Search results for: psychosocial interventions
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2153

Search results for: psychosocial interventions

1793 Improving Breastfeeding Practices and Infants’ Growth through Promoting for “Feed Your Baby like a Baby’’

Authors: Ammal M. Metwally, Walaa A. Basha, Ghada A. Abdel-Latif, Amira S. El Rifay

Abstract:

Introduction: Improving breastfeeding practices does not always link to interventions relying on improving nutrition awareness and education alone but needs cultural and behavioral insights. Aim: Our study provided educational intervention through the use of the social marketing (SM) approach, which was respectable to societal norms allowing more conscious choices by mothers to achieve the maximum potential of physical growth of their infants. This study evaluated the effectiveness of the used approach for improving breastfeeding practices and the physical growth of infants aged up to 2 years. Methodology: A quasi-experimental intervention design with a posttest-only control design was done over three years duration to motivate mothers’ voluntary behavioral change toward breastfeeding promotion using SM principles: product, price, place, and promotion. The interventions targeted 464 pregnant women in their last trimester, mothers of children up to 2 years, and 1454 women in their childbearing period. Results: Most mothers showed increased awareness about the benefits of breastfeeding and became interested in breastfeeding their children outside the house using the breastfeeding cover (Gawn). Breastfeeding initiation, exclusive breastfeeding under six months, frequency of breastfeeding per day, and percentage of children who continued breastfeeding till two years were significantly increased (from 30%, 23 %, 56%, and 32% to 62 %, 47.3 %, 69 %, and 43.5 %). With the attention of the nutritional educational sessions three or more times, the majority of indicators had the most significant improvement. The females who recorded underweight results over males during the first two years of life significantly improved after the intervention (from 53.8 % to 15.4%, respectively). At the same time, females that were found to be obese before the intervention (7.7 %) became no longer obese. Conclusions: Nutritional interventions that are based on the use SM approach showed improvement for the majority of the key performance indicators. Although they doubled their value before the intervention, the majority were still modest (below 50 %). With sustained use of the SM approach, infants will achieve their maximum potential for physical growth by providing economically disadvantaged mothers with breastfeeding support.

Keywords: social marketing approach, early breastfeeding initiation, exclusive breastfeeding, responsiveness to cues of hunger and satiety, physical growth of infants

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1792 Integrated Waste-to-Energy Approach: An Overview

Authors: Tsietsi J. Pilusa, Tumisang G. Seodigeng

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This study evaluates the benefits of advanced waste management practices in unlocking waste-to-energy opportunities within the solid waste industry. The key drivers of sustainable waste management practices, specifically with respect to packaging waste-to-energy technology options are discussed. The success of a waste-to-energy system depends significantly on the appropriateness of available technologies, including those that are well established as well as those that are less so. There are hard and soft interventions to be considered when packaging an integrated waste treatment solution. Technology compatibility with variation in feedstock (waste) quality and quantities remains a key factor. These factors influence the technology reliability in terms of production efficiencies and product consistency, which in turn, drives the supply and demand network. Waste treatment technologies rely on the waste material as feedstock; the feedstock varies in quality and quantities depending on several factors; hence, the technology fails, as a result. It is critical to design an advanced waste treatment technology in an integrated approach to minimize the possibility of technology failure due to unpredictable feedstock quality, quantities, conversion efficiencies, and inconsistent product yield or quality. An integrated waste-to-energy approach offers a secure system design that considers sustainable waste management practices.

Keywords: emerging markets, evaluation tool, interventions, waste treatment technologies

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1791 The Role of Teacher-Student Relationship on Teachers’ Attitudes towards School Bullying

Authors: Ghada Shahrour, Nusiebeh Ananbh, Heyam Dalky, Mohammad Rababa, Fatmeh Alzoubi

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Positive teacher-student relationship has been found to affect students’ attitudes towards bullying and, in turn, their engagement in bullying behavior. However, no investigation has been conducted to explore whether teacher-student relationship affects teachers’ attitudes towards bullying. The aim of this study was to examine the role of teacher-student relationship on teachers’ attitudes towards bullying in terms of bullying seriousness, empathic responding, and likelihood to intervene in bullying situation. A cross-sectional, descriptive design was employed among a convenience sample of 173 school teachers (50.9% female) of 12 to 17-year-old students. The teachers were recruited from secondary public schools of three governorates in the Northern district of Jordan. Each group of students has multiple teachers for different subjects. Results showed that teacher-student relationship is partially related to teachers’ attitudes towards bullying. More specifically, having a close teacher-student relationship significantly increased teachers’ perception of bullying seriousness and empathy but not the likelihood to intervene. Research is needed to examine teachers’ obstacles for not providing bullying interventions, as the barriers may be culturally contextualized. Meanwhile, interventions that promote quality teacher-student relationship are necessary to increase teachers’ perception of bullying seriousness and empathy. Students have been found to adopt the values of their teachers, and this may deter them from engaging in bullying behavior.

Keywords: school bullying, teachers’ attitudes, teacher-student relationship, adolescent students

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1790 Assessing Narcissism in Students of Psychology: An Administered Study

Authors: Sahiti Ganduri, Kavya Sreenivasan, Venya Lankala

Abstract:

The narcissistic personality is a condition that causes individuals to have an inflated perception of self, giving themselves higher self-importance. It is necessary and interesting to study narcissistic traits in students of different majors. This can be a crucial environmental or psychosocial marker/indicator of narcissism which can also be of substantial importance in the field of education. This study focuses on identifying narcissism in students of psychology background. The narcissistic personality inventory was administered to 114 psychology students of different universities (public and private) in India. The results of our study provided evidence of the fact that narcissistic traits are higher in male psychology students as compared to female psychology students. Further, this paper has provided evidence that narcissistic traits are higher in leaders as compared to non-leaders.

Keywords: college students, disorder, gender, leadership, narcissistic personality, personality, students, traits

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1789 Scooping Review Towards Different Use of Monitoring Technology Devices in Caring with Older Adults with Cognitive Impairment: A Model for Nursing Care Management

Authors: Hind Mohammed A. Asiri, Asia Mohammed Asiri, Hana Falah Alruwaili, Joseph Almazan

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With the rapid growth of the older adult population, an underlying growth of public health concern is also seen. Various technologies were developed to help mitigate the arising problems of older adults with cognitive impairment and the improvement of their cognitive functions. This scooping review used the Joanna Briggs Institute (JBI) and the PRISMA extension for scoping reviews. The eligibility criteria were defined using the Population, Concept, Context (PCC) framework, as described in the JBI’s Reviewers Manual (Peters et al.,2020). The population of interest for this review is older adults 65 years old or older. Studies involving monitoring technology devices utilized in caring with older adult with cognitive impairment. This scoping review has shown information that researchers are more focused on creating alternative and novel methods or technological devices and use these as a tool for designing interventions depending on the data of the patient. This study has shown the type of technologies that have been explored in terms of assessing, detecting, monitoring, and interventions for cognitive impairment. Thus, there is a need for this technology to be applied in the practical field to further strengthen the evidence that it could enhance the lives of older adults.

Keywords: technology devices, cognitive impairment, older adult, nursing care, caring

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1788 The M Health Paradigm for the Chronic Care Management of Obesity: New Opportunities in Clinical Psychology and Medicine

Authors: Gianluca Castelnuovo, Gian Mauro Manzoni, Giada Pietrabissa, Stefania Corti, Emanuele Giusti, Roberto Cattivelli, Enrico Molinari, Susan Simpson

Abstract:

Obesity is currently an important public health problem of epidemic proportions (globesity). Moreover Binge Eating Disorder (BED) is typically connected with obesity, even if not occurring exclusively in conjunction with overweight conditions. Typically obesity with BED requires a longer term treatment in comparison with simple obesity. Rehabilitation interventions that aim at improving weight-loss, reducing obesity-related complications and changing dysfunctional behaviors, should ideally be carried out in a multidisciplinary context with a clinical team composed of psychologists, dieticians, psychiatrists, endocrinologists, nutritionists, physiotherapists, etc. Long-term outpatient multidisciplinary treatments are likely to constitute an essential aspect of rehabilitation, due to the growing costs of a limited inpatient approach. Internet-based technologies can improve long-term obesity rehabilitation within a collaborative approach. The new m health (m-health, mobile health) paradigm, defined as clinical practices supported by up to date mobile communication devices, could increase compliance- engagement and contribute to a significant cost reduction in BED and obesity rehabilitation. Five psychological components need to be considered for successful m Health-based obesity rehabilitation in order to facilitate weight-loss.1) Self-monitoring. Portable body monitors, pedometers and smartphones are mobile and, therefore, can be easily used, resulting in continuous self-monitoring. 2) Counselor feedback and communication. A functional approach is to provide online weight-loss interventions with brief weekly or monthly counselor or psychologist visits. 3) Social support. A group treatment format is typically preferred for behavioral weight-loss interventions. 4) Structured program. Technology-based weight-loss programs incorporate principles of behavior therapy and change with structured weekly protocolos including nutrition, exercise, stimulus control, self-regulation strategies, goal-setting. 5) Individually tailored program. Interventions specifically designed around individual’s goals typically record higher rates of adherence and weight loss. Opportunities and limitations of m health approach in clinical psychology for obesity and BED are discussed, taking into account future research directions in this promising area.

Keywords: obesity, rehabilitation, out-patient, new technologies, tele medicine, tele care, m health, clinical psychology, psychotherapy, chronic care management

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1787 The Use of Social Stories and Digital Technology as Interventions for Autistic Children; A State-Of-The-Art Review and Qualitative Data Analysis

Authors: S. Hussain, C. Grieco, M. Brosnan

Abstract:

Background and Aims: Autism is a complex neurobehavioural disorder, characterised by impairments in the development of language and communication skills. The study involved a state-of-art systematic review, in addition to qualitative data analysis, to establish the evidence for social stories as an intervention strategy for autistic children. An up-to-date review of the use of digital technologies in the delivery of interventions to autistic children was also carried out; to propose the efficacy of digital technologies and the use of social stories to improve intervention outcomes for autistic children. Methods: Two student researchers reviewed a range of randomised control trials and observational studies. The aim of the review was to establish if there was adequate evidence to justify recommending social stories to autistic patients. Students devised their own search strategies to be used across a range of search engines, including Ovid-Medline, Google Scholar and PubMed. Students then critically appraised the generated literature. Additionally, qualitative data obtained from a comprehensive online questionnaire on social stories was also thematically analysed. The thematic analysis was carried out independently by each researcher, using a ‘bottom-up’ approach, meaning contributors read and analysed responses to questions and devised semantic themes from reading the responses to a given question. The researchers then placed each response into a semantic theme or sub-theme. The students then joined to discuss the merging of their theme headings. The Inter-rater reliability (IRR) was calculated before and after theme headings were merged, giving IRR for pre- and post-discussion. Lastly, the thematic analysis was assessed by a third researcher, who is a professor of psychology and the director for the ‘Centre for Applied Autism Research’ at the University of Bath. Results: A review of the literature, as well as thematic analysis of qualitative data found supporting evidence for social story use. The thematic analysis uncovered some interesting themes from the questionnaire responses, relating to the reasons why social stories were used and the factors influencing their effectiveness in each case. However, overall, the evidence for digital technologies interventions was limited, and the literature could not prove a causal link between better intervention outcomes for autistic children and the use of technologies. However, they did offer valid proposed theories for the suitability of digital technologies for autistic children. Conclusions: Overall, the review concluded that there was adequate evidence to justify advising the use of social stories with autistic children. The role of digital technologies is clearly a fast-emerging field and appears to be a promising method of intervention for autistic children; however, it should not yet be considered an evidence-based approach. The students, using this research, developed ideas on social story interventions which aim to help autistic children.

Keywords: autistic children, digital technologies, intervention, social stories

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1786 Industrial Ergonomics Improvement at a Refrigerator Manufacturing Company in Iran: An Approach on Interventional Ergonomics

Authors: Hassan S. Naeini

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Nowadays a lot of people are working in several sorts of industrial sectors in which there are some risk factors which threaten human being especially in developing countries. One of the main problems which effect on workers’ health refers to Ergonomics. Ergonomics as multidisciplinary science concerns workers’ health and safety in terms of somatic and mental concepts. Surely ergonomics interventions and improvement make a better condition for workers and change the quality of working life to better condition. In this study, one of the factories in Iran which is producing some kinds of small and medium size of refrigerators was chosen as the sample. The preliminary ergonomics observation of the mentioned factory showed that there are some risk factors in terms of ergonomics aspects, so an ergonomic intervention was defined, then some ergonomic assessment methods such as NMQ,OWAS, and Environmental Ergonomic Assessment were used. Also Anthropometric measurement was done. This study shows that there are some workstations and plants which suffer some degrees of ergonomic problems. Considering with the gathered data, illumination, noise control and workstation design in metal workstation are known as the priority actions. Some parts of the mentioned interventions are ongoing actions. it seems that the mentioned intervention and workstations design make a better condition for workers, because ergonomics make a safer and more sustainable environments for human being.

Keywords: anthropometry, ergonomics, health, NMQ, OWAS

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1785 The Role of Clinical Pharmacist Intervention in Collaborative Drug Therapy Management to Improve Outcomes and Decrease Hospitalization in Heart Failure Clinic

Authors: Sanaa Mekdad, Leenah Alsayed

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Pharmacists play an important role in the CDTM in the care of patients with heart failure (HF). CDTM allows specialized, dedicated clinical pharmacists in a formal agreement in collaborative practice with physicians. Thus, the aim of this study is to investigate the role of cardiology clinical pharmacists in CDTM in decreasing hospitalization and cost. We studied patients with left ventricular systolic dysfunction in a cluster-randomized selection in a tertiary care center. We allocated 296 patients to pharmacist intervention from 1480 patients. Results: With an acceptance rate of 86%, we documented 696 interventions carried out by clinical pharmacists in cardiology. The average intervention was 2.4 patients, and the admission after interventions decreased from 0.79 to. 0.24 (p value = 0.001). Conclusions: In HF CDTM, clinical pharmacists play a crucial role in enhancing medication management, patient education, and lifestyle modification of patients with chronic heart failure. These efforts improve patients' outcomes and lower costs by reducing hospitalization and other associated expenses.

Keywords: cardiology, medication management, heart failure, outpatient therapy, pharmacist-based services, chronic heart failure, heart failure recommendations, CDTM, Middle East, pharmacist-based services, quality of life, pharmacist

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1784 Assessing the Impact of Pharmacist-Led Medication Therapy Management on Treatment Adherence and Clinical Outcomes in Cancer Patients: A Prospective Intervention Study

Authors: Omer Ibrahim Abdallh Omer

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Cancer patients often face complex medication regimens, leading to challenges in treatment adherence and clinical outcomes. Pharmacist-led medication therapy management (MTM) has emerged as a potential solution to optimize medication use and improve patient outcomes in oncology settings. In this prospective intervention study, we aimed to evaluate the impact of pharmacist-led MTM on treatment adherence and clinical outcomes among cancer patients. Participants were randomized to receive either pharmacist-led MTM or standard care, with assessments conducted at baseline and follow-up visits. Pharmacist interventions included medication reconciliation, adherence counseling, and personalized care plans. Our findings reveal that pharmacist-led MTM significantly improved medication adherence rates and clinical outcomes compared to standard care. Patients receiving pharmacist interventions reported higher satisfaction levels and perceived value in pharmacist involvement in their cancer care. These results underscore the critical role of pharmacists in optimizing medication therapy and enhancing patient-centered care in oncology settings. Integration of pharmacist-led MTM into routine cancer care pathways holds promise for improving treatment outcomes and quality of life for cancer patients.

Keywords: cancer, medications adherence, medication therapy management, pharmacist

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1783 Comparison of Quality of Life One Year after Bariatric Intervention: Systematic Review of the Literature with Bayesian Network Meta-Analysis

Authors: Piotr Tylec, Alicja Dudek, Grzegorz Torbicz, Magdalena Mizera, Natalia Gajewska, Michael Su, Tanawat Vongsurbchart, Tomasz Stefura, Magdalena Pisarska, Mateusz Rubinkiewicz, Piotr Malczak, Piotr Major, Michal Pedziwiatr

Abstract:

Introduction: Quality of life after bariatric surgery is an important factor when evaluating the final result of the treatment. Considering the vast surgical options, we tried to globally compare available methods in terms of quality of following the surgery. The aim of the study is to compare the quality of life a year after bariatric intervention using network meta-analysis methods. Material and Methods: We performed a systematic review according to PRISMA guidelines with Bayesian network meta-analysis. Inclusion criteria were: studies comparing at least two methods of weight loss treatment of which at least one is surgical, assessment of the quality of life one year after surgery by validated questionnaires. Primary outcomes were quality of life one year after bariatric procedure. The following aspects of quality of life were analyzed: physical, emotional, general health, vitality, role physical, social, mental, and bodily pain. All questionnaires were standardized and pooled to a single scale. Lifestyle intervention was considered as a referenced point. Results: An initial reference search yielded 5636 articles. 18 studies were evaluated. In comparison of total score of quality of life, we observed that laparoscopic sleeve gastrectomy (LSG) (median (M): 3.606, Credible Interval 97.5% (CrI): 1.039; 6.191), laparoscopic Roux en-Y gastric by-pass (LRYGB) (M: 4.973, CrI: 2.627; 7.317) and open Roux en-Y gastric by-pass (RYGB) (M: 9.735, CrI: 6.708; 12.760) had better results than other bariatric intervention in relation to lifestyle interventions. In the analysis of the physical aspects of quality of life, we notice better results in LSG (M: 3.348, CrI: 0.548; 6.147) and in LRYGB procedure (M: 5.070, CrI: 2.896; 7.208) than control intervention, and worst results in open RYGB (M: -9.212, CrI: -11.610; -6.844). Analyzing emotional aspects, we found better results than control intervention in LSG, in LRYGB, in open RYGB, and laparoscopic gastric plication. In general health better results were in LSG (M: 9.144, CrI: 4.704; 13.470), in LRYGB (M: 6.451, CrI: 10.240; 13.830) and in single-anastomosis gastric by-pass (M: 8.671, CrI: 1.986; 15.310), and worst results in open RYGB (M: -4.048, CrI: -7.984; -0.305). In social and vital aspects of quality of life, better results were observed in LSG and LRYGB than control intervention. We did not find any differences between bariatric interventions in physical role, mental and bodily aspects of quality of life. Conclusion: The network meta-analysis revealed that better quality of life in total score one year after bariatric interventions were after LSG, LRYGB, open RYGB. In physical and general health aspects worst quality of life was in open RYGB procedure. Other interventions did not significantly affect the quality of life after a year compared to dietary intervention.

Keywords: bariatric surgery, network meta-analysis, quality of life, one year follow-up

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1782 Balance Rigor, Relevance and Socio-Emotional Learning in Math

Authors: Abimbola Akintounde

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Supporting the social and emotional needs of young adolescents has become an emergent concern for schools around the world. Yet educators remain in a dilemma regarding the optimum approach for integrating social and emotional learning (SEL) into their content area instruction. The purpose of this study was to explore the perception of secondary students regarding their schoolwide SEL interventions. Twenty-four International Baccalaureate students in a final year mathematics course at an American Public Secondary School near Washington D. C. were randomly selected for participation in this study via an online electronic survey. The participants in this study used Likert-scale items to rate the effectiveness of the socio-emotional and character development programs being implemented at their schools. Respondents also ranked their preferred mode of delivery of social and emotional support programs. About 71% of the teenagers surveyed preferred SEL support rendered via interactive team-building activities and games, 42% of the high school students in the study ranked focus group discussions as their preferred format for SEL interventions, while only 13% of the respondents in the study regarded lectures and presentations as their preferred mode of SEL delivery. About one-fourth of the study participants agreed that explicit instruction was critical to enhancing students’ wellness, 79% agreed that SEL programs should foster less teacher talk, while 88% of the students indicated that student engagement was critical to their mental health. Eighty percent of the teenagers surveyed decried that the focus of their school-wide social and emotional programs was poorly prioritized. About two-thirds of the students agreed that social justice and equity issues should be embedded in their schools’ advisory programs. More than half of the respondents agitated for strategies for managing stress and their school workload. About 54% of the respondents also clamored for SEL programs that reinforce emotion regulation and coping strategies for anxiety. Based on the findings of this study, recommendations were proffered for best practices in the design and implementation of effective learner-friendly social and emotional development interventions.

Keywords: SEL, math anxiety, student support, emotion regulation, social awareness, self awareness, self management, relationship building

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1781 Unveiling Mental Health Nuances of Male Indian Classical Dancers

Authors: Madhura Bapat, Uma Krishnan

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Exploring the redefinition of masculinity through the experiences of male Indian classical dancers, this qualitative research focuses on their perceived quality of life, psychosocial challenges, and coping strategies. This study aims to explore the mental health nuances of male Indian classical dancers through an in-depth understanding of their lived experiences with dance. The benefits and personal journeys of dancers, particularly in Indian classical forms, reveal insights into culture, gender, and societal expectations. Men in Indian classical dance frequently encounter stigma due to prevailing gender norms in the arts and society. Acknowledgment of these experiences is key to understanding issues of identity, mental wellness, and communal acceptance of male Indian classical dancers in the Indian dance scenario. This study follows an interpretive phenomenological approach to follow the lived experiences of male Indian classical dancers. Male Indian classical dancers were selected using criterion-based sampling. The participants are male, fluent in English and pursue Indian classical dance styles professionally, like Kathak, Bharatanatyam, Chhau, etc. Six participants were recruited for personal, semi-structured, in-depth interviews. A focus group discussion with four participants was conducted to explore the stigma surrounding their roles. The data were analyzed using interpretive phenomenological analysis (IPA), revealing superordinate themes of (1) identity fragmentation and negotiation in gendered social contexts; (2) gendered constraints and artistic expression; (3) psychosocial distress and mental health challenges; (4) coping mechanisms and resilience; and (5) stigmatization and social integration dynamics. Male Indian classical dancers grapple with identity formation, navigating a paradox of self-perception, artistic identity, and societal expectation. They reported experiencing emasculation, compromising artistic expression, and struggling with gender norms and gendered training constraints. They have faced name-calling, bullying, taunting, slandering, and discrimination. These experiences have led to psychological challenges and distress. However, the paradox continues as male dancers use adaptive coping strategies despite the adversities that intertwine self-perception, societal pressures, and their passion for dance. This research sheds light on the intersection of gender, mental health, and art. These findings provide a strong foundation for making changes in the dance community for acceptance of male dancers, policy making for better job opportunities for male dancers and mental health services to be provided to help them deal with distress. The study offers valuable insights into how male classical dancers navigate stigma and mental health challenges in gendered social contexts, contributing to a deeper understanding of identity formation in the arts.

Keywords: gendered experiences, Indian classical dance, male dancers, mental health, stigma

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1780 Corporate Governance Reforms in a Developing Economy: Making a Case for Upstream and Downstream Interventions

Authors: Franklin Nakpodia, Femi Olan

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A blend of internal factors (firm performance, internal stakeholders) and external pressures (globalisation, technology, corporate scandals) have intensified calls for corporate governance reforms. While several countries and their governments have responded to these calls, the effect of such reforms on corporate governance systems across countries remains mixed. In particular, the literature reports that the effectiveness of corporate governance interventions in many developing economies is limited. Relying on the corporate governance system in Africa’s largest economy (Nigeria), this research addresses two issues. First, this study explores why previous corporate governance reforms have failed and second, the article investigates what reforms could improve corporate governance practices in the country. In addressing the above objectives, this study adopts a qualitative approach that permits data collection via semi-structured interviews with 21 corporate executives. The data supports the articulation of two sequential levels of reforms (i.e., the upstream and downstream reforms). The upstream reforms focus on two crucial but often overlooked areas that undermine reform effectiveness, i.e., the extent of government commitment and an enabling environment. The downstream reforms combine awareness and regulatory elements to proffer a path to robust corporate governance in the country. Furthermore, findings from this study stress the need to consider the use of a bottom-up approach to corporate governance practice and policymaking in place of the dominant top-down strategy.

Keywords: bottom-up approach, corporate governance, reforms, regulation

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1779 Catchment Nutrient Balancing Approach to Improve River Water Quality: A Case Study at the River Petteril, Cumbria, United Kingdom

Authors: Nalika S. Rajapaksha, James Airton, Amina Aboobakar, Nick Chappell, Andy Dyer

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Nutrient pollution and their impact on water quality is a key concern in England. Many water quality issues originate from multiple sources of pollution spread across the catchment. The river water quality in England has improved since 1990s and wastewater effluent discharges into rivers now contain less phosphorus than in the past. However, excess phosphorus is still recognised as the prevailing issue for rivers failing Water Framework Directive (WFD) good ecological status. To achieve WFD Phosphorus objectives, Wastewater Treatment Works (WwTW) permit limits are becoming increasingly stringent. Nevertheless, in some rural catchments, the apportionment of Phosphorus pollution can be greater from agricultural runoff and other sources such as septic tanks. Therefore, the challenge of meeting the requirements of watercourses to deliver WFD objectives often goes beyond water company activities, providing significant opportunities to co-deliver activities in wider catchments to reduce nutrient load at source. The aim of this study was to apply the United Utilities' Catchment Systems Thinking (CaST) strategy and pilot an innovative permitting approach - Catchment Nutrient Balancing (CNB) in a rural catchment in Cumbria (the River Petteril) in collaboration with the regulator and others to achieve WFD objectives and multiple benefits. The study area is mainly agricultural land, predominantly livestock farms. The local ecology is impacted by significant nutrient inputs which require intervention to meet WFD obligations. There are a range of Phosphorus inputs into the river, including discharges from wastewater assets but also significantly from agricultural contributions. Solely focusing on the WwTW discharges would not have resolved the problem hence in order to address this issue effectively, a CNB trial was initiated at a small WwTW, targeting the removal of a total of 150kg of Phosphorus load, of which 13kg were to be reduced through the use of catchment interventions. Various catchment interventions were implemented across selected farms in the upstream of the catchment and also an innovative polonite reactive filter media was implemented at the WwTW as an alternative to traditional Phosphorus treatment methods. During the 3 years of this trial, the impact of the interventions in the catchment and the treatment works were monitored. In 2020 and 2022, it respectively achieved a 69% and 63% reduction in the phosphorus level in the catchment against the initial reduction target of 9%. Phosphorus treatment at the WwTW had a significant impact on overall load reduction. The wider catchment impact, however, was seven times greater than the initial target when wider catchment interventions were also established. While it is unlikely that all the Phosphorus load reduction was delivered exclusively from the interventions implemented though this project, this trial evidenced the enhanced benefits that can be achieved with an integrated approach, that engages all sources of pollution within the catchment - rather than focusing on a one-size-fits-all solution. Primarily, the CNB approach and the act of collaboratively engaging others, particularly the agriculture sector is likely to yield improved farm and land management performance and better compliance, which can lead to improved river quality as well as wider benefits.

Keywords: agriculture, catchment nutrient balancing, phosphorus pollution, water quality, wastewater

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1778 A Stepped Care mHealth-Based Approach for Obesity with Type 2 Diabetes in Clinical Health Psychology

Authors: Gianluca Castelnuovo, Giada Pietrabissa, Gian Mauro Manzoni, Margherita Novelli, Emanuele Maria Giusti, Roberto Cattivelli, Enrico Molinari

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Diabesity could be defined as a new global epidemic of obesity and being overweight with many complications and chronic conditions. Such conditions include not only type 2 diabetes, but also cardiovascular diseases, hypertension, dyslipidemia, hypercholesterolemia, cancer, and various psychosocial and psychopathological disorders. The financial direct and indirect burden (considering also the clinical resources involved and the loss of productivity) is a real challenge in many Western health-care systems. Recently the Lancet journal defined diabetes as a 21st-century challenge. In order to promote patient compliance in diabesity treatment reducing costs, evidence-based interventions to improve weight-loss, maintain a healthy weight, and reduce related comorbidities combine different treatment approaches: dietetic, nutritional, physical, behavioral, psychological, and, in some situations, pharmacological and surgical. Moreover, new technologies can provide useful solutions in this multidisciplinary approach, above all in maintaining long-term compliance and adherence in order to ensure clinical efficacy. Psychological therapies with diet and exercise plans could better help patients in achieving weight loss outcomes, both inside hospitals and clinical centers and during out-patient follow-up sessions. In the management of chronic diseases clinical psychology play a key role due to the need of working on psychological conditions of patients, their families and their caregivers. mHealth approach could overcome limitations linked with the traditional, restricted and highly expensive in-patient treatment of many chronic pathologies: one of the best up-to-date application is the management of obesity with type 2 diabetes, where mHealth solutions can provide remote opportunities for enhancing weight reduction and reducing complications from clinical, organizational and economic perspectives. A stepped care mHealth-based approach is an interesting perspective in chronic care management of obesity with type 2 diabetes. One promising future direction could be treating obesity, considered as a chronic multifactorial disease, using a stepped-care approach: -mhealth or traditional based lifestyle psychoeducational and nutritional approach. -health professionals-driven multidisciplinary protocols tailored for each patient. -inpatient approach with the inclusion of drug therapies and other multidisciplinary treatments. -bariatric surgery with psychological and medical follow-up In the chronic care management of globesity mhealth solutions cannot substitute traditional approaches, but they can supplement some steps in clinical psychology and medicine both for obesity prevention and for weight loss management.

Keywords: clinical health psychology, mhealth, obesity, type 2 diabetes, stepped care, chronic care management

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1777 First 1000 Days of Life: Mothers' Economic Hardship of Caring for Their Babies

Authors: Athena Pedro, Laura Bradfield, Mike Dare, Zandile Bantwana, Ashley Nayman

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The purpose of the research was to explore mother’s unique experience and knowledge of mothering in the first 1000 day of their child’s life, from birth to age 2. The study used a qualitative research methodology with an exploratory research design. A sample of 12 mothers was used, comprising different racial backgrounds from low income areas in the Western Cape. The data was collected by means of semi-structured, in-depth interviews, which were transcribed verbatim, analysed using Braun’s and Clark’s (2006) six phases of thematic analysis. Some of the findings revealed that the mothers who participated in the study were consistently unable to feed their children and themselves due to profound and extreme situations of poverty, stress, and lack of infrastructural support. These mothers residing in low-income communities are not adequately supported both financially and socially and are often unable to meet the needs of their infants within the first 1000 days. Given the consequential nature of this period, it is imperative that mothers are able to access such support. Single mothers especially are in need of social and financial support. Appropriate interventions are required to assist mothers generally but more specifically, mothers who have children within the first 1000 days of life. By implementing appropriate interventions to address these needs, it will assist mothers to ensure optimal developmental growth of their children. This will positively impact the developmental trajectory of children in South Africa.

Keywords: caring, economic hardship, first one thousand days, mothers

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1776 A Protocol of Procedures and Interventions to Accelerate Post-Earthquake Reconstruction

Authors: Maria Angela Bedini, Fabio Bronzini

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The Italian experiences, positive and negative, of the post-earthquake are conditioned by long times and structural bureaucratic constraints, also motivated by the attempt to contain mafia infiltration and corruption. The transition from the operational phase of the emergency to the planning phase of the reconstruction project is thus hampered by a series of inefficiencies and delays, incompatible with the need for rapid recovery of the territories in crisis. In fact, intervening in areas affected by seismic events means at the same time associating the reconstruction plan with an urban and territorial rehabilitation project based on strategies and tools in which prevention and safety play a leading role in the regeneration of territories in crisis and the return of the population. On the contrary, the earthquakes that took place in Italy have instead further deprived the territories affected of the minimum requirements for habitability, in terms of accessibility and services, accentuating the depopulation process, already underway before the earthquake. The objective of this work is to address with implementing and programmatic tools the procedures and strategies to be put in place, today and in the future, in Italy and abroad, to face the challenge of the reconstruction of activities, sociality, services, risk mitigation: a protocol of operational intentions and firm points, open to a continuous updating and implementation. The methodology followed is that of the comparison in a synthetic form between the different Italian experiences of the post-earthquake, based on facts and not on intentions, to highlight elements of excellence or, on the contrary, damage. The main results obtained can be summarized in technical comparison cards on good and bad practices. With this comparison, we intend to make a concrete contribution to the reconstruction process, certainly not only related to the reconstruction of buildings but privileging the primary social and economic needs. In this context, the recent instrument applied in Italy of the strategic urban and territorial SUM (Minimal Urban Structure) and the strategic monitoring process become dynamic tools for supporting reconstruction. The conclusions establish, by points, a protocol of interventions, the priorities for integrated socio-economic strategies, multisectoral and multicultural, and highlight the innovative aspects of 'inversion' of priorities in the reconstruction process, favoring the take-off of 'accelerator' interventions social and economic and a more updated system of coexistence with risks. In this perspective, reconstruction as a necessary response to the calamitous event can and must become a unique opportunity to raise the level of protection from risks and rehabilitation and development of the most fragile places in Italy and abroad.

Keywords: an operational protocol for reconstruction, operational priorities for coexistence with seismic risk, social and economic interventions accelerators of building reconstruction, the difficult post-earthquake reconstruction in Italy

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1775 End-Users Tools to Empower and Raise Awareness of Behavioural Change towards Energy Efficiency

Authors: G. Calleja-Rodriguez, N. Jimenez-Redondo, J. J. Peralta Escalante

Abstract:

This research work aims at developing a solution to take advantage of the potential energy saving related to occupants behaviour estimated in between 5-30 % according to existing studies. For that purpose, the following methodology has been followed: 1) literature review and gap analysis, 2) define concept and functional requirements, 3) evaluation and feedback by experts. As result, the concept for a tool-box that implements continuous behavior change interventions named as engagement methods and based on increasing energy literacy, increasing energy visibility, using bonus system, etc. has been defined. These engagement methods are deployed through a set of ICT tools: Building Automation and Control System (BACS) add-ons services installed in buildings and Users Apps installed in smartphones, smart-TVs or dashboards. The tool-box called eTEACHER identifies energy conservation measures (ECM) based on energy behavioral change through a what-if analysis that collects information about the building and its users (comfort feedback, behavior, etc.) and carry out cost-effective calculations to provide outputs such us efficient control settings of building systems. This information is processed and showed in an attractive way as tailored advice to the energy end-users. Therefore, eTEACHER goal is to change the behavior of building´s energy users towards energy efficiency, comfort and better health conditions by deploying customized ICT-based interventions taking into account building typology (schools, residential, offices, health care centres, etc.), users profile (occupants, owners, facility managers, employers, etc.) as well as cultural and demographic factors. One of the main findings of this work is the common failure when technological interventions on behavioural change are done to not consult, train and support users regarding technological changes leading to poor performance in practices. As conclusion, a strong need to carry out social studies to identify relevant behavioural issues and to identify effective pro-evironmental behavioral change strategies has been identified.

Keywords: energy saving, behavioral bhange, building users, engagement methods, energy conservation measures

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1774 Adolescent Social Anxiety, School Satisfaction, and School Absenteeism; Findings from Young-HUNT3 and Norwegian National Education Data

Authors: Malik D. Halidu, Cathrine F. Moe, Tommy Haugan

Abstract:

Purpose: The demand for effective school-based interventions in shaping adolescents' unmet mental health needs is growing. Grounding in the functional contextualism approach, this study investigates the role of school satisfaction (SS) in serving as a buffer to school absenteeism (SAB) among adolescents experiencing social anxiety (SA). Methods: A unique and large population-based sample of adolescents (upper secondary school pupils; n= 1864) from the Young-HUNT 3 survey dataset merged with the national educational registry from Norway. Moderation regression analysis was performed using Stata 17. Results: We find a statistically significant moderating role of school satisfaction on the relationship between social anxiety and school absenteeism (β=-0.109,p<0.01) among upper secondary school pupils. Among socially anxious adolescents associated with a higher perceived quality of school life, it functions as a buffer by reducing the positive relationship between SA and SAB. But, there was no statistically significant difference between social anxiety and school absenteeism for adolescents with low school satisfaction. Conclusion: Overall, the study's hypothesis model was statistically supported and contributes to the discourse that school satisfaction as a target of school-based interventions can effectively improve school outcomes (e.g., reduced absenteeism) among socially anxious pupils.

Keywords: social anxiety, school satisfaction, school absenteeism, Norwegian adolescent

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1773 Culturally Adapting Videos to Involve Nigerian Patients with Cancer in Clinical Trials

Authors: Abiola Falilat Ibraheem, Akinyimika Sowunmi, Valerie Otti

Abstract:

Background: Introduction of innovative cancer clinical trials to Nigeria is a critical step in addressing global inequities of cancer burden. Low health and clinical trial literacy among Nigerian patients have been sighted as a significant barrier to ensuring that patients enrolled in clinical trials are truly informed. Video intervention has been shown to be the most proactive method to improving patient’s clinical trial knowledge. In the US, video interventions have been successful at improving education about cancer clinical trials among minority patients. Thus, this study aimed to apply and adapt video interventions addressing attitudinal barriers peculiar to Nigerian patients. Methods: A hospital-based representative mixed-method study was conducted at the Lagos State University Teaching Hospital (LASUTH) from July to December 2020, comprising of cancer patients aged 18 and above. Patients were randomly selected during every clinic day, of which 63 patients volunteered to participate in this study. We first administered a cancer literacy survey to determine patients’ knowledge about clinical trials. For patients who had prior knowledge, a pre-intervention test was administered, after which a 15-minute video (attitudes and intention to enroll in therapeutic clinical trials (AIET)) to improve patients’ knowledge, perception, and attitudes towards clinical trials was played, and then ended by administering a post-intervention test to the patients. For patients who had no prior knowledge, the AIET video was played for them, followed by the post-intervention test. Results: Out of 63 patients sampled, 43 (68.3%) had breast cancer. On average, patients agreed to understand their cancer diagnosis and treatment very well. 84.1% of patients had never heard about cancer clinical trials, and 85.7% did not know what cancer clinical trials were. There was a strong positive relationship (r=0.916) between the pretest and posttest, which means that the intervention improved patients’ knowledge, perception, and attitudes about cancer clinical trials. In the focus groups, patients recommended adapting the video in Nigerian settings and representing all religions in order to address trust in local clinical trialists. Conclusion: Due to the small size of patients, change in clinical trial knowledge was not statistically significant. However, there is a trend suggesting that culturally adapted video interventions can be used to improve knowledge and perception about cancer clinical trials.

Keywords: clinical trials, culturally targeted intervention, patient education, video intervention

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1772 The Effect of an Occupational Therapy Programme on Sewing Machine Operators

Authors: N. Dunleavy, E. Lovemore, K. Siljeur, D. Jackson, M. Hendricks, M. Hoosain, N. Plastow, S. Marais

Abstract:

Background: The work requirements of sewing machine operators cause physical and emotional strain. Past ergonomic interventions have been provided to alleviate physical concerns; however, a holistic, multimodal intervention was needed to improve these factors. Aim: The study aimed to examine the effect of an occupational therapy programme on sewing machine operators’ pain, mental health, and productivity within a factory in the South African context. Methods: A pilot randomised control trial was conducted with 22 sewing machine operators within a single factory. Stratified randomisation was used to determine the experimental (EG) and control groups (CG), using measures for pain intensity, level of depression (mental health), and productivity rates as stratification variables. The EG received the multimodal intervention, incorporating education, seating adaptations, and mental health intervention. In three months, the CG will receive the same intervention. Pre- and post-intervention testing have occurred with upcoming three- and six-month follow-ups. Results: Immediate results indicate a statistically significant decrease in pain in both experimental and control groups; no change in productivity scores and depression between the two groups. This may be attributed to external factors. The values for depression further showed no statistical significance between the two groups and within pre-and post-test results. The Statistical Program for Social Sciences (SPSS) version-24 was used as the data analysis testing, where all the tests will be evaluated at a 5% significance level. Contribution of research: The research adds to the body of knowledge informing the Occupational Therapy role in work settings, providing evidence on the effectiveness of workplace-based multimodal interventions. Conclusion: The study provides initial data on the effectiveness of a pilot randomised control trial on pain and mental health in South Africa. Results indicated no quantitative change between the experimental and control groups; however, qualitative data suggest a clinical significance of the findings.

Keywords: ergonomics programme, occupational therapy, sewing machine operators, workplace-based multimodal interventions

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1771 Abandoning 'One-Time' Optional Information Literacy Workshops for Year 1 Medical Students and Gearing towards an 'Embedded Librarianship' Approach

Authors: R. L. David, E. C. P. Tan, M. A. Ferenczi

Abstract:

This study aimed to investigate the effect of a 'one-time' optional Information Literacy (IL) workshop to enhance Year 1 medical students' literature search, writing, and citation management skills as directed by a customized five-year IL framework developed for LKC Medicine students. At the end of the IL workshop, the overall rated 'somewhat difficult' when finding, citing, and using information from sources. The study method is experimental using a standardized IL test to study the cohort effect of a 'one-time' optional IL workshop on Year 1 students; experimental group in comparison to Year 2 students; control group. Test scores from both groups were compared and analyzed using mean scores and one-way analysis of variance (ANOVA). Unexpectedly, there were no statistically significant differences between group means as determined by One-Way ANOVA (F₁,₁₉₃ = 3.37, p = 0.068, ηp² = 0.017). Challenges and shortfalls posed by 'one-time' interventions raised a rich discussion to adopt an 'embedded librarianship' approach, which shifts the medial librarians' role into the curriculum and uses Team Based Learning to teach IL skills to medical students. The customized five-year IL framework developed for LKC Medicine students becomes a useful librarian-faculty model for embedding and bringing IL into the classroom.

Keywords: information literacy, 'one-time' interventions, medical students, standardized tests, embedded librarianship, curriculum, medical librarians

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1770 Medical Social Work: Connotation, Prospects, and Challenges in Pakistan

Authors: Syeda Mahnaz Hassan

Abstract:

Social work as a specialized field, grounded in scientific knowledge and skills, is more inclined towards problem-solving process rather than charity focused approach. Medical social work, as a primary method, deals with the bio-psychosocial-spiritual elements of an individual with a problem and assesses the pliability and strength of the patients, social support systems, and their families, to assist the patients to resolve their problems independently. The medical social worker, also known as case-worker or care-worker, has to play a substantial role in the rehabilitation and retrieval of an affected person. This paper examines the roles played and responsibilities discharged by the Medical Social Workers internationally and specifically concerning Pakistan. The capacity constraints and challenges confronted by Medical Social Workers in hospitals have also been highlighted, and some policy implications have been suggested to enhance the capabilities of Medical Social Workers for serving the patients in a befitting manner.

Keywords: medical social work, Pakistan, patients, rehabilitation

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1769 Gender Moderates the Association Between Symbolization Trait (But Not Internalization Trait) and Smoking Behaviour

Authors: Kuay Hue San, Muaz Haqim Shaharum, Nasir Yusoff

Abstract:

Gender plays a big role in psychosocial development. This study aimed to investigate whether gender moderates the relationship between moral identity (internalization and symbolization) and risk-smoking behavior. An online cross-sectional study was carried out on 388 (61% female) youths who fulfilled the study’s inclusion and exclusion criteria. While viewing images of smoking behavior, participants rated their emotional state, which ranged from unpleasant to pleasant. Participants were also asked to fill out the eight-item Moral Identity Scale and provide their socio-demographic information. Gender significantly moderated the relationship between symbolization and smoking behavior. However, the moderation effect was not shown by internalization Finding highlights the implication of gender on moral identity and smoking behavior and the importance of considering this in the public health intervention and program.

Keywords: smoking behaviour, gender, emotion, moral identity

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1768 Prospects for Sustainable Chemistry in South Africa: A Plural Healthcare System

Authors: Ntokozo C. Mthembu

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The notion of sustainable chemistry has become significant in the discourse for a global post-colonial era, including South Africa, especially when it comes to access to the general health system and related policies in relation to disease or ease of human life. In view of the stubborn vestiges of coloniality in the daily lives of indigenous African people in general, the fundamentals of present Western medical and traditional medicine systems and related policies in the democratic era were examined in this study. The situation of traditional healers in relation to current policy was also reviewed. The advent of democracy in South Africa brought about a variety of development opportunities and limitations, particularly with respect to indigenous African knowledge systems such as traditional medicine. There were high hopes that the limitations of previous narrow cultural perspectives would be rectified in the democratic era through development interventions, but some sections of society, such as traditional healers, remain marginalised. The Afrocentric perspective was explored in dissecting government interventions related to traditional medicine. This article highlights that multiple medical systems should be adopted and that health policies should be aligned in order to guarantee mutual respect and to address the remnants of colonialism in South Africa, Africa and the broader global community.

Keywords: traditional healing system, healers, pluralist healthcare system, post-colonial era

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1767 Leveraging Artificial Intelligence to Analyze the Interplay between Social Vulnerability Index and Mobility Dynamics in Pandemics

Authors: Joshua Harrell, Gideon Osei Bonsu, Susan Garza, Clarence Conner, Da’Neisha Harris, Emma Bukoswki, Zohreh Safari

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The Social Vulnerability Index (SVI) stands as a pivotal tool for gauging community resilience amidst diverse stressors, including pandemics like COVID-19. This paper synthesizes recent research and underscores the significance of SVI in elucidating the differential impacts of crises on communities. Drawing on studies by Fox et al. (2023) and Mah et al. (2023), we delve into the application of SVI alongside emerging data sources to uncover nuanced insights into community vulnerability. Specifically, we explore the utilization of SVI in conjunction with mobility data from platforms like SafeGraph to probe the intricate relationship between social vulnerability and mobility dynamics during the COVID-19 pandemic. By leveraging 16 community variables derived from the American Community Survey, including socioeconomic status and demographic characteristics, SVI offers actionable intelligence for guiding targeted interventions and resource allocation. Building upon recent advancements, this paper contributes to the discourse on harnessing AI techniques to mitigate health disparities and fortify public health resilience in the face of pandemics and other crises.

Keywords: social vulnerability index, mobility dynamics, data analytics, health equity, pandemic preparedness, targeted interventions, data integration

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1766 Web-Based Alcohol Prevention among Iranian Medical University Students: A Randomized Control Trail

Authors: Farzad Jalilian, Mehdi Mirzaei Alavijeh

Abstract:

Background: E-interventions as a universal approach to prevent a high-risk behavior, such as alcohol drinking. This study was conducted to evaluate web-based alcohol drinking preventative intervention efficiency among medical university students in Iran. Methods: Overall, 150 freshman and sophomore male student’s college students participated in this study as intervention and control group. This was a longitudinal randomized pre- and post-test series control group design panel study to implement a behavior modification based intervention to alcohol drinking prevention among college students. Cross-tabulation, t-test, repeated measures, and GEE by using SPSS statistical package, version 21 was used for the statistical analysis. The participants were followed up for 6 months with data collection scheduled at baseline, 3 and 6 months. The primary outcomes are attitude, self-control, and sensation seeking. Furthermore, the secondary outcome is comparing alcohol drinking among the study groups. Results: It was found significant reduce in average response for an attitude towards alcohol drinking and sensation seeking among intervention group (P < 0.05). But after intervention not significant difference between intervention and control group of improve self-control and reduce alcohol drinking (P > 0.05). Conclusion: Our intervention has been accompanied with reducing alcohol use rate. These findings indicate that e-intervention may be effectiveness approach to address the alcohol prevention among college students.

Keywords: e-interventions, alcohol drinking, students, Iran

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1765 The Analyses of July 15 Coup Attempt through the Turkish Press

Authors: Yasemin Gülşen Yılmaz, Süleyman Hakan Yılmaz, Muhammet Erbay

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Military interventions have an important place in the Turkish Political History. Military interventions are commonly called coup in the society. By coup we mean that the armed forces seize political power either by a group of officer in the army or by chain of command. Coups not only weaken but also suspend the democracy in a country. All periods of coup created its own victims. Two military coups which took place in May 27, 1960 and September 12, 1980 are the most important ones in terms of political and social effect in the Turkish Political History. Apart these, March 12, 1971, February 28, 1997 and April 27, 2007 e-memorandum are the periods when Army submitted a memorandum and intervened the political government indirectly. Beside the memorandums and coups there were also many coup attempts that have been experienced in the Turkish Political History. In this study, we examined the coup attempted by FETO’s military members in the evening of July 15, 2016 from the point of the Turkish Press. Cumhuriyet, Haber Türk, Hürriyet, Milliyet, Sabah, Star, Yeni Akit and Yeni Şafak Newspapers which have different publication policies were examined within the scope of the study. The first pages of the newspapers dated July 16, 2016 were examined using content analysis method. The headlines, news, news headlines and the visual materials used for news were examined and the collected data were analysed.

Keywords: July 15, news, military coup, press

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1764 Upgrades for Hydric Supply in Water System Distribution: Use of the Bayesian Network and Technical Expedients

Authors: Elena Carcano, James Ball

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This work details the strategies adopted by the Italian Water Utilities during the distribution of water in emergency conditions which glide from earthquakes and droughts to floods and fires. Several water bureaus located over the national territory have been interviewed, and the collected information has been used in a database of potential interventions to be taken. The work discusses the actions adopted by water utilities. These are generally prioritized in order to minimize the social, temporal, and economic burden that the damaged and nearby areas need to support. Actions are defined relying on the Bayesian Network Approach, which constitutes the hard core of any decision support system. The Bayesian Networks give answers to interventions to real and most likely risky cases. The added value of this research consists in supplying the National Bureau, namely Protezione Civile, in charge of managing havoc and catastrophic situations with a univocal plot outline so as to be able to handle actions uniformly at the expense of different local laws or contradictory customs which squander any recovery conditions, proper technical service, and economic aids. The paper is organized as follows: in section 1, the introduction is stated; section 2 provides a brief discussion of BNNs (Bayesian Networks), section 3 introduces the adopted methodology; and in the last sections, results are presented, and conclusions are drawn.

Keywords: hierarchical process, strategic plan, water emergency conditions, water supply

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