Search results for: private schools in Bangkok
Commenced in January 2007
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Edition: International
Paper Count: 3633

Search results for: private schools in Bangkok

123 Special Educational Needs Coordinators in England: Changemakers in Mainstream School Settings

Authors: Saneeya Qureshi

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This paper reports doctoral research into the impact of Special Educational Needs Coordinators (SENCOs) on teachers in England, UK. Since 1994, it has been compulsory for all mainstream schools in the UK to have a SENCO who co-ordinates assessment and provision for supporting pupils with Special Educational Needs (SEN), helping teachers to develop and implement optimal SEN planning and resources. SENCOs’ roles have evolved as various policies continually redefined SEN provision, impacting their positioning within the school hierarchical structure. SENCOs in England are increasingly recognised as key members of school senior management teams. In this paper, It will be argued that despite issues around the transformative ‘professionalisation’ of their role, and subsequent conflict around boundaries and power relations, SENCOs enhance teachers’ abilities in terms of delivering optimal SEN provision. There is a significant international dimension to the issue: a similar role in respect of SEN management already exists in countries such as Ireland, Finland and Singapore, whilst in other countries, such as Italy and India, the introduction of a role similar to that of a SENCO is currently under discussion. The research question addressed is: do SENCOs enhance teachers’ abilities to be effective teachers of children with Special Educational Needs? The theoretical framework of the project is that of interpretivism, as it is acknowledged that there are contexts and realities are social constructions. The study applied a mixed method approach consisting of two phases. The first phase involved a purposive survey (n=42) of 223 primary school SENCOs, which enabled a deeper insight into SENCOs’ perceptions of their roles in relation to teachers. The second phase consisted of semi-structured interviews (n=36) of SENCOs, teachers and head teachers, in addition to school SEN-related documentation scrutiny. ‘Trustworthiness’ was accomplished through data and methodological triangulation, in addition to a rigorous process of coding and thematic analysis. The research was informed by an Ethical Code as per national guidelines. Research findings point to the evolutionary aspect of the SENCO role having engendered a culture of expectations amongst practitioners, as SENCOs transition from being ‘fixers’ to being ‘enablers’ of teachers. Outcomes indicate that SENCOs can empower teaching staff through the dissemination of specialist knowledge. However, there must be resources clearly identified for such dissemination to take place. It is imperative that both SENCOs and teachers alike address the issue of absolution of responsibility that arises when the ownership and accountability for the planning and implementation of SEN provision are not clarified so as to ensure the promotion of a positive school ethos around inclusive practices. Optimal outcomes through effective SEN interventions and teaching practices are positively correlated with the inclusion of teachers in the planning and execution of SEN provisions. An international audience can consider how the key findings are being manifest in a global context, with reference to their own educational settings. Research outcomes can aid the development of specific competencies needed to shape optimal inclusive educational settings in accordance with the official global priorities pertaining to inclusion.

Keywords: inclusion, school professionals, school leadership, special educational needs (SEN), special educational needs coordinators (SENCOs)

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122 Nigerian Football System: Examining Micro-Level Practices against a Global Model for Integrated Development of Mass and Elite Sport

Authors: Iorwase Derek Kaka’an, Peter Smolianov, Steven Dion, Christopher Schoen, Jaclyn Norberg, Charles Gabriel Iortimah

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This study examines the current state of football in Nigeria to identify the country's practices, which could be useful internationally, and to determine areas for improvement. Over 200 sources of literature on sport delivery systems in successful sports nations were analyzed to construct a globally applicable model of elite football integrated with mass participation, comprising of the following three levels: macro (socio-economic, cultural, legislative, and organizational), meso (infrastructures, personnel, and services enabling sports programs) and micro level (operations, processes, and methodologies for the development of individual athletes). The model has received scholarly validation and has shown to be a framework for program analysis that is not culturally bound. It has recently been utilized for further understanding such sports systems as US rugby, tennis, soccer, swimming, and volleyball, as well as Dutch and Russian swimming. A questionnaire was developed using the above-mentioned model. Survey questions were validated by 12 experts including academicians, executives from sports governing bodies, football coaches, and administrators. To identify best practices and determine areas for improvement of football in Nigeria, 116 coaches completed the questionnaire. Useful exemplars and possible improvements were further identified through semi-structured discussions with 10 Nigerian football administrators and experts. Finally, a content analysis of the Nigeria Football Federation's website and organizational documentation was conducted. This paper focuses on the micro level of Nigerian football delivery, particularly talent search and development as well as advanced athlete preparation and support. Results suggested that Nigeria could share such progressive practices as the provision of football programs in all schools and full-time coaches paid by governments based on the level of coach education. Nigerian football administrators and coaches could provide better football services affordable for all, where success in mass and elite sports is guided by science focused on athletes' needs. Better implemented could be international best practices such as lifelong guidelines for health and excellence of everyone and integration of fitness tests into player development and ranking as done in best Dutch, English, French, Russian, Spanish, and other European clubs; integration of educational and competitive events for elite and developing athletes as well as fans as done at the 2018 World Cup Russia; and academies with multi-stage athlete nurturing as done by Ajax in Africa as well as Barcelona FC and other top clubs expanding across the world. The methodical integration of these practices into the balanced development of mass and elite football will help contribute to international sports success as well as national health, education, crime control, and social harmony in Nigeria.

Keywords: football, high performance, mass participation, Nigeria, sport development

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121 The Provisional National Defense Council cum National Democratic Congress Government and Tourism Development in Ghana: A Reflection

Authors: Yobo Opare-Addo

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Ghana came under a military and democratic rule of the same leadership from 1981-2000. These were the Provisional National Defense Council (PNDC), a military government and a democratic government, the National Democratic Congress (NDC) both under the leadership of Flt. Lt. J.J. Rawlings. Meanwhile the year 1985 marked a turning point in the development of the tourism industry in Ghana. Interest in tourism among African governments and for that matter the ‘PNDC cum NDC Government’ (PNDC/NDC) arose because of adverse developments in intangible exports and a corresponding decline in commodity export earnings. The ‘PNDC/NDC Government’ undertook measures and policies to improve the tourism industry and at the same time embarked on export diversification to reap the foreign exchange that the industry could generate in Ghana. The objective of this paper is to examine the measures and policies of the PNDC/NDC to improve the tourism industry in order to reap the foreign exchange. It specifically interrogates the role of the government as an agent of tourism development, through its deliberate creation of a conducive environment for tourism to flourish, the involvement of the private sector both foreign and local and the provision of tourism facilities and infrastructure and how these factors impacted on the tourism industry in Ghana. In the final analysis it evaluates the degree of success of the PNDC/NDC Government in this arena of Ghana’s socio-cultural and economic development. Introduction The Provisional National Defense Council (PNDC), a military government under the leadership of Flt. Lt J.J. Rawlings overthrew a constitutionally elected government of People’s National Party in 1981. In 1992, the National Democratic Congress (NDC) won the general election conducted in December. Flt. Lt. J.J. Rawlings, the party’s leader became the President of the Fourth Republic from January 1993 to December 2000. It was refreshing to see Ghanaians embrace democracy with renewed energy, zeal, and enthusiasm. This paper takes a critical look at the efforts of the PNDC cum NDC Government (PNDC/NDC) to develop tourism in Ghana during the period from 1981-2000 Methodology: Qualitative method of research was adopted for the study. Data was collected from both primary and secondary sources, and analysis was done using descriptive analysis because descriptive analysis made it possible to describe or summarize the statistical data in the research. To gather data from primary sources, questionnaires, oral interviews, and semi-structured discussions were conducted. Respondents included public officials from Ghana Tourist Board, Ministry of Tourism, Hoteliers, restaurant operators and travel and tour operators in Accra. Secondary data sources included articles in journals, reports, magazines, bulletins, and books. The major findings included statistical data for tourism arrivals and receipts during the period and the status of the industry by the year 2000. Conclusion: The paper contributes to knowledge on political and historical aspects of tourism development in Ghana, which is almost non-existent, attitudes of the PNDC cum NDC government towards tourism development and the debates on the generation of foreign exchange to Ghana and third world countries.

Keywords: ghana, infrastructure, policies, privatization, tourism facilities

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120 An Exploration of Special Education Teachers’ Practices in a Preschool Intellectual Disability Centre in Saudi Arabia

Authors: Faris Algahtani

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Background: In Saudi Arabia, it is essential to know what practices are employed and considered effective by special education teachers working with preschool children with intellectual disabilities, as a prerequisite for identifying areas for improvement. Preschool provision for these children is expanding through a network of Intellectual Disability Centres while, in primary schools, a policy of inclusion is pursued and, in mainstream preschools, pilots have been aimed at enhancing learning in readiness for primary schooling. This potentially widens the attainment gap between preschool children with and without intellectual disabilities, and influences the scope for improvement. Goal: The aim of the study was to explore special education teachers’ practices and perceived perceptions of those practices for preschool children with intellectual disabilities in Saudi Arabia Method: A qualitative interpretive approach was adopted in order to gain a detailed understanding of how special education teachers in an IDC operate in the classroom. Fifteen semi-structured interviews were conducted with experienced and qualified teachers. Data were analysed using thematic analysis, based on themes identified from the literature review together with new themes emerging from the data. Findings: American methods strongly influenced teaching practices, in particular TEACCH (Treatment and Education of Autistic and Communication related handicapped Children), which emphasises structure, schedules and specific methods of teaching tasks and skills; and ABA (Applied Behaviour Analysis), which aims to improve behaviours and skills by concentrating on detailed breakdown and teaching of task components and rewarding desired behaviours with positive reinforcement. The Islamic concept of education strongly influenced which teaching techniques were used and considered effective, and how they were applied. Tensions were identified between the Islamic approach to disability, which accepts differences between human beings as created by Allah in order for people to learn to help and love each other, and the continuing stigmatisation of disability in many Arabic cultures, which means that parents who bring their children to an IDC often hope and expect that their children will be ‘cured’. Teaching methods were geared to reducing behavioural problems and social deficits rather than to developing the potential of the individual child, with some teachers recognizing the child’s need for greater freedom. Relationships with parents could in many instances be improved. Teachers considered both initial teacher education and professional development to be inadequate for their needs and the needs of the children they teach. This can be partly attributed to the separation of training and development of special education teachers from that of general teachers. Conclusion: Based on the findings, teachers’ practices could be improved by the inclusion of general teaching strategies, parent-teacher relationships and practical teaching experience in both initial teacher education and professional development. Coaching and mentoring support from carefully chosen special education teachers could assist the process, as could the presence of a second teacher or teaching assistant in the classroom.

Keywords: special education, intellectual disabilities, early intervention , early childhood

Procedia PDF Downloads 118
119 Resolving Urban Mobility Issues through Network Restructuring of Urban Mass Transport

Authors: Aditya Purohit, Neha Bansal

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Unplanned urbanization and multidirectional sprawl of the cities have resulted in increased motorization and deteriorating transport conditions like traffic congestion, longer commuting, pollution, increased carbon footprint, and above all increased fatalities. In order to overcome these problems, various practices have been adopted including– promoting and implementing mass transport; traffic junction channelization; smart transport etc. However, these methods are found to be primarily focusing on vehicular mobility rather than people accessibility. With this research gap, this paper tries to resolve the mobility issues for Ahmedabad city in India, which being the economic capital Gujarat state has a huge commuter and visitor inflow. This research aims to resolve the traffic congestion and urban mobility issues focusing on Gujarat State Regional Transport Corporation (GSRTC) for the city of Ahmadabad by analyzing the existing operations and network structure of GSRTC followed by finding possibilities of integrating it with other modes of urban transport. The network restructuring (NR) methodology is used with appropriate variations, based on commuter demand and growth pattern of the city. To do these ‘scenarios’ based on priority issues (using 12 parameters) and their best possible solution, are established after route network analysis for 2700 population sample of 20 traffic junctions/nodes across the city. Approximately 5% sample (of passenger inflow) at each node is considered using random stratified sampling technique two scenarios are – Scenario 1: Resolving mobility issues by use of Special Purpose Vehicle (SPV) in joint venture to GSRTC and Private Operators for establishing feeder service, which shall provide a transfer service for passenger for movement from inner city area to identified peripheral terminals; and Scenario 2: Augmenting existing mass transport services such as BRTS and AMTS for using them as feeder service to the identified peripheral terminals. Each of these has now been analyzed for the best suitability/feasibility in network restructuring. A desire-line diagram is constructed using this analysis which indicated that on an average 62% of designated GSRTC routes are overlapping with mass transportation service routes of BRTS and AMTS in the city. This has resulted in duplication of bus services causing traffic congestion especially in the Central Bus Station (CBS). Terminating GSRTC services on the periphery of the city is found to be the best restructuring network proposal. This limits the GSRTC buses at city fringe area and prevents them from entering into the city core areas. These end-terminals of GSRTC are integrated with BRTS and AMTS services which help in segregating intra-state and inter-state bus services. The research concludes that absence of integrated multimodal transport network resulted in complexity of transport access to the commuters. As a further scope of research comparing and understanding of value of access time in total travel time and its implication on generalized cost on trip and how it varies city wise may be taken up.

Keywords: mass transportation, multi-modal integration, network restructuring, travel behavior, urban transport

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118 Toward the Decarbonisation of EU Transport Sector: Impacts and Challenges of the Diffusion of Electric Vehicles

Authors: Francesca Fermi, Paola Astegiano, Angelo Martino, Stephanie Heitel, Michael Krail

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In order to achieve the targeted emission reductions for the decarbonisation of the European economy by 2050, fundamental contributions are required from both energy and transport sectors. The objective of this paper is to analyse the impacts of a largescale diffusion of e-vehicles, either battery-based or fuel cells, together with the implementation of transport policies aiming at decreasing the use of motorised private modes in order to achieve greenhouse gas emission reduction goals, in the context of a future high share of renewable energy. The analysis of the impacts and challenges of future scenarios on transport sector is performed with the ASTRA (ASsessment of TRAnsport Strategies) model. ASTRA is a strategic system-dynamic model at European scale (EU28 countries, Switzerland and Norway), consisting of different sub-modules related to specific aspects: the transport system (e.g. passenger trips, tonnes moved), the vehicle fleet (composition and evolution of technologies), the demographic system, the economic system, the environmental system (energy consumption, emissions). A key feature of ASTRA is that the modules are linked together: changes in one system are transmitted to other systems and can feed-back to the original source of variation. Thanks to its multidimensional structure, ASTRA is capable to simulate a wide range of impacts stemming from the application of transport policy measures: the model addresses direct impacts as well as second-level and third-level impacts. The simulation of the different scenarios is performed within the REFLEX project, where the ASTRA model is employed in combination with several energy models in a comprehensive Modelling System. From the transport sector perspective, some of the impacts are driven by the trend of electricity price estimated from the energy modelling system. Nevertheless, the major drivers to a low carbon transport sector are policies related to increased fuel efficiency of conventional drivetrain technologies, improvement of demand management (e.g. increase of public transport and car sharing services/usage) and diffusion of environmentally friendly vehicles (e.g. electric vehicles). The final modelling results of the REFLEX project will be available from October 2018. The analysis of the impacts and challenges of future scenarios is performed in terms of transport, environmental and social indicators. The diffusion of e-vehicles produces a consistent reduction of future greenhouse gas emissions, although the decarbonisation target can be achieved only with the contribution of complementary transport policies on demand management and supporting the deployment of low-emission alternative energy for non-road transport modes. The paper explores the implications through time of transport policy measures on mobility and environment, underlying to what extent they can contribute to a decarbonisation of the transport sector. Acknowledgements: The results refer to the REFLEX project which has received grants from the European Union’s Horizon 2020 research and innovation program under Grant Agreement No. 691685.

Keywords: decarbonisation, greenhouse gas emissions, e-mobility, transport policies, energy

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117 Hydrogeomatic System for the Economic Evaluation of Damage by Flooding in Mexico

Authors: Alondra Balbuena Medina, Carlos Diaz Delgado, Aleida Yadira Vilchis Fránces

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In Mexico, each year news is disseminated about the ravages of floods, such as the total loss of housing, damage to the fields; the increase of the costs of the food, derived from the losses of the harvests, coupled with health problems such as skin infection, etc. In addition to social problems such as delinquency, damage in education institutions and the population in general. The flooding is a consequence of heavy rains, tropical storms and or hurricanes that generate excess water in drainage systems that exceed its capacity. In urban areas, heavy rains can be one of the main factors in causing flooding, in addition to excessive precipitation, dam breakage, and human activities, for example, excessive garbage in the strainers. In agricultural areas, these can hardly achieve large areas of cultivation. It should be mentioned that for both areas, one of the significant impacts of floods is that they can permanently affect the livelihoods of many families, cause damage, for example in their workplaces such as farmlands, commercial or industry areas and where services are provided. In recent years, Information and Communication Technologies (ICT) have had an accelerated development, being reflected in the growth and the exponential evolution of the innovation giving; as a result, the daily generation of new technologies, updates, and applications. Innovation in the development of Information Technology applications has impacted on all areas of human activity. They influence all the orders of life of individuals, reconfiguring the way of perceiving and analyzing the world such as, for instance, interrelating with people as individuals and as a society, in the economic, political, social, cultural, educational, environmental, etc. Therefore the present work describes the creation of a system of calculation of flood costs for housing areas, retail establishments and agricultural areas from the Mexican Republic, based on the use and application of geotechnical tools being able to be useful for the benefit of the sectors of public, education and private. To generate analysis of hydrometereologic affections and with the obtained results to realize the Geoinformatics tool was constructed from two different points of view: the geoinformatic (design and development of GIS software) and the methodology of flood damage validation in order to integrate a tool that provides the user the monetary estimate of the effects caused by the floods. With information from the period 2000-2014, the functionality of the application was corroborated. For the years 2000 to 2009 only the analysis of the agricultural and housing areas was carried out, incorporating for the commercial establishment's information of the period 2010 - 2014. The method proposed for the resolution of this research project is a fundamental contribution to society, in addition to the tool itself. Therefore, it can be summarized that the problems that are in the physical-geographical environment, conceiving them from the point of view of the spatial analysis, allow to offer different alternatives of solution and also to open up slopes towards academia and research.

Keywords: floods, technological innovation, monetary estimation, spatial analysis

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116 Examining the Critical Factors for Success and Failure of Common Ticketing Systems

Authors: Tam Viet Hoang

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With a plethora of new mobility services and payment systems found in our cities and across modern public transportation systems, several cities globally have turned to common ticketing systems to help navigate this complexity. Helping to create time and space-differentiated fare structures and tariff schemes, common ticketing systems can optimize transport utilization rates, achieve cost efficiencies, and provide key incentives to specific target groups. However, not all cities and transportation systems have enjoyed a smooth journey towards the adoption, roll-out, and servicing of common ticketing systems, with both the experiences of success and failure being attributed to a wide variety of critical factors. Using case study research as a methodology and cities as the main unit of analysis, this research will seek to address the fundamental question of “what are the critical factors for the success and failure of common ticketing systems?” Using rail/train systems as the entry point for this study will start by providing a background to the evolution of transport ticketing and justify the improvements in operational efficiency that can be achieved through common ticketing systems. Examining the socio-economic benefits of common ticketing, the research will also help to articulate the value derived for different key identified stakeholder groups. By reviewing case studies of the implementation of common ticketing systems in different cities, the research will explore lessons learned from cities with the aim to elicit factors to ensure seamless connectivity integrated e-ticketing platforms. In an increasingly digital age and where cities are now coming online, this paper seeks to unpack these critical factors, undertaking case study research drawing from literature and lived experiences. Offering us a better understanding of the enabling environment and ideal mixture of ingredients to facilitate the successful roll-out of a common ticketing system, interviews will be conducted with transport operators from several selected cities to better appreciate the challenges and strategies employed to overcome those challenges in relation to common ticketing systems. Meanwhile, as we begin to see the introduction of new mobile applications and user interfaces to facilitate ticketing and payment as part of the transport journey, we take stock of numerous policy challenges ahead and implications on city-wide and system-wide urban planning. It is hoped that this study will help to identify the critical factors for the success and failure of common ticketing systems for cities set to embark on their implementation while serving to fine-tune processes in those cities where common ticketing systems are already in place. Outcomes from the study will help to facilitate an improved understanding of common pitfalls and essential milestones towards the roll-out of a common ticketing system for railway systems, especially for emerging countries where mass rapid transit transport systems are being considered or in the process of construction.

Keywords: common ticketing, public transport, urban strategies, Bangkok, Fukuoka, Sydney

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115 Menstruating Bodies and Social Control – Insights From Dignity Without Danger: Collaboratively Analysing Menstrual Stigma and Taboos in Nepal

Authors: Sara Parker, Kay Standing

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This paper will share insights into how menstruators bodies in Nepal are viewed and controlled in Nepal due to the deeply held stigmas and taboos that exist that frame menstrual blood as impure and polluting. It draws on a British Academy Global Challenges Research (BA/GCRF) funded project, ‘Dignity Without Danger,’ that ran from December 2019 to 2022. In Nepal, beliefs and myths around menstrual related practices prevail and vary in accordance to time, generation, caste and class. Physical seclusion and/or restrictions include the consumption of certain foods, the ability to touch certain people and objects, and restricted access to water sources. These restrictions not only put women at risk of poor health outcomes, but they also promote discrimination and challenge fundamental human rights. Despite the pandemic, a wealth of field research and creative outputs have been generated to help break the silence that surrounds menstruation and also highlights the complexity of addressing the harms associated with the exclusion from sacred and profane spaces that menstruators face. Working with locally recruited female research assistants, NGOS and brining together academics from the UK and Nepal, we explore the intersecting factors that impact on menstrual experiences and how they vary throughout Nepal. WE concur with Tamang that there is no such thing as a ‘Nepali Woman’, and there is no one narrative that captures the experiences of menstruators in Nepal. These deeply held beliefs and practices mean that menstruators are denied their right to a dignified menstruation. By being excluded from public and private spaces, such as temples and religious sites, as well as from kitchens and your own bedroom in your own home, these beliefs impact on individuals in complex and interesting ways. Existing research in Nepal by academics and activists demonstrates current programmes and initiatives do not fully address the misconceptions that underpin the exclusionary practices impacting on sexual and reproductive health, a sense of well being and highlight more work is needed in this area. Research has been conducted in all 7 provinces and through exploring and connecting disparate stories, artefacts and narratives, we will deepen understanding of the complexity of menstrual practices enabling local stakeholders to challenge exclusionary practices. By using creative methods to engage with stakeholders and share our research findings as well as highlighting the wealth of activism in Nepal. We highlight the importance of working with local communities, leaders and cutting across disciplines and agencies to promote menstrual justice and dignity. Our research findings and creative outputs that we share on social media channels such as Dignity Without Danger Facebook, Instagram and you tube stress the value of employing a collaborative action research approach to generate material which helps local people take control of their own narrative and change social relations that lead to harmful practices.

Keywords: menstruation, Nepal, stigma, social norms

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114 Effectiveness of Participatory Ergonomic Education on Pain Due to Work Related Musculoskeletal Disorders in Food Processing Industrial Workers

Authors: Salima Bijapuri, Shweta Bhatbolan, Sejalben Patel

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Ergonomics concerns the fitting of the environment and the equipment to the worker. Ergonomic principles can be employed in different dimensions of the industrial sector. Participation of all the stakeholders is the key to the formulation of a multifaceted and comprehensive approach to lessen the burden of occupational hazards. Taking responsibility for one’s own work activities by acquiring sufficient knowledge and potential to influence the practices and outcomes is the basis of participatory ergonomics and even hastens the process to identify workplace hazards. The study was aimed to check how participatory ergonomics can be effective in the management of work-related musculoskeletal disorders. Method: A mega kitchen was identified in a twin city of Karnataka, India. Consent was taken, and the screening of workers was done using observation methods. Kitchen work was structured to include different tasks, which included preparation, cooking, distributing, and serving food, packing food to be delivered to schools, dishwashing, cleaning and maintenance of kitchen and equipment, and receiving and storing raw material. Total 100 workers attended the education session on participatory ergonomics and its role in implementing the correct ergonomic practices, thus preventing WRMSDs. Demographic details and baseline data on related musculoskeletal pain and discomfort were collected using the Nordic pain questionnaire and VAS score pre- and post-study. Monthly visits were made, and the education sessions were reiterated on each visit, thus reminding, correcting, and problem-solving of each worker. After 9 months with a total of 4 such education session, the post education data was collected. The software SPSS 20 was used to analyse the collected data. Results: The majority of them (78%), depending on the availability and feasibility, participated in the intervention workshops were arranged four times. The average age of the participants was 39 years. The percentage of female participants was 79.49%, and 20.51% of participants comprised of males. The Nordic Musculoskeletal Questionnaire (NMQ) showed that knee pain was the most commonly reported complaint (62%) from the last 12 months with a mean VAS of 6.27, followed by low back pain. Post intervention, the mean VAS Score was reduced significantly to 2.38. The comparison of pre-post scores was made using Wilcoxon matched pairs test. Upon enquiring, it was found that, the participants learned the importance of applying ergonomics at their workplace which inturn was beneficial for them to handle any problems arising at their workplace on their own with self confidence. Conclusion: The participatory ergonomics proved effective with workers of mega kitchen, and it is a feasible and practical approach. The advantage of the given study area was that it had a sophisticated and ergonomically designed workstation; thus it was the lack of education and practical knowledge to use these stations was of utmost need. There was a significant reduction in VAS scores with the implementation of changes in the working style, and the knowledge of ergonomics helped to decrease physical load and improve musculoskeletal health.

Keywords: ergonomic awareness session, mega kitchen, participatory ergonomics, work related musculoskeletal disorders

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113 Innovation Outputs from Higher Education Institutions: A Case Study of the University of Waterloo, Canada

Authors: Wendy De Gomez

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The University of Waterloo is situated in central Canada in the Province of Ontario- one hour from the metropolitan city of Toronto. For over 30 years, it has held Canada’s top spot as the most innovative university; and has been consistently ranked in the top 25 computer science and top 50 engineering schools in the world. Waterloo benefits from the federal government’s over 100 domestic innovation policies which have assisted in the country’s 15th place global ranking in the World Intellectual Property Organization’s (WIPO) 2022 Global Innovation Index. Yet undoubtedly, the University of Waterloo’s unique characteristics are what propels its innovative creativeness forward. This paper will provide a contextual definition of innovation in higher education and then demonstrate the five operational attributes that contribute to the University of Waterloo’s innovative reputation. The methodology is based on statistical analyses obtained from ranking bodies such as the QS World University Rankings, a secondary literature review related to higher education innovation in Canada, and case studies that exhibit the operationalization of the attributes outlined below. The first attribute is geography. Specifically, the paper investigates the network structure effect of the Toronto-Waterloo high-tech corridor and the resultant industrial relationships built there. The second attribute is University Policy 73-Intellectal Property Rights. This creator-owned policy grants all ownership to the creator/inventor regardless of the use of the University of Waterloo property or funding. Essentially, through the incentivization of IP ownership by all researchers, further commercialization and entrepreneurship are formed. Third, this IP policy works hand in hand with world-renowned business incubators such as the Accelerator Centre in the dedicated research and technology park and velocity, a 14-year-old facility that equips and guides founders to build and scale companies. Communitech, a 25-year-old provincially backed facility in the region, also works closely with the University of Waterloo to build strong teams, access capital, and commercialize products. Fourth, Waterloo’s co-operative education program contributes 31% of all co-op participants to the Canadian economy. Home to the world’s largest co-operative education program, data shows that over 7,000 from around the world recruit Waterloo students for short- and long-term placements- directly contributing to the student’s ability to learn and optimize essential employment skills when they graduate. Finally, the students themselves at Waterloo are exceptional. The entrance average ranges from the low 80s to the mid-90s depending on the program. In computer, electrical, mechanical, mechatronics, and systems design engineering, to have a 66% chance of acceptance, the applicant’s average must be 95% or above. Singularly, none of these five attributes could lead to the university’s outstanding track record of innovative creativity, but when bundled up into a 1000 acre- 100 building main campus with 6 academic faculties, 40,000+ students, and over 1300 world-class faculty, the recipe for success becomes quite evident.

Keywords: IP policy, higher education, economy, innovation

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112 Conceptualizing the Moroccan Amazigh

Authors: Sanaa Riaz

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The free people, Amazigh (plural Imazighen), often known by the more popular exonym, Berber, are spread across several North African countries with the highest population in Morocco have been substantially misunderstood and differentially showcased by entities from western-school educated scholars to human, health and women’s rights organizations, to the State to the international community. This paper is an examination of the various conceptualization of the Imazighen. With the popularity of the Arab Spring movement to oust monarchical and dictatorial rulers across the Middle East and North Africa in Morocco, the Moroccan monarchy introduced various reform programs to win public favor. These included social, economic and educational reforms to incorporate marginalized groups such as the Imazighen. The monarchy has ushered Amazigh representation in public offices and landscape through Amazigh script, even though theirs has been an oral culture. After the Arab Spring, the Justice and Development party, an Islamist party took over in Morocco due to its accessibility to the masses, In Sept. 2021, unlike the case of Egypt and Tunisia where military and constitutional means were sought, Morocco successfully removed it from power through the ballot, resulting in a real victory for the neutral monarchy and its representation as a moderate, secular and liberal force for the nation. As a result, supporting the perpetuation of Amazigh linguistic identity also became synonymous to making a secular statement as a Muslim. It has led to the telling of Amazigh identity at state museums as one representing the indigenous, pure, diverse, culturally-rich and united Morocco. Reform efforts have also prioritized an amiable look towards the economic and familial links of Moroccan Jews with the few thousand families still left in the country and a showcasing through museums and cultural centers of the Jewish identity as Moroccan first. In that endeavor, it is interesting to note the coverage of Jews as the indigenous of Morocco through the embracing of their “folk” cultural and religious practices, those that are not continued outside Morocco. In this epistemology, the concept of the Moroccan Jew becomes similar to the indigenous Amazigh, both cherished as the oldest peoples of Morocco and symbols of its unity and resilience. In the urban discourse, Amazigh identity is a concept that continues to be part of the deliberations of elites and scholars graduating from French schools on the incorporation of rural and illiterate Morocco in economic and educational advancement. Yet, with the constant influx of migrants from Western Sahara into cities like Fez and Marrakesh, Amazigh has often been described as the umbrella term of those of “mixed” ethnic ancestry who constitute the country’s free population. In sum, Amazigh identity highlights the changing discourse on marginalized communities, human rights, representation, Moroccan nationhood, and regional and transnational politics. The aim of this paper is to analyze perceptions of Amazigh identity in Morocco post-2021 ousting of the Islamist party using data from state-sponsored museum displays and cultural centers collected in Summer 2022 and scholarly analyses of Amazigh identity, representation and rights in Morocco.

Keywords: Amazigh identity, Morocco, representation, state politics

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111 Modeling Discrimination against Gay People: Predictors of Homophobic Behavior against Gay Men among High School Students in Switzerland

Authors: Patrick Weber, Daniel Gredig

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Background and Purpose: Research has well documented the impact of discrimination and micro-aggressions on the wellbeing of gay men and, especially, adolescents. For the prevention of homophobic behavior against gay adolescents, however, the focus has to shift on those who discriminate: For the design and tailoring of prevention and intervention, it is important to understand the factors responsible for homophobic behavior such as, for example, verbal abuse. Against this background, the present study aimed to assess homophobic – in terms of verbally abusive – behavior against gay people among high school students. Furthermore, it aimed to establish the predictors of the reported behavior by testing an explanatory model. This model posits that homophobic behavior is determined by negative attitudes and knowledge. These variables are supposed to be predicted by the acceptance of traditional gender roles, religiosity, orientation toward social dominance, contact with gay men, and by the perceived expectations of parents, friends and teachers. These social-cognitive variables in turn are assumed to be determined by students’ gender, age, immigration background, formal school level, and the discussion of gay issues in class. Method: From August to October 2016, we visited 58 high school classes in 22 public schools in a county in Switzerland, and asked the 8th and 9th year students on three formal school levels to participate in survey about gender and gay issues. For data collection, we used an anonymous self-administered questionnaire filled in during class. Data were analyzed using descriptive statistics and structural equation modelling (Generalized Least Square Estimates method). The sample included 897 students, 334 in the 8th and 563 in the 9th year, aged 12–17, 51.2% being female, 48.8% male, 50.3% with immigration background. Results: A proportion of 85.4% participants reported having made homophobic statements in the 12 month before survey, 4.7% often and very often. Analysis showed that respondents’ homophobic behavior was predicted directly by negative attitudes (β=0.20), as well as by the acceptance of traditional gender roles (β=0.06), religiosity (β=–0.07), contact with gay people (β=0.10), expectations of parents (β=–0.14) and friends (β=–0.19), gender (β=–0.22) and having a South-East-European or Western- and Middle-Asian immigration background (β=0.09). These variables were predicted, in turn, by gender, age, immigration background, formal school level, and discussion of gay issues in class (GFI=0.995, AGFI=0.979, SRMR=0.0169, CMIN/df=1.199, p>0.213, adj. R2 =0.384). Conclusion: Findings evidence a high prevalence of homophobic behavior in the responding high school students. The tested explanatory model explained 38.4% of the assessed homophobic behavior. However, data did not found full support of the model. Knowledge did not turn out to be a predictor of behavior. Except for the perceived expectation of teachers and orientation toward social dominance, the social-cognitive variables were not fully mediated by attitudes. Equally, gender and immigration background predicted homophobic behavior directly. These findings demonstrate the importance of prevention and provide also leverage points for interventions against anti-gay bias in adolescents – also in social work settings as, for example, in school social work, open youth work or foster care.

Keywords: discrimination, high school students, gay men, predictors, Switzerland

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110 Impact of the COVID-19 Pandemic and Social Isolation on the Clients’ Experiences in Counselling and their Access to Services: Perspectives of Violence Against Women Program Staff - A Qualitative Study

Authors: Habiba Nahzat, Karen Crow, Lisa Manuel, Maria Huijbregts

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Background and Rationale: The World Health Organization (WHO) declared COVID-19 a pandemic on March 11, 2020. Shortly after, the Ontario provincial and Toronto municipal governments also released multiple directives that led to the mass closure of businesses both in the public and private sectors. Recent research has identified connections between Intimate Partner Violence (IPV) and COVID-19 related stressors - especially because of lockdown and social isolation measures. Psychological impacts of lengthy seclusion coupled with disconnection from extended family and diminished support services can take a toll on families at risk and may increase mental health issues and the prevalence of IPV. Research Question: Thus, the purpose of the study was to understand the perspective of the Violence Against Women (VAW) program staff on the impact of the COVID-19 pandemic; we especially wanted to understand staff views of restrictions on clients’ counseling experiences and the ability to access services in general. The study also aimed to examine VAW program staff experiences regarding remote work and explore how the pandemic restriction measures affected the ability of their program operations to support their clients and each other. Method: A cross-sectional, descriptive qualitative study was conducted with a purposive sample of 9 VAW program staff – eight VAW counselors and one VAW manager. Prior to data collection, program staff collaborated in the development of the study purpose, interview questions and methodology. Ethics approval was obtained from the sponsoring organization’s Research Ethics Board. In-depth individual interviews were conducted with study participants using a semi-structured interview questionnaire. Brief demographic information was also collected prior to the interview. Descriptive statistics were used to analyze quantitative data and qualitative data was analyzed by thematic content analysis. Results: Findings from this study indicate that the COVID-19 pandemic restrictions had an adverse impact on clients seeking VAW services based on VAW staff perspectives. Program staff reported a perceived increase in abuse among women, especially in emotional and financial abuse and experiences of isolation and trauma. Findings further highlight the challenges women experienced when trying to access services in general as well as counseling and legal services. This was perceived to be more prominent among newcomers and marginalized women. The study also revealed client and staff challenges when participating in virtual counseling, their innovations and clients’ creativity in accessing needed counseling and how staff over time adapted to providing virtual support during the pandemic. Conclusion and Next Steps: This study builds upon existing evidence on the impact of COVID-19 restrictions on VAW and may inform future research to better understand the association between the COVID-19 pandemic restrictions and VAW on a broader scale and to inform and support possible short-term and long-term changes in the client experience and counselling practice.

Keywords: COVID-19, pandemic, virtual, violence against women (VAW)

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109 Oncoplastic Augmentation Mastopexy: Aesthetic Revisional Surgery in Breast Conserving Therapy

Authors: Bar Y. Ainuz, Harry M. Salinas, Aleeza Ali, Eli B. Levitt, Austin J. Pourmoussa, Antoun Bouz, Miguel A. Medina

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Introduction: Breast conservation therapy remains the mainstay surgical treatment for early breast cancer. Oncoplastic techniques, in conjunction with lumpectomy and adjuvant radiotherapy, have been demonstrated to achieve good aesthetic results without adversely affecting cancer outcomes in the treatment of patients with macromastia or significant ptosis. In our patient population, many women present for breast conservation with pre-existing cosmetic implants or with breast volumes too small for soft tissue, only oncoplastic techniques. Our study evaluated a consecutive series of patients presenting for breast conservation undergoing concomitant oncoplastic-augmentation-mastopexy (OAM) with a contralateral augmentation-mastopexy for symmetry. Methods: OAM surgical technique involves simultaneous lumpectomy with exchange or placement of implants, oncoplastic mastopexy, and concomitant contralateral augmentation mastopexy for symmetry. Patients undergoing lumpectomy for breast conservation as outpatients were identified via retrospective chart review at a high volume private academic affiliated community-based cancer center. Patients with ptosis and either pre-existing breast implants or insufficient breast volume undergoing oncoplastic implant placement (or exchange) and mastopexy were included in the study. Operative details, aesthetic outcomes, and complications were assessed. Results: Over a continuous three-year period, with a two-surgeon cohort, 30 consecutive patients (56 breasts, 4 unilateral procedures) were identified. Patients had an average age of 52.5 years and an average BMI of 27.5, with 40% smokers or former smokers. The average operative time was 2.5 hours, the average implant size removed was 352 cc, and the average implant size placed was 300 cc. All new implants were smooth silicone, with the majority (92%) placed in a retropectoral fashion. 40% of patients received chemotherapy, and 80% of patients received whole breast adjuvant photon radiotherapy with a total radiation dose of either 42.56 or 52.56 Gy. The average and median length of follow-up were both 8.2 months. Of the 24 patients that received radiotherapy, 21% had asymmetry due to capsular contracture. A total of 7 patients (29.2%) underwent revisions for either positive margins (12.5%), capsular contracture (8.3%), implant loss (4.2%), or cosmetic concerns (4.2%). One patient developed a pulmonary embolism in the acute postoperative period and was treated with anticoagulant therapy. Conclusion: Oncoplastic augmentation mastopexy is a safe technique with good aesthetic outcomes and acceptable complication rates for ptotic patients with breast cancer and a paucity of breast volume or pre-existing implants who wish to pursue breast-conserving therapy. The revision rates compare favorably with single-stage cosmetic augmentation procedures as well as other oncoplastic techniques described in the literature. The short-term capsular contracture rates seem lower than the rates in patients undergoing radiation after mastectomy and implant-based reconstruction. Long term capsular contractures and revision rates are too early to know in this cohort.

Keywords: breast conserving therapy, oncoplastic augmentation mastopexy, capsular contracture, breast reconstruction

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108 An Argument for Agile, Lean, and Hybrid Project Management in Museum Conservation Practice: A Qualitative Evaluation of the Morris Collection Conservation Project at the Sainsbury Centre for Visual Arts

Authors: Maria Ledinskaya

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This paper is part case study and part literature review. It seeks to introduce Agile, Lean, and Hybrid project management concepts from business, software development, and manufacturing fields to museum conservation by looking at their practical application on a recent conservation project at the Sainsbury Centre for Visual Arts. The author outlines the advantages of leaner and more agile conservation practices in today’s faster, less certain, and more budget-conscious museum climate where traditional project structures are no longer as relevant or effective. The Morris Collection Conservation Project was carried out in 2019-2021 in Norwich, UK, and concerned the remedial conservation of around 150 Abstract Constructivist artworks bequeathed to the Sainsbury Centre by private collectors Michael and Joyce Morris. It was a medium-sized conservation project of moderate complexity, planned and delivered in an environment with multiple known unknowns – unresearched collection, unknown conditions and materials, unconfirmed budget. The project was later impacted by the COVID-19 pandemic, introducing indeterminate lockdowns, budget cuts, staff changes, and the need to accommodate social distancing and remote communications. The author, then a staff conservator at the Sainsbury Centre who acted as project manager on the Morris Project, presents an incremental, iterative, and value-based approach to managing a conservation project in an uncertain environment. The paper examines the project from the point of view of Traditional, Agile, Lean, and Hybrid project management. The author argues that most academic writing on project management in conservation has focussed on a Traditional plan-driven approach – also known as Waterfall project management – which has significant drawbacks in today’s museum environment due to its over-reliance on prediction-based planning and its low tolerance to change. In the last 20 years, alternative Agile, Lean and Hybrid approaches to project management have been widely adopted in software development, manufacturing, and other industries, although their recognition in the museum sector has been slow. Using examples from the Morris Project, the author introduces key principles and tools of Agile, Lean, and Hybrid project management and presents a series of arguments on the effectiveness of these alternative methodologies in museum conservation, including the ethical and practical challenges to their implementation. These project management approaches are discussed in the context of consequentialist, relativist, and utilitarian developments in contemporary conservation ethics. Although not intentionally planned as such, the Morris Project had a number of Agile and Lean features which were instrumental to its successful delivery. These key features are identified as distributed decision-making, a co-located cross-disciplinary team, servant leadership, focus on value-added work, flexible planning done in shorter sprint cycles, light documentation, and emphasis on reducing procedural, financial, and logistical waste. Overall, the author’s findings point in favour of a hybrid model, which combines traditional and alternative project processes and tools to suit the specific needs of the project.

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

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107 Sustainability in Higher Education: A Case of Transition Management from a Private University in Turkey (Ongoing Study)

Authors: Ayse Collins

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The Agenda 2030 puts Higher Education Institutions (HEIs) in the situation where they should emphasize ways to promote sustainability accordingly. However, it is still unclear: a) how sustainability is understood, and b) which actions have been taken in both discourse and practice by HEIs regarding the three pillars of sustainability, society, environment, and economy. There are models of sustainable universities developed by different authors from different countries; For Example, The Global Reporting Initiative (GRI) methodology which offers a variety of indicators to diagnose performance. However, these models have never been developed for universities in particular. Any model, in this sense, cannot be completed adequately without defining the appropriate tools to measure, analyze and control the performance of initiatives. There is a need to conduct researches in different universities from different countries to understand where we stand in terms of sustainable higher education. Therefore, this study aims at exploring the actions taken by a university in Ankara, Turkey, since Agenda 2030 should consider localizing its objectives and targets according to a certain geography. This university just announced 2021-2022 as “Sustainability Year.” Therefore, this research is a multi-methodology longitudinal study and uses the theoretical framework of the organization and transition management (TM). It is designed to examine the activities as being strategic, tactical, operational, and reflexive in nature and covers the six main aspects: academic community, administrative staff, operations and services, teaching, research, and extension. The preliminary research will answer the role of the top university governance, perception of the stakeholders (students, instructors, administrative and support staff) regarding sustainability, and the level of achievement at the mid-evaluation and final, end of year evaluation. TM Theory is a multi-scale, multi-actor, process-oriented approach with the analytical framework to explore and promote change in social systems. Therefore, the stages and respective methodology for collecting data in this research is: Pre-development Stage: a) semi-structured interviews with university governance, c) open-ended survey with faculty, students, and administrative staff d) Semi-structured interviews with support staff, and e) analysis of current secondary data for sustainability. Take-off Stage: a) semi-structured interviews with university governance, faculty, students, administrative and support staff, b) analysis of secondary data. Breakthrough stabilization a) survey with all stakeholders at the university, b) secondary data analysis by using selected indicators for the first sustainability report for universities The findings from the predevelopment stage highlight how stakeholders, coming from different faculties, different disciplines with different identities and characteristics, face the sustainability challenge differently. Though similar sustainable development goals ((social, environmental, and economic) are set in the institution, there are differences across disciplines and among different stakeholders, which need to be considered to reach the optimum goal. It is believed that the results will help changes in HEIs organizational culture to embed sustainability values in their strategic planning, academic and managerial work by putting enough time and resources to be successful in coping with sustainability.

Keywords: higher education, sustainability, sustainability auditing, transition management

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106 The End Justifies the Means: Using Programmed Mastery Drill to Teach Spoken English to Spanish Youngsters, without Relying on Homework

Authors: Robert Pocklington

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Most current language courses expect students to be ‘vocational’, sacrificing their free time in order to learn. However, pupils with a full-time job, or bringing up children, hardly have a spare moment. Others just need the language as a tool or a qualification, as if it were book-keeping or a driving license. Then there are children in unstructured families whose stressful life makes private study almost impossible. And the countless parents whose evenings and weekends have become a nightmare, trying to get the children to do their homework. There are many arguments against homework being a necessity (rather than an optional extra for more ambitious or dedicated students), making a clear case for teaching methods which facilitate full learning of the key content within the classroom. A methodology which could be described as Programmed Mastery Learning has been used at Fluency Language Academy (Spain) since 1992, to teach English to over 4000 pupils yearly, with a staff of around 100 teachers, barely requiring homework. The course is structured according to the tenets of Programmed Learning: small manageable teaching steps, immediate feedback, and constant successful activity. For the Mastery component (not stopping until everyone has learned), the memorisation and practice are entrusted to flashcard-based drilling in the classroom, leading all students to progress together and develop a permanently growing knowledge base. Vocabulary and expressions are memorised using flashcards as stimuli, obliging the brain to constantly recover words from the long-term memory and converting them into reflex knowledge, before they are deployed in sentence building. The use of grammar rules is practised with ‘cue’ flashcards: the brain refers consciously to the grammar rule each time it produces a phrase until it comes easily. This automation of lexicon and correct grammar use greatly facilitates all other language and conversational activities. The full B2 course consists of 48 units each of which takes a class an average of 17,5 hours to complete, allowing the vast majority of students to reach B2 level in 840 class hours, which is corroborated by an 85% pass-rate in the Cambridge University B2 exam (First Certificate). In the past, studying for qualifications was just one of many different options open to young people. Nowadays, youngsters need to stay at school and obtain qualifications in order to get any kind of job. There are many students in our classes who have little intrinsic interest in what they are studying; they just need the certificate. In these circumstances and with increasing government pressure to minimise failure, teachers can no longer think ‘If they don’t study, and fail, its their problem’. It is now becoming the teacher’s problem. Teachers are ever more in need of methods which make their pupils successful learners; this means assuring learning in the classroom. Furthermore, homework is arguably the main divider between successful middle-class schoolchildren and failing working-class children who drop out: if everything important is learned at school, the latter will have a much better chance, favouring inclusiveness in the language classroom.

Keywords: flashcard drilling, fluency method, mastery learning, programmed learning, teaching English as a foreign language

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105 Owning (up to) the 'Art of the Insane': Re-Claiming Personhood through Copyright Law

Authors: Mathilde Pavis

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From Schumann to Van Gogh, Frida Kahlo, and Ray Charles, the stories narrating the careers of artists with physical or mental disabilities are becoming increasingly popular. From the emergence of ‘pathography’ at the end of 18th century to cinematographic portrayals, the work and lives of differently-abled creative individuals continue to fascinate readers, spectators and researchers. The achievements of those artists form the tip of the iceberg composed of complex politico-cultural movements which continue to advocate for wider recognition of disabled artists’ contribution to western culture. This paper envisages copyright law as a potential tool to such end. It investigates the array of rights available to artists with intellectual disabilities to assert their position as authors of their artwork in the twenty-first-century looking at international and national copyright laws (UK and US). Put simply, this paper questions whether an artist’s intellectual disability could be a barrier to assert their intellectual property rights over their creation. From a legal perspective, basic principles of non-discrimination would contradict the representation of artists’ disability as an obstacle to authorship as granted by intellectual property laws. Yet empirical studies reveal that artists with intellectual disabilities are often denied the opportunity to exercise their intellectual property rights or any form of agency over their work. In practice, it appears that, unlike other non-disabled artists, the prospect for differently-abled creators to make use of their right is contingent to the context in which the creative process takes place. Often will the management of such rights rest with the institution, art therapist or mediator involved in the artists’ work as the latter will have necessitated greater support than their non-disabled peers for a variety of reasons, either medical or practical. Moreover, the financial setbacks suffered by medical institutions and private therapy practices have renewed administrators’ and physicians’ interest in monetising the artworks produced under their supervision. Adding to those economic incentives, the rise of criminal and civil litigation in psychiatric cases has also encouraged the retention of patients’ work by therapists who feel compelled to keep comprehensive medical records to shield themselves from liability in the event of a lawsuit. Unspoken transactions, contracts, implied agreements and consent forms have thus progressively made their way into the relationship between those artists and their therapists or assistants, disregarding any notions of copyright. The question of artists’ authorship finds itself caught in an unusually multi-faceted web of issues formed by tightening purse strings, ethical concerns and the fear of civil or criminal liability. Whilst those issues are playing out behind closed doors, the popularity of what was once called the ‘Art of the Insane’ continues to grow and open new commercial avenues. This socio-economic context exacerbates the need to devise a legal framework able to help practitioners, artists and their advocates navigate through those issues in such a way that neither this minority nor our cultural heritage suffers from the fragmentation of the legal protection available to them.

Keywords: authorship, copyright law, intellectual disabilities, art therapy and mediation

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104 Digital Health During a Pandemic: Critical Analysis of the COVID-19 Contact Tracing Apps

Authors: Mohanad Elemary, Imose Itua, Rajeswari B. Matam

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Virologists and public health experts have been predicting potential pandemics from coronaviruses for decades. The viruses which caused the SARS and MERS pandemics and the Nipah virus led to many lost lives, but still, the COVID-19 pandemic caused by the SARS-CoV2 virus surprised many scientific communities, experts, and governments with its ease of transmission and its pathogenicity. Governments of various countries reacted by locking down entire populations to their homes to combat the devastation caused by the virus, which led to a loss of livelihood and economic hardship to many individuals and organizations. To revive national economies and support their citizens in resuming their lives, governments focused on the development and use of contact tracing apps as a digital way to track and trace exposure. Google and Apple introduced the Exposure Notification Systems (ENS) framework. Independent organizations and countries also developed different frameworks for contact tracing apps. The efficiency, popularity, and adoption rate of these various apps have been different across countries. In this paper, we present a critical analysis of the different contact tracing apps with respect to their efficiency, adoption rate and general perception, and the governmental strategies and policies, which led to the development of the applications. When it comes to the European countries, each of them followed an individualistic approach to the same problem resulting in different realizations of a similarly functioning application with differing results of use and acceptance. The study conducted an extensive review of existing literature, policies, and reports across multiple disciplines, from which a framework was developed and then validated through interviews with six key stakeholders in the field, including founders and executives in digital health startups and corporates as well as experts from international organizations like The World Health Organization. A framework of best practices and tactics is the result of this research. The framework looks at three main questions regarding the contact tracing apps; how to develop them, how to deploy them, and how to regulate them. The findings are based on the best practices applied by governments across multiple countries, the mistakes they made, and the best practices applied in similar situations in the business world. The findings include multiple strategies when it comes to the development milestone regarding establishing frameworks for cooperation with the private sector and how to design the features and user experience of the app for a transparent, effective, and rapidly adaptable app. For the deployment section, several tactics were discussed regarding communication messages, marketing campaigns, persuasive psychology, and the initial deployment scale strategies. The paper also discusses the data privacy dilemma and how to build for a more sustainable system of health-related data processing and utilization. This is done through principles-based regulations specific for health data to allow for its avail for the public good. This framework offers insights into strategies and tactics that could be implemented as protocols for future public health crises and emergencies whether global or regional.

Keywords: contact tracing apps, COVID-19, digital health applications, exposure notification system

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103 Unmasking Virtual Empathy: A Philosophical Examination of AI-Mediated Emotional Practices in Healthcare

Authors: Eliana Bergamin

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This philosophical inquiry, influenced by the seminal works of Annemarie Mol and Jeannette Pols, critically examines the transformative impact of artificial intelligence (AI) on emotional caregiving practices within virtual healthcare. Rooted in the traditions of philosophy of care, philosophy of emotions, and applied philosophy, this study seeks to unravel nuanced shifts in the moral and emotional fabric of healthcare mediated by AI-powered technologies. Departing from traditional empirical studies, the approach embraces the foundational principles of care ethics and phenomenology, offering a focused exploration of the ethical and existential dimensions of AI-mediated emotional caregiving. At its core, this research addresses the introduction of AI-powered technologies mediating emotional and care practices in the healthcare sector. By drawing on Mol and Pols' insights, the study offers a focused exploration of the ethical and existential dimensions of AI-mediated emotional caregiving. Anchored in ethnographic research within a pioneering private healthcare company in the Netherlands, this critical philosophical inquiry provides a unique lens into the dynamics of AI-mediated emotional practices. The study employs in-depth, semi-structured interviews with virtual caregivers and care receivers alongside ongoing ethnographic observations spanning approximately two and a half months. Delving into the lived experiences of those at the forefront of this technological evolution, the research aims to unravel subtle shifts in the emotional and moral landscape of healthcare, critically examining the implications of AI in reshaping the philosophy of care and human connection in virtual healthcare. Inspired by Mol and Pols' relational approach, the study prioritizes the lived experiences of individuals within the virtual healthcare landscape, offering a deeper understanding of the intertwining of technology, emotions, and the philosophy of care. In the realm of philosophy of care, the research elucidates how virtual tools, particularly those driven by AI, mediate emotions such as empathy, sympathy, and compassion—the bedrock of caregiving. Focusing on emotional nuances, the study contributes to the broader discourse on the ethics of care in the context of technological mediation. In the philosophy of emotions, the investigation examines how the introduction of AI alters the phenomenology of emotional experiences in caregiving. Exploring the interplay between human emotions and machine-mediated interactions, the nuanced analysis discerns implications for both caregivers and caretakers, contributing to the evolving understanding of emotional practices in a technologically mediated healthcare environment. Within applied philosophy, the study transcends empirical observations, positioning itself as a reflective exploration of the moral implications of AI in healthcare. The findings are intended to inform ethical considerations and policy formulations, bridging the gap between technological advancements and the enduring values of caregiving. In conclusion, this focused philosophical inquiry aims to provide a foundational understanding of the evolving landscape of virtual healthcare, drawing on the works of Mol and Pols to illuminate the essence of human connection, care, and empathy amid technological advancements.

Keywords: applied philosophy, artificial intelligence, healthcare, philosophy of care, philosophy of emotions

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102 The Theme 'Leyli and Majnun', the Ancient Legend of the East in the Cognominal Symphonic Poem of Great Composer Gara Garayev on Specific and Non–Specific Content

Authors: Vusala Amirbayova

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The science of modern musicology, based on the achievements of a number of neighboring science fields, has more deeply penetrated into the sphere of artistic content of the art of music and developed a new scientific methodology, methods and approaches for a comprehensive study of the problem. In this regard, a new theory developed by the famous Russian musician-scientist, professor V. Kholopova – the specific and non – specific content of music – draws the attention with its different philosophical foundation and covering historical periods of the art of composing. The scientist related her theory to the art of European composer’s creativity, and did not include musical professionalism and especially, folklore creativity existing in other continent in her circle of interest. The researcher made an effort to explain triad (the world of ideas, emotions and subjects) which is included in the general content of music in the example of composers’ works belonging to different periods and cultures. In this respect, the artistic content of works has been deeply and comprehensively analyzed new philosophical basis. The theme ‘Leyli and Majnun’ was developed by many poets as one of the ancient legends of the East, and each artist was able to give a unique artistic interpretation of the work. This literary source was successfully developed in cognominal opera of great U. Hajibeyli in Azerbaijani music and its embodiment with symphonic means required great skill and courage from Gara Garayev. Unlike opera, as there is the opportunity to show the plot of ‘Leyli and Majnun’ in the symphonic poem, the composer achieved to reflect the main purpose of its idea convincingly with pure musical means, and created a great work with tragic spirit having a great emotional impact. Though the artistic content and form of ‘Leyli and Majnun’ symphonic poem have been sufficiently analyzed by music theorists until now, in our opinion, it is for the first time that the work is considered from the point of specific music content. Therefore, we will make an effort to penetrate into a specific layer of its artistic content after firstly reviewing the poem with traditional methods in the general plan. The use of both national fret – intonations and the system of major – minor by G. Garayev is based on well-tempered root. The composer, widely using national fret – intonations and model harmonic means on this ground, achieved to express the spirit and content of the poem. It perfectly embodies the grandeur and immortality of divine love, and the struggle of powerful human personality with the forces of despotism. Gara Garayev said about this work: “My most sublime goal and desire is to explain the literary issue that love endures to all obstacles and overcomes even death”. The music of ‘Leyli and Majnun’ symphonic poem is rich with deep desires and sharp contradictions. G.Garayev reflected these wonderful ideas about the power of music in his book ‘Articles, schools and sayings’: “Music is the decoration of life and a powerful source of inspiration”.

Keywords: content, music, symphonic, theory

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101 Reducing Road Traffic Accident: Rapid Evidence Synthesis for Low and Middle Income Countries

Authors: Tesfaye Dagne, Dagmawit Solomon, Firmaye Bogale, Yosef Gebreyohannes, Samson Mideksa, Mamuye Hadis, Desalegn Ararso, Ermias Woldie, Tsegaye Getachew, Sabit Ababor, Zelalem Kebede

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Globally, road traffic accident (RTA) is causing millions of deaths and injuries every year. It is one of the leading causes of death among people of all age groups and the problem is worse among young reproductive age group. Moreover the problem is increasing with an increasing number of vehicles. The majority of the problem happen in low and middle income countries (LMIC), even if the number of vehicles in these countries is low compared to their population. So, the objective of this paper is to summarize the best available evidence on interventions that can reduce road traffic accidents in low and middle income countries (LMIC). Method: A rapid evidence synthesis approach adapted from the SURE Rapid Response Service was applied to search, appraise and summarize the best available evidence on effective intervention in reducing road traffic injury. To answer the question under review, we searched for relevant studies from databases including PubMed, the Cochrane Library, TRANSPORT, Health system evidence, Epistemonikos, and SUPPORT summary. The following key terms were used for searching: Road traffic accident, RTA, Injury, Reduc*, Prevent*, Minimiz*, “Low and middle-income country”, LMIC. We found 18 articles through a search of different databases mentioned above. After screening for the titles and abstracts of the articles, four of them which satisfy the inclusion criteria were included in the final review. Then we appraised and graded the methodological quality of systematic reviews that are deemed to be highly relevant using AMSTAR. Finding: The identified interventions to reduce road traffic accidents were legislation and enforcement, public awareness/education, speed control/ rumble strips, road improvement, mandatory motorcycle helmet, graduated driver license, street lighting. Legislation and Enforcement: Legislation focusing on mandatory motorcycle helmet usage, banning cellular phone usage when driving, seat belt laws, decreasing the legal blood alcohol content (BAC) level from 0.06 g/L to 0.02 g/L bring the best result where enforcement is there. Public Awareness/Education: focusing on seat belt use, child restraint use, educational training in health centers and schools/universities, and public awareness with media through the distribution of videos, posters/souvenirs, and pamphlets are effective in the short run. Speed Control: through traffic calming bumps, or speed bumps, rumbled strips are effective in reducing accidents and fatality. Mandatory Motorcycle Helmet: is associated with reduction in mortality. Graduated driver’s license (GDL): reduce road traffic injury by 19%. Street lighting: is a low-cost intervention which may reduce road traffic accidents.

Keywords: evidence synthesis, injury, rapid review, reducing, road traffic accident

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100 Health Inequalities in the Global South: Identification of Poor People with Disabilities in Cambodia to Generate Access to Healthcare

Authors: Jamie Lee Harder

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In the context of rapidly changing social and economic circumstances in the developing world, this paper analyses access to public healthcare for poor people with disabilities in Cambodia. Like other countries of South East Asia, Cambodia is developing at rapid pace. The historical past of Cambodia, however, has set former social policy structures to zero. This past forces Cambodia and its citizens to implement new public health policies to align with the needs of social care, healthcare, and urban planning. In this context, the role of people with disabilities (PwDs) is crucial as new developments should and can take into consideration their specific needs from the beginning onwards. This paper is based on qualitative research with expert interviews and focus group discussions in Cambodia. During the field work it became clear that the identification tool for the poorest households (HHs) does not count disability as a financial risk to fall into poverty neither when becoming sick nor because of higher health expenditures and/or lower income because of the disability. The social risk group of poor PwDs faces several barriers in accessing public healthcare. The urbanization, the socio-economic health status, and opportunities for education; all influence social status and have an impact on the health situation of these individuals. Cambodia has various difficulties with providing access to people with disabilities, mostly due to barriers regarding finances, geography, quality of care, poor knowledge about their rights and negative social and cultural beliefs. Shortened budgets and the lack of prioritizations lead to the need for reorientation of local communities, international and national non-governmental organizations and social policy. The poorest HHs are identified with a questionnaire, the IDPoor program, for which the Ministry of Planning is responsible. The identified HHs receive an ‘Equity Card’ which provides access free of charge to public healthcare centers and hospitals among other benefits. The dataset usually does not include information about the disability status. Four focus group discussions (FGD) with 28 participants showed various barriers in accessing public healthcare. These barriers go far beyond a missing ramp to access the healthcare center. The contents of the FGDs were ratified and repeated during the expert interviews with the local Ministries, NGOs, international organizations and private persons working in the field. The participants of the FGDs faced and continue to face high discrimination, low capacity to work and earn an own income, dependency on others and less social competence in their lives. When discussing their health situation, we identified, a huge difference between those who are identified and hold an Equity Card and those who do not. Participants reported high costs without IDPoor identification, positive experiences when going to the health center in terms of attitude and treatment, low satisfaction with specific capacities for treatments, negative rumors, and discrimination with the consequence of fear to seek treatment in many cases. The problem of accessing public healthcare by risk groups can be adapted to situations in other countries.

Keywords: access, disability, health, inequality, Cambodia

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99 Development of an Artificial Neural Network to Measure Science Literacy Leveraging Neuroscience

Authors: Amanda Kavner, Richard Lamb

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Faster growth in science and technology of other nations may make staying globally competitive more difficult without shifting focus on how science is taught in US classes. An integral part of learning science involves visual and spatial thinking since complex, and real-world phenomena are often expressed in visual, symbolic, and concrete modes. The primary barrier to spatial thinking and visual literacy in Science, Technology, Engineering, and Math (STEM) fields is representational competence, which includes the ability to generate, transform, analyze and explain representations, as opposed to generic spatial ability. Although the relationship is known between the foundational visual literacy and the domain-specific science literacy, science literacy as a function of science learning is still not well understood. Moreover, the need for a more reliable measure is necessary to design resources which enhance the fundamental visuospatial cognitive processes behind scientific literacy. To support the improvement of students’ representational competence, first visualization skills necessary to process these science representations needed to be identified, which necessitates the development of an instrument to quantitatively measure visual literacy. With such a measure, schools, teachers, and curriculum designers can target the individual skills necessary to improve students’ visual literacy, thereby increasing science achievement. This project details the development of an artificial neural network capable of measuring science literacy using functional Near-Infrared Spectroscopy (fNIR) data. This data was previously collected by Project LENS standing for Leveraging Expertise in Neurotechnologies, a Science of Learning Collaborative Network (SL-CN) of scholars of STEM Education from three US universities (NSF award 1540888), utilizing mental rotation tasks, to assess student visual literacy. Hemodynamic response data from fNIRsoft was exported as an Excel file, with 80 of both 2D Wedge and Dash models (dash) and 3D Stick and Ball models (BL). Complexity data were in an Excel workbook separated by the participant (ID), containing information for both types of tasks. After changing strings to numbers for analysis, spreadsheets with measurement data and complexity data were uploaded to RapidMiner’s TurboPrep and merged. Using RapidMiner Studio, a Gradient Boosted Trees artificial neural network (ANN) consisting of 140 trees with a maximum depth of 7 branches was developed, and 99.7% of the ANN predictions are accurate. The ANN determined the biggest predictors to a successful mental rotation are the individual problem number, the response time and fNIR optode #16, located along the right prefrontal cortex important in processing visuospatial working memory and episodic memory retrieval; both vital for science literacy. With an unbiased measurement of science literacy provided by psychophysiological measurements with an ANN for analysis, educators and curriculum designers will be able to create targeted classroom resources to help improve student visuospatial literacy, therefore improving science literacy.

Keywords: artificial intelligence, artificial neural network, machine learning, science literacy, neuroscience

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98 Cultural Intelligence for the Managers of Tomorrow: A Data-Based Analysis of the Antecedents and Training Needs of Today’s Business School Students

Authors: Justin Byrne, Jose Ramon Cobo

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The growing importance of cross- or intercultural competencies (used here interchangeably) for the business and management professionals is now a commonplace in both academic and professional literature. This reflects two parallel developments. On the one hand, it is a consequence of the increased attention paid to a whole range of 'soft skills', now seen as fundamental in both individuals' and corporate success. On the other hand, and more specifically, the increasing demand for interculturally competent professionals is a corollary of ongoing processes of globalization, which multiply and intensify encounters between individuals and companies from different cultural backgrounds. Business schools have, for some decades, responded to the needs of the job market and their own students by providing students with training in intercultural skills, as they are encouraged to do so by the major accreditation agencies on both sides of the Atlantic. Adapting Early and Ang's (2003) formulation of Cultural Intelligence (CQ), this paper aims to help fill the lagunae in the current literature on intercultural training in three main ways. First, it offers an in-depth analysis of the CQ of a little studied group: contemporary Millenial and 'Generation Z' Business School students. The level of analysis distinguishes between the four different dimensions of CQ, cognition, metacognition, motivation and behaviour, and thereby provides a detailed picture of the strengths and weaknesses in CQ of the group as a whole, as well as of different sub-groups and profiles of students. Secondly, by crossing these individual-level findings with respondents' socio-cultural and educational data, this paper also proposes and tests hypotheses regarding the relative impact and importance of four possible antecedents of intercultural skills identified in the literature: prior international experience; intercultural training, foreign language proficiency, and experience of cultural diversity in habitual country of residence. Third, we use this analysis to suggest data-based intercultural training priorities for today's management students. These conclusions are based on the statistical analysis of individual responses of some 300 Bachelor or Masters students in a major European Business School provided to two on-line surveys: Ang, Van Dyne, et al's (2007) standard 20-question self-reporting CQ Scale, and an original questionnaire designed by the authors to collate information on respondent's socio-demographic and educational profile relevant to our four hypotheses and explanatory variables. The data from both instruments was crossed in both descriptive statistical analysis and regression analysis. This research shows that there is no statistically significant and positive relationship between the four antecedents analyzed and overall CQ level. The exception in this respect is the statistically significant correlation between international experience, and the cognitive dimension of CQ. In contrast, the results show that the combination of international experience and foreign language skills acting together, does have a strong overall impact on CQ levels. These results suggest that selecting and/or training students with strong foreign language skills and providing them with international experience (through multinational programmes, academic exchanges or international internships) constitutes one effective way of training culturally intelligent managers of tomorrow.

Keywords: business school, cultural intelligence, millennial, training

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97 Universal Health Coverage 2019 in Indonesia: The Integration of Family Planning Services in Current Functioning Health System

Authors: Fathonah Siti, Ardiana Irma

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Indonesia is currently on its track to achieve Universal Health Coverage (UHC) by 2019. The program aims to address issues on disintegration in the implementation and coverage of various health insurance schemes and fragmented fund pooling. Family planning service is covered as one of benefit packages under preventive care. However, little has been done to examine how family planning program are appropriately managed across levels of governments and how family planning services are delivered to the end user. The study is performed through focus group discussion to related policy makers and selected programmers at central and district levels. The study is also benefited from relevant studies on family planning in the UHC scheme and other supporting data. The study carefully investigates some programmatic implications when family planning is integrated in the UHC program encompassing the need to recalculate contraceptive logistics for beneficiaries (eligible couple); policy reformulation for contraceptive service provision including supply chain management; establishment of family planning standard of procedure; and a call to update Management Information System. The study confirms that there is a significant increase in the numbers of contraceptive commodities needs to be procured by the government. Holding an assumption that contraceptive prevalence rate and commodities cost will be as expected increasing at 0.5% annually, the government need to allocate almost IDR 5 billion by 2019, excluded fee for service. The government shifts its focus to maintain eligible health facilities under National Population and Family Planning Board networks. By 2019, the government has set strategies to anticipate the provision of family planning services to 45.340 health facilities distributed in 514 districts and 7 thousand sub districts. Clear division of authorities has been established among levels of governments. Three models of contraceptive supply planning have been developed and currently in the process of being institutionalized. Pre service training for family planning services has been piloted in 10 prominent universities. The position of private midwives has been appreciated as part of the system. To ensure the implementation of quality and health expenditure control, family planning standard has been established as a reference to determine set of services required to deliver to the clients properly and types of health facilities to conduct particular family planning services. Recognition to individual status of program participation has been acknowledged in the Family Enumeration since 2015. The data is precisely recorded by name by address for each family and its members. It supplies valuable information to 15.131 Family Planning Field Workers (FPFWs) to provide information and education related to family planning in an attempt to generate demand and maintain the participation of family planning acceptors who are program beneficiaries. Despite overwhelming efforts described above, some obstacles remain. The program experiences poor socialization and yet removes geographical barriers for those living in remote areas. Family planning services provided for this sub population conducted outside the scheme as a complement strategy. However, UHC program has brought remarkable improvement in access and quality of family planning services.

Keywords: beneficiary, family planning services, national population and family planning board, universal health coverage

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96 A Proposal of a Strategic Framework for the Development of Smart Cities: The Argentinian Case

Authors: Luis Castiella, Mariano Rueda, Catalina Palacio

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The world’s rapid urbanisation represents an excellent opportunity to implement initiatives that are oriented towards a country’s general development. However, this phenomenon has created considerable pressure on current urban models, pushing them nearer to a crisis. As a result, several factors usually associated with underdevelopment have been steadily rising. Moreover, actions taken by public authorities have not been able to keep up with the speed of urbanisation, which has impeded them from meeting the demands of society, responding with reactionary policies instead of with coordinated, organised efforts. In contrast, the concept of a Smart City which emerged around two decades ago, in principle, represents a city that utilises innovative technologies to remedy the everyday issues of the citizen, empowering them with the newest available technology and information. This concept has come to adopt a wider meaning, including human and social capital, as well as productivity, economic growth, quality of life, environment and participative governance. These developments have also disrupted the management of institutions such as academia, which have become key in generating scientific advancements that can solve pressing problems, and in forming a specialised class that is able to follow up on these breakthroughs. In this light, the Ministry of Modernisation of the Argentinian Nation has created a model that is rooted in the concept of a ‘Smart City’. This effort considered all the dimensions that are at play in an urban environment, with careful monitoring of each sub-dimensions in order to establish the government’s priorities and improving the effectiveness of its operations. In an attempt to ameliorate the overall efficiency of the country’s economic and social development, these focused initiatives have also encouraged citizen participation and the cooperation of the private sector: replacing short-sighted policies with some that are coherent and organised. This process was developed gradually. The first stage consisted in building the model’s structure; the second, at applying the method created on specific case studies and verifying that the mechanisms used respected the desired technical and social aspects. Finally, the third stage consists in the repetition and subsequent comparison of this experiment in order to measure the effects on the ‘treatment group’ over time. The first trial was conducted on 717 municipalities and evaluated the dimension of Governance. Results showed that levels of governmental maturity varied sharply with relation to size: cities with less than 150.000 people had a strikingly lower level of governmental maturity than cities with more than 150.000 people. With the help of this analysis, some important trends and target population were made apparent, which enabled the public administration to focus its efforts and increase its probability of being successful. It also permitted to cut costs, time, and create a dynamic framework in tune with the population’s demands, improving quality of life with sustained efforts to develop social and economic conditions within the territorial structure.

Keywords: composite index, comprehensive model, smart cities, strategic framework

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95 Songwriting in the Postdigital Age: Using TikTok and Instagram as Online Informal Learning Technologies

Authors: Matthias Haenisch, Marc Godau, Julia Barreiro, Dominik Maxelon

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In times of ubiquitous digitalization and the increasing entanglement of humans and technologies in musical practices in the 21st century, it is to be asked, how popular musicians learn in the (post)digital Age. Against the backdrop of the increasing interest in transferring informal learning practices into formal settings of music education the interdisciplinary research association »MusCoDA – Musical Communities in the (Post)Digital Age« (University of Erfurt/University of Applied Sciences Clara Hoffbauer Potsdam, funded by the German Ministry of Education and Research, pursues the goal to derive an empirical model of collective songwriting practices from the study of informal lelearningf songwriters and bands that can be translated into pedagogical concepts for music education in schools. Drawing on concepts from Community of Musical Practice and Actor Network Theory, lelearnings considered not only as social practice and as participation in online and offline communities, but also as an effect of heterogeneous networks composed of human and non-human actors. Learning is not seen as an individual, cognitive process, but as the formation and transformation of actor networks, i.e., as a practice of assembling and mediating humans and technologies. Based on video stimulated recall interviews and videography of online and offline activities, songwriting practices are followed from the initial idea to different forms of performance and distribution. The data evaluation combines coding and mapping methods of Grounded Theory Methodology and Situational Analysis. This results in network maps in which both the temporality of creative practices and the material and spatial relations of human and technological actors are reconstructed. In addition, positional analyses document the power relations between the participants that structure the learning process of the field. In the area of online informal lelearninginitial key research findings reveal a transformation of the learning subject through the specific technological affordances of TikTok and Instagram and the accompanying changes in the learning practices of the corresponding online communities. Learning is explicitly shaped by the material agency of online tools and features and the social practices entangled with these technologies. Thus, any human online community member can be invited to directly intervene in creative decisions that contribute to the further compositional and structural development of songs. At the same time, participants can provide each other with intimate insights into songwriting processes in progress and have the opportunity to perform together with strangers and idols. Online Lelearnings characterized by an increase in social proximity, distribution of creative agency and informational exchange between participants. While it seems obvious that traditional notions not only of lelearningut also of the learning subject cannot be maintained, the question arises, how exactly the observed informal learning practices and the subject that emerges from the use of social media as online learning technologies can be transferred into contexts of formal learning

Keywords: informal learning, postdigitality, songwriting, actor-network theory, community of musical practice, social media, TikTok, Instagram, apps

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94 Study of the Association between Salivary Microbiological Data, Oral Health Indicators, Behavioral Factors, and Social Determinants among Post-COVID Patients Aged 7 to 12 Years in Tbilisi City

Authors: Lia Mania, Ketevan Nanobashvili

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Background: The coronavirus disease COVID-19 has become the cause of a global health crisis during the current pandemic. This study aims to fill the paucity of epidemiological studies on the impact of COVID-19 on the oral health of pediatric populations. Methods: It was conducted an observational, cross-sectional study in Georgia, in Tbilisi (capital of Georgia), among 7 to 12-year-old PCR or rapid test-confirmed post-Covid populations in all districts of Tbilisi (10 districts in total). 332 beneficiaries who were infected with Covid within one year were included in the study. The population was selected in schools of Tbilisi according to the principle of cluster selection. A simple random selection took place in the selected clusters. According to this principle, an equal number of beneficiaries were selected in all districts of Tbilisi. By July 1, 2022, according to National Center for Disease Control and Public Health data (NCDC.Ge), the number of test-confirmed cases in the population aged 0-18 in Tbilisi was 115137 children (17.7% of all confirmed cases). The number of patients to be examined was determined by the sample size. Oral screening, microbiological examination of saliva, and administration of oral health questionnaires to guardians were performed. Statistical processing of data was done with SPSS-23. Risk factors were estimated by odds ratio and logistic regression with 95% confidence interval. Results: Statistically reliable differences between the averages of oral health indicators in asymptomatic and symptomatic covid-infected groups are: for caries intensity (DMF+def) t=4.468 and p=0.000, for modified gingival index (MGI) t=3.048, p=0.002, for simplified oral hygiene index (S-OHI) t=4.853; p=0.000. Symptomatic covid-infection has a reliable effect on the oral microbiome (Staphylococcus aureus, Candida albicans, Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus epidermalis); (n=332; 77.3% vs n=332; 58.0%; OR=2.46, 95%CI: 1.318-4.617). According to the logistic regression, it was found that the severity of the covid infection has a significant effect on the frequency of pathogenic and conditionally pathogenic bacteria in the oral cavity B=0.903 AOR=2.467 (CL 1.318-4.617). Symptomatic covid-infection affects oral health indicators, regardless of the presence of other risk factors, such as parental employment status, tooth brushing behaviors, carbohydrate meal, fruit consumption. (p<0.05). Conclusion: Risk factors (parental employment status, tooth brushing behaviors, carbohydrate consumption) were associated with poorer oral health status in a post-Covid population of 7- to 12-year-old children. However, such a risk factor as symptomatic ongoing covid-infection affected the oral microbiome in terms of the abundant growth of pathogenic and conditionally pathogenic bacteria (Staphylococcus aureus, Candida albicans, Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus epidermalis) and further worsened oral health indicators. Thus, a close association was established between symptomatic covid-infection and microbiome changes in the post-covid period; also - between the variables of oral health indicators and the symptomatic course of covid-infection.

Keywords: oral microbiome, COVID-19, population based research, oral health indicators

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