal player performances and bettors' profits significantly decrease when post-season matches are included. This study contributes by developing a new approach to detect anomalous matches and player performances, and assisting investigators in identifying responsible parties. While we cannot conclusively establish reasons behind unusual player performances, our findings suggest factors such as team financial difficulties, executive mismanagement, and individual player contract issues.

Keywords: anomaly match detection, match fixing, match outcome forecasting, problematic players identification

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963 Emotional Intelligence and Gender Role Attitudes of Married Individuals: Moderating Role of Gender and Work Status

Authors: Saima Kalsoom, Sobia Masood, Muhammad Faran

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This study aimed to examine the association between emotional intelligence and gender role attitudes of married individuals. Another aim of this study was to test the moderating role of gender work status of married individuals for predicting gender role attitudes from emotional intelligence. A sample of (N = 500) married working men and women (both working & housewives) was approached through purposive convenience sampling technique. The data was collected employing cross-sectional research design. The indigenous versions of the Gender Role Attitudes Scale and perceived Emotional Intelligence Scale were used. The results of alpha coefficients for both the scales and subscales used in this study designated satisfactory evidence for internal consistency and reliability. Assessment of correlation coefficients showed significant positive correlation between gender role attitudes and emotional intelligence, subfactors of emotional intelligence i.e., emotional self-regulation, emotional self-awareness, and interpersonal skills with gender role attitudes. Results of model testing revealed that gender (the effect was significant for women) and work status (the effect was more significant for married working women than married working men and housewives) of the married individuals significantly moderated the relationship between emotional intelligence and gender role attitudes into the positive direction. Further, it was also found that gender and work status also moderated the relationship between emotional self-regulation (as sub factor of emotional intelligence) and gender role attitudes in a positive direction. In conclusion, this empirical evidence is vital contribution derived from the traditional and collectivistic socio-cultural background of Pakistan.

Keywords: gender role attitudes, emotional intelligence, emotional self-regulation, gender, work status, married working women

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962 DUSP16 Inhibition Rescues Neurogenic and Cognitive Deficits in Alzheimer's Disease Mice Models

Authors: Huimin Zhao, Xiaoquan Liu, Haochen Liu

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The major challenge facing Alzheimer's Disease (AD) drug development is how to effectively improve cognitive function in clinical practice. Growing evidence indicates that stimulating hippocampal neurogenesis is a strategy for restoring cognition in animal models of AD. The mitogen-activated protein kinase (MAPK) pathway is a crucial factor in neurogenesis, which is negatively regulated by Dual-specificity phosphatase 16 (DUSP16). Transcriptome analysis of post-mortem brain tissue revealed up-regulation of DUSP16 expression in AD patients. Additionally, DUSP16 was involved in regulating the proliferation and neural differentiation of neural progenitor cells (NPCs). Nevertheless, whether the effect of DUSP16 on ameliorating cognitive disorders by influencing NPCs differentiation in AD mice remains unclear. Our study demonstrates an association between DUSP16 SNPs and clinical progression in individuals with mild cognitive impairment (MCI). Besides, we found that increased DUSP16 expression in both 3×Tg and SAMP8 models of AD led to NPC differentiation impairments. By silencing DUSP16, cognitive benefits, the induction of AHN and synaptic plasticity, were observed in AD mice. Furthermore, we found that DUSP16 is involved in the process of NPC differentiation by regulating c-Jun N-terminal kinase (JNK) phosphorylation. Moreover, the increased DUSP16 may be regulated by the ETS transcription factor (ELK1), which binds to the promoter region of DUSP16. Loss of ELK1 resulted in decreased DUSP16 mRNA and protein levels. Our data uncover a potential regulatory role for DUSP16 in adult hippocampal neurogenesis and provide a possibility to find the target of AD intervention.

Keywords: alzheimer's disease, cognitive function, DUSP16, hippocampal neurogenesis

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961 Research on the Planning Spatial Mode of China's Overseas Industrial Park

Authors: Sidong Zhao, Xingping Wang

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Recently, the government of China has provided strong support the developments of overseas industrial parks. The global distribution of China overseas industrial parks has gradually moved from the 'sparks of fire' to the 'prairie fires.' The support and distribution have promoted developing overseas industrial parks to a strategy of constructing a China's new open economic system and a typical representative of the 'Chinese wisdom' and the 'China's plans' that China has contributed to the globalization of the new era under the initiative of the Belt and Road. As the industrial parks are the basis of 'work/employment', a basic function of a city (Athens Constitution), planning for developments of industrial parks has become a long-term focus of urban planning. Based on the research of the planning and the analysis of the present developments of some typical China overseas industrial parks, we found some interesting rules: First, large numbers of the China overseas industrial parks are located in less developed countries. These industrial parks have become significant drives of the developments of the host cities and even the regions in those countries, especially in investment, employment and paid tax fee for the local, etc. so, the planning and development of overseas industrial parks have received extensive attention. Second, there are some problems in the small part of the overseas Park, such as the planning of the park not following the planning of the host city and lack of implementation of the park planning, etc. These problems have led to the difficulties of the implementation of the planning and the sustainable developments of the parks. Third, a unique pattern of space development has been formed. in the dimension of the patterns of regional spatial distribution, there are five characteristics - along with the coast, along the river, along with the main traffic lines and hubs, along with the central urban area and along the connections of regions economic. In the dimension of the spatial relationships between the industrial park and the city, there is a growing and evolving trend as 'separation – integration - union'. In the dimension of spatial mode of the industrial parks, there are different patterns of development, such as a specialized industrial park, complex industrial park, characteristic town and new urban area of industry, etc. From the perspective of the trends of the developments and spatial modes, in the future, the planning of China overseas industrial parks should emphasize the idea of 'building a city based on the industrial park'. In other words, it's making the developments of China overseas industrial parks move from 'driven by policy' to 'driven by the functions of the city', accelerating forming the system of China overseas industrial parks and integrating the industrial parks and the cities.

Keywords: overseas industrial park, spatial mode, planning, China

Procedia PDF Downloads 182
960 Assessing the Feasibility of Commercial Meat Rabbit Production in the Kumasi Metropolis of Ghana

Authors: Nana Segu Acquaah-Harrison, James Osei Mensah, Richard Aidoo, David Amponsah, Amy Buah, Gilbert Aboagye

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The study aimed at assessing the feasibility of commercial meat rabbit production in the Kumasi Metropolis of Ghana. Structured and unstructured questionnaires were utilized in obtaining information from two hundred meat consumers and 15 meat rabbit farmers. Data were analyzed using Net Present Value (NPV), Internal Rate of Return (IRR), Benefit Cost Ratio (BCR)/Profitability Index (PI) technique, percentages and chi-square contingency test. The study found that the current demand for rabbit meat is low (36%). The desirable nutritional attributes of rabbit meat and other socio economic factors of meat consumers make the potential demand for rabbit meat high (69%). It was estimated that GH¢5,292 (approximately $ 2672) was needed as a start-up capital for a 40-doe unit meat rabbit farm in Kumasi Metropolis. The cost of breeding animals, housing and equipment formed 12.47%, 53.97% and 24.87% respectively of the initial estimated capital. A Net Present Value of GH¢ 5,910.75 (approximately $ 2984) was obtained at the end of the fifth year, with an internal rate return and profitability index of 70% and 1.12 respectively. The major constraints identified in meat rabbit production were low price of rabbit meat, shortage of fodder, pest and diseases, high cost of capital, high cost of operating materials and veterinary care. Based on the analysis, it was concluded that meat rabbit production is feasible in the Kumasi Metropolis of Ghana. The study recommends embarking on mass advertisement; farmer association and adapting to new technologies in the production process will help to enhance productivity.

Keywords: feasibility, commercial meat rabbit, production, Kumasi, Ghana

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959 Association between Severe Acidemia before Endotracheal Intubation and the Lower First Attempt Intubation Success Rate

Authors: Keiko Naito, Y. Nakashima, S. Yamauchi, Y. Kunitani, Y. Ishigami, K. Numata, M. Mizobe, Y. Homma, J. Takahashi, T. Inoue, T. Shiga, H. Funakoshi

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Background: A presence of severe acidemia, defined as pH < 7.2, is common during endotracheal intubation for critically ill patients in the emergency department (ED). Severe acidemia is widely recognized as a predisposing factor for intubation failure. However, it is unclear that acidemic condition itself actually makes endotracheal intubation more difficult. We aimed to evaluate if a presence of severe acidemia before intubation is associated with the lower first attempt intubation success rate in the ED. Methods: This is a retrospective observational cohort study in the ED of an urban hospital in Japan. The collected data included patient demographics, such as age, sex, and body mass index, presence of one or more factors of modified LEMON criteria for predicting difficult intubation, reasons for intubation, blood gas levels, airway equipment, intubation by emergency physician or not, and the use of the rapid sequence intubation technique. Those with any of the following were excluded from the analysis: (1) no blood gas drawn before intubation, (2) cardiopulmonary arrest, and (3) under 18 years of age. The primary outcome was the first attempt intubation success rates between a severe acidemic patients (SA) group and a non-severe acidemic patients (NA) group. Logistic regression analysis was used to test the first attempt success rates for intubations between those two groups. Results: Over 5 years, a total of 486 intubations were performed; 105 in the SA group and 381 in the NA group. The univariate analysis showed that the first attempt intubation success rate was lower in the SA group than in the NA group (71.4% vs 83.5%, p < 0.01). The multivariate logistic regression analysis identified that severe acidemia was significantly associated with the first attempt intubation failure (OR 1.9, 95% CI 1.03-3.68, p = 0.04). Conclusions: A presence of severe acidemia before endotracheal intubation lowers the first attempt intubation success rate in the ED.

Keywords: acidemia, airway management, endotracheal intubation, first-attempt intubation success rate

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958 Wearable Devices Could Reduce the Risk of Injury in Parasomnias Phenotypes

Authors: Vivian Correa

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Hypothesis There are typical patterns - phenotypes - of sleep behaviors by age and biological sex groups of parasomnia patients where wearable devices could avoid injuries. Materials and methods We analyzed public video records on sleep-related behaviors likely representing parasomnias, looking for phenotypes in different groups. We searched public internet databases using the keywords “sleepwalking”, “sleep eating,” “sleep sex”, and “aggression in sleep” in six languages. Poor-quality vide-records and those showing apparently faked sleep behaviors were excluded. We classified the videos into estimated sex and age (children, adults, elderly) groups; scored the activity types by a self-made scoring scale; and applied binary logistic regression for analyzing the association between sleep behaviors versus the groups by STATA package providing 95% confidence interval and the probability of statistical significance. Results 224 videos (102 women) were analyzed. The odds of sleepwalking and related dangerous behaviors were lower in the elderly than in adults (P<0.025). Females performed complex risky behaviors during sleepwalking more often than males (P<0.012). Elderly people presented emotional behaviors less frequently than adults (P<0.004), and females showed them twice often as males. Elderly males had 40-fold odds compared to adults and children to perform aggressive movements and 70-fold odds of complex movements in the bed compared to adults. Conclusion Unlike other groups, the high chances of adults being sleepwalkers and elderly males performing intense and violent movements in bed showed us the importance of developing wearable parasomnia devices to prevent injuries.

Keywords: parasomnia, wearable devices, sleepwalking, RBD

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957 Retrofitting Adaptive Reuse into Palaces of Northern India

Authors: Shefali Nayak

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The architectural appeal, familiarity, and idiom of culturally significant structures are due to societal attachment to various movements, historical association or deviation. Generally, the urge to preserve a building in the northern part of India is driven either by emotional dogma or rational thinking, but, it is also influenced by traditional affinity. The northern region of India has an assortment of palaces and Havelis belonging to various time periods and families with vernacular yet signature style of architecture. Many of them are either successfully conserved by being put into adaptive reuse and some of them have been midst controversies and continued to remain in ruins. The research focuses on comparing successful examples of adaptive reuse such as Neemrana, Mehrangargh Fort palace with a few other merchant havelis converted into heritage hotels. Furthermore, evaluates the architectural aspects of structure, materials, plumbing and electrical installations, as well as specific challenges faced by heritage professionals practicing sustainability, while respecting traditional feelings of various stakeholders. This paper concludes through the analysis of the case study that, its highly unlikely for sustainable design cannot be used as a stand-alone application for heritage structures or cities, it needs the support of architecture conservation to be put into practice. However, it is often demanding to fit a new use of a building into an aged structure. This paper records modern-day generic requirements that reflect challenges faced by different architects, while conserving a heritage structure and retrofitting it into today's requisites. The research objective is to establish how conservation, restoration, and urban regeneration are closely related to sustainable architecture in historical cities.

Keywords: architecture conservation, architecture heritage, adaptive reuse, retrofitting, sustainability, urban regeneration

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956 The International Constitutional Order and Elements of Human Rights

Authors: Girma Y. Iyassu Menelik

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“The world is now like a global village!” so goes the saying that shows that due to development and technology the countries of the world are now closely linked. In the field of Human rights there is a close relationship in the way that rights are recognised and enforced. This paper will show that human rights have evolved from ancient times through important landmarks such as the Magna Carta, the French Declaration of Rights of Man and of the Citizen and the American Bill of Rights. The formation of the United Nations after the Second World War resulted in the need to codify and protect human rights. There are some rights which are so fundamental that they are found in international and continental instruments, national constitutions and domestic legislation. In the civil and political sphere they include the right to vote, to freedom of association, speech and assembly, right to life, privacy and fair trial. In the economic and social sphere you have the right to work, protection of the family, social security and rights to education, health and shelter. In some instance some rights can be suspended in times of public emergency but such derogations shall be circumscribed by the law and in most constitutions such limitations are subject to judicial review. However, some rights are so crucial that they cannot be derogated from under any circumstances and these include the right to life, recognition before the law, freedom from torture and slavery and of thought, conscience and religion. International jurisprudence has been developed to protect fundamental rights and avoid discrimination on the grounds of race, colour, sex, language or social origin. The elaborate protection system go to show that these rights have become part of the international order and they have universal application. We have now got to a stage where UDHR, ICCPR and ICESCR and have come to be regarded as part of an international bill of rights with horizontal and vertical enforcement mechanisms involving state parties, NGO’s , international bodies and other organs.

Keywords: rights, international, constitutional, state, judiciary

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955 Teenagers in Conflict with Law: Exploratory Study about Psychic Suffering

Authors: Carolina Alcântara, Ileno Costa

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This study had the objective to systemize the main psycho-social and socioeducational aspects that related with the psychic suffering of adolescents in conflict of law and freedom privation. This research wanted to verify the signals and symptoms identified trough themselves perceptions related to their condition of health/insanity. In a similar way, it was objectified to know the opinions of the ambient conditions of the institution the use of the currently available resources for Health Service and Educational Service. The methodological proposal is based on the quant-qualitative analysis of interviews half-structuralized carried through with 36 teenagers was using psychiatric medication continuously. The data had pointed the experiences of sleeplessness and nightmares, associates or not with experiences of loss of reality (hallucinations) had constituted the illness most frequent. The self-punishment behavior appeared at second place. With regard to the ambient factors, it was verified that institution had, in general way, guaranteed the physical integrity and the maintenance of the health. Amongst the current available resources of Health Service, the administration of anticonvulsivants, in association with other psychotropic drugs has been widely used. The school was viewed as important device of available in the institution. By means of the adolescent’s understanding who do not like to go to the school, they don’t disqualify the knowledge, in contrast, they wanted for knowledge, however, they were frustrated for not having their educational supplies adequately, affirming that the school is weak or they do not learn. Finally, among the possible conclusions guided for the Winnicott’s thought, it was observed that institution in analysis is a representative of the paternal function. However, to begin the self-cure process is necessary that formation of therapeutical bonds. The group of teachers is identified as the main tool of change.

Keywords: serious psychic suffering, adolescent in conflict with the law, delinquency, privation of freedom

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954 Farmers' Perspective on Soil Health in the Indian Punjab: A Quantitative Analysis of Major Soil Parameters

Authors: Sukhwinder Singh, Julian Park, Dinesh Kumar Benbi

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Although soil health, which is recognized as one of the key determinants of sustainable agricultural development, can be measured by a range of physical, chemical and biological parameters, the widely used parameters include pH, electrical conductivity (EC), organic carbon (OC), plant available phosphorus (P) and potassium (K). Soil health is largely affected by the occurrence of natural events or human activities and can be improved by various land management practices. A database of 120 soil samples collected from farmers’ fields spread across three major agro-climatic zones of Punjab suggested that the average pH, EC, OC, P and K was 8.2 (SD = 0.75, Min = 5.5, Max = 9.1), 0.27 dS/m (SD = 0.17, Min = 0.072 dS/m, Max = 1.22 dS/m), 0.49% (SD = 0.20, Min = 0.06%, Max = 1.2%), 19 mg/kg soil (SD = 22.07, Min = 3 mg/kg soil, Max = 207 mg/kg soil) and 171 mg/kg soil (SD = 47.57, Min = 54 mg/kg soil, Max = 288 mg/kg soil), respectively. Region-wise, pH, EC and K were the highest in south-western district of Ferozpur whereas farmers in north-eastern district of Gurdaspur had the best soils in terms of OC and P. The soils in the central district of Barnala had lower OC, P and K than the respective overall averages while its soils were normal but skewed towards alkalinity. Besides agro-climatic conditions, the size of landholding and farmer education showed a significant association with Soil Fertility Index (SFI), a composite index calculated using the aforementioned parameters’ normalized weightage. All the four stakeholder groups cited the current cropping patterns, burning of rice crop residue, and imbalanced use of chemical fertilizers for change in soil health. However, the current state of soil health in Punjab is unclear, which needs further investigation based on temporal data collected from the same field to see the short and long-term impacts of various crop combinations and varied cropping intensity levels on soil health.

Keywords: soil health, punjab agriculture, sustainability, soil fertility index

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953 Time Pressure and Its Effect at Tactical Level of Disaster Management

Authors: Agoston Restas

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Introduction: In case of managing disasters decision makers can face many times such a special situation where any pre-sign of the drastically change is missing therefore the improvised decision making can be required. The complexity, ambiguity, uncertainty or the volatility of the situation can require many times the improvisation as decision making. It can be taken at any level of the management (strategic, operational and tactical) but at tactical level the main reason of the improvisation is surely time pressure. It is certainly the biggest problem during the management. Methods: The author used different tools and methods to achieve his goals; one of them was the study of the relevant literature, the other one was his own experience as a firefighting manager. Other results come from two surveys that are referred to; one of them was an essay analysis, the second one was a word association test, specially created for the research. Results and discussion: This article proves that, in certain situations, the multi-criteria, evaluating decision-making processes simply cannot be used or only in a limited manner. However, it can be seen that managers, directors or commanders are many times in situations that simply cannot be ignored when making decisions which should be made in a short time. The functional background of decisions made in a short time, their mechanism, which is different from the conventional, was studied lately and this special decision procedure was given the name recognition-primed decision. In the article, author illustrates the limits of the possibilities of analytical decision-making, presents the general operating mechanism of recognition-primed decision-making, elaborates on its special model relevant to managers at tactical level, as well as explore and systemize the factors that facilitate (catalyze) the processes with an example with fire managers.

Keywords: decision making, disaster managers, recognition primed decision, model for making decisions in emergencies

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952 Nurse Practitioner Led Pediatric Primary Care Clinic in a Tertiary Care Setting: Improving Access and Health Outcomes

Authors: Minna K. Miller, Chantel. E. Canessa, Suzanna V. McRae, Susan Shumay, Alissa Collingridge

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Primary care provides the first point of contact and access to health care services. For the pediatric population, the goal is to help healthy children stay healthy and to help those that are sick get better. Primary care facilitates regular well baby/child visits; health promotion and disease prevention; investigation, diagnosis and management of acute and chronic illnesses; health education; both consultation and collaboration with, and referral to other health care professionals. There is a protective association between regular well-child visit care and preventable hospitalization. Further, low adherence to well-child care and poor continuity of care are independently associated with increased risk of hospitalization. With a declining number of family physicians caring for children, and only a portion of pediatricians providing primary care services, it is becoming increasingly difficult for children and their families to access primary care. Nurse practitioners are in a unique position to improve access to primary care and improve health outcomes for children. Limited literature is available on the nurse practitioner role in primary care pediatrics. The purpose of this paper is to describe the development, implementation and evaluation of a Nurse Practitioner-led pediatric primary care clinic in a tertiary care setting. Utilizing the participatory, evidence-based, patient-focused process for advanced practice nursing (PEPPA framework), this paper highlights the results of the initial needs assessment/gap analysis, the new service delivery model, populations served, and outcome measures.

Keywords: access, health outcomes, nurse practitioner, pediatric primary care, PEPPA framework

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