Search results for: staff engagement
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2680

Search results for: staff engagement

310 Executive Leadership in Kinesiology, Exercise and Sport Science: The Five 'C' Concept

Authors: Jim Weese

Abstract:

The Kinesiology, Exercise and Sport Science environment remain excellent venues for leadership research. Prescribed leadership (coaching), emergent leadership (players and organizations), and executive leadership are all popular themes in the research literature. Leadership remains a popular area of inquiry in the sport management domain as well as an interesting area for practitioners who wish to heighten their leadership practices and effectiveness. The need for effective leadership in these areas given competing demands for attention and resources may be at an all-time high. The presenter has extensive research and practical experience in the area and has developed his concept based on the latest leadership literature. He refers to this as the Five ’C’s of Leadership. These components, noted below, have been empirically validated and have served as the foundation for extensive consulting with academic, sport, and business leaders. Credibility (C1) is considered the foundation of leadership. There are two components to this area, namely: (a) leaders being respected for having the relevant knowledge, insights, and experience to be seen as credible sources of information, and (b) followers perceiving the leader as being a person of character, someone who is honest, reliable, consistent, and trustworthy. Compelling Vision (C2) refers to the leader’s ability to focus the attention of followers on a desired end goal. Effective leaders understand trends and developments in their industry. They also listen attentively to the needs and desires of their stakeholders and use their own instincts and experience to shape these ideas into an inspiring vision that is effectively and continuously communicated. Charismatic Communicator (C3) refers to the leader’s ability to formally and informally communicate with members. Leaders must deploy mechanisms and communication techniques to keep their members informed and engaged. Effective leaders sprinkle in ‘proof points’ that reinforce the vision’s relevance and/or the unit’s progress towards its attainment. Contagious Enthusiasm (C4) draws on the emotional intelligence literature as it relates to exciting and inspiring followers. Effective leaders demonstrate a level of care, commitment, and passion for their people and feelings of engagement permeate the group. These leaders genuinely care about the task at hand, and for the people working to make it a reality. Culture Builder (C5) is the capstone component of the model and is critical to long-term success and survival. Organizational culture refers to the dominant beliefs, values and attitudes of members of a group or organization. Some have suggested that developing and/or imbedding a desired culture for an organization is the most important responsibility for a leader. The author outlines his Five ‘C’s’ of Leadership concept and provide direct application to executive leadership in Kinesiology, Exercise and Sport Science.

Keywords: effectiveness, leadership, management, sport

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309 Forest Degradation and Implications for Rural Livelihood in Kaimur Reserve Forest of Bihar, India

Authors: Shashi Bhushan, Sucharita Sen

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In India, forest and people are inextricably linked since millions of people live adjacent to or within protected areas and harvest forest products. Indian forest has their own legacy to sustain by its own climatic nature with several social, economic and cultural activities. People surrounding forest areas are not only dependent on this resource for their livelihoods but also for the other source, like religious ceremonies, social customs and herbal medicines, which are determined by the forest like agricultural land, groundwater level, and soil fertility. The assumption that fuelwood and fodder extraction, which is the part of local livelihood leads to deforestation, has so far been the dominant mainstream views in deforestation discourses. Given the occupational division across social groups in Kaimur reserve forest, the differential nature of dependence of forest resources is important to understand. This paper attempts to assess the nature of dependence and impact of forest degradation on rural households across various social groups. Also, an additional element that is added to the enquiry is the way degradation of forests leading to scarcity of forest-based resources impacts the patterns of dependence across various social groups. Change in forest area calculated through land use land cover analysis using remote sensing technique and examination of different economic activities carried out by the households that are forest-based was collected by primary survey in Kaimur reserve forest of state of Bihar in India. The general finding indicates that the Scheduled Tribe and Scheduled Caste communities, the most socially and economically deprived sections of the rural society are involved in a significant way in collection of fuelwood, fodder, and fruits, both for self-consumption and sale in the market while other groups of society uses fuelwood, fruit, and fodder for self-use only. Depending on the local forest resources for fuelwood consumption was the primary need for all social groups due to easy accessibility and lack of alternative energy source. In last four decades, degradation of forest made a direct impact on rural community mediated through the socio-economic structure, resulting in a shift from forest-based occupations to cultivation and manual labour in agricultural and non-agricultural activities. Thus there is a need to review the policies with respect to the ‘community forest management’ since this study clearly throws up the fact that engagement with and dependence on forest resources is socially differentiated. Thus tying the degree of dependence and forest management becomes extremely important from the view of ‘sustainable’ forest resource management. The statization of forest resources also has to keep in view the intrinsic way in which the forest-dependent population interacts with the forest.

Keywords: forest degradation, livelihood, social groups, tribal community

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308 The Attitudes of Senior High School Students Toward Work Immersion Programs of Nazareth School of National University

Authors: Kim Katherine Castillo, Nelson John Datubatang, Terrence Phillip Dy, Norelie Hampac, Reichen Crismark Martinez, Nina Faith Pantinople, Jose Dante Santos II, Marchel Ann Santos, Sophia Abigail Santiago, Zyrill Xsar San Juan, Aira Mae Tagao, Crystal Kylla Viagedor

Abstract:

The Work Immersion Program was implemented to help students gain abundant work-related experiences while on-site; additionally, the program aims to help students improve their competencies and interpersonal skills as they are given the option to join the workforce if they ever choose to do so after senior high school. The work immersion experience posed diverse challenges for students, spanning personal, financial, engagement, environmental, and equipment-related domains. These included the need for assistance in time management, transportation expenses, and procurement of materials. Furthermore, students faced difficulties in independent task completion and encountered suboptimal work environments. Addressing these multifaceted obstacles is crucial to optimize the educational outcomes of work immersion programs. In addition to the challenges, several other issues have been identified, including the absence of standardized work immersion programs across schools and industries, the challenges in securing appropriate work immersion placements, the necessity for enhanced monitoring and evaluation of program effectiveness, and the limited availability of field programs aligned with students' chosen courses. Furthermore, there is a lack of comprehensive information regarding the attitudes of Senior High School students toward work immersion programs within their respective schools. This study aims to investigate the attitudes of senior high school students at Nazareth School of National University towards work immersion programs, with a focus on identifying factors that influence their perception and participation, including collegiality and expectations. By exploring the students' attitudes, the research endeavors to enhance the school's work immersion programs and contribute to the overall educational experience of the students. This study addresses challenges related to work immersion programs, focusing on six subtopics: Work Immersion, Work Immersion in the Philippines, Students' Attitudes, Factors Affecting Students' Attitudes, Effectiveness of Work Immersion for Senior High School Students, and Students' Perception and Willingness to Participate. Using a descriptive research design, the study examines the attitudes of senior high school students at Nazareth School of National University in Manila. Data was collected from 100 students, representing different academic strands, through a 35-item researcher-made survey. Descriptive statistics, including measures of central tendency and variability, will be used to analyze the data using JASP, providing valuable insights into the students' attitudes toward work immersion.

Keywords: attitudes, challenges, educational outcomes, work immersion programs

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307 Forensic Nursing in the Emergency Department: The Overlooked Roles

Authors: E. Tugba Topcu

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The emergency services are usually the first places to encounter forensic cases. Hence, it is important to consider forensics from the perspective of the emergency services staff and the physiological and psychological consequences that may arise as a result of behaviour by itself or another person. Accurate and detailed documentation of the situation in which the patient first arrives at the emergency service and preservation of the forensic findings is pivotal for the subsequent forensic investigation. The first step in determining whether or not a forensic case exists is to perform a medical examination of the patient. For each individual suspected to be part of a forensic case, police officers should be informed at the same time as the medical examination is being conducted. Violent events are increasing every year and with an increase in the number of forensic cases, emergency service workers have increasing responsibility and consequently play a key role in protecting, collecting and arranging the forensic evidence. In addition, because the emergency service workers involved in forensic events typically have information about the accused and/or victim, as well as evidence related to the events and the cause of injuries, police officers often require their testimony. However, both nurses and other health care personnel do not typically have adequate expertise in forensic medicine. Emergency nurses should take an active role for determining that whether any patient admitted to the emergency services is a clinical forensic patient the emergency service with injury and requiring possible punishment and knowing of their roles and responsibilities in this area provides legal protection as well as the protection of the judicial affair. Particularly, in emergency services, where rapid patient turnover and high workload exists, patient registration and case reporting may not exist. In such instances, the witnesses, typically the nurses, are often consulted for information. Knowledge of forensic medical matters plays a vital role in achieving justice. According to the Criminal Procedure Law, Article 75, Paragraph 3, ‘an internal body examination or the taking of blood or other biological samples from the body can be performed only by a doctor or other health professional member’. In favour of this item, the clinic nurse and doctor are mainly responsible for evaluating forensic cases in emergency departments, performing the examination, collecting evidence, and storing and reporting data. The courts place considerable importance on determining whether a suspect is the victim or accused and, thus, in terms of illuminating events, it is crucial that any evidence is gathered carefully and appropriately. All the evidence related to the forensic case including the forensic report should be handed over to the police officers. In instances where forensic evidence cannot be collected and the only way to obtain the evidence is the hospital environment, health care personnel in emergency services need to have knowledge about the diagnosis of forensic evidence, the collection of evidence, hiding evidence and provision of the evidence delivery chain.

Keywords: emergency department, emergency nursing, forensic cases, forensic nursing

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306 Neuropsychiatric Outcomes of Intensive Music Therapy in Stroke Rehabilitation A Premilitary Investigation

Authors: Honey Bryant, Elvina Chu

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Stroke is the leading cause of disability in adults in Canada and directly related to depression, anxiety, and sleep disorders; with an estimated annual cost of $50 billion in health care. Strokes not only impact the individual but society as a whole. Current stroke rehabilitation does not include Music Therapy, although it has success in clinical research in the use of stroke rehabilitation. This study examines the use of neurologic music therapy (NMT) in conjunction with stroke rehabilitation to improve sleep quality, reduce stress levels, and promote neurogenesis. Existing research on NMT in stroke is limited, which means any conclusive information gathered during this study will be significant. My novel hypotheses are a.) stroke patients will become less depressed and less anxious with improved sleep following NMT. b.) NMT will reduce stress levels and promote neurogenesis in stroke patients admitted for rehabilitation. c.) Beneficial effects of NMT will be sustained at least short-term following treatment. Participants were recruited from the in-patient stroke rehabilitation program at Providence Care Hospital in Kingston, Ontario, Canada. All participants-maintained stroke rehabilitation treatment as normal. The study was spilt into two groups, the first being Passive Music Listening (PML) and the second Neurologic Music Therapy (NMT). Each group underwent 10 sessions of intensive music therapy lasting 45 minutes for 10 consecutive days, excluding weekends. Psychiatric Assessments, Epworth Sleepiness Scale (ESS), Hospital Anxiety & Depression Rating Scale (HADS), and Music Engagement Questionnaire (MusEQ), were completed, followed by a general feedback interview. Physiological markers of stress were measured through blood pressure measurements and heart rate variability. Serum collections reviewed neurogenesis via Brain-derived neurotrophic factor (BDNF) and stress markers of cortisol levels. As this study is still on-going, a formal analysis of data has not been fully completed, although trends are following our hypotheses. A decrease in sleepiness and anxiety is seen upon the first cohort of PML. Feedback interviews have indicated most participants subjectively felt more relaxed and thought PML was useful in their recovery. If the hypothesis is supported, larger external funding which will allow for greater investigation of the use of NMT in stroke rehabilitation. As we know, NMT is not covered under Ontario Health Insurance Plan (OHIP), so there is limited scientific data surrounding its uses as a clinical tool. This research will provide detailed findings of the treatment of neuropsychiatric aspects of stroke. Concurrently, a passive music listening study is being designed to further review the use of PML in rehabilitation as well.

Keywords: music therapy, psychotherapy, neurologic music therapy, passive music listening, neuropsychiatry, counselling, behavioural, stroke, stroke rehabilitation, rehabilitation, neuroscience

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305 Roadway Infrastructure and Bus Safety

Authors: Richard J. Hanowski, Rebecca L. Hammond

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Very few studies have been conducted to investigate safety issues associated with motorcoach/bus operations. The current study investigates the impact that roadway infrastructure, including locality, roadway grade, traffic flow and traffic density, have on bus safety. A naturalistic driving study was conducted in the U.S.A that involved 43 motorcoaches. Two fleets participated in the study and over 600,000 miles of naturalistic driving data were collected. Sixty-five bus drivers participated in this study; 48 male and 17 female. The average age of the drivers was 49 years. A sophisticated data acquisition system (DAS) was installed on each of the 43 motorcoaches and a variety of kinematic and video data were continuously recorded. The data were analyzed by identifying safety critical events (SCEs), which included crashes, near-crashes, crash-relevant conflicts, and unintentional lane deviations. Additionally, baseline (normative driving) segments were also identified and analyzed for comparison to the SCEs. This presentation highlights the need for bus safety research and the methods used in this data collection effort. With respect to elements of roadway infrastructure, this study highlights the methods used to assess locality, roadway grade, traffic flow, and traffic density. Locality was determined by manual review of the recorded video for each event and baseline and was characterized in terms of open country, residential, business/industrial, church, playground, school, urban, airport, interstate, and other. Roadway grade was similarly determined through video review and characterized in terms of level, grade up, grade down, hillcrest, and dip. The video was also used to make a determination of the traffic flow and traffic density at the time of the event or baseline segment. For traffic flow, video was used to assess which of the following best characterized the event or baseline: not divided (2-way traffic), not divided (center 2-way left turn lane), divided (median or barrier), one-way traffic, or no lanes. In terms of traffic density, level-of-service categories were used: A1, A2, B, C, D, E, and F. Highlighted in this abstract are only a few of the many roadway elements that were coded in this study. Other elements included lighting levels, weather conditions, roadway surface conditions, relation to junction, and roadway alignment. Note that a key component of this study was to assess the impact that driver distraction and fatigue have on bus operations. In this regard, once the roadway elements had been coded, the primary research questions that were addressed were (i) “What environmental condition are associated with driver choice of engagement in tasks?”, and (ii) “what are the odds of being in a SCE while engaging in tasks while encountering these conditions?”. The study may be of interest to researchers and traffic engineers that are interested in the relationship between roadway infrastructure elements and safety events in motorcoach bus operations.

Keywords: bus safety, motorcoach, naturalistic driving, roadway infrastructure

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304 Tuberculosis Outpatient Treatment in the Context of Reformation of the Health Care System

Authors: Danylo Brindak, Viktor Liashko, Olexander Chepurniy

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Despite considerable experience in implementation of the best international approaches and services within response to epidemy of multi-drug resistant tuberculosis, the results of situation analysis indicate the presence of faults in this area. In 2014, Ukraine (for the first time) was included in the world’s five countries with the highest level of drug-resistant tuberculosis. The effectiveness of its treatment constitutes only 35% in the country. In this context, the increase in allocation of funds to control the epidemic of multidrug-resistant tuberculosis does not produce perceptible positive results. During 2001-2016, only the Global Fund to fight AIDS, Tuberculosis, and Malaria allocated to Ukraine more than USD 521,3 million for programs of tuberculosis and HIV/AIDS control. However, current conditions in post-Semashko system create little motivation for rational use of resources or cost control at inpatient TB facilities. There is no motivation to reduce overdue hospitalization and to target resources to priority sectors of modern tuberculosis control, including a model of care focused on the patient. In the presence of a line-item budget at medical institutions, based on the input factors as the ratios of beds and staff, there is a passive disposal of budgetary funds by health care institutions and their employees who have no motivation to improve quality and efficiency of service provision. Outpatient treatment of tuberculosis is being implemented in Ukraine since 2011 and has many risks, namely creation of parallel systems, low consistency through dependence on funding for the project, reduced the role of the family doctor, the fragmentation of financing, etc. In terms of reforming approaches to health system financing, which began in Ukraine in late 2016, NGO Infection Control in Ukraine conducted piloting of a new, motivating method of remuneration of employees in primary health care. The innovative aspect of this funding mechanism is cost according to results of treatment. The existing method of payment on the basis of the standard per inhabitant (per capita ratio) was added with motivating costs according to results of work. The effectiveness of such treatment of TB patients at the outpatient stage is 90%, while in whole on the basis of a current system the effectiveness of treatment of newly diagnosed pulmonary TB with positive swab is around 60% in the country. Even though Ukraine has 5.24 TB beds per 10 000 citizens. Implemented pilot model of ambulatory treatment will be used for the creation of costs system according to results of activities, the integration of TB and primary health and social services and their focus on achieving results, the reduction of inpatient treatment of tuberculosis.

Keywords: health care reform, multi-drug resistant tuberculosis, outpatient treatment efficiency, tuberculosis

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303 Environment Patterns and Mental Health of Older Adults in Long-Term Care Facilities: The Role of Activity Profiles

Authors: Shiau-Fang Chao, Yu-Chih Chen

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Owing to physical limitations and restrained lifestyle, older long-term care (LTC) residents are more likely to be affected by their environment than their community-dwelling counterparts. They also participate fewer activities and experience worse mental health than healthy older adults. This study adopts the ICF model to determine the extent to which the clustered patterns of LTC environment and activity participation are associated with older residents’ mental health. Method: Data were collected from a stratified equal probability sample of 634 older residents in 155 LTC institutions in Taiwan. Latent profile analysis (LPA) and latent class analysis (LCA) were conducted to explore the profiles for environment and activity participation. Multilevel modeling was performed to elucidate the relationships among environment profiles, activity profiles, and mental health. Results: LPA identified three mutually exclusive environment profiles (Low-, Moderate-, and High-Support Environment) based on the physical, social, and attitudinal environmental domains, consolidated from 12 environmental measures. LCA constructed two distinct activity profiles (Low- and High-Activity Participation) across seven activity domains (outdoor, volunteer-led leisure, spiritual, household chores, interpersonal exchange, social, and sedentary activity) that were factored from 20 activities. Compared to the Low-Support Environment class, older adults in the Moderate- and High-Support Environment classes had better mental health. Older residents in the Moderate- and High-Support Environment classes were more likely to be in the “High Activity” class, which in turn, exhibited better mental health. Conclusion: This study advances the current knowledge through rigorous methods and study design. The study findings lead to several conclusions. First, this study supports the use of ICF framework to institutionalized older individuals with functional limitations and demonstrates that both measures of environment and activity participation can be refined from multiple indicators. Second, environmental measures that encompass the physical, social, and attitudinal domains would provide a more comprehensive assessment on the place where an older individual embeds. Third, simply counting activities in which an older individual participates or considering a certain type of activity may not capture his or her way of life. Practitioners should not only focus on group or leisure activities within the institutions; rather, more efforts should be made to consider residents’ preferences for everyday life and support their remaining ability by encouraging continuous participation in activities they still willing and capable to perform. Fourth, environment and activity participation are modifiable factors which have greater potential to strengthen older LTC residents’ mental health, and activity participation should be considered in the link between environment and mental health. A combination of enhanced physical, social, and attitudinal environments, and continual engagement in various activities may optimize older LTC residents’ mental health.

Keywords: activity, environment, mental health, older LTC residents

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302 Airport Pavement Crack Measurement Systems and Crack Density for Pavement Evaluation

Authors: Ali Ashtiani, Hamid Shirazi

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This paper reviews the status of existing practice and research related to measuring pavement cracking and using crack density as a pavement surface evaluation protocol. Crack density for pavement evaluation is currently not widely used within the airport community and its use by the highway community is limited. However, surface cracking is a distress that is closely monitored by airport staff and significantly influences the development of maintenance, rehabilitation and reconstruction plans for airport pavements. Therefore crack density has the potential to become an important indicator of pavement condition if the type, severity and extent of surface cracking can be accurately measured. A pavement distress survey is an essential component of any pavement assessment. Manual crack surveying has been widely used for decades to measure pavement performance. However, the accuracy and precision of manual surveys can vary depending upon the surveyor and performing surveys may disrupt normal operations. Given the variability of manual surveys, this method has shown inconsistencies in distress classification and measurement. This can potentially impact the planning for pavement maintenance, rehabilitation and reconstruction and the associated funding strategies. A substantial effort has been devoted for the past 20 years to reduce the human intervention and the error associated with it by moving toward automated distress collection methods. The automated methods refer to the systems that identify, classify and quantify pavement distresses through processes that require no or very minimal human intervention. This principally involves the use of a digital recognition software to analyze and characterize pavement distresses. The lack of established protocols for measurement and classification of pavement cracks captured using digital images is a challenge to developing a reliable automated system for distress assessment. Variations in types and severity of distresses, different pavement surface textures and colors and presence of pavement joints and edges all complicate automated image processing and crack measurement and classification. This paper summarizes the commercially available systems and technologies for automated pavement distress evaluation. A comprehensive automated pavement distress survey involves collection, interpretation, and processing of the surface images to identify the type, quantity and severity of the surface distresses. The outputs can be used to quantitatively calculate the crack density. The systems for automated distress survey using digital images reviewed in this paper can assist the airport industry in the development of a pavement evaluation protocol based on crack density. Analysis of automated distress survey data can lead to a crack density index. This index can be used as a means of assessing pavement condition and to predict pavement performance. This can be used by airport owners to determine the type of pavement maintenance and rehabilitation in a more consistent way.

Keywords: airport pavement management, crack density, pavement evaluation, pavement management

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301 Neighborhood Sustainability Assessment Tools: A Conceptual Framework for Their Use in Building Adaptive Capacity to Climate Change

Authors: Sally Naji, Julie Gwilliam

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Climate change remains a challenging matter for the human and the built environment in the 21st century, where the need to consider adaptation to climate change in the development process is paramount. However, there remains a lack of information regarding how we should prepare responses to this issue, such as through developing organized and sophisticated tools enabling the adaptation process. This study aims to build a systematic framework approach to investigate the potentials that Neighborhood Sustainability Assessment tools (NSA) might offer in enabling both the analysis of the emerging adaptive capacity to climate change. The analysis of the framework presented in this paper aims to discuss this issue in three main phases. The first part attempts to link sustainability and climate change, in the context of adaptive capacity. It is argued that in deciding to promote sustainability in the context of climate change, both the resilience and vulnerability processes become central. However, there is still a gap in the current literature regarding how the sustainable development process can respond to climate change. As well as how the resilience of practical strategies might be evaluated. It is suggested that the integration of the sustainability assessment processes with both the resilience thinking process, and vulnerability might provide important components for addressing the adaptive capacity to climate change. A critical review of existing literature is presented illustrating the current lack of work in this field, integrating these three concepts in the context of addressing the adaptive capacity to climate change. The second part aims to identify the most appropriate scale at which to address the built environment for the climate change adaptation. It is suggested that the neighborhood scale can be considered as more suitable than either the building or urban scales. It then presents the example of NSAs, and discusses the need to explore their potential role in promoting the adaptive capacity to climate change. The third part of the framework presents a comparison among three example NSAs, BREEAM Communities, LEED-ND, and CASBEE-UD. These three tools have been selected as the most developed and comprehensive assessment tools that are currently available for the neighborhood scale. This study concludes that NSAs are likely to present the basis for an organized framework to address the practical process for analyzing and yet promoting Adaptive Capacity to Climate Change. It is further argued that vulnerability (exposure & sensitivity) and resilience (Interdependence & Recovery) form essential aspects to be addressed in the future assessment of NSA’s capability to adapt to both short and long term climate change impacts. Finally, it is acknowledged that further work is now required to understand impact assessment in terms of the range of physical sectors (Water, Energy, Transportation, Building, Land Use and Ecosystems), Actor and stakeholder engagement as well as a detailed evaluation of the NSA indicators, together with a barriers diagnosis process.

Keywords: adaptive capacity, climate change, NSA tools, resilience, sustainability

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300 A Framework for Teaching the Intracranial Pressure Measurement through an Experimental Model

Authors: Christina Klippel, Lucia Pezzi, Silvio Neto, Rafael Bertani, Priscila Mendes, Flavio Machado, Aline Szeliga, Maria Cosendey, Adilson Mariz, Raquel Santos, Lys Bendett, Pedro Velasco, Thalita Rolleigh, Bruna Bellote, Daria Coelho, Bruna Martins, Julia Almeida, Juliana Cerqueira

Abstract:

This project presents a framework for teaching intracranial pressure monitoring (ICP) concepts using a low-cost experimental model in a neurointensive care education program. Data concerning ICP monitoring contribute to the patient's clinical assessment and may dictate the course of action of a health team (nursing, medical staff) and influence decisions to determine the appropriate intervention. This study aims to present a safe method for teaching ICP monitoring to medical students in a Simulation Center. Methodology: Medical school teachers, along with students from the 4th year, built an experimental model for teaching ICP measurement. The model consists of a mannequin's head with a plastic bag inside simulating the cerebral ventricle and an inserted ventricular catheter connected to the ICP monitoring system. The bag simulating the ventricle can also be changed for others containing bloody or infected simulated cerebrospinal fluid. On the mannequin's ear, there is a blue point indicating the right place to set the "zero point" for accurate pressure reading. The educational program includes four steps: 1st - Students receive a script on ICP measurement for reading before training; 2nd - Students watch a video about the subject created in the Simulation Center demonstrating each step of the ICP monitoring and the proper care, such as: correct positioning of the patient, anatomical structures to establish the zero point for ICP measurement and a secure range of ICP; 3rd - Students train the procedure in the model. Teachers help students during training; 4th - Student assessment based on a checklist form. Feedback and correction of wrong actions. Results: Students expressed interest in learning ICP monitoring. Tests concerning the hit rate are still being performed. ICP's final results and video will be shown at the event. Conclusion: The study of intracranial pressure measurement based on an experimental model consists of an effective and controlled method of learning and research, more appropriate for teaching neurointensive care practices. Assessment based on a checklist form helps teachers keep track of student learning progress. This project offers medical students a safe method to develop intensive neurological monitoring skills for clinical assessment of patients with neurological disorders.

Keywords: neurology, intracranial pressure, medical education, simulation

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299 A Study on Unplanned Settlement in Kabul City

Authors: Samir Ranjbar, Nasrullah Istanekzai

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According to a report published in The Guardian, Kabul, the capital city of Afghanistan is the fifth fastest growing city in the world, whose population has increased fourfold since 2001 from 1.2 million to 4.8 million people. The main reason for this increment is identified as the return of Afghans migrated during the civil war. In addition to the return of immigrants, a steep economic growth due to foreign assistance in last decade creating lots of job opportunities in Kabul resulted in the attraction of individuals from the neighboring provinces as well. However, the development of urban facilities such as water supply system, housing transportation and waste management systems has yet to catch up with this rapid increase in population. Since Kabul city has developed traditionally and municipal governance had very limited capacity to implement municipal bylaws. As an unwanted consequence of this growth 70% of Kabul citizens contributed to developing informal settlement for which we can say that around three million people living in informally settled areas, lacking the very vital social and physical infrastructures of livelihood. This research focuses on a region with 30 ha area and 2100 people residents in the center of Kabul city. A comprehensive land readjustment concept plan has been formulated for this area. Through this concept plan, physical and social infrastructure has been demonstrated and analyzed. Findings of this paper propose a solution for the problems of this unplanned area in Kabul which is readjusting of unplanned area by a self-supporting process. This process does not need governmental budget and can be applied by government, private sectors and landowner associations. Furthermore, by implementing the Land Readjustment process, conceptual plans can be built for unplanned areas, maximum facilities can be brought to the residents’ urban life, improve the environment for the users’ benefit, promote the culture and sense of cooperation, participation and coexistence in the mind of people, improving the transport system, improvement in economic status (the value of land increases due to infrastructure availability and land legalization). In addition to all these benefits for the public, we can raise the revenue of government by collecting the taxes from landowners. This process is implemented in most of countries of the world, it was implemented for the first time in Germany and after that in most cities of Japan as well, and is known as one of the effective processes for infrastructural development. To sum up, the notable characteristic of the Land readjustment process is that it works on the concept of mutual interest in which both landowners and the government take advantage. However, in this process, the engagement of community is very important and without public cooperation, this process can face the failure.

Keywords: land readjustment, informal settlement, Kabul, Afghanistan

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298 Risk and Coping: Understanding Community Responses to Calls for Disaster Evacuation in Central Philippines

Authors: Soledad Natalia M. Dalisay, Mylene De Guzman

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In archipelagic countries like the Philippines, many communities thrive along coastal areas. The sea is the community members’ main source of livelihood and the site of many cultural activities. For these communities, the sea is their life and livelihood. Nevertheless, the sea also poses a hazard during the rainy season when typhoons frequent their communities. Coastal communities often encounter threats from storm surges and flooding that are common when there are typhoons. During such periods, disaster evacuation programs are implemented. However, in many instances, evacuation has been the bane of local government officials implementing such programs in their communities as resistance from community members is often encountered. Such resistance is often viewed by program implementers as due to the fact that people were hard headed and ignorant of the potential impacts of living in hazard prone areas. This paper argues that it is not for these reasons that people refused to evacuate. Drawing from data collected from fieldwork done in three sites in Central Philippines affected by super typhoon Haiyan, this study aimed to provide a contextualized understanding of peoples’ refusal to heed disaster evacuation warnings. This study utilized the multi-sited ethnography approach with in-depth episodic interviews, focus group discussions, participatory risk mapping and key informant interviews in gathering data on peoples’ experiences and insights specifically on evacuation during typhoon Haiyan. This study showed that people have priorities and considerations vital in their social lives that they are protecting in their refusal to leave their homes for pre-emptive evacuation. It is not that they are not aware of the risks when the face the hazard. It is more that they had faith in the local knowledge and strategies that they have developed since the time of their ancestors as a result of living and engaging with hazards in their areas for as long as they could remember. The study also revealed that risk in encounters with hazards was gendered. Furthermore, previous engagement with local government officials and the manner in which the pre-emptive evacuation programs were implemented had cast doubt on the value of such programs in saving their lives. Life in the designated evacuation areas can be as dangerous if not more compared with living in their coastal homes. There seems to be the impression that in the evacuation program of the government, people were being moved from hazard zones to death zones. Thus, this paper ends with several recommendations that may contribute to building more responsive evacuation programs that aim to build people’s resilience while taking into consideration the local moral world in communities in identified hazard zones.

Keywords: coastal communities, disaster evacuation, disaster risk perception, social and cultural responses to hazards

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297 Missed Opportunities for Immunization of under Five Children in Calabar South County Cros River State, Nigeria, the Way Forward

Authors: Celestine Odigwe, Epoke Lincoln, Rhoda-Dara Ephraim

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Background; Immunization against the childhood killer diseases is the cardinal strategy for the prevention of these diseases all over the world in under five children, these diseases include; Tuberculosis, Measles, Polio, Tetanus, Diphthria, Pertusis, Yellow Fever, Hepatitis B, Haemophilus Influenza type B. 6.9 million children die before their fifth birthday , 80% of the worlds death in children under 5 years occur in 25 countries most in Africa and Asia and 2 million children can be saved each year with routine immunization Therefore failure to achieve total immunization coverage puts several children at risk. Aim; The aim of the study was to ascertain the prevalence, Investigate the various reasons and causes why several under five children in a suburb of calabar municipal county fail to get the required immunizations as at and when due and possibly the consequences, so that efforts can be re-directed towards the solution of the problems so identified. Methods; the study was a community based cross sectional study. The respondents were the mothers/guardians of the sampled children who were all aged 0-59 months. To be eligible for recruitment into the study, the parent or guardian was required to give an informed consent, reside within the Calabar South County with his/her children aged 0-59 months. We calculated our sample size using the Leslie-Kish formula and we used a two-staged sampling method, first to ballot for the wards to be involved and then to select four of the most populated ones in the wards chosen. Data collection was by interviewer administered structured questionnaire (Appendix I), Data collected was entered and analyzed using Statistical Package for the Social Sciences (SPSS) Version 20. Percentages were calculated and represented using charts and tables Results; The number of children sampled was 159. We found that 150 were fully immunized and 9 were not, the prevalence of missed opportunity was 32% from the study. The reasons for missed opportunities were varied, ranging from false contraindications, logistical problems resulting in very poor access roads to health facilities and poor organization of health centers together with negative health worker attitudes. Some of the consequences of these missed opportunities were increased susceptibility to vaccine preventable diseases, resurgence of the above diseases and increased morbidity and mortality of children aged less than 5 years. Conclusion; We found that ignorance on the part of both parents/guardians and health care staff together with infrastructural inadequacies in the county such as- roads, poor electric power supply for storage of vaccines were hugely responsible for most missed opportunities for immunization. The details of these and suggestions for improvement and the way forward are discussed.

Keywords: missed opportunity, immunization, under five, Calabar south

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296 Educational Institutional Approach for Livelihood Improvement and Sustainable Development

Authors: William Kerua

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The PNG University of Technology (Unitech) has mandatory access to teaching, research and extension education. Given such function, the Agriculture Department has established the ‘South Pacific Institute of Sustainable Agriculture and Rural Development (SPISARD)’ in 2004. SPISARD is established as a vehicle to improve farming systems practiced in selected villages by undertaking pluralistic extension method through ‘Educational Institutional Approach’. Unlike other models, SPISARD’s educational institutional approach stresses on improving the whole farming systems practiced in a holistic manner and has a two-fold focus. The first is to understand the farming communities and improve the productivity of the farming systems in a sustainable way to increase income, improve nutrition and food security as well as livelihood enhancement trainings. The second is to enrich the Department’s curriculum through teaching, research, extension and getting inputs from farming community. SPISARD has established number of model villages in various provinces in Papua New Guinea (PNG) and with many positive outcome and success stories. Adaption of ‘educational institutional approach’ thus binds research, extension and training into one package with the use of students and academic staff through model village establishment in delivering development and extension to communities. This centre (SPISARD) coordinates the activities of the model village programs and linkages. The key to the development of the farming systems is establishing and coordinating linkages, collaboration, and developing partnerships both within and external institutions, organizations and agencies. SPISARD has a six-point step strategy for the development of sustainable agriculture and rural development. These steps are (i) establish contact and identify model villages, (ii) development of model village resource centres for research and trainings, (iii) conduct baseline surveys to identify problems/needs of model villages, (iv) development of solution strategies, (v) implementation and (vi) evaluation of impact of solution programs. SPISARD envisages that the farming systems practiced being improved if the villages can be made the centre of SPISARD activities. Therefore, SPISARD has developed a model village approach to channel rural development. The model village when established become the conduit points where teaching, training, research, and technology transfer takes place. This approach is again different and unique to the existing ones, in that, the development process take place in the farmers’ environment with immediate ‘real time’ feedback mechanisms based on the farmers’ perspective and satisfaction. So far, we have developed 14 model villages and have conducted 75 trainings in 21 different areas/topics in 8 provinces to a total of 2,832 participants of both sex. The aim of these trainings is to directly participate with farmers in the pursuit to improving their farming systems to increase productivity, income and to secure food security and nutrition, thus to improve their livelihood.

Keywords: development, educational institutional approach, livelihood improvement, sustainable agriculture

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295 Debriefing Practices and Models: An Integrative Review

Authors: Judson P. LaGrone

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Simulation-based education in curricula was once a luxurious component of nursing programs but now serves as a vital element of an individual’s learning experience. A debriefing occurs after the simulation scenario or clinical experience is completed to allow the instructor(s) or trained professional(s) to act as a debriefer to guide a reflection with a purpose of acknowledging, assessing, and synthesizing the thought process, decision-making process, and actions/behaviors performed during the scenario or clinical experience. Debriefing is a vital component of the simulation process and educational experience to allow the learner(s) to progressively build upon past experiences and current scenarios within a safe and welcoming environment with a guided dialog to enhance future practice. The aim of this integrative review was to assess current practices of debriefing models in simulation-based education for health care professionals and students. The following databases were utilized for the search: CINAHL Plus, Cochrane Database of Systemic Reviews, EBSCO (ERIC), PsycINFO (Ovid), and Google Scholar. The advanced search option was useful to narrow down the search of articles (full text, Boolean operators, English language, peer-reviewed, published in the past five years). Key terms included debrief, debriefing, debriefing model, debriefing intervention, psychological debriefing, simulation, simulation-based education, simulation pedagogy, health care professional, nursing student, and learning process. Included studies focus on debriefing after clinical scenarios of nursing students, medical students, and interprofessional teams conducted between 2015 and 2020. Common themes were identified after the analysis of articles matching the search criteria. Several debriefing models are addressed in the literature with similarities of effectiveness for participants in clinical simulation-based pedagogy. Themes identified included (a) importance of debriefing in simulation-based pedagogy, (b) environment for which debriefing takes place is an important consideration, (c) individuals who should conduct the debrief, (d) length of debrief, and (e) methodology of the debrief. Debriefing models supported by theoretical frameworks and facilitated by trained staff are vital for a successful debriefing experience. Models differed from self-debriefing, facilitator-led debriefing, video-assisted debriefing, rapid cycle deliberate practice, and reflective debriefing. A reoccurring finding was centered around the emphasis of continued research for systematic tool development and analysis of the validity and effectiveness of current debriefing practices. There is a lack of consistency of debriefing models among nursing curriculum with an increasing rate of ill-prepared faculty to facilitate the debriefing phase of the simulation.

Keywords: debriefing model, debriefing intervention, health care professional, simulation-based education

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294 Leadership and Entrepreneurship in Higher Education: Fostering Innovation and Sustainability

Authors: Naziema Begum Jappie

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Leadership and entrepreneurship in higher education have become critical components in navigating the evolving landscape of academia in the 21st century. This abstract explores the multifaceted relationship between leadership and entrepreneurship within the realm of higher education, emphasizing their roles in fostering innovation and sustainability. Higher education institutions, often characterized as slow-moving and resistant to change, are facing unprecedented challenges. Globalization, rapid technological advancements, changing student demographics, and financial constraints necessitate a reimagining of traditional models. Leadership in higher education must embrace entrepreneurial thinking to effectively address these challenges. Entrepreneurship in higher education involves cultivating a culture of innovation, risk-taking, and adaptability. Visionary leaders who promote entrepreneurship within their institutions empower faculty and staff to think creatively, seek new opportunities, and engage with external partners. These entrepreneurial efforts lead to the development of novel programs, research initiatives, and sustainable revenue streams. Innovation in curriculum and pedagogy is a central aspect of leadership and entrepreneurship in higher education. Forward-thinking leaders encourage faculty to experiment with teaching methods and technology, fostering a dynamic learning environment that prepares students for an ever-changing job market. Entrepreneurial leadership also facilitates the creation of interdisciplinary programs that address emerging fields and societal challenges. Collaboration is key to entrepreneurship in higher education. Leaders must establish partnerships with industry, government, and non-profit organizations to enhance research opportunities, secure funding, and provide real-world experiences for students. Entrepreneurial leaders leverage their institutions' resources to build networks that extend beyond campus boundaries, strengthening their positions in the global knowledge economy. Financial sustainability is a pressing concern for higher education institutions. Entrepreneurial leadership involves diversifying revenue streams through innovative fundraising campaigns, partnerships, and alternative educational models. Leaders who embrace entrepreneurship are better equipped to navigate budget constraints and ensure the long-term viability of their institutions. In conclusion, leadership and entrepreneurship are intertwined elements essential to the continued relevance and success of higher education institutions. Visionary leaders who champion entrepreneurship foster innovation, enhance the student experience, and secure the financial future of their institutions. As academia continues to evolve, leadership and entrepreneurship will remain indispensable tools in shaping the future of higher education. This abstract underscores the importance of these concepts and their potential to drive positive change within the higher education landscape.

Keywords: entrepreneurship, higher education, innovation, leadership

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293 Teen Insights into Drugs, Alcohol, and Nicotine: A National Survey of Adolescent Attitudes toward Addictive Substances

Authors: Linda Richter

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Background and Significance: The influence of parents on their children’s attitudes and behaviors is immense, even as children grow out of what one might assume to be their most impressionable years and into teenagers. This study specifically examines the potential that parents have to prevent or reduce the risk of adolescent substance use, even in the face of considerable environmental influences to use nicotine, alcohol, or drugs. Methodology: The findings presented are based on a nationally representative survey of 1,014 teens aged 12-17 living in the United States. Data were collected using an online platform in early 2018. About half the sample was female (51%), 49% was aged 12-14, and 51% was aged 15-17. The margin of error was +/- 3.5%. Demographic data on the teens and their families were available through the survey platform. Survey items explored adolescent respondents’ exposure to addictive substances; the extent to which their sources of information about these substances are reliable or credible; friends’ and peers’ substance use; their own intentions to try substances in the future; and their relationship with their parents. Key Findings: Exposure to nicotine, alcohol, or other drugs and misinformation about these substances were associated with a greater likelihood that adolescents have friends who use drugs and that they have intentions to try substances in the future, which are known to directly predict actual teen substance use. In addition, teens who reported a positive relationship with their parents and having parents who are involved in their lives had a lower likelihood of having friends who use drugs and of having intentions to try substances in the future. This relationship appears to be mediated by parents’ ability to reduce the extent to which their children are exposed to substances in their environment and to misinformation about them. Indeed, the findings indicated that teens who reported a good relationship with their parents and those who reported higher levels of parental monitoring had significantly higher odds of reporting a lower number of risk factors than teens with a less positive relationship with parents or less monitoring. There also were significantly greater risk factors associated with substance use among older teens relative to younger teens. This shift appears to coincide directly with the tendency of parents to pull back in their monitoring and their involvement in their adolescent children’s lives. Conclusion: The survey findings underscore the importance of resisting the urge to completely pull back as teens age and demand more independence since that is exactly when the risks for teen substance use spike and young people need their parents and other trusted adults to be involved more than ever. Particularly through the cultivation of a healthy, positive, and open relationship, parents can help teens receive accurate and credible information about substance use and also monitor their whereabouts and exposure to addictive substances. These findings, which come directly from teens themselves, demonstrate the importance of continued parental engagement throughout children’s lives, regardless of their age and the disincentives to remaining involved and connected.

Keywords: adolescent, parental monitoring, prevention, substance use

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292 The Symbolic Power of the IMF: Looking through Argentina’s New Period of Indebtedness

Authors: German Ricci

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The research aims to analyse the symbolic power of the International Monetary Fund (IMF) in its relationship with a borrowing country, drawing upon Pierre Bourdieu’s Field Theory. This theory of power, typical of constructivist structuralism, has been minor used in international relations. Thus, selecting this perspective offers a new understanding of how the IMF's power operates and is structured. The IMF makes periodic economic reviews in which the staff evaluates the Government's performance. It also offers “last instance” loans when private external credit is not accessible. This relationship generates great expectations in financial agents because the IMF’s statements indicate the capacity of the Nation-State to meet its payment obligations (or not). Therefore, it is argued that the IMF is a legitimate actor for financial agents concerned about a government facing an economic crisis both for the effects of its immediate economic contribution through loans and the promotion of adjustment programs, helpful to guarantee the payment of the external debt. This legitimacy implies a symbolic power relationship in addition to the already known economic power relationship. Obtaining the IMF's consent implies that the government partially puts its political-economic decisions into play since the monetary policy must be agreed upon with the Fund. This has consequences at the local level. First, it implies that the debtor state must establish a daily relationship with the Fund. This everyday interaction with the Fund influences how officials and policymakers internalize the meaning of political management. On the other hand, if the Government has access to the IMF's seal of approval, the State will be again in a position to re-enter the financial market and go back into debt to face external debt. This means that private creditors increase the chances of collecting the debt and, again, grant credits. Thus, it is argued that the borrowing country submits to the relationship with the IMF in search of the latter's economic and symbolic capital. Access to this symbolic capital has objective and subjective repercussions at the national level that might tend to reproduce the relevance of the financial market and legitimizes the IMF’s intervention during economic crises. The paper has Argentina as its case study, given its historical relationship with the IMF and the relevance of the current indebtedness period, which remains largely unexplored. Argentina’s economy is characterized by recurrent financial crises, and it is the country to which the Fund has lent the most in its entire history. It surpasses more than three times the second, Egypt. In addition, Argentina is currently the country that owes the most to the Fund after receiving the largest loan ever granted by the IMF in 2018, and a new agreement in 2022. While the historical strong association with the Fund culminated in the most acute economic and social crisis in the country’s contemporary history, producing an unprecedented political and institutional crisis in 2001, Argentina still recognized the IMF as the only way out during economic crises.

Keywords: IMF, fields theory, symbolic power, Argentina, Bourdieu

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291 Case Study Analysis of 2017 European Railway Traffic Management Incident: The Application of System for Investigation of Railway Interfaces Methodology

Authors: Sanjeev Kumar Appicharla

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This paper presents the results of the modelling and analysis of the European Railway Traffic Management (ERTMS) safety-critical incident to raise awareness of biases in the systems engineering process on the Cambrian Railway in the UK using the RAIB 17/2019 as a primary input. The RAIB, the UK independent accident investigator, published the Report- RAIB 17/2019 giving the details of their investigation of the focal event in the form of immediate cause, causal factors, and underlying factors and recommendations to prevent a repeat of the safety-critical incident on the Cambrian Line. The Systems for Investigation of Railway Interfaces (SIRI) is the methodology used to model and analyze the safety-critical incident. The SIRI methodology uses the Swiss Cheese Model to model the incident and identify latent failure conditions (potentially less than adequate conditions) by means of the management oversight and risk tree technique. The benefits of the systems for investigation of railway interfaces methodology (SIRI) are threefold: first is that it incorporates the “Heuristics and Biases” approach advanced by 2002 Nobel laureate in Economic Sciences, Prof Daniel Kahneman, in the management oversight and risk tree technique to identify systematic errors. Civil engineering and programme management railway professionals are aware of the role “optimism bias” plays in programme cost overruns and are aware of bow tie (fault and event tree) model-based safety risk modelling techniques. However, the role of systematic errors due to “Heuristics and Biases” is not appreciated as yet. This overcomes the problems of omission of human and organizational factors from accident analysis. Second, the scope of the investigation includes all levels of the socio-technical system, including government, regulatory, railway safety bodies, duty holders, signaling firms and transport planners, and front-line staff such that lessons are learned at the decision making and implementation level as well. Third, the author’s past accident case studies are supplemented with research pieces of evidence drawn from the practitioner's and academic researchers’ publications as well. This is to discuss the role of system thinking to improve the decision-making and risk management processes and practices in the IEC 15288 systems engineering standard and in the industrial context such as the GB railways and artificial intelligence (AI) contexts as well.

Keywords: accident analysis, AI algorithm internal audit, bounded rationality, Byzantine failures, heuristics and biases approach

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290 Carbon Footprint of Educational Establishments: The Case of the University of Alicante

Authors: Maria R. Mula-Molina, Juan A. Ferriz-Papi

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Environmental concerns are increasingly obtaining higher priority in sustainability agenda of educational establishments. This is important not only for its environmental performance in its own right as an organization, but also to present a model for its students. On the other hand, universities play an important role on research and innovative solutions for measuring, analyzing and reducing environmental impacts for different activities. The assessment and decision-making process during the activity of educational establishments is linked to the application of robust indicators. In this way, the carbon footprint is a developing indicator for sustainability that helps understand the direct impact on climate change. But it is not easy to implement. There is a large amount of considering factors involved that increases its complexity, such as different uses at the same time (research, lecturing, administration), different users (students, staff) or different levels of activity (lecturing, exam or holidays periods). The aim of this research is to develop a simplified methodology for calculating and comparing carbon emissions per user at university campus considering two main aspects for carbon accountings: Building operations and transport. Different methodologies applied in other Spanish university campuses are analyzed and compared to obtain a final proposal to be developed in this type of establishments. First, building operation calculation considers the different uses and energy sources consumed. Second, for transport calculation, the different users and working hours are calculated separately, as well as their origin and traveling preferences. For every transport, a different conversion factor is used depending on carbon emissions produced. The final result is obtained as an average of carbon emissions produced per user. A case study is applied to the University of Alicante campus in San Vicente del Raspeig (Spain), where the carbon footprint is calculated. While the building operation consumptions are known per building and month, it does not happen with transport. Only one survey about the habit of transport for users was developed in 2009/2010, so no evolution of results can be shown in this case. Besides, building operations are not split per use, as building services are not monitored separately. These results are analyzed in depth considering all factors and limitations. Besides, they are compared to other estimations in other campuses. Finally, the application of the presented methodology is also studied. The recommendations concluded in this study try to enhance carbon emission monitoring and control. A Carbon Action Plan is then a primary solution to be developed. On the other hand, the application developed in the University of Alicante campus cannot only further enhance the methodology itself, but also render the adoption by other educational establishments more readily possible and yet with a considerable degree of flexibility to cater for their specific requirements.

Keywords: building operations, built environment, carbon footprint, climate change, transport

Procedia PDF Downloads 295
289 The M Health Paradigm for the Chronic Care Management of Obesity: New Opportunities in Clinical Psychology and Medicine

Authors: Gianluca Castelnuovo, Gian Mauro Manzoni, Giada Pietrabissa, Stefania Corti, Emanuele Giusti, Roberto Cattivelli, Enrico Molinari, Susan Simpson

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Obesity is currently an important public health problem of epidemic proportions (globesity). Moreover Binge Eating Disorder (BED) is typically connected with obesity, even if not occurring exclusively in conjunction with overweight conditions. Typically obesity with BED requires a longer term treatment in comparison with simple obesity. Rehabilitation interventions that aim at improving weight-loss, reducing obesity-related complications and changing dysfunctional behaviors, should ideally be carried out in a multidisciplinary context with a clinical team composed of psychologists, dieticians, psychiatrists, endocrinologists, nutritionists, physiotherapists, etc. Long-term outpatient multidisciplinary treatments are likely to constitute an essential aspect of rehabilitation, due to the growing costs of a limited inpatient approach. Internet-based technologies can improve long-term obesity rehabilitation within a collaborative approach. The new m health (m-health, mobile health) paradigm, defined as clinical practices supported by up to date mobile communication devices, could increase compliance- engagement and contribute to a significant cost reduction in BED and obesity rehabilitation. Five psychological components need to be considered for successful m Health-based obesity rehabilitation in order to facilitate weight-loss.1) Self-monitoring. Portable body monitors, pedometers and smartphones are mobile and, therefore, can be easily used, resulting in continuous self-monitoring. 2) Counselor feedback and communication. A functional approach is to provide online weight-loss interventions with brief weekly or monthly counselor or psychologist visits. 3) Social support. A group treatment format is typically preferred for behavioral weight-loss interventions. 4) Structured program. Technology-based weight-loss programs incorporate principles of behavior therapy and change with structured weekly protocolos including nutrition, exercise, stimulus control, self-regulation strategies, goal-setting. 5) Individually tailored program. Interventions specifically designed around individual’s goals typically record higher rates of adherence and weight loss. Opportunities and limitations of m health approach in clinical psychology for obesity and BED are discussed, taking into account future research directions in this promising area.

Keywords: obesity, rehabilitation, out-patient, new technologies, tele medicine, tele care, m health, clinical psychology, psychotherapy, chronic care management

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288 Connecting the Dots: Bridging Academia and National Community Partnerships When Delivering Healthy Relationships Programming

Authors: Nicole Vlasman, Karamjeet Dhillon

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Over the past four years, the Healthy Relationships Program has been delivered in community organizations and schools across Canada. More than 240 groups have been facilitated in collaboration with 33 organizations. As a result, 2157 youth have been engaged in the programming. The purpose and scope of the Healthy Relationships Program are to offer sustainable, evidence-based skills through small group implementation to prevent violence and promote positive, healthy relationships in youth. The program development has included extensive networking at regional and national levels. The Healthy Relationships Program is currently being implemented, adapted, and researched within the Resilience and Inclusion through Strengthening and Enhancing Relationships (RISE-R) project. Alongside the project’s research objectives, the RISE-R team has worked to virtually share the ongoing findings of the project through a slow ontology approach. Slow ontology is a practice integrated into project systems and structures whereby slowing the pace and volume of outputs offers creative opportunities. Creative production reveals different layers of success and complements the project, the building blocks for sustainability. As a result of integrating a slow ontology approach, the RISE-R team has developed a Geographic Information System (GIS) that documents local landscapes through a Story Map feature, and more specifically, video installations. Video installations capture the cartography of space and place within the context of singular diverse community spaces (case studies). By documenting spaces via human connections, the project captures narratives, which further enhance the voices and faces of the community within the larger project scope. This GIS project aims to create a visual and interactive flow of information that complements the project's mixed-method research approach. Conclusively, creative project development in the form of a geographic information system can provide learning and engagement opportunities at many levels (i.e., within community organizations and educational spaces or with the general public). In each of these disconnected spaces, fragmented stories are connected through a visual display of project outputs. A slow ontology practice within the context of the RISE-R project documents activities on the fringes and within internal structures; primarily through documenting project successes as further contributions to the Centre for School Mental Health framework (philosophy, recruitment techniques, allocation of resources and time, and a shared commitment to evidence-based products).

Keywords: community programming, geographic information system, project development, project management, qualitative, slow ontology

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287 Social and Educational AI for Diversity: Research on Democratic Values to Develop Artificial Intelligence Tools to Guarantee Access for all to Educational Tools and Public Services

Authors: Roberto Feltrero, Sara Osuna-Acedo

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Responsible Research and Innovation have to accomplish one fundamental aim: everybody has to participate in the benefits of innovation, but also innovation has to be democratic; that is to say, everybody may have the possibility to participate in the decisions in the innovation process. Particularly, a democratic and inclusive model of social participation and innovation includes persons with disabilities and people at risk of discrimination. Innovations on Artificial Intelligence for social development have to accomplish the same dual goal: improving equality for accessing fields of public interest like education, training and public services, as well as improving civic and democratic participation in the process of developing such innovations for all. This research aims to develop innovations, policies and policy recommendations to apply and disseminate such artificial intelligence and social model for making educational and administrative processes more accessible. First, designing a citizen participation process to engage citizens in the designing and use of artificial intelligence tools for public services. This will result in improving trust in democratic institutions contributing to enhancing the transparency, effectiveness, accountability and legitimacy of public policy-making and allowing people to participate in the development of ethical standards for the use of such technologies. Second, improving educational tools for lifelong learning with AI models to improve accountability and educational data management. Dissemination, education and social participation will be integrated, measured and evaluated in innovative educational processes to make accessible all the educational technologies and content developed on AI about responsible and social innovation. A particular case will be presented regarding access for all to educational tools and public services. This accessibility requires cognitive adaptability because, many times, legal or administrative language is very complex. Not only for people with cognitive disabilities but also for old people or citizens at risk of educational or social discrimination. Artificial Intelligence natural language processing technologies can provide tools to translate legal, administrative, or educational texts to a more simple language that can be accessible to everybody. Despite technological advances in language processing and machine learning, this becomes a huge project if we really want to respect ethical and legal consequences because that kinds of consequences can only be achieved with civil and democratic engagement in two realms: 1) to democratically select texts that need and can be translated and 2) to involved citizens, experts and nonexperts, to produce and validate real examples of legal texts with cognitive adaptations to feed artificial intelligence algorithms for learning how to translate those texts to a more simple and accessible language, adapted to any kind of population.

Keywords: responsible research and innovation, AI social innovations, cognitive accessibility, public participation

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286 Clinical Manifestations, Pathogenesis and Medical Treatment of Stroke Caused by Basic Mitochondrial Abnormalities (Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like Episodes, MELAS)

Authors: Wu Liching

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Aim This case aims to discuss the pathogenesis, clinical manifestations and medical treatment of strokes caused by mitochondrial gene mutations. Methods Diagnosis of ischemic stroke caused by mitochondrial gene defect by means of "next-generation sequencing mitochondrial DNA gene variation detection", imaging examination, neurological examination, and medical history; this study took samples from the neurology ward of a medical center in northern Taiwan cases diagnosed with acute cerebral infarction as the research objects. Result This case is a 49-year-old married woman with a rare disease, mitochondrial gene mutation inducing ischemic stroke. She has severe hearing impairment and needs to use hearing aids, and has a history of diabetes. During the patient’s hospitalization, the blood test showed that serum Lactate: 7.72 mmol/L, Lactate (CSF) 5.9 mmol/L. Through the collection of relevant medical history, neurological evaluation showed changes in consciousness and cognition, slow response in language expression, and brain magnetic resonance imaging examination showed subacute bilateral temporal lobe infarction, which was an atypical type of stroke. The lineage DNA gene has m.3243A>G known pathogenic mutation point, and its heteroplasmic level is 24.6%. This pathogenic point is located in MITOMAP and recorded as Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes (MELAS) , Leigh Syndrome and other disease-related pathogenic loci, this mutation is located in ClinVar and recorded as Pathogenic (dbSNP: rs199474657), so it is diagnosed as a case of stroke caused by a rare disease mitochondrial gene mutation. After medical treatment, there was no more seizure during hospitalization. After interventional rehabilitation, the patient's limb weakness, poor language function, and cognitive impairment have all improved significantly. Conclusion Mitochondrial disorders can also be associated with abnormalities in psychological, neurological, cerebral cortical function, and autonomic functions, as well as problems with internal medical diseases. Therefore, the differential diagnoses cover a wide range and are not easy to be diagnosed. After neurological evaluation, medical history collection, imaging and rare disease serological examination, atypical ischemic stroke caused by rare mitochondrial gene mutation was diagnosed. We hope that through this case, the diagnosis of rare disease mitochondrial gene variation leading to cerebral infarction will be more familiar to clinical medical staff, and this case report may help to improve the clinical diagnosis and treatment for patients with similar clinical symptoms in the future.

Keywords: acute stroke, MELAS, lactic acidosis, mitochondrial disorders

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285 Goal-Setting in a Peer Leader HIV Prevention Intervention to Improve Preexposure Prophylaxis Access among Black Men Who Have Sex with Men

Authors: Tim J. Walsh, Lindsay E. Young, John A. Schneider

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Background: The disproportionate rate of HIV infection among Black men who have sex with men (BMSM) in the United States suggest the importance of Preexposure Prophylaxis (PrEP) interventions for this population. As such, there is an urgent need for innovative outreach strategies that extend beyond the traditional patient-provider relationship to reach at-risk populations. Training members of the BMSM community as peer change agents (PCAs) is one such strategy. An important piece of this training is goal-setting. Goal-setting not only encourages PCAs to define the parameters of the intervention according to their lived experience, it also helps them plan courses of action. Therefore, the aims of this mixed methods study are: (1) Characterize the goals that BMSM set at the end of their PrEP training and (2) Assess the relationship between goal types and PCA engagement. Methods: Between March 2016 and July 2016, preliminary data were collected from 68 BMSM, ages 18-33, in Chicago as part of an ongoing PrEP intervention. Once enrolled, PCAs participate in a half-day training in which they learn about PrEP, practice initiating conversations about PrEP, and identify strategies for supporting at-risk peers through the PrEP adoption process. Training culminates with a goal-setting exercise, whereby participants establish a goal related to their role as a PCA. Goals were coded for features that either emerged from the data itself or existed in extant goal-setting literature. The main outcomes were (1) number of PrEP conversations PCAs self-report during booster conversations two weeks following the intervention and (2) number of peers PCAs recruit into the study that completed the PrEP workshop. Results: PCA goals (N=68) were characterized in terms of four features: Specificity, target population, personalization, and purpose defined. To date, PCAs report a collective 52 PrEP conversations. 56, 25, and 6% of PrEP conversations occurred with friends, family, and sexual partners, respectively. PCAs with specific goals had more PrEP conversations with at-risk peers compared to those with vague goals (58% vs. 42%); PCAs with personalized goals had more PrEP conversations compared to those with de-personalized goals (60% vs. 53%); and PCAs with goals that defined a purpose had more PrEP conversations compared to those who did not define a purpose (75% vs. 52%). 100% of PCAs with goals that defined a purpose recruited peers into the study compared to 45 percent of PCAs with goals that did not define a purpose. Conclusion: Our preliminary analysis demonstrates that BMSM are motivated to set and work toward a diverse set of goals to support peers in PrEP adoption. PCAs with goals involving a clearly defined purpose had more PrEP conversations and greater peer recruitment than those with goals lacking a defined purpose. This may indicate that PCAs who define their purpose at the outset of their participation will be more engaged in the study than those who do not. Goal-setting may be considered as a component of future HIV prevention interventions to advance intervention goals and as an indicator of PCAs understanding of the intervention.

Keywords: HIV prevention, MSM, peer change agent, preexposure prophylaxis

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284 Analysis of the Barriers and Aids That Lecturers Offer to Students with Disabilities

Authors: Anabel Moriña

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In recent years, advances have been made in disability policy at Spanish universities, especially in terms of creating more inclusive learning environments. Nevertheless, while efforts to foster inclusion at the tertiary level -and the growing number of students with disabilities at university- are clear signs of progress, serious barriers to full participation in learning still exist. The research shows that university responses to diversity tend to be reactive, not proactive; as a result, higher education (HE) environments can be especially disabling. It has been demonstrated that the performance of students with disabilities is closely linked to the good will of university faculty and staff. Lectures are key players when it comes to helping or hindering students throughout the teaching/learning process. This paper presents an analysis of how lecturers respond to students with disabilities, the initial question being: do lecturers aid or hinder students? The general aim is to analyse-by listen to the students themselves-lecturers barriers and support identified as affecting academic performance and overall perception of the higher education (HE) experience. Biographical-narrative methodology was employed. This research analysed the results differentiating by fields of knowledge. The research was conducted in two phases: discussion groups along with individual oral/written interviews were set up with 44 students with disabilities and mini life histories were completed for 16 students who participated in the first stage. The study group consisted of students with disabilities enrolled during three academic years. The results of this paper noted that participating students identified many more barriers than bridges when speaking about the role lecturers play in their learning experience. Findings are grouped into several categories: Faculty attitudes when “dealing with” students with disabilities, teaching methodologies, curricular adaptations, and faculty training in working with students. Faculty does not always display appropriate attitudes towards students with disabilities. Study participants speak of them turning their backs on their problems-or behaving in an awkward manner. In many cases, it seems lecturers feel that curricular adaptations of any kind are a form of favouritism. Positive attitudes, however, often depend almost entirely on the good will of faculty and-although well received by students-are hard to come by. As the participants themselves suggest, this study confirms that good teaching practices not only benefit students with disabilities but the student body as a whole. In this sense, inclusive curricula provide new opportunities for all students. A general coincidence has been the lack of training on behalf of lecturers to adequately attend disabled students, and the need to cover this shortage. This can become a primary barrier and is more often due to deficient faculty training than to inappropriate attitudes on the part of lecturers. In conclusion, based on this research we can conclude that more barriers than bridges exist. That said, students do report receiving a good deal of support from their lecturers-although almost exclusively in a spirit of good will; when lecturers do help, however, it tends to have a very positive impact on students' academic performance.

Keywords: barriers, disability, higher education, lecturers

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283 The Role of Behavioral Syndromes in Human-Cattle Interactions: A Physiological Approach

Authors: Fruzsina Luca Kézér, Viktor Jurkovich, Ottó Szenci, János Tőzsér, Levente Kovács

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Positive interaction between people and animals could have a favorable effect on the welfare and production by reducing stress levels. However, to the repeated contact with humans (e.g. farm staff, veterinarians or herdsmen), animals may respond with escape behavior or avoidance, which both have negative effects on the ease of handling, welfare and may lead to the expression of aggressive behaviors. Rough or aversive handling can impair health and the function of the cardiac autonomic activity due to fear and stress, which also can be determined by certain parameters of heart rate variability (HRV). Although the essential relationships between fear from humans and basal tone of the autonomic nervous system were described by the authors previously, several questions remained unclear in terms of the associations between different coping strategies (behavioral syndromes) of the animals and physiological responsiveness to humans. The main goal of this study was to find out whether human behavior and emotions to the animals have an impact on cardiac function and behavior of animals with different coping styles in response situations. Therefore, in the present study, special (fear, approaching, restraint, novel arena, novel object) tests were performed on healthy, 2-year old heifers (n = 104) differing in coping styles [reactive (passive) vs. proactive (active) coping]. Animals were categorized as reactive or proactive based on the following tests: 1) aggressive behavior at the feeding bunk, 2) avoidance from an approaching person, 3) immobility, and 4) daily activity (number of posture changes). Heart rate, the high frequency (HF) component of HRV as a measure of vagal activity and the ratio between the low frequency (LF) and HF components (LF/HF ratio) as a parameter of sympathetic nervous system activity were calculated for all individual during lying posture (baseline) and for response situations in novel object, novel arena, and unfamiliar person tests (both for 5 min), respectively. The differences between baseline and response were compared between groups. Higher sympathetic (higher heart rates and LF/HF ratios) and lower parasympathetic activity (lower HF) was found for proactive animals in response situations than for reactive (passive) animals either during the novel object, the novel arena and the unfamiliar person test. It suggests that animals with different behavioral traits differ in their immediate autonomic adaptation to novelty and people. Based on our preliminary results, it seems, that the analysis of HRV can help to understand the physiological manifestation of responsiveness to novelty and human presence in dairy cattle with different behavioral syndromes.

Keywords: behavioral syndromes, human-cattle interaction, novel arena test, physiological responsiveness, proactive coping, reactive coping

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282 Public Participation in Political Transformation: From the Coup D’etat in 2014 to the Events Leading up to the Proposed Election in 2018 in Thailand

Authors: Pataramon Satalak, Sakrit Isariyanon, Teerapong Puripanik

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This article uses the recent events in Thailand as a case study for examining why democratic transition is necessary during political upheaval to ensure that the people’s power remains unaffected. After seizing power in May 2014, the military, backed by anti-government protestors, selected and established their own system to govern the country. They set up the National Council for Peace and Order (NCPO) which established a People’s Assembly, aiming to reach a compromise between the conflicting opinions of former, pro-government and anti-government protesters. It plans to achieve this through political reform before returning sovereign power to the people via an election in 2018. If a governmental authority is not representative of the people (e.g. a military government) it does not count as a legitimate government. During the last four years of military government, from May 2014 to January 2018, their rule of Thailand has been widely controversial, specifically regarding their commitment to democracy, human rights violations and their manipulation of the rule of law. Democratic legitimacy relies not only on established mechanisms for public participation (like referendums or elections) but also public participation based on accessible and educational reform (often via NGOs) to ensure that the free and fair will of the people can be expressed. Through their actions over the last three years, the Thai military government has damaged both of these components, impacting future public participation in politics. The authors make some observations about the specific actions the military government has taken to erode the democratic legitimacy of future public participation: the increasing dominance of military courts over civil courts; civil society’s limited involvement in political activities; the drafting of a new constitution and their attempt to master support through referenda and its consequence for delaying organic law-making process; the structure of the legislative powers (Senate and the members of parliament); and the control of people’s basic freedoms of expression, movement and assembly in political activities. One clear consequence of the military government’s specific actions over the last three years is the increased uncertainty amongst Thai people that their fundamental freedoms and political rights will be respected in the future. This will directly affect their participation in future democratic processes. The military government’s actions (e.g. their response to the UN representatives) will also have influenced potential international engagement in Thai civil society to help educate disadvantaged people about their rights, and their participation in the political arena. These actions challenge the democratic idea that there should be a checking and balancing of power between people and government. These examples provide evidence that a democratic transition is crucial during any process of political transformation.

Keywords: political tranformation, public participation, Thailand coup d'etat 2014, election 2018

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281 Analyzing the Mission Drift of Social Business: Case Study of Restaurant Providing Professional Training to At-Risk Youth

Authors: G. Yanay-Ventura, H. Desivilya Syna, K. Michael

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Social businesses are based on the idea that an enterprise can be established for the sake of profit and, at the same time, with the aim of fulfilling social goals. Yet, the question of how these goals can be integrated in practice to derive parallel benefit in both realms still needs to be examined. Particularly notable in this context is the ‘governance challenge’ of social businesses, meaning the danger of the mission drifts from the social goal in the pursuit of good business. This study is based on an evaluation study of a social business that operates as a restaurant providing professional training to at-risk youth. The evaluation was based on the collection of a variety of data through interviews with stakeholders in the enterprise (directors and managers, business partners, social partners, and position holders in the restaurant and the social enterprise), a focus group consisting of the youth receiving the professional training, observations of the restaurant’s operation, and analysis of the social enterprise’s primary documents. The evaluation highlighted significant strengths of the social enterprise, including reaching relatively fast business sustainability, effective management of the restaurant, stable employment of the restaurant staff, and effective management of the social project. The social enterprise and business management have both enjoyed positive evaluations from a variety of stakeholders. Clearly, the restaurant was deemed by all a promising young business. However, the social project suffered from a 90% dropout rate among the youth entering its ranks, extreme monthly fluctuation in the number of youths participating, and a distinct minority of the youth who have succeeded in completing their training period. Possible explanations of the high dropout rate included the small number of cooks, which impeded the effectiveness of the training process and the provision of advanced cooking skills; lack of clarity regarding the essence and the elements of training; and lack of a meaningful peer group for the youth engaged in the program. Paradoxically, despite the stakeholders’ great appreciation for the social enterprise, the challenge of governability was also formidable, revealing a tangible risk of mission drift in the reduction of the social enterprise’s target population and a breach of the commitment made to the youth with regard to practical training. The risk of mission drifts emerged as a hidden and evasive issue for the stakeholders, who revealed a deep appreciation for the management and the outcomes of the social enterprise. The challenge of integration, therefore, requires an in-depth examination of how to maintain a successful business without hindering the achievement of the social goal. The study concludes that clear conceptualization of the training process and its aims, increased cooks’ participation in the social project, and novel conceptions with regard to the evaluation of success could serve to benefit the youth and impede mission drift.

Keywords: evaluation study, management, mission drift, social business

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