Search results for: professional protocol
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3026

Search results for: professional protocol

566 Health Information Needs and Utilization of Information and Communication Technologies by Medical Professionals in a Northern City of India

Authors: Sonika Raj, Amarjeet Singh, Vijay Lakshmi Sharma

Abstract:

Introduction: In 21st century, due to revolution in Information and Communication Technologies (ICTs), there has been phenomenal development in quality and quantity of knowledge in the field of medical science. So, the access to relevant information to physicians is critical to the delivery of effective healthcare services to patients. The study was conducted to assess the information needs and attitudes of the medical professionals; to determine the sources and channels of information used by them; to ascertain the current usage of ICTs and the barriers faced by them in utilization of ICTs in health information access. Methodology: This descriptive cross-sectional study was carried in 2015 on hundred medical professionals working in public and private sectors of Chandigarh. The study used both quantitative and qualitative method for data collection. A semi structured questionnaire and interview schedule was used to collect data on information seeking needs, access to ICTs and barriers to healthcare information access. Five Data analysis was done using SPSS-16 and qualitative data was analyzed using thematic approach. Results: The most preferred sources to access healthcare information were internet (85%), trainings (61%) and communication with colleagues (57%). They wanted information on new drug therapy and latest developments in respective fields. All had access to computer with but almost half assessed their computer knowledge as average and only 3% had received training regarding usage. Educational status (p=0.004), place of work (p=0.004), number of years in job (p=0.004) and sector of job (p=0.04) of doctors were found to be significantly associated with their active search for information. The major themes that emerged from in-views were need; types and sources of healthcare information; exchange of information among different levels of healthcare providers; usage of ICTs to obtain and share information; barriers to access of healthcare information and quality of health information materials and involvement in their development process Conclusion and Recommendations: The medical professionals need information in their in their due course of work. However, information needs of medical professionals were not being adequately met. There should be training of professional regarding internet skills and the course on bioinformatics should be incorporated in the curricula of medical students. The policy framework must be formulated that will encourage and promote the use of ICTs as tools for health information access and dissemination.

Keywords: health information, ICTs, medical professionals, qualitative

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565 The Development of an Anaesthetic Crisis Manual for Acute Critical Events: A Pilot Study

Authors: Jacklyn Yek, Clara Tong, Shin Yuet Chong, Yee Yian Ong

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Background: While emergency manuals and cognitive aids (CA) have been used in high-hazard industries for decades, this has been a nascent field in healthcare. CAs can potentially offset the large cognitive load involved in crisis resource management and possibly facilitate the efficient performance of key steps in treatment. A crisis manual was developed based on local guidelines and the latest evidence-based information and introduced to a tertiary hospital setting in Singapore. Hence, the objective of this study is to evaluate the effectiveness of the crisis manual in guiding response and management of critical events. Methods: 7 surgical teams were recruited to participate in a series of simulated emergencies in high-fidelity operating room simulator over the period of April to June 2018. All teams consisted of a surgical consultant and medical officer/registrar, anesthesia consultant and medical officer/registrar; as well as a circulating, scrub and anesthetic nurse. Each team performed a simulated operation in which 1 or more of the crisis events occurred. The teams were randomly assigned to a scenario of the crisis manual and all teams were deemed to be equal in experience and knowledge. Before the simulation, teams were instructed on proper checklist use but the use of the checklist was optional. Results: 7 simulation sessions were performed, consisting of the following scenarios: Airway fire, Massive Transfusion Protocol, Malignant Hyperthermia, Eclampsia, and Difficult Airway. Out of the 7 surgical teams, 2 teams made use of the crisis manual – of which both teams had encountered a ‘Malignant Hyperthermia’ scenario. These team members reflected that the crisis manual assisted allowed them to work in a team, especially being able to involve the surgical doctors who were unfamiliar with the condition and management. A run chart plotted showed a possible upward trend, suggesting that with increasing awareness and training, staff would become more likely to initiate the use of the crisis manual. Conclusion: Despite the high volume load in this tertiary hospital, certain crises remain rare and clinicians are often caught unprepared. A crisis manual is an effective tool and easy-to-use repository that can improve patient outcome and encourage teamwork. With training, familiarity would allow clinicians to be increasingly comfortable with reaching out for the crisis manual. More simulation training would need to be conducted to determine its effectiveness.

Keywords: crisis resource management, high fidelity simulation training, medical errors, visual aids

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564 Effects of an Envious Experience on Schadenfreude and Economic Decisions Making

Authors: Pablo Reyes, Vanessa Riveros Fiallo, Cesar Acevedo, Camila Castellanos, Catalina Moncaleano, Maria F. Parra, Laura Colmenares

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Social emotions are physiological, cognitive and behavioral phenomenon that intervene in the mechanisms of adaptation of individuals and their context. These are mediated by interpersonal relationship and language. Such emotions are subdivided into moral and comparison. The present research emphasizes two comparative emotions: Envy and Schadenfreude. Envy arises when a person lack of quality, possessions or achievements and these are superior in someone else. The Schadenfreude (SC) expresses the pleasure that someone experienced by the misfortune of the other. The relationship between both emotions has been questioned before. Hence there are reports showing that envy increases and modulates SC response. Other documents suggest that envy causes SC response. However, the methodological approach of the topic has been made through self-reports, as well as the hypothetical scenarios. Given this problematic, the neuroscience social framework provides an alternative and demonstrates that social emotions have neurophysiological correlates that can be measured. This is relevant when studying social emotions that are reprehensible like envy or SC are. When tested, the individuals tend to report low ratings due to social desirability. In this study, it was drawn up a proposal in research's protocol and the progress on its own piloting. The aim is to evaluate the effect of feeling envy and Schadenfreude has on the decision-making process, as well as the cooperative behavior in an economic game. To such a degree, it was proposed an experimental model that will provoke to feel envious by performing games against an unknown opponent. The game consists of asking general knowledge questions. The difficulty level in questions and the strangers' facial response have been manipulated in order to generate an ecological comparison framework and be able to arise both envy and SC emotions. During the game, an electromyography registry will be made for two facial muscles that have been associated with the expressiveness of envy and SC emotions. One of the innovations of the current proposal is the measurement of the effect that emotions have on a specific behavior. To that extent, it was evaluated the effect of each condition on the dictators' economic game. The main intention is to evaluate if a social emotion can modulate actions that have been associated with social norms, in the literacy. The result of the evaluation of a pilot model (without electromyography record and self-report) have shown an association between envy and SC, in a way that as the individuals report a greater sense of envy, the greater the chance to experience SC. The results of the economic game show a slight tendency towards profit maximization decisions. It is expected that at the time of using real cash this behavior will be strengthened and also to correlate with the responses of electromyography.

Keywords: envy, schadenfreude, electromyography, economic games

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563 Single-Case Experimental Design: Exploratory Pilot Study on the Feasibility and Effect of Virtual Reality for Pain and Anxiety Management During Care

Authors: Corbel Camille, Le Cerf Flora, Corveleyn Xavier

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Introduction: Aging is a physiological phenomenon accompanied by anatomical and cognitive changes leading to anxiety and pain. This could have significant impacts on quality of life, life expectancy, and the progression of cognitive disorders. Virtual Reality Intervention (VRI) is increasingly recognized as a non-pharmacological approach to alleviate pain and anxiety in children and young adults. However, while recent studies have explored the feasibility of applying VRI in the older population, confirmation through studies is still required to establish its benefits in various contexts. Objective: This pilot study, following a clinical trial methodology international recommendation for VRI in healthcare, aims to evaluate the feasibility and effects of using VRI with a 101-year-old woman residing in a nursing home undergoing weekly painful and anxious wound dressing changes. Methods: Following the international recommendations, this study focused on feasibility and preliminary results. A Single Case Experimental Design protocol consists of two distinct phases: control (Phase A) and personalized VRI (Phase B), each lasting for 6 sessions. Data were collected before, during and after the care, using measures of pain (Algoplus and numerical scale), anxiety (Hospital anxiety scale and numerical scale), VRI experience (semi-structured interview) and physiological measures. Results: The results suggest that the utilization of VRI is both feasible and well-tolerated by the participant. VRI contributed to a decrease in pain and anxiety during care sessions, with a more significant impact on pain compared to anxiety, which showed a gradual and slight decrease. Physiological data, particularly those related to stress, also indicate a reduction in physiological activity during VRI. Conclusion: This pilot study confirms the feasibility and benefits of using virtual reality in managing pain and anxiety in an older adult in a nursing home. In light of these results, it is essential that future studies focus on setting up randomized controlled trials (RCTs). These studies should involve a representative number of older adults to ensure generalizable data. This rigorous, controlled methodology will enable us to assess the effectiveness of virtual reality more accurately in various care settings, measure its impact on clinical parameters such as pain and anxiety, and explore the long-term implications of this intervention.

Keywords: anxiety reduction, nursing home, older adult, pain management, virtual reality

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562 Pre-service Social Studies Teachers Readiness in Promoting 21st Century Learning: Evidence from a Ghanaian University

Authors: Joseph Bentil

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Successful acquisition of 21st-century competencies needed by students to navigate through the ever-changing world requires that they are taught and molded by 21st-century teachers with the needed professional competencies. Accordingly, this study sought to understand the readiness and how efficacious pre-service Social Studies specialism students are towards the implementation of the Common Core Social Studies Curriculum in the Junior High Schools in Ghana. Theory of Experience served as the theoretical lens for the study. Working within the pragmatist paradigm, this study utilized the cross-sectional descriptive survey design with a mixed method approach where, through census sampling technique, all the 120 pre-service Social Studies specialism students were sampled for the study. A structured questionnaire and an interview guide were the instruments employed for data collection. Descriptive statistics (mean, standard deviation and inferential statistics like independent samples t-test, one-way between groups ANOVA and Pearson Product Moment Correlation) were employed in the analysis the research questions and hypotheses with the aid of version 28 of SPSS while the qualitative data was analyzed using thematic analysis. The findings discovered that pre-service Social Studies teachers were highly ready and efficacious towards implementing the Common Core Junior High School Social Studies curriculum. However, male pre-service teachers were highly efficacious and ready than their female counterparts. Besides, it was disclosed that pre-service teachers within the 31-40 years age bracket were found to be highly efficacious and ready than their colleagues with 20-30 and below 20 years age bracket respectively. The findings further revealed that there was a moderate and statistically significant positive relationship between pre-service teachers’ readiness and efficacy in implementing the Common Core Social Studies curriculum. Therefore, the study recommended that interventional programmes aimed at raising the readiness and efficacy beliefs of pre-service teachers should be targeted towards female preservice teachers and those below 20 years age bracket for successful implementation and realization of the competencies enshrined in the common core social Studies curriculum.

Keywords: pre-service, readiness, social studies, teachers

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561 Application of Mesenchymal Stem Cells in Diabetic Therapy

Authors: K. J. Keerthi, Vasundhara Kamineni, A. Ravi Shanker, T. Rammurthy, A. Vijaya Lakshmi, Q. Hasan

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Pancreatic β-cells are the predominant insulin-producing cell types within the Islets of Langerhans and insulin is the primary hormone which regulates carbohydrate and fat metabolism. Apoptosis of β-cells or insufficient insulin production leads to Diabetes Mellitus (DM). Current therapy for diabetes includes either medical management or insulin replacement and regular monitoring. Replacement of β- cells is an attractive treatment option for both Type-1 and Type-2 DM in view of the recent paper which indicates that β-cells apoptosis is the common underlying cause for both the Types of DM. With the development of Edmonton protocol, pancreatic β-cells allo-transplantation became possible, but this is still not considered as standard of care due to subsequent requirement of lifelong immunosuppression and the scarcity of suitable healthy organs to retrieve pancreatic β-cell. Fetal pancreatic cells from abortuses were developed as a possible therapeutic option for Diabetes, however, this posed several ethical issues. Hence, in the present study Mesenchymal stem cells (MSCs) were differentiated into insulin producing cells which were isolated from Human Umbilical cord (HUC) tissue. MSCs have already made their mark in the growing field of regenerative medicine, and their therapeutic worth has already been validated for a number of conditions. HUC samples were collected with prior informed consent as approved by the Institutional ethical committee. HUC (n=26) were processed using a combination of both mechanical and enzymatic (collagenase-II, 100 U/ml, Gibco ) methods to obtain MSCs which were cultured in-vitro in L-DMEM (Low glucose Dulbecco's Modified Eagle's Medium, Sigma, 4.5 mM glucose/L), 10% FBS in 5% CO2 incubator at 37°C. After reaching 80-90% confluency, MSCs were characterized with Flowcytometry and Immunocytochemistry for specific cell surface antigens. Cells expressed CD90+, CD73+, CD105+, CD34-, CD45-, HLA-DR-/Low and Vimentin+. These cells were differentiated to β-cells by using H-DMEM (High glucose Dulbecco's Modified Eagle's Medium,25 mM glucose/L, Gibco), β-Mercaptoethanol (0.1mM, Hi-Media), basic Fibroblast growth factor (10 µg /L,Gibco), and Nicotinamide (10 mmol/L, Hi-Media). Pancreatic β-cells were confirmed by positive Dithizone staining and were found to be functionally active as they released 8 IU/ml insulin on glucose stimulation. Isolating MSCs from usually discarded, abundantly available HUC tissue, expanding and differentiating to β-cells may be the most feasible cell therapy option for the millions of people suffering from DM globally.

Keywords: diabetes mellitus, human umbilical cord, mesenchymal stem cells, differentiation

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560 Including Local Economic and Anthropometric Parameters in the Design of an Stand up Wheelchair

Authors: Urrutia Fernando, López Jessica, Sánchez Carlos, San Antonio Thalía

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Ecuador, as a signatory country of the convention of the rights of persons with disabilities (CRPD) has, in the recent years, strengthened the structures and legal framework required to protect this minority comprised of 13.2% of its total population. However, the reality is that this group has disproportionately low earnings and low educational attainment in comparison with the general population. The main struggles, to promote job placement of wheelchairs users, are environmental discrimination caused by accessibility in structures and transportation, this mainly due to the cost, for private and public entities, of performing the reasonable accommodation they require. It is widely known that product development and production is needed to support effective implementation of the CRPD and that walking and standing are the major life activities, in this context the objective of this investigation is to promote job placement of wheelchair user in the province of Tungurahua by means of the design, production and marketing of a customized stand up wheelchair. Exploratory interviews and measurements were performed in a representative sample of working age wheelchairs users that develop their disability after achieving their physical maturity and that are capable of performing professional activities with their upper limbs, this in order to detect the user’s preference and determine the local economic and anthropometric parameters to be included in the wheelchair design. The findings reveal factors that uniquely impact quality of life and development for people with a mobility disability within the context of the province, first that transportation is a big issue since public buses does not have accessibility for wheelchair users and the absence of curb cuts and the presence of trash bins over the sidewalks among other hinders an economic independent mobility, second that the proposal based in the idea of modifying the wheelchairs to make it able to overcome certain obstacles helps people in wheelchair to improve their independent living and by reducing the costs of modification for the employer could improve their chances of finding work.

Keywords: anthropometrics, job placement, stand up wheelchair, user centered design

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559 A Qualitative Study of Approaches Used by Physiotherapists to Educate Patients with Chronic Low Back Pain

Authors: Styliani Soulioti, Helen Fiddler

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The aim of this study was to investigate the approaches used by physiotherapists in the education of patients with chronic low back pain (cLBP) and the rationale that underpins their choice of approach. Therapeutic patient education (TPE) is considered to be an important aspect of modern physiotherapy practice, as it helps patients achieve better self-management and a better understanding of their problem. Previous studies have explored this subject, but the reasoning behind the choices physiotherapists make as educators has not been widely explored, thus making it difficult to understand areas that could be addressed in order to improve the application of TPE.A qualitative study design, guided by a constructivist epistemology was used in this research project. Semi-structured interviews were used to collect data from 7 physiotherapists. Inductive coding and thematic analysis were used, which allowed key themes to emerge. Data analysis revealed two overarching themes: 1) patient-centred versus therapist-centred educational approaches, and 2) behaviourist versus constructivist educational approaches. Physiotherapists appear to use a patient-centred-approach when they explore patients’ beliefs about cLBP and treatment expectations. However, treatment planning and goal-setting were guided by a therapist-centred approach, as physiotherapists appear to take on the role of the instructor/expert, whereas patients were viewed as students. Using a constructivist approach, physiotherapists aimed to provide guidance to patients by combining their professional knowledge with the patients’ individual knowledge, to help the patient better understand their problem, reflect upon it and find a possible solution. However, educating patients about scientific facts concerning cLBP followed a behaviourist approach, as an instructor/student relationship was observed and the learning content was predetermined and transmitted in a one-way manner. The results of this study suggest that a lack of consistency appears to exist in the educational approaches used by physiotherapists. Although patient-centeredness and constructivism appear to be the aims set by physiotherapists in order to optimise the education they provide, a student-teacher relationship appears to dominate when it comes to goal-setting and delivering scientific information.

Keywords: chronic low back pain, educational approaches, health education, patient education

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558 The 2017 Summer Campaign for Night Sky Brightness Measurements on the Tuscan Coast

Authors: Andrea Giacomelli, Luciano Massetti, Elena Maggi, Antonio Raschi

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The presentation will report the activities managed during the Summer of 2017 by a team composed by staff from a University Department, a National Research Council Institute, and an outreach NGO, collecting measurements of night sky brightness and other information on artificial lighting, in order to characterize light pollution issues on portions of the Tuscan coast, in Central Italy. These activities combine measurements collected by the principal scientists, citizen science observations led by students, and outreach events targeting a broad audience. This campaign aggregates the efforts of three actors: the BuioMetria Partecipativa project, which started collecting light pollution data on a national scale in 2008 with an environmental engineering and free/open source GIS core team; the Institute of Biometeorology from the National Research Council, with ongoing studies on light and urban vegetation and a consolidated track record in environmental education and citizen science; the Department of Biology from the University of Pisa, which started experiments to assess the impact of light pollution in coastal environments in 2015. While the core of the activities concerns in situ data, the campaign will account also for remote sensing data, thus considering heterogeneous data sources. The aim of the campaign is twofold: (1) To test actions of citizen and student engagement in monitoring sky brightness (2) To collect night sky brightness data and test a protocol for applications to studies on the ecological impact of light pollution, with a special focus on marine coastal ecosystems. The collaboration of an interdisciplinary team in the study of artificial lighting issues is not a common case in Italy, and the possibility of undertaking the campaign in Tuscany has the added value of operating in one of the territories where it is possible to observe both sites with extremely high lighting levels, and areas with extremely low light pollution, especially in the Southern part of the region. Combining environmental monitoring and communication actions in the context of the campaign, this effort will contribute to the promotion of night skies with a good quality as an important asset for the sustainability of coastal ecosystems, as well as to increase citizen awareness through star gazing, night photography and actively participating in field campaign measurements.

Keywords: citizen science, light pollution, marine coastal biodiversity, environmental education

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557 Prompting and Encouraging Community Hydration through Education: A Realist Review and Evaluation Exploring Hydration in a Population at Risk of Frailty

Authors: Mark Davies, Carolyn Wallace, Christina Lloydwin, Tom Powell

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Background: Frailty is increasingly recognized as a public health problem within an aging population. It is often characterized as an accumulation of clinical symptoms with progressive decline. We contend that dehydration is potentially the missing link driving the cycle of frailty; it contributes to malnutrition and cognitive decline and is a risk factor for other conditions. Frailty may also impact on fluid intake in cognitively intact older adults, indicating the cyclical nature of dehydration contributing to increasing frailty. Aim: To examine the relationships between fluid, hydration, and frailty in older adults in order to determine what works, for whom, how, why, and in what circumstances. Methods: A Realist Synthesis was first undertaken with n=50 studies, leading to the development of a Refined Programme Theory (RPT) articulating what hydration interventions work, for whom, to what degree, in what contexts, and how & why. Within the subsequent evaluation, the RPT was further confirmed/refuted/refined following semi-structured interviews with n=8 participants (healthcare professionals and patients). The RAMESES Quality Standards were followed throughout the study. Results: The Refined Programme Theory (RPT) highlighted three factors that result in optimized hydration for frail older people, i.e., Developing an Understanding Around Hydration, Empowering Participation, and System Reconfiguration. Our RPT indicates that hydration interventions work by developing an understanding of the importance of hydration, mitigating physical & cognitive barriers, increasing the agency of the patient, using a prompting process to reinforce drinking behavior, and routinizing hydration as a dimension of overall care. Conclusion: The study indicates that a greater understanding of the importance of hydration is required for all parties. Patients also require physical and psychological support if they are to be active agents in meeting their hydration needs. At a wider ‘system’ level, organizations must work in an integrated manner introducing processes that enable continuing professional development (CPD), encourage ongoing holistic assessment, and routinize hydration support.

Keywords: frailty, dehydration, older adults, realist review, realist evaluation

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556 Rheometer Enabled Study of Tissue/biomaterial Frequency-Dependent Properties

Authors: Polina Prokopovich

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Despite the well-established dependence of cartilage mechanical properties on the frequency of the applied load, most research in the field is carried out in either load-free or constant load conditions because of the complexity of the equipment required for the determination of time-dependent properties. These simpler analyses provide a limited representation of cartilage properties thus greatly reducing the impact of the information gathered hindering the understanding of the mechanisms involved in this tissue replacement, development and pathology. More complex techniques could represent better investigative methods, but their uptake in cartilage research is limited by the highly specialised training required and cost of the equipment. There is, therefore, a clear need for alternative experimental approaches to cartilage testing to be deployed in research and clinical settings using more user-friendly and financial accessible devices. Frequency dependent material properties can be determined through rheometry that is an easy to use requiring a relatively inexpensive device; we present how a commercial rheometer can be adapted to determine the viscoelastic properties of articular cartilage. Frequency-sweep tests were run at various applied normal loads on immature, mature and trypsinased (as model of osteoarthritis) cartilage samples to determine the dynamic shear moduli (G*, G′ G″) of the tissues. Moduli increased with increasing frequency and applied load; mature cartilage had generally the highest moduli and GAG depleted samples the lowest. Hydraulic permeability (KH) was estimated from the rheological data and decreased with applied load; GAG depleted cartilage exhibited higher hydraulic permeability than either immature or mature tissues. The rheometer-based methodology developed was validated by the close comparison of the rheometer-obtained cartilage characteristics (G*, G′, G″, KH) with results obtained with more complex testing techniques available in literature. Rheometry is relatively simpler and does not require highly capital intensive machinery and staff training is more accessible; thus the use of a rheometer would represent a cost-effective approach for the determination of frequency-dependent properties of cartilage for more comprehensive and impactful results for both healthcare professional and R&D.

Keywords: tissue, rheometer, biomaterial, cartilage

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555 An Exploratory Study of Entrepreneurial Satisfaction among Older Founders

Authors: Catarina Seco Matos, Miguel Amaral

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The developed world is facing falling birth rates and rising life expectancies. As a result, the overall demographic structure of societies is becoming markedly older. This leads to an economic and political pressure towards the extension of individuals’ working lives. On the other hand, evidence shows that some older workers choose to stay in the labour force as employees, whereas others choose to pursue a more entrepreneurial occupational path. Thus, entrepreneurship or self-employment may be an option for socioeconomic participation of older individuals. Previous research on senior entrepreneurship is scarce and it focuses mainly on entrepreneurship determinants and individuals’ intentions. The fact that entrepreneurship is perceived as a voluntary or involuntary decision or as a positive or a negative outcome by older individuals is, to the best of our knowledge, still unexplored in the literature. In order to analyse the determinants of entrepreneurial satisfaction among older individuals, primary data were obtained from a unique questionnaire survey, which was sent to Portuguese senior entrepreneurs who have launched their company aged 50 and over (N=181). Portugal is one of the countries in the world with the with the largest ageing population and with a high proportion of older individuals who remain active after their official retirement age – which makes it an extremely relevant case study on senior entrepreneurship. Findings suggest that non pecuniary factors (rather than pecuniary) are the main driver for entrepreneurship at older ages. Specifically, results show that the will to remain active is the main motivation of older individuals to become entrepreneurs. This is line with the activity and continuity theories. Furthermore, senior entrepreneurs tend to have had an active working life (using their professional experience as a proxy) and, thus, want to keep the same lifestyle at an older age (in line with theory of continuity). Finally, results show that even though older individuals’ companies may not show the best financial performance that does not seem to affect their satisfaction with the company and with entrepreneurship in general. The present study aims at exploring, discussing and bring new research on senior entrepreneurship to the fore, rather than assuming purely deductive approach; hence, further confirmatory analyses with larger sets from different countries of data are required.

Keywords: active ageing, entrepreneurship, older entrepreneur, Portugal, satisfaction, senior entrepreneur

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554 Challenging the Standard 24 Equal Quarter Tones Theory in Arab Music: A Case Study of Tetrachords Bayyātī and ḤIjāz

Authors: Nabil Shair

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Arab music maqām (Arab modal framework) is founded, among other main characteristics, on microtonal intervals. Notwithstanding the importance and multifaceted nature of intonation in Arab music, there is a paucity of studies examining this subject based on scientific and quantitative approaches. The present-day theory concerning the Arab tone system is largely based on the pioneering treatise of Mīkhā’īl Mashāqah (1840), which proposes the theoretical division of the octave into 24 equal quarter tones. This kind of equal-tempered division is incompatible with the performance practice of Arab music, as many professional Arab musicians conceptualize additional pitches beyond the standard 24 notes per octave. In this paper, we refute the standard theory presenting the scale of well-tempered quarter tones by implementing a quantitative analysis of the performed intonation of two prominent tetrachords in Arab music, namely bayyātī and ḥijāz. This analysis was conducted with the help of advanced computer programs, such as Sonic Visualiser and Tony, by which we were able to obtain precise frequency data (Hz) of each tone every 0.01 second. As a result, the value (in cents) of all three intervals of each tetrachord was measured and accordingly compared to the theoretical intervals. As a result, a specific distribution of a range of deviation from the equal-tempered division of the octave was detected, especially the detection of a diminished first interval of bayyātí and diminished second interval of ḥijāz. These types of intonation entail a considerable amount of flexibility, mainly influenced by surrounding tones, direction and function of the measured tone, ornaments, text, personal style of the performer and interaction with the audience. This paper seeks to contribute to the existing literature dealing with intonation in Arab music, as it is a vital part of the performance practice of this musical tradition. In addition, the insights offered by this paper and its novel methodology might also contribute to the broadening of the existing pedagogic methods used to teach Arab music.

Keywords: Arab music, intonation, performance practice, music theory, oral music, octave division, tetrachords, music of the middle east, music history, musical intervals

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553 Risk Assessment and Haloacetic Acids Exposure in Drinking Water in Tunja, Colombia

Authors: Bibiana Matilde Bernal Gómez, Manuel Salvador Rodríguez Susa, Mildred Fernanda Lemus Perez

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In chlorinated drinking water, Haloacetic acids have been identified and are classified as disinfection byproducts originating from reaction between natural organic matter and/or bromide ions in water sources. These byproducts can be generated through a variety of chemical and pharmaceutical processes. The term ‘Total Haloacetic Acids’ (THAAs) is used to describe the cumulative concentration of dichloroacetic acid, trichloroacetic acid, monochloroacetic acid, monobromoacetic acid, and dibromoacetic acid in water samples, which are usually measured to evaluate water quality. Chronic presence of these acids in drinking water has a risk of cancer in humans. The detection of THAAs for the first time in 15 municipalities of Boyacá was accomplished in 2023. Aim is to describe the correlation between the levels of THAAs and digestive cancer in Tunja, a city in Colombia with higher rates of digestive cancer and to compare the risk across 15 towns, taking into account factors such as water quality. A research project was conducted with the aim of comparing water sources based on the geographical features of the town, describing the disinfection process in 15 municipalities, and exploring physical properties such as water temperature and pH level. The project also involved a study of contact time based on habits documented through a survey, and a comparison of socioeconomic factors and lifestyle, in order to assess the personal risk of exposure. Data on the levels of THAAs were obtained after characterizing the water quality in urban sectors in eight months of 2022. This, based on the protocol described in the Stage 2 DBP of the United States Environmental Protection Agency (USEPA) from 2006, which takes into account the size of the population being supplied. A cancer risk assessment was conducted to evaluate the likelihood of an individual developing cancer due to exposure to pollutants THAAs. The assessment considered exposure methods like oral ingestion, skin absorption, and inhalation. The chronic daily intake (CDI) for these exposure routes was calculated using specific equations. The lifetime cancer risk (LCR) was then determined by adding the cancer risks from the three exposure routes for each HAA. The risk assessment process involved four phases: exposure assessment, toxicity evaluation, data gathering and analysis, and risk definition and management. The results conclude that there is a cumulative higher risk of digestive cancer due to THAAs exposure in drinking water.

Keywords: haloacetic acids, drinking water, water quality, cancer risk assessment

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552 The Diagnostic Utility and Sensitivity of the Xpert® MTB/RIF Assay in Diagnosing Mycobacterium tuberculosis in Bone Marrow Aspirate Specimens

Authors: Nadhiya N. Subramony, Jenifer Vaughan, Lesley E. Scott

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In South Africa, the World Health Organisation estimated 454000 new cases of Mycobacterium tuberculosis (M.tb) infection (MTB) in 2015. Disseminated tuberculosis arises from the haematogenous spread and seeding of the bacilli in extrapulmonary sites. The gold standard for the detection of MTB in bone marrow is TB culture which has an average turnaround time of 6 weeks. Histological examinations of trephine biopsies to diagnose MTB also have a time delay owing mainly to the 5-7 day processing period prior to microscopic examination. Adding to the diagnostic delay is the non-specific nature of granulomatous inflammation which is the hallmark of MTB involvement of the bone marrow. A Ziehl-Neelson stain (which highlights acid-fast bacilli) is therefore mandatory to confirm the diagnosis but can take up to 3 days for processing and evaluation. Owing to this delay in diagnosis, many patients are lost to follow up or remain untreated whilst results are awaited, thus encouraging the spread of undiagnosed TB. The Xpert® MTB/RIF (Cepheid, Sunnyvale, CA) is the molecular test used in the South African national TB program as the initial diagnostic test for pulmonary TB. This study investigates the optimisation and performance of the Xpert® MTB/RIF on bone marrow aspirate specimens (BMA), a first since the introduction of the assay in the diagnosis of extrapulmonary TB. BMA received for immunophenotypic analysis as part of the investigation into disseminated MTB or in the evaluation of cytopenias in immunocompromised patients were used. Processing BMA on the Xpert® MTB/RIF was optimised to ensure bone marrow in EDTA and heparin did not inhibit the PCR reaction. Inactivated M.tb was spiked into the clinical bone marrow specimen and distilled water (as a control). A volume of 500mcl and an incubation time of 15 minutes with sample reagent were investigated as the processing protocol. A total of 135 BMA specimens had sufficient residual volume for Xpert® MTB/RIF testing however 22 specimens (16.3%) were not included in the final statistical analysis as an adequate trephine biopsy and/or TB culture was not available. Xpert® MTB/RIF testing was not affected by BMA material in the presence of heparin or EDTA, but the overall detection of MTB in BMA was low compared to histology and culture. Sensitivity of the Xpert® MTB/RIF compared to both histology and culture was 8.7% (95% confidence interval (CI): 1.07-28.04%) and sensitivity compared to histology only was 11.1% (95% CI: 1.38-34.7%). Specificity of the Xpert® MTB/RIF was 98.9% (95% CI: 93.9-99.7%). Although the Xpert® MTB/RIF generates a faster result than histology and TB culture and is less expensive than culture and drug susceptibility testing, the low sensitivity of the Xpert® MTB/RIF precludes its use for the diagnosis of MTB in bone marrow aspirate specimens and warrants alternative/additional testing to optimise the assay.

Keywords: bone marrow aspirate , extrapulmonary TB, low sensitivity, Xpert® MTB/RIF

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551 Mortar Positioning Effects on Uniaxial Compression Behavior in Hollow Concrete Block Masonry

Authors: José Álvarez Pérez, Ramón García Cedeño, Gerardo Fajardo-San Miguel, Jorge H. Chávez Gómez, Franco A. Carpio Santamaría, Milena Mesa Lavista

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The uniaxial compressive strength and modulus of elasticity in hollow concrete block masonry (HCBM) represent key mechanical properties for structural design considerations. These properties are obtained through experimental tests conducted on prisms or wallettes and depend on various factors, with the HCB contributing significantly to overall strength. One influential factor in the compressive behaviour of masonry is the thickness and method of mortar placement. Mexican regulations stipulate mortar placement over the entire net area (full-shell) for strength computation based on the gross area. However, in professional practice, there's a growing trend to place mortar solely on the lateral faces. Conversely, the United States of America standard dictates mortar placement and computation over the net area of HCB. The Canadian standard specifies mortar placement solely on the lateral face (Face-Shell-Bedding), where computation necessitates the use of the effective load area, corresponding to the mortar's placement area. This research aims to evaluate the influence of different mortar placement methods on the axial compression behaviour of HCBM. To achieve this, an experimental campaign was conducted, including: (1) 10 HCB specimens with mortar on the entire net area, (2) 10 HCB specimens with mortar placed on the lateral faces, (3) 10 prisms of 2-course HCB under axial compression with mortar in full-shell, (4) 10 prisms of 2-course HCB under axial compression with mortar in face-shell-bedding, (5) 10 prisms of 3-course HCB under axial compression with mortar in full-shell, (6) 10 prisms of 3-course HCB under axial compression with mortar in face-shell-bedding, (7) 10 prisms of 4-course HCB under axial compression with mortar in full-shell, and, (8) 10 prisms of 4-course HCB under axial compression with mortar in face-shell-bedding. A combination of sulphur and fly ash in a 2:1 ratio was used for the capping material, meeting the average compressive strength requirement of over 35 MPa as per NMX-C-036 standards. Additionally, a mortar with a strength of over 17 MPa was utilized for the prisms. The results indicate that prisms with mortar placed over the full-shell exhibit higher strength compared to those with mortar over the face-shell-bedding. However, the elastic modulus was lower for prisms with mortar placement over the full-shell compared to face-shell bedding.

Keywords: masonry, hollow concrete blocks, mortar placement, prisms tests

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550 Correlation Between Cytokine Levels and Lung Injury in the Syrian Hamster (Mesocricetus Auratus) Covid-19 Model

Authors: Gleb Fomin, Kairat Tabynov, Nurkeldy Turebekov, Dinara Turegeldiyeva, Rinat Islamov

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The level of major cytokines in the blood of patients with COVID-19 varies greatly depending on age, gender, duration and severity of infection, and comorbidity. There are two clinically significant cytokines, IL-6 and TNF-α, which increase in levels in patients with severe COVID-19. However, in a model of COVID-19 in hamsters, TNF-α levels are unchanged or reduced, while the expression of other cytokines reflects the profile of cytokines found in patients’ plasma. The aim of our study was to evaluate the relationship between the level of cytokines in the blood, lungs, and lung damage in the model of the Syrian hamster (Mesocricetus auratus) infected with the SARS-CoV-2 strain. The study used outbred female and male Syrian hamsters (n=36, 4 groups) weighing 80-110 g and 5 months old (protocol IACUC, #4, 09/22/2020). Animals were infected intranasally with the hCoV-19/Kazakhstan/KazNAU-NSCEDI-481/2020 strain and euthanized at 3 d.p.i. The level of cytokines IL-6, TNF-α, IFN-α, and IFN-γ was determined by ELISA MyBioSourse (USA) for hamsters. Lung samples were subjected to histological processing. The presence of pathological changes in histological preparations was assessed on a 3-point scale. The work was carried out in the ABSL-3 laboratory. The data were analyzed in GraphPad Prism 6.00 (GraphPad Software, La Jolla, California, USA). The work was supported by the MES RK grant (AP09259865). In the blood, the level of TNF-α increased in males (p=0.0012) and IFN-γ in males and females (p=0.0001). On the contrary, IFN-α production decreased (p=0.0006). Only TNF-α level increased in lung tissues (p=0.0011). Correlation analysis showed a negative relationship between the level of IL-6 in the blood and lung damage in males (r -0.71, p=0.0001) and females (r-0.57, p=0.025). On the contrary, in males, the level of IL-6 in the lungs and score is positively correlated (r 0.80, p=0.01). The level of IFN-γ in the blood (r -0.64, p=0.035) and lungs (r-0.72, p=0.017) in males has a negative correlation with lung damage. No links were found for TNF-α and IFN-α. The study showed a positive association between lung injury and tissue levels of IL-6 in male hamsters. It is known that in humans, high concentrations of IL-6 in the lungs are associated with suppression of cellular immunity and, as a result, with an increase in the severity of COVID-19. TNF-α and IFN-γ play a key role in the pathogenesis of COVID-19 in hamsters. However, the mechanisms of their activity require more detailed study. IFN-α plays a lesser role in direct lung injury in a Syrian hamster model. We have shown the significance of tissue IL-6 and IFN-γ as predictors of the severity of lung damage in COVID-19 in the Syrian hamster model. Changes in the level of cytokines in the blood may not always reflect pathological processes in the lungs with COVID-19.

Keywords: syrian hamster, COVID-19, cytokines, biological model

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549 Proposition of an Integrative Model for Assessing the Effectiveness of the Performance Management System

Authors: Mariana L. de Araújo, Pedro P. M. Menezes

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Research on strategic human resource management (SHRM) has made progress in the last few decades, showing a relationship between policies and practices of human resource management (HRM) and improving organizational results. That's because demonstrating the effectiveness of any HRM or other organizational practice, which means the extent that this can operate as a tool to achieve organizational performance, is a complex and arduous task to execute. Even today, there isn't consensus about "effectiveness," and the tools to measure the effectiveness are disconnected and not convincing. It is not different from the performance management system (PMS) effectiveness. A disproportionate focus on specific criteria adopted and an accumulation of studies that don't relate to the others, which damages the development of the field. Therefore, it aimed to evaluate the effectiveness of the PMS through models, dimensions, criteria, and measures. The objective of this study is to propose a theoretical-integrative model for evaluating PMS based on the literature in the PMS field. So, the PRISMA protocol was applied to carry out a systematic review, resulting in 57 studies. After performing the content analysis, we identified six dimensions: learning, societal impact, reaction, financial results, operational results and transfer, and 22 categories. In this way, a theoretical-integrative model for assessing the effectiveness of PMS was proposed based on the findings of this study, in which it was possible to confirm that the effectiveness construct is somewhat complex when viewing that most of the reviewed studies considered multiple dimensions in their assessment. In addition, we identified that the most immediate and proximal results of PMS are the most adopted by the studies; conversely, the studies adopted less distal outcomes to assess the effectiveness of PMS. Another finding of this research is that the reviewed studies predominantly analyze from the individual or psychological perspective, even when it comes to criteria whose phenomena are at an organizational level. Therefore, this study converges with a trend recently identified when referring to a process of "psychologization" in which GP studies, in general, have demonstrated macro results of the GP system from an individual perspective. Therefore, given the identification of a methodological pattern, the predominant influence of individual and psychological aspects in studies on HRM in administration is highlighted, demonstrated by the reflection on the practically absolute way of measuring the effectiveness of PMS from perceptual and subjective measures. Therefore, based on the recognition of the patterns identified, the model proposed to promote studies on the subject more broadly and profoundly to broaden and deepen the perspective of the field of management's interests so that the evaluation of the effectiveness of PMS can promote inputs on the impact of the PMS system in organizational performance. Finally, the findings encourage reflections on assessing the effectiveness of PMS through the theoretical-integrative model developed so that the field can promote new theoretical and practical perspectives.

Keywords: performance management, strategic human resource management, effectiveness, organizational performance

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548 The Roman Fora in North Africa Towards a Supportive Protocol to the Decision for the Morphological Restitution

Authors: Dhouha Laribi Galalou, Najla Allani Bouhoula, Atef Hammouda

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This research delves into the fundamental question of the morphological restitution of built archaeology in order to place it in its paradigmatic context and to seek answers to it. Indeed, the understanding of the object of the study, its analysis, and the methodology of solving the morphological problem posed, are manageable aspects only by means of a thoughtful strategy that draws on well-defined epistemological scaffolding. In this stream, the crisis of natural reasoning in archaeology has generated multiple changes in this field, ranging from the use of new tools to the integration of an archaeological information system where urbanization involves the interplay of several disciplines. The built archaeological topic is also an architectural and morphological object. It is also a set of articulated elementary data, the understanding of which is about to be approached from a logicist point of view. Morphological restitution is no exception to the rule, and the inter-exchange between the different disciplines uses the capacity of each to frame the reflection on the incomplete elements of a given architecture or on its different phases and multiple states of existence. The logicist sequence is furnished by the set of scattered or destroyed elements found, but also by what can be called a rule base which contains the set of rules for the architectural construction of the object. The knowledge base built from the archaeological literature also provides a reference that enters into the game of searching for forms and articulations. The choice of the Roman Forum in North Africa is justified by the great urban and architectural characteristics of this entity. The research on the forum involves both a fairly large knowledge base but also provides the researcher with material to study - from a morphological and architectural point of view - starting from the scale of the city down to the architectural detail. The experimentation of the knowledge deduced on the paradigmatic level, as well as the deduction of an analysis model, is then carried out on the basis of a well-defined context which contextualises the experimentation from the elaboration of the morphological information container attached to the rule base and the knowledge base. The use of logicist analysis and artificial intelligence has allowed us to first question the aspects already known in order to measure the credibility of our system, which remains above all a decision support tool for the morphological restitution of Roman Fora in North Africa. This paper presents a first experimentation of the model elaborated during this research, a model framed by a paradigmatic discussion and thus trying to position the research in relation to the existing paradigmatic and experimental knowledge on the issue.

Keywords: classical reasoning, logicist reasoning, archaeology, architecture, roman forum, morphology, calculation

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547 Motivators and Barriers to High-Tech Entrepreneurship in the Israeli-Arab Community

Authors: Vered Holzmann, Ramzi Halabi

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The current research investigates motivators and barriers to high-tech entrepreneurship in the Israeli-Arab Community. With the aim to exploit the capacity of Israel as a 'start-up nation', we identify the most important aspects to promote integration of Israeli-Arab entrepreneurs in high-tech startups and business companies, thus impact the socio-economic status of the Arab community in Israel. We reviewed the literature on the role of high-tech and entrepreneurship in the Israeli economy, the profile of the Israeli-Arab community with regard to education and employability, and the characteristics of minority entrepreneurship to understand entrepreneurs' intentions, their incentives to choose the entrepreneurial route on one hand and the obstacles that they face on the other hand. Based on the literature review, we conducted an integrated study that included a survey among 73 Israeli-Arabs involved in high-tech entrepreneurship and 16 semi-structured interviews with Israeli-Arab and Jewish entrepreneurs and leaders in the high-tech industry. We analyzed the data to explore personal and social motivating factors to entrepreneurship as well as educational and socio-economical barriers for entrepreneurship. Three major elements were found to be the most influential on Arab high-tech entrepreneurship in Israel: education, financial resources, and strategic-institutional support. The relationship between education and employability that is well-known with regard to general education, requires two additional aspects in the field of high-tech entrepreneurship: education of technology and engineering, and education of business and entrepreneurship. The study findings reveal that the main motivation factors for entrepreneurship are development of creative ideas and improvement of the socio-economic status, while financial-related factors and lack of institutional and governmental support are perceived as impediments to entrepreneurial activities. Financing difficulties are mainly derived from discriminating financial environment and lack of professional networking. The relationship between entrepreneurship and economic growth seems to be clear and simple; thus it is a national interest to encourage entrepreneurship among the Arab community, and especially high-tech entrepreneurship which has a significant role in the economic growth of Israel.

Keywords: high-tech industry, innovation management, Israeli-Arab community, minority entrepreneurship, motivating factors and barriers

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546 Development of a Novel Clinical Screening Tool, Using the BSGE Pain Questionnaire, Clinical Examination and Ultrasound to Predict the Severity of Endometriosis Prior to Laparoscopic Surgery

Authors: Marlin Mubarak

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Background: Endometriosis is a complex disabling disease affecting young females in the reproductive period mainly. The aim of this project is to generate a diagnostic model to predict severity and stage of endometriosis prior to Laparoscopic surgery. This will help to improve the pre-operative diagnostic accuracy of stage 3 & 4 endometriosis and as a result, refer relevant women to a specialist centre for complex Laparoscopic surgery. The model is based on the British Society of Gynaecological Endoscopy (BSGE) pain questionnaire, clinical examination and ultrasound scan. Design: This is a prospective, observational, study, in which women completed the BSGE pain questionnaire, a BSGE requirement. Also, as part of the routine preoperative assessment patient had a routine ultrasound scan and when recto-vaginal and deep infiltrating endometriosis was suspected an MRI was performed. Setting: Luton & Dunstable University Hospital. Patients: Symptomatic women (n = 56) scheduled for laparoscopy due to pelvic pain. The age ranged between 17 – 52 years of age (mean 33.8 years, SD 8.7 years). Interventions: None outside the recognised and established endometriosis centre protocol set up by BSGE. Main Outcome Measure(s): Sensitivity and specificity of endometriosis diagnosis predicted by symptoms based on BSGE pain questionnaire, clinical examinations and imaging. Findings: The prevalence of diagnosed endometriosis was calculated to be 76.8% and the prevalence of advanced stage was 55.4%. Deep infiltrating endometriosis in various locations was diagnosed in 32/56 women (57.1%) and some had DIE involving several locations. Logistic regression analysis was performed on 36 clinical variables to create a simple clinical prediction model. After creating the scoring system using variables with P < 0.05, the model was applied to the whole dataset. The sensitivity was 83.87% and specificity 96%. The positive likelihood ratio was 20.97 and the negative likelihood ratio was 0.17, indicating that the model has a good predictive value and could be useful in predicting advanced stage endometriosis. Conclusions: This is a hypothesis-generating project with one operator, but future proposed research would provide validation of the model and establish its usefulness in the general setting. Predictive tools based on such model could help organise the appropriate investigation in clinical practice, reduce risks associated with surgery and improve outcome. It could be of value for future research to standardise the assessment of women presenting with pelvic pain. The model needs further testing in a general setting to assess if the initial results are reproducible.

Keywords: deep endometriosis, endometriosis, minimally invasive, MRI, ultrasound.

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545 Systems Intelligence in Management (High Performing Organizations and People Score High in Systems Intelligence)

Authors: Raimo P. Hämäläinen, Juha Törmänen, Esa Saarinen

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Systems thinking has been acknowledged as an important approach in the strategy and management literature ever since the seminal works of Ackhoff in the 1970´s and Senge in the 1990´s. The early literature was very much focused on structures and organizational dynamics. Understanding systems is important but making improvements also needs ways to understand human behavior in systems. Peter Senge´s book The Fifth Discipline gave the inspiration to the development of the concept of Systems Intelligence. The concept integrates the concepts of personal mastery and systems thinking. SI refers to intelligent behavior in the context of complex systems involving interaction and feedback. It is a competence related to the skills needed in strategy and the environment of modern industrial engineering and management where people skills and systems are in an increasingly important role. The eight factors of Systems Intelligence have been identified from extensive surveys and the factors relate to perceiving, attitude, thinking and acting. The personal self-evaluation test developed consists of 32 items which can also be applied in a peer evaluation mode. The concept and test extend to organizations too. One can talk about organizational systems intelligence. This paper reports the results of an extensive survey based on peer evaluation. The results show that systems intelligence correlates positively with professional performance. People in a managerial role score higher in SI than others. Age improves the SI score but there is no gender difference. Top organizations score higher in all SI factors than lower ranked ones. The SI-tests can also be used as leadership and management development tools helping self-reflection and learning. Finding ways of enhancing learning organizational development is important. Today gamification is a new promising approach. The items in the SI test have been used to develop an interactive card game following the Topaasia game approach. It is an easy way of engaging people in a process which both helps participants see and approach problems in their organization. It also helps individuals in identifying challenges in their own behavior and in improving in their SI.

Keywords: gamification, management competence, organizational learning, systems thinking

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544 A Comparative Analysis of Lexical Bundles in Academic Writing: Insights from Persian and Native English Writers in Applied Linguistics

Authors: Elham Shahrjooi Haghighi

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This research explores how lexical bundles are utilized in writing in the field of linguistics by comparing professional Persian writers with native English writers using corpus-based studies and advanced computational techniques to examine the occurrence and characteristics of lexical bundles in academic writings. The review of literature emphasizes how important lexical bundles are, in organizing discussions and conveying opinions in both spoken and written language contexts across genres and proficiency levels in fields of study. Previous research has indicated that native English writers tend to employ an array and diversity of bundles than non-native writers do; these bundles are essential elements in academic writing. In this study’s methodology section, the research utilizes a corpus-based method to analyze a collection of writings such as research papers and advanced theses at the doctoral and masters’ levels. The examination uncovers variances in the utilization of groupings between writers who are native speakers of Persian and those who are native English speakers with the latter group displaying a greater occurrence and variety, in types of groupings. Furthermore, the research delves into how these groupings contribute to aspects classifying them into categories based on their relevance to research text structure and individuals as outlined in Hyland’s framework. The results show that Persian authors employ phrases and demonstrate distinct structural and functional tendencies in comparison to native English writers. This variation is linked to differing language skills, levels, disciplinary norms and cultural factors. The study also highlights the pedagogical implications of these findings, suggesting that targeted instruction on the use of lexical bundles could enhance the academic writing skills of non-native speakers. In conclusion, this research contributes to the understanding of lexical bundles in academic writing by providing a detailed comparative analysis of their use by Persian and native English writers. The insights from this study have important implications for language education and the development of effective writing strategies for non-native English speakers in academic contexts.

Keywords: lexical bundles, academic writing, comparative analysis, computational techniques

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543 Application of Strategic Management Tools

Authors: Abenezer Nigussie

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Strategic control practice is a critical exercise, as it provides a sturdy influence towards firms or production partners to achieve the full implementation of effective predetermined plans. The importance of strategic control in a company is often measured by observing the relationship between strategic management and organizational performance. The conventional philosophy of strategic control in academia and the industry places significant emphasis on the ability to plan and execute initiatives. In contrast, the same emphasis on strategic management has received less attention in the housing industry. Although the pressures of project performance can often obscure the wider social, economic, and professional context in which strategic management is undertaken, it is these broad contextual areas that make strategic control a vital issue for construction businesses. Rapidly changing social and technological issues are creating an informed environment that will appear very different in the coming decades from what is experienced in today’s companies. Construction project activity is not adequately led by strategic management tools; projects are mostly executed through simple plans and schedules. The issues that this thesis addresses and solves involve the successful accompaniment of the construction project process through these strategic management tools. The second important aspect is an evaluation of project activity, which is mostly done through simple economic and technical valuation. However, during this research, effective strategic management tools are evaluated and suggested for the assessment of project activities. The research introduces a study of the current strategic management practices of construction companies and also presents the concept of strategic management and the areas that companies need to address to compete in the global market. A summary of an industry survey is documented along with the historical research that prompted the investigation of these topics with a focus on the implementation of tools. Strategic management is a concept that concerns making decisions and taking corrective actions to achieve the future goals and objectives of a company. The objective of this paper is to review the practice of strategic management in construction companies. Questionnaires were distributed to major construction companies listed under categories of each project capable of specifying the complete expression of strategic management tools. Findings of the research showed that the majority of development companies practice strategic management tools in the process and implementation of each tool.

Keywords: strategic management, management, analysis, project management

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542 The Meaning in Life and the Content of Mental Images of Temporal Mental Simulations in Poles and Americans

Authors: Katarzyna Pasternak

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Experiencing the meaning of life is widely recognised as a vital element of well-being and central human motivation. Studies have shown that a higher meaning of life is associated, among other things, with a higher quality of life, higher levels of happiness and better declared health. The subject of the study is the meaning in life measured with The Meaning in Life Questionnaire and the presence of such emotions as nostalgia, awe and hope, and the content of imaginations measured after temporal mental simulations in Americans and Poles. The respondents had to imagine themselves in future, in 40 years and describe two events that would take place at that time. Next, participants assessed the importance of the events described by them, recognised whether during their journey through time they felt awe, hope and nostalgia, and answered the questionnaire examining the meaning in life. 204 (102 from Poland 102 from the USA ) people aged 21 to 60 participated in the study. The study checked whether there were differences in the content of the imaginations of the respondents from Poland and USA, and whether there were statistically significant difference between the declared sense of meaning in life among participants from both countries. The result of the study hane shown that there were no differences in the overall result obtained by the participants in The Meaning in Life Questionnaire , while there were statistically significant differences among the subscales of the questionnaire. It turned out that Americans have a higher presence of meaning in life than Poles, but they obtained lower results in searching of meaning in life. Studies have also shown that there was a statistically significant difference between Poles and Americans in feeling awe after a mental simulation. Poles felt higher level of awe. Images about the future differed between Poles and Americans. Poles judged that the events they described were very important to them. Interestingly, the content of American participants’ imaginations was dominated by topics related to the future of the world, ecology and world peace. There were also ideas about nice moments spent with friends and family. Among Poles, ideas related to professional career and development as well as family events dominated. Research shows that despite the lack of differences in the general meaning in life, Poles are more focused on searching for meaning in life than Americans. The study shows interesting differences between the two cultures.

Keywords: meaning in life, mental simulations, imaginations, temporal mental simulations, future, cultural differences

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541 Can Zirconia Wings of Resin Retained Cantilever Bridges Be Effectively Bonded To Tooth Tissue When Compared With Metal Wings In The Anterior Dentition in vivo? - A Systematic Review.

Authors: Ariyan S. Araghi, Guy C. Jackson, Stephen J. Bonsor

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Materials & Methods: A systematic literature search was undertaken using pre-determined inclusion and exclusion criteria. This review followed the Preferred Reporting Items for Systemic Reviews and Meta-Analysis (PRISMA) statement. Several databases were used to search for randomised control trials and longitudinal cohort studies, which were published less than thirty years ago. A total of 54 studies met the predefined inclusion criteria. Four studies reviewed the success, survival, and failure characteristics of zirconia framework resin retained bridges, whilst two reviewed non-precious metal resin retained bridges. Results: The analysis of the studies revealed an overall survival rate of 95.9% for zirconia-based restorations compared to 90.7% for non-precious metal frameworks. Non-precious metal resin retained bridges displayed a higher overall failure rate of 11.9% compared to 4.6% for zirconia-based restorations in the analysed papers. The most frequent complications were wing debonding for the non-precious metal wing group, whereas substructure fracture and veneering ceramic fracture were more prevalent for the zirconia arm of the study. Conclusion: Both types of resin retained bridges provide effective medium to long-term survival. Zirconia-based frameworks will provide marginally increased success and survival and greatly improved aesthetics. However, catastrophic failure is more likely with zirconia-based restorations. Non-precious metal is time tested but performs worse than its zirconia counterpart with regards to longevity; it does not exhibit the same framework fractures as zirconia. Cement choice and attention to the adhesive bonding systems used appear to be paramount to restoration longevity with both restoration subtypes. Furthermore, improved longevity can be seen when air particle abrasion is incorporated into the adhesive protocol. Within the limitations of this study, it has been determined that zirconia-based resin retained bridges can be effectively used in anterior cantilever bridges. Clinical Significance: Zirconia-based resin retained bridges have been demonstrating promising results in terms of improved success and survival characteristics, together with improved aesthetics when compared to non-precious metal winged resin retained bridges. Their popularity is increasing in the age of digital dentistry as many restorations are manufactured using such technology. It is essential that clinicians understand the limitations of each material type and principles of adhesion to ensure restoration longevity.

Keywords: resin retained bridge, fixed partial denture, zirconia bridge, adhesive bridge

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540 Evaluation of Environmental Management System Implementation of Construction Projects in Turkey

Authors: Aydemir Akyürek, Osman Nuri Ağdağ

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Construction industry is in a rapid development for many years around the world and especially in Turkey. In the last three years sector has 10% growth and provides significant support on Turkey’s national economy. Many construction projects are on-going at urban and rural areas of Turkey which have substantial environmental impacts. Environmental impacts during construction phase are quite diversified and widespread. Environmental impacts of construction industry cannot be inspected properly in all cases and negative impacts may occur frequently in many projects in Turkey. In this study, implementation of ISO 14001 Environmental Management System (EMS) in construction plants is evaluated. In the beginning stage quality management systems generally reviewed and ISO 14001 EMS is selected for implementation. Standard requirements are examined first and implementation of every standard requirement is elaborated for the selected construction plant in the following stage. Key issues and common problems, gained benefits by execution of this type of international EMS standard are examined. As can be seen in sample projects, construction projects are being completed very fast and contractors are working in a highly competitive environment with low profit ratios in our country and mostly qualified work force cannot be accessible. Addition to this there are deficits on waste handling and environmental infrastructure. Besides construction companies which have substantial investments on EMSs can be faced with difficulties on competitiveness in domestic market, however professional Turkish contractors which implementing managements systems in larger scale at international projects are gaining successful results. Also the concept of ‘construction project management’ which is being implemented in successful projects worldwide cannot be implemented except larger projects in Turkey. In case of nonexistence of main management system (quality) implementation of EMSs cannot be managed. Despite all constraints, EMSs that will be implemented in this industry with commitment of top managements and demand of customers will be an enabling, facilitating tool to determine environmental aspects and impacts of construction sites, will provide higher compliance levels for environmental legislation, to establish best available methods for operational control on waste management, chemicals management etc. and to plan monitoring and measurement, to prioritize environmental aspects for investment schedules and waste management.

Keywords: environmental management system, construction projects, ISO 14001, quality

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539 How to Talk about It without Talking about It: Cognitive Processing Therapy Offers Trauma Symptom Relief without Violating Cultural Norms

Authors: Anne Giles

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Humans naturally wish they could forget traumatic experiences. To help prevent future harm, however, the human brain has evolved to retain data about experiences of threat, alarm, or violation. When given compassionate support and assistance with thinking helpfully and realistically about traumatic events, most people can adjust to experiencing hardships, albeit with residual sad, unfortunate memories. Persistent, recurrent, intrusive memories, difficulty sleeping, emotion dysregulation, and avoidance of reminders, however, may be symptoms of Post-traumatic Stress Disorder (PTSD). Brain scans show that PTSD affects brain functioning. We currently have no physical means of restoring the system of brain structures and functions involved with PTSD. Medications may ease some symptoms but not others. However, forms of "talk therapy" with cognitive components have been found by researchers to reduce, even resolve, a broad spectrum of trauma symptoms. Many cultures have taboos against talking about hardships. Individuals may present themselves to mental health care professionals with severe, disabling trauma symptoms but, because of cultural norms, be unable to speak about them. In China, for example, relationship expectations may include the belief, "Bad things happening in the family should stay in the family (jiāchǒu bùkě wàiyán 家丑不可外扬)." The concept of "family (jiā 家)" may include partnerships, close and extended families, communities, companies, and the nation itself. In contrast to many trauma therapies, Cognitive Processing Therapy (CPT) for Post-traumatic Stress Disorder asks its participants to focus not on "what" happened but on "why" they think the trauma(s) occurred. The question "why" activates and exercises cognitive functioning. Brain scans of individuals with PTSD reveal executive functioning portions of the brain inadequately active, with emotion centers overly active. CPT conceptualizes PTSD as a network of cognitive distortions that keep an individual "stuck" in this under-functioning and over-functioning dynamic. Through asking participants forms of the question "why," plus offering a protocol for examining answers and relinquishing unhelpful beliefs, CPT assists individuals in consciously reactivating the cognitive, executive functions of their brains, thus restoring normal functioning and reducing distressing trauma symptoms. The culturally sensitive components of CPT that allow people to "talk about it without talking about it" may offer the possibility for worldwide relief from symptoms of trauma.

Keywords: cognitive processing therapy (CPT), cultural norms, post-traumatic stress disorder (PTSD), trauma recovery

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538 Nuclear Materials and Nuclear Security in India: A Brief Overview

Authors: Debalina Ghoshal

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Nuclear security is the ‘prevention and detection of, and response to unauthorised removal, sabotage, unauthorised access, illegal transfer or other malicious acts involving nuclear or radiological material or their associated facilities.’ Ever since the end of Cold War, nuclear materials security has remained a concern for global security. However, with the increase in terrorist attacks not just in India especially, security of nuclear materials remains a priority. Therefore, India has made continued efforts to tighten its security on nuclear materials to prevent nuclear theft and radiological terrorism. Nuclear security is different from nuclear safety. Physical security is also a serious concern and India had been careful of the physical security of its nuclear materials. This is more so important since India is expanding its nuclear power capability to generate electricity for economic development. As India targets 60,000 MW of electricity production by 2030, it has a range of reactors to help it achieve its goal. These include indigenous Pressurised Heavy Water Reactors, now standardized at 700 MW per reactor Light Water Reactors, and the indigenous Fast Breeder Reactors that can generate more fuel for the future and enable the country to utilise its abundant thorium resource. Nuclear materials security can be enhanced through two important ways. One is through proliferation resistant technologies and diplomatic efforts to take non proliferation initiatives. The other is by developing technical means to prevent any leakage in nuclear materials in the hands of asymmetric organisations. New Delhi has already implemented IAEA Safeguards on their civilian nuclear installations. Moreover, the IAEA Additional Protocol has also been ratified by India in order to enhance its transparency of nuclear material and strengthen nuclear security. India is a party to the IAEA Conventions on Nuclear Safety and Security, and in particular the 1980 Convention on the Physical Protection of Nuclear Material and its amendment in 2005, Code of Conduct in Safety and Security of Radioactive Sources, 2006 which enables the country to provide for the highest international standards on nuclear and radiological safety and security. India's nuclear security approach is driven by five key components: Governance, Nuclear Security Practice and Culture, Institutions, Technology and International Cooperation. However, there is still scope for further improvements to strengthen nuclear materials and nuclear security. The NTI Report, ‘India’s improvement reflects its first contribution to the IAEA Nuclear Security Fund etc. in the future, India’s nuclear materials security conditions could be further improved by strengthening its laws and regulations for security and control of materials, particularly for control and accounting of materials, mitigating the insider threat, and for the physical security of materials during transport. India’s nuclear materials security conditions also remain adversely affected due to its continued increase in its quantities of nuclear material, and high levels of corruption among public officials.’ This paper would study briefly the progress made by India in nuclear and nuclear material security and the step ahead for India to further strengthen this.

Keywords: India, nuclear security, nuclear materials, non proliferation

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537 Fostering Organizational Learning across the Canadian Sport System through Leadership and Mentorship Development of Sport Science Leaders

Authors: Jennifer Walinga, Samantha Heron

Abstract:

The goal of the study was to inform the design of effective leadership and mentorship development programming for sport science leaders within the network of Canadian sport institutes and centers. The LEAD (Learn, Engage, Accelerate, Develop) program was implemented to equip sport science leaders with the leadership knowledge, skills, and practice to foster a high - performance culture, enhance the daily training environment, and contribute to optimal performance in sport. After two years of delivery, this analysis of LEAD’s effect on individual and organizational health and performance factors informs the quality of future deliveries and identifies best practice for leadership development across the Canadian sport system and beyond. A larger goal for this project was to inform the public sector more broadly and position sport as a source of best practice for human and social health, development, and performance. The objectives of this study were to review and refine the LEAD program in collaboration with Canadian Sport Institute and Centre leaders, 40-50 participants from three cohorts, and the LEAD program advisory committee, and to trace the effects of the LEAD leadership development program on key leadership mentorship and organizational health indicators across the Canadian sport institutes and centers so as to capture best practice. The study followed a participatory action research framework (PAR) using semi structured interviews with sport scientist participants, program and institute leaders inquiring into impact on specific individual and organizational health and performance factors. Findings included a strong increase in self-reported leadership knowledge, skill, language and confidence, enhancement of human and organizational health factors, and the opportunity to explore more deeply issues of diversity and inclusion, psychological safety, team dynamics, and performance management. The study was significant in building sport leadership and mentorship development strategies for managing change efforts, addressing inequalities, and building personal and operational resilience amidst challenges of uncertainty, pressure, and constraint in real time.

Keywords: sport leadership, sport science leader, leadership development, professional development, sport education, mentorship

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