Search results for: ESG scores
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1490

Search results for: ESG scores

1250 Adaptation and Validation of Voice Handicap Index in Telugu Language

Authors: B. S. Premalatha, Kausalya Sahani

Abstract:

Background: Voice is multidimensional which convey emotion, feelings, and communication. Voice disorders have an adverse effect on the physical, emotional and functional domains of an individual. Self-rating by clients about their voice problem helps the clinicians to plan intervention strategies. Voice handicap index is one such self-rating scale contains 30 questions that quantify the functional, physical and emotional impacts of a voice disorder on a patient’s quality of life. Each subsection has 10 questions. Though adapted and validated versions of VHI are available in other Indian languages but not in Telugu, which is a Dravidian language native to India. It is mainly spoken in Andhra Pradesh and neighbouring states in southern India. Objectives: To adapt and validate the English version of Voice Handicap Index (VHI) into Telugu language and evaluate its internal consistency and clinical validate in Telugu speaking population. Materials: The study carried out in three stages. First stage was a forward translation of English version of VHI, was given to ten experts, who were well proficient in writing and reading Telugu and five speech-language pathologists to translate into Telugu. Second Stage was backward translation where translated version of Telugu was given to a different group of ten experts (who were well proficient in writing and reading Telugu) and five speech-language pathologists who were native Telugu speakers and had good proficiency in Telugu and English. The third stage was an administration of translated version on Telugu to the targeted population. Totally 40 clinical subjects and 40 normal controls served as participants, and each group had 26 males and 14 females’ age range of 20 to 60 years. Clinical group comprised of individuals with laryngectomee with the Tracheoesophageal puncture (n=18), laryngitis (n=11), vocal nodules (n=7) and vocal fold palsy (n=4). Participants were asked to mark of their each experience on a 5 point equal appearing scale (0=never, 1=almost never, 2=sometimes, 3=almost always, 4=always) with a maximum total score of 120. Results: Statistical analysis was made by using SPSS software (22.0.0 Version). Mean, standard deviation and percentage (%) were calculated all the participants for both the groups. Internal consistency of VHI in Telugu was found to be excellent with the consistency scores for all the domains such as physical, emotional and functional are 0.742, 0.934and 0.938. The validity of scores showed a significant difference between clinical population and control group for domains like physical, emotional and functional and total scores. P value found to be less than 0.001( < 0.001). Negative correlation found in age and gender among self-domains such as physical, emotional and functional total scores in dysphonic and control group. Conclusion: The present study indicated that VHI in Telugu is able to discriminate participants having voice pathology from normal populations, which make this as a valid tool to collect information about their voice from the participants.

Keywords: adaptation, Telugu Version, translation, Voice Handicap Index (VHI)

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1249 Development and Validation of a Coronary Heart Disease Risk Score in Indian Type 2 Diabetes Mellitus Patients

Authors: Faiz N. K. Yusufi, Aquil Ahmed, Jamal Ahmad

Abstract:

Diabetes in India is growing at an alarming rate and the complications caused by it need to be controlled. Coronary heart disease (CHD) is one of the complications that will be discussed for prediction in this study. India has the second most number of diabetes patients in the world. To the best of our knowledge, there is no CHD risk score for Indian type 2 diabetes patients. Any form of CHD has been taken as the event of interest. A sample of 750 was determined and randomly collected from the Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N.M.C., A.M.U., Aligarh, India. Collected variables include patients data such as sex, age, height, weight, body mass index (BMI), blood sugar fasting (BSF), post prandial sugar (PP), glycosylated haemoglobin (HbA1c), diastolic blood pressure (DBP), systolic blood pressure (SBP), smoking, alcohol habits, total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), physical activity, duration of diabetes, diet control, history of antihypertensive drug treatment, family history of diabetes, waist circumference, hip circumference, medications, central obesity and history of CHD. Predictive risk scores of CHD events are designed by cox proportional hazard regression. Model calibration and discrimination is assessed from Hosmer Lemeshow and area under receiver operating characteristic (ROC) curve. Overfitting and underfitting of the model is checked by applying regularization techniques and best method is selected between ridge, lasso and elastic net regression. Youden’s index is used to choose the optimal cut off point from the scores. Five year probability of CHD is predicted by both survival function and Markov chain two state model and the better technique is concluded. The risk scores for CHD developed can be calculated by doctors and patients for self-control of diabetes. Furthermore, the five-year probabilities can be implemented as well to forecast and maintain the condition of patients.

Keywords: coronary heart disease, cox proportional hazard regression, ROC curve, type 2 diabetes Mellitus

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1248 The Effectiveness of Psychodrama on Self-esteem Enhancement in Adolescent Boys

Authors: Saeed Dehnavi, Zahra Dehnavi

Abstract:

Background: Psychodrama, as a form of art therapy, helps people to enact and use role-plays for a specific problem, rather than just talking about it, in an effort to review the problem, gain feedback from group members, find appropriate solutions, and practice them for their life. This paper evaluated the effectiveness of psychodrama on enhancing self-esteem of young adolescent boys. Methodology: This is aquasi-experimental research study, using a pre-post testing plan with control group.From four secondary schools in Kermanshah – Iran, 210 adolescent boys (aged 13 and 14 years) were asked to complete Koper Smith's self-esteem measure scale. Given the low self-esteem scores (less than the cut-off of 23), a number of 20 individuals were selected and randomly placed into two control and experimental groups. The experimental group participated in a twelve-session psychodrama therapy plan for 6 weeks, while the control group received no intervention. Data analysis was carried out by the analysis of covariance (ANCOVA). Results: The results of ANCOVA analysis showed an increase in the post-test scores for self-esteem, and such increase was statistically significant. Conclusion: The findings indicated the effectiveness of psychodrama on self-esteem enhancement of young boys. During psychodrama sessions, the adolescents learned to take the initiative, communicate with others in an excited state, and improve their self-esteem with positive and constructive experiences.

Keywords: psychodrama, self-esteem, young adolescents, boys

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1247 Exploring Safety Culture in Interventional Radiology: A Cross-Sectional Survey on Team Members' Attitudes

Authors: Anna Bjällmark, Victoria Persson, Bodil Karlsson, May Bazzi

Abstract:

Introduction: Interventional radiology (IR) is a continuously growing discipline that allows minimally invasive treatments of various medical conditions. The IR environment is, in several ways, comparable to the complex and accident-prone operation room (OR) environment. This implies that the IR environment may also be associated with various types of risks related to the work process and communication in the team. Patient safety is a central aspect of healthcare and involves the prevention and reduction of adverse events related to patient care. To maintain patient safety, it is crucial to build a safety culture where the staff are encouraged to report events and incidents that may have affected patient safety. It is also important to continuously evaluate the staff´s attitudes to patient safety. Despite the increasing number of IR procedures, research on the staff´s view regarding patients is lacking. Therefore, the main aim of the study was to describe and compare the IR team members' attitudes to patient safety. The secondary aim was to evaluate whether the WHO safety checklist was routinely used for IR procedures. Methods: An electronic survey was distributed to 25 interventional units in Sweden. The target population was the staff working in the IR team, i.e., physicians, radiographers, nurses, and assistant nurses. A modified version of the Safety Attitudes Questionnaire (SAQ) was used. Responses from 19 of 25 IR units (44 radiographers, 18 physicians, 5 assistant nurses, and 1 nurse) were received. The respondents rated their level of agreement for 27 items related to safety culture on a five-point Likert scale ranging from “Disagree strongly” to “Agree strongly.” Data were analyzed statistically using SPSS. The percentage of positive responses (PPR) was calculated by taking the percentage of respondents who got a scale score of 75 or higher. The respondents rated which corresponded to response options “Agree slightly” or “Agree strongly”. Thus, average scores ≥ 75% were classified as “positive” and average scores < 75% were classified as “non-positive”. Findings: The results indicated that the IR team had the highest factor scores and the highest percentages of positive responses in relation to job satisfaction (90/94%), followed by teamwork climate (85/92%). In contrast, stress recognition received the lowest ratings (54/25%). Attitudes related to these factors were relatively consistent between different professions, with only a few significant differences noted (Factor score: p=0.039 for job satisfaction, p=0.050 for working conditions. Percentage of positive responses: p=0.027 for perception of management). Radiographers tended to report slightly lower values compared to other professions for these factors (p<0.05). The respondents reported that the WHO safety checklist was not routinely used at their IR unit but acknowledged its importance for patient safety. Conclusion: This study reported high scores concerning job satisfaction and teamwork climate but lower scores concerning perception of management and stress recognition indicating that the latter are areas of improvement. Attitudes remained relatively consistent among the professions, but the radiographers reported slightly lower values in terms of job satisfaction and perception of the management. The WHO safety checklist was considered important for patient safety.

Keywords: interventional radiology, patient safety, safety attitudes questionnaire, WHO safety checklist

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1246 A Comparison of Anger State and Trait Anger Among Adolescents with and without Visual Impairment

Authors: Sehmus Aslan, Sibel Karacaoglu, Cengiz Sevgin, Ummuhan Bas Aslan

Abstract:

Objective: Anger expression style is an important moderator of the effects on the person and person’s environment. Anger and anger expression have become important constructs in identifying individuals at high risk for psychological difficulties. To our knowledge, there is no information about anger and anger expression of adolescents with visual impairment. The aim of this study was to compare anger and anger expression among adolescents with and without visual impairment. Methods: Thirty-eight adolescents with visual impairment (18 female, 20 male) and 44 adolescents without visual impairment (22 female, 24 male), in totally 84 adolescents aged between 12 to 15 years, participated in the study. Anger and anger expression of the participants assessed with The State-Trait Anger Scale (STAS). STAS, a self-report questionnaire, is designed to measure the experience and expression of anger. STAS has four subtitles including continuous anger, anger in, anger out and anger control. Reliability and validity of the STAS have been well established among adolescents. Mann-Whitney U Test was used for statistical analysis. Results: No significant differences were found in the scores of continuous anger and anger out between adolescents with and without visual impairment (p < 0.05). On the other hand, there were differences in scores of anger control and anger in between adolescents with and without visual impairment (p>0.05). The score of anger control in adolescents with visual impairment were higher compared with adolescents without visual impairment. Meanwhile, the adolescents with visual impairment had lower score for anger in compared with adolescents without visual impairment. Conclusions: The results of this study suggest that there is no difference in anger level among adolescents with and without visual impairment meanwhile there is difference in anger expression.

Keywords: adolescent, anger, impaired, visual

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1245 The Effect of Bihemisferic Transcranial Direct Current Stimulation Therapy on Upper Extremity Motor Functions in Stroke Patients

Authors: Dilek Cetin Alisar, Oya Umit Yemisci, Selin Ozen, Seyhan Sozay

Abstract:

New approaches and treatment modalities are being developed to make patients more functional and independent in stroke rehabilitation. One of these approaches is transcranial direct stimulation therapy (tDCS), which aims to improve the hemiplegic upper limb function of stroke patients. tDCS therapy is not in the routine rehabilitation program; however, the studies about tDCS therapy on stroke rehabilitation was increased in recent years. Evaluate the effect of tDCS treatment on upper extremity motor function in patients with subacute stroke was aimed in our study. 32 stroke patients (16 tDCS group, 16 sham groups) who were hospitalized for rehabilitation in Başkent University Physical Medicine and Rehabilitation Clinic between 01.08.2016-20.01-2018 were included in the study. The conventional upper limb rehabilitation program was used for both tDCS and control group patients for 3 weeks, 5 days a week, for 60-120 minutes a day. In addition to the conventional stroke rehabilitation program in the tDAS group, bihemispheric tDCS was administered for 30 minutes daily. Patients were evaluated before treatment and after 1 week of treatment. Functional independence measure self-care score (FIM), Brunnstorm Recovery Stage (BRS), and Fugl-Meyer (FM) upper extremity motor function scale were used. There was no difference in demographic characteristics between the groups. There were no significant differences between BRS and FM scores in two groups, but there was a significant difference FIM score (p=0.05. FIM, BRS, and FM scores are significantly in the tDCS group, when before therapy and after 1 week of therapy, however, no difference is found in the shame group (p < 0,001). When FBS and FM scores were compared, there were statistical significant differences in tDCS group (p < 0,001). In conclusion, this randomized double-blind study showed that bihemispheric tDCS treatment was found to be superior to upper extremity motor and functional enhancement in addition to conventional rehabilitation methods in subacute stroke patients. In order for tDCS therapy to be used routinely in stroke rehabilitation, there is a need for more comprehensive, long-termed, randomized controlled clinical trials in order to find answers to many questions, such as the duration and intensity of treatment.

Keywords: cortical stimulation, motor function, rehabilitation, stroke

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1244 The Effectiveness of Psychodrama on Anxiety Enhancement in Adolescent Boys

Authors: Saeed Dehnavi, Marjan Pooee

Abstract:

Background - Psychodrama, as a form of art therapy, helps people to enact and use role-plays for a specific problem, rather than just talking about it, in an effort to review the problem, gain feedback from group members, find appropriate solutions, and practice them for their life. This paper evaluated the effectiveness of psychodrama on enhancing anxiety of young adolescent boys. Methodology - This is aquasi-experimental research study, using a pre-post testing plan with control group. From four secondary schools in Kermanshah - Iran, 210 adolescent boys (aged 13 and 14 years) were asked to complete Koper Smith's self-esteem measure scale. Given the low self-esteem scores (less than the cut-off of 23), a number of 20 individuals were selected and randomly placed into two control and experimental groups. The experimental group participated in a twelve-session psychodrama therapy plan for 6 weeks, while the control group received no intervention. Data analysis was carried out by the analysis of covariance (ANCOVA). Results - The results of ANCOVA analysis showed an increase in the post-test scores for anxiety, and such increase was statistically significant. Conclusion - The findings indicated the effectiveness of psychodrama on anxiety enhancement of young boys. During psychodrama sessions, the adolescents learned to take the initiative, communicate with others in an excited state, and improve their anxiety with positive and constructive experiences.

Keywords: anxiety, art therapy, psychodrama, young adolescents

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1243 Use of Cloud-Based Virtual Classroom in Connectivism Learning Process to Enhance Information Literacy and Self-Efficacy for Undergraduate Students

Authors: Kulachai Kultawanich, Prakob Koraneekij, Jaitip Na-Songkhla

Abstract:

The way of learning has been changed into a new paradigm since the improvement of network and communication technology, so learners have to interact with massive amount of the information. Thus, information literacy has become a critical set of abilities required by every college and university in the world. Connectivism is considered to be an alternative way to design information literacy course in online learning environment, such as Virtual Classroom (VC). With the change of learning pedagogy, VC is employed to improve the social capability by integrating cloud-based technology. This paper aims to study the use of Cloud-based Virtual Classroom (CBVC) in Connectivism learning process to enhance information literacy and self-efficacy of twenty-one undergraduate students who registered in an e-publishing course at Chulalongkorn University. The data were gathered during 6 weeks of the study by using the following instruments: (1) Information literacy test (2) Information literacy rubrics (3) Information Literacy Self-Efficacy (ILSE) Scales and (4) Questionnaire. The result indicated that students have information literacy and self-efficacy posttest mean scores higher than pretest mean scores at .05 level of significant after using CBVC in Connectivism learning process. Additionally, the study identified that the Connectivism learning process proved useful for developing information rich environment and a sense of community, and the CBVC proved useful for developing social connection.

Keywords: cloud-based, virtual classroom, connectivism, information literacy

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1242 Usage of Cord Blood Stem Cells of Asphyxia Infants for Treatment

Authors: Ahmad Shah Farhat

Abstract:

Background: Prenatal asphyxia or birth asphyxia is the medical situation resulting from a newborn infant that lasts long enough during the birth process to cause physical harm, usually to the brain. Human umbilical cord blood (UCB) is a well-established source of hematopoietic stem/progenitor cells (HSPCs) for allogeneic stem cell transplantation. These can be used clinically to care for children with malignant diseases. Low O2 can cause in proliferation and differentiation of stem cells. Method: the cord blood of 11 infants with 3-5 Apgar scores or need to cardiac pulmonary Resuscitation as an asphyxia group and ten normal infants with more than 8 Apgar scores as the normal group was collected, and after isolating hematopoietic stem cells, the cells were cultured in enriched media for 14 days to compare the numbers of colonies by microscope. Results: There was a significant difference in the number of RBC precursor colonies (red colonies) in cultured media with 107 cord blood hematopoietic stem cells of infants who were exposed to hypoxemia in two wells of palate. There was not a significant difference in the number of white cell colonies in the two groups in the two wells of the plate. Conclusion: Hypoxia in the perinatal period can cause the increase of hematopoietic stem cells of cord blood, special red precursor stem cells in vitro, like an increase of red blood cells in the body when exposed to low oxygen conditions. Thus, it will be usable.

Keywords: asphyxia, neonre, stem cell, red cell

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1241 Assessment of the Entrepreneurial Trends of Agricultural Undergraduates: A Study at Faculty of Agriculture, Eastern University, Sri Lanka

Authors: Tharsinithevy Kirupananthan, Thivahary Geretharan

Abstract:

Since creation of agricultural enterprises going to reflect the micro and macro level development of Sri Lanka, it is vey important to study the entrepreneurial trends of Agricultural Undergraduates. Likert scale scoring method was used to assess the responses of involvement, Role model effect, aware of demands, confidence and willingness. 37.8% were strongly agreed to do full time business. The average score for to do agriculture businesses were between agree and strongly agree. The average scores for role model effects were less than agree. Average score for aware of needs of society was less than agree. 75.7% of them were able to identify the demands of the society. The demands identified were human capital, self sufficient domestic production, safe and nutritional foods. The confidence of having enough skills score was less than agree. 64.1% of them were owned special skills to carry out entrepreneurial activities. Such skills were possession of different human capitals management skills. The willingness responses scores were more than agree. 61.5% of them were discussed their business plan. Their dream plans were development of new food products, Quality planting materials, harmless method of cultivation and floricultural industry. Those were supported by government policies and other related organizations.

Keywords: agricultural undergraduates, entrepreneurial trends, likert scale Sri Lanka

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1240 Evidence-Based Practice Attributes across Nursing Roles at a Children’s Hospital

Authors: Rose Chapman Rodriguez

Abstract:

Problem: Evidence-based practice (EBP) attributes are significantly associated with EBP implementation science, which improves patient care outcomes. Nurses influence EBP, yet little is known of the specific EBP attributes of pediatric nurses in their clinical sub-specialties. Aim: This study aims to investigate the relationship between nursing academic degree, years of experience, and clinical specialty, with mean survey scores on EBP belief, organizational culture, and implementation scales across all levels of nursing in a Children’s Hospital. Methods: A convenience sample of nurses (n=185) participated in a descriptive, cross-sectional, correlational study in May 2023. The electronic surveys comprised 11 demographic questions and nine survey items from the short-version EBP Beliefs Scale (Cronbach α = 0.81), Organizational Culture and Readiness Scale for System-wide Integration Scale (Cronbach α = 0.87), and EBP Implementation Scale (Cronbach α = 0.89). Findings: EBP belief scores were notably higher in nurses working in neonatology (m=4.33), critical care (m=4.47), and among nurse leaders (m=4.50). There was a statistically significant difference in EBP organizational culture among nurse leaders (m = 3.95, p=0.039) compared to clinical nurses (m = 3.34) and advanced practice nurses (m = 3.34). EBP implementation was favorable in neonatology (m=4.20), acute care (m=4.05), and nurse leaders (m=4.33). No significant difference or correlation was found in EBP belief, organizational culture, or implementation mean scores related to nurses' age, academic nursing degree, or years of experience in our cohort (EBP beliefs (r = -.06, p = .400), organizational readiness (r = .02, p = .770), and implementation scales (r = .01, p = .867). Conclusions: This study identified nurse’s EBP attributes in a Children’s Hospital using key variables studied in EBP social cognitive theory and learning theory. Magnet status, shared governance structure, specialty certification, and nurse leaders play a significant role in favorable EBP culture and implementation. Nurses’ unit level ‘group culture’ may vary depending on the EBP attributes and collaborative efforts of local teams. Opportunities for mentoring were identified, which may continue to enhance EBP implementation science across all nursing roles in our pediatric organization.

Keywords: evidence-based practice, peditrics, nursing roles, implementation

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1239 The Effects on Hand Function with Robot-Assisted Rehabilitation for Children with Cerebral Palsy: A Pilot Study

Authors: Fen-Ling Kuo, Hsin-Chieh Lee, Han-Yun Hsiao, Jui-Chi Lin

Abstract:

Background: Children with cerebral palsy (CP) usually suffered from mild to maximum upper limb dysfunction such as having difficulty in reaching and picking up objects, which profoundly affects their participation in activities of daily living (ADLs). Robot-assisted rehabilitation provides intensive physical training in improving sensorimotor function of the hand. Many researchers have extensively studied the effects of robot-assisted therapy (RT) for the paretic upper limb in patients with stroke in recent years. However, few studies have examined the effect of RT on hand function in children with CP. The purpose of this study is to investigate the effectiveness of Gloreha Sinfonia, a robotic device with a dynamic arm support system mainly focus on distal upper-limb training, on improvements of hand function and ADLs in children with CP. Methods: Seven children with moderate CP were recruited in this case series study. RT using Gloreha Sinfonia was performed 2 sessions per week, 60 min per session for 6 consecutive weeks, with 12 times in total. Outcome measures included the Fugl-Meyer Assessment-upper extremity (FMA-UE), the Box and Block Test, the electromyography activity of the extensor digitorum communis muscle (EDC) and brachioradialis (BR), a grip dynamometer for motor evaluation, and the ABILHAND-Kids for measuring manual ability to manage daily activities, were performed at baseline, after 12 sessions (end of treatment) and at the 1-month follow-up. Results: After 6 weeks of robot-assisted treatment of hand function, there were significant increases in FMA-UE shoulder/elbow scores (p=0.002), FMA-UE wrist/hand scores (p=0.002), and FMA-UE total scores (p=0.002). There were also significant improvements in the BR mean value (p = 0.015) and electrical agonist-antagonist muscle ratio (p=0.041) in grasping a 1-inch cube task. These gains were maintained for a month after the end of the intervention. Conclusion: RT using Gloreha Sinfonia for hand function training may contribute toward the improvement of upper extremity function and efficacy in recruiting BR muscle in children with CP. The results were maintained at one month after intervention.

Keywords: activities of daily living, cerebral palsy, hand function, robotic rehabilitation

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1238 Modeling Environmental, Social, and Governance Financial Assets with Lévy Subordinated Processes and Option Pricing

Authors: Abootaleb Shirvani, Svetlozar Rachev

Abstract:

ESG stands for Environmental, Social, and Governance and is a non-financial factor that investors use to specify material risks and growth opportunities in their analysis process. ESG ratings provide a quantitative measure of socially responsible investment, and it is essential to incorporate ESG ratings when modeling the dynamics of asset returns. In this article, we propose a triple subordinated Lévy process for incorporating numeric ESG ratings into dynamic asset pricing theory to model the time series properties of the stock returns. The motivation for introducing three layers of subordinator is twofold. The first two layers of subordinator capture the skew and fat-tailed properties of the stock return distribution that cannot be explained well by the existing Lévy subordinated model. The third layer of the subordinator introduces ESG valuation and incorporates numeric ESG ratings into dynamic asset pricing theory and option pricing. We employ the triple subordinator Lévy model for developing the ESG-valued stock return model, derive the implied ESG score surfaces for Microsoft, Apple, and Amazon stock returns, and compare the shape of the ESG implied surface scores for these stocks.

Keywords: ESG scores, dynamic asset pricing theory, multiple subordinated modeling, Lévy processes, option pricing

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1237 Comparison of Computerized Dynamic Posturography and Functional Head Impulse Test Scores after of Hatha Yoga Practice and Resistance-Based Aerobic Exercise in Adult Female Yoga Practitioners

Authors: Çağla Aras, Kübra Bi̇nay, Aysberg Şamil önlü, Mine Baydan Aran, Dicle Aras

Abstract:

The purpose of the present research was to investigate the acute effects of 30-min hatha yoga and 30-min resistance-based aerobic exercise (RBAE) on computerized dynamic posturography (CDP) and functional head impulse test (fHIT) scores in adult female yoga practitioners. To reach this aim, ten participants executed CDP and fHIT three times in total: at rest, after yoga, and after RBAE. The yoga practice lasted a total of 30 minutes, including 25 min of asanas and 5 minutes of savasana. RBAE lasted a total of 30 minutes with an intensity of 70-75% of the heart rate reserve method. When the results were examined, no change was observed in any parameters of the fHIT scores due to resting or exercise implementation. On the contrary, some changes were observed in CDP test results depending on the type of exercise. The post-RBAE somatosensory and visual systems values were higher than resting (p<0.05). The composite balance score derived after RBAE was found to be improved when compared to post-yoga and resting values (p<0.01). Lastly, the post-RBAE vestibular system score was found to be statistically significantly higher than the post-Yoga values. In addition, it was observed that body composition parameters, especially decreasing BW, LBM, PBF, MBF and TBW, were associated with improved postural stability values. According to the results, it can be stated that neither hatha yoga nor resistance-based aerobic exercise has an acute effect on functional vestibulo-ocular reflex. In addition, although there was no change in balance level after yoga, it was observed that RBAE performed at 70-75% of the heart rate reserve and for 30 minutes had positive acute effects on postural stability and balance.

Keywords: hatha yoga, resistance training, aerobic training, high intensity training, computerized dynamic posturography, functional head impulse test

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1236 Smart Books as a Supporting Tool for Developing Skills of Designing and Employing Webquest 2.0

Authors: Huda Alyami

Abstract:

The present study aims to measure the effectiveness of an "Interactive eBook" in order to develop skills of designing and employing webquests for female intern teachers. The study uses descriptive analytical methodology as well as quasi-experimental methodology. The sample of the study consists of (30) female intern teachers from the Department of Special Education (in the tracks of Gifted Education and Learning Difficulties), during the first semester of the academic year 2015, at King Abdul-Aziz University in Jeddah city. The sample is divided into (15) female intern teachers for the experimental group, and (15) female intern teachers for the control group. A set of qualitative and quantitative tools have been prepared and verified for the study, embodied in: a list of the designing webquests' skills, a list of the employing webquests' skills, a webquests' knowledge achievement test, a product rating card, an observation card, and an interactive ebook. The study concludes the following results: 1. After pre-control, there are statistically significant differences, at the significance level of (α ≤ 0.05), between the mean scores of the experimental and the control groups in the post measurement of the webquests' knowledge achievement test, in favor of the experimental group. 2. There are statistically significant differences, at the significance level of (α ≤ 0.05), between the mean scores of experimental and control groups in the post measurement of the product rating card in favor of the experimental group. 3. There are statistically significant differences, at the significance level of (α ≤ 0.05), between the mean scores of experimental and control groups in the post measurement of the observation card for the experimental group. In the light of the previous findings, the study recommends the following: taking advantage of interactive ebooks when teaching all educational courses for various disciplines at the university level, creating educational participative platforms to share educational interactive ebooks for various disciplines at the local and regional levels. The study suggests conducting further qualitative studies on the effectiveness of interactive ebooks, in addition to conducting studies on the use of (Web 2.0) in webquests.

Keywords: interactive eBook, webquest, design, employing, develop skills

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1235 Use of Apple Pomace as a Source of Dietary Fibre in Mutton Nuggets

Authors: Aamina B. Hudaa, Rehana Akhtera, Massarat Hassana, Mir Monisab

Abstract:

Mutton nuggets produced with the addition of apple pomace at the levels of 0% (Control), 5% (Treatment 1), 10% (Treatment 2), and 15% (Treatment 3) were evaluated for emulsion stability, cooking yield, pH, proximate composition, texture analysis and sensory properties. Apple pomace addition resulted in significantly higher (p ≤ 0.05) emulsion stability and cooking yield of treatments in comparison to control and pH values were significantly higher (p ≤ 0.05) for the control as compared to treatments. Among the treatments, the product with 15% apple pomace had significantly (p ≤ 0.05) highest moisture content, and protein, ash and fat contents were significantly (p ≤ 0.05) higher in control than treatment groups. Crude fiber content of control was found significantly (p ≤ 0.05) lower in comparison to nuggets formulated with 5%, 10% and 15% apple pomace and was found to increase significantly (p ≤ 0.05) with the increasing levels of apple pomace. Hardness of the products significantly (p ≤ 0.05) decreased with addition of apple pomace, whereas springiness, cohesiveness, chewiness and gumminess showed a non-significant (p ≥ 0.05) decrease with the levels of apple pomace. Sensory evaluation showed significant (p ≤ 0.05) reduction in texture, flavour and overall acceptability scores of treatment products; however the scores were in the range of acceptability and T-1 showed better acceptability among apple pomace incorporated treatments.

Keywords: Mutton nuggets, apple pomace, textural properties, sensory evaluation

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1234 Utilization Of Guar Gum As Functional Fat Replacer In Goshtaba, A Traditional Indian Meat Product

Authors: Sajad A. Rather, F. A. Masoodi, Rehana Akhter, S. M. Wani, Adil Gani

Abstract:

Modern trend towards convenience foods has resulted in increased production and consumption of restructured meat products and are of great importance to the meat industry. In meat products fat plays an important role in cooking properties, texture & sensory scores, however, high fat contents in particular animal fats provide high amounts of saturated fatty acids and cholesterol and are associated with several types of non communicable diseases such as obesity, hypertension and coronary heart diseases. Thus, fat reduction has generally been seen as an important strategy to produce healthier meat products. This study examined the effects of reducing fat level from 20% to 10% and substituting mutton back fat with guar gum (0.5%, 1% & 1.5%) on cooking properties, proximate composition, lipid and protein oxidation, texture, microstructure and sensory characteristics of goshtaba- a traditional meat product of J & K, India were investigated and compared with high fat counterparts. Reduced- fat goshtaba samples containing guar gum had significantly (p ≤ 0.05) higher yield, less shrinkage, more moisture retention and more protein content than the control sample. TBARs and protein oxidation (carbonyl content) values of the control was significantly (p ≤ 0.05) higher than reduced fat goshtaba samples and showed a positive correlation between lipid and protein oxidation. Hardness, gumminess & chewiness of the control (20%) were significantly higher than reduced fat goshtaba samples. Microstructural differences were significant (p ≤ 0.05) between control and treated samples due to an increased moisture content in the reduced fat samples. Sensory evaluation showed significant (p ≤ 0.05) reduction in texture, flavour and overall acceptability scores of treatment products; however the scores for 0.5% and 1% treated samples were in the range of acceptability. Guar gum may also be used as a source of soluble dietary fibre in food products and a number of clinical studies have shown a reduction in postprandial glycemia and insulinemia on consumption of guar gum, with the mechanism being attributed to an increased transit time in the stomach and small intestine, which may have been due to the viscosity of the meal hindering the access of glucose to the epithelium.

Keywords: goshtaba, guar gum, traditional, fat reduction, acceptability

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1233 The Effectiveness of Warm-Water Footbath on Fatigue in Cancer Patient Undergoing Chemotherapy

Authors: Yu-Wen Lin, Li-Ni Liu

Abstract:

Introduction: Fatigue is the most common symptoms experienced by cancer patients undergoing chemotherapy. Patients receiving anticancer therapies develop a higher proportion of fatigue compared with patients who do not receive anticancer therapies. Fatigue has significant impacts on quality of life, daily activities, mood status, and social behaviors. A warm-water footbath (WWF) at 41℃ promotes circulation and removes metabolites resulting in improving sleep and relieving fatigue. The aim of this study is to determine the effectiveness of WWF for relieving fatigue with cancer patients undergoing chemotherapy. Materials and Methods: This is a single-center, prospective, quasi-experimental design study in the oncology ward in Taiwan. Participants in this study were assigned to WWF group as experimental group and standard care group as a control group by purposive sampling. In the WWF group, the participants were asked to soak their feet in 42-43℃ water 15 minutes for consecutive 6 days at one day before chemotherapy. Each participant was evaluated for fatigue level by the Taiwanese version of the Brief Fatigue Inventory (BFI-T). BFI-T was completed for consecutive 8 days of the study. The primary outcome was compared the BFI-T score of WWF group to the standard care group. Results: There were 60 participants enrolled in this study. Thirty participants were assigned to WWF group and 30 participants were assigned to standard care group. Both groups have comparable characteristic. The BFI-T scores of both groups were increased associated with the days of chemotherapy. The highest BFI-T scores of both groups were on the day 4 of chemotherapy. The BFI-T scores of both groups were decreased since day 5 and significantly decreased in WWF group on day 5 compared to standard care group (4.17 vs. 5.7, P < .05). At the end of the study the fatigue at its worse were significantly decreased in WWF group (2.33 vs. 4.37, P < .001). There was no adverse event reported in this study. Conclusion: WWF is an easy, safe, non-invasive, and relatively inexpensive nursing intervention for improving fatigue of cancer patients undergoing chemotherapy. In summary, this study shows the WWF is a simple complementary care method, and it is effective for improving and relieving fatigue in a short time. Through improving fatigue is a way to enhance the quality of life which is important for cancer patients undergoing chemotherapy. Larger prospective randomized controlled trial and long-term effectiveness and outcomes of WWF should be performed to confirm this study.

Keywords: chemotherapy, warm-water footbath, fatigue, Taiwanese version of the brief fatigue inventory

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1232 Patient Reported Outcome Measures Post Implant Based Reconstruction Basildon Hospital

Authors: Danny Fraser, James Zhang

Abstract:

Aim of the study: Our study aims to identify any statistically significant evidence as it relates to PROMs for mastectomy and implant-based reconstruction to guide future surgical management. Method: The demographic, pre and post-operative treatment and implant characteristics were collected of all patients at Basildon hospital who underwent breast reconstruction from 2017-2023. We used the Breast-Q psychosocial well-being, physical well-being, and satisfaction with breasts scales. An Independent t-test was conducted for each group, and linear regression of age and implant size. Results: 69 patients were contacted, and 39 PROMs returned. The mean age of patients was 57.6. 40% had smoked before, and 40.8% had BMI>30. 29 had pre-pectoral placement, and 40 had subpectoral placement. 17 had smooth implants, and 52 textured. Sub pectoral placement was associated with higher (75.7 vs. 61.9 p=0.046) psychosocial scores than pre pectoral, and textured implants were associated with a lower physical score than the smooth surface (34.7 VS 50.2 P=0.046). On linear regression, age was positively associated (p=0.007) with psychosocial score. Conclusion: We present a large cohort of patients who underwent breast reconstruction. Understanding the PROMs of these procedures can guide clinicians, patients and policy makers to be more informed of the course of rehabilitation of these operations. Significance: We have found that from a patient perspective subpectoral implant placement was associated with a statistically significant improvement in psychosocial scores.

Keywords: breast surgery, mastectomy, breast implants, oncology

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1231 A Geographical Information System Supported Method for Determining Urban Transformation Areas in the Scope of Disaster Risks in Kocaeli

Authors: Tayfun Salihoğlu

Abstract:

Following the Law No: 6306 on Transformation of Disaster Risk Areas, urban transformation in Turkey found its legal basis. In the best practices all over the World, the urban transformation was shaped as part of comprehensive social programs through the discourses of renewing the economic, social and physical degraded parts of the city, producing spaces resistant to earthquakes and other possible disasters and creating a livable environment. In Turkish practice, a contradictory process is observed. In this study, it is aimed to develop a method for better understanding of the urban space in terms of disaster risks in order to constitute a basis for decisions in Kocaeli Urban Transformation Master Plan, which is being prepared by Kocaeli Metropolitan Municipality. The spatial unit used in the study is the 50x50 meter grids. In order to reflect the multidimensionality of urban transformation, three basic components that have spatial data in Kocaeli were identified. These components were named as 'Problems in Built-up Areas', 'Disaster Risks arising from Geological Conditions of the Ground and Problems of Buildings', and 'Inadequacy of Urban Services'. Each component was weighted and scored for each grid. In order to delimitate urban transformation zones Optimized Outlier Analysis (Local Moran I) in the ArcGIS 10.6.1 was conducted to test the type of distribution (clustered or scattered) and its significance on the grids by assuming the weighted total score of the grid as Input Features. As a result of this analysis, it was found that the weighted total scores were not significantly clustering at all grids in urban space. The grids which the input feature is clustered significantly were exported as the new database to use in further mappings. Total Score Map reflects the significant clusters in terms of weighted total scores of 'Problems in Built-up Areas', 'Disaster Risks arising from Geological Conditions of the Ground and Problems of Buildings' and 'Inadequacy of Urban Services'. Resulting grids with the highest scores are the most likely candidates for urban transformation in this citywide study. To categorize urban space in terms of urban transformation, Grouping Analysis in ArcGIS 10.6.1 was conducted to data that includes each component scores in significantly clustered grids. Due to Pseudo Statistics and Box Plots, 6 groups with the highest F stats were extracted. As a result of the mapping of the groups, it can be said that 6 groups can be interpreted in a more meaningful manner in relation to the urban space. The method presented in this study can be magnified due to the availability of more spatial data. By integrating with other data to be obtained during the planning process, this method can contribute to the continuation of research and decision-making processes of urban transformation master plans on a more consistent basis.

Keywords: urban transformation, GIS, disaster risk assessment, Kocaeli

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1230 Designing a Cricket Team Selection Method Using Super-Efficient DEA and Semi Variance Approach

Authors: Arnab Adhikari, Adrija Majumdar, Gaurav Gupta, Arnab Bisi

Abstract:

Team formation plays an instrumental role in the sports like cricket. Existing literature reveals that most of the works on player selection focus only on the players’ efficiency and ignore the consistency. It motivates us to design an improved player selection method based on both player’s efficiency and consistency. To measure the players’ efficiency measurement, we employ a modified data envelopment analysis (DEA) technique namely ‘super-efficient DEA model’. We design a modified consistency index based on semi variance approach. Here, we introduce a new parameter called ‘fitness index’ for consistency computation to assess a player’s fitness level. Finally, we devise a single performance score using both efficiency score and consistency score with the help of a linear programming model. To test the robustness of our method, we perform a rigorous numerical analysis to determine the all-time best One Day International (ODI) Cricket XI. Next, we conduct extensive comparative studies regarding efficiency scores, consistency scores, selected team between the existing methods and the proposed method and explain the rationale behind the improvement.

Keywords: decision support systems, sports, super-efficient data envelopment analysis, semi variance approach

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1229 Stress Perception, Social Supports and Family Function among Military Inpatients with Adjustment Disorders in Taiwan

Authors: Huey-Fang Sun, Wei-Kai Weng, Mei-Kuang Chao, Hui-Shan Hsu, Tsai-Yin Shih

Abstract:

Psycho-social stress is important for mental illness and the presence of emotional and behavioral symptoms to an identifiable event is the central feature of adjustment disorders. However, whether patients with adjustment disorders have been raised in family with poor family functions and social supports and have higher stress perception than their peer group when they both experienced a similar stressful environment remains unknown. The specific aims of the study are to investigate the correlation among the family function, social supports and the level of stress perception and to test the hypothesis that military patients with adjustment disorders would have lower family function, lower social supports and higher stress perception than their healthy colleagues recruited in the same cohort for military services given their common exposure to similar stressful environments. Methods: The study was conducted in four hospitals of northern part of Taiwan from July 1, 2015 to June 30, 2017 and a matched case-control study design was used. The inclusion criteria for potential patient participants were psychiatric inpatients that serviced in military during the study period and met the diagnosis of adjustment disorders. Patients who had been admitted to psychiatric ward before or had illiteracy problem were excluded. A healthy military control sample matched by the same military service unit, gender, and recruited cohort was invited to participate the study as well. Totally 74 participants (37 patients and 37 controls) completed the consent forms and filled out the research questionnaires. Questionnaires used in the study included Perceived Stress Scale (PSS) as a measure of stress perception; Family APGAR as a measure of family function, and Multidimensional Scale of Perceived Social Support (MSPSS) as a measure of social supports. Pearson correlation analysis and t-test were applied for statistical analysis. Results: The analysis results showed that PSS level significantly negatively correlated with three social support subscales (family subscale, r= -.37, P < .05; friend subscale, r= -.38, P < .05; significant other subscale, r= -.39, P < .05). A negative correlation between PSS level and Family APGAR only reached a borderline significant level (P= .06). The t-test results for PSS scores, Family APGAR levels, and three subscale scores of MSPSS between patient and control participants were all significantly different (P < .001, P < .05, P < .05, P < .05, P < .05, respectively) and the patient participants had higher stress perception scores, lower social supports and lower family function scores than the healthy control participants. Conclusions: Our study suggested that family function and social supports were negatively correlated with patients’ subjective stress perception. Military patients with adjustment disorders tended to have higher stress perception and lower family function and social supports than those military peers who remained healthy and still provided services in their military units.

Keywords: adjustment disorders, family function, social support, stress perception

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1228 Enhancing Academic and Social Skills of Elementary School Students with Autism Spectrum Disorder by an Intensive and Comprehensive Teaching Program

Authors: Piyawan Srisuruk, Janya Boonmeeprasert, Romwarin Gamlunglert, Benjamaporn Choikhruea, Ornjira Jaraepram, Jarin Boonsuchat, Sakdadech Singkibud, Kusalaporn Chaiudomsom, Chanatiporn Chonprai, Pornchanaka Tana, Suchat Paholpak

Abstract:

Objective: To develop an Intensive and comprehensive program (ICP) for the Inclusive Class Teacher (ICPICT) to teach elementary students (ES) with ASD in order to enhance the students’ academic and social skills (ASS) and to study the effect of the teaching program. Methods: The purposive sample included 15 Khon Kaen inclusive class teachers and their 15 elementary students. All the students were diagnosed by a child and adolescent psychiatrist to have DSM-5 level 1 ASD. The study tools included 1) an ICP to teach teachers about ASD, a teaching method to enhance academic and social skills for ES with ASD, and an assessment tool to assess the teacher’s knowledge before and after the ICP. 2) an ICPICT to teach ES with ASD to enhance their ASS. The project taught 10 sessions, 3 hours each. The ICPICT had its teaching structure. Teaching media included: pictures, storytelling, songs, and plays. The authors taught and demonstrated to the participant teachers how to teach with the ICPICT until the participants could display the correct teaching method. Then the teachers taught ICPICT at school by themselves 3) an assessment tool to assess the students’ ASS before and after the completion of the study. The ICP to teach the teachers, the ICPICT, and the relevant assessment tools were developed by the authors and were adjusted until consensus agreed as appropriate for researching by 3 curriculum of teaching children with ASD experts. The data were analyzed by descriptive and analytic statistics via SPSS version 26. Results: After the briefing, the teachers increased the mean score, though not with statistical significance, of knowledge of ASD and how to teach ES with ASD on ASS (p = 0.13). Teaching ES with ASD with the ICPICT could increase the mean scores of the students’ skills in learning and expressing social emotions, relationships with a friend, transitioning, and skills in academic function 3.33, 2.27, 2.94, and 3.00 scores (full scores were 18, 12, 15 and 12, Paired T-Test p = 0.007, 0.013, 0.028 and 0.003 respectively). Conclusion: The program to teach academic and social skills simultaneously in an intensive and comprehensive structure could enhance both the academic and social skills of elementary students with ASD. Keywords: Elementary students, autism spectrum, academic skill, social skills, intensive program, comprehensive program, integration.

Keywords: academica and social skills, students with autism, intensive and comprehensive, teaching program

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1227 An Evaluation of Self-Esteem in Physically Disabled Adults Who Particapated in Sports

Authors: Ummuhan Bas Aslan, Sehmus Aslan

Abstract:

Objective: Physical disability includes impairments, activity limitations, and participation restrictions. Individuals with physical disabilities have lower self-esteem compared non-disabled people. Self-esteem is widely accepted as a key indicator of emotional stability and adjustment to life demands. There is very limited study to investigate the effect of sports on self-esteem in physically disabled people. The aim of the present study was to evaluate of self-esteem in physically disabled adults who participated in sports. Methods: Fifty physically disabled adults who participated in sports aged between 18 to 35 years participated in the study. Self-esteem of the participants was assessed by Rosenberg Self-Esteem Scale. The scale is a 10-item measure of global self-esteem. The higher score on the scale indicates greater self-esteem. Scores between 15 and 25 are the normal range of and scores below 15 suggest low self-esteem. Results: Average age of participants was 25.18±6.20 years. 58% of the participants were 23 (46.0%) of the participants were wheelchair users, 8 (16.0%) were mobile with a walking aid and 19 (38.0%) were mobile without a walking aid. The length of physically disabled adults had been participating in their sports (basketball: 54%, athleticism: 32%, volleyball: 6%, cycling: 6%) was 4.94±3.86 years. The average Rosenberg Self-Esteem Scale score of the participants was 21.88 ±4.34. Conclusions: Our results suggest that physically disabled adults who participated in sports have the healthy level of self-esteem. Participating in sports could have positive effects on self-esteem in that physically, disabled people. There is needed future comparative studies on this topic.

Keywords: adult, physical disability, self-esteem, sport

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1226 Correlation of Depression and Anxiety with Glycemic Control in Children with Type I Diabetes Mellitus

Authors: Sujata Sethi, Pawan Kumar, Sameer Aggarwal

Abstract:

Depression and anxiety are of significant concern in youth with type 1 diabetes mellitus (T1DM) and these are correlated with glycemic control in multiple ways. The extent of depression and anxiety in children with T1DM remains poorly studied in India. The index study aimed to find the prevalence of depression and anxiety and their correlation with HbA1c (glycated hemoglobin) levels in children with T1DM. Material and methods: This study was a cross-sectional study carried out on a purposive sample of 45 children with T1DM. Depressive symptoms were assessed using Children’s Depression Rating Scale-Revised (CDRS-R) and anxiety symptoms were assessed using Spence Children’s Anxiety Scale (SCAS). Glycated hemoglobin (HbA1c) levels of all the participants were recorded. Results: 43 out of 45 children were analyzed as HbA1c status for two was not known. 48.8% were females. Mean age was 12.95+2.04. The average duration of diabetes was 3.63+1.82. Mean CDRS-R score was 41.6+12.25 and mean SCAS score was 33.07+12.29. Mean recording of HbA1c level was 7.90+1.51. 27 (62.8%) out of 43 participants had abnormal scores on CDRS-R and 24 (55.8%) out of 43 had abnormal scores on SCAS. The correlation coefficient between HbA1c levels and the CDRS-R score came out to be 0.57 and between HbA1c and SCAS, it was 0.53. Both correlations were significant with the p-value of < 0.02. Conclusion: Children with T1DM have high co-morbidity of depression and anxiety which is significantly correlated with the HbA1c levels. Thus, it becomes important to screen the patients for depression and anxiety for better outcomes.

Keywords: anxiety, depression, HbA1c, T1DM

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1225 The Impact of Public Open Space System on Housing Price in Chicago

Authors: Si Chen, Le Zhang, Xian He

Abstract:

The research explored the influences of public open space system on housing price through hedonic models, in order to support better open space plans and economic policies. We have three initial hypotheses: 1) public open space system has an overall positive influence on surrounding housing prices. 2) Different public open space types have different levels of influence on motivating surrounding housing prices. 3) Walking and driving accessibilities from property to public open spaces have different statistical relation with housing prices. Cook County, Illinois, was chosen to be a study area since data availability, sufficient open space types, and long-term open space preservation strategies. We considered the housing attributes, driving and walking accessibility scores from houses to nearby public open spaces, and driving accessibility scores to hospitals as influential features and used real housing sales price in 2010 as a dependent variable in the built hedonic model. Through ordinary least squares (OLS) regression analysis, General Moran’s I analysis and geographically weighted regression analysis, we observed the statistical relations between public open spaces and housing sale prices in the three built hedonic models and confirmed all three hypotheses.

Keywords: hedonic model, public open space, housing sale price, regression analysis, accessibility score

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1224 Abandoning 'One-Time' Optional Information Literacy Workshops for Year 1 Medical Students and Gearing towards an 'Embedded Librarianship' Approach

Authors: R. L. David, E. C. P. Tan, M. A. Ferenczi

Abstract:

This study aimed to investigate the effect of a 'one-time' optional Information Literacy (IL) workshop to enhance Year 1 medical students' literature search, writing, and citation management skills as directed by a customized five-year IL framework developed for LKC Medicine students. At the end of the IL workshop, the overall rated 'somewhat difficult' when finding, citing, and using information from sources. The study method is experimental using a standardized IL test to study the cohort effect of a 'one-time' optional IL workshop on Year 1 students; experimental group in comparison to Year 2 students; control group. Test scores from both groups were compared and analyzed using mean scores and one-way analysis of variance (ANOVA). Unexpectedly, there were no statistically significant differences between group means as determined by One-Way ANOVA (F₁,₁₉₃ = 3.37, p = 0.068, ηp² = 0.017). Challenges and shortfalls posed by 'one-time' interventions raised a rich discussion to adopt an 'embedded librarianship' approach, which shifts the medial librarians' role into the curriculum and uses Team Based Learning to teach IL skills to medical students. The customized five-year IL framework developed for LKC Medicine students becomes a useful librarian-faculty model for embedding and bringing IL into the classroom.

Keywords: information literacy, 'one-time' interventions, medical students, standardized tests, embedded librarianship, curriculum, medical librarians

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1223 Competence of the Health Workers in Diagnosing and Managing Complicated Pregnancies: A Clinical Vignette Based Assessment in District and Sub-District Hospitals in Bangladesh

Authors: Abdullah Nurus Salam Khan, Farhana Karim, Mohiuddin Ahsanul Kabir Chowdhury, S. Masum Billah, Nabila Zaka, Alexander Manu, Shams El Arifeen

Abstract:

Globally, pre-eclampsia (PE) and ante-partum haemorrhage (APH) are two major causes of maternal mortality. Prompt identification and management of these conditions depend on competency of the birth attendants. Since these conditions are infrequent to be observed, clinical vignette based assessment could identify the extent of health worker’s competence in managing emergency obstetric care (EmOC). During June-August 2016, competence of 39 medical officers (MO) and 95 nurses working in obstetric ward of 15 government health facilities (3 district hospital, 12 sub-district hospital) was measured using clinical vignettes on PE and APH. The vignettes resulted in three outcome measures: total vignette scores, scores for diagnosis component, and scores for management component. T-test was conducted to compare mean vignette scores and linear regression was conducted to measure the strength and association of vignette scores with different cadres of health workers, facility’s readiness for EmOC and average annual utilization of normal deliveries after adjusting for type of health facility, health workers’ work experience, training status on managing maternal complication. For each of the seven component of EmOC items (administration of injectable antibiotics, oxytocic and anticonvulsant; manual removal of retained placenta, retained products of conception; blood transfusion and caesarean delivery), if any was practised in the facility within last 6 months, a point was added and cumulative EmOC readiness score (range: 0-7) was generated for each facility. The yearly utilization of delivery cases were identified by taking the average of all normal deliveries conducted during three years (2013-2015) preceding the survey. About 31% of MO and all nurses were female. Mean ( ± sd) age of the nurses were higher than the MO (40.0 ± 6.9 vs. 32.2 ± 6.1 years) and also longer mean( ± sd) working experience (8.9 ± 7.9 vs. 1.9 ± 3.9 years). About 80% health workers received any training on managing maternal complication, however, only 7% received any refresher’s training within last 12 months. The overall vignette score was 8.8 (range: 0-19), which was significantly higher among MO than nurses (10.7 vs. 8.1, p < 0.001) and the score was not associated with health facility types, training status and years of experience of the providers. Vignette score for management component (range: 0-9) increased with higher annual average number of deliveries in their respective working facility (adjusted β-coefficient 0.16, CI 0.03-0.28, p=0.01) and increased with each unit increase in EmOC readiness score (adjusted β-coefficient 0.44, CI 0.04-0.8, p=0.03). The diagnosis component of vignette score was not associated with any of the factors except it was higher among the MO than the nurses (adjusted β-coefficient 1.2, CI 0.13-2.18, p=0.03). Lack of competence in diagnosing and managing obstetric complication by the nurses than the MO is of concern especially when majority of normal deliveries are conducted by the nurses. Better EmOC preparedness of the facility and higher utilization of normal deliveries resulted in higher vignette score for the management component; implying the impact of experiential learning through higher case management. Focus should be given on improving the facility readiness for EmOC and providing the health workers periodic refresher’s training to make them more competent in managing obstetric cases.

Keywords: Bangladesh, emergency obstetric care, clinical vignette, competence of health workers

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1222 The Mediator Role of Social Competence in the Relation between Effortful Control and Maths Achievement

Authors: M. A. Fernández-Vilar, M. D. Galián, E. Ato

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The aim of this work was to analyze the relation between children´s effortful control and Maths achievement in a sample of 447 Spanish children aged between 6 and 8 years. Traditionally, the literature confirms that higher level of effortful control has been associated with higher academic achievement, but there are few studies that include the effect that children´s social competence exert to this relation. To measure children’s effortful control parents were given the TMCQ (Temperament in Middle Childhood Questionnaire), and Maths achievement was taken from teacher´s rates. To measure social competence, we used the nominations method in the classroom context. Results confirmed that higher effortful control predicted a better maths achievement, whereas lower effortful control scores predicted lower Maths scores. Using a statistical modeling approach, we tested a mediation model that revealed the mediating role of social competence (popularity and rejection) in the relation between effortful control and Maths achievement. Concretely, higher social competence (higher popularity and lower rejection) seems to mediate the better Maths achievement showed by better self´regulated children. Therefore, an adequate social competence mediates the positive effect that self-regulatory capacity exerts to academic achievement. The clinical implications of the present findings should be considered. Specifically, rejected children must be detected and evaluated in community settings, such as school or community programs, due the relevant role of social competence in the relation between temperament and academic achievement.

Keywords: effortful control, maths achievement, social competence, mediation

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1221 Perception of Nursing Students’ Engagement With Emergency Remote Learning During COVID 19 Pandemic

Authors: Jansirani Natarajan, Mickael Antoinne Joseph

Abstract:

The COVID-19 pandemic has interrupted face-to-face education and forced universities into an emergency remote teaching curriculum over a short duration. This abrupt transition in the Spring 2020 semester left both faculty and students without proper preparation for continuing higher education in an online environment. Online learning took place in different formats, including fully synchronous, fully asynchronous, and blended in our university through the e-learning platform MOODLE. Studies have shown that students’ engagement, is a critical factor for optimal online teaching. Very few studies have assessed online engagement with ERT during the COVID-19 pandemic. Purpose: Therefore, this study, sought to understand how the sudden transition to emergency remote teaching impacted nursing students’ engagement with online courses in a Middle Eastern public university. Method: A cross-sectional descriptive research design was adopted in this study. Data were collected through a self-reported online survey using Dixon’s online students’ engagement questionnaire from a sample of 177 nursing students after the ERT learning semester. Results The maximum possible engagement score was 95, and the maximum scores in the domains of skills engagement, emotional engagement, participation engagement, and performance engagement were 30, 25, 30, and 10 respectively. Dixson (2010) noted that a mean item score of ≥3.5 (total score of ≥66.5) represents a highly engaged student. The majority of the participants were females (71.8%) and 84.2% were regular BSN students. Most of them (32.2%) were second-year students and 52% had a CGPA between 2 and 3. Most participants (56.5%) had low engagement scores with ERT learning during the COVID lockdown. Among the four engagement domains, 78% had low engagement scores for the participation domain. There was no significant association found between the engagement and the demographic characteristics of the participants. Conclusion The findings supported the importance of engaging students in all four categories skill, emotional, performance, and participation. Based on the results, training sessions were organized for faculty on various strategies for engaging nursing students in all domains by using the facilities available in the MOODLE (online e-learning platform). It added value as a dashboard of information regarding ERT for the administrators and nurse educators to introduce numerous active learning strategies to improve the quality of teaching and learning of nursing students in the University.

Keywords: engagement, perception, emergency remote learning, COVID-19

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