Search results for: fear of childbirth
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 556

Search results for: fear of childbirth

166 Studying Perceived Stigma, Economic System Justification and Social Mobility Beliefs of Socially Vulnerable (Poor) People: The Case of Georgia

Authors: Nazi Pharsadanishvili, Anastasia Kitiashvili

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The importance of studying the social-psychological features of people living in poverty is often emphasized in international research. Building a multidimensional economic framework for reducing poverty grounded in people’s experiences and values is the main goal of famous Poverty Research Centers (such as Oxford Poverty and Human Development Initiative, Abdul Latif Jameel Poverty Action Lab). The aims of the proposed research are to investigate the following characteristics of socially vulnerable people living in Georgia: 1) The features of the perceived stigma of poverty; 2) economic system justification and social justice beliefs; 3) Perceived social mobility and actual attempts at upward social mobility. Qualitative research was conducted to address the indicated research goals and descriptive research questions. Conducting in-depth interviews was considered to be the most appropriate method to capture the vivid feelings and experiences of people living in poverty. 17 respondents (registered in the unified database of socially vulnerable families) participated in in-depth interviews. According to the research results, socially vulnerable people living in Georgia perceive stigma targeted toward them. Two sub-dimensions were identified in perceived stigma: experienced stigma and internalized stigma. Experienced stigma reflects the instances of being discriminated and perceptions of negative treatment from other members of society. Internalized stigma covers negative personal emotions, the feelings of shame, the fear of future stigmatization, and self-isolation. The attitudes and justifications of the existing economic system affect people’s attempts to cope with poverty. Complex analysis of those results is important during the planning and implementing of social welfare reforms. Particularly, it is important to implement poverty stigma reduction mechanisms and help socially vulnerable people to see real perspectives on upward social mobility.

Keywords: coping with poverty, economic system justification, perceived stigma of poverty, upward social mobility

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165 Changing Pattern of Drug Abuse: An Outpatient Department Based Study from India

Authors: Anshu Gupta, Charu Gupta

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Background: Punjab, a border state in India has achieved notoriety world over for its drug abuse problem. People right from school kids to elderly are hooked to drugs. This pattern of substance abuse is prevalent in both cities and villages alike. Excess of younger population in India has further aggravated the situation. It is feared that the benefits of India’s economic growth may well be negated by the rising substance abuse especially in this part of the country. It is quite evident that the pattern of substance abuse tends to change over time which is an impediment in the formulation of effective strategies to tackle this issue. Aim: Purpose of the study was to ascertain the change in the pattern of drug abuse for two consecutive years in the out patient department (OPD) population. Method: The study population comprised of all the patients reporting for deaddiction to the psychiatry outpatient department over a period of twelve months for two consecutive years. All the patients were evaluated by the International Classification of Diseases; 10 criteria for substance abuse/dependence. Results: A considerably high prevalence of substance abuse was present in the Indian population. In general, there was an increase in prevalence from first to the second year, especially among the female population. Increase in prevalence of substance abuse appeared to be more prominent among the younger age group of both the sexes. A significant increase in intravenous drug abuse was observed. Peer pressure and parental imitation were the major factors fueling substance abuse. Precipitation or fear of withdrawal symptoms was the major factor preventing abstinence. Substance abuse had a significant effect on the health and interpersonal relations of these patients. Summary/Conclusion: Drug abuse and addiction are on the rise throughout India. Changing cultural values, increasing economic stress and dwindling supportive bonds appear to be leading to initiation of substance abuse. Need of the hour is to formulate a comprehensive strategy to bring about an overall reduction in the use of drugs.

Keywords: deaddiction, peer pressure, parental imitation, substance abuse/dependance

Procedia PDF Downloads 179
164 The Emergence of Construction Mafia in South Africa: The Implication on the Construction Industry

Authors: Thandokazi Nyangiwe, Christopher Amoah, Charles P. Mukumba

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The South African construction sector is threatened by emerging black business forums called construction mafias. The emergence of the construction mafia has culminated in the disruptions and abandonment of construction sites resulting in the loss of jobs for construction workers. The paper examines the origin of construction mafias and their impact on the construction sector, including the potential ways to cope with their operations. A qualitative research approach was adopted for this study using open-ended interview questions to gather information from 30 key construction industry stakeholders, including contractors, subcontractors, consultants, and the construction project communities. Content and thematic analysis were used to analyse the data collected. The findings suggest that most participants do not fully understand the existence and operations of construction mafias in the construction industry. Construction mafias claim to be part of the local business forums. They disrupt construction projects and demand a certain amount, usually 30% of the construction value. Construction mafias frequently resort to intimidation and violence if their demands are unmet. Their operations have resulted in delayed completion of construction projects, abandonment of projects, and loss of income for the contractor and jobs for the construction workers. The interviews were limited to construction stakeholders. Because of the nature of the mafias’ operations, they could not be accessed for interviews for fear of being identified because of the connotation attached to their role as construction mafias. Construction project owners face disruptions of projects resulting in loss of equipment, materials, and income. Therefore, there is a need to sensitise the construction stakeholders in the construction industry regarding the existence and operations of the construction mafia and the implications on construction project performance and delivery. The findings will give insight into the operations of the construction mafias in the South African construction industry, which has caused disruptions in construction project sites. Stakeholders must find solutions to address the construction mafias’ disruptive actions on construction projects. The study presents an initial inquiry that will come up with how to manage and cope with the growing operations of construction mafias in the South African construction industry.

Keywords: black business forums, construction mafia, emergence, implication

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163 The State of Oral Health after COVID-19 Lockdown: A Systematic Review

Authors: Faeze omid, Morteza Banakar

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Background: The COVID-19 pandemic has had a significant impact on global health and healthcare systems, including oral health. The lockdown measures implemented in many countries have led to changes in oral health behaviors, access to dental care, and the delivery of dental services. However, the extent of these changes and their effects on oral health outcomes remains unclear. This systematic review aims to synthesize the available evidence on the state of oral health after the COVID-19 lockdown. Methods: We conducted a systematic search of electronic databases (PubMed, Embase, Scopus, and Web of Science) and grey literature sources for studies reporting on oral health outcomes after the COVID-19 lockdown. We included studies published in English between January 2020 and March 2023. Two reviewers independently screened the titles, abstracts, and full texts of potentially relevant articles and extracted data from included studies. We used a narrative synthesis approach to summarize the findings. Results: Our search identified 23 studies from 12 countries, including cross-sectional surveys, cohort studies, and case reports. The studies reported on changes in oral health behaviors, access to dental care, and the prevalence and severity of dental conditions after the COVID-19 lockdown. Overall, the evidence suggests that the lockdown measures had a negative impact on oral health outcomes, particularly among vulnerable populations. There were decreases in dental attendance, increases in dental anxiety and fear, and changes in oral hygiene practices. Furthermore, there were increases in the incidence and severity of dental conditions, such as dental caries and periodontal disease, and delays in the diagnosis and treatment of oral cancers. Conclusion: The COVID-19 pandemic and associated lockdown measures have had significant effects on oral health outcomes, with negative impacts on oral health behaviors, access to care, and the prevalence and severity of dental conditions. These findings highlight the need for continued monitoring and interventions to address the long-term effects of the pandemic on oral health.

Keywords: COVID-19, oral health, systematic review, dental public health

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162 Correlation Studies in Nutritional Intake, Health Status and Clinical Examination of Young Adult Girls

Authors: Sonal Tuljaram Kame

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Growth and development is based on proper diet. A balanced diet contains all the nutrients in required quantum. Although physical growth is completed by young adulthood, the body tissues remain in a dynamic state with catabolism slightly exceeding anabolism, resulting in a net decrease in the number of cells. After the years of adolescence which cause upheavals in the life of the person, the individual struggle to emerge as an adult who know who he is and what his goals are. During this period nutrients are needed for maintaining the health and energy is required for physical functions and physical activities. The nutritional requirement in young adulthood differs from other periods of life. Iron is needed for haemoglobin synthesis and necessitates by the considerable examination of blood volume. Young adult girls need to ensure adequate intake of iron as they loose 0.5 mg/day by way of menstruation. This is complete awareness about nutritional and health on the other side there is widespread ignorance about nutrition and health among young adult girls. The young adult girls who are aware about nutrition and health seem to be very conscious about nutritional intake and health. Figure consciousness and fear of obesity leads to self imposed intake of nutrients. It may result in various health problems. The study was planned to investigate nutrient intake, find relation between nutritional intake, clinical examination score and health status of young adult girls. The present study is based on the data collected from 120 young adult girls studying in four different competitive exams coaching academies in Akola city of Maharashtra. It was found that nutritional intake of these young adult girls was below the recommended level, nutritional knowledge level and nutritional intake are associated attributes, calories, calcium and protein intake is positively correlated with clinical examination and health status. It was concluded that well planned nutritional counseling for the young adult girls can help prevent nutritional deficiency diseases and disorders which may lead to anaemic condition in young adult girls. Girls need to be educated on intake of iron and vitamin B12.

Keywords: nutritional intake, health status, young adult girls, correlation studies

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161 “Chasing Hope”: Parents’ Perspectives on Complementary and Alternative Interventions for Autism Spectrum Disorder Children in Kazakhstan

Authors: Sofiya An, Akbota Kanderzhanova, Assel Akhmetova, Faye Foster, Chee K. Chan

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Healthcare, education and social support for children with autism in Kazakhstan has been evolving and transforming over the last three decades. There is still limited knowledge of the use of complementary and alternative medicine by families caring for autistic children in this post-Soviet region. An exploratory qualitative focus group study of Kazakhstani families was carried out to capture and understand their experiences of using complementary and alternative (CAM) medicine. A total of six focus groups were conducted in five cities across the country including Nur-Sultan, Almaty, Kyzylorda, Karaganda and Taraz. The perceived factors driving the availability, choice, and use of complementary and alternative medicine by families of autistic children in the country were distilled and evaluated. The data collected was analyzed using a framework analysis and themes and subthemes were developed. Two major themes stood out. The first was the “unmet needs”, which relates to the predisposing factors that motivate parents to CAM uptake, and the second was the “chasing hope”, which relates to the enabling factors that facilitate parents’ uptake of CAM. Fear of missing out (FOMO) is a latent underlying motivation underscoring these two themes as well. Parents of autism spectrum disorder (ASD) children in Kazakhstan have to deal with many challenges when seeking treatment for their children with ASD. They are prepared and resort to try out whatever CAM interventions available. The motivation and rationale of choice of use is driven by the lack of options and the hope of any potential positive outcome rather than from rational decisions based on efficacy or the evidence-based data of CAM. Parents get desperate and are willing to try CAM regardless of and independent of their cultural and belief systems and they do not want to miss out just in case it might work. This study also gives an international and cross-cultural perspective on the motives, choice and practice of parents with ASD children using CAM in Kazakhstan, a Central Asian country.

Keywords: autism spectrum disorder, Central Asia, complementary and alternative medicine, cross-cultural perspective, qualitative research

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160 Re-Victimization of Sex Trafficking Victims in Canada: Literature Review

Authors: Adrianna D. Hendricks

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This paper examines the factors that contribute to the re-traumatization of victims of sex trafficking within the Canadian context. Sex trafficking occurring domestically in Canada is severely under-researched, stigmatized, and under-prosecuted, leading to the re-traumatization of victims by various levels of government. This is in part due to the Canadian criminal justice system unethically utilizing prostitution laws in cases of sex trafficking and partially due to the unaddressed stigmatization victims face within the justice system itself. Utilizing evidence from a current literature review, personal correspondence, and personal life experiences, this paper will demonstrate the need for victim involvement in policy reform. The current literature review was done through an academic database search using the terms: “Sex Trafficking, Exploitation, Canada”, with the limitation of articles written within the last five years and written within the Canadian context. Overall, from the results, only eight articles precisely matched the criteria. The current literature argues strongly and unanimously for more research and education of professionals who have close contact with high-risk populations (doctors, police officers, social workers, etc.) to protect both minors and adults from being sexually trafficked. Additionally, for women and girls who do not have Canadian citizenship, the fear of deportation becomes a barrier to disclosing exploitation experiences to professionals. There is a desperate need for more research done in tandem with survivors and victims to inform policymaking in a meaningful way. The researcher is a survivor of sex trafficking both as a youth and as an adult, giving the researcher a unique insight into the realities of the criminal justice system for victims of sex trafficking. Congruent to the current research, the author calls for standardized professional training for people in healthcare, police officers, court officials, and victim services, with the additional layer of victim involvement. Justice for victims/survivors can only be obtained if they have been consulted and believed. Without meaningful consultation with survivors, victims who are both minors and adults will continue to fall through the cracks in policy.

Keywords: Canadian policy, re-traumatization, sex-trafficking, stigmatization

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159 Psychosocial Experience of Parents of Children with Conduct Disorder in Thulamela, South Africa

Authors: Constance Singo, Choja Oduaran

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Child mental disorders are strongly associated with different forms of challenges, including behavioural problems. The burden of care for children with a mental disorder is high and put primary caregivers, parents in particular, at risk of poor mental wellbeing. Understanding the experience of parents of children with mental disorders is crucial to developing a relevant intervention to assist them to attain optimal mental wellbeing. The aim of this study was to explore the experiences of parents of children with conduct disorder by focussing on the psychological and social stress experience of the parents in raising and caring for their children with conduct disorder. A qualitative research approach, using in-depth interview was utilized in this study. Purposive and snowballing sampling techniques were used to select 9 parents of children with conduct disorder in Thulamela Municipality, Limpopo Province of South Africa. Participants comprising of 2 males and 7 females aged between 30 years and 49 years were interviewed individually at scheduled appointment in-home setting. Interviews were conducted in both English and Setswana language. Data collected in Setswana language were translated to English by 'expert in language translation'. Ethical approval was obtained from appropriate authority before data collection. Thematic analysis was conducted to analyse the collected data. The findings identified anger, fear, depressive symptoms, denial, and suicidal ideation as predominant psychological experiences of the parents. Furthermore, deteriorated interpersonal relationships with family and community members, financial stress, and stigma emerged as social problems being the experience of the parents. It was concluded that parents of children with conduct disorder are highly traumatized by the challenges of caring for their children. We recommend professional engagement in terms of counselling service to support the parents. There is also a need for massive enlightenment programmes for members of the community in order to support the parents of children with child mental disorders.

Keywords: conduct disorder, parents, psychosocial experiences, South Africa

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158 Remote BioMonitoring of Mothers and Newborns for Temperature Surveillance Using a Smart Wearable Sensor: Techno-Feasibility Study and Clinical Trial in Southern India

Authors: Prem K. Mony, Bharadwaj Amrutur, Prashanth Thankachan, Swarnarekha Bhat, Suman Rao, Maryann Washington, Annamma Thomas, N. Sheela, Hiteshwar Rao, Sumi Antony

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The disease burden among mothers and newborns is caused mostly by a handful of avoidable conditions occurring around the time of childbirth and within the first month following delivery. Real-time monitoring of vital parameters of mothers and neonates offers a potential opportunity to impact access as well as the quality of care in vulnerable populations. We describe the design, development and testing of an innovative wearable device for remote biomonitoring (RBM) of body temperatures in mothers and neonates in a hospital in southern India. The architecture consists of: [1] a low-cost, wearable sensor tag; [2] a gateway device for ‘real-time’ communication link; [3] piggy-backing on a commercial GSM communication network; and [4] an algorithm-based data analytics system. Requirements for the device were: long battery-life upto 28 days (with sampling frequency 5/hr); robustness; IP 68 hermetic sealing; and human-centric design. We undertook pre-clinical laboratory testing followed by clinical trial phases I & IIa for evaluation of safety and efficacy in the following sequence: seven healthy adult volunteers; 18 healthy mothers; and three sets of babies – 3 healthy babies; 10 stable babies in the Neonatal Intensive Care Unit (NICU) and 1 baby with hypoxic ischaemic encephalopathy (HIE). The 3-coin thickness, pebble-design sensor weighing about 8 gms was secured onto the abdomen for the baby and over the upper arm for adults. In the laboratory setting, the response-time of the sensor device to attain thermal equilibrium with the surroundings was 4 minutes vis-a-vis 3 minutes observed with a precision-grade digital thermometer used as a reference standard. The accuracy was ±0.1°C of the reference standard within the temperature range of 25-40°C. The adult volunteers, aged 20 to 45 years, contributed a total of 345 hours of readings over a 7-day period and the postnatal mothers provided a total of 403 paired readings. The mean skin temperatures measured in the adults by the sensor were about 2°C lower than the axillary temperature readings (sensor =34.1 vs digital = 36.1); this difference was statistically significant (t-test=13.8; p<0.001). The healthy neonates provided a total of 39 paired readings; the mean difference in temperature was 0.13°C (sensor =36.9 vs digital = 36.7; p=0.2). The neonates in the NICU provided a total of 130 paired readings. Their mean skin temperature measured by the sensor was 0.6°C lower than that measured by the radiant warmer probe (sensor =35.9 vs warmer probe = 36.5; p < 0.001). The neonate with HIE provided a total of 25 paired readings with the mean sensor reading being not different from the radian warmer probe reading (sensor =33.5 vs warmer probe = 33.5; p=0.8). No major adverse events were noted in both the adults and neonates; four adult volunteers reported mild sweating under the device/arm band and one volunteer developed mild skin allergy. This proof-of-concept study shows that real-time monitoring of temperatures is technically feasible and that this innovation appears to be promising in terms of both safety and accuracy (with appropriate calibration) for improved maternal and neonatal health.

Keywords: public health, remote biomonitoring, temperature surveillance, wearable sensors, mothers and newborns

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157 Emotional Intelligence in Educational Arena and Its Pragmatic Concerns

Authors: Mehar Fatima

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This study intends to make analysis of Emotional Intelligence (EI) in the process of pedagogy and look into its repercussions in different educational institutions including school, college, and university in the capital state of India, Delhi in 2015. Field of education is a complex area with challenging issues in a modern society. Education is the breeding ground for nurturing human souls, and personalities. Since antiquity, man has been in search of truth, wisdom, contentment, peace. His efforts have brought him to acquire these through hardship, evidently through the process of teaching and learning. Computer aids and artificial intelligence have made life easy but complex. Efficient pedagogy involves direct human intervention despite the flux of technological advancements. Time and again, pedagogical practices demand sincere human efforts to understand and improve upon life’s many pragmatic concerns. Apart from the intense academic scientific approaches, EI in academia plays a vital role in the growth of education, positively achieving national progression; ‘pedagogy of pragmatic purpose.’ Use of literature is found to be one of the valuable pragmatic tools of Emotional Intelligence. This research examines the way literature provides useful influence in building better practices in teaching-learning process. The present project also scrutinizes various pieces of world literature and translation, incorporating efforts of intellectuals in promoting comprehensive amity. The importance of EI in educational arena with its pragmatic uses was established by the study of interviews, and questionnaire collected from teachers and students. In summary the analysis of obtained empirical data makes it possible to accomplish that the use Emotional Intelligence in academic scenario yields multisided positive pragmatic outcomes; positive attitude, constructive aptitude, value-added learning, enthusiastic participation, creative thinking, lower apprehension, diminished fear, leading to individual as well as collective advancement, progress, and growth of pedagogical agents.

Keywords: emotional intelligence, human efforts, pedagogy, pragmatic concerns

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156 Disabilities in Railways: Proposed Changes to the Design of Railway Compartments for the Inclusion of Differently Abled Persons

Authors: Bathmajaa Muralisankar

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As much as railway station infrastructure designs and ticket-booking norms have been changed to facilitate use by differently abled persons, the railway train compartments themselves have not been made user-friendly for differently abled persons. Owing to safety concerns, dependency on others for their travel, and fear of isolation, differently abled people do not prefer travelling by train. Rather than including a dedicated compartment open only to the differently abled, including the latter with others in the normal compartment (with the proposed modifications discussed here) will make them feel secure and make for an enhanced travel experience for them. This approach also represents the most practical way to include a particular category of people in the mainstream society. Lowering the height of the compartment doors and providing a wider entrance with a ramp will provide easy entry for those using wheelchairs. As well, removing the first two alternate rows and the first two side seats will not only widen the passage and increase seating space but also improve wheelchair turning radius. This will help them travel without having to depend on others. Seating arrangements may be done to accommodate their family members near them instead of isolating the differently abled in a separate compartment. According to present ticket-booking regulations of the Indian Railways, three to four disabled persons may travel without their family or one to two along with their family, and the numbers may be added or reduced. To help visually challenged and hearing-impaired persons, in addition to the provision of special instruments, railings, and textured footpaths and flooring, the seat numbers above the seats may be set in metal or plastic as an outward projection so the visually impaired can touch and feel the numbers. Braille boards may be included at the entrance to the compartment along with seat numbers in the aforementioned projected manner. These seat numbers may be designed as buttons, which when pressed results in an announcement of the seat number in the applicable local language as well as English. Emergency buttons, rather than emergency chains, within the easy reach of disabled passengers will also help them.

Keywords: dependency, differently abled, inclusion, mainstream society

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155 Automatic Processing of Trauma-Related Visual Stimuli in Female Patients Suffering From Post-Traumatic Stress Disorder after Interpersonal Traumatization

Authors: Theresa Slump, Paula Neumeister, Katharina Feldker, Carina Y. Heitmann, Thomas Straube

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A characteristic feature of post-traumatic stress disorder (PTSD) is the automatic processing of disorder-specific stimuli that expresses itself in intrusive symptoms such as intense physical and psychological reactions to trauma-associated stimuli. That automatic processing plays an essential role in the development and maintenance of symptoms. The aim of our study was, therefore, to investigate the behavioral and neural correlates of automatic processing of trauma-related stimuli in PTSD. Although interpersonal traumatization is a form of traumatization that often occurs, it has not yet been sufficiently studied. That is why, in our study, we focused on patients suffering from interpersonal traumatization. While previous imaging studies on PTSD mainly used faces, words, or generally negative visual stimuli, our study presented complex trauma-related and neutral visual scenes. We examined 19 female subjects suffering from PTSD and examined 19 healthy women as a control group. All subjects did a geometric comparison task while lying in a functional-magnetic-resonance-imaging (fMRI) scanner. Trauma-related scenes and neutral visual scenes that were not relevant to the task were presented while the subjects were doing the task. Regarding the behavioral level, there were not any significant differences between the task performance of the two groups. Regarding the neural level, the PTSD patients showed significant hyperactivation of the hippocampus for task-irrelevant trauma-related stimuli versus neutral stimuli when compared with healthy control subjects. Connectivity analyses revealed altered connectivity between the hippocampus and other anxiety-related areas in PTSD patients, too. Overall, those findings suggest that fear-related areas are involved in PTSD patients' processing of trauma-related stimuli even if the stimuli that were used in the study were task-irrelevant.

Keywords: post-traumatic stress disorder, automatic processing, hippocampus, functional magnetic resonance imaging

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154 Study on the Effect of Pre-Operative Patient Education on Post-Operative Outcomes

Authors: Chaudhary Itisha, Shankar Manu

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Patient satisfaction represents a crucial aspect in the evaluation of health care services. Preoperative teaching provides the patient with pertinent information concerning the surgical process and the intended surgical procedure as well as anticipated patient behavior (anxiety, fear), expected sensation, and the probable outcomes. Although patient education is part of Accreditation protocols, it is not uniform at most places. The aim of this study was to try to assess the benefit of preoperative patient education on selected post-operative outcome parameters; mainly, post-operative pain scores, requirement of additional analgesia, return to activity of daily living and overall patient satisfaction, and try to standardize few education protocols. Dependent variables were measured before and after the treatment on a study population of 302 volunteers. Educational intervention was provided by the Investigator in the preoperative period to the study group through personal counseling. An information booklet contained detailed information was also provided. Statistical Analysis was done using Chi square test, Mann Whitney u test and Fischer Exact Test on a total of 302 subjects. P value <0.05 was considered as level of statistical significance and p<0.01 was considered as highly significant. This study suggested that patients who are given a structured, individualized and elaborate preoperative education and counseling have a better ability to cope up with postoperative pain in the immediate post-operative period. However, there was not much difference when the patients have had almost complete recovery. There was no difference in the requirement of additional analgesia among the two groups. There is a positive effect of preoperative counseling on expected return to the activities of daily living and normal work schedule. However, no effect was observed on the activities in the immediate post-operative period. There is no difference in the overall satisfaction score among the two groups of patients. Thus this study concludes that there is a positive benefit as suggested by the results for pre-operative patient education. Although the difference in various parameters studied might not be significant over a long term basis, they definitely point towards the benefits of preoperative patient education. 

Keywords: patient education, post-operative pain, postoperative outcomes, patient satisfaction

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153 Identifying, Reporting and Preventing Medical Errors Among Nurses Working in Critical Care Units At Kenyatta National Hospital, Kenya: Closing the Gap Between Attitude and Practice

Authors: Jared Abuga, Wesley Too

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Medical error is the third leading cause of death in US, with approximately 98,000 deaths occurring every year as a result of medical errors. The world financial burden of medication errors is roughly USD 42 billion. Medication errors may lead to at least one death daily and injure roughly 1.3 million people every year. Medical error reporting is essential in creating a culture of accountability in our healthcare system. Studies have shown that attitudes and practice of healthcare workers in reporting medical errors showed that the major factors in under-reporting of errors included work stress and fear of medico-legal consequences due to the disclosure of error. Further, the majority believed that increase in reporting medical errors would contribute to a better system. Most hospitals depend on nurses to discover medication errors because they are considered to be the sources of these errors, as contributors or mere observers, consequently, the nurse’s perception of medication errors and what needs to be done is a vital feature to reducing incidences of medication errors. We sought to explore knowledge among nurses on medical errors and factors affecting or hindering reporting of medical errors among nurses working at the emergency unit, KNH. Critical care nurses are faced with many barriers to completing incident reports on medication errors. One of these barriers which contribute to underreporting is a lack of education and/or knowledge regarding medication errors and the reporting process. This study, therefore, sought to determine the availability and the use of reporting systems for medical errors in critical care unity. It also sought to establish nurses’ perception regarding medical errors and reporting and document factors facilitating timely identification and reporting of medical errors in critical care settings. Methods: The study used cross-section study design to collect data from 76 critical care nurses from Kenyatta Teaching & Research National Referral Hospital, Kenya. Data analysis and results is ongoing. By October 2022, we will have analysis, results, discussions, and recommendations of the study for purposes of the conference in 2023

Keywords: errors, medical, kenya, nurses, safety

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152 Anxiety Factors in the Saudi EFL Learners

Authors: Fariha Asif

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The Saudi EFL learners face a number of problems in EFL learning, anxiety is the most potent one among those. It means that its resolution can lead to better language skills in Saudi students. That’s why, the study is carried out and is considered to be of interest to the Saudi language learners, educators and the policy makers because of the potentially negative impact that anxiety has on English language learning. The purpose of the study is to explore the factors that cause language anxiety in the Saudi EFL learners while learning speaking skills and the influence it casts on communication in the target language. The investigation of the anxiety-producing factors that arise while learning to communicate in the target language will hopefully broaden the insight into the issue of language anxiety and will help language teachers in making the classroom environment less stressful. The study seeks to answer the questions such as what are the psycholinguistic factors that cause language anxiety among ESL/EFL learners in learning and speaking English Language, especially in the context of the Saudi students. What are the socio-cultural factors that cause language anxiety among Saudi EFL learners in learning and speaking English Language? How is anxiety manifested in the language learning of the Saudi EFL learners? And which strategies can be used to successfully cope with language anxiety? The scope of the study is limited to the college and university English Teachers and subject specialists (males and females) in public sectors colleges and universities in Saudi Arabia. Some of the key findings of the study are:, Anxiety plays an important role in English as foreign language learning for the Saudi EFL learners. Some teachers believe that anxiety bears negatives effects for the learners, while some others think that anxiety serves a positive outcome for the learners by giving them an extra bit of motivation to do their best in English language learning. Language teachers seem to have consensus that L1 interference is one of the major factors that cause anxiety among the Saudi EFL learners. Most of the Saudi EFL learners are found to have fear of making mistakes. They don’t take initiative and opt to keep quiet and don’t respond fearing that they would make mistakes and this would ruin their image in front of their peers. Discouraging classroom environment is also counted as one of the major anxiety causing factors. The teachers, who don’t encourage learners positively, make them anxious and they start avoiding class participation. It is also found that English language teachers have their important role to minimize the negative effects of anxiety in the classes. The teachers’ positive encouragement can do wonders in this regard. A positive, motivating and encouraging class environment is essential to produce desired results in English language learning for the Saudi EFL learners.

Keywords: factors, psychology, speaking, EFL

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151 Women and Terrorism in Nigeria: Policy Templates for Addressing Complex Challenges in a Changing Democratic State

Authors: Godiya Pius Atsiya

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One of the most devastating impacts of terrorism on the Nigerian state is the danger it has posed on women, children and other vulnerable groups. The complexity of terrorism in Nigeria, especially in most parts of Northern Nigeria has entrenched unprecedented security challenges such as refugee crisis, kidnapping, food shortages, increase in death tolls, malnutrition, fear, rape and several other psychological factors. Of particular interest in this paper as it relates to terrorism is the high rate of Internally Displaced Persons(IDPs), with women, children and the aged being the most affected. Empirical evidence arising from recent development in Nigeria’s North-East geo-political zone shows that large numbers of refugees fleeing the Boko Haram attacks have doubled. The attendant consequences of this mass exodus of people in the affected areas are that the victims now suffer untold and unwarranted economic hardship. In another dimension, recent findings have it that most powerless women and young teenage girls have been forcefully conscripted into the Islamic extremist groups and used as shields. In some respect, these groups of people have been used as available tools for suicide bombing and other criminal tendencies, the result of which can be detrimental to social cohesion and integration. This work is a theoretical insight into terrorism discourses; hence, the paper relies on existing works of scholars in carrying out the research. The paper argues that the implications of terrorism on women gender have grounding effects on the moral psyche of women who are supposed to be home managers and custodians of morality in society. The burden of terrorism and all it tends to propagate has literally upturned social lives and hence, Nigeria is gradually being plunged into the Hobesian state of nature. As a panacea to resolving this social malaise, the paper submits that government and indeed, all stakeholders in the nation’s democratic project must expedite action to nip this trend in the bud. The paper sums up with conclusion and other alternative policy measures to mitigate the challenges of terrorism in Nigeria.

Keywords: changing democratic state, policy measures, terrorism, women

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150 Preservation of Near-Extinct African Culture: The Case of Yoruba Proverbs

Authors: Makinde David Olajide

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Proverb is an important aspect of most indigenous culture in Africa including that of the Yoruba people of southwestern Nigeria. As revealed by recent studies, Yoruba proverbs as an important cultural heritage are threatened and near extinct. This fear of proverb extinct in Yoruba cultural growth has been observed and expressed at different fora by many researchers and professionals including Art historians, culture patrons, social critics’ and teachers among others. Investigation revealed that the intangible nature of proverb is largely responsible for its continuous disappearance in the language structure and creative speeches which give the unique identity to the Yoruba people. Some of the factors that are responsible for culture extinct include: absence of moonlight stories by the elderly, the nuclear family system, and total assimilation of western culture, the concept of modernity and urban nature of Yoruba towns among others. Therefore, to preserve this creative heritage (proverb), there is need for a conscious shift of the traditional role of proverbs in speech development to its use as tool for artistic creations and expressions in visual form. The study was carried out between June, 2013 and February, 2015 in three Yoruba towns; Ilorin, Ede and Ogbomoso selected from Kwara, Osun and Oyo states respectively. The data used in this study were collected through oral and structured interviews. Fifteen interviewers were purposively selected in each of the study areas. It also employs the use of electronic and printed media to generate relevant literature on the subject matter. The study revealed that many Yoruba proverbs are preserved or hidden in text books, monograph, home videos, films and pastoral messages. However, this has not stopped the problem of lack of understanding of its usage, meaning and reasons for its extinction that may hinder its preservation for the incoming generations. This study concludes that indigenous culture can be revived and preserved for future generations when there is a conscious attempt to integrate or convert their traditional roles for present day realities and relevance in our social and educational needs.

Keywords: culture, assimilation, extinct, heritage, preservation

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149 Dynamic Capabilities and Disorganization: A Conceptual Exploration

Authors: Dinuka Herath, Shelley Harrington

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This paper prompts debate about whether disorganization can be positioned as a mechanism that facilitates the creation and enactment of important dynamic capabilities within an organization. This particular article is a conceptual exploration of the link between dynamic capabilities and disorganization and presents the case for agent-based modelling as a viable methodological tool which can be used to explore this link. Dynamic capabilities are those capabilities that an organization needs to sustain competitive advantage in complex environments. Disorganization is the process of breaking down restrictive organizational structures and routines that commonly reside in organizations in order to increase organizational performance. In the 20th century, disorganization was largely viewed as an undesirable phenomenon within an organization. However, the concept of disorganization has been revitalized and garnered research interest in the recent years due to studies which demonstrate some of the advantages of disorganization to an organization. Furthermore, recent Agent-based simulation studies have shown the capability of disorganization to be managed and argue for disorganization to be viewed as an enabler of organizational productivity. Given the natural state of disorganization and resulting fear this can create, this paper argues that instead of trying to ‘correct’ disorganization, it should be actively encouraged to have functional purpose. The study of dynamic capabilities emerged as a result of heightened dynamism and consequentially the very nature of dynamism denotes a level of fluidity and flexibility, something which this paper argues many organizations do not truly foster due to a constrained commitment to organization and order. We argue in this paper that the very state of disorganization is a state that should be encouraged to develop dynamic capabilities needed to not only deal with the complexities of the modern business environment but also to sustain competitive success. The significance of this paper stems from the fact that both dynamic capabilities and disorganization are two concepts that are gaining prominence in their respective academic genres. Despite the attention each concept has received individually, no conceptual link has been established to depict how they actually interact with each other. We argue that the link between these two concepts present a novel way of looking at organizational performance. By doing so, we explore the potential of these two concepts working in tandem in order to increase organizational productivity which has significant implications for both academics and practitioners alike.

Keywords: agent-based modelling, disorganization, dynamic capabilities, performance

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148 Antecedents and Impacts of Human Capital Flight in the Sub-Saharan Africa with Specific Reference to the Higher Education Sector: Conceptual Model

Authors: Zelalem B. Gurmessa, Ignatius W. Ferreira, Henry F. Wissink

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The aim of this paper is to critically examine the factors contributing to academic brain drain in the Sub-Saharan Africa with specific reference to the higher education sector. Africa in general and Sub-Saharan African (SSA) countries, in particular, are experiencing an exodus of highly trained, qualified and competent human resources to other developing and developed countries thereby threatening the overall development of the relevant regions and impeding both public and private service delivery systems in the nation states. The region is currently in a dire situation in terms of health care services, education, science, and technology. The contribution of SSA countries to Science, Technology and Innovation is relatively minimal owing to the migration of skilled professionals due to both push and pull factors. The phenomenon calls for both international and trans-boundary, regional, national and institutional interventions to curb the exodus. Based on secondary data and the review of the literature, the article conceptualizes the antecedents and impacts of human capital flight or brain drain in the SSA countries from a higher education perspective. To this end, the article explores the magnitude, causes, and impacts of brain drain in the region. Despite the lack of consistent data on the magnitude of academic brain drain in the region, a critical analysis of the existing sources shows that pay disparity between developing and developed countries, the lack of enabling working conditions at source countries, fear of security due to political turmoil or unrest, the availability of green pastures and opportunity for development in the receiving countries were identified as major factors contributing to academic brain drain in the region. This hampers the socio-economic, technological and political development of the region. The paper also recommends that further research can be undertaken on the magnitude, causes, characteristics and impact of brain drain on the sustainability and competitiveness of SSA higher education institutions in the region.

Keywords: brain drain, higher education, sub-Saharan Africa, sustainable development

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147 Livestock Depredation by Large Predators: Patterns, Perceptions and Implications for Conservation and Livelihoods in Karakoram Mountain Ranges

Authors: Muhammad Zafar Khan, Babar Khan, Muhammad Saeed Awan, Farida Begum

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Livestock depredation has greater significance in pastoral societies like Himalaya-Karakoram-Hindu Kush mountain ranges. The dynamics of depredation by large predators (snow leopard and wolf) and its implications for conservation and livelihoods of local people was investigated by household surveys in Hushey valley of Central Karakoram National Park, Pakistan. We found that, during five years (2008-12) 90% of the households in the valley had lost their livestock to snow leopard and wolf, accounting for 4.3% of the total livestock holding per year. On average each household had to bear a loss of 0.8 livestock head per year, equivalent to Pak Rupees 9,853 (US$ 101), or 10% of the average annual cash income. Majority of the predation incidences occurred during late summer in alpine pastures, mostly at night when animals were not penned properly. The prey animals in most of the cases were females or young ones. Of the total predation incidences, 60% were attributed to snow leopard, 37% to wolf, while in 3% the predator was unknown. The fear of snow leopard is greater than that of wolf. As immediate response on predation, majority of the local people (64%, n=99) preferred to report the case to their village conservation committee, 32% had no response while only 1% tended to kill the predator. The perceived causes of predation were: poor guarding practices (77%); reduction in wild prey (13%) and livestock being the favourite food of predators (10%). The most preferred strategies for predator management, according to the respondents were improved and enhanced guarding of livestock (72%), followed by increasing wild prey (18%) and lethal control (10%). To strike a balance between predator populations and pastoral livelihoods, better animal husbandry practices should be promoted including: improved guarding through collective hiring of skilled shepherds; corral improvement and use of guard dogs.

Keywords: Panthera unica, Canis lupus, Karakoram, human-carnivore conflict, predation

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146 Beliefs, Attitudes, and Understanding of Childhood Cancer Among White and Latino Parents in the Phoenix Metropolitan Area: A Comparative Study

Authors: Florence Awde

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In 2023, it was expected 350 parents in Arizona would have a child receive a cancer diagnosis (Welcome Arizona Cancer Foundation For Children, n.d.). The news of a child’s diagnosis with cancer can be overwhelming and confusing, especially for those lucky enough to lack a personal tie to the disease that takes approximately 1800 children’s lives each year in the United States (Deegan et al., n.d.). A parent’s beliefs, attitudes, and understandings surrounding cancer are vital for medical staff to provide adequate and culturally competent care for each patient, especially across cultural and ethnic lines in regions housing multicultural populations. Arizona's cultural/linguistic mosaic houses many White and Latino populations and English and Spanish speakers. Variations in insurance coverage, from those insured through public insurance programs (e.g., Medicaid) or private insurance plans (e.g., employee-sponsored insurance) versus those uninsured, also factor into health-seeking attitudes and behaviors. To further understand parental attitudes, understandings, and beliefs towards childhood cancer, 22 parents (11 of Latino ethnicity, 11 of White ethnicity) were interviewed on these facets of childhood cancer, despite 21 of the 22 never having a child receive a cancer diagnosis. The exploration of these perceptions across ethnic lines revealed a higher report of fear-orientated beliefs amongst Latino parents--hypothesized to be rooted in the starkly contrasting lack of belief in the possibility of recovering for children with cancer, compared to their white counterparts who displayed more optimism in the recovery process. Further, this study’s results lay the foundation for future scholarship to explore avenues of information dispersal to Latino parents that correct misconceptions of health outcomes and enable earlier intervention to be possible, ultimately correlating to better health and treatment outcomes by increasing parental health literacy rates for childhood cancer in the Phoenix Metropolitan.

Keywords: Childhood Cancer, Parental Beliefs, Parental Attitudes, Parental Understandings, Phoenix Metropolitan, Culturally Competent Care, Health Disparities, Health Inequities

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145 The Threat of International Terrorism and Its Impact on UK Migration Policy and Practice

Authors: Baljit Soroya

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Transnational communities are as a consequence of greater mobility of people, globalization and digitization have had a major impact on international relations and diasporas in the context of external conflicts. To a significant extent conflicts are becoming deterritorialised and informed by both internal (state politics) and external (foreign policy) players such as in Iraq and Syria leading to forced migration of unprecedented levels within the last two decades. The situation of forced migrants has, it is suggested, worsened as a consequence of the neo-liberal policies and requirements of organizations such as the European Bank. A case example of this being that of Greece, and the exacerbation of insecurity for Greek nationals and the demonization of refugees seeking sanctuary. This has been as a consequence, in part, of the neoliberal dogma of the European Bank. The article analyses the complex intersection of the real and perceived threats of international terrorism and the manner in which UK migration policy and Practice is unfolding. The policy and practice developments are explored in the context of the shift in politics in both the UK and wider Europe to the far right and the drift of main stream political parties to the right. In many cases, the mainstream political groupings, have co-opted the fears as presented by far right organization for political their own political gains, such as in the UK and France In its analysis it will be argued that, whilst international terrorism is an issue of concern, however in the context of the UK it is not of the same scale as the effects of climate change or indeed domestic violence. Given that, the question has to be asked why the threat of international terrorism is having such an impact on UK migration policy and practice and, specifically refugees. Furthermore, it is argued that this policy and practice are being formulated within a narrative that portrays migrants as the problem both in relation to terrorism and the disenfranchisement of ‘ordinary white communities’. The intersectionality of social, economic inequalities, fear of international terrorism, increase in conflicts and the political climate have contributed to a lack of trust of political establishments that have in turn sought to impress the public with their anti-immigrant rhetoric and policy agendas. The article ends by suggesting that whilst politics and political affiliations have become fractured there are nevertheless spaces for collective action, particularly in relation to issues of refugees.

Keywords: international terrorism, migration policy, conflict, media, community, politics

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144 Reading Literacy, Storytelling and Cognitive Learning: an Effective Connection in Sustainability Education

Authors: Rosa Tiziana Bruno

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The connection between education and sustainability has been posited to have benefit for realizing a social development compatible with environmental protection. However, an educational paradigm based on the passage of information or on the fear of a catastrophe might not favor the acquisition of eco-identity. To build a sustainable world, it is necessary to "become people" in harmony with other human beings, being aware of belonging to the same human community that is part of the natural world. This can only be achieved within an authentic educating community and the most effective tools for building educating communities are reading literacy and storytelling. This paper is the report of a research-action carried out in this direction, in agreement with the sociology department of the University of Salerno, which involved four hundred children and their teachers in a path based on the combination of reading literacy, storytelling, autobiographical writing and outdoor education. The goal of the research was to create an authentic educational community within the school, capable to encourage the acquisition of an eco-identity by the pupils, that is, personal and relational growth in the full realization of the Self, in harmony with the social and natural environment, with a view to an authentic education for sustainability. To ensure reasonable validity and reliability of findings, the inquiry started with participant observation and a process of triangulation has been used including: semi-structured interview, socio-semiotic analysis of the conversation and time budget. Basically, a multiple independent sources of data was used to answer the questions. Observing the phenomenon through multiple "windows" helped to comparing data through a variety of lenses. All teachers had the experience of implementing a socio-didactic strategy called "Fiabadiario" and they had the possibility to use it with approaches that fit their students. The data being collected come from the very students and teachers who are engaged with this strategy. The educational path tested during the research has produced sustainable relationships and conflict resolution within the school system and between school and families, creating an authentic and sustainable learning community.

Keywords: educating community, education for sustainability, literature in education, social relations

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143 COVID-19 Case: A Definition of Infodemia through Online Italian Journalism

Authors: Concetta Papapicco

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The spreading of new Coronavirus (COVID-19) in addition to becoming a global phenomenon, following the declaration of a pandemic state, has generated excessive access to information, sometimes not thoroughly screened, which makes it difficult to navigate a given topic because of the difficulty of finding reliable sources. As a result, there is a high level of contagion, understood as the spread of the virus, but also as the spread of information in a viral and harmful way, which prompted the World Health Organization to coin the term Infodemia to give 'a name' the phenomenon of excessive information. With neologism 'Infodemia', the World Health Organization (OMS) wanted, in these days when fear of the coronavirus is raging, point out that perhaps the greatest danger of global society in the age of social media. This phenomenon is the distortion of reality in the rumble of echoes and comments of the global community on real or often invented facts. The general purpose of the exploratory study is to investigate how the coronavirus situation is described from journalistic communication. Starting from La Repubblica online, as a reference journalistic magazine, as a specific objective, the research aims to understand the way in which journalistic communication describes the phenomenon of the COVID-19 virus spread, the spread of contagion and restrictive measures of social distancing in the Italian context. The study starts from the hypothesis that if the circulation of information helps to create a social representation of the phenomenon, the excessive accessibility to sources of information (Infodemia) can be modulated by the 'how' the phenomenon is described by the journalists. The methodology proposed, in fact, in the exploratory study is a quanti-qualitative (mixed) method. A Content Analysis with the SketchEngine software is carried out first. In support of the Content Analysis, a Diatextual Analysis was carried out. The Diatextual Analysis is a qualitative analysis useful to detect in the analyzed texts, that is the online articles of La Repubblica on the topic of coronavirus, Subjectivity, Argomentativity, and Mode. The research focuses mainly on 'Mode' or 'How' are the events related to coronavirus in the online articles of La Repubblica about COVID-19 phenomenon. The results show the presence of the contrast vision about COVID-19 situation in Italy.

Keywords: coronavirus, Italian infodemia, La Republica online, mix method

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142 Enhancing Accessibility to Sexual and Reproductive Health Services and Rights: Inclusive Access Among Teen Mothers in Rwamagana District, Rwanda

Authors: Bagweneza Vedaste, Rugema Joselyne, Twagirayezu Innocent, Nikuze Bellancille, Nyirazigama Alice, Ishimwe Bazakare Marie Laetitia, Kaberuka Gerard, Mukeshimana Madeleine

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Background: Teen pregnancies have dramatically increased across the country in the past few years. Teen mothers usually face difficulties accessing the reproductive health (RH) services due to different reasons that include fear of getting discriminated or seen by other people. Some teen mothers do not also know their rights regarding the RH services, and they sometimes get discriminated. Little is known in Rwanda regarding how these teen mothers access the RH services compared to the general population, and views of teen mothers on their rights to access these services have not been clearly documented in the country. Specific Aims: To explore baseline information about SRH services among teen mothers; to explore factors that contribute to the use of SRH services among teen mothers; to identify strategies to increase awareness on SRHR (Sexual and Reproductive Health and Rights) among teen mothers in targeted area; and to explore views of teen mothers on rights for SRH services. Research design/Methodology: The qualitative exploratory descriptive research will be used among the teen mothers in five selected health centers of Rwamagana district. The study will use the qualitative descriptive study design. Setting: The study will be conducted in five selected health centers of Rwamagana district, which has been chosen due to a higher number of adolescent pregnancies in Eastern Province according to the DHS 2019-2020. Participants: The participants in this study will be teenage mothers who conceived after turning 11 but have delivered before turning 19. As the upper age for teenage is 19 years, this means that the researchers anticipated that those conceiving at 19 years may deliver in their twenties, which was the upper age limit in this study. Data collection measures: A semi-structured interview guide will be used to gather information from the respondents in focus group discussions. Significance: The findings of this study will provide a picture regarding the access of teen mothers to SRHS and their rights to SRH services. They will increase their awareness regarding SRH services and rights. Finally, the findings may help to address barriers faced by teen mothers to reach, pay and utilize SRHS.

Keywords: sexual and reproductive health services, inclusiveness, qualitative study, adolescent mothers

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141 Barriers to Health Promotion Advice Delivered by Paramedics and Emergency Department Nurses – Promoted Study

Authors: B. Schofield, F. Gul, S. McClean, R. Hoskins, R. Terry, U. Rolfe, A. Gibson, S. Voss, J. Benger

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Aim: The aim of this study is to determine whether and how health promotion activities are undertaken by paramedics and emergency department nurses and investigate ways of overcoming potential barriers. Background: Paramedics and emergency department nurses are uniquely placed to reach millions of people and could use these contacts as positive opportunities to help people improve their health by identifying people with risk factors and provide information, brief interventions, and signposting to locally provided services. These interventions can be carried out when the opportunity arises, typically take no more than a few minutes, have a low financial cost and can be a highly efficient method of health promotion. Methodology: Three NHS Emergency Departments and four Ambulance Trusts in England were recruited to the study. A link to an online survey was distributed to paramedics and emergency department nurses at participating sites. Staff were invited to participate in virtual semi-structured interviews. Patients seen, treated, and discharged at the participating sites were invited to virtual semistructured interviews. Findings: A total of 331 survey responses were received, 21 virtual semi-structured staff interviews and 11 patient interviews were completed. Staff reported lack of time to prioritise, lack of knowledge, resources, and confidence as barriers. Receptiveness of patients guided their decision to undertake health promotion activities. They reported a desire to learn how to undertake health promotion conversations. Emergency department nurses felt more supported than paramedics by their organisations to undertake health promotion activities. Patients were not aware of health promotion activities and reported fear and lack of privacy as barriers. Conclusions: These results will guide the development of an intervention to support the provision of health promotion by staff in urgent and emergency care settings. The components of the intervention will be mapped to a framework which will consider the needs of staff working within these settings, patients they treat, and organisational issues and practices related to the implementation of such an intervention.

Keywords: emergency service, hospital, nursing, allied health personnel, emergency medical services, health promotion

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140 Children of Quarantine: A Post COVID-19 Mental Health Dilemma

Authors: Salman Abdul Majeed, Vidur Solanki, Ruqiya Shama Tareen

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BACKGROUND: The COVID-19 pandemic has affected the way of living as we have known for all strata of society. While disease containment measures imposed by governmental agencies have been instrumental in controlling the spread of the virus, it has had profound collateral impacts on all populations. However, the disruption caused in the lives of one segment of population has been far more damaging than most others: the emotional wellbeing of our child and adolescent populations. This impact was even more pronounced in children who already suffered from neurodevelopmental or psychiatric disorders. In particular, school closures have not only led to profound social isolation, but also negative impacts on normal developmental opportunities and interruptions in mental health services obtained through school systems. It is too soon to understand the full impacts of quarantine, isolation, stress of social detachment and fear of pandemic, but we have started to see the devastating impact on C&A already. This review intends to shed light on the current understanding of psychiatric wellbeing of C&A during COVID-19 pandemic. METHOD: Literature search utilizing key words COVID-19 and children, quarantine and children, social isolation, Loneliness, pandemic stress and children, and mental health of children, disease containment measures was carried out. Over 200 articles were identified, out of which 81 articles were included in this review article. RESULTS: The disruption caused by COVID-19 in the lives of C&A is much more damaging and its impact is far reaching. The C&A ED visits for possible suicide attempts have jumped to 22.3% in 2020 and 39.1% during 2021. One study utilizing T1-weighted structural images, computed the thickness of cortical and subcortical structures including amygdala, hippocampus, and nucleus accumbens. The Peri-COVID group showed reduced cortical and subcortical thickness and more advanced brain aging compared to pre pandemic studies. CONCLUSION: Mental health resources for C&A remain under funded, neglected, and inaccessible to population that needs it most. Children with ongoing mental health disorders were impacted worst, along with those with predisposed biopsychosocial risk factors.

Keywords: COVID-19 and children, quarantine and children, social isolation, Loneliness, pandemic stress and children, disease containment measures, mental health of children

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139 Service Strategy And Innovation In The Food Service Industry: Basis For Designing A Competitive Advantage Model

Authors: Ma. Dina Datiles Jimenez

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Service strategy and service Innovation has something to do with the success of the foodservice business. The foodservice business nowadays has become more competitive, and technology driven. This study aimed to determine and investigate the service innovation and strategies of the food service industry and the challenges during the pandemic to serve as the basis for a competitive advantage model. The study used mixed methods, including descriptive quantitative and qualitative methods. The Metro Manila foodservice managers were the target population of the study, which consisted of an estimated 1500 respondents from the selected cities. The assessment of service innovation for the following dimensions: product-related dimension; market-related dimension; process-related dimension; and organization-related dimension, when classified according to profile, was very large for age, gender, and educational attainment. When respondents are classified according to profile, the service strategy in terms of customer service strategy, after-sales service strategy, maintenance service strategy, research and development-oriented service strategy, and operational services strategy were all assessed with a very large extent of implementation. There was a significant difference in all four aspects of service innovation when classified based on age. However, for gender, only the market and process dimensions showed significant differences, while the product and organization conveyed no significant differences. Consequently, the evidence was not enough to prove that educational attainment differs from one another on the four aspects of service innovation. There was sufficient evidence to prove that the ages differ from one another in all aspects of service strategies. While gender and educational attainment showed no significant difference in the assessment of service strategies, Training on the trends in the foodservice industry during the pandemic is offered; technical maintenance is evident; the company allotted budget for outsourcing training; the quality control system; and online customer feedback were revealed as major indicators for service strategy. Fear of viruses, limited customers, a minimal work force, and low revenues were identified as challenges faced by the foodservice industry.

Keywords: foodservice industry, service innovation, service strategy, competitive advantage, sustainability, technology

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138 The Role of Women in Criminal Organizations

Authors: Rossella Marzullo

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Family plays a central role in the Calabrian criminal organization, which draws its strength from blood ties and gender stereotypes that still impose a strong verticalization of intra-family relationships for the benefit of men. However, female figures are of great importance in the organizational structure of the 'Ndrangheta families, despite the fact that they appear to be formally suffocated by the culture of gender subordination still strongly present in the archaic world of criminal organizations. And this is so much true that over time, the women of the 'Ndrangheta have added to the function of ‘internal containment’, the increasingly explicit function of intermediaries in the ‘external’ activities of the clan. But what happens in the 'Ndrangheta if women break the bond and decide to speak? The results are shocking. When a woman starts talking to ask the institutions for help, the system ‘goes crazy’, because the woman is considered the means of consolidating and transmitting family codes: she educates, forges, holds the structure together. If a woman from the 'Ndrangheta decides to speak out and get out of the family bottlenecks of the clan, she does not exclusively destroy the family; she destroys the system. This happens because, while not playing the same roles as men within organizations, women carry out support activities as intermediaries for the circulation of communications, thus ensuring the operability of the gang in practice and on a daily basis. Crossing the border means breaking the bonds of belonging, thus questioning one's own identity and reconstructing it according to other points of reference. How much these disruptive choices are feared by the men of the 'Ndrangheta has been seen in the dramatic stories of Lea Garofalo and Maria Concetta Cacciola: the fear of the breaking of the family pact, of the earthquake that arises from within, has marked their fate of death, useful both to stop the judicial action and to recompose the organization's estate under the aegis of terror. With physical, psychological violence, underhanded torture, and moral blackmail, the men of the mafia family tried to heal the shock caused by the voices of women, relying on violence and yet another attempt to subordinate them. This proves that the 'Ndrangheta is really afraid of them. The female voices of the 'Ndrangheta, who have shaken a consolidated and considered intangible system, represent the anti-'ndrangheta par excellence; in their choices, there is an even stronger desire to break with the mafia world.

Keywords: families, gender, ‘Ndrangheta, stereotypes

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137 Gender, Sexual Diversity and Professional Practice Learning: Promoting the Equality of University Students

Authors: Caroline Bradbury-Jones, Maria Clark, Eleanor Molloy, Nicki Ward

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Background: Significant developments in the protection of Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) rights culminated in their inclusion in the Equality Act 2010. This provides legal protection against discrimination including the Public Sector Equality Duty requiring public bodies to consider all individuals when carrying out their day-to-day work. In the UK, whilst the Higher Education sector has made some commitment to eliminating discrimination and addressing LGBTQ inclusivity, there are two particular problems specifically affecting students on professional programmes: -All students will come into contact with LGBTQ patients/clients/students and need to be equipped to respond appropriately to their diverse needs but evidence suggests that this is not always the case. -Many LGBTQ students have specific concerns on professional placements; often ‘going back in the closet’ or feeling uncertain how to respond to questions about their personal lives and being reticent to challenge discrimination against LGBTQ patients/clients/students for fear of reprisal. Study aim: To investigate how best to prepare all students to deal with the issue of gender and sexual diversity and to support LGBTQ students in negotiating (non) disclosure in practice placements. Methods: This multi-method study was conducted in 2017 in the UK. It comprised a student survey, focus group interview with students and a national benchmarking exercise. Findings: Preliminary findings are that there is considerable variation across professional programmes regarding the preparation of students to respond to LGBTQ issues. Similarly, there is considerable difference between the level of preparedness experienced by students irrespective of whether they identify as LGBTQ. Discussion: Nationally there are a number of ‘best practice’ examples that we share in this presentation. These contain important details and guidance about how to better prepare university students for professional practice, and to contribute to eliminating discrimination and addressing LGBTQ inclusivity. Conclusions: The presentation will appeal to delegates who are interested in the equality agenda regarding LGBTQ people. The study findings will be discussed and debated to explore their impact on higher education and learning and to identify ways to integrate best practice into professional curricula across the UK and beyond.

Keywords: diversity, equality, practice, sexuality, students, university

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