Search results for: tender documentation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 405

Search results for: tender documentation

165 'Get the DNR': Exploring the Impact of an Educational eModule on Internal Medicine Residents' Attitudes and Approaches to Goals of Care Conversations

Authors: Leora Branfield Day, Stephanie Saunders, Leah Steinberg, Shiphra Ginsburg, Christine Soong

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Introduction: Discordance between patients expressed and documented preferences at the end of life is common. Although junior trainees frequently lead goals of care (GOC) conversations, lack of training can result in poor communication. Based on a needs assessment, we developed an interactive electronic learning module (eModule) for conducting patient-centred GOC discussions. The purpose of this study was to evaluate the impact of the eModule on residents’ attitudes towards GOC conversations. Methods: First-year internal medicine residents (n=11) from the University of Toronto selected using purposive sampling underwent semi-structured interviews before and after completing a GOC eModule. Interviews were anonymized, transcribed and open-coded using NVivo. Using a constructivist grounded theory approach, we developed a framework to understand the attitudes of residents to GOC conversations before and after viewing the module. Results: Before the module, participants described limited training and negative emotions towards GOC conversations. Many focused on code status and procedure choices (e.g., ventilation) instead of eliciting patient-centered values. Pressure to “get the DNR" led to conflicting feelings and distress. After the module, participants’ approached conversations with a greater focus on patient values and process. They felt more prepared and comfortable, recognizing the complexity of conversations and the importance of patient-centeredness. Conclusions: A novel GOC eModule allowed residents to develop a patient-centered and standardized approach to GOC conversations while improving confidence and preparedness. This resource could be an effective strategy toward attaining a critical communication competency among learners with the potential to enhance accurate GOC documentation.

Keywords: goals of care conversations, communication skills, emodule, medical education

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164 ABET Accreditation Process for Engineering and Technology Programs: Detailed Process Flow from Criteria 1 to Criteria 8

Authors: Amit Kumar, Rajdeep Chakrabarty, Ganesh Gupta

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This paper illustrates the detailed accreditation process of Accreditation Board of Engineering and Technology (ABET) for accrediting engineering and Technology programs. ABET is a non-governmental agency that accredits engineering and technology, applied and natural sciences, and computing sciences programs. ABET was founded on 10th May 1932 and was founded by Institute of Electrical and Electronics Engineering. International industries accept ABET accredited institutes having the highest standards in their academic programs. In this accreditation, there are eight criteria in general; criterion 1 describes the student outcome evaluations, criteria 2 measures the program's educational objectives, criteria 3 is the student outcome calculated from the marks obtained by students, criteria 4 establishes continuous improvement, criteria 5 focus on curriculum of the institute, criteria 6 is about faculties of this institute, criteria 7 measures the facilities provided by the institute and finally, criteria 8 focus on institutional support towards staff of the institute. In this paper, we focused on the calculative part of each criterion with equations and suitable examples, the files and documentation required for each criterion, and the total workflow of the process. The references and the values used to illustrate the calculations are all taken from the samples provided at ABET's official website. In the final section, we also discuss the criterion-wise score weightage followed by evaluation with timeframe and deadlines.

Keywords: Engineering Accreditation Committee, Computing Accreditation Committee, performance indicator, Program Educational Objective, ABET Criterion 1 to 7, IEEE, National Board of Accreditation, MOOCS, Board of Studies, stakeholders, course objective, program outcome, articulation, attainment, CO-PO mapping, CO-PO-SO mapping, PDCA cycle, degree certificates, course files, course catalogue

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163 Shifting to Electronic Operative Notes in Plastic surgery

Authors: Samar Mousa, Galini Mavromatidou, Rebecca Shirley

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Surgeons carry out numerous operations in the busy burns and plastic surgery department daily. Writing an accurate operation note with all the essential information is crucial for communication not only within the plastics team but also to the multi-disciplinary team looking after the patient, including other specialties, nurses and GPs. The Royal college of surgeons of England, in its guidelines of good surgical practice, mentioned that the surgeon should ensure that there are clear (preferably typed) operative notes for every procedure. The notes should accompany the patient into recovery and to the ward and should give sufficient detail to enable continuity of care by another doctor. The notes should include the Date and time, Elective/emergency procedure, Names of the operating surgeon and assistant, Name of the theatre anesthetist, Operative procedure carried out, Incision, Operative diagnosis, Operative findings, Any problems/complications, Any extra procedure performed and the reason why it was performed, Details of tissue removed, added or altered, Identification of any prosthesis used, including the serial numbers of prostheses and other implanted materials, Details of closure technique, Anticipated blood loss, Antibiotic prophylaxis (where applicable), DVT prophylaxis (where applicable), Detailed postoperative care instructions and Signature. Fourteen random days were chosen in December 2021 to assess the accuracy of operative notes and post-operative care. A total of 163 operative notes were examined. The average completion rates in all domains were 85.4%. An electronic operative note template was designed to cover all domains mentioned in the Royal College of surgeons' good surgical practice. It is kept in the hospital drive for all surgeons to use.

Keywords: operative notes, plastic surgery, documentation, electronic

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162 Cystic Ganglionosis in Child: Rare Entity

Authors: Jatinder Pal Singh, Harpreet Singh, Gagandeep Singh Digra, Mandeep Kaur Sidhu, Pawan Kumar

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Introduction: Ganglion cyst is a benign condition in which there is a cystic lesion in relation to a joint or a tendon sheath arising from myxoid degeneration of fibrous connective tissue. These can be unilocular or multilocular. In rare cases, there may be multiple ganglion cysts, known as cystic ganglionosis. They can occur at any age but are commonly seen in adults. Clinically they may be asymptomatic or present as swelling or mass effect in adjacent structures. These are common in extremities such as hands and feet. Case Presentation: 11-year-old female child presented with slowly progressive painless swelling of her right hand since the age of 4. Antenatal and perinatal history was unremarkable. Her family history was negative. She denies fever, malaise, morning stiffness, weight loss, fatigue, restriction of joint movements, or any sensory and motor deficit. Lab parameters were negative for inflammatory or infectious etiology. No other joint or extremity involvement was present. On physical examination, the swelling was present on the dorsum and palmer aspect of the right hand and wrist. They were non-tender on palpation without any motor or sensory deficit. MRI hand revealed multiple well-defined fluid signal intensity cystic appearing lesions in periarticular/intraarticular locations in relation to distal radio-ulnar, radio-carpal, intercarpal, carpometacarpal, metacarpophalangeal and interphalangeal joints as well as peritendinous location around flexor tendons more so in the region of wrist, palm, 1st and 5th digit and along extensor tendons in the region of wrist, largest one noted along flexor pollicis longus tendon in thenar region and along 1st digit measuring approx. 4.6 x 1.2 x 1.2 centimeter. Pressure erosions and bone remodelling were noted in the bases of the 2nd to 5th metacarpals, capitate, trapezoid, the distal shaft of 1st metacarpal, and proximal phalanx of 1st digit. Marrow edema was noted in the base and proximal shaft of the 4th metacarpal and proximal shaft of the 3rd metacarpal – likely stress or pressure related. The patient was advised of aspiration, but the family refused the procedure. Therefore the patient was kept on conservative treatment. Conclusion: Cystic ganglionosis is a rare condition with very few cases reported in the medical literature. Its prevalence and association are not known because of the rarity of this condition. It should be considered as an important differential in patients presenting with soft tissue swelling in extremities. Treatment option includes conservative management, aspiration, and surgery. Aspiration has a high recurrence rate. Although surgery has a low recurrence rate, it carries a high rate of complications. Imaging with MRI is essential for confirmation of the cystic nature of lesions and their relation with the joint capsules or tendons. This helps in differentiating from other soft tissue lesions and presurgical planning.

Keywords: radiology, rare, cystic ganglionosis, child

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161 3D Modeling Approach for Cultural Heritage Structures: The Case of Virgin of Loreto Chapel in Cusco, Peru

Authors: Rony Reátegui, Cesar Chácara, Benjamin Castañeda, Rafael Aguilar

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Nowadays, heritage building information modeling (HBIM) is considered an efficient tool to represent and manage information of cultural heritage (CH). The basis of this tool relies on a 3D model generally obtained from a cloud-to-BIM procedure. There are different methods to create an HBIM model that goes from manual modeling based on the point cloud to the automatic detection of shapes and the creation of objects. The selection of these methods depends on the desired level of development (LOD), level of information (LOI), grade of generation (GOG), as well as on the availability of commercial software. This paper presents the 3D modeling of a stone masonry chapel using Recap Pro, Revit, and Dynamo interface following a three-step methodology. The first step consists of the manual modeling of simple structural (e.g., regular walls, columns, floors, wall openings, etc.) and architectural (e.g., cornices, moldings, and other minor details) elements using the point cloud as reference. Then, Dynamo is used for generative modeling of complex structural elements such as vaults, infills, and domes. Finally, semantic information (e.g., materials, typology, state of conservation, etc.) and pathologies are added within the HBIM model as text parameters and generic models families, respectively. The application of this methodology allows the documentation of CH following a relatively simple to apply process that ensures adequate LOD, LOI, and GOG levels. In addition, the easy implementation of the method as well as the fact of using only one BIM software with its respective plugin for the scan-to-BIM modeling process means that this methodology can be adopted by a larger number of users with intermediate knowledge and limited resources since the BIM software used has a free student license.

Keywords: cloud-to-BIM, cultural heritage, generative modeling, HBIM, parametric modeling, Revit

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160 Performance Measurement by Analytic Hierarchy Process in Performance Based Logistics

Authors: M. Hilmi Ozdemir, Gokhan Ozkan

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Performance Based Logistics (PBL) is a strategic approach that enables creating long-term and win-win relations among stakeholders in the acquisition. Contrary to the traditional single transactions, the expected value is created by the performance of the service pertaining to the strategic relationships in this approach. PBL motivates all relevant stakeholders to focus on their core competencies to produce the desired outcome in a collective way. The desired outcome can only be assured with a cost effective way as long as it is periodically measured with the right performance parameters. Thus, defining these parameters is a crucial step for the PBL contracts. In performance parameter determination, Analytic Hierarchy Process (AHP), which is a multi-criteria decision making methodology for complex cases, was used within this study for a complex system. AHP has been extensively applied in various areas including supply chain, inventory management, outsourcing, and logistics. This methodology made it possible to convert end-user’s main operation and maintenance requirements to sub criteria contained by a single performance parameter. Those requirements were categorized and assigned weights by the relevant stakeholders. Single performance parameter capable of measuring the overall performance of a complex system is the major outcome of this study. The parameter deals with the integrated assessment of different functions spanning from training, operation, maintenance, reporting, and documentation that are implemented within a complex system. The aim of this study is to show the methodology and processes implemented to identify a single performance parameter for measuring the whole performance of a complex system within a PBL contract. AHP methodology is recommended as an option for the researches and the practitioners who seek for a lean and integrated approach for performance assessment within PBL contracts. The implementation of AHP methodology in this study may help PBL practitioners from methodological perception and add value to AHP in becoming prevalent.

Keywords: analytic hierarchy process, performance based logistics, performance measurement, performance parameters

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159 Gender and Sustainable Rural Tourism: A Study into the Experiences and the Roles of Local Women in the Sundarbans Area of Bangladesh

Authors: Jakia Rajoana

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The key aim of this research is to achieve Sustainable Rural Tourism (SRT) through women’s empowerment in the Sundarbans area of Bangladesh. Women in rural areas in developing countries depend on biomass for their survival and that of their family. Yet they have an unequal access to resources as well as decision making, thus making them more vulnerable to any changes in the environment. Women in the developing countries experience gender inequality which is culturally embedded resulting into women having less access to and control over financial and material resources, information, and also a lack of recognition of their contribution as compared to men. Their disadvantaged social position is augmented by their extreme poverty, little or no power they have over their own lives vis-à-vis the disproportionate burden they bear in reproduction and child-raising. Despite the significance of the need to pay attention to gender related issues in sustainable rural tourism (SRT), research remains rather scant. For instance, there is very little research that illustrates the role of women in tourism in the Sundarbans area. Thus empirically, this research seeks to fill a significant gap by focusing on rural areas and in particular focus on considerably under-researched area, namely the Sundarbans women’s role in tourism. In order to fully comprehend their experiences and life stories, this research will apply the empowerment theory and consider it along with the research on sustainable rural tourism. Since, women’s empowerment can act as a potential tool for SRT development and also examine the role tourism plays in the lives of Sundarbans’ women. Methodologically, this study will follow a qualitative research design using an ethnographic approach. Participant observation, semi- structured interviews, and documentation will be the primary data collection instruments in four communities – Shayamnagar, Koyra, Mongla and Sarankhola – in the Sundarbans area. It is hoped that by focusing on the life stories of these invisible women, research is better able to engage with nuances inherent in marginal and significantly under-researched communities.

Keywords: gender, sustainable rural tourism, women empowerment, Sundarbans

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158 Quantifying Late Cenozoic Out‐of‐Sequence Thrusting at Chaura, Sutlej Valley, Himachal Pradesh, India

Authors: Rajkumar Ghosh

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Out-of-sequence thrusts (OOST) are reported at different geographic locations with various local names along Siwalik Himalaya (SH), Lesser Himalaya (LH), Higher Himalaya (HH) from Bhutan, India, Nepal, and Pakistan Himalayan range. Most of OOSTs have been identified within the upper LH, and the lower HH based on geochronological age jump across. These thrusts activated from Late Miocene to recent. The Chaura Thrust (CT) was deciphered from age jump of Apatite Fission Track (AFT) and considered as blind thrust base on variable exhumation rates in Chaura region, Satluj river valley, Himachal Pradesh. CT is located north of Jhakri Thrust (JhT) and is also differently identified as Sarahan thrust (ST). Structural documentation from the rocks near the OOST in Chaura was not so far done. Detail structural study of the Jeori Group of rocks was carried out in this study to understand the manifestation of the Chaura thrust and associated structures in meso- to micro-scale. Box fold, scar fold, kink fold, crenulation cleavages, and boudins are developed in the Chaura region. These structures usually do not indicate shear sense. When studied under an optical microscope, the Chaura samples reveal that the mica fish are usually lenticular with aspect ratio (R) varying from 6–11 and inclination angle (α) from 15–40°. According to ‘R’ and ‘α’, elongated sigmoid shaped mica fish and parallelogram shaped mica fish were also documented. Asymmetric mica fish demonstrate top-to-S/SW ductile shear, which is similar as that of Chaura thrust. Grain boundary migration (GBM) structures in quartzo-feldspathic grains from Jeori Group of rocks indicate deformation temperature ranging from 400 to 650°C. This can indicate that the OOST at Chaura, i.e., the Chaura Thrust, underwent thrusting in the ductile regime.

Keywords: out-of-sequence thrust, chaura thrust, sarahan thrust, jakhri thrust, higher himalaya, s/c- fabric

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157 Mapping the Quotidian Life of Practitioners of Various Religious Sects in Late Medieval Bengal: Portrayals on the Front Façades of the Baranagar Temple Cluster

Authors: I. Gupta, B. Karmakar

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Bengal has a long history (8th century A.D. onwards) of decorating the wall of brick-built temples with curved terracotta plaques on a diverse range of subjects. These could be considered as one of the most significant visual archives to understand the various facets of the then contemporary societies. The temples under focus include Char-bangla temple complex (circa 1755 A.D.), Bhavanishvara temple (circa 1755 A.D.) and the Gangeshvara Shiva Jor-bangla temple (circa 1753 A.D.), located within a part of the river Bhagirathi basin in Baranagar, Murshidabad, West Bengal, India. Though, a diverse range of subjects have been intricately carved mainly on the front façades of the Baranagar temple cluster, the study specifically concentrates on depictions related to religious and non-religious acts performed by practitioners of various religious sects of late medieval Bengal with the intention to acquire knowledge about the various facets of their life. Apart from this, the paper also mapped the spatial location of these religious performers on the temples’ façades to examine if any systematic plan or arrangement had been employed for connoting a particular idea. Further, an attempt is made to provide a commentary on the attire worn by followers of various religious sects of late medieval Bengal. The primary materials for the study comprise the depictions which denote religious activities carved on the terracotta plaques. The secondary material has been collected from published and unpublished theses, journals and books. These data have been further supplemented with photographic documentation, some useful line-drawings and descriptions in table format to get a clear understanding of the concerned issues.

Keywords: attire, scheme of allocation, terracotta temple, various religious sect

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156 Improving Graduate Student Writing Skills: Best Practices and Outcomes

Authors: Jamie Sundvall, Lisa Jennings

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A decline in writing skills and abilities of students entering graduate school has become a focus for university systems within the United States. This decline has become a national trend that requires reflection on the intervention strategies used to address the deficit and unintended consequences as outcomes in the profession. Social work faculty is challenged to increase written scholarship within the academic setting. However, when a large number of students in each course have writing deficits, there is a shift from focus on content, ability to demonstrate competency, and application of core social work concepts. This qualitative study focuses on the experiences of online faculty who support increasing scholarship through writing and are following best practices preparing students academically to see improvements in written presentation in classroom work. This study outlines best practices to improve written academic presentation, especially in an online setting. The research also highlights how a student’s ability to show competency and application of concepts may be overlooked in the online setting. This can lead to new social workers who are prepared academically, but may unable to effectively advocate and document thought presentation in their writing. The intended progression of writing across all levels of higher education moves from summary, to application, and into abstract problem solving. Initial findings indicate that it is important to reflect on practices used to address writing deficits in terms of academic writing, competency, and application. It is equally important to reflect on how these methods of intervention impact a student post-graduation. Specifically, for faculty, it is valuable to assess a social worker’s ability to engage in continuity of documentation and advocacy at micro, mezzo, macro, and international levels of practice.

Keywords: intervention, professional impact, scholarship, writing

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155 Completion of the Modified World Health Organization (WHO) Partograph during Labour in Public Health Institutions of Addis Ababa, Ethiopia

Authors: Engida Yisma, Berhanu Dessalegn, Ayalew Astatkie, Nebreed Fesseha

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Background: The World Health Organization (WHO) recommends using the partograph to follow labour and delivery, with the objective to improve health care and reduce maternal and foetal morbidity and death. Methods: A retrospective document review was undertaken to assess the completion of the modified WHO partograph during labour in public health institutions of Addis Ababa, Ethiopia. A total of 420 of the modified WHO partographs used to monitor mothers in labour from five public health institutions that provide maternity care were reviewed. A structured checklist was used to gather the required data. The collected data were analyzed using SPSS version 16.0. Frequency distributions, cross-tabulations and a graph were used to describe the results of the study. Results: All facilities were using the modified WHO partograph. The correct completion of the partograph was very low. From 420 partographs reviewed across all the five health facilities, foetal heart rate was recorded into the recommended standard in 129(30.7%) of the partographs, while 138 (32.9%) of cervical dilatation and 87 (20.70%) of uterine contractions were recorded to the recommended standard. The study did not document descent of the presenting part in 353 (84%). Moulding in 364 (86.7%) of the partographs reviewed was not recorded. Documentation of state of the liquor was 113(26.9%), while the maternal blood pressure was recorded to standard only in 78(18.6%) of the partographs reviewed. Conclusions: This study showed a poor completion of the modified WHO partographs during labour in public health institutions of Addis Ababa, Ethiopia. The findings may reflect poor management of labour and indicate the need for pre-service and periodic on-job training of health workers on the proper completion of the partograph. Regular supportive supervision, provision of guidelines and mandatory health facility policy are also needed in support of a collaborative effort to reduce maternal and perinatal deaths.

Keywords: modified WHO partograph, completion, public health institutions, Addis Ababa, Ethiopia

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154 Stimulating the Social Emotional Development of Children through Play Activities: The Role of Teachers and Parents Support

Authors: Mahani Razali, Nordin Mamat

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The purpose of this research is to identify the teacher’s role and parent’s participation to develop children`s socio emotion through play activities. This research is based on three main objectives which are to identify children`s socio emotion during play activities, teacher’s role and parent’s participation to develop children`s socio emotion. This qualitative study was carried out among 25 pre-school children, three teachers and three parents as the research sample. On the other hand, parent’s support was obtained from their discussions, supervisions and communication at home. The data collection procedures involved structured observation which was to identify socio emotional development element among pre-school children through play activities; as for semi-structured interviews, it was done to study the perception of the teachers and parents on the acquired socio emotional development among the children. Besides, documentation analysis method was used as to triangulate acquired information with observations and interviews. In this study, the qualitative data analysis was tabulated in descriptive manner with frequency and percentage format. This study primarily focused on five main socio emotional elements among the pre-school children: 1) Cooperation, 2) Confidence and Courage, 3) Ability to communicate, 4) patience, and 5) Tolerance. The findings of this study were presented in the form of case to case manner from the researches sample. Findings revealed that the children showed positive outcomes on the socio emotional development during their play. Both teachers and parents showed positive perceptions towards the acquired socio emotional development during their play activities. In conclusion, this research summarizes that teacher’s role and parent’s support can improve children`s socio emotional development through play activities. As a whole, this research highlighted the significance of play activities as to stimulate socio emotional development among the pre-school children.

Keywords: social emotional, children, play activities, stimulating

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153 Report of Soundings in Tappeh Shahrestan in Order to Determine Its Field and Propose Privacy, Documenting and Systematic Review of Geophysical Studies

Authors: Reza Mehrafarin, Nafiseh Mirshekari, Mahyar Mehrafarin

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In 25 km southeast of Zabul (center of Sistan, in the east of Iran), a large hill can be seen. This hill, which is located next to the bend of the Sistan river, is known as the Tappeh Shahrestan. The length of the Tappeh Shahrestan is 1350 meters, its width is 360 meters, and its height is 20 meters, which in total reaches to 48 hectares. The capital of Sistan province was Ram Shahrestan in the Sassanid period, according to Iranian historical texts and Sassanid Pahlavi traditions. The city was abandoned because the nearby river dried up. Then another capital was built in Sistan called Zarang. But due to the long passage of time since the destruction of the city, its real location was forgotten and and some archaeologists have suggested different areas as the main location of the Ram Shahrestan. In 2018, the first archaeological field activities took place on and around the hillin order to answer this question: was Tappe Shahristan the same as Ram Shahristan, the capital of Sistan, during the Sassanid period? In order to answer this question, archaeological field activities were carried out on and around the hill. The field activities of the first season included the followings: 1- Preparation of hill topography and plan metric 3-Archaeogeophysics studies 3-Methodical study of archeology 4-Determining the range of the hill by soundings5-Documentation of the hill 6-Classification, typology, and comparison of pottery typology. The results of archaeological field activities in the first phase of Tappeh Shahrestan showed that this ancient site was the same city of Ram Shahrestan, the capital of Sistan, during the Sassanid period. The beginning of settlement in this city was the third century BC and the time of leaving was the end of the third century AD. The most important factors in the creation of the city was the abundant water of the Sistan River and its convenient location, and the most important reason for the abandonment of the city was the Sistan River, whose water completely dried up.

Keywords: archaeological surveys, archaeological soundings, ram shahrestan, sistan, tappeh shahrestan

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152 Performance of Rural and Urban Adult Participants on Neuropsychological Tests in Zambia

Authors: Happy Zulu

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Neuropsychological examination is an important way of formally assessing brain function. While there is so much documentation about the influence that some factors, such as age and education, have on neuropsychological tests (NP), not so much has been done to assess the influence that residency (rural/urban) may have. The specific objectives of this study were to establish if there is a significant difference in mean test scores on NP tests between rural and urban participants and to assess which tests on the Zambia Neurobehavioural Test Battery (ZNTB) are more affected by the participants‘ residency (rural/urban) and to determine the extent to which education, gender, and age predict test performance on NP tests for rural and urban participants. The participants (324) were drawn from both urban and rural areas of Zambia (Rural = 152 and Urban = 172). However, only 234 participants (Rural = 152 and Urban 82) were used for all the analyses in this particular study. The 234 participants were used as the actual proportion of the rural vs urban population in Zambia was 65% : 35%, respectively (CSO, 2003). The rural-urban ratio for the participants that were captured during the data collection process was 152 : 172, respectively. Thus, all the rural participants (152) were included and 90 of the 172 urban participants were randomly excluded so that the rural/urban ratio reached the desired 65% : 35 % which was the required ideal statistic for appropriate representation of the actual population in Zambia. Data on NP tests were analyzed from 234 participants, rural (N=152) reflecting 65% and urban (N=82) reflecting 35%. T-tests indicated that urban participants had superior performances in all the seven NP test domains, and all the mean differences in all these domains were found to be statistically significant. Residency had a large or moderate effect in five domains, while its effect size was small only in two of the domains. A standard multiple regression revealed that education, age and residency as predictor variables made a significant contribution to variance in performance on various domains of the ZNTB. However, the gender of participants was not a major factor in determining one‘s performance on neuropsychological tests. This particular report is part of an ongoing, larger, cutting-edge study aimed at formulating the normative data for Zambia with regard to performance on neuropsychological tests. This is necessary for appropriate, effective, and efficient assessment or diagnosis of various neurocognitive and neurobehavioural deficits that a number of people may currently be suffering from. It has been shown in this study that it is vital to make careful analyses of the variables that may be associated with one‘s performance on neuropsychological tests.

Keywords: neuropsychology, neurobehavioural, residency, Zambia

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151 Tiger Team Strategy as a Health District Response to the COVID-19 Pandemic in Sydney, Australia during the Period between March 2020 to January 2022

Authors: Rehana Khan

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Background: The study investigates the experiences of Tiger Teams within the Sydney Local Health District during the COVID-19 pandemic. Aim: The aims were to understand the experiences of the Tiger Team members, to evaluate the effectiveness of Tiger Teams, and to elicit any learnings for future implementation of Tiger Teams in a similar context. Methods: Tiger Team members who worked from March 2020 to January 2022 were approached, with 23 members agreeing to participate in the study. Individual interviews were undertaken by a researcher on a virtual platform. Thematic analysis was used to analyse the data. Saturation was deemed to have been reached when no new themes or subthemes arose within the final three interviews. Results: Four themes emerged: diversity worked well in Tiger Teams; fear of the unknown and challenging conversations were the main challenges of Tiger Teams; improved use of resources and more structure around the strategy of the Tiger Team model would help in future implementations; and Sydney Local Health District’s response to the pandemic was uniformly considered effective in keeping the community safe. In relation to Sydney Local Health District’s response in future pandemics, participants suggested having a pool of staff in readiness to undertake Tiger Team duties when required; prioritise staff welfare at all levels of involvement during a pandemic; maintaining transparent communication and relationship building between Executive level, Tiger Team members and clinical floor level in relation to decision making; and improve documentation, including evaluations of the COVID-19 pandemic response. Implications: The study provides constructive insights into the experiences of Tiger Team members, and these findings will help inform future planning for surge and secondment of staff in public health emergencies.

Keywords: Tiger Team, pandemic response, future planning, COVID-19

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150 Marketing Strategy and Marketing Mix for Rural Tour Package in Bali: Case Study of Munduk

Authors: Made Darmiati, Ni Putu Evi Wijayanti, Ni Ketut Wiwiek Agustina, Putu Gde Arie Yudhistira, Marcel Hardono

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The establishment of tourist village has been the main concern for pro-poor tourism in Indonesia especially in Bali in order to create alternative tourist destination. The case study of this research was Munduk, a tourist village located in Buleleng Regency, Bali Province. Munduk has been unstable in terms of tourist visit in 2012 until 2016. The concept of marketing strategy and its marketing mix are concepts that suitable for application in Munduk as the prime owner of trekking and other rural tour packages to increase the number of visitor in particularly during low season. The research study aims to determine the internal factors (strengths and weaknesses) and external factors (opportunities and threats) impacting the number of tourist visit so that they could formulate appropriate marketing strategy for Munduk Tourist Village. Data has been obtained by observation, interviews with stakeholders, questionnaire to 100 participants and documentation. In addition, this research study uses descriptive qualitative methods and techniques known as SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis by internal factors and external factors impacting the level of tourist visit to Munduk Tourist Village in Buleleng Regency, Bali. The sampling was done by ‘accidental sampling technique’ to obtain the participants to analyse the results of the SWOT analysis. Further assessment of internal and external weights has resulted respectively (1.84 , 1.84) which are in the first quadrant of the diagram in which S-O (Strengths-Opportunities) Strategy. As the prime owner of the trekking and other rural tour packages in the village, Munduk should maximise its strengths and take other opportunities as possible to wrap and design trekking and other rural tour packages and then offer the package to travel agents in Bali.

Keywords: marketing mix, marketing strategy, rural tourism, SWOT matrix

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149 Empowered Women Entrepreneurs and Sustainable Rural Tourism: A Study into the Voices and Experiences of Local Women in the Sundarbans Area of Bangladesh

Authors: Jakia Rajoana

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The aim of this paper is to examine the role of women entrepreneurs in bringing about sustainable rural tourism (SRT) development in Sundarbans area of Bangladesh. Theoretically, it draws upon empowerment and entrepreneurial marketing concepts. Women entrepreneurship development and lack of empowered women as role models is an important issue for developing economies in South Asia. Despite the substantial role women play in rural economy of Sundarbans, their contribution remains overlooked as enterprises led by them are run on an informal basis and their business acumen is not taken seriously both by their families and society at large. Studies on SRT fail to engage in sufficient depth with the term applied in this paper as ‘invisible women on the margins’ who run their enterprises with no formal training or societal/familial support. Moreover, the link between their (non) tourism enterprise and their empowerment remains under-theorized. Thus empirically, this research seeks to fill a significant gap by focusing on a considerably under-researched Sundarbans region. Methodologically, this study follows a qualitative research design using visual ethnographic approach. Participant observation, semi-structured interviews, and documentation are the primary data collection instruments in three coastal communities – Munshigonj, Burigoalini and Gabura – in the Sundarbans area. By focusing on the narratives of these under-investigated women, this work aims to provide in-depth and nuanced insights into salient issues on marginal communities experience from rural women’s perspectives. Initial findings illustrate that the Sundarbans women have low income due to no or little education. In addition, socio-cultural and religious factors also restrict the scope of their extensive contribution to workplace. In addition, physical and social violence which is a common occurrence for these women inhibits their agency and contributes to their disempowerment.

Keywords: gender, empowerment, entrepreneurial marketing, sustainable rural tourism, Sundarbans

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148 Social Licence to Operate Methodology to Secure Commercial, Community and Regulatory Approval for Small and Large Scale Fisheries

Authors: Kelly S. Parkinson, Katherine Y. Teh-White

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Futureye has a bespoke social licence to operate methodology which has successfully secured community approval and commercial return for fisheries which have faced regulatory and financial risk. This unique approach to fisheries management focuses on delivering improved social and environmental outcomes to support the fishing industry make steps towards achieving the United Nations SDGs. An SLO is the community’s implicit consent for a business or project to exist. An SLO must be earned and maintained alongside regulatory licences. In current and new operations, it helps you to anticipate and measure community concerns around your operations – leading to more predictable and sensible policy outcomes that will not jeopardise your commercial returns. Rising societal expectations and increasing activist sophistication mean the international fishing industry needs to resolve community concerns at each stage their supply chain. Futureye applied our tested social licence to operate (SLO) methodology to help Austral Fisheries who was being attacked by activists concerned about the sustainability of Patagonian Toothfish. Austral was Marine Stewardship Council certified, but pirates were making the overall catch unsustainable. Austral wanted to be carbon neutral. SLO provides a lens on the risk that helps industries and companies act before regulatory and political risk escalates. To do this assessment, we have a methodology that assesses the risk that we can then translate into a process to create a strategy. 1) Audience: we understand the drivers of change and the transmission of those drivers across all audience segments. 2) Expectation: we understand the level of social norming of changing expectations. 3) Outrage: we understand the technical and perceptual aspects of risk and the opportunities to mitigate these. 4) Inter-relationships: we understand the political, regulatory, and reputation system so that we can understand the levers of change. 5) Strategy: we understand whether the strategy will achieve a social licence through bringing the internal and external stakeholders on the journey. Futureye’s SLO methodologies helped Austral to understand risks and opportunities to enhance its resilience. Futureye reviewed the issues, assessed outrage and materiality and mapped SLO threats to the company. Austral was introduced to a new way that it could manage activism, climate action, and responsible consumption. As a result of Futureye’s work, Austral worked closely with Sea Shepherd who was campaigning against pirates illegally fishing Patagonian Toothfish as well as international governments. In 2016 Austral launched the world’s first carbon neutral fish which won Austral a thirteen percent premium for tender on the open market. In 2017, Austral received the prestigious Banksia Foundation Sustainability Leadership Award for seafood that is sustainable, healthy and carbon neutral. Austral’s position as a leader in sustainable development has opened doors for retailers all over the world. Futureye’s SLO methodology can identify the societal, political and regulatory risks facing fisheries and position them to proactively address the issues and become an industry leader in sustainability.

Keywords: carbon neutral, fisheries management, risk communication, social licence to operate, sustainable development

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147 Fractured Neck of Femur Patients; The Feeding Problems

Authors: F. Christie, M. Staber

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Malnutrition is a predictor of poor clinical outcome in the elderly. Up to 60% of hip fracture patients are clinically malnourished on admission. This study assessed the perioperative nutritional state of patients admitted with a proximal femoral fracture and examined if adequate nutritional support was achieved. Methods: Prospective, the observational audit of 30 patients, admitted with a proximal femoral fracture, over a one-month period. We recorded: patient demographics; surgical delay; nutritional state on admission; documentation of Malnutrition Universal Screening Tool (MUST) score; dietician input and daily calorie intake through food charts. The nutritional state was re-assessed weekly and at discharge. The outcome was measured by the length of hospital stay and thirty-day mortality. Results: Mean age 87, M:F 1:2 and all patients were ASA three or four. Five patients (17%) had a prolonged ( >24 hours) fasting period. All patients had a MUST score completed on admission, 27% were underweight and 30% were high risk for malnutrition. Twenty-six patients (87%) were appropriately assessed for dietician referral. Thirteen patients had food charts; on average, hospital meals provided 1500kcal daily. No patient achieved > 75% of the provided calories with 69% of patients achieving 50% or less. Only three patients were started on nutritional supplements. Twenty-three patients (77%) lost weight, averaging 6% weight loss during admission. Mean length of stay (LOS) was 23 days and 30-day mortality 9%. Four patients (13%) gained weight, their mean LOS was 17 days and 30-day mortality 0%. Discussion: Malnutrition in the elderly originates in the community. Following major trauma it’s difficult to reverse nutritional deficits in hospitals. It’s therefore concerning that no high-risk patient achieved their recommended calorie intake. Perioperative optimisation needs to include early nutritional intervention, early anaesthetic review and adjusted anaesthetic techniques to support feeding.

Keywords: trauma, nutrition, neck of femur fracture

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146 Developing a Research Culture in the Faculty of Engineering and Information Technology at the Central University of Technology, Free State: Implications for Knowledge Management

Authors: Mpho Agnes Mbeo, Patient Rambe

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The thirteenth year of the Central University of Technology, Free State’s (CUT) transition from a vocational and professional training orientation institution (i.e. a technikon) into a university with a strong research focus has neither been a smooth nor an easy one. At the heart of this transition was the need to transform the psychological faculties of academic and research staffs compliment who were accustomed to training graduates for industrial placement. The lack of a culture of research that fully embraces a strong ethos of conducting world-class research needed to be addressed. The induction and socialisation of academic staff into the development and execution of cutting-edge research also required the provision of research support and the creation of a conducive academic environment for research, both for emerging and non-research active academics. Drawing on ten cases, comprising four heads of departments, three prolific established researchers, and three emerging researchers, this study explores the challenges faced in establishing a strong research culture at the university. Furthermore, it gives an account of the extent to which the current research interventions have addressed the perceivably “missing research culture”, and the implications of these interventions for knowledge management. Evidence suggests that the endowment of an ideal institutional research environment (comprising strong internet networks, persistent connectivity on and off campus), research peer mentorship, and growing publication outputs should be matched by a coherent research incentive culture and strong research leadership. This is critical to building new knowledge and entrenching knowledge management founded on communities of practice and scholarly networking through the documentation and communication of research findings. The study concludes that the multiple policy documents set for the different domains of research may be creating pressure on researchers to engage research activities and increase output at the expense of research quality.

Keywords: Central University of Technology, performance, publication, research culture, university

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145 Project Marayum: Creating a Community Built Mobile Phone Based, Online Web Dictionary for Endangered Philippine Languages

Authors: Samantha Jade Sadural, Kathleen Gay Figueroa, Noel Nicanor Sison II, Francis Miguel Quilab, Samuel Edric Solis, Kiel Gonzales, Alain Andrew Boquiren, Janelle Tan, Mario Carreon

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Of the 185 languages in the Philippines, 28 are endangered, 11 are dying off, and 4 are extinct. Language documentation, as a prerequisite to language education, can be one of the ways languages can be preserved. Project Marayum is envisioned to be a collaboratively built, mobile phone-based, online dictionary platform for Philippine languages. Although there are many online language dictionaries available on the Internet, Project Marayum aims to give a sense of ownership to the language community's dictionary as it is built and maintained by the community for the community. From a seed dictionary, members of a language community can suggest changes, add new entries, and provide language examples. Going beyond word definitions, the platform can be used to gather sample sentences and even audio samples of word usage. These changes are reviewed by language experts of the community, sourced from the local state universities or local government units. Approved changes are then added to the dictionary and can be viewed instantly through the Marayum website. A companion mobile phone application allows users to browse the dictionary in remote areas where Internet connectivity is nonexistent. The dictionary will automatically be updated once the user regains Internet access. Project Marayum is still a work in progress. At the time of this abstract's writing, the Project has just entered its second year. Prototypes are currently being tested with the Asi language of Romblon island as its initial language testbed. In October 2020, Project Marayum will have both a webpage and mobile application with Asi, Ilocano, and Cebuano language dictionaries available for use online or for download. In addition, the Marayum platform would be then easily expandable for use of the more endangered language communities. Project Marayum is funded by the Philippines Department of Science and Technology.

Keywords: collaborative language dictionary, community-centered lexicography, content management system, software engineering

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144 Morphology and Risk Factors for Blunt Aortic Trauma in Car Accidents: An Autopsy Study

Authors: Ticijana Prijon, Branko Ermenc

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Background: Blunt aortic trauma (BAT) includes various morphological changes that occur during deceleration, acceleration and/or body compression in traffic accidents. The various forms of BAT, from limited laceration of the intima to complete transection of the aorta, depends on the force acting on the vessel wall and the tolerance of the aorta to injury. The force depends on the change in velocity, the dynamics of the accident and of the seating position in the car. Tolerance to aortic injury depends on the anatomy, histological structure and pathomorphological alterations due to aging or disease of the aortic wall.An overview of the literature and medical documentation reveals that different terms are used to describe certain forms of BAT, which can lead to misinterpretation of findings or diagnoses. We therefore, propose a classification that would enable uniform systematic screening of all forms of BAT. We have classified BAT into three morphologycal types: TYPE I (intramural), TYPE II (transmural) and TYPE III (multiple) aortic ruptures with appropriate subtypes. Methods: All car accident casualties examined at the Institute of Forensic Medicine from 2001 to 2009 were included in this retrospective study. Autopsy reports were used to determine the occurrence of each morphological type of BAT in deceased drivers, front seat passengers and other passengers in cars and to define the morphology of BAT in relation to the accident dynamics and the age of the fatalities. Results: A total of 391 fatalities in car accidents were included in the study. TYPE I, TYPE II and TYPE III BAT were observed in 10,9%, 55,6% and 33,5%, respectively. The incidence of BAT in drivers, front seat and other passengers was 36,7%, 43,1% and 28,6%, respectively. In frontal collisions, the incidence of BAT was 32,7%, in lateral collisions 54,2%, and in other traffic accidents 29,3%. The average age of fatalities with BAT was 42,8 years and of those without BAT 39,1 years. Conclusion: Identification and early recognition of the risk factors of BAT following a traffic accident is crucial for successful treatment of patients with BAT. Front seat passengers over 50 years of age who have been injured in a lateral collision are the most at risk of BAT.

Keywords: aorta, blunt trauma, car accidents, morphology, risk factors

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143 Descriptive Assessment of Health and Safety Regulations and Its Current Situation in the Construction Industry of Pakistan

Authors: Khawaja A. Wahaj Wani, Aykut Erkal

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Pakistan's construction industry, a key player in economic development, has experienced remarkable growth. However, the surge in activities has been accompanied by dangerous working conditions, attributed to legislative gaps and flaws. Unhealthy construction practices, uncertain site conditions, and hazardous environments contribute to a concerning rate of injuries and fatalities. The principal aim of this research study is to undertake a thorough evaluation based on the assessment of the current situation of Health & Safety policies and the surveys performed by stakeholders of Pakistan with the aim of providing solution-centric methodologies for the enforcement of health and safety regulations within construction companies operating on project sites. Recognizing the pivotal role that the construction industry plays in bolstering a nation's economy, it is imperative to address the pressing need for heightened awareness among site engineers and laborers. The study adopts a robust approach, utilizing questionnaire surveys and interviews. As an exclusive investigative study, it encompasses all stakeholders: clients, consultants, contractors, and subcontractors. Targeting PEC-registered companies. Safety performance was assessed through the examination of sixty safety procedures using SPSS-18. A high Cronbach's alpha value of 0.958 ensures data reliability, and non-parametric tests were employed due to the non-normal distribution of data. The safety performance evaluation revealed significant insights. "Using Hoists and Cranes" and "Precautionary Measures (Shoring and Excavation)" exhibited commendable safety levels. Conversely, "Trainings on Safety" displayed a lower safety performance, alongside areas such as "Safety in Contract Documentation," "Meetings for Safety," and "Worker Participation," indicating room for improvement. These findings provide stakeholders with a detailed understanding of current safety measures within Pakistan's construction industry.

Keywords: construction industry, health and safety regulations, Pakistan, risk management

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142 Effective Public Health Communication: Vaccine Health Messaging with Aboriginal and Torres Strait Islander Peoples

Authors: Maria Karidakis, Barbara Kelly

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The challenges precipitated by the advent of COVID-19 have brought to the fore the task governments and key stakeholders are faced with; ensuring public health communication is readily accessible to vulnerable populations. COVID-19 has presented challenges for the provision and reception of timely, accessible, and accurate health information pertaining to vaccine health messaging to Aboriginal and Torres Strait Islander peoples. The aim of this qualitative study was to explore strategies used by Aboriginal-led organisations to improve communication about COVID-19 and vaccination for their communities and to explore how these mediation and outreach strategies were received by community members. We interviewed 6 Aboriginal-led organisations and 15 community members from several states across Australian, and these interviews were analysed thematically. The findings suggest that effective public health communication is enhanced when aFirst nations-led response defines the governance that happens in First Nations communities. Pro-active and self-determining Aboriginal leadership and decision-making helps drive the response to counter a growing trend towards vaccine hesitancy. Other strategies include establishing partnerships with government departments and relevant non-governmental organisations to ensure services are implemented and culturally appropriate. The outcomes of this research will afford policymakers, stakeholders in healthcare, and cultural mediators the capacity to identify strengths and potential problems associated with pandemic health information and to subsequently implement creative and culturally specific solutions that go beyond the provision of written documentation via translation or interpreting. It will also enable governing bodies to adjust multilingual polices and to adopt mediation strategies that will improve information delivery and intercultural services on a national and international level.

Keywords: intercultural communication, qualitative, public health communication, COVID-19, pandemic, mediated communication, first nations people

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141 Reduplication In Urdu-Hindi Nonsensical Words: An OT Analysis

Authors: Riaz Ahmed Mangrio

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Reduplication in Urdu-Hindi affects all major word categories, particles, and even nonsensical words. It conveys a variety of meanings, including distribution, emphasis, iteration, adjectival and adverbial. This study will primarily discuss reduplicative structures of nonsensical words in Urdu-Hindi and then briefly look at some examples from other Indo-Aryan languages to introduce the debate regarding the same structures in them. The goal of this study is to present counter-evidence against Keane (2005: 241), who claims “the base in the cases of lexical and phrasal echo reduplication is always independently meaningful”. However, Urdu-Hindi reduplication derives meaningful compounds from nonsensical words e.g. gũ mgũ (A) ‘silent and confused’ and d̪əb d̪əb-a (N) ‘one’s fear over others’. This needs a comprehensive examination to see whether and how the various structures form patterns of a base-reduplicant relationship or, rather, they are merely sub lexical items joining together to form a word pattern of any grammatical category in content words. Another interesting theoretical question arises within the Optimality framework: in an OT analysis, is it necessary to identify one of the two constituents as the base and the other as reduplicant? Or is it best to consider this a pattern, but then how does this fit in with an OT analysis? This may be an even more interesting theoretical question. Looking for the solution to such questions can serve to make an important contribution. In the case at hand, each of the two constituents is an independent nonsensical word, but their echo reduplication is nonetheless meaningful. This casts significant doubt upon Keane’s (2005: 241) observation of some examples from Hindi and Tamil reduplication that “the base in cases of lexical and phrasal echo reduplication is always independently meaningful”. The debate on the point becomes further interesting when the triplication of nonsensical words in Urdu-Hindi e.g. aẽ baẽ ʃaẽ (N) ‘useless talk’ is also seen, which is equally important to discuss. The example is challenging to Harrison’s (1973) claim that only the monosyllabic verbs in their progressive forms reduplicate twice to result in triplication, which is not the case with the example presented. The study will consist of a thorough descriptive analysis of the data for the purpose of documentation, and then there will be OT analysis.

Keywords: reduplication, urdu-hindi, nonsensical, optimality theory

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140 The Influence of the Institutional Environment in Increasing Wealth: The Case of Women Business Operators in a Rural Setting

Authors: S. Archsana, Vajira Balasuriya

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In Trincomalee of Sri Lanka, a post-conflict area, resettlement projects and policy initiatives are taking place to improve the wealth of the rural communities through promoting economic activities by way of encouraging the rural women to opt to commence and operate Micro and Small Scale (MSS) businesses. This study attempts to identify the manner in which the institutional environment could facilitate these MSS businesses owned and operated by women in the rural environment. The respondents of this study are the beneficiaries of the Divi Neguma Development Training Program (DNDTP); a project designed to aid women owned MSS businesses, in Trincomalee district. 96 women business operators, who had obtained financing facilities from the DNDTP, are taken as the sample based on fixed interval random sampling method. The study reveals that primary challenges encountered by 82% of the women business operators are lack of initial capital followed by 71% initial market finding and 35% access to technology. The low level of education and language barriers are the constraints in accessing support agencies/service providers. Institutional support; specifically management and marketing services, have a significant relationship with wealth augmentation. Institutional support at the setting-up stage of businesses are thin whereas terms and conditions of the finance facilities are perceived as ‘too challenging’. Although diversification enhances wealth of the rural women business operators, assistance from the institutional framework to prepare financial reports that are required for business expansion is skinny. The study further reveals that institutional support is very much weak in terms of providing access to new technology and identifying new market networks. A mechanism that could facilitate the institutional framework to support the rural women business operators to access new technology and untapped market segments, and assistance in preparation of legal and financial documentation is recommended.

Keywords: business facilitation, institutional support, rural women business operators, wealth augmentation

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139 Tectonic Complexity: Out-of-Sequence Thrusting in the Higher Himalaya of Jhakri-Sarahan region, Himachal Pradesh, India

Authors: Rajkumar Ghosh

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The study focuses on the tectonics of out-of-sequence thrusting (OOST) in the NW region of the Himalaya, particularly in Himachal Pradesh. The research aims to identify the features and nature of OOST in the field and the associated rock types and lithological boundaries in the field of NW Himalaya, Himachal Pradesh, India. The research employs fieldwork and micro-structure observations, correlations, and analyses to identify and analyze the OOST features and associated rock types. The study reveals the presence of three OOSTs, namely Jhakri Thrust (JT), Sarahan Thrust (ST), and Chaura Thrust (CT), which consist of several branches, some of which are still active. The thrust system exhibits varying internal geometry, including box folds, boudins, scar folds, crenulation cleavages, kink folds, and tension gashes. The CT, which is concealed beneath Jutogh Thrust sheet, represents a steepened downward thrust, while the JT has a western dip and is south-westward verging. The research provides crucial information on the tectonics of OOST in the NW region of the Himalaya, particularly in Himachal Pradesh, which is crucial in understanding the regional geological evolution and associated hazards. The data were collected through fieldwork and micro-structure observations, correlations, and analyses of rock samples. The data were analyzed using tectonic and geochronological techniques to identify the nature and characteristics of OOST. The research addressed the question of identifying Higher Himalayan OOST in the field of NW Himalaya, Himachal Pradesh, India, and the associated rock types and lithological boundaries. The study concludes that there is minimal documentation and a lack of suitable exposure of rocks to generalize the features of OOST in the field in NW Higher Himalaya, Himachal Pradesh. The study recommends more extensive mapping and fieldwork to improve understanding of OOST in the region.

Keywords: out-of-sequence thrust (OOST), main central thrust (MCT), jhakri thrust (JT), sarahan thrust (ST), chaura thrust (CT), higher himalaya (HH)

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138 Creation and Implementation of A New Palliative Care Drug Chart, via A Closed-Loop Audit

Authors: Asfa Hussain, Chee Tang, Mien Nguyen

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Introduction: The safe usage of medications is dependent on clear, well-documented prescribing. Medical drug charts should be regularly checked to ensure that they are fit for purpose. Aims: The purpose of this study was to evaluate whether the Isabel Hospice drug charts were effective or prone to medical errors. The aim was to create a comprehensive palliative care drug chart in line with medico-legal guidelines and to minimise drug administration and prescription errors. Methodology: 50 medical drug charts were audited from March to April 2020, to assess whether they complied with medico-legal guidelines, in a hospice within East of England. Meetings were held with the larger multi-disciplinary team (MDT), including the pharmacists, nursing staff and doctors, to raise awareness of the issue. A preliminary drug chart was created, using the input from the wider MDT. The chart was revised and trialled over 15 times, and each time feedback from the MDT was incorporated into the subsequent template. In the midst of the COVID-19 pandemic in September 2020, the finalised drug chart was trialled. 50 new palliative drug charts were re-audited, to evaluate the changes made. Results: Prescribing and administration errors were high prior to the implementation of the new chart. This improved significantly after introducing the new drug charts, therefore improving patient safety and care. The percentage of inadequately documented allergies went down from 66% to 20% and incorrect oxygen prescription from 40% to 16%. The prescription drug-drug interactions decreased by 30%. Conclusion: It is vital to have clear standardised drug charts, in line with medico-legal standards, to allow ease of prescription and administration of medications and ensure optimum patient-centred care. This closed loop audit demonstrated significant improvement in documentation and prevention of possible fatal drug errors and interactions.

Keywords: palliative care, drug chart, medication errors, drug-drug interactions, COVID-19, patient safety

Procedia PDF Downloads 141
137 Developing Indicators in System Mapping Process Through Science-Based Visual Tools

Authors: Cristian Matti, Valerie Fowles, Eva Enyedi, Piotr Pogorzelski

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The system mapping process can be defined as a knowledge service where a team of facilitators, experts and practitioners facilitate a guided conversation, enable the exchange of information and support an iterative curation process. System mapping processes rely on science-based tools to introduce and simplify a variety of components and concepts of socio-technical systems through metaphors while facilitating an interactive dialogue process to enable the design of co-created maps. System maps work then as “artifacts” to provide information and focus the conversation into specific areas around the defined challenge and related decision-making process. Knowledge management facilitates the curation of that data gathered during the system mapping sessions through practices of documentation and subsequent knowledge co-production for which common practices from data science are applied to identify new patterns, hidden insights, recurrent loops and unexpected elements. This study presents empirical evidence on the application of these techniques to explore mechanisms by which visual tools provide guiding principles to portray system components, key variables and types of data through the lens of climate change. In addition, data science facilitates the structuring of elements that allow the analysis of layers of information through affinity and clustering analysis and, therefore, develop simple indicators for supporting the decision-making process. This paper addresses methodological and empirical elements on the horizontal learning process that integrate system mapping through visual tools, interpretation, cognitive transformation and analysis. The process is designed to introduce practitioners to simple iterative and inclusive processes that create actionable knowledge and enable a shared understanding of the system in which they are embedded.

Keywords: indicators, knowledge management, system mapping, visual tools

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136 Assessment of the Possible Effects of Biological Control Agents of Lantana camara and Chromolaena odorata in Davao City, Mindanao, Philippines

Authors: Cristine P. Canlas, Crislene Mae L. Gever, Patricia Bea R. Rosialda, Ma. Nina Regina M. Quibod, Perry Archival C. Buenavente, Normandy M. Barbecho, Cynthia Adeline A. Layusa, Michael Day

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Invasive plants have an impact on global biodiversity and ecosystem function, and their management is a complex and formidable task. Two of these invasive plant species, Lantana camara and Chromolaena odorata, are found in the Philippines. Lantana camara has the ability to suppress the growth of and outcompete neighboring plants. Chromolaena odorata causes serious agricultural and economical damage and causes fire hazards during dry season. In addition, both species has been reported to poison livestock. One of the known global management strategies to control invasive plants is the introduction of biological control agents. These natural enemies of the invasive plants reduce population density and impacts of the invasive plants, resulting in the balance of the nature in their invasion. Through secondary data sources, interviews, and field validation (e.g. microhabitat searches, sweep netting, opportunistic sampling, photo-documentation), we investigated whether the biocontrol agents previously released by the Philippine Coconut Authority (PCA) in their Davao Research Center to control these invasive plants are still present and are affecting their respective host weeds. We confirm the presence of the biocontrol agent of L. camara, Uroplata girardi, which was introduced in 1985, and Cecidochares connexa, a biocontrol agent of C. odorata released in 2003. Four other biocontrol agents were found to affect L. camara. Signs of damage (e.g. stem galls in C. odorata, and leaf mines in L. camara) signify that these biocontrol agents have successfully established outside of their release site in Davao. Further investigating the extent of the spread of these biocontrol agents in the Philippines and their damage to the two weeds will contribute to the management of invasive plant species in the country.

Keywords: invasive alien species, biological control agent, entomology, worst weeds

Procedia PDF Downloads 342