Search results for: ownership status
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3632

Search results for: ownership status

1142 Causes of Jaundice and Skin Rashes Amongst Children in Selected Rural Communities in the Gambia

Authors: Alhage Drammeh

Abstract:

The research is on the occurrence of certain diseases among children in rural and far-flung parts of the Gambia and the extent to which they are caused by lack of access to clean water. A baseline survey was used to discover, describe, and explain the actual processes. The paper explains the purpose of the research, which is majorly to improve the health condition of children, especially those living in rural communities. The paper also gives a brief overview of the socio-economic situation of The Gambia, emphasizing its status as a Least Developed Country (LDC) and the majority of its population living below the poverty line, with women and children hardest hit. The research used as case studies of two rural communities in the Gambia -Basse Dampha Kunda Village and Foni Besse. Data was collected through oral interviews and medical tests conducted among people in both villages, with an emphasis on children. The demographic detail of those tested is tabulated for a clearer understanding. The results were compared, revealing that skin rashes, hepatitis, and certain other diseases are more prevalent in communities lacking access to safe drinking water. These results were also presented in a tabular form. The study established how some policy failures and neglect on the part of the Government of The Gambia are imperiling the health of many rural dwellers in the country, the most glaring being that the research team was unable to test water samples collected from the two communities, as there are no laboratory reagents for testing water anywhere in The Gambia. Many rural communities lack basic amenities, especially clean and potable water, as well as health facilities. The study findings also highlighted the need for healthcare providers and medical NGOs to voice the plight of rural dwellers and collaborate with the government to set up health facilities in rural areas of The Gambia.

Keywords: jaundice, skin rashes, children, rural communities, the Gambia, causes

Procedia PDF Downloads 67
1141 From Within a Domestic Violence Shelter Identifying the Sociological and Psychological Impact of Refugee Muslim Women and Children in America

Authors: Asma Inge-Hanif, Ayyub Ansari Hanif

Abstract:

The impact of conflicts, the subsequent refugee migration to America and their attempted use of societal resources implicate the lack of further humanitarian aid as a consequence of the abrupt decrease in services and policy changes stemming from new governmental mandates and Executive Orders. Statistical research data indicates a substantial decline in access to standardized health services by refugee women creating a significant alteration in the management of their maternal health care in America, previously shown to result in decreased mortality and morbidity. Studying nursing at Howard University in Washington, D.C., observed doctors were not always sensitive to the needs and modesty concerns of immigrant Muslim women - often unintentionally. Among health care professionals, the prevailing belief should be that every man, woman and child has the right to quality care in a dignified manner and the achievement of optimal health and well-being, regardless of race, creed, socio-economic level or status. In 1987 Muslimat Al Nisaa Health and Social Services Center was established to care for underserved and uninsured women and children. This Center, plus the subsequent shelter, provided direct access to those homeless, refugees, human trafficking and women victims of domestic violence was established and provides the data for this study. Understanding specific culture, social, economic and religious nuances respects their diversity and addressing their basic human needs that they achieve optimal success. The ultimate goal being to facilitate the rescue and housing of those whom escaped from a country/communities where girls are devalued, brought, sold and abused.

Keywords: women, refugee, domestic violence, health care

Procedia PDF Downloads 89
1140 Descriptive Study of Tropical Tree Species in Commercial Interest Biosphere Reserve Luki in the Democratic Republic of Congo (DRC)

Authors: Armand Okende, Joëlle De Weerdt, Esther Fichtler, Maaike De Ridder, Hans Beeckman

Abstract:

The rainforest plays a crucial role in regulating the climate balance. The biodiversity of tropical rainforests is undeniable, but many aspects remain poorly known, which directly influences its management. Despite the efforts of sustainable forest management, human pressure in terms of exploitation and smuggling of timber forms a problem compared to exploited species whose status is considered "vulnerable" on the IUCN red list compiled by. Commercial species in Class III of the Democratic Republic of Congo are the least known in the market operating, and their biology is unknown or non-existent. Identification of wood in terms of descriptions and anatomical measurements of the wood is in great demand for various stakeholders such as scientists, customs, IUCN, etc. The objective of this study is the qualitative and quantitative description of the anatomical characteristics of commercial species in Class III of DR Congo. The site of the Luki Biosphere Reserve was chosen because of its high tree species richness. This study focuses on the wood anatomy of 14 commercial species of Class III of DR Congo. Thirty-four wooden discs were collected for these species. The following parameters were measured in the field: Diameter at breast height (DBH), total height and geographic coordinates. Microtomy, identification of vessel parameters (diameter, density and grouping) and photograph of the microscopic sections and determining age were performed in this study. The results obtained are detailed anatomical descriptions of species in Class III of the Democratic Republic of Congo.

Keywords: sustainable management of forest, rainforest, commercial species of class iii, vessel diameter, vessel density, grouping vessel

Procedia PDF Downloads 215
1139 Design of a Fuzzy Expert System for the Impact of Diabetes Mellitus on Cardiac and Renal Impediments

Authors: E. Rama Devi Jothilingam

Abstract:

Diabetes mellitus is now one of the most common non communicable diseases globally. India leads the world with largest number of diabetic subjects earning the title "diabetes capital of the world". In order to reduce the mortality rate, a fuzzy expert system is designed to predict the severity of cardiac and renal problems of diabetic patients using fuzzy logic. Since uncertainty is inherent in medicine, fuzzy logic is used in this research work to remove the inherent fuzziness of linguistic concepts and uncertain status in diabetes mellitus which is the prime cause for the cardiac arrest and renal failure. In this work, the controllable risk factors "blood sugar, insulin, ketones, lipids, obesity, blood pressure and protein/creatinine ratio" are considered as input parameters and the "the stages of cardiac" (SOC)" and the stages of renal" (SORD) are considered as the output parameters. The triangular membership functions are used to model the input and output parameters. The rule base is constructed for the proposed expert system based on the knowledge from the medical experts. Mamdani inference engine is used to infer the information based on the rule base to take major decision in diagnosis. Mean of maximum is used to get a non fuzzy control action that best represent possibility distribution of an inferred fuzzy control action. The proposed system also classifies the patients with high risk and low risk using fuzzy c means clustering techniques so that the patients with high risk are treated immediately. The system is validated with Matlab and is used as a tracking system with accuracy and robustness.

Keywords: Diabetes mellitus, fuzzy expert system, Mamdani, MATLAB

Procedia PDF Downloads 294
1138 A Study on Hierarchy and Popularity of Foreign TV Series with Different Origin Countries among Chinese Audiences from a Uses and Gratification Perspective

Authors: Terigele

Abstract:

Cultural products are always shelved into different classes of a hierarchy that separates so-called highbrow and lowbrow cultures. This study illustrated that audiences might even construct a hierarchy according to the origin countries when consuming certain products. Chinese audiences now have access to TV series from all around the world thanks to the internet. TV series from different origin countries show some particular features in terms of length, theme, plots, accessibility, seriousness etc. Their audiences were therefore stereotyped because of what they watch. Based on in-depth interviews with 20 participants, this research has following findings: 1) Most popular origin countries of foreign TV series in China are Korea, the United States, the United Kingdom, Japan and European countries in a descending order. Korean TV series are most popular because they are less serious and more accessible compared to others. 2) In the hierarchy of the TV series, European TV series stand on the top followed by British and American TV series. Japanese TV series are also categorized into highbrow class. Korean TV series are at the bottom and always seen as lowbrow cultural products. 3) Most audiences consume TV series from more than one origin countries and have different needs when watching them. Participants reported that they watch European TV series because those TV series are more artistic than their counterparts and of great quality. They watch British and American TV series mainly to improve their English and to learn about the culture. They find Japanese TV series very enjoyable with a large variety of themes and impressive lines. Audiences watch Korean TV series mostly to entertain and kill time. 4) Audiences do care about cultural taste. Especially those who watch European, British and American TV series usually tend to consider audiences who watch nothing but Korean TV series to be shallow. On the other hand, Korean TV series’ audiences seem to care less about the hierarchy of the TV series. Even when they discuss the hierarchy, they tend to accept the judgments with ironies and jokes. Future studies can dig deeply into the genre and content of TV series with different origin countries and also investigate more about the psychology of audiences regarding the gender, age, education, socioeconomic status etc.

Keywords: foreign TV series, hierarchy, popularity, uses and gratification

Procedia PDF Downloads 243
1137 Dynamics of Smallholder Farmer Adoption of High Value Horticultural Crops in Indonesia

Authors: Suprehatin Suprehatin

Abstract:

Improving the participation of smallholder farmers in horticultural value chains to benefit from the rapidly growing demand for high-value agricultural products is one strategy for raising farm income. However, smallholder farmer participation in Indonesian horticultural value chains is under-researched. To address this knowledge gap, this study aims to describe the current status of horticultural crop adoption in Indonesia and analyze the motivations and dynamics of smallholder farmer participation in horticultural value chains: why some small farmers join these new and potentially profitable chains and continue their participation. This study also examines the characteristics of farmers who adopted and those who did not adopt a new horticultural crop with respect to the household (farmer), farm and institutional characteristics. The analysis was conducted using unique data from a 2013 survey of 960 Indonesian farmers on Java Island that produce a variety of agricultural products. Basic statistical analysis showed relatively low adoption rates (10%) of new horticultural crops amongst 960 selected Indonesian farmers with different decisions made in terms of number and timing of new horticultural crop adoption. Adopters were motivated mainly by higher profit, higher yield, and more cash opportunities. The result also showed that current low rates of horticultural crop adoption are associated with a variety of factors, such as lower levels of education among farmers, resource constraints, lack of information on horticultural crop production and low participation in farmer groups. These findings will be helpful for policymakers when designing policies and programs to promote greater participation of Indonesian smallholder farmers in horticultural value chains. In other words, a revitalisation of agricultural policy beyond staple food is important to seize potential benefits from the ongoing agricultural food market transformation.

Keywords: farmer adoption, high value, horticultural crops, Indonesia

Procedia PDF Downloads 284
1136 Conspiracy Theories and the Right to Believe

Authors: Zwelenkani Mdlalose

Abstract:

From the moment Covid 19 was declared a pandemic it became clear that conspiracy theories would significantly impact our response to the crisis that the virus was to become. Central to the interest in conspiracy theories evoked by a pandemic is a more general concern for the impact they have on society and social harmony. The specific brand of Conspiracy Theory that is in question is not any and all theories about conspiracies but rather those conspiracy theories which contradict official accounts. For example, where the official account on the terrorist attacks of September 11 2001 is of a conspiracy involving 19 militants associated with the Islamic extremist group al-Qaeda against targets in the United States, the nature of conspiracy theory under study is the one contradicting this official account to the extent that its attributes the attacks not to al-Qaeda militants but to actors in the United States government itself. The study is not an investigation into the truth value of conspiracy theories but rather an attempt at observing the essential qualities of the type of belief that is belief in conspiracy theories compared to belief in official accounts provided by authoritative sources such as governments, experts and mainstream media. These qualities include the psychological, epistemic and socio-political foundations on which belief in conspiracy theories are established. Based on a foundational understanding of the sort of belief that are beliefs in conspiracy theories, we may then extrapolate implied ethical demands on both authoritative bodies and actors as well as believers in conspiracy theories. For example: in their unofficial ‘non-factual’ status, is there not some violation of epistemic right in the same way we observe in cases where people are prejudiced because of their religious beliefs? In other words, is there an epistemic injustice suffered by believers in conspiracy theories in the way their beliefs are rejected as illegitimate? Conversely, to what extent do believers bear an epistemic responsibility in their adoption of their beliefs in conspiracy theories. From this position, perhaps we can then develop responses to the problem that foster greater social harmony even in the midst of suspicion and distrust.

Keywords: conspiracy theories, subjugated knowledge, epistemic injustice, epistemic responsibility

Procedia PDF Downloads 102
1135 Responsibility to Protect and State Sovereignty: The Case of Syria

Authors: Renu Kumari

Abstract:

State sovereignty refers to the ability and power of a state to be independent and not to have any interference of external actors in its internal affairs. This phenomenon has been accepted by International Law, which gives rights to the state to maintain its autonomy and territorial integrity without the interference of other actors. In of 1980’s and 1990’s the world has witnessed the worst case of human rights violence for instance, Rwanda genocide, the conflict in former Yugoslavia, Kosovo, Burundi, and Chad so and so forth. Though human rights violence is not a new phenomenon, it has been present all over the world in different time and space. But in 1990’s after the devastation of these conflicts and violence the world community came up with the notion of humanitarian intervention in which some states took the responsibility of protecting human rights violations and on the in order to protect they can intervene in the internal matters of a state specifically during civil war where state is unable to protect its people. Later on these so-called world community realized that intervention itself is a negative term that was criticized also therefore they came up with a different notion that sounded positive which known as responsibility to protect. In 2005 onwards, the notion of responsibility to protect accepted and recognized by the United Nations and states at a larger level. In the case of Syria on the name of responsibility to protect foreign interventions took place and due to the internal war Syrian people were already facing many problems, the government was not able to protect them. External invasion caused many devastating outcomes to the country. This paper is an attempt to analyze various dimensions of invasion of external affairs of a particular state and the status of sovereignty. Firstly, it lays out the notion of humanitarian intervention and then the responsibility to protect. Secondly, it looks in the case of Syria since 2011, the conflict of Syria. Thirdly it focuses on various efforts made by international organizations and other actors. Lastly, it looks why and how other actors intervene in the internal matter of Syria.

Keywords: state sovereignty, external actors, intervention, responsibility to protect

Procedia PDF Downloads 171
1134 Kissing Cervical Spine Schwannomas in a Young Female from a Low Resource Setting: A Case Report

Authors: Joseph Mary Ssembatya, Blessing Michael Taremwa

Abstract:

Background: Multiple schwannomas are typically associated with neurofibromatosis type 1 (NF1), but rare cases occur independently of neurofibromatosis. Schwannomas are benign, slow-growing tumors, primarily affecting the cervical and lumbar spine. When large, they may extend over multiple vertebral levels, posing surgical challenges. Case Presentation: A 13-year-old Ugandan Munyankore female patient, presented with a 6-year history of progressive quadriparesis, particularly in the lower limbs. Clinical examination showed hypertonia and hyperreflexia, with no indicators of neurofibromatosis or prior trauma. MRI revealed two “kissing” schwannomas extending from C2 to T2 in the cervical spine. Decompressive surgery was performed through laminoplasty and partial lesion resection, and histology confirmed schwannoma. Two weeks postoperatively, the patient experienced cerebrospinal fluid (CSF) leakage, neck pain, and headache, which required re-operation and duraplasty. Following these interventions, the patient’s neurological status stabilized, with noted improvement in lower limb strength. Discussion: “Kissing” schwannomas are most frequently documented in the cerebellopontine angle, rarely in the spine, and even more rarely in children. While multiple schwannomas are often associated with NF2, this case had no family history or clinical signs of the disorder. Giant invasive spinal schwannomas (GISS) that span multiple vertebrae demand intricate surgical approaches due to their proximity to neurovascular structures. Conclusion: This is the first reported case of kissing cervical schwannomas in a young patient from a low- to middle-income country. Surgical decompression, though challenging, is critical for neurological recovery in such advanced cases.

Keywords: kissing schwannoma, cervical spine, low resource, young, uganda

Procedia PDF Downloads 18
1133 An Investigation of the Science Process Skills of 48-66 Months Old Children

Authors: Nilüfer Kuru, Berrin Akman

Abstract:

In this study, science process skills of children with ages varying between 48-months and 66-months are analyzed. Science process skills of children are investigated in terms of factors including gender of children, attendance of children to the previous educational institution and duration of their attendance, educational background of their parents, ages of children and teachers, professional experience of teachers, educational background, and department of graduation of teachers, type of pre-school education institution of teachers and children. Sample of research consists of 250 children aged between 48-months and 66-months who attend state and private kindergartens under the Ministry of National Education, nursery classes of elementary schools and kindergartens of establishments in central districts of Ankara and 50 teachers who serve in these children’s classes. Science Observation Form, reached from the website of Alaska Department of Education & Early, are analyzed in terms of language, content, construct validity, and reliability by the researchers. Additionally, Personal Information Form is also developed by the researchers. Data obtained in the study are analyzed with SPSS 16.0 package program to obtain percentage and frequency, Kruskal Wallis H-test, and Mann- Whitney U test, which are one of the non-parametric tests, are used. Within the context of this study it has been seen that independent variables of age, type of school attending and status of attendance to pre-school education, educational background of children’s father are meaningful expositive in gaining science process skills for children. It has been seen that period of service of teachers, duration of attendance to pre-school education for children, gender of children and educational background of children’s mother are not meaningful expositive in gaining science process skills for children.

Keywords: preschool, science process skills, early childhood education, science

Procedia PDF Downloads 369
1132 Canopy Temperature Acquired from Daytime and Nighttime Aerial Data as an Indicator of Trees’ Health Status

Authors: Agata Zakrzewska, Dominik Kopeć, Adrian Ochtyra

Abstract:

The growing number of new cameras, sensors, and research methods allow for a broader application of thermal data in remote sensing vegetation studies. The aim of this research was to check whether it is possible to use thermal infrared data with a spectral range (3.6-4.9 μm) obtained during the day and the night to assess the health condition of selected species of deciduous trees in an urban environment. For this purpose, research was carried out in the city center of Warsaw (Poland) in 2020. During the airborne data acquisition, thermal data, laser scanning, and orthophoto map images were collected. Synchronously with airborne data, ground reference data were obtained for 617 studied species (Acer platanoides, Acer pseudoplatanus, Aesculus hippocastanum, Tilia cordata, and Tilia × euchlora) in different health condition states. The results were as follows: (i) healthy trees are cooler than trees in poor condition and dying both in the daytime and nighttime data; (ii) the difference in the canopy temperatures between healthy and dying trees was 1.06oC of mean value on the nighttime data and 3.28oC of mean value on the daytime data; (iii) condition classes significantly differentiate on both daytime and nighttime thermal data, but only on daytime data all condition classes differed statistically significantly from each other. In conclusion, the aerial thermal data can be considered as an alternative to hyperspectral data, a method of assessing the health condition of trees in an urban environment. Especially data obtained during the day, which can differentiate condition classes better than data obtained at night. The method based on thermal infrared and laser scanning data fusion could be a quick and efficient solution for identifying trees in poor health that should be visually checked in the field.

Keywords: middle wave infrared, thermal imagery, tree discoloration, urban trees

Procedia PDF Downloads 116
1131 Examining How Youth Use Mobile Devices for Health Information: Preliminary Findings of a Survey Study with High School Students in Croatia

Authors: Sung Un Kim, Ivana Martinović, Snježana Stanarević Katavić

Abstract:

As more and more youth use mobile devices, such as tablets and smartphones, for information seeking in their everyday lives, the purpose of this study is to understand the behaviors of youth seeking health information on mobile devices. The specific objective of this study is to examine 1) for what health issues youth use mobile devices, 2) for what reasons youth use mobile devices to obtain health information, 3) in what ways youth use mobile devices for health information, and 4) the features of health applications that youth find useful. The researchers devised a questionnaire for this study. Four hundred eight students from two high schools, located in Osijek, Croatia, participated by answering the questionnaire (281 girls and 127 boys). The collected data were analyzed using descriptive statistics and content analysis. The results show that among all participants, about 85 percent (n = 344) reported having used mobile devices for health information. The most frequent health topic for which they had been using mobile devices is physical activity (n = 273), followed by eating issues and nutrition (n = 224), mental health (n = 160), sexual health (n = 157), alcohol, drugs, and tobacco (n = 125), safety (n = 96) and particular diseases (n = 62). They use mobile devices to obtain health information due to the ease of use (n = 342), the ease of sharing health information (n = 281), portability (n = 215), timeliness (n = 162), and the ease of tracking/recording/monitoring health status (n = 147). Of those who have used mobile devices for health information, three-quarters (n = 261) use mobile devices to search health information, while 32.8% (n =113) use applications and 31.7% (n =109) browse information. Those who have used applications for health information (n = 113) consider the alert feature (n=107) as the most useful, followed by the tracking/recording/monitoring feature (n =92), the customized information feature (n = 86), the video feature (n = 58), and the sharing feature (n =39). It is notable that although health applications have been actively developed and studied, a majority of the participants search for or browse information on mobile devices, instead of using applications. The researchers will discuss reasons that some of them did not use mobile devices to obtain health information, students’ concerns about using health applications, and features that they wish to have in health applications.

Keywords: Croatia, health information, information seeking behaviors, mobile devices, youth

Procedia PDF Downloads 405
1130 Measurement of Sarcopenia Associated with the Extent of Gastrointestinal Oncological Disease

Authors: Adrian Hang Yue Siu, Matthew Holyland, Sharon Carey, Daniel Steffens, Nabila Ansari, Cherry E. Koh

Abstract:

Introduction: Peritoneal malignancies are challenging cancers to manage. While cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS and HIPEC) may offer a cure, it’s considered radical and morbid. Pre-emptive identification of deconditioned patients for optimization may mitigate the risks of surgery. However, the difficulty lies in the scarcity of validated predictive tools to identify high-risk patients. In recent times, there has been growing interest in sarcopenia, which can occur as a result of malnutrition and malignancies. Therefore, the purpose of this study was to assess the utility of sarcopenia in predicting post-operative outcomes. Methods: A single quaternary-center retrospective study of CRS and HIPEC patients between 2017-2020 was conducted to determine the association between pre-operative sarcopenia and post-operative outcomes. Lumbar CT images were analyzed using Slice-o-matic® to measure sarcopenia. Results : Cohort (n=94) analysis found that 40% had sarcopenia, with a majority being female (53.2%) and a mean age of 55 years. Sarcopenia was statistically associated with decreased weight compared to non-sarcopenia patients, 72.7kg vs. 82.2kg (p=0.014) and shorter overall survival, 1.4 years vs. 2.1 years (p=0.032). Post-operatively, patients with sarcopenia experienced more post-operative complications (p=0.001). Conclusion: Complex procedures often require optimization to prevent complications and improve survival. While patient biomarkers – BMI and weight – are used for optimization, this research advocates for the identification of sarcopenia status for pre-operative planning. Sarcopenia may be an indicator of advanced disease requiring further treatment and is an emerging area of research. Larger studies are required to confirm these findings and to assess the reversibility of sarcopenia after surgery.

Keywords: sarcopaenia, cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, surgical oncology

Procedia PDF Downloads 85
1129 Reconstruction of the 'Bakla' as an Identity

Authors: Oscar H. Malaco Jr.

Abstract:

Homosexuality has been adapted as the universal concept that defines the deviations from the heteronormative parameters of society. Sexual orientation and gender identities have been used in a concretely separate manner the same way as the dynamics between man and woman, male and female, gender and sex operate. These terms are all products of human beings’ utilization of language. Language has proven its power to define and determine the status and the categories of the subjects in society. This tool developed by human beings provides a definition of their own specific cultural community and their individual selves that either claim or oppugn their space in the social hierarchy. The label ‘bakla’ is reasoned as an identity which is a reaction to the spectral disposition of gender and sexuality in the Philippine society. To expose the Filipino constitutes of bakla is the major attempt of this study. Through the methods of Sikolohiyang Pilipino (Filipino Psychology), namely Pagtatanung-tanong (asking questions) and Pakikipagkuwentuhan (story-telling), the utterances of the bakla were gathered and analyzed in a rhetorical and ideological manner. Furthermore, the Dramatistic Pentad of Kenneth Burke was adapted as a methodology and also utilized as a perspective of analysis. The results suggest that the bakla as an identity carries the hurdles of class. The performativity of the bakla is proven to be a cycle propelled by their guilt to be identified and recognized as subjects in a society where heteronormative power contests their gender and sexual expressions as relatively aberrational to the binary gender and sexual roles. The labels, hence, are potent structures that control the disposition of the bakla in the society, reflecting an aspect of the disposition of Filipino identities. After all, performing kabaklaan in the Philippine society is interplay between resistance and conformity to the hegemonic dominions as a result of imperial attempts to universalize the concept of homosexuality between and among distant cultural communities.

Keywords: gender identity, sexual orientation, rhetoric, performativity

Procedia PDF Downloads 444
1128 English Language Proficiency and Use as Determinants of Transactional Success in Gbagi Market, Ibadan, Nigeria

Authors: A. Robbin

Abstract:

Language selection can be an efficient negotiation strategy employed by both service or product providers and their customers to achieve transactional success. The transactional scenario in Gbagi Market, Ibadan, Nigeria provides an appropriate setting for the exploration of the Nigerian multilingual situation with its own interesting linguistic peculiarities which questions the functionality of the ‘Lingua Franca’ in trade situations. This study examined English Language proficiency among Yoruba Traders in Gbagi Market, Ibadan and its use as determinants of transactional success during service encounters. Randomly selected Yoruba-English bilingual traders and customers were administered questionnaires and the data subjected to statistical and descriptive analysis using Giles Communication Accommodation Theory. Findings reveal that only fifty percent of the traders used for the study were proficient in speaking English language. Traders with minimal proficiency in Standard English, however, resulted in the use of the Nigerian Pidgin English. Both traders and customers select the Mother Tongue, which is the Yoruba Language during service encounters but are quick to converge to the other’s preferred language as the transactional exchange demands. The English language selection is not so much for the prestige or lingua franca status of the language as it is for its functions, which include ease of communication, negotiation, and increased sales. The use of English during service encounters is mostly determined by customer’s linguistic preference which the trader accommodates to for better negotiation and never as a first choice. This convergence is found to be beneficial as it ensures sales and return patronage. Although the English language is not a preferred code choice in Gbagi Market, it serves a functional trade strategy for transactional success during service encounters in the market.

Keywords: communication accommodation theory, language selection, proficiency, service encounter, transaction

Procedia PDF Downloads 160
1127 Deficiencies in Vitamin A and Iron Supply Potential of Selected Indigenous Complementary Foods of Infants in Uganda

Authors: Richard Kajjura, Joyce Kikafunda, Roger Whitehead

Abstract:

Introduction: Indigenous complementary recipes for children (6-23 months) are bulky and inextricably linked. The potential contribution of indigenous complementary foods to infant’s vitamin A and iron needs is not well investigated in Uganda. Less is known whether children in Uganda are living with or without adequate supply of vitamin A and iron nutrients. In this study, vitamin A and iron contents were assessed in the complementary foods fed to infants aged 6-11 months in a Peri-urban setting in Kampala District in Central Uganda. Objective: Assessment of vitamin A and iron contents of indigenous complementary foods of children as fed and associated demographic factor. Method: In a cross sectional study design, one hundred and three (153) households with children aged 6-11 months were randomly selected to participate in the assessment. Complementary food samples were collected from the children’s mothers/caretakers at the time of feeding the child. The mothers’ socio-demographic characteristics of age, education, marital status, occupation and sex collected a semi-qualitative questionnaire. The Vitamin A and iron contents in the complementary foods were analyzed using a UV/VIS spectrophotometer for vitamin A and Atomic Absorption spectrophotometer for iron samples. The data was analyzed using Gene-stat software program. Results: The mean vitamin A content was 97.0± 72.5 µg while that of iron was 1.5 ± 0.4 mg per 100g of food sample as fed. The contribution of indigenous complementary foods found was 32% for vitamin A and 15% iron of the recommended dietary allowance. Age of children was found to be significantly associated Vitamin A and Iron supply potential. Conclusion: The contribution of indigenous complementary foods to infant’s vitamin A and iron needs was low. Complementary foods in Uganda are more likely to be deficient in vitamin A and iron content. Nutrient dense dietary supplementation should be intervened in to make possible for Ugandan children attain full growth potential.

Keywords: indigenous complementary food, infant, iron, vitamin A

Procedia PDF Downloads 479
1126 Modeling of Masonry In-Filled R/C Frame to Evaluate Seismic Performance of Existing Building

Authors: Tarek M. Alguhane, Ayman H. Khalil, M. N. Fayed, Ayman M. Ismail

Abstract:

This paper deals with different modeling aspects of masonry infill: no infill model, Layered shell infill model, and strut infill model. These models consider the complicated behavior of the in-filled plane frames under lateral load similar to an earthquake load. Three strut infill models are used: NBCC (2005) strut infill model, ASCE/SEI 41-06 strut infill model and proposed strut infill model based on modification to Canadian, NBCC (2005) strut infill model. Pushover and modal analyses of a masonry infill concrete frame with a single storey and an existing 5-storey RC building have been carried out by using different models for masonry infill. The corresponding hinge status, the value of base shear at target displacement as well as their dynamic characteristics have been determined and compared. A validation of the structural numerical models for the existing 5-storey RC building has been achieved by comparing the experimentally measured and the analytically estimated natural frequencies and their mode shapes. This study shows that ASCE/SEI 41-06 equation underestimates the values for the equivalent properties of the diagonal strut while Canadian, NBCC (2005) equation gives realistic values for the equivalent properties. The results indicate that both ASCE/SEI 41-06 and Canadian, NBCC (2005) equations for strut infill model give over estimated values for dynamic characteristic of the building. Proposed modification to Canadian, NBCC (2005) equation shows that the fundamental dynamic characteristic values of the building are nearly similar to the corresponding values using layered shell elements as well as measured field results.

Keywords: masonry infill, framed structures, RC buildings, non-structural elements

Procedia PDF Downloads 279
1125 The Nexus of Federalism and Economic Development: A Politico-Economic Analysis of Balochistan, Pakistan

Authors: Rameesha Javaid

Abstract:

Balochistan, the largest landmass named after and dominated by the 55% Baloch population, which has had a difficult anti-center history like their brothers the Kurds of Middle East, reluctantly acceded to Pakistan in 1947. The region, which attained the status of a province after two decades of accession, has lagged behind in social development and economic growth as compared to the other three federating units. The province has seen the least financial autonomy and administrative decentralization both in autocratic and democratic dispensations under geostrategic and security considerations. Significant corrections have been recently made in the policy framework through changing the formula for intra-provincial National Finance Award, curtailing the number of subjects under federal control, and reactivating the Council of Common Interests. Yet policymaking remains overwhelmingly bureaucratic under a weak parliamentary oversight. The provincial coalition governments are unwieldy and directionless. The government machinery has much less than the optimal capability, character, integrity, will, and opportunity to perform. Decentralization further loses its semblance in the absence of local governments for long intervals and with the hold of hereditary tribal chiefs. Increased allocations failed to make an impact in the highest per capita cost environment due to long distances and scattered settlements. Decentralization, the basic ingredient of federalism has remained mortgaged to geo-strategic factors, internal security perceptions, autocratic and individualistic styles of governments, bureaucratic policymaking structures, bad governance, non-existent local governments, and feudalistic tribal lords. This suboptimal federalism speaks for the present underdevelopment in Balochistan and will earmark the milestones in the future.

Keywords: Balochistan, economic development, federalism, political economy

Procedia PDF Downloads 312
1124 Gender and Language: Exploring Sociolinguistic Differences

Authors: Marvelyn F. Carolino, Charlene R. Cunanan, Gellien Faith O. Masongsong, Berlinda A. Ofrecio

Abstract:

This study delves into the language usage differences among men, women, and individuals with other gender preferences. It specifically centers on the sociolinguistic aspects within the English majors at the College of Education of Rizal Technological University-Pasig, spanning from the first-year to fourth-year levels. The researchers employed a triangulation approach for data collection, utilizing a validated self-made questionnaire, interviews, and observations. The results revealed that language usage among different genders is influenced by a combination of cultural norms, social dynamics, and technological factors. Cultural norms significantly shape how respondents use language, as they conform to expected speech patterns based on their gender. Social factors, such as peer pressure, were found to impact language usage for individuals of all genders. This influence was viewed as constructive for personal development rather than inhibiting performance or communication. In terms of technological factors, respondents strongly agreed that the time spent on social media and educational applications influenced their language use. These platforms provided opportunities to expand and enhance their vocabulary. Additionally, the study employed hypothesis testing through the z-test formula to assess the impact of demographic profiles on language usage differences among genders. The results indicated that gender, economic status, locality, and ethnicity did not show statistically significant differences in language use. This lack of significant variation in findings was attributed to the relatively homogeneous demographic profile of respondents, primarily composed of females with low-income backgrounds and Tagalog ethnicity. This demographic similarity likely minimized the diversity of responses.

Keywords: gender, language, sociolinguistics, differences

Procedia PDF Downloads 101
1123 Analysis of the Demographic Variable Associated with Common Pregnancy Related Illnesses among Pregnant Mothers in Anambra

Authors: Nkiru Nnaemezie, J. O. Okafor

Abstract:

The high mortality as a result of pregnancy related illnesses is a global public health problem and a source of concern to most countries including Nigeria. This study was therefore designed to determine the Demographic Variables associated with common pregnancy related illnesses among pregnant mothers in Awka South Local Government Area of Anambra State. The design of the study was an expost-facto research design. All the folders of the pregnant mothers that were studied from 2010-2014 formed the population of the study which included 10,250 folders. Based on the content of the folders, a researcher developed pro-forma (RDP) was used for data collection. Five research questions and five hypotheses were postulated for the study. Research questions postulated were answered using simple percentage. Hypotheses stated were analyzed at 0.05 level of significance using chi-square (X²) statistics. The result among others showed that pregnant mothers within 15-29 years had the most pregnancy related illnesses than mothers on other age brackets. Pregnant mothers with 0-1 parity level experienced the most pregnancy related illnesses than mothers on other parity levels. Public servants experienced the most pregnancy related illnesses than mothers in other occupations. Married pregnant mothers experienced the most pregnancy related illnesses than single mothers. Pregnant mothers with secondary education had the most pregnancy related illnesses than mothers in other education levels. There were significant differences in the common pregnancy related illnesses among the pregnant mothers of the study in relation to the demographic variables of the study which included age, parity, occupation, marital status and educational level. Based on the findings, conclusions were drawn, and the following recommendations among others were made: there is need for health education in terms of educating those pregnant mothers during antenatal clinics; single mothers should be advised to register for antenatal early enough.

Keywords: analysis, demographic variables, pregnancy related illnesses, pregnant mothers

Procedia PDF Downloads 260
1122 Evaluation of the Analytic for Hemodynamic Instability as a Prediction Tool for Early Identification of Patient Deterioration

Authors: Bryce Benson, Sooin Lee, Ashwin Belle

Abstract:

Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring

Procedia PDF Downloads 190
1121 Potential Climate Change Impacts on the Hydrological System of the Harvey River Catchment

Authors: Hashim Isam Jameel Al-Safi, P. Ranjan Sarukkalige

Abstract:

Climate change is likely to impact the Australian continent by changing the trends of rainfall, increasing temperature, and affecting the accessibility of water quantity and quality. This study investigates the possible impacts of future climate change on the hydrological system of the Harvey River catchment in Western Australia by using the conceptual modelling approach (HBV mode). Daily observations of rainfall and temperature and the long-term monthly mean potential evapotranspiration, from six weather stations, were available for the period (1961-2015). The observed streamflow data at Clifton Park gauging station for 33 years (1983-2015) in line with the observed climate variables were used to run, calibrate and validate the HBV-model prior to the simulation process. The calibrated model was then forced with the downscaled future climate signals from a multi-model ensemble of fifteen GCMs of the CMIP3 model under three emission scenarios (A2, A1B and B1) to simulate the future runoff at the catchment outlet. Two periods were selected to represent the future climate conditions including the mid (2046-2065) and late (2080-2099) of the 21st century. A control run, with the reference climate period (1981-2000), was used to represent the current climate status. The modelling outcomes show an evident reduction in the mean annual streamflow during the mid of this century particularly for the A1B scenario relative to the control run. Toward the end of the century, all scenarios show a relatively high reduction trends in the mean annual streamflow, especially the A1B scenario, compared to the control run. The decline in the mean annual streamflow ranged between 4-15% during the mid of the current century and 9-42% by the end of the century.

Keywords: climate change impact, Harvey catchment, HBV model, hydrological modelling, GCMs, LARS-WG

Procedia PDF Downloads 264
1120 Turin, from Factory City to Talents Power Player: The Role of Private Philanthropy Agents of Innovation in the Revolution of Human Capital Market in the Contemporary Socio-Urban Scenario

Authors: Renato Roda

Abstract:

With the emergence of the so-called 'Knowledge Society', the implementation of policies to attract, grow and retain talents, in an academic context as well, has become critical –both in the perspective of didactics and research and as far as administration and institutional management are concerned. At the same time, the contemporary philanthropic entities/organizations, which are evolving from traditional types of social support towards new styles of aid, envisaged to go beyond mere monetary donations, face the challenge of brand-new forms of complexity in supporting such specific dynamics of the global human capital market. In this sense, it becomes unavoidable for the philanthropic foundation, while carrying out their daily charitable tasks, to resort to innovative ways to facilitate the acquisition and the promotion of talents by academic and research institutions. In order to deepen such a specific perspective, this paper features the case of Turin, former 'factory city' of Italy’s North West, headquarters -and main reference territory- of Italy’s largest and richest private formerly bank-based philanthropic foundation, the Fondazione Compagnia di San Paolo. While it was assessed and classified as 'medium' in the city Global Talent Competitiveness Index (GTCI) of 2020, Turin has nevertheless acquired over the past months status of impact laboratory for a whole series of innovation strategies in the competition for the acquisition of excellence human capital. Leading actors of this new city vision are the foundations with their specifically adjusted financial engagement and a consistent role of stimulus towards innovation for research and education institutions.

Keywords: human capital, post-Fordism, private foundation, war on talents

Procedia PDF Downloads 173
1119 Stressful Life Events and Their Influence on Childhood Obesity and Emotional Well-Being: Cross-Sectional Study

Authors: M. Rojo, M. Blanco, T. Lacruz, S. Solano, L. Beltran, M. Graell, A. R. Sepulveda.

Abstract:

There is an association between an early accumulation of Stressful Life Events (SLE) during childhood and various physical and psychological health complications. However, there are only a few studies on this topic in children and adolescents with overweight or obesity. The general aim of the study was to evaluate the accumulation and type of SLE in 200 children from 8 to 12 years old and analyze the relationship with their emotional well-being and weight status (obesity, overweight and normal weight). The children and their families completed an interview. The evaluated variables that are included in this study are sociodemographic measures, medical/psychological history, anthropometric measures (BMI, z-BMI), and psychological variables (children's clinical interview K-SADS-PL(Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version) and battery of questionnaires). Results: Children with overweight and obesity accumulate more stressful events from an early age and have a significantly higher percentage of psychiatric diagnoses, compared to their peers with normal weight. Presenting a child psychiatric disorder is related to greater z-BMI and the total number of SLE (p < 0.001). A higher z-BMI is also related to a greater number of stressful events during childhood. There is also a positive and significant relationship between the total number of SLE and worse emotional well-being (higher levels of anxious and depressive symptoms and low self-esteem of children) (p < 0.01). Conclusion: Children with overweight and obesity grow up in a family, school, and social context where more stressors are accumulated. This is also directly associated with worse emotional well-being. It is necessary to implement multidisciplinary prevention and intervention strategies in different changes (school, family, and health). This study is included in a project funded by the Ministry of Innovation and Science (PSI2011-23127).

Keywords: childhood obesity, emotional well-being, psychopathology, stressful life events

Procedia PDF Downloads 127
1118 Potentials and Challenges of Implementing Participatory Irrigation Management, Tanzania

Authors: Pilly Joseph Kagosi

Abstract:

The study aims at assessing challenges observed during implementation of participatory irrigation management (PIM) approach for food security in semi-arid areas of Tanzania. Data were collected through questionnaire, PRA tools, key informants discussion, Focus Group Discussion (FGD), participant observation and literature review. Data collected from questionnaire was analyzed using SPSS while PRA data was analyzed with the help of local communities during PRA exercise. Data from other methods were analyzed using content analysis. The study revealed that PIM approach has contribution in improved food security at household level due to involvement of communities in water management activities and decision making which enhanced availability of water for irrigation and increased crop production. However there were challenges observed during implementation of the approach including; minimum participation of beneficiaries in decision making during planning and designing stages, meaning inadequate devolution of power among scheme owners; Inadequate and lack of transparency on income expenditure in Water Utilization Associations’ (WUAs), water conflict among WUAs members, conflict between farmers and livestock keepers and conflict between WUAs leaders and village government regarding training opportunities and status; WUAs rules and regulation are not legally recognized by the National court and few farmers involved in planting trees around water sources. However it was realized that some of the mentioned challenges were rectified by farmers themselves facilitated by government officials. The study recommends that, the identified challenges need to be rectified for farmers to realize impotence of PIM approach as it was realized by other Asian countries.

Keywords: potentials of implementing participatory approach, challenges of participatory approach, irrigation management, Tanzania

Procedia PDF Downloads 307
1117 Sustainable Use of Agricultural Waste to Enhance Food Security and Conserve the Environment

Authors: M. M. Tawfik, Ezzat M. Abd El Lateef, B. B. Mekki, Amany A. Bahr, Magda H. Mohamed, Gehan S. Bakhoom

Abstract:

The rapid increase in the world’s population coupled by decrease the arable land per capita has resulted into an increased demand for food which has in turn led to the production of large amounts of agricultural wastes, both at the farmer, municipality and city levels. Agricultural wastes can be a valuable resource for improving food security. Unfortunately, agricultural wastes are likely to cause pollution to the environment or even harm to human health. This calls for increased public awareness on the benefits and potential hazards of agricultural wastes, especially in developing countries. Agricultural wastes (residual stalks, straw, leaves, roots, husks, shells etcetera) and animal waste (manures) are widely available, renewable and virtually free, hence they can be an important resource. They can be converted into heat, steam, charcoal, methanol, ethanol, bio diesel as well as raw materials (animal feed, composting, energy and biogas construction etcetera). agricultural wastes are likely to cause pollution to the environment or even harm to human health, if it is not used in a sustainable manner. Organic wastes could be considered an important source of biofertilizer for enhancing food security in the small holder farming communities that would not afford use of expensive inorganic fertilizers. Moreover, these organic wastes contain high levels of nitrogen, phosphorus, potassium, and organic matter important for improving nutrient status of soils in urban agriculture. Organic compost leading to improved crop yields and its nutritional values as compared with inorganic fertilization. This paper briefly reviews how agricultural wastes can be used to enhance food security and conserve the environment.

Keywords: agricultural waste, organic compost, environment, valuable resources

Procedia PDF Downloads 523
1116 Analysis of Underground Logistics Transportation Technology and Planning Research: Based on Xiong'an New Area, China

Authors: Xia Luo, Cheng Zeng

Abstract:

Under the promotion of the Central Committee of the Communist Party of China and the State Council in 2017, Xiong'an New Area is the third crucial new area in China established after Shenzhen and Shanghai. Its constructions' significance lies in mitigating Beijing's non-capital functions and exploring a new mode of optimizing development in densely populated and economically intensive areas. For this purpose, developing underground logistics can assume the role of goods distribution in the capital, relieve the road transport pressure in Beijing-Tianjin-Hebei Urban Agglomeration, adjust and optimize the urban layout and spatial structure of it. Firstly, the construction planning of Xiong'an New Area and underground logistics development are summarized, especially the development status abroad, the development trend, and bottlenecks of underground logistics in China. This paper explores the technicality, feasibility, and necessity of four modes of transportation. There are pneumatic capsule pipeline (PCP) technology, the CargoCap technology, cable hauled mule, and automatic guided vehicle (AGV). The above technical parameters and characteristics are introduced to relevant experts or scholars. Through establishing an indicator system, carrying out a questionnaire survey with the Delphi method, the final suggestion is obtained: China should develop logistics vehicles similar to CargoCap, adopting rail mode and driverless mode. Based on China's temporal and spatial logistics demand and the geographical pattern of Xiong'an New Area, the construction scale, technical parameters, node location, and other vital parameters of underground logistics are planned. In this way, we hope to speed up the new area's construction and the logistics industry's innovation.

Keywords: the Xiong'an new area, underground logistics, contrastive analysis, CargoCap, logistics planning

Procedia PDF Downloads 129
1115 A Surrealist Play of Associations: Neoliberalism, Critical Pedagogy and Surrealism in Secondary English Language Arts

Authors: Stephanie Ho

Abstract:

This project utilizes principles derived from the Surrealist movement to prioritize creative and critical thinking in secondary English Language Arts (ELA). The implementation of Surrealist-style pedagogies within an ELA classroom will be rooted in critical, radical pedagogy, which addresses the injustices caused by economic-oriented educational systems. The use of critical pedagogy will enable the subversive artistic and political aims of Surrealism to be transmitted to a classroom context. Through aesthetic reading strategies, appreciative questioning and dialogue, students will actively critique the power dynamics which structure (and often restrict) their lives. Within the ELA domain, cost-effective approaches often replace the actual “arts” of ELA. This research will therefore explore how Surrealist-oriented pedagogies could restore imaginative freedom and deconstruct conceptual barriers (normative standards, curricular constraints, and status quo power relations) in secondary ELA. This research will also examine how Surrealism can be used as a political and pedagogical model to treat societal problems mirrored in ELA classrooms. The stakeholders are teachers, as they experience constant pressure within their practices. Similarly, students encounter rigorous, results-based pressures. These dynamics contribute to feelings of powerlessness, thus reinforcing a formulaic model of ELA. The ELA curriculum has potential to create laboratories for critical discussion and active movement towards social change. This proposed research strategy of Surrealist-oriented pedagogies could enable students to experiment with social issues and develop senses of agency and voice that reflect awareness of contemporary society while simultaneously building their ELA skills.

Keywords: arts-informed pedagogies, language arts, literature, surrealism

Procedia PDF Downloads 135
1114 A Multicriteria Analysis of Energy Poverty Index: A Case Study of Non-interconnected Zones in Colombia

Authors: Angelica Gonzalez O, Leonardo Rivera Cadavid, Diego Fernando Manotas

Abstract:

Energy poverty considers a population that does not have access to modern energy service. In particular, an area of a country that is not connected to the national electricity grid is known as a Non-Interconnected Zone (NIZ). Access to electricity has a significant impact on the welfare and development opportunities of the population. Different studies have shown that most health problems have an empirical cause and effect relationship with multidimensional energy poverty. Likewise, research has been carried out to review the consequences of not having access to electricity, and its results have concluded a statistically significant relationship between energy poverty and sources of drinking water, access to clean water, risks of mosquito bites, obesity, sterilization, marital status, occupation, and residence. Therefore, extensive research has been conducted in the construction of an energy poverty measure based on an index. Some of these studies introduce a Multidimensional Energy Poverty Index (MEPI), Compose Energy Poverty Index (CEPI), Low Income High Costs indicator (LIHC), among others. For this purpose, this study analyzes the energy poverty index using a multicriteria analysis determining the set of feasible alternatives - for which Colombia's ZNI will be used as a case study - to be considered in the problem and the set of relevant criteria in the characterization of the ZNI, from which the prioritization is obtained to determine the level of adjustment of each alternative with respect to the performance in each criterion. Additionally, this study considers the installation of Micro-Grids (MG). This is considered a straightforward solution to this problem because an MG is a local electrical grid, able to operate in grid-connected and island mode. Drawing on those insights, this study compares an energy poverty index considering an MG installation and calculates the impacts of different criterias in an energy poverty index in NIZ.

Keywords: multicirteria, energy poverty, rural, microgrids, non-interconnect zones

Procedia PDF Downloads 118
1113 'Get the DNR': Exploring the Impact of an Educational eModule on Internal Medicine Residents' Attitudes and Approaches to Goals of Care Conversations

Authors: Leora Branfield Day, Stephanie Saunders, Leah Steinberg, Shiphra Ginsburg, Christine Soong

Abstract:

Introduction: Discordance between patients expressed and documented preferences at the end of life is common. Although junior trainees frequently lead goals of care (GOC) conversations, lack of training can result in poor communication. Based on a needs assessment, we developed an interactive electronic learning module (eModule) for conducting patient-centred GOC discussions. The purpose of this study was to evaluate the impact of the eModule on residents’ attitudes towards GOC conversations. Methods: First-year internal medicine residents (n=11) from the University of Toronto selected using purposive sampling underwent semi-structured interviews before and after completing a GOC eModule. Interviews were anonymized, transcribed and open-coded using NVivo. Using a constructivist grounded theory approach, we developed a framework to understand the attitudes of residents to GOC conversations before and after viewing the module. Results: Before the module, participants described limited training and negative emotions towards GOC conversations. Many focused on code status and procedure choices (e.g., ventilation) instead of eliciting patient-centered values. Pressure to “get the DNR" led to conflicting feelings and distress. After the module, participants’ approached conversations with a greater focus on patient values and process. They felt more prepared and comfortable, recognizing the complexity of conversations and the importance of patient-centeredness. Conclusions: A novel GOC eModule allowed residents to develop a patient-centered and standardized approach to GOC conversations while improving confidence and preparedness. This resource could be an effective strategy toward attaining a critical communication competency among learners with the potential to enhance accurate GOC documentation.

Keywords: goals of care conversations, communication skills, emodule, medical education

Procedia PDF Downloads 137