Search results for: economic analyses
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2343

Search results for: economic analyses

243 The Resource-Base View of Organization and Innovation: Recognition of Significant Relationship in an Organization

Authors: Francis Deinmodei W. Poazi, Jasmine O. Tamunosiki-Amadi, Maurice Fems

Abstract:

In recent times the resource-based view (RBV) of strategic management has recorded a sizeable attention yet there has not been a considerable scholarly and managerial discourse, debate and attention. As a result, this paper gives special bit of critical reasoning as well as top-notch analyses and relationship between RBV and organizational innovation. The study examines those salient aspects of RBV that basically have the will power in ensuring the organization's capacity to go for innovative capability. In achieving such fit and standpoint, the paper joins other relevant academic discourse and empirical evidence. To this end, a reasonable amount of contributions in setting the ground running for future empirical researches would have been provided. More so, the study is guided and built on the following strength and significance: Firstly, RBV sees resources as heterogeneity which forms a strong point of strength and allows organisations to gain competitive advantage. In order words, competitive advantage can be achieved or delivered to the organization when resources are distinctively utilized in a valuable manner more than the envisaged competitors of the organization. Secondly, RBV is significantly influential in determining the real resources that are available in the organization with a view to locate capabilities within in order to attract more profitability into the organization when applied. Thus, there will be more sustainable growth and success in the ever competitive and emerging market. Thus, to have succinct description of the basic methodologies, the study adopts both qualitative as well as quantitative approach with a view to have a broad samples of opinion in establishing and identifying key and strategic organizational resources to enable managers of resources to gain a competitive advantage as well as generating a sustainable increase and growth in profit. Furthermore, a comparative approach and analysis was used to examine the performance of RBV within the organization. Thus, the following are some of the findings of the study: it is clear that there is a nexus between RBV and growth of competitively viable organizations. More so, in most parts, organizations have heterogeneous resources domiciled in their organizations but not all organizations as it was specifically and intelligently adopting the tenets of RBV to strengthen heterogeneity of resources which allows organisations to gain competitive advantage. Other findings of this study reveal that of managerial perception of RBV with respect to application and transformation of resources to achieve a profitable end. It is against this backdrop, the importance of RBV cannot be overemphasized; the study is strongly convinced and think that RBV view is one focal and distinct approach that is focused on internal to outside strategy which engenders sourcing or generating resources internally as well as having the quest to apply such internally sourced resources diligently to increase or gain competitive advantage.

Keywords: Competitive advantage, innovation, organisation, recognition, resource-based view.

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242 Industrial Wastewater Sludge Treatment in Chongqing, China

Authors: Victor Emery David Jr, Jiang Wenchao, Yasinta John, Md. Sahadat Hossain

Abstract:

Sludge originates from the process of treatment of wastewater. It is the byproduct of wastewater treatment containing concentrated heavy metals and poorly biodegradable trace organic compounds, as well as potentially pathogenic organisms (viruses, bacteria, etc.) which are usually difficult to treat or dispose of. China, like other countries, is no stranger to the challenges posed by increase of wastewater. Treatment and disposal of sludge has been a problem for most cities in China. However, this problem has been exacerbated by other issues such as lack of technology, funding, and other factors. Suitable methods for such climatic conditions are still unavailable for modern cities in China. Against this background, this paper seeks to describe the methods used for treatment and disposal of sludge from industries and suggest a suitable method for treatment and disposal in Chongqing/China. From the research conducted, it was discovered that the highest treatment rate of sludge in Chongqing was 10.08%. The industrial waste piping system is not separated from the domestic system. Considering the proliferation of industry and urbanization, there is a likelihood that the production of sludge in Chongqing will increase. If the sludge produced is not properly managed, this may lead to adverse health and environmental effects. Disposal costs and methods for Chongqing were also included in this paper’s analysis. Research showed that incineration is the most expensive method of sludge disposal in China/Chongqing. Subsequent research therefore considered optional alternatives such as composting. Composting represents a relatively cheap waste disposal method considering the vast population, current technology and economic conditions of Chongqing, as well as China at large.

Keywords: Sludge, disposal of sludge, treatment, industrial sludge, Chongqing, wastewater.

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241 Co-payment Strategies for Chronic Medications: A Qualitative and Comparative Analysis at European Level

Authors: Pedro M. Abreu, Bruno R. Mendes

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The management of pharmacotherapy and the process of dispensing medicines is becoming critical in clinical pharmacy due to the increase of incidence and prevalence of chronic diseases, the complexity and customization of therapeutic regimens, the introduction of innovative and more expensive medicines, the unbalanced relation between expenditure and revenue as well as due to the lack of rationalization associated with medication use. For these reasons, co-payments emerged in Europe in the 70s and have been applied over the past few years in healthcare. Co-payments lead to a rationing and rationalization of user’s access under healthcare services and products, and simultaneously, to a qualification and improvement of the services and products for the end-user. This analysis, under hospital practices particularly and co-payment strategies in general, was carried out on all the European regions and identified four reference countries, that apply repeatedly this tool and with different approaches. The structure, content and adaptation of European co-payments were analyzed through 7 qualitative attributes and 19 performance indicators, and the results expressed in a scorecard, allowing to conclude that the German models (total score of 68,2% and 63,6% in both elected co-payments) can collect more compliance and effectiveness, the English models (total score of 50%) can be more accessible, and the French models (total score of 50%) can be more adequate to the socio-economic and legal framework. Other European models did not show the same quality and/or performance, so were not taken as a standard in the future design of co-payments strategies. In this sense, we can see in the co-payments a strategy not only to moderate the consumption of healthcare products and services, but especially to improve them, as well as a strategy to increment the value that the end-user assigns to these services and products, such as medicines.

Keywords: Clinical pharmacy, co-payments, healthcare, medicines.

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240 Power Production Performance of Different Wave Energy Converters in the Southwestern Black Sea

Authors: Ajab G. Majidi, Bilal Bingölbali, Adem Akpınar

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This study aims to investigate the amount of energy (economic wave energy potential) that can be obtained from the existing wave energy converters in the high wave energy potential region of the Black Sea in terms of wave energy potential and their performance at different depths in the region. The data needed for this purpose were obtained using the calibrated nested layered SWAN wave modeling program version 41.01AB, which was forced with Climate Forecast System Reanalysis (CFSR) winds from 1979 to 2009. The wave dataset at a time interval of 2 hours was accumulated for a sub-grid domain for around Karaburun beach in Arnavutkoy, a district of Istanbul city. The annual sea state characteristic matrices for the five different depths along with a vertical line to the coastline were calculated for 31 years. According to the power matrices of different wave energy converter systems and characteristic matrices for each possible installation depth, the probability distribution tables of the specified mean wave period or wave energy period and significant wave height were calculated. Then, by using the relationship between these distribution tables, according to the present wave climate, the energy that the wave energy converter systems at each depth can produce was determined. Thus, the economically feasible potential of the relevant coastal zone was revealed, and the effect of different depths on energy converter systems is presented. The Oceantic at 50, 75 and 100 m depths and Oyster at 5 and 25 m depths presents the best performance. In the 31-year long period 1998 the most and 1989 is the least dynamic year.

Keywords: Annual power production, Black Sea, efficiency, power production performance, wave energy converter.

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239 Off-Shore Port Management on the Environmental Issue - Case Study of Sichang Harbor

Authors: Sarisa Pechpoothong

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The research is to minimize environmental damage pertinent to maritime activities about the operation of lighter boat anchorage and its tugboat. The guidance on upgrading current harbor service and infrastructure has been provided to Kho Sichang Municpality. This will involve a study of the maritime logistics of the water area under jurisdiction of the Sichang island Municipality and possible recommendations may involve charging taxes, regulations and fees. With implementing these recommendations will help in protection of the marine environment and in increasing operator functionality. Additionally, our recommendation is to generate a consistent revenue stream to the municipality. The action items contained in this research are feasible and effective, the success of these initiatives are heavily dependent upon successful promotion and enforcement. Promoting new rules and regulations effectively and peacefully can be done through theories and techniques used in the psychology of persuasion. In order to assure compliance with the regulations, the municipality must maintain stringent patrols and fines for violators. In order to become success, the Municipality must preserve a consistent, transparent and significant enforcement system. Considering potential opportunities outside of the current state of the municipality, the authors recommend that Koh Sichang be given additional jurisdiction to capture value from the master vessels, as well as to confront the more significant environmental challenges these vessels pose. Finally, the authors recommend that the Port of Koh Sichang Island obtain a free port status in order to increase economic viability and overall sustainability.

Keywords: Harbor, Garbage Collection Service, Environment, Off-shore port.

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238 Creative Element Analysis of Machinery Creativity Contest Works

Authors: Chin-Pin, Chen, Shi-Chi, Shiao, Ting-Hao, Lin

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Current industry is facing the rapid development of new technology in the world and fierce changes of economic environment in the society so that the industry development trend gradually does not focus on labor, but leads the industry and the academic circle with innovation and creativity. The development trend in machinery industry presents the same situation. Based on the aim of Creativity White Paper, Ministry of Education in Taiwan promotes and develops various creativity contests to cope with the industry trend. Domestic students and enterprises have good performance on domestic and international creativity contests in recent years. There must be important creative elements in such creative works to win the award among so many works. Literature review and in-depth interview with five creativity contest awarded instructors are first proceeded to conclude 15 machinery creative elements, which are further compared with the creative elements of machinery awarded creative works in past five years to understand the relationship between awarded works and creative elements. The statistical analysis results show that IDEA (Industrial Design Excellence Award) contains the most creative elements among four major international creativity contests. That is, most creativity review focuses on creative elements that are comparatively stricter. Concerning the groups participating in creativity contests, enterprises consider more creative elements of the creative works than other two elements for contests. From such contest works, creative elements of “replacement or improvement”, “convenience”, and “modeling” present higher significance. It is expected that the above findings could provide domestic colleges and universities with reference for participating in creativity related contests in the future.

Keywords: Machinery, creativity contest, creative elements, creativity works.

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237 Optimizing the Components of Grid-Independent Microgrids for Rural Electrification Utilizing Solar Panel and Supercapacitor

Authors: Astiaj Khoramshahi, Hossein Ahmadi Danesh Ashtiani, Ahmad Khoshgard, Hamidreza Damghani, Leila Damghani

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Rural electrification rates are generally low in Iran and many parts of the world that lack sustainable renewable energy resources. Many homes are based on polluting solutions such as crude oil and diesel generators for lighting, heating, and charging electrical gadgets. Small-scale portable solar battery packs are accessible to the public; however, they have low capacity and are challenging to be distributed in developing countries. To design a battery-based microgrid power systems, the load profile is one of the key parameters. Additionally, the reliability of the system should be taken into account. A conventional microgrid system can be either AC or coupling DC. Both AC and DC microgrids have advantages and disadvantages depending on their application and can be either connected to the main grid or perform independently. This article proposes a tool for optimal sizing of microgrid-independent systems via respective analysis. To show such an analysis, the type of power generation, number of panels, battery capacity, microgrid size, and group of available consumers should be considered. Therefore, the optimization of different design scenarios is based on number of solar panels and super saving sources, ranges of the depth of discharges, to calculate size and estimate the overall cost. Generally, it is observed that there is an inverse relationship between the depth spectrum of discharge and the solar microgrid costs.

Keywords: Storage, super-storage, grid-independent, economic factors, microgrid.

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236 Optimization of the Characteristic Straight Line Method by a “Best Estimate“ of Observed, Normal Orthometric Elevation Differences

Authors: Mahmoud M. S. Albattah

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In this paper, to optimize the “Characteristic Straight Line Method" which is used in the soil displacement analysis, a “best estimate" of the geodetic leveling observations has been achieved by taking in account the concept of 'Height systems'. This concept has been discussed in detail and consequently the concept of “height". In landslides dynamic analysis, the soil is considered as a mosaic of rigid blocks. The soil displacement has been monitored and analyzed by using the “Characteristic Straight Line Method". Its characteristic components have been defined constructed from a “best estimate" of the topometric observations. In the measurement of elevation differences, we have used the most modern leveling equipment available. Observational procedures have also been designed to provide the most effective method to acquire data. In addition systematic errors which cannot be sufficiently controlled by instrumentation or observational techniques are minimized by applying appropriate corrections to the observed data: the level collimation correction minimizes the error caused by nonhorizontality of the leveling instrument's line of sight for unequal sight lengths, the refraction correction is modeled to minimize the refraction error caused by temperature (density) variation of air strata, the rod temperature correction accounts for variation in the length of the leveling rod' s Invar/LO-VAR® strip which results from temperature changes, the rod scale correction ensures a uniform scale which conforms to the international length standard and the introduction of the concept of the 'Height systems' where all types of height (orthometric, dynamic, normal, gravity correction, and equipotential surface) have been investigated. The “Characteristic Straight Line Method" is slightly more convenient than the “Characteristic Circle Method". It permits to evaluate a displacement of very small magnitude even when the displacement is of an infinitesimal quantity. The inclination of the landslide is given by the inverse of the distance reference point O to the “Characteristic Straight Line". Its direction is given by the bearing of the normal directed from point O to the Characteristic Straight Line (Fig..6). A “best estimate" of the topometric observations was used to measure the elevation of points carefully selected, before and after the deformation. Gross errors have been eliminated by statistical analyses and by comparing the heights within local neighborhoods. The results of a test using an area where very interesting land surface deformation occurs are reported. Monitoring with different options and qualitative comparison of results based on a sufficient number of check points are presented.

Keywords: Characteristic straight line method, dynamic height, landslides, orthometric height, systematic errors.

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235 Key Performance Indicators of Cold Supply Chain Practices in the Agriculture Sector: An Empirical Study on Egyptian Export Companies

Authors: Ahmed Barakat, Nourhan A. Saad, Mahmoud Hammad

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Tracking and monitoring agricultural products, cold chain activities, and transportation in real-time can effectively ensure both the quality and safety of agricultural products, as well as reduce overall logistics costs. Effective supply chain practices are one of the main requirements for enhancing agricultural business in Egypt. Cold chain is among the best practices for the storage and transportation of perishable goods and has potential within the agricultural sector in Egypt. This practice has the scope of reducing the wastage of food and increasing the profitability with a reduction in costs. Even though it has several implementation challenges for the farmers, traders, and people involved in the entire supply chain, it has highlighted better benefits for all and for the export of goods for the economic progression for Egypt. The aim of this paper is to explore cold supply chain practices for the agriculture sector in Egypt, to enhance the export performance of fresh goods. In this context, this study attempts to explore those aspects of the performance of cold supply chain practices that can enhance the functioning of the agriculture sector in Egypt from the perspective of export companies (traders) and farmers. Based on the empirical results obtained by data collection from the farmers and traders, the study argues that there is a significant association between cold supply chain practices and enhancement of the agriculture value chain. The paper thus highlights the contribution of the study with final conclusions and limitations with scope for future research.

Keywords: Agriculture sector, cold chain management, export companies, non-traded goods, supply chain management.

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234 Utilizing Fly Ash Cenosphere and Aerogel for Lightweight Thermal Insulating Cement-Based Composites

Authors: Asad Hanif, Pavithra Parthasarathy, Zongjin Li

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Thermal insulating composites help to reduce the total power consumption in a building by creating a barrier between external and internal environment. Such composites can be used in the roofing tiles or wall panels for exterior surfaces. This study purposes to develop lightweight cement-based composites for thermal insulating applications. Waste materials like silica fume (an industrial by-product) and fly ash cenosphere (FAC) (hollow micro-spherical shells obtained as a waste residue from coal fired power plants) were used as partial replacement of cement and lightweight filler, respectively. Moreover, aerogel, a nano-porous material made of silica, was also used in different dosages for improved thermal insulating behavior, while poly vinyl alcohol (PVA) fibers were added for enhanced toughness. The raw materials including binders and fillers were characterized by X-Ray Diffraction (XRD), X-Ray Fluorescence spectroscopy (XRF), and Brunauer–Emmett–Teller (BET) analysis techniques in which various physical and chemical properties of the raw materials were evaluated like specific surface area, chemical composition (oxide form), and pore size distribution (if any). Ultra-lightweight cementitious composites were developed by varying the amounts of FAC and aerogel with 28-day unit weight ranging from 1551.28 kg/m3 to 1027.85 kg/m3. Excellent mechanical and thermal insulating properties of the resulting composites were obtained ranging from 53.62 MPa to 8.66 MPa compressive strength, 9.77 MPa to 3.98 MPa flexural strength, and 0.3025 W/m-K to 0.2009 W/m-K as thermal conductivity coefficient (QTM-500). The composites were also tested for peak temperature difference between outer and inner surfaces when subjected to heating (in a specially designed experimental set-up) by a 275W infrared lamp. The temperature difference up to 16.78 oC was achieved, which indicated outstanding properties of the developed composites to act as a thermal barrier for building envelopes. Microstructural studies were carried out by Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray Spectroscopy (EDS) for characterizing the inner structure of the composite specimen. Also, the hydration products were quantified using the surface area mapping and line scale technique in EDS. The microstructural analyses indicated excellent bonding of FAC and aerogel in the cementitious system. Also, selective reactivity of FAC was ascertained from the SEM imagery where the partially consumed FAC shells were observed. All in all, the lightweight fillers, FAC, and aerogel helped to produce the lightweight composites due to their physical characteristics, while exceptional mechanical properties, owing to FAC partial reactivity, were achieved.

Keywords: Sustainable development, fly ash cenosphere, aerogel, lightweight, cement, composite.

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233 Level of Acceptability of Moringa oleifera Diversified Products among Rural and Urban Dwellers in Nigeria

Authors: Mojisola F. Oyewole, Franscisca T. Adetoro, Nkiru T. Meludu

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Moringa oleifera is a nutritious vegetable tree with varieties of potential uses, as almost every part of the Moringa oleifera tree can be used for food. This study was conducted in Oyo State, Nigeria, to find out the level of acceptability of Moringa oleifera diversified products among rural and urban dwellers. Purposive sampling was used to select two local governments’ areas. Stratified sampling technique was also used to select one community each from rural and urban areas while snowball sampling technique was used to select ten respondents each from the two communities, making a total number of forty respondents. Data were analyzed using frequencies, percentages, Chi-square, Pearson Product Moment Correlation and regression analysis. Result from the study revealed that majority of the respondents (80%) fell within the age range of 20-49 years and 55% of them were male, 55% were married, 70% of them were Christians, 80% of them had tertiary education. The result also showed that 85% were aware of the Moringa plant and (65%) of them have consumed Moringa oleifera and the perception statements on the benefits of Moringa oleifera indicated that (52.5%) of the respondents rated Moringa oleifera to be favorable, most of them had high acceptability for Moringa egusi soup, Moringa tea, Moringa pap and yam pottage with Moringa. The result of the hypotheses testing showed that there is a significant relationship between sex of the respondents and acceptability of the diversified Moringa oleifera products (x2=6.465, p = 0.011). There is also a significant relationship between family size of the respondents level of acceptability of the Moringa oleifera products (r = 0.327, p = 0.040). Based on the level of acceptability of Moringa oleifera diversified products; the plant is of great economic importance to the populace. Therefore, there should be more public awareness through the media to enlighten people on the beneficial effects of Moringa oleifera.

Keywords: Acceptability, Moringa oleifera, Diversified, Product, Dwellers.

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232 Quantification of Biomethane Potential from Anaerobic Digestion of Food Waste at Vaal University of Technology

Authors: Kgomotso Matobole, Pascal Mwenge, Tumisang Seodigeng

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The global urbanisation and worldwide economic growth have caused a high rate of food waste generation, resulting in environmental pollution. Food waste disposed on landfills decomposes to produce methane (CH4), a greenhouse gas. Inadequate waste management practices contribute to food waste polluting the environment. Thus effective organic fraction of municipal solid waste (OFMSW) management and treatment are attracting widespread attention in many countries. This problem can be minimised by the employment of anaerobic digestion process, since food waste is rich in organic matter and highly biodegradable, resulting in energy generation and waste volume reduction. The current study investigated the Biomethane Potential (BMP) of the Vaal University of Technology canteen food waste using anaerobic digestion. Tests were performed on canteen food waste, as a substrate, with total solids (TS) of 22%, volatile solids (VS) of 21% and moisture content of 78%. The tests were performed in batch reactors, at a mesophilic temperature of 37 °C, with two different types of inoculum, primary and digested sludge. The resulting CH4 yields for both food waste with digested sludge and primary sludge were equal, being 357 Nml/g VS. This indicated that food waste form this canteen is rich in organic and highly biodegradable. Hence it can be used as a substrate for the anaerobic digestion process. The food waste with digested sludge and primary sludge both fitted the first order kinetic model with k for primary sludge inoculated food waste being 0.278 day-1 with R2 of 0.98, whereas k for digested sludge inoculated food waste being 0.034 day-1, with R2 of 0.847.

Keywords: Anaerobic digestion, biogas, biomethane potential, food waste.

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231 Assessment of Negative Impacts Affecting Public Transportation Modes and Infrastructure in Burgersfort Town towards Building Urban Sustainability

Authors: Ntloana Hlabishi Peter

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The availability of public transportation modes and qualitative infrastructure is a burning issue that affects urban sustainability. Public transportation is indispensable in providing adequate transportation means to people at an affordable price, and it promotes public transport reliance. Burgersfort town has a critical condition on the urban public transportation infrastructure which affects the bus and taxi public transport modes and the existing infrastructure. The municipality is regarded as one of the mining towns in Limpopo Province considering the availability of mining activities and proposal on establishment of a Special Economic Zone (SEZ). The study aim is to assess the efficacy of current public transportation infrastructure and to propose relevant recommendations that will unlock the possibility of future supportable public transportation systems. The Key Informant Interview (KII) was used to acquire data on the views from commuters and stakeholders involved. There KII incorporated three relevant questions in relation to services rendered in public transportation. Relevant literature relating to public transportation modes and infrastructure revealed the imperatives of public transportation infrastructure, and relevant legislation was reviewed concerning public transport infrastructure. The finding revealed poor conditions on the public transportation ranks and also inadequate parking space for public transportation modes. The study reveals that 100% of people interviewed were not satisfied with the condition of public transportation infrastructure and 100% are not satisfied with the services offered by public transportation sectors. The findings revealed that the municipality is the main player who can upgrade the existing conditions of public transportation. The study recommended that an intermodal transportation facility must be established to resolve the emerging challenges.

Keywords: Public transportation, modes, infrastructure, urban sustainability.

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230 Human Trafficking: The Kosovar Perspective of Fighting the Phenomena through Police and Civil Society Cooperation

Authors: Samedin Mehmeti

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The rationale behind this study is considering combating and preventing the phenomenon of trafficking in human beings from a multidisciplinary perspective that involves many layers of the society. Trafficking in human beings is an abhorrent phenomenon highly affecting negatively the victims and their families in both human and material aspect, sometimes causing irreversible damages. The longer term effects of this phenomenon, in countries with a weak economic development and extremely young and dynamic population, such as Kosovo, without proper measures to prevented and control can cause tremendous damages in the society. Given the fact that a complete eradication of this phenomenon is almost impossible, efforts should be concentrated at least on the prevention and controlling aspects. Treating trafficking in human beings based on traditional police tactics, methods and proceedings cannot bring satisfactory results. There is no doubt that a multi-disciplinary approach is an irreplaceable requirement, in other words, a combination of authentic and functional proactive and reactive methods, techniques and tactics. Obviously, police must exercise its role in preventing and combating trafficking in human beings, a role sanctioned by the law, however, police role and contribution cannot by any means considered complete if all segments of the society are not included in these efforts. Naturally, civil society should have an important share in these collaborative and interactive efforts especially in preventive activities such as: awareness on trafficking risks and damages, proactive engagement in drafting appropriate legislation and strategies, law enforcement monitoring and direct or indirect involvement in protective and supporting activities which benefit the victims of trafficking etc.

Keywords: Civil society, cooperation, police, trafficking in human beings.

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229 Critical Approach to Define the Architectural Structure of a Health Prototype in a Rural Area of Brazil

Authors: Domenico Chizzoniti, Monica Moscatelli, Letizia Cattani, Luca Preis

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A primary healthcare facility in developing countries should be a multifunctional space able to respond to different requirements: Flexibility, modularity, aggregation and reversibility. These basic features could be better satisfied if applied to an architectural artifact that complies with the typological, figurative and constructive aspects of the context in which it is located. Therefore, the purpose of this paper is to identify a procedure that can define the figurative aspects of the architectural structure of the health prototype for the marginal areas of developing countries through a critical approach. The application context is the rural areas of the Northeast of Bahia in Brazil. The prototype should be located in the rural district of Quingoma, in the municipality of Lauro de Freitas, a particular place where there is still a cultural fusion of black and indigenous populations. Based on the historical analysis of settlement strategies and architectural structures in spaces of public interest or collective use, this paper aims to provide a procedure able to identify the categories and rules underlying typological and figurative aspects, in order to detect significant and generalizable elements, as well as materials and constructive techniques typically adopted in the rural areas of Brazil. The object of this work is therefore not only the recovery of certain constructive approaches but also the development of a procedure that integrates the requirements of the primary healthcare prototype with its surrounding economic, social, cultural, settlement and figurative conditions.

Keywords: Architectural typology, Developing countries, Local construction techniques, Primary health care.

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228 Study of the Thermal Performance of Bio-Sourced Materials Used as Thermal Insulation in Buildings under Humid Tropical Climate

Authors: Guarry Montrose, Ted Soubdhan

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In the fight against climate change, the energy consuming building sector must also be taken into account to solve this problem. In this case thermal insulation of buildings using bio-based materials is an interesting solution. Therefore, the thermal performance of some materials of this type has been studied. The advantages of these natural materials of plant origin are multiple, biodegradable, low economic cost, renewable and readily available. The use of biobased materials is widespread in the building sector in order to replace conventional insulation materials with natural materials. Vegetable fibers are very important because they have good thermal behaviour and good insulating properties. The aim of using bio-sourced materials is in line with the logic of energy control and environmental protection, the approach is to make the inhabitants of the houses comfortable and reduce their energy consumption (energy efficiency). In this research we will present the results of studies carried out on the thermal conductivity of banana leaves, latan leaves, vetivers fibers, palm kernel fibers, sargassum, coconut leaves, sawdust and bulk sugarcane leaves. The study on thermal conductivity was carried out in two ways, on the one hand using the flash method, and on the other hand a so-called hot box experiment was carried out. We will discuss and highlight a number of influential factors such as moisture and air pockets present in the samples on the thermophysical properties of these materials, in particular thermal conductivity. Finally, the result of a thermal performance test of banana leaves on a roof in Haiti will also be presented in this work.

Keywords: Buildings, insulating properties, natural materials of plant origin, thermal performance.

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227 Oil Exploitation, Environmental Injustice and Decolonial Nonrecognition: Exploring the Historical Accounts of Host Communities in South-Eastern Nigeria

Authors: Ejikeme Kanu

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This research explores the environmental justice of host communities in south-eastern Nigeria whose source of livelihood has been destroyed due to oil exploitation. Environmental justice scholarship in the area often adopts Western liberal ideology from a more macro level synthesis (Niger Delta). This study, therefore, explored the sufficiency or otherwise of the adoption of Western liberal ideology in the framing of Environmental Justice (EJ) in the area which neglects the impact of colonialism and cultural domination. Archival research supplemented by secondary analysis of literature guided this study. Drawing from data analysis, the paper first argues that micro-level studies are required to either validate or invalidate the studies done at the macro-level (Niger Delta) which has often been used to generalise around environmental injustice done within the host communities even though the communities (South-eastern) differ significantly from (South-south) in terms of language, culture, the socio-political and economic formation which indicate that the drivers of EJ may differ among them. Secondly, the paper argues that EJ framing from the Western worldview adopted in the study area is insufficient to understand environmental injustice suffered in the study area and there is the need for EJ framing that will consider the impact of colonialism and nonrecognition of the cultural identities of the host communities which breed EJ. The study, therefore, concludes by drawing from decolonial theory to consider how the framing of EJ would move beyond the western liberal EJ to Indigenous EJ.

Keywords: Culture, decolonial, environmental justice, indigenous environmental justice, nonrecognition.

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226 Social Interaction Dynamics Exploration: The Case Study of El Sherouk City

Authors: Nardine El Bardisy, Wolf Reuter, Ayat Ismail

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In Egypt, there is continuous housing demand as a result of rapid population growth. In 1979, this forced the government to establish new urban communities in order to decrease stress around delta. New Urban Communities Authority (NUCA) was formulated to take the responsibly of this new policy. These communities suffer from social life deficiency due to their typology, which is separated island with barriers. New urban communities’ typology results from the influence of neoliberalism movement and modern city planning forms. The lack of social interaction in these communities at present should be enhanced in the future. On a global perspective, sustainable development calls for creating more sustainable communities which include social, economic and environmental aspects. From 1960, planners were highly focusing on the promotion of the social dimension in urban development plans. The research hypothesis states: “It is possible to promote social interaction in new urban communities through a set of socio-spatial recommended strategies that are tailored for Greater Cairo Region context”. In order to test this hypothesis, the case of El-Sherouk city is selected, which represents the typical NUCA development plans. Social interaction indicators were derived from literature and used to explore different social dynamics in the selected case. The tools used for exploring case study are online questionnaires, face to face questionnaires, interviews, and observations. These investigations were analyzed, conclusions and recommendations were set to improve social interaction.

Keywords: New urban communities, modern planning, social Interaction, Social life.

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225 An Architectural Study on the Railway Station Buildings in Malaysia during British Era, 1885-1957

Authors: Nor Hafizah Anuar, M. Gul Akdeniz

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This paper attempted on emphasize on the station buildings façade elements. Station buildings were essential part of the transportation that reflected the technology. Comparative analysis on architectural styles will also be made between the railway station buildings of Malaysia and any railway station buildings which have similarities. The Malay Peninsula which is strategically situated between the Straits of Malacca and the South China Sea makes it an ideal location for trade. Malacca became an important trading port whereby merchants from around the world stopover to exchange various products. The Portuguese ruled Malacca for 130 years (1511–1641) and for the next century and a half (1641–1824), the Dutch endeavoured to maintain an economic monopoly along the coasts of Malaya. Malacca came permanently under British rule under the Anglo-Dutch Treaty, 1824. Up to Malaysian independence in 1957, Malaya saw a great influx of Chinese and Indian migrants as workers to support its growing industrial needs facilitated by the British. The growing tin ore mining and rubber industry resulted as the reason of the development of the railways as urgency to transport it from one place to another. The existence of railway transportation becomes more significant when the city started to bloom and the British started to build grandeur buildings that have different functions; administrative buildings, town and city halls, railway stations, public works department, courts, and post offices.

Keywords: Malaysia, railway station, architectural design, façade elements.

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224 The Cooperation among Insulin, Cortisol and Thyroid Hormones in Morbid Obese Children and Metabolic Syndrome

Authors: Orkide Donma, Mustafa M. Donma

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Obesity, a disease associated with a low-grade inflammation, is a risk factor for the development of metabolic syndrome (MetS). So far, MetS risk factors such as parameters related to glucose and lipid metabolisms as well as blood pressure were considered for the evaluation of this disease. There are still some ambiguities related to the characteristic features of MetS observed particularly in pediatric population. Hormonal imbalance is also important, and quite a lot information exists about the behaviour of some hormones in adults. However, the hormonal profiles in pediatric metabolism have not been cleared yet. The aim of this study is to investigate the profiles of cortisol, insulin, and thyroid hormones in children with MetS. The study population was composed of morbid obese (MO) children without (Group 1) and with (Group 2) MetS components. WHO BMI-for age and sex percentiles were used for the classification of obesity. The values above 99 percentile were defined as morbid obesity. Components of MetS (central obesity, glucose intolerance, high blood pressure, high triacylglycerol levels, low levels of high density lipoprotein cholesterol) were determined. Anthropometric measurements were performed. Ratios as well as obesity indices were calculated. Insulin, cortisol, thyroid stimulating hormone (TSH), free T3 and free T4 analyses were performed by electrochemiluminescence immunoassay. Data were evaluated by statistical package for social sciences program. p<0.05 was accepted as the degree for statistical significance. The mean ages±SD values of Group 1 and Group 2 were 9.9±3.1 years and 10.8±3.2 years, respectively. Body mass index (BMI) values were calculated as 27.4±5.9 kg/m2 and 30.6±8.1 kg/m2, successively. There were no statistically significant differences between the ages and BMI values of the groups. Insulin levels were statistically significantly increased in MetS in comparison with the levels measured in MO children. There was not any difference between MO children and those with MetS in terms of cortisol, T3, T4 and TSH. However, T4 levels were positively correlated with cortisol and negatively correlated with insulin. None of these correlations were observed in MO children. Cortisol levels in both MO as well as MetS group were significantly correlated. Cortisol, insulin, and thyroid hormones are essential for life. Cortisol, called the control system for hormones, orchestrates the performance of other key hormones. It seems to establish a connection between hormone imbalance and inflammation. During an inflammatory state, more cortisol is produced to fight inflammation. High cortisol levels prevent the conversion of the inactive form of the thyroid hormone T4 into active form T3. Insulin is reduced due to low thyroid hormone. T3, which is essential for blood sugar control- requires cortisol levels within the normal range. Positive association of T4 with cortisol and negative association of it with insulin are the indicators of such a delicate balance among these hormones also in children with MetS.

Keywords: Children, cortisol, insulin, metabolic syndrome, thyroid hormones.

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223 Exploring Communities of Practice through Public Health Walks for Nurse Education

Authors: Jacqueline P. Davies

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Introduction: Student nurses must develop skills in observation, communication and reflection as well as public health knowledge from their first year of training. This paper will explain a method developed for students to collect their own findings about public health in urban areas. These areas are both rich in the history of old public health that informs the content of many traditional public health walks, but are also locations where new public health concerns about chronic disease are concentrated. The learning method explained in this paper enables students to collect their own data and write original work as first year students. Examples of their findings will be given. Methodology: In small groups, health care students are instructed to walk in neighbourhoods near to the hospitals they will soon attend as apprentice nurses. On their walks, they wander slowly, engage in conversations, and enter places open to the public. As they drift, they observe with all five senses in the real three dimensional world to collect data for their reflective accounts of old and new public health. They are encouraged to stop for refreshments and taste, as well as look, hear, smell, and touch while on their walk. They reflect as a group and later develop an individual reflective account in which they write up their deep reflections about what they observed on their walk. In preparation for their walk, they are encouraged to look at studies of quality of Life and other neighbourhood statistics as well as undertaking a risk assessment for their walk. Findings: Reflecting on their walks, students apply theoretical concepts around social determinants of health and health inequalities to develop their understanding of communities in the neighbourhoods visited. They write about the treasured historical architecture made of stone, bronze and marble which have outlived those who built them; but also how the streets are used now. The students develop their observations into thematic analyses such as: what we drink as illustrated by the empty coke can tossed into a now disused drinking fountain; the shift in home-life balance illustrated by streets where families once lived over the shop which are now walked by commuters weaving around each other as they talk on their mobile phones; and security on the street, with CCTV cameras placed at regular intervals, signs warning trespasses and barbed wire; but little evidence of local people watching the street. Conclusion: In evaluations of their first year, students have reported the health walk as one of their best experiences. The innovative approach was commended by the UK governing body of nurse education and it received a quality award from the nurse education funding body. This approach to education allows students to develop skills in the real world and write original work.

Keywords: Education, innovation. nursing, urban.

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222 Expanding Affordable Housing through Inclusionary Zoning in the City of Toronto

Authors: Sam Moshaver

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Reasonably priced and well-constructed housing must be an integral and element supporting a healthy society. The absence of housing everyone in society can afford negatively affects the people's health, education, ability to get jobs, develop their community. Without access to decent housing, economic development, integration of immigrants and inclusiveness, the society is negatively impacted. Canada has a sterling record in creating housing compared to many other nations around the globe. Canadian housing gets support from a mature and responsive mortgage network and a top-quality construction industry as well as safe and excellent quality building materials that are readily available. Yet 1.7 million Canadian households occupy substandard abodes. During the past hundred years, Canada's government has made a wide variety of attempts to provide decent residential facilities every Canadian can afford. Despite these laudable efforts, today Canada is left with housing that is inadequate for many Canadians. People who own their housing are given all kinds of privileges and perks, while people with relatively low incomes who rent their apartments or houses are discriminated against. To help solve these problems, zoning that is based on an "inclusionary" philosophy is tool developed to help provide people the affordable residences that they need. No, thirty years after its introduction, this type of zoning has been shown effective in helping build and provide Canadians with a houses or apartments they can afford to pay for. Using this form of zoning can have different results +depending on where and how it is used. After examining Canadian affordable housing and four American cases where this type of zoning was enforced in the USA, this makes various recommendations for expanding Canadians' access to housing they can afford.

Keywords: Affordable Housing, Inclusionary Zoning Low- Income Housing, Toronto Housing.

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221 Determinants of Never Users of Contraception – Results from Pakistan Demographic and Health Survey 2012-13

Authors: Arsalan Jabbar, Wajiha Javed, Nelofer Mehboob, Zahid Memon

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Introduction: There are multiple social, individual and cultural factors that influence an individual’s decision to adopt family planning methods especially among non-users in patriarchal societies like Pakistan. Non-users, if targeted efficiently, can contribute significantly to country’s CPR. A research study showed that nonusers if convinced to adopt lactational amenorrhea method can shift to long term methods in future. Research shows that if non users are targeted efficiently a 59% reduction in unintended pregnancies in Saharan Africa and South-Central and South-East Asia is anticipated. Methods: We did secondary data analysis on Pakistan Demographic Heath Survey (2012-13) dataset. Use of contraception (never-use/ever-use) was the outcome variable. At univariate level Chi-square/Fisher Exact test was used to assess relationship of baseline covariates with contraception use. Then variables to be incorporated in the model were checked for multicollinearity, confounding and interaction. Then binary logistic regression (with an urban-rural stratification) was done to find relationship between contraception use and baseline demographic and social variables. Results: The multivariate analyses of the study showed that younger women (≤ 29 years)were more prone to be never users as compared to those who were >30 years and this trend was seen in urban areas (AOR 1.92, CI 1.453-2.536) as well as rural areas (AOR 1.809, CI 1.421-2.303). While looking at regional variation, women from urban Sindh (AOR 1.548, CI 1.142-2.099) and urban Balochistan (AOR 2.403, CI 1.504-3.839) had more never users as compared to other urban regions. Women in the rich wealth quintile were more never users and this was seen both in urban and rural localities (urban (AOR 1.106 CI .753-1.624); rural areas (AOR 1.162, CI .887-1.524)) even though these were not statistically significant. Women idealizing more children (>4) are more never users as compared to those idealizing less children in both urban (AOR 1.854, CI 1.275-2.697) and rural areas (AOR 2.101, CI 1.514-2.916). Women who never lost a pregnancy were more inclined to be nonusers in rural areas (AOR 1.394, CI 1.127-1.723) .Women familiar with only traditional or no method had more never users in rural areas (AOR 1.717, CI 1.127-1.723) but in urban areas it wasn’t significant. Women unaware of Lady Health Worker’s presence in their area were more never users especially in rural areas (AOR 1.276, CI 1.014-1.607). Women who did not visit any care provider were more never users (urban (AOR 11.738, CI 9.112-15.121) rural areas (AOR 7.832, CI 6.243-9.826)). Discussion/Conclusion: This study concluded that government, policy makers and private sector family planning programs should focus on the untapped pool of never users (younger women from underserved provinces, in higher wealth quintiles, who desire more children.). We need to make sure to cover catchment areas where there are less LHWs and less providers as ignorance to modern methods and never been visited by an LHW are important determinants of never use. This all is in sync with previous literate from similar developing countries.

Keywords: Contraception, Demographic and Health Survey, Family Planning, Never users.

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220 Clinical Signs of Neonatal Calves in Experimental Colisepticemia

Authors: Samad Lotfollahzadeh

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Escherichia coli (E. coli) is the most isolated bacteria from blood circulation of septicemic calves. Given the prevalence of septicemia in animals and its economic importance in veterinary practice, better understanding of changes in clinical signs following disease, may contribute to early detection of disorder. The present study has been carried out to detect changes of clinical signs in induced sepsis in calves with E. coli. Colisepticemia has been induced in 10 twenty-day old healthy Holstein- Frisian calves with intravenous injection of 1.5 X 109 colony forming units (cfu) of O111:H8 strain of E. coli. Clinical signs including rectal temperature, heart rate, respiratory rate, shock, appetite, sucking reflex, feces consistency, general behavior, dehydration and standing ability were recorded in experimental calves during 24 hours after induction of colisepticemia. Blood culture was also carried out from calves four times during experiment. ANOVA with repeated measure is used to see changes of calves’ clinical signs to experimental colisepticemia, and values of P≤ 0.05 was considered statistically significant. Mean values of rectal temperature and heart rate as well as median values of respiratory rate, appetite, suckling reflex, standing ability and feces consistency of experimental calves increased significantly during study (P<0.05). In the present study median value of shock score was not significantly increased in experimental calves (P> 0.05). The results of present study showed that total score of clinical signs in calves with experimental colisepticemia increased significantly, although score of some clinical signs such as shock did not change significantly.

Keywords: Calves, Clinical signs scoring, E. coli O111:H8, Experimental colisepticemia,

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219 Linguistic Competence Analysis and the Development of Speaking Instructional Material

Authors: Felipa M. Rico

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Linguistic oral competence plays a vital role in attaining effective communication. Since the English language is considered as universally used language and has a high demand skill needed in the work-place, mastery is the expected output from learners. To achieve this, learners should be given integrated differentiated tasks which help them develop and strengthen the expected skills. This study aimed to develop speaking instructional supplementary material to enhance the English linguistic competence of Grade 9 students in areas of pronunciation, intonation and stress, voice projection, diction and fluency. A descriptive analysis was utilized to analyze the speaking level of performance of the students in order to employ appropriate strategies. There were two sets of respondents: 178 Grade 9 students selected through a stratified sampling and chosen at random. The other set comprised English teachers who evaluated the usefulness of the devised teaching materials. A teacher conducted a speaking test and activities were employed to analyze the speaking needs of students. Observation and recordings were also used to evaluate the students’ performance. The findings revealed that the English pronunciation of the students was slightly unclear at times, but generally fair. There were lapses but generally they rated moderate in intonation and stress, because of other language interference. In terms of voice projection, students have erratic high volume pitch. For diction, the students’ ability to produce comprehensible language is limited, and as to fluency, the choice of vocabulary and use of structure were severely limited. Based on the students’ speaking needs analyses, the supplementary material devised was based on Nunan’s IM model, incorporating context of daily life and global work settings, considering the principle that language is best learned in the actual meaningful situation. To widen the mastery of skill, a rich learning environment, filled with a variety instructional material tends to foster faster acquisition of the requisite skills for sustained learning and development. The role of IM is to encourage information to stick in the learners’ mind, as what is seen is understood more than what is heard. Teachers say they found the IM “very useful.” This implied that English teachers could adopt the materials to improve the speaking skills of students. Further, teachers should provide varied opportunities for students to get involved in real life situations where they could take turns in asking and answering questions and share information related to the activities. This would minimize anxiety among students in the use of the English language.

Keywords: Fluency, intonation, instructional materials, linguistic competence, pronunciation.

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218 Supplier Selection Using Sustainable Criteria in Sustainable Supply Chain Management

Authors: Richa Grover, Rahul Grover, V. Balaji Rao, Kavish Kejriwal

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Selection of suppliers is a crucial problem in the supply chain management. On top of that, sustainable supplier selection is the biggest challenge for the organizations. Environment protection and social problems have been of concern to society in recent years, and the traditional supplier selection does not consider about this factor; therefore, this research work focuses on introducing sustainable criteria into the structure of supplier selection criteria. Sustainable Supply Chain Management (SSCM) is the management and administration of material, information, and money flows, as well as coordination among business along the supply chain. All three dimensions - economic, environmental, and social - of sustainable development needs to be taken care of. Purpose of this research is to maximize supply chain profitability, maximize social wellbeing of supply chain and minimize environmental impacts. Problem statement is selection of suppliers in a sustainable supply chain network by ranking the suppliers against sustainable criteria identified. The aim of this research is twofold: To find out what are the sustainable parameters that can be applied to the supply chain, and to determine how these parameters can effectively be used in supplier selection. Multicriteria decision making tools will be used to rank both criteria and suppliers. AHP Analysis will be used to find out ratings for the criteria identified. It is a technique used for efficient decision making. TOPSIS will be used to find out rating for suppliers and then ranking them. TOPSIS is a MCDM problem solving method which is based on the principle that the chosen option should have the maximum distance from the negative ideal solution (NIS) and the minimum distance from the ideal solution.

Keywords: Sustainable supply chain management, supplier selection, MCDM tools, AHP analysis, TOPSIS method.

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217 Constructing Masculinity through Images: Content Analysis of Lifestyle Magazines in Croatia

Authors: Marija Lončar, Zorana Šuljug Vučica, Magdalena Nigoević

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Diverse social, cultural and economic trends and changes in contemporary societies influence the ways masculinity is represented in a variety of media. Masculinity is constructed within media images as a dynamic process that changes slowly over time and is shaped by various social factors. In many societies, dominant masculinity is still associated with authority, heterosexuality, marriage, professional and financial success, ethnic dominance and physical strength. But contemporary media depict men in ways that suggest a change in the approach to media images. The number of media images of men, which promote men’s identity through their body, have increased. With the male body more scrutinized and commodified, it is necessary to highlight how the body is represented and which visual elements are crucial since the body has an important role in the construction of masculinities. The study includes content analysis of male body images in the advertisements of different men’s and women’s lifestyle magazines available in Croatia. The main aim was to explore how masculinities are currently being portrayed through body regarding age, physical appearance, fashion, touch and gaze. The findings are also discussed in relation to female images since women are central in many of the processes constructing masculinities and according to the recent conceptualization of masculinity. Although the construction of male images varies through body features, almost all of them convey the message that men’s identity could be managed through manipulation and by enhancing the appearance. Furthermore, they suggest that men should engage in “bodywork” through advertised products, activities and/or practices, in order to achieve their preferred social image.

Keywords: Body images, content analysis, lifestyle magazines, masculinity.

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216 Relevant Stakeholders in Environmental Management Organization: The Case of Industries Três Rios/RJ

Authors: Beatriz dos Anjos Furtado, Marina Barreiros Lamim, Camila Avozani Zago, Julianne Alvim Milward-de-Azevedo, Luís Cláudio Meirelles de Medeiros

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The intense process of economic acceleration, expansion of industrial activities and capitalism, combined with population growth, while promoting the development, bring environmental consequences and dynamics of locations. It can be seen that society is seeking to break with old paradigms of capitalist society, seeking to reconcile growth with sustainable development, with a change of mentality of the stakeholders of the production process (shareholders, employees, suppliers, customers, governments, and neighbors, groups citizens and the public in general). In this context, this research aims to map the stakeholders interested in environmental management in industries located in the city of Três Rios/RJ. The city of Três Rios is located in South-Central region of the state of Rio de Janeiro - Brazil. Methodological resources used refer to descriptive and field research, whose nature is qualitative and quantitative. It is also of multicases studies in the study area, and the data collection occurred by means of semi-structured questionnaires and interviews with employees related to the environmental area of the industries located in Três Rios and registered at the Federation of Industries the State of Rio de Janeiro - FIRJAN in the version of 2013 and active in federal revenue. Through this research it observed, among other things, the stakeholders involved in the environmental management process of “Três Rios” industry respondents, and those responding to the demands of environmental management.

Keywords: Environmental management, environmental practices, industry, stakeholders.

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215 Government of Ghana’s Budget: Its Functions, Coverage, Classification, and Integration with Chart of Accounts

Authors: Mohammed Sani Abdulai

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Government budgets are the primary instruments for formulating and implementing a country’s fiscal policy objectives, development priorities, and the overall socio-economic aspirations of its people. Thus, in this paper, the author examined the Government of Ghana’s budgets with respect to their functions, coverage, classifications, and integration with the country’s chart of accounts. The author did so by amalgamating the research findings of extant literature with (a) the operational and procedural guidelines underpinning the formulation and execution of the government’s budgets; (b) the recommendations made by various development partners and thinktanks on reforming the country’s budgeting processes and procedures; and (c) the lessons Ghana could learn from the budget reform efforts of other countries. By way of research findings, the paper showed that the Government of Ghana’s budgets in terms of function are both eclectic and multidimensional. On coverage, the paper showed that the country’s budgets duly cover the revenues and expenditures of the general government (i.e., both the central and sub-national governments). Finally, on classifications, the paper noted with delight the Government of Ghana’s effort in providing classificatory codes to both its national development agenda and such international development goals as the AU’s Agenda 2063 and the UN’s Sustainable Development Goals. However, the paper found some significant lapses that require a complete overhaul and structuring on the integrations of its budget classifications with its chart of accounts. Thus, the paper concluded with a detailed examination of the challenges confronting the country’s current chart of accounts and recommendations for addressing them.

Keywords: Budget, budgetary transactions, budgetary governance, Chart of Accounts, classification, composition, coverage, Public Financial Management.

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214 A Study of Applying the Use of Breathing Training to Palliative Care Patients, Based on the Bio-Psycho-Social Model

Authors: Wenhsuan Lee, Yachi Chang, Yingyih Shih

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In clinical practices, it is common that while facing the unknown progress of their disease, palliative care patients may easily feel anxious and depressed. These types of reactions are a cause of psychosomatic diseases and may also influence treatment results. However, the purpose of palliative care is to provide relief from all kinds of pains. Therefore, how to make patients more comfortable is an issue worth studying. This study adopted the “bio-psycho-social model” proposed by Engel and applied spontaneous breathing training, in the hope of seeing patients’ psychological state changes caused by their physiological state changes, improvements in their anxious conditions, corresponding adjustments of their cognitive functions, and further enhancement of their social functions and the social support system. This study will be a one-year study. Palliative care outpatients will be recruited and assigned to the experimental group or the control group for six outpatient visits (once a month), with 80 patients in each group. The patients of both groups agreed that this study can collect their physiological quantitative data using an HRV device before the first outpatient visit. They also agreed to answer the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire” before the first outpatient visit, to fill a self-report questionnaire after each outpatient visit, and to answer the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire” after the last outpatient visit. The patients of the experimental group agreed to receive the breathing training under HRV monitoring during the first outpatient visit of this study. Before each of the following three outpatient visits, they were required to fill a self-report questionnaire regarding their breathing practices after going home. After the outpatient visits, they were taught how to practice breathing through an HRV device and asked to practice it after going home. Later, based on the results from the HRV data analyses and the pre-tests and post-tests of the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire”, the influence of the breathing training in the bio, psycho, and social aspects were evaluated. The data collected through the self-report questionnaires of the patients of both groups were used to explore the possible interfering factors among the bio, psycho, and social changes. It is expected that this study will support the “bio-psycho-social model” proposed by Engel, meaning that bio, psycho, and social supports are closely related, and that breathing training helps to transform palliative care patients’ psychological feelings of anxiety and depression, to facilitate their positive interactions with others, and to improve the quality medical care for them.

Keywords: Palliative care, breathing training, bio-psycho-social Model, heart rate variability.

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