Search results for: overseas doctors struggles.
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 619

Search results for: overseas doctors struggles.

529 Introduction, Establishment, and Transformation: An Initial Exploration of the Cultural Shifts and Influence of Fa Yi Chong De, Yi-Kuan-Tao in Malaysian Chinese Community

Authors: Lim Pey Huan

Abstract:

Yi-Kuan-Tao has been developing in Malaysia for nearly 60 years. It was initially introduced from mainland China and later from Taiwan starting from the 1970s. Yi-Kuan-Tao was considered a 'new religion' for the local Chinese community in Malaysia in its early stages, as Chinese immigrants primarily practiced Taoism, Buddhism, Christianity, or Catholicism upon settling in the region. The overseas propagation and development of Yi-Kuan-Tao today primarily occur through Taiwanese temples, which began spreading abroad as early as 1949. Particularly since the 1970s, with the rapid economic growth of Taiwan, various branches of Taiwanese Yi-Kuan-Tao have gained economic strength to propagate abroad, further expanding the influence of Yi-Kuan-Tao overseas. Southeast Asia is the region out from Taiwan where the propagation and development of Yi-Kuan-Tao are fastest and most concentrated. With approximately over 6 million Chinese inhabitants, Malaysia's pursuit of traditional Chinese culture has led to a flourishing interest in Yi-Kuan-Tao, particularly its advocacy of the unity of Confucianism, Buddhism, and Taoism, with an emphasis on promoting Confucian thought. Moreover, Taiwan's rapid economic development since the 1970s has enabled Yi-Kuan-Tao to allocate significant human and financial resources for external propagation efforts. Additionally, Malaysia's government has adopted a relatively tolerant policy towards religion since that time, further fostering the flourishing development of Yi-Kuan-Tao in Malaysia. Furthermore, this thesis aims to strengthen the lineage and continuity of the Yi-Kuan-Tao tradition, particularly the branch of Fa Yi Chong De, through the perspective of Heavenly Mandate (天命). By examining the different origins and ethnic backgrounds, it investigates how the Malaysian Chinese community has experienced different changes through the cultural baptism of religion, thus delving into the religious influence of Yi-Kuan-Tao. Given that the Fa Yi Chong De Academy in Taiwan is currently in an active development and construction phase, academic works related to Yi-Kuan-Tao will lay a more solid academic foundation for the future establishment of the academy.

Keywords: initial exploration, cultural shifts, Yi-Kuan-Tao, Malaysian Chinese community

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528 Influenza Vaccination Acceptance and Refusal Reasons among Tunisian Elderly

Authors: Ghassen Kharroubi, Ines Cherif, Leila Bouabid, Adel Gharbi, Aicha Boukthir, Margaret McCarron, Nissaf Ben Alaya, Afif Ben Salah, Jihene Bettaieb

Abstract:

Influenza vaccination (IV) is recommended for elderly persons, especially those with underlying conditions. In countries where IV rates in the elderly remain unsatisfactory, exploring attitudes of older persons toward the flu vaccine could be useful to identify barriers and facilitators to IV. The aim of this study was to determine the reasons for IV acceptance or decline in the Tunisian elderly. A national cross-sectional study was conducted in 2019, among persons aged 60 years and over with chronic disease. Data were collected using a standard administered questionnaire. Of the 1191 older persons included, 19.4% received the influenza vaccine in the 2018-2019 flu season. The two main reasons that may lead to refusal of vaccination were concerns that the vaccine could cause side effects (71.5%) and a belief that the vaccine was ineffective (33.9%). The main reason that may lead to accepting vaccination was a doctor’s recommendation (41.1%). Doctors were by far the most trusted source for information regarding influenza vaccine (91.5%) followed by pharmacists (17.6%). Our results highlighted the important role that doctors could play in promoting IV among the Tunisian elderly. Physicians should correct misconceptions about adverse events and the efficiency of the vaccine. In fact, influenza vaccines are generally effective and safe among older persons.

Keywords: attitudes, influenza vaccination, older persons, Tunisia

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527 Reducing Tobacco Consumption in a Rural Village of Sri Lanka Though a Community Based Health Promotion Intervention

Authors: B. A. N. Madubashini, S. Anojan, S. Thurka, N. M. C. J. Nawasinghe, G. A. S. Milanga, W. M. I. S. Weerakoon, I. D. N. Ihalahewage

Abstract:

Evidence-based health promotional approaches are known to be successful ways of reducing tobacco consumption in a rural village. Hence tobacco prevention is essential in improving lives of people, and community-based approaches are considered as effective. This community-based health promotion intervention implemented to reduce high consumption of tobacco in a rural area in Sri Lanka. This intervention was conducted in a rural village of Sri Lanka. In the beginning, facilitation discussions conducted with community members to identify determinants leading to tobacco consumption among villagers. Intervention was planed based on those determinants. Community actions through small active groups to demote smoking were generated. Children groups displayed cigarette buds collected around common places such as temple to community gatherings including funeral welfare society elaborating the cost and the money spent on cigarettes. A till (expenditure box) was introduced, and smokers in family were encouraged to put money on a cigarette to it when they decide to smoke instead. This way they could monitor potential savings if quit. Children groups introduced a tool 'Engalanthe puthata (for overseas son)' to shops. Shop owners agreed to add a pebble to a box whenever they sell a cigarette. The money spent on cigarettes in that shop was calculated regularly, and that was considered as money sent to tobacco company overseas, so to the son of the company owner. This was useful to encourage quitting and to stop selling cigarette in the shops. All four shops in the community volunteered to stop selling cigarettes. Eleven percent of users quitted smoking and 37% users reduced smoking. Child empowerment was high, and 60% of children had shown their disapproval on smoking publicly at least once. Similar community-based health promotion intervention can be used to generate community actions leading to reduction of tobacco consumption.

Keywords: cigarette, community, empowerment, health promotion, intervention

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526 The Need to Teach the Health Effects of Climate Change in Medical Schools

Authors: Ábrám Zoltán

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Introduction: Climate change is now a major health risk, and its environmental and health effects have become frequently discussed topics. The consequences of climate change are clearly visible in natural disasters and excess deaths caused by extreme weather conditions. Global warming and the increasingly frequent extreme weather events have direct, immediate effects or long-term, indirect effects on health. For this reason, it is a need to teach the health effects of climate change in medical schools. Material and methods: We looked for various surveys, studies, and reports on the main pathways through which global warming affects health. Medical schools face the challenge of teaching the health implications of climate change and integrating knowledge about the health effects of climate change into medical training. For this purpose, there were organised World Café workshops for three target groups: medical students, academic staff, and practising medical doctors. Results: Among the goals of the research is the development of a detailed curriculum for medical students, which serves to expand their knowledge in basic education. At the same time, the project promotes the increase of teacher motivation and the development of methodological guidelines for university teachers; it also provides further training for practicing doctors. The planned teaching materials will be developed in a format suitable for traditional face-to-face teaching, as well as e-learning teaching materials. CLIMATEMED is a project based on the cooperation of six universities and institutions from four countries, the aim of which is to improve the curriculum and expand knowledge about the health effects of climate change at medical universities. Conclusions: In order to assess the needs, summarize the proposals, to develop the necessary strategy, World Café type, one-and-a-half to two-hour round table discussions will take place separately for medical students, academic staff, and practicing doctors. The CLIMATEMED project can facilitate the integration of knowledge about the health effects of climate change into curricula and can promote practical use. The avoidance of the unwanted effects of global warming and climate change is not only a public matter, but it is also a challenge to change our own lifestyle. It is the responsibility of all of us to protect the Earth's ecosystem and the physical and mental health of ourselves and future generations.

Keywords: climate change, health effects, medical schools, World Café, medical students

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525 Assessing the Competence of Junior Pediatric Doctors in Managing Pediatric Diabetic Ketoacidosis: An Exploration Across Pediatric Care Units

Authors: Mai Ali

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Advancing beyond the junior stage of a paediatrician’s career is a crucial step where they accumulate essential skills and knowledge. This process prepares them for the challenges they'll encounter throughout their profession, particularly in dealing with paediatric emergencies. This can be especially demanding for trainees specializing in fields like endocrinology, particularly in the management of Diabetic Ketoacidosis (DKA) in the UK. In different societal contexts, junior doctors, whether specializing in pediatrics or other medical fields, are generally expected to possess a fundamental level of knowledge and skills necessary for managing diabetic ketoacidosis (DKA) emergencies. These physicians consistently concurred in recognizing prevalent problems in the healthcare facilities they examined. Such issues include the lack of established guidelines for DKA treatment and the inadequate availability of comprehensive training opportunities. The abstract underscores the critical importance of junior paediatricians acquiring expertise in managing paediatric emergencies, with a specific focus on DKA. Commonly, issues like the lack of standardized protocols and training deficiencies are recurring themes across healthcare facilities. This research proposal aims to conduct a thematic analysis of the proficiency of paediatric trainees in the United Kingdom when handling DKA in various clinical contexts. The primary goal is to assess their competency and suggest effective strategies for comprehensive DKA training improvement.

Keywords: junior pediatrician, DKA, standardized protocols, level of competence

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524 The Overseas Promotion of National Identity by France and Japan for Global Outreach: A Comparative and Discursive Analysis of Their Narratives on Public Diplomacy since the End of the Cold War

Authors: Natsuko D'Aprile

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The construction of Nation-States is a historical process that produces a type of national identity and culture that States nowadays mobilise for global outreach. National culture, as a set of norms and values influencing individuals’ actions and decisions, produces a type of policy making of various strategies that impact how a Nation is promoted overseas. The 1990s were marked by a resurgence of the debates on national identity. This period is believed to have paved the way for nationalism and witnessed increased attention to analytical approaches to identity. Public diplomacy is a concrete example of how national culture is mobilised to project a favourable image of a Nation abroad, especially in the narratives on national identity mobilised by diplomatic actors. Public diplomacy is understood as providing tools for States to build and project strategic narratives that represent events and identities in an attempt to influence domestic and foreign audiences, be they domestic or foreign. France and Japan received little attention on the matter. This research hence aims to investigate how France and Japan have mobilised narratives on national identity since the 1990s in the context of their public diplomacy. To understand how identities are framed, qualitative and quantitative discourse analysis has been performed on a corpus of various speeches held by French and Japanese political actors in which they present their diplomacy goals, as well as official documents provided by both Ministries of Foreign Affairs. This analysis showed that the French discourse integrates a narrative on France’s universal vocation, relying on the expression of a Nation whose model is worldly applicable and has the legitimacy to influence international decisions. The Japanese discourse does not concretely emphasise Japanese or Asian values, except for some narratives integrating Confucian and Shintō values. It rather revolves around the need for Japan to ensure its citizens’ security and prosperity, hence the need for the Government to contribute to peace in the Asia-Pacific region and the world.

Keywords: comparative politics, culture, discourse analysis, narratives, public diplomacy

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523 A Text-Oriented Study on Treatises and the End of the Struggles in Silius

Authors: Arianna Sacerdoti

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This paper is original and fills, to our best Knowledge, a gap in secondary literature. It analyzes the presence of treatises in Silius Italicus’ Punica and what happens in the plot when a struggle ends. As a result, we will understand if treatises are stipulated or broken, and which narrative devices go with the presence of treatises and the end of the battles. Methodology will be text-oriented, and all the passages will be presented in the Latin language and discussed. In concluding, it is important to understand – in a poem based on war – the role of treatises and the end of battles in Silius Italicus.

Keywords: Flavian Epic, Silius Italicus, Punica, treatises

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522 Capacity Building and Training of Health Personals for Disaster Preparedness in North East India

Authors: U. K. Tamuli

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Introduction: North East India is graced with natural beauty and hazards. This area is prone to major earthquakes, floods, landslides, accidents, terrorist activities etc. Academy of Trauma (AOT), an NGO of Doctors, conducts training programs, mock drills, field trials amongst the doctors and paramedics in North East India. The present study is to evaluate the efficacy of such training in terms of sensitivity, awareness, and delivery systems of the products. Here the health care delivery system for disaster management is inadequate. Clear guideline of mass casualty management is unavailable. AOT has initiated steps to increase the awareness and handling of mass casualty management to improve the emergency health care delivery system. Method: AOT has conducted training programmes on emergency health management, mass casualty management and hospital preparedness amongst 800 doctors and 1200 paramedics in twenty-two districts of Assam in Northeast India. The training module consists of lectures, hands-on workshop using manikins, mock drills, distribution of manuals, emergency management exercises, periodic exchange of experience and debriefings. AOT evaluates the impact of these trainings by conducting pre and post tests of delegates, trainer’s evaluation, delegate’s satisfaction and confidence level and their suggestions. Results: The module, training, hands-on workshops, mock drills were highly appreciated. There is significant improvement in scores on the post-training tests. The confidence level of the participants has risen to deal with emergency medical situation Conclusion: These kinds of trainings increase the awareness of the medical members to handle mass casualties in different situations. One such training actually sensitises the delegates. Repetition of such training, TOT (Training-of-Trainers) programs, and individual efforts of delegates are extremely important for sustenance and success of health care delivery service during disasters in the developing countries. Further collaboration, assistance, networking, suggestions from established global agencies in this field will be highly appreciated.

Keywords: capacity building, North East India, non-governmental organization, trauma

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521 Unlocking Health Insights: Studying Data for Better Care

Authors: Valentina Marutyan

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Healthcare data mining is a rapidly developing field at the intersection of technology and medicine that has the potential to change our understanding and approach to providing healthcare. Healthcare and data mining is the process of examining huge amounts of data to extract useful information that can be applied in order to improve patient care, treatment effectiveness, and overall healthcare delivery. This field looks for patterns, trends, and correlations in a variety of healthcare datasets, such as electronic health records (EHRs), medical imaging, patient demographics, and treatment histories. To accomplish this, it uses advanced analytical approaches. Predictive analysis using historical patient data is a major area of interest in healthcare data mining. This enables doctors to get involved early to prevent problems or improve results for patients. It also assists in early disease detection and customized treatment planning for every person. Doctors can customize a patient's care by looking at their medical history, genetic profile, current and previous therapies. In this way, treatments can be more effective and have fewer negative consequences. Moreover, helping patients, it improves the efficiency of hospitals. It helps them determine the number of beds or doctors they require in regard to the number of patients they expect. In this project are used models like logistic regression, random forests, and neural networks for predicting diseases and analyzing medical images. Patients were helped by algorithms such as k-means, and connections between treatments and patient responses were identified by association rule mining. Time series techniques helped in resource management by predicting patient admissions. These methods improved healthcare decision-making and personalized treatment. Also, healthcare data mining must deal with difficulties such as bad data quality, privacy challenges, managing large and complicated datasets, ensuring the reliability of models, managing biases, limited data sharing, and regulatory compliance. Finally, secret code of data mining in healthcare helps medical professionals and hospitals make better decisions, treat patients more efficiently, and work more efficiently. It ultimately comes down to using data to improve treatment, make better choices, and simplify hospital operations for all patients.

Keywords: data mining, healthcare, big data, large amounts of data

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520 Decision Making System for Clinical Datasets

Authors: P. Bharathiraja

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Computer Aided decision making system is used to enhance diagnosis and prognosis of diseases and also to assist clinicians and junior doctors in clinical decision making. Medical Data used for decision making should be definite and consistent. Data Mining and soft computing techniques are used for cleaning the data and for incorporating human reasoning in decision making systems. Fuzzy rule based inference technique can be used for classification in order to incorporate human reasoning in the decision making process. In this work, missing values are imputed using the mean or mode of the attribute. The data are normalized using min-ma normalization to improve the design and efficiency of the fuzzy inference system. The fuzzy inference system is used to handle the uncertainties that exist in the medical data. Equal-width-partitioning is used to partition the attribute values into appropriate fuzzy intervals. Fuzzy rules are generated using Class Based Associative rule mining algorithm. The system is trained and tested using heart disease data set from the University of California at Irvine (UCI) Machine Learning Repository. The data was split using a hold out approach into training and testing data. From the experimental results it can be inferred that classification using fuzzy inference system performs better than trivial IF-THEN rule based classification approaches. Furthermore it is observed that the use of fuzzy logic and fuzzy inference mechanism handles uncertainty and also resembles human decision making. The system can be used in the absence of a clinical expert to assist junior doctors and clinicians in clinical decision making.

Keywords: decision making, data mining, normalization, fuzzy rule, classification

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519 Overcoming Urban Challenges through Culture and Social Sustainability in Caracas’ Barrios

Authors: Gabriela Quintana Vigiola

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Social sustainability is an issue scarcely addressed by different authors, being one of its key factors the psychosocial processes of sense of place, sense of community and appropriation. In Caracas’s barrios (Venezuela) these were developed through sharing the construction of the place and different struggles that brought the neighbours together. However, one of the main problems they face is criminal violence, hence being its social sustainability threatened and affected by it. This matter can be addressed by acknowledging communities’ sense of place and engaging in cultural events.

Keywords: Caracas’ barrios, cultural engagement, developing countries, social sustainability

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518 Factors Affecting Test Automation Stability and Their Solutions

Authors: Nagmani Lnu

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Test automation is a vital requirement of any organization to release products faster to their customers. In most cases, an organization has an approach to developing automation but struggles to maintain it. It results in an increased number of Flaky Tests, reducing return on investments and stakeholders’ confidence. Challenges grow in multiple folds when automation is for UI behaviors. This paper describes the approaches taken to identify the root cause of automation instability in an extensive payments application and the best practices to address that using processes, tools, and technologies, resulting in a 75% reduction of effort.

Keywords: automation stability, test stability, Flaky Test, test quality, test automation quality

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517 Introduction of Digital Radiology to Improve the Timeliness in Availability of Radiological Diagnostic Images for Trauma Care

Authors: Anuruddha Jagoda, Samiddhi Samarakoon, Anil Jasinghe

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In an emergency department ‘where every second count for patient’s management’ timely availability of X- rays play a vital role in early diagnosis and management of patients. Trauma care centers rely heavily on timely radiologic imaging for patient care and radiology plays a crucial role in the emergency department (ED) operations. A research study was carried out to assess timeliness of availability of X-rays and total turnaround time at the Accident Service of National Hospital of Sri Lanka which is the premier trauma center in the country. Digital Radiology system was implemented as an intervention to improve the timeliness of availability of X-rays. Post-implementation assessment was carried out to assess the effectiveness of the intervention. Reduction in all three aspects of waiting times namely waiting for initial examination by doctors, waiting until X –ray is performed and waiting for image availability was observed after implementation of the intervention. However, the most significant improvement was seen in waiting time for image availability and reduction in time for image availability had indirect impact on reducing waiting time for initial examination by doctors and waiting until X –ray is performed. The most significant reduction in time for image availability was observed when performing 4-5 X rays with DR system. The least improvement in timeliness was seen in patients who are categorized as critical.

Keywords: emergency department, digital radilogy, timeliness, trauma care

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516 An Exploratory Case Study of the Transference of Skills and Dispositions Used by a Newly Qualified Teacher

Authors: Lynn Machin

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Using the lens of a theoretical framework relating to learning to learn the intention of the case study was to explore how transferable the teaching and learning skills of a newly qualified teacher (post-compulsory education) were when used in an overseas, unfamiliar and challenging post-compulsory educational environment. Particularly, the research sought to explore how this newly qualified teacher made use of the skills developed during their teacher training and to ascertain if, and what, other skills were necessary in order for them to have a positive influence on their learners and for them to be able to thrive within a different country and learning milieu. This case study looks at the experience of a trainee teacher who recently qualified in the UK to teach in post compulsory education (i.e. post 16 education). Rather than gaining employment in a UK based academy or college of further education this newly qualified teacher secured her first employment as a teacher in a province in China. Moreover, the newly qualified teacher had limited travel experience and had never travelled to Asia. She was one of the quieter and more reserved members on the one year teacher training course and was the least likely of the group to have made the decision to work abroad. How transferable the pedagogical skills that she had gained during her training would be when used in a culturally different and therefore (to her, challenging) environment was a key focus of the study. Another key focus was to explore the dispositions being used by the newly qualified teacher in order for her to teach and to thrive in an overseas educational environment. The methodological approach used for this study was both interpretative and qualitative. Associated methods were: Observation: observing the wider and operational practice of the newly qualified teacher over a five day period, and their need, ability and willingness to be reflective, resilient, reciprocal and resourceful. Interview: semi-structured interview with the newly qualified teacher following the observation of her practice. Findings from this case study illuminate the modifications made by the newly qualified teacher to her bank of teaching and learning strategies as well as the essentiality of dispositions used by her to know how to learn and also, crucially, to be ready and willing to do so. Such dispositions include being resilient, resourceful, reciprocal and reflective; necessary in order to adapt to the emerging challenges encountered by the teacher during their first months of employment in China. It is concluded that developing the skills to teach is essential for good teaching and learning practices. Having dispositions that enable teachers to work in ever changing conditions and surroundings is, this paper argues, essential for transferability and longevity of use of these skills.

Keywords: learning, post-compulsory, resilience, transferable

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515 The Effect of Motivation of Chinese Tourists to Visit North Korea on Their Revisit Intention: Focused on the Tourists with the Experience of Visiting North Korea

Authors: Kim Jin-OK, Lee Jin-Eui, Han Seung-Hoon, Kim Nam-Jo

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This study aimed to analyze the effect of the motivation of Chinese tourists to visit North Korea on their decision making process. Chinese tourists account for a considerable portion of foreign tourists in the world, while North Korea is the favorite tourist attraction of Chinese tourists. The motivation to visit North Korea was divided into three factors: the redness, which is the modern cultural heritage of Communism based on the red tourism accounting for the significant portion of domestic tourism, the novelty of the special environment of North Korean society, and the convenience of tour to North Korea in terms of geographical distance and policy of China. Red tourism refers to visiting the places of revolutionary events, monuments, artifacts and the residences of previous communist leaders, and other places related to the past Chinese Communist Party. As a revolutionary tourism, red tourism has recently been taking place in the old communist countries to recall their memories on the revolutionary places in China, as well as in North Korea, Vietnam, Cambodia, Russia, Bulgaria, Cuba, etc. In order to examine the effect of the segmented motivations on the revisit intention of Chinese tourists who have experienced a tour to North Korea, this study employed the model of goal-directed behavior, a model developed by adding a variable of emotion to the theory of planned behavior, which has a strong explanatory power on the decision making process of people in social science. For achieving the aim of the study, the data was collected through the survey in Dandong, China against Chinese tourists who have visited North Korea. The results of this study found that not only the novelty of North Korea, but also the redness, which accounts for the largest proportion in the domestic tourism, are significantly affecting overseas tour of Chinese tourists at this time point where overseas tour of Chinese tourists continue to increase. The results, therefore, suggest that the old communist countries, including those in Asia, need an emotional promotion strategy that stimulates nostalgia by focusing on the redness of the modern cultural heritage of Communism to attract Chinese tourists.

Keywords: model of goal-directed behavior, modern cultural heritage, North Korea, red tourism

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514 Use of WhatsApp Messenger for Optimal Healthcare Operational Communication during the COVID-19 Pandemic

Authors: Josiah O. Carter, Charlotte Hayden, Elizabeth Arthurs

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Background: During the COVID-19 pandemic, hospital management policies have changed frequently and rapidly. This has created novel challenges in keeping the workforce abreast of these changes to enable them to deliver safe and effective care. Traditional communication methods, e.g. email, do not keep pace with the rapidly changing environment in the hospital, resulting in inaccurate, irrelevant, or outdated information being communicated, resulting in inefficiencies in patient care. Methods: The creation of a WhatsApp messaging group within the medical division at the Bristol Royal Infirmary has enabled senior clinicians and the hospital management team to update the medical workforce in real-time. It has two primary functions: (1) To enable dissemination of a concise, important operational summary. This comprises information on bed status and infection control procedural changes. It is fed directly from a daily critical incident briefing (2) To facilitate a monthly scheduled question and answer (Q&A) session for junior doctors to clarify issues with clinical directors, rota, and management staff. Additional ad-hoc updates are sent out for time-critical information; otherwise, it mainly functions as a broadcast-only group to prevent important information from being lost amongst other communication. All junior doctors within the medical division were invited to join the group. At present, the group comprises 131 participants, of which 10 are administrative staff (rota coordinators, management staff & clinical directors); the remaining 121 are junior clinicians working within the medical division. An electronic survey via Microsoft forms was sent out to junior doctors via the WhatsApp group and via email to assess its utilisation and effectiveness with the aim of quality improvements. Results: Of the 121 group participants, 19 completed the questionnaire (response rate 15.7%). Of these, 16/19 (84.2%) used it regularly, and 12/19 (63.2%) rated it as the most useful source for reliable updates relating to the hospital response to the COVID-19 pandemic, whereas only 2/19 (10.5%) found the trust intranet and the trust COVID-19 operational email update most useful. Respondents rated the WhatsApp group more useful as an information source (mean score 7.7/10) than as a means of providing feedback to management staff (mean score 6.3/10). Qualitative feedback suggested information around ward closures and changes to COVID cohorting, along with updates on staffing issues, were most useful. Respondents also noted the Q&A sessions were an efficient way of relaying feedback about management decisions but that it would be preferable if these sessions could be delivered more frequently. Discussion: During the current global COVID-19 pandemic, there is an increased need for rapid dissemination of critical information within NHS trusts; this includes communication between junior doctors, managers, and senior clinicians. The versatility of WhatsApp permits a variety of functions allowing for regular updates, the dissemination of time-critical information, and enables conversing and feedback. The project has demonstrated that reserved and well-managed use of a WhatsApp group is a welcome, efficient and practical means of communication between the senior management team and the junior medical workforce.

Keywords: communication, COVID-19, hospital management, WhatsApp

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513 From Context to Text and Back Again: Teaching Toni Morrison Overseas

Authors: Helena Maragou

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Introducing Toni Morrison’s fiction to a classroom overseas entails a significant pedagogical investment, from monitoring students’ uncertain journey through Morrison’s shifty semantics to filling in the gaps of cultural knowledge and understanding for the students to be able to relate text to context. A rewarding process, as Morrison’s works present a tremendous opportunity for transnational dialogue, an opportunity that hinges upon Toni Morrison’s bringing to the fore the untold and unspeakable lives of racial ‘Others’, but also, crucially, upon her broader critique of Western ideological hegemony. This critique is a fundamental aspect of Toni Morrison’s politics and one that appeals to young readers of Toni Morrison in Greece at a time when the questioning of institutions and ideological traditions is precipitated by regional and global change. It is more or less self-evident that to help a class of international students get aboard a Morrison novel, an instructor should begin by providing them with cultural context. These days, students’ exposure to Hollywood representations of the African American past and present, as well as the use of documentaries, photography, music videos, etc., as supplementary class material, provide a starting point, a workable historical and cultural framework for textual comprehension. The true challenge, however, lies ahead: it is one thing for students to intellectually grasp the historical hardships and traumas of Morrison’s characters and to even engage in aesthetic appreciation of Morrison’s writing; quite another to relate to her works as articulations of experiences akin to their own. The great challenge, then, is in facilitating students’ discovery of the universal Morrison, the author who speaks across cultures while voicing the untold tales of her own people; this process of discovery entails, on a pedagogical level, that students be guided through the works’ historical context, to plunge into the intricacies of Morrison’s discourse, itself an elaborate linguistic booby trap, so as to be finally brought to reconsider their own historical experiences using the lens of Morrison’s fiction. The paper will be based on experience of teaching a Toni Morrison seminar to a class of Greek students at the American College of Greece and will draw from students’ exposure and responses to Toni Morrison’s “Nobel Prize Lecture,” as well as her novels Song of Solomon and Home.

Keywords: toni morrison, international classroom, pedagogy, African American literature

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512 Criminal Justice System, Health and Imprisonment in India

Authors: Debolina Chatterjee, Suhita Chopra Chatterjee

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Imprisonment is an expansive concept, as it is regulated by laws under criminal justice system of the state. The state sets principles of punishment to control offenders and also puts limits to excess punitive control. One significant way through which it exercises control is through rules governing healthcare of imprisoned population. Prisons signify specialized settings which accommodate both medical and legal concerns. The provision of care operates within the institutional paradigm of punishment. This requires the state to negotiate adequately between goals of punishment and fulfilment of basic human rights of offenders. The present study is based on a critical analysis of prison healthcare standards in India, which include government policies and guidelines. It also demonstrates how healthcare is delivered by drawing insights from a primary study conducted in a correctional home in the state of West Bengal, India, which houses both male and female inmates. Forty women were interviewed through semi-structured interviews, followed by focus group discussions. Doctors and administrative personnel were also interviewed. Findings show how institutional practices control women through subversion of the role of doctors to prison administration. Also, poor healthcare infrastructure, unavailability of specialized services, hierarchies between personnel and inmates make prisons unlikely sites for therapeutic intervention. The paper further discusses how institutional practices foster gender-based discriminatory practices.

Keywords: imprisonment, Indian prisons, prison healthcare, punishment

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511 Global News Coverage of the Pandemic: Towards an Ethical Framework for Media Professionalism

Authors: Anantha S. Babbili

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This paper analyzes the current media practices dominant in global journalistic practices within the framework of world press theories of Libertarian, Authoritarian, Communist, and Social Responsibility to evaluate their efficacy in addressing their role in the coverage of the coronavirus, also known as COVID-19. The global media flows, determinants of news coverage, and international awareness and the Western view of the world will be critically analyzed within the context of the prevalent news values that underpin free press and media coverage of the world. While evaluating the global discourse paramount to a sustained and dispassionate understanding of world events, this paper proposes an ethical framework that brings clarity devoid of sensationalism, partisanship, right-wing and left-wing interpretations to a breaking and dangerous development of a pandemic. As the world struggles to contain the coronavirus pandemic with death climbing close to 6,000 from late January to mid-March, 2020, the populations of the developed as well as the developing nations are beset with news media renditions of the crisis that are contradictory, confusing and evoking anxiety, fear and hysteria. How are we to understand differing news standards and news values? What lessons do we as journalism and mass media educators, researchers, and academics learn in order to construct a better news model and structure of media practice that addresses science, health, and media literacy among media practitioners, journalists, and news consumers? As traditional media struggles to cover the pandemic to its audience and consumers, social media from which an increasing number of consumers get their news have exerted their influence both in a positive way and in a negative manner. Even as the world struggles to grasp the full significance of the pandemic, the World Health Organization (WHO) has been feverishly battling an additional challenge related to the pandemic in what it termed an 'infodemic'—'an overabundance of information, some accurate and some not, that makes it hard for people to find trustworthy sources and reliable guidance when they need it.' There is, indeed, a need for journalism and news coverage in times of pandemics that reflect social responsibility and ethos of public service journalism. Social media and high-tech information corporations, collectively termed GAMAF—Google, Apple, Microsoft, Amazon, and Facebook – can team up with reliable traditional media—newspapers, magazines, book publishers, radio and television corporates—to ease public emotions and be helpful in times of a pandemic outbreak. GAMAF can, conceivably, weed out sensational and non-credible sources of coronavirus information, exotic cures offered for sale on a quick fix, and demonetize videos that exploit peoples’ vulnerabilities at the lowest ebb. Credible news of utility delivered in a sustained, calm, and reliable manner serves people in a meaningful and helpful way. The world’s consumers of news and information, indeed, deserve a healthy and trustworthy news media – at least in the time of pandemic COVID-19. Towards this end, the paper will propose a practical model for news media and journalistic coverage during times of a pandemic.

Keywords: COVID-19, international news flow, social media, social responsibility

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510 Technological Developments in Logistics and its Applications in the Army

Authors: Gökhan Balci

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“Armies march on their stomachs “mentioned Napoleon, who drew attentıon to the importance of logistics for the armies…In today’s World, in whıch continental trade gained importance, the crucial role of logistics became conspicuous since it was accepted by the business World that an effective logistics system is the key factor for success. Depending of the new developments in technology and techniques of logistics, the modern military institutions increase their effectiveness. The modern national armies or allied forces which operate in overseas, realize the importance of logistics as well. This study will focus on the applications of logistics in civilian business sector and modern armies, which may shed light on logistical problems of the other armies.

Keywords: modern logistics, application in armies, new technology in logistics, new developments in technology

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509 A Study on the Strategy for Domestic Space Industry Activation

Authors: Hangil Park, Hwayeon Song, Jingyung Sim

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In this study, a business ecosystem of a domestic space industry is comprehensively analyzed to derive the influence factors. The priority level of each element as well as the disparity between the ideal and reality are investigated through a literature review and an expert survey. The three major influence factors determined are: (a) investment scale and approach, (b) propulsion system, and (c) industrialization with overseas expansion. Related issues based on the current status are evaluated, followed by a proposed activation strategy. This research's findings offer a direction for R&D budget allocation and law system maintenance for the activation of the domestic space industry.

Keywords: space industry, activation, strategy, business ecosystem

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508 Artificial Intelligence-Generated Previews of Hyaluronic Acid-Based Treatments

Authors: Ciro Cursio, Giulia Cursio, Pio Luigi Cursio, Luigi Cursio

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Communication between practitioner and patient is of the utmost importance in aesthetic medicine: as of today, images of previous treatments are the most common tool used by doctors to describe and anticipate future results for their patients. However, using photos of other people often reduces the engagement of the prospective patient and is further limited by the number and quality of pictures available to the practitioner. Pre-existing work solves this issue in two ways: 3D scanning of the area with manual editing of the 3D model by the doctor or automatic prediction of the treatment by warping the image with hand-written parameters. The first approach requires the manual intervention of the doctor, while the second approach always generates results that aren’t always realistic. Thus, in one case, there is significant manual work required by the doctor, and in the other case, the prediction looks artificial. We propose an AI-based algorithm that autonomously generates a realistic prediction of treatment results. For the purpose of this study, we focus on hyaluronic acid treatments in the facial area. Our approach takes into account the individual characteristics of each face, and furthermore, the prediction system allows the patient to decide which area of the face she wants to modify. We show that the predictions generated by our system are realistic: first, the quality of the generated images is on par with real images; second, the prediction matches the actual results obtained after the treatment is completed. In conclusion, the proposed approach provides a valid tool for doctors to show patients what they will look like before deciding on the treatment.

Keywords: prediction, hyaluronic acid, treatment, artificial intelligence

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507 Business Intelligence Dashboard Solutions for Improving Decision Making Process: A Focus on Prostate Cancer

Authors: Mona Isazad Mashinchi, Davood Roshan Sangachin, Francis J. Sullivan, Dietrich Rebholz-Schuhmann

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Background: Decision-making processes are nowadays driven by data, data analytics and Business Intelligence (BI). BI as a software platform can provide a wide variety of capabilities such as organization memory, information integration, insight creation and presentation capabilities. Visualizing data through dashboards is one of the BI solutions (for a variety of areas) which helps managers in the decision making processes to expose the most informative information at a glance. In the healthcare domain to date, dashboard presentations are more frequently used to track performance related metrics and less frequently used to monitor those quality parameters which relate directly to patient outcomes. Providing effective and timely care for patients and improving the health outcome are highly dependent on presenting and visualizing data and information. Objective: In this research, the focus is on the presentation capabilities of BI to design a dashboard for prostate cancer (PC) data that allows better decision making for the patients, the hospital and the healthcare system related to a cancer dataset. The aim of this research is to customize a retrospective PC dataset in a dashboard interface to give a better understanding of data in the categories (risk factors, treatment approaches, disease control and side effects) which matter most to patients as well as other stakeholders. By presenting the outcome in the dashboard we address one of the major targets of a value-based health care (VBHC) delivery model which is measuring the value and presenting the outcome to different actors in HC industry (such as patients and doctors) for a better decision making. Method: For visualizing the stored data to users, three interactive dashboards based on the PC dataset have been developed (using the Tableau Software) to provide better views to the risk factors, treatment approaches, and side effects. Results: Many benefits derived from interactive graphs and tables in dashboards which helped to easily visualize and see the patients at risk, better understanding the relationship between patient's status after treatment and their initial status before treatment, or to choose better decision about treatments with fewer side effects regarding patient status and etc. Conclusions: Building a well-designed and informative dashboard is related to three important factors including; the users, goals and the data types. Dashboard's hierarchies, drilling, and graphical features can guide doctors to better navigate through information. The features of the interactive PC dashboard not only let doctors ask specific questions and filter the results based on the key performance indicators (KPI) such as: Gleason Grade, Patient's Age and Status, but may also help patients to better understand different treatment outcomes, such as side effects during the time, and have an active role in their treatment decisions. Currently, we are extending the results to the real-time interactive dashboard that users (either patients and doctors) can easily explore the data by choosing preferred attribute and data to make better near real-time decisions.

Keywords: business intelligence, dashboard, decision making, healthcare, prostate cancer, value-based healthcare

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506 The Study on Corpse Floating Time in Shanghai Region of China

Authors: Hang Meng, Wen-Bin Liu, Bi Xiao, Kai-Jun Ma, Jian-Hui Xie, Geng Fei, Tian-Ye Zhang, Lu-Yi Xu, Dong-Chuan Zhang

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The victims in water are often found in the coastal region, along river region or the region with lakes. In China, the examination for the bodies of victims in the water is conducted by forensic doctors working in the public security bureau. Because the enter water time for most of the victims are not clear, and often lack of monitor images and other information, so to find out the corpse enter water time for victims is very difficult. After the corpse of the victim enters the water, it sinks first, then corruption gas produces, which can make the density of the corpse to be less than water, and thus rise again. So the factor that determines the corpse floating time is temperature. On the basis of the temperature data obtained in Shanghai region of China (Shanghai is a north subtropical marine monsoon climate, with an average annual temperature of about 17.1℃. The hottest month is July, the average monthly temperature is 28.6℃, and the coldest month is January, the average monthly temperature is 4.8℃). This study selected about 100 cases with definite corpse enter water time and corpse floating time, analyzed the cases and obtained the empirical law of the corpse floating time. For example, in the Shanghai region, on June 15th and October 15th, the corpse floating time is about 1.5 days. In early December, the bodies who entered the water will go up around January 1st of the following year, and the bodies who enter water in late December will float in March of next year. The results of this study can be used to roughly estimate the water enter time of the victims in Shanghai. Forensic doctors around the world can also draw on the results of this study to infer the time when the corpses of the victims in the water go up.

Keywords: corpse enter water time, corpse floating time, drowning, forensic pathology, victims in the water

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505 Improving Junior Doctor Induction Through the Use of Simple In-House Mobile Application

Authors: Dmitriy Chernov, Maria Karavassilis, Suhyoun Youn, Amna Izhar, Devasenan Devendra

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Introduction and Background: A well-structured and comprehensive departmental induction improves patient safety and job satisfaction amongst doctors. The aims of our Project were as follows: 1. Assess the perceived preparedness of junior doctors starting their rotation in Acute Medicine at Watford General Hospital. 2. Develop a supplemental Induction Guide and Pocket reference in the form of an iOS mobile application. 3. To collect feedback after implementing the mobile application following a trial period of 8 weeks with a small cohort of junior doctors. Materials and Methods: A questionnaire was distributed to all new junior trainees starting in the department of Acute Medicine to assess their experience of current induction. A mobile Induction application was developed and trialled over a period of 8 weeks, distributed in addition to the existing didactic induction session. After the trial period, the same questionnaire was distributed to assess improvement in induction experience. Analytics data were collected with users’ consent to gauge user engagement and identify areas of improvement of the application. A feedback survey about the app was also distributed. Results: A total of 32 doctors used the application during the 8-week trial period. The application was accessed 7259 times in total, with the average user spending a cumulative of 37 minutes 22 seconds on the app. The most used section was Clinical Guidelines, accessed 1490 times. The App Feedback survey revealed positive reviews: 100% of participants (n=15/15) responded that the app improved their overall induction experience compared to other placements; 93% (n=14/15) responded that the app improved overall efficiency in completing daily ward jobs compared to previous rotations; and 93% (n=14/15) responded that the app improved patient safety overall. In the Pre-App and Post-App Induction Surveys, participants reported: a 48% improvement in awareness of practical aspects of the job; a 26% improvement of awareness on locating pathways and clinical guidelines; a 40% reduction of feelings of overwhelmingness. Conclusions and recommendations: This study demonstrates the importance of technology in Medical Education and Clinical Induction. The mobile application average engagement time equates to over 20 cumulative hours of on-the-job training delivered to each user, within an 8-week period. The most used and referred to section was clinical guidelines. This shows that there is high demand for an accessible pocket guide for this type of material. This simple mobile application resulted in a significant improvement in feedback about induction in our Department of Acute Medicine, and will likely impact workplace satisfaction. Limitations of the application include: post-app surveys had a small number of participants; the app is currently only available for iPhone users; some useful sections are nested deep within the app, lacks deep search functionality across all sections; lacks real time user feedback; and requires regular review and updates. Future steps for the app include: developing a web app, with an admin dashboard to simplify uploading and editing content; a comprehensive search functionality; and a user feedback and peer ratings system.

Keywords: mobile app, doctor induction, medical education, acute medicine

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504 Need of Medicines Information OPD in Tertiary Health Care Settings: A Cross Sectional Study

Authors: Swanand Pathak, Kiran R. Giri, Reena R. Giri, Kamlesh Palandurkar, Sangita Totade, Rajesh Jha, S. S. Patel

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Background: Population burden, illiteracy, availability of few doctors for larger group of population leads to many unanswered questions left in a patient’s mind. Incomplete information results into noncompliance, therapeutic failure, and adverse drug reactions (ADR). It is very important to establish a system which will provide noncommercial, independent, unbiased source of medicine information. Medicines Info OPD is a concept and step towards safe and appropriate use of medicines. Objective: (1) to assess the present status of knowledge about the medicines in the patients and its correlation with education; (2) to assess the medicine information dispensing modalities, their use and sufficiency from the patients view point; (3) to assess the overall need for Medicines Information OPD in present scenario. Materials and Methods: A pre-validated questionnaire based study was conducted amongst 500 patients of tertiary health care hospital. The questionnaire consisted of specific questions regarding understanding of prescription, knowledge about adverse drug reaction, view about self-medication and opinion regarding the need of Medicines Info OPD. Results: Significantly large proportion of patients opined that doctors do not have sufficient time in current Indian healthcare to explain the prescription and they are not aware of adverse drug reactions, expiry date or use the package inserts etc. Conclusion: Clinically relevant, up to date, user specific, independent, objective and unbiased Medicines Info OPD is essential for appropriate drug use and can help in a big way to common public to address many problems faced by them.

Keywords: information, prescription, unbiased, clinically relevant

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503 Explaining the Role of Iran Health System in Polypharmacy among the Elderly

Authors: Mohsen Shati, Seyede Salehe Mortazavi, Seyed Kazem Malakouti, Hamidreza Khanke Fazlollah Ahmadi

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Taking unnecessary or excessive medication or using drugs with no indication (polypharmacy) by people of all ages, especially the elderly, is associated with increased adverse drug reactions (ADR), medical errors, hospitalization and escalating the costs. It may be facilitated or impeded by the healthcare system. In this study, we are going to describe the role of the health system in the practice of polypharmacy in Iranian elderly. In this Inductive qualitative content analysis using Graneheim and Lundman methods, purposeful sample selection until saturation has been made. Participants have been selected from doctors, pharmacists, policy-makers and the elderly. A total of 25 persons (9 men and 16 women) have participated in this study. Data analysis after incorporating codes with similar characteristics revealed 14 subcategories and six main categories of the referral system, physicians’ accessibility, health data management, drug market, laws enforcement, and social protection. Some of the conditions of the healthcare system have given rise to polypharmacy in the elderly. In the absence of a comprehensive specialty and subspecialty referral system, patients may go to any physician office so may well be confused about numerous doctors' prescriptions. Electronic records not being prepared for the patients, failure to comply with laws, lack of robust enforcement for the existing laws and close surveillance are among the contributing factors. Inadequate insurance and supportive services are also evident. Age-specific care providing has not yet been institutionalized, while, inadequate specialist workforce playing a major role. So, one may not ignore the health system as contributing factor in designing effective interventions to fix the problem.

Keywords: elderly, polypharmacy, health system, qualitative study

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502 Motherhood Constrained: The Minotaur Legend Reimagined Through the Perspective of Marginalized Mothers

Authors: Gevorgianiene Violeta, Sumskiene Egle

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Background. Child removal is a profound and life-altering measure that significantly impacts both children and their mothers. Unfortunately, mothers with intellectual disabilities are disproportionately affected by the removal of their children. This action is often taken due to concerns about the mother's perceived inability to care for the child, instances of abuse and neglect, or struggles with addiction. In many cases, the failure to meet society's standards of a "good mother" is seen as a deviation from conventional norms of femininity and motherhood. From an institutional perspective, separating a child from their mother is sometimes viewed as a step toward restoring justice or doing what is considered "right." In another light, this act of child removal can be seen as the removal of a mother from her child, an attempt to shield society from the complexities and fears associated with motherhood for women with disabilities. This separation can be likened to the Greek legend of the Minotaur, a fearsome beast confined within an impenetrable labyrinth. By reimagining this legend, we can see the social fears surrounding 'mothering with intellectual disability' as deeply sealed within an unreachable place. The Aim of this Presentation. Our goal with this presentation is to draw from our research and the metaphors found in the Greek legend to delve into the profound challenges faced by mothers with intellectual disabilities in raising their children. These challenges often become entangled within an insurmountable labyrinth, including navigating complex institutional bureaucracies, enduring persistent doubts cast upon their maternal competencies, battling unfavorable societal narratives, and struggling to retain custody of their children. Coupled with limited social support networks, these challenges frequently lead to situations resulting in maternal failure and, ultimately, child removal. On a broader scale, this separation of a child from their mother symbolizes society’s collective avoidance of confronting the issue of 'mothering with disability,' which can only be effectively addressed through united efforts. Conclusion. Just as in the labyrinth of the Minotaur legend, the struggles faced by mothers with disabilities in their pursuit of retaining their children reveal the need for a metaphorical 'string of Ariadne.' This string symbolizes the support offered by social service providers, communities, and the loved ones these women often dream of but rarely encounter in their lives.

Keywords: motherhood, disability, child removal, support.

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501 Indo-Pak Relationship: Understanding the Past to Make Sense of the Future

Authors: Aneri Mehta, Krunal Mehta

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The unpredictable and vacillating relationship between India and Pakistan since days of Independence struggle is known world over. And this instability has never lost its magnitude to decrease the tensions between the two countries. Since India aspires to run for the race of future superpower and Pakistan struggles to remove the tag of a highly fickle and under developed economy; ruined largely not by the outsiders, but its own people and systems; it becomes really important to gauge what steps would these neighbors take in years to come. The progress and stability of both countries heavily relies on the favorable equations between the two nations. Therefore the paper tries to trace some roots of their faltering relationship and attempts to predict their future in a multidimensional perspective.

Keywords: economy, faltering relationship, multidimensional perspective, international relations

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500 CAGE Questionnaire as a Screening Tool for Hazardous Drinking in an Acute Admissions Ward: Frequency of Application and Comparison with AUDIT-C Questionnaire

Authors: Ammar Ayad Issa Al-Rifaie, Zuhreya Muazu, Maysam Ali Abdulwahid, Dermot Gleeson

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The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.

Keywords: alcohol screening, AUDIT-C, CAGE, hazardous drinking

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