Search results for: behavioral and emotional disorders
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3587

Search results for: behavioral and emotional disorders

827 Aquatic Environmental Effects of Black Shale in Eastern Kentucky through the Measurement of Chemical and Physical Properties

Authors: Mitchell T. Grothaus, Cory Grigsby, Timothy S. Hare

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This study aims to determine if there is a relationship between elevated cancer risks in eastern Kentucky and the environmental effects of black shale. Previous research shows that black shale formations, such as those in eastern Kentucky contain high levels of toxic elements including arsenic and radon compared to average rocks and sediment. Similarly, the population of eastern Kentucky has higher rates of many health conditions, including lung cancer and cardiovascular disease, than surrounding regions. These poor health outcomes are typically explained in relation to social, economic, behavioral, and healthcare factors. The rates of many conditions, however, have not decreased as these factors improve with regional development. Black shale is known to affect environmental conditions such as by increasing radiation levels and heavy metal toxicity. We are mapping the effects of black shale through monitoring radiation, microbes, and chemical standards of water sources. In this presentation, we report on our measuring pH, dissolved oxygen, total dissolved solids, conductivity, temperature, and discharge and comparison with water quality standards from the Kentucky Department for Environmental Protection. The conditions of water sources combined with an environmental survey of the surrounding areas provide a greater understanding of why the people in eastern Kentucky face the current health issues.

Keywords: black shale, eastern Kentucky, environmental impact, water quality

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826 Navigating Disruption: Key Principles and Innovations in Modern Management for Organizational Success

Authors: Ahmad Haidar

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This research paper investigates the concept of modern management, concentrating on the development of managerial practices and the adoption of innovative strategies in response to the fast-changing business landscape caused by Artificial Intelligence (AI). The study begins by examining the historical context of management theories, tracing the progression from classical to contemporary models, and identifying key drivers of change. Through a comprehensive review of existing literature and case studies, this paper provides valuable insights into the principles and practices of modern management, offering a roadmap for organizations aiming to navigate the complexities of the contemporary business world. The paper examines the growing role of digital technology in modern management, focusing on incorporating AI, machine learning, and data analytics to streamline operations and facilitate informed decision-making. Moreover, the research highlights the emergence of new principles, such as adaptability, flexibility, public participation, trust, transparency, and digital mindset, as crucial components of modern management. Also, the role of business leaders is investigated by studying contemporary leadership styles, such as transformational, situational, and servant leadership, emphasizing the significance of emotional intelligence, empathy, and collaboration in fostering a healthy organizational culture. Furthermore, the research delves into the crucial role of environmental sustainability, corporate social responsibility (CSR), and corporate digital responsibility (CDR). Organizations strive to balance economic growth with ethical considerations and long-term viability. The primary research question for this study is: "What are the key principles, practices, and innovations that define modern management, and how can organizations effectively implement these strategies to thrive in the rapidly changing business landscape?." The research contributes to a comprehensive understanding of modern management by examining its historical context, the impact of digital technologies, the importance of contemporary leadership styles, and the role of CSR and CDR in today's business landscape.

Keywords: modern management, digital technology, leadership styles, adaptability, innovation, corporate social responsibility, organizational success, corporate digital responsibility

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825 Analysis of the Development of Communicative Skills After Participating in the Equine-Assisted-Therapy Program Step-By-Step in Communication

Authors: Leticia Souza Guirra, Márcia Eduarda Vieira Ramos, Edlaine Souza Pereira, Leticia Correa Celeste

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Introduction: Studies indicate that equine-assisted therapy enables improvements in several areas of functioning that are impaired in children with autism spectrum disorder (ASD), such as social interaction and communication. Objective: The study proposes to analyze the development of dialogic skills of a verbal child with ASD after participating in the equine-assisted therapy Step By Step in Communication. Method: This is quantitative and qualitative research through a case study. It refers to a 6 years old child diagnosed with ASD belonging to a group of practitioners of the Brazilian National Equine-Assited-Therapy Association. The Behavioral Observation Protocol (PROC) was used to evaluate communicative skills before and after the intervention, which consisted of 24 sessions once a week. Results: All conversational skills increased their frequency, with participation in dialogue and initiation of interaction. The child also increases the habit of waiting for his turn and answering the interlocutor. The emission of topics not related to conversation and echolalia showed a significant decrease after the intervention. Conclusion: The studied child showed improvement in communicative skills after participating in the equine-assisted therapy Step By Step in Communication. Contributions: This study contributes to a greater understanding of the impact of equine-assisted therapy on the communicative abilities of children with ASD.

Keywords: equine-assisted-therapy, autism spectrum disorder, language, communication, language and hearing sciences

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824 Evaluation of Modulus of Elasticity by Non-Destructive Method of Hybrid Fiber Reinforced Concrete

Authors: Erjola Reufi, Thomas Beer

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Plain, unreinforced concrete is a brittle material, with a low tensile strength, limited ductility and little resistance to cracking. In order to improve the inherent tensile strength of concrete there is a need of multi directional and closely spaced reinforcement, which can be provided in the form of randomly distributed fibers. Fiber reinforced concrete (FRC) is a composite material consisting of cement, sand, coarse aggregate, water and fibers. In this composite material, short discrete fibers are randomly distributed throughout the concrete mass. The behavioral efficiency of this composite material is far superior to that of plain concrete and many other construction materials of equal cost. The present experimental study considers the effect of steel fibers and polypropylene fiber on the modulus of elasticity of concrete. Hook end steel fibers of length 5 cm and 3 cm at volume fraction of 0.25%, 0.5% and 1.% were used. Also polypropylene fiber of length 12, 6, 3 mm at volume fraction 0.1, 0.25, and 0.4 % were used. Fifteen mixtures has been prepared to evaluate the effect of fiber on modulus of elasticity of concrete. Ultrasonic pulse velocity (UPV) and resonant frequency methods which are two non-destructive testing techniques have been used to measure the elastic properties of fiber reinforced concrete. This study found that ultrasonic wave propagation is the most reliable, easy and cost effective testing technique to use in the determination of the elastic properties of the FRC mix used in this study.

Keywords: fiber reinforced concrete(FRC), polypropylene fiber, resonance, ultrasonic pulse velocity, steel fiber

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823 The Application of Transcranial Direct Current Stimulation (tDCS) Combined with Traditional Physical Therapy to Address Upper Limb Function in Chronic Stroke: A Case Study

Authors: Najmeh Hoseini

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Strokerecovery happens through neuroplasticity, which is highly influenced by the environment, including neuro-rehabilitation. Transcranial direct current stimulation (tDCS) may enhance recovery by modulating neuroplasticity. With tDCS, weak direct currents are applied noninvasively to modify excitability in the cortical areas under its electrodes. Combined with functional activities, this may facilitate motor recovery in neurologic disorders such as stroke. The purpose of this case study was to examine the effect of tDCS combined with 30 minutes of traditional physical therapy (PT)on arm function following a stroke. A 29-year-old male with chronic stroke involving the left middle cerebral artery territory went through the treatment protocol. Design The design included 5 weeks of treatment: 1 week of traditional PT, 2 weeks of sham tDCS combined with traditional PT, and 2 weeks of tDCS combined with traditional PT. PT included functional electrical stimulation (FES) of wrist extensors followed by task-specific functional training. Dual hemispheric tDCS with 1 mA intensity was applied on the sensorimotor cortices for the first 20 min of the treatment combined with FES. Assessments before and after each treatment block included Modified Ashworth Scale, ChedokeMcmaster Arm and Hand inventory, Action Research Arm Test (ARAT), and the Box and Blocks Test. Results showed reduced spasticity in elbow and wrist flexors only after tDCS combination weeks (+1 to 0). The patient demonstrated clinically meaningful improvements in gross motor and fine motor control over the duration of the study; however, components of the ARAT that require fine motor control improved the greatest during the experimental block. Average time improvement compared to baseline was26.29 s for tDCS combination weeks, 18.48 s for sham tDCS, and 6.83 for PT standard of care weeks. Combining dual hemispheric tDCS with the standard of care PT demonstrated improvements in hand dexterity greater than PT alone in this patient case.

Keywords: tDCS, stroke, case study, physical therapy

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822 Suicide Conceptualization in Adolescents through Semantic Networks

Authors: K. P. Valdés García, E. I. Rodríguez Fonseca, L. G. Juárez Cantú

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Suicide is a global, multidimensional and dynamic problem of mental health, which requires a constant study for its understanding and prevention. When research of this phenomenon is done, it is necessary to consider the different characteristics it may have because of the individual and sociocultural variables, the importance of this consideration is related to the generation of effective treatments and interventions. Adolescents are a vulnerable population due to the characteristics of the development stage. The investigation was carried out with the objective of identifying and describing the conceptualization of adolescents of suicide, and in this process, we find possible differences between men and women. The study was carried out in Saltillo, Coahuila, Mexico. The sample was composed of 418 volunteer students aged between 11 and 18 years. The ethical aspects of the research were reviewed and considered in all the processes of the investigation with the participants, their parents and the schools to which they belonged, psychological attention was offered to the participants and preventive workshops were carried in the educational institutions. Natural semantic networks were the instrument used, since this hybrid method allows to find and analyze the social concept of a phenomenon; in this case, the word suicide was used as an evocative stimulus and participants were asked to evoke at least five words and a maximum 10 that they thought were related to suicide, and then hierarchize them according to the closeness with the construct. The subsequent analysis was carried with Excel, yielding the semantic weights, affective loads and the distances between each of the semantic fields established according to the words reported by the subjects. The results showed similarities in the conceptualization of suicide in adolescents, men and women. Seven semantic fields were generated; the words were related in the discourse analysis: 1) death, 2) possible triggering factors, 3) associated moods, 4) methods used to carry it out, 5) psychological symptomatology that could affect, 6) words associated with a rejection of suicide, and finally, 7) specific objects to carry it out. One of the necessary aspects to consider in the investigations of complex issues such as suicide is to have a diversity of instruments and techniques that adjust to the characteristics of the population and that allow to understand the phenomena from the social constructs and not only theoretical. The constant study of suicide is a pressing need, the loss of a life from emotional difficulties that can be solved through psychiatry and psychological methods requires governments and professionals to pay attention and work with the risk population.

Keywords: adolescents, psychological construct, semantic networks, suicide

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821 The Liminal Performances of Female-Led (Sufi) Rituals: An Anthropological in Pakistan

Authors: Sana Iqbal

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The female voice in Sufi poetry has been studied as a symbol of humility and devotion. Throughout the centuries, the Sufi shrines have also sheltered women and have served as a source of emotional strength in times of difficulty. Although women have been central to Sufi Islam, female-led rituals and performances (of veneration) are rarely studied as acts of empowerment and symbols of healing. This is especially true for rituals performed in informal spaces, which require going beyond the shrine practices. The rituals and meanings associated with Khizr Khwaja (or Sindhi Hindu god Jhelelal) among women in Punjab can serve as a useful case study to unpack some of these meanings. The paper aims to shed light on female-led rituals among women from Punjab associated with the folkloric traditions associated with Khizar Khwaja, Zinda Pir, Jhulelal or river god in the South Asian region to protect mariners from possible risks (since trade was primarily dependent on water channels) or for inducing timely rain date back to the 10th century in Sindh. However, these meanings and associations have evolved and the paper thus aims to establish a relationship between this figure and the women in Punjab by analysing the findings from an ethnographic study. It traces the historical meanings and significance attached to the divine figure and the wells (informal spaces) associated with him since the rituals performed by women is now infused solely with seeking fertility or to be blessed with a successful pregnancy, as opposed to him being celebrated for other reasons in older times. These associations beg the question of what women gain out of these rituals and making offerings to the mysterious figure of Khizr. Anecdotal evidence in the form of interviews conducted in Bhakar and Talwandi (Punjab) during the summer of 2015 helped to explore the stories related to this legend while also allowing us to witness some of the female-led ritual practices. It can be said that the symbols adopted in the ritual practices invoke liminality for women, which is a blend of opposites. The paper argues that this liminality/journey has been used as a vehicle to transcend all worldly structures of power and it symbolically emphasises the richness of feminine love/devotion and grants healing to female devotees.

Keywords: transgression, gender, liminality, ritual

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820 Innovative In-Service Training Approach to Strengthen Health Care Human Resources and Scale-Up Detection of Mycobacterium tuberculosis

Authors: Tsegahun Manyazewal, Francesco Marinucci, Getachew Belay, Abraham Tesfaye, Gonfa Ayana, Amaha Kebede, Tsegahun Manyazewal, Francesco Marinucci, Getachew Belay, Abraham Tesfaye, Gonfa Ayana, Amaha Kebede, Yewondwossen Tadesse, Susan Lehman, Zelalem Temesgen

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In-service health trainings in Sub-Saharan Africa are mostly content-centered with higher disconnection with the real practice in the facility. This study intended to evaluate in-service training approach aimed to strengthen health care human resources. A combined web-based and face-to-face training was designed and piloted in Ethiopia with the diagnosis of tuberculosis. During the first part, which lasted 43 days, trainees accessed web-based material and read without leaving their work; while the second part comprised a one-day hands-on evaluation. Trainee’s competency was measured using multiple-choice questions, written-assignments, exercises and hands-on evaluation. Of 108 participants invited, 81 (75%) attended the course and 71 (88%) of them successfully completed. Of those completed, 73 (90%) scored a grade from A to C. The approach was effective to transfer knowledge and turn it into practical skills. In-service health training should transform from a passive one-time-event to a continuous behavioral change of participants and improvements on their actual work.

Keywords: Ethiopia, health care, Mycobacterium tuberculosis, training

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819 The Effects of Food Matrix and Different Excipient Foods on β-Carotene Bioaccessibility in Carrots

Authors: Birgul Hizlar, Sibel Karakaya

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Nowadays, consumers are more and more aware of the benefits beyond basic nutrition provided by food and food compounds. Between these, carotenoids have been demonstrated to exhibit multiple health benefits (for example, some types of cancer, cardiovascular diseases, eye disorders, among others). However, carotenoid bioaccessibility and bioavailability is generally rather low due to their specific localization in plant tissue and lipophilic nature. This situation is worldwide issue, since both developed and developing countries have their interest and benefits in increasing the uptake of carotenoids from the human diet. Recently, a new class of foods designed to improve the bioaccessibility/bioavailability of orally administered bioactive compounds is introduced: excipient foods. Excipient foods are specially designed foods which are prepared depending on the physicochemical properties of target bioactive compounds and increasing the bioavailability or bioaccessibility of bioactive compound. In this study, effects of food matrix (greating, boiling and mashing) and different excipient foods (olive oil, lemon juice, whey curd and dried artichoke leaf powder) on bioaccessibility of β-carotene in carrot were investigated by means of simulating in vitro gastrointestinal (GI) digestion. β-carotene contents of grated, boiled and mashed (after boiling process) carrots were 79.28, 147.63 and 151.19 μg/g respectively. No significant differences among boiled and mashed samples indicated that mashing process had no effect on the release of β-carotene from the food matrix (p > 0.05). On the contrary, mashing causes significant increase in the β-carotene bioaccessibility (p < 0.05). The highest β-carotene content was found in the mashed carrots incorporated with olive oil and lemon juice (C2). However, no significant differences between that sample and C1 (mashed carrot with lemon juice, olive oil, dried artichoke leaf powder), C3 (mashed carrot with addition of olive oil, lemon juice, whey curd) and). Similarly, the highest β-carotene bioaccessibility (50.26%) was found mashed C3 sample (p < 0.05). The increase in the bioaccessibility was approximately 5 fold and 50 fold when compared to grated and mashed samples containing olive oil, lemon juice and whey curd. The results demonstrate that both, food matrix and excipient foods, are able to increase the bioaccessibility of β-carotene.

Keywords: bioaccessibility, carotenoids, carrot, β-carotene

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818 A Study on Abnormal Behavior Detection in BYOD Environment

Authors: Dongwan Kang, Joohyung Oh, Chaetae Im

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Advancement of communication technologies and smart devices in the recent times is leading to changes into the integrated wired and wireless communication environments. Since early days, businesses had started introducing environments for mobile device application to their operations in order to improve productivity (efficiency) and the closed corporate environment gradually shifted to an open structure. Recently, individual user's interest in working environment using mobile devices has increased and a new corporate working environment under the concept of BYOD is drawing attention. BYOD (bring your own device) is a concept where individuals bring in and use their own devices in business activities. Through BYOD, businesses can anticipate improved productivity (efficiency) and also a reduction in the cost of purchasing devices. However, as a result of security threats caused by frequent loss and theft of personal devices and corporate data leaks due to low security, companies are reluctant about adopting BYOD system. In addition, without considerations to diverse devices and connection environments, there are limitations in detecting abnormal behaviors such as information leaks which use the existing network-based security equipment. This study suggests a method to detect abnormal behaviors according to individual behavioral patterns, rather than the existing signature-based malicious behavior detection and discusses applications of this method in BYOD environment.

Keywords: BYOD, security, anomaly behavior detection, security equipment, communication technologies

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817 A Protocol for Usability of Teaching to Students with Learning Difficulties at University: An Italian Research

Authors: Tamara Zappaterra

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The Learning Difficulties have an evolutionary nature. The international research has focused its analysis on the characteristics of Learning Difficulties in childhood, but we are still far from a thorough understanding of the nature of such disorders in adolescence and adulthood. Such issues become even more urgent in the university context. Spelling, meaning, and appropriate use of the specific vocabulary of the various disciplines represent an additional challenge for the dyslexic student. This paper explores the characteristics of Learning Difficulties in adulthood and the impact with the university teaching. It presents the results of an interdisciplinary project (educational, medical and engineering area) at University of Florence. The purpose of project is to design of a protocol for usability of teaching and individual study at university level. The project, after a first reconnaissance of user needs that have been reached with the participation of the very same protagonists, is at the stage of guidelines drafting for inclusion and education, to be used by teachers, students and administrative staff. The methodologies used are a questionnaire built on purpose and a series of focus groups with users. For collecting data during the focus groups it was decided to use a method typical of the Quality Function Deployment, a tool originally used for quality management, whose versatility makes it easy to use in a number of different context. The paper presents furthermore the findings of the project, the most significant elements of the guidelines for teaching, i.e. the section for teachers, whose aim is to implement a Learning Difficulties-friendly teaching, even at the university level, in compliance with italian Law 170/2010. The Guidelines for the didactic and inclusion of Learning Difficulties students of the University of Florence are articulated around a global and systemic plan of action, meant to accompany and protect the students during their study career, even before enrolling at the University, with different declination: the logistical, relational, educational, and didactic levels have been considered. These guidelines in Italy received the endorsement of the CNUDD. It is a systemic intervention plan for Learning Difficulties students, which roused and keeps rousing the interest of all the university system, with a radical consideration on academic teaching. Since while we try to provide the best Learning Difficulties-friendly didactic in compliance with the rules, no one can be exempted from a wider consideration on the nature and the quality of university teaching offered to all students.

Keywords: didactic tools, learning difficulties, special and inclusive education, university teaching

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816 Critical Evaluation of the Transformative Potential of Artificial Intelligence in Law: A Focus on the Judicial System

Authors: Abisha Isaac Mohanlal

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Amidst all suspicions and cynicism raised by the legal fraternity, Artificial Intelligence has found its way into the legal system and has revolutionized the conventional forms of legal services delivery. Be it legal argumentation and research or resolution of complex legal disputes; artificial intelligence has crept into all legs of modern day legal services. Its impact has been largely felt by way of big data, legal expert systems, prediction tools, e-lawyering, automated mediation, etc., and lawyers around the world are forced to upgrade themselves and their firms to stay in line with the growth of technology in law. Researchers predict that the future of legal services would belong to artificial intelligence and that the age of human lawyers will soon rust. But as far as the Judiciary is concerned, even in the developed countries, the system has not fully drifted away from the orthodoxy of preferring Natural Intelligence over Artificial Intelligence. Since Judicial decision-making involves a lot of unstructured and rather unprecedented situations which have no single correct answer, and looming questions of legal interpretation arise in most of the cases, discretion and Emotional Intelligence play an unavoidable role. Added to that, there are several ethical, moral and policy issues to be confronted before permitting the intrusion of Artificial Intelligence into the judicial system. As of today, the human judge is the unrivalled master of most of the judicial systems around the globe. Yet, scientists of Artificial Intelligence claim that robot judges can replace human judges irrespective of how daunting the complexity of issues is and how sophisticated the cognitive competence required is. They go on to contend that even if the system is too rigid to allow robot judges to substitute human judges in the recent future, Artificial Intelligence may still aid in other judicial tasks such as drafting judicial documents, intelligent document assembly, case retrieval, etc., and also promote overall flexibility, efficiency, and accuracy in the disposal of cases. By deconstructing the major challenges that Artificial Intelligence has to overcome in order to successfully invade the human- dominated judicial sphere, and critically evaluating the potential differences it would make in the system of justice delivery, the author tries to argue that penetration of Artificial Intelligence into the Judiciary could surely be enhancive and reparative, if not fully transformative.

Keywords: artificial intelligence, judicial decision making, judicial systems, legal services delivery

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815 The Impact of Temperamental Traits of Candidates for Aviation School on Their Strategies for Coping with Stress during Selection Exams in Physical Education

Authors: Robert Jedrys, Zdzislaw Kobos, Justyna Skrzynska, Zbigniew Wochynski

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Professions connected to aviation require an assessment of the suitability of health, psychological and psychomotor skills and overall physical fitness of the organism, who applies. Assessment of the physical condition is conducted by the committees consisting of aero-medical specialists in clinical medicine and aviation. In addition, psychological predispositions should be evaluated by specialized psychologists familiar with the specifics of the tasks and requirements for the various positions in aviation. Both, physical abilities and general physical fitness of candidates for aviation shall be assessed during the selection exams, which also test the ability to deal with stress what is very important in aviation. Hence, the mentioned exams in physical education not only help to judge on the ranking in candidates in terms of their efficiency and performance, but also allows to evaluate the functioning under stress measured using psychological tests. Moreover, before-test stress is a predictors of successfulness in the next stages of education and practical training in the aviation. The aim of the study was to evaluate the influence of temperamental traits on strategies used for coping with stress during selection exams in physical education, deciding on admission to aviation school. The study involved 30 candidates for fighter pilot training in aviation school . To evaluate the temperament 'The Formal Characteristics of Behavior-Temperament Inventory' (FCB-TI) by B. Zawadzki and J.Strelau was used. To determine the pattern of coping with stress 'The Coping Inventory for Stressful Situations' (CISS) to N. S. Endler and J. D. A. Parker were engaged. Study of temperament and styles of coping with stress was conducted directly before the exam selection of physical education. The results were analyzed with 'Statistica 9' program. The studies showed that:-There is a negative correlation between such a temperament feature as 'perseverance' and preferred style of coping with stress concentrated on the task (r = -0.590; p < 0.004); -There is a positive correlation between such a feature of temperament as 'emotional reactivity,' and preference to deal with a stressful situation with ‘style centered on emotions’ (r = 0.520; p <0.011); -There is a negative correlation between such a feature of temperament as ‘strength’ and ‘style of coping with stress concentrated on emotions’ (r = -0.580; p < 0.004). Studies indicate that temperament traits determine the perception of stress and preferred coping styles used during the selection, as during the exams in physical education.

Keywords: aviation, physical education, stress, temperamental traits

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814 Pediatric Hearing Aid Use: A Study Based on Data Logging Information

Authors: Mina Salamatmanesh, Elizabeth Fitzpatrick, Tim Ramsay, Josee Lagacé, Lindsey Sikora, JoAnne Whittingham

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Introduction: Hearing loss (HL) is one of the most common disorders that presents at birth and in early childhood. Universal newborn hearing screening (UNHS) has been adopted based on the assumption that with early identification of HL, children will have access to optimal amplification and intervention at younger ages, therefore, taking advantage of the brain’s maximal plasticity. One particular challenge for parents in the early years is achieving consistent hearing aid (HA) use which is critical to the child’s development and constitutes the first step in the rehabilitation process. This study examined the consistency of hearing aid use in young children based on data logging information documented during audiology sessions in the first three years after hearing aid fitting. Methodology: The first 100 children who were diagnosed with bilateral HL before 72 months of age since 2003 to 2015 in a pediatric audiology clinic and who had at least two hearing aid follow-up sessions with available data logging information were included in the study. Data from each audiology session (age of child at the session, average hours of use per day (for each ear) in the first three years after HA fitting) were collected. Clinical characteristics (degree of hearing loss, age of HA fitting) were also documented to further understanding of factors that impact HA use. Results: Preliminary analysis of the results of the first 20 children shows that all of them (100%) have at least one data logging session recorded in the clinical audiology system (Noah). Of the 20 children, 17(85%) have three data logging events recorded in the first three years after HA fitting. Based on the statistical analysis of the first 20 cases, the median hours of use in the first follow-up session after the hearing aid fitting in the right ear is 3.9 hours with an interquartile range (IQR) of 10.2h. For the left ear the median is 4.4 and the IQR is 9.7h. In the first session 47% of the children use their hearing aids ≤5 hours, 12% use them between 5 to 10 hours and 22% use them ≥10 hours a day. However, these children showed increased use by the third follow-up session with a median (IQR) of 9.1 hours for the right ear and 2.5, and of 8.2 hours for left ear (IQR) IQR is 5.6 By the third follow-up session, 14% of children used hearing aids ≤5 hours, while 38% of children used them ≥10 hours. Based on the primary results, factors like age and level of HL significantly impact the hours of use. Conclusion: The use of data logging information to assess the actual hours of HA provides an opportunity to examine the: a) challenges of families of young children with HAs, b) factors that impact use in very young children. Data logging when used collaboratively with parents, can be a powerful tool to identify problems and to encourage and assist families in maximizing their child’s hearing potential.

Keywords: hearing loss, hearing aid, data logging, hours of use

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813 Challenges and Practical Tips for Advance Care Planning and End-of-Life Communications With Cancer Patients in Global Pandemic

Authors: Poonam Goswami

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Background: The diagnosis of a serious illness like cancer can have an impact on a patient’s emotional well-being and may result in psychological symptoms, anxiety, depression, and loss of control. Advance care planning discussions ensure patients’ values and goals of care, including patients’ freedom to choose their place of death, are respected. Unfortunately, these discussions are often delayed and are not initiated early in patients’ cancer trajectory. As a result, patients’ wishes often remains unknown until the last phase of their life. Evidence suggests that many patients inappropriately receive aggressive treatment near the end of life, which does lead to higher resource utilization, decreased quality of life, and increased cost. Additionally, the novel coronavirus disease 2019 (COVID-19) pandemic challenged the health care systems worldwide and raised important ethical issues, especially regarding the potential need for rationing health care in the context of scarce resources and crisis capacity. The importance of goal concordant care is now even substantially important and is heightened in the context of this pandemic. Problem: Although there is growing evidence on the effects of the ACP on the completion of advanced directives, improved patient and family concordance for preferences for medical care, and receipt of care, there is still a lack of standardized ACP conversation strategies for patients with cancer. Methods: The Key concepts of ACP include (1) assessing patient and family readiness, (2) identifying a surrogate decision maker ( medical power of attorney), (3) exploring patient and family understanding of the disease and treatment options,(4) discussing the values and goals of care, and options for end-of-life care, (5) documenting patient preferences in the medical record, and (6) revisiting the discussions at every change in the treatment plan and /or change in clinical status, including at every hospitalization. Conclusion/Implication for practice: Advance Care Planning (ACP) and end-of-life (EOL) discussions are important for patients, families, and health care providers. Adopting the verbal and nonverbal communication strategies can help overcome the barriers to effective communication on these difficult discussions. ACP with goals of care discussions should not be delayed until the patient is hospitalized.

Keywords: advance care planning, end of life, cancer, global, pandemic

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812 Implementation of Inclusive Education in DepEd-Dasmarinas: Basis for Inclusion Program Framework

Authors: Manuela S. Tolentino, John G. Nepomuceno

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The purpose of this investigation was to assess the implementation of inclusive education (IE) in 6 elementary and 5 secondary public schools in the City Schools Division of Dasmarinas. Participants in this study were 11 school heads, 73 teachers, 22 parents and 22 students (regular and with special needs) who were selected using purposive sampling. A 30-item questionnaire was used to gather data on the extent of the implementation of IE in the division while focus group discussion (FGD) was used to gather insights on what facilitate and hinder the implementation of the IE program. This study assessed the following variables: school culture and environment, inclusive education policy implementation, and curriculum design and practices. Data were analyzed using frequency count, mean and ranking. Results revealed that participants have similar assessment on the extent of the implementation of IE. School heads rated school culture and environment as highest in terms of implementation while teachers and pupils chose curriculum design and practices. On the other hand, parents felt that inclusive education policies are implemented best. School culture and environment are given high ratings. Participants perceived that the IE program in the division is making everyone feel welcome regardless of age, sex, social status, physical, mental and emotional state; students with or without disability are equally valued, and students help each. However, some aspects of the IE program implementation are given low ratings namely: partnership between staff, parents and caregivers, school’s effort to minimize discriminatory practice, and stakeholders sharing the philosophy of inclusion. As regards education policy implementation, indicators with the highest ranks were school’s effort to admit students from the locality especially students with special needs, and the implementation of the child protection policy and anti-bullying policy. The results of the FGD revealed that both school heads and teachers possessed the welcoming gesture to accommodate students with special needs. This can be linked to the increasing enrolment of SNE in the division. However, limitations of the teachers’ knowledge on handling learners, facilities and collaboration among stakeholders hinder the implementation of IE program. Based on the findings, inclusion program framework was developed for program enhancement. This will be the basis for the improvement of the program’s efficiency, the relationship between stakeholders, and formulation of solutions.

Keywords: inclusion, inclusive education, framework, special education

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811 Factors of Major Depressive Disorder (MDD): Prevalence of Social Support on Stress within Parental Depression

Authors: Calvin Chiu, Samar Saade Needham

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The factors associated with the development of major depressive disorder (MDD) have been an ongoing area of concern within the field of psychopathology. Among parents, the rise in stress factors for individuals receiving less social support contributes to an increase in MDD cases. Understanding the causal aspects of MDD through the interworking of stress development within social support disparities provides critical insights into preventive measures for depressive symptoms. The present study seeks to assess the impact of social support on stress formation within MDD. Such that single parents lacking social support prompt an increase in stress formation, which proliferates the progression of MDD. Participants in this study were 450 ethnic minority mothers and fathers experiencing health inequities during pregnancy and early childhood. Perceived stress, social support, and depression are assessed by multi-item questionnaires that produce score ranges for general findings. Results indicated that lower social support scores resulted in higher depression scores, and higher perceived stress scores produced higher depression scores. Furthermore, single parents reported higher depression scores. These findings overlap with studies on paternal depression and suggest that MDD is a product of stress accumulation due to declining social support systems. Future studies may specify effective social support systems for decreasing stress accumulation in MDD formation in preventive strategies.

Keywords: major depressive disorder, stress formation, cognitive-behavioral outcomes, deficit-based behaviors

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810 Investigating the Critical Drivers of Behavior: The Case of Online Taxi Services

Authors: Rosa Hendijani, Mohammadhesam Hajighasemi

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As of late, the sharing economy has become an important type of business model. Online taxi services are one example that has grown rapidly around the world. This study examines the factors influencing the use of online taxis as one form of IT-enabled sharing services based on the theory of planned behavior (TPB). Based on the theory of planned behavior, these factors can be divided into three categories, including the ones related to attitude (e.g., image and perceived usefulness), normative believes (e.g., subjective norms), and behavioral control (e.g., technology facilitating conditions and self-efficacy). Three other factors were also considered based on the literature, including perceived economic benefits, openness towards using shared services, and perceived availability. The effect of all these variables was tested both directly and indirectly through intention as the mediating variable. A survey method was used to test the research hypotheses. In total, 361 individuals partook in the study. The results of a multiple regression analysis on behavior showed that perceived economic benefits, compatibility, and subjective norms were important factors influencing behavior among online taxi users. In addition, intention partially mediated the effect of perceived economic benefits and compatibility on behavior. It can be concluded that perceived economic benefits, compatibility, and subjective norms are the three main factors that influence behavior among online taxi users.

Keywords: collaborative consumption, IT-enabled sharing services model, online taxi, sharing economy, theory of planned behavior

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809 Knowledge Transformation Flow (KTF) of Visually Impaired Students: The Virtual Knowledge System as a New Service Innovation

Authors: Chatcai Tangsri, Onjaree Na-Takuatoong

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This paper aims to present the key factors that support the decision to use the technology and to present the knowledge transformation flow of visually impaired students after the use of virtual knowledge system as proposed as a new service innovation to universities in Thailand. Correspondents of 27 visually impaired students are involved in this research. Total of 25 students are selected from the University that mainly conducts non-classroom teaching environment; while another 2 visually impaired students are selected from classroom teaching environment. All of them are fully involved in the study along 8 weeks duration. All correspondents are classified into 5 small groups in various conditions. The research results revealed that the involvement from knowledge facilitator can push out for the behavioral actual use of the virtual knowledge system although there is no any developed intention to use behaviors. Secondly, the situations that the visually impaired students inadequate of the knowledge sources that usually provided by assistants i.e. peers, audio files etc. In this case, they will use the virtual knowledge system for both knowledge access and knowledge transfer request. With this evidence, the need of knowledge would play a stronger role than all technology acceptance factors. Finally, this paper revealed that the knowledge transfer in the normal method that students have a chance to physically meet up is still confirmed as their preference method. In term of other aspects of technology acceptance, it will be discussed together with challenges and recommendations at the end of this paper.

Keywords: knowledge system, visually impaired students, higher education, knowledge management enable technology, synchronous/asynchronous knowledge access, synchronous/asynchronous knowledge transfer

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808 Predicting Intentions of Physical Activity in Patients with Coronary Artery Disease: Attitudes, Subjective Norms and Perceived Behavioral Control

Authors: Shadi Kanan, Ghada Shahrour, Barbara Broome, Donna Bernert, Muntaha Alibrahim, Dana Hansen

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Coronary artery disease is responsible for over 7 million deaths a year worldwide. In developing countries, such as Jordan, the incidence of coronary artery disease exceeds that of developed countries. One contributing factor to this disparity is decreased physical activity among the population, for reasons related to specific cultural and religious values. Using the theory of planned behaviour, the purpose of this study was to investigate the intentions of Jordanian patients with coronary artery disease regarding physical activity. A total of 109 patients with coronary artery disease were recruited for this cross-sectional study from King Abdullah University Hospital in Jordan. A 15-item questionnaire based on the theory of planned behaviour was used to assess participants’ attitudes, subjective norms, perceived behavioural control and intentions towards engagement in physical activity. Perceived behavioural control was found to have the strongest significant relationship with participants’ intentions to engage in physical activity. Barriers to physical activity included lack of time, lack of support from family or friends, and feelings of exhaustion. Lifestyle interventions for patients with coronary artery disease should focus on fostering a sense of control over the environment to encourage patients to engage in physical activity.

Keywords: coronary artery disease, perceived behavioural control, subjective norms, theory of planned behaviour

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807 Optical Coherence Tomography in Parkinson’s Disease: A Potential in-vivo Retinal α-Synuclein Biomarker in Parkinson’s Disease

Authors: Jessica Chorostecki, Aashka Shah, Fen Bao, Ginny Bao, Edwin George, Navid Seraji-Bozorgzad, Veronica Gorden, Christina Caon, Elliot Frohman

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Background: Parkinson’s Disease (PD) is a neuro degenerative disorder associated with the loss of dopaminergic cells and the presence α-synuclein (AS) aggregation in of Lewy bodies. Both dopaminergic cells and AS are found in the retina. Optical coherence tomography (OCT) allows high-resolution in-vivo examination of retinal structure injury in neuro degenerative disorders including PD. Methods: We performed a cross-section OCT study in patients with definite PD and healthy controls (HC) using Spectral Domain SD-OCT platform to measure the peripapillary retinal nerve fiber layer (pRNFL) thickness and total macular volume (TMV). We performed intra-retinal segmentation with fully automated segmentation software to measure the volume of the RNFL, ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), and the outer nuclear layer (ONL). Segmentation was performed blinded to the clinical status of the study participants. Results: 101 eyes from 52 PD patients (mean age 65.8 years) and 46 eyes from 24 HC subjects (mean age 64.1 years) were included in the study. The mean pRNFL thickness was not significantly different (96.95 μm vs 94.42 μm, p=0.07) but the TMV was significantly lower in PD compared to HC (8.33 mm3 vs 8.58 mm3 p=0.0002). Intra-retinal segmentation showed no significant difference in the RNFL volume between the PD and HC groups (0.95 mm3 vs 0.92 mm3 p=0.454). However, GCL, IPL, INL, and ONL volumes were significantly reduced in PD compared to HC. In contrast, the volume of OPL was significantly increased in PD compared to HC. Conclusions: Our finding of the enlarged OPL corresponds with mRNA expression studies showing localization of AS in the OPL across vertebrate species and autopsy studies demonstrating AS aggregation in the deeper layers of retina in PD. We propose that the enlargement of the OPL may represent a potential biomarker of AS aggregation in PD. Longitudinal studies in larger cohorts are warranted to confirm our observations that may have significant implications in disease monitoring and therapeutic development.

Keywords: Optical Coherence Tomography, biomarker, Parkinson's disease, alpha-synuclein, retina

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806 Sustaining the Organizational Performance as Well as Maintaining Employee Satisfaction by Governing Work Life Balance

Authors: I. Gupta, C. Kathpal

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Introduction: Time is really the only capital that any human being has, and the only thing he cannot afford to lose. Work life balance is a contested term on which researchers have begun to study in 1960s. Work-life balance refers to how people allocate time between their jobs and other pursuits, such as family, hobbies, and community involvement and includes the mental health fitness of the employees so that the future goal of organization to sustain the employees and earning profits can be achieved. Every organization primarily involves making a parity between the employees' work and their personal life by contributing the maximum. Aims and Objectives: The aim of the present study is to examine the impact of work-life balance as well as employee satisfaction on the organizational performance by evaluating the inter-related factors in order to maintain the healthy growth of concerns. Materials and Methods: To realize the aim of the study, an unstructured questionnaire, as well as face to face interview, was conducted from 100 persons which consisted majority of male members of top as well as middle level positions in the various organizations. The prime source of data collection was primary; however, the study has also used the theoretical contribution done in this respective field by various researchers. Results: Majority of the respondents were males(80%) from age group of 25-45. The collected data was analyzed through hypothesis testing statistical techniques such as correlation analysis, single regression analysis and ANOVA which has rejected the null hypothesis that there is no relation between work-life interface and organizational performance. The major finding of this study is that work-life balance is directly related to the organizations performance. The results show that the organization which works on the employee satisfaction earns more. Along with, there is a reduction of turnout rates, absenteeism, moreover, enhancement of productivity as well as revenue of corporations. Conclusion: The present study reflects that the disparity in the work-life balance gives invitation to many disorders either mental or physical which leads the dearth in performance. As a result, not only employees, however, organizations also suffers which is clearly shown in the interviews conducted face to face with employees. The study is not targeting the particular class of audience; however, it brings out benefits to the masses.

Keywords: work-life balance, performance, culture, organization, satisfaction

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805 Short-Term Effects of Environmentally Relevant Concentrations of Organic UV Filters on Signal Crayfish Pacifastacus Leniusculus

Authors: Viktoriia Malinovska, Iryna Kuklina, Katerina Grabicova, Milos Buric, Pavel Kozak

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Personal care products, including organic UV filters, are considered emerging contaminants and their toxic effects have been a concern for the last decades. Sunscreen compounds continually enter the surface waters via sewage water treatment due to incomplete removal and during human recreational and laundry activities. Despite the environmental occurrence of organic UV filters in the freshwater environment, little is known about their impacts on aquatic biota. In this study, environmentally relevant concentrations of 5-Benzoyl-4-hydroxy-2-methoxybenzenesulfonic acid (BP-4, 2.5 µg/L) and 2-Phenylbenzimidazole-5-sulfonic acid (PBSA, 3 µg/L) were used to evaluate the cardiac and locomotor responses of signal crayfish Pacifastacus leniusculus during a short time period. The effects of these compounds were evident in experimental animals. Specimens exposed to both tested compounds exhibited significantly bigger changes in distance moved and time movement than controls. Significant differences in changes in mean heart rate were detected in both PBSA and BP-4 experimental groups compared to control groups. Such behavioral and physiological alterations demonstrate the ecological effects of selected sunscreen compounds during a short time period. Since the evidence of the impacts of sunscreen compounds is scarce, the knowledge of how organic UV filters influence aquatic organisms is of key importance for future research.

Keywords: aquatic pollutants, behavior, freshwaters, heart rate, invertebrate

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804 Development and Validation of an Instrument Measuring the Coping Strategies in Situations of Stress

Authors: Lucie Côté, Martin Lauzier, Guy Beauchamp, France Guertin

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Stress causes deleterious effects to the physical, psychological and organizational levels, which highlight the need to use effective coping strategies to deal with it. Several coping models exist, but they don’t integrate the different strategies in a coherent way nor do they take into account the new research on the emotional coping and acceptance of the stressful situation. To fill these gaps, an integrative model incorporating the main coping strategies was developed. This model arises from the review of the scientific literature on coping and from a qualitative study carried out among workers with low or high levels of stress, as well as from an analysis of clinical cases. The model allows one to understand under what circumstances the strategies are effective or ineffective and to learn how one might use them more wisely. It includes Specific Strategies in controllable situations (the Modification of the Situation and the Resignation-Disempowerment), Specific Strategies in non-controllable situations (Acceptance and Stubborn Relentlessness) as well as so-called General Strategies (Wellbeing and Avoidance). This study is intended to undertake and present the process of development and validation of an instrument to measure coping strategies based on this model. An initial pool of items has been generated from the conceptual definitions and three expert judges have validated the content. Of these, 18 items have been selected for a short form questionnaire. A sample of 300 students and employees from a Quebec university was used for the validation of the questionnaire. Concerning the reliability of the instrument, the indices observed following the inter-rater agreement (Krippendorff’s alpha) and the calculation of the coefficients for internal consistency (Cronbach's alpha) are satisfactory. To evaluate the construct validity, a confirmatory factor analysis using MPlus supports the existence of a model with six factors. The results of this analysis suggest also that this configuration is superior to other alternative models. The correlations show that the factors are only loosely related to each other. Overall, the analyses carried out suggest that the instrument has good psychometric qualities and demonstrates the relevance of further work to establish predictive validity and reconfirm its structure. This instrument will help researchers and clinicians better understand and assess coping strategies to cope with stress and thus prevent mental health issues.

Keywords: acceptance, coping strategies, stress, validation process

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803 The Effect of an Occupational Therapy Programme on Sewing Machine Operators

Authors: N. Dunleavy, E. Lovemore, K. Siljeur, D. Jackson, M. Hendricks, M. Hoosain, N. Plastow, S. Marais

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Background: The work requirements of sewing machine operators cause physical and emotional strain. Past ergonomic interventions have been provided to alleviate physical concerns; however, a holistic, multimodal intervention was needed to improve these factors. Aim: The study aimed to examine the effect of an occupational therapy programme on sewing machine operators’ pain, mental health, and productivity within a factory in the South African context. Methods: A pilot randomised control trial was conducted with 22 sewing machine operators within a single factory. Stratified randomisation was used to determine the experimental (EG) and control groups (CG), using measures for pain intensity, level of depression (mental health), and productivity rates as stratification variables. The EG received the multimodal intervention, incorporating education, seating adaptations, and mental health intervention. In three months, the CG will receive the same intervention. Pre- and post-intervention testing have occurred with upcoming three- and six-month follow-ups. Results: Immediate results indicate a statistically significant decrease in pain in both experimental and control groups; no change in productivity scores and depression between the two groups. This may be attributed to external factors. The values for depression further showed no statistical significance between the two groups and within pre-and post-test results. The Statistical Program for Social Sciences (SPSS) version-24 was used as the data analysis testing, where all the tests will be evaluated at a 5% significance level. Contribution of research: The research adds to the body of knowledge informing the Occupational Therapy role in work settings, providing evidence on the effectiveness of workplace-based multimodal interventions. Conclusion: The study provides initial data on the effectiveness of a pilot randomised control trial on pain and mental health in South Africa. Results indicated no quantitative change between the experimental and control groups; however, qualitative data suggest a clinical significance of the findings.

Keywords: ergonomics programme, occupational therapy, sewing machine operators, workplace-based multimodal interventions

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802 A Recommender System for Job Seekers to Show up Companies Based on Their Psychometric Preferences and Company Sentiment Scores

Authors: A. Ashraff

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The increasing importance of the web as a medium for electronic and business transactions has served as a catalyst or rather a driving force for the introduction and implementation of recommender systems. Recommender Systems play a major role in processing and analyzing thousands of data rows or reviews and help humans make a purchase decision of a product or service. It also has the ability to predict whether a particular user would rate a product or service based on the user’s profile behavioral pattern. At present, Recommender Systems are being used extensively in every domain known to us. They are said to be ubiquitous. However, in the field of recruitment, it’s not being utilized exclusively. Recent statistics show an increase in staff turnover, which has negatively impacted the organization as well as the employee. The reasons being company culture, working flexibility (work from home opportunity), no learning advancements, and pay scale. Further investigations revealed that there are lacking guidance or support, which helps a job seeker find the company that will suit him best, and though there’s information available about companies, job seekers can’t read all the reviews by themselves and get an analytical decision. In this paper, we propose an approach to study the available review data on IT companies (score their reviews based on user review sentiments) and gather information on job seekers, which includes their Psychometric evaluations. Then presents the job seeker with useful information or rather outputs on which company is most suitable for the job seeker. The theoretical approach, Algorithmic approach and the importance of such a system will be discussed in this paper.

Keywords: psychometric tests, recommender systems, sentiment analysis, hybrid recommender systems

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801 Gender Differences in Negotiation: Considering the Usual Driving Forces

Authors: Claude Alavoine, Ferkan Kaplanseren

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Negotiation is a specific form of interaction based on communication in which the parties enter into deliberately, each with clear but different interests or goals and a mutual dependency towards a decision due to be taken at the end of the confrontation. Consequently, negotiation is a complex activity involving many different disciplines from the strategic aspects and the decision making process to the evaluation of alternatives or outcomes and the exchange of information. While gender differences can be considered as one of the most researched topic within negotiation studies, empirical works and theory present many conflicting evidences and results about the role of gender in the process or the outcome. Furthermore, little interest has been shown over gender differences in the definition of what is negotiation, its essence or fundamental elements. Or, as differences exist in practices, it might be essential to study if the starting point of these discrepancies does not come from different considerations about what is negotiation and what will encourage the participants in their strategic decisions. Some recent and promising experiments made with diverse groups show that male and female participants in a common and shared situation barely consider the same way the concepts of power, trust or stakes which are largely considered as the usual driving forces of any negotiation. Furthermore, results from Human Resource self-assessment tests display and confirm considerable differences between individuals regarding essential behavioral dimensions like capacity to improvise and to achieve, aptitude to conciliate or to compete and orientation towards power and group domination which are also part of negotiation skills. Our intention in this paper is to confront these dimensions with negotiation’s usual driving forces in order to build up new paths for further research.

Keywords: negotiation, gender, trust, power, stakes, strategies

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800 Decision-Making Under Uncertainty in Obsessive-Compulsive Disorder

Authors: Helen Pushkarskaya, David Tolin, Lital Ruderman, Ariel Kirshenbaum, J. MacLaren Kelly, Christopher Pittenger, Ifat Levy

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Obsessive-Compulsive Disorder (OCD) produces profound morbidity. Difficulties with decision making and intolerance of uncertainty are prominent clinical features of OCD. The nature and etiology of these deficits are poorly understood. We used a well-validated choice task, grounded in behavioral economic theory, to investigate differences in valuation and value-based choice during decision making under uncertainty in 20 unmedicated participants with OCD and 20 matched healthy controls. Participants’ choices were used to assess individual decision-making characteristics. Compared to controls, individuals with OCD were less consistent in their choices and less able to identify options that were unambiguously preferable. These differences correlated with symptom severity. OCD participants did not differ from controls in how they valued uncertain options when outcome probabilities were known (risk) but were more likely than controls to avoid uncertain options when these probabilities were imprecisely specified (ambiguity). These results suggest that the underlying neural mechanisms of valuation and value-based choices during decision-making are abnormal in OCD. Individuals with OCD show elevated intolerance of uncertainty, but only when outcome probabilities are themselves uncertain. Future research focused on the neural valuation network, which is implicated in value-based computations, may provide new neurocognitive insights into the pathophysiology of OCD. Deficits in decision-making processes may represent a target for therapeutic intervention.

Keywords: obsessive compulsive disorder, decision-making, uncertainty intolerance, risk aversion, ambiguity aversion, valuation

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799 Behavior and Obesity: The Perception of Healthcare Professionals Concerning the Role of Behavior on Obesity

Authors: Saeed Wahass

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Objective: Obesity is epidemic, affecting all societies and cultures. Most serious medical illnesses are attributed to obesity. For this reason, all healthcare systems worldwide have focused on obesity for both intervention and prevention. However, there is scientific evidence supporting that obesity is treatable through implementing different modalities of interventions. They include biological interventions like medications and bariatric surgeries and behavioral interventions. It seems healthcare professionals may suggest the quick and the easiest interventions for obesity like surgery, ignoring other modesties that might require efforts from their sides and patients as well. Searching on the onset, progression and prevention, behavior plays a major role. As a result, psychological interventions have become increasingly core for intervention and prevention of obesity. They are effective and cost effective in dealing with obesity. Methods: A questionnaire describing the role of behavior on obesity and the way it can be prevented and treated was distributed to a group of health professionals who are dealing with obesity e.g. bariatric surgeons, bariatric physicians, psychologists, health educators, nurses and social workers. Results: 88% of healthcare professionals believed that behavior plays a major role on the onset and progression of obesity, 95% of them recognized that obesity can be prevented with consideration for behavior factors. A major proportion (87%) of the respondents see that psychological interventions are effective and cost effective in treating obesity. Conclusions: It optimistically appears that the majority of healthcare professionals believe that behavior is a key component in understanding, preventing and treating obesity. This outcome may help in developing specific training courses for healthcare professionals, who are dealing with obesity concerning the way they can treat patients behaviorally and, moreover, educating the community.

Keywords: behavior, obesity, healthcare provider, psychological interventions

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798 Vitamin D Levels in Relation to Thyroid Disorders

Authors: Binaya Tamang, Buddhhi Raj Pokhrel, Narayan Gautam

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Background: There may be a connection between thyroid function and vitamin D status since both bind to similar nuclear hormone receptors and have similar response regions on gene promoters. The purpose of the current study was to investigate the relationship between thyroid hormones and vitamin D levels in females who were attending a tertiary care center in western Nepal and were either hypothyroid or euthyroid. Methods: This hospital-based cross-sectional study was carried out between March 2020 and March 2021 by the Biochemistry department of the Universal College of Medical Sciences (UCMS), Bhairahawa, Province No. 5, Nepal, in cooperation with Internal medicine. Prior to the study, institutional review committee approval (UCMS/IRC/008/20) was acquired from UCMS. Women who visited the Internal Medicine OPD of UCMS and were advised to get a thyroid function test (TFT) were included in the study population. Only those who were willing to participate in the study were enrolled after the goals and advantages of the study had been explained to them. Participants who had recently used vitamin D supplements and medications that affected thyroid hormones were excluded. The participants gave their consent verbally and in writing. After getting the consent, a convenient sample technique was applied. Serum was isolated after drawing 3 ml of blood in a plain vial. Chemiluminescence assay was used to analyze vitamin D and thyroid hormones (MAGLUMI 2000). SPSS version 16.0 for Windows was used to conduct the statistical analysis. Statistical significance was defined as a P-value < 0.05. Results: Majority of the study population (n=214, 71%) had insufficient serum vitamin D levels. Among the thyroid groups, the median Vitamin D levels were significantly lower in hypothyroid (16.88 ng/ml) as compared to the euthyroid groups (25.01 ng/ml) (P<0.001). Similarly, serum Vitamin D levels were considerably lower in the obese population (16.86 ng/ml) as compared to the normal BMI group (24.90 ng/ml) (P<0.001) as well as in the vegetarian (15.43 ng.ml) than mixed diet consumer (24.89 ng/ml) (P<0.01). Even after the adjustment for these variables, the Vitamin D levels were significantly lower in the hypothyroid population than in the euthyroid group (P<0.001). Conclusion: Comparing the hypothyroid population to the euthyroid, the median serum vitamin D levels were considerably lower. We were alarmed to see that the majority of euthyroid participants also had low levels of vitamin D. Therefore if left untreated, low vitamin D levels in hypothyroid patients could worsen their health further.

Keywords: vitamin D, thyroid hormones, euthyroid, hypothyroid, Nepal

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