Search results for: positive and negative impacts
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11217

Search results for: positive and negative impacts

297 A Sustainable Training and Feedback Model for Developing the Teaching Capabilities of Sessional Academic Staff

Authors: Nirmani Wijenayake, Louise Lutze-Mann, Lucy Jo, John Wilson, Vivian Yeung, Dean Lovett, Kim Snepvangers

Abstract:

Sessional academic staff at universities have the most influence and impact on student learning, engagement, and experience as they have the most direct contact with undergraduate students. A blended technology-enhanced program was created for the development and support of sessional staff to ensure adequate training is provided to deliver quality educational outcomes for the students. This program combines innovative mixed media educational modules, a peer-driven support forum, and face-to-face workshops to provide a comprehensive training and support package for staff. Additionally, the program encourages the development of learning communities and peer mentoring among the sessional staff to enhance their support system. In 2018, the program was piloted on 100 sessional staff in the School of Biotechnology and Biomolecular Sciences to evaluate the effectiveness of this model. As part of the program, rotoscope animations were developed to showcase ‘typical’ interactions between staff and students. These were designed around communication, confidence building, consistency in grading, feedback, diversity awareness, and mental health and wellbeing. When surveyed, 86% of sessional staff found these animations to be helpful in their teaching. An online platform (Moodle) was set up to disseminate educational resources and teaching tips, to host a discussion forum for peer-to-peer communication and to increase critical thinking and problem-solving skills through scenario-based lessons. The learning analytics from these lessons were essential in identifying difficulties faced by sessional staff to further develop supporting workshops to improve outcomes related to teaching. The face-to-face professional development workshops were run by expert guest speakers on topics such as cultural diversity, stress and anxiety, LGBTIQ and student engagement. All the attendees of the workshops found them to be useful and 88% said they felt these workshops increase interaction with their peers and built a sense of community. The final component of the program was to use an adaptive e-learning platform to gather feedback from the students on sessional staff teaching twice during the semester. The initial feedback provides sessional staff with enough time to reflect on their teaching and adjust their performance if necessary, to improve the student experience. The feedback from students and the sessional staff on this model has been extremely positive. The training equips the sessional staff with knowledge and insights which can provide students with an exceptional learning environment. This program is designed in a flexible and scalable manner so that other faculties or institutions could adapt components for their own training. It is anticipated that the training and support would help to build the next generation of educators who will directly impact the educational experience of students.

Keywords: designing effective instruction, enhancing student learning, implementing effective strategies, professional development

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296 A System for Preventing Inadvertent Exposition of Staff Present outside the Operating Theater: Description and Clinical Test

Authors: Aya Al Masri, Kamel Guerchouche, Youssef Laynaoui, Safoin Aktaou, Malorie Martin, Fouad Maaloul

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Introduction: Mobile C-arms move throughout operating rooms of the operating theater. Being designed to move between rooms, they are not equipped with relays to retrieve the exposition information and export it outside the room. Therefore, no light signaling is available outside the room to warn the X-ray emission for staff. Inadvertent exposition of staff outside the operating theater is a real problem for radiation protection. The French standard NFC 15-160 require that: (1) access to any room containing an X-ray emitting device must be controlled by a light signage so that it cannot be inadvertently crossed, and (2) setting up an emergency button to stop the X-ray emission. This study presents a system that we developed to meet these requirements and the results of its clinical test. Materials and methods: The system is composed of two communicating boxes: o The "DetectBox" is to be installed inside the operating theater. It identifies the various operation states of the C-arm by analyzing its power supply signal. The DetectBox communicates (in wireless mode) with the second box (AlertBox). o The "AlertBox" can operate in socket or battery mode and is to be installed outside the operating theater. It detects and reports the state of the C-arm by emitting a real time light signal. This latter can have three different colors: red when the C-arm is emitting X-rays, orange when it is powered on but does not emit X-rays, and green when it is powered off. The two boxes communicate on a radiofrequency link exclusively carried out in the ‘Industrial, Scientific and Medical (ISM)’ frequency bands and allows the coexistence of several on-site warning systems without communication conflicts (interference). Taking into account the complexity of performing electrical works in the operating theater (for reasons of hygiene and continuity of medical care), this system (having a size <10 cm²) works in complete safety without any intrusion in the mobile C-arm and does not require specific electrical installation work. The system is equipped with emergency button that stops X-ray emission. The system has been clinically tested. Results: The clinical test of the system shows that: it detects X-rays having both high and low energy (50 – 150 kVp), high and low photon flow (0.5 – 200 mA: even when emitted for a very short time (<1 ms)), Probability of false detection < 10-5, it operates under all acquisition modes (continuous, pulsed, fluoroscopy mode, image mode, subtraction and movie mode), it is compatible with all C-arm models and brands. We have also tested the communication between the two boxes (DetectBox and AlertBox) in several conditions: (1) Unleaded room, (2) leaded room, and (3) rooms with particular configuration (sas, great distances, concrete walls, 3 mm of lead). The result of these last tests was positive. Conclusion: This system is a reliable tool to alert the staff present outside the operating room for X-ray emission and insure their radiation protection.

Keywords: Clinical test, Inadvertent staff exposition, Light signage, Operating theater

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295 The Influence of Age and Education on Patients' Attitudes Towards Contraceptives in Rural California

Authors: Shivani Thakur, Jasmin Dominguez Cervantes, Ahmed Zabiba, Fatima Zabiba, Sandhini Agarwal, Kamalpreet Kaur, Hussein Maatouk, Shae Chand, Omar Madriz, Tiffany Huang, Saloni Bansal

Abstract:

Contraceptives are an effective public health achievement, allowing for family planning and reducing the risk of sexually transmitted diseases (STDs). California’s rural Central Valley has high rates of teenage pregnancy and STDs. Factors affecting contraceptive usage here may include religious concerns, financial issues, and regional variations in the accessibility and availability of contraceptives. The increasing population and diversity of the Central Valley make the understanding of the determinants of unintended pregnancy and STDs increasingly nuanced. Patients in California’s Central Valley were surveyed at 6 surgical clinics to assess attitudes toward contraceptives. The questionnaire consisted of demographics and 14 Likert-scale statements investigating patients’ feelings regarding contraceptives. Parametric and non-parametric analysis was performed on the Likert statements. A correlation matrix for the Likert-scale statements was used to evaluate the strength of the relationship between each question. 76 patients aged 18-75 years completed the questionnaire. 90% of the participants were female, 76% Hispanic, 36% married, 44% with an income range between 30-60K, and 83% were between childbearing ages. 60% of participants stated they are currently using or had used some type of contraceptive. 25% of participants had at least one unplanned pregnancy. The most common type of contraceptives used were oral contraceptives(28%) and condoms(38%). The top reasons for patients’ contraceptive usage were: prevention of pregnancy (72%), safe sex/prevention of STDs (32%), and regulation of menstrual cycle (19%). Further analysis of Likert responses revealed that contraception usage increased due to approval of contraceptives (x̄=3.98, σ =1.02); partner approval of contraceptives (x̄=3.875, σ =1.16); and reduced anxiety about pregnancy (x̄=3.875, σ =1.23). Younger females (18-34 years old) agreed more with the statement that the cost of contraceptive supplies is too expensive than older females (35-75 years old), (x̄=3.2, σ = 1.4 vs x̄=2.8, σ =1.3, p<0.05). Younger females (44%) were also more likely to use short-acting contraceptive methods (oral and male condoms) compared to older females (64%) who use long-acting methods (implants/ intrauterine devices). 51% of Hispanic females were using some type of contraceptive. Of those Hispanic females who do not use contraceptives, 33% stated having no children, and all plan to have at least one child in the future. 35% of participants had a bachelor's degree. Those with bachelor’s degrees were more likely to use contraceptives, 58% vs 51%, p<0.05, and less likely to have unplanned pregnancy, 50% vs. 12%, p<0.01. There is increasing use and awareness among patients in rural settings concerning contraceptives. Our finding shows that younger women and women with higher educational attainment tend to have more positive attitudes towards the use of contraceptives. This work gives physicians an understanding of patients’ concerns about contraceptive methods and offers insight into culturally competent intervention programs that respect individual values.

Keywords: contraceptives, public health, rural california, women of child baring age

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294 Achieving Sustainable Development through Transformative Pedagogies in Universities

Authors: Eugene Allevato

Abstract:

Developing a responsible personal worldview is central to sustainable development, but achieving quality education to promote transformative learning for sustainability is thus far, poorly understood. Most programs involving education for sustainable development rely on changing behavior, rather than attitudes. The emphasis is on the scientific and utilitarian aspect of sustainability with negligible importance on the intrinsic value of nature. Campus sustainability projects include building sustainable gardens and implementing energy-efficient upgrades, instead of focusing on educating for sustainable development through exploration of students’ values and beliefs. Even though green technology adoption maybe the right thing to do, most schools are not targeting the root cause of the environmental crisis; they are just providing palliative measures. This study explores the under-examined factors that lead to pro-environmental behavior by investigating the environmental perceptions of both college business students and personnel of green organizations. A mixed research approach of qualitative, based on structured interviews, and quantitative instruments was developed including 30 college-level students’ interviews and 40 green organization staff members involved in sustainable activities. The interviews were tape-recorded and transcribed for analysis. Categorization of the responses to the open‐ended questions was conducted with the purpose of identifying the main types of factors influencing attitudes and correlating with behaviors. Overall the findings of this study indicated a lack of appreciation for nature, and inability to understand interconnectedness and apply critical thinking. The results of the survey conducted on undergraduate students indicated that the responses of business and liberal arts students by independent t-test were significantly different, with a p‐value of 0.03. While liberal arts students showed an understanding of human interdependence with nature and its delicate balance, business students seemed to believe that humans were meant to rule over the rest of nature. This result was quite intriguing from the perspective that business students will be defining markets, influencing society, controlling and managing businesses that supposedly, in the face of climate change, shall implement sustainable activities. These alarming results led to the focus on green businesses in order to better understand their motivation to engage in sustainable activities. Additionally, a probit model revealed that childhood exposure to nature has a significantly positive impact in pro-environmental attitudes to most of the New Ecological Paradigm scales. Based on these findings, this paper discusses educators including Socrates, John Dewey and Paulo Freire in the implementation of eco-pedagogy and transformative learning following a curriculum with emphasis on critical and systems thinking, which are deemed to be key ingredients in quality education for sustainable development.

Keywords: eco-pedagogy, environmental behavior, quality education for sustainable development, transformative learning

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293 Optimal Pressure Control and Burst Detection for Sustainable Water Management

Authors: G. K. Viswanadh, B. Rajasekhar, G. Venkata Ramana

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Water distribution networks play a vital role in ensuring a reliable supply of clean water to urban areas. However, they face several challenges, including pressure control, pump speed optimization, and burst event detection. This paper combines insights from two studies to address these critical issues in Water distribution networks, focusing on the specific context of Kapra Municipality, India. The first part of this research concentrates on optimizing pressure control and pump speed in complex Water distribution networks. It utilizes the EPANET- MATLAB Toolkit to integrate EPANET functionalities into the MATLAB environment, offering a comprehensive approach to network analysis. By optimizing Pressure Reduce Valves (PRVs) and variable speed pumps (VSPs), this study achieves remarkable results. In the Benchmark Water Distribution System (WDS), the proposed PRV optimization algorithm reduces average leakage by 20.64%, surpassing the previous achievement of 16.07%. When applied to the South-Central and East zone WDS of Kapra Municipality, it identifies PRV locations that were previously missed by existing algorithms, resulting in average leakage reductions of 22.04% and 10.47%. These reductions translate to significant daily Water savings, enhancing Water supply reliability and reducing energy consumption. The second part of this research addresses the pressing issue of burst event detection and localization within the Water Distribution System. Burst events are a major contributor to Water losses and repair expenses. The study employs wireless sensor technology to monitor pressure and flow rate in real time, enabling the detection of pipeline abnormalities, particularly burst events. The methodology relies on transient analysis of pressure signals, utilizing Cumulative Sum and Wavelet analysis techniques to robustly identify burst occurrences. To enhance precision, burst event localization is achieved through meticulous analysis of time differentials in the arrival of negative pressure waveforms across distinct pressure sensing points, aided by nodal matrix analysis. To evaluate the effectiveness of this methodology, a PVC Water pipeline test bed is employed, demonstrating the algorithm's success in detecting pipeline burst events at flow rates of 2-3 l/s. Remarkably, the algorithm achieves a localization error of merely 3 meters, outperforming previously established algorithms. This research presents a significant advancement in efficient burst event detection and localization within Water pipelines, holding the potential to markedly curtail Water losses and the concomitant financial implications. In conclusion, this combined research addresses critical challenges in Water distribution networks, offering solutions for optimizing pressure control, pump speed, burst event detection, and localization. These findings contribute to the enhancement of Water Distribution System, resulting in improved Water supply reliability, reduced Water losses, and substantial cost savings. The integrated approach presented in this paper holds promise for municipalities and utilities seeking to improve the efficiency and sustainability of their Water distribution networks.

Keywords: pressure reduce valve, complex networks, variable speed pump, wavelet transform, burst detection, CUSUM (Cumulative Sum), water pipeline monitoring

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292 Corporate Social Responsibility and Corporate Reputation: A Bibliometric Analysis

Authors: Songdi Li, Louise Spry, Tony Woodall

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Nowadays, Corporate Social responsibility (CSR) is becoming a buzz word, and more and more academics are putting efforts on CSR studies. It is believed that CSR could influence Corporate Reputation (CR), and they hold a favourable view that CSR leads to a positive CR. To be specific, the CSR related activities in the reputational context have been regarded as ways that associate to excellent financial performance, value creation, etc. Also, it is argued that CSR and CR are two sides of one coin; hence, to some extent, doing CSR is equal to establishing a good reputation. Still, there is no consensus of the CSR-CR relationship in the literature; thus, a systematic literature review is highly in need. This research conducts a systematic literature review with both bibliometric and content analysis. Data are selected from English language sources, and academic journal articles only, then, keyword combinations are applied to identify relevant sources. Data from Scopus and WoS are gathered for bibliometric analysis. Scopus search results were saved in RIS and CSV formats, and Web of Science (WoS) data were saved in TXT format and CSV formats in order to process data in the Bibexcel software for further analysis which later will be visualised by the software VOSviewer. Also, content analysis was applied to analyse the data clusters and the key articles. In terms of the topic of CSR-CR, this literature review with bibliometric analysis has made four achievements. First, this paper has developed a systematic study which quantitatively depicts the knowledge structure of CSR and CR by identifying terms closely related to CSR-CR (such as ‘corporate governance’) and clustering subtopics emerged in co-citation analysis. Second, content analysis is performed to acquire insight on the findings of bibliometric analysis in the discussion section. And it highlights some insightful implications for the future research agenda, for example, a psychological link between CSR-CR is identified from the result; also, emerging economies and qualitative research methods are new elements emerged in the CSR-CR big picture. Third, a multidisciplinary perspective presents through the whole bibliometric analysis mapping and co-word and co-citation analysis; hence, this work builds a structure of interdisciplinary perspective which potentially leads to an integrated conceptual framework in the future. Finally, Scopus and WoS are compared and contrasted in this paper; as a result, Scopus which has more depth and comprehensive data is suggested as a tool for future bibliometric analysis studies. Overall, this paper has fulfilled its initial purposes and contributed to the literature. To the author’s best knowledge, this paper conducted the first literature review of CSR-CR researches that applied both bibliometric analysis and content analysis; therefore, this paper achieves its methodological originality. And this dual approach brings advantages of carrying out a comprehensive and semantic exploration in the area of CSR-CR in a scientific and realistic method. Admittedly, its work might exist subjective bias in terms of search terms selection and paper selection; hence triangulation could reduce the subjective bias to some degree.

Keywords: corporate social responsibility, corporate reputation, bibliometric analysis, software program

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291 The Usefulness of Medical Scribes in the Emengecy Department

Authors: Victor Kang, Sirene Bellahnid, Amy Al-Simaani

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Efficient documentation and completion of clerical tasks are pillars of efficient patient-centered care in acute settings such as the emergency department (ED). Medical scribes aid physicians with documentation, navigation of electronic health records, results gathering, and communication coordination with other healthcare teams. However, the use of medical scribes is not widespread, with some hospitals even continuing to discontinue their programs. One reason for this could be the lack of studies that have outlined concrete improvements in efficiency and patient and provider satisfaction in emergency departments before and after incorporating scribes. Methods: We conducted a review of the literature concerning the implementation of a medical scribe program and emergency department performance. For this review, a narrative synthesis accompanied by textual commentaries was chosen to present the selected papers. PubMed was searched exclusively. Initially, no date limits were set, but seeing as the electronic medical record was officially implemented in Canada in 2013, studies published after this date were preferred as they provided insight into the interplay between its implementation and scribes on quality improvement. Results: Throughput, efficiency, and cost-effectiveness were the most commonly used parameters in evaluating scribes in the Emergency Department. Important throughput metrics, specifically door-to-doctor and disposition time, were significantly decreased in emergency departments that utilized scribes. Of note, this was shown to be the case in community hospitals, where the burden of documentation and clerical tasks would fall directly upon the attending physician. Academic centers differ in that they rely heavily on residents and students; so the implementation of scribes has been shown to have limited effect on these metrics. However, unique to academic centers was the provider’s perception of incrased time for teaching was unique to academic centers. Consequently, providers express increased work satisfaction in relation to time spent with patients and in teaching. Patients, on the other hand, did not demonstrate a decrease in satisfaction in regards to the care that was provided, but there was no significant increase observed either. Of the studies we reviewed, one of the biggest limitations was the lack of significance in the data. While many individual studies reported that medical scribes in emergency rooms improved relative value units, patient satisfaction, provider satisfaction, and increased number of patients seen, there was no statistically significant improvement in the above criteria when compiled in a systematic review. There is also a clear publication bias; very few studies with negative results were published. To prove significance, data from more emergency rooms with scribe programs would need to be compiled which also includes emergency rooms who did not report noticeable benefits. Furthermore, most data sets focused only on scribes in academic centers. Conclusion: Ultimately, the literature suggests that while emergency room physicians who have access to medical scribes report higher satisfaction due to lower clerical burdens and can see more patients per shift, there is still variability in terms of patient and provider satisfaction. Whether or not this variability exists due to differences in training (in-house trainees versus contractors), population profile (adult versus pediatric), setting (academic versus community), or which shifts scribe work cannot be determined based on the studies that exist. Ultimately, more scribe programs need to be evaluated to determine whether these variables affect outcomes and prove whether scribes significantly improve emergency room efficiency.

Keywords: emergency medicine, medical scribe, scribe, documentation

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290 Head and Neck Extranodal Rosai-Dorfman Disease- Utility of immunohistochemistry

Authors: Beverly Wang

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Background: Rosai-Dorfman disease (RDD), aka sinus histiocytosis with massive lymphadenopathy, is a rare, idiopathic histiocytic proliferative disorder. Although RDD can be seen involving the head and neck lymph nodes, rarely it can affect other extranodal sites. It present 3 unique cases of RDD affecting the nasal cavity, paranasal sinuses, and ear canal. The initial clinical presentation on two cases mimicked a malignant neoplasm. The 3rd case of RDD co-existed with a cholesteatoma of the ear canal. The clinical presentation, histology and immunohistochemical stains, and radiographic findings are discussed. Design: An overview of 3 cases of RDD affected sinonasal cavity and ear canal from UCI Medical Center was conducted. Case 1: A 61 year old male complaining of breathing difficulty presented with bilateral polypoid sinonasal masses and severe nasal obstruction. The masses elevated the nasal floor, and involved the anterior nasal septum to lateral wall. It was endoscopically excised. At intraoperative consultation, frozen section reported a pleomorphic spindle cell neoplasm with scattered large atypical spindle cells, resembling a high grade sarcoma. Case 2: A 46 year old male presented with recurrent bilateral maxillary chronic sinusitis with mass formation, clinically suspicious for malignant lymphoma. Excisional tissue sample showed large irregular spindled histiocytes with abundant granular and vacuolated cytoplasm. Case 3: A 36 year old female with a history of asthma initially presented with left-sided chronic otalgia, occasional nausea, vertigo, and fluctuating pain exacerbated by head movement and temperature changes. CT scan revealed an external auditory canal mass extending to the middle ear, coexisting with a small cholesteatoma. Results: The morphology of all cases revealed large atypical spindled histiocytes resembling fibrohistiocytic or myofibroblastic proliferative neoplasms. Scattered emperipolesis was seen. All 3 cases were confirmed as extranodal sinus RDD, confirmed by immunohistochemistry. The large atypical cells were positive for S100, CD68, and CD163. No evidence for malignancy was identified. Case 3 showed concurrent RDD co-existing with a cholesteatoma. Conclusion: Due to its rarity and variable clinical presentations, the diagnosis of RDD is seldom clinically considered. Extranodal sinus RDD morphologically can be pitfall as mimicker of spindly neoplasm, especially at intraoperative consultation. It can create diagnostic and therapeutic challenges. Correlation of radiological findings with histologic features will help to reach the diagnosis.

Keywords: head and neck, extranodal, rosai-dorfman disease, mimicker, immunohistochemistry

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289 Barriers to Social Entrepreneurship by Refugees: An Explorative Study How Prior Experience Influences Social Orientation

Authors: D. M. Koers, A. J. Groen, P. D. Englis, R. Harms

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We are witnessing the largest level of displacement of people since World War II. Refugees want to become independent as quickly as possible and build a new, safe future; however, access to the labor market is difficult and they face many problems that are not easily solved. This makes self-employment including social entrepreneurship a valuable alternative. Our research studied refugee-based entrepreneurship and examined whether prior knowledge, unmet personal needs and contextual factors influence how refugees recognize opportunities and if this influences their social orientation. In addition, we examine the barriers refugees face when starting up a company in the Netherlands. We use a case study design with a mixed-method approach, combining in-depth interviews and survey data. Data was collected from two Dutch entrepreneurial training programs in the Netherlands. We have a sample size of 27 latent refugee entrepreneurs. Our results show that refugees score high on the social entrepreneurial measures. They perceive themselves as having a strong social vision and are determined to defend a social need. They also score high on sustainability and state that their business ideas improve the quality of life on the long run. Based on these findings, we did not expect that only 5 participants had business ideas with a social orientation. In this group, 37,5% started a company before and 77.8% used their personal experience to come up with this business idea. Another 70,3% had the higher professional education or academic education. In the interviews, we found that they often copy and paste their gained experience from a previous profession on their new context and expect that it would work well. The social aspect lies in their cultural values and personal beliefs but is not reflected in their business models. One of the reasons could be that the context in which the refugee operates as a moderator suppressing the social mission and social value creation opportunities. Refugees are first and foremost focused on their survival. They do not want to be on social welfare and feel a strong need to be independent. Since they cannot access the labor market easily and face labor market discrimination they want to start a company. Another factor that explains lack of the social orientation in their business ideas is that social entrepreneurship is not a known concept in their home countries. Their idea of entrepreneurship differs substantially. We found that a huge barrier for refugees is their expectations about setting up a business, which are often not realistic because they have little knowledge about the system, institutions and corresponding red tape. In those instances, can the institutional configuration of a country, cultural differences, and perspective on entrepreneurship hinders social entrepreneurship. In conclusion, there might be latent potential for social entrepreneurship in refugees but there are many barriers to overcome. Overcoming these barriers can enhance local communities and enhance integration. In addition it has a positive financial impact on the host country because it reduces the pressure on the social system and stimulate the economy.

Keywords: immigrant entrepreneurship, refugee entrepreneurship, social entrepreneurship, prior experience, opportunity recognition

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288 Cost Based Analysis of Risk Stratification Tool for Prediction and Management of High Risk Choledocholithiasis Patients

Authors: Shreya Saxena

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Background: Choledocholithiasis is a common complication of gallstone disease. Risk scoring systems exist to guide the need for further imaging or endoscopy in managing choledocholithiasis. We completed an audit to review the American Society for Gastrointestinal Endoscopy (ASGE) scoring system for prediction and management of choledocholithiasis against the current practice at a tertiary hospital to assess its utility in resource optimisation. We have now conducted a cost focused sub-analysis on patients categorized high-risk for choledocholithiasis according to the guidelines to determine any associated cost benefits. Method: Data collection from our prior audit was used to retrospectively identify thirteen patients considered high-risk for choledocholithiasis. Their ongoing management was mapped against the guidelines. Individual costs for the key investigations were obtained from our hospital financial data. Total cost for the different management pathways identified in clinical practice were calculated and compared against predicted costs associated with recommendations in the guidelines. We excluded the cost of laparoscopic cholecystectomy and considered a set figure for per day hospital admission related expenses. Results: Based on our previous audit data, we identified a77% positive predictive value for the ASGE risk stratification tool to determine patients at high-risk of choledocholithiasis. 47% (6/13) had an magnetic resonance cholangiopancreatography (MRCP) prior to endoscopic retrograde cholangiopancreatography (ERCP), whilst 53% (7/13) went straight for ERCP. The average length of stay in the hospital was 7 days, with an additional day and cost of £328.00 (£117 for ERCP) for patients awaiting an MRCP prior to ERCP. Per day hospital admission was valued at £838.69. When calculating total cost, we assumed all patients had admission bloods and ultrasound done as the gold standard. In doing an MRCP prior to ERCP, there was a 130% increase in cost incurred (£580.04 vs £252.04) per patient. When also considering hospital admission and the average length of stay, it was an additional £1166.69 per patient. We then calculated the exact costs incurred by the department, over a three-month period, for all patients, for key investigations or procedures done in the management of choledocholithiasis. This was compared to an estimate cost derived from the recommended pathways in the ASGE guidelines. Overall, 81% (£2048.45) saving was associated with following the guidelines compared to clinical practice. Conclusion: MRCP is the most expensive test associated with the diagnosis and management of choledocholithiasis. The ASGE guidelines recommend endoscopy without an MRCP in patients stratified as high-risk for choledocholithiasis. Our audit that focused on assessing the utility of the ASGE risk scoring system showed it to be relatively reliable for identifying high-risk patients. Our cost analysis has shown significant cost savings per patient and when considering the average length of stay associated with direct endoscopy rather than an additional MRCP. Part of this is also because of an increased average length of stay associated with waiting for an MRCP. The above data supports the ASGE guidelines for the management of high-risk for choledocholithiasis patients from a cost perspective. The only caveat is our small data set that may impact the validity of our average length of hospital stay figures and hence total cost calculations.

Keywords: cost-analysis, choledocholithiasis, risk stratification tool, general surgery

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287 Work Related Outcomes of Perceived Authentic Leadership: Moderating Role of Organizational Structures

Authors: Aisha Zubair, Anila Kamal

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Leadership styles and practices greatly influence the organizational effectiveness and productivity. It also plays an important role in employees’ experiences of positive emotions at workplace and creative work behaviors. Authentic leadership as a newly emerging concept has been found as a significant predictor of various desirable work related outcomes. However, leadership practices and its work related outcomes, to a great extent, are determined by the very nature of the organizational structures (tall and flat). Tall organizations are characterized by multiple hierarchical layers with predominant vertical communication patterns, and narrow span of control; while flat organizations are featured by few layers of management employing both horizontal and vertical communication styles, and wide span of control. Therefore, the present study was undertaken to determine the work related outcomes of perceived authentic leadership; that is work related flow and creative work behavior among employees of flat and tall organizations. Moreover, it was also intended to determine the moderating role of organizational structure (flat and tall) in the relationship between perceived authentic leadership with work related flow and creative work behavior. In this regard, two types of companies have been considered; that is, banks as a form of tall organizational structure with multiple hierarchical structures while software companies have been considered as flat organizations with minimal layers of management. Respondents (N = 1180) were full time regular employees of marketing departments of banks (600) and software companies (580) including both men and women with age range of 22-52 years (M = 33.24; SD = 7.81). Confirmatory Factor Analysis yielded factor structures of measures of work related flow and creative work behavior in accordance to the theoretical models. However, model of authentic leadership exhibited variation in terms of two items which were not included in the final measure of the perceived authentic leadership. Results showed that perceived authentic leadership was positively associated with work related flow and creative work behavior. Likewise, work related flow was positively aligned with creative work behavior. Furthermore, type of organizational structure significantly moderated the relationship of perceived authentic leadership with work related flow and creative work behavior. Results of independent sample t-test showed that employees working in flat organization reflected better perceptions of authentic leadership; higher work related flow and elevated levels of creative work behavior as compared to those working in tall organizations. It was also found that employees with extended job experience and more job duration in the same organization displayed better perceptions of authentic leadership, reported more work related flow and augmented levels of creative work behavior. Findings of the present study distinctively highlighted the similarities as well as differences in the interactions of major constructs which function differentially in the context of tall (banks) and flat (software companies) organizations. Implications of the present study for employees and management as well as future recommendations were also discussed.

Keywords: creative work behavior, organizational structure, perceived authentic leadership, work related flow

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286 Multiple Primary Pulmonary Meningiomas: A Case Report

Authors: Wellemans Isabelle, Remmelink Myriam, Foucart Annick, Rusu Stefan, Compère Christophe

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Primary pulmonary meningioma (PPM) is a very rare tumor, and its occurrence has been reported only sporadically. Multiple PPMs are even more exceptional, and herein, we report, to the best of our knowledge, the fourth case, focusing on the clinicopathological features of the tumor. Moreover, the possible relationship between the use of progesterone–only contraceptives and the development of these neoplasms will be discussed. Case Report: We report a case of a 51-year-old female presenting three solid pulmonary nodules, with the following localizations: right upper lobe, middle lobe, and left lower lobe, described as incidental findings on computed tomography (CT) during a pre-bariatric surgery check-up. The patient revealed no drinking or smoking history. The physical exam was unremarkable except for the obesity. The lesions ranged in size between 6 and 24 mm and presented as solid nodules with lobulated contours. The largest lesion situated in the middle lobe had mild fluorodeoxyglucose (FDG) uptake on F-18 FDG positron emission tomography (PET)/CT, highly suggestive of primary lung neoplasm. For pathological assessment, video-assisted thoracoscopic middle lobectomy and wedge resection of the right upper nodule was performed. Histological examination revealed relatively well-circumscribed solid proliferation of bland meningothelial cells growing in whorls and lobular nests, presenting intranuclear pseudo-inclusions and psammoma bodies. No signs of anaplasia were observed. The meningothelial cells expressed diffusely Vimentin, focally Progesterone receptors and were negative for epithelial (cytokeratin (CK) AE1/AE3, CK7, CK20, Epithelial Membrane Antigen (EMA)), neuroendocrine markers (Synaptophysin, Chromogranin, CD56) and Estrogenic receptors. The proliferation labelling index Ki-67 was low (<5%). Metastatic meningioma was ruled out by brain and spine magnetic resonance imaging (MRI) scans. The third lesion localized in the left lower lobe was followed-up and resected three years later because of its slow but significant growth (14 mm to 16 mm), alongside two new infra centimetric lesions. Those three lesions showed a morphological and immunohistochemical profile similar to previously resected lesions. The patient was disease-free one year post-last surgery. Discussion: Although PPMs are mostly benign and slow-growing tumors with an excellent prognosis, they do not present specific radiological characteristics, and it is difficult to differentiate it from other lung tumors, histopathologic examination being essential. Aggressive behavior is associated with atypical or anaplastic features (WHO grades II–III) The etiology is still uncertain and different mechanisms have been proposed. A causal connection between sexual hormones and meningothelial proliferation has long been suspected and few studies examining progesterone only contraception and meningioma risk have all suggested an association. In line with this, our patient was treated with Levonorgestrel, a progesterone agonist, intra-uterine device (IUD). Conclusions: PPM, defined by the typical histological and immunohistochemical features of meningioma in the lungs and the absence of central nervous system lesions, is an extremely rare neoplasm, mainly solitary and associating, and indolent growth. Because of the unspecific radiologic findings, it should always be considered in the differential diagnosis of lung neoplasms. Regarding multiple PPM, only three cases are reported in the literature, and this is the first described in a woman treated by a progesterone-only IUD to the best of our knowledge.

Keywords: pulmonary meningioma, multiple meningioma, meningioma, pulmonary nodules

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285 Association of Temperature Factors with Seropositive Results against Selected Pathogens in Dairy Cow Herds from Central and Northern Greece

Authors: Marina Sofia, Alexios Giannakopoulos, Antonia Touloudi, Dimitris C Chatzopoulos, Zoi Athanasakopoulou, Vassiliki Spyrou, Charalambos Billinis

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Fertility of dairy cattle can be affected by heat stress when the ambient temperature increases above 30°C and the relative humidity ranges from 35% to 50%. The present study was conducted on dairy cattle farms during summer months in Greece and aimed to identify the serological profile against pathogens that could affect fertility and to associate the positive serological results at herd level with temperature factors. A total of 323 serum samples were collected from clinically healthy dairy cows of 8 herds, located in Central and Northern Greece. ELISA tests were performed to detect antibodies against selected pathogens that affect fertility, namely Chlamydophila abortus, Coxiella burnetii, Neospora caninum, Toxoplasma gondii and Infectious Bovine Rhinotracheitis Virus (IBRV). Eleven climatic variables were derived from the WorldClim version 1.4. and ArcGIS V.10.1 software was used for analysis of the spatial information. Five different MaxEnt models were applied to associate the temperature variables with the locations of seropositive Chl. abortus, C. burnetii, N. caninum, T. gondii and IBRV herds (one for each pathogen). The logistic outputs were used for the interpretation of the results. ROC analyses were performed to evaluate the goodness of fit of the models’ predictions. Jackknife tests were used to identify the variables with a substantial contribution to each model. The seropositivity rates of pathogens varied among the 8 herds (0.85-4.76% for Chl. abortus, 4.76-62.71% for N. caninum, 3.8-43.47% for C. burnetii, 4.76-39.28% for T. gondii and 47.83-78.57% for IBRV). The variables of annual temperature range, mean diurnal range and maximum temperature of the warmest month gave a contribution to all five models. The regularized training gains, the training AUCs and the unregularized training gains were estimated. The mean diurnal range gave the highest gain when used in isolation and decreased the gain the most when it was omitted in the two models for seropositive Chl.abortus and IBRV herds. The annual temperature range increased the gain when used alone and decreased the gain the most when it was omitted in the models for seropositive C. burnetii, N. caninum and T. gondii herds. In conclusion, antibodies against Chl. abortus, C. burnetii, N. caninum, T. gondii and IBRV were detected in most herds suggesting circulation of pathogens that could cause infertility. The results of the spatial analyses demonstrated that the annual temperature range, mean diurnal range and maximum temperature of the warmest month could affect positively the possible pathogens’ presence. Acknowledgment: This research has been co‐financed by the European Regional Development Fund of the European Union and Greek national funds through the Operational Program Competitiveness, Entrepreneurship and Innovation, under the call RESEARCH–CREATE–INNOVATE (project code: T1EDK-01078).

Keywords: dairy cows, seropositivity, spatial analysis, temperature factors

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284 Recurrent Torsades de Pointes Post Direct Current Cardioversion for Atrial Fibrillation with Rapid Ventricular Response

Authors: Taikchan Lildar, Ayesha Samad, Suraj Sookhu

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Atrial fibrillation with rapid ventricular response results in the loss of atrial kick and shortened ventricular filling time, which often leads to decompensated heart failure. Pharmacologic rhythm control is the treatment of choice, and patients frequently benefit from the restoration of sinus rhythm. When pharmacologic treatment is unsuccessful or a patient declines hemodynamically, direct cardioversion is the treatment of choice. Torsades de pointes or “twisting of the points'' in French, is a rare but under-appreciated risk of cardioversion therapy and accounts for a significant number of sudden cardiac death each year. A 61-year-old female with no significant past medical history presented to the Emergency Department with worsening dyspnea. An electrocardiogram showed atrial fibrillation with rapid ventricular response, and a chest X-ray was significant for bilateral pulmonary vascular congestion. Full-dose anticoagulation and diuresis were initiated with moderate improvement in symptoms. A transthoracic echocardiogram revealed biventricular systolic dysfunction with a left ventricular ejection fraction of 30%. After consultation with an electrophysiologist, the consensus was to proceed with the restoration of sinus rhythm, which would likely improve the patient’s heart failure symptoms and possibly the ejection fraction. A transesophageal echocardiogram was negative for left atrial appendage thrombus; the patient was treated with a loading dose of amiodarone and underwent successful direct current cardioversion with 200 Joules. The patient was placed on telemetry monitoring for 24 hours and was noted to have frequent premature ventricular contractions with subsequent degeneration to torsades de pointes. The patient was found unresponsive and pulseless; cardiopulmonary resuscitation was initiated with cardioversion, and return of spontaneous circulation was achieved after four minutes to normal sinus rhythm. Post-cardiac arrest electrocardiogram showed sinus bradycardia with heart-rate corrected QT interval of 592 milliseconds. The patient continued to have frequent premature ventricular contractions and required two additional cardioversions to achieve a return of spontaneous circulation with intravenous magnesium and lidocaine. An automatic implantable cardioverter-defibrillator was subsequently implanted for secondary prevention of sudden cardiac death. The backup pacing rate of the automatic implantable cardioverter-defibrillator was set higher than usual in an attempt to prevent premature ventricular contractions-induced torsades de pointes. The patient did not have any further ventricular arrhythmias after implantation of the automatic implantable cardioverter-defibrillator. Overdrive pacing is a method utilized to treat premature ventricular contractions-induced torsades de pointes by preventing a patient’s susceptibility to R on T-wave-induced ventricular arrhythmias. Pacing at a rate of 90 beats per minute succeeded in controlling the arrhythmia without the need for traumatic cardiac defibrillation. In our patient, conversion of atrial fibrillation with rapid ventricular response to normal sinus rhythm resulted in a slower heart rate and an increased probability of premature ventricular contraction occurring on the T-wave and ensuing ventricular arrhythmia. This case highlights direct current cardioversion for atrial fibrillation with rapid ventricular response resulting in persistent ventricular arrhythmia requiring an automatic implantable cardioverter-defibrillator placement with overdrive pacing to prevent a recurrence.

Keywords: refractory atrial fibrillation, atrial fibrillation, overdrive pacing, torsades de pointes

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283 Creative Resolutions to Intercultural Conflicts: The Joint Effects of International Experience and Cultural Intelligence

Authors: Thomas Rockstuhl, Soon Ang, Kok Yee Ng, Linn Van Dyne

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Intercultural interactions are often challenging and fraught with conflicts. To shed light on how to interact effectively across cultures, academics and practitioners alike have advanced a plethora of intercultural competence models. However, the majority of this work has emphasized distal outcomes, such as job performance and cultural adjustment, rather than proximal outcomes, such as how individuals resolve inevitable intercultural conflicts. As a consequence, the processes by which individuals negotiate challenging intercultural conflicts are not well understood. The current study advances theorizing on intercultural conflict resolution by exploring antecedents of how people resolve intercultural conflicts. To this end, we examine creativity – the generation of novel and useful ideas – in the context of resolving cultural conflicts in intercultural interactions. Based on the dual-identity theory of creativity, we propose that individuals with greater international experience will display greater creativity and that the relationship is accentuated by individual’s cultural intelligence. Two studies test these hypotheses. The first study comprises 84 senior university students, drawn from an international organizational behavior course. The second study replicates findings from the first study in a sample of 89 executives from eleven countries. Participants in both studies provided protocols of their strategies for resolving two intercultural conflicts, as depicted in two multimedia-vignettes of challenging intercultural work-related interactions. Two research assistants, trained in intercultural management but blind to the study hypotheses, coded all strategies for their novelty and usefulness following scoring procedures for creativity tasks. Participants also completed online surveys of demographic background information, including their international experience, and cultural intelligence. Hierarchical linear modeling showed that surprisingly, while international experience is positively associated with usefulness, it is unrelated to novelty. Further, a person’s cultural intelligence strengthens the positive effect of international experience on usefulness and mitigates the effect of international experience on novelty. Theoretically, our findings offer an important theoretical extension to the dual-identity theory of creativity by identifying cultural intelligence as an important individual difference moderator that qualifies the relationship between international experience and creative conflict resolution. In terms of novelty, individuals higher in cultural intelligence seem less susceptible to rigidity effects of international experiences. Perhaps they are more capable of assessing which aspects of culture are relevant and apply relevant experiences when they brainstorm novel ideas. For utility, individuals high in cultural intelligence are better able to leverage on their international experience to assess the viability of their ideas because their richer and more organized cultural knowledge structure allows them to assess possible options more efficiently and accurately. In sum, our findings suggest that cultural intelligence is an important and promising intercultural competence that fosters creative resolutions to intercultural conflicts. We hope that our findings stimulate future research on creativity and conflict resolution in intercultural contexts.

Keywords: cultural Intelligence, intercultural conflict, intercultural creativity, international experience

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282 Expanding Behavioral Crisis Care: Expansion of Psychiatric and Addiction-Care Services through a 23/7 Behavioral Crisis Center

Authors: Garima Singh

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Objectives: Behavioral Crisis Center (BCC) is a community solution to a community problem. There has been an exponential increase in the incidence and prevalence of mental health crises around the world. The effects of the crisis negatively impact our patients and their families and strain the law enforcement and emergency room. The goal of the multi-disciplinary care model is to break the crisis cycle and provide 24-7 rapid access to an acre and crisis stabilization. We initiated our first BCC care center in 2020 in the midst of the COVID pandemic and have seen a remarkable improvement in patient ‘care and positive financial outcome. Background: Mental illnesses are common in the United States. Nearly one in five U.S. adults live with a mental illness (52.9 million in 2020). This number represented 21.0% of all U.S. adults. To address some of these challenges and help our community, In May 2020, we opened our first Behavioral crisis center (BCC). Since then, we have served more than 2500 patients and is the first southwest Missouri’s first 24/7 facility for crisis–level behavioral health and substance use needs. It has been proven to be a more effective place than emergency departments, jails, or local law enforcement. Methods: BCC was started in 2020 to serve the unmet need of the community and provide access to behavioral health and substance use services identified in the community. Funding was possible with significant investment from the county and Missouri Foundation for Health, with contributions from medical partners. It is a multi-disciplinary care center consisting of Physicians, nurse practitioners, nurses, behavioral technicians, peer support specialists, clinical intake specialists, and clinical coordinators and hospitality specialists. The center provides services including psychiatry care, outpatient therapy, community support services, primary care, peer support and engagement. It is connected to a residential treatment facility for substance use treatment for continuity of care and bridging the gap, which has resulted in the completion of treatment and better outcomes. Results: BCC has proven to be a great resource to the community and the Missouri Health Coalition is providing funding to replicate the model in other regions and work on a similar model for children and adolescents. Overall, 29% of the patients seen at BCC are stabilized and discharged with outpatient care. 50% needed acute stabilization in a hospital setting and 21% required long-term admission, mostly for substance use treatment. The local emergency room had a 42% reduction in behavioral health encounters compared to the previous 3 years. Also, by a quick transfer to BCC, the average stay in ER was reduced by 10 hours and time to follow up behavioral health assessment decreased by an average of 4 hours. Uninsured patients are also provided Medicaid application assistance which has benefited 55% of individuals receiving care at BCC. Conclusions: BCC is impacting community health and improving access to quality care and substance use treatment. It is a great investment for our patients and families.

Keywords: BCC, behvaioral health, community health care, addiction treatment

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281 Lignin Valorization: Techno-Economic Analysis of Three Lignin Conversion Routes

Authors: Iris Vural Gursel, Andrea Ramirez

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Effective utilization of lignin is an important mean for developing economically profitable biorefineries. Current literature suggests that large amounts of lignin will become available in second generation biorefineries. New conversion technologies will, therefore, be needed to carry lignin transformation well beyond combustion to produce energy, but towards high-value products such as chemicals and transportation fuels. In recent years, significant progress on catalysis has been made to improve transformation of lignin, and new catalytic processes are emerging. In this work, a techno-economic assessment of two of these novel conversion routes and comparison with more established lignin pyrolysis route were made. The aim is to provide insights into the potential performance and potential hotspots in order to guide the experimental research and ease the commercialization by early identifying cost drivers, strengths, and challenges. The lignin conversion routes selected for detailed assessment were: (non-catalytic) lignin pyrolysis as the benchmark, direct hydrodeoxygenation (HDO) of lignin and hydrothermal lignin depolymerisation. Products generated were mixed oxygenated aromatic monomers (MOAMON), light organics, heavy organics, and char. For the technical assessment, a basis design followed by process modelling in Aspen was done using experimental yields. A design capacity of 200 kt/year lignin feed was chosen that is equivalent to a 1 Mt/y scale lignocellulosic biorefinery. The downstream equipment was modelled to achieve the separation of the product streams defined. For determining external utility requirement, heat integration was considered and when possible gasses were combusted to cover heating demand. The models made were used in generating necessary data on material and energy flows. Next, an economic assessment was carried out by estimating operating and capital costs. Return on investment (ROI) and payback period (PBP) were used as indicators. The results of the process modelling indicate that series of separation steps are required. The downstream processing was found especially demanding in the hydrothermal upgrading process due to the presence of significant amount of unconverted lignin (34%) and water. Also, external utility requirements were found to be high. Due to the complex separations, hydrothermal upgrading process showed the highest capital cost (50 M€ more than benchmark). Whereas operating costs were found the highest for the direct HDO process (20 M€/year more than benchmark) due to the use of hydrogen. Because of high yields to valuable heavy organics (32%) and MOAMON (24%), direct HDO process showed the highest ROI (12%) and the shortest PBP (5 years). This process is found feasible with a positive net present value. However, it is very sensitive to the prices used in the calculation. The assessments at this stage are associated with large uncertainties. Nevertheless, they are useful for comparing alternatives and identifying whether a certain process should be given further consideration. Among the three processes investigated here, the direct HDO process was seen to be the most promising.

Keywords: biorefinery, economic assessment, lignin conversion, process design

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280 Leptin Levels in Cord Blood and Their Associations with the Birth of Small, Large and Appropriate for Gestational Age Infants in Southern Sri Lanka

Authors: R. P. Hewawasam, M. H. A. D. de Silva, M. A. G. Iresha

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In recent years childhood obesity has increased to pan-epidemic proportions along with a concomitant increase in obesity-associated morbidity. Birth weight is an important determinant of later adult health, with neonates at both ends of the birth weight spectrum at risk of future health complications. Consequently, infants who are born large for gestational age (LGA) are more likely to be obese in childhood and adolescence and are at risk of cardiovascular and metabolic complications later in life. Adipose tissue plays a role in linking events in fetal growth to the subsequent development of adult diseases. In addition to its role as a storage depot for fat, adipose tissue produces and secrets a number of hormones of importance in modulating metabolism and energy homeostasis. Cord blood leptin level has been positively correlated with fetal adiposity at birth. It is established that Asians have lower skeletal muscle mass, low bone mineral content and excess body fat for a given body mass index indicating a genetic predisposition in the occurrence of obesity. To our knowledge, studies have never been conducted in Sri Lanka to determine the relationship between adipocytokine profile in cord blood and anthropometric parameters in newborns. Thus, the objective of this study is to establish the above relationship for the Sri Lankan population to implement awareness programs to minimize childhood obesity in the future. Umbilical cord blood was collected from 90 newborns (Male 40, Female 50; gestational age 35-42 weeks) after double clamping the umbilical cord before separation of the placenta and the concentration of leptin was measured by ELISA technique. Anthropometric parameters of the newborn such as birth weight, length, ponderal index, occipital frontal, chest, hip and calf circumferences were measured. Pearson’s correlation was used to assess the relationship between leptin and anthropometric parameters while the Mann-Whitney U test was used to assess the differences in cord blood leptin levels between small for gestational age (SGA), appropriate for gestational age (AGA) and LGA infants. There was a significant difference (P < 0.05) between the cord blood leptin concentrations of LGA infants (12.67 ng/mL ± 2.34) and AGA infants (7.10 ng/mL ± 0.90). However, a significant difference was not observed between leptin levels of SGA infants (8.86 ng/mL ± 0.70) and AGA infants. In both male and female neonates, umbilical leptin levels showed significant positive correlations (P < 0.05) with birth weight of the newborn, pre-pregnancy maternal weight and pre pregnancy BMI between the infants of large and appropriate for gestational ages. Increased concentrations of leptin levels in the cord blood of large for gestational age infants suggest that they may be involved in regulating fetal growth. Leptin concentration of Sri Lankan population was not significantly deviated from published data of Asian populations. Fetal leptin may be an important predictor of neonatal adiposity; however, interventional studies are required to assess its impact on the possible risk of childhood obesity.

Keywords: appropriate for gestational age, childhood obesity, leptin, anthropometry

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279 Education Delivery in Youth Justice Centres: Inside-Out Prison Exchange Program Pedagogy in an Australian Context

Authors: Tarmi A'Vard

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This paper discusses the transformative learning experience for students participating in the Inside-Out Prison Exchange Program (Inside-out) and explores the value this pedagogical approach may have in youth justice centers. Inside-Out is a semester-long university course which is unique as it takes 15 university students, with their textbook and theory-based knowledge, behind the walls to study alongside 15 incarcerated students, who have the lived experience of the criminal justice system. Inside-out is currently offered in three Victorian prisons, expanding to five in 2020. The Inside-out pedagogy which is based on transformative dialogic learning is reliant upon the participants sharing knowledge and experiences to develop an understanding and appreciation of the diversity and uniqueness of one another. Inside-out offers the class an opportunity to create its own guidelines for dialogue, which can lead to the student’s sense of equality, which is fundamental in the success of this program. Dialogue allows active participation by all parties in reconciling differences, collaborating ideas, critiquing and developing hypotheses and public policies, and encouraging self-reflection and exploration. The structure of the program incorporates the implementation of circular seating (where the students alternate between inside and outside), activities, individual reflective tasks, group work, and theory analysis. In this circle everyone is equal, this includes the educator, who serves as a facilitator more so than the traditional teacher role. A significant function of the circle is to develop a group consciousness, allowing the whole class to see itself as a collective, and no one person holds a superior role. This also encourages participants to be responsible and accountable for their behavior and contributions. Research indicates completing academic courses, like Inside-Out, contributes positively to reducing recidivism. Inside-Out’s benefits and success in many adult correctional institutions have been outlined in evaluation reports and scholarly articles. The key findings incorporate the learning experiences for the students in both an academic capability and professional practice and development. Furthermore, stereotypes and pre-determined ideas are challenged, and there is a promotion of critical thinking and evidence of self-discovery and growth. There is empirical data supporting positive outcomes of education in youth justice centers in reducing recidivism and increasing the likelihood of returning to education upon release. Hence, this research could provide the opportunity to increase young people’s engagement in education which is a known protective factor for assisting young people to move away from criminal behavior. In 2016, Tarmi completed the Inside-Out educator training in Philadelphia, Pennsylvania, and has developed an interest in exploring the pedagogy of Inside-Out, specifically targeting young offenders in a Youth Justice Centre.

Keywords: dialogic transformative learning, inside-out prison exchange program, prison education, youth justice

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278 Inputs and Outputs of Innovation Processes in the Colombian Services Sector

Authors: Álvaro Turriago-Hoyos

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Most research tends to see innovation as an explanatory factor in achieving high levels of competitiveness and productivity. More recent studies have begun to analyze the determinants of innovation in the services sector as opposed to the much-discussed industrial sector of a country’s economy. This research paper focuses on the services sector in Colombia, one of Latin America’s fastest growing and biggest economies. Over the past decade, much of Colombia’s economic expansion has relied on commodity exports (mainly oil and coffee) whilst the industrial sector has performed relatively poorly. Such developments highlight the potential of the innovative role played by the services sector of the Colombian economy and its future growth prospects. This research paper analyzes the relationship between inputs, which at the same time are internal sources of innovation (such as R&D activities), and external sources that are improved by technology acquisition. The outputs are basically the four kinds of innovation that the OECD Oslo Manual recognizes: product, process, marketing and organizational innovations. The instrument used to measure this input-output relationship is based on Knowledge Production Function approaches. We run Probit models in order to identify the existing relationships between the above inputs and outputs, but also to identify spill-overs derived from interactions of the components of the value chain of the services firms analyzed: customers, suppliers, competitors, and complementary firms. Data are obtained from the Colombian National Administrative Department of Statistics for the period 2008 to 2013 published in the II and III Colombian National Innovation Survey. A short summary of the results obtained lead to conclude that firm size and a firm’s level of technological development turn out to be important discriminating factors for the description of the innovative process at the firm level. The model’s outcomes show a positive impact on the probability of introducing any kind of innovation both on R&D and Technology Acquisition investment. Also, cooperation agreements with customers, research institutes, competitors, and the suppliers are significant. Belonging to a particular industrial group is an important determinant but only to product and organizational innovation. It is possible to establish that Health Services, Education, Computer, Wholesale trade, and Financial Intermediation are the ISIC sectors, which report the highest number of frequencies of the considered set of firms. Those five sectors of the sixteen considered, in all cases, explained more than half of the total of all kinds of innovations. Product Innovation, which is followed by Marketing Innovation, gets the highest results. Displaying the same set of firms distinguishing by size, and belonging to high and low tech services sector shows that the larger the firms the larger a number of innovations, but also that always high-tech firms show a better innovation performance.

Keywords: Colombia, determinants of innovation, innovation, services sector

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277 Improving Physical, Social, and Mental Health Outcomes for People Living with an Intellectual Disability through Cycling

Authors: Sarah Faulkner, Patrick Faulkner, Caroline Ellison

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Improved mental and physical health, community connection, and increased life satisfaction has been strongly associated with bike riding for those with and without a disability. However, much evidence suggests that people living with a disability face increased barriers to engaging in cycling compared to members of the general population. People with an intellectual disability often live more sedentary and socially isolated lives that negatively impact their mental and physical health, as well as life satisfaction. This paper is based on preliminary findings from a three-year intervention cycling project funded by the South Australian Government. The cycling project was developed in partnership with community stakeholders that provided weekly instruction, training, and support to individuals living with intellectual disabilities to increase their capacity in cycling. This project aimed to support people living with intellectual disabilities to foster and facilitate improved physical and mental health, confidence, and independence and enhance social networking through their engagement in community cycling. The program applied principles of social role valorisation (SRV) theory as its guiding framework. Preliminary data collected is based on qualitative interviews with over 50 program participants, results from two participant wellness questionnaires, as well as a perceptually regulated exercise test administered throughout the project implementation. Preliminary findings are further supplemented with ethnographic analyses by the researchers who took a phenology of life experience approach. Preliminary findings of the program suggest a variety of social motivations behind participants' desire to learn cycling that acknowledges previous barriers to engagement and cycling’s role to address feelings of loneliness and social isolation. Meaningful health benefits can be achieved as demonstrated by increases in predicted V02 max measures, suggesting that physical intervention can not only improve physical health outcomes but also provide a variety of other social benefits. Initial engagement in the project has demonstrated an increase in participants' sense of confidence, well-being, and physical fitness. Implementation of the project in partnership with a variety of community stakeholders has identified a number of critical factors and processes necessary for future service replication, sustainability, and success. Findings from this intervention study contribute to the development of a knowledge base on how best to support individuals living with an intellectual disability to partake in bike riding and increase positive outcomes associated with their capacity building, social interaction, increased physical activity, physical health, and mental well-being. The initial findings of this study provide critical academic insights into the social and physical benefits of cycling for people living with a disability, as well as practical advice for future human service applications.

Keywords: cycling, disability, social inclusion, capacity building

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276 The Study of Mirror Self-Recognition in Wildlife

Authors: Azwan Hamdan, Mohd Qayyum Ab Latip, Hasliza Abu Hassim, Tengku Rinalfi Putra Tengku Azizan, Hafandi Ahmad

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Animal cognition provides some evidence for self-recognition, which is described as the ability to recognize oneself as an individual separate from the environment and other individuals. The mirror self-recognition (MSR) or mark test is a behavioral technique to determine whether an animal have the ability of self-recognition or self-awareness in front of the mirror. It also describes the capability for an animal to be aware of and make judgments about its new environment. Thus, the objectives of this study are to measure and to compare the ability of wild and captive wildlife in mirror self-recognition. Wild animals from the Royal Belum Rainforest Malaysia were identified based on the animal trails and salt lick grounds. Acrylic mirrors with wood frame (200 x 250cm) were located near to animal trails. Camera traps (Bushnell, UK) with motion-detection infrared sensor are placed near the animal trails or hiding spot. For captive wildlife, animals such as Malayan sun bear (Helarctos malayanus) and chimpanzee (Pan troglodytes) were selected from Zoo Negara Malaysia. The captive animals were also marked using odorless and non-toxic white paint on its forehead. An acrylic mirror with wood frame (200 x 250cm) and a video camera were placed near the cage. The behavioral data were analyzed using ethogram and classified through four stages of MSR; social responses, physical inspection, repetitive mirror-testing behavior and realization of seeing themselves. Results showed that wild animals such as barking deer (Muntiacus muntjak) and long-tailed macaque (Macaca fascicularis) increased their physical inspection (e.g inspecting the reflected image) and repetitive mirror-testing behavior (e.g rhythmic head and leg movement). This would suggest that the ability to use a mirror is most likely related to learning process and cognitive evolution in wild animals. However, the sun bear’s behaviors were inconsistent and did not clearly undergo four stages of MSR. This result suggests that when keeping Malayan sun bear in captivity, it may promote communication and familiarity between conspecific. Interestingly, chimp has positive social response (e.g manipulating lips) and physical inspection (e.g using hand to inspect part of the face) when they facing a mirror. However, both animals did not show any sign towards the mark due to lost of interest in the mark and realization that the mark is inconsequential. Overall, the results suggest that the capacity for MSR is the beginning of a developmental process of self-awareness and mental state attribution. In addition, our findings show that self-recognition may be based on different complex neurological and level of encephalization in animals. Thus, research on self-recognition in animals will have profound implications in understanding the cognitive ability of an animal as an effort to help animals, such as enhanced management, design of captive individuals’ enclosures and exhibits, and in programs to re-establish populations of endangered or threatened species.

Keywords: mirror self-recognition (MSR), self-recognition, self-awareness, wildlife

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275 Single Cell Rna Sequencing Operating from Benchside to Bedside: An Interesting Entry into Translational Genomics

Authors: Leo Nnamdi Ozurumba-Dwight

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Single-cell genomic analytical systems have proved to be a platform to isolate bulk cells into selected single cells for genomic, proteomic, and related metabolomic studies. This is enabling systematic investigations of the level of heterogeneity in a diverse and wide pool of cell populations. Single cell technologies, embracing techniques such as high parameter flow cytometry, single-cell sequencing, and high-resolution images are playing vital roles in these investigations on messenger ribonucleic acid (mRNA) molecules and related gene expressions in tracking the nature and course of disease conditions. This entails targeted molecular investigations on unit cells that help us understand cell behavoiur and expressions, which can be examined for their health implications on the health state of patients. One of the vital good sides of single-cell RNA sequencing (scRNA seq) is its probing capacity to detect deranged or abnormal cell populations present within homogenously perceived pooled cells, which would have evaded cursory screening on the pooled cell populations of biological samples obtained as part of diagnostic procedures. Despite conduction of just single-cell transcriptome analysis, scRNAseq now permits comparison of the transcriptome of the individual cells, which can be evaluated for gene expressional patterns that depict areas of heterogeneity with pharmaceutical drug discovery and clinical treatment applications. It is vital to strictly work through the tools of investigations from wet lab to bioinformatics and computational tooled analyses. In the precise steps for scRNAseq, it is critical to do thorough and effective isolation of viable single cells from the tissues of interest using dependable techniques (such as FACS) before proceeding to lysis, as this enhances the appropriate picking of quality mRNA molecules for subsequent sequencing (such as by the use of Polymerase Chain Reaction machine). Interestingly, scRNAseq can be deployed to analyze various types of biological samples such as embryos, nervous systems, tumour cells, stem cells, lymphocytes, and haematopoietic cells. In haematopoietic cells, it can be used to stratify acute myeloid leukemia patterns in patients, sorting them out into cohorts that enable re-modeling of treatment regimens based on stratified presentations. In immunotherapy, it can furnish specialist clinician-immunologist with tools to re-model treatment for each patient, an attribute of precision medicine. Finally, the good predictive attribute of scRNAseq can help reduce the cost of treatment for patients, thus attracting more patients who would have otherwise been discouraged from seeking quality clinical consultation help due to perceived high cost. This is a positive paradigm shift for patients’ attitudes primed towards seeking treatment.

Keywords: immunotherapy, transcriptome, re-modeling, mRNA, scRNA-seq

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274 Isolation and Structural Elucidation of 20 Hydroxyecdystone from Vitex doniana Sweet Stem Bark

Authors: Mustapha A. Tijjani, Fanna I. Abdulrahman, Irfan Z. Khan, Umar K. Sandabe, Cong Li

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Air dried sample V. doniana after collection and identification was extracted with ethanol and further partition with chloroform, ethyl acetate and n-butanol. Ethanolic extract (11.9g) was fractionated on a silica gel accelerated column chromatography using solvents such as n-hexane, ethyl acetate and methanol. Each eluent fractions (150ml aliquots) were collected and monitored with thin layer chromatography. Fractions with similar Rf values from same solvents system were pooled together. Phytochemical test of all the fractions were performed using standard procedure. Complete elution yielded 48 fractions (150ml/fraction) which were pooled to 24 fractions base on the Rf values. It was further recombined and 12 fractions were obtained on the basis on Rf values and coded Vd1 to Vd12 fractions. Vd8 was further eluted with ethylacetate and methanol and gave fourteen sub fractions Vd8-a, -Vd8-m. Fraction Vd8-a (56mg) gave a white crystal compound coded V1. It was further checked on TLC and observed under ultraviolet lamp and was found to give a single spot. The Rf values were calculated to be 0.433. The melting point was determined using Gallenkamp capillary melting point apparatus and found to be 241-243°C uncorrected. Characterization of the isolated compound coded V1 was done using FT-infra-red spectroscopy, HNMR, 13CNMR(1and 2D) and HRESI-MS. The IR spectrum of compound V1 shows prominent peaks that corresponds to OHstr (3365cm-1) and C=0 (1652cm-1) etc. This spectrum suggests that among the functional moiety in compound V1 are the carbonyl and hydroxyl group. The 1H NMR (400 MHz) spectrum of compound V1 in DMSO-d6 displayed five singlet signals at δ 0.72 (3H, s, H-18), 0.79 (3H, s, H-19), 1.03 (3H, s, H-21), 1.04 (3H, s, H-26), 1.06 (3H, s, H-27) each integrating for three protons indicating the five methyl functional groups present in the compound. It further showed a broad singlet at δ 5.58 integrated for 1 H due to an olefinic H-atom adjacent to the carbonyl carbon atom. Three signals at δ 3.10 (d, J = 9.0 Hz, H-22), 3.59 (m, 1H, 2H-a) and 3.72 (m, 1H, 3H-e), each integrating for one proton is due to oxymethine protons indicating that three oxymethine H-atoms are present in the compound. These all signals are characteristic to the ecdysteroid skeletons. The 13C-NMR spectrum showed the presence of 27 carbon atoms, suggesting that may be steroid skeleton. The DEPT-135 experiment showed the presence of five CH3, eight CH2, and seven CH groups, and seven quaternary C-atoms. The molecular formula was established as C27H44O7 by high resolution electron spray ionization-mass spectroscopy (HRESI-MS) positive ion mode m/z 481.3179. The signals in mass spectrum are 463, 445, and 427 peaks corresponding to losses of one, two, three, or four water molecules characteristic for ecdysterone skeleton reported in the literature. Based on the spectral analysis (HNMR, 13CNMR, DEPT, HMQC, IR, HRESI-MS) the compound V1 is thus concluded to have ecdysteriod skeleton and conclusively conforms with 2β, 3β 14α, 20R, 22R, 25-hexahydroxy-5 β cholest-7-ene-6- one, or 2, 3, 14, 20, 22, 25 hexahydroxy cholest-7-ene-6-one commonly known as 20-hydroxyecdysone.

Keywords: vitex, phytochemical, purification, isolation, chromatography, spectroscopy

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273 Spatial and Temporal Variability of Meteorological Drought Including Atmospheric Circulation in Central Europe

Authors: Andrzej Wałęga, Marta Cebulska, Agnieszka Ziernicka-Wojtaszek, Wojciech Młocek, Agnieszka Wałęga, Tommaso Caloiero

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Drought is one of the natural phenomena influencing many aspects of human activities like food production, agriculture, industry, and the ecological conditions of the environment. In the area of the Polish Carpathians, there are periods with a deficit of rainwater and an increasing frequency in dry months, especially in the cold half of the year. The aim of this work is a spatial and temporal analysis of drought, expressed as SPI in a heterogenous area of the Polish Carpathian and of the highland Region in the Central part of Europe based on long-term precipitation data. Also, to our best knowledge, for the first time in this work, drought characteristics analyzed via the SPI were discussed based on the atmospheric circulation calendar. The study region is the Upper Vistula Basin, located in the southern and south-eastern part of Poland. In this work, monthly precipitation from 56 rainfall stations was analysed from 1961 to 2022. The 3-, 6-, 9-, and 12-month Standardized Precipitation Index (SPI) were used as indicators of meteorological drought. For the 3-month SPI, the main climatic mechanisms determining extreme droughts were defined based on the calendar of synoptic circulations. The Mann-Kendall test was used to detect the trend of extreme droughts. Statistically significant trends of SPI were observed on 52.7% of all analyzed stations, and in most cases, a positive trend was observed. Statistically significant trends were more frequently observed in stations located in the western part of the analyzed region. Long-term droughts, represented by the 12-month SPI, occurred in all stations but not in all years. Short-term droughts (3-month SPI) were most frequent in the winter season, 6 and 9-month SPI in winter and spring, and 12-month SPI in winter and autumn, respectively. The spatial distribution of drought was highly diverse. The most intensive drought occurred in 1984, with the 6-month SPI covering 98% of the analyzed region and the 9 and 12-month SPI covering 90% of the entire region. Droughts exhibit a seasonal pattern, with a dominant 10-year periodicity for all analyzed variants of SPI. Additionally, Fourier analysis revealed a 2-year periodicity for the 3-, 6-, and 9-month SPI and a 31-year periodicity for the 12-month SPI. The results provide insights into the typical climatic conditions in Poland, with strong seasonality in precipitation. The study highlighted that short-term extreme droughts, represented by the 3-month SPI, are often caused by anticyclonic situations with high-pressure wedges Ka and Wa, and anticyclonic West as observed in 52.3% of cases. These findings are crucial for understanding the spatial and temporal variability of short and long-term extreme droughts in Central Europe, particularly for the agriculture sector dominant in the northern part of the analyzed region, where drought frequency is highest.

Keywords: atmospheric circulation, drought, precipitation, SPI, the Upper Vistula Basin

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272 Disrupting Traditional Industries: A Scenario-Based Experiment on How Blockchain-Enabled Trust and Transparency Transform Nonprofit Organizations

Authors: Michael Mertel, Lars Friedrich, Kai-Ingo Voigt

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Based on principle-agent theory, an information asymmetry exists in the traditional donation process. Consumers cannot comprehend whether nonprofit organizations (NPOs) use raised funds according to the designated cause after the transaction took place (hidden action). Therefore, charity organizations have tried to appear transparent and gain trust by using the same marketing instruments for decades (e.g., releasing project success reports). However, none of these measures can guarantee consumers that charities will use their donations for the purpose. With awareness of misuse of donations rising due to the Ukraine conflict (e.g., funding crime), consumers are increasingly concerned about the destination of their charitable purposes. Therefore, innovative charities like the Human Rights Foundation have started to offer donations via blockchain. Blockchain technology has the potential to establish profound trust and transparency in the donation process: Consumers can publicly track the progress of their donation at any time after deciding to donate. This ensures that the charity is not using donations against its original intent. Hence, the aim is to investigate the effect of blockchain-enabled transactions on the willingness to donate. Sample and Design: To investigate consumers' behavior, we use a scenario-based experiment. After removing participants (e.g., due to failed attention checks), 3192 potential donors participated (47.9% female, 62.4% bachelor or above). Procedure: We randomly assigned the participants to one of two scenarios. In all conditions, the participants read a scenario about a fictive charity organization called "Helper NPO." Afterward, the participants answered questions regarding their perception of the charity. Manipulation: The first scenario (n = 1405) represents a typical donation process, where consumers donate money without any option to track and trace. The second scenario (n = 1787) represents a donation process via blockchain, where consumers can track and trace their donations respectively. Using t-statistics, the findings demonstrate a positive effect of donating via blockchain on participants’ willingness to donate (mean difference = 0.667, p < .001, Cohen’s d effect size = 0.482). A mediation analysis shows significant effects for the mediation of transparency (Estimate = 0.199, p < .001), trust (Estimate = 0.144, p < .001), and transparency and trust (Estimate = 0.158, p < .001). The total effect of blockchain usage on participants’ willingness to donate (Estimate = 0.690, p < .001) consists of the direct effect (Estimate = 0.189, p < .001) and the indirect effects of transparency and trust (Estimate = 0.501, p < .001). Furthermore, consumers' affinity for technology moderates the direct effect of blockchain usage on participants' willingness to donate (Estimate = 0.150, p < .001). Donating via blockchain is a promising way for charities to engage consumers for several reasons: (1) Charities can emphasize trust and transparency in their advertising campaigns. (2) Established charities can target new customer segments by specifically engaging technology-affine consumers in the future. (3) Charities can raise international funds without previous barriers (e.g., setting up bank accounts). Nevertheless, increased transparency can also backfire (e.g., disclosure of costs). Such cases require further research.

Keywords: blockchain, social sector, transparency, trust

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271 Optimizing Usability Testing with Collaborative Method in an E-Commerce Ecosystem

Authors: Markandeya Kunchi

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Usability testing (UT) is one of the vital steps in the User-centred design (UCD) process when designing a product. In an e-commerce ecosystem, UT becomes primary as new products, features, and services are launched very frequently. And, there are losses attached to the company if an unusable and inefficient product is put out to market and is rejected by customers. This paper tries to answer why UT is important in the product life-cycle of an E-commerce ecosystem. Secondary user research was conducted to find out work patterns, development methods, type of stakeholders, and technology constraints, etc. of a typical E-commerce company. Qualitative user interviews were conducted with product managers and designers to find out the structure, project planning, product management method and role of the design team in a mid-level company. The paper tries to address the usual apprehensions of the company to inculcate UT within the team. As well, it stresses upon factors like monetary resources, lack of usability expert, narrow timelines, and lack of understanding of higher management as some primary reasons. Outsourcing UT to vendors is also very prevalent with mid-level e-commerce companies, but it has its own severe repercussions like very little team involvement, huge cost, misinterpretation of the findings, elongated timelines, and lack of empathy towards the customer, etc. The shortfalls of the unavailability of a UT process in place within the team and conducting UT through vendors are bad user experiences for customers while interacting with the product, badly designed products which are neither useful and nor utilitarian. As a result, companies see dipping conversions rates in apps and websites, huge bounce rates and increased uninstall rates. Thus, there was a need for a more lean UT system in place which could solve all these issues for the company. This paper highlights on optimizing the UT process with a collaborative method. The degree of optimization and structure of collaborative method is the highlight of this paper. Collaborative method of UT is one in which the centralised design team of the company takes for conducting and analysing the UT. The UT is usually a formative kind where designers take findings into account and uses in the ideation process. The success of collaborative method of UT is due to its ability to sync with the product management method employed by the company or team. The collaborative methods focus on engaging various teams (design, marketing, product, administration, IT, etc.) each with its own defined roles and responsibility in conducting a smooth UT with users In-house. The paper finally highlights the positive results of collaborative UT method after conducting more than 100 In-lab interviews with users across the different lines of businesses. Some of which are the improvement of interaction between stakeholders and the design team, empathy towards users, improved design iteration, better sanity check of design solutions, optimization of time and money, effective and efficient design solution. The future scope of collaborative UT is to make this method leaner, by reducing the number of days to complete the entire project starting from planning between teams to publishing the UT report.

Keywords: collaborative method, e-commerce, product management method, usability testing

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270 Feasibility and Acceptability of Mindfulness-Based Cognitive Therapy in People with Depression and Cardiovascular Disorders: A Feasibility Randomised Controlled Trial

Authors: Modi Alsubaie, Chris Dickens, Barnaby Dunn, Andy Gibson, Obioha Ukoumunned, Alison Evans, Rachael Vicary, Manish Gandhi, Willem Kuyken

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Background: Depression co-occurs in 20% of people with cardiovascular disorders, can persist for years and predicts worse physical health outcomes. While psychosocial treatments have been shown to effectively treat acute depression in those with comorbid cardiovascular disorders, to date there has been no evaluation of approaches aiming to prevent relapse and treat residual depression symptoms in this group. Therefore, the current study aimed to examine the feasibility and acceptability of a randomised controlled trial design evaluating an adapted version of mindfulness-based cognitive therapy (MBCT) designed specifically for people with co-morbid depression and cardiovascular disorders. Methods: A 3-arm feasibility randomised controlled trial was conducted, comparing MBCT adapted for people with cardiovascular disorders plus treatment as usual (TAU), mindfulness-based stress reduction (MBSR) plus TAU, and TAU alone. Participants completed a set of self-report measures of depression severity, anxiety, quality of life, illness perceptions, mindfulness, self-compassion and affect and had their blood pressure taken immediately before, immediately after, and three months following the intervention. Those in the adapted-MBCT arm additionally underwent a qualitative interview to gather their views about the adapted intervention. Results: 3400 potentially eligible participants were approached when attending an outpatient appointment at a cardiology clinic or via a GP letter following a case note search. 242 (7.1%) were interested in taking part, 59 (1.7%) were screened as being suitable, and 33 (<1%) were eventually randomised to the three groups. The sample was heterogeneous in terms of whether they reported current depression or had a history of depression and the time since the onset of cardiovascular disease (one to 25 years). Of 11 participants randomised to adapted MBCT seven completed the full course, levels of home mindfulness practice were high, and positive qualitative feedback about the intervention was given. Twenty-nine out of 33 participants randomised completed all the assessment measures at all three-time points. With regards to the primary outcome (depression), five out of the seven people who completed the adapted MBCT and three out of five under MBSR showed significant clinical change, while in TAU no one showed any clinical change at the three-month follow-up. Conclusions: The adapted MBCT intervention was feasible and acceptable to participants. However, aspects of the trial design were not feasible. In particular, low recruitment rates were achieved, and there was a high withdrawal rate between screening and randomisation. Moreover, the heterogeneity in the sample was high meaning the adapted intervention was unlikely to be well tailored to all participants needs. This suggests that if the decision is made to move to a definitive trial, study recruitment procedures will need to be revised to more successfully recruit a target sample that optimally matches the adapted intervention.

Keywords: mindfulness-based cognitive therapy (MBCT), depression, cardiovascular disorders, feasibility, acceptability

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269 Voices of the Students From a Fully Inclusive Classroom

Authors: Ashwini Tiwari

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Introduction: Inclusive education for all is a multifaceted approach that requires system thinking and the promotion of a "Culture of Inclusion." Such can only be achieved through the collaboration of multiple stakeholders at the community, regional, state, national, and international levels. Researchers have found effective practices used in inclusive general classrooms are beneficial to all students, including students with disabilities, those who experience challenges academically and socially, and students without disabilities as well. However, to date, no statistically significant effects on the academic performance of students without disabilities in the presence of students with disabilities have been revealed. Therefore, proponents against inclusive education practices, based solely on their beliefs regarding the detrimental effects of students without disabilities, appears to have unfounded perceptions. This qualitative case study examines students' perspectives and beliefs about inclusive education in a middle school in South Texas. More specifically, this study examined students understanding of how inclusive education practices intersect with the classroom community. The data was collected from the students attending fully inclusive classrooms through interviews and focus groups. The findings suggest that peer integration and friendships built during classes are an essential part of schooling for both disabled and non-disabled students. Research Methodology: This qualitative case study used observations and focus group interviews with 12 middle school students attending an inclusive classroom at a public school located in South Texas. The participant of this study includes eight females and five males. All the study participants attend a fully inclusive middle school with special needs peers. Five of the students had disabilities. The focus groups and interviews were conducted during for entire academic year, with an average of one focus group and observation each month. The data were analyzed using the constant comparative method. The data from the focus group and observation were continuously compared for emerging codes during the data collection process. Codes were further refined and merged. Themes emerged as a result of the interpretation at the end of the data analysis process. Findings and discussion: This study was conducted to examine disabled and non-disabled students' perspectives on the inclusion of disabled students. The study revealed that non-disabled students generally have positive attitudes toward their disabled peers. The students in the study did not perceive inclusion as a special provision; rather, they perceived inclusion as a way of instructional practice. Most of the participants in the study spoke about the multiple benefits of inclusion. They emphasized that peer integration and friendships built during classes are an essential part of their schooling. Students believed that it was part of their responsibility to assist their peers in the ways possible. This finding is in line with the literature that the personality of children with disabilities is not determined by their disability but rather by their social environment and its interaction with the child. Interactions with peers are one of the most important socio-cultural conditions for the development of children with disabilities.

Keywords: inclusion, special education, k-12 education, student voices

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268 Evaluation of Bagh Printing Motifs and Processes of Madhya Pradesh: From Past to Contemporary

Authors: Kaveri Dutta, Ratna Sharma

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Indian traditional textile is a synthesis of various cultures. Art and crafts of a country showcases the rich cultural and artistic history of that nation. Prehistorically Indian handicrafts were basically made for day to day use; the yearning for aesthetic application soon saw the development of flooding designs and motifs. Similarly, Bagh print a traditional hand block Print with natural colours an Indian handicraft practiced in Bagh, Madhya Pradesh(India). Bagh print has its roots in Sindh, which is now a part of Pakistan. The present form of Bagh printing actually started in 1962 when the craftsmen migrated from Manavar to the neighboring town of Bagh situated in Madhya Pradesh and hence Bagh has always been associated with this printing style. Bagh printing basically involved blocks that are carved onto motifs that represent flora such as Jasmine, Mushroom leheriya and so on. There are some prints that were inspired by the jaali work that embellished the Taj Mahal and various other forts. Inspiration is also drawn from the landscapes and geometrical figures. The motifs evoke various moods in the serenity of the prints and that is the catchy element of Bagh prints. The development in this traditional textile is as essential as in another field. Nowadays fashion trends are fragile and innovative changes over existing fashion field in the short span is the demand of times. We must make efforts to preserve this cultural heritage of arts and crafts and this is done either by documenting the various ancient traditions or by making a blend of it. Since this craft is well known over the world, but the need is to document the original motif, fabric, technology and colors used in contemporary fashion. Hence keeping above points in mind this study on bagh print textiles of Madhya Pradesh work has been formulated. The information incorporated in the paper was based on secondary data taken from relevant books, journals, museum visit and articles. Besides for the demographic details and working profile of the artisans dealt with printing, an interview schedule was carried out in three regions of Madhya Pradesh. This work of art was expressed in Cotton fabric. For this study selected traditional motifs for Bang printing was used. Some of the popular traditional Bagh motifs are Jasmine, Mushroom leheriya, geometrical figures and jaali work. The Bagh printed cotton fabrics were developed into a range of men’s ethic wear in combination with embroideries from Rajasthan. Products developed were bandhgala jackets, kurtas, serwani and dupattas. From the present study, it can be observed that the embellished traditional Bang printed range of ethnic men’s wear resulted in the fresh and colourful pattern. The embroidered Bagh printed cotton fabric also created a huge change in a positive way among artisans of the three regions.

Keywords: art and craft of Madhya Pradesh, evolution of printing in India, history of Bagh printing, sources of inspiration

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