Search results for: online satisfaction
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3988

Search results for: online satisfaction

268 Increasing The Role of Civil Society through LAPOR!: National Complaint Handling System in Indonesia

Authors: Izzati Nabiyla Risfa

Abstract:

The role of civil society has become an important issue in national and international level nowadays. Government all over the world started to realize that the involvement of civil society can boost up public services and better policy making. Global Policy Forum stated that there are five good reasons for civil society to be engaged in global governance; (1) to conferring legitimacy on policy decisions; (2) to increasing the pool of policy ideas; (3) to support less powerful governments; (4) countering a lack of political will; and (5) helping states to put nationalism aside. Indonesia also keeps up with this good trend. In November 2011, Indonesian Government set up LAPOR! (means “to report” in Indonesian), an online portal for complaints about public services, which is accessible through its website lapor.ukp.go.id. LAPOR! also accessible through social media (Twitter, Facebook) and text message. This program is an initiative from the government to provide an integrated and accessible portal for the Indonesian public to submit complaints and inquiries as a means of enhancing public participation in national development programs. LAPOR! aims to catalyze public participation as well as to have a more coordinated national complaint handling mechanism. The goal of this program is to increase the role of civil society in order to develop better public services. Thus, LAPOR! works in a simplest way possible. Public can submit any complaints or report their problem concerning development programs and public services simply through the website, short message services to 1708 and mobile applications for BlackBerry and Android. LAPOR! will then transfer every validated input to relevant institutions to be featured and responded on the website. LAPOR! is now integrated with 81 Ministries, 5 local government, and 44 State Owned Enterprise. Public can also give comments, likes or share them through Facebook and Twitter to have a discussion and to ensure the completeness of the reports. LAPOR! has unexpectedly contributed to various successful cases concerning public services. So far the portal has over 280,704 registered users, receiving an average of 1,000 reports every day. Government's response rate increase time to time, with 81% of complaints and inquiries have been solved or are being investigated. This paper will examine the effectiveness of LAPOR! as a tools to increase the role of civil society in order to develop better public services in Indonesia. Beside their promising story, there still are various difficulties that need to be solved. With qualitative approach as methodology for this research, writers will also explore potential improvement of LAPOR! so it can perform effectively as a leading national complaint handling system in Indonesia.

Keywords: civil society, government, Indonesia, public services

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267 Thinking Lean in ICU: A Time Motion Study Quantifying ICU Nurses’ Multitasking Time Allocation

Authors: Fatma Refaat Ahmed, PhD, RN. Assistant Professor, Department of Nursing, College of Health Sciences, University of Sharjah, UAE. ([email protected]). Sally Mohamed Farghaly, Nursing Administration Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt. ([email protected])

Abstract:

Context: Intensive care unit (ICU) nurses often face pressure and constraints in their work, leading to the rationing of care when demands exceed available time and resources. Observations suggest that ICU nurses are frequently distracted from their core nursing roles by non-core tasks. This study aims to provide evidence on ICU nurses' multitasking activities and explore the association between nurses' personal and clinical characteristics and their time allocation. Research Aim: The aim of this study is to quantify the time spent by ICU nurses on multitasking activities and investigate the relationship between their personal and clinical characteristics and time allocation. Methodology: A self-observation form utilizing the "Diary" recording method was used to record the number of tasks performed by ICU nurses and the time allocated to each task category. Nurses also reported on the distractions encountered during their nursing activities. A convenience sample of 60 ICU nurses participated in the study, with each nurse observed for one nursing shift (6 hours), amounting to a total of 360 hours. The study was conducted in two ICUs within a university teaching hospital in Alexandria, Egypt. Findings: The results showed that ICU nurses completed 2,730 direct patient-related tasks and 1,037 indirect tasks during the 360-hour observation period. Nurses spent an average of 33.65 minutes on ventilator care-related tasks, 14.88 minutes on tube care-related tasks, and 10.77 minutes on inpatient care-related tasks. Additionally, nurses spent an average of 17.70 minutes on indirect care tasks per hour. The study identified correlations between nursing time and nurses' personal and clinical characteristics. Theoretical Importance: This study contributes to the existing research on ICU nurses' multitasking activities and their relationship with personal and clinical characteristics. The findings shed light on the significant time spent by ICU nurses on direct care for mechanically ventilated patients and the distractions that require attention from ICU managers. Data Collection: Data were collected using self-observation forms completed by participating ICU nurses. The forms recorded the number of tasks performed, the time allocated to each task category, and any distractions encountered during nursing activities. Analysis Procedures: The collected data were analyzed to quantify the time spent on different tasks by ICU nurses. Correlations were also examined between nursing time and nurses' personal and clinical characteristics. Question Addressed: This study addressed the question of how ICU nurses allocate their time across multitasking activities and whether there is an association between nurses' personal and clinical characteristics and time allocation. Conclusion: The findings of this study emphasize the need for a lean evaluation of ICU nurses' activities to identify and address potential gaps in patient care and distractions. Implementing lean techniques can improve efficiency, safety, clinical outcomes, and satisfaction for both patients and nurses, ultimately enhancing the quality of care and organizational performance in the ICU setting.

Keywords: motion study, ICU nurse, lean, nursing time, multitasking activities

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266 Urban and Building Information Modeling’s Applications for Environmental Education: Case Study of Educational Campuses

Authors: Samar Alarif

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Smart sustainable educational campuses are the latest paradigm of innovation in the education domain. Campuses become a hub for sustainable environmental innovations. University has a vital role in paving the road for digital transformations in the infrastructure domain by preparing skilled engineers and specialists. The open digital platform enables smart campuses to simulate real education experience by managing their infrastructure within the curriculums. Moreover, it allows the engagement between governments, businesses, and citizens to push for innovation and sustainable services. Urban and building information modeling platforms have recently attained widespread attention in smart campuses due to their applications and benefits for creating the campus's digital twin in the form of an open digital platform. Qualitative and quantitative strategies were used in directing this research to develop and validate the UIM/BIM platform benefits for smart campuses FM and its impact on the institution's sustainable vision. The research findings are based on literature reviews and case studies of the TU berlin El-Gouna campus. Textual data will be collected using semi-structured interviews with actors, secondary data like BIM course student projects, documents, and publications related to the campus actors. The study results indicated that UIM/BIM has several benefits for the smart campus. Universities can achieve better capacity-building by integrating all the actors in the UIM/BIM process. Universities would achieve their community outreach vision by launching an online outreach of UIM/BIM course for the academic and professional community. The UIM/BIM training courses would integrate students from different disciplines and alumni graduated as well as engineers and planners and technicians. Open platforms enable universities to build a partnership with the industry; companies should be involved in the development of BIM technology courses. The collaboration between academia and the industry would fix the gap, promote the academic courses to reply to the professional requirements, and transfer the industry's academic innovations. In addition to that, the collaboration between academia, industry, government vocational and training centers, and civil society should be promoted by co-creation workshops, a series of seminars, and conferences. These co-creation activities target the capacity buildings and build governmental strategies and policies to support expanding the sustainable innovations and to agree on the expected role of all the stakeholders to support the transformation.

Keywords: smart city, smart educational campus, UIM, urban platforms, sustainable campus

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265 Application of Pedicled Perforator Flaps in Large Cavities of the Breast

Authors: Neerja Gupta

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Objective-Reconstruction of large cavities of the breast without contralateral symmetrisation Background- Reconstruction of breast includes a wide spectrum of procedures from displacement to regional and distant flaps. The pedicled Perforator flaps cover a wide spectrum of reconstruction surgery for all quadrants of the breast, especially in patients with comorbidities. These axial flaps singly or adjunct are based on a near constant perforator vessel, a ratio of 2:1 at its entry in a flap is good to maintain vascularity. The perforators of lateral chest wall viz LICAP, LTAP have overlapping perfurosomes without clear demarcation. LTAP is localized in the narrow zone between the lateral breast fold and anterior axillary line,2.5-3.8cm from the fold. MICAP are localized at 1-2 cm from sternum. Being 1-2mm in diameter, a Single perforator is good to maintain the flap. LICAP has a dominant perforator in 6th-11th spaces, while LTAP has higher placed dominant perforators in 4th and 5th spaces. Methodology-Six consecutive patients who underwent reconstruction of the breast with pedicled perforator flaps were retrospectively analysed. Selections of the flap was done based on the size and locations of the tumour, anticipated volume loss, willingness to undergo contralateral symmetrisation, cosmetic expectations, and finances available.3 patients underwent vertical LTAP, the distal limit of the flap being the inframammary crease. 3 patients underwent MICAP, oriented along the axis of rib, the distal limit being the anterior axillary line. Preoperative identification was done using a unidirectional hand held doppler. The flap was raised caudal to cranial, the pivot point of rotation being the vessel entry into the skin. The donor area is determined by the skin pinch. Flap harvest time was 20-25 minutes. Intra operative vascularity was assessed with dermal bleed. The patient immediate pre, post-operative and follow up pics were compared independently by two breast surgeons. Patients were given a breast Q questionnaire (licensed) for scoring. Results-The median age of six patients was 46. Each patient had a hospital stay of 24 hours. None of the patients was willing for contralateral symmetrisation. The specimen dimensions were from 8x6.8x4 cm to 19x16x9 cm. The breast volume reconstructed range was 30 percent to 45 percent. All wide excision had free margins on frozen. The mean flap dimensions were 12x5x4.5 cm. One LTAP underwent marginal necrosis and delayed wound healing due to seroma. Three patients were phyllodes, of which one was borderline, and 2 were benign on final histopathology. All other 3 patients were invasive ductal cancer and have completed their radiation. The median follow up is 7 months the satisfaction scores at median follow of 7 months are 90 for physical wellbeing and 85 for surgical results. Surgeons scored fair to good in Harvard score. Conclusion- Pedicled perforator flaps are a valuable option for 3/8th volume of breast defects. LTAP is preferred for tumours at the Central, upper, and outer quadrants of the breast and MICAP for the inner and lower quadrant. The vascularity of the flap is dependent on the angiosomalterritories; adequate venous and cavity drainage.

Keywords: breast, oncoplasty, pedicled, perforator

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264 The Use of Video Conferencing to Aid the Decision in Whether Vulnerable Patients Should Attend In-Person Appointments during a COVID Pandemic

Authors: Nadia Arikat, Katharine Blain

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During the worst of the COVID pandemic, only essential treatment was provided for patients needing urgent care. With the prolonged extent of the pandemic, there has been a return to more routine referrals for paediatric dentistry advice and treatment for specialist conditions. However, some of these patients and/or their carers may have significant medical issues meaning that attending in-person appointments carries additional risks. This poses an ethical dilemma for clinicians. This project looks at how a secure video conferencing platform (“Near Me”) has been used to assess the need and urgency for in-person new patient visits, particularly for patients and families with additional risks. “Near Me” is a secure online video consulting service used by NHS Scotland. In deciding whether to bring a new patient to the hospital for an appointment, the clinical condition of the teeth together with the urgency for treatment need to be assessed. This is not always apparent from the referral letter. In addition, it is important to judge the risks to the patients and carers of such visits, particularly if they have medical issues. The use and effectiveness of “Near Me” consultations to help decide whether vulnerable paediatric patients should have in-person appointments will be illustrated and discussed using two families: one where the child is medically compromised (Alagille syndrome with previous liver transplant), and the other where there is a medically compromised parent (undergoing chemotherapy and a bone marrow transplant). In both cases, it was necessary to take into consideration the risks and moral implications of requesting that they attend the dental hospital during a pandemic. The option of remote consultation allowed further clinical information to be evaluated and the families take part in the decision-making process about whether and when such visits should be scheduled. These cases will demonstrate how medically compromised patients (or patients with vulnerable carers), could have their dental needs assessed in a socially distanced manner by video consultation. Together, the clinician and the patient’s family can weigh up the risks, with regards to COVID-19, of attending for in-person appointments against the benefit of having treatment. This is particularly important for new paediatric patients who have not yet had a formal assessment. The limitations of this technology will also be discussed. It is limited by internet availability, the strength of the connection, the video quality and families owning a device which allows video calls. For those from a lower socio-economic background or living in some rural areas, this may not be possible or limit its usefulness. For the two patients discussed in this project, where the urgency of their dental condition was unclear, video consultation proved beneficial in deciding an appropriate outcome and preventing unnecessary exposure of vulnerable people to a hospital environment during a pandemic, demonstrating the usefulness of such technology when it is used appropriately.

Keywords: COVID-19, paediatrics, triage, video consultations

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263 Degradation Kinetics of Cardiovascular Implants Employing Full Blood and Extra-Corporeal Circulation Principles: Mimicking the Human Circulation In vitro

Authors: Sara R. Knigge, Sugat R. Tuladhar, Hans-Klaus HöFfler, Tobias Schilling, Tim Kaufeld, Axel Haverich

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Tissue engineered (TE) heart valves based on degradable electrospun fiber scaffold represent a promising approach to overcome the known limitations of mechanical or biological prostheses. But the mechanical stress in the high-pressure system of the human circulation is a severe challenge for the delicate materials. Hence, the prediction of the scaffolds` in vivo degradation kinetics must be as accurate as possible to prevent fatal events in future animal or even clinical trials. Therefore, this study investigates whether long-term testing in full blood provides more meaningful results regarding the degradation behavior than conventional tests in simulated body fluids (SBF) or Phosphate Buffered Saline (PBS). Fiber mats were produced from a polycaprolactone (PCL)/tetrafluoroethylene solution by electrospinning. The morphology of the fiber mats was characterized via scanning electron microscopy (SEM). A maximum physiological degradation environment utilizing a test set-up with porcine full blood was established. The set-up consists of a reaction vessel, an oxygenator unit, and a roller pump. The blood parameters (pO2, pCO2, temperature, and pH) were monitored with an online test system. All tests were also carried out in the test circuit with SBF and PBS to compare conventional degradation media with the novel full blood setting. The polymer's degradation is quantified by SEM picture analysis, differential scanning calorimetry (DSC), and Raman spectroscopy. Tensile and cyclic loading tests were performed to evaluate the mechanical integrity of the scaffold. Preliminary results indicate that PCL degraded slower in full blood than in SBF and PBS. The uptake of water is more pronounced in the full blood group. Also, PCL preserved its mechanical integrity longer when degraded in full blood. Protein absorption increased during the degradation process. Red blood cells, platelets, and their aggregates adhered on the PCL. Presumably, the degradation led to a more hydrophilic polymeric surface which promoted the protein adsorption and the blood cell adhesion. Testing degradable implants in full blood allows for developing more reliable scaffold materials in the future. Material tests in small and large animal trials thereby can be focused on testing candidates that have proven to function well in an in-vivo-like setting.

Keywords: Electrospun scaffold, full blood degradation test, long-term polymer degradation, tissue engineered aortic heart valve

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262 Optimization of the Administration of Intravenous Medication by Reduction of the Residual Volume, Taking User-Friendliness, Cost Efficiency, and Safety into Account

Authors: A. Poukens, I. Sluyts, A. Krings, J. Swartenbroekx, D. Geeroms, J. Poukens

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Introduction and Objectives: It has been known for many years that with the administration of intravenous medication, a rather significant part of the planned to be administered infusion solution, the residual volume ( the volume that remains in the IV line and or infusion bag), does not reach the patient and is wasted. This could possibly result in under dosage and diminished therapeutic effect. Despite the important impact on the patient, the reduction of residual volume lacks attention. An optimized and clearly stated protocol concerning the reduction of residual volume in an IV line is necessary for each hospital. As described in my Master’s thesis, acquiring the degree of Master in Hospital Pharmacy, administration of intravenous medication can be optimized by reduction of the residual volume. Herewith effectiveness, user-friendliness, cost efficiency and safety were taken into account. Material and Methods: By usage of a literature study and an online questionnaire sent out to all Flemish hospitals and hospitals in the Netherlands (province Limburg), current flush methods could be mapped out. In laboratory research, possible flush methods aiming to reduce the residual volume were measured. Furthermore, a self-developed experimental method to reduce the residual volume was added to the study. The current flush methods and the self-developed experimental method were compared to each other based on cost efficiency, user-friendliness and safety. Results: There is a major difference between the Flemish and the hospitals in the Netherlands (Province Limburg) concerning the approach and method of flushing IV lines after administration of intravenous medication. The residual volumes were measured and laboratory research showed that if flushing was done minimally 1-time equivalent to the residual volume, 95 percent of glucose would be flushed through. Based on the comparison, it became clear that flushing by use of a pre-filled syringe would be the most cost-efficient, user-friendly and safest method. According to laboratory research, the self-developed experimental method is feasible and has the advantage that the remaining fraction of the medication can be administered to the patient in unchanged concentration without dilution. Furthermore, this technique can be applied regardless of the level of the residual volume. Conclusion and Recommendations: It is recommendable to revise the current infusion systems and flushing methods in most hospitals. Aside from education of the hospital staff and alignment on a uniform substantiated protocol, an optimized and clear policy on the reduction of residual volume is necessary for each hospital. It is recommended to flush all IV lines with rinsing fluid with at least the equivalent volume of the residual volume. Further laboratory and clinical research for the self-developed experimental method are needed before this method can be implemented clinically in a broader setting.

Keywords: intravenous medication, infusion therapy, IV flushing, residual volume

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261 Evaluation of Regional Anaesthesia Practice in Plastic Surgery: A Retrospective Cross-Sectional Study

Authors: Samar Mousa, Ryan Kerstein, Mohanad Adam

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Regional anaesthesia has been associated with favourable outcomes in patients undergoing a wide range of surgeries. Beneficial effects have been demonstrated in terms of postoperative respiratory and cardiovascular endpoints, 7-day survival, time to ambulation and hospital discharge, and postoperative analgesia. Our project aimed at assessing the regional anaesthesia practice in the plastic surgery department of Buckinghamshire trust and finding out ways to improve the service in collaboration with the anaesthesia team. It is a retrospective study associated with a questionnaire filled out by plastic surgeons and anaesthetists to get the full picture behind the numbers. The study period was between 1/3/2022 and 23/5/2022 (12 weeks). The operative notes of all patients who had an operation under plastic surgery, whether emergency or elective, were reviewed. The criteria of suitable candidates for the regional block were put by the consultant anaesthetists as follows: age above 16, single surgical site (arm, forearm, leg, foot), no drug allergy, no pre-existing neuropathy, no bleeding disorders, not on ant-coagulation, no infection to the site of the block. For 12 weeks, 1061 operations were performed by plastic surgeons. Local cases were excluded leaving 319 cases. Of the 319, 102 patients were suitable candidates for regional block after applying the previously mentioned criteria. However, only seven patients had their operations under the regional block, and the rest had general anaesthesia that could have been easily avoided. An online questionnaire was filled out by both plastic surgeons and anaesthetists of different training levels to find out the reasons behind the obvious preference for general over regional anaesthesia, even if this was against the patients’ interest. The questionnaire included the following points: training level, time taken to give GA or RA, factors that influence the decision, percentage of RA candidates that had GA, reasons behind this percentage, recommendations. Forty-four clinicians filled out the questionnaire, among which were 23 plastic surgeons and 21 anaesthetists. As regards the training level, there were 21 consultants, 4 associate specialists, 9 registrars, and 10 senior house officers. The actual percentage of patients who were good candidates for RA but had GA instead is 93%. The replies estimated this percentage as between 10-30%. 29% of the respondents thought that this percentage is because of surgeons’ preference to have GA rather than RA for their operations without medical support for the decision. 37% of the replies thought that anaesthetists prefer giving GA even if the patient is a suitable candidate for RA. 22.6% of the replies thought that patients refused to have RA, and 11.3% had other causes. The recommendations were in 5 main accesses, which are protocols and pathways for regional blocks, more training opportunities for anaesthetists on regional blocks, providing a separate block room in the hospital, better communication between surgeons and anaesthetists, patient education about the benefits of regional blocks.

Keywords: regional anaesthesia, regional block, plastic surgery, general anaesthesia

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260 Automated Adaptions of Semantic User- and Service Profile Representations by Learning the User Context

Authors: Nicole Merkle, Stefan Zander

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Ambient Assisted Living (AAL) describes a technological and methodological stack of (e.g. formal model-theoretic semantics, rule-based reasoning and machine learning), different aspects regarding the behavior, activities and characteristics of humans. Hence, a semantic representation of the user environment and its relevant elements are required in order to allow assistive agents to recognize situations and deduce appropriate actions. Furthermore, the user and his/her characteristics (e.g. physical, cognitive, preferences) need to be represented with a high degree of expressiveness in order to allow software agents a precise evaluation of the users’ context models. The correct interpretation of these context models highly depends on temporal, spatial circumstances as well as individual user preferences. In most AAL approaches, model representations of real world situations represent the current state of a universe of discourse at a given point in time by neglecting transitions between a set of states. However, the AAL domain currently lacks sufficient approaches that contemplate on the dynamic adaptions of context-related representations. Semantic representations of relevant real-world excerpts (e.g. user activities) help cognitive, rule-based agents to reason and make decisions in order to help users in appropriate tasks and situations. Furthermore, rules and reasoning on semantic models are not sufficient for handling uncertainty and fuzzy situations. A certain situation can require different (re-)actions in order to achieve the best results with respect to the user and his/her needs. But what is the best result? To answer this question, we need to consider that every smart agent requires to achieve an objective, but this objective is mostly defined by domain experts who can also fail in their estimation of what is desired by the user and what not. Hence, a smart agent has to be able to learn from context history data and estimate or predict what is most likely in certain contexts. Furthermore, different agents with contrary objectives can cause collisions as their actions influence the user’s context and constituting conditions in unintended or uncontrolled ways. We present an approach for dynamically updating a semantic model with respect to the current user context that allows flexibility of the software agents and enhances their conformance in order to improve the user experience. The presented approach adapts rules by learning sensor evidence and user actions using probabilistic reasoning approaches, based on given expert knowledge. The semantic domain model consists basically of device-, service- and user profile representations. In this paper, we present how this semantic domain model can be used in order to compute the probability of matching rules and actions. We apply this probability estimation to compare the current domain model representation with the computed one in order to adapt the formal semantic representation. Our approach aims at minimizing the likelihood of unintended interferences in order to eliminate conflicts and unpredictable side-effects by updating pre-defined expert knowledge according to the most probable context representation. This enables agents to adapt to dynamic changes in the environment which enhances the provision of adequate assistance and affects positively the user satisfaction.

Keywords: ambient intelligence, machine learning, semantic web, software agents

Procedia PDF Downloads 256
259 A Case Report: The Role of Gut Directed Hypnotherapy in Resolution of Irritable Bowel Syndrome in a Medication Refractory Pediatric Male Patient

Authors: Alok Bapatla, Pamela Lutting, Mariastella Serrano

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Background: Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain associated with altered bowel habits in the absence of an underlying organic cause. Although the exact etiology of IBS is not fully understood, one of the leading theories postulates a pathology within the Brain-Gut Axis that leads to an overall increase in gastrointestinal sensitivity and pejorative changes in gastrointestinal motility. Research and clinical practice have shown that Gut Directed Hypnotherapy (GDH) has a beneficial clinical role in improving Mind-Gut control and thereby comorbid conditions such as anxiety, abdominal pain, constipation, and diarrhea. Aims: This study presents a 17-year old male with underlying anxiety and a one-year history of IBS-Constipation Predominant Subtype (IBS-C), who has demonstrated impressive improvement of symptoms following GDH treatment following refractory trials with medications including bisacodyl, senna, docusate, magnesium citrate, lubiprostone, linaclotide. Method: The patient was referred to a licensed clinical psychologist specializing in clinical hypnosis and cognitive-behavioral therapy (CBT), who implemented “The Standardized Hypnosis Protocol for IBS” developed by Dr. Olafur S. Palsson, Psy.D at the University of North Carolina at Chapel Hill. The hypnotherapy protocol consisted of a total of seven weekly 45-minute sessions supplemented with a 20-minute audio recording to be listened to once daily. Outcome variables included the GAD-7, PHQ-9 and DCI-2, as well as self-ratings (ranging 0-10) for pain (intensity and frequency), emotional distress about IBS symptoms, and overall emotional distress. All variables were measured at intake prior to administration of the hypnosis protocol and at the conclusion of the hypnosis treatment. A retrospective IBS Questionnaire (IBS Severity Scoring System) was also completed at the conclusion of the GDH treatment for pre-and post-test ratings of clinical symptoms. Results: The patient showed improvement in all outcome variables and self-ratings, including abdominal pain intensity, frequency of abdominal pain episodes, emotional distress relating to gut issues, depression, and anxiety. The IBS Questionnaire showed a significant improvement from a severity score of 400 (defined as severe) prior to GDH intervention compared to 55 (defined as complete resolution) at four months after the last session. IBS Questionnaire subset questions that showed a significant score improvement included abdominal pain intensity, days of pain experienced per 10 days, satisfaction with bowel habits, and overall interference of life affected by IBS symptoms. Conclusion: This case supports the existing research literature that GDH has a significantly beneficial role in improving symptoms in patients with IBS. Emphasis is placed on the numerical results of the IBS Questionnaire scoring, which reflects a patient who initially suffered from severe IBS with failed response to multiple medications, who subsequently showed full and sustained resolution

Keywords: pediatrics, constipation, irritable bowel syndrome, hypnotherapy, gut-directed hypnosis

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258 Subcontractor Development Practices and Processes: A Conceptual Model for LEED Projects

Authors: Andrea N. Ofori-Boadu

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The purpose is to develop a conceptual model of subcontractor development practices and processes that strengthen the integration of subcontractors into construction supply chain systems for improved subcontractor performance on Leadership in Energy and Environmental Design (LEED) certified building projects. The construction management of a LEED project has an important objective of meeting sustainability certification requirements. This is in addition to the typical project management objectives of cost, time, quality, and safety for traditional projects; and, therefore increases the complexity of LEED projects. Considering that construction management organizations rely heavily on subcontractors, poor performance on complex projects such as LEED projects has been largely attributed to the unsatisfactory preparation of subcontractors. Furthermore, the extensive use of unique and non-repetitive short term contracts limits the full integration of subcontractors into construction supply chains and hinders long-term cooperation and benefits that could enhance performance on construction projects. Improved subcontractor development practices are needed to better prepare and manage subcontractors, so that complex objectives can be met or exceeded. While supplier development and supply chain theories and practices for the manufacturing sector have been extensively investigated to address similar challenges, investigations in the construction sector are not that obvious. Consequently, the objective of this research is to investigate effective subcontractor development practices and processes to guide construction management organizations in their development of a strong network of high performing subcontractors. Drawing from foundational supply chain and supplier development theories in the manufacturing sector, a mixed interpretivist and empirical methodology is utilized to assess the body of knowledge within literature for conceptual model development. A self-reporting survey with five-point Likert scale items and open-ended questions is administered to 30 construction professionals to estimate their perceptions of the effectiveness of 37 practices, classified into five subcontractor development categories. Data analysis includes descriptive statistics, weighted means, and t-tests that guide the effectiveness ranking of practices and categories. The results inform the proposed three-phased LEED subcontractor development program model which focuses on preparation, development and implementation, and monitoring. Highly ranked LEED subcontractor pre-qualification, commitment, incentives, evaluation, and feedback practices are perceived as more effective, when compared to practices requiring more direct involvement and linkages between subcontractors and construction management organizations. This is attributed to unfamiliarity, conflicting interests, lack of trust, and resource sharing challenges. With strategic modifications, the recommended practices can be extended to other non-LEED complex projects. Additional research is needed to guide the development of subcontractor development programs that strengthen direct involvement between construction management organizations and their network of high performing subcontractors. Insights from this present research strengthen theoretical foundations to support future research towards more integrated construction supply chains. In the long-term, this would lead to increased performance, profits and client satisfaction.

Keywords: construction management, general contractor, supply chain, sustainable construction

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257 Current Status and Influencing Factors of Transition Status of Newly Graduated Nurses in China: A Multi-center Cross-sectional Study

Authors: Jia Wang, Wanting Zhang, Yutong Xv, Zihan Guo, Weiguang Ma

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Background: Before becoming qualified nurses, newly graduated nurses(NGNs) must experience a painful transition period, even transition shocks. Transition shocks are public health issues. To address the transition issue of NGNs, many programs or interventions have been developed and implemented. However, there are no studies to understand and assess the transition state of newly graduated nurses from work to life, from external abilities to internal emotions. Aims: Assess the transition status of newly graduated nurses in China. Identify the factors influencing the transition status of newly graduated nurses. Methods: The multi-center cross-sectional study design was adopted. From May 2022 to June 2023, 1261 newly graduated nurse in hospitals were surveyed online with the the Demographic Questionnaire and Transition Status Scale for Newly Graduated Nurses. SPSS 26.0 were used for data input and statistical analysis. Statistic description were adopted to evaluate the demographic characteristics and transition status of NGNs. Independent-samples T-test, Analysis of Variance and Multiple regression analysis was used to explore the influencing factors of transition status. Results: The total average score of Transition Status Scale for Newly Graduated Nurses was 4.00(SD = 0.61). Among the various dimensions of Transition Status, the highest dimension was competence for nursing work, while the lowest dimension was balance between work and life. The results showed factors influencing the transition status of NGNs include taught by senior nurses, night shift status, internship department, attribute of working hospital, province of work and residence, educational background, reasons for choosing nursing, types of hospital, and monthly income. Conclusion: At present, the transition status score of new nurses in China is relatively high, and NGNs are more likely to agree with their own transition status, especially the dimension of competence for nursing work. However, they have a poor level of excess in terms of life-work balance. Nursing managers should reasonably arrange the working hours of NGNs, promote their work-life balance, increase the salary and reward mechanism of NGNs, arrange experienced nursing mentors to teach, optimize the level of hospitals, provide suitable positions for NGNs with different educational backgrounds, pay attention to the culture shock of NGNs from other provinces, etc. Optimize human resource management by intervening in these factors that affect the transition of new nurses and promote a better transition of new nurses.

Keywords: newly graduated nurse, transition, humanistic car, nursing management, nursing practice education

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256 Working From Home: On the Relationship Between Place Attachment to Work Place, Extraversion and Segmentation Preference to Burnout

Authors: Diamant Irene, Shklarnik Batya

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In on to its widespread effects on health and economic issues, Covid-19 shook the work and employment world. Among the prominent changes during the pandemic is the work-from-home trend, complete or partial, as part of social distancing. In fact, these changes accelerated an existing tendency of work flexibility already underway before the pandemic. Technology and means of advanced communications led to a re-assessment of “place of work” as a physical space in which work takes place. Today workers can remotely carry out meetings, manage projects, work in groups, and different research studies point to the fact that this type of work has no adverse effect on productivity. However, from the worker’s perspective, despite numerous advantages associated with work from home, such as convenience, flexibility, and autonomy, various drawbacks have been identified such as loneliness, reduction of commitment, home-work boundary erosion, all risk factors relating to the quality of life and burnout. Thus, a real need has arisen in exploring differences in work-from-home experiences and understanding the relationship between psychological characteristics and the prevalence of burnout. This understanding may be of significant value to organizations considering a future hybrid work model combining in-office and remote working. Based on Hobfoll’s Theory of Conservation of Resources, we hypothesized that burnout would mainly be found among workers whose physical remoteness from the workplace threatens or hinders their ability to retain significant individual resources. In the present study, we compared fully remote and partially remote workers (hybrid work), and we examined psychological characteristics and their connection to the formation of burnout. Based on the conceptualization of Place Attachment as the cognitive-emotional bond of an individual to a meaningful place and the need to maintain closeness to it, we assumed that individuals characterized with Place Attachment to the workplace would suffer more from burnout when working from home. We also assumed that extrovert individuals, characterized by the need of social interaction at the workplace and individuals with segmentationpreference – a need for separation between different life domains, would suffer more from burnout, especially among fully remote workers relative to partially remote workers. 194 workers, of which 111 worked from home in full and 83 worked partially from home, aged 19-53, from different sectors, were tested using an online questionnaire through social media. The results of the study supported our assumptions. The repercussions of these findings are discussed, relating to future occupational experience, with an emphasis on suitable occupational adjustment according to the psychological characteristics and needs of workers.

Keywords: working from home, burnout, place attachment, extraversion, segmentation preference, Covid-19

Procedia PDF Downloads 163
255 Mental Balance, Emotional Balance, and Stress Management: The Role of Ancient Vedic Philosophy from India

Authors: Emily Schulz

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The ancient Vedic culture from India had traditions that supported all aspects of health, including psychological health, and are relevant in the current era. These traditions have been compiled by Professor Dr. Purna, a rare Himalayan Master, into the Purna Health Management System (PHMS). The PHMS is a unique, holistic, and integrated approach to health management. It is comprised of four key factors: Health, Fitness, and Nutrition (HF&N), Life Balance (Stress Management) (LB-SM), Spiritual Growth and Development (SG&D); and Living in Harmony with the Natural Environment (LHWNE). The purpose of the PHMS is to give people the tools to take responsibility for managing their own holistic health and wellbeing. A study using a cross-sectional mixed-methods anonymous online survey was conducted during 2017-2018. Adult students of Professor Dr. Purna were invited to participate through announcements made at various events He held throughout the globe. Follow-up emails were sent with consenting language for interested parties and provided them with a link to the survey. Participation in the study was completely voluntary and no incentives were given to respond to the survey. The overall aim of the study was to investigate the effectiveness of implementation of the PHMS on practitioners' emotional balance. However, given the holistic nature of the PHMS, survey questions also inquired about participants’ physical health, stress level, ability to manage stress, and wellbeing using Likert scales. The survey also included some open-ended questions to gain an understanding of the participants’ experiences with the PHMS relative to their emotional balance. In total, 52 people out of 253 potential respondents participated in the study. Data were analyzed using nonparametric Spearman’s Rho correlation coefficient (rs) since the data were not on a normal distribution. Statistical significance was set at p < .05. Results of the study suggested that there are moderate to strong statistically significant relationships (p < .001) between participants' frequent implementation of each of the four key factors of the PHMS and self-reported mental/emotional health (HF&N rs = 0.42; LB-SM rs = 0.54; SG&D rs = 0.49; LHWNE rs = 0.45) Results also demonstrated statistically significant relationships (p < .001) between participants' frequent implementation of each of the four key factors of the PHMS and their self-reported ability to manage stress (HF&N rs = 0.44; LB-SM rs = 0.55; SG&D rs = 0.39; LHWNE rs = 0.55). Additionally, those who reported experiencing better physical health also reported better mental/emotional health (rs = 0.49, p < .001) and better ability to manage stress (rs = 0.46, p < .001). The findings of this study suggest that wisdom from the ancient Vedic culture may be useful for those working in the field of psychology and related fields who would like to assist clients in calming their mind and emotions and managing their stress levels.

Keywords: balanced emotions, balanced mind, stress management, Vedic philosophy

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254 Partnering With Key Stakeholders for Successful Implementation of Inhaled Analgesia for Specific Emergency Department Presentations

Authors: Sarah Hazelwood, Janice Hay

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Methoxyflurane is an inhaled analgesic administered via a disposable inhaler, which has been used in Australia for 40 years for the management of pain in children & adults. However, there is a lack of data for methoxyflurane as a frontline analgesic medication within the emergency department (ED). This study will investigate the usefulness of methoxyflurane in a private inner-city ED. The study concluded that the inclusion of all key stakeholders in the prescribing, administering & use of this new process led to comprehensive uptake & vastly positive outcomes for consumer & health professionals. Method: A 12-week prospective pilot study was completed utilizing patients presenting to the ED in pain (numeric pain rating score > 4) that fit the requirement of methoxyflurane use (as outlined in the Australian Prescriber information package). Nurses completed a formatted spreadsheet for each interaction where methoxyflurane was used. Patient demographics, day, time, initial numeric pain score, analgesic response time, the reason for use, staff concern (free text), & patient feedback (free text), & discharge time was documented. When clinical concern was raised, the researcher retrieved & reviewed patient notes. Results: 140 methoxyflurane inhalers were used. 60% of patients were 31 years of age & over (n=82) with 16% aged 70+. The gender split; 51% male: 49% female. Trauma-related pain (57%) saw the highest use of administration, with the evening hours (1500-2259) seeing the greatest numbers used (39%). Tuesday, Thursday & Sunday shared the highest daily use throughout the study. A minimum numerical pain score of 4/10 (n=13, 9%), with the ranges of 5 - 7/10 (moderate pain) being given by almost 50% of patients. Only 3 instances of pain scores increased post use of methoxyflurane (all other entries showed pain score < initial rating). Patients & staff noted obvious analgesic response within 3 minutes (n= 96, 81%, of administration). Nurses documented a change in patient vital signs for 4 of the 15 patient-related concerns; the remaining concerns were due to “gagging” on the taste, or “having a coughing episode”; one patient tried to leave the department before the procedure was attended (very euphoric state). Upon review of the staff concerns – no adverse events occurred & return to therapeutic vitals occurred within 10 minutes. Length of stay for patients was compared with similar presentations (such as dislocated shoulder or ankle fracture) & saw an average 40-minute decrease in time to discharge. Methoxyflurane treatment was rated “positively” by > 80% of patients – with remaining feedback related to mild & transient concerns. Staff similarly noted a positive response to methoxyflurane as an analgesic & as an added tool for frontline analgesic purposes. Conclusion: Methoxyflurane should be used on suitable patient presentations requiring immediate, short term pain relief. As a highly portable, non-narcotic avenue to treat pain this study showed obvious therapeutic benefit, positive feedback, & a shorter length of stay in the ED. By partnering with key stake holders, this study determined methoxyflurane use decreased work load, decreased wait time to analgesia, and increased patient satisfaction.

Keywords: analgesia, benefits, emergency, methoxyflurane

Procedia PDF Downloads 107
253 Study of Polish and Ukrainian Volunteers Helping War Refugees. Psychological and Motivational Conditions of Coping with Stress of Volunteer Activity

Authors: Agata Chudzicka-Czupała, Nadiya Hapon, Liudmyla Karamushka, Marta żywiołek-Szeja

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Objectives: The study is about the determinants of coping with stress connected with volunteer activity for Russo-Ukrainian war 2022 refugees. We examined the mental health reactions, chosen psychological traits, and motivational functions of volunteers working in Poland and Ukraine in relation to their coping with stress styles. The study was financed with funds from the Foundation for Polish Science in the framework of the FOR UKRAINE Programme. Material and Method: The study was conducted in 2022. The study was a quantitative, questionnaire-based survey. Data was collected through an online survey. The volunteers were asked to assess their propensity to use different styles of coping with stress connected with their activity for Russo-Ukrainian war refugees using The Brief Coping Orientation to Problems Experienced Inventory (Brief-COPE) questionnaire. Depression, anxiety, and stress were measured using the Depression, Anxiety, and Stress (DASS)-21 item scale. Chosen psychological traits, psychological capital and hardiness, were assessed by The Psychological Capital Questionnaire and The Norwegian Revised Scale of Hardiness (DRS-15R). Then The Volunteer Function Inventory (VFI) was used. The significance of differences between the variable means of the samples was tested by the Student's t-test. We used multivariate linear regression to identify factors associated with coping with stress styles separately for each national sample. Results: The sample consisted of 720 volunteers helping war refugees (in Poland, 435 people, and 285 in Ukraine). The results of the regression analysis indicate variables that are significant predictors of the propensity to use particular styles of coping with stress (problem-focused style, emotion-focused style and avoidant coping). These include levels of depression and stress, individual psychological characteristics and motivational functions, different for Polish and Ukrainians. Ukrainian volunteers are significantly more likely to use all three coping with stress styles than Polish ones. The results also prove significant differences in the severity of anxiety, stress and depression, the selected psychological traits and motivational functions studied, which led volunteers to participate in activities for war refugees. Conclusions: The results show that depression and stress severity, as well as psychological capital and hardiness, and motivational factors are connected with coping with stress behavior. The results indicate the need for increased attention to the well-being of volunteers acting under stressful conditions. They also prove the necessity of guiding the selection of people for specific types of volu

Keywords: anxiety, coping with stress styles, depression, hardiness, mental health, motivational functions, psychological capital, resilience, stress, war, volunteer, civil society

Procedia PDF Downloads 46
252 Coping with Incompatible Identities in Russia: Case of Orthodox Gays

Authors: Siuzan Uorner

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The era of late modernity is characterized, on the one hand, by social disintegration, values of personal freedom, tolerance, and self-expression. Boundaries between the accessible and the elitist, normal and abnormal are blurring. On the other hand, traditional social institutions, such as religion (especially Russian Orthodox Church), exist, criticizing lifestyle and worldview other than conventionally structured canons. Despite the declared values and opportunities in late modern society, people's freedom is ambivalent. Personal identity and its aspects are becoming a subject of choice. Hence, combinations of identity aspects can be incompatible. Our theoretical framework is based on P. Ricoeur's concept of narrative identity and hermeneutics, E. Goffman’s theory of social stigma, self-presentation, discrepant roles and W. James lectures about varieties of religious experience. This paper aims to reconstruct ways of coping with incompatible identities of Orthodox gays (an extreme sampling of a combination of sexual orientation and religious identity in a heteronormative society). This study focuses on the discourse of Orthodox gay parishioners and ROC gay priests in Russia (sampling ‘hard to reach’ populations because of the secrecy of gay community in ROC and sensitivity of the topic itself). We conducted a qualitative research design, using in-depth personal semi-structured online-interviews. Recruiting of informants took place in 'Nuntiare et Recreare' (Russian movement of religious LGBT) page in VKontakte through the post with an invitation to participate in the research. In this work, we analyzed interview transcripts using axial coding. We chose the Grounded Theory methodology to construct a theory from empirical data and contribute to the growing body of knowledge in ways of harmonizing incompatible identities in late modern societies. The research has found that there are two types of conflicts Orthodox gays meet with: canonic contradictions (postulates of Scripture and its interpretations) and problems in social interaction, mainly with ROC priests and Orthodox parishioners. We have revealed semantic meanings of most commonly used words that appear in the narratives (words such as ‘love’, ‘sin’, ‘religion’ etc.). Finally, we have reconstructed biographical patterns of LGBT social movements’ involvement. This paper argues that all incompatibilities are harmonizing in the narrative itself. As Ricoeur has suggested, the narrative configuration allows the speaker to gather facts and events together and to compose causal relationships between them. Sexual orientation and religious identity are getting along and harmonizing in the narrative.

Keywords: gay priests, incompatible identities, narrative identity, Orthodox gays, religious identity, ROC, sexual orientation

Procedia PDF Downloads 112
251 Generation-Based Travel Decision Analysis in the Post-Pandemic Era

Authors: Hsuan Yu Lai, Hsuan Hsuan Chang

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The consumer decision process steps through problems by weighing evidence, examining alternatives, and choosing a decision path. Currently, the COVID 19 made the tourism industry encounter a huge challenge and suffer the biggest amount of economic loss. It would be very important to reexamine the decision-making process model, especially after the pandemic, and consider the differences among different generations. The tourism industry has been significantly impacted by the global outbreak of COVID-19, but as the pandemic subsides, the sector is recovering. This study addresses the scarcity of research on travel decision-making patterns among generations in Taiwan. Specifically targeting individuals who frequently traveled abroad before the pandemic, the study explores differences in decision-making at different stages post-outbreak. So this study investigates differences in travel decision-making among individuals from different generations during/after the COVID-19 pandemic and examines the moderating effects of social media usage and individuals' perception of health risks. The study hypotheses are “there are significant differences in the decision-making process including travel motivation, information searching preferences, and criteria for decision-making” and that social-media usage and health-risk perception would moderate the results of the previous study hypothesis. The X, Y, and Z generations are defined and categorized based on a literature review. The survey collected data including their social-economic background, travel behaviors, motivations, considerations for destinations, travel information searching preferences, and decision-making criteria before/after the pandemic based on the reviews of previous studies. Data from 656 online questionnaires were collected between January to May 2023 and from Taiwanese travel consumers who used to travel at least one time abroad before Covid-19. SPSS is used to analyze the data with One-Way ANOVA and Two-Way ANOVA. The analysis includes demand perception, information gathering, alternative comparison, purchase behavior, and post-travel experience sharing. Social media influence and perception of health risks are examined as moderating factors. The findings show that before the pandemic, the Y Generation preferred natural environments, while the X Generation favored historical and cultural sites compared to the Z Generation. However, after the outbreak, the Z Generation displayed a significant preference for entertainment activities. This study contributes to understanding changes in travel decision-making patterns following COVID-19 and the influence of social media and health risks. The findings have practical implications for the tourism industry.

Keywords: consumer decision-making, generation study, health risk perception, post-pandemic era, social media

Procedia PDF Downloads 37
250 A Randomized, Controlled Trial to Test Behavior Change Techniques to Improve Low Intensity Physical Activity in Older Adults

Authors: Ciaran Friel, Jerry Suls, Mark Butler, Patrick Robles, Samantha Gordon, Frank Vicari, Karina W. Davidson

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Physical activity guidelines focus on increasing moderate-intensity activity for older adults, but adherence to recommendations remains low. This is despite the fact that scientific evidence supports that any increase in physical activity is positively correlated with health benefits. Behavior change techniques (BCTs) have demonstrated effectiveness in reducing sedentary behavior and promoting physical activity. This pilot study uses a Personalized Trials (N-of-1) design to evaluate the efficacy of using four BCTs to promote an increase in low-intensity physical activity (2,000 steps of walking per day) in adults aged 45-75 years old. The 4 BCTs tested were goal setting, action planning, feedback, and self-monitoring. BCTs were tested in random order and delivered by text message prompts requiring participant engagement. The study recruited health system employees in the target age range, without mobility restrictions and demonstrating interest in increasing their daily activity by a minimum of 2,000 steps per day for a minimum of five days per week. Participants were sent a Fitbit® fitness tracker with an established study account and password. Participants were recommended to wear the Fitbit device 24/7 but were required to wear it for a minimum of ten hours per day. Baseline physical activity was measured by Fitbit for two weeks. In the 8-week intervention phase of the study, participants received each of the four BCTs, in random order, for a two-week period. Text message prompts were delivered daily each morning at a consistent time. All prompts required participant engagement to acknowledge receipt of the BCT message. Engagement is dependent upon the BCT message and may have included recording that a detailed plan for walking has been made or confirmed a daily step goal (action planning, goal setting). Additionally, participants may have been directed to a study dashboard to view their step counts or compare themselves to their baseline average step count (self-monitoring, feedback). At the end of each two-week testing interval, participants were asked to complete the Self-Efficacy for Walking Scale (SEW_Dur), a validated measure that assesses the participant’s confidence in walking incremental distances, and a survey measuring their satisfaction with the individual BCT that they tested. At the end of their trial, participants received a personalized summary of their step data in response to each individual BCT. The analysis will examine the novel individual-level heterogeneity of treatment effect made possible by N-of-1 design and pool results across participants to efficiently estimate the overall efficacy of the selected behavioral change techniques in increasing low-intensity walking by 2,000 steps, five days per week. Self-efficacy will be explored as the likely mechanism of action prompting behavior change. This study will inform the providers and demonstrate the feasibility of an N-of-1 study design to effectively promote physical activity as a component of healthy aging.

Keywords: aging, exercise, habit, walking

Procedia PDF Downloads 71
249 Intelligent Control of Agricultural Farms, Gardens, Greenhouses, Livestock

Authors: Vahid Bairami Rad

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The intelligentization of agricultural fields can control the temperature, humidity, and variables affecting the growth of agricultural products online and on a mobile phone or computer. Smarting agricultural fields and gardens is one of the best and best ways to optimize agricultural equipment and has a 100 percent direct effect on the growth of plants and agricultural products and farms. Smart farms are the topic that we are going to discuss today, the Internet of Things and artificial intelligence. Agriculture is becoming smarter every day. From large industrial operations to individuals growing organic produce locally, technology is at the forefront of reducing costs, improving results and ensuring optimal delivery to market. A key element to having a smart agriculture is the use of useful data. Modern farmers have more tools to collect intelligent data than in previous years. Data related to soil chemistry also allows people to make informed decisions about fertilizing farmland. Moisture meter sensors and accurate irrigation controllers have made the irrigation processes to be optimized and at the same time reduce the cost of water consumption. Drones can apply pesticides precisely on the desired point. Automated harvesting machines navigate crop fields based on position and capacity sensors. The list goes on. Almost any process related to agriculture can use sensors that collect data to optimize existing processes and make informed decisions. The Internet of Things (IoT) is at the center of this great transformation. Internet of Things hardware has grown and developed rapidly to provide low-cost sensors for people's needs. These sensors are embedded in IoT devices with a battery and can be evaluated over the years and have access to a low-power and cost-effective mobile network. IoT device management platforms have also evolved rapidly and can now be used securely and manage existing devices at scale. IoT cloud services also provide a set of application enablement services that can be easily used by developers and allow them to build application business logic. Focus on yourself. These development processes have created powerful and new applications in the field of Internet of Things, and these programs can be used in various industries such as agriculture and building smart farms. But the question is, what makes today's farms truly smart farms? Let us put this question in another way. When will the technologies associated with smart farms reach the point where the range of intelligence they provide can exceed the intelligence of experienced and professional farmers?

Keywords: food security, IoT automation, wireless communication, hybrid lifestyle, arduino Uno

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248 Nuclear Near Misses and Their Learning for Healthcare

Authors: Nick Woodier, Iain Moppett

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Background: It is estimated that one in ten patients admitted to hospital will suffer an adverse event in their care. While the majority of these will result in low harm, patients are being significantly harmed by the processes meant to help them. Healthcare, therefore, seeks to make improvements in patient safety by taking learning from other industries that are perceived to be more mature in their management of safety events. Of particular interest to healthcare are ‘near misses,’ those events that almost happened but for an intervention. Healthcare does not have any guidance as to how best to manage and learn from near misses to reduce the chances of harm to patients. The authors, as part of a larger study of near-miss management in healthcare, sought to learn from the UK nuclear sector to develop principles for how healthcare can identify, report, and learn from near misses to improve patient safety. The nuclear sector was chosen as an exemplar due to its status as an ultra-safe industry. Methods: A Grounded Theory (GT) methodology, augmented by a scoping review, was used. Data collection included interviews, scenario discussion, field notes, and the literature. The review protocol is accessible online. The GT aimed to develop theories about how nuclear manages near misses with a focus on defining them and clarifying how best to support reporting and analysis to extract learning. Near misses related to radiation release or exposure were focused on. Results: Eightnuclear interviews contributed to the GT across nuclear power, decommissioning, weapons, and propulsion. The scoping review identified 83 articles across a range of safety-critical industries, with only six focused on nuclear. The GT identified that nuclear has a particular focus on precursors and low-level events, with regulation supporting their management. Exploration of definitions led to the recognition of the importance of several interventions in a sequence of events, but that do not solely rely on humans as these cannot be assumed to be robust barriers. Regarding reporting and analysis, no consistent methods were identified, but for learning, the role of operating experience learning groups was identified as an exemplar. The safety culture across nuclear, however, was heard to vary, which undermined reporting of near misses and other safety events. Some parts of the industry described that their focus on near misses is new and that despite potential risks existing, progress to mitigate hazards is slow. Conclusions: Healthcare often sees ‘nuclear,’ as well as other ultra-safe industries such as ‘aviation,’ as homogenous. However, the findings here suggest significant differences in safety culture and maturity across various parts of the nuclear sector. Healthcare can take learning from some aspects of management of near misses in nuclear, such as how they are defined and how learning is shared through operating experience networks. However, healthcare also needs to recognise that variability exists across industries, and comparably, it may be more mature in some areas of safety.

Keywords: culture, definitions, near miss, nuclear safety, patient safety

Procedia PDF Downloads 81
247 Youth Health Promotion Project for Indigenous People in Canada: Together against Bullying and Cyber-Dependence

Authors: Mohamed El Fares Djellatou, Fracoise Filion

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The Ashukin program that means bridge in Naskapi or Atikamekw language, has been designed to offer a partnership between nursing students and an indigenous community. The students design a health promotion project tailored to the needs of the community. The issues of intimidation in primary school and cyber-dependence in high school were some concerns in a rural Atikamekw community. The goal of the project was to have a conversation with indigenous youths, aged 10-16 years old, on the challenges presented by intimidation and cyber dependence as well as promoting healthy relationships online and within the community. Methods: Multiple progressive inquiry questions (PIQs) were used to assess the feasibility and importance of this project for the Atikamekw nation, and to determine a plan to follow. The theoretical foundations to guide the conception of the project were the Population Health Promotion Model (PHPM), the First Nations Holistic Lifelong Learning Model, and the Medicine Wheel. A broad array of social determinants of health were addressed, including healthy childhood development, personal health practices, and coping skills, and education. The youths were encouraged to participate in interactive educational sessions, using PowerPoint presentations and pamphlets as the main effective strategies. Additional tools such as cultural artworks and physical activities were introduced to strengthen the inter-relational and team spirit within the Indigenous population. A quality assurance tool (QAT) was developed specifically to determine the appropriateness of these health promotion tools. Improvements were guided by the feedback issued by the indigenous schools’ teachers and social workers who filled the QATs. Post educational sessions, quantitative results have shown that 93.48% of primary school students were able to identify the different types of intimidation, 72.65% recognized more than two strategies, and 52.1% were able to list at least four resources to diffuse intimidation. On the other hand, around 75% of the adolescents were able to name at least three negative effects, and 50% listed three strategies to reduce cyber-dependence. This project was meant to create a bridge with the First Nation through health promotion, a population that is known to be disadvantaged due to systemic health inequity and disparities. Culturally safe care was proposed to deal with the two identified priority issues, and an educational toolkit was given to both schools to ensure the sustainability of the project. The project was self-financed through fundraising activities, and it yielded better results than expected.

Keywords: indigenous, first nation, bullying, cyber-dependence, internet addiction, intimidation, youth, adolescents, school, community nursing, health promotion

Procedia PDF Downloads 78
246 Principal Well-Being at Hong Kong: A Quantitative Investigation

Authors: Junjun Chen, Yingxiu Li

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The occupational well-being of school principals has played a vital role in the pursuit of individual and school wellness and success. However, principals’ well-being worldwide is under increasing threat because of the challenging and complex nature of their work and growing demands for school standardisation and accountability. Pressure is particularly acute in the post-pandemicfuture as principals attempt to deal with the impact of the pandemic on top of more regular demands. This is particularly true in Hong Kong, as school principals are increasingly wedged between unparalleled political, social, and academic responsibilities. Recognizing the semantic breadth of well-being, scholars have not determined a single, mutually agreeable definition but agreed that the concept of well-being has multiple dimensions across various disciplines. The multidimensional approach promises more precise assessments of the relationships between well-being and other concepts than the ‘affect-only’ approach or other single domains for capturing the essence of principal well-being. The multiple-dimension well-being concept is adopted in this project to understand principal well-being in this study. This study aimed to understand the situation of principal well-being and its influential drivers with a sample of 670 principals from Hong Kong and Mainland China. An online survey was sent to the participants after the breakout of COVID-19 by the researchers. All participants were well informed about the purposes and procedure of the project and the confidentiality of the data prior to filling in the questionnaire. Confirmatory factor analysis and structural equation modelling performed with Mplus were employed to deal with the dataset. The data analysis procedure involved the following three steps. First, the descriptive statistics (e.g., mean and standard deviation) were calculated. Second, confirmatory factor analysis (CFA) was used to trim principal well-being measurement performed with maximum likelihood estimation. Third, structural equation modelling (SEM) was employed to test the influential factors of principal well-being. The results of this study indicated that the overall of principal well-being were above the average mean score. The highest ranking in this study given by the principals was to their psychological and social well-being (M = 5.21). This was followed by spiritual (M = 5.14; SD = .77), cognitive (M = 5.14; SD = .77), emotional (M = 4.96; SD = .79), and physical well-being (M = 3.15; SD = .73). Participants ranked their physical well-being the lowest. Moreover, professional autonomy, supervisor and collegial support, school physical conditions, professional networking, and social media have showed a significant impact on principal well-being. The findings of this study will potentially enhance not only principal well-being, but also the functioning of an individual principal and a school without sacrificing principal well-being for quality education in the process. This will eventually move one step forward for a new future - a wellness society advocated by OECD. Importantly, well-being is an inside job that begins with choosing to have wellness, whilst supports to become a wellness principal are also imperative.

Keywords: well-being, school principals, quantitative, influential factors

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245 Strengths Profiling: An Alternative Approach to Assessing Character Strengths Based on Personal Construct Psychology

Authors: Sam J. Cooley, Mary L. Quinton, Benjamin J. Parry, Mark J. G. Holland, Richard J. Whiting, Jennifer Cumming

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Practitioners draw attention to people’s character strengths to promote empowerment and well-being. This paper explores the possibility that existing approaches for assessing character strengths (e.g., the Values in Action survey; VIA-IS) could be even more autonomy supportive and empowering when combined with strengths profiling, an ideographic tool informed by personal construct theory (PCT). A PCT approach ensures that: (1) knowledge is co-created (i.e., the practitioner is not seen as the ‘expert’ who leads the process); (2) individuals are not required to ‘fit’ within a prescribed list of characteristics; and (3) individuals are free to use their own terminology and interpretations. A combined Strengths Profiling and VIA approach was used in a sample of homeless youth (aged 16-25) who are commonly perceived as ‘hard-to-engage’ through traditional forms of assessment. Strengths Profiling was completed face-to-face in small groups. Participants (N = 116) began by listing a variety of personally meaningful characteristics. Participants gave each characteristic a score out of ten for how important it was to them (1 = not so important; 10 = very important), their ideal competency, and their current competency (1 = poor; 10 = excellent). A discrepancy score was calculated for each characteristic (discrepancy score = ideal score - current score x importance), whereby a lower discrepancy score indicated greater satisfaction. Strengths Profiling was used at the beginning and end of a 10-week positive youth development programme. Experiences were captured through video diary room entries made by participants and through reflective notes taken by the facilitators. Participants were also asked to complete a pre-and post-programme questionnaire, measuring perceptions of well-being, self-worth, and resilience. All of the young people who attended the strengths profiling session agreed to complete a profile, and the majority became highly engaged in the process. Strengths profiling was found to be an autonomy supportive and empowering experience, with each participant identifying an average of 10 character strengths (M = 10.27, SD = 3.23). In total, 215 different character strengths were identified, each with varying terms and definitions used, which differed greatly between participants and demonstrated the value in soliciting personal constructs. Using the participants’ definitions, 98% of characteristics were categorized deductively into the VIA framework. Bravery, perseverance, and hope were the character strengths that featured most, whilst temperance and courage received the highest discrepancy scores. Discrepancy scores were negatively correlated with well-being, self-worth, and resilience, and meaningful improvements were recorded following the intervention. These findings support the use of strengths profiling as a theoretically-driven and novel way to engage disadvantaged youth in identifying and monitoring character strengths. When young people are given the freedom to express their own characteristics, the resulting terminologies extend beyond the language used in existing frameworks. This added freedom and control over the process of strengths identification encouraged youth to take ownership over their profiles and apply their strengths. In addition, the ability to transform characteristics post hoc into the VIA framework means that strengths profiling can be used to explore aggregated/nomothetic hypotheses, whilst still benefiting from its ideographic roots.

Keywords: ideographic, nomothetic, positive youth development, VIA-IS, assessment, homeless youth

Procedia PDF Downloads 172
244 Master Di-Chiao: A Great Practitioner of Earth Store Bodhisattva's Compassion

Authors: Mei-Hsia Dai

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Venerable Master Di-Chiao has been devoted all her life practicing the Earth Store Bodhisattva’s spirit and is one of the greatest masters in modern Buddhism. All Buddha and Bodhisattvas pay great respect to the Earth Store Bodhisattva because He vowed that He would not become Buddha until the hell is empty, and He would only achieve Bodhi until all sentient beings have been saved. The aim of this study is to investigate Venerable Master Di-Chiao, who actualizes the Buddha’s teaching and practices the Earth Store Bodhisattva’s compassion and apply them to help people. In fact, she has integrated her learning to teach people how to eliminate their karmic suffering with her close attention and full effort, even though she would be hurt all over or she had to sacrifice her own life. This qualitative research gathers data in terms of a field study, including an interview with Venerable Master Di-Chiao, a book about the Master and three books about true stories of people saved by the Master, and about 300 online feedbacks from her disciples and followers explaining how they were helped by the Master through their difficulties, together with a year-long observation at the Dharma services held in Taipei Di-Zang Temple. This article is divided into four parts: The first part depicts Master Di-Chiao’s original intent of being a nun and her three-step-one-bow pilgrimage experience around Taiwan. Part two illustrates the invitation of the Master’s being the Abbess of Tsiang-Te Temple, which was designated by Bodhisattva Avalokitesvara in a manager’s dream of the temple, and many unexpected difficulties ahead of the cultivation in the Master’s Buddha Path. In addition to maintenance of Tsiang-Te Temple, the third part will discuss the purpose of founding Taipei Di-Zang Temple, in which the Master always tries her best with various methods to cultivate good seeds for her disciples and followers and watches out for their karma and does her utmost effort to help them overcome it. The final part will briefly explain the Three Buddhalization: Buddhist wedding, Buddhist prenatal education and Buddhist family, which the Master has been advocating and considers them the essence of constructing a harmonious society and having a meaningful and enlightening life. Extraordinary results of practicing the Three Buddhalization will be given. Findings show that Master’s Di-Chiao’s actualization of Buddha’s teaching and Bodhisattva’s compassion is incredibly amazing and powerful, and she has helped countless people to conquer their difficulties and purify their evil habits. With the Master’s assistance and their hardworking and faith to the Master’s teaching, some of her disciples and followers have gone to the Maitreya Inside Realm, where the future Buddha has resided, and continue their cultivation. True stories will be presented to illuminate the incredibility of the Master’s compassion, her brevity and perseverance in the course of the Buddhahood. Venerable Master Di-Chiao is the embodiment of the Earth Store Bodhisattva for her disciples and followers.

Keywords: compassion, the Earth Store Bodhisattva, three Buddhalization, venerable Master Di-Chiao

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243 Distinguishing Substance from Spectacle in Violent Extremist Propaganda through Frame Analysis

Authors: John Hardy

Abstract:

Over the last decade, the world has witnessed an unprecedented rise in the quality and availability of violent extremist propaganda. This phenomenon has been fueled primarily by three interrelated trends: rapid adoption of online content mediums by creators of violent extremist propaganda, increasing sophistication of violent extremist content production, and greater coordination of content and action across violent extremist organizations. In particular, the self-styled ‘Islamic State’ attracted widespread attention from its supporters and detractors alike by mixing shocking video and imagery content in with substantive ideological and political content. Although this practice was widely condemned for its brutality, it proved to be effective at engaging with a variety of international audiences and encouraging potential supporters to seek further information. The reasons for the noteworthy success of this kind of shock-value propaganda content remain unclear, despite many governments’ attempts to produce counterpropaganda. This study examines violent extremist propaganda distributed by five terrorist organizations between 2010 and 2016, using material released by the ‎Al Hayat Media Center of the Islamic State, Boko Haram, Al Qaeda, Al Qaeda in the Arabian Peninsula, and Al Qaeda in the Islamic Maghreb. The time period covers all issues of the infamous publications Inspire and Dabiq, as well as the most shocking video content released by the Islamic State and its affiliates. The study uses frame analysis to distinguish thematic from symbolic content in violent extremist propaganda by contrasting the ways that substantive ideology issues were framed against the use of symbols and violence to garner attention and to stylize propaganda. The results demonstrate that thematic content focuses significantly on diagnostic frames, which explain violent extremist groups’ causes, and prognostic frames, which propose solutions to addressing or rectifying the cause shared by groups and their sympathizers. Conversely, symbolic violence is primarily stylistic and rarely linked to thematic issues or motivational framing. Frame analysis provides a useful preliminary tool in disentangling substantive ideological and political content from stylistic brutality in violent extremist propaganda. This provides governments and researchers a method for better understanding the framing and content used to design narratives and propaganda materials used to promote violent extremism around the world. Increased capacity to process and understand violent extremist narratives will further enable governments and non-governmental organizations to develop effective counternarratives which promote non-violent solutions to extremists’ grievances.

Keywords: countering violent extremism, counternarratives, frame analysis, propaganda, terrorism, violent extremism

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242 Smart Mobility Planning Applications in Meeting the Needs of the Urbanization Growth

Authors: Caroline Atef Shoukry Tadros

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Massive Urbanization growth threatens the sustainability of cities and the quality of city life. This raised the need for an alternate model of sustainability, so we need to plan the future cities in a smarter way with smarter mobility. Smart Mobility planning applications are solutions that use digital technologies and infrastructure advances to improve the efficiency, sustainability, and inclusiveness of urban transportation systems. They can contribute to meeting the needs of Urbanization growth by addressing the challenges of traffic congestion, pollution, accessibility, and safety in cities. Some example of a Smart Mobility planning application are Mobility-as-a-service: This is a service that integrates different transport modes, such as public transport, shared mobility, and active mobility, into a single platform that allows users to plan, book, and pay for their trips. This can reduce the reliance on private cars, optimize the use of existing infrastructure, and provide more choices and convenience for travelers. MaaS Global is a company that offers mobility-as-a-service solutions in several cities around the world. Traffic flow optimization: This is a solution that uses data analytics, artificial intelligence, and sensors to monitor and manage traffic conditions in real-time. This can reduce congestion, emissions, and travel time, as well as improve road safety and user satisfaction. Waycare is a platform that leverages data from various sources, such as connected vehicles, mobile applications, and road cameras, to provide traffic management agencies with insights and recommendations to optimize traffic flow. Logistics optimization: This is a solution that uses smart algorithms, blockchain, and IoT to improve the efficiency and transparency of the delivery of goods and services in urban areas. This can reduce the costs, emissions, and delays associated with logistics, as well as enhance the customer experience and trust. ShipChain is a blockchain-based platform that connects shippers, carriers, and customers and provides end-to-end visibility and traceability of the shipments. Autonomous vehicles: This is a solution that uses advanced sensors, software, and communication systems to enable vehicles to operate without human intervention. This can improve the safety, accessibility, and productivity of transportation, as well as reduce the need for parking space and infrastructure maintenance. Waymo is a company that develops and operates autonomous vehicles for various purposes, such as ride-hailing, delivery, and trucking. These are some of the ways that Smart Mobility planning applications can contribute to meeting the needs of the Urbanization growth. However, there are also various opportunities and challenges related to the implementation and adoption of these solutions, such as the regulatory, ethical, social, and technical aspects. Therefore, it is important to consider the specific context and needs of each city and its stakeholders when designing and deploying Smart Mobility planning applications.

Keywords: smart mobility planning, smart mobility applications, smart mobility techniques, smart mobility tools, smart transportation, smart cities, urbanization growth, future smart cities, intelligent cities, ICT information and communications technologies, IoT internet of things, sensors, lidar, digital twin, ai artificial intelligence, AR augmented reality, VR virtual reality, robotics, cps cyber physical systems, citizens design science

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241 Evaluating the Teaching and Learning Value of Tablets

Authors: Willem J. A. Louw

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The wave of new advanced computing technology that has been developed during the recent past has significantly changed the way we communicate, collaborate and collect information. It has created a new technology environment and paradigm in which our children and students grow-up and this impacts on their learning. Research confirmed that Generation Y students have a preference for learning in the new technology environment. The challenge or question is: How do we adjust our teaching and learning to make the most of these changes. The complexity of effective and efficient teaching and learning must not be underestimated and changes must be preceded by proper objective research to prevent any haphazard developments that could do more harm than benefit. A blended learning approach has been used in the Forestry department for a few numbers of years including the use of electronic-peer assisted learning (e-pal) in a fixed-computer set-up within a learning management system environment. It was decided to extend the investigation and do some exploratory research by using a range of different Tablet devices. For this purpose, learning activities or assignments were designed to cover aspects of communication, collaboration and collection of information. The Moodle learning management system was used to present normal module information, to communicate with students and for feedback and data collection. Student feedback was collected by using an online questionnaire and informal discussions. The research project was implemented in 2013, 2014 and 2015 amongst first and third-year students doing a forestry three-year technical tertiary qualification in commercial plantation management. In general, more than 80% of the students alluded to that the device was very useful in their learning environment while the rest indicated that the devices were not very useful. More than ninety percent of the students acknowledged that they would like to continue using the devices for all of their modules whilst the rest alluded to functioning efficiently without the devices. Results indicated that information collection (access to resources) was rated the highest advantageous factor followed by communication and collaboration. The main general advantages of using Tablets were listed by the students as being mobility (portability), 24/7 access to learning material and information of any kind on a user friendly device in a Wi-Fi environment, fast computing process speeds, saving time, effort and airtime through skyping and e-mail, and use of various applications. Ownership of the device is a critical factor while the risk was identified as a major potential constraint. Significant differences were reported between the different types and quality of Tablets. The preferred types are those with a bigger screen and the ones with overall better functionality and quality features. Tablets significantly increase the collaboration, communication and information collection needs of the students. It does, however, not replace the need of a computer/laptop because of limited storage and computation capacity, small screen size and inefficient typing.

Keywords: tablets, teaching, blended learning, tablet quality

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240 Personalized Climate Change Advertising: The Role of Augmented Reality (A.R.) Technology in Encouraging Users for Climate Change Action

Authors: Mokhlisur Rahman

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The growing consensus among scientists and world leaders indicates that immediate action should be considered regarding the climate change phenomenon. However, climate change is no more a global issue but a personal one. Thus, individual participation is necessary to address such a significant issue. Studies show that individuals who perceive climate change as a personal issue are more likely to act toward it. This abstract presents augmented reality (A.R.) technology in the social media platform Facebook video advertising. The idea involves creating a video advertisement that enables users to interact with the video by navigating its features and experiencing the result uniquely and engagingly. This advertisement uses A.R. to bring changes, such as people making changes in real-life scenarios by simple clicks on the video and hearing an instant rewarding fact about their choices. The video shows three options: room, lawn, and driveway. Users select one option and engage in interaction based on while holding the camera in their personal spaces: Suppose users select the first option, room, and hold their camera toward spots such as by the windows, balcony, corners, and even walls. In that case, the A.R. offers users different plants appropriate for those unoccupied spaces in the room. Users can change the options of the plants and see which space at their house deserves a plant that makes it more natural. When a user adds a natural element to the video, the video content explains a piece of beneficiary information about how the user contributes to the world more to be livable and why it is necessary. With the help of A.R., if users select the second option, lawn, and hold their camera toward their lawn, the options are various small trees for their lawn to make it more environmentally friendly and decorative. The video plays a beneficiary explanation here too. Suppose users select the third option, driveway, and hold their camera toward their driveway. In that case, the A.R. video option offers unique recycle bin designs using A.I. measurement of spaces. The video plays audio information on anthropogenic contribution to greenhouse gas emission. IoT embeds tracking code in the video ad on Facebook, which stores the exact number of views in the cloud for data analysis. An online survey at the end collects short qualitative answers. This study helps understand the number of users involved and willing to change their behavior; It makes personalized advertising in social media. Considering the current state of climate change, the urgency for action is increasing. This ad increases the chance to make direct connections with individuals and gives a sense of personal responsibility for climate change to act

Keywords: motivations, climate, iot, personalized-advertising, action

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239 Lessons Learned from a Chronic Care Behavior Change Program: Outcome to Make Physical Activity a Habit

Authors: Doaa Alhaboby

Abstract:

Behavior change is a complex process that often requires ongoing support and guidance. Telecoaching programs have emerged as effective tools in facilitating behavior change by providing personalized support remotely. This abstract explores the lessons learned from a randomized controlled trial (RCT) evaluation of a telecoaching program focused on behavior change for Diabetics and discusses strategies for implementing these lessons to overcome the challenge of making physical activity a habit. The telecoaching program involved participants engaging in regular coaching sessions delivered via phone calls. These sessions aimed to address various aspects of behavior change, including goal setting, self-monitoring, problem-solving, and social support. Over the course of the program, participants received personalized guidance tailored to their unique needs and preferences. One of the key lessons learned from the RCT was the importance of engagement, readiness to change and the use of technology. Participants who set specific, measurable, attainable, relevant, and time-bound (SMART) goals were more likely to make sustained progress toward behavior change. Additionally, regular self-monitoring of behavior and progress was found to be instrumental in promoting accountability and motivation. Moving forward, implementing the lessons learned from the RCT can help individuals overcome the hardest part of behavior change: making physical activity a habit. One strategy is to prioritize consistency and establish a regular routine for physical activity. This may involve scheduling workouts at the same time each day or week and treating them as non-negotiable appointments. Additionally, integrating physical activity into daily life routines and taking into consideration the main challenges that can stop the process of integrating physical activity routines into the daily schedule can help make it more habitual. Furthermore, leveraging technology and digital tools can enhance adherence to physical activity goals. Mobile apps, wearable activity trackers, and online fitness communities can provide ongoing support, motivation, and accountability. These tools can also facilitate self-monitoring of behavior and progress, allowing individuals to track their activity levels and adjust their goals as needed. In conclusion, telecoaching programs offer valuable insights into behavior change and provide strategies for overcoming challenges, such as making physical activity a habit. By applying the lessons learned from these programs and incorporating them into daily life, individuals can cultivate sustainable habits that support their long-term health and well-being.

Keywords: lifestyle, behavior change, physical activity, chronic conditions

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