Search results for: simulation-based teaching plan
Commenced in January 2007
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Paper Count: 4795

Search results for: simulation-based teaching plan

235 Development and Evaluation of a Cognitive Behavioural Therapy Based Smartphone App for Low Moods and Anxiety

Authors: David Bakker, Nikki Rickard

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Smartphone apps hold immense potential as mental health and wellbeing tools. Support can be made easily accessible and can be used in real-time while users are experiencing distress. Furthermore, data can be collected to enable machine learning and automated tailoring of support to users. While many apps have been developed for mental health purposes, few have adhered to evidence-based recommendations and even fewer have pursued experimental validation. This paper details the development and experimental evaluation of an app, MoodMission, that aims to provide support for low moods and anxiety, help prevent clinical depression and anxiety disorders, and serve as an adjunct to professional clinical supports. MoodMission was designed to deliver cognitive behavioural therapy for specifically reported problems in real-time, momentary interactions. Users report their low moods or anxious feelings to the app along with a subjective units of distress scale (SUDS) rating. MoodMission then provides a choice of 5-10 short, evidence-based mental health strategies called Missions. Users choose a Mission, complete it, and report their distress again. Automated tailoring, gamification, and in-built data collection for analysis of effectiveness was also included in the app’s design. The development process involved construction of an evidence-based behavioural plan, designing of the app, building and testing procedures, feedback-informed changes, and a public launch. A randomized controlled trial (RCT) was conducted comparing MoodMission to two other apps and a waitlist control condition. Participants completed measures of anxiety, depression, well-being, emotional self-awareness, coping self-efficacy and mental health literacy at the start of their app use and 30 days later. At the time of submission (November 2016) over 300 participants have participated in the RCT. Data analysis will begin in January 2017. At the time of this submission, MoodMission has over 4000 users. A repeated-measures ANOVA of 1390 completed Missions reveals that SUDS (0-10) ratings were significantly reduced between pre-Mission ratings (M=6.20, SD=2.39) and post-Mission ratings (M=4.93, SD=2.25), F(1,1389)=585.86, p < .001, np2=.30. This effect was consistent across both low moods and anxiety. Preliminary analyses of the data from the outcome measures surveys reveal improvements across mental health and wellbeing measures as a result of using the app over 30 days. This includes a significant increase in coping self-efficacy, F(1,22)=5.91, p=.024, np2=.21. Complete results from the RCT in which MoodMission was evaluated will be presented. Results will also be presented from the continuous outcome data being recorded by MoodMission. MoodMission was successfully developed and launched, and preliminary analysis suggest that it is an effective mental health and wellbeing tool. In addition to the clinical applications of MoodMission, the app holds promise as a research tool to conduct component analysis of psychological therapies and overcome restraints of laboratory based studies. The support provided by the app is discrete, tailored, evidence-based, and transcends barriers of stigma, geographic isolation, financial limitations, and low health literacy.

Keywords: anxiety, app, CBT, cognitive behavioural therapy, depression, eHealth, mission, mobile, mood, MoodMission

Procedia PDF Downloads 241
234 Quantifying the Aspect of ‘Imagining’ in the Map of Dialogical inquiry

Authors: Chua Si Wen Alicia, Marcus Goh Tian Xi, Eunice Gan Ghee Wu, Helen Bound, Lee Liang Ying, Albert Lee

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In a world full of rapid changes, people often need a set of skills to help them navigate an ever-changing workscape. These skills, often known as “future-oriented skills,” include learning to learn, critical thinking, understanding multiple perspectives, and knowledge creation. Future-oriented skills are typically assumed to be domain-general, applicable to multiple domains, and can be cultivated through a learning approach called Dialogical Inquiry. Dialogical Inquiry is known for its benefits of making sense of multiple perspectives, encouraging critical thinking, and developing learner’s capability to learn. However, it currently exists as a quantitative tool, which makes it hard to track and compare learning processes over time. With these concerns, the present research aimed to develop and validate a quantitative tool for the Map of Dialogical Inquiry, focusing Imagining aspect of learning. The Imagining aspect four dimensions: 1) speculative/ look for alternatives, 2) risk taking/ break rules, 3) create/ design, and 4) vision/ imagine. To do so, an exploratory literature review was conducted to better understand the dimensions of Imagining. This included deep-diving into the history of the creation of the Map of Dialogical Inquiry and a review on how “Imagining” has been conceptually defined in the field of social psychology, education, and beyond. Then, we synthesised and validated scales. These scales measured the dimension of Imagination and related concepts like creativity, divergent thinking regulatory focus, and instrumental risk. Thereafter, items were adapted from the aforementioned procured scales to form items that would contribute to the preliminary version of the Imagining Scale. For scale validation, 250 participants were recruited. A Confirmatory Factor Analysis (CFA) sought to establish dimensionality of the Imagining Scale with an iterative procedure in item removal. Reliability and validity of the scale’s dimensions were sought through measurements of Cronbach’s alpha, convergent validity, and discriminant validity. While CFA found that the distinction of Imagining’s four dimensions could not be validated, the scale was able to establish high reliability with a Cronbach alpha of .96. In addition, the convergent validity of the Imagining scale was established. A lack of strong discriminant validity may point to overlaps with other components of the Dialogical Map as a measure of learning. Thus, a holistic approach to forming the tool – encompassing all eight different components may be preferable.

Keywords: learning, education, imagining, pedagogy, dialogical teaching

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233 A Comparative Analysis of Liberation and Contemplation in Sankara and Aquinas

Authors: Zeite Shumneiyang Koireng

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Liberation is the act of liberating or the state of being liberated. Indian philosophy, in general, understands liberation as moksa, which etymological is derived from the Sanskrit root muc+ktin meaning to loose, set free, to let go, discharge, release, liberate, deliver, etc. According to Indian schools of thought, moksa is the highest value on realizing which nothing remains to be realized. It is the cessation of birth and death, all kinds of pain and at the same time, it is the realization of one’s own self. Sankara’s Advaita philosophy is based on the following propositions: Brahman is the only Reality; the world has apparent reality, and the soul is not different from Brahman. According to Sankara, Brahman is the basis on which the world form appears; it is the sustaining ground of all various modification. It is the highest self and the self of all reveals himself by dividing himself [ as it was in the form of various objects] in multiple ways. The whole world is the manifestation of the Supreme Being. Brahman modifying itself into the Atman or internal self of all things is the world. Since Brahman is the Upadhana karana of the world, the sruti speaks of the world as the modification of Brahman into the Atman of the effect. Contemplation as the fulfillment of man finds a radical foundation in Aquinas teaching concerning the natural end or as he also referred to it, natural desire. The third book of the Summa Contra Gentiles begins the study of happiness with a consideration of natural desire. According to him, all creatures, even those devoid of understanding are ordered to God as an ultimate end. Intrinsically, a part of every nature is a tendency or inclination, originating in the natural form and tendency toward the end for which the possessor of nature exists. It is the study of the nature and finality of inclination that Aquinas establishes through an argument of induction man’s Contemplation of God as the fulfillment of his nature. The present paper is attempted to critically approach two important, seminal and originated thought, representing Indian and Western traditions which mark on the thinking of their respective times. Both these thoughts- Advaitic concept of Liberation in the Indian tradition and the concept of Contemplation in Thomas Aquinas’ Summa Contra Gentiles’- confront directly the question of the ultimate meaning of human existence. According to Sankara, it is knowledge and knowledge alone which is the means of moksa and the highest knowledge is moksa itself. Liberation in Sankara Vedanta is attained as a process of purification of self, which gradually and increasingly turns into purer and purer intentional construction. Man’s inner natural tendency for Aquinas is towards knowledge. The human subject is driven to know more and more about reality and in particular about the highest reality. Contemplation of this highest reality is fulfillment in the philosophy of Aquinas. Rather, Contemplation is the perfect activity in man’s present state of existence.

Keywords: liberation, Brahman, contemplation, fulfillment

Procedia PDF Downloads 166
232 Combining the Production of Radiopharmaceuticals with the Department of Radionuclide Diagnostics

Authors: Umedov Mekhroz, Griaznova Svetlana

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In connection with the growth of oncological diseases, the design of centers for diagnostics and the production of radiopharmaceuticals is the most relevant area of healthcare facilities. The design of new nuclear medicine centers should be carried out from the standpoint of solving the following tasks: the availability of medical care, functionality, environmental friendliness, sustainable development, improving the safety of drugs, the use of which requires special care, reducing the rate of environmental pollution, ensuring comfortable conditions for the internal microclimate, adaptability. The purpose of this article is to substantiate architectural and planning solutions, formulate recommendations and principles for the design of nuclear medicine centers and determine the connections between the production and medical functions of a building. The advantages of combining the production of radiopharmaceuticals and the department of medical care: less radiation activity is accumulated, the cost of the final product is lower, and there is no need to hire a transport company with a special license for transportation. A medical imaging department is a structural unit of a medical institution in which diagnostic procedures are carried out in order to gain an idea of the internal structure of various organs of the body for clinical analysis. Depending on the needs of a particular institution, the department may include various rooms that provide medical imaging using radiography, ultrasound diagnostics, and the phenomenon of nuclear magnetic resonance. The production of radiopharmaceuticals is an object intended for the production of a pharmaceutical substance containing a radionuclide and intended for introduction into the human body or laboratory animal for the purpose of diagnosis, evaluation of the effectiveness of treatment, or for biomedical research. The research methodology includes the following subjects: study and generalization of international experience in scientific research, literature, standards, teaching aids, and design materials on the topic of research; An integrated approach to the study of existing international experience of PET / CT scan centers and the production of radiopharmaceuticals; Elaboration of graphical analysis and diagrams based on the system analysis of the processed information; Identification of methods and principles of functional zoning of nuclear medicine centers. The result of the research is the identification of the design principles of nuclear medicine centers with the functions of the production of radiopharmaceuticals and the department of medical imaging. This research will be applied to the design and construction of healthcare facilities in the field of nuclear medicine.

Keywords: architectural planning solutions, functional zoning, nuclear medicine, PET/CT scan, production of radiopharmaceuticals, radiotherapy

Procedia PDF Downloads 64
231 Comparative Quantitative Study on Learning Outcomes of Major Study Groups of an Information and Communication Technology Bachelor Educational Program

Authors: Kari Björn, Mikael Soini

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Higher Education system reforms, especially Finnish system of Universities of Applied Sciences in 2014 are discussed. The new steering model is based on major legislative changes, output-oriented funding and open information. The governmental steering reform, especially the financial model and the resulting institutional level responses, such as a curriculum reforms are discussed, focusing especially in engineering programs. The paper is motivated by management need to establish objective steering-related performance indicators and to apply them consistently across all educational programs. The close relationship to governmental steering and funding model imply that internally derived indicators can be directly applied. Metropolia University of Applied Sciences (MUAS) as a case institution is briefly introduced, focusing on engineering education in Information and Communications Technology (ICT), and its related programs. The reform forced consolidation of previously separate smaller programs into fewer units of student application. New curriculum ICT students have a common first year before they apply for a Major. A framework of parallel and longitudinal comparisons is introduced and used across Majors in two campuses. The new externally introduced performance criteria are applied internally on ICT Majors using data ex-ante and ex-post of program merger.  A comparative performance of the Majors after completion of joint first year is established, focusing on previously omitted Majors for completeness of analysis. Some new research questions resulting from transfer of Majors between campuses and quota setting are discussed. Practical orientation identifies best practices to share or targets needing most attention for improvement. This level of analysis is directly applicable at student group and teaching team level, where corrective actions are possible, when identified. The analysis is quantitative and the nature of the corrective actions are not discussed. Causal relationships and factor analysis are omitted, because campuses, their staff and various pedagogical implementation details contain still too many undetermined factors for our limited data. Such qualitative analysis is left for further research. Further study must, however, be guided by the relevance of the observations.

Keywords: engineering education, integrated curriculum, learning outcomes, performance measurement

Procedia PDF Downloads 202
230 A Deep Dive into the Multi-Pronged Nature of Student Engagement

Authors: Rosaline Govender, Shubnam Rambharos

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Universities are, to a certain extent, the source of under-preparedness ideologically, structurally, and pedagogically, particularly since organizational cultures often alienate students by failing to enable epistemological access. This is evident in the unsustainably low graduation rates that characterize South African higher education, which indicate that under 30% graduate in minimum time, under two-thirds graduate within 6 years, and one-third have not graduated after 10 years. Although the statistics for the Faculty of Accounting and Informatics at the Durban University of Technology (DUT) in South Africa have improved significantly from 2019 to 2021, the graduation (32%), throughput (50%), and dropout rates (16%) are still a matter for concern as the graduation rates, in particular, are quite similar to the national statistics. For our students to succeed, higher education should take a multi-pronged approach to ensure student success, and student engagement is one of the ways to support our students. Student engagement depends not only on students’ teaching and learning experiences but, more importantly, on their social and academic integration, their sense of belonging, and their emotional connections in the institution. Such experiences need to challenge students academically and engage their intellect, grow their communication skills, build self-discipline, and promote confidence. The aim of this mixed methods study is to explore the multi-pronged nature of student success within the Faculty of Accounting and Informatics at DUT and focuses on the enabling and constraining factors of student success. The sources of data were the Mid-year student experience survey (N=60), the Hambisa Student Survey (N=85), and semi structured focus group interviews with first, second, and third year students of the Faculty of Accounting and Informatics Hambisa program. The Hambisa (“Moving forward”) focus area is part of the Siyaphumelela 2.0 project at DUT and seeks to understand the multiple challenges that are impacting student success which create a large “middle” cohort of students that are stuck in transition within academic programs. Using the lens of the sociocultural influences on student engagement framework, we conducted a thematic analysis of the two surveys and focus group interviews. Preliminary findings indicate that living conditions, choice of program, access to resources, motivation, institutional support, infrastructure, and pedagogical practices impact student engagement and, thus, student success. It is envisaged that the findings from this project will assist the university in being better prepared to enable student success.

Keywords: social and academic integration, socio-cultural influences, student engagement, student success

Procedia PDF Downloads 46
229 Design of Experiment for Optimizing Immunoassay Microarray Printing

Authors: Alex J. Summers, Jasmine P. Devadhasan, Douglas Montgomery, Brittany Fischer, Jian Gu, Frederic Zenhausern

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Immunoassays have been utilized for several applications, including the detection of pathogens. Our laboratory is in the development of a tier 1 biothreat panel utilizing Vertical Flow Assay (VFA) technology for simultaneous detection of pathogens and toxins. One method of manufacturing VFA membranes is with non-contact piezoelectric dispensing, which provides advantages, such as low-volume and rapid dispensing without compromising the structural integrity of antibody or substrate. Challenges of this processinclude premature discontinuation of dispensing and misaligned spotting. Preliminary data revealed the Yp 11C7 mAb (11C7)reagent to exhibit a large angle of failure during printing which may have contributed to variable printing outputs. A Design of Experiment (DOE) was executed using this reagent to investigate the effects of hydrostatic pressure and reagent concentration on microarray printing outputs. A Nano-plotter 2.1 (GeSIM, Germany) was used for printing antibody reagents ontonitrocellulose membrane sheets in a clean room environment. A spotting plan was executed using Spot-Front-End software to dispense volumes of 11C7 reagent (20-50 droplets; 1.5-5 mg/mL) in a 6-test spot array at 50 target membrane locations. Hydrostatic pressure was controlled by raising the Pressure Compensation Vessel (PCV) above or lowering it below our current working level. It was hypothesized that raising or lowering the PCV 6 inches would be sufficient to cause either liquid accumulation at the tip or discontinue droplet formation. After aspirating 11C7 reagent, we tested this hypothesis under stroboscope.75% of the effective raised PCV height and of our hypothesized lowered PCV height were used. Humidity (55%) was maintained using an Airwin BO-CT1 humidifier. The number and quality of membranes was assessed after staining printed membranes with dye. The droplet angle of failure was recorded before and after printing to determine a “stroboscope score” for each run. The DOE set was analyzed using JMP software. Hydrostatic pressure and reagent concentration had a significant effect on the number of membranes output. As hydrostatic pressure was increased by raising the PCV 3.75 inches or decreased by lowering the PCV -4.5 inches, membrane output decreased. However, with the hydrostatic pressure closest to equilibrium, our current working level, membrane output, reached the 50-membrane target. As the reagent concentration increased from 1.5 to 5 mg/mL, the membrane output also increased. Reagent concentration likely effected the number of membrane output due to the associated dispensing volume needed to saturate the membranes. However, only hydrostatic pressure had a significant effect on stroboscope score, which could be due to discontinuation of dispensing, and thus the stroboscope check could not find a droplet to record. Our JMP predictive model had a high degree of agreement with our observed results. The JMP model predicted that dispensing the highest concentration of 11C7 at our current PCV working level would yield the highest number of quality membranes, which correlated with our results. Acknowledgements: This work was supported by the Chemical Biological Technologies Directorate (Contract # HDTRA1-16-C-0026) and the Advanced Technology International (Contract # MCDC-18-04-09-002) from the Department of Defense Chemical and Biological Defense program through the Defense Threat Reduction Agency (DTRA).

Keywords: immunoassay, microarray, design of experiment, piezoelectric dispensing

Procedia PDF Downloads 152
228 The Acquisition of Spanish L4 by Learners with Croatian L1, English L2 and Italian L3

Authors: Barbara Peric

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The study of acquiring a third and additional language has garnered significant focus within second language acquisition (SLA) research. Initially, it was commonly viewed as merely an extension of second language acquisition (SLA). However, in the last two decades, numerous researchers have emphasized the need to recognize the unique characteristics of third language acquisition (TLA). This recognition is crucial for understanding the intricate cognitive processes that arise from the interaction of more than two linguistic systems in the learner's mind. This study investigates cross-linguistic influences in the acquisition of Spanish as a fourth language by students who have Croatian as a first language (L1). English as a second language (L2), and Italian as a third language (L3). Observational data suggests that influence or transfer of linguistic elements can arise not only from one's native language (L1) but also from non-native languages. This implies that, for individuals proficient in multiple languages, the native language doesn't consistently hold a superior position. Instead, it should be examined alongside other potential sources of linguistic transfer. Earlier studies have demonstrated that high proficiency in a second language can significantly impact cross-linguistic influences when acquiring a third and additional language. Among the extensively examined factors, the typological relationship stands out as one of the most scrutinized variables. The goal of the present study was to explore whether language typology and formal similarity or proficiency in the second language had a more significant impact on L4 acquisition. Participants in this study were third-year undergraduate students at Rochester Institute of Technology’s subsidiary in Croatia (RIT Croatia). All the participants had exclusively Croatian as L1, English as L2, Italian as L3 and were learning Spanish as L4 at the time of the study. All the participants had a high level of proficiency in English and low level of proficiency in Italian. Based on the error analysis the findings indicate that for some types of lexical errors such as coinage, language typology had a more significant impact and Italian language was the preferred source of transfer despite the law proficiency in that language. For some other types of lexical errors, such as calques, second language proficiency had a more significant impact, and English language was the preferred source of transfer. On the other hand, Croatian, Italian, and Spanish are more similar in the area of morphology due to higher degree of inflection compared to English and the strongest influence of the Croatian language was precisely in the area of morphology. The results emphasize the need to consider linguistic resemblances between the native language (L1) and the third and additional language as well as the learners' proficiency in the second language when developing successful teaching strategies for acquiring the third and additional language. These conclusions add to the expanding knowledge in the realm of Second Language Acquisition (SLA) and offer practical insights for language educators aiming to enhance the effectiveness of learning experiences in acquiring a third and additional language.

Keywords: third and additional language acquisition, cross-linguistic influences, language proficiency, language typology

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227 Opportunities and Challenges in Midwifery Education: A Literature Review

Authors: Abeer M. Orabi

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Midwives are being seen as a key factor in returning birth care to a normal physiologic process that is woman-centered. On the other hand, more needs to be done to increase access for every woman to professional midwifery care. Because of the nature of the midwifery specialty, the magnitude of the effect that can result from a lack of knowledge if midwives make a mistake in their care has the potential to affect a large number of the birthing population. So, the development, running, and management of midwifery educational programs should follow international standards and come after a thorough community needs assessment. At the same time, the number of accredited midwifery educational programs needs to be increased so that larger numbers of midwives will be educated and qualified, as well as access to skilled midwifery care will be increased. Indeed, the selection of promising midwives is important for the successful completion of an educational program, achievement of the program goals, and retention of graduates in the field. Further, the number of schooled midwives in midwifery education programs, their background, and their experience constitute some concerns in the higher education industry. Basically, preceptors and clinical sites are major contributors to the midwifery education process, as educational programs rely on them to provide clinical practice opportunities. In this regard, the selection of clinical training sites should be based on certain criteria to ensure their readiness for the intended training experiences. After that, communication, collaboration, and liaison between teaching faculty and field staff should be maintained. However, the shortage of clinical preceptors and the massive reduction in the number of practicing midwives, in addition to unmanageable workloads, act as significant barriers to midwifery education. Moreover, the medicalized approach inherent in the hospital setting makes it difficult to practice the midwifery model of care, such as watchful waiting, non-interference in normal processes, and judicious use of interventions. Furthermore, creating a motivating study environment is crucial for avoiding unnecessary withdrawal and retention in any educational program. It is well understood that research is an essential component of any profession for achieving its optimal goal and providing a foundation and evidence for its practices, and midwifery is no exception. Midwives have been playing an important role in generating their own research. However, the selection of novel, researchable, and sustainable topics considering community health needs is also a challenge. In conclusion, ongoing education and research are the lifeblood of the midwifery profession to offer a highly competent and qualified workforce. However, many challenges are being faced, and barriers are hindering their improvement.

Keywords: barriers, challenges, midwifery education, educational programs

Procedia PDF Downloads 91
226 Emotional State and Cognitive Workload during a Flight Simulation: Heart Rate Study

Authors: Damien Mouratille, Antonio R. Hidalgo-Muñoz, Nadine Matton, Yves Rouillard, Mickael Causse, Radouane El Yagoubi

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Background: The monitoring of the physiological activity related to mental workload (MW) on pilots will be useful to improve aviation safety by anticipating human performance degradation. The electrocardiogram (ECG) can reveal MW fluctuations due to either cognitive workload or/and emotional state since this measure exhibits autonomic nervous system modulations. Arguably, heart rate (HR) is one of its most intuitive and reliable parameters. It would be particularly interesting to analyze the interaction between cognitive requirements and emotion in ecologic sets such as a flight simulator. This study aims to explore by means of HR the relation between cognitive demands and emotional activation. Presumably, the effects of cognition and emotion overloads are not necessarily cumulative. Methodology: Eight healthy volunteers in possession of the Private Pilot License were recruited (male; 20.8±3.2 years). ECG signal was recorded along the whole experiment by placing two electrodes on the clavicle and left pectoral of the participants. The HR was computed within 4 minutes segments. NASA-TLX and Big Five inventories were used to assess subjective workload and to consider the influence of individual personality differences. The experiment consisted in completing two dual-tasks of approximately 30 minutes of duration into a flight simulator AL50. Each dual-task required the simultaneous accomplishment of both a pre-established flight plan and an additional task based on target stimulus discrimination inserted between Air Traffic Control instructions. This secondary task allowed us to vary the cognitive workload from low (LC) to high (HC) levels, by combining auditory and visual numerical stimuli to respond to meeting specific criteria. Regarding emotional condition, the two dual-tasks were designed to assure analogous difficulty in terms of solicited cognitive demands. The former was realized by the pilot alone, i.e. Low Arousal (LA) condition. In contrast, the latter generates a high arousal (HA), since the pilot was supervised by two evaluators, filmed and involved into a mock competition with the rest of the participants. Results: Performance for the secondary task showed significant faster reaction times (RT) for HA compared to LA condition (p=.003). Moreover, faster RT was found for LC compared to HC (p < .001) condition. No interaction was found. Concerning HR measure, despite the lack of main effects an interaction between emotion and cognition is evidenced (p=.028). Post hoc analysis showed smaller HR for HA compared to LA condition only for LC (p=.049). Conclusion. The control of an aircraft is a very complex task including strong cognitive demands and depends on the emotional state of pilots. According to the behavioral data, the experimental set has permitted to generate satisfactorily different emotional and cognitive levels. As suggested by the interaction found in HR measure, these two factors do not seem to have a cumulative impact on the sympathetic nervous system. Apparently, low cognitive workload makes pilots more sensitive to emotional variations. These results hint the independency between data processing and emotional regulation. Further physiological data are necessary to confirm and disentangle this relation. This procedure may be useful for monitoring objectively pilot’s mental workload.

Keywords: cognitive demands, emotion, flight simulator, heart rate, mental workload

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225 Multicenter Baseline Survey to Outline Antimicrobial Prescribing Practices at Six Public Sectortertiary Care Hospitals in a Low Middle Income Country

Authors: N. Khursheed, M. Fatima, S. Jamal, A. Raza, S. Rattani, Q. Ahsan, A. Rasheed, M. Jawed

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Introduction: Antibiotics are among the commonly prescribed medicines to treat bacterial infections. Their misuse intensifies resistance, and overuse incurs heavy losses to the healthcare system in terms of increased treatment costs and enhanced disease burden. Studies show that 40% of empirically used antibiotics are irrationally utilized. The objective of this study was to evaluate prescribing pattern of antibiotics at six public sector tertiary care hospitals across Pakistan. Methods: A multicenter cross-sectional point prevalence survey (PPS) was conducted in selected wards of six public sector tertiary care hospitals in Pakistan as part of the Clinical Engagement program by Fleming Fund Country Grant Pakistan in collaboration with Indus Hospital & Health Network (IHHN) from February to March 2021, these included Jinnah Postgraduate Medical Center and Dr. Ruth K. M. Pfau Civil Hospital from Karachi, Sheikh Zayed Hospital Lahore, Nishtar Medical University Hospital Multan, Medical Teaching Institute Hayatabad Medical Complex Peshawar, and Provincial Headquarters Hospital Gilgit. WHO PPS methodology was used for data collection (Hospital, ward, and patient level data was collected). Data was entered into the open-source Kobo Collect application and was analyzed using SPSS (version 22.0). Findings: Medical records of 837 in-patients were surveyed, of which the prevalence of antibiotics use was 78.5%. The most commonly prescribed antimicrobial was Ceftriaxone (21.7%) which is categorized in the Watch group of WHO AWaRe Classification, followed by Metronidazole (17.3%), Cefoperazone/Sulbactam (8.4%), Co-Amoxiclav (6.3%) and Piperacillin/Tazobactam (5.9%). The antibiotics were prescribed largely for surgical prophylaxis (36.7%), followed by community-acquired infections (24.7%). One antibiotic was prescribed to 46.7%, two to 39.9%, and three or more to 12.5 %. Two of six (30%) hospitals had functional drug and therapeutic committees, three (50%) had infection prevention and control committees, and one facility had an antibiotic formulary. Conclusion: Findings demonstrate high consumption of broad-spectrum antimicrobials and emphasizes the importance of expanding the antimicrobial stewardship program. Mentoring clinical teams will help to rationalize antimicrobial use.

Keywords: antimicrobial resistance, antimicrobial stewardship, point prevalence survey, antibiotics

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224 Investigating Reading Comprehension Proficiency and Self-Efficacy among Algerian EFL Students within Collaborative Strategic Reading Approach and Attributional Feedback Intervention

Authors: Nezha Badi

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It has been shown in the literature that Algerian university students suffer from low levels of reading comprehension proficiency, which hinder their overall proficiency in English. This low level is mainly related to the methodology of teaching reading which is employed by the teacher in the classroom (a teacher-centered environment), as well as students’ poor sense of self-efficacy to undertake reading comprehension activities. Arguably, what is needed is an approach necessary for enhancing students’ self-beliefs about their abilities to deal with different reading comprehension activities. This can be done by providing them with opportunities to take responsibility for their own learning (learners’ autonomy). As a result of learning autonomy, learners’ beliefs about their abilities to deal with certain language tasks may increase, and hence, their language learning ability. Therefore, this experimental research study attempts to assess the extent to which an integrated approach combining one particular reading approach known as ‘collaborative strategic reading’ (CSR), and teacher’s attributional feedback (on students’ reading performance and strategy use) can improve the reading comprehension skill and the sense of self-efficacy of EFL Algerian university students. It also seeks to examine students’ main reasons for their successful or unsuccessful achievements in reading comprehension activities, and whether students’ attributions for their reading comprehension outcomes can be modified after exposure to the instruction. To obtain the data, different tools including a reading comprehension test, questionnaires, an observation, an interview, and learning logs were used with 105 second year Algerian EFL university students. The sample of the study was divided into three groups; one control group (with no treatment), one experimental group (CSR group) who received a CSR instruction, and a second intervention group (CSR Plus group) who received teacher’s attribution feedback in addition to the CSR intervention. Students in the CSR Plus group received the same experiment as the CSR group using the same tools, except that they were asked to keep learning logs, for which teacher’s feedback on reading performance and strategy use was provided. The results of this study indicate that the CSR and the attributional feedback intervention was effective in improving students’ reading comprehension proficiency and sense of self-efficacy. However, there was not a significant change in students’ adaptive and maladaptive attributions for their success and failure d from the pre-test to the post-test phase. Analysis of the perception questionnaire, the interview, and the learning logs shows that students have positive perceptions about the CSR and the attributional feedback instruction. Based on the findings, this study, therefore, seeks to provide EFL teachers in general and Algerian EFL university teachers in particular with pedagogical implications on how to teach reading comprehension to their students to help them achieve well and feel more self-efficacious in reading comprehension activities, and in English language learning more generally.

Keywords: attributions, attributional feedback, collaborative strategic reading, self-efficacy

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223 The Degree Project-Course in Swedish Teacher Education – Deliberative and Transformative Perspectives on the Formative Assessment Practice

Authors: Per Blomqvist

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The overall aim of this study is to highlight how the degree project-course in teacher education has developed over time at Swedish universities, above all regarding changes in the formative assessment practices in relation to student's opportunities to take part in writing processes that can develop both their independent critical thinking, subject knowledge, and academic writing skills. Theoretically, the study is based on deliberative and transformative perspectives of teaching academic writing in higher education. The deliberative perspective is motivated by the fact that it is the universities and their departments' responsibility to give the students opportunities to develop their academic writing skills, while there is little guidance on how this can be implemented. The transformative perspective is motivated by the fact that education needs to be adapted to the student's prior knowledge and developed in relation to the student group. Given the academisation of education and the new student groups, this is a necessity. The empirical data consists of video recordings of teacher groups' conversations at three Swedish universities. The conversations were conducted as so-called collective remembering interviews, a method to stimulate the participants' memory through social interaction, and focused on addressing issues on how the degree project-course in teacher education has changed over time. Topic analysis was used to analyze the conversations in order to identify common descriptions and expressions among the teachers. The result highlights great similarities in how the degree project-course has changed over time, both from a deliberative and a transformative perspective. The course is characterized by a “strong framing,” where the teachers have great control over the work through detailed instructions for the writing process and detailed templates for the text. This is justified by the fact that the education has been adapted based on the student teachers' lack of prior subject knowledge. The strong framing places high demands on continuous discussions between teachers about, for example, which tools the students have with them and which linguistic and textual tools are offered in the education. The teachers describe that such governance often leads to conflicts between teachers from different departments because reading and writing are always part of cultural contexts and are linked to different knowledge, traditions, and values. The problem that is made visible in this study raises questions about how students' opportunities to develop independence and make critical judgments in academic writing are affected if the writing becomes too controlled and if passing students becomes the main goal of education.

Keywords: formative assessment, academic writing, degree project, higher education, deliberative perspective, transformative perspective

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222 Calpoly Autonomous Transportation Experience: Software for Driverless Vehicle Operating on Campus

Authors: F. Tang, S. Boskovich, A. Raheja, Z. Aliyazicioglu, S. Bhandari, N. Tsuchiya

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Calpoly Autonomous Transportation Experience (CATE) is a driverless vehicle that we are developing to provide safe, accessible, and efficient transportation of passengers throughout the Cal Poly Pomona campus for events such as orientation tours. Unlike the other self-driving vehicles that are usually developed to operate with other vehicles and reside only on the road networks, CATE will operate exclusively on walk-paths of the campus (potentially narrow passages) with pedestrians traveling from multiple locations. Safety becomes paramount as CATE operates within the same environment as pedestrians. As driverless vehicles assume greater roles in today’s transportation, this project will contribute to autonomous driving with pedestrian traffic in a highly dynamic environment. The CATE project requires significant interdisciplinary work. Researchers from mechanical engineering, electrical engineering and computer science are working together to attack the problem from different perspectives (hardware, software and system). In this abstract, we describe the software aspects of the project, with a focus on the requirements and the major components. CATE shall provide a GUI interface for the average user to interact with the car and access its available functionalities, such as selecting a destination from any origin on campus. We have developed an interface that provides an aerial view of the campus map, the current car location, routes, and the goal location. Users can interact with CATE through audio or manual inputs. CATE shall plan routes from the origin to the selected destination for the vehicle to travel. We will use an existing aerial map for the campus and convert it to a spatial graph configuration where the vertices represent the landmarks and edges represent paths that the car should follow with some designated behaviors (such as stay on the right side of the lane or follow an edge). Graph search algorithms such as A* will be implemented as the default path planning algorithm. D* Lite will be explored to efficiently recompute the path when there are any changes to the map. CATE shall avoid any static obstacles and walking pedestrians within some safe distance. Unlike traveling along traditional roadways, CATE’s route directly coexists with pedestrians. To ensure the safety of the pedestrians, we will use sensor fusion techniques that combine data from both lidar and stereo vision for obstacle avoidance while also allowing CATE to operate along its intended route. We will also build prediction models for pedestrian traffic patterns. CATE shall improve its location and work under a GPS-denied situation. CATE relies on its GPS to give its current location, which has a precision of a few meters. We have implemented an Unscented Kalman Filter (UKF) that allows the fusion of data from multiple sensors (such as GPS, IMU, odometry) in order to increase the confidence of localization. We also noticed that GPS signals can easily get degraded or blocked on campus due to high-rise buildings or trees. UKF can also help here to generate a better state estimate. In summary, CATE will provide on-campus transportation experience that coexists with dynamic pedestrian traffic. In future work, we will extend it to multi-vehicle scenarios.

Keywords: driverless vehicle, path planning, sensor fusion, state estimate

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221 Street Naming and Property Addressing Systems for New Development in Ghana: A Case Study of Nkawkaw in the Kwahu West Municipality

Authors: Jonathan Nii Laryea Ashong, Samuel Opare

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Current sustainable cities debate focuses on the formidable problems for the Ghana’s largest urban and rural agglomerations, the majority of all urban dwellers continue to reside in far smaller urban settlements. It is estimated that by year 2030, almost all the Ghana’s population growth will likely be intense in urban areas including Nkawkaw in the Kwahu West Municipality of Ghana. Nkawkaw is situated on the road and former railway between Accra and Kumasi, and lies about halfway between these cities. It is also connected by road to Koforidua and Konongo. According to the 2013 census, Nkawkaw has a settlement population of 61,785. Many international agencies, government and private architectures’ are been asked to adequately recognize the naming of streets and property addressing system among the 170 districts across Ghana. The naming of streets and numbering of properties is to assist Metropolitan, Municipal and District Assemblies to manage the processes for establishing coherent address system nationally. Street addressing in the Nkawkaw in the Kwahu West Municipality which makes it possible to identify the location of a parcel of land, public places or dwellings on the ground based on system of names and numbers, yet agreement on how to progress towards it remains elusive. Therefore, reliable and effective development control for proper street naming and property addressing systems are required. The Intelligent Addressing (IA) technology from the UK is being used to name streets and properties in Ghana. The intelligent addressing employs the technique of unique property Reference Number and the unique street reference number which would transform national security and other service providers’ ability to respond rapidly to distress calls. Where name change is warranted following the review of existing streets names, the Physical Planning Department (PPDs) shall, in consultation with the relevant traditional authorities and community leadership (or relevant major stakeholders), select a street name in accordance with the provisions of the policy and the processes outlined for street name change for new development. In the case of existing streets with no names, the respective PPDs shall, in consultation with the relevant traditional authorities and community leadership (or relevant major stakeholders), select a street name in accordance with the requirements set out in municipality. Naming of access ways proposed for new developments shall be done at the time of developing sector layouts (subdivision maps) for the designated areas. In the case of private gated developments, the developer shall submit the names of the access ways as part of the plan and other documentation forwarded to the Municipal District Assembly for approval. The names shall be reviewed first by the PPD to avoid duplication and to ensure conformity to the required standards before submission to the Assembly’s Statutory Planning Committee for approval. The Kwahu West Municipality is supposed to be self-sustaining, providing basic services to inhabitants as a result of proper planning layouts, street naming and property addressing system that prevail in the area. The implications of these future projections are discussed.

Keywords: Nkawkaw, Kwahu west municipality, street naming, property, addressing system

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220 Study of the Diaphragm Flexibility Effect on the Inelastic Seismic Response of Thin Wall Reinforced Concrete Buildings (TWRCB): A Purpose to Reduce the Uncertainty in the Vulnerability Estimation

Authors: A. Zapata, Orlando Arroyo, R. Bonett

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Over the last two decades, the growing demand for housing in Latin American countries has led to the development of construction projects based on low and medium-rise buildings with thin reinforced concrete walls. This system, known as Thin Walls Reinforced Concrete Buildings (TWRCB), uses walls with thicknesses from 100 to 150 millimetres, with flexural reinforcement formed by welded wire mesh (WWM) with diameters between 5 and 7 millimetres, arranged in one or two layers. These walls often have irregular structural configurations, including combinations of rectangular shapes. Experimental and numerical research conducted in regions where this structural system is commonplace indicates inherent weaknesses, such as limited ductility due to the WWM reinforcement and thin element dimensions. Because of its complexity, numerical analyses have relied on two-dimensional models that don't explicitly account for the floor system, even though it plays a crucial role in distributing seismic forces among the resilient elements. Nonetheless, the numerical analyses assume a rigid diaphragm hypothesis. For this purpose, two study cases of buildings were selected, low-rise and mid-rise characteristics of TWRCB in Colombia. The buildings were analyzed in Opensees using the MVLEM-3D for walls and shell elements to simulate the slabs to involve the effect of coupling diaphragm in the nonlinear behaviour. Three cases are considered: a) models without a slab, b) models with rigid slabs, and c) models with flexible slabs. An incremental static (pushover) and nonlinear dynamic analyses were carried out using a set of 44 far-field ground motions of the FEMA P-695, scaled to 1.0 and 1.5 factors to consider the probability of collapse for the design base earthquake (DBE) and the maximum considered earthquake (MCE) for the model, according to the location sites and hazard zone of the archetypes in the Colombian NSR-10. Shear base capacity, maximum displacement at the roof, walls shear base individual demands and probabilities of collapse were calculated, to evaluate the effect of absence, rigid and flexible slabs in the nonlinear behaviour of the archetype buildings. The pushover results show that the building exhibits an overstrength between 1.1 to 2 when the slab is considered explicitly and depends on the structural walls plan configuration; additionally, the nonlinear behaviour considering no slab is more conservative than if the slab is represented. Include the flexible slab in the analysis remarks the importance to consider the slab contribution in the shear forces distribution between structural elements according to design resistance and rigidity. The dynamic analysis revealed that including the slab reduces the collapse probability of this system due to have lower displacements and deformations, enhancing the safety of residents and the seismic performance. The strategy of including the slab in modelling is important to capture the real effect on the distribution shear forces in walls due to coupling to estimate the correct nonlinear behaviour in this system and the adequate distribution to proportionate the correct resistance and rigidity of the elements in the design to reduce the possibility of damage to the elements during an earthquake.

Keywords: thin wall reinforced concrete buildings, coupling slab, rigid diaphragm, flexible diaphragm

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219 Assessing Professionalism, Communication, and Collaboration among Emergency Physicians by Implementing a 360-Degree Evaluation

Authors: Ahmed Al Ansari, Khalid Al Khalifa

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Objective: Multisource feedback (MSF), also called the 360-Degree evaluation is an evaluation process by which questionnaires are distributed amongst medical peers and colleagues to assess physician performance from different sources other than the attending or the supervising physicians. The aim of this study was to design, implement, and evaluate a 360-Degree process in assessing emergency physicians trainee in the Kingdom of Bahrain. Method: The study was undertaken in Bahrain Defense Force Hospital which is a military teaching hospital in the Kingdom of Bahrain. Thirty emergency physicians (who represent the total population of the emergency physicians in our hospital) were assessed in this study. We developed an instrument modified from the Physician achievement review instrument PAR which was used to assess Physician in Alberta. We focused in our instrument to assess professionalism, communication skills and collaboration only. To achieve face and content validity, table of specification was constructed and a working group was involved in constructing the instrument. Expert opinion was considered as well. The instrument consisted of 39 items; were 15 items to assess professionalism, 13 items to assess communication skills, and 11 items to assess collaboration. Each emergency physicians was evaluated with 3 groups of raters, 4 Medical colleague emergency physicians, 4 medical colleague who are considered referral physicians from different departments, and 4 Coworkers from the emergency department. Independent administrative team was formed to carry on the responsibility of distributing the instruments and collecting them in closed envelopes. Each envelope was consisted of that instrument and a guide for the implementation of the MSF and the purpose of the study. Results: A total of 30 emergency physicians 16 males and 14 females who represent the total number of the emergency physicians in our hospital were assessed. The total collected forms is 269, were 105 surveys from coworkers working in emergency department, 93 surveys from medical colleague emergency physicians, and 116 surveys from referral physicians from different departments. The total mean response rates were 71.2%. The whole instrument was found to be suitable for factor analysis (KMO = 0.967; Bartlett test significant, p<0.00). Factor analysis showed that the data on the questionnaire decomposed into three factors which counted for 72.6% of the total variance: professionalism, collaboration, and communication. Reliability analysis indicated that the instrument full scale had high internal consistency (Cronbach’s α 0.98). The generalizability coefficients (Ep2) were 0.71 for the surveys. Conclusions: Based on the present results, the current instruments and procedures have high reliability, validity, and feasibility in assessing emergency physicians trainee in the emergency room.

Keywords: MSF system, emergency, validity, generalizability

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218 Investigating Student Behavior in Adopting Online Formative Assessment Feedback

Authors: Peter Clutterbuck, Terry Rowlands, Owen Seamons

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In this paper we describe one critical research program within a complex, ongoing multi-year project (2010 to 2014 inclusive) with the overall goal to improve the learning outcomes for first year undergraduate commerce/business students within an Information Systems (IS) subject with very large enrolment. The single research program described in this paper is the analysis of student attitudes and decision making in relation to the availability of formative assessment feedback via Web-based real time conferencing and document exchange software (Adobe Connect). The formative assessment feedback between teaching staff and students is in respect of an authentic problem-based, team-completed assignment. The analysis of student attitudes and decision making is investigated via both qualitative (firstly) and quantitative (secondly) application of the Theory of Planned Behavior (TPB) with a two statistically-significant and separate trial samples of the enrolled students. The initial qualitative TPB investigation revealed that perceived self-efficacy, improved time-management, and lecturer-student relationship building were the major factors in shaping an overall favorable student attitude to online feedback, whilst some students expressed valid concerns with perceived control limitations identified within the online feedback protocols. The subsequent quantitative TPB investigation then confirmed that attitude towards usage, subjective norms surrounding usage, and perceived behavioral control of usage were all significant in shaping student intention to use the online feedback protocol, with these three variables explaining 63 percent of the variance in the behavioral intention to use the online feedback protocol. The identification in this research of perceived behavioral control as a significant determinant in student usage of a specific technology component within a virtual learning environment (VLE) suggests that VLEs could now be viewed not as a single, atomic entity, but as a spectrum of technology offerings ranging from the mature and simple (e.g., email, Web downloads) to the cutting-edge and challenging (e.g., Web conferencing and real-time document exchange). That is, that all VLEs should not be considered the same. The results of this research suggest that tertiary students have the technological sophistication to assess a VLE in this more selective manner.

Keywords: formative assessment feedback, virtual learning environment, theory of planned behavior, perceived behavioral control

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217 Audit Examining Maternity Assessment Suite Triage Compliance with Birmingham Symptom Specific Obstetric Triage System in a London Teaching Hospital

Authors: Sarah Atalla, Shubham Gupta, Kim Alipio, Tanya Maric

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Background: Chelsea and Westminster Hospital have introduced the Birmingham Symptom Specific Obstetric Triage System (BSOTS) for patients who present acutely to the Maternity Assessment Suite (MAS) to prioritise care by urgency. The primary objective was to evaluate whether BSOTS was used appropriately to assess patients (defined as a 90% threshold). The secondary objective was to assess whether patients were seen within their designated triaged timeframe (defined as a 90% threshold). Methodology: MAS records were retrospectively reviewed for a randomly selected one-week period of data from 2020 (21/09/2020 - 27/09/2020). 189 patients presented to MAS during this time. Data were collected on the presenting complaint, time of attendance (divided into four time categories), and triage colour code for the urgency of a review by a doctor (red: immediately, orange: within 15 minutes, yellow: within 1 hour, green: within 4 hours). The number of triage waiting times that were breached and the outcome of the attendance was noted. Results: 49% of patients presenting to MAS during this time period were triaged, which therefore did not meet the 90% target. 67% of patients who were triaged were seen within their allocated timeframe as designated by their triage colour code, which therefore did not meet the 90% target. The most frequent reason for patient attendance was reduced fetal movements (30.5% of attendances). The busiest time of day (when most patients presented) was between 06:01-12:00, and this was also when the highest number of patients were not triaged (26 patients or 54% of patients presenting in this time category). The most used triage category (59%) was the green colour code (to be seen by a doctor within 4 hours), followed by orange (24%), yellow (14%), and red (3%). 45% of triaged patients were admitted, whilst 55% were discharged. 62% of patients allocated to the green triage category were discharged, as compared to 56% of yellow category patients, 27% of orange category patients, and 50% of red category patients. The time of patient presentation to the hospital was also associated with the level of urgency and outcome. Patients presenting from 12:01 to 18:00 were more likely to be discharged (72% discharged) compared to 00:01-06:00 where only 12.5% of patients were discharged. Conclusion: The triage system for assessing the urgency of acutely presenting obstetric patients is only being effectively utilised for 49% of patients. There is potential for enhancing the employment of the triage system to enable further efficiency and boost the promotion of patient safety. It is noted that MAS was busiest at 06:01 - 12:00 when there was also the highest number of non-triaged patients – this highlights some areas where we can improve, including higher levels of staffing, better use of BSOTS to triage patients, and patient education.

Keywords: birmingham, BSOTS, maternal, obstetric, pregnancy, specific, symptom, triage

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216 Accomplishing Mathematical Tasks in Bilingual Primary Classrooms

Authors: Gabriela Steffen

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Learning in a bilingual classroom not only implies learning in two languages or in an L2, it also means learning content subjects through the means of bilingual or plurilingual resources, which is of a qualitatively different nature than ‘monolingual’ learning. These resources form elements of a didactics of plurilingualism, aiming not only at the development of a plurilingual competence, but also at drawing on plurilingual resources for nonlinguistic subject learning. Applying a didactics of plurilingualism allows for taking account of the specificities of bilingual content subject learning in bilingual education classrooms. Bilingual education is used here as an umbrella term for different programs, such as bilingual education, immersion, CLIL, bilingual modules in which one or several non-linguistic subjects are taught partly or completely in an L2. This paper aims at discussing first results of a study on pupil group work in bilingual classrooms in several Swiss primary schools. For instance, it analyses two bilingual classes in two primary schools in a French-speaking region of Switzerland that follows a part of their school program through German in addition to French, the language of instruction in this region. More precisely, it analyses videotaped classroom interaction and in situ classroom practices of pupil group work in a mathematics lessons. The ethnographic observation of pupils’ group work and the analysis of their interaction (analytical tools of conversational analysis, discourse analysis and plurilingual interaction) enhance the description of whole-class interaction done in the same (and several other) classes. While the latter are teacher-student interactions, the former are student-student interactions giving more space to and insight into pupils’ talk. This study aims at the description of the linguistic and multimodal resources (in German L2 and/or French L1) pupils mobilize while carrying out a mathematical task. The analysis shows that the accomplishment of the mathematical task takes place in a bilingual mode, whether the whole-class interactions are conducted rather in a bilingual (German L2-French L1) or a monolingual mode in L2 (German). The pupils make plenty of use of German L2 in a setting that lends itself to use French L1 (peer groups with French as a dominant language, in absence of the teacher and a task with a mathematical aim). They switch from French to German and back ‘naturally’, which is regular for bilingual speakers. Their linguistic resources in German L2 are not sufficient to allow them to (inter-)act well enough to accomplish the task entirely in German L2, despite their efforts to do so. However, this does not stop them from carrying out the task in mathematics adequately, which is the main objective, by drawing on the bilingual resources at hand.

Keywords: bilingual content subject learning, bilingual primary education, bilingual pupil group work, bilingual teaching/learning resources, didactics of plurilingualism

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215 Online Course of Study and Job Crafting for University Students: Development Work and Feedback

Authors: Hannele Kuusisto, Paivi Makila, Ursula Hyrkkanen

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Introduction: There have been arguments about the skills university students should have when graduated. Current trends argue that as well as the specific job-related skills the graduated students need problem-solving, interaction and networking skills as well as self-management skills. Skills required in working life are also considered in the Finnish national project called VALTE (short for 'prepared for working life'). The project involves 11 Finnish school organizations. As one result of this project, a five-credit independent online course in study and job engagement as well as in study and job crafting was developed at Turku University of Applied Sciences. The aim of the oral or e-poster presentation is to present the online course developed in the project. The purpose of this abstract is to present the development work of the online course and the feedback received from the pilots. Method: As the University of Turku is the leading partner of the VALTE project, the collaborative education platform ViLLE (https://ville.utu.fi, developed by the University of Turku) was chosen as the online platform for the course. Various exercise types with automatic assessment were used; for example, quizzes, multiple-choice questions, classification exercises, gap filling exercises, model answer questions, self-assessment tasks, case tasks, and collaboration in Padlet. In addition, the free material and free platforms on the Internet were used (Youtube, Padlet, Todaysmeet, and Prezi) as well as the net-based questionnaires about the study engagement and study crafting (made with Webropol). Three teachers with long teaching experience (also with job crafting and online pedagogy) and three students working as trainees in the project developed the content of the course. The online course was piloted twice in 2017 as an elective course for the students at Turku University of Applied Sciences, a higher education institution of about 10 000 students. After both pilots, feedback from the students was gathered and the online course was developed. Results: As the result, the functional five-credit independent online course suitable for students of different educational institutions was developed. The student feedback shows that students themselves think that the developed online course really enhanced their job and study crafting skills. After the course, 91% of the students considered their knowledge in job and study engagement as well as in job and study crafting to be at a good or excellent level. About two-thirds of the students were going to exploit their knowledge significantly in the future. Students appreciated the variability and the game-like feeling of the exercises as well as the opportunity to study online at the time and place they chose themselves. On a five-point scale (1 being poor and 5 being excellent), the students graded the clarity of the ViLLE platform as 4.2, the functionality of the platform as 4.0 and the easiness of operating as 3.9.

Keywords: job crafting, job engagement, online course, study crafting, study engagement

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214 Near-Peer Mentoring/Curriculum and Community Enterprise for Environmental Restoration Science

Authors: Lauren B. Birney

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The BOP-CCERS (Billion Oyster Project- Curriculum and Community Enterprise for Restoration Science) Near-Peer Mentoring Program provides the long-term (five-year) support network to motivate and guide students toward restoration science-based CTE pathways. Students are selected from middle schools with actively participating BOP-CCERS teachers. Teachers will nominate students from grades 6-8 to join cohorts of between 10 and 15 students each. Cohorts are comprised primarily of students from the same school in order to facilitate mentors' travel logistics as well as to sustain connections with students and their families. Each cohort is matched with an exceptional undergraduate or graduate student, either a BOP research associate or STEM mentor recruited from collaborating City University of New York (CUNY) partner programs. In rare cases, an exceptional high school junior or senior may be matched with a cohort in addition to a research associate or graduate student. In no case is a high school student or minor be placed individually with a cohort. Mentors meet with students at least once per month and provide at least one offsite field visit per month, either to a local STEM Hub or research lab. Keeping with its five-year trajectory, the near-peer mentoring program will seek to retain students in the same cohort with the same mentor for the full duration of middle school and for at least two additional years of high school. Upon reaching the final quarter of 8th grade, the mentor will develop a meeting plan for each individual mentee. The mentee and the mentor will be required to meet individually or in small groups once per month. Once per quarter, individual meetings will be substituted for full cohort professional outings. The mentor will organize the entire cohort on a field visit or educational workshop with a museum or aquarium partner. In addition to the mentor-mentee relationship, each participating student will also be asked to conduct and present his or her own BOP field research. This research is ideally carried out with the support of the students’ regular high school STEM subject teacher; however, in cases where the teacher or school does not permit independent study, the student will be asked to conduct the research on an extracurricular basis. Near-peer mentoring affects students’ social identities and helps them to connect to role models from similar groups, ultimately giving them a sense of belonging. Qualitative and quantitative analytics were performed throughout the study. Interviews and focus groups also ensued. Additionally, an external evaluator was utilized to ensure project efficacy, efficiency, and effectiveness throughout the entire project. The BOP-CCERS Near Peer Mentoring program is a peer support network in which high school students with interest or experience in BOP (Billion Oyster Project) topics and activities (such as classroom oyster tanks, STEM Hubs, or digital platform research) provide mentorship and support for middle school or high school freshmen mentees. Peer mentoring not only empowers those students being taught but also increases the content knowledge and engagement of mentors. This support provides the necessary resources, structure, and tools to assist students in finding success.

Keywords: STEM education, environmental science, citizen science, near peer mentoring

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213 Qualitative Evaluation of the Morris Collection Conservation Project at the Sainsbury Centre of Visual Arts in the Context of Agile, Lean and Hybrid Project Management Approaches

Authors: Maria Ledinskaya

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This paper examines the Morris Collection Conservation Project at the Sainsbury Centre for Visual Arts in the context of Agile, Lean, and Hybrid project management. It is part case study and part literature review. To date, relatively little has been written about non-traditional project management approaches in heritage conservation. This paper seeks to introduce Agile, Lean, and Hybrid project management concepts from business, software development, and manufacturing fields to museum conservation, by referencing their practical application on a recent museum-based conservation project. The Morris Collection Conservation Project was carried out in 2019-2021 in Norwich, UK, and concerned the remedial conservation of around 150 Abstract Constructivist artworks bequeathed to the Sainsbury Centre for Visual Arts by private collectors Michael and Joyce Morris. The first part introduces the chronological timeline and key elements of the project. It describes a medium-size conservation project of moderate complexity, which was planned and delivered in an environment with multiple known unknowns – unresearched collection, unknown condition and materials, unconfirmed budget. The project was also impacted by the unknown unknowns of the COVID-19 pandemic, such as indeterminate lockdowns, and the need to accommodate social distancing and remote communications. The author, a staff conservator at the Sainsbury Centre who acted as project manager on the Morris Collection Conservation Project, presents an incremental, iterative, and value-based approach to managing a conservation project in an uncertain environment. Subsequent sections examine the project from the point of view of Traditional, Agile, Lean, and Hybrid project management. The author argues that most academic writing on project management in conservation has focussed on a Traditional plan-driven approach – also known as Waterfall project management – which has significant drawbacks in today’s museum environment, due to its over-reliance on prediction-based planning and its low tolerance to change. In the last 20 years, alternative Agile, Lean and Hybrid approaches to project management have been widely adopted in software development, manufacturing, and other industries, although their recognition in the museum sector has been slow. Using examples from the Morris Collection Conservation Project, the author introduces key principles and tools of Agile, Lean, and Hybrid project management and presents a series of arguments on the effectiveness of these alternative methodologies in museum conservation, as well as the ethical and practical challenges to their implementation. These project management approaches are discussed in the context of consequentialist, relativist, and utilitarian developments in contemporary conservation ethics, particularly with respect to change management, bespoke ethics, shared decision-making, and value-based cost-benefit conservation strategy. The author concludes that the Morris Collection Conservation Project had multiple Agile and Lean features which were instrumental to the successful delivery of the project. These key features are identified as distributed decision making, a co-located cross-disciplinary team, servant leadership, focus on value-added work, flexible planning done in shorter sprint cycles, light documentation, and emphasis on reducing procedural, financial, and logistical waste. Overall, the author’s findings point largely in favour of a Hybrid model which combines traditional and alternative project processes and tools to suit the specific needs of the project.

Keywords: project management, conservation, waterfall, agile, lean, hybrid

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212 A Randomized, Controlled Trial To Test Behavior Change Techniques (BCTS) To Improve Low Intensity Physical Activity In Older Adults

Authors: Ciaran Friel, Jerry Suls, Patrick Robles, Frank Vicari, Joan Duer-Hefele, Karina W. Davidson

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Physical activity guidelines focus on increasing moderate intensity activity for older adults, but adherence to recommendations remains low. This is despite the fact that scientific evidence supports that any increase in physical activity is positively correlated with health benefits. Behavior change techniques (BCTs) have demonstrated effectiveness in reducing sedentary behavior and promoting physical activity. This pilot study uses a Personalized Trials (N-of-1) design to evaluate the efficacy of using four BCTs to promote an increase in low-intensity physical activity (2,000 steps of walking per day) in adults aged 45-75 years old. The 4 BCTs tested were goal setting, action planning, feedback, and self-monitoring. BCTs were tested in random order and delivered by text message prompts requiring participant response. The study recruited health system employees in the target age range, without mobility restrictions and demonstrating interest in increasing their daily activity by a minimum of 2,000 steps per day for a minimum of five days per week. Participants were sent a Fitbit Charge 4 fitness tracker with an established study account and password. Participants were recommended to wear the Fitbit device 24/7, but were required to wear it for a minimum of ten hours per day. Baseline physical activity was measured by the Fitbit for two weeks. Participants then engaged with a clinical research coordinator to review comprehension of the text message content and required actions for each of the BCTs to be tested. Participants then selected a consistent daily time in which they would receive their text message prompt. In the 8 week intervention phase of the study, participants received each of the four BCTs, in random order, for a two week period. Text message prompts were delivered daily at a time selected by the participant. All prompts required an interactive response from participants and may have included recording their detailed plan for walking or daily step goal (action planning, goal setting). Additionally, participants may have been directed to a study dashboard to view their step counts or compare themselves with peers (self-monitoring, feedback). At the end of each two week testing interval, participants were asked to complete the Self-Efficacy for Walking Scale (SEW_Dur), a validated measure that assesses the participant’s confidence in walking incremental distances and a survey measuring their satisfaction with the individual BCT that they tested. At the end of their trial, participants received a personalized summary of their step data in response to each individual BCT. Analysis will examine the novel individual-level heterogeneity of treatment effect made possible by N-of-1 design, and pool results across participants to efficiently estimate the overall efficacy of the selected behavioral change techniques in increasing low-intensity walking by 2,000 steps, 5 days per week. Self-efficacy will be explored as the likely mechanism of action prompting behavior change. This study will inform the providers and demonstrate the feasibility of N-of-1 study design to effectively promote physical activity as a component of healthy aging.

Keywords: aging, exercise, habit, walking

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211 Influencing Factors for Job Satisfaction and Turnover Intention of Surgical Team in the Operating Rooms

Authors: Shu Jiuan Chen, Shu Fen Wu, I. Ling Tsai, Chia Yu Chen, Yen Lin Liu, Chen-Fuh Lam

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Background: Increased emotional stress in workplace and depressed job satisfaction may significantly affect the turnover intention and career life of personnel. However, very limited studies have reported the factors influencing the turnover intention of the surgical team members in the operating rooms, where extraordinary stress is normally exit in this isolated medical care unit. Therefore, this study aimed to determine the environmental and personal characteristic factors that might be associated with job satisfaction and turnover intention in the non-physician staff who work in the operating rooms. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses, nurse anesthetists, surgeon assistants, orderly and other non-physician staff. Numerical and categorical data were analyzed using unpaired t-test and Chi-square test, as appropriate (SPSS, version 20.0). Results: A total of 167 effective questionnaires were collected from 200 eligible, non-physician personnel who worked in the operating room (response rate 83.5%). The overall satisfaction of all responders was 45.64 ± 7.17. In comparison to those who had more than 4-year working experience in the operating rooms, the junior staff ( ≤ 4-year experience) reported to have significantly higher satisfaction in workplace environment and job contentment, as well as lower intention to quit (t = 6.325, P =0.000). Among the different specialties of surgical team members, nurse anesthetists were associated with significantly lower levels of job satisfaction (P=0.043) and intention to stay (x² = 8.127, P < 0.05). Multivariate regression analysis demonstrates job title, seniority, working shifts and job satisfaction are the significant independent predicting factors for quit jobs. Conclusion: The results of this study highlight that increased work seniorities ( > 4-year working experience) are associated with significantly lower job satisfaction, and they are also more likely to leave their current job. Increased workload in supervising the juniors without appropriate job compensation (such as promotions in job title and work shifts) may precipitate their intention to quit. Since the senior staffs are usually the leaders and core members in the operating rooms, the retention of this fundamental manpower is essential to ensure the safety and efficacy of surgical interventions in the operating rooms.

Keywords: surgical team, job satisfaction, resignation intention, operating room

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210 Implementation of a Web-Based Clinical Outcomes Monitoring and Reporting Platform across the Fortis Network

Authors: Narottam Puri, Bishnu Panigrahi, Narayan Pendse

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Background: Clinical Outcomes are the globally agreed upon, evidence-based measurable changes in health or quality of life resulting from the patient care. Reporting of outcomes and its continuous monitoring provides an opportunity for both assessing and improving the quality of patient care. In 2012, International Consortium Of HealthCare Outcome Measurement (ICHOM) was founded which has defined global Standard Sets for measuring the outcome of various treatments. Method: Monitoring of Clinical Outcomes was identified as a pillar of Fortis’ core value of Patient Centricity. The project was started as an in-house developed Clinical Outcomes Reporting Portal by the Fortis Medical IT team. Standard sets of Outcome measurement developed by ICHOM were used. A pilot was run at Fortis Escorts Heart Institute from Aug’13 – Dec’13.Starting Jan’14, it was implemented across 11 hospitals of the group. The scope was hospital-wide and major clinical specialties: Cardiac Sciences, Orthopedics & Joint Replacement were covered. The internally developed portal had its limitations of report generation and also capturing of Patient related outcomes was restricted. A year later, the company provisioned for an ICHOM Certified Software product which could provide a platform for data capturing and reporting to ensure compliance with all ICHOM requirements. Post a year of the launch of the software; Fortis Healthcare has become the 1st Healthcare Provider in Asia to publish Clinical Outcomes data for the Coronary Artery Disease Standard Set comprising of Coronary Artery Bypass Graft and Percutaneous Coronary Interventions) in the public domain. (Jan 2016). Results: This project has helped in firmly establishing a culture of monitoring and reporting Clinical Outcomes across Fortis Hospitals. Given the diverse nature of the healthcare delivery model at Fortis Network, which comprises of hospitals of varying size and specialty-mix and practically covering the entire span of the country, standardization of data collection and reporting methodology is a huge achievement in itself. 95% case reporting was achieved with more than 90% data completion at the end of Phase 1 (March 2016). Post implementation the group now has one year of data from its own hospitals. This has helped identify the gaps and plan towards ways to bridge them and also establish internal benchmarks for continual improvement. Besides the value created for the group includes: 1. Entire Fortis community has been sensitized on the importance of Clinical Outcomes monitoring for patient centric care. Initial skepticism and cynicism has been countered by effective stakeholder engagement and automation of processes. 2. Measuring quality is the first step in improving quality. Data analysis has helped compare clinical results with best-in-class hospitals and identify improvement opportunities. 3. Clinical fraternity is extremely pleased to be part of this initiative and has taken ownership of the project. Conclusion: Fortis Healthcare is the pioneer in the monitoring of Clinical Outcomes. Implementation of ICHOM standards has helped Fortis Clinical Excellence Program in improving patient engagement and strengthening its commitment to its core value of Patient Centricity. Validation and certification of the Clinical Outcomes data by an ICHOM Certified Supplier adds confidence to its claim of being leaders in this space.

Keywords: clinical outcomes, healthcare delivery, patient centricity, ICHOM

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209 Exploring the Current Practice of Integrating Sustainability into the Social Studies and Citizenship Education Curriculum in the Saudi Educational Context

Authors: Aiydh Aljeddani, Fran Martin

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The study mainly aims at exploring and understanding the current practice of social studies and citizenship education curriculum contribution to sustainability literacy and competency of the ninth and tenth grade students in the Saudi general education context. This study stems from a need for conducting research in general education contexts in order to prepare future graduate students who possess fundamental elements of education for sustainable development. To the best of our knowledge, the literature on education for sustainable development reveals that little research has been conducted so far on general education contexts and this study will add new knowledge in the literature. The study is interpretive in nature and employs a qualitative case study approach, and ethnography methodologies to understand deeply this complex educational phenomenon. 167 participants took part in this study, they were from six general education schools and made up of 25 teachers, and 142 students. Document analysis, semi-structured interviews, nominal group technique, and passive participant observation were used in order to gather the data for this study. The outcomes of the study showed the keenness of the Saudi government on promoting and raising awareness education for sustainable development among its younger generation via a sustainable development promoting curriculum. However, applying this vision in a real school setting, particularly via the social studies and citizenship education curriculum in grades nine and ten, has been challenging for different reasons as revealed by this study. First, incorporating sustainability in the social studies and citizenship education curriculum in the Saudi grade ninth and tenth grade, is based on the vision of the Saudi government but the ministry of education’s rules and regulations do not support it. Moreover, the circulars issued by the ministry are also not supportive of teachers and students efforts to implement a sustainable development education curriculum. Second, teachers, as members of this community who play a significant role in achieving the objectives of incorporating sustainability, are often seen as technicians and not as professional human beings. They are confined to the curriculum, the classroom and stripped of their will power by the school management and the educational administration. The subjects, who are students here, are also not prepared nor guided to achieve the objects. In addition, the tools mediated between subjects and objects are not convenient. There were some major challenges regarding the contradictions in incorporating sustainability processes such as demanding creativity from a teacher who is overloaded with tasks irrelevant to teaching and teachers’ training programs not meeting the teachers’ training needs.

Keywords: practice, integrating sustainability, curriculum, educational context

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208 Solar and Galactic Cosmic Ray Impacts on Ambient Dose Equivalent Considering a Flight Path Statistic Representative to World-Traffic

Authors: G. Hubert, S. Aubry

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The earth is constantly bombarded by cosmic rays that can be of either galactic or solar origin. Thus, humans are exposed to high levels of galactic radiation due to altitude aircraft. The typical total ambient dose equivalent for a transatlantic flight is about 50 μSv during quiet solar activity. On the contrary, estimations differ by one order of magnitude for the contribution induced by certain solar particle events. Indeed, during Ground Level Enhancements (GLE) event, the Sun can emit particles of sufficient energy and intensity to raise radiation levels on Earth's surface. Analyses of GLE characteristics occurring since 1942 showed that for the worst of them, the dose level is of the order of 1 mSv and more. The largest of these events was observed on February 1956 for which the ambient dose equivalent rate is in the orders of 10 mSv/hr. The extra dose at aircraft altitudes for a flight during this event might have been about 20 mSv, i.e. comparable with the annual limit for aircrew. The most recent GLE, occurred on September 2017 resulting from an X-class solar flare, and it was measured on the surface of both the Earth and Mars using the Radiation Assessment Detector on the Mars Science Laboratory's Curiosity Rover. Recently, Hubert et al. proposed a GLE model included in a particle transport platform (named ATMORAD) describing the extensive air shower characteristics and allowing to assess the ambient dose equivalent. In this approach, the GCR is based on the Force-Field approximation model. The physical description of the Solar Cosmic Ray (i.e. SCR) considers the primary differential rigidity spectrum and the distribution of primary particles at the top of the atmosphere. ATMORAD allows to determine the spectral fluence rate of secondary particles induced by extensive showers, considering altitude range from ground to 45 km. Ambient dose equivalent can be determined using fluence-to-ambient dose equivalent conversion coefficients. The objective of this paper is to analyze the GCR and SCR impacts on ambient dose equivalent considering a high number statistic of world-flight paths. Flight trajectories are based on the Eurocontrol Demand Data Repository (DDR) and consider realistic flight plan with and without regulations or updated with Radar Data from CFMU (Central Flow Management Unit). The final paper will present exhaustive analyses implying solar impacts on ambient dose equivalent level and will propose detailed analyses considering route and airplane characteristics (departure, arrival, continent, airplane type etc.), and the phasing of the solar event. Preliminary results show an important impact of the flight path, particularly the latitude which drives the cutoff rigidity variations. Moreover, dose values vary drastically during GLE events, on the one hand with the route path (latitude, longitude altitude), on the other hand with the phasing of the solar event. Considering the GLE occurred on 23 February 1956, the average ambient dose equivalent evaluated for a flight Paris - New York is around 1.6 mSv, which is relevant to previous works This point highlights the importance of monitoring these solar events and of developing semi-empirical and particle transport method to obtain a reliable calculation of dose levels.

Keywords: cosmic ray, human dose, solar flare, aviation

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207 Learning Instructional Managements between the Problem-Based Learning and Stem Education Methods for Enhancing Students Learning Achievements and their Science Attitudes toward Physics the 12th Grade Level

Authors: Achirawatt Tungsombatsanti, Toansakul Santiboon, Kamon Ponkham

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Strategies of the STEM education was aimed to prepare of an interdisciplinary and applied approach for the instructional of science, technology, engineering, and mathematics in an integrated students for enhancing engagement of their science skills to the Problem-Based Learning (PBL) method in Borabu School with a sample consists of 80 students in 2 classes at the 12th grade level of their learning achievements on electromagnetic issue. Research administrations were to separate on two different instructional model groups, the 40-experimental group was designed with the STEM instructional experimenting preparation and induction in a 40-student class and the controlling group using the PBL was designed to students identify what they already know, what they need to know, and how and where to access new information that may lead to the resolution of the problem in other class. The learning environment perceptions were obtained using the 35-item Physics Laboratory Environment Inventory (PLEI). Students’ creating attitude skills’ sustainable development toward physics were assessed with the Test Of Physics-Related Attitude (TOPRA) The term scaling was applied to the attempts to measure the attitude objectively with the TOPRA was used to assess students’ perceptions of their science attitude toward physics. Comparisons between pretest and posttest techniques were assessed students’ learning achievements on each their outcomes from each instructional model, differently. The results of these findings revealed that the efficiency of the PLB and the STEM based on criteria indicate that are higher than the standard level of the 80/80. Statistically, significant of students’ learning achievements to their later outcomes on the controlling and experimental physics class groups with the PLB and the STEM instructional designs were differentiated between groups at the .05 level, evidently. Comparisons between the averages mean scores of students’ responses to their instructional activities in the STEM education method are higher than the average mean scores of the PLB model. Associations between students’ perceptions of their physics classes to their attitudes toward physics, the predictive efficiency R2 values indicate that 77%, and 83% of the variances in students’ attitudes for the PLEI and the TOPRA in physics environment classes were attributable to their perceptions of their physics PLB and the STEM instructional design classes, consequently. An important of these findings was contributed to student understanding of scientific concepts, attitudes, and skills as evidence with STEM instructional ought to higher responding than PBL educational teaching. Statistically significant between students’ learning achievements were differentiated of pre and post assessments which overall on two instructional models.

Keywords: learning instructional managements, problem-based learning, STEM education, method, enhancement, students learning achievements, science attitude, physics classes

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206 The Importance of Developing Pedagogical Agency Capacities in Initial Teacher Formation: A Critical Approach to Advance in Social Justice

Authors: Priscilla Echeverria

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This paper addresses initial teacher formation as a formative space in which pedagogy students develop a pedagogical agency capacity to contribute to social justice, considering ethical, political, and epistemic dimensions. This paper is structured by discussing first the concepts of agency, pedagogical interaction, and social justice from a critical perspective; and continues offering preliminary results on the capacity of pedagogical agency in novice teachers after the analysis of critical incidents as a research methodology. This study is motivated by the concern that responding to the current neoliberal scenario, many initial teacher formation (ITF) programs have reduced the meaning of education to instruction, and pedagogy to methodology, favouring the formation of a technical professional over a reflective or critical one. From this concern, this study proposes that the restitution of the subject is an urgent task in teacher formation, so it is essential to enable him in his capacity for action and advance in eliminating institutionalized oppression insofar as it affects that capacity. Given that oppression takes place in human interaction, through this work, I propose that initial teacher formation develops sensitivity and educates the gaze to identify oppression and take action against it, both in pedagogical interactions -which configure political, ethical, and epistemic subjectivities- as in the hidden and official curriculum. All this from the premise that modelling democratic and dialogical interactions are basic for any program that seeks to contribute to a more just and empowered society. The contribution of this study lies in the fact that it opens a discussion in an area about which we know little: the impact of the type of interactions offered by university teaching at ITF on the capacity of future teachers to be pedagogical agents. For this reason, this study seeks to gather evidence of the result of this formation, analysing the capacity of pedagogical agency of novice teachers, or, in other words, how capable the graduates of secondary pedagogies are in their first pedagogical experiences to act and make decisions putting the formative purposes that they are capable of autonomously defining before technical or bureaucratic issues imposed by the curriculum or the official culture. This discussion is part of my doctoral research, "The importance of developing the capacity for ethical-political-epistemic agency in novice teachers during initial teacher formation to contribute to social justice", which I am currently developing in the Educational Research program of the University of Lancaster, United Kingdom, as a Conicyt fellow for the 2019 cohort.

Keywords: initial teacher formation, pedagogical agency, pedagogical interaction, social justice, hidden curriculum

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