Search results for: formulating objectives

Authors: Indujeeva Keerthila Peiris

Abstract:

The secular view of mindfulness has some connotation to the original meaning of mindfulness mentioned in the Theravada Buddhist texts (Pāli Canon), but there is a substantial difference in the meaning of the two. Secular Mindfulness Based Interventions (MBI) focus on stilling the mind, which may provide short-term benefits and help individuals to deal with physical pain, grief, and distress. However, as with many popular educational innovations, the foundational values of mindfulness strategies have been distorted and subverted in a number of instances in which ‘McMindfulness’ programmes have been implemented with a view to reducing mindfulness mediation as a self-help technique that is easily misappropriated for the exclusive pursuit of corporate objectives, employee pacification, and commercial profit. The intention of this paper is not to critique the misappropriations of mindfulness. Instead, to go back to the root source and bring insights from the Buddhist Pāli Canon and its associated teachings on mindfulness in its own terms. In the Buddha’s discourses, as preserved in the Pāli Canon, there is nothing more significant than the understanding and practice of ‘Satipatthãna’. The Satipatthāna Sutta , the ‘Discourse on the Establishment of Mindfulness,’ opens with a proclamation highlighting both the purpose of this training and its methodology. The right practice of mindfulness is the gateway to understanding the Buddha’s teaching. However, although this concept is widely discussed among the Dhamma practitioners, it is the least understood one of them all. The purpose of this paper is to understand deeper meaning of mindfulness as it was originally intended by the Teacher. The natural state of mind is that it wanders. It wanders into the past, the present, and the future. One’s ability to hold attention to a mind object (emotion, thought, feeling, sensation, sense impression) called ‘concentration’. The intentional concentration process does not lead to wisdom. However, the development of wisdom starts when the mind is calm, concentrated, and unified. The practice of insight contemplation aims at gaining a direct understanding of the real nature of phenomena. According to the Buddha’s teaching, there are three basic facts of all existence: 1) impermanence (anicca in Pāli) ; 2) fabrication (also commonly known as suffering, unsatisfactoriness, sankhara or dukka in Pāli); 3) not-self (insubstantiality or impersonality, annatta in Pāli ). The entire Buddhist doctrine is based on these three facts. The problem is our ignorance covers reality. It is not that a person sees the emptiness of them or that we try to see the emptiness of our experience by conceptually thinking that they are empty. It is an experiential outcome that happens when the cause-and- effect overrides the self-view (sakkaya dhitti), and ignorance is known as ignorance and eradicated once and for all. Therefore, the right view (samma dhitti) is the starting point of the path, not ethical conduct (sila) or samadhi (jhana). In order to develop the right view, we need to first listen to the correct Dhamma and possess Yoniso manasikara (right comprehension) to know the five aggregates as five aggregates.

Keywords: mindfulness, spirituality, buddhism, pali canon

Procedia PDF Downloads 52

Authors: Hidehiro Endo, Taizo Shigemichi

Abstract:

Introduction & Objectives: In 2008, the revised course of study for elementary schools was published by MEXT, and from the beginning of the academic year of 2011-2012, foreign language activities (English lessons) became mandatory for 5th and 6th graders in Japanese elementary schools. Foreign language activities are currently offered once a week for approximately 50 minutes by elementary school teachers, assistant language teachers who are native speakers of English, volunteers, among others, with the purpose of helping children become accustomed to functional English. However, the new policy has disclosed a myriad of issues in conducting foreign language activities since the majority of the current elementary school teachers has neither English teaching experience nor English proficiency. Nevertheless, converting foreign language activities into English, as a subject in Japanese elementary schools (for 5th and 6th graders) from 2020 is what MEXT currently envisages with the purpose of reforming English education in Japan. According to their new proposal, foreign language activities will be mandatory for 3rd and 4th graders from 2020. Consequently, gaining better access to English learning opportunities becomes one of the primary concerns even in early childhood education. Thus, in this project, we aim to explore some nursery schools’ attempts at providing toddlers with online English lessons via Skype. The main purpose of this project is to look deeply into what roles online English lessons in the nursery schools play in guiding nursery school children to enjoy learning the English language as well as to acquire English communication skills. Research Methods: Setting; The main research site is a nursery school located in the northern part of Japan. The nursery school has been offering a 20-minute online English lesson via Skype twice a week to 7 toddlers since September 2015. The teacher of the online English lessons is a male person who lives in the Philippines. Fieldwork & Data; We have just begun collecting data by attending the Skype English lessons. Direct observations are the principal components of the fieldwork. By closely observing how the toddlers respond to what the teacher does via Skype, we examine what components stimulate the toddlers to pay attention to the English lessons. Preliminary Findings & Expected Outcomes: Although both data collection and analysis are ongoing, we found that the online English teacher remembers the first name of each toddler and calls them by their first name via Skype, a technique that is crucial in motivating the toddlers to actively participate in the lessons. In addition, when the teacher asks the toddlers the name of a plastic object such as grapes in English, the toddlers tend to respond to the teacher in Japanese. Accordingly, the effective use of Japanese in teaching English for nursery school children need to be further examined. The anticipated results of this project are an increased recognition of the significance of creating English language learning opportunities for nursery school children and a significant contribution to the field of early childhood education.

Keywords: teaching children, English education, early childhood education, nursery school

Procedia PDF Downloads 304

Authors: Thomas J. Bell III

Abstract:

This paper explores the value of assimilating certification training within a traditional course curriculum. This innovative approach is believed to increase stakeholder value within the Computer Information System program at Texas Wesleyan University. Stakeholder value is obtained from increased job marketability and critical thinking skills that create employment-ready graduates. This paper views value as first developing the capability to earn an industry-recognized certification, which provides the student with more job placement compatibility while allowing the use of critical thinking skills in a liberal arts business program. Graduates with industry-based credentials are often given preference in the hiring process, particularly in the information technology sector. And without a pioneering curriculum that better prepares students for an ever-changing employment market, its educational value is dubiously questioned. Since certifications are trending in the hiring process, academic programs should explore the viability of incorporating certification training into teaching pedagogy and courses curriculum. This study will examine the use of the balanced scorecard across four performance dimensions (financial, customer, internal process, and innovation) to measure the stakeholder value of certification training within a traditional course curriculum. The balanced scorecard as a strategic management tool may provide insight for leveraging resource prioritization and decisions needed to achieve various curriculum objectives and long-term value while meeting multiple stakeholders' needs, such as students, universities, faculty, and administrators. The research methodology will consist of quantitative analysis that includes (1) surveying over one-hundred students in the CIS program to learn what factor(s) contributed to their certification exam success or failure, (2) interviewing representatives from the Texas Workforce Commission to identify the employment needs and trends in the North Texas (Dallas/Fort Worth) area, (3) reviewing notable Workforce Innovation and Opportunity Act publications on training trends across several local business sectors, and (4) analyzing control variables to identify specific correlations between industry alignment and job placement to determine if a correlation exists. These findings may provide helpful insight into impactful pedagogical teaching techniques and curriculum that positively contribute to certification credentialing success. And should these industry-certified students land industry-related jobs that correlate with their certification credential value, arguably, stakeholder value has been realized.

Keywords: certification exam teaching pedagogy, exam preparation, testing techniques, exam study tips, passing certification exams, embedding industry certification and curriculum alignment, balanced scorecard performance evaluation

Procedia PDF Downloads 78

Authors: Jaeyoung Lee, Minji Je

Abstract:

Objectives: In adolescence, adolescents are curious about sex, but sexual experience before becoming an adult can cause the risk of high probability of sexually transmitted infection. Therefore, it is very important to prevent sexually transmitted infections so that adolescents can grow in healthy and upright way. Adolescent females, especially, have sexual behavior distinguished from that of male adolescents. Protecting female adolescents’ reproductive health is even more important since it is directly related to the childbirth of the next generation. This study, thus, investigated the predictors of sexually transmitted infection in adolescent females with sexual experiences based on the National Health Statistics in Korea. Methods: This study was conducted based on the National Health Statistics in Korea. The 11th Korea Youth Behavior Web-based Survey in 2016 was conducted in the type of anonymous self-reported survey in order to find out the health behavior of adolescents. The target recruitment group was middle and high school students nationwide as of April 2016, and 65,528 students from a total of 800 middle and high schools participated. The study was conducted in 537 female high school students (Grades 10–12) among them. The collected data were analyzed as complex sampling design using SPSS statistics 22. The strata, cluster, weight, and finite population correction provided by Korea Center for Disease Control & Prevention (KCDC) were reflected to constitute complex sample design files, which were used in the statistical analysis. The analysis methods included Rao-Scott chi-square test, complex samples general linear model, and complex samples multiple logistic regression analysis. Results: Out of 537 female adolescents, 11.9% (53 adolescents) had experiences of venereal infection. The predictors for venereal infection of the subjects were ‘age at first intercourse’ and ‘sexual intercourse after drinking’. The sexually transmitted infection of the subjects was decreased by 0.31 times (p=.006, 95%CI=0.13-0.71) for middle school students and 0.13 times (p<.001, 95%CI=0.05-0.32) for high school students whereas the age of the first sexual experience was under elementary school age. In addition, the sexually transmitted infection of the subjects was 3.54 times (p < .001, 95%CI=1.76-7.14) increased when they have experience of sexual relation after drinking alcohol, compared to those without the experience of sexual relation after drinking alcohol. Conclusions: The female adolescents had high probability of sexually transmitted infection if their age for the first sexual experience was low. Therefore, the female adolescents who start sexual experience earlier shall have practical sex education appropriate for their developmental stage. In addition, since the sexually transmitted infection increases, if they have sexual relations after drinking alcohol, the consideration for prevention of alcohol use or intervention of sex education shall be required. When health education intervention is conducted for health promotion for female adolescents in the future, it is necessary to reflect the result of this study.

Keywords: adolescent, coitus, female, sexually transmitted diseases

Procedia PDF Downloads 172

Authors: Sarah Pfoser, Lisa-Maria Putz, Thomas Berger

Abstract:

In the EU, the transport sector accounts for roughly one fourth of the total greenhouse gas emissions. In fact, the transport sector is one of the main contributors of greenhouse gas emissions. Climate protection targets aim to reduce the negative effects of greenhouse gas emissions (e.g. climate change, global warming) worldwide. Achieving a modal shift to foster environmentally friendly modes of transport such as rail and inland waterways is an important strategy to fulfill the climate protection targets. The present paper goes beyond these conventional transport modes and reflects upon currently emerging high-performance transport modes that yield the potential of complementing future transport systems in an efficient way. It will be defined which properties describe high-performance transport modes, which types of technology are included and what is their potential to contribute to a sustainable future transport network. The first step of this paper is to compile state-of-the-art information about high-performance transport modes to find out which technologies are currently emerging. A multidimensional impact analysis will be conducted afterwards to evaluate which of the technologies is most promising. This analysis will be performed from a spatial, social, economic and environmental perspective. Frequently used instruments such as cost-benefit analysis and SWOT analysis will be applied for the multidimensional assessment. The estimations for the analysis will be derived based on desktop research and discussions in an interdisciplinary team of researchers. For the purpose of this work, high-performance transport modes are characterized as transport modes with very fast and very high throughput connections that could act as efficient extension to the existing transport network. The recently proposed hyperloop system represents a potential high-performance transport mode which might be an innovative supplement for the current transport networks. The idea of hyperloops is that persons and freight are shipped in a tube at more than airline speed. Another innovative technology consists in drones for freight transport. Amazon already tests drones for their parcel shipments, they aim for delivery times of 30 minutes. Drones can, therefore, be considered as high-performance transport modes as well. The Trans-European Transport Networks program (TEN-T) addresses the expansion of transport grids in Europe and also includes high speed rail connections to better connect important European cities. These services should increase competitiveness of rail and are intended to replace aviation, which is known to be a polluting transport mode. In this sense, the integration of high-performance transport modes as described above facilitates the objectives of the TEN-T program. The results of the multidimensional impact analysis will reveal potential future effects of the integration of high-performance modes into transport networks. Building on that, a recommendation on the following (research) steps can be given which are necessary to ensure the most efficient implementation and integration processes.

Keywords: drones, future transport networks, high performance transport modes, hyperloops, impact analysis

Procedia PDF Downloads 304

Authors: Tal Braverman Uriel, Tal Litvak Hirsch

Abstract:

Background and Objectives: Little or only partial emphasis has been placed on exploring the complexity of consensual non-monogamous relationships. The term "polyamory" refers to consensual non-monogamy, and it is defined as having emotional and/or sexual relations simultaneously with two or more people, the consent and knowledge of all the partners concerned. Managing multiple romantic relationships with different people evokes more emotions, leads to more emotional conflicts arising from different interests, and demands practical strategies. An individual's transition from a monogamous lifestyle to a consensual non-monogamous lifestyle yields new challenges, accompanied by stress, uncertainty, and question marks, as do other life-changing events, such as divorce or transition to parenthood. The study examines both the process of transition and adaptation to a consensually non-monogamous relationship, as well as the coping mechanism involved in the daily conduct of this lifestyle. The research focuses on understanding the consequences, challenges, and coping methods from a personal, marital, and familial point of view and focuses on 40 middle-aged individuals (20 men and 20 women ages 40-60). The research sheds light on a way of life that has not been previously studied in Israel and is still considered unacceptable. Theories of crisis (e.g., as Folkman and Lazarus) were applied, and as a result, a deeper understanding of the subject was reached, all while focusing on multiple aspects of dealing with stress. The basic research question examines the consequences of entering a polyamorous life from a personal point of view as an individual, partner, and parent and the ways of coping with these consequences. Method: The research is conducted with a narrative qualitative approach in the interpretive paradigm, including semi-structured in-depth interviews. The method of analysis is thematic. Results: The findings indicate that in most cases, an individual's motivation to open the relationship is mainly a longing for better sexuality and for an added layer of excitement to their lives. Most of the interviewees were assisted by their spouses in the process, as well as by social networks and podcasts on the subject. Some of them therapeutic professionals from the field are helpful. It also clearly emerged that among those who experienced acute emotional crises with the primary partner or painful separations from secondary partners, all believed polyamory to be the adequate way of life for them. Finally, a key resource for managing tension and stress is the ability to share and communicate with the primary partner. Conclusions: The study points to the challenges and benefits of a non-monogamous lifestyle as well as the use of coping mechanisms and resources that are consistent with the existing theory and research in the field in the context of life changes. The study indicates the need to expand the research canvas in the future in the context of parenting and the consequences for children.

Keywords: a-monogamy, consent, family, stress, tension

Procedia PDF Downloads 48

Authors: Meirav Eshkol, Miri Blaufeld, Rinat Basal

Abstract:

Aim: The working environment in rural clinics is often isolated and distant from major health centers. In these circumstances, rural health care faces numerous challenges. The hope is that, in the immediate future and in the medium and long range, the rural nursing staff will realize their full professional and personal potential to their own satisfaction and to the health and welfare of their patients. Background: Rural nurses work mostly alone or with very few colleagues, and have the authority to make professional decisions, a fact which often requires them to make critical decisions in pressure situations. In addition, the expectations set for these nurses are extremely high, a fact which requires them to be extremely skilled and to fulfill their professional potential. They are required to provide high-quality and comprehensive care to the individual, the family, and the community and to maintain close interaction with the community. Work in a rural setting requires the flexibility to perform multiple tasks in an isolated setting, often far removed from major health centers. In order to maintain professional satisfaction for the rural nurse, expanded direction and training are required in professional know-how, and in the development of new and existing skills, toward the goal of treating a diverse population and to obtain a comprehensive view of the components of a diagnosis for treatment and to develop an understanding appropriate to the presented reality. Objective: To provide knowledge and to expand and develop professional skills in the prevention and advancement of health in the care of a diverse patient population. The development of strategies and skills for work under pressure alone instills expertise in performing multiple tasks in diverse disciplines. To reduce feelings of stress and burnout. Methodology: This course is the first and one of a kind in Clalit - the biggest health organisation in Israel. Observing and identifying the needs of the nurses in the field relating to the development of professional and personal skills defining goals and objectives, and determining the content of a course designed for rural nurses and kibbutz nurses who are not Clalit employees. Results: 43 nurses participated and 30 answered the feedback questionnaire. The rating of their experience was 4.33 (on a scale of 1-5, with 5 being the highest ranking). 92% indicated the importance of meeting with additional nurses to teach their colleagues. 83% of the nurses indicated an increased sense of organizational belonging. 60% indicated that the course helped to reduce feelings of stress and burnout in becoming a better rural nurse. 80% indicated that the course helped them establish intra-organizational professional cooperation and initiating processes. Conclusion: The course is an instrument which aids in increasing the feeling of organizational belonging, reducing feelings of stress and burnout, creation of relationships and cooperation both within and outside of the organization, increased the realization of the potential of the village nurse.

Keywords: rural nurse, alone, burnout, multiple tasks

Procedia PDF Downloads 41

Authors: Shotiros Protong

Abstract:

The incidents of sudden landslides in Thailand during the past decade have occurred frequently and more severely. It is necessary to focus on the principal parameters used for analysis such as land cover land use, rainfall values, characteristic of soil and digital elevation model (DEM). The combination of intense rainfall and severe monsoons is increasing due to global climate change. Landslide occurrences rapidly increase during intense rainfall especially in the rainy season in Thailand which usually starts around mid-May and ends in the middle of October. The rain-triggered landslide hazard analysis is the focus of this research. The combination of geotechnical and hydrological data are used to determine permeability, conductivity, bedding orientation, overburden and presence of loose blocks. The regional landslide hazard mapping is developed using the Slope Stability Index SINMAP model supported on Arc GIS software version 10.1. Geological and land use data are used to define the probability of landslide occurrences in terms of geotechnical data. The geological data can indicate the shear strength and the angle of friction values for soils above given rock types, which leads to the general applicability of the approach for landslide hazard analysis. To address the research objectives, the methods are described in this study: setup and calibration of the SINMAP model, sensitivity of the SINMAP model, geotechnical laboratory, landslide assessment at present calibration and landslide assessment under future climate simulation scenario A2 and B2. In terms of hydrological data, the millimetres/twenty-four hours of average rainfall data are used to assess the rain triggered landslide hazard analysis in slope stability mapping. During 1954-2012 period, is used for the baseline of rainfall data at the present calibration. The climate change in Thailand, the future of climate scenarios are simulated by spatial and temporal scales. The precipitation impact is need to predict for the climate future, Statistical Downscaling Model (SDSM) version 4.2, is used to assess the simulation scenario of future change between latitude 16o 26’ and 18o 37’ north and between longitude 98o 52’ and 103o 05’ east by SDSM software. The research allows the mapping of risk parameters for landslide dynamics, and indicates the spatial and time trends of landslide occurrences. Thus, regional landslide hazard mapping under present-day climatic conditions from 1954 to 2012 and simulations of climate change based on GCM scenarios A2 and B2 from 2013 to 2099 related to the threshold rainfall values for the selected the study area in Uttaradit province in the northern part of Thailand. Finally, the landslide hazard mapping will be compared and shown by areas (km2 ) in both the present and the future under climate simulation scenarios A2 and B2 in Uttaradit province.

Keywords: landslide hazard, GIS, slope stability index (SINMAP), landslides, Thailand

Procedia PDF Downloads 531

Authors: Martin Grootveld, Benita Percival, Sarah Moumtaz, Kerry L. Grootveld

Abstract:

Objectives/Hypotheses: The adverse health effect potential of dietary lipid oxidation products (LOPs) has evoked much clinical interest. Therefore, we employed a ¹H NMR-linked Principal Component Regression (PCR) chemometrics modelling strategy to explore relationships between data matrices comprising (1) aldehydic LOP concentrations generated in culinary oils/fats when exposed to laboratory-simulated shallow frying practices, and (2) the prior saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acid (PUFA) contents of such frying media (FM), together with their heating time-points at a standard frying temperature (180 ^oC). Methods: Corn, sunflower, extra virgin olive, rapeseed, linseed, canola, coconut and MUFA-rich algae frying oils, together with butter and lard, were heated according to laboratory-simulated shallow-frying episodes at 180 ^oC, and FM samples were collected at time-points of 0, 5, 10, 20, 30, 60, and 90 min. (n = 6 replicates per sample). Aldehydes were determined by ¹H NMR analysis (Bruker AV 400 MHz spectrometer). The first (dependent output variable) PCR data matrix comprised aldehyde concentration scores vectors (PC1* and PC2*), whilst the second (predictor) one incorporated those from the fatty acid content/heating time variables (PC1-PC4) and their first-order interactions. Results: Structurally complex trans,trans- and cis,trans-alka-2,4-dienals, 4,5-epxy-trans-2-alkenals and 4-hydroxy-/4-hydroperoxy-trans-2-alkenals (group I aldehydes predominantly arising from PUFA peroxidation) strongly and positively loaded on PC1*, whereas n-alkanals and trans-2-alkenals (group II aldehydes derived from both MUFA and PUFA hydroperoxides) strongly and positively loaded on PC2*. PCR analysis of these scores vectors (SVs) demonstrated that PCs 1 (positively-loaded linoleoylglycerols and [linoleoylglycerol]:[SFA] content ratio), 2 (positively-loaded oleoylglycerols and negatively-loaded SFAs), 3 (positively-loaded linolenoylglycerols and [PUFA]:[SFA] content ratios), and 4 (exclusively orthogonal sampling time-points) all powerfully contributed to aldehydic PC1* SVs (p 10^-3 to < 10^-9), as did all PC1-3 x PC4 interaction ones (p 10^-5 to < 10^-9). PC2* was also markedly dependent on all the above PC SVs (PC2 > PC1 and PC3), and the interactions of PC1 and PC2 with PC4 (p < 10^-9 in each case), but not the PC3 x PC4 contribution. Conclusions: NMR-linked PCR analysis is a valuable strategy for (1) modelling the generation of aldehydic LOPs in heated cooking oils and other FM, and (2) tracking their unsaturated fatty acid (UFA) triacylglycerol sources therein.

Keywords: frying oils, lipid oxidation products, frying episodes, chemometrics, principal component regression, NMR Analysis, cytotoxic/genotoxic aldehydes

Procedia PDF Downloads 144

Authors: Theoni Soublis

Abstract:

The COVID-19 pandemic created a severe interruption in teaching and learning in K-12 schools. It is essential that educational researchers, teachers, and administrators understand the long term effects that COVID-19 had on a variety of stakeholders in education. This investigation aims to analyze the research since the beginning of the pandemic that focuses specifically on teacher retention, resilience, and training. The results of this investigation will help to inform future research in order to better understand how the institution of education can continue to be prepared and to better prepare for future significant shifts in the modalities of instruction. The results of this analysis will directly impact the field of education as it will broaden the scope of understanding regarding how COVID- 19 impacted teaching and learning. The themes that will emerge from the data analysis will directly inform policy makers, administrators, and researchers about how to best implement training and curriculum design in order to support teacher effectiveness this in the classroom. Educational researchers have written about how teacher morale plummeted and how many teachers reported early burnout and higher stress levels. Teachers’ stress and anxiety soared during the COVID-19 pandemic, but so has their resilience and dedication to the field of education. This research aims to understand how public-school teachers overcame teaching obstacles presented to them during COVID-19. Research has been conducted to identify a variety of information regarding the impact the pandemic has had on K-12 teachers, students, and families. This research aims to understand how teachers continued to pursue their teaching objectives without significant training of effective online instruction methods. Not many educators even heard of the video conferencing platform Zoom before the spring of 2020. Researchers are interested in understanding how teachers used their expertise, prior knowledge, and training to institute immediate and effective online learning environments, what types of relationships did teachers build with students while teaching 100% remotely, and how did relationships change with students while teaching remotely? Furthermore, did the teacher-student relationship propel teacher resolve to be successful while teaching during a pandemic. Recent world events have significantly impacted the field of public-school teaching. The pandemic forced teachers to shift their paradigm about how to maintain high academic expectations, meet state curriculum standards, and assess students learning gains to make data-informed decisions while simultaneously adapting modes of instruction through multiple outlets with little to no training on remote, synchronous, asynchronous, virtual, and hybrid teaching. While it would be very interesting to study how teaching positively impacted students learning during the pandemic, I am more interested in understanding how teaches stayed the course and maintained their mental health while dealing with the stress and pressure of teaching during COVID-19.

Keywords: teacher retention, COVID-19, teacher education, teacher moral

Procedia PDF Downloads 59

Authors: Sayyed Mostafa Ahmadi, Neda Raeesi

Abstract:

Background and Objectives: Cervical spondylosis is a common problem that affects the adult spine and is the most common cause of radiculopathy and myelopathy in older patients. Anterior discectomy and fusion is a well-known technique in degenerative cervical disc disease. However, one of the late undesirable complications is adjacent disc degeneration, which affects about 91% of patients in ten years. Many factors can be effective in causing this complication, but some are still debatable. Discovering these risk factors and eliminating them can improve the quality of life. Methods: This is a retrospective cohort study. All patients who underwent anterior discectomy and fusion surgery in the neurosurgery ward of Imam Khomeini Hospital between 2013 and 2016 were evaluated. Their demographic information was collected. All patients were visited and examined for radiculopathy, myelopathy, and muscular force. At the same visit, all patients were asked to have a facelift, and neck profile, as well as a neck MRI(General Tesla 3). Preoperative graphs were used to measure the diameter of the cervical canal(Pavlov ratio) and to evaluate sagittal alignment(Cobb Angle). Preoperative MRI of patients was reviewed for anterior and posterior longitudinal ligament calcification. Result: In this study, 57 patients were studied. The mean age of patients was 50.63 years, and 49.1% were male. Only 3.5% of patients had anterior and posterior longitudinal ligament calcification. Symptomatic ASD was observed in 26.6%. The X-rays and MRIs showed evidence of 80.7% radiological ASD. Among patients who underwent one-level surgery, 20% had symptomatic ASD, but among patients who underwent two-level surgery, the rate of ASD was 50%.In other words, the higher the number of surfaces that are operated and fused, the higher the probability of symptomatic ASD(P-value <0.05). The X-rays and MRIs showed 80.7% of radiological ASD. Among patients who underwent surgery at one level, 78% had radiological ASD, and this number was 92% among patients who underwent two-level surgery(P-value> 0.05). Demographic variables such as age, sex, height, weight, and BMI did not have a significant effect on the incidence of radiological ASD(P-value> 0.05), but sex and height were two influential factors on symptomatic ASD(P-value <0.05). Other related variables such as family history, smoking and exercise also have no significant effect(P-value> 0.05). Radiographic variables such as Pavlov ratio and sagittal alignment were also unaffected by the incidence of radiological and symptomatic ASD(P-value> 0.05). The number of surgical surfaces and the incidence of anterior and posterior longitudinal ligament calcification before surgery also had no statistically significant effect(P-value> 0.05). In the study of the ability of the neck to move in different directions, none of these variables are statistically significant in the two groups with radiological and symptomatic ASD and the non-affected group(P-value> 0.05). Conclusion: According to the findings of this study, this disease is considered to be a multifactorial disease. The incidence of radiological ASD is much higher than symptomatic ASD (80.7% vs. 26.3%) and sex, height and number of fused surfaces are the only factors influencing the incidence of symptomatic ASD and no variable influences radiological ASD.

Keywords: risk factors, anterior neck disectomy and fusion, adjucent segment degeneration, complication

Procedia PDF Downloads 28

Authors: Merih Welay Welesilassie

Abstract:

Language is a potent instrument that does not only serve the purpose of communication but also plays a pivotal role in shaping our cultural practices and identities. The right to choose one's language is a fundamental human right that helps to safeguard the integrity of both personal and communal identities. Language holds immense significance in Ethiopia, a nation with a diverse linguistic landscape that extends beyond mere communication to delineate administrative boundaries. Consequently, depriving Ethiopians of their linguistic rights represents a multifaceted punishment, more complex than food embargoes. In the aftermath of the civil war that shook Ethiopia in November 2020, displacing millions and resulting in the loss of hundreds of thousands of lives, concerns have been raised about the preservation of the indigenous Tigrayan language and culture. This is particularly true following the annexation of western Tigray into the Amhara region and the implementation of an Amharic-only language and culture education policy. This scholarly inquiry explores the intricacies surrounding the Amhara regional state's prohibition of Tigrayans' indigenous language and culture and the subsequent adoption of a monolingual and monocultural Amhara language and culture in western Tigray. The study adopts the linguistic genocide conceptual framework as an analytical tool to gain a deeper insight into the factors that contributed to and facilitated this significant linguistic and cultural shift. The research was conducted by interviewing ten teachers selected through a snowball sampling. Additionally, document analysis was performed to support the findings. The findings revealed that the push for linguistic and cultural assimilation was driven by various political and economic factors and the desire to promote a single language and culture policy. This process, often referred to as ‘Amharanization,’ aimed to homogenize the culture and language of the society. The Amhara authorities have enacted several measures in pursuit of their objectives, including the outlawing of the Tigrigna language, punishment for speaking Tigrigna, imposition of the Amhara language and culture, mandatory relocation, and even committing heinous acts that have inflicted immense physical and emotional suffering upon members of the Tigrayan community. Upon conducting a comprehensive analysis of the contextual factors, actions, intentions, and consequences, it has been posited that there may be instances of linguistic genocide taking place in the Western Tigray region. The present study sheds light on the severe consequences that could arise because of implementing monolingual and monocultural policies in multilingual areas. Through thoroughly scrutinizing the implications of such policies, this study provides insightful recommendations and directions for future research in this critical area.

Keywords: linguistic genocide, linguistic human right, mother tongue, Western Tigray

Procedia PDF Downloads 29

Authors: Sally Abu Sabaa, Lindsey Gutt

Abstract:

In an attempt to use education as a way of raising a socially responsible and engaged global citizen, the YU-Bridge program, the largest and fastest pathway program of its kind in North America, has embarked on the journey of integrating general themes from the UN’s sustainable developmental goals (SDGs) in its English for Academic Purposes (EAP) curriculum. The purpose of this initiative was to redefine the general philosophy of education in the middle of a pandemic and align with York University’s University Academic Plan that was released in summer 2020 framed around the SDGs. The YUB program attracts international students from all over the world but mainly from China, and its goal is to enable students to achieve the minimum language requirement to join their undergraduate courses at York University. However, along with measuring outcomes, objectives, and the students’ GPA, instructors and academics are always seeking innovation of the YUB curriculum to adapt to the ever growing challenges of academics in the university context, in order to focus more on subject matter that students will be exposed to in their undergraduate studies. However, with the sudden change that has happened globally with the advance of the COVID-19 pandemic, and other natural disasters like the increase in forest fires and floods, rethinking the philosophy and goal of education was a must. Accordingly, the SDGs became the solid pillars upon which we, academics and administrators of the program, could build a new curriculum and shift our perspective from simply ESL education to education with moral and ethical goals. The preliminary implementation of this initiative was supported by an institutional-wide consultation with EAP instructors who have diverse experiences, disciplines, and interests. Along with brainstorming sessions and mini-pilot projects preceding the integration of the SDGs in the YUB-EAP curriculum, those meetings led to creating a general outline of a curriculum and an assessment framework that has the SDGs at its core with the medium of ESL used for language instruction. Accordingly, a community of knowledge exchange was spontaneously created and facilitated by instructors. This has led to knowledge, resources, and teaching pedagogies being shared and examined further. In addition, experiences and reactions of students are being shared, leading to constructive discussions about opportunities and challenges with the integration of the SDGs. The discussions have branched out to discussions about cultural and political barriers along with a thirst for knowledge and engagement, which has resulted in increased engagement not only on the part of the students but the instructors as well. Later in the program, two surveys will be conducted: one for the students and one for the instructors to measure the level of engagement of each in this initiative as well as to elicit suggestions for further development. This paper will describe this fundamental step into using ESL methodology as a mode of disseminating essential ethical and socially correct knowledge for all learners in the 21st Century, the students’ reactions, and the teachers’ involvement and reflections.

Keywords: EAP, curriculum, education, global citizen

Procedia PDF Downloads 162

Authors: Amar Ghelani

Abstract:

People with auditory verbal hallucinations (AVH) who seek support from mental health services commonly report feeling unheard and invalidated in their interactions with social workers and psychiatric professionals. Current mental health training and clinical approaches have proven to be inadequate in addressing the complex nature of voice hearing. Childhood trauma is a key factor in the development of AVH and can render people more vulnerable to hearing both supportive and/or disturbing voices. Lived experiences of racism, poverty, and immigration are also associated with development of what is broadly classified as psychosis. Despite evidence affirming the influence of environmental factors on voice hearing, the Western biomedical system typically conceptualizes this experience as a symptom of genetically-based mental illnesses which requires diagnosis and treatment. Overemphasis on psychiatric medications, referrals, and directive approaches to people’s problems has shifted clinical interventions away from assessing and addressing problems directly related to AVH. The Maastricht approach offers voice hearers and mental health workers an alternative and respectful starting point for understanding and coping with voices. The approach was developed by voice hearers in partnership with mental health professionals and entails an innovative method to assess and create meaning from voice hearing and related life stressors. The objectives of the approach are to help people who hear voices: (1) understand the problems and/or people the voices may represent in their history, and (2) cope with distress and find solutions to related problems. The Maastricht approach has also been found to help voice hearers integrate emotional conflicts, reduce avoidance or fear associated with AVH, improve therapeutic relationships, and increase a sense of control over internal experiences. The proposed oral presentation will be guided by a recovery-oriented theoretical framework which suggests healing from psychological wounds occurs through social connections and community support systems. The presentation will start with a brainstorming exercise to identify participants pre-existing knowledge of the subject matter. This will lead into a literature review on the relations between trauma, intersectionality, and AVH. An overview of the Maastricht approach and review of research related to its therapeutic risks and benefits will follow. Participants will learn trauma-informed coping skills and questions which can help voice hearers make meaning from their experiences. The presentation will conclude with a review of resources and learning opportunities where participants can expand their knowledge of the Hearing Voices Movement and Maastricht approach.

Keywords: Maastricht interview, recovery, therapeutic assessment, voice hearing

Procedia PDF Downloads 84

Authors: J. M. Geyser

Abstract:

Lamb is a popular meat throughout the world, particularly in Europe, the Middle East and Oceania. However, the conventional lamb industry faces challenges related to environmental sustainability, climate change, consumer health and dwindling profit margins. This has stimulated an increasing demand for organic lamb, as it is perceived to increase environmental sustainability, offer superior quality, taste, and nutritional value, which is appealing to farmers, including small-scale and female farmers, as it often commands a premium price. Despite its advantages, organic lamb production presents challenges, with a significant hurdle being the high production costs encompassing organic certification, lower stocking rates, higher mortality rates and marketing cost. These costs impact the profitability and competitiveness or organic lamb producers, particularly female and small-scale farmers, who often encounter additional obstacles, such as limited access to resources and markets. Therefore, this paper examines the cost of producing organic lambs and its impact on female farmers and raises the research question: “Is organic lamb production the saving grace for female and small-scale farmers?” Objectives include estimating and comparing production costs and profitability or organic lamb production with conventional lamb production, analyzing influencing factors, and assessing opportunities and challenges for female and small-scale farmers. The hypothesis states that organic lamb production can be a viable and beneficial option for female and small-scale farmers, provided that they can overcome high production costs and access premium markets. The study uses a mixed-method approach, combining qualitative and quantitative data. Qualitative data involves semi-structured interviews with ten female and small-scale farmers engaged in organic lamb production in South Africa. The interview covered topics such as farm characteristics, practices, cost components, mortality rates, income sources and empowerment indicators. Quantitative data used secondary published information and primary data from a female farmer. The research findings indicate that when a female farmer moves from conventional lamb production to organic lamb production, the cost in the first year of organic lamb production exceed those of conventional lamb production by over 100%. This is due to lower stocking rates and higher mortality rates in the organic system. However, costs start decreasing in the second year as stocking rates increase due to manure applications on grazing and lower mortality rates due to better worm resistance in the herd. In conclusion, this article sheds light on the economic dynamics of organic lamb production, particularly focusing on its impact on female farmers. To empower female farmers and to promote sustainable agricultural practices, it is imperative to understand the cost structures and profitability of organic lamb production.

Keywords: cost analysis, empowerment, female farmers, organic lamb production

Procedia PDF Downloads 36

Authors: John W. Travis

Abstract:

There is an epidemic of couples separating after a child is born into a family, generally with the father leaving emotionally or physically in the first few years after birth. This separation creates high levels of stress for both parents, especially the primary parent, leaving her (or him) less available to the infant for healthy attachment and nurturing. The deterioration of the couple’s bond leaves parents increasingly under-resourced, and the dependent child in a compromised environment, with an increased likelihood of developing an attachment disorder. Objectives: To understand the dynamics of a couple, once the additional and extensive demands of a newborn are added to a nuclear family structure, and to identify effective ways to support all members of the family to thrive. Qualitative studies interviewed men, women, and couples after pregnancy and the early years as a family, regarding key destructive factors, as well as effective tools for the couple to retain a strong bond. In-depth analysis of a few cases, including the author’s own experience, reveal deeper insights about subtle factors, replicated in wider studies. Using a self-assessment survey, many fathers report feeling abandoned, due to the close bond of the mother-baby unit, and in turn, withdrawing themselves, leaving the mother without support and closeness to resource her for the baby. Fathers report various types of abandonment, from his partner to his mother, with whom he did not experience adequate connection as a child. The study identified a key destructive factor to be unrecognized wounding from childhood that was carried into the relationship. The study culminated in the naming of Male Postpartum Abandonment Syndrome (MPAS), describing the epidemic in industrialized cultures with the nuclear family as the primary configuration. A growing family system often collapses without a minimum number of adult caregivers per infant, approximately four per infant (3.87), which allows for proper healing and caretaking. In cases with no additional family or community beyond one or two parents, the layers of abandonment and trauma result in the deterioration of a couple’s relationship and ultimately the family structure. The solution includes engaging community in support of new families. The study identified (and recommends) specific resources to assist couples in recognizing and healing trauma and disconnection at multiple levels. Recommendations include wider awareness and availability of resources for healing childhood wounds and greater community-building efforts to support couples for the whole family to thrive.

Keywords: abandonment, attachment, community building, family and marital functioning, healing childhood wounds, infant wellness, intimacy, marital satisfaction, relationship quality, relationship satisfaction

Procedia PDF Downloads 202

Authors: Pedro Gomes, Luís Sá Castelo, António Lopes, Marta Maio, Pedro Mota, Adélia Avelar, António Marques Dias

Abstract:

Introduction: Total Knee Arthroplasty (TKA) has contributed to improvement of patient`s quality of life, although it has been associated with some complications including component loosening and polyethylene wear. To prevent these complications various fixation techniques have been employed. Hybrid TKA with cemented tibial and cementless femoral components have shown favourable outcomes, although it still lack of consensus in the literature. Objectives: To evaluate the clinical and radiographic results of hybrid versus cemented TKA with an average 5 years follow-up and analyse the survival rates. Methods: A retrospective study of 125 TKAs performed in 92 patients at our institution, between 2006 to 2008, with a minimum follow-up of 2 years. The same prosthesis was used in all knees. Hybrid TKA fixation was performed in 96 knees, with a mean follow-up of 4,8±1,7 years (range, 2–8,3 years) and 29 TKAs received fully cemented fixation with a mean follow-up of 4,9±1,9 years (range, 2-8,3 years). Selection for hybrid fixation was nonrandomized and based on femoral component fit. The Oxford Knee Score (OKS 0-48) was evaluated for clinical assessment and Knee Society Roentgenographic Evaluation Scoring System was used for radiographic outcome. The survival rate was calculated using the Kaplan-Meier method, with failures defined as revision of either the tibial or femoral component for aseptic failures and all-causes (aseptic and infection). Analysis of survivorship data was performed using the log-rank test. SPSS (v22) was the computer program used for statistical analysis. Results: The hybrid group consisted of 72 females (75%) and 24 males (25%), with mean age 64±7 years (range, 50-78 years). The preoperative diagnosis was osteoarthritis (OA) in 94 knees (98%), rheumatoid arthritis (RA) in 1 knee (1%) and Posttraumatic arthritis (PTA) in 1 Knee (1%). The fully cemented group consisted of 23 females (79%) and 6 males (21%), with mean age 65±7 years (range, 47-78 years). The preoperative diagnosis was OA in 27 knees (93%), PTA in 2 knees (7%). The Oxford Knee Scores were similar between the 2 groups (hybrid 40,3±2,8 versus cemented 40,2±3). The percentage of radiolucencies seen on the femoral side was slightly higher in the cemented group 20,7% than the hybrid group 11,5% p0.223. In the cemented group there were significantly more Zone 4 radiolucencies compared to the hybrid group (13,8% versus 2,1% p0,026). Revisions for all causes were performed in 4 of the 96 hybrid TKAs (4,2%) and 1 of the 29 cemented TKAs (3,5%). The reason for revision was aseptic loosening in 3 hybrid TKAs and 1 of the cemented TKAs. Revision was performed for infection in 1 hybrid TKA. The hybrid group demonstrated a 7 years survival rate of 93% for all-cause failures and 94% for aseptic loosening. No significant difference in survivorship was seen between the groups for all-cause failures or aseptic failures. Conclusions: Hybrid TKA yields similar intermediate-term results and survival rates as fully cemented total knee arthroplasty and remains a viable option in knee joint replacement surgery.

Keywords: hybrid, survival rate, total knee arthroplasty, orthopaedic surgery

Procedia PDF Downloads 567

Authors: Okunola Oluseye Ademola

Abstract:

The study investigated various socio-cultural factors influencing adherence to antiretroviral drugs among people living with HIV in a University Teaching Hospital in South-western Nigeria. The objectives are to examine the perception of people living with HIV/AIDS (PLWHA) of antiretroviral therapy (ART) in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, investigate the influence of socio-cultural factors on adherence of PLWHA to treatment regimen in the study area and assess the prevalence of adherence to ART among PLWHA in the study area. It was a cross-sectional where both qualitative and quantitative research methods were adopted. The participants were HIV diagnosed patients attending clinic at the Obafemi Awolowo University Teaching Hospitals Complex in Ile-Ife between the ages of 18 and 60 years. Also three healthcare delivery personnel working in the clinic were interviewed. Out of the 3007 patients receiving treatment, using Fischer’s formula of sampling technique, 336 patients living with HIV/AIDS were selected for the study. These participants had been on antiretroviral drugs for more than six months prior to the study and were selected using simple random sampling technique. Two focus group discussion sessions comprising of 10 male and 10 female living with HIV and currently on ART were conducted. These groups were purposively selected based on their being on ART for more than one year. Also in-depth interviews were conducted among three purposively selected healthcare givers (an experienced nurse, a doctor and a pharmacist) who are working in this clinic. All the participants were interviewed at the clinic on the various clinic days. Data were collected using a structured questionnaire, an interview guide and tape-recorder. The quantitative data were analysed using descriptive and inferential statistics. Content analysis was employed to analyse responses from IDI and FGD sessions. The findings from the study revealed a very positive perception to ART among PLWHA which was about 86.3% while the level of adherence to ART was 89.0% among the respondents. There was a very strong relationship between social and family supports and the degree of adherence to ART in the PLWHA. Nutrition, polygamy, difficulty in financing transportation fare to the clinic, unemployment, drug hawkers, religion, excuse duty from work and waking up very early were highlighted as socio-cultural barriers to adherence to ART. Fear of death, strong family support, religion belief, not seeking alternative treatment, absence of rituals and perceived improved health status were identified as very strong facilitators to adherence. The study concluded that to achieve a very optimal outcome in the management of HIV among PLWHA, various social and cultural contexts should be taken into consideration as this study was able to ascertain the influence of various socio-cultural factors militating and facilitating adherence to ART.

Keywords: ART, HIV, PLWHA, socio-cultural

Procedia PDF Downloads 251

Authors: R. Christopher, C. Brandt, N. Damons

Abstract:

Background: The sequence of prevention model states that by constant assessment of injury, injury mechanisms and risk factors are identified, highlighting that collecting and recording of data is a core approach for preventing injuries. Several screening tools are available for use in the clinical setting. These screening techniques only recently received research attention, hence there is a dearth of inconsistent and controversial data regarding their applicability, validity, and reliability. Several systematic reviews related to common soccer injuries have been conducted; however, none of them addressed the screening tools for common soccer injuries. Objectives: The purpose of this study was to conduct a review of screening tools and their accuracy for common injuries in soccer. Methods: A systematic scoping review was performed based on the Joanna Briggs Institute procedure for conducting systematic reviews. Databases such as SPORT Discus, Cinahl, Medline, Science Direct, PubMed, and grey literature were used to access suitable studies. Some of the key search terms included: injury screening, screening, screening tool accuracy, injury prevalence, injury prediction, accuracy, validity, specificity, reliability, sensitivity. All types of English studies dating back to the year 2000 were included. Two blind independent reviewers selected and appraised articles on a 9-point scale for inclusion as well as for the risk of bias with the ACROBAT-NRSI tool. Data were extracted and summarized in tables. Plot data analysis was done, and sensitivity and specificity were analyzed with their respective 95% confidence intervals. I² statistic was used to determine the proportion of variation across studies. Results: The initial search yielded 95 studies, of which 21 were duplicates, and 54 excluded. A total of 10 observational studies were included for the analysis: 3 studies were analysed quantitatively while the remaining 7 were analysed qualitatively. Seven studies were graded low and three studies high risk of bias. Only high methodological studies (score > 9) were included for analysis. The pooled studies investigated tools such as the Functional Movement Screening (FMS™), the Landing Error Scoring System (LESS), the Tuck Jump Assessment, the Soccer Injury Movement Screening (SIMS), and the conventional hamstrings to quadriceps ratio. The accuracy of screening tools was of high reliability, sensitivity and specificity (calculated as ICC 0.68, 95% CI: 52-0.84; and 0.64, 95% CI: 0.61-0.66 respectively; I² = 13.2%, P=0.316). Conclusion: Based on the pooled results from the included studies, the FMS™ has a good inter-rater and intra-rater reliability. FMS™ is a screening tool capable of screening for common soccer injuries, and individual FMS™ scores are a better determinant of performance in comparison with the overall FMS™ score. Although meta-analysis could not be done for all the included screening tools, qualitative analysis also indicated good sensitivity and specificity of the individual tools. Higher levels of evidence are, however, needed for implication in evidence-based practice.

Keywords: accuracy, screening tools, sensitivity, soccer injuries, specificity

Procedia PDF Downloads 146

Authors: Rafael Santos, Clara Pimenta Do Vale, Barbara Bogoni, Poul Henning Kirkegaard

Abstract:

In the last decades, the relevance of hand drawing has decreased in the scope of architectural education. However, some schools continue to recognize its decisive role, not only in the architectural design teaching, but in the whole of architectural training. With this paper it is intended to present the results of a research developed on the following problem: the practise of hand drawing as a premier form of representation in architectural design teaching. The research had as its object the educational model of the Faculty of Architecture of the University of Porto (FAUP) and was led by three main objectives: to identify the circumstance that promoted hand drawing as a form of representation in FAUP's model; to characterize the types of hand drawing and their role in that model; to determine the particularities of hand drawing as a premier form of representation in architectural design teaching. Methodologically, the research was conducted according to a qualitative embedded single-case study design. The object – i.e., the educational model – was approached in FAUP case considering its Context and three embedded unities of analysis: the educational Purposes, Principles and Practices. In order to guide the procedures of data collection and analysis, a Matrix for the Characterization (MCC) was developed. As a methodological tool, the MCC allowed to relate the three embedded unities of analysis with the three main sources of evidence where the object manifests itself: the professors, expressing how the model is Assumed; the architectural design classes, expressing how the model is Achieved; and the students, expressing how the model is Acquired. The main research methods used were the naturalistic and participatory observation, in-person-interview and documentary and bibliographic review. The results reveal that the educational model of FAUP – following the model of the former Porto School – was largely due to the methodological foundations created with the hand drawing teaching-learning processes. In the absence of a culture of explicit theoretical elaboration or systematic research, hand drawing was the support for the continuity of the school, an expression of a unified thought about what should be the reflection and practice of architecture. As a form of representation, hand drawing plays a transversal role in the entire educational model, since its purposes are not limited to the conception of architectural design – it is also a means for perception, analysis and synthesis. Regarding the architectural design teaching, there seems to be an understanding of three complementary dimensions of didactics: the instrumental, methodological and propositional dimension. At FAUP, hand drawing is recognized as the common denominator among these dimensions, according to the idea of "globality of drawing". It is expected that the knowledge base developed in this research may have three main contributions: to contribute to the maintenance and valorisation of FAUP’s model; through the precise description of the methodological procedures, to contribute by transferability to similar studies; through the critical and objective framework of the problem underlying the hand drawing in architectural design teaching, to contribute to the broader discussion concerning the contemporary challenges on architectural education.

Keywords: architectural design teaching, architectural education, forms of representation, hand drawing

Procedia PDF Downloads 97

Authors: Rasmita Mishra, Chander Shekher

Abstract:

Background: Population ageing is an inevitable outcome of demographic transition. Due to increased life expectancy, the old age population in India and worldwide has increased, and it will continue to grow more alarmingly in the near future. There are redundant austerity that has been bestowed upon the widows, thus, the life of widows is never been easy in India. The loss of spouse along with other disadvantaged socioeconomic intermediaries like illiteracy and poverty often make the life of widows more difficult to live. Methodology: Ethical statement: The study used secondary data available in the public domain for its wider use in social research. Thus, there was no requirement of ethical consent in the present study. Data source: Building a Knowledge Base on Population Aging in India (BKPAI), 2011 dataset is used to fulfill the objectives of this study. It was carried out in seven states – Himachal Pradesh, Kerala, Maharashtra, Odisha, Punjab, Tamil Nadu, and West Bengal – having a higher percentage of the population in the age group 60 years and above compared to the national average. Statistical analysis: Descriptive and inferential statistics were used to understand the level of elderly widows and incidence of abuse against them in India and selected states. Bivariate and Trivariate analysis were carried out to check the pattern of abuse by selected covariates. Chi-Square test is used to verify the significance of the association. Further, Discriminant Analysis (DA) is carried out to understand which factor can separate out group of neglect and non-neglect elderly. Result: With the addition of 27 million from 2001 to 2011, the total elderly population in India is more than 100 million. Elderly females aged 60+ were more widows than their counterpart elderly males. This pattern was observed across selected states and at national level. At national level, more than one tenth (12 percent) of elderly experienced abuse in their lifetime. Incidence of abuse against elderly widows within family was considerably higher than the outside the family. This pattern was observed across the selected place and abuse in the study. In discriminant analysis, the significant difference between neglected and non-neglected elderly on each of the independent variables was examined using group mean and ANOVA. Discussion: The study is the first of its kind to assess the incidence of abuse against elderly widows using large-scale survey data. Another novelty of this study is that it has assessed for those states in India whereby the proportion of elderly is higher than the national average. Place and perpetrators involved in the abuse against elderly widows certainly envisaged the safeness in the present living arrangement of elderly widows. Conclusion: Due to the increasing life expectancy it is expected that the number of elderly will increase much faster than before. As biologically women live longer than men, there will be more women elderly than men. With respect to the living arrangement, after the demise of the spouse, elderly widows are more likely to live with their children who emerged as the main perpetrator of abuse.

Keywords: elderly abuse, emotional abuse physical abuse, material abuse, psychological abuse, quality of life

Procedia PDF Downloads 390

Authors: Bintou Jobe

Abstract:

Background: The research is focused on the concept of equality, diversity, and inclusion (EDI) and the need to achieve equity by treating individuals according to their circumstances and needs. The research is rooted in the UK Equality Act 2010, which emphasizes the importance of equal opportunities for all individuals regardless of their background and social life. However, inequality persists in society, particularly for those from minority backgrounds who face discrimination. Research Aim: The aim of this research is to promote equality, diversity, and inclusion by encouraging the regeneration of minds and the eradication of stereotypes. The focus is on promoting good Equality, Diversity and Inclusion practices in various settings, including schools, colleges, universities, and workplaces, to create environments where every individual feels a sense of belonging. Methodology: The research utilises a literature review approach to gather information on promoting inclusivity, diversity, and inclusion. Findings: The research highlights the significance of promoting equality, diversity, and inclusion practices to ensure that individuals receive the respect and dignity they deserve. It emphasises the importance of treating individuals based on their unique circumstances and needs rather than relying on stereotypes. The research also emphasises the benefits of diversity and inclusion in enhancing innovation, creativity, and productivity. The theoretical importance of this research is to raise awareness about the importance of regenerating minds, challenging stereotypes, and promoting equality, diversity, and inclusion. The emphasis is on treating individuals based on their circumstances and needs rather than relying on generalizations. Diversity and inclusion are beneficial in different settings, as highlighted by the research. By raising awareness about the importance of mind regeneration, eradicating stereotypes, and promoting equality, diversity, and inclusion, this research makes a significant contribution to the subject area. It emphasizes the necessity of treating individuals based on their unique circumstances instead of relying on generalizations. However, the methodology could be strengthened by incorporating primary research to complement the literature review approach. Data Collection and Analysis Procedures: The research utilised a literature review approach to gather relevant information on promoting inclusivity, diversity, and inclusion. NVivo software application was used to analysed and synthesize the findings to identify themes and support the research aim and objectives. Question Addressed: This research addresses the question of how to promote inclusivity, diversity, and inclusion and reduce the prevalence of stereotypes and prejudice. It explores the need to treat individuals based on their unique circumstances and needs rather than relying on generic assumptions. Encourage individuals to adopt a more inclusive approach. Provide managers with responsibility and training that helps them understand the importance of their roles in shaping the workplace culture. Have an equality, diversity, and inclusion manager from a majority background at the senior level who can speak up for underrepresented groups and flag any issues that need addressing. Conclusion: The research emphasizes the importance of promoting equality, diversity, and inclusion practices to create a fairer society. It highlights the need to challenge stereotypes, treat individuals according to their circumstances and needs, and promote a culture of respect and dignity.

Keywords: equality, fairer society, inclusion, diversity

Procedia PDF Downloads 24

Authors: Heather Warfield, Brad Genereux

Abstract:

Military personnel encounter a number of challenges when separating from military service to include career uncertainty, relational/family dynamics, trauma as a result of military experiences, reconceptualization of identity, and existential issues related to purpose, meaning making and framing of the military experience(s). Embedded within military culture are well-defined rites of passage and a significant sense of belonging. Consequently, transition out of the military can result in the loss of such rites of passage and belongingness. However, a pilgrimage journey can provide the time and space to engage in a new rite of passage, to construct a new pilgrim identity, and a to develop deep social relationships that lead to a sense of belongingness to a particular pilgrim community as well as to the global community of pilgrims across numerous types of pilgrimage journeys. The aims of the current paper are to demonstrate the rationale for why pilgrimage journeys are particularly significant for military veterans, provide an overview of an innovative program that facilitates the Camino de Santiago pilgrimage for military veterans, and discusses the lessons learned from the initial pilot project of a recently established program. Veterans on the Camino (VOC) is an emerging nongovernmental organization in the USA. Founded by a military veteran, after leaving his military career, the primary objective of the organization is to facilitate healing for veterans via the Camino de Santiago pilgrimage journey. As part of the program, participants complete a semi-structured interview at three time points – pre, during, and post journey. The interview items are based on ongoing research by the principal investigator and address such constructs as meaning-making, wellbeing, therapeutic benefits and transformation. In addition, program participants complete The Sources of Meaning and Meaning in Life Questionnaire (SoMe). The pilot program occurred in the spring of 2017. Five participants were selected after an extensive application process and review by a three-person selection board. The selection criteria included demonstrated compatibility with the program objectives (i.e., prior military experience, availability for a 40 day journey, and awareness of the need for a transformational intervention). The participants were connected as a group through a private Facebook site and interacted with one another for several months prior to the pilgrimage. Additionally, the participants were interviewed prior to beginning the pilgrimage, at one point during the pilgrimage and immediately following the conclusion of the pilgrimage journey. The interviews yielded themes related to loss, meaning construction, renewed hope in humanity, and a commitment to future goals. The lessons learned from this pilot project included a confirmation of the need for such a program, a need for greater focus on logistical details, and the recognition that the pilgrimage experience needs to continue in some manner once the veterans return home.

Keywords: pilgrimage, healing, military veterans, Camino de Santiago

Procedia PDF Downloads 261

Authors: Elisabeth Mamani-Mategula

Abstract:

Background: Anaemia has significant consequences on both the mother and child's health as it results in maternal haemorrhage, low childbirth weight, premature delivery, poor organ development, and infections at birth and hence the need for treatment. In low-middle income countries, anaemic pregnant women are recommended to take 30 mg to 60 mg of elemental iron daily throughout pregnancy which are often poorly tolerated and adhered to. A potential alternative to oral iron is intravenous (IV) iron which allows the saturation of the body’s iron stores quickly. Currently, a randomised controlled trial on the Effect of intravenous iron on Anaemia in Malawian Pregnant women (REVAMP) is underway. Since this is new in Africa and Malawi is the second country to implement it, its acceptability to both the providers and end-users is not known. Suppose the use of IV iron during pregnancy would be acceptable in Malawi, it could change how we treat and manage pregnant women with anaemia and be scaled up throughout Malawi to improve maternal and child health. Objectives: To identify the barriers and facilitators of implementing IV iron in the Malawian healthcare system and identify ‘touchpoints’ and co-develop strategies to support and inform the implementation of the trial Methodology: A qualitative study was conducted with policymakers, government partners, and health managers through in-depth interviews to identify barriers and facilitators relating to the implementation of IV iron in the health system of Malawi. From the interviews, touchpoints were identified that formed the basis of the discussion in further discussing the barriers and suggested solutions in the co-design workshops with the community members and the health workers, respectively. We purposively recruited 20 health workers (10 male, 10 Female). 20 community members (10 male, 10 female) were recruited randomly. Data was collected through group discussions and interactive sessions and was recorded through audios, flip charts, and sticky notes. We familiarized ourselves with the data and identified themes. Results: Two co-design workshops were conducted with different community members and different health worker carders. Identified individual factors included lack of knowledge about anaemia, lack of male involvement, the attitude of health workers and patient non-compliance with appointments. Community factors included myths and misconceptions about IV iron, including associating the use of IV iron with vampirism and covid 19 vaccination. Health system factors identified were a shortage of staff and equipment, unfamiliarity with IV iron and its cost. Discussion: The use of IV iron, as suggested by the community members and health workers, demands civic education through bringing awareness to end-users and training to providers. Through these co-design workshops, community sensitization and awareness, briefing and training of health workers and creation of educational materials were done.

Keywords: acceptability, IV iron, barriers, facilitators, co-design

Procedia PDF Downloads 103

Authors: Shiva Naidoo, Kristena Yossef, Grimm Jimm, Mirza Wasique, Eric Kemmerer, Joshua Obuch, Anand Mahadevan

Abstract:

Background: Fiducial markers effectively enhance tumor target visibility prior to Stereotactic Body Radiation Therapy or Proton therapy. To streamline clinical practice, fiducial placement guidelines from a robotic radiosurgery vendor were examined with the goals of optimizing and standardizing feasible geometries for each treatment indication. Clinical examples of prostate, renal, and pancreatic cases are presented. Methods: Vendor guidelines (Accuray, Sunnyvale, Ca) suggest implantation of 4–6 fiducials at least 20 mm apart, with at least a 15-degree angular difference between fiducials, within 50 mm or less from the target centroid, to ensure that any potential fiducial motion (e.g., from respiration or abdominal/pelvic pressures) will mimic target motion. Also recommended is that all fiducials can be seen in 45-degree oblique views with no overlap to coincide with the robotic radiosurgery imaging planes. For the prostate, a standardized geometry that meets all these objectives is a 2 cm-by-2 cm square in the coronal plane. The transperineal implant of two pairs of preloaded tandem fiducials makes the 2 cm-by-2 cm square geometry clinically feasible. This technique may be applied for renal cancer, except repositioned in a sagittal plane, with the retroperitoneal placement of the fiducials into the tumor. Pancreatic fiducial placement via endoscopic ultrasound (EUS) is technically more challenging, as fiducial placement is operator-dependent, and lesion access may be limited by adjacent vasculature, tumor location, or restricted mobility of the EUS probe in the duodenum. Fluoroscopically assisted fiducial placement during EUS can help ensure fiducial markers are deployed with optimal geometry and visualization. Results: Among the first 22 fiducial cases on a newly installed robotic radiosurgery system, live x-ray images for all nine prostatic cases had excellent fiducial visualization at the treatment console. Renal and pancreatic fiducials were not as clearly visible due to difficult target access and smaller caliber insertion needle/fiducial usage. The geometry of the first prostate case was used to ensure accurate geometric marker placement for the remaining 8 cases. Initially, some of the renal and pancreatic fiducials were closer than the 20 mm recommendation, and interactive feedback with the proceduralists led to subsequent fiducials being too far to the edge of the tumor. Further feedback and discussion of all cases are being used to help guide standardized geometries and achieve ideal fiducial placement. Conclusion: The ideal tradeoffs of fiducial visibility versus the thinnest possible gauge needle to avoid complications needs to be systematically optimized among all patients, particularly in regards to body habitus. Multidisciplinary collaboration among proceduralists and radiation oncologists can lead to improved outcomes.

Keywords: fiducial, prostate cancer, renal cancer, pancreatic cancer, radiotherapy

Procedia PDF Downloads 68

Authors: Henry Kiptum Yatich, Ronald Chepkilot, Aquilars Mutuku Kalio

Abstract:

Studies on energy management have focused on environmental conservation, reduction in production and operation expenses. However, transferring gains of energy management practices to competitive advantage is importance to manufacturers in Kenya. Success in managing competitive advantage arises out of a firm’s ability in identifying and implementing actions that can give the company an edge over its rivals. Manufacturing firms in Kenya are the highest consumers of both electricity and petroleum products. In this regard, the study posits that transfer of the gains of energy management practices to competitive advantage is imperative. The study was carried in Nairobi and its environs, which hosts the largest number of manufacturers. The study objectives were; to determine the level of implementing energy management regulations on sustaining competitive advantage, to determine the level of implementing company energy management policy on competitive advantage, to examine the level of implementing energy efficient technology on sustaining competitive advantage, and to assess the percentage energy expenditure on sustaining competitive advantage among manufacturing firms. The study adopted a survey research design, with a study population of 145,987. A sample of 384 respondents was selected randomly from 21 proportionately selected firms. Structured questionnaires were used to collect data. Data analysis was done using descriptive statistics (mean and standard deviations) and inferential statistics (correlation, regression, and T-test). Data is presented using tables and diagrams. The study found that Energy Management Regulations, Company Energy Management Policies, and Energy Expenses are significant predictors of Competitive Advantage (CA). However, Energy Efficient Technology as a component of Energy Management Practices did not have a significant relationship with Competitive Advantage. The study revealed that the level of awareness in the sector stood at 49.3%. Energy Expenses in the sector stood at an average of 10.53% of the firm’s total revenue. The study showed that gains from energy efficiency practices can be transferred to competitive strategies so as to improve firm competitiveness. The study recommends that manufacturing firms should consider energy management practices as part of its strategic agenda in assessing and reviewing their energy management practices as possible strategies for sustaining competitiveness. The government agencies such as Energy Regulatory Commission, the Ministry of Energy and Petroleum, and Kenya Association of Manufacturers should enforce the energy management regulations 2012, and with enhanced stakeholder involvement and sensitization so as promote sustenance of firm competitiveness. Government support in providing incentives and rebates for acquisition of energy efficient technologies should be pursued. From the study limitation, future experimental and longitudinal studies need to be carried out. It should be noted that energy management practices yield enormous benefits to all stakeholders and that the practice should not be considered a competitive tool but rather as a universal practice.

Keywords: energy, efficiency, management, guidelines, policy, technology, competitive advantage

Procedia PDF Downloads 361

Authors: Lik Hang Gary Wong

Abstract:

Background: Practice learning is crucial for preparing the healthcare profession to meet the real challenge upon graduation. Students are required to demonstrate their competence in managing interpersonal challenges, such as teamwork with other professionals and communicating well with the service users, during the placement. Such competence precedes clinical practice, and it may eventually affect students' actual performance in a clinical context. Unfortunately, there were limited studies investigating how such competence affects students' performance in practice learning. Objectives: The aim of this study is to investigate how self-rated interpersonal competence affects students' actual performance during clinical placement. Methods: 40 occupational therapy students from Hong Kong were recruited in this study. Prior to the clinical placement (level two or above), they completed an online survey that included the Interpersonal Communication Competence Scale (ICCS) measuring self-perceived competence in interpersonal communication. Near the end of their placement, the clinical educator rated students’ performance with the Student Practice Evaluation Form - Revised edition (SPEF-R). The SPEF-R measures the eight core competency domains required for an entry-level occupational therapist. This study adopted the cross-sectional observational design. Pearson correlation and multiple regression are conducted to examine the relationship between students' interpersonal communication competence and their actual performance in clinical placement. Results: The ICCS total scores were significantly correlated with all the SPEF-R domains, with correlation coefficient r ranging from 0.39 to 0.51. The strongest association was found with the co-worker communication domain (r = 0.51, p < 0.01), followed by the information gathering domain (r = 0.50, p < 0.01). Regarding the ICCS total scores as the independent variable and the rating in various SPEF-R domains as the dependent variables in the multiple regression analyses, the interpersonal competence measures were identified as a significant predictor of the co-worker communication (R² = 0.33, β = 0.014, SE = 0.006, p = 0.026), information gathering (R² = 0.27, β = 0.018, SE = 0.007, p = 0.011), and service provision (R² = 0.17, β = 0.017, SE = 0.007, p = 0.020). Moreover, some specific communication skills appeared to be especially important to clinical practice. For example, immediacy, which means whether the students were readily approachable on all social occasions, correlated with all the SPEF-R domains, with r-values ranging from 0.45 to 0.33. Other sub-skills, such as empathy, interaction management, and supportiveness, were also found to be significantly correlated to most of the SPEF-R domains. Meanwhile, the ICCS scores correlated differently with the co-worker communication domain (r = 0.51, p < 0.01) and the communication with the service user domain (r = 0.39, p < 0.05). It suggested that different communication skill sets would be required for different interpersonal contexts within the workplace. Conclusion: Students' self-perceived interpersonal communication competence could predict their actual performance during clinical placement. Moreover, some specific communication skills were more important to the co-worker communication but not to the daily interaction with the service users. There were implications on how to better prepare the students to meet the future challenge upon graduation.

Keywords: interpersonal competence, clinical education, healthcare professional education, occupational therapy, occupational therapy students

Procedia PDF Downloads 42

Authors: Vesna Vulić

Abstract:

Croatia has made large steps forward in the development of higher education over the past 10 years. Purposes and objectives of the tertiary education system are focused on the personal development of young people so that they obtain competences for employment on a flexible labour market. The most frequent tensions between the tertiary institutions and employers are complaints that the current tertiary education system still supplies students with an abundance of theoretical knowledge and not enough practical skills. Polytechnics and schools of professional higher education should deliver professional education and training that will satisfy the needs of their local communities. The 21^st century sets demand on undergraduates as well as their lecturers to strive for the highest standards. The skills students acquire during their studies should serve the needs of their future professional careers. In this context, teaching English for Specific Purposes (ESP) presents an enormous challenge for teachers. They have to cope with teaching the language in classes with a large number of students, limitations of time, inadequate equipment and teaching material; most frequently, this leads to focusing on specialist vocabulary neglecting the development of skills and competences required for future employment. Globalization has transformed the labour market and set new standards a perspective employee should meet. When knowledge of languages is considered, new generic skills and competences are required. Not only skillful written and oral communication is needed, but also information, media, and technology literacy, learning skills which include critical and creative thinking, collaborating and communicating, as well as social skills. The aim of this paper is to evaluate the needs of two groups of ESP first year Undergraduate Professional Administrative Study students taking ESP as a mandatory course: 47 first-year Undergraduate Professional Administrative Study students, 21 first-year employed part-time Undergraduate Professional Administrative Study students and 30 graduates with a degree in Undergraduate Professional Administrative Study with various amounts of work experience. The survey adopted a quantitative approach with the aim to determine the differences between the groups in their perception of the four language skills and different areas of law, as well as getting the insight into students' satisfaction with the current course and their motivation for studying ESP. Their perceptions will be compared to the results of the questionnaire conducted among sector professionals in order to examine how they perceive the same elements of the ESP course content and to what extent it fits into their working environment. The results of the survey indicated that there is a strong correlation between acquiring work experience and the level of importance given to particular areas of law studied in an ESP course which is in line with our initial hypothesis. In conclusion, the results of the survey should help lecturers in re-evaluating and updating their ESP course syllabi.

Keywords: English for Specific Purposes (ESP), language skills, motivation, needs analysis

Procedia PDF Downloads 280

Authors: Shahid Noor, Kazim Najjad, Muhammad Nasir, Irshad Bhutto, Abdul Samad Memon, Khurram Anwar, Tehseen Riaz, Mian Muhammad Hanif, Nauman A. Mallik, Saeed Ahmed, Israr Ahmed, Ali Yasir

Abstract:

Background: Musculoskeletal pain is the most common complaint presented to the health practitioner. It is well known that untreated or under-treated pain can have a significant negative impact on an individual’s quality of life (QoL). Objectives: This study was conducted across 10 sites in six (6) major cities of Pakistan to evaluate the tolerability, safety, and the clinical response of Nuberol Forte® (Paracetamol 650 mg + Orphenadrine 50 mg) to musculoskeletal pain in routine Pakistani practice and its impact on improving the patient’s QoL. Design & Methods: This NFORT-EFFECT observational, prospective multicenter study was conducted in compliance with Good Clinical Practice guidelines and local regulatory requirements. The study sponsor was "The Searle Company Limited, Pakistan. To maintain the GCP compliances, the sponsor assigned the CRO for the site and data management. Ethical approval was obtained from an independent ethics committee. The IEC reviewed the progress of the study. Written informed consent was obtained from the study participants, and their confidentiality was maintained throughout the study. A total of 399 patients with known prescreened musculoskeletal conditions and pain who attended the study sites were recruited, as per the inclusion/exclusion criteria (clinicaltrials.gov ID# NCT04765787). The recruited patients were then prescribed Paracetamol (650 mg) and Orphenadrine (50 mg) combination (Nuberol Forte®) for 7 to 14 days as per the investigator's discretion based on the pain intensity. After the initial screening (visit 1), a follow-up visit was conducted after 1-2 weeks of the treatment (visit 2). Study Endpoints: The primary objective was to assess the pain management response of Nuberol Forte treatment and the overall safety of the drug. The Visual Analogue Scale (VAS) scale was used to measure pain severity. Secondary to pain, the patients' health-related quality of life (HRQoL) was also assessed using the Muscle, Joint Measure (MJM) scale. The safety was monitored on the first dose by the patients. These assessments were done on each study visit. Results: Out of 399 enrolled patients, 49.4% were males, and 50.6% were females with a mean age of 47.24 ± 14.20 years. Most patients were presented with Knee Osteoarthritis (OA), i.e., 148(38%), followed by backache 70(18.2%). A significant reduction in the mean pain score was observed after the treatment with the combination of Paracetamol and Orphenadrine (p<0.05). Furthermore, an overall improvement in the patient’s QoL was also observed. During the study, only ten patients reported mild adverse events (AEs). Conclusion: The combination of Paracetamol and Orphenadrine (Nuberol Forte®) exhibited effective pain management among patients with musculoskeletal conditions and also improved their QoL.

Keywords: musculoskeletal pain, orphenadrine/paracetamol combination, pain management, quality of life, Pakistani population

Procedia PDF Downloads 140

Authors: Florence Roselle Adalin, Misha Louise Delariarte, Fabbette Laire Lagas, Sarah Emanuelle Mejia, Lika Mizukoshi, Irish Paullen Palomeno, Gibrianne Alistaire Ramos, Danica Pauline Ramos, Josefina Tuazon, Jo Leah Flores

Abstract:

Pain, often a missed and undertreated symptom, affects the quality of life of individuals. Nurses are key players in providing effective pain management to decrease morbidity and mortality of patients in pain. Nurses’ knowledge and attitude on pain greatly affect their ability on assessment and management. The Pain Society of the Philippines recognized the inadequacy and inaccessibility of data on the knowledge, skills, and attitude of nurses on pain management in the country. This study may be the first of its kind in the county, giving it the potential to contribute greatly to nursing education and practice through providing valuable baseline data. Objectives: This study aims to describe the level of knowledge and attitude, and current practices of nurses on pain assessment and management; and determine the relationship of nurses’ knowledge and attitude with years of experience, training on pain management and clinical area of practice. Methodology: A survey research design was employed. Four hospitals were selected through purposive sampling. A total of 235 Medical-Surgical Unit and Intensive Care Unit (ICU) nurses participated in the study. The tool used is a combination of demographic survey, Nurses’ Knowledge and Attitude Survey Regarding Pain (NKASRP), Acute Pain Evidence Based Practice Questionnaire (APEBPQ) with self-report questions on non-pharmacologic pain management. The data obtained was analysed using descriptive statistics, two sample T-tests for clinical areas and training; and Pearson product correlation to identify relationship of level of knowledge and attitude with years of experience. Results and Analysis: The mean knowledge and attitude score of the nurses was 47.14%. Majority answered ‘most of the time’ or ‘all the time’ on 84.12% of practice items on pain assessment, implementation of non-pharmacologic interventions, evaluation and documentation. Three of 19 practice items describing morphine and opioid administration in special populations were only done ‘a little of the time’. Most utilized non-pharmacologic interventions were deep breathing exercises (79.66%), massage therapy (27.54%), and ice therapy (26.69%). There was no significant relationship between knowledge scores and years of clinical experience (p = 0.05, r= -0.09). Moreover, there was not enough evidence to show difference in nurses’ knowledge and attitude scores in relation to presence of training (p = 0.41) or areas (Medical-Surgical or ICU) of clinical practice (p = 0.53). Conclusion and Recommendations: Findings of the study showed that the level of knowledge and attitude of nurses on pain assessment and management is suboptimal; and no relationship between nurses’ knowledge and attitude and years of experience. It is recommended that further studies look into the nursing curriculum on pain education, culture-specific pain management protocols and evidence-based practices in the country.

Keywords: knowledge and attitude, nurses, pain management, practices on pain management

Procedia PDF Downloads 317