Search results for: home delivery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3314

Search results for: home delivery

584 An International Curriculum Development for Languages and Technology

Authors: Miguel Nino

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

Keywords: curriculum, international, languages, technology

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583 The Impact of Leadership Style and Sense of Competence on the Performance of Post-Primary School Teachers in Oyo State, Nigeria

Authors: Babajide S. Adeokin, Oguntoyinbo O. Kazeem

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The not so pleasing state of the nation's quality of education has been a major area of research. Many researchers have looked into various aspects of the educational system and organizational structure in relation to the quality of service delivery of the staff members. However, there is paucity of research in areas relating to the sense of competence and commitment in relation to leadership styles. Against this backdrop, this study investigated the impact of leadership style and sense of competence on the performance of post-primary school teachers in Oyo state Nigeria. Data were generated across public secondary schools in the city using survey design method. Ibadan as a metropolis has eleven local government areas contained in it. A systematic random sampling technique of the eleven local government areas in Ibadan was done and five local government areas were selected. The selected local government areas are Akinyele, Ibadan North, Ibadan North-East, Ibadan South and Ibadan South-West. Data were obtained from a range of two – three public secondary schools selected in each of the local government areas mentioned above. Also, these secondary schools are a representation of the variations in the constructs under consideration across the Ibadan metropolis. Categorically, all secondary school teachers in Ibadan were clustered into selected schools in those found across the five local government areas. In all, a total of 272 questionnaires were administered to public secondary school teachers, while 241 were returned. Findings revealed that transformational leadership style makes room for job commitment when compared with transactional and laissez-faire leadership styles. Teachers with a high sense of competence are more likely to demonstrate more commitment to their job than others with low sense of competence. We recommend that, it is important an assessment is made of the leadership styles employed by principals and school administrators. This guides administrators and principals in to having a clear, comprehensive knowledge of the style they currently adopt in the management of the staff and the school as a whole; and know where to begin the adjustment process from. Also to make an impact on student achievement, being attentive to teachers’ levels of commitment may be an important aspect of leadership for school principals.

Keywords: Ibadan, leadership style, sense of competence, teachers, public secondary schools

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582 Comprehensive Geriatric Assessments: An Audit into Assessing and Improving Uptake on Geriatric Wards at King’s College Hospital, London

Authors: Michael Adebayo, Saheed Lawal

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The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.

Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality

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581 Comparison between RILM, JSTOR, and WorldCat Used to Search for Secondary Literature

Authors: Stacy Jarvis

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Databases such as JSTOR, RILM and WorldCat have been the main source and storage of literature in the music orb. The Reference Index to Music Literature is a bibliographic database of over 2.6 million citations to writings about music from over 70 countries. The Research Institute produces RILM for the Study of Music at the University of Buffalo. JSTOR is an e-library of academic journals, books, and primary sources. Database JSTOR helps scholars find, utilise, and build upon a vast range of literature through a powerful teaching and research platform. Another database, WorldCat, is the world's biggest library catalogue, assisting scholars in finding library materials online. An evaluation of these databases in the music sphere is conducted by looking into the description and intended use and finding similarities and differences among them. Through comparison, it is found that these aim to serve different purposes, though they have the same goal of providing and storing literature. Also, since each database has different parts of literature that it majors on, the intended use of the three databases is evaluated. This can be found in the description, scope, and intended uses section. These areas are crucial to the research as it addresses the functional or literature differences among the three databases. It is also found that these databases have different quantitative potentials. This is determined by addressing the year each database began collecting literature and the number of articles, periodicals, albums, conference proceedings, music, dissertations, digital media, essays collections, journal articles, monographs, online resources, reviews, and reference materials that can be found in each one of them. This can be found in the sections- description, scope and intended uses and the importance of the database in identifying literature on different topics. To compare the delivery of services to the users, the importance of databases in identifying literature on different topics is also addressed in the section -the importance of databases in identifying literature on different topics. Even though these databases are used in research, they all have disadvantages and advantages. This is addressed in the sections on advantages and disadvantages. This will be significant in determining which of the three is the best. Also, it will help address how the shortcomings of one database can be addressed by utilising two databases together while conducting research. It is addressed in the section- a combination of RILM and JSTOR. All this information revolves around the idea that a huge amount of quantitative and qualitative data can be found in the presented databases on music and digital content; however, each of the given databases has a different construction and material features contributing to the musical scholarship in its way.

Keywords: RILM, JSTOR, WorldCat, database, literature, research

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580 Educating for Acceptance or Action: Bachelor of Social Work Education in Canada

Authors: Elizabeth Radian

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In a challenging era of neoliberalism and managerialism in social services, the status of Canadian social work education at the Bachelor of Social Work level (BSW) was examined to determine how prepared students were to practice in a time of resource cutbacks and insecurity. Curricula in BSW programs was the focus as this generalist degree results in the greatest number of social work graduates in Canada, most of whom work at the front lines in service delivery. The study reviewed the practice frameworks that students in BSW programs were exposed to. Traditionally, schools of social work have embraced two major practice frameworks. The person in environment framework is a well-established practice framework taught in most schools. The framework offers some focus on smaller scale social change, tweaking existing arrangements and is more accepting of the status quo. An alternate practice framework taught in fewer schools has been described as a structural, progressive or anti oppressive framework. This latter framework challenges the status quo, is focused on social justice and social transformation, often incorporating social action strategies to ensure marginalized voices are heard. Using a content analysis methodology of keywords and phrases to delineate framework orientation, practice frameworks articulated in the curricula were determined by reviewing the mission/mandate of schools offering a BSW degree, their core course outlines and core course textbooks. Social action, as one strategy for initiating social change and transformation was considered. Initial research for 28 schools was completed in 2000, with follow up replications of the initial study in 2005 and 2014. These earlier studies displayed that the dominant practice framework taught in BSW programs was the person in environment framework. A lesser number of schools were categorized as primarily offering a structural, progressive or anti oppressive framework. The findings from the current study of 39 Canadian schools of social work are considered to determine how prominent structural, progressive and anti oppressive frameworks exist in current BSW curricula. This study can assist in contemplating the question – are we educating future practitioners for acceptance or action.

Keywords: social work education and pedagogy, social change, social justice, social services

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579 Engineering a Tumor Extracellular Matrix Towards an in vivo Mimicking 3D Tumor Microenvironment

Authors: Anna Cameron, Chunxia Zhao, Haofei Wang, Yun Liu, Guang Ze Yang

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Since the first publication in 1775, cancer research has built a comprehensive understanding of how cellular components of the tumor niche promote disease development. However, only within the last decade has research begun to establish the impact of non-cellular components of the niche, particularly the extracellular matrix (ECM). The ECM, a three-dimensional scaffold that sustains the tumor microenvironment, plays a crucial role in disease progression. Cancer cells actively deregulate and remodel the ECM to establish a tumor-promoting environment. Recent work has highlighted the need to further our understanding of the complexity of this cancer-ECM relationship. In vitro models use hydrogels to mimic the ECM, as hydrogel matrices offer biological compatibility and stability needed for long term cell culture. However, natural hydrogels are being used in these models verbatim, without tuning their biophysical characteristics to achieve pathophysiological relevance, thus limiting their broad use within cancer research. The biophysical attributes of these gels dictate cancer cell proliferation, invasion, metastasis, and therapeutic response. Evaluating the three most widely used natural hydrogels, Matrigel, collagen, and agarose gel, the permeability, stiffness, and pore-size of each gel were measured and compared to the in vivo environment. The pore size of all three gels fell between 0.5-6 µm, which coincides with the 0.1-5 µm in vivo pore size found in the literature. However, the stiffness for hydrogels able to support cell culture ranged between 0.05 and 0.3 kPa, which falls outside the range of 0.3-20,000 kPa reported in the literature for an in vivo ECM. Permeability was ~100x greater than in vivo measurements, due in large part to the lack of cellular components which impede permeation. Though, these measurements prove important when assessing therapeutic particle delivery, as the ECM permeability decreased with increasing particle size, with 100 nm particles exhibiting a fifth of the permeability of 10 nm particles. This work explores ways of adjusting the biophysical characteristics of hydrogels by changing protein concentration and the trade-off, which occurs due to the interdependence of these factors. The global aim of this work is to produce a more pathophysiologically relevant model for each tumor type.

Keywords: cancer, extracellular matrix, hydrogel, microfluidic

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578 Research on Innovation Service based on Science and Technology Resources in Beijing-Tianjin-Hebei

Authors: Runlian Miao, Wei Xie, Hong Zhang

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In China, Beijing-Tianjin-Hebei is regarded as a strategically important region because itenjoys highest development in economic development, opening up, innovative capacity and andpopulation. Integrated development of Beijing-Tianjin-Hebei region is increasingly emphasized by the government recently years. In 2014, it has ascended to one of the national great development strategies by Chinese central government. In 2015, Coordinated Development Planning Compendium for Beijing-Tianjin-Hebei Region was approved. Such decisions signify Beijing-Tianjin-Hebei region would lead innovation-driven economic development in China. As an essential factor to achieve national innovation-driven development and significant part of regional industry chain, the optimization of science and technology resources allocation will exert great influence to regional economic transformation and upgrading and innovation-driven development. However, unbalanced distribution, poor sharing of resources and existence of information isolated islands have contributed to different interior innovation capability, vitality and efficiency, which impeded innovation and growth of the whole region. Under such a background, to integrate and vitalize regional science and technology resources and then establish high-end, fast-responding and precise innovation service system basing on regional resources, would be of great significance for integrated development of Beijing-Tianjin-Hebei region and even handling of unbalanced and insufficient development problem in China. This research uses the method of literature review and field investigation and applies related theories prevailing home and abroad, centering service path of science and technology resources for innovation. Based on the status quo and problems of regional development of Beijing-Tianjin-Hebei, theoretically, the author proposed to combine regional economics and new economic geography to explore solution to problem of low resource allocation efficiency. Further, the author puts forward to applying digital map into resource management and building a platform for information co-building and sharing. At last, the author presents the thought to establish a specific service mode of ‘science and technology plus digital map plus intelligence research plus platform service’ and suggestion on co-building and sharing mechanism of 3 (Beijing, Tianjin and Hebei ) plus 11 (important cities in Hebei Province).

Keywords: Beijing-Tianjin-Hebei, science and technology resources, innovation service, digital platform

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577 Evaluating and Supporting Student Engagement in Online Learning

Authors: Maria Hopkins

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Research on student engagement is founded on a desire to improve the quality of online instruction in both course design and delivery. A high level of student engagement is associated with a wide range of educational practices including purposeful student-faculty contact, peer to peer contact, active and collaborative learning, and positive factors such as student satisfaction, persistence, achievement, and learning. By encouraging student engagement, institutions of higher education can have a positive impact on student success that leads to retention and degree completion. The current research presents the results of an online student engagement survey which support faculty teaching practices to maximize the learning experience for online students. The ‘Indicators of Engaged Learning Online’ provide a framework that measures level of student engagement. Social constructivism and collaborative learning form the theoretical basis of the framework. Social constructivist pedagogy acknowledges the social nature of knowledge and its creation in the minds of individual learners. Some important themes that flow from social constructivism involve the importance of collaboration among instructors and students, active learning vs passive consumption of information, a learning environment that is learner and learning centered, which promotes multiple perspectives, and the use of social tools in the online environment to construct knowledge. The results of the survey indicated themes that emphasized the importance of: Interaction among peers and faculty (collaboration); Timely feedback on assignment/assessments; Faculty participation and visibility; Relevance and real-world application (in terms of assignments, activities, and assessments); and Motivation/interest (the need for faculty to motivate students especially those that may not have an interest in the coursework per se). The qualitative aspect of this student engagement study revealed what instructors did well that made students feel engaged in the course, but also what instructors did not do well, which could inform recommendations to faculty when expectations for teaching a course are reviewed. Furthermore, this research provides evidence for the connection between higher student engagement and persistence and retention in online programs, which supports our rationale for encouraging student engagement, especially in the online environment because attrition rates are higher than in the face-to-face environment.

Keywords: instructional design, learning effectiveness, online learning, student engagement

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576 Predictors of Quality of Life among Older Refugees Aging out of Place

Authors: Jonix Owino, Heather Fuller

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Refugees flee from their home countries due to civil unrest, war, persecution and migrate to Western countries such as the United States in search of a safe haven. Transitioning into a new society and culture can be challenging, thereby affecting refugee’s quality of life and well-being in the host communities. Moreover, as individuals age, they experience physical, cognitive and socioemotional changes that may impact their quality of life. However, little is known about the predictors of quality of life among aging refugees. It is not clear how quality of life varies by age, that is, between midlife refugees in comparison to their older counterparts. In addition to age, other sociodemographic factors such as gender, socioeconomic status, or country of origin are likely to have differential associations to quality of life, yet research on such variations among older refugees is sparse. Thus the present study seeks to explore factors associated with quality of life by asking the following research questions: 1) Do sociodemographic factors (such as age and gender) predict quality of life among older refugees, 2) Is there an association between social integration and quality of life, and 3) Is there an association between migratory related experiences (such as post migratory adjustments) and quality of life. The present study recruited 90 refugees (primarily originating from Bhutan, Somalia, Burundi, and Sudan) aged 50 or older living in the US. The participants completed a structured questionnaire which assessed factors such as participant’s sociodemographic attributes (e.g., age, gender, length of residence in the US, country of origin, employment, level of education, and marital status), and validated measures of social integration, post-migration living difficulties, and quality of life. Preliminary results suggest sociodemographic variability in quality of life among these refugees. Further analyses will be conducted using hierarchical regression analyses to address the following hypotheses: first, it is hypothesized that quality of life will vary by age and gender such that younger refugees and men will report higher quality of life. Second, it is expected that refugees with greater levels of social integration will also report better quality of life. Finally, post-migration factors such as language barriers and family stress are hypothesized to predict poorer quality of life. Further results will be analyzed, including potential moderating effects of age and gender, and resulting findings will be interpreted and discussed. The findings from this study have potential implications for communities on how they can better support older refugees as well as develop social programs that can effectively cater to their well-being. Conclusions will be drawn and discussed in light of policies related to both aging and refugee migration within the context of the US.

Keywords: aging out of place, migration, older refugees, quality of life, social integration

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575 The Effect of Dementia on Family Members

Authors: Shakeela Ahmed, Nabanita Hazarika

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The study aims to understand the effects of dementia on family members. The primary objectives of this research are to identify the main reasons for dementia among the elderly, understand the struggles and stigmas faced by the family members, and understand the effects of dementia on family members. The research employs a qualitative method and utilizes unstructured interviews with family members, counselors and caregivers. A descriptive research design is employed, and thematic analysis is used to analyze the data. A total of 17 family members in the age group of 54-69 years were interviewed, along with 2 counselors and 2 caretakers. In understanding dementia, the researcher has reviewed articles, and the studies revealed diverse meanings, symptoms, stages attached to dementia, and the complex interplay of protective and risk factors for dementia. However, in understanding dementia and its effects on families, there is a lack of studies in relation to the significant effects of dementia on family members and their role as primary caregivers. Therefore, an attempt has been made to understand the effects of dementia on family members, along with ways to improve dementia care for family members. The purpose of the study was to understand the effects and challenges of dementia on family members, the psychosocial reasons for dementia among the elderly, and the various struggles and stigmas faced by the family members of dementia patients. The major findings of the study indicate that people with dementia are cared for by family members at home. Dementia has a significant impact on family members. Family member's quality of life is affected; they experience feelings of anxiety, stress, irritation, frustration, and fear as they watch their loved ones struggle with dementia. They also experience financial strain, as dementia care, medication, and therapy are expensive. Another common impact is the role reversal of family members for their loved ones with dementia. There is a lack of awareness and social understanding about dementia, which leads to family members experiencing stigma and struggles. Caregivers are unable to take care of themselves, and many times, the primary caregiver, a spouse who is elderly, experiences acute stress and a physical inability to meet the demands of being a caregiver. Strategies to improve dementia care are understanding dementia, being patient with the person, showing love and care for the person, avoiding provoking the person, distracting them, offering reassurance, playing their favorite music, talking about things they love, going through old memories, following a structured routine, and remaining calm. The study has made an attempt to provide strategies to manage dementia care, understanding the struggles family members go through, and raising awareness about dementia that will enable further research and investigations.

Keywords: elderly, dementia, stigma, family members

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574 Delays for Emergency Cesarean Sections and Neonatal Outcomes in Three Rural District Hospitals in Rwanda: A Retrospective Cross-Sectional Study

Authors: J. Niyitegeka, G. Nshimirimana, A. Silverstein, J. Odhiambo, Y. Lin, T. Nkurunziza, R. Riviello, S. Rulisa, P. Banguti, H. Magge, M. Macharia, J. P. Dushime, R. Habimana, B. Hedt-Gauthier

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In low-resource settings, women needing an emergency cesarean section experiences various delays in both reaching and receiving care that is often linked to poor neonatal outcomes. In this study, we quantified different measures of delays and assessed the association between these delays and neonatal outcomes at three rural district hospitals in Rwanda. This retrospective study included 441 neonates and their mothers who underwent emergency cesarean sections in 2015 at Butaro, Kirehe and Rwinkwavu District Hospitals. Four possible delays were measured: Time from start of labor to district hospital admission, travel time from a health center to the district hospital, time from admission to surgical incision, and time from the decision for the emergency cesarean section to surgical incision. Neonatal outcomes were categorized as unfavorable (APGAR < 7 or death) and favorable (APGAR ≥ 7). We assessed the relationship between each type of delay and neonatal outcomes using multivariate logistic regression. In our study, 38.7% (108 out of 279) of neonates’ mothers labored for 12 to 24 hours before hospital admission and 44.7% (159 of 356) of mothers were transferred from health centers that required 30 to 60 minutes of travel time to reach the district hospital. 48.1% (178 of 370) of caesarean sections started within five hours after admission and 85.2% (288 of 338) started more than thirty minutes after the decision for the emergency cesarean section was made. Neonatal outcomes were significantly worse among mothers with more than 90 minutes of travel time from the health center to the district hospital compared to health centers attached to the hospital (OR = 5.12, p = 0.02). Neonatal outcomes were also significantly different depending on decision to incision intervals; neonates with cesarean deliveries starting more than thirty minutes after decision had better outcomes than those started immediately (OR = 0.32, p = 0.04). Interventions that decrease barriers to access to maternal health care services can improve neonatal outcome after emergency cesarean section. Triaging could explain the inverse relationship between time from decision to incision and neonatal outcome; this must be studied more in the future.

Keywords: Africa, emergency obstetric care, rural health delivery, maternal and child health

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573 Positive Shock: The PhD Journey of International Students at UK Universities: A Qualitative Interpretative Phenomenological Study

Authors: Dounyazad Sour

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This research examines international doctoral students’ reflections on their journey and experiences of studying for a PhD in the UK. Since the early 1990s, the international students’ number in the UK has increased. The significant contribution of these international students to the cultural and academic diversity of the UK universities’ doctoral programmes is widely acknowledged. The substantial fees these students bring to British Higher Education institutions is also much appreciated. The rationale for undertaking this study grew from personal experience of studying in the UK. Through membership in different groups both online and, when regulations permitted it, face to face social groups, it quickly became apparent that among all students, there were both shared and individual experiences of struggles and triumphs. This insight led to the decision to investigate these matters in greater detail. This in-depth qualitative interpretative study, inspired by a phenomenological approach, offers fresh insights into academic, social and cultural experiences of international PhD students in the UK. Data collection was carried out in the UK over a period of three months, deploying focus groups, individual semi-structured interviews, and images selected by participants that represent their feelings towards their experiences. The ten participants are attending different UK universities, studying a range of disciplines and have diverse backgrounds. Interviews and discussions took place in the participants' preferred languages; Arabic, English and French. The analysis shows that the participants had experienced two types of shock: negative and positive. Negative shocks, which have seen considerable attention in the field of international students’ experiences, relate to unexpected incidents that happened to the participants in relation to their interactions with others: people from different backgrounds and people from the same background. This impacted their experience negatively through experiencing feelings of anxiety, stress, low self-esteem and xenophobia, all these hindering factors contribute to make international students struggle to adapt to the new environment. Positive shocks, which have remained largely under-researched in the field of international students’ experiences, refer to all the positive occurrences that participants experienced. For instance, a shop assistant saying: “do you need any help, honey?” which brought a sense of belonging, feeling home, safety, and satisfaction to the respondents, and made their experiences less challenging. This investigation will offer insights into the PhD international students’ experiences and shed new light on the shocks that can work as facilitators, rather than as inhibitors.

Keywords: international students, PhD journey, phenomenological approach, positive shock

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572 The Role of the Coach in Elite Equestrian Sport

Authors: Victoria Lewis, L. Dumbell

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The British Equestrian Federation (BEF) aims to develop a holistic coach education and certification program, moving away from traditional autocratic instruction in line with the UK Coaching Framework. This framework is based on generic coaching science research where the coach is cited as a pivotal aspect in developing sporting success. Theoretic knowledge suggests that the role of the sports coach is to develop the physical, tactical, technical and psychological attributes of the athlete and is responsible for the planning, organization and delivery of the training plan and competition schedule. However, to the best of the author’s knowledge, there is no empirical evidence to suggest that is the role required in equestrian sport as the rider takes responsibility for many of these tasks. This research aimed to address the void in current knowledge by gaining an understanding of coaching in equestrian sport in order to improve coaching education system through awareness of the role of the coach. Objectives were to examine the relationship between coach and rider at elite level in equestrian sport providing empirical evidence to suggest that the rider is, in part, ‘self –coached’. To identify the elite equestrian coaches’ role in coaching these ‘self-coached riders. A qualitative method using semi-structured interviews was used. A sample of elite coaches (N=3) and elite riders (N=3) were interviewed. Analysis of the transcripts revealed a total of 534 meaning units that were further grouped into sub-themes and general themes from the coaches’ perspective and the riders’ perspective. This led to the development of a final thematic structure revealing major dimensions that characterized coaching in elite equestrian sport. It was found that the riders at the elite level coach themselves the majority of the time, therefore, can be considered as ‘self-coached’ athletes. However, they do use elite coaches in a mentoring and consultancy role, where they seek guidance from the coach on specific problems, to sound ideas off or to seek reassurance that what they are doing is correct. Findings from this research suggest that the rider-coach relationship at the elite level is a professional one, based on trust and respect, but not a close relationship as seen in other sports. The results show the imperative need for the BEF to educate coaches in coaching the self-coached rider at the elite level, particularly in terms of mentoring skills. As well as incorporating rider education aimed at developing the independent, self-coached riders.

Keywords: coaching, elite sport, equestrian, self coached

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571 Achieving Design-Stage Elemental Cost Planning Accuracy: Case Study of New Zealand

Authors: Johnson Adafin, James O. B. Rotimi, Suzanne Wilkinson, Abimbola O. Windapo

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An aspect of client expenditure management that requires attention is the level of accuracy achievable in design-stage elemental cost planning. This has been a major concern for construction clients and practitioners in New Zealand (NZ). Pre-tender estimating inaccuracies are significantly influenced by the level of risk information available to estimators. Proper cost planning activities should ensure the production of a project’s likely construction costs (initial and final), and subsequent cost control activities should prevent unpleasant consequences of cost overruns, disputes and project abandonment. If risks were properly identified and priced at the design stage, observed variance between design-stage elemental cost plans (ECPs) and final tender sums (FTS) (initial contract sums) could be reduced. This study investigates the variations between design-stage ECPs and FTS of construction projects, with a view to identifying risk factors that are responsible for the observed variance. Data were sourced through interviews, and risk factors were identified by using thematic analysis. Access was obtained to project files from the records of study participants (consultant quantity surveyors), and document analysis was employed in complementing the responses from the interviews. Study findings revealed the discrepancies between ECPs and FTS in the region of -14% and +16%. It is opined in this study that the identified risk factors were responsible for the variability observed. The values obtained from the analysis would enable greater accuracy in the forecast of FTS by Quantity Surveyors. Further, whilst inherent risks in construction project developments are observed globally, these findings have important ramifications for construction projects by expanding existing knowledge on what is needed for reasonable budgetary performance and successful delivery of construction projects. The findings contribute significantly to the study by providing quantitative confirmation to justify the theoretical conclusions generated in the literature from around the world. This therefore adds to and consolidates existing knowledge.

Keywords: accuracy, design-stage, elemental cost plan, final tender sum

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570 Pooled Analysis of Three School-Based Obesity Interventions in a Metropolitan Area of Brazil

Authors: Rosely Sichieri, Bruna K. Hassan, Michele Sgambato, Barbara S. N. Souza, Rosangela A. Pereira, Edna M. Yokoo, Diana B. Cunha

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Obesity is increasing at a fast rate in low and middle-income countries where few school-based obesity interventions have been conducted. Results of obesity prevention studies are still inconclusive mainly due to underestimation of sample size in cluster-randomized trials and overestimation of changes in body mass index (BMI). The pooled analysis in the present study overcomes these design problems by analyzing 4,448 students (mean age 11.7 years) from three randomized behavioral school-based interventions, conducted in public schools of the metropolitan area of Rio de Janeiro, Brazil. The three studies focused on encouraging students to change their drinking and eating habits over one school year, with monthly 1-h sessions in the classroom. Folders explaining the intervention program and suggesting the participation of the family, such as reducing the purchase of sodas were sent home. Classroom activities were delivered by research assistants in the first two interventions and by the regular teachers in the third one, except for culinary class aimed at developing cooking skills to increase healthy eating choices. The first intervention was conducted in 2005 with 1,140 fourth graders from 22 public schools; the second, with 644 fifth graders from 20 public schools in 2010; and the last one, with 2,743 fifth and sixth graders from 18 public schools in 2016. The result was a non-significant change in BMI after one school year of positive changes in dietary behaviors associated with obesity. Pooled intention-to-treat analysis using linear mixed models was used for the overall and subgroup analysis by BMI status, sex, and race. The estimated mean BMI changes were from 18.93 to 19.22 in the control group and from 18.89 to 19.19 in the intervention group; with a p-value of change over time of 0.94. Control and intervention groups were balanced at baseline. Subgroup analyses were statistically and clinically non-significant, except for the non-overweight/obese group with a 0.05 reduction of BMI comparing the intervention with control. In conclusion, this large pooled analysis showed a very small effect on BMI only in the normal weight students. The results are in line with many of the school-based initiatives that have been promising in relation to modifying behaviors associated with obesity but of no impact on excessive weight gain. Changes in BMI may require great changes in energy balance that are hard to achieve in primary prevention at school level.

Keywords: adolescents, obesity prevention, randomized controlled trials, school-based study

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569 Efficiency and Equity in Italian Secondary School

Authors: Giorgia Zotti

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This research comprehensively investigates the multifaceted interplay determining school performance, individual backgrounds, and regional disparities within the landscape of Italian secondary education. Leveraging data gleaned from the INVALSI 2021-2022 database, the analysis meticulously scrutinizes two fundamental distributions of educational achievements: the standardized Invalsi test scores and official grades in Italian and Mathematics, focusing specifically on final-year secondary school students in Italy. Applying a comprehensive methodology, the study initially employs Data Envelopment Analysis (DEA) to assess school performances. This methodology involves constructing a production function encompassing inputs (hours spent at school) and outputs (Invalsi scores in Italian and Mathematics, along with official grades in Italian and Math). The DEA approach is applied in both of its versions: traditional and conditional. The latter incorporates environmental variables such as school type, size, demographics, technological resources, and socio-economic indicators. Additionally, the analysis delves into regional disparities by leveraging the Theil Index, providing insights into disparities within and between regions. Moreover, in the frame of the inequality of opportunity theory, the study quantifies the inequality of opportunity in students' educational achievements. The methodology applied is the Parametric Approach in the ex-ante version, considering diverse circumstances like parental education and occupation, gender, school region, birthplace, and language spoken at home. Consequently, a Shapley decomposition is applied to understand how much each circumstance affects the outcomes. The outcomes of this comprehensive investigation unveil pivotal determinants of school performance, notably highlighting the influence of school type (Liceo) and socioeconomic status. The research unveils regional disparities, elucidating instances where specific schools outperform others in official grades compared to Invalsi scores, shedding light on the intricate nature of regional educational inequalities. Furthermore, it emphasizes a heightened inequality of opportunity within the distribution of Invalsi test scores in contrast to official grades, underscoring pronounced disparities at the student level. This analysis provides insights for policymakers, educators, and stakeholders, fostering a nuanced understanding of the complexities within Italian secondary education.

Keywords: inequality, education, efficiency, DEA approach

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568 Polymeric Sustained Biodegradable Patch Formulation for Wound Healing

Authors: Abhay Asthana, Gyati Shilakari Asthana

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It’s the patient compliance and stability in combination with controlled drug delivery and biocompatibility that forms the core feature in present research and development of sustained biodegradable patch formulation intended for wound healing. The aim was to impart sustained degradation, sterile formulation, significant folding endurance, elasticity, biodegradability, bio-acceptability and strength. The optimized formulation was developed using component including polymers including Hydroxypropyl methyl cellulose, Ethylcellulose, and Gelatin, and Citric Acid PEG Citric acid (CPEGC) triblock dendrimers and active Curcumin. Polymeric mixture dissolved in geometric order in suitable medium through continuous stirring under ambient conditions. With continued stirring Curcumin was added with aid of DCM and Methanol in optimized ratio to get homogenous dispersion. The dispersion was sonicated with optimum frequency and for given time and later casted to form a patch form. All steps were carried out under under strict aseptic conditions. The formulations obtained in the acceptable working range were decided based on thickness, uniformity of drug content, smooth texture and flexibility and brittleness. The patch kept on stability using butter paper in sterile pack displayed folding endurance in range of 20 to 23 times without any evidence of crack in an optimized formulation at room temperature (RT) (24 ± 2°C). The patch displayed acceptable parameters after stability study conducted in refrigerated conditions (8±0.2°C) and at RT (24 ± 2°C) upto 90 days. Further, no significant changes were observed in critical parameters such as elasticity, biodegradability, drug release and drug content during stability study conducted at RT 24±2°C for 45 and 90 days. The drug content was in range 95 to 102%, moisture content didn’t exceeded 19.2% and patch passed the content uniformity test. Percentage cumulative drug release was found to be 80% in 12h and matched the biodegradation rate as drug release with correlation factor R2>0.9. The biodegradable patch based formulation developed shows promising results in terms of stability and release profiles.

Keywords: sustained biodegradation, wound healing, polymers, stability

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567 Place-Based Practice: A New Zealand Rural Nursing Study

Authors: Jean Ross

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Rural nursing is not an identified professional identity in the UK, unlike the USA, Canada, and Australia which recognizes rural nursing as a specialty scope of practice. In New Zealand rural nursing is an underrepresented aspect of nursing practice, is misunderstood and does not fit easily within the wider nursing profession and policies governing practice. This study situated within the New Zealand context adds to the international studies’ aligned with rural nursing practice. The study addresses a gap in the literature by striving to identify and strengthen the awareness of and increase rural nurses’ understanding and articulation of their changing and adapting identity and furthermore an opportunity to appreciate their contribution to the delivery of rural health care. In addition, this study adds to the growing global rural nursing knowledge and theoretical base. This research is a continuation of the author’s academic involvement and ongoing relationships with the rural nursing sector, national policy analysts and health care planners since the 1990s. These relationships have led to awareness, that despite rural nurses’ efforts to explain the particular nuances which make up their practice, there has been little recognition by profession to establish rural nursing as a specialty. The research explored why nurses’ who practiced in the rural Otago region of New Zealand, between the 1990s and early 2000s moved away from the traditional identity as a district, practice or public health nurse and looked towards a more appropriate identity which reflected their emerging practice. This qualitative research situated within the interpretive paradigm embeds this retrospective study within the discipline of nursing and engages with the concepts of place and governmentality. National key informant and Otago regional rural nurse interviews generated data and were analyzed using thematic analysis. Stemming from the analyses, an analytical diagrammatic matrix was developed demonstrating rural nursing as a ‘place–based practice’ governed both from within and beyond location presenting how the nurse aligns the self in the rural community as a meaningful provider of health care. Promoting this matrix may encourage a focal discussion point within the international spectrum of nursing and likewise between rural and non-rural nurses which it is hoped will generate further debate in relation to the different nuances aligned with rural nursing practice. Further, insights from this paper may capture key aspects and issues related to identity formation in respect to rural nurses, from the UK, New Zealand, Canada, USA, and Australia.

Keywords: matrix, place, nursing, rural

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566 An Ethnographic Study of Workforce Integration of Health Care Workers with Refugee Backgrounds in Ageing Citizens in Germany

Authors: A. Ham, A. Kuckert-Wostheinrich

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Demographic changes, like the ageing population in European countries and shortage of nursing staff, the increasing number of people with severe cognitive impairment, and elderly socially isolated people raise important questions about who will provide long-term care for ageing citizens. Due to the so-called refugee crisis in 2015, some health care institutions for ageing citizens in Europe invited first generation immigrants to start a nursing career and providing them language skills, nursing training, and internships. The aim of this ethnographic research was to explore the social processes affecting workforce integration and how newcomers enact good care in ageing citizens in a German nursing home. By ethnographic fieldwork, 200 hours of participant observations, 25 in-depth interviews with immigrants and established staff, 2 focus groups with 6 immigrants, and 6 established staff members, data were analysed. The health care institution provided the newcomers a nursing program on psychogeriatric theory and nursing skills in the psychogeriatric field and professional oriented language skills. Courses of health prevention and theater plays accompanied the training. The knowledge learned in education could be applied in internships on the wards. Additionally, diversity and inclusivity courses were given to established personal for cultural awareness and sensitivity. They learned to develop a collegial attitude of respect and appreciation, regardless of gender, nationality, ethnicity, religion or belief, age sexual orientation, or disability and identity. The qualitative data has shown that social processes affected workforce integration, like organizational constraints, staff shortages, and a demanding workload. However, zooming in on the interactions between newcomers and residents, we noticed how they tinkered to enact good care by embodied caring, playing games, singing and dancing. By situational acting and practical wisdom in nursing care, the newcomers could meet the needs of ageing residents. Thus, when health care institutions open up nursing programs for newcomers with refugees’ backgrounds and focus on talent instead of shortcomings, we might as well stimulate the unknown competencies, attitudes, skills, and expertise of newcomers and create excellent nurses for excellent care.

Keywords: established staff, Germany, nursing, refugees

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565 Challenges to Ensure Food Safety through Sanitation and Hygiene Coverage in Bangladesh

Authors: Moshiur Rahman, Tahmida Jakia

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Bangladesh, a densely populated South Asian country is home to more than 160 million people. In two decades ago, the people of this developing nation drank heavily contaminated surface water. Over the past thirty years, the country, and its development partners, has undertaken extensive efforts to provide microbiologically safe groundwater based drinking water through the use of tube-wells. About 85% of the people now drink tube-well water from about 11 million tube-wells/hand pumps. However, diarrhoeal and other water-related diseases are still reported among the major causes of morbidity and mortality among Bangladeshi children. This implies that the mode of transmission of pathogens through water and/or other modes continue. In addition, massive scale arsenic contamination has been recently reported in the ground water. Thirty five million people may be at risk of consuming arsenic contaminated water exceeding 0.05 mg/l in Bangladesh. Drinking of arsenic contaminated water has been linked with skin problems, cancer, cardiovascular diseases, neurological diseases, eye problems, cancer of the internal organs, and other diseases. In the study area, Narail district, recent investigations about existing water quality situations indicated presence of low to high levels of arsenic, salinity, iron, manganese and bacteriological contamination risks. As challenges for safe water exist; it is likely that sanitation and food hygiene practices are poor which lead threat to ensure food security.The main attempt of this study is to find out the challenges to ensure food security andprovide probable solutions to ensure food safety towards 0.7 million of people in study area. A survey has been conducted at Lohagara and Kalia sub district of Narail district with a pretested questionnaire. Primary data are collected through a questionnaire, while secondary data are collected from pertinent offices as well as academic journals. FGD has also been done to know the knowledge regarding water, sanitation as well as food preparation and consumption practice of community people in study area. The major focus of this study is to assess the state of sanitation and food hygiene condition of rural people. It is found that most of the villagers have lack of knowledge about food safety. Open defecation rate is high which lead threat to ensure food security.

Keywords: food safety, challenges, hygiene, Bangladesh

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564 The Impact of the Covid-19 Pandemic on Marine-Wildlife Tourism in Massachusetts, United States

Authors: K. C. Bloom, Cynde McInnis

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The Covid-19 pandemic has caused immense changes in the way that we live, work and travel. The impact of these changes is readily apparent in tourism to Massachusetts and the region of New England. Whereas, in general, Massachusetts and New England are a hotspot for travelers from around the world, this form of travel has largely been shut down due to the pandemic. One such area where the impact has been felt is in marine-based wildlife tourism. Massachusetts is home to not only whales but also seals and great white sharks. Prior to the pandemic, whale watching had long been a popular activity while seal and shark tourism has been a developing one. Given that seeing a great white shark was rare in New England for many years, shark tourism has not played a role in the economies of the region until recently. While whales have steadily been found within the marine environments of Massachusetts and whale watching has been a popular attraction since the mid-1970s, the lack of great white sharks in New England was, in part, a response to a change in their environment in that a favorite food source, the gray seals, were culled by regional fishermen as the fishermen believed that seals were taking their catch. This retaliatory behavior ended when the Marine Mammal Protection Act of 1972 (MMPA) was passed. The MMPA prohibited the killing of seals and since then the seal population has increased to traditional numbers (Tech Times, 2014). Given the increase in the seal population in New England, and especially Cape Cod, Massachusetts, there has been a similar increase in the numbers of great white sharks. In fact, over the time between 2004 and 2014, the number of sightings increased from an average of two per year to more than 20 (NY Post, 7/21/14). This has increased even more over the last six years. As a result, residents and businesses in Massachusetts have begun to embrace the great whites as a potential tourism draw. Local business owners are considering opening up cage diving and shark viewing businesses while there has also been an increase in shark-related merchandise throughout the Cape Cod region. Combined with a large whale watching industry, marine-based wildlife tourism is big business to Massachusetts. With the Covid-19 pandemic shuttering international travel, this study aims to look at the impacts of the pandemic on this industry. Through interviews with marine-based wildlife tourism businesses as well as survey data collection from visitors, this study looks at the holistic impacts of the Covid-19 pandemic on an important part of the marine tourism industry in the state.

Keywords: marine tourism, ecotourism, Covid, wildlife

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563 Inclusion Complexes of Some Imidazoline Drugs with Cucurbit[N]Uril (N=7,8): Preparation, Characterization and Theoretical Calculations

Authors: Fakhreldin O. Suliman, Alia H. Al-Battashi

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This work explored the interaction of three different imidazoline drugs, naphazoline nitrate (NPH), oxymetazoline hydrochloride (OXY) and xylometazoline hydrochloride (XYL) with two different synthesized cucurbit[n]urils CB[n], cucurbit[7]uril (CB[7]) and cucuribit[8]uril (CB[8]). Three binary inclusion complexes have been investigated in solution and in the solid state. The solid complexes were obtained by lyophilization, whereas the physical mixtures of guests and hosts at a stoichiometric ratio of 1:1 were obtained for each drug. 1HNMR, electrospray ionization mass spectrometry (ESI-MS), and matrix-assisted laser desorption-ionization time-of-flight (MALDI-TOF) mass spectrometry was used to study the complexes prepared in aqueous media. The lyophilized solid complexes were characterized by Fourier transform-infrared spectroscopy (FT-IR), powder X-ray diffractometry (PXRD), thermogravimetric analysis (TGA), and differential scanning calorimetry (DSC). MS, FT-IR and PXRD experimental results established in this work reveal that NPH, OXY and XYL molecules form stable inclusion complexes with the two hosts. The TGA and DSC confirmed the enhancement of the thermal stability of each drug and the production of a thermally stable solid complex. The 1HNMR has shown that the protons of the guests faced shifting in ppm and broadening of their peaks upon the formation of inclusion complexes with the selected CB[n]. The aromatic protons of the guest exhibited the highest changes in the chemical shifts and shape of the NMR peaks, suggesting their inclusion into the cavity of the CB[n]. The diffusion coefficients (D), developed from the diffusion-controlled NMR Spectroscopy (DOSY) measurements, for the complexation of the selected imidazoline drugs with CB[7] and CB[8], were decreased in the presence of hosts compared to the free guests indicating the formation of the guest-host adduct. Furthermore, we conducted molecular dynamic simulations and quantum mechanics calculations on these complexes. The results of the theoretical study corroborate the experimental findings and have also shed light on the mechanism of inclusion of the guests into the two hosts. This study generates initial data for potential drug delivery or drug formulation systems for these three selected imidazoline drug compounds based on their inclusion into the CB[n] cavities.

Keywords: cucurbit[n]urils, imidazoline, inclusion complexes, molecular dynamics, DFT calculations, mass spectrometry

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562 Socioeconomic Burden of a Diagnosis of Cervical Cancer in Women in Rural Uganda: Findings from a Phenomenological Study

Authors: Germans Natuhwera, Peter Ellis, Acuda Wilson, Anne Merriman, Martha Rabwoni

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Objective: The aim of the study was to diagnose the socio-economic burden and impact of a diagnosis of cervical cancer (CC) in rural women in the context of low-resourced country Uganda, using a phenomenological enquiry. Methods: This was a multi-site phenomenological inquiry, conducted at three hospice settings; Mobile Hospice Mbarara in southwestern, Little Hospice Hoima in Western, and Hospice Africa Uganda Kampala in central Uganda. A purposive sample of women with a histologically confirmed diagnosis of CC was recruited. Data was collected using open-ended audio-recorded interviews conducted in the native languages of participants. Interviews were transcribed verbatim in English, and Braun and Clarke’s (2019) framework of thematic analysis was used. Results: 13 women with a mean age of 49.2 and age range 29-71 participated in the study. All participants were of low socioeconomic status. The majority (84.6%) had advanced disease at diagnosis. A fuller reading of transcripts produced four major themes clustered under; (1) socioeconomic characteristics of women, (2) impact of CC on women’s relationships, (3) disrupted and impaired activities of daily living (ADLs), and (4) economic disruptions. Conclusions: A diagnosis of CC introduces significant socio-economic disruptions in a woman’s and her family’s life. CC causes disability, impairs the woman and her family’s productivity hence exacerbating levels of poverty in the home. High and expensive out-of-pocket expenditure on treatment, investigations, and transport costs further compound the socio-economic burden. Decentralizing cancer care services to regional centers, scaling up screening services, subsidizing costs of cancer care services, or making cervical cancer care treatment free of charge, strengthening monitoring mechanisms in public facilities to curb the vice of healthcare workers soliciting bribes from patients, increased mass awareness campaigns about cancer, training more healthcare professionals in cancer investigation and management, and palliative care, and introducing an introductory course on gynecologic cancers into all health training institutions are recommended.

Keywords: activities of daily living, cervical cancer, out-of-pocket, expenditure, phenomenology, socioeconomic

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561 Establishing a Communication Framework in Response to the COVID-19 Pandemic in a Tertiary Government Hospital in the Philippines

Authors: Nicole Marella G. Tan, Al Joseph R. Molina, Raisa Celine R. Rosete, Soraya Elisse E. Escandor, Blythe N. Ke, Veronica Marie E. Ramos, Apolinario Ericson B. Berberabe, Jose Jonas D. del Rosario, Regina Pascua-Berba, Eileen Liesl A. Cubillan, Winlove P. Mojica

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Emergency risk and health communications play a vital role in any pandemic response. However, the Philippine General Hospital (PGH) lacked a system of information delivery that could effectively fulfill the hospital’s communication needs as a COVID-19 referral hospital. This study aimed to describe the establishment of a communication framework for information dissemination within a tertiary government hospital during the COVID-19 pandemic and evaluated the perceived usefulness of its outputs. This is a mixed quantitative-qualitative study with two phases. Phase 1 documented the formation and responsibilities of the Information Education Communication (IEC) Committee. Phase 2 evaluated its output and outcomes through a hospital-wide survey of 528 healthcare workers (HCWs) using a pre-tested questionnaire. In-depth explanations were obtained from five focused group discussions (FGD) amongst various HCW subgroups. Descriptive analysis was done using STATA 16 while qualitative data were synthesized thematically. Communication practices in PGH were loosely structured at the beginning of the pandemic until the establishment of the IEC Committee. The IEC Committee was well-represented by concerned stakeholders. Nine types of infographics tackled different aspects of the hospital’s health operations after thorough inputs from concerned offices. Internal and external feedback mechanisms ensured accurate infographics. Majority of the survey respondents (98.67%) perceived these as useful in their work or daily lives. FGD participants cited the relevance of infographics to their occupations, suggested improvements, and hoped that these efforts would be continued in the future. Sustainability and comprehensive reach were the main concerns in this undertaking. The PGH COVID-19 IEC framework was developed through trial and testing as there were no existing formal structures to communicate health risks and to properly direct the HCWs in the chaotic time of a pandemic. It is a continuously evolving framework which is perceived as useful by HCWs and is hoped to be sustained in the future.

Keywords: COVID-19, pandemic, health communication, infographics, social media

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560 Bionaut™: A Breakthrough Robotic Microdevice to Treat Non-Communicating Hydrocephalus in Both Adult and Pediatric Patients

Authors: Suehyun Cho, Darrell Harrington, Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Alex Kiselyov, Michael Shpigelmacher

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Bionaut Labs, LLC is developing a minimally invasive robotic microdevice designed to treat non-communicating hydrocephalus in both adult and pediatric patients. The device utilizes biocompatible microsurgical particles (Bionaut™) that are specifically designed to safely and reliably perform accurate fenestration(s) in the 3rd ventricle, aqueduct of Sylvius, and/or trapped intraventricular cysts of the brain in order to re-establish normal cerebrospinal fluid flow dynamics and thereby balance and/or normalize intra/intercompartmental pressure. The Bionaut™ is navigated to the target via CSF or brain tissue in a minimally invasive fashion with precise control using real-time imaging. Upon reaching the pre-defined anatomical target, the external driver allows for directing the specific microsurgical action defined to achieve the surgical goal. Notable features of the proposed protocol are i) Bionaut™ access to the intraventricular target follows a clinically validated endoscopy trajectory which may not be feasible via ‘traditional’ rigid endoscopy: ii) the treatment is microsurgical, there are no foreign materials left behind post-procedure; iii) Bionaut™ is an untethered device that is navigated through the subarachnoid and intraventricular compartments of the brain, following pre-designated non-linear trajectories as determined by the safest anatomical and physiological path; iv) Overall protocol involves minimally invasive delivery and post-operational retrieval of the surgical Bionaut™. The approach is expected to be suitable to treat pediatric patients 0-12 months old as well as adult patients with obstructive hydrocephalus who fail traditional shunts or are eligible for endoscopy. Current progress, including platform optimization, Bionaut™ control, and real-time imaging and in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of ovine models, will be discussed.

Keywords: Bionaut™, cerebrospinal fluid, CSF, fenestration, hydrocephalus, micro-robot, microsurgery

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559 Treatment of Premalignant Lesions: Curcumin a Promising Non-Surgical Option

Authors: Heba A. Hazzah, Ragwa M. Farid, Maha M. A. Nasra, Mennatallah Zakria, Magda A. El Massik, Ossama Y. Abdallah

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Introduction: Curcumin (Cur) is a polyphenol derived from the herbal remedy and dietary spice turmeric. It possesses diverse anti-inflammatory and anti-cancer properties following oral or topical administration. The buccal delivery of curcumin can be useful for both systemic and local disease treatments such as gingivitis, periodontal diseases, oral carcinomas, and precancerous oral lesions. Despite of its high activity, it suffers a limited application due to its low oral bioavailability, poor aqueous solubility, and instability. Aim: Preparation and characterization of curcumin solid lipid nanoparticles with a high loading capacity into a mucoadhesive gel for buccal application. Methodology: Curcumin was formulated as nanoparticles using different lipids, namely Gelucire 39/01, Gelucire 50/13, Precirol, Compritol, and Polaxomer 407 as a surfactant. The SLN were dispersed in a mucoadhesive gel matrix to be applied to the buccal mucosa. All formulations were evaluated for their content, entrapment efficiency, particle size, in vitro drug dialysis, ex vivo mucoadhesion test, and ex vivo permeation study using chicken buccal mucosa. Clinical evaluation was conducted on 15 cases suffering oral erythroplakia and erosive lichen planus. Results: The results showed high entrapment efficiency reaching almost 90 % using Gelucire 50, the loaded gel with Cur-SLN showed good adhesion property and 25 minutes in vivo residence time. In addition to stability enhancement for the Cur powder. All formulae did not show any drug permeated however, a significant amount of Cur was retained within the mucosal tissue. Pain and lesion sizes were significantly reduced upon topical treatment. Complete healing was observed after 6 weeks of treatment. Conclusion: These results open a room for the pharmaceutical technology to optimize the use of this golden magical powder to get the best out of it. In addition, the lack of local anti-inflammatory compounds with reduced side effects intensifies the importance of studying natural products for this purpose.

Keywords: curcumin, erythroplakia, mucoadhesive, pain, solid lipid nanoparticles

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558 Reviewing Performance Assessment Frameworks for Urban Sanitation Services in India

Authors: Gaurav Vaidya, N. R. Mandal

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UN Summit, 2000 had resolved to provide access to sanitation to whole humanity as part of ‘Millennium Development Goals -2015’. However, more than one third of world’s population still did not have the access to basic sanitation facilities by 2015. Therefore, it will be a gigantic challenge to achieve goal-6 of ‘UN Sustainable Development Goal’ to ensure availability and sustainable management of sanitation for all by the year 2030. Countries attempt to find out own ways of meeting this challenge of providing access to safe sanitation and as part of monitoring the actions have prepared varied types of ‘performance assessment frameworks (PAF)’. India introduced Service Level Benchmarking (SLB) in 2010 to set targets and achieve the goals of NUSP. Further, a method of reviewing performance was introduced as ‘Swachh Sarvekshan’ (Cleanliness Surveys) in 2016 and in 2017 guidelines for the same was revised. This study, as a first step, reviews the documents in use in India with a conclusion that the frameworks adopted are based on target setting, financial allocation and performance in achieving the targets set. However, it does not focus upon sanitation needs holistically i.e., areas and aspects not targeted through projects are not covered in the performance assessment. In this context, as a second step, this study reviews literature available on performance assessment frameworks for urban sanitation in selected other countries and compares the same with that in India. The outcome of the comparative review resulted in identification of unaddressed aspects as well as inadequacy of parameters in Indian context. Thirdly, in an attempt to restructure the performance assessment process and develop an index in urban sanitation, researches done in other urban services such as health and education were studied focusing on methods of measuring under-performance. As a fourth step, a tentative modified framework is suggested with the help of understanding drawn from above for urban sanitation using stages of Urban Sanitation Service Chain Management (SSCM) and modified set of parameters drawn from the literature review in the first and second steps. This paper reviews existing literature on SSCM procedures, Performance Index in sanitation and other urban services and identifies a tentative list of parameters and a framework for measuring under-performance in sanitation services. This may aid in preparation of a Service Delivery Under-performance Index (SDUI) in future.

Keywords: assessment, performance, sanitation, services

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557 Analysis of Scholarly Communication Patterns in Korean Studies

Authors: Erin Hea-Jin Kim

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This study aims to investigate scholarly communication patterns in Korean studies, which focuses on all aspects of Korea, including history, culture, literature, politics, society, economics, religion, and so on. It is called ‘national study or home study’ as the subject of the study is itself, whereas it is called ‘area study’ as the subject of the study is others, i.e., outside of Korea. Understanding of the structure of scholarly communication in Korean studies is important since the motivations, procedures, results, or outcomes of individual studies may be affected by the cooperative relationships that appear in the communication structure. To this end, we collected 1,798 articles with the (author or index) keyword ‘Korean’ published in 2018 from the Scopus database and extracted the institution and country of the authors using a text mining technique. A total of 96 countries, including South Korea, was identified. Then we constructed a co-authorship network based on the countries identified. The indicators of social network analysis (SNA), co-occurrences, and cluster analysis were used to measure the activity and connectivity of participation in collaboration in Korean studies. As a result, the highest frequency of collaboration appears in the following order: S. Korea with the United States (603), S. Korea with Japan (146), S. Korea with China (131), S. Korea with the United Kingdom (83), and China with the United States (65). This means that the most active participants are S. Korea as well as the USA. The highest rank in the role of mediator measured by betweenness centrality appears in the following order: United States (0.165), United Kingdom (0.045), China (0.043), Japan (0.037), Australia (0.026), and South Africa (0.023). These results show that these countries contribute to connecting in Korean studies. We found two major communities among the co-authorship network. Asian countries and America belong to the same community, and the United Kingdom and European countries belong to the other community. Korean studies have a long history, and the study has emerged since Japanese colonization. However, Korean studies have never been investigated by digital content analysis. The contributions of this study are an analysis of co-authorship in Korean studies with a global perspective based on digital content, which has not attempted so far to our knowledge, and to suggest ideas on how to analyze the humanities disciplines such as history, literature, or Korean studies by text mining. The limitation of this study is that the scholarly data we collected did not cover all domestic journals because we only gathered scholarly data from Scopus. There are thousands of domestic journals not indexed in Scopus that we can consider in terms of national studies, but are not possible to collect.

Keywords: co-authorship network, Korean studies, Koreanology, scholarly communication

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556 Inner and Outer School Contextual Factors Associated with Poor Performance of Grade 12 Students: A Case Study of an Underperforming High School in Mpumalanga, South Africa

Authors: Victoria L. Nkosi, Parvaneh Farhangpour

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Often a Grade 12 certificate is perceived as a passport to tertiary education and the minimum requirement to enter the world of work. In spite of its importance, many students do not make this milestone in South Africa. It is important to find out why so many students still fail in spite of transformation in the education system in the post-apartheid era. Given the complexity of education and its context, this study adopted a case study design to examine one historically underperforming high school in Bushbuckridge, Mpumalanga Province, South Africa in 2013. The aim was to gain a understanding of the inner and outer school contextual factors associated with the high failure rate among Grade 12 students.  Government documents and reports were consulted to identify factors in the district and the village surrounding the school and a student survey was conducted to identify school, home and student factors. The randomly-sampled half of the population of Grade 12 students (53) participated in the survey and quantitative data are analyzed using descriptive statistical methods. The findings showed that a host of factors is at play. The school is located in a village within a municipality which has been one of the poorest three municipalities in South Africa and the lowest Grade 12 pass rate in the Mpumalanga province.   Moreover, over half of the families of the students are single parents, 43% are unemployed and the majority has a low level of education. In addition, most families (83%) do not have basic study materials such as a dictionary, books, tables, and chairs. A significant number of students (70%) are over-aged (+19 years old); close to half of them (49%) are grade repeaters. The school itself lacks essential resources, namely computers, science laboratories, library, and enough furniture and textbooks. Moreover, teaching and learning are negatively affected by the teachers’ occasional absenteeism, inadequate lesson preparation, and poor communication skills. Overall, the continuous low performance of students in this school mirrors the vicious circle of multiple negative conditions present within and outside of the school. The complexity of factors associated with the underperformance of Grade 12 students in this school calls for a multi-dimensional intervention from government and stakeholders. One important intervention should be the placement of over-aged students and grade-repeaters in suitable educational institutions for the benefit of other students.

Keywords: inner context, outer context, over-aged students, vicious cycle

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555 Micelles Made of Pseudo-Proteins for Solubilization of Hydrophobic Biologicals

Authors: Sophio Kobauri, David Tugushi, Vladimir P. Torchilin, Ramaz Katsarava

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Hydrophobic / hydrophilically modified functional polymers are of high interest in modern biomedicine due to their ability to solubilize water-insoluble / poorly soluble (hydrophobic) drugs. Among the many approaches that are being developed in this direction, one of the most effective methods is the use of polymeric micelles (PMs) (micelles formed by amphiphilic block-copolymers) for solubilization of hydrophobic biologicals. For therapeutic purposes, PMs are required to be stable and biodegradable, although quite a few amphiphilic block-copolymers are described capable of forming stable micelles with good solubilization properties. For obtaining micelle-forming block-copolymers, polyethylene glycol (PEG) derivatives are desirable to use as hydrophilic shell because it represents the most popular biocompatible hydrophilic block and various hydrophobic blocks (polymers) can be attached to it. Although the construction of the hydrophobic core, due to the complex requirements and micelles structure development, is the very actual and the main problem for nanobioengineers. Considering the above, our research goal was obtaining biodegradable micelles for the solubilization of hydrophobic drugs and biologicals. For this purpose, we used biodegradable polymers– pseudo-proteins (PPs)(synthesized with naturally occurring amino acids and other non-toxic building blocks, such as fatty diols and dicarboxylic acids) as hydrophobic core since these polymers showed reasonable biodegradation rates and excellent biocompatibility. In the present study, we used the hydrophobic amino acid – L-phenylalanine (MW 4000-8000Da) instead of L-leucine. Amino-PEG (MW 2000Da) was used as hydrophilic fragments for constructing the suitable micelles. The molecular weight of PP (the hydrophobic core of micelle) was regulated by variation of used monomers ratios. Micelles were obtained by dissolving of synthesized amphiphilic polymer in water. The micelle-forming property was tested using dynamic light scattering (Malvern zetasizer NanoZSZEN3600). The study showed that obtaining amphiphilic block-copolymer form stable neutral micelles 100 ± 7 nm in size at 10mg/mL concentration, which is considered as an optimal range for pharmaceutical micelles. The obtained preliminary data allow us to conclude that the obtained micelles are suitable for the delivery of poorly water-soluble drugs and biologicals.

Keywords: amino acid – L-phenylalanine, pseudo-proteins, amphiphilic block-copolymers, biodegradable micelles

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