Search results for: national health insurance program
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 15224

Search results for: national health insurance program

12854 Selection of Indigenous Tree Species and Microbial Inoculation for the Restoration of Degraded Uplands

Authors: Nelly S. Aggangan, Julieta A. Anarna

Abstract:

Indigenous tree species are priority planting materials for the National Greening Program of the Department of Environment and Natural Resources. Areas for reforestation are marginal grasslands where plant growth is stunted and seedling survival is low. This experiment was conducted to compare growth rates and seedling survival of seven indigenous reforestation species. Narra (Pterocarpus indicus), salago (Wikstroemia lanceolata), kisubeng (Sapindus saponaria), tuai (Biscofia javanica), batino (Alstonia macrophylla), bani (Pongamina pinnata) and ipil (Intsia bijuga) were inoculated with Mykovam® (mycorrhizal fungi) and Bio-N® (N2-fixing bacteria) during pricking. After five months in the nursery, the treated seedlings were planted in degraded upland acidic red soil in Cavinti, Laguna (Luzon). During outplanting, all mycorrhiza inoculated seedlings had 50-80% mycorrhizal roots while the control ones had 5-10% mycorrhizal roots. Mykovam increased height of narra, salago and kisubeng. Stem diameter was bigger in mycorrhizal salago than the control. After two years in the field, Mykovam®+Bio-N® inoculated narra, salago and bani gave 95% survival while non-mycorrhizal tuai gave the lowest survival (25%). Inoculated seedlings grew faster than the control. Highest height increase was in batino (103%), followed by bani (95%), ipil (59%), narra (58%), tuai (53%) and kisubeng was the lowest (10%). Stem diameter was increased by Mykovam® from 13-39% over the control. Highest stem diameter was obtained from narra (50%), followed by bani (40%), batino (36%), ipil (33%), salago (28%), kisubeng and tuai (12%) had the lowest. In conclusion, Mykovam® inoculated batino, bani, narra, salago and ipil can be selected to restore degraded upland acidic red soil in the Philippines.

Keywords: Azospirillum spp., Bio-N®, Mykovam®, nitrogen fixing bacteria, acidic red soil

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12853 Determinants of Income Diversification among Support Zone Communities of National Parks in Nigeria

Authors: Daniel Etim Jacob, Samuel Onadeko, Edem A. Eniang, Imaobong Ufot Nelson

Abstract:

This paper examined determinants of income diversification among households in support zones communities of national parks in Nigeria. This involved the use household data collected through questionnaires administered randomly among 1009 household heads in the study area. The data obtained were analyzed using probability and non-probability statistical analysis such as regression and analysis of variance to test for mean difference between parks. The result obtained indicates that majority of the household heads were male (92.57%0, between the age class of 21 – 40 years (44.90%), had non-formal education (38.16%), were farmers (65.21%), owned land (95.44%), with a household size of 1 – 5 (36.67%) and an annual income range of ₦401,000 - ₦600,000 (24.58%). Mean Simpson index of diversity showed a general low (0.375) level of income diversification among the households. Income, age, off-farm dependence, education, household size and occupation where significant (p<0.01) factors that affected households’ income diversification. The study recommends improvement in the existing infrastructures and social capital in the communities as avenues to improve the livelihood and ensure positive conservation behaviors in the study area.

Keywords: income diversification, protected area, livelihood, poverty, Nigeria

Procedia PDF Downloads 136
12852 Clinical Staff Perceptions of the Quality of End-of-Life Care in an Acute Private Hospital: A Mixed Methods Design

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

Abstract:

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

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

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12851 Seismic Response of Large-Scale Rectangular Steel-Plate Concrete Composite Shear Walls

Authors: Siamak Epackachi, Andrew S. Whittaker, Amit H. Varma

Abstract:

An experimental program on steel-plate concrete (SC) composite shear walls was executed in the NEES laboratory at the University at Buffalo. Four large-size specimens were tested under displacement-controlled cyclic loading. The design variables considered in the testing program included wall thickness, reinforcement ratio, and faceplate slenderness ratio. The aspect ratio (height-to-length) of the four walls was 1.0. Each SC wall was installed on top of a re-usable foundation block. A bolted baseplate to RC foundation connection was used for all four walls. The walls were identified to be flexure-critical. This paper presents the damage to SC walls at different drift ratios, the cyclic force-displacement relationships, energy dissipation and equivalent viscous damping ratios, the strain and stress fields in the steel faceplates and the contribution of the steel faceplates to the total shear load, the variation of vertical strain in the steel faceplates along the length of the wall, near the base, at different drift ratios, the contributions of shear, flexure, and base rotation to the total lateral displacement, the displacement ductility of the SC walls, and the cyclic secant stiffness of the four SC walls.

Keywords: steel-plate composite shear wall, safety-related nuclear structure, flexure-critical wall, cyclic loading

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12850 Engagement as a Predictor of Student Flourishing in the Online Classroom

Authors: Theresa Veach, Erin Crisp

Abstract:

It has been shown that traditional students flourish as a function of several factors including level of academic challenge, student/faculty interactions, active/collaborative learning, enriching educational experiences, and supportive campus environment. With the increase in demand for remote or online courses, factors that result in academic flourishing in the virtual classroom have become more crucial to understand than ever before. This study seeks to give insight into those factors that impact student learning, overall student wellbeing, and flourishing among college students enrolled in an online program. 4160 unique students participated in the completion of End of Course Survey (EOC) before final grades were released. Quantitative results from the survey are used by program directors as a measure of student satisfaction with both the curriculum and the faculty. In addition, students also submitted narrative comments in an open comment field. No prompts were given for the comment field on the survey. The purpose of this analysis was to report on the qualitative data available with the goal of gaining insight into what matters to students. Survey results from July 1st, 2016 to December 1st, 2016 were compiled into spreadsheet data sets. The analysis approach used involved both key word and phrase searches and reading results to identify patterns in responses and to tally the frequency of those patterns. In total, just over 25,000 comments were included in the analysis. Preliminary results indicate that it is the professor-student relationship, frequency of feedback and overall engagement of both instructors and students that are indicators of flourishing in college programs offered in an online format. This qualitative study supports the notion that college students flourish with regard to 1) education, 2) overall student well-being and 3) program satisfaction when overall engagement of both the instructor and the student is high. Ways to increase engagement in the online college environment were also explored. These include 1) increasing student participation by providing more project-based assignments, 2) interacting with students in meaningful ways that are both high in frequency and in personal content, and 3) allowing students to apply newly acquired knowledge in ways that are meaningful to current life circumstances and future goals.

Keywords: college, engagement, flourishing, online

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12849 Trauma System in England: An Overview and Future Directions

Authors: Raheel Shakoor Siddiqui, Sanjay Narayana Murthy, Manikandar Srinivas Cheruvu, Kash Akhtar

Abstract:

Major trauma is a dynamic public health epidemic that is continuously evolving. Major trauma care services rely on multi-disciplinary team input involving highly trained pre and in-hospital critical care teams. Pre-hospital critical care teams (PHCCTs), major trauma centres (MTCs), trauma units, and rehabilitation facilities all form an efficient and organised trauma system. England comprises 27 MTCs funded by the National Health Service (NHS). Major trauma care entails enhanced resuscitation protocols coupled with the expertise of dedicated trauma teams and rapid radiological imaging to improve trauma outcomes. Literature reports a change in the demographic of major trauma as elderly patients (silver trauma) with injuries sustained from a fall of 2 metres or less commonly present to services. Evidence of an increasing population age with multiple comorbidities necessitates treatment within the first hour of injury (golden hour) to improve trauma survival outcomes. Staffing and funding pressures within the NHS have subsequently led to a shortfall of available physician-led PHCCTs. Thus, there is a strong emphasis on targeted research and funding to appropriately deploy resources to deprived areas. This review article will discuss the current English trauma system whilst critically appraising present challenges, identifying insufficiencies, and recommending aims for an improved future trauma system in England.

Keywords: trauma, orthopaedics, major trauma, trauma system, trauma network

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12848 Response of First Bachelor of Medicine, Bachelor of Surgery (MBBS) Students to Integrated Learning Program

Authors: Raveendranath Veeramani, Parkash Chand, H. Y. Suma, A. Umamageswari

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Background and Aims: The aim of this study was to evaluate students’ perception of Integrated Learning Program[ILP]. Settings and Design: A questionnaire was used to survey and evaluate the perceptions of 1styear MBBS students at the Department of Anatomy at our medical college in India. Materials and Methods: The first MBBS Students of Anatomy were involved in the ILP on the Liver and extra hepatic biliary apparatus integrating the Departments of Anatomy, Biochemistry and Hepato-biliary Surgery. The evaluation of the ILP was done by two sets of short questionnaire that had ten items using the Likert five-point grading scale. The data involved both the students’ responses and their grading. Results: A majority of students felt that the ILP was better in as compared to the traditional lecture method of teaching.The integrated teaching method was better at fulfilling learning objectives (128 students, 83%), enabled better understanding (students, 94%), were more interesting (140 students, 90%), ensured that they could score better in exams (115 students, 77%) and involved greater interaction (100 students, 66%), as compared to traditional teaching methods. Most of the students (142 students, 95%) opined that more such sessions should be organized in the future. Conclusions: Responses from students show that the integrated learning session should be incorporated even at first phase of MBBS for selected topics so as to create interest in the medical sciences at the entry level and to make them understand the importance of basic science.

Keywords: integrated learning, students response, vertical integration, horizontal integration

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12847 Learning the C-A-Bs: Resuscitation Training at Rwanda Military Hospital

Authors: Kathryn Norgang, Sarah Howrath, Auni Idi Muhire, Pacifique Umubyeyi

Abstract:

Description : A group of nurses address the shortage of trained staff to respond to critical patients at Rwanda Military Hospital (RMH) by developing a training program and a resuscitation response team. Members of the group who received the training when it first launched are now trainer of trainers; all components of the training program are organized and delivered by RMH staff-the clinical mentor only provides adjunct support. This two day training is held quarterly at RMH; basic life support and exposure to interventions for advanced care are included in the test and skills sign off. Seventy staff members have received the training this year alone. An increased number of admission/transfer to ICU due to successful resuscitation attempts is noted. Lessons learned: -Number of staff trained 2012-2014 (to be verified). -Staff who train together practice with greater collaboration during actual resuscitation events. -Staff more likely to initiate BLS if peer support is present-more staff trained equals more support. -More access to Advanced Cardiac Life Support training is necessary now that the cadre of BLS trained staff is growing. Conclusions: Increased access to training, peer support, and collaborative practice are effective strategies to strengthening resuscitation capacity within a hospital.

Keywords: resuscitation, basic life support, capacity building, resuscitation response teams, nurse trainer of trainers

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12846 Effects of the Quality Construction of Public Construction in Taiwan to Implementation Three Levels Quality Management Institution

Authors: Hsin-Hung Lai, Wei Lo

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Whether it is in virtue or vice for a construction quality of public construction project, it is one of the important indicators for national economic development and overall construction, the impact on the quality of national life is very deep. In recent years, a number of scandal of public construction project occurred, the requirements of the government agencies and the public require the quality of construction of public construction project are getting stricter than ever, the three-level public construction project construction quality of quality control system implemented by the government has a profound impact. This study mainly aggregated the evolution of ISO 9000 quality control system, the difference between the practice of implementing management of construction quality by many countries and three-level quality control of our country, so we explored and found that almost all projects of enhancing construction quality are dominated by civil organizations in foreign countries, whereas, it is induced by the national power in our country and develop our three-level quality control system and audit mechanism based on IOS system and implement the works by legislation, we also explored its enhancement and relevance with construction quality of public construction project that are intervened by such system and national power, and it really presents the effectiveness of construction quality been enhanced by the audited result. The three-level quality control system of our country to promote the policy of public construction project is almost same with the quality control system of many developed countries; however our country mainly implements such system on public construction project only, we promote the three-level quality control system is for enhancing the quality of public construction project, for establishing effective quality management system, so as to urge, correct and prevent the defects of quality management by manufacturers, whereas, those developed countries is comprehensively promoting (both public construction project and civil construction) such system. Therefore, this study is to explore the scope for public construction project only; the most important is the quality recognition by the executor, either good quality or deterioration is not a single event, there is a certain procedure extends from the demand and feasibility analysis, design, tendering, contracting, construction performance, inspection, continuous improvement, completion and acceptance, transferring and meeting the needs of the users, all of mentioned above have a causal relationship and it is a systemic problems. So the best construction quality would be manufactured and managed by reasonable cost if it is by extensive thinking and be preventive. We aggregated the implemented results in the past 10 years (2005 to 2015), the audited results of both in central units and local ones were slightly increased in A-grade while those listed in B-grade were decreased, although the levels were not evidently upgraded, yet, such result presents that the construction quality of concept of manufacturers are improving, and the construction quality has been established in the design stage, thus it is relatively beneficial to the enhancement of construction quality of overall public construction project.

Keywords: ISO 9000, three-level quality control system, audit and review mechanism for construction implementation, quality of construction implementation

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12845 Factors That Influence Willingness to Pay for Theatre Performances: The Case of Lithuanian National Drama Theatre

Authors: Rusne Kregzdaite

Abstract:

The value of the cultural sector stems from the symbolic exploration that differentiates cultural organisations from other product or service organisations. As a result, the cultural sector has a dual impact on the socio-economic system: the economic value (expressed in terms of market relations) created influences the dynamics of the country's financial indicators, while the cultural (non-market) value indirectly contributes to the welfare of the state through changes in societal values, creativity transformations and cultural needs of the country. Measurement of indirect (cultural value) impacts is difficult, but in the case of the cultural sector (especially when it comes to economically inefficient state-funded culture), it helps to reveal the essential characteristics of the sector. The study aims to analyze the value of cultural organisations that are invisible in market processes and to base it on quantified calculations. This was be done by analyzing the usefulness of the consumer, incorporating not only the price paid but also the social and cultural decision-making factors that determine the spectator's choice (time dedicated for a visit, additional costs, content, previous experiences, corporate image). This may reflect the consumer's real choice to consume (all the costs he incurs may be considered the financial equivalent of his experience with the cultural establishment). The research methodology was tested by analyzing the performing arts sector and applying methods to the Lithuanian national drama theatre case. The empirical research consisted of a survey (more than 800 participants) of Lithuanian national drama theatre visitors to different performances. The willingness to pay and travel costs methods were used. Analysis of different performances lets identifies the factor that increases willingness to pay for the performance and affects theatre attendance. The research stresses the importance of cultural value and social perspective of the cultural sector and relates it to the discussions of public funding of culture.

Keywords: cultural economics, performing arts, willingness to pay, travel cost analysis, performing arts management

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12844 Software Architecture Implications on Development Productivity: A Case of Malawi Point of Care Electronic Medical Records

Authors: Emmanuel Mkambankhani, Tiwonge Manda

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Software platform architecture includes system components, their relationships, and design, as well as evolution principles. Software architecture and documentation affect a platform's customizability and openness to external innovators, thus affecting developer productivity. Malawi Point of Care (POC) Electronic Medical Records System (EMRS) follows some architectural design standards, but it lacks third-party innovators and is difficult to customize as compared to CommCare and District Health Information System 2 (DHIS2). Improving software architecture and documentation for the Malawi POC will increase productivity and third-party contributions. A conceptual framework based on Generativity and Boundary Resource Model (BRM) was used to compare the three platforms. Interviews, observations, and document analysis were used to collect primary and secondary data. Themes were found by analyzing qualitative and quantitative data, which led to the following results. Configurable, flexible, and cross-platform software platforms and the availability of interfaces (Boundary Resources) that let internal and external developers interact with the platform's core functionality, hence boosting developer productivity. Furthermore, documentation increases developer productivity, while its absence inhibits the use of resources. The study suggests that the architecture and openness of the Malawi POC EMR software platform will be improved by standardizing web application program interfaces (APIs) and making interfaces that can be changed by the user. In addition, increasing the availability of documentation and training will improve the use of boundary resources, thus improving internal and third-party development productivity.

Keywords: health systems, configurable platforms, software architecture, software documentation, software development productivity

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12843 Introduction of Integrated Image Deep Learning Solution and How It Brought Laboratorial Level Heart Rate and Blood Oxygen Results to Everyone

Authors: Zhuang Hou, Xiaolei Cao

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The general public and medical professionals recognized the importance of accurately measuring and storing blood oxygen levels and heart rate during the COVID-19 pandemic. The demand for accurate contactless devices was motivated by the need for cross-infection reduction and the shortage of conventional oximeters, partially due to the global supply chain issue. This paper evaluated a contactless mini program HealthyPai’s heart rate (HR) and oxygen saturation (SpO2) measurements compared with other wearable devices. In the HR study of 185 samples (81 in the laboratory environment, 104 in the real-life environment), the mean absolute error (MAE) ± standard deviation was 1.4827 ± 1.7452 in the lab, 6.9231 ± 5.6426 in the real-life setting. In the SpO2 study of 24 samples, the MAE ± standard deviation of the measurement was 1.0375 ± 0.7745. Our results validated that HealthyPai utilizing the Integrated Image Deep Learning Solution (IIDLS) framework, can accurately measure HR and SpO2, providing the test quality at least comparable to other FDA-approved wearable devices in the market and surpassing the consumer-grade and research-grade wearable standards.

Keywords: remote photoplethysmography, heart rate, oxygen saturation, contactless measurement, mini program

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12842 Impact of Experiential Learning on Executive Function, Language Development, and Quality of Life for Adults with Intellectual and Developmental Disabilities (IDD)

Authors: Mary Deyo, Zmara Harrison

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This study reports the outcomes of an 8-week experiential learning program for 6 adults with Intellectual and Developmental Disabilities (IDD) at a day habilitation program. The intervention foci for this program include executive function, language learning in the domains of expressive, receptive, and pragmatic language, and quality of life. The interprofessional collaboration aimed at supporting adults with IDD to reach person-centered, functional goals across skill domains is critical. This study is a significant addition to the speech-language pathology literature in that it examines a therapy method that potentially meets this need while targeting domains within the speech-language pathology scope of practice. Communication therapy was provided during highly valued and meaningful hands-on learning experiences, referred to as the Garden Club, which incorporated all aspects of planting and caring for a garden as well as related journaling, sensory, cooking, art, and technology-based activities. Direct care staff and an undergraduate research assistant were trained by SLP to be impactful language guides during their interactions with participants in the Garden Club. SLP also provided direct therapy and modeling during Garden Club. Research methods used in this study included a mixed methods analysis of a literature review, a quasi-experimental implementation of communication therapy in the context of experiential learning activities, Quality of Life participant surveys, quantitative pre- post- data collection and linear mixed model analysis, qualitative data collection with qualitative content analysis and coding for themes. Outcomes indicated overall positive changes in expressive vocabulary, following multi-step directions, sequencing, problem-solving, planning, skills for building and maintaining meaningful social relationships, and participant perception of the Garden Project’s impact on their own quality of life. Implementation of this project also highlighted supports and barriers that must be taken into consideration when planning similar projects. Overall findings support the use of experiential learning projects in day habilitation programs for adults with IDD, as well as additional research to deepen understanding of best practices, supports, and barriers for implementation of experiential learning with this population. This research provides an important contribution to research in the fields of speech-language pathology and other professions serving adults with IDD by describing an interprofessional experiential learning program with positive outcomes for executive function, language learning, and quality of life.

Keywords: experiential learning, adults, intellectual and developmental disabilities, expressive language, receptive language, pragmatic language, executive function, communication therapy, day habilitation, interprofessionalism, quality of life

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12841 Investigating Self-Confidence Influence on English as a Foreign Language Student English Language Proficiency Level

Authors: Ali A. Alshahrani

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This study aims to identify Saudi English as a Foreign Language (EFL) students' perspectives towards using the English language in their studies. The study explores students' self-confident and its association with students' actual performance in English courses in their different academic programs. A multimodal methodology was used to fulfill the research purpose and answer the research questions. A 25-item survey questionnaire and final examination grades were used to collect data. Two hundred forty-one students agreed to participate in the study. They completed the questionnaire and agreed to release their final grades to be a part of the collected data. The data were coded and analyzed by SPSS software. The findings indicated a significant difference in students' performance in English courses between participants' academic programs on the one hand. Students' self-confidence in their English language skills, on the other hand, was not significantly different between participants' academic programs. Data analysis also revealed no correlational relationship between students' self-confidence level and their language skills and their performance. The study raises more questions about other vital factors such as course instructors' views of the materials, faculty members of the target department, family belief in the usefulness of the program, potential employers. These views and beliefs shape the student's preparation process and, therefore, should be explored further.

Keywords: English language intensive program, language proficiency, performance, self-confidence

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12840 Process of Analysis, Evaluation and Verification of the 'Real' Redevelopment of the Public Open Space at the Neighborhood’s Stairs: Case Study of Serres, Greece

Authors: Ioanna Skoufali

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The present study is directed towards adaptation to climate change closely related to the phenomenon of the urban heat island (UHI). This issue is widespread and common to different urban realities, but particularly in Mediterranean cities that are characterized by dense urban. The attention of this work of redevelopment of the open space is focused on mitigation techniques aiming to solve local problems such as microclimatic parameters and the conditions of thermal comfort in summer, related to urban morphology. This quantitative analysis, evaluation, and verification survey involves the methodological elaboration applied in a real study case by Serres, through the experimental support of the ENVImet Pro V4.1 and BioMet software developed: i) in two phases concerning the anteoperam (phase a1 # 2013) and the post-operam (phase a2 # 2016); ii) in scenario A (+ 25% of green # 2017). The first study tends to identify the main intervention strategies, namely: the application of cool pavements, the increase of green surfaces, the creation of water surface and external fans; moreover, it obtains the minimum results achieved by the National Program 'Bioclimatic improvement project for public open space', EPPERAA (ESPA 2007-2013) related to the four environmental parameters illustrated below: the TAir = 1.5 o C, the TSurface = 6.5 o C, CDH = 30% and PET = 20%. In addition, the second study proposes a greater potential for improvement than postoperam intervention by increasing the vegetation within the district towards the SW/SE. The final objective of this in-depth design is to be transferable in homogeneous cases of urban regeneration processes with obvious effects on the efficiency of microclimatic mitigation and thermal comfort.

Keywords: cool pavements, microclimate parameters (TAir, Tsurface, Tmrt, CDH), mitigation strategies, outdoor thermal comfort (PET & UTCI)

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12839 Killed by the ‘Subhuman’: Jane Longhurst’s Murder and the Construction of the ‘Extreme Pornography’ Problem in the British National Press

Authors: Dimitrios Akrivos, Alexandros K. Antoniou

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This paper looks at the crucial role of the British news media in the construction of extreme pornography as a social problem, suggesting that this paved the way for the subsequent criminalization of such material through the introduction of the Criminal Justice and Immigration Act 2008. Focusing on the high-profile case of Graham Coutts, it examines the British national press’ reaction to Jane Longhurst’s murder through a qualitative content analysis of 251 relevant news articles. Specifically, the paper documents the key arguments expressed in the corresponding claims-making process. It considers the different ways in which the consequent ‘trial by media’ presented this exceptional case as the ‘tip of the iceberg’ and eventually translated into policy. The analysis sheds light on the attempts to ‘piggyback’ the issue of extreme pornography on child sexual abuse images as well as the textual and visual mechanisms used to establish an ‘us versus them’ dichotomy in the pertinent media discourse. Finally, the paper assesses the severity of the actual risk posed by extreme pornography, concluding that its criminalization should not merely be dismissed as the outcome of an institutionalized media panic.

Keywords: criminalization, extreme pornography, social problem, trial by media

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12838 An International Curriculum Development for Languages and Technology

Authors: Miguel Nino

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When considering the challenges of a changing and demanding globalizing world, it is important to reflect on how university students will be prepared for the realities of internationalization, marketization and intercultural conversation. The present study is an interdisciplinary program designed to respond to the needs of the global community. The proposal bridges the humanities and science through three different fields: Languages, graphic design and computer science, specifically, fundamentals of programming such as python, java script and software animation. Therefore, the goal of the four year program is twofold: First, enable students for intercultural communication between English and other languages such as Spanish, Mandarin, French or German. Second, students will acquire knowledge in practical software and relevant employable skills to collaborate in assisted computer projects that most probable will require essential programing background in interpreted or compiled languages. In order to become inclusive and constructivist, the cognitive linguistics approach is suggested for the three different fields, particularly for languages that rely on the traditional method of repetition. This methodology will help students develop their creativity and encourage them to become independent problem solving individuals, as languages enhance their common ground of interaction for culture and technology. Participants in this course of study will be evaluated in their second language acquisition at the Intermediate-High level. For graphic design and computer science students will apply their creative digital skills, as well as their critical thinking skills learned from the cognitive linguistics approach, to collaborate on a group project design to find solutions for media web design problems or marketing experimentation for a company or the community. It is understood that it will be necessary to apply programming knowledge and skills to deliver the final product. In conclusion, the program equips students with linguistics knowledge and skills to be competent in intercultural communication, where English, the lingua franca, remains the medium for marketing and product delivery. In addition to their employability, students can expand their knowledge and skills in digital humanities, computational linguistics, or increase their portfolio in advertising and marketing. These students will be the global human capital for the competitive globalizing community.

Keywords: curriculum, international, languages, technology

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12837 A Global Perspective on Urban Environmental Problems in Developing Countries: The Case of Turkey

Authors: Nükhet Konuk, N. Gamze Turan, Yüksel Ardalı

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Cities play a vital role in the social fabric of countries and in national and regional economic growth worldwide; however, the environmental effects of such growth need to be assessed and managed better. The critical and most immediate problems faced by cities of developing countries are the health impacts of urban pollution that derive from inadequate water, sanitation, drainage and solid waste services, poor urban and industrial waste management, and air pollution. As globalization continues, earth's natural processes transform local problems into international issues. The aim of this study is to provide a broad overview of the pollution from urban wastes and emissions in Turkey which is a developing country. It is aimed to underline the significance of reorganizing the institutional tools in a worldwide perspective in order to generate coherent solutions to urban problems, and to enhance urban quality.

Keywords: environmental pollution, developing countries, environmental degradation, urban environmental problems

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12836 Evaluating Effectiveness of Training and Development Corporate Programs: The Russian Agribusiness Context

Authors: Ekaterina Tikhonova

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This research is aimed to evaluate the effectiveness of T&D (Training and Development) on the example of two T&D programs for the Executive TOP Management run in 2012, 2015-2016 in Komos Group. This study is commissioned to research the effectiveness of two similar corporate T&D programs (within one company) in two periods of time (2012, 2015-2016) through evaluating the programs’ effectiveness using the four-level Kirkpatrick’s model of evaluating T&D programs and calculating ROI as an instrument for T&D program measuring by Phillips’ formula. The research investigates the correlation of two figures: the ROI calculated and the rating percentage scale per the ROI implementation (Wagle’s scale). The study includes an assessment of feedback 360 (Kirkpatrick's model) and Phillips’ ROI Methodology that provides a step-by-step process for collecting data, summarizing and processing the collected information. The data is collected from the company accounting data, the HR budgets, MCFO and the company annual reports for the research periods. All analyzed data and reports are organized and presented in forms of tables, charts, and graphs. The paper also gives a brief description of some constrains of the research considered. After ROI calculation, the study reveals that ROI ranges between the average implementation (65% to 75%) by Wagle’s scale that can be considered as a positive outcome. The paper also gives some recommendations how to use ROI in practice and describes main benefits of ROI implementation.

Keywords: ROI, organizational performance, efficacy of T&D program, employee performance

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12835 Mental Health and Well-Being: Capacity Building of Community to Respond to Mental Health Needs of Transgender Populations

Authors: Harjyot Khosa

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In India and south Asia, stigma and discrimination against transgender community remain disproportionately high. Lack of mental health care restricts effective treatment and care for both physical and mental health. Knowledge assessment of 80 counsellors across India reflected that only 28% counsellors knew about the transgender community. Whereas, only 6% of them felt, that transgender community require a specific mental health support, considering the stigma they face in day to day life. Lastly, 62% did agree that they require specific training to address unmet needs of transgender community. A robust counselling module was developed with focus on technical counselling skills and strategies, specific counselling issues, identity and sexuality, disclosure, hormone therapy and sex reassignment surgery. Mental health related support should be an integral part of government and non-government programs for the overall well-being of transgender community who face stigma and discrimination at every level. Needs based capacity building and technical assistance is required towards providing mental health support for transgender populations and their partners.

Keywords: identity and sexuality, mental health, stigma, transgender

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12834 Simultech - Innovative Country-Wide Ultrasound Training Center

Authors: Yael Rieder, Yael Gilboa, S. O. Adva, Efrat Halevi, Ronnie Tepper

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Background: Operation of ultrasound equipment is a core skill for many clinical specialties. As part of the training program at -Simultech- a simulation center for Ob\Gyn at the Meir Medical Center, Israel, teaching how to operate ultrasound equipment requires dealing with misunderstandings of spatial and 3D orientation, failure of the operator to hold a transducer correctly, and limited ability to evaluate the data on the screen. We have developed a platform intended to endow physicians and sonographers with clinical and operational skills of obstetric ultrasound. Simultech's simulations are focused on medical knowledge, risk management, technology operations and physician-patient communication. The simulations encompass extreme work conditions. Setup: Between eight and ten of the eight hundred and fifty physicians and sonographers of the Clalit health services from seven hospitals and eight community centers across Israel, participate in individual Ob/Gyn training sessions each week. These include Ob/Gyn specialists, experts, interns, and sonographers. Innovative teaching and training methodologies: The six-hour training program includes: (1) An educational computer program that challenges trainees to deal with medical questions based upon ultrasound pictures and films. (2) Sophisticated hands-on simulators that challenge the trainees to practice correct grip of the transducer, elucidate pathology, and practice daily tasks such as biometric measurements and analysis of sonographic data. (3) Participation in a video-taped simulation which focuses on physician-patient communications. In the simulation, the physician is required to diagnose the clinical condition of a hired actress based on the data she provides and by evaluating the assigned ultrasound films accordingly. Giving ‘bad news’ to the patient may put the physician in a stressful situation that must be properly managed. (4) Feedback at the end of each phase is provided by a designated trainer, not a physician, who is specially qualified by Ob\Gyn senior specialists. (5) A group exercise in which the trainer presents a medico-legal case in order to encourage the participants to use their own experience and knowledge to conduct a productive ‘brainstorming’ session. Medical cases are presented and analyzed by the participants together with the trainer's feedback. Findings: (1) The training methods and content that Simultech provides allows trainees to review their medical and communications skills. (2) Simultech training sessions expose physicians to both basic and new, up-to-date cases, refreshing and expanding the trainee's knowledge. (3) Practicing on advanced simulators enables trainees to understand the sonographic space and to implement the basic principles of ultrasound. (4) Communications simulations were found to be beneficial for trainees who were unaware of their interpersonal skills. The trainer feedback, supported by the recorded simulation, allows the trainee to draw conclusions about his performance. Conclusion: Simultech was found to contribute to physicians at all levels of clinical expertise who deal with ultrasound. A break in daily routine together with attendance at a neutral educational center can vastly improve performance and outlook.

Keywords: medical training, simulations, ultrasound, Simultech

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12833 Predictive Factors of Healthcare-Associated Infections and Antibiotic Use Patterns: A Cross-Sectional Survey at the Charles Nicolle Hospital of Tunis

Authors: Nouira Mariem, Ennigrou Samir

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.

Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia

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12832 A Cross-Sectional Study of Parents’ Knowledge, Attitude, and Health-Seeking Behaviour Towards Childhood Tuberculosis during COVID-19 Pandemic: Lessons Learned from Indonesia

Authors: Windy Rakhmawati, Suryani Suryani, Sri Hendrawati, Nenden Nur Asriyani Maryam

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Tuberculosis (TB) is one of the leading causes of death in the world. Fear of COVID-19 has made people reluctant to visit health facilities, leading to disruptions to childhood TB control programs, which may increase household transmission and delay diagnosis and treatment. This study aimed to describe parents' knowledge, attitudes, and health-seeking behaviour towards childhood TB during the COVID-19 pandemic. This cross-sectional study was performed on 392 parents with TB children in three provinces with the highest proportion of TB cases in Indonesia. This study was conducted from February to December 2022. The inclusion criteria of respondents were parents with a child aged 0-14 years old with TB diagnosis who live with their parents. Data were collected using the Knowledge, Attitude, and Practice (KAP) survey guidelines from the World Health Organization and analyzed descriptively, as well as Spearman’s correlation. Overall, 392 parents of children with TB had poor knowledge (51.8%) including about causes, risk factors, transmission, symptoms, treatment, and prevention, which about 52.3%, 55.1%, 61.2%, 69.6%, 100%, 59.2%, respectively. Parents' health service-seeking behaviour towards Child TB was not normally distributed (P < 0.05) with knowledge test results (.000) and Seeking Health Services (.000). Health-seeking behaviour of parents in pediatric TB care was self-medication or self-treatment (86.2%), Traditional health seeking behaviour (4.8%), and modern health seeking behaviour (8.9%). The correlation between knowledge and seeking health services (Sig= .609) means there is no correlation between knowledge about TB and parents' health-seeking behaviour. Furthermore, 60.2% of the respondents would be shocked if their child had TB. More than half of the families in this study have poor knowledge and did self-medication or self-treatment regarding health-seeking behaviour for TB disease. Therefore, health workers, especially nurses, must provide TB-related education and health promotion and emphasize the importance of early detection. Health workers can also optimize their role in caring for and providing care to patients by increasing their trust in health workers, which will impact health-seeking behaviour in the future.

Keywords: attitude, child, health seeking behaviour, knowledge, tuberculosis

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12831 A Comparative Study on the Effectiveness of Conventional Physiotherapy Program, Mobilization and Taping with Proprioceptive Training for Patellofemoral Pain Syndrome

Authors: Mahesh Mitra

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Introduction and Purpose: Patellofemoral Pain Syndrome [PFPS] is characterized by pain or discomfort seemingly originating from the contact of posterior surface of Patella with Femur. Given the multifactorial causes and high prevalence there is a need of proper management technique. Also a more comprehensive and best possible Physiotherapy treatment approach has to be devised to enhance the performance of the individual with PFPS. Purpose of the study was to: - Prevalence of PFPS in various sports - To determine if there exists any relationship between the Body Mass Index[BMI] and Pain Intensity in the person playing a sport. - To evaluate the effect of conventional Physiotherapy program, Mobilization and Taping with Proprioceptive training on PFPS. Hypothesis 1. Prevalence is not the same with different sporting activities 2. There is a relationship between BMI and Pain intensity. 3. There is no significant difference in the improvement with the different treatment approaches. Methodology: A sample of 200 sports men were tested for the prevalence of PFPS and their anthropometric measurements were obtained to check for the correlation between BMI vs Pain intensity. Out of which 80 diagnosed cases of PFPS were allotted into three treatment groups and evaluated for Pain at rest and at activity and KUJALA scale. Group I were treated with conventional Physiotherapy that included TENS application and Exercises, Group II were treated with compression mobilization along with exercises, Group III were treated with Taping and Proprioceptive exercises. The variables Pain on rest, activity and KUJALA score were measured initially, at 1 week and at the end of 2 weeks after respective treatment. Data Analysis - Prevalence percentage of PFPS in each sport - Pearsons Correlation coefficient to find the relationship between BMI and Pain during activity. - Repeated measures analysis of variance [ANOVA] to find out the significance during Pre, Mid and Post-test difference among - Newman Kuel Post hoc Test - ANCOVA for the difference amongst group I, II and III. Results and conclusion It was concluded that PFPS was more prevalent in volley ball players [80%] followed by football and basketball [66%] players, then in hand ball and cricket players [46.6%] and 40% in tennis players. There was no relationship between BMI of the individual and Pain intensity. All the three treatment approaches were effective whereas mobilization and taping were more effective than Conventional Physiotherapy program.

Keywords: PFPS, KUJALA score, mobilization, proprioceptive training

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12830 A Case Study of the Influence of the Covid-19 pandemic on Racial and Ethnic Gaps in Behavioral Health Care Access

Authors: Shantol McIntosh

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Due to environmental and underlying health disparities, the COVID-19 pandemic has caused an added set of economic implications worldwide. Black and Hispanic individuals are more susceptible to contract COVID-19, and if they do, they are more likely to have a severe case that necessitates hospitalization or results in death (Altarum et al., 2020). The literature shows that disparities in health and health treatment are nothing new as they have been recorded for decades and indicate systemic and structural imbalances rooted in racism and discrimination. The purpose of this study is to determine the frequency with which these populations have access to healthcare and treatment. The study will also highlight the key drivers of health disparities. Findings and implications for research and policy will be discussed.

Keywords: COVID-19, racial and ethnic disparities, discrimination, policy

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12829 Violence and Unintentional Injuries among Secondary School Students in Jordan

Authors: Malakeh Zuhdi Malak, Mahmoud Taher Kalaldeh

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In Jordan, no available data exists regarding violence and unintentional injuries among secondary school students aged 15-19 years. The purpose of this study was to assess the violence and unintentional injuries among those students, and to compare these two behaviors between male and female students. A descriptive cross-sectional design was carried out on randomly selected eight comprehensive secondary schools (four schools for females and four schools for males) from the public school educational directorate located in Amman. A modified Arabic version of the General School Health Survey questionnaire was used to measure violence and unintentional injuries. A sample of 750 secondary school students was studied. The findings showed that 26.8 % of students had been physically attacked. Overall, 43.3 % of students had been involved in a physical fight and 20.1% of them had been bullied. Overall, 45.3% of students were seriously injured. There was a difference between male and female students regarding to physical attack, physical fight, and serious injuries. In conclusion, it is necessary to develop effective training program in life skills for students that functions to reduce risk-taking behaviors that often leading to violence and unintentional injuries.

Keywords: secondary school students, violence, unintentional injuries, bullying

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12828 Development of a Rice Fortification Technique Using Vacuum Assisted Rapid Diffusion for Low Cost Encapsulation of Fe and Zn

Authors: R. A. C. H. Seneviratne, M. Gunawardana, R. P. N. P. Rajapakse

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To address the micronutrient deficiencies in the Asian region, the World Food Program in its current mandate highlights the requirement of employing efficient fortification of micronutrients in rice, under the program 'Scaling-up Rice Fortification in Asia'. The current industrial methods of rice fortification with micronutrients are not promising due to poor permeation or retention of fortificants. This study was carried out to develop a method to improve fortification of micronutrients in rice by removing the air barriers for diffusing micronutrients through the husk. For the purpose, soaking stage of paddy was coupled with vacuum (- 0.6 bar) for different time periods. Both long and short grain varieties of paddy (BG 352 and BG 358, respectively) initially tested for water uptake during hot soaking (70 °C) under vacuum (28.5 and 26.15%, respectively) were significantly (P < 0.05) higher than that of non-vacuum conditions (25.24 and 25.45% respectively), exhibiting the effectiveness of water diffusion into the rice grains through the cleared pores under negative pressure. To fortify the selected micronutrients (iron and zinc), paddy was vacuum-soaked in Fe2+ or Zn2+ solutions (500 ppm) separately for one hour, and continued soaking for another 3.5 h without vacuum. Significantly (P<0.05) higher amounts of Fe2+ and Zn2+ were observed throughout the soaking period, in both short and long grain varieties of rice compared to rice treated without vacuum. To achieve the recommended limits of World Food Program standards for fortified iron (40-48 mg/kg) and zinc (60-72 mg/kg) in rice, soaking was done with different concentrations of Fe2+ or Zn2+ for varying time periods. For both iron and zinc fortifications, hot soaking (70 °C) in 400 ppm solutions under vacuum (- 0.6 bar) during the first hour followed by 2.5 h under atmospheric pressure exhibited the optimum fortification (Fe2+: 46.59±0.37 ppm and Zn2+: 67.24±1.36 ppm) with a greater significance (P < 0.05) compared to the controls (Fe2+: 38.84±0.62 ppm and Zn2+: 52.55±0.55 ppm). This finding was further confirmed by the XRF images, clearly showing a greater fixation of Fe2+ and Zn2+ in the rice grains under vacuum treatment. Moreover, there were no significant (P>0.05) differences among both Fe2+ and Zn2+ contents in fortified rice even after polishing and washing, confirming their greater retention. A seven point hedonic scale showed that the overall acceptability for both iron and zinc fortified rice were significantly (P < 0.05) higher than the parboiled rice without fortificants. With all the drawbacks eliminated, per kilogram cost will be less than US$ 1 for both iron and zinc fortified rice. The new method of rice fortification studied and developed in this research, can be claimed as the best method in comparison to other rice fortification methods currently deployed.

Keywords: fortification, vacuum assisted diffusion, micronutrients, parboiling

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12827 Media Representation of China: A Content Analysis of Coverage of China-Related Energy in the New York Times

Authors: Lian Liu

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By analyzing the content of the New York Times' China-related energy reports, this study aims to explore the construction of China's national image by the mainstream media in the United States. The study analyzes three aspects of the coverage: topics, reporting tendencies, and countries involved. The results of the study show that economic issues are the main focus of the New York Times’ China-related energy coverage, followed by political issues and environmental issues. Overall, the coverage tendency was mainly negative, but positive coverage was dominated by science and technology issues. In addition, the study found that U.S.-China relations and Sino-Russian relations were important contexts for the construction of China's national image in the NYT's China-related energy coverage. These stories highlight China's interstate interactions with the United States, Japan, and Russia, which serve as important links in the coverage. The findings of this study reveal some characteristics and trends of the U.S. mainstream media's country image of China, which are important for a deeper understanding of the U.S.-China relationship and the media's influence on the construction of the country's image.

Keywords: media coverage, China, content analysis, visualization technology

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12826 Comparing of Hypogonadism Frequency between Metabolic Syndrome Men with Normal Men

Authors: Armaghan Moravej Aleali, Seyed Bahman Ghaderian, Homeira Rashidi, Mahmoud Mapar

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Background and Objective The metabolic syndrome (MetS) is considered the most important public health threat of the 21st century. This syndrome is characterized by a cluster of cardiovascular risk factors including increased central abdominal obesity, elevated triglycerides, reduced high-density lipoprotein, high blood pressure, increased fasting glucose, and hyperinsulinemia. MetS has been associated with hypogonadism and erectile dysfunction (ED), and MetS may be considered a risk factor for ED. The aim of this study was finding an association between metabolic syndrome and hypogonadism in Khouzestan, Iran. Subjects and Methods: In this study, 60 patients divided into two groups consisted of 30 cases (with metabolic syndrome) and 30 controls. Total and free Serum Testosterone and FBS in all of them were measured. Data was analyzed with SPSS20 program. Results: There was a significant difference between two groups about free Testosterone (P=0.01), FBS (P=0.002) and LH (P=0.03). Conclusion: According to this finding, it is thought the prevalence of hypogonadism in men with metabolic syndrome is more than the general population.

Keywords: metabolic syndrome, fasting blood sugar, hypogonadism, testosterone

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12825 Social Studies Teachers’ Sustained, Collaborative Professional Development Centered Round Innovative Curriculum Materials

Authors: Cory Callahan

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Here the author synthesizes findings and implications from two research studies that comprise a continuing line of inquiry into the potential of an innovative professional development program to help in-service teachers understand and implement a complex model of social studies instruction. The paper specifically explores the question: To what degree can a collaborative professional development program centered around innovative curriculum materials help social studies teachers understand and implement a powerful social studies approach? Findings suggest the teachers increasingly incorporated substantive thinking (i.e., second-order historical domain knowledge) into their respective practice and they facilitated students’ use of historical photographs as evidence to begin to answer a compelling question. The teachers also began to effectively support students’ abilities to make claims about the past. Implications include the foregrounding of high-quality questions during planning and the need for explicit guidance in the form of structures and procedures (i.e., scaffolds) to help teachers systematically review students’ work products. The work shared here may contribute to scholarship that posits explanations for why teacher-support is routinely ineffectual and suggests ways to provide substantive collaborative support for in-service social studies teachers.

Keywords: educative curriculum, social studies, professional development, lesson study

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