Search results for: experience
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4637

Search results for: experience

1697 Patient Advocates to Improve Access to Justice in Involuntary Hospitalisation

Authors: Zuzana Durajova, Natasa Diatkova, Shreya Bhardwaj

Abstract:

This paper introduces the project START, its activities, goals, evaluation and final results. Over the past few decades, the legal discourse surrounding mental health has resulted in improvement in patient rights (in Netherlands, etc.), the appointment of Ombudspersons for psychiatric patients (in Austria, Sweden) and facilitating the participation of patients in decision-making processes. Czech legislation already recognizes the position of “patient’s advocate” as a person of trust. However, this instrument is not very widely known and rarely used in practice. In the pilot study of the project, legal training for patient advocacy is provided to persons with experience with mental health problems/psychiatric hospitalization chosen from a Czech-based NGO. These persons (patient advocates) visit patients in involuntary hospitalization in one closed ward in the chosen psychiatric institution. During visits, the patient advocates inform patients about their legal standing, their procedural rights and also offer them individual support in contacting their counsel, family members etc. To understand the effect of the intervention, qualitative interviews and participant observations are conducted with the patients, advocates, the hospital management and staff and other identifiable stakeholders, such as government officials responsible for mental health care reform. The interviews are held before, during and after the intervention (support from patient advocates in hospitals). Given the ethical quandaries arising from using psychiatric wards as a field setting, we assume a participatory approach to ensure respect for patient boundaries and dignity. Through this project, we seek to establish a profession of patient advocates based on professional standards.

Keywords: patient advocacy, involuntary hospitalization, Czech Republic, patient Rights, professionalization

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1696 Establishment of Virtual Fracture Clinic in Princess Royal Hospital Telford: Experience and Recommendations during the First 9 Months

Authors: Tahir Khaleeq, Patrick Lancaster, Keji Fakoya, Pedro Ferreira, Usman Ahmed

Abstract:

Introduction: Virtual fracture clinics (VFC) have been shown to be a safe and cost-effective way of managing outpatient referrals to the orthopaedic department. During the coronavirus pandemic there has been a push to reduce unnecessary patient contact whilst maintaining patient safety. Materials and Methods: A protocol was developed by the clinical team in collaboration with Advanced Physiotherapy Practitioners (APP) on how to manage common musculoskeletal presentations to A&E prior to COVID as part of routine service development. Patients broadly triaged into 4 categories; discharge with advice, referral to VFC, referral to face to face clinic or discussion with on call team. The first 9 months of data were analysed to assess types of injury seen and outcomes. Results: In total 2489 patients were referred to VFC from internal and external sources. 734 patients were discharged without follow-up and 182 patients were discharged for physiotherapy review. Only 3 patients required admission. Regarding follow-ups, 431 patients had a virtual follow-up while 1036 of patients required further face to face follow up. 87 patients were triaged into subspecialty clinics. 37 patients were felt to have been referred inappropriately. Discussion: BOA guidelines suggest all patients need to be reviewed within 72 hours of their orthopaedic injury. Implementation of a VFC allows this target to be achieved and at the same time reduce patient contact. Almost half the patients were discharged following VFC review, the remaining patients were appropriately followed up. This is especially relevant in the current pandemic where reducing unnecessary trips to hospital will benefit the patient as well as make the most of the resources available.

Keywords: virtual fracture clinic, lockdown, trauma and orthopaedics, Covid- 19

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1695 Integrated Business Model Innovation in Nigerian Higher Education: Challenges and Prospects

Authors: Nonso Ochinanwata, Patrick Oseloka Ezepue

Abstract:

This paper explores challenges and prospects in Nigerian higher education. The paper develops an integrated business model that aimed to innovate Nigeria higher education system. A survey and semi-structured interview among Nigerian higher education academics, students and graduates are used to explore the challenges and prospects. The study provides a comparison between lecturers, students and graduates opinions to evaluate challenges and prospects in Nigerian higher institutions. The study found to achieve efficient and effectiveness innovation in Nigerian higher education, there is a need for higher institutions to collaborate with industry professionals and other stakeholders such as company management, and government policy makers in designing higher education institutions curricula. The study found that the curriculum design and delivery need to blend theoretical understanding and real-life experience from industry, and with social cultural influences related to Nigerian environment. This will enable lecturers to organise their teaching and assessments such that students can learn around theoretical and practical study themes. The curriculum design and delivery need to link the core ideas to challenging problems in society, nationally and globally. Hence, this approach will support business start-ups and social entrepreneurship which resolve key societal problems. The study suggests that higher education executives, directors, deans, head of departments, and even individual academics need to emulate innovative business managers to create value-adding products and services from innovative research and academic work.

Keywords: higher education, curriculum innovation, business model innovation, teaching and research excellence, economic development

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1694 Managing Pseudoangiomatous Stromal Hyperplasia Appropriately and Safely: A Retrospective Case Series Review

Authors: C. M. Williams, R. English, P. King, I. M. Brown

Abstract:

Introduction: Pseudoangiomatous Stromal Hyperplasia (PASH) is a benign fibrous proliferation of breast stroma affecting predominantly premenopausal women with no significant increased risk of breast cancer. Informal recommendations for management have continued to evolve over recent years from surgical excision to observation, although there are no specific national guidelines. This study assesses the safety of a non-surgical approach to PASH management by review of cases at a single centre. Methods: Retrospective case series review (January 2011 – August 2016) was conducted on consecutive PASH cases. Diagnostic classification (clinical, radiological and histological), management outcomes, and breast cancer incidence were recorded. Results: 43 patients were followed up for median of 25 months (3-64) with 75% symptomatic at presentation. 12% of cases (n=5) had a radiological score (BIRADS MMG or US) ≥ 4 of which 3 were confirmed malignant. One further malignancy was detected and proven radiologically occult and contralateral. No patients were diagnosed with a malignancy during follow-up. Treatment evolved from 67% surgical in 2011 to 33% in 2016. Conclusions: The management of PASH has transitioned in line with other published experience. The preliminary findings suggest this appears safe with no evidence of missed malignancies; however, longer follow up is required to confirm long-term safety. Recommendations: PASH with suspicious radiological findings ( ≥ U4/R4) warrants multidisciplinary discussion for excision. In the absence of histological or radiological suspicion of malignancy, PASH can be safely managed without surgery.

Keywords: benign breast disease, conservative management, malignancy, pseudoangiomatous stromal hyperplasia, surgical excision

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1693 Opioid Administration on Patients Hospitalized in the Emergency Department

Authors: Mani Mofidi, Neda Valizadeh, Ali Hashemaghaee, Mona Hashemaghaee, Soudabeh Shafiee Ardestani

Abstract:

Background: Acute pain and its management remained the most complaint of emergency service admission. Diagnostic and therapeutic procedures add to patients’ pain. Diminishing the pain increases the quality of patient’s feeling and improves the patient-physician relationship. Aim: The aim of this study was to evaluate the outcomes and side effects of opioid administration in emergency patients. Material and Methods: patients admitted to ward II emergency service of Imam Khomeini hospital, who received one of the opioids: morphine, pethidine, methadone or fentanyl as an analgesic were evaluated. Their vital signs and general condition were examined before and after drug injection. Also, patient’s pain experience were recorded as numerical rating score (NRS) before and after analgesic administration. Results: 268 patients were studied. 34 patients were addicted to opioid drugs. Morphine had the highest rate of prescription (86.2%), followed by pethidine (8.5%), methadone (3.3%) and fentanyl (1.68). While initial NRS did not show significant difference between addicted patients and non-addicted ones, NRS decline and its score after drug injection were significantly lower in addicted patients. All patients had slight but statistically significant lower respiratory rate, heart rate, blood pressure and O2 saturation. There was no significant difference between different kind of opioid prescription and its outcomes or side effects. Conclusion: Pain management should be always in physicians’ mind during emergency admissions. It should not be assumed that an addicted patient complaining of pain is malingering to receive drug. Titration of drug and close monitoring must be in the curriculum to prevent any hazardous side effects.

Keywords: numerical rating score, opioid, pain, emergency department

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1692 Length of Pregnancy and Dental Caries Observation in Relation to BMI

Authors: Edit Xhajanka, Gresa Baboci, Irene Malagnino, Mimoza Canga, Vito Antonio Malagnino

Abstract:

Purpose: This study aimed at identifying dental caries increment or reduction, based on factors such as smoking, the scaling of teeth, BMI before and during pregnancy, carbohydrates consumption in relation to childbirth. Material and method: In this observational study, the sample included a total of 98 pregnant women and their age class was 18-45 years old, with a median age of 31.5 years. The setting of the participants resides in Vlora –Albania. Moreover, 64.4% were from the city and 35.6% were from the nearby villages. The study was conducted in the time period January 2018 –June 2021. Body mass index (BMI) was calculated using the standard formula (kg/m²). Maternal pre, during and post-pregnancy BMI was collected by using a validated questionnaire. Statistical analysis was performed using IBM SPSS Statistics 23.0. The significance level (α) was set at 0.05, whereas P-value and analysis of variance (ANOVA) were used to analyze the data. Results: Based on the data analysis, 44.4% of the sample declared that they did smoke before pregnancy and 55.6% not smoked during their pregnancy. As a result, no association was found between smoking and length of pregnancy P=0.95. There is also a strong relation (P=0.000) between the number of teeth with caries before pregnancy and the number of teeth with caries during pregnancy. There is a significant relationship between the scaling of teeth and childbirth, P=0.05. BMI before and during pregnancy in relation to carbohydrates consumption have a significant correlation P=0.004 and P=0.002. The values of BMI before and during pregnancy in relation to childbirth have a strong correlation: P=0.043 and P=0.040, respectively. As a result, obesity was associated with preterm birth. The percentage of children born during 34-36 weeks of pregnancy was 69%, and children born during 32-34 weeks of pregnancy were 31%. CONCLUSION: There was a positive association between dental caries experience, BMI and carbohydrates consumption. Obesity in pregnancy is increasing worldwide; that is why this study suggests the importance of an appropriate weight before and during pregnancy.

Keywords: BMI, dental caries, pregnancy, scaling, smoking

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1691 The Impact of Generative AI Illustrations on Aesthetic Symbol Consumption among Consumers: A Case Study of Japanese Anime Style

Authors: Han-Yu Cheng

Abstract:

This study aims to explore the impact of AI-generated illustration works on the aesthetic symbol consumption of consumers in Taiwan. The advancement of artificial intelligence drawing has lowered the barriers to entry, enabling more individuals to easily enter the field of illustration. Using Japanese anime style as an example, with the development of Generative Artificial Intelligence (Generative AI), an increasing number of illustration works are being generated by machines, sparking discussions about aesthetics and art consumption. Through surveys and the analysis of consumer perspectives, this research investigates how this influences consumers' aesthetic experiences and the resulting changes in the traditional art market and among creators. The study reveals that among consumers in Taiwan, particularly those interested in Japanese anime style, there is a pronounced interest and curiosity surrounding the emergence of Generative AI. This curiosity is particularly notable among individuals interested in this style but lacking the technical skills required for creating such artworks. These works, rooted in elements of Japanese anime style, find ready acceptance among enthusiasts of this style due to their stylistic alignment. Consequently, they have garnered a substantial following. Furthermore, with the reduction in entry barriers, more individuals interested in this style but lacking traditional drawing skills have been able to participate in producing such works. Against the backdrop of ongoing debates about artistic value since the advent of artificial intelligence (AI), Generative AI-generated illustration works, while not entirely displacing traditional art, to a certain extent, fulfill the aesthetic demands of this consumer group, providing a similar or analogous aesthetic consumption experience. Additionally, this research underscores the advantages and limitations of Generative AI-generated illustration works within this consumption environment.

Keywords: generative AI, anime aesthetics, Japanese anime illustration, art consumption

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1690 Beyond Adoption: Econometric Analysis of Impacts of Farmer Innovation Systems and Improved Agricultural Technologies on Rice Yield in Ghana

Authors: Franklin N. Mabe, Samuel A. Donkoh, Seidu Al-Hassan

Abstract:

In order to increase and bridge the differences in rice yield, many farmers have resorted to adopting Farmer Innovation Systems (FISs) and Improved Agricultural Technologies (IATs). This study econometrically analysed the impacts of adoption of FISs and IATs on rice yield using multinomial endogenous switching regression (MESR). Nine-hundred and seven (907) rice farmers from Guinea Savannah Zone (GSZ), Forest Savannah Transition Zone (FSTZ) and Coastal Savannah Zone (CSZ) were used for the study. The study used both primary and secondary data. FBO advice, rice farming experience and distance from farming communities to input markets increase farmers’ adoption of only FISs. Factors that increase farmers’ probability of adopting only IATs are access to extension advice, credit, improved seeds and contract farming. Farmers located in CSZ have higher probability of adopting only IATs than their counterparts living in other agro-ecological zones. Age and access to input subsidy increase the probability of jointly adopting FISs and IATs. FISs and IATs have heterogeneous impact on rice yield with adoption of only IATs having the highest impact followed by joint adoption of FISs and IATs. It is important for stakeholders in rice subsector to champion the provision of improved rice seeds, the intensification of agricultural extension services and contract farming concept. Researchers should endeavour to researched into FISs.

Keywords: farmer innovation systems, improved agricultural technologies, multinomial endogenous switching regression, treatment effect

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1689 Human Development and Entrepreneurship: Examining the Sources of Freedom and Unfreedom in the Realization of Entrepreneurship in Iran

Authors: Iman Shabanzadeh

Abstract:

The purpose of this research is to understand the lived experience of private sector entrepreneurs in facing the sources of freedom and unfreedom and benefiting from opportunities and basic capabilities in the process of realizing entrepreneurial ability in order to get closer to the macro situation of the narrative of human development in Iranian society. Therefore, the main question of the present research is to figure out what sources of freedom and social opportunities and unfreedom entrepreneurs in Iran's society benefit from the process of transforming their potential entrepreneurial abilities into entrepreneurial and business enterprises. In terms of methodology, the current research method will be thematic analysis in the form of semi-structured interviews with entrepreneurs active in small and medium-sized enterprises in Tehran, whose process of establishing and expanding their entrepreneurial activity has been in the last two decades. By examining the possibilities and refusals of advancing these people in the three stages of 'Idea creation and desire for entrepreneurship’, ‘Starting and creating a business’, and finally, ‘Continuing and expanding the business’, the findings of the research show the impact of five main resources for people to realize their potential talents, from the stage of creating an idea to expanding their business. These sources include' family institution,’ ‘education institution,’ ‘social norms and beliefs,’ ‘government and market,’ and ‘personality components of the entrepreneur.’ Finally, the findings are reported in three levels of basic themes (fifteen items), organizing themes (five items), and comprehensive themes (one item) and in the form of a theme network.

Keywords: entrepreneurship, human development, capability, sources of freedom

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1688 Exploring the Determinants of Boko Haram Terrorism in Nigerian Security Systems and Economy

Authors: Abara Onu, Augustine Mina Ephraim, Emmanuel Teidi

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Terrorism has been a major challenge and is so dare to the Nigerian government in recent times. The actions and activities of the Islamic sect known as Boko Haram had led to enormous loss of lives and properties in the country, mostly the Northern part of Nigeria. Some of these activities entails bombings, suicide attacks, intimidations, sporadic gunfire of the unarmed, blameless and innocent Nigerians, burning of police stations and churches, kidnappings, raping of school girls and women. Nigeria has also been included amongst one of the terrorist countries of the world. This has serious implications for the development of Nigerian economy. Although, Nigeria had made several worried hard work to deal with these challenges masqueraded by terrorism and insecurity in the country but the rate of insurgency and insecurity is still worrisome. The study looks at exploring the determinants of Boko Haram terrorism in Nigerian security systems and economy. Data used for the study work was from questionnaire administered, using Analysis of Variance (ANOVA) method to analyse the data. The result shows that Ideology and funding are significant basic factors that propelled the Boko Haram group in Nigeria. The Boko Haram disaster poses a significant threat to Nigeria’s economy and the military is the best option and solution in tackling the Boko Haram menace in Nigeria. The work x-rayed the following recommendations; government should declare war on terrorism and as well seek support and cooperation from international communities who in time or the other might have faced with this kind ugly experience and challenge and were able to tackle it. Nigerian Military needs to be more empowered with high dangerous weapons to combat the insurgency as well as beef up security across the Country to curb the threats.

Keywords: terrorism, economy, Boko Haram, Nigeria

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1687 Stigma and Discrimination toward Mental Illness: Translation and Validation of the Attribution Questionnaire-27 (AQ-27)

Authors: Gokcen Akyurek, Hulya Kayihan, Deniz Yuce, Selen Yilmaz

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The stigma towards mental illness is still very rooted in our society, despite the number of studies, campaigns, and anti-stigma programs developed in recent years. Stigma represents a serious obstacle to recovery and social integration for people who experience a mental illness, affecting directly their well-being and quality of life. It implies that these persons have to deal with many other barriers apart from the disease symptoms (1-5). Convergent, recent literature suggests that less positive attitudes by mental health professionals interfere with the self-determination and recovery process (4-10).The aim of this study was to translate the Attribution Questionnaire-27 (AQ-27) to the Turkish language (AQ-27-T), and to examine the reliability and validity of this new Turkish version. Cultural adaptation was implemented according to the internationally suggested method. To determine the understandability and appropriateness of this measure for the Turkish culture, a pretest was administered and the final form was generated. Then, 424 randomly chosen people took part in the study. Participant’s mean age was 36.9±12.7 years and %52 of them female. Cronbach's alpha and intra-class coefficients were used to estimate instrument reliability. The AQ-27-T was assessed again 14 days later for test retest reliability. The AQ-27-T demonstrated acceptable internal consistency, with a Cronbach's alpha of 0.88 for the total scale and ranging between 0.86 and 0.89 for the items. The test-retest reliability was good, with Pearson correlation coefficients of 0.79 for the total scale and ranging between 0.35 and 0.77 for the items (p<0.05). Correlation between subscales was moderate-good, with Pearson correlation coefficients of 0.18-0.88 (p<0.05). Fit indices of the model supported the factor structure and paths. The AQ-27-T is a reliable measure to assess stigmatizing attitudes in Turkish.

Keywords: attribution questionnaire, validity, reliability, stigma

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1686 Entrepreneurship And Heritage Tourism: Identifying Opportunities Around Tsodilo Hills World Heritage Site

Authors: O. Nthoi-Molefe, V. Makwinja

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In the North West district of Botswana, Heritage tourism has the potential to offer tremendous economic and social opportunities for local communities in terms of supporting Tourism product development and entrepreneurship. This paper Identifies that Cultural Heritage Entrepreneur brings to the market goods and services, organizes and runs cultural heritage in a commercial or non-profit manner depending on characteristics of cultural resources identified. Data was collected through a series of focus group discussions that included sixteen village community members within the region. Data collected was transcribed and then further analyzed thematically to bring forward results to be analysed. Using Tsodilo Hills World Heritage Site as a case study, the researchers acknowledged that Cultural Heritage Entrepreneurs in that area should use a creative approach in order toidentify suitable solutions for financing different tourism activities starting with sponsored events, grant funds, donations, including the benefits of financial opportunities brough be foreign visitors and domestic tourists alike. The researchers also identified a need for specialized training for the identified entrepreneurs in order to maintain quality services of tourism products and sites (interpretation), information for tourists, visitation services, diversification, and upgrading of the heritage experience. The research reveals that the identified Cultural Heritage Entrepreneurs prefer economic motivation, exploitation over the cultural value of their resources, further calling for recommendations of the research that emphasize on the need for detailed training on how to valorize their cultural resources for the growth of Tourism in the area.

Keywords: education, community development, entrepreneurship, cultural tourism

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1685 Signs and Symbols of a Modern Sufi Ceremony in Istanbul

Authors: Antonio De Lisa

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The aim of this contribution is to describe a Sufi ceremony personally observed and recorded in Istanbul. It is part of research on the semiotics of religion that has been going on for some time. Over the centuries, Sufism has produced remarkable literature, elaborated mainly in the context of Arabic literature and Persian literature, but has also found expression in many other languages (Turkish, Indian, Malayo-Indonesian, etc.). Among the genres cultivated are: devotional books (prayers, meditation, spiritual exercises, etc.); the hagiographic texts, containing the biographies and sentences of the best-known Sufis; the texts that illustrate the abodes or stations of the spiritual path; finally, the theoretical treatises on various topics, often of an apologetic nature. Another typical expression of Sufism is in the literature in verse, which includes first-rate poets of both Arabic (Ibn al-Farid, Ibn 'Arabi) and Persian (Farid al-Din al-Attar, Rumi, Hafez, Gohar Shahi) expression. To observe an authentic Sufi ceremony, we contacted the Silivrikapı Mevlana Cultural Center in Istanbul. The ceremony we will talk about is a characteristic of the brotherhood called Mevleviyye (Mawlawiyya), so called from Mawlānā ('our lord', in Turkish: Mevlānā) Jalāl al-Dīn Muḥammad Rūmī (13th century) better known as the brotherhood of the Whirling Dervishes, founded in Konya. The characteristic of the order is to pray about one's love for Allah with music and dance in a ritual that has the name of Semà. The dance is a swirling movement in a group, representing a mystical journey of the spiritual ascent of man through the mind and love for the 'perfect'. Turning towards the truth, the follower of the group ascends towards love, passing beyond the World and Nothingness. After asceticism, he returns to the common world to communicate his own experience.

Keywords: semiotics of religion, sufi, rumi, islamic philosophy

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1684 Business Program Curriculum with Industry-Recognized Certifications: An Empirical Study of Exam Results and Program Curriculum

Authors: Thomas J. Bell III

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Pursuing a business degree is fraught with perplexing questions regarding the rising tuition cost and the immediate value of earning a degree. Any decision to pursue an undergraduate business degree is perceived to have value if it facilitates post-graduate job placement. Business programs have decreased value in the absence of innovation in business programs that close the skills gap between recent graduates and employment opportunities. Industry-based certifications are seemingly becoming a requirement differentiator among job applicants. Texas Wesleyan University offers a Computer Information System (CIS) program with an innovative curriculum that integrates industry-recognized certification training into its traditional curriculum with core subjects and electives. This paper explores a culture of innovation in the CIS business program curriculum that creates sustainable stakeholder value for students, employers, the community, and the university. A quantitative research methodology surveying over one-hundred students in the CIS program will be used to examine factors influencing the success or failure of students taking certification exams. Researchers will analyze control variables to identify specific correlations between practice exams, teaching pedagogy, study time, age, work experience, etc. This study compared various exam preparation techniques to corresponding exam results across several industry certification exams. The findings will aid in understanding control variables with correlations that positively and negatively impact exam results. Such discovery may provide useful insight into pedagogical impact indicators that positively contribute to certification exam success and curriculum enhancement.

Keywords: taking certification exams, exam training, testing skills, exam study aids, certification exam curriculum

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1683 Impact of Mammographic Screening on Ethnic Inequalities in Breast Cancer Stage at Diagnosis and Survival in New Zealand

Authors: Sanjeewa Seneviratne, Ian Campbell, Nina Scott, Ross Lawrenson

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Introduction: Indigenous Māori women experience a 60% higher breast cancer mortality rate compared with European women in New Zealand. We explored the impact of difference in the rate of screen detected breast cancer between Māori and European women on more advanced disease at diagnosis and lower survival in Māori women. Methods: All primary in-situ and invasive breast cancers diagnosed in screening age women (as defined by the New Zealand National Breast Cancer Screening Programme) between 1999 and 2012 in the Waikato area were identified from the Waikato Breast Cancer Register and the national screening database. Association between screen versus non-screen detection and cancer stage at diagnosis and survival were compared by ethnicity and socioeconomic deprivation. Results: Māori women had 50% higher odds of being diagnosed with more advance staged cancer compared with NZ European women, a half of which was explained by the lower rate of screen detected cancer in Māori women. Significantly lower breast cancer survival rates were observed for Māori compared with NZ European and most deprived compared with most affluent socioeconomic groups for symptomatically detected breast cancer. No significant survival differences by ethnicity or socioeconomic deprivation were observed for screen detected breast cancer. Conclusions: Low rate of screen detected breast cancer appears to be a major contributor for more advanced stage disease at diagnosis and lower breast cancer survival in Māori compared with NZ European women. Increasing screening participation for Māori has the potential to substantially reduce breast cancer mortality inequity between Māori and NZ European women.

Keywords: breast cancer, screening, ethnicity, inequity

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1682 Importance of Field Hospitals in Trauma Management: An Experience from Nepal Earthquake

Authors: Krishna Gopal Lageju

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On 25th April 2015, a 7.6 magnitude earthquake struck Gorkha district of Nepal, which resulted over 8,790 deaths and 22,300 injuries. In addition, almost one-third of the country’s healthcare service has been disrupted. A total of 1,211 health facilities became non-operational, due to 446 completely and other 765 partially damaged. Nearly 84 percent (375 out of 446) of the completely damaged health facilities are in the 14 most affected districts. As a result, the ability of health facilities to respond to health care needs has been harshly affected. In addition, 18 health workers lost their lives and 75 are injured, which added further challenges in the delivery of health services. Thus, to address the immediate health needs in the most devastated areas, Nepal Red Cross Society (NRCS) in coordination with IFRC and Nepal Government, 8 Field hospitals established with surgical capacities, where around 492 international Emergency Response Units (ERUs) Members are mobilized for 3 months period. More than 54,000 patients have been treated in the Red Cross operated field hospitals. Trauma cases accounted 9,180 (17%) of the total patients off which 1,285 (14%) are major surgical cases. Most of the case loads 44,830 (83%) are outpatients and 9,180 patients got inpatients service. Similarly, 112 births have been performed in the field hospitals. Inpatient mortality rate remained 1.5% (21 deaths), many of them are presented with critical injuries or illnesses. No outbreak has been seen during the ERU operation. Deployment of ERUs together with national health workers are very important to address the immediate health needs of the affected communities. This will ease for transition and handover of emergency service and equipments to local provider. Likewise, capacity building of local staff as on the job training on various clinical teachings would be another important issue to look at before phasing out such services.

Keywords: trauma management, critical injuries, earthquake, health

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1681 Knowledge Management Efficiency of Personnel in Rajamangala University of Technology Srivijaya Songkhla, Thailand

Authors: Nongyao Intasaso, Atchara Rattanama, Navarat Pewnual

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This research is survey research purposed to study the factor affected to knowledge management efficiency of personnel in Rajamangala University of Technology Srivijaya, and study the problem of knowledge management affected to knowledge development of personnel in the university. The tool used in this study is structures questioner standardize rating scale in 5 levels. The sample selected by purposive sampling and there are 137 participation calculated in 25% of population. The result found that factor affected to knowledge management efficiency in the university included (1) result from the organization factor found that the university provided project or activity that according to strategy and mission of knowledge management affected to knowledge management efficiency in highest level (x̅ = 4.30) (2) result from personnel factor found that the personnel are eager for knowledge and active to learning to develop themselves and work (Personal Mastery) affected to knowledge management efficiency in high level (x̅ = 3.75) (3) result from technological factor found that the organization brought multimedia learning aid to facilitate learning process affected to knowledge management efficiency in high level (x̅ = 3.70) and (4) the result from learning factor found that the personnel communicated and sharing knowledge and opinion based on acceptance to each other affected to knowledge management efficiency in high level (x̅ = 3.78). The problem of knowledge management in the university included the personnel do not change their work behavior, insufficient of collaboration, lack of acceptance in knowledge and experience to each other, and limited budget. The solutions to solve these problems are the university should be support sufficient budget, the university should follow up and evaluate organization development based on knowledge using, the university should provide the activity emphasize to personnel development and assign the committee to process and report knowledge management procedure.

Keywords: knowledge management, efficiency, personnel, learning process

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1680 English Language Teachers' Perceptions of Educational Research

Authors: Pinar Sali, Esim Gursoy, Ebru Atak Damar

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Teachers’ awareness of and involvement in educational research (ER) is regarded as an indispensable aspect of professional growth and development. It is also believed to be a catalyst for effective teaching and learning. This strong emphasis on the significance of teacher research engagement has sparked inquiry into how teachers construe ER and whether or not they practice it. However, there seems to exist a few researches on teachers’ perceptions of and experience with ER in the field of English Language Teaching (ELT). The present study thus attempts to fill this gap in the ELT literature and aims to unearth English language teachers’ perceptions of ER. Understanding these perceptions would undoubtedly aid in the development of strategies to promote teacher interest and involvement in research. The participants of the present study are 70 English language teachers in public and private schools in Turkey. A mixed-method approach has been used in the study. Both qualitative and quantitative data have been gathered by means of a questionnaire consisting of two parts. The first part of the questionnaire consists of 20 close-ended items of Teachers’ Attitude Scale Towards Educational Research (TASTER). The second part of the questionnaire has been developed by the researchers via an extensive literature review and consists of a mixture of close- and open-ended questions. In addition, 15 language teachers have been interviewed for an in-depth understanding of the results. Descriptive statistics and dual comparisons have been employed for the quantitative data, and the qualitative data have been analyzed by means of content analysis. The present study provides intriguing information as to the English language teachers’ perceptions of the usefulness and practicality of ER as well as the value they attain to it. The findings are discussed in relation to language teacher education. The research has implications for the teacher education process, teacher trainers and policy makers.

Keywords: attitudes toward educational research, educational research, language teachers, teacher research

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1679 Stressors Faced by Border Security Officers: The Singapore Experience

Authors: Jansen Ang, Andrew Neo, Dawn Chia

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Border Security is unlike mainstream policing in that officers are essentially in static deployment, working round the clock every day and every hour of the year looking for illegitimate entry of persons and goods. In Singapore, Border Security officers perform multiple functions to ensure the nation’s safety and security. They are responsible for safeguarding the borders of Singapore to prevent threats from entering the country. Being the first line of defence in ensuring the nation’s border security officers are entrusted with the responsibility of screening travellers inbound and outbound of Singapore daily. They examined 99 million arrivals and departures at the various checkpoints in 2014, which is a considerable volume compared to most immigration agencies. The officers’ work scopes also include cargo clearance, protective and security functions of checkpoints. The officers work in very demanding environment which can range from the smog at the land checkpoints to the harshness of the ports at the sea checkpoints. In addition, all immigration checkpoints are located at the boundaries, posing commuting challenges for officers. At the land checkpoints, festive seasons and school breaks are peak periods as given the surge of inbound and outbound travellers at the various checkpoints. Such work provides unique challenges in comparison to other law enforcement duties. This paper assesses the current stressors faced by officers of a border security agency through the conduct of ground observations as well as a perceived stress survey as well as recommendations in combating stressors faced by border security officers. The findings from the field observations and surveys indicate organisational and operational stressors that are unique to border security and recommends interventions in managing these stressors. Understanding these stressors would better inform border security agencies on the interventions needed to enhance the resilience of border security officers.

Keywords: border security, Singapore, stress, operations

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1678 Matching Coping Strategies to Athletic Retirement Stressors among Japanese Female Athletes

Authors: Miyako Oulevey, David Lavallee, Naohiko Kohtake

Abstract:

Retirement from sport can be stressful to athletes for many reasons. Accordingly, it is necessary to match coping strategies depending on the stressors. One of the athlete career assistance programs for Japanese top athletes in Japan, the Japan Olympic Committee Career Academy (JCA), has focused on the service contents regarding occupational supports which can be said to cope with financial and occupational stress; however, other supports such as psychological support were unclear due to the lack of psychological professionals in the JCA. Tailoring the program, it is important to match the needs of the athletes at athletic retirement with the service contents. Japanese Olympic athletes have been found to retire for different reasons. Especially female athletes who competed in the Summer Olympic Games were found to retire with psychological reasons. The purpose of this research was to investigate the types of stressors Japanese female athletes experience as a result of athletic retirement. As part of the study, 44 female retired athletes from 13 competitive sports completed an open-ended questionnaire. The KJ method was used to analyze stress experienced as a result of retirement. As a result, nine conceptualized stressors were aggregated such as “Conflict with athletic identity”, “Desire to live as an athlete”, and “Career plan after retirement”. In order to match the coping strategies according to the stressors, each stressor was classified with the four types of adjustments; psychological, social, financial, and occupational changes. As a result, the stressor relating to psychological adjustment accounted for 69.0% of coping-related needs, the financial and occupational adjustment was 21.8%, and social adjustment was 9.2%. In conclusion, coping strategies according to the stressors are suggested.

Keywords: athletic retirement, coping, female athlete, stress

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1677 The Underestimation of Cultural Risk in the Execution of Megaprojects

Authors: Alan Walsh, Peter Walker, Michael Ellis

Abstract:

There is a real danger that both practitioners and researchers considering risks associated with megaprojects ignore or underestimate the impacts of cultural risk. The paper investigates the potential impacts of a failure to achieve cultural unity between the principal actors executing a megaproject. The principle relationships include the relationships between the principle Contractors and the project stakeholders or the project stakeholders and their principle advisors, Western Consultants. This study confirms that cultural dissonance between these parties can delay or disrupt the megaproject execution and examines why cultural issues should be prioritized as a significant risk factor in megaproject delivery. This paper addresses the practical impacts and potential mitigation measures, which may reduce cultural dissonance for a megaproject's delivery. This information is retrieved from on-going case studies in live infrastructure megaprojects in Europe and the Middle East's GCC states, from Western Consultants' perspective. The collaborating researchers each have at least 30 years of construction experience and are engaged in architecture, project management and contracts management, dealing with megaprojects in Europe or the GCC. After examining the cultural interfaces they have observed during the execution of megaprojects, they conclude that globally, culture significantly influences their efficient delivery. The study finds that cultural risk is ever-present, where different nationalities co-manage megaprojects and that cultural conflict poses a real threat to the timely delivery of megaprojects. The study indicates that the higher the cultural distance between the principal actors, the more pronounced the risk, with the risk of cultural dissonance more prominent in GCC megaprojects. The findings support a more culturally aware and cohesive team approach and recommend cross-cultural training to mitigate the effects of cultural disparity.

Keywords: cultural risk underestimation, cultural distance, megaproject characteristics, megaproject execution

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1676 Qualitative Analysis of Current Child Custody Evaluation Practices

Authors: Carolyn J. Ortega, Stephen E. Berger

Abstract:

The role of the custody evaluator is perhaps one of the most controversial and risky endeavors in clinical practice. Complaints filed with licensing boards regarding a child-custody evaluation constitute the second most common reason for such an event. Although the evaluator is expected to answer for the family-law court what is in the “best interest of the child,” there is a lack of clarity on how to establish this in any empirically validated manner. Hence, practitioners must contend with a nebulous framework in formulating their methodological procedures that inherently places them at risk in an already litigious context. This study sought to qualitatively investigate patterns of practice among doctoral practitioners conducting child custody evaluations in the area of Southern California. Ten psychologists were interviewed who devoted between 25 and 100% of their California private practice to custody work. All held Ph.D. degrees with a range of eight to 36 years of experience in custody work. Semi-structured interviews were used to investigate assessment practices, ensure adherence to guidelines, risk management, and qualities of evaluators. Forty-three Specific Themes were identified using Interpretive Phenomenological Analysis (IPA). Seven Higher Order Themes clustered on salient factors such as use of Ethics, Law, Guidelines; Parent Variables; Child Variables; Psychologist Variables; Testing; Literature; and Trends. Evaluators were aware of the ever-present reality of a licensure complaint and thus presented idiosyncratic descriptions of risk management considerations. Ambiguity about quantifying and validly tapping parenting abilities was also reviewed. Findings from this study suggested a high reliance on unstructured and observational methods in child custody practices.

Keywords: forensic psychology, psychological testing, assessment methodology, child custody

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1675 Computerized Cognitive Training and Psychological Resiliency among Adolescents with Learning Disabilities

Authors: Verd Shomrom, Gilat Trabelsi

Abstract:

The goal of the study was to examine the effects of Computerized Cognitive Training (CCT) with and without cognitive mediation on Executive Function (EF) (planning and self- regulation) and on psychological resiliency among adolescents with Attention Deficits Hyperactive Disorder (ADHD) with or without Learning Disabilities (LD). Adolescents diagnosed with Attention Deficit Disorder and / or Learning Disabilities have multidimensional impairments that result from neurological damage. This work explored the possibility of influencing cognitive aspects in the field of Executive Functions (specifically: patterns of planning and self-regulation) among adolescents with a diagnosis of Attention Deficit Disorder and / or Learning Disabilities who study for a 10-12 grades. 46 adolescents with ADHD and/or with LD were randomly applied to experimental and control groups. All the participants were tested (BRC- research version, Resiliency quaternaries) before and after the intervention: mediated/ non-mediated Computerized Cognitive Training (MINDRI). The results indicated significant effects of cognitive modification in the experimental group, between pre and post Phases, in comparison to control group, especially in self- regulation (BRC- research version, Resiliency quaternaries), and on process analysis of Computerized Cognitive Training (MINDRI). The main conclusion was that even short- term mediation synchronized with CCT could greatly enhance the performance of executive functions demands. Theoretical implications for the positive effects of MLE in combination with CCT indicate the ability for cognitive change. The practical implication is the awareness and understanding of efficient intervention processes to enhance EF, learning awareness, resiliency and self-esteem of adolescents in their academic and daily routine.

Keywords: attention deficits hyperactive disorder, computerized cognitive training, executive function, mediated learning experience, learning disabilities

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1674 The Impact of Artificial Intelligence on Pharmacy and Pharmacology

Authors: Mamdouh Milad Adly Morkos

Abstract:

Despite having the greatest rates of mortality and morbidity in the world, low- and middle-income (LMIC) nations trail high-income nations in terms of the number of clinical trials, the number of qualified researchers, and the amount of research information specific to their people. Health inequities and the use of precision medicine may be hampered by a lack of local genomic data, clinical pharmacology and pharmacometrics competence, and training opportunities. These issues can be solved by carrying out health care infrastructure development, which includes data gathering and well-designed clinical pharmacology training in LMICs. It will be advantageous if there is international cooperation focused at enhancing education and infrastructure and promoting locally motivated clinical trials and research. This paper outlines various instances where clinical pharmacology knowledge could be put to use, including pharmacogenomic opportunities that could lead to better clinical guideline recommendations. Examples of how clinical pharmacology training can be successfully implemented in LMICs are also provided, including clinical pharmacology and pharmacometrics training programmes in Africa and a Tanzanian researcher's personal experience while on a training sabbatical in the United States. These training initiatives will profit from advocacy for clinical pharmacologists' employment prospects and career development pathways, which are gradually becoming acknowledged and established in LMICs. The advancement of training and research infrastructure to increase clinical pharmacologists' knowledge in LMICs would be extremely beneficial because they have a significant role to play in global health

Keywords: electromagnetic solar system, nano-material, nano pharmacology, pharmacovigilance, quantum theoryclinical simulation, education, pharmacology, simulation, virtual learning low- and middle-income, clinical pharmacology, pharmacometrics, career development pathways

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1673 Analyzing the Effectiveness of Communication Practices and Processes within Project-Based Firms

Authors: Paul Saah, Charles Mbohwa, Nelson Sizwe Madonsela

Abstract:

The capacity to deliver projects on schedule, within budget, and to the pleasure of the client depends on effective communication, which is the lifeblood of project-based businesses. In order to pinpoint areas for development and shed light on the crucial role that communication plays in project success, the aim of this study is to evaluate the efficacy of communication practises and processes inside project-based organisations. In order to analyse concepts and get a greater grasp of their theoretical basis, this study's methodology combines a careful review of the relevant literature with a conceptual analysis of the subject. Data from a varied sample of project-based businesses spanning all industries and sizes were collected via document analysis. The relationship between communication practises, and processes were investigated in connection to key performance measures such as project outcomes, client satisfaction, and team dynamics. According to the study's findings, project-based businesses that adopt effective communication practises, and procedures experience a reduction in unfavourable experiences, stronger integration, and coordination, clarity of purpose, and practises that can hasten problem resolution. However, failing to adopt effective communication practises and procedures in project-based company result in counter issues, including project derailment from the schedule, failure to meet goals, inefficient use of existing resources, and failure to meet organisational goals. Therefore, optimising their communication practises, and procedures are crucial for sustainable growth and competitive advantage as project-based enterprises continue to play a crucial part in today's dynamic business scene.

Keywords: effective communication, project-based firms, communication practices, project success, communication strategies

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1672 The Ideology of the Jordanian Media Women’s Discourse: Lana Mamkgh as an Example

Authors: Amani Hassan Abu Atieh

Abstract:

This study aims at examining the patterns of ideology reflected in the written discourse of women writers in the media of Jordan; Lana Mamkgh is taken as an example. This study critically analyzes the discursive, linguistic, and cognitive representations that she employs as an agent in the institutionalized discourse of the media. Grounded in van Dijk’s critical discourse analysis approach to Sociocognitive Discourse Studies, the present study builds a multilayer framework that encompasses van Dijk’s triangle: discourse, society, and cognition. Specifically, the study attempts to analyze, at both micro and macro levels, the underlying cognitive processes and structures, mainly ideology and discursive strategies, which are functional in the production of women’s discourse in terms of meaning, forms, and functions. Cognitive processes that social actors adopt are underlined by experience/context and semantic mental models on the one hand and social cognition on the other. This study is based on qualitative research and adopts purposive sampling, taking as an example a sample of an opinion article written by Lana Mamkgh in the Arabic Jordanian Daily, Al Rai. Taking her role as an agent in the public sphere, she stresses the National and feminist ideologies, demonstrating the use of assertive, evaluative, and expressive linguistic and rhetorical devices that appeal to the logic, ethics, and emotions of the addressee. Highlighting the agency of Jordanian writers in the media, the study sought to achieve the macro goal of dispensing political and social justice to the underprivileged. Further, the study seeks to prove that the voice of Jordanian women, viewed as underrepresented and invisible in the public arena, has come through clearly.

Keywords: critical discourse analysis, sociocognitive theory, ideology, women discourse, media

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1671 Analysis of Pressure Drop in a Concentrated Solar Collector with Direct Steam Production

Authors: Sara Sallam, Mohamed Taqi, Naoual Belouaggadia

Abstract:

Solar thermal power plants using parabolic trough collectors (PTC) are currently a powerful technology for generating electricity. Most of these solar power plants use thermal oils as heat transfer fluid. The latter is heated in the solar field and transfers the heat absorbed in an oil-water heat exchanger for the production of steam driving the turbines of the power plant. Currently, we are seeking to develop PTCs with direct steam generation (DSG). This process consists of circulating water under pressure in the receiver tube to generate steam directly into the solar loop. This makes it possible to reduce the investment and maintenance costs of the PTCs (the oil-water exchangers are removed) and to avoid the environmental risks associated with the use of thermal oils. The pressure drops in these systems are an important parameter to ensure their proper operation. The determination of these losses is complex because of the presence of the two phases, and most often we limit ourselves to describing them by models using empirical correlations. A comparison of these models with experimental data was performed. Our calculations focused on the evolution of the pressure of the liquid-vapor mixture along the receiver tube of a PTC-DSG for pressure values and inlet flow rates ranging respectively from 3 to 10 MPa, and from 0.4 to 0.6 kg/s. The comparison of the numerical results with experience allows us to demonstrate the validity of some models according to the pressures and the flow rates of entry in the PTC-DSG receiver tube. The analysis of these two parameters’ effects on the evolution of the pressure along the receiving tub, shows that the increase of the inlet pressure and the decrease of the flow rate lead to minimal pressure losses.

Keywords: direct steam generation, parabolic trough collectors, Ppressure drop, empirical models

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1670 Ilizarov's External Fixator. A Bone Regeneration Method Little Used in Africa. Our Experience of 20 Years in Cameroon.

Authors: Ibrahima Farikou, Kolontchang Gatchou Alberic Lionel, Tsiagadgui Jean Gustave, Ngo Yamben Marie-Ange, Handy Eone Daniel

Abstract:

Introduction: It was in 1956 that Ilizarov pioneered the concept of osteogenesis in distraction by the device that bears his name to help produce bone and soft tissue regeneration and bone consolidation. This technique is not widely used in Africa where, however, its applications are numerous (loss of bone substances, congenital or acquired malformations). Our goal is to bring the indications of Ilizarov's device back to our practice conditions. Methods: Our study was conducted in 2 hospitals over a period of 20 years. For the retrospective phase, this study included all complete usable records of patients operated on in the Ilizarov external fixator department, and for the prospective phase, all patients operated on in the departments with complete usable records. Our sample was consecutive and not exhaustive. Data were analyzed by SPSS software version 23.0. Results: A total of 52 patients were reviewed. The average age of our patients was 14.7 years. The sex ratio was 1.6 in favor of men. The lower limb was the most affected (49), with a predominance of the tibia (62.4%). The average elongation was 6.4 cm. Traumatic acquired pathologies (delayed union, malunion) represented 60.6%. The mean time to union was seven months. Correction of the limb length discrepancy or filling of loss of bone substance was obtained in 75% of cases. Functionally, 80.8% of the patients treated had regained autonomy at the end of treatment, but in 17.3% of the patients, pain and limping persisted. Conclusion: This technique should be popularized in Africa because the benefit that would accrue to patients is invaluable and would be an attractive alternative to many amputations sometimes carried out in Africa by despair.

Keywords: ilizarov, external fixator, limb lengthening, bone regeneration, africa

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1669 A Methodology to Integrate Data in the Company Based on the Semantic Standard in the Context of Industry 4.0

Authors: Chang Qin, Daham Mustafa, Abderrahmane Khiat, Pierre Bienert, Paulo Zanini

Abstract:

Nowadays, companies are facing lots of challenges in the process of digital transformation, which can be a complex and costly undertaking. Digital transformation involves the collection and analysis of large amounts of data, which can create challenges around data management and governance. Furthermore, it is also challenged to integrate data from multiple systems and technologies. Although with these pains, companies are still pursuing digitalization because by embracing advanced technologies, companies can improve efficiency, quality, decision-making, and customer experience while also creating different business models and revenue streams. In this paper, the issue that data is stored in data silos with different schema and structures is focused. The conventional approaches to addressing this issue involve utilizing data warehousing, data integration tools, data standardization, and business intelligence tools. However, these approaches primarily focus on the grammar and structure of the data and neglect the importance of semantic modeling and semantic standardization, which are essential for achieving data interoperability. In this session, the challenge of data silos in Industry 4.0 is addressed by developing a semantic modeling approach compliant with Asset Administration Shell (AAS) models as an efficient standard for communication in Industry 4.0. The paper highlights how our approach can facilitate the data mapping process and semantic lifting according to existing industry standards such as ECLASS and other industrial dictionaries. It also incorporates the Asset Administration Shell technology to model and map the company’s data and utilize a knowledge graph for data storage and exploration.

Keywords: data interoperability in industry 4.0, digital integration, industrial dictionary, semantic modeling

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1668 A Primary Care Diagnosis of Middle-Aged Men with Oral Cancer Who Underwent Extensive Resection and Flap Repair: A Case Report

Authors: Ching-Yi Huang, Pi-Fen Cheng, Hui-Zhu Chen, Shi Ting Huang, Heng-Hua Wang

Abstract:

This is a case of oral cancer after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap. The nursing period lasted From September 25 to October 3, 2017, through observation, interview, physical assessment, and medical record review, the author identified the following nursing problems: acute pain, impaired oral mucous membrane, and body image change. During the nursing period, the author provided individual and overall nursing care and established mutual trust through the use of empathy. Author listened and eased the patient's physical indisposition, such as wound pain, we use medications and acupuncture massage to relieve pain. However, for oral mucosa change caused by surgery, provide continuous and complete oral care and oral exercise training to improve oral mucosal healing and restore swallowing function. In the body-image changes, guided him to express his feeling after the body-image change, and enhanced support and from the family, and encouraged him to attend head and neck cancer survivor alliance which allowed the patient to accept the altered body image and reaffirm self-worth. Hopefully, through sharing this nursing experience will help to the nursing care quality of nursing care for oral cancer patients after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap.

Keywords: oral cancer, acute pain, impaired oral mucous membrane, body image change

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