Search results for: whole school interventions
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4849

Search results for: whole school interventions

859 Access of Refugees in Rural Areas to Regular Medication during COVID-19 Era: International Organization for Migration, Jordan Experience

Authors: Rasha Shoumar

Abstract:

Background: Since the onset of the Syria crisis in 2011, Jordan has hosted many Syrian refugees, many of which are residing in urban and rural areas. Vulnerability of refugees has increased due to the COVID-19 pandemic, adding to their already existing challenge in access to medical services, rendering them vulnerable to the complications of untreated medical conditions and amplifying their risk for severe COVID-19 disease. To improve health outcomes and access to health care services in a COVID-19 context, IOM (The International Organization for Migration) provided health services including awareness raising, direct primary health care through mobile teams and referrals to secondary services were extended to the vulnerable populations of refugees. Method: 6 community health volunteers were trained and deployed to different governorates to provide COVID-19 and non-communicable disease awareness and collect data rated to non-communicable disease and access to medical health services. Primary health care services were extended to 7 governorates through a mobile medical team, providing medical management. The collected Data was reviewed and analyzed. Results: 2150 refugees in rural areas were reached out by community health volunteers, out of which 78 received their medications through the Ministry of Health, 121 received their medications through different non-governmental organizations, 665 patients couldn’t afford buying any medications, 1286 patients were occasionally buying their medications when they were able to afford it. 853 patients received medications and follow up through IOM mobile clinics, the most common conditions were hypertension, diabetes, hyperlipidemia, anemia, heart disease, thyroid disease, asthma, seizures, and psychiatric conditions. 709 of these patients had more than 3 of the comorbidities. Multiple cases were referred for secondary and tertiary lifesaving interventions. Conclusion: Non communicable diseases are highly prevalent among refugee population in Jordan, access to medical services have proven to be a challenge in rural areas especially during the COVID-19 era, many of the patients have multiple uncontrolled medical conditions placing them at risk for complications and risk for severe COVID-19 disease. Deployment of mobile clinics to rural areas plays an essential role in managing such medical conditions, thus improving the continuum of health care approach, physical and mental wellbeing of refugees and reducing the risk for severe COVID-19 disease among this group, taking us one step forward toward universal health access.

Keywords: COVID-19, refugees, mobile clinics, primary health care

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858 Analyzing the Impact of Indian Architecture on the Architecture of Cambodia, Thailand and Indonesia

Authors: Sriranjani Srinivasan

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To appreciate Indian art and architecture by studying it in India alone will only lead to partial understanding of the whole story and the variety of the statement has been amply proved by subsequent decades of patient research. The results of the work of the Archaeological Survey of India forms only one half of the picture, the other half emerges with the studies of the archaeology and art of the Far East that progressed almost simultaneously under the Archaeological Survey of the Dutch East Indies, the École française d'Extrême-Orient (EFEO), or French School of Asian Studies, and allied institutions. The conclusions arrived at have only rendered the assertion that India produced her ultimate master pieces only through foreign influences and in foreign lands (the South-Eastern peninsular and archipelagic regions) almost axiomatic. Angkor in Cambodia and Borobudur in Java, undoubtedly the two greatest architectural marvels of Indian genius, for in content and spirit these (and other monuments of varying magnitudes), are purely Indian, would well illustrate the statement mentioned earlier. Stimulated research followed the discoveries and among the many studies and publications of such pioneers like Coedes, Parmentier, Coomaraswamy and many others in Dutch, French and English made growing contributions to the subject. This paper will discuss in detail the impact of India on the architecture of South East Asia by detailed comparison of architectural styles, elements, and construction materials of a few specific architectural master pieces, in both India and South East Asian countries. It will also analyze the reasoning behind the influence of India on South East Asian countries in spite of them being exposed to the equally culturally rich and civilized kingdoms of China. The intention of this paper is to understand that, conquest by war is not always the only reason for architectural influences and impacts.

Keywords: architectural influence, Buddhist architecture, Indian architecture, Southeast Asian architecture

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857 Assess the Risk Behaviours and Safer Sex Practices among Male Attendees in a Sexual Health Setting

Authors: B. M. M. D. Mendis, L. I. Rajapaksa, P. S. K. Gunathunga, R. C. Fernando, M. Jayalath

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Background / introduction: During the year 2011, 8511 males received services from the sexual health clinics island wide. At present there is only limited information on the risk behaviours of male attendees. Information on risk behaviours related to STI /HIV transmission is helpful in planning suitable prevention interventions. Aim(s)/objectives: The objectives were to determines the sexual partners (other than the marital partner and regular partners) responsible for transmitting STI( Sexually transmitted infections)/ HIV and to understand the practice of safer sex. Methods: Study was a clinic based prospective study conducted for a one year period using an interviewer administered questionnaire. Results: 983 attendees were interviewed. . Mean age was 34.02 years. 75% of the sample had completed GCE O/L (ordinary level examination). Skilled labourers, drivers and forces/police comprised 40% of the sample. 50% admitted sex with a casual female, 12% with a casual male, and 13% with CSW (commercial sex workers) while MSW (male sex workers) exposures were minimal. It was identified that younger males had more contacts with males, and regular female partners while more older males with CSW. Anal sex among males was reported by 11.5%. 20.5% used alcohol frequently and 5.9% used drugs and 1.4% injected. Common STI were genital herpes (7.9%), Non gonococcal urethritis (6.2%) and gonorrhoea (6.2%). Among those who had contacts with FSW 6.7% gonorrhoea (GC), 8.2% non gonococcal urethritis (NGU), 7.5% genital herpes and 0.7% HIV. Non regular partner exposures 3.7% had gonorrhoea, 8.3% NGU, 6.6% genital herpes and 0.8% HIV. Among MSM contacts 10.6% had GC, 4.5% NGU, 5.3% genital herpes, 5.3% secondary syphilis and 0.8% HIV. Only 9.0% used condoms correctly. Friends, doctors, newspapers, internet, and forces were important sources of information on condoms. Non use of condoms were due to worry about satisfaction (24.6%) and faith in the partner (25.6%). Discussion/conclusion: Casual partners for unsafe sex is a concern. MSM and CSW are remained as an important source of infection. Early Syphilis and gonorrhoea infections were mostly seen among MSM exposures. The findings indicate that the male population in the sample had satisfactory education. However, still the unsafe sexual contacts are common. . Newspapers, internet were more important sources of information on condoms. Low condom use remains another concern.. More males contracted STI through casual partners. Therefore strategies used for prevention need to be revisited also emphasizing on general population where casual partners represent. . Increasing awareness of men and women through mass media and primary health care teams may be important strategies that can be used to keep the HIV epidemic in a low level.

Keywords: STI, HIV, Males, safe sex practices

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856 Quality and Qualitative Education for All, Panacea for Insecurity and Political Unrest in Nigeria

Authors: Babatunde Joel Todowede

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It is a public knowledge that lack of quality and qualitative education breeds problems besetting Nigeria as a nation today. This paper entitled “Quality and Qualitative Education for all, panacea for insecurity and political unrest in Nigeria” seeks to explore how quality and qualitative education for all will tends to put an end to insecurity and political unrest in Nigeria as a Nation. It may be pertinent to note at this juncture that the development of any modern society or nation is primarily hinged on the functionality of its educational system. There is no developed nation in the world today, which does not owe its advancement to quality and qualitative education. In other words, Education is a vital instrument in the nation’s economic competitiveness, in its people, and in its communities. Hence, Education is not luxury to be cut in difficult economic times – it is an essential element of growth. In fact, education is the bedrock of any society that hopes to be numbered among the developed economies in the world. Nigeria, as a nation, has made continual efforts to assume its rightful place in education on the African continent, but has not been quite lucky. Interestingly however, Quality and Qualitative Education for all will come about if all stakeholders in the Education Sector perform their roles with skill and efficiency. Education is a very sensitive area, hence, needs to be passionate about education, and focused on building a future for the sector.” Quality and qualitative education instill significant core values in every student, which shape them into mature, caring and independent individuals. These values include commitment, collaboration, integrity, responsibility and respect. By imbibing these values in every aspect of their life, they are able to contribute their skills and talents while supporting each other in attaining their lifelong goals. This paper identified lack of proper education as the bane of insecurity and political unrest in the Country and urged the government to review the policy in a way that there will be quality and standard to check insurgency in the Country. More so, until the fallen standard of education in Nigeria is fixed to engage out of school children, the incessant attack on innocent Nigerians, particularly in the North East may get worse.

Keywords: quality and qualitative education, panacea, insecurity, political unrest

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855 Comparing the Effect of Group Education and Multimedia Software on Knowledge, Attitude and Self-Efficacy Mothers about of Sexual Health Education to the Boys of between 12-14 Years Old

Authors: Mirzaii Khadigeh

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Background and objectives: Sexual health education is an important part of health promotion services. The major role of sex education is on mothers’ shoulders. So, they have to be equipped with enough knowledge, attitude and self-efficacy for teens’ education. The present study aimed to determine the effect of team-learning and multimedia software on mothers’ knowledge, attitudes and self-efficacy in sexual health education to 12-14-year-old sons in Mashhad in 1395. Materials and methods: In this research, two experimental and one control group were employed using random sampling, which was done on 132 mothers of high school pupils. They were randomly assigned into experimental and control groups. The data were collected using demographic information and a researcher-constructed questionnaire to investigate the mothers’ knowledge, attitude, and self-efficacy and DASS21(The Depression, Anxiety and Stress Scale). They were run after confirming their reliability and validity. Intervention for the multimedia group was in the form of four CDs- each for 45 minutes- that were given to the mothers each week. At the end of the fourth week, a question-and-answer session was administered for 60 minutes. The team-learning group received intervention once a week (totally four weeks). Two weeks later, the data were collected and analyzed via Chi-square, Fisher, Kruskal-Wallis and ANOVA. Findings: Knowledge, attitude and self-efficacy of mothers in sexual health before the intervention did not have any significant differences (p >0.05). At the end of the study, the difference between the scores of the knowledge, attitude and self-efficacy in the three groups was meaningfully different (p < 0/001), but the difference between the two groups of multimedia and team-learning was not significant (p> 0.05 ). Discussion and conclusion: The result reported the efficacy of both team-leaning and multimedia software, which implies that the multimedia software training method was as effective as team-learning training one on the knowledge, attitude and self-efficacy of mothers. But, the multimedia training method is highly advised due to its availability, flexibility, and interest.

Keywords: training one on the knowledge, attitude, self-efficacy of mothers, boys

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854 A Review of Teaching and Learning of Mother Tongues in Nigerian Schools; Yoruba as a Case Study

Authors: Alonge Isaac Olusola

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Taking a cue from countries such as China and Japan, there is no doubt that the teaching and learning of Mother Tongue ( MT) or Language of Immediate Environment (LIE) is a potential source of development in every country. The engine of economic, scientific, technological and political advancement would be more functional when the language of instruction for teaching and learning in schools is in the child’s mother tongue. The purpose of this paper therefore, is to delve into the genesis of the official recognition given to the teaching and learning of Nigerian languages at national level with special focus on Yoruba language. Yoruba language and other Nigerian languages were placed on a national pedestal by a Nigerian Educational Minister, Late Professor Babatunde Fafunwa, who served under the government of General Ibrahim Babangida (1985 – 1993). Through his laudable effort, the teaching and learning of Nigerian languages in schools all over the nation was incorporated officially in the national policy of education. Among all the Nigerian languages, Hausa, Igbo and Yoruba were given foremost priorities because of the large population of their speakers. Since the Fafunwa era, Yoruba language has become a national subject taught in primary, secondary and tertiary institutions in Nigeria. However, like every new policy, its implementation has suffered several forms of criticisms and impediments from governments, policy makers, curriculum developers, school administrators, teachers and learners. This paper has been able to arrive at certain findings through oral interviews, questionnaires and evaluation of pupils/students enrolment and performances in Yoruba language with special focus on the South-west and North central regions of Nigeria. From the research carried out, some factors have been found to be responsible for the successful implementation or otherwise of Yoruba language instruction policy in some schools, colleges and higher institutions in Nigeria. In conclusion, the paper made recommendations on how the National Policy of Education would be implemented to enhance the teaching and learning of Yoruba language in all Nigerian schools.

Keywords: language of immediate environment, mother tongue, national policy of education, yoruba language

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853 Verb Bias in Mandarin: The Corpus Based Study of Children

Authors: Jou-An Chung

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The purpose of this study is to investigate the verb bias of the Mandarin verbs in children’s reading materials and provide the criteria for categorization. Verb bias varies cross-linguistically. As Mandarin and English are typological different, this study hopes to shed light on Mandarin verb bias with the use of corpus and provide thorough and detailed criteria for analysis. Moreover, this study focuses on children’s reading materials since it is a significant issue in understanding children’s sentence processing. Therefore, investigating verb bias of Mandarin verbs in children’s reading materials is also an important issue and can provide further insights into children’s sentence processing. The small corpus is built up for this study. The corpus consists of the collection of school textbooks and Mandarin Daily News for children. The files are then segmented and POS tagged by JiebaR (Chinese segmentation with R). For the ease of analysis, the one-word character verbs and intransitive verbs are excluded beforehand. The total of 20 high frequency verbs are hand-coded and are further categorized into one of the three types, namely DO type, SC type and other category. If the frequency of taking Other Type exceeds the threshold of 25%, the verb is excluded from the study. The results show that 10 verbs are direct object bias verbs, and six verbs are sentential complement bias verbs. The paired T-test was done to assure the statistical significance (p = 0.0001062 for DO bias verb, p=0.001149 for SC bias verb). The result has shown that in children’s reading materials, the DO biased verbs are used more than the SC bias verbs since the simplest structure of sentences is easier for children’s sentence comprehension or processing. In sum, this study not only discussed verb bias in child's reading materials but also provided basic coding criteria for verb bias analysis in Mandarin and underscored the role of context. Sentences are easier for children’s sentence comprehension or processing. In sum, this study not only discussed verb bias in child corpus, but also provided basic coding criteria for verb bias analysis in Mandarin and underscored the role of context.

Keywords: corpus linguistics, verb bias, child language, psycholinguistics

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852 MAFB Expression in LPS-Induced Exosomes: Revealing the Connection to sepsis-trigerred Hepatic Injury

Authors: Gizaw Mamo Gebeyehu, Marianna Pap, Geza Makkai, Tibor Z. Janosi, Shima Rashidian, Tibor A. Rauch

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Sepsis poses a significant global health threat, necessitating extensive exploration of indicators tied to its pathological mechanisms and multi-organ dysfunction. While murine studies have shed light on sepsis, the intricate cellular and molecular landscape in human sepsis remains enigmatic. Exploring the influence of activated monocyte-derived exosomes in sepsis sheds light on a promising pathway for understanding the intricate cellular and molecular mechanisms involved in this condition in humans. In sepsis, exosome-borne mRNA and miRNA orchestrate immune response gene expression in recipient cells. Yet, the specifics of exosome-mediated cell-to-cell communication, especially how mRNA cargoes modulate gene expression in recipient cells, remain poorly understood. This study aims to elucidate the precise molecular pathways through which exosomal mRNA cargo, particularly MAFB, contributes to the developing sepsis-induced molecular aberrations in liver tissues, employing rigorously defined cell culture conditions. THP-1 cells were treated with LPS to induce changes in exosomal RNA profiles. Exosomes were isolated and characterized using microscopy and mass spectrometry. RNA was extracted from exosomes and sequenced. The most abundant exosomal mRNAs were subjected to GO analysis for functional annotation analysis and KEGG database analysis to identify the involved enriched pathways. PCR (Polymerase Chain Reaction), RNA sequencing, and Western blotting were involved to analyze changes in gene expression, protein levels, and signaling pathways within the liver cells( HepG2) after exposure to exosomal MAFB. This study pinpoints exosomal MAFB as a potential key regulator linked to liver cell damage during sepsis, along with associated genes (miR155HG, H3F3A, and possibly JARD2) forming a crucial molecular pathway contributing to liver cell injury, Together, these elements indicate a vital molecular pathway that plays a significant role in the emergence of liver cell injury during sepsis.. These findings suggest the importance of further research on these components for potential therapeutic interventions in managing acute liver damage in sepsis.

Keywords: sepsis, exososome, exosomal MAFB, LPS-induced THP-1 cells, RNA profiles, sepsis-triggered liver injury

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851 Telemedicine Versus Face-to-Face Follow up in General Surgery: A Randomized Controlled Trial

Authors: Teagan Fink, Lynn Chong, Michael Hii, Brett Knowles

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Background: Telemedicine is a rapidly advancing field providing healthcare to patients at a distance from their treating clinician. There is a paucity of high-quality evidence detailing the safety and acceptability of telemedicine for postoperative outpatient follow-up. This randomized controlled trial – conducted prior to the COVID 19 pandemic – aimed to assess patient satisfaction and safety (as determined by readmission, reoperation and complication rates) of telephone compared to face-to-face clinic follow-up after uncomplicated general surgical procedures. Methods: Patients following uncomplicated laparoscopic appendicectomy or cholecystectomy and laparoscopic or open umbilical or inguinal hernia repairs were randomized to a telephone or face-to-face outpatient clinic follow-up. Data points including patient demographics, perioperative details and postoperative outcomes (eg. wound healing complications, pain scores, unplanned readmission to hospital and return to daily activities) were compared between groups. Patients also completed a Likert patient satisfaction survey following their consultation. Results: 103 patients were recruited over a 12-month period (21 laparoscopic appendicectomies, 65 laparoscopic cholecystectomies, nine open umbilical hernia repairs, six laparoscopic inguinal hernia repairs and two laparoscopic umbilical hernia repairs). Baseline patient demographics and operative interventions were the same in both groups. Patient or clinician-reported concerns on postoperative pain, use of analgesia, wound healing complications and return to daily activities at clinic follow-up were not significantly different between the two groups. Of the 58 patients randomized to the telemedicine arm, 40% reported high and 60% reported very high patient satisfaction. Telemedicine clinic mean consultation times were significantly shorter than face-to-face consultation times (telemedicine 10.3 +/- 7.2 minutes, face-to-face 19.2 +/- 23.8 minutes, p-value = 0.014). Rates of failing to attend clinic were not significantly different (telemedicine 3%, control 6%). There was no increased rate of postoperative complications in patients followed up by telemedicine compared to in-person. There were no unplanned readmissions, return to theatre, or mortalities in this study. Conclusion: Telemedicine follow-up of patients undergoing uncomplicated general surgery is safe and does not result in any missed diagnosis or higher rates of complications. Telemedicine provides high patient satisfaction and steps to implement this modality in inpatient care should be undertaken.

Keywords: general surgery, telemedicine, patient satisfaction, patient safety

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850 The Work Book Tool, a Lifelong Chronicle: Part of the "Designprogrammet" at the Design School of the University in Kalmar, Sweden

Authors: Henriette Jarild-Koblanck, Monica Moro

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The research has been implemented at the Kalmar University now LNU Linnaeus University inside the Design Program (Designprogrammet) for several years. The Work Book tool was created using the framework of the Bologna declaration. The project concerns primarily pedagogy and design methodology, focusing on how we evaluate artistic work processes and projects and on how we can develop the preconditions for cross-disciplinary work. The original idea of the Work Book springs from the steady habit of the Swedish researcher and now retired full professor and dean Henriette Koblanck to put images, things and colours in a notebook, right from her childhood, writing down impressions and reflections. On this preliminary thought of making use of a work book, in a form freely chosen by the user, she began to develop the Design Program (Designprogrammet) that was applied at the Kalmar University now LNU Linnaeus University, where she called a number of professionals to collaborate, among them Monica Moro an Italian designer, researcher, and teacher in the field of colour and shape. The educational intention is that the Work Book should become a tool that is both inspirational for the process of thinking and intuitional creating, and personal support for both rational and technical thinking. The students were to use the Work Book not only to visually and graphically document their results from investigations, experiments and thoughts but also as a tool to present their works to others, -students, tutors and teachers, or to other stakeholders they discussed the proceedings with. To help the students a number of matrixes were developed oriented to evaluate the projects in elaboration, based on the Bologna Declaration. In conclusion, the feedback from the students is excellent; many are still using the Work Book as a professional tool as in their words they consider it a rather accurate representation of their working process, and furthermore of themselves, so much that many of them have used it as a portfolio when applying for jobs.

Keywords: academic program, art, assessment of student’s progress, Bologna Declaration, design, learning, self-assessment

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849 Comparing the Contribution of General Vocabulary Knowledge and Academic Vocabulary Knowledge to Learners' Academic Achievement

Authors: Reem Alsager, James Milton

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Coxhead’s (2000) Academic Word List (AWL) believed to be essential for students pursuing higher education and helps differentiate English for Academic Purposes (EAP) from General English as a course of study, and it is thought to be important for comprehending English academic texts. It has been described that AWL is an infrequent, discrete set of vocabulary items unreachable from general language. On the other hand, it has been known for a period of time that general vocabulary knowledge is a good predictor of academic achievement. This study, however, is an attempt to measure and compare the contribution of academic knowledge and general vocabulary knowledge to learners’ GPA and examine what knowledge is a better predictor of academic achievement and investigate whether AWL as a specialised list of infrequent words relates to the frequency effect. The participants were comprised of 44 international postgraduate students in Swansea University, all from the School of Management, following the taught MSc (Master of Science). The study employed the Academic Vocabulary Size Test (AVST) and the XK_Lex vocabulary size test. The findings indicate that AWL is a list based on word frequency rather than a discrete and unique word list and that the AWL performs the same function as general vocabulary, with tests of each found to measure largely the same quality of knowledge. The findings also suggest that the contribution that AWL knowledge provides for academic success is not sufficient and that general vocabulary knowledge is better in predicting academic achievement. Furthermore, the contribution that academic knowledge added above the contribution of general vocabulary knowledge when combined is really small and noteworthy. This study’s results are in line with the argument and suggest that it is the development of general vocabulary size is an essential quality for academic success and acquiring the words of the AWL will form part of this process. The AWL by itself does not provide sufficient coverage, and is probably not specialised enough, for knowledge of this list to influence this general process. It can be concluded that AWL as an academic word list epitomizes only a fraction of words that are actually needed for academic success in English and that knowledge of academic vocabulary combined with general vocabulary knowledge above the most frequent 3000 words is what matters most to ultimate academic success.

Keywords: academic achievement, academic vocabulary, general vocabulary, vocabulary size

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848 Hermeneutics: Comparative Study of Shri Guru Granth Sahib's Schools of Interpretation

Authors: Amandeep Kaur

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All religions enlighten truth which provides spiritual tranquility. But, the language of these holy books is not easy to understand because these have divine language. That's why hermeneutical Study is necessary to understand these Scriptures. There is a separate theoretical framework to study all the disciplines of language, literature, religion etc. Similarly the discipline of interpretation has its own theoretical framework known as hermeneutics. It is a science of interpretation that put forward the best ways and methods of interpretation. But in this modern world, hermeneutics is considered as a theoretical-cum-philosophical discipline. It is vast study of understanding texts. Hermeneutics is especially related to the study of religious scriptures like the Bible, the Qur'an, the Vedas and the Shri Guru Granth Sahib and many more. It is mainly the Western concept which has a great old tradition because it used the Bible as the foremost holy scripture for definition and interpretation. The Discipline of the Indian hermeneutics was led by Mimamsa School. The reference of the word hermeneutics in works of Ancient Greek philosophers indicates towards the antiquity of this word. Shri Guru Granth Sahib's schools of interpretation like Udasi, Nirmala, Sevapanthi and Gyani came into existence to interpret the discourse of Shri Guru Granth Sahib. These are sects of Sikhism and have great contribution to interpret and preach Guru Granth Sahib's revelation. This research paper will represent the comparative study of these sects methods, tools and styles of interpreting the meaning of this holy book. Interpretation is basically textual based process. So, all these schools have chosen Guru Granth Sahib for textual study. Some of the schools have done a whole interpretation of Guru Granth Sahib. But, some of them have done only interpretation of prominent banies i.e Japuji Sahib, Anand Sahib, Assa-di-war etc. This study will also throw lights on sect's historical background and contribution. At last conclusion of this paper is that all the schools have done gurbani interpretation according to their own philosophical and theological point of view. These schools have many similarities and differences among their way of interpretation. It will be discussed briefly.

Keywords: Gyani, hermeneutics, Mimamsa, Nirmala, Sevapanthi, Udasi

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847 Individual and Contextual Factors Associated with Modern Contraceptive Use among Sexually Active Adolescents and Young Women in Zambia: A Multilevel Analysis

Authors: Chinyama Lukama, Million Phiri, Namuunda Mutombo

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Background: Improving access and utilization to high-quality sexual and reproductive health (SRH) information and services, including family planning (FP) commodities, is central to the global developmental agenda of sub-Saharan Africa (SSA). Despite the importance of family planning use in enhancing maternal health outcomes and fertility reduction, the prevalence of adolescents and young women using modern contraception is generally low in SSA. Zambia is one of the countries in Southern Africa with a high prevalence of teenage pregnancies and fertility rates. Despite many initiatives that have been implemented to improve access and demand for family planning commodities, utilization of FP, especially among adolescents and young women, has generally been low. The objective of this research agenda was to better understand the determinants of modern contraceptive use in adolescents and young women in Zambia. This analysis produced findings that will be critical for informing the strengthening of sexual and reproductive health policy strategies aimed at bolstering the provision and use of maternal health services in order to further improve maternal health outcomes in the country. Method: The study used the recent data from the Demographic and Health Survey of 2018. A sample of 3,513 adolescents and young women (ADYW) were included in the analysis. Multilevel logistic regression models were employed to examine the association of individual and contextual factors with modern contraceptive use among adolescents and young women. Results: The prevalence of modern contraception among sexually active ADYW in Zambia was 38.1% [95% CI, 35.9, 40.4]. ADYW who had secondary or higher level education [aOR = 2.16, 95% CI=1.35–3.47], those with exposure to listening to the radio or watching television [aOR = 1.26, 95% CI=1.01–1.57], and those who had decision-making power at household level [aOR = 2.18, 95% CI=1.71–2.77] were more likely to use modern contraceptives. Conversely, strong neighborhood desire for large family size among ADYW [aOR = 0.65 95% CI = 0.47–0.88] was associated with less likelihood to use modern contraceptives. Community access to family planning information through community health worker visits increased the likelihood [aOR = 1.48, 95% CI=1.16–1.91] of using modern contraception among ADYW. Conclusion: The study found that both individual and community factors were key in influencing modern contraceptive use among adolescents and young women in Zambia. Therefore, when designing family planning interventions, the Government of Zambia, through its policymakers and sexual reproductive health program implementers at the Ministry of Health, in collaboration with stakeholders, should consider the community context. There should also be deliberate actions to encourage family planning education through the media.

Keywords: adolescents, young women, modern contraception use, fertility, family planning

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846 Rupture in the Paradigm of the International Policy of Illicit Drugs in the Field of Public Health and within the Framework of the World Health Organization, 2001 to 2016

Authors: Emy Nayana Pinto, Denise Bomtempo Birche De Carvalho

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In the present study, the harmful use of illicit drugs is seen as a public health problem and as one of the expressions of the social question, since its consequences fall mainly on the poorer classes of the population. This perspective is a counterpoint to the dominant paradigm on illicit drug policy at the global level, whose centrality lies within the criminal justice arena. The 'drug problem' is internationally combated through fragmented approaches that focus its actions on banning and criminalizing users. In this sense, the research seeks to answer the following key questions: What are the influences of the prohibitionism in the recommendations of the United Nations (UN), the World Health Organization (WHO), and the formulation of drug policies in member countries? What are the actors that have been provoking the prospect of breaking with the prohibitionist paradigm? What is the WHO contribution to the rupture with the prohibitionist paradigm and the displacement of the drug problem in the field of public health? The general objective of this work is to seek evidence from the perspective of rupture with the prohibitionist paradigm in the field of drugs policies at the global and regional level, through analysis of documents of the World Health Organization (WHO), between the years of 2001 to 2016. The research was carried out in bibliographical and documentary sources. The bibliographic sources contributed to the approach with the object and the theoretical basis of the research. The documentary sources served to answer the research questions and evidence the existence of the perspective of change in drug policy. Twenty-two documents of the UN system were consulted, of which fifteen had the contribution of the World Health Organization (WHO). In addition to the documents that directly relate to the subject of the research, documents from various agencies, programs, and offices, such as the Joint United Nations Program on HIV/AIDS (UNAIDS) and the United Nations Office on Drugs and Crime (UNODC), which also has drugs as the central or transversal theme of its performance. The results showed that from the 2000s it was possible to find in the literature review and in the documentary analysis evidence of the critique of the prohibitionist paradigm parallel to the construction of a new perspective for drug policy at the global level and the displacement of criminal justice approaches for the scope of public health, with the adoption of alternative and pragmatic interventions based on human rights, scientific evidence and the reduction of social damages and health by the misuse of illicit drugs.

Keywords: illicit drugs, international organizations, prohibitionism, public health, World Health Organization

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845 Rural Sanitation in India: Special Context in the State of Odisa

Authors: Monalisha Ghosh, Asit Mohanty

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The lack of sanitation increases living costs, decreases spend on education and nutrition, lowers income earning potential, and threatens safety and welfare. This is especially true for rural India. Only 32% of rural households have their own toilets and that less than half of Indian households have a toilet at home. Of the estimated billion people in the world who defecate in the open, more than half reside in rural India. It is empirically established that poor sanitation leads to high infant mortality rate and low income generation in rural India. In India, 1,600 children die every day before reaching their fifth birthday and 24% of girls drop out of school as the lack of basic sanitation. Above all, lack of sanitation is not a symptom of poverty but a major contributing factor. According to census 2011, 67.3% of the rural households in the country still did not have access to sanitation facilities. India’s sanitation deficit leads to losses worth roughly 6% of its gross domestic product (GDP) according to World Bank estimates by raising the disease burden in the country. The dropout rate for girl child is thirty percent in schools in rural areas because of lack of sanitation facilities for girl students. The productivity loss per skilled labors during a year is calculated at Rs.44, 160 in Odisha. The performance of the state of Odisha has not been satisfactory in improving sanitation facilities. The biggest challenge is triggering behavior change in vast section of rural population regarding need to use toilets. Another major challenge is funding and implementation for improvement of sanitation facility. In an environment of constrained economic resources, Public Private Partnership in form of performance based management or maintenance contract will be all the more relevant to improve the sanitation status in rural sector.

Keywords: rural sanitation, infant mortality rate, income, granger causality, pooled OLS method test public private partnership

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844 Investigating the Relationship Between Alexithymia and Mobile Phone Addiction Along with the Mediating Role of Anxiety, Stress and Depression: A Path Analysis Study and Structural Model Testing

Authors: Pouriya Darabiyan, Hadis Nazari, Kourosh Zarea, Saeed Ghanbari, Zeinab Raiesifar, Morteza Khafaie, Hanna Tuvesson

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Introduction Since the beginning of mobile phone addiction, alexithymia, depression, anxiety and stress have been stated as risk factors for Internet addiction, so this study was conducted with the aim of investigating the relationship between Alexithymia and Mobile phone addiction along with the mediating role of anxiety, stress and depression. Materials and methods In this descriptive-analytical and cross-sectional study in 2022, 412 students School of Nursing & Midwifery of Ahvaz Jundishapur University of Medical Sciences were included in the study using available sampling method. Data collection tools were: Demographic Information Questionnaire, Toronto Alexithymia Scale (TAS-20), Depression, Anxiety, Stress Scale (DASS-21) and Mobile Phone Addiction Index (MPAI). Frequency, Pearson correlation coefficient test and linear regression were used to describe and analyze the data. Also, structural equation models and path analysis method were used to investigate the direct and indirect effects as well as the total effect of each dimension of Alexithymia on Mobile phone addiction with the mediating role of stress, depression and anxiety. Statistical analysis was done by SPSS version 22 and Amos version 16 software. Results Alexithymia was a predictive factor for mobile phone addiction. Also, Alexithymia had a positive and significant effect on depression, anxiety and stress. Depression, anxiety and stress had a positive and significant effect on mobile phone addiction. Depression, anxiety and stress variables played the role of a relative mediating variable between Alexithymia and mobile phone addiction. Alexithymia through depression, anxiety and stress also has an indirect effect on Internet addiction. Conclusion Alexithymia is a predictive factor for mobile phone addiction; And the variables of depression, anxiety and stress play the role of a relative mediating variable between Alexithymia and mobile phone addiction.

Keywords: alexithymia, mobile phone, depression, anxiety, stress

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

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

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

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

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842 Disaster Education and Children with Visual Impairment

Authors: Vassilis Argyropoulos, Magda Nikolaraizi, Maria Papazafiri

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This study describes a series of learning workshops, which took place within CUIDAR project. The workshops aimed to empower children to share their experiences and views in relation to natural hazards and disasters. The participants in the workshops were ten primary school students who had severe visual impairments or multiple disabilities and visual impairments (MDVI). The main objectives of the workshops were: a) to promote access of the children through the use of appropriate educational material such as texts in braille, enlarged text, tactile maps and the implementation of differentiated instruction, b) to make children aware regarding their rights to have access to information and to participate in planning and decision-making especially in relation to disaster education programs, and c) to encourage children to have an active role during the workshops through child-led and experiential learning activities. The children expressed their views regarding the meaning of hazards and disasters. Following, they discussed their experiences and emotions regarding natural hazards and disasters, and they chose to place the emphasis on a hazard, which was more pertinent to them, their community and their region, namely fires. Therefore, they recalled fires that have caused major disasters, and they discussed about the impact that these fires had on their community or on their country. Furthermore, they were encouraged to become aware regarding their own role and responsibility to prevent a fire or get prepared and know how to behave if a fire occurs. They realized that prevention and preparation are a matter of personal responsibility. They also felt the responsibility to inform their own families. Finally, they met important people involved in fire protection such as rescuers and firefighters and had the opportunity to carry dialogues. In conclusion, through child led workshops, experiential and accessible activities, the students had the opportunity to share their own experiences, to express their views and their questions, to broaden their knowledge and to realize their personal responsibility in disaster risk reduction, specifically in relation to fires.

Keywords: accessibility, children, disasters, visual impairment

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841 The Impact of Migrants’ Remittances on Household Poverty and Income Inequality: A case Study of Mazar-i-Sharif, Balkh Province, Afghanistan

Authors: Baqir Khawari

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This study critically examines the influence of remittances on household poverty and income inequality in Mazar-i-Sharif, Balkh Province, Afghanistan, utilizing robust OLS and Logit models with a rigorous multi-random sampling method. The empirical findings reveal that a 1% increase in per capita international remittances is associated with a substantial 0.071% and 0.059% rise in per capita income during the fiscal years 2019/20 and 2020/21, respectively. Furthermore, this increase significantly mitigates the per capita depth of poverty by 0.0272% and 0.025% and the severity of poverty by 0.0149% and 0.0145% over the same periods. Notably, the impact of international remittances on poverty alleviation surpasses that of internal remittances. In addressing income inequality, the analysis demonstrates that remittances contribute to a reduction in the Gini coefficient by 2% in 2019/20 and 7% in 2020/21, underscoring their pivotal role in promoting equitable economic distribution. However, the COVID-19 pandemic has posed significant challenges, diminishing remittance flows and, consequently, their positive effects on household welfare. The logistic regression results further corroborate these findings, indicating that increased per capita remittances, both international and internal, markedly decrease the likelihood of households falling below the poverty line. Specifically, a 1% rise in per capita external remittances reduces this likelihood by 4.5% in 2019/20 and by 3.7% in 2020/21, while internal remittances decrease it by 3% and 2.4%, respectively. The study also explores the demographic determinants of poverty. Larger household sizes and older household heads correlate positively with poverty, whereas higher education levels among household heads and members, and a greater proportion of male members, correlate negatively with poverty incidence and severity. Female-headed households are disproportionately affected by poverty, exacerbated by socio-cultural restrictions. Despite these adversities, the data suggest that remittances are a crucial instrument for poverty alleviation and income inequality reduction in Afghanistan. The findings advocate for policy interventions aimed at enhancing formal remittance channels, promoting education, and empowering women. Effective governance and sustained international assistance are essential to harness the full potential of remittances in combating poverty and inequality. This study highlights the need for strategic, multifaceted approaches to foster sustainable economic development in Afghanistan’s challenging socio-political context.

Keywords: migration, remittances, poverty, inequality, COVID-19, Afghanistan

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840 E-Learning Platform for School Kids

Authors: Gihan Thilakarathna, Fernando Ishara, Rathnayake Yasith, Bandara A. M. R. Y.

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E-learning is a crucial component of intelligent education. Even in the midst of a pandemic, E-learning is becoming increasingly important in the educational system. Several e-learning programs are accessible for students. Here, we decided to create an e-learning framework for children. We've found a few issues that teachers are having with their online classes. When there are numerous students in an online classroom, how does a teacher recognize a student's focus on academics and below-the-surface behaviors? Some kids are not paying attention in class, and others are napping. The teacher is unable to keep track of each and every student. Key challenge in e-learning is online exams. Because students can cheat easily during online exams. Hence there is need of exam proctoring is occurred. In here we propose an automated online exam cheating detection method using a web camera. The purpose of this project is to present an E-learning platform for math education and include games for kids as an alternative teaching method for math students. The game will be accessible via a web browser. The imagery in the game is drawn in a cartoonish style. This will help students learn math through games. Everything in this day and age is moving towards automation. However, automatic answer evaluation is only available for MCQ-based questions. As a result, the checker has a difficult time evaluating the theory solution. The current system requires more manpower and takes a long time to evaluate responses. It's also possible to mark two identical responses differently and receive two different grades. As a result, this application employs machine learning techniques to provide an automatic evaluation of subjective responses based on the keyword provided to the computer as student input, resulting in a fair distribution of marks. In addition, it will save time and manpower. We used deep learning, machine learning, image processing and natural language technologies to develop these research components.

Keywords: math, education games, e-learning platform, artificial intelligence

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839 A Comprehensive Comparative Study on Seasonal Variation of Parameters Involved in Site Characterization and Site Response Analysis by Using Microtremor Data

Authors: Yehya Rasool, Mohit Agrawal

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The site characterization and site response analysis are the crucial steps for reliable seismic microzonation of an area. So, the basic parameters involved in these fundamental steps are required to be chosen properly in order to efficiently characterize the vulnerable sites of the study region. In this study, efforts are made to delineate the variations in the physical parameter of the soil for the summer and monsoon seasons of the year (2021) by using Horizontal-to-Vertical Spectral Ratios (HVSRs) recorded at five sites of the Indian Institute of Technology (Indian School of Mines), Dhanbad, Jharkhand, India. The data recording at each site was done in such a way that less amount of anthropogenic noise was recorded at each site. The analysis has been done for five seismic parameters like predominant frequency, H/V ratio, the phase velocity of Rayleigh waves, shear wave velocity (Vs), compressional wave velocity (Vp), and Poisson’s ratio for both the seasons of the year. From the results, it is observed that these parameters majorly vary drastically for the upper layers of soil, which in turn may affect the amplification ratios and probability of exceedance obtained from seismic hazard studies. The HVSR peak comes out to be higher in monsoon, with a shift in predominant frequency as compared to the summer season of the year 2021. Also, the drastic reduction in shear wave velocity (up to ~10 m) of approximately 7%-15% is also perceived during the monsoon period with a slight decrease in compressional wave velocity. Generally, the increase in the Poisson ratios is found to have higher values during monsoon in comparison to the summer period. Our study may be very beneficial to various agricultural and geotechnical engineering projects.

Keywords: HVSR, shear wave velocity profile, Poisson ratio, microtremor data

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838 Enabling Self-Care and Shared Decision Making for People Living with Dementia

Authors: Jonathan Turner, Julie Doyle, Laura O’Philbin, Dympna O’Sullivan

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People living with dementia should be at the centre of decision-making regarding goals for daily living. These goals include basic activities (dressing, hygiene, and mobility), advanced activities (finances, transportation, and shopping), and meaningful activities that promote well-being (pastimes and intellectual pursuits). However, there is limited involvement of people living with dementia in the design of technology to support their goals. A project is described that is co-designing intelligent computer-based support for, and with, people affected by dementia and their carers. The technology will support self-management, empower participation in shared decision-making with carers and help people living with dementia remain healthy and independent in their homes for longer. It includes information from the patient’s care plan, which documents medications, contacts, and the patient's wishes on end-of-life care. Importantly for this work, the plan can outline activities that should be maintained or worked towards, such as exercise or social contact. The authors discuss how to integrate care goal information from such a care plan with data collected from passive sensors in the patient’s home in order to deliver individualized planning and interventions for persons with dementia. A number of scientific challenges are addressed: First, to co-design with dementia patients and their carers computerized support for shared decision-making about their care while allowing the patient to share the care plan. Second, to develop a new and open monitoring framework with which to configure sensor technologies to collect data about whether goals and actions specified for a person in their care plan are being achieved. This is developed top-down by associating care quality types and metrics elicited from the co-design activities with types of data that can be collected within the home, from passive and active sensors, and from the patient’s feedback collected through a simple co-designed interface. These activities and data will be mapped to appropriate sensors and technological infrastructure with which to collect the data. Third, the application of machine learning models to analyze data collected via the sensing devices in order to investigate whether and to what extent activities outlined via the care plan are being achieved. The models will capture longitudinal data to track disease progression over time; as the disease progresses and captured data show that activities outlined in the care plan are not being achieved, the care plan may recommend alternative activities. Disease progression may also require care changes, and a data-driven approach can capture changes in a condition more quickly and allow care plans to evolve and be updated.

Keywords: care goals, decision-making, dementia, self-care, sensors

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837 A Quality Improvement Approach for Reducing Stigma and Discrimination against Young Key Populations in the Delivery of Sexual Reproductive Health and Rights Services

Authors: Atucungwiire Rwebiita

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Introduction: In Uganda, provision of adolescent sexual reproductive health and rights (SRHR) services for key population is still hindered by negative attitudes, stigma and discrimination (S&D) at both the community and facility levels. To address this barrier, Integrated Community Based Initiatives (ICOBI) with support from SIDA is currently implementing a quality improvement (QI) innovative approach for strengthening the capacity of key population (KP) peer leaders and health workers to deliver friendly SRHR services without S&D. Methods: Our innovative approach involves continuous mentorship and coaching of 8 QI teams at 8 health facilities and their catchment areas. Each of the 8 teams (comprised of 5 health workers and 5 KP peer leaders) are facilitated twice a month by two QI Mentors in a 2-hour mentorship session over a period of 4 months. The QI mentors were provided a 2-weeks training on QI approaches for reducing S&D against young key populations in the delivery of SRHR Services. The mentorship sessions are guided by a manual where teams base to analyse root causes of S&D and develop key performance indicators (KPIs) in the 1st and 2nd second sessions respectively. The teams then develop action plans in the 3rd session and review implementation progress on KPIs at the end of subsequent sessions. The KPIs capture information on the attitude of health workers and peer leaders and the general service delivery setting as well as clients’ experience. A dashboard is developed to routinely track the KPIs for S&D across all the supported health facilities and catchment areas. After 4 months, QI teams share documented QI best practices and tested change packages on S&D in a learning and exchange session involving all the teams. Findings: The implementation of this approach is showing positive results. So far, QI teams have already identified the root causes of S&D against key populations including: poor information among health workers, fear of a perceived risk of infection, perceived links between HIV and disreputable behaviour. Others are perceptions that HIV & STIs are divine punishment, sex work and homosexuality are against religion and cultural values. They have also noted the perception that MSM are mentally sick and a danger to everyone. Eight QI teams have developed action plans to address the root causes of S&D. Conclusion: This approach is promising, offers a novel and scalable means to implement stigma-reduction interventions in facility and community settings.

Keywords: key populations, sexual reproductive health and rights, stigma and discrimination , quality improvement approach

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836 Caregiver’s Perception Regarding Diagnosis Disclosure to Children Living with Human Immunodeficiency Virus in Resource-Limited Settings: Observational Study from India

Authors: Ramesh Chand Chauhan, Sanjay Kumar Rai, Shashi kant, Rakesh Lodha, Nand Kumar

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Background: With a better understanding of HIV pathogenesis and availability of antiretroviral therapy more children are growing and entering in teenage group; informing children of their own HIV status has become an important aspect of long-term disease management. There is little evidence of how and when this type of disclosure takes place in a resource-limited setting. Methods: A cross-sectional study was conducted from June 2010 to May 2011 among a dyads of 156 HIV-infected children and their caregivers, those were visiting pediatric clinic at a tertiary care hospital in Delhi, India. The study protocol was approved by the Institute Ethics Committee. After taking written informed consent; pretested structured questionnaire was administered to caregivers during routine clinic visits. Information regarding socio-demographic characteristics, awareness of HIV infection status among children and their perception regarding disclosure was collected. Mean and frequencies were calculated and chi-square and logistic regression test were applied. Results: The mean age of children was 8.4 ±3.45 years. Among them 73.7% were male and 39.1% were orphans. Among 156 enrolled children, 74.4% (n=116) were of ≥ 6 years and were assessed for disclosure. Only 18.1% (n=21) children had been informed of their HIV status. Of those under 9 years, 6.4% knew their status, whereas 18.4% of 9-11 years and 35.5% of 12-14 years children knew they had HIV. Awareness among males (23.3%) was higher than females (3.3%). Both age and sex of child were significantly (p<0.01) associated with disclosure status. Other factors favoring disclosure were orphan-hood, non-perinatal mode of transmission (OR = 4.32; 95% CI 1.01-7.12), ART initiation (OR = 4.21; 95% CI 1.03-6.98), and caregiver educated beyond primary level (OR = 1.89; 95% CI 1.03-3.26). Repeated enquiry regarding the visit to clinic was the most common reason (66.6%) for disclosure. In 52.4% children disclosure was done with the involvement of other family members. 82.5% caregivers felt the age of > 10 years is appropriate for disclosing the HIV infection status to the child. Conclusion: Detailed guidelines on disclosure are required focusing on children of school-going age with perinatal infection who are not on ART and with caregivers of low educational status.

Keywords: HIV, children, India, disclosure

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835 Autonomy in Pregnancy and Childbirth: The Next Frontier of Maternal Health Rights Advocacy

Authors: Alejandra Cardenas, Ona Flores, Fabiola Gretzinger

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Since the 1990s, legal strategies for the promotion and protection of maternal health rights have achieved significant gains. Successful litigation in courts around the world have shown that these rights can be judicially enforceable. Governments and international organizations have acknowledged the importance of a human rights-based approach to maternal mortality and morbidity, and obstetric violence has been recognized as a human rights issue. Despite the progress made, maternal mortality has worsened in some regions of the world, while progress has stagnated elsewhere, and mistreatment in maternal care is reported almost universally. In this context, issues of maternal autonomy and decision-making during pregnancy, labor, and delivery as a critical barrier to access quality maternal health have been largely overlooked. Indeed, despite the principles of autonomy and informed consent in medical interventions being well-established in international and regional norms, how they are applied particularly during childbirth and pregnancy remains underdeveloped. National and global legal standards and decisions related to maternal health were reviewed and analyzed to determine how maternal autonomy and decision-making during pregnancy, labor, and delivery have been protected (or not) by international and national courts. The results of this legal research and analysis lead to the conclusion that a few standards have been set by courts regarding pregnant people’s rights to make choices during pregnancy and birth; however, most undermine the agency of pregnant people. These decisions recognize obstetric violence and gender-based discrimination, but fail to protect pregnant people’s autonomy, privacy, and their right to informed consent. As current human rights standards stand today, maternal health is the only field in medicine and law in which informed consent can be overridden, and patients can be forced to submit to treatments against their will. Unconsented treatment and loss of agency during pregnancy and childbirth can have long-term physical and mental impacts, reduce satisfaction and trust in health systems, and may deter future health-seeking behaviors. This research proposes a path forward that focuses on the pregnant person as an independent agent, relying on the doctrine of self-determination during pregnancy and childbirth, which includes access to the necessary conditions to enable autonomy and choice throughout pregnancy and childbirth as a critical step towards our approaches to reduce maternal mortality, morbidity, and mistreatment, and realize the promise of access to quality maternal health as a human right.

Keywords: autonomy in childbirth and pregnancy, choice, informed consent, jurisprudential analysis

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834 Plantar Neuro-Receptor Activation in Total Knee Arthroplasty Patients: Impact on Clinical Function, Pain, and Stiffness - A Randomized Controlled Trial

Authors: Woolfrey K., Woolfrey M., Bolton C. L., Warchuk D.

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Objectives: Osteoarthritis is the most common joint disease of adults worldwide. Despite total knee arthroplasty (TKA) demonstrating high levels of success, 20% of patients report dissatisfaction with their result. VOXX Wellness Stasis Socks are embedded with a proprietary pattern of neuro-receptor activation points that have been proven to activate a precise neuro-response, according to the pattern theory of haptic perception, which stimulates improvements in pain and function. The use of this technology in TKA patients may prove beneficial as an adjunct to recovery as many patients suffer from deficits to their proprioceptive system caused by ligamentous damage and alterations to mechanoreceptors during the procedure. We hypothesized that VOXX Wellness Stasis Socks are a safe, cost-effective, and easily scalable strategy to support TKA patients through their recovery. Design: Double-blinded, placebo-controlled randomized trial. Participants: Patients scheduled to receive TKA were considered eligible for inclusion in the trial. Interventions: Intervention group (I): VOXX Wellness Stasis socks containing receptor point-activation technology. Control group (C): VOXX Wellness Stasis socks without receptor point-activation technology. Sock use during the waking hours x 6 weeks. Main Outcome Measures: Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) questionnaire completed at baseline, 2 weeks, and 6 weeks to assess pain, stiffness, and physical function. Results: Data analysis using SPSS software. P-values, effect sizes, and confidence intervals are reported to assess clinical relevance of the finding. Physical status classifications were compared using t-test. Within-subject and between-subject differences in the mean WOMAC were analyzed by ANOVA. Effect size was analyzed using Cramer’s V. Consistent improvement in WOMAC scores for pain and stiffness at 2 weeks post op in the I over the C group. The womac scores assessing physical function showed a consistent improvement at both 2 and 6 weeks post op in the I group compared to C group. Conclusions: VOXX proved to be a low cost, safe intervention in TKA to help patients improve with regard to pain, stiffness, and physical function. Disclosures: None

Keywords: osteoarthritis, RCT, pain management, total knee arthroplasty

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833 Exploring the Efficacy of Context-Based Instructional Strategy in Fostering Students Achievement in Chemistry

Authors: Charles U. Eze, Joy Johnbest Egbo

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The study investigated the effect of Context-Based Instructional Strategy (CBIS) on students’ achievement in chemistry. CBIS was used as an experimental group and expository method (EM) as a control group, sources showed that students poor achievement in chemistry is from teaching strategy adopted by the chemistry teachers. Two research questions were answered, and two null hypotheses were formulated and tested. This strategy recognizes the need for student-centered, relevance of tasks and students’ voice; it also helps students develop creative and critical learning skills. A quasi-experimental (non-equivalent, pretest, posttest control group) design was adopted for the study. The population for the study comprised all senior secondary class one (SSI) students who were offering chemistry in co-education schools in Agbani Education zone. The instrument for data collection was a self-developed Basic Chemistry Achievement Test (BCAT). Relevant data were collected from a sample of SSI chemistry students using purposive random sampling techniques from two co-education schools in Agbani Education Zone of Enugu State, Nigeria. A reliability co-efficient was obtained for the instrument using Kuder-Richardson formula 20. Mean and standard deviation scores were used to answer the research questions while two-way analysis of covariance (ANCOVA) was used to test the hypotheses. The findings showed that the experimental group taught with context-based instructional strategy (CBIS) obtained a higher mean achievement score than the control group in the post BCAT; male students had higher mean achievement scores than their female counterparts. The difference was significant. It was recommended, among others, that CBIS should be given more emphasis in the training and re-training program of secondary school chemistry teachers.

Keywords: context-based instructional strategy, expository strategy, student-centered

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832 A Lung Cancer Patient Grief Counseling Nursing Experience

Authors: Syue-Wen Lin

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Objective: This article explores the nursing experience of a 64-year-old female lung cancer patient who underwent a thoracoscopic left lower lobectomy and treatment. The patient has a history of diabetes. The nursing process included cancer treatment, postoperative pain management, wound care and healing, and family grief counseling. Methods: The nursing period is from March 11 to March 15, 2024. During this time, strict aseptic wound dressing procedures and advanced wound care techniques are employed to promote wound healing and prevent infection. Postoperatively, due to the development of aspiration pneumonia and worsening symptoms, re-intubation was necessary. Given the patient's advanced cancer and deteriorating condition, the nursing team provided comprehensive grief counseling and care tailored to both the patient's physical and psychological needs, as well as the emotional needs of the family. Considering the complexity of the patient's condition, including advanced cancer, palliative care was also integrated into the overall nursing process to alleviate discomfort and provide psychological support. Results: Using Gordon's Functional Health Patterns for assessment, including evaluating the patient's medical history, physical assessment, and interviews, to provide individualized nursing care, it is important to collect data that will help understand the patient's physical, psychological, social, and spiritual dimensions. The interprofessional critical care team collaborates with the hospice team to help understand the psychological state of the patient's family and develop a comprehensive approach to care. Family meetings should be convened, and support should be provided to patients during the final stages of their lives. Additionally, the combination of cancer care, pain management, wound care, and palliative care ensures comprehensive support for the patient throughout her recovery, thereby improving her quality of life. Conclusion: Lung cancer and aspiration pneumonia present significant challenges to patients, and the nursing team not only provides critical care but also addresses individual patient needs through cancer care, pain management, wound care, and palliative care interventions. These measures have effectively improved the quality of life of patients, provided compassionate palliative care to terminally ill patients, and allowed them to spend the last mile of their lives with their families. Nursing staff work closely with families to develop comprehensive care plans to ensure patients receive high-quality medical care as well as psychological support and a comfortable recovery environment.

Keywords: grief counseling, lung cancer, palliative care, nursing experience

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831 Evaluation of Soil Erosion Risk and Prioritization for Implementation of Management Strategies in Morocco

Authors: Lahcen Daoudi, Fatima Zahra Omdi, Abldelali Gourfi

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In Morocco, as in most Mediterranean countries, water scarcity is a common situation because of low and unevenly distributed rainfall. The expansions of irrigated lands, as well as the growth of urban and industrial areas and tourist resorts, contribute to an increase of water demand. Therefore in the 1960s Morocco embarked on an ambitious program to increase the number of dams to boost water retention capacity. However, the decrease in the capacity of these reservoirs caused by sedimentation is a major problem; it is estimated at 75 million m3/year. Dams and reservoirs became unusable for their intended purposes due to sedimentation in large rivers that result from soil erosion. Soil erosion presents an important driving force in the process affecting the landscape. It has become one of the most serious environmental problems that raised much interest throughout the world. Monitoring soil erosion risk is an important part of soil conservation practices. The estimation of soil loss risk is the first step for a successful control of water erosion. The aim of this study is to estimate the soil loss risk and its spatial distribution in the different fields of Morocco and to prioritize areas for soil conservation interventions. The approach followed is the Revised Universal Soil Loss Equation (RUSLE) using remote sensing and GIS, which is the most popular empirically based model used globally for erosion prediction and control. This model has been tested in many agricultural watersheds in the world, particularly for large-scale basins due to the simplicity of the model formulation and easy availability of the dataset. The spatial distribution of the annual soil loss was elaborated by the combination of several factors: rainfall erosivity, soil erodability, topography, and land cover. The average annual soil loss estimated in several basins watershed of Morocco varies from 0 to 50t/ha/year. Watersheds characterized by high-erosion-vulnerability are located in the North (Rif Mountains) and more particularly in the Central part of Morocco (High Atlas Mountains). This variation of vulnerability is highly correlated to slope variation which indicates that the topography factor is the main agent of soil erosion within these basin catchments. These results could be helpful for the planning of natural resources management and for implementing sustainable long-term management strategies which are necessary for soil conservation and for increasing over the projected economic life of the dam implemented.

Keywords: soil loss, RUSLE, GIS-remote sensing, watershed, Morocco

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830 A Preliminary Finding Regarding Nutrition Information Needs among Family Physicians in Turkey

Authors: F. Nur Baran Aksakal, Özge Dinç, H. Tanju Besler, Begüm Mutuş, Özlem Üliç Çatar, Orhan Aydoğdu, Serhat Ünal

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Healthy eating habits are associated not only with the newborn, child, and maternal health but also with longer life expectancy by acting as a protective factor against non-communicable diseases such as obesity, diabetes, cardiovascular diseases, and cancer. The role of nutrition in medical education is to provide information about the relationship between healthy nutrition and malnutrition as well as diet-related non-communicable diseases. Considering the information pollution experienced in the field of nutrition and health in the society, it is seen that more than half of the population receives information from family physicians as the closest counseling unit. However, postgraduate nutrition education programs for physicians and other health professionals who wish to improve their current knowledge of the role of nutrition communication in the prevention and management of chronic diseases are limited worldwide. However, nutrition courses are either not included in the undergraduate medical education curriculum of physicians or they are insufficient. Based on this need, the main aim of the study group was to develop a "Nutrition and Nutrition Communication Training for Physicians" program that would be conducted in cooperation with the Sabri Ülker Foundation and the Federation of Family Physicians Associations (AHEF). This program is the first online nutrition and nutrition communication information platform for physicians in Turkey. This program aims to present the concept of adequate and balanced nutrition to physicians, the importance of nutrition in diseases with scientific data, and to gain communication skills that may be necessary while transferring scientific information to the public. A needs assessment questionnaire was applied to identify pre-program training needs. A study plan was made to allow the participation of all family physicians in the population, and a complete inventory was targeted. In other words, we aimed to reach the whole source without taking a section of the population. Participation in the training is based on volunteerism. The needs assessment study is conducted using 25,102 family physicians for whom email addresses are available. The online questionnaire was sent to all the family physicians with a reminder email one week after the first one, and 1308 responded. Considering the topics determined, a training program was prepared for family physicians under eight online training titles, starting in March 2022, and conducted once every two weeks. The number of audience members present at each session was between 1217 and 1673, and a minimum of 17 and a maximum of 53 questions were received in each session. We strongly believe that to prevent individuals' health problems and to have better control over chronic diseases, the information level of physicians should be increased via these kinds of interventions, and better collaboration between family physicians and dieticians should be established.

Keywords: nutrition communication, nutrition training, communication, nutrition

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