Search results for: best evidence
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3759

Search results for: best evidence

1419 Transcriptome and Metabolome Analysis of a Tomato Solanum Lycopersicum STAYGREEN1 Null Line Generated Using Clustered Regularly Interspaced Short Palindromic Repeats/Cas9 Technology

Authors: Jin Young Kim, Kwon Kyoo Kang

Abstract:

The SGR1 (STAYGREEN1) protein is a critical regulator of plant leaves in chlorophyll degradation and senescence. The functions and mechanisms of tomato SGR1 action are poorly understood and worthy of further investigation. To investigate the function of the SGR1 gene, we generated a SGR1-knockout (KO) null line via clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9-mediated gene editing and conducted RNA sequencing and gas chromatography tandem mass spectrometry (GC-MS/MS) analysis to identify the differentially expressed genes. The SlSGR1 (Solanum lycopersicum SGR1) knockout null line clearly showed a turbid brown color with significantly higher chlorophyll and carotenoid content compared to wild-type (WT) fruit. Differential gene expression analysis revealed 728 differentially expressed genes (DEGs) between WT and sgr1 #1-6 line, including 263 and 465 downregulated and upregulated genes, respectively, for which fold change was >2, and the adjusted p-value was <0.05. Most of the DEGs were related to photosynthesis and chloroplast function. In addition, the pigment, carotenoid changes in sgr1 #1-6 line was accumulated of key primary metabolites such as sucrose and its derivatives (fructose, galactinol, raffinose), glycolytic intermediates (glucose, G6P, Fru6P) and tricarboxylic acid cycle (TCA) intermediates (malate and fumarate). Taken together, the transcriptome and metabolite profiles of SGR1-KO lines presented here provide evidence for the mechanisms underlying the effects of SGR1 and molecular pathways involved in chlorophyll degradation and carotenoid biosynthesis.

Keywords: tomato, CRISPR/Cas9, null line, RNA-sequencing, metabolite profiling

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1418 Understanding the Semantic Network of Tourism Studies in Taiwan by Using Bibliometrics Analysis

Authors: Chun-Min Lin, Yuh-Jen Wu, Ching-Ting Chung

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The formulation of tourism policies requires objective academic research and evidence as support, especially research from local academia. Taiwan is a small island, and its economic growth relies heavily on tourism revenue. Taiwanese government has been devoting to the promotion of the tourism industry over the past few decades. Scientific research outcomes by Taiwanese scholars may and will help lay the foundations for drafting future tourism policy by the government. In this study, a total of 120 full journal articles published between 2008 and 2016 from the Journal of Tourism and Leisure Studies (JTSL) were examined to explore the scientific research trend of tourism study in Taiwan. JTSL is one of the most important Taiwanese journals in the tourism discipline which focuses on tourism-related issues and uses traditional Chinese as the study language. The method of co-word analysis from bibliometrics approaches was employed for semantic analysis in this study. When analyzing Chinese words and phrases, word segmentation analysis is a crucial step. It must be carried out initially and precisely in order to obtain meaningful word or word chunks for further frequency calculation. A word segmentation system basing on N-gram algorithm was developed in this study to conduct semantic analysis, and 100 groups of meaningful phrases with the highest recurrent rates were located. Subsequently, co-word analysis was employed for semantic classification. The results showed that the themes of tourism research in Taiwan in recent years cover the scope of tourism education, environmental protection, hotel management, information technology, and senior tourism. The results can give insight on the related issues and serve as a reference for tourism-related policy making and follow-up research.

Keywords: bibliometrics, co-word analysis, word segmentation, tourism research, policy

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1417 Geomorphologic Evolution of the Southern Habble-Rud River Basin, North of Iran

Authors: Maryam Jaberi, Siavosh Shayan, Mojtaba Yamani

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Habble-Rud River basin (HR), up to 100 km length, one of the largest watersheds which drain into deserts to the north of Central Iran (Dasht-e Kavir). This stream is oblique with the NE-SW trending, flow in the southern range of central Alborz Mountains and the northern border of Central Iran. The end of the ~17 km suddenly change direction and with the southern trending to have a morphology which meanders passes through the Alborz Mountain ridge and flows into the Garmsar plain where it forms one of the largest alluvial fans in Iran, i.e. the vast Garmsar alluvial fan with an area of 476 km2. This study was carried out through morphometric analyses, longitudinal river profiles, and study of geomorpholic evidence such as fluvial terraces, gypsum-salt domes, seismic data, and satellite images. This study aimed to investigate the changes in the pattern of rivers in the southern part of the HR river basin. The southern part of HR river basin located at the southern foothills of the Central Alborz is characterized the thrust faults (Sorkheh-Kalut and Garmsar faults), folds,diapirs and arid climate. The activity of more than 10 salt domes that belong to the Oligocene-Miocene period has considerably influenced the pattern of streams in this region. Dissolution of these domes has not only reduced the quality of water and soil resources, but also has led to the formation of badlands and gullies.Our results indicated that the pattern of rivers in the southern part of HR river basin was influenced by discharge of the HR river in Quaternary, geological structure, subsidence of Central Iran and vertical uplift of Alborz mountain. These agents caused the formation meanders in the southern part of the HR River and evaluation of the seasonal rivers like Shoor-Darre and Garmabsar.

Keywords: geomorphologic evaluation, rivers pattern, Habble-Rud River basin, seasonal rivers

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1416 Psychedelic Assisted-Treatment for Patients with Opioid Use Disorder

Authors: Daniele Zullino, Gabriel Thorens, Léonice Furtado, Federico Seragnoli, Radu Iuga, Louise Penzenstadler

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Context: Since the start of the 21st century, there has been a resurgence of interest in psychedelics, marked by a renewed focus on scientific investigations into their therapeutic potential. While psychedelic therapy has gained recognition for effectively treating depression and anxiety disorders, notable progress has been made in the clinical development of substances like psilocybin. Moreover, mounting evidence suggests promising applications of Lysergic acid diethylamide (LSD) and psilocybin in the field of addiction medicine. In Switzerland, compassionate treatment with LSD and psilocybin has been permitted since 2014 through exceptional licenses granted by the Federal Office of Public Health. This treatment approach is also available within the Geneva treatment program, extending its accessibility to patients undergoing opioid-assisted treatment involving substances like morphine and diacetylmorphine. The aim of this study is to assess the feasibility of psychedelic-assisted therapy in patients with opioid use disorder who are undergoing opioid-assisted treatment. This study addresses the question of whether psychedelic-assisted therapy can be successfully implemented in patients with opioid use disorder. It also explores the effects of psychedelic therapy on the patient's experiences and outcomes. Methodology: This is an open case series on six patients who have undergone at least one session with either LSD (100-200 micrograms) or psilocybin (20-40 mg). The patients were assessed using the Five Dimensional Altered States of Consciousness (5D-ASC)-Scale. The data were analyzed descriptively to identify patterns and trends in the patients' experiences. Results: The patients experienced substantial positive psychedelic effects during the psychedelic sessions without significant adverse effects. The patients reported positive experiences and improvements in their condition. Conclusion: The findings of this study support the feasibility and potential efficacy of psychedelic-assisted therapy in patients undergoing opioid-assisted treatment.

Keywords: psychedelics, psychedelic-assisted treatment, opioid use disorder, addiction, LSD, psilocybin

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1415 Effects of Non-Diagnostic Haptic Information on Consumers' Product Judgments and Decisions

Authors: Eun Young Park, Jongwon Park

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A physical touch of a product can provide ample diagnostic information about the product attributes and quality. However, consumers’ product judgments and purchases can be erroneously influenced by non-diagnostic haptic information. For example, consumers’ evaluations of the coffee they drink could be affected by the heaviness of a cup that is used for just serving the coffee. This important issue has received little attention in prior research. The present research contributes to the literature by identifying when and how non-diagnostic haptic information can have an influence and why such influence occurs. Specifically, five studies experimentally varied the content of non-diagnostic haptic information, such as the weight of a cup (heavy vs. light) and the texture of a cup holder (smooth vs. rough), and then assessed the impact of the manipulation on product judgments and decisions. Results show that non-diagnostic haptic information has a biasing impact on consumer judgments. For example, the heavy (vs. light) cup increases consumers’ perception of the richness of coffee in it, and the rough (vs. smooth) texture of a cup holder increases the perception of the healthfulness of fruit juice in it, which in turn increases consumers’ purchase intentions of the product. When consumers are cognitively distracted during the touch experience, the impact of the content of haptic information is no longer evident, but the valence (positive vs. negative) of the haptic experience influences product judgments. However, consumers are able to avoid the impact of non-diagnostic haptic information, if and only if they are both knowledgeable about the product category and undistracted from processing the touch experience. In sum, the nature of the influence by non-diagnostic haptic information (i.e., assimilation effect vs. contrast effect vs. null effect) is determined by the content and valence of haptic information, the relative impact of which depends on whether consumers can identify the content and source of the haptic information. Theoretically, to our best knowledge, this research is the first to document the empirical evidence of the interplay between cognitive and affective processes that determines the impact of non-diagnostic haptic information. Managerial implications are discussed.

Keywords: consumer behavior, haptic information, product judgments, touch effect

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1414 Earnings Management and Tone Management: Evidence from the UK

Authors: Salah Kayed Kayed, Jessica Hong Yang

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This study investigates, whether earnings management in the audited financial statements is associated with tone management in the narrative sections of the annual report in the UK. Earnings management and narrative disclosure are communication strategies used from managers to communicate with investors or other users. Because earnings management and narrative disclosure stem from managers, they can exploit this by doing manipulation in their earnings, and simultaneously disclosing qualitative text (narrative information) in their reports as a tone of words, which will affect users’ perception, and hence users will be misinformed. The association between earnings and tone management can be explained by the self-serving, through cognitive reference points, theory. The sample period lasts from 2010 to 2015, and the sample comprises all non-financial firms that consider under FTSE 350 in any year during the sample period. A list of words from previous research is used to measure the tone in the narrative sections of the annual report. Because this study focuses on the managerial strategic choice and the subjective issues that come from management, it uses the abnormal tone to capture the managerial discretion on tone, and a number of different discretionary accruals proxies to measure earnings management, where accruals management is considered as a manipulation tool from managers to change the users' perception. This research is motivated to fulfil the literature gap by examining the association between earnings and tone management. Moreover, if firms that apply earnings management use tone management to mislead investors, it is beneficial for investors, policy makers, standard setters, or other users to know whether there is an association between earnings management and tone management. Clearly, we believe that this study is fundamental in the accounting context, where it evaluates the communication strategies that are used in firms' financial reports. Consistent with prior research, it is expected that tone management is positively associated with earnings management. This means that firms that use earnings management have incentives to manipulate in their narrative disclosure through tone of words, to reflect a good perception for users, which will conceal the earnings management techniques used in their reporting.

Keywords: earnings management, FTSE 350, narrative disclosure, tone management

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1413 Credibility and Personal Social Media Use of Health Professionals: A Field Study

Authors: Abrar Al-Hasan

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Objectives: There is ongoing discourse regarding the potential risks to health professionals' reputations and credibility arising from their personal social media use. However, the specific impacts on professional credibility and the health professional-client relationship remain largely unexplored. This study aims to investigate the type and frequency of the content posted by health professionals on their Instagram accounts and its influence on their credibility and the professional-client relationship. Methodology: In a controlled field study, participants reviewed randomly assigned mock Instagram profiles of health professionals. Mock profiles were constructed according to gender (female/male), social media usage (high/low), and social media richness (high/ low), with richness increasing from posts to stories to reels and personal content type (high /low). Participants then rated the profile owners’ credibility on a visual analog scale. An analysis of variance compared these ratings, and mediation analyses assessed the influence of credibility ratings on participants' willingness to become clients of the mock health professional. Results: Results from 315 participants showed that health professionals with personal Instagram profiles displaying high social media richness were perceived as more credible than those with lower social media richness. Low social media usage is perceived as more credible than high social media usage. Personal content type is perceived as less credible as compared to those with low personal content type. Contributions: These findings provide initial evidence of the impact of health professionals' personal online disclosures on credibility and the health professional-client relationship. Understanding public perceptions of professionalism and credibility is essential for informing e-professionalism guidelines and promoting best practices in social media use among health professionals.

Keywords: credibility, consumer behavior, social media, media richness, healthcare professionals

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1412 Empowering Leadership and Constructive Voice: A Sequential Mediation Analysis

Authors: Umamaheswara Rao Jada, Susmita Mukhopadhyay

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In the present highly complex, dynamic and interdependent organizational environment, employees' ideas, opinions and suggestions which is technically referred to as ‘constructive employee voice’ is increasingly being recognized and valued. Literature has consistently demonstrated the relevance of leadership in employee voicing behavior, however the new form of leadership, ‘empowering leadership’ has not been given much attention. The study, therefore, devotes itself to the effort to explore the impact of this new form of leadership on employee voice behavior and the interplay with leader member exchange (LMX) and psychological safety as mediators in the same. The study utilizes structural equation modeling for analyzing the data collected from 310 Indian service industry employees through the questionnaire developed for the study. The findings of the study demonstrate the significant impact of empowering form of leadership on employees’ constructive voice behavior. Additionally, supporting results were observed for the mediating impact of leader member exchange (LMX) and psychological safety between empowering leadership and employees’ constructive voice behavior. The results of this study provide insights into the intervening mechanisms by linking leaders’ empowering behavior with employees’ constructive voice, while also highlighting the potential importance of LMX relationship in organizations and psychological safety in the context of constructive voice behavior. The study brings forth the relevance of the new form of leadership, ‘empowering leadership’ for fostering the better exchange of ideas, opinions, and suggestions between leaders and followers which tend to benefit the organization, providing empirical evidence of the sequential mediation of LMX and psychological safety. The piece of work is assumed to benefit the leaders in organizations by providing them the basis for adopting empowering form of leadership in light of results displayed.

Keywords: constructive voice, empowering leadership, leader member exchange (LMX), psychological safety, sequential mediation, structural equation modeling

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1411 Engaging Students in Spatial Thinking through Design Education: Case Study of a Biomimicry Design Project in the Primary Classroom

Authors: Caiwei Zhu, Remke Klapwijk

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Spatial thinking, a way of thinking based on the understanding and reasoning of spatial concepts and representations, is embedded in science, technology, engineering, arts, and mathematics (STEAM) learning. Aside from many studies that successfully used targeted training to improve students’ spatial thinking skills, few have closely examined how spatial thinking can be trained in classroom settings. Design and technology education, which receives increasing attention towards its integration into formal curriculums, inherently encompasses a wide range of spatial activities, such as constructing mental representations of design ideas, mentally transforming objects and materials to form designs, visually communicating design plans through annotated drawings, and creating 2D and 3D design artifacts. Among different design topics, biomimicry offers a unique avenue for students to recognize and analyze the shapes and structures in nature. By mapping the forms of plants and animals onto functions, students gain inspiration to solve human design challenges. This study is one of the first to highlight opportunities for training spatial thinking in a biomimicry design project for primary school students. Embracing methodological principles of educational design-based research, this case study is conducted along with iterations in the design of the intervention and collaboration with teachers. Data are harvested from small groups of 10- to 12-year-olds at an international school in the Netherlands. Classroom videos, semi-structured interviews with students, design drawings and artifacts, formative assessment, and the pre- and post-intervention spatial test triangulate evidence for students' spatial thinking. In addition to contributing to a theory of integrating spatial thinking in the primary curriculum, mechanisms underlying such improvement in spatial thinking are explored and discussed.

Keywords: biomimicry, design and technology education, primary education, spatial thinking

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1410 Case Study of Sexual Violence Victim Assessment in Semarang Regency

Authors: Sujana T, Kurniasari MD, Ayakeding AM

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Background: Sexual violence is one of the violence with high incidence in Indonesia. Purpose: This research aims to describe the implementation of sexual violence victim assessment in Semarang Regency. Method: This research is a qualitative research with embeded single case study design. Data is analized with two units of analysis. The first unit of analysis is victim’s examiner with minimum one year of work experience. Semi-structured interview method is used to obtain the data. The second unit of analysis is document related. The data is taken by observing the pathway and description of every document and how it supported each implementation of assessment. Results: This study is resulted with three themes, which are: The first theme is assessments of sexual violence in Semarang regency has been standardized. The laws of the Republic of Indonesia have regulated the handling of victims of sexual violence in outline. Victims of sexual violence can be dealt with by the police, the Integrated Service Center for Women and Children Empowerment and the Regional General Hospital. Each examination site has different operational procedures standards for dealing with victims of sexual violence. Cooperation with family and witnesses is also required in the review process to obtain accurate results and evidence; The second idea that resulted from this study is there are inhibits factors in the assessments process. Victims sometimes feel embarrassed and reluctant to recount the chronological events during reporting. The examining officer should be able to approach and build a trust to convince the victim to be able to cooperate. The third theme is there are other things to consider in the process of assessing victims of sexual violence. Ensuring implementation in accordance with applicable operational procedures standards, providing exclusive examination rooms, counseling and safeguarding the privacy of victims are important to be considered in the assessment.

Keywords: assessment, case study, Semarang regency, sexual violence

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1409 Coping Mechanisms for Families in Raising a Child with Disability in Bangladesh: Family Members' Perspectives

Authors: Reshma P. Nuri, Ebenezer Dassah

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Introduction: Raising a child with a disability can affect family members in different ways. However, this can be determined by the way in which a family member copes with the situation. There is little research that explores how families develop coping strategies to overcome barriers in raising CWDs. Objective: This study explored family members’ coping mechanism in raising a child with disability in Bangladesh. Method: A qualitative approach that involved 20 interviews with family members of CWDs. A purposive sampling procedure was used in selecting the study participants. A digital recorder was used to record all the interviews. Transcriptions were done in Bengali, translated into English, and then imported to NVivo software 12 for analysis. Thematic analysis was used to analyze the data. Results: The study revealed that family members adopted different coping strategies for their CWDs, including seeking support from formal (e.g., service providers) and informal sources (family members and friends); relying on religious beliefs; accepting the situation. Additionally, to cope with extra cost in raising CWDs, family members strategies included relying on overtime work; borrowing money from financial institutions; selling or mortgaging assets; and replying on donations from community members. Finally, some families had to reduce spending on food and buying toys for their CWDs. Conclusion: This qualitative study highlighted a range of coping mechanism adopted by family members in Bangladesh. The information provided in this study is potentially important to policy makers and service providers as it presents evidence on the coping mechanism of families in raising their CWDs. This underscores the need for policy design and service delivery in government support system in Bangladesh and potentially in other low- and middle-income contexts.

Keywords: Bangladesh, children with disabilities, coping mechanism, family members

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1408 Emotions Triggered by Children’s Literature Images

Authors: Ana Maria Reis d'Azevedo Breda, Catarina Maria Neto da Cruz

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The role of images/illustrations in communicating meanings and triggering emotions assumes an increasingly relevant role in contemporary texts, regardless of the age group for which they are intended or the nature of the texts that host them. It is no coincidence that children's books are full of illustrations and that the image/text ratio decreases as the age group grows. The vast majority of children's books can be considered multimodal texts containing text and images/illustrations interacting with each other to provide the young reader with a broader and more creative understanding of the book's narrative. This interaction is very diverse, ranging from images/illustrations that are not essential for understanding the storytelling to those that contribute significantly to the meaning of the story. Usually, these books are also read by adults, namely by parents, educators, and teachers who act as mediators between the book and the children, explaining aspects that are or seem to be too complex for the child's context. It should be noted that there are books labeled as children's books that are clearly intended for both children and adults. In this work, following a qualitative and interpretative methodology based on written productions, participant observation, and field notes, we will describe the perceptions of future teachers of the 1st cycle of basic education, attending a master's degree at a Portuguese university, about the role of the image in literary and non-literary texts, namely in mathematical texts, and how these can constitute precious resources for emotional regulation and for the design of creative didactic situations. The analysis of the collected data allowed us to obtain evidence regarding the evolution of the participants' perception regarding the crucial role of images in children's literature, not only as an emotional regulator for young readers but also as a creative source for the design of meaningful didactical situations, crossing other scientific areas, other than the mother tongue, namely mathematics.

Keywords: children’s literature, emotions, multimodal texts, soft skills

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1407 Examining the Role of Brand Equity and Explore the Influence of Consumers' Brand Relationship Quality

Authors: Jim Shih-Chiao Chin , Tsai Lin Hsu, Shui Lien Chen

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This article extends the relation between company’s employee and customers in market. According to the previous researches, most researchers analyzed and focused on customers’ brand perception. In the recently, some scholars star to explore the brand management from company viewpoint. The aim of this study is to explore whether consumers perception would be affected by the firm brand. This research would like to examine the relationship between individual consumers and corporate brands in the business-to-consumers sector. First, the study develops a framework that the connection with consumer and company. Second, this article uses three dimensions, brand knowledge, brand commitment, and brand equity to measure employees’ loyalty of brand and applies brand relationship quality to gauge the level of brand’s importance in consumer’s mind. This paper uses SPSS 20.0 and AMOS 20.0 to test consumers’ minds toward the brand equity which the company provides. There are totally 862 valid questionnaires returned, and 431 participants are consumers; the other 431 participants are employees. Those questionnaires are one-by-one to consumer and employee so those are 431 pairs questionnaires. Based on 431 pairs of consumers and company’s employees, analyzed results show that brand knowledge and brand commitment play important roles influencing brand equity. The results also demonstrate the extra-role brand equity positively impact on the brand relationship quality of consumers. In addition, the findings reveal that the company can improve brand relationship quality of consumers by enhancing extra-role brand equity. There is a sufficient evidence denote that brand relationship quality not only shows about the brand of customers’ thought but also implies company how to build the brand to impress on consumers. These findings provide the degree of the brand in consumers’ cognition. The brand-owner employee can reference the conclusion to creative new strategic to the next time or can be one of the company’s competitive advantages. Those results and conclusions are contributed to management practice and future.

Keywords: brand knowledge, brand commitment, brand equity, brand relationship quality

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1406 Dermoscopy Compliance: Improving Melanoma Detection Pathways Through Quality Improvement

Authors: Max Butler

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Melanoma accounts for 80% of skin cancer-related deaths globally. The poor prognosis and increasing incidence of melanoma impose a significant burden on global healthcare systems. Early detection, precise diagnosis, and preventative strategies are critical to improving patient outcomes. Dermoscopy is the gold standard for specialist assessments of pigmented skin lesions, as it can differentiate between benign and malignant growths with greater accuracy than visual inspection. In the United Kingdom, guidelines from the National Institute of Clinical Excellence (NICE) state dermoscopy should be used in all specialist assessments of pigmented skin lesions. Compliance with this guideline is low, resulting in missed and delayed melanoma diagnoses. To address this problem, a quality improvement project was initiated at Buckinghamshire Healthcare Trust (BHT) within the plastic surgery department. The target group was a trainee and consultant plastic surgeons conducting outpatient skin cancer clinics. Analysis of clinic documentation over a one-month period found that only 62% (38/61) of patients referred with pigmented skin lesions were examined using dermoscopy. To increase dermoscopy rates, teaching was delivered to the department highlighting national guidelines and the evidence base for dermoscopic examination. In addition, clinic paperwork was redesigned to include a text box for dermoscopic examination. Reauditing after the intervention found a significant increase in dermoscopy rates (52/61, p = 0.014). In conclusion, implementing a quality improvement project with targeted teaching and documentation template templates successfully increased dermoscopy rates. This is a promising step toward improving early melanoma detection and patient outcomes.

Keywords: melanoma, dermoscopy, plastic surgery, quality improvement

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1405 Redirection of Cytokine Production Patterns by Dydrogesterone, an Orally-Administered Progestogen

Authors: Raj Raghupathy

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Recurrent Spontaneous Miscarriage (RSM) is a common form of pregnancy loss, 50% of which are due to ‘unexplained’ causes. Evidence exists to suggest that RSM may be caused by immunologic factors such as cytokines which are critical molecules of the immune system, with an impressive array of capabilities. An association appears to exist between Th2-type reactivity (mediated by Th2 or anti-inflammatory cytokines) and normal, successful pregnancy, and between unexplained RSM and Th1 cytokine dominance. If pro-inflammatory cytokines are indeed associated with pregnancy loss, the suppression of these cytokines, and thus the ‘redirection’ of maternal reactivity, may help prevent cytokine-mediated pregnancy loss. The objective of this study was to explore the possibility of modulating cytokine production using Dydrogesterone (Duphaston®), an orally-administered progestogen. Peripheral blood mononuclear cells from 34 women with a history of at least 3 unexplained recurrent miscarriages were stimulated in vitro with a mitogen (to elicit cytokine production) in the presence and absence of dydrogesterone. Levels of selected pro- and anti-inflammatory cytokines produced by peripheral blood mononuclear cells were measured after exposure to these progestogens. Dydrogesterone down-regulates the production of pro-inflammatory cytokines and up-regulates the production of anti-inflammatory cytokines. The ratios of Th2 to Th1 cytokines are markedly elevated in the presence of dydrogesterone, indicating a shift from potentially harmful maternal Th1 reactivity to a more pregnancy-conducive Th2 profile. We used a progesterone receptor antagonist to show that this cytokine-modulating effect of dydrogesterone is mediated via the progesterone receptor. Dydrogesterone also induces the production of the Progesterone-Induced Blocking Factor (PIBF); lymphocytes exposed to PIBF produce higher levels of Th2 cytokines, affecting a Th1 → Th2 cytokine shift which could be favourable to the success of pregnancy. We conclude that modulation of maternal cytokine production profiles is possible with dydrogesterone which has the merits that it can be administered orally and that it is safe.

Keywords: cytokines, dydrogesterone, progesterone, recurrent spontaneous miscarriage

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1404 Canada's "Flattened Curve": A Geospatail Temporal Analysis of Canada's Amelioration of The Sars-Cov-2 Pandemic Through Coordinated Government Intervention

Authors: John Ahluwalia

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As an affluent first-world nation, Canada took swift and comprehensive action during the outbreak of the SARS-CoV-2 (COVID-19) pandemic compared to other countries in the same socio-economic cohort. The United States has stumbled to overcome obstacles most developed nations have faced, which has led to significantly more per capita cases and deaths. The initial outbreaks of COVID-19 occurred in the US and Canada within days of each other and posed similar potentially catastrophic threats to public health, the economy, and governmental stability. On a macro level, events that take place in the US have a direct impact on Canada. For example, both countries tend to enter and exit economic recessions at approximately the same time, they are each other’s largest trading partners, and their currencies are inexorably linked. Variables intrinsic to Canada’s national infrastructure have been instrumental in the country’s efforts to flatten the curve of COVID-19 cases and deaths. Canada’s coordinated multi-level governmental effort has allowed it to create and enforce policies related to COVID-19 at both the national and provincial levels. Canada’s policy of universal health care is another variable. Health care and public health measures are enforced on a provincial level, and it is within each province’s jurisdiction to dictate standards for public safety based on scientific evidence. Rather than introducing confusion and the possibility of competition for resources such as PPE and vaccines, Canada’s multi-level chain of government authority has provided consistent policies supporting national public health and local delivery of medical care. This paper will demonstrate that the coordinated efforts on provincial and federal levels have been the linchpin in Canada’s relative success in containing the deadly spread of the COVID-19 virus.

Keywords: COVID-19, canada, GIS, geospatial analysis

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1403 Integrating Critical Stylistics and Visual Grammar: A Multimodal Stylistic Approach to the Analysis of Non-Literary Texts

Authors: Shatha Khuzaee

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The study develops multimodal stylistic approach to analyse a number of BBC online news articles reporting some key events from the so called ‘Arab Uprisings’. Critical stylistics (CS) and visual grammar (VG) provide insightful arguments to the ways ideology is projected through different verbal and visual modes, yet they are mode specific because they examine how each mode projects its meaning separately and do not attempt to clarify what happens intersemiotically when the two modes co-occur. Therefore, it is the task undertaken in this research to propose multimodal stylistic approach that addresses the issue of ideology construction when the two modes co-occur. Informed by functional grammar and social semiotics, the analysis attempts to integrate three linguistic models developed in critical stylistics, namely, transitivity choices, prioritizing and hypothesizing along with their visual equivalents adopted from visual grammar to investigate the way ideology is constructed, in multimodal text, when text/image participate and interrelate in the process of meaning making on the textual level of analysis. The analysis provides comprehensive theoretical and analytical elaborations on the different points of integration between CS linguistic models and VG equivalents which operate on the textual level of analysis to better account for ideology construction in news as non-literary multimodal texts. It is argued that the analysis well thought out a plan that would remark the first step towards the integration between the well-established linguistic models of critical stylistics and that of visual analysis to analyse multimodal texts on the textual level. Both approaches are compatible to produce multimodal stylistic approach because they intend to analyse text and image depending on whatever textual evidence is available. This supports the analysis maintain the rigor and replicability needed for a stylistic analysis like the one undertaken in this study.

Keywords: multimodality, stylistics, visual grammar, social semiotics, functional grammar

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1402 Evaluation of Classification Algorithms for Diagnosis of Asthma in Iranian Patients

Authors: Taha SamadSoltani, Peyman Rezaei Hachesu, Marjan GhaziSaeedi, Maryam Zolnoori

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Introduction: Data mining defined as a process to find patterns and relationships along data in the database to build predictive models. Application of data mining extended in vast sectors such as the healthcare services. Medical data mining aims to solve real-world problems in the diagnosis and treatment of diseases. This method applies various techniques and algorithms which have different accuracy and precision. The purpose of this study was to apply knowledge discovery and data mining techniques for the diagnosis of asthma based on patient symptoms and history. Method: Data mining includes several steps and decisions should be made by the user which starts by creation of an understanding of the scope and application of previous knowledge in this area and identifying KD process from the point of view of the stakeholders and finished by acting on discovered knowledge using knowledge conducting, integrating knowledge with other systems and knowledge documenting and reporting.in this study a stepwise methodology followed to achieve a logical outcome. Results: Sensitivity, Specifity and Accuracy of KNN, SVM, Naïve bayes, NN, Classification tree and CN2 algorithms and related similar studies was evaluated and ROC curves were plotted to show the performance of the system. Conclusion: The results show that we can accurately diagnose asthma, approximately ninety percent, based on the demographical and clinical data. The study also showed that the methods based on pattern discovery and data mining have a higher sensitivity compared to expert and knowledge-based systems. On the other hand, medical guidelines and evidence-based medicine should be base of diagnostics methods, therefore recommended to machine learning algorithms used in combination with knowledge-based algorithms.

Keywords: asthma, datamining, classification, machine learning

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1401 Developing Urban Design and Planning Approach to Enhance the Efficiency of Infrastructure and Public Transportation in Order to Reduce GHG Emissions

Authors: A. Rostampouryasouri, A. Maghoul, S. Tahersima

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The rapid growth of urbanization and the subsequent increase in population in cities have resulted in the destruction of the environment to cater to the needs of citizens. The industrialization of urban life has led to the production of pollutants, which has significantly contributed to the rise of air pollution. Infrastructure can have both positive and negative effects on air pollution. The effects of infrastructure on air pollution are complex and depend on various factors such as the type of infrastructure, location, and context. This study examines the effects of infrastructure on air pollution, drawing on a range of empirical evidence from Iran and China. Our paper focus for analyzing the data is on the following concepts: 1. Urban design and planning principles and practices 2. Infrastructure efficiency and optimization strategies 3. Public transportation systems and their environmental impact 4. GHG emissions reduction strategies in urban areas 5. Case studies and best practices in sustainable urban development This paper employs a mixed methodology approach with a focus on developmental and applicative purposes. The mixed methods approach combines both quantitative and qualitative research methods to provide a more comprehensive understanding of the research topic. A group of 20 architectural specialists and experts who are proficient in the field of research, design, and implementation of green architecture projects were interviewed in a systematic and purposeful manner. The research method was based on content analysis using MAXQDA2020 software. The findings suggest that policymakers and urban planners should consider the potential impacts of infrastructure on air pollution and take measures to mitigate negative effects while maximizing positive ones. This includes adopting a nature-based approach to urban planning and infrastructure development, investing in information infrastructure, and promoting modern logistic transport infrastructure.

Keywords: GHG emissions, infrastructure efficiency, urban development, urban design

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1400 Transforming Data into Knowledge: Mathematical and Statistical Innovations in Data Analytics

Authors: Zahid Ullah, Atlas Khan

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The rapid growth of data in various domains has created a pressing need for effective methods to transform this data into meaningful knowledge. In this era of big data, mathematical and statistical innovations play a crucial role in unlocking insights and facilitating informed decision-making in data analytics. This abstract aims to explore the transformative potential of these innovations and their impact on converting raw data into actionable knowledge. Drawing upon a comprehensive review of existing literature, this research investigates the cutting-edge mathematical and statistical techniques that enable the conversion of data into knowledge. By evaluating their underlying principles, strengths, and limitations, we aim to identify the most promising innovations in data analytics. To demonstrate the practical applications of these innovations, real-world datasets will be utilized through case studies or simulations. This empirical approach will showcase how mathematical and statistical innovations can extract patterns, trends, and insights from complex data, enabling evidence-based decision-making across diverse domains. Furthermore, a comparative analysis will be conducted to assess the performance, scalability, interpretability, and adaptability of different innovations. By benchmarking against established techniques, we aim to validate the effectiveness and superiority of the proposed mathematical and statistical innovations in data analytics. Ethical considerations surrounding data analytics, such as privacy, security, bias, and fairness, will be addressed throughout the research. Guidelines and best practices will be developed to ensure the responsible and ethical use of mathematical and statistical innovations in data analytics. The expected contributions of this research include advancements in mathematical and statistical sciences, improved data analysis techniques, enhanced decision-making processes, and practical implications for industries and policymakers. The outcomes will guide the adoption and implementation of mathematical and statistical innovations, empowering stakeholders to transform data into actionable knowledge and drive meaningful outcomes.

Keywords: data analytics, mathematical innovations, knowledge extraction, decision-making

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1399 Occupational Stress and Lipid Profile among Drivers in Ismailia City, Egypt

Authors: Amani Waheed, Adel Mishriky, Rasha Farouk, Essam Abdallah, Sarah Hussein

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Background: Occupational stress plays a crucial role in professional drivers' health. They are exposed to high workloads, low physical activity, high demand and low decisions as well as poor lifestyle factors including poor diet, sedentary work, and smoking. Dyslipidemia is a well-established modifiable cardiovascular risk factor. Occupational stress and other forms of chronic stress have been associated with raised levels of atherogenic lipids. Although stress management has some evidence in improving lipid profile, the association between occupational stress and dyslipidemia is not clear. Objectives: To assess the relational between occupational stress and lipid profile among professional drivers. Methodology: A cross-sectional study conducted at a large company in Ismailia City, Egypt, where, 131 professional drivers divided into 44 car drivers, 43 bus drivers, and 44 truck drivers were eligible after applying exclusion criteria. Occupational stress index (OSI), non-occupational risk factors of dyslipidemia were assessed using interview structured questionnaire. Blood pressure, body mass index (BMI) and lipid profile were measured. Results: The mean of total OSI score was 79.98 ± 6.14. The total OSI score is highest among truck drivers (82.16 ± 4.62), then bus drivers (80.26 ± 6.02) and lowest among car drivers (77.55 ± 6.79) with statistically significant. Eighty percent had Dyslipidemia. The duration of driving hours per day, exposure to passive smoking and increased BMI were the risk factors. No statistical significance between Total OSI score and dyslipidemia. Using, logistic regression analysis, occupational stress, duration of driving hours per day, and BMI were positive significant predictors for dyslipidemia. Conclusion: Professional drivers are exposed to occupational stress. A high proportion of drivers have dyslipidemia. Total OSI score doesn't have statistically significant relation with dyslipidemia.

Keywords: body mass index, dyslipidaemia, occupational stress, professional drivers

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1398 Exploring Gender-Base Salary Disparities and Equities Among University Presidents

Authors: Daniel Barkley, Jianyi Zhu

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This study investigates base salary differentials and gender equity among university presidents across 427 U.S. colleges and universities. While endowments typically do not directly determine university presidents' base salaries, our analysis reveals a noteworthy pattern: endowments explain more than half of the variance in female university presidents' base salaries, compared to a mere 0.69 percent for males. Moreover, female presidents' base salaries tend to rise much faster than male base salaries with increasing university endowments. This disparate impact of endowments on base salaries implies an endowment threshold for achieving gender pay equity. We develop an analytical model predicting an endowment threshold for achieving gender equality and empirically estimate this equity threshold using data from over 427 institutions. Surprisingly, the fields of science and athletics have emerged as sources of gender-neutral base pay. Both male and female university presidents with STEM backgrounds command higher base salaries than those without such qualifications. Additionally, presidents of universities affiliated with Power 5 conferences consistently receive higher base salaries regardless of gender. Consistent with the theory of human capital accumulation, the duration of the university presidency incrementally raises base salaries for both genders but at a diminishing rate. Curiously, prior administrative leadership experience as a vice president, provost, dean, or department chair does not significantly influence base salaries for either gender. By providing empirical evidence and analytical models predicting an endowment threshold for achieving gender equality in base salaries, the study offers valuable insights for policymakers, university administrators, and other stakeholders. These findings hold crucial policy implications, informing strategies to promote gender equality in executive compensation within higher education institutions.

Keywords: higher education, endowments, base salaries, university presidents

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1397 Engineering Education for Sustainable Development in China: Perceptions Bias between Experienced Engineers and Engineering Students

Authors: Liang Wang, Wei Zhang

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Nowadays, sustainable development has increasingly become an important research topic of engineering education. Existing research on Engineering Education for Sustainable Development (EESD) has highlighted the importance of perceptions for ethical responsibility to address sustainable development in practice. However, whether and how the professional engineering experience affects those perceptions has not been proved, especially in a Chinese context. Our study fills this gap by investigating the perceptions bias of EESD between experienced engineers and engineering students. We specifically examined what EESD means for experienced engineers and engineering students using a triple-dimensional model to understand if there are obvious differences between the two groups. Our goal is to make the benefits of these experiences more accessible in school context. The data (n=438) came from a questionnaire created and adapted from previously published studies containing 288 students from mechanical or civil engineering and 150 civil engineers with rich working experience, and the questionnaire was distributed during Fall 2020. T-test was used to find the difference in different dimensions between the two groups. The statistical results show that there is a significant difference in the perceptions of EESD between experienced engineers and inexperienced engineering students in China. Experienced engineers tend to consider sustainable development from ecological, economic, and social perspectives, while engineering students' answers focus more on ecology and ignore economic and social dimensions to some extend. The findings provide empirical evidence that professional experience is helpful to cultivate the cognition and ability of sustainable development in engineering education. The results of this work indicate that more practical content should be added to engineering education to promote sustainable development. In addition, for the design of engineering courses and professional practice systems for sustainable development, we should not only pay attention to the ecological aspects but also emphasize the coordination of ecological, economic, and socially sustainable development (e.g., engineer's ethical responsibility).

Keywords: engineering education, sustainable development, experienced engineers, engineering students

Procedia PDF Downloads 93
1396 Experience of Intimate Partner Violence and Mental Health Status of Women of Reproductive Age Group in a Rural Community in Southwest Nigeria

Authors: Ayodeji Adebayo, Tolulope Soyannwo, Oluwakemi A. Sigbeku

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Intimate Partner Violence (IPV) is a significant public health problem with adverse health consequences. There is increasing evidence of association of IPV with mental health problems. Understanding the association between IPV and mental health status of women of reproductive aged group in the rural communities in Nigeria can provide information to improve maternal health status. Therefore, this study was conducted to examine the relationship between experience of IPV and mental health status of women of reproductive aged group in a rural community in Southwest Nigeria. A community based cross-sectional survey was conducted using a cluster sampling technique to select 283 non-pregnant women of reproductive age group (15-49 years Mental health was assessed based on respondents’ experience of any symptoms of depression, anxiety and/or low self-esteem. IPV was assessed over a period of 12 months and the forms of IPV assessed were emotional, physical and sexual. An interviewer administered questionnaire was used to collect information on experience of IPV, reproductive history and factors influencing mental health. Data was analyzed using descriptive statistics, Chi-square and multivariate logistic regression at 5% level of significance. The mean age of respondents was 26.1± 7.8 with 57.1% aged 15-24years. More than half (58.0%) were married. Overall, 60.7% of respondents had mental health problems while 84.8% experienced all categories of violence. The pattern of IPV includes physical violence (10.7%), emotional violence (82.7%) and sexual violence (20.8%). Women who experienced sexual violence by a partner are most likely to suffer from all mental issues. Also, gynaecological morbidities are associated with increasing risk of mental health problems. The research demonstrates an urgent need for mental health policies to recognize the relationship between intimate partner violence, gynaecological morbidities and mental health problems in women in Nigeria.

Keywords: intimate partner violence, mental health, reproductive age group, women

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1395 Making Food Science Education and Research Activities More Attractive for University Students and Food Enterprises by Utilizing Open Innovative Space-Approach

Authors: Anna-Maria Saarela

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At the Savonia University of Applied Sciences (UAS), curriculum and studies have been improved by applying an Open Innovation Space approach (OIS). It is based on multidisciplinary action learning. The key elements of OIS-ideology are work-life orientation, and student-centric communal learning. In this approach, every participant can learn from each other and innovations will be created. In this social innovation educational approach, all practices are carried out in close collaboration with enterprises in real-life settings, not in classrooms. As an example, in this paper, Savonia UAS’s Future Food RDI hub (FF) shows how OIS practices are implemented by providing food product development and consumer research services for enterprises in close collaboration with academicians, students and consumers. In particular one example of OIS experimentation in the field is provided by a consumer research carried out utilizing verbal analysis protocol combined with audio-visual observation (VAP-WAVO). In this case, all co-learners were acting together in supermarket settings to collect the relevant data for a product development and the marketing department of a company. The company benefitted from the results obtained, students were more satisfied with their studies, educators and academicians were able to obtain good evidence for further collaboration as well as renewing curriculum contents based on the requirements of working life. In addition, society will benefit over time as young university adults find careers more easily through their OIS related food science studies. Also this knowledge interaction model re-news education practices and brings working-life closer to educational research institutes.

Keywords: collaboration, education, food science, industry, knowledge transfer, RDI, student

Procedia PDF Downloads 359
1394 Theoretical Comparisons and Empirical Illustration of Malmquist, Hicks–Moorsteen, and Luenberger Productivity Indices

Authors: Fatemeh Abbasi, Sahand Daneshvar

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Productivity is one of the essential goals of companies to improve performance, which as a strategy-oriented method, determines the basis of the company's economic growth. The history of productivity goes back centuries, but most researchers defined productivity as the relationship between a product and the factors used in production in the early twentieth century. Productivity as the optimal use of available resources means that "more output using less input" can increase companies' economic growth and prosperity capacity. Also, having a quality life based on economic progress depends on productivity growth in that society. Therefore, productivity is a national priority for any developed country. There are several methods for calculating productivity growth measurements that can be divided into parametric and non-parametric methods. Parametric methods rely on the existence of a function in their hypotheses, while non-parametric methods do not require a function based on empirical evidence. One of the most popular non-parametric methods is Data Envelopment Analysis (DEA), which measures changes in productivity over time. The DEA evaluates the productivity of decision-making units (DMUs) based on mathematical models. This method uses multiple inputs and outputs to compare the productivity of similar DMUs such as banks, government agencies, companies, airports, Etc. Non-parametric methods are themselves divided into the frontier and non frontier approaches. The Malmquist productivity index (MPI) proposed by Caves, Christensen, and Diewert (1982), the Hicks–Moorsteen productivity index (HMPI) proposed by Bjurek (1996), or the Luenberger productivity indicator (LPI) proposed by Chambers (2002) are powerful tools for measuring productivity changes over time. This study will compare the Malmquist, Hicks–Moorsteen, and Luenberger indices theoretically and empirically based on DEA models and review their strengths and weaknesses.

Keywords: data envelopment analysis, Hicks–Moorsteen productivity index, Leuenberger productivity indicator, malmquist productivity index

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1393 The Impact of Hybrid Working Models on Employee Engagement

Authors: Sibylle Tellenbach, Julie Haddock-Millar, Francis Bidault

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The aim of this research is to understand the extent to which hybrid working models have influenced employee engagement in the Swiss financial sector. The context for this research is the transition out of the pandemic and the changes that have occurred between 2020 and 2023. Since the pandemic, many financial services companies have had to rethink their working model for office-based employees, as this group of employees has been able to experience a new way of working and, thus, greater freedom and flexibility. For a large number of companies, it was a huge change to shift from the traditional office-based to a new hybrid working model. A heightened focus on employee engagement has become a necessity in order to understand and respond to the challenges presented by the shift in a working model. This new way of working, partly office-based and partly virtual, has led to ambiguities about the impact on the engagement of hybrid teams. Therefore, the research question is: How hybrid working models have influenced employee engagement to what extent? The methodological approach is a narrative inquiry with four similar functional teams within four Swiss financial companies. Semi-structured interviews will be conducted with managers from middle management and their individual team members. The findings will demonstrate whether this shift in the working model influenced individual team members’ engagement and to what extent. The contribution of this research is two-fold. First, the research makes a theoretical contribution, presenting evidence of the impact of hybrid working on individual team members’ engagement in a specific sector and context, enhancing current knowledge on the challenges in working model transition. Second, this research will make a practice-based contribution, recommending ways to enhance the engagement of hybrid teams in a specific context. These recommendations may be applied in wider sectors and teams.

Keywords: employee engagement, hybrid teams, hybrid working models, Swiss financial sector, team engagement

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1392 The Role of Art and Music in Enriching Adult Learning in Maltese as a Second Language

Authors: Jacqueline Zammit

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Currently, a considerable number of individuals from different backgrounds are being drawn to Malta due to its favourable environment for business, investment, and employment. This influx has led to a growing interest among expats in learning Maltese as a second language (ML2) to enrich their experience of working and residing in Malta. However, the intricacies of Maltese grammar, particularly challenging for second language (L2) learners unfamiliar with Arabic, can pose difficulties in the learning process. Furthermore, it's worth noting that the teaching of ML2 is an emerging field with limited existing research on effective pedagogical strategies. The realm of second language acquisition (SLA) can be notably demanding for adults, requiring well-founded interventions to facilitate learning. Among these interventions, approaches grounded in empirical evidence have incorporated artistic and musical elements to augment SLA. Both art and music have proven roles in facilitating L2 communication, aiding vocabulary retention, and improving comprehension skills. This study aims to delve into the utilization of music and art as catalysts for enhancing the progress of adult learners in mastering ML2. The research employs a qualitative methodology, employing a sample selected through convenience sampling, which encompassed 37 adult learners of ML2. These participants engaged in individual interviews. The data derived from these interviews were subjected to thorough analysis. The outcomes of the study underscore the substantial positive influence exerted by art and music on the academic advancement of adult ML2 learners. Notably, it emerged from the participants' accounts that the current ML2 curricula lack the integration of art and music. Therefore, this study advocates for the incorporation of art and music components within both traditional classroom settings and online ML2 courses. The intention is to bolster the academic accomplishments of adult learners in the realm of Maltese as a second language, bridging the current gap between theory and practice.

Keywords: academic accomplishment, mature learners, visual art, learning Maltese as a second language, musical involvement, acquiring a second language

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1391 The Determinants of Financial Ratio Disclosures and Quality: Evidence from an Emerging Market

Authors: Ben Kwame Agyei-Mensah

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This study investigated the influence of firm-specific characteristics which include proportion of Non-Executive Directors, ownership concentration, firm size, profitability, debt equity ratio, liquidity and leverage on the extent and quality of financial ratios disclosed by firms listed on the Ghana Stock Exchange. The research was conducted through detailed analysis of the 2012 financial statements of the listed firms. Descriptive analysis was performed to provide the background statistics of the variables examined. This was followed by regression analysis which forms the main data analysis. The results of the extent of financial ratio disclosure level, mean of 62.78%, indicate that most of the firms listed on the Ghana Stock Exchange did not overwhelmingly disclose such ratios in their annual reports. The results of the low quality of financial ratio disclosure mean of 6.64% indicate that the disclosures failed woefully to meet the International Accounting Standards Board's qualitative characteristics of relevance, reliability, comparability and understandability. The results of the multiple regression analysis show that leverage (gearing ratio) and return on investment (dividend per share) are associated on a statistically significant level as far as the extent of financial ratio disclosure is concerned. Board ownership concentration and proportion of (independent) non-executive directors, on the other hand were found to be statistically associated with the quality of financial ratio disclosed. There is a significant negative relationship between ownership concentration and the quality of financial ratio disclosure. This means that under a higher level of ownership concentration less quality financial ratios are disclosed. The findings also show that there is a significant positive relationship between board composition (proportion of non-executive directors) and the quality of financial ratio disclosure.

Keywords: voluntary disclosure, firm-specific characteristics, financial reporting, financial ratio disclosure, Ghana stock exchange

Procedia PDF Downloads 575
1390 The Effect of Vertical Integration on Operational Performance: Evaluating Physician Employment in Hospitals

Authors: Gary Young, David Zepeda, Gilbert Nyaga

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This study investigated whether vertical integration of hospitals and physicians is associated with better care for patients with cardiac conditions. A dramatic change in the U.S. hospital industry is the integration of hospital and physicians through hospital acquisition of physician practices. Yet, there is little evidence regarding whether this form of vertical integration leads to better operational performance of hospitals. The study was conducted as an observational investigation based on a pooled, cross-sectional database. The study sample comprised over hospitals in the State of California. The time frame for the study was 2010 to 2012. The key performance measure was hospitals’ degree of compliance with performance criteria set out by the federal government for managing patients with cardiac conditions. These criteria relate to the types of clinical tests and medications that hospitals should follow for cardiac patients but hospital compliance requires the cooperation of a hospital’s physicians. Data for this measure was obtained from a federal website that presents performance scores for U.S. hospitals. The key independent variable was the percentage of cardiologists that a hospital employs (versus cardiologists who are affiliated but not employed by the hospital). Data for this measure was obtained from the State of California which requires hospitals to report financial and operation data each year including numbers of employed physicians. Other characteristics of hospitals (e.g., information technology for cardiac care, volume of cardiac patients) were also evaluated as possible complements or substitutes for physician employment by hospitals. Additional sources of data included the American Hospital Association and the U.S. Census. Empirical models were estimated with generalized estimating equations (GEE). Findings suggest that physician employment is positively associated with better hospital performance for cardiac care. However, findings also suggest that information technology is a substitute for physician employment.

Keywords: physician employment, hospitals, verical integration, cardiac care

Procedia PDF Downloads 386