Search results for: cognitive behavioral intervention
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4730

Search results for: cognitive behavioral intervention

380 From Forked Tongues to Tinkerbell Ears: Rethinking the Criminalization of Alternative Body Modification in the UK

Authors: Luci V. Hyett

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The criminal law of England and Wales currently deems that a person cannot consent to the infliction of injury upon their own body, where the level of harm is considered to be Actual or Grevious. This renders the defence of consent of the victim as being unavailable to those persons carrying out an Alternative Body Modification procedure. However, the criminalization of consensual injury is more appropriately deemed as being categorized as an offense against public morality and not one against the person, which renders the State’s involvement in the autonomous choices of a consenting adult, when determining what can be done to one’s own body, an arbitrary one. Furthermore, to recognise in law that a person is capable of giving a valid consent to socially acceptable cosmetic interventions that largely consist of procedures designed to aesthetically please men and, not those of people who want to modify their bodies for other reasons means that patriarchal attitudes are continuing to underpin public repulsion and inhibit social acceptance of such practices. Theoretical analysis will begin with a juridical examination of R v M(B) [2019] QB 1 where the High Court determined that Alternative Body Modification was not a special category exempting a person so performing from liability for Grevious Bodily Harm using the defence of consent. It will draw from its reasoning which considered that ‘the removal of body parts were medical procedures being carried out for no medical reason by someone not qualified to carry them out’ which will form the basis of this enquiry. It will consider the philosophical work of Georgio Agamben when analysing whether the biopolitical climate in the UK, which places the optimization of the perfect, healthy body at the centre of political concern can explain why those persons who wish to engage in Alternative Body Modification are treated as the ‘Exception’ to that which is normal using the ‘no medical reason’ canon to justify criminalisation, rather than legitimising the industry through regulation. It will consider, through a feminist lens, the current conflict in law between traditional cosmetic interventions which alter one’s physical appearance for socially accepted aesthetic purposes such as those to the breast, lip and buttock and, modifications described as more outlandish such as earlobe stretching, tooth filing and transdermal implants to create horns and spikes under the skin. It will assert that ethical principles relating to the psychological impact of body modification described as ‘alternative’ is used as a means to exclude person’s seeking such a procedure from receiving safe and competent treatment via a registered cosmetic surgeon which leads to these increasingly popular surgery’s being performed in Tattoo parlours throughout the UK as an extension to other socially acceptable forms of self-modification such as piercings. It will contend that only by ‘inclusive exclusion’ will those ‘othered’ through ostracisation be welcomed into the fold of normality and this can only be achieved through recognition of alternative body modification as a legitimate cosmetic intervention, subject to the same regulatory framework as existing practice. This would assist in refocusing the political landscape by erring on the side of liberty rather than that of biology.

Keywords: biopolitics, body modification, consent, criminal law

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379 Evaluating an Educational Intervention to Reduce Pesticide Exposure Among Farmers in Nigeria

Authors: Gift Udoh, Diane S. Rohlman, Benjamin Sindt

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BACKGROUND: There is concern regarding the widespread use of pesticides and impacts on public health. Farmers in Nigeria frequently apply pesticides, including organophosphate pesticides which are known neurotoxicants. They receive little guidance on how much to apply or information about safe handling practices. Pesticide poisoning is one of the major hazards that farmers face in Nigeria. Farmers continue to use highly neurotoxic pesticides for agricultural activities. Because farmers receive little or no information on safe handling and how much to apply, they continue to develop severe and mild illnesses caused by high exposures to pesticides. The project aimed to reduce pesticide exposure among rural farmers in Nigeria by identifying hazards associated with pesticide use and developing and pilot testing training to reduce exposures to pesticides utilizing the hierarchy of controls system. METHODS: Information on pesticide knowledge, behaviors, barriers to safety, and prevention methods was collected from farmers in Nigeria through workplace observations, questionnaires, and interviews. Pre and post-surveys were used to measure farmer’s knowledge before and after the delivery of pesticide safety training. Training topics included the benefits and risks of using pesticides, routes of exposure and health effects, pesticide label activity, use and selection of PPE, ways to prevent exposure and information on local resources. The training was evaluated among farmers and changes in knowledge, attitudes and behaviors were collected prior to and following the training. RESULTS: The training was administered to 60 farmers, a mean age of 35, with a range of farming experience (<1 year to > 50 years). There was an overall increase in knowledge after the training. In addition, farmers perceived a greater immediate risk from exposure to pesticides and their perception of their personal risk increased. For example, farmers believed that pesticide risk is greater to children than to adults, recognized that just because a pesticide is put on the market doesn’t mean it is safe, and they were more confident that they could get advice about handling pesticides. Also, there was greater awareness about behaviors that can increase their exposure (mixing pesticides with bare hands, eating food in the field, not washing hands before eating after applying pesticides, walking in fields recently sprayed, splashing pesticides on their clothes, pesticide storage). CONCLUSION: These results build on existing evidence from a 2022 article highlighting the need for pesticide safety training in Nigeria which suggested that pesticide safety educational programs should focus on community-based, grassroots-style, and involve a family-oriented approach. Educating farmers on agricultural safety while letting them share their experiences with their peers is an effective way of creating awareness on the dangers associated with handling pesticides. Also, for rural communities, especially in Nigeria, pesticide safety pieces of training may not be able to reach some locations, so intentional scouting of rural farming communities and delivering pesticide safety training will improve knowledge of pesticide hazards. There is a need for pesticide information centers to be situated in rural farming communities or agro supply stores, which gives rural farmers information.

Keywords: pesticide exposure, pesticide safety, nigeria, rural farming, pesticide education

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378 Building User Behavioral Models by Processing Web Logs and Clustering Mechanisms

Authors: Madhuka G. P. D. Udantha, Gihan V. Dias, Surangika Ranathunga

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Today Websites contain very interesting applications. But there are only few methodologies to analyze User navigations through the Websites and formulating if the Website is put to correct use. The web logs are only used if some major attack or malfunctioning occurs. Web Logs contain lot interesting dealings on users in the system. Analyzing web logs has become a challenge due to the huge log volume. Finding interesting patterns is not as easy as it is due to size, distribution and importance of minor details of each log. Web logs contain very important data of user and site which are not been put to good use. Retrieving interesting information from logs gives an idea of what the users need, group users according to their various needs and improve site to build an effective and efficient site. The model we built is able to detect attacks or malfunctioning of the system and anomaly detection. Logs will be more complex as volume of traffic and the size and complexity of web site grows. Unsupervised techniques are used in this solution which is fully automated. Expert knowledge is only used in validation. In our approach first clean and purify the logs to bring them to a common platform with a standard format and structure. After cleaning module web session builder is executed. It outputs two files, Web Sessions file and Indexed URLs file. The Indexed URLs file contains the list of URLs accessed and their indices. Web Sessions file lists down the indices of each web session. Then DBSCAN and EM Algorithms are used iteratively and recursively to get the best clustering results of the web sessions. Using homogeneity, completeness, V-measure, intra and inter cluster distance and silhouette coefficient as parameters these algorithms self-evaluate themselves to input better parametric values to run the algorithms. If a cluster is found to be too large then micro-clustering is used. Using Cluster Signature Module the clusters are annotated with a unique signature called finger-print. In this module each cluster is fed to Associative Rule Learning Module. If it outputs confidence and support as value 1 for an access sequence it would be a potential signature for the cluster. Then the access sequence occurrences are checked in other clusters. If it is found to be unique for the cluster considered then the cluster is annotated with the signature. These signatures are used in anomaly detection, prevent cyber attacks, real-time dashboards that visualize users, accessing web pages, predict actions of users and various other applications in Finance, University Websites, News and Media Websites etc.

Keywords: anomaly detection, clustering, pattern recognition, web sessions

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377 Depth of Field: Photographs, Narrative and Reflective Learning Resource for Health Professions Educators

Authors: Gabrielle Brand, Christopher Etherton-Beer

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The learning landscape of higher education environment is changing, with an increased focus over the past decade on how educators might begin to cultivate reflective skills in health professions students. In addition, changing professional requirements demand that health professionals are adequately prepared to practice in today’s complex Australian health care systems, including responding to changing demographics of population ageing. To counteract a widespread perception of health professions students’ disinterest in caring for older persons, the authors will report on an exploratory, mixed method research study that used photographs, narrative and small group work to enhance medical and nursing students’ reflective learning experience. An innovative photo-elicitation technique and reflective questioning prompts were used to increase engagement, and challenge students to consider new perspectives (around ageing) by constructing shared storylines in small groups. The qualitative themes revealed how photographs, narratives and small group work created learning spaces for reflection whereby students could safely explore their own personal and professional values, beliefs and perspectives around ageing. By providing the space for reflection, the students reported how they found connection and meaning in their own learning through a process of self-exploration that often challenged their assumptions of both older people and themselves as future health professionals. By integrating cognitive and affective elements into the learning process, this research demonstrates the importance of embedding visual methodologies that enhance reflection and transformative learning. The findings highlight the importance of integrating the arts into predominantly empirically driven health professional curricula and can be used as a catalyst for individual and/or collective reflection which can potentially enhance empathy, insight and understanding of the lived experiences of older patients. Based on these findings, the authors have developed ‘Depth of Field: Exploring Ageing’ an innovative, interprofessional, digital reflective learning resource that uses Prezi Inc. software (storytelling tool that presents ideas on a virtual canvas) to enhance students’ reflective capacity in the higher education environment.

Keywords: narrative, photo-elicitation, reflective learning, qualitative research

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376 A Case Study on Experiences of Clinical Preceptors in the Undergraduate Nursing Program

Authors: Jacqueline M. Dias, Amina A Khowaja

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Clinical education is one of the most important components of a nursing curriculum as it develops the students’ cognitive, psychomotor and affective skills. Clinical teaching ensures the integration of knowledge into practice. As the numbers of students increase in the field of nursing coupled with the faculty shortage, clinical preceptors are the best choice to ensure student learning in the clinical settings. The clinical preceptor role has been introduced in the undergraduate nursing programme. In Pakistan, this role emerged due to a faculty shortage. Initially, two clinical preceptors were hired. This study will explore clinical preceptors views and experiences of precepting Bachelor of Science in Nursing (BScN) students in an undergraduate program. A case study design was used. As case studies explore a single unit of study such as a person or very small number of subjects; the two clinical preceptors were fundamental to the study and served as a single case. Qualitative data were obtained through an iterative process using in depth interviews and written accounts from reflective journals that were kept by the clinical preceptors. The findings revealed that the clinical preceptors were dedicated to their roles and responsibilities. Another, key finding was that clinical preceptors’ prior knowledge and clinical experience were valuable assets to perform their role effectively. The clinical preceptors found their new role innovative and challenging; it was stressful at the same time. Findings also revealed that in the clinical agencies there were unclear expectations and role ambiguity. Furthermore, clinical preceptors had difficulty integrating theory into practice in the clinical area and they had difficulty in giving feedback to the students. Although this study is localized to one university, generalizations can be drawn from the results. The key findings indicate that the role of a clinical preceptor is demanding and stressful. Clinical preceptors need preparation prior to precepting students on clinicals. Also, institutional support is fundamental for their acceptance. This paper focuses on the views and experiences of clinical preceptors undertaking a newly established role and resonates with the literature. The following recommendations are drawn to strengthen the role of the clinical preceptors: A structured program for clinical preceptors is needed along with mentorship. Clinical preceptors should be provided with formal training in teaching and learning with emphasis on clinical teaching and giving feedback to students. Additionally, for improving integration of theory into practice, clinical modules should be provided ahead of the clinical. In spite of all the challenges, ten more clinical preceptors have been hired as the faculty shortage continues to persist.

Keywords: baccalaureate nursing education, clinical education, clinical preceptors, nursing curriculum

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375 Covid-19 Lockdown Experience of Elderly Female as Reflected in Their Artwork

Authors: Liat Shamri-Zeevi, Neta Ram-Vlasov

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Today the world as a whole is attempting to cope with the COVID-19, which has affected all facets of personal and social life from country-wide confinement to maintaining social distance and taking protective measures to maintain hygiene. One of the populations faced with the most severe restrictions is seniors. Various studies have shown that creativity plays a crucial role in dealing with crisis events. Painting - regardless of media - allows for emotional and cognitive processing of these situations, and enables the expression of experiences in a tangible creative way that conveys and endows meaning to the artwork. The current study was conducted in Israel immediately after a 6-week lockdown. It was designed to specifically examine the impact of the COVID-19 pandemic on the quality of life of elderly women as reflected in their artworks. The sample was composed of 21 Israeli women aged 60-90, in good mental health (without diagnosed dementia or Alzheimer's), all of whom were Hebrew-speaking, and retired with an extended family, who indicated that they painted and had engaged in artwork on an ongoing basis throughout the lockdown (from March 12 to May 30, 2020). The participants' artworks were collected, and a semi-structured in-depth interview was conducted that lasted one to two hours. The participants were asked about their feelings during the pandemic and the artworks they produced during this time, and completed a questionnaire on well-being and mental health. The initial analysis of the interviews and artworks revealed themes related to the specific role of each piece of artwork. The first theme included notions that the artwork was an activity and a framework for doing, which supported positive emotions, and provided a sense of vitality during the closure. Most of the participants painted images of nature and growth which were ascribed concrete and symbolic meaning. The second theme was that the artwork enabled the processing of difficult and /or conflicting emotions related to the situation, including anxiety about death and loneliness that were symbolically expressed in the artworks, such as images of the Corona virus and the respiratory machines. The third theme suggested that the time and space prompted by the lockdown gave the participants time for a gathering together of the self, and freed up time for creative activities. Many participants stated that they painted more and more frequently during the Corona lockdown. At the conference, additional themes and findings will be presented.

Keywords: Corona virus, artwork, quality of life of elderly

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374 Estimating the Relationship between Education and Political Polarization over Immigration across Europe

Authors: Ben Tappin, Ryan McKay

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The political left and right appear to disagree not only over questions of value but, also, over questions of fact—over what is true “out there” in society and the world. Alarmingly, a large body of survey data collected during the past decade suggests that this disagreement tends to be greatest among the most educated and most cognitively sophisticated opposing partisans. In other words, the data show that these individuals display the widest political polarization in their reported factual beliefs. Explanations of this polarization pattern draw heavily on cultural and political factors; yet, the large majority of the evidence originates from one cultural and political context—the United States, a country with a rather unique cultural and political history. One consequence is that widening political polarization conditional on education and cognitive sophistication may be due to idiosyncratic cultural, political or historical factors endogenous to US society—rather than a more general, international phenomenon. We examined widening political polarization conditional on education across Europe, over a topic that is culturally and politically contested; immigration. To do so, we analyzed data from the European Social Survey, a premier survey of countries in and around the European area conducted biennially since 2002. Our main results are threefold. First, we see widening political polarization conditional on education over beliefs about the economic impact of immigration. The foremost countries showing this pattern are the most influential in Europe: Germany and France. However, we also see heterogeneity across countries, with some—such as Belgium—showing no evidence of such polarization. Second, we find that widening political polarization conditional on education is a product of sorting. That is, highly educated partisans exhibit stronger within-group consensus in their beliefs about immigration—the data do not support the view that the more educated partisans are more polarized simply because the less educated fail to adopt a position on the question. Third, and finally, we find some evidence that shocks to the political climate of countries in the European area—for example, the “refugee crisis” of summer 2015—were associated with a subsequent increase in political polarization over immigration conditional on education. The largest increase was observed in Germany, which was at the centre of the so-called refugee crisis in 2015. These results reveal numerous insights: they show that widening political polarization conditional on education is not restricted to the US or native English-speaking culture; that such polarization emerges in the domain of immigration; that it is a product of within-group consensus among the more educated; and, finally, that exogenous shocks to the political climate may be associated with subsequent increases in political polarization conditional on education.

Keywords: beliefs, Europe, immigration, political polarization

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373 Prevalence and Associated Risk Factors of Age-Related Macular Degeneration in the Retina Clinic at a Tertiary Center in Makkah Province, Saudi Arabia: A Retrospective Record Review

Authors: Rahaf Mandura, Fatmah Abusharkh, Layan Kurdi, Rahaf Shigdar, Khadijah Alattas

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Introduction: Age-related macular degeneration (AMD) in older individuals are serious health issues that severely impact the quality of life of millions globally. In 2020, the fourth leading cause of blindness worldwide was AMD. The global prevalence of AMD is estimated to be around 8.7%. AMD is a progressive disease involving the macular region of the retina, and it has a complex pathophysiology. RPE cell dysfunction plays a crucial step in the pathway leading to irreversible degeneration of photoreceptors with yellowish lipid-rich, protein-containing drusen deposits accumulating between Bruch's membrane and the RPE. Furthermore, lipofuscinogenesis, drusogenesis, inflammation, and neovascularization are four main processes responsible for the formation of the two types of AMD: the wet (exudative, neovascular) and dry (non-exudative, geographic atrophy) types. We retrospectively evaluated the prevalence of AMD among patients visiting the retina clinic at King Abdulaziz University Hospital (Jeddah, Makkah Province, Saudi Arabia) to identify the commonly associated risk factors of AMD. Methods: The records of 3,067 individuals from 2017 to 2021 were reviewed. Of these, 1,935 satisfied the inclusion criteria and were included in this study. We excluded all patient below 18 years, and those who did not undergo fundus imaging or attend their booked appointments, follow-ups, treatments, and referrals were excluded. Results: The prevalence of AMD among the patients was 4%. The age of patients with AMD was significantly greater than those without AMD (72.4 ± 9.8 years vs. 57.2 ± 15.5 years; p < 0.001). Participants with a family history of AMD tended to have the disease more than those without such a history (85.7% vs. 45%; p = 0.043). Ex- and current smokers were more likely to have AMD than non-smokers (34% and 18.6% vs. 7.2%; p < 0.001). Patients with hypertension and those without type 1 diabetes were at a higher risk of developing AMD than those without hypertension (5.5% vs. 2.8%; p = 0.002) and those with type 1 diabetes (4.2% vs. 0.8%; p = 0.040). In contrast, sex, nationality, type 2 diabetes, and abnormal lipid profile were not significantly associated with AMD. Regarding the clinical characteristics of AMD cases, most cases (70.4%) were of the dry type and affected both eyes (77.2%). The disease duration was ≥5 years in 43.1% of the patients. The most frequent chronic diseases associated with AMD were type 2 diabetes (69.1%), hypertension (61.7%), and dyslipidemia (18.5%). Conclusion: In summary, our single tertiary center study showed that AMD is widely prevalent in Jeddah, Saudi Arabia (4%) and linked to a wide range of risk factors. Some of these are modifiable risk factors that can be adjusted to help reduce AMD occurrence. Furthermore, this study has shown the importance of screening and follow-up of family members of patients with AMD to promote early detection and intervention of AMD. We recommend conducting further research on AMD in Saudi Arabia. Concerning the study design, a community-based cross-sectional study would be more helpful for assessing the disease's prevalence. Finally, recruiting a larger sample size is required for more accurate estimation.

Keywords: age related macular degeneration, prevelence, risk factor, dry AMD

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372 The Development of the Psychosomatic Nursing Model from an Evidence-Based Action Research on Proactive Mental Health Care for Medical Inpatients

Authors: Chia-Yi Wu, Jung-Chen Chang, Wen-Yu Hu, Ming-Been Lee

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In nearly all physical health conditions, suicide risk is increased compared to healthy people even after adjustment for age, gender, mental health, and substance use diagnoses. In order to highlight the importance of suicide risk assessment for the inpatients and early identification and engagement for inpatients’ mental health problems, a study was designed aiming at developing a comprehensive psychosomatic nursing engagement (PSNE) model with standardized operation procedures informing how nurses communicate, assess, and engage with the inpatients with emotional distress. The purpose of the study was to promote the gatekeeping role of clinical nurses in performing brief assessment and interventions to detect depression and anxiety symptoms among the inpatients, particularly in non-psychiatric wards. The study will be carried out in a 2000-bed university hospital in Northern Taiwan in 2019. We will select a ward for trial and develop feasible procedures and in-job training course for the nurses to offer mental health care, which will also be validated through professional consensus meeting. The significance of the study includes the following three points: (1) The study targets at an important but less-researched area of PSNE model in the cultural background of Taiwan, where hospital service is highly accessible, but mental health and suicide risk assessment are hardly provided by non-psychiatric healthcare personnel. (2) The issue of PSNE could be efficient and cost-effective in the identification of suicide risks at an early stage to prevent inpatient suicide or to reduce future suicide risk by early treatment of mental illnesses among the high-risk group of hospitalized patients who are more than three-times lethal to suicide. (3) Utilizing a brief tool with its established APP ('The Five-item Brief Symptom Rating Scale, BSRS-5'), we will invent the standardized procedure of PSNE and referral steps in collaboration with the medical teams across the study hospital. New technological tools nested within nursing assessment/intervention will concurrently be invented to facilitate better care quality. The major outcome measurements will include tools for early identification of common mental distress and suicide risks, i.e., the BSRS-5, revised BSRS-5, and the 9-item Concise Mental Health Checklist (CMHC-9). The main purpose of using the CMHC-9 in clinical suicide risk assessment is mainly to provide care and build-up therapeutic relationship with the client, so it will also be used to nursing training highlighting the skills of supportive care. Through early identification of the inpatients’ depressive symptoms or other mental health care needs such as insomnia, anxiety, or suicide risk, the majority of the nursing clinicians would be able to engage in critical interventions that alleviate the inpatients’ suffering from mental health problems, given a feasible nursing input.

Keywords: mental health care, clinical outcome improvement, clinical nurses, suicide prevention, psychosomatic nursing

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371 Case-Based Reasoning for Modelling Random Variables in the Reliability Assessment of Existing Structures

Authors: Francesca Marsili

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The reliability assessment of existing structures with probabilistic methods is becoming an increasingly important and frequent engineering task. However probabilistic reliability methods are based on an exhaustive knowledge of the stochastic modeling of the variables involved in the assessment; at the moment standards for the modeling of variables are absent, representing an obstacle to the dissemination of probabilistic methods. The framework according to probability distribution functions (PDFs) are established is represented by the Bayesian statistics, which uses Bayes Theorem: a prior PDF for the considered parameter is established based on information derived from the design stage and qualitative judgments based on the engineer past experience; then, the prior model is updated with the results of investigation carried out on the considered structure, such as material testing, determination of action and structural properties. The application of Bayesian statistics arises two different kind of problems: 1. The results of the updating depend on the engineer previous experience; 2. The updating of the prior PDF can be performed only if the structure has been tested, and quantitative data that can be statistically manipulated have been collected; performing tests is always an expensive and time consuming operation; furthermore, if the considered structure is an ancient building, destructive tests could compromise its cultural value and therefore should be avoided. In order to solve those problems, an interesting research path is represented by investigating Artificial Intelligence (AI) techniques that can be useful for the automation of the modeling of variables and for the updating of material parameters without performing destructive tests. Among the others, one that raises particular attention in relation to the object of this study is constituted by Case-Based Reasoning (CBR). In this application, cases will be represented by existing buildings where material tests have already been carried out and an updated PDFs for the material mechanical parameters has been computed through a Bayesian analysis. Then each case will be composed by a qualitative description of the material under assessment and the posterior PDFs that describe its material properties. The problem that will be solved is the definition of PDFs for material parameters involved in the reliability assessment of the considered structure. A CBR system represent a good candi¬date in automating the modelling of variables because: 1. Engineers already draw an estimation of the material properties based on the experience collected during the assessment of similar structures, or based on similar cases collected in literature or in data-bases; 2. Material tests carried out on structure can be easily collected from laboratory database or from literature; 3. The system will provide the user of a reliable probabilistic description of the variables involved in the assessment that will also serve as a tool in support of the engineer’s qualitative judgments. Automated modeling of variables can help in spreading probabilistic reliability assessment of existing buildings in the common engineering practice, and target at the best intervention and further tests on the structure; CBR represents a technique which may help to achieve this.

Keywords: reliability assessment of existing buildings, Bayesian analysis, case-based reasoning, historical structures

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370 Ankle Fracture Management: A Unique Cross Departmental Quality Improvement Project

Authors: Langhit Kurar, Loren Charles

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Introduction: In light of recent BOAST 12 (August 2016) published guidance on management of ankle fractures, the project aimed to highlight key discrepancies throughout the care trajectory from admission to point of discharge at a district general hospital. Wide breadth of data covering three key domains: accident and emergency, radiology, and orthopaedic surgery were subsequently stratified and recommendations on note documentation, and outpatient follow up were made. Methods: A retrospective twelve month audit was conducted reviewing results of ankle fracture management in 37 patients. Inclusion criterion involved all patients seen at Darent Valley Hospital (DVH) emergency department with radiographic evidence of an ankle fracture. Exclusion criterion involved all patients managed solely by nursing staff or having sustained purely ligamentous injury. Medical notes, including discharge summaries and the PACS online radiographic tool were used for data extraction. Results: Cross-examination of the A & E domain revealed limited awareness of the BOAST 12 recent publication including requirements to document skin integrity and neurovascular assessment. This had direct implications as this would have changed the surgical plan for acutely compromised patients. The majority of results obtained from the radiographic domain were satisfactory with appropriate X-rays taken in over 95% of cases. However, due to time pressures within A & E, patients were often left without a post manipulation XRAY in a backslab. Poorly reduced fractures were subsequently left for a long period resulting in swollen ankles and a time-dependent lag to surgical intervention. This had knocked on implications for prolonged inpatient stay resulting in hospital-acquired co-morbidity including pressure sores. Discussion: The audit has highlighted several areas of improvement throughout the disease trajectory from review in the emergency department to follow up as an outpatient. This has prompted the creation of an algorithm to ensure patients with significant fractures presenting to the emergency department are seen promptly and treatment expedited as per recent guidance. This includes timing for X-rays taken in A & E. Re-audit has shown significant improvement in both documentation at time of presentation and appropriate follow-up strategies. Within the orthopedic domain, we are in the process of creating an ankle fracture pathway to ensure imaging and weight bearing status are made clear to the consulting clinicians in an outpatient setting. Significance/Clinical Relevance: As a result of the ankle fracture algorithm we have adapted the BOAST 12 guidance to shape an intrinsic pathway to not only improve patient management within the emergency department but also create a standardised format for follow up.

Keywords: ankle, fracture, BOAST, radiology

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369 An Ethnographic Study of Workforce Integration of Health Care Workers with Refugee Backgrounds in Ageing Citizens in Germany

Authors: A. Ham, A. Kuckert-Wostheinrich

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Demographic changes, like the ageing population in European countries and shortage of nursing staff, the increasing number of people with severe cognitive impairment, and elderly socially isolated people raise important questions about who will provide long-term care for ageing citizens. Due to the so-called refugee crisis in 2015, some health care institutions for ageing citizens in Europe invited first generation immigrants to start a nursing career and providing them language skills, nursing training, and internships. The aim of this ethnographic research was to explore the social processes affecting workforce integration and how newcomers enact good care in ageing citizens in a German nursing home. By ethnographic fieldwork, 200 hours of participant observations, 25 in-depth interviews with immigrants and established staff, 2 focus groups with 6 immigrants, and 6 established staff members, data were analysed. The health care institution provided the newcomers a nursing program on psychogeriatric theory and nursing skills in the psychogeriatric field and professional oriented language skills. Courses of health prevention and theater plays accompanied the training. The knowledge learned in education could be applied in internships on the wards. Additionally, diversity and inclusivity courses were given to established personal for cultural awareness and sensitivity. They learned to develop a collegial attitude of respect and appreciation, regardless of gender, nationality, ethnicity, religion or belief, age sexual orientation, or disability and identity. The qualitative data has shown that social processes affected workforce integration, like organizational constraints, staff shortages, and a demanding workload. However, zooming in on the interactions between newcomers and residents, we noticed how they tinkered to enact good care by embodied caring, playing games, singing and dancing. By situational acting and practical wisdom in nursing care, the newcomers could meet the needs of ageing residents. Thus, when health care institutions open up nursing programs for newcomers with refugees’ backgrounds and focus on talent instead of shortcomings, we might as well stimulate the unknown competencies, attitudes, skills, and expertise of newcomers and create excellent nurses for excellent care.

Keywords: established staff, Germany, nursing, refugees

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368 Learning with Music: The Effects of Musical Tension on Long-Term Declarative Memory Formation

Authors: Nawras Kurzom, Avi Mendelsohn

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The effects of background music on learning and memory are inconsistent, partly due to the intrinsic complexity and variety of music and partly to individual differences in music perception and preference. A prominent musical feature that is known to elicit strong emotional responses is musical tension. Musical tension can be brought about by building anticipation of rhythm, harmony, melody, and dynamics. Delaying the resolution of dominant-to-tonic chord progressions, as well as using dissonant harmonics, can elicit feelings of tension, which can, in turn, affect memory formation of concomitant information. The aim of the presented studies was to explore how forming declarative memory is influenced by musical tension, brought about within continuous music as well as in the form of isolated chords with varying degrees of dissonance/consonance. The effects of musical tension on long-term memory of declarative information were studied in two ways: 1) by evoking tension within continuous music pieces by delaying the release of harmonic progressions from dominant to tonic chords, and 2) by using isolated single complex chords with various degrees of dissonance/roughness. Musical tension was validated through subjective reports of tension, as well as physiological measurements of skin conductance response (SCR) and pupil dilation responses to the chords. In addition, music information retrieval (MIR) was used to quantify musical properties associated with tension and its release. Each experiment included an encoding phase, wherein individuals studied stimuli (words or images) with different musical conditions. Memory for the studied stimuli was tested 24 hours later via recognition tasks. In three separate experiments, we found positive relationships between tension perception and physiological measurements of SCR and pupil dilation. As for memory performance, we found that background music, in general, led to superior memory performance as compared to silence. We detected a trade-off effect between tension perception and memory, such that individuals who perceived musical tension as such displayed reduced memory performance for images encoded during musical tension, whereas tense music benefited memory for those who were less sensitive to the perception of musical tension. Musical tension exerts complex interactions with perception, emotional responses, and cognitive performance on individuals with and without musical training. Delineating the conditions and mechanisms that underlie the interactions between musical tension and memory can benefit our understanding of musical perception at large and the diverse effects that music has on ongoing processing of declarative information.

Keywords: musical tension, declarative memory, learning and memory, musical perception

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367 The Quantum Theory of Music and Human Languages

Authors: Mballa Abanda Luc Aurelien Serge, Henda Gnakate Biba, Kuate Guemo Romaric, Akono Rufine Nicole, Zabotom Yaya Fadel Biba, Petfiang Sidonie, Bella Suzane Jenifer

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The main hypotheses proposed around the definition of the syllable and of music, of the common origin of music and language, should lead the reader to reflect on the cross-cutting questions raised by the debate on the notion of universals in linguistics and musicology. These are objects of controversy, and there lies its interest: the debate raises questions that are at the heart of theories on language. It is an inventive, original, and innovative research thesis. A contribution to the theoretical, musicological, ethno musicological, and linguistic conceptualization of languages, giving rise to the practice of interlocution between the social and cognitive sciences, the activities of artistic creation, and the question of modeling in the human sciences: mathematics, computer science, translation automation, and artificial intelligence. When you apply this theory to any text of a folksong of a world-tone language, you do not only piece together the exact melody, rhythm, and harmonies of that song as if you knew it in advance but also the exact speaking of this language. The author believes that the issue of the disappearance of tonal languages and their preservation has been structurally resolved, as well as one of the greatest cultural equations related to the composition and creation of tonal, polytonal, and random music. The experimentation confirming the theorization, I designed a semi-digital, semi-analog application that translates the tonal languages of Africa (about 2,100 languages) into blues, jazz, world music, polyphonic music, tonal and anatonal music, and deterministic and random music). To test this application, I use music reading and writing software that allows me to collect the data extracted from my mother tongue, which is already modeled in the musical staves saved in the ethnographic (semiotic) dictionary for automatic translation ( volume 2 of the book). The translation is done (from writing to writing, from writing to speech, and from writing to music). Mode of operation: you type a text on your computer, a structured song (chorus-verse), and you command the machine a melody of blues, jazz, and world music or variety, etc. The software runs, giving you the option to choose harmonies, and then you select your melody.

Keywords: language, music, sciences, quantum entenglement

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366 Intercultural Competence among Jewish and Arab Students Studying Together in an Academic Institution in Israel

Authors: Orly Redlich

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Since the establishment of the state of Israel, and as a result of various events that led to it, Jewish citizens and Arab citizens of the state have been in constant conflict, which finds its expression in most levels of life. Therefore, the attitude of one group member to the other group members is mostly tense, loaded, and saturated with mutual suspicion. Within this reality, in many higher education institutions in Israel, Jews and Arabs meet with each other intensively and for several years. For some students, this is their first opportunity for a meaningful cross-cultural encounter. These intercultural encounters, which allow positive interactions between members of different cultural groups, may contribute to the formation of "intercultural competence" which means long-term change in knowledge, attitudes, and behavior towards 'the other culture'. The current study examined the concept of the ‘other’ among Jewish and Arab students studying together and their "intercultural competence". The study also examined whether there is a difference in the perception of the ‘other’ between students studying in different academic programs, and between students taking academic courses on multiculturalism. This quantitative study was conducted among 274 Arab and Jewish students studying together, for bachelors or master's degree, in various academic programs at the Israel Academic College of Ramat-Gan. The background data of the participants are varied, in terms of religion, origin, religiosity, employment status, living area, and marital status. The main hypothesis is that academic, social, and intercultural encounters between Jewish and Arab students, who attend college together, will be a significant factor in building "intercultural competence". Additionally, the existence of "intercultural competence" has been linked to demographic characteristics of the students, as well as the nature of intercultural encounters between Jews and Arabs in a higher education institution. The dependent variables were measured by a self-report questionnaire, using the components of '"intercultural competence"' among students, which are: 1. Cognitive knowledge of the ‘others’, 2. Feelings towards the ‘others’, 3. Change in attitudes towards the 'others', and 4. Change in behavior towards the ‘others’. The findings indicate a higher "intercultural competence" among Arab students than Jews; it was also found higher level of "intercultural competence" among Educational Counseling students than the other respondents. The importance of this research lies in finding the means to develop "intercultural competence" among Jewish and Arab students, which may reduce prejudice and stereotypes towards the other culture and may even prevent occurrences of alienation and violence in cross-cultural encounters in Israel.

Keywords: cross-cultural learning, intercultural competence, Jewish and Arab students, multiculturalism

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365 Foundations for Global Interactions: The Theoretical Underpinnings of Understanding Others

Authors: Randall E. Osborne

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In a course on International Psychology, 8 theoretical perspectives (Critical Psychology, Liberation Psychology, Post-Modernism, Social Constructivism, Social Identity Theory, Social Reduction Theory, Symbolic Interactionism, and Vygotsky’s Sociocultural Theory) are used as a framework for getting students to understand the concept of and need for Globalization. One of critical psychology's main criticisms of conventional psychology is that it fails to consider or deliberately ignores the way power differences between social classes and groups can impact the mental and physical well-being of individuals or groups of people. Liberation psychology, also known as liberation social psychology or psicología social de la liberación, is an approach to psychological science that aims to understand the psychology of oppressed and impoverished communities by addressing the oppressive sociopolitical structure in which they exist. Postmodernism is largely a reaction to the assumed certainty of scientific, or objective, efforts to explain reality. It stems from a recognition that reality is not simply mirrored in human understanding of it, but rather, is constructed as the mind tries to understand its own particular and personal reality. Lev Vygotsky argued that all cognitive functions originate in, and must therefore be explained as products of social interactions and that learning was not simply the assimilation and accommodation of new knowledge by learners. Social Identity Theory discusses the implications of social identity for human interactions with and assumptions about other people. Social Identification Theory suggests people: (1) categorize—people find it helpful (humans might be perceived as having a need) to place people and objects into categories, (2) identify—people align themselves with groups and gain identity and self-esteem from it, and (3) compare—people compare self to others. Social reductionism argues that all behavior and experiences can be explained simply by the affect of groups on the individual. Symbolic interaction theory focuses attention on the way that people interact through symbols: words, gestures, rules, and roles. Meaning evolves from human their interactions in their environment and with people. Vygotsky’s sociocultural theory of human learning describes learning as a social process and the origination of human intelligence in society or culture. The major theme of Vygotsky’s theoretical framework is that social interaction plays a fundamental role in the development of cognition. This presentation will discuss how these theoretical perspectives are incorporated into a course on International Psychology, a course on the Politics of Hate, and a course on the Psychology of Prejudice, Discrimination and Hate to promote student thinking in a more ‘global’ manner.

Keywords: globalization, international psychology, society and culture, teaching interculturally

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364 E-Commerce Product Return Management Effects on Consumer Experience and Satisfaction: A Fast-Fashion Perspective

Authors: Nora Alomar, Bianca Alexandra Stefa, Saleh Bazi

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This research uncovers the determinants that drive millennial consumers to adhere to product return of fast-fashion products purchases via e-commerce and what effects it has on consumer experience and satisfaction. Online consumption has skyrocketed, with e-commerce being the only, most reliable, and safe method of shopping during and post Covid-19. It has been noted customers are demanding a wide variety of product characteristics and a generous optimal return policy. The authors have selected to examine millennial consumers as they are digital natives and have an affinity for researching, reading product reviews, and shopping online, with a great spending power due to a higher disposable income in comparison to other generations. A multi-study approach is adopted, where study one (interviews, sample of 20 respondents) investigates the factors that drive product return, and study two (PLS-SEM, sample of 250 respondents) looks into the relationships of product return management against behavioral outcomes by having the generated factors (from study one) as moderators. Five themes are generated from study one (return policies, product characteristics, delivery lead time, seasonality, product trial & overspending). The authors identify that two out of the five factors (seasonality, product trial & overspending) have not been highlighted by the literature. The paper examines 11 hypotheses, where 10 are supported. Findings highlight the quality of the product return management influences the overall millennial customer experience and satisfaction. Findings also indicate that product return management was identified to have a significant negative effect on customer experience. Additionally, seasonality has a significant but negative moderation, which means increasing seasonality decreases the relationship between product return management and customer experience and satisfaction. Results highlight that return policies have a significant negative influence on the relationship between returning a product and customer experience and satisfaction. Moreover, product characteristics are also identified to have a significant negative influence on the relationship between returning a product and customer experience and satisfaction. This study further examines the influence of the factors on direct e-commerce websites and third-party e-commerce websites. Findings showcase a strong statistical significance for the increased rate of return of fast-fashion products on third-party websites. This paper aids practitioners in taking strategic decisions related to return management, to improve the quality of logistical services and, in turn, increase profitability.

Keywords: customer experience, customer satisfaction, e-commerce, fast-fashion, product returns

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363 Empowering Youth Through Pesh Poultry: A Transformative Approach to Addressing Unemployment and Fostering Sustainable Livelihoods in Busia District, Uganda

Authors: Bisemiire Anthony,

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PESH Poultry is a business project proposed specifically to solve unemployment and income-related problems affecting the youths in the Busia district. The project is intended to transform the life of the youth in terms of economic, social and behavioral, as well as the domestic well-being of the community at large. PESH Poultry is a start-up poultry farm that will be engaged in the keeping of poultry birds, broilers and layers for the production of quality and affordable poultry meat and eggs respectively and other poultry derivatives targeting consumers in eastern Uganda, for example, hotels, restaurants, households and bakeries. We intend to use a semi-intensive system of farming, where water and some food are provided in a separate nighttime shelter for the birds; our location will be in Lumino, Busia district. The poultry project will be established and owned by Bisemiire Anthony, Nandera Patience, Naula Justine, Bwire Benjamin and other investors. The farm will be managed and directed by Nandera Patience, who has five years of work experience and business administration knowledge. We will sell poultry products, including poultry eggs, chicken meat, feathers and poultry manure. We also offer consultancy services for poultry farming. Our eggs and chicken meat are hygienic, rich in protein and high quality. We produce processes and packages to meet the standard organization of Uganda and international standards. The business project shall comprise five (5) workers on the key management team who will share various roles and responsibilities in the identified business functions such as marketing, finance and other related poultry farming activities. PESH Poultry seeks 30 million Ugandan shillings in long-term financing to cover start-up costs, equipment, building expenses and working capital. Funding for the launch of the business will be provided primarily by equity from the investors. The business will reach positive cash flow in its first year of operation, allowing for the expected repayment of its loan obligations. Revenue will top UGX 11,750,000, and net income will reach about UGX115 950,000 in the 1st year of operation. The payback period for our project is 2 years and 3 months. The farm plans on starting with 1000 layer birds and 1000 broiler birds, 20 workers in the first year of operation.

Keywords: chicken, pullets, turkey, ducks

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362 Learning Trajectories of Mexican Language Teachers: A Cross-Cultural Comparative Study

Authors: Alberto Mora-Vazquez, Nelly Paulina Trejo Guzmán

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This study examines the learning trajectories of twelve language teachers who were former students of a BA in applied linguistics at a Mexican state university. In particular, the study compares the social, academic and professional trajectories of two groups of teachers, six locally raised and educated ones and six repatriated ones from the U.S. Our interest in undertaking this research lies in the wide variety of students’ backgrounds we as professors in the BA program have witnessed throughout the years it has been around. Ever since the academic program started back in 2006, the student population has been made up of students whose backgrounds are highly diverse in terms of English language proficiency level, professional orientations and degree of cross-cultural awareness. Such diversity is further evidenced by the ongoing incorporation of some transnational students who have lived and studied in the United States for a significant period of time before their enrolment in the BA program. This, however, is not an isolated event as other researchers have reported this phenomenon in other TESOL-related programs of Mexican universities in the literature. Therefore, this suggests that their social and educational experiences are quite different from those of their Mexican born and educated counterparts. In addition, an informal comparison of the participation in formal teaching activities of the two groups at the beginning of their careers also suggested that significant differences in teacher training and development needs could also be identified. This issue raised questions about the need to examine the life and learning trajectories of these two groups of student teachers so as to develop an intervention plan aimed at supporting and encouraging their academic and professional advancement based on their particular needs. To achieve this goal, the study makes use of a combination of retrospective life-history research and the analysis of academic documents. The first approach uses interviews for data-collection. Through the use of a narrative life-history interview protocol, teachers were asked about their childhood home context, their language learning and teaching experiences, their stories of studying applied linguistics, and self-description. For the analysis of participants’ educational outcomes, a wide range of academic records, including reports of language proficiency exams results and language teacher training certificates, were used. The analysis revealed marked differences between the two groups of teachers in terms of academic and professional orientations. The locally educated teachers tended to graduate first, to look for further educational opportunities after graduation, to enter the language teaching profession earlier, and to expand their professional development options more than their peers. It is argued that these differences can be explained by their identities, which are made up of the interplay of influences such as their home context, their previous educational experiences and their cultural background. Implications for language teacher trainers and applied linguistics academic program administrators are provided.

Keywords: beginning language teachers, life-history research, Mexican context, transnational students

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361 Determination of Energy and Nutrients Composition of Potential Ready-to-Use Therapeutic Food Formulated from Locally Available Resources

Authors: Amina Sa'id Muhammad, Asmau Ishaq Alhassan, Beba Raymond, Fatima Bello

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Severe acute malnutrition (SAM) remains a major killer of children under five years of age. Nigeria has the second highest burden of stunted children in the world, with a national prevalence rate of 32 percent of children under five. An estimated 2 million children in Nigeria suffer from severe acute malnutrition (SAM), and 3.9% of children in northwest Nigeria suffer from SAM, which is significantly higher than the national average of 2.1%. Community-Based Management of Acute Malnutrition (CMAM) has proven to be an effective intervention in the treatment of SAM in children using Ready-to-Use Therapeutic Food (RUTF). Ready-to-use therapeutic food (RUTF) is a key component for the treatment of Severe Acute Malnutrition. It contains all the energy and nutrients required for rapid catch-up growth and used particularly in the treatment of children over 6 months of age with SAM without medical complications. However, almost all RUTFs are currently imported to Nigeria from other countries. Shortages of RUTF due to logistics (shipping costs, delays, donor fatigue etc) and funding issues present a threat to the achievement of the 2030 World Health Assembly (WHA) targets for reducing malnutrition in addition to 2030 SDGs 2 (Zero Hunger), 3 (Good Health and Wellbeing), 12 (Responsible Consumption and Production), and 17 (Partnerships for the Goals), thus undermining its effectiveness in combating malnutrition On the other hand, the availability of human and material resources that will aid local production of RUTF presents an opportunity to fill in the gap in regular RUTF supply. About one thousand Nigerian children die of malnutrition-related causes every day, reaching a total of 361,000 each year. Owing to the high burden of malnutrition in Nigeria, the local production of RUTF is a logical step, that will ensure increased availability, acceptability, access, and efficiency in supply, and at lower costs. Objective(s): The objectives of this study were therefore, to formulate RUTF from locally available resources and to determine its energy and nutrients composition, incommensurate with the standard/commercial RUTF. Methods: Three samples of RUTF were formulated using locally available resources (soya beans, wheat, rice, baobab, brown-sugar, date palm and soya oil); which were subjected to various analysis to determine their energy/proximate composition, vitamin and mineral contents and organoleptic properties were also determined using sensory evaluation. Results: The energy values of the three samples of locally produced RUTF were found to be in conformity with WHO recommendation of ≥ 500 kcal per 100g. The energy values of the three RUTF samples produced in the current study were found to be 563.08, 503.67 and 528.98 kcal respectively. Sample A, B and C had protein content of 13.56% 16.71% and 14.62% respectively, which were higher than that of commercial RUTF (10.9%). Conclusions/recommendations: The locally formulated RUTF samples had energy value of more than 500 kcal per 100g; with an appreciable amount of macro and micro nutrients. The appearance, taste, flavor and general acceptability of the formulated RUTF samples were also commendable.

Keywords: energy, malnutrition, nutrients, RUTF

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360 Nurturing Scientific Minds: Enhancing Scientific Thinking in Children (Ages 5-9) through Experiential Learning in Kids Science Labs (STEM)

Authors: Aliya K. Salahova

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Scientific thinking, characterized by purposeful knowledge-seeking and the harmonization of theory and facts, holds a crucial role in preparing young minds for an increasingly complex and technologically advanced world. This abstract presents a research study aimed at fostering scientific thinking in early childhood, focusing on children aged 5 to 9 years, through experiential learning in Kids Science Labs (STEM). The study utilized a longitudinal exploration design, spanning 240 weeks from September 2018 to April 2023, to evaluate the effectiveness of the Kids Science Labs program in developing scientific thinking skills. Participants in the research comprised 72 children drawn from local schools and community organizations. Through a formative psychology-pedagogical experiment, the experimental group engaged in weekly STEM activities carefully designed to stimulate scientific thinking, while the control group participated in daily art classes for comparison. To assess the scientific thinking abilities of the participants, a registration table with evaluation criteria was developed. This table included indicators such as depth of questioning, resource utilization in research, logical reasoning in hypotheses, procedural accuracy in experiments, and reflection on research processes. The data analysis revealed dynamic fluctuations in the number of children at different levels of scientific thinking proficiency. While the development was not uniform across all participants, a main leading factor emerged, indicating that the Kids Science Labs program and formative experiment exerted a positive impact on enhancing scientific thinking skills in children within this age range. The study's findings support the hypothesis that systematic implementation of STEM activities effectively promotes and nurtures scientific thinking in children aged 5-9 years. Enriching education with a specially planned STEM program, tailoring scientific activities to children's psychological development, and implementing well-planned diagnostic and corrective measures emerged as essential pedagogical conditions for enhancing scientific thinking abilities in this age group. The results highlight the significant and positive impact of the systematic-activity approach in developing scientific thinking, leading to notable progress and growth in children's scientific thinking abilities over time. These findings have promising implications for educators and researchers, emphasizing the importance of incorporating STEM activities into educational curricula to foster scientific thinking from an early age. This study contributes valuable insights to the field of science education and underscores the potential of STEM-based interventions in shaping the future scientific minds of young children.

Keywords: Scientific thinking, education, STEM, intervention, Psychology, Pedagogy, collaborative learning, longitudinal study

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359 Differential in Dynamics of Contraceptive Practices with Women's Sexual Empowerment in Selected South Asian Countries: Evidence from Two Decades DHS Surveys, 1990 and 2012

Authors: Brajesh

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Introduction: It is generally believed that women's lack power to making decision may restrict their use of modern contraceptives practices. However, few studies have examined the different dimensions of women's empowerment and contraceptive use in Asian content. Pervasive gendered inequities and norms regarding the subordination of women give Asian men disproportionately more power than women, particularly in relation to the sex. We hypothesize that lack of sexual empowerment may pose an important barrier to reproductive health and adoption of family planning methods. Using the Demographic Health Survey, we examine the association between women’s sexual empowerment and contraceptive use in Nepal, Bangladesh and Pakistan. Objectives: To understand the trend and pattern of contraceptive choices and use among women due to sexual empowerment in selected south Asian countries. To examine the association between women’s sexual empowerment and contraceptive practices among non-pregnant married and partnered women in Nepal, Bangladesh and Pakistan. Methods: Data came from the latest round of Demographic and Health Surveys conducted between 2010-12 in and during deacde1990 -92 in Nepal, Bangladesh and Pakistan. Responses from married or cohabiting women aged 15-49 years were analyzed for six dimensions of empowerment and the current use of female-only methods or couple of methods. Bi-variate and multivariate multinomial regressions were used to identify associations between the empowerment dimensions and method use. Results: Positive associations were found between the overall empowerment score and method use in all countries (relative risk ratios, 1.1-1.3). In multivariate analysis, household economic decision-making was associated with the use of either female-only or couple methods (relative risk ratios -1. 1 for all), as was agreement on fertility preferences (RRR-1.3-1.6) and the ability to negotiate sexual activity (RRR -1. 1-1.2). In Bangladesh, women's negative attitudes toward domestic violence were correlated with the use of couple of methods (RRR -1. 1). Increasing levels of sexual empowerment were found to be associated with use of contraceptives, even after adjusting for demographic predictors of contraceptive use. This association is moderated by the wealth. Formal education, increasing wealth, and being in an unmarried partnership are associated with contraceptive use, whereas women who identify as being Muslim are less likely to use contraceptives than those who identify as being Hindus or other. These findings suggest that to achieve universal access to reproductive health services, gendered disparities in sexual empowerment, particularly among economically disadvantaged women, need to be better addressed. Conclusions: Intervention programs aimed at increasing contraceptive use may need to involve different approaches, including promoting couples' discussion of fertility preferences and family planning, improving women's self-efficacy in negotiating sexual activity and increasing their economic independence. Policies are needed to encourage the rural families to give their girls a chance of attending higher level education and professional course so that can get a better job opportunity and can economically support their family as son are expected to do.

Keywords: reproductive and child health (RCH), relative risk ratios (RRR), demographic and health survey (DHS), women’s sexual empowerment (WSE)

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358 The Connection Between the Semiotic Theatrical System and the Aesthetic Perception

Authors: Păcurar Diana Istina

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The indissoluble link between aesthetics and semiotics, the harmonization and semiotic understanding of the interactions between the viewer and the object being looked at, are the basis of the practical demonstration of the importance of aesthetic perception within the theater performance. The design of a theater performance includes several structures, some considered from the beginning, art forms (i.e., the text), others being represented by simple, common objects (e.g., scenographic elements), which, if reunited, can trigger a certain aesthetic perception. The audience is delivered, by the team involved in the performance, a series of auditory and visual signs with which they interact. It is necessary to explain some notions about the physiological support of the transformation of different types of stimuli at the level of the cerebral hemispheres. The cortex considered the superior integration center of extransecal and entanged stimuli, permanently processes the information received, but even if it is delivered at a constant rate, the generated response is individualized and is conditioned by a number of factors. Each changing situation represents a new opportunity for the viewer to cope with, developing feelings of different intensities that influence the generation of meanings and, therefore, the management of interactions. In this sense, aesthetic perception depends on the detection of the “correctness” of signs, the forms of which are associated with an aesthetic property. Fairness and aesthetic properties can have positive or negative values. Evaluating the emotions that generate judgment and implicitly aesthetic perception, whether we refer to visual emotions or auditory emotions, involves the integration of three areas of interest: Valence, arousal and context control. In this context, superior human cognitive processes, memory, interpretation, learning, attribution of meanings, etc., help trigger the mechanism of anticipation and, no less important, the identification of error. This ability to locate a short circuit produced in a series of successive events is fundamental in the process of forming an aesthetic perception. Our main purpose in this research is to investigate the possible conditions under which aesthetic perception and its minimum content are generated by all these structures and, in particular, by interactions with forms that are not commonly considered aesthetic forms. In order to demonstrate the quantitative and qualitative importance of the categories of signs used to construct a code for reading a certain message, but also to emphasize the importance of the order of using these indices, we have structured a mathematical analysis that has at its core the analysis of the percentage of signs used in a theater performance.

Keywords: semiology, aesthetics, theatre semiotics, theatre performance, structure, aesthetic perception

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357 Mapping Alternative Education in Italy: The Case of Popular and Second-Chance Schools and Interventions in Lombardy

Authors: Valeria Cotza

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School drop-out is a multifactorial phenomenon that in Italy concerns all those underage students who, at different school stages (up to 16 years old) or training (up to 18 years old), manifest educational difficulties from dropping out of compulsory education without obtaining a qualification to repetition rates and absenteeism. From the 1980s to the 2000s, there was a progressive attenuation of the economic and social model towards a multifactorial reading of the phenomenon, and the European Commission noted the importance of learning about the phenomenon through approaches able to integrate large-scale quantitative surveys with qualitative analyses. It is not a matter of identifying the contextual factors affecting the phenomenon but problematising them by means of systemic and comprehensive in-depth analysis. So, a privileged point of observation and field of intervention are those schools that propose alternative models of teaching and learning to the traditional ones, such as popular and second-chance schools. Alternative schools and interventions grew in these years in Europe as well as in the US and Latin America, working in the direction of greater equity to create the conditions (often absent in conventional schools) for everyone to achieve educational goals. Against extensive Anglo-Saxon and US literature on this topic, there is yet no unambiguous definition of alternative education, especially in Europe, where second-chance education has been most studied. There is little literature on a second chance in Italy and almost none on alternative education (with the exception of method schools, to which in Italy the concept of “alternative” is linked). This research aims to fill the gap by systematically surveying the alternative interventions in the area and beginning to explore some models of popular and second-chance schools and experiences through a mixed methods approach. So, the main research objectives concern the spread of alternative education in the Lombardy region, the main characteristics of these schools and interventions, and their effectiveness in terms of students’ well-being and school results. This paper seeks to answer the first point by presenting the preliminary results of the first phase of the project dedicated to mapping. Through the Google Forms platform, a questionnaire is being distributed to all schools in Lombardy and some schools in the rest of Italy to map the presence of alternative schools and interventions and their main characteristics. The distribution is also taking place thanks to the support of the Milan Territorial and Lombardy Regional School Offices. Moreover, other social realities outside the school system (such as cooperatives and cultural associations) can be questioned. The schools and other realities to be questioned outside Lombardy will also be identified with the support of INDIRE (Istituto Nazionale per Documentazione, Innovazione e Ricerca Educativa, “National Institute for Documentation, Innovation and Educational Research”) and based on existing literature and the indicators of “Futura” Plan of the PNRR (Piano Nazionale di Ripresa e Resilienza, “National Recovery and Resilience Plan”). Mapping will be crucial and functional for the subsequent qualitative and quantitative phase, which will make use of statistical analysis and constructivist grounded theory.

Keywords: school drop-out, alternative education, popular and second-chance schools, map

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356 Polar Bears in Antarctica: An Analysis of Treaty Barriers

Authors: Madison Hall

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The Assisted Colonization of Polar Bears to Antarctica requires a careful analysis of treaties to understand existing legal barriers to Ursus maritimus transport and movement. An absence of land-based migration routes prevent polar bears from accessing southern polar regions on their own. This lack of access is compounded by current treaties which limit human intervention and assistance to ford these physical and legal barriers. In a time of massive planetary extinctions, Assisted Colonization posits that certain endangered species may be prime candidates for relocation to hospitable environments to which they have never previously had access. By analyzing existing treaties, this paper will examine how polar bears are limited in movement by humankind’s legal barriers. International treaties may be considered codified reflections of anthropocentric values of the best knowledge and understanding of an identified problem at a set point in time, as understood through the human lens. Even as human social values and scientific insights evolve, so too must treaties evolve which specify legal frameworks and structures impacting keystone species and related biomes. Due to costs and other myriad difficulties, only a very select number of species will be given this opportunity. While some species move into new regions and are then deemed invasive, Assisted Colonization considers that some assistance may be mandated due to the nature of humankind’s role in climate change. This moral question and ethical imperative against the backdrop of escalating climate impacts, drives the question forward; what is the potential for successfully relocating a select handful of charismatic and ecologically important life forms? Is it possible to reimagine a different, but balanced Antarctic ecosystem? Listed as a threatened species under the U.S. Endangered Species Act, a result of the ongoing loss of critical habitat by melting sea ice, polar bears have limited options for long term survival in the wild. Our current regime for safeguarding animals facing extinction frequently utilizes zoos and their breeding programs, to keep alive the genetic diversity of the species until some future time when reintroduction, somewhere, may be attempted. By exploring the potential for polar bears to be relocated to Antarctica, we must analyze the complex ethical, legal, political, financial, and biological realms, which are the backdrop to framing all questions in this arena. Can we do it? Should we do it? By utilizing an environmental ethics perspective, we propose that the Ecological Commons of the Arctic and Antarctic should not be viewed solely through the lens of human resource management needs. From this perspective, polar bears do not need our permission, they need our assistance. Antarctica therefore represents a second, if imperfect chance, to buy time for polar bears, in a world where polar regimes, not yet fully understood, are themselves quickly changing as a result of climate change.

Keywords: polar bear, climate change, environmental ethics, Arctic, Antarctica, assisted colonization, treaty

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355 A Case of Borderline Personality Disorder: An Explanatory Study of Unconscious Conflicts through Dream-Analysis

Authors: Mariam Anwaar, Kiran B. Ahmad

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Borderline Personality Disorder (BPD) is an invasive presence of affect instability, disturbance in self-concept and attachment in relationships. The profound indicator is the dichotomous approach of the world in which the ego categorizes individuals, especially their significant others, into secure or threatful beings, leaving little room for a complex combination of characteristics in one person. This defense mechanism of splitting their world has been described through the explanatory model of unconscious conflict theorized by Sigmund Freud’s Electra Complex in the Phallic Stage. The central role is of the father with whom the daughter experiences penis envy, thus identifying with the mother’s characteristics to receive the father’s attention. However, Margret Mahler, an object relation theorist, elucidates the central role of the mother and that the split occurs during the pre-Electra complex stage. Amid the 14 and 24 months of the infant, it acknowledges the world away from the mother as they have developed milestones such as crawling. In such novelty, the infant crawls away from the mother creating a sense of independence (individuation). On the other hand, being distant causes anxiety, making them return to their original object of security (separation). In BPD, the separation-individuation stage is disrupted, due to contradictory actions of the caregiver, which results in splitting the object into negative and positive aspects, repressing the former and adhering to the latter for survival. Thus, with time, the ego distorts the reality into dichotomous categories, using the splitting defenses, and the mental representation of the self is distorted due to the internalization of the negative objects. The explanatory model was recognized in the case study of Fizza, at 21-year-old Pakistani female, residing in Karachi. Her marital status is single with an occupation being a dental student. Fizza lives in a nuclear family but is surrounded by her extended family as they all are in close vicinity. She came with the complaints of depressive symptoms for two-years along with self-harm due to severe family conflicts. Through the intervention of Dialectical Behavior Therapy (DBT), the self-harming actions were reduced, however, this libidinal energy transformed into claustrophobic symptoms and, along with this, Fizza has always experienced vivid dreams. A retrospective method of Jungian dream-analysis was applied to locate the origins of the splitting in the unconscious. The result was the revelation of a sexual harassment trauma at the age of six-years which was displaced in the form of self-harm. In addition to this, the presence of a conflict at the separation-individuation stage was detected during the dream-analysis, and it was the underlying explanation of the claustrophobic symptoms. This qualitative case study implicates the use of a patient’s subjective experiences, such as dreams, to journey through the spiral of the unconscious in order to not only detect repressed memories but to use them in psychotherapy as a means of healing the patient.

Keywords: borderline personality disorder, dream-analysis, Electra complex, separation-individuation, splitting, unconscious

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354 Investigating English Dominance in a Chinese-English Dual Language Program: Teachers' Language Use and Investment

Authors: Peizhu Liu

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Dual language education, also known as immersion education, differs from traditional language programs that teach a second or foreign language as a subject. Instead, dual language programs adopt a content-based approach, using both a majority language (e.g., English, in the case of the United States) and a minority language (e.g., Spanish or Chinese) as a medium of instruction to teach math, science, and social studies. By granting each language of instruction equal status, dual language education seeks to educate not only meaningfully but equitably and to foster tolerance and appreciation of diversity, making it essential for immigrants, refugees, indigenous peoples, and other marginalized students. Despite the cognitive and academic benefits of dual language education, recent literature has revealed that English is disproportionately privileged across dual language programs. Scholars have expressed concerns about the unbalanced status of majority and minority languages in dual language education, as favoring English in this context may inadvertently reaffirm its dominance and moreover fail to serve the needs of children whose primary language is not English. Through a year-long study of a Chinese-English dual language program, the extensively disproportionate use of English has also been observed by the researcher. However, despite the fact that Chinese-English dual language programs are the second-most popular program type after Spanish in the United States, this issue remains underexplored in the existing literature on Chinese-English dual language education. In fact, the number of Chinese-English dual language programs being offered in the U.S. has grown rapidly, from 8 in 1988 to 331 as of 2023. Using Norton and Darvin's investment model theory, the current study investigates teachers' language use and investment in teaching Chinese and English in a Chinese-English dual language program at an urban public school in New York City. The program caters to a significant number of minority children from working-class families. Adopting an ethnographic and discourse analytic approach, this study seeks to understand language use dynamics in the program and how micro- and macro-factors, such as students' identity construction, parents' and teachers' language ideologies, and the capital associated with each language, influence teachers' investment in teaching Chinese and English. The research will help educators and policymakers understand the obstacles that stand in the way of the goal of dual language education—that is, the creation of a more inclusive classroom, which is achieved by regarding both languages of instruction as equally valuable resources. The implications for how to balance the use of the majority and minority languages will also be discussed.

Keywords: dual language education, bilingual education, language immersion education, content-based language teaching

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353 Coping Strategies and Characterization of Vulnerability in the Perspective of Climate Change

Authors: Muhammad Umer Mehmood, Muhammad Luqman, Muhammad Yaseen, Imtiaz Hussain

Abstract:

Climate change is an arduous fact, which could not be unheeded easily. It is a phenomenon which has brought a collection of challenges for the mankind. Scientists have found many of its negative impacts on the life of human being and the resources on which the life of humanity is dependent. There are many issues which are associated with the factor of prime importance in this study, 'climate change'. Whenever changes happen in nature, they strike the whole globe. Effects of these changes vary from region to region. Climate of every region of this globe is different from the other. Even within a state, country or the province has different climatic conditions. So it is mandatory that the response in that specific region and the coping strategy of this specific region should be according to the prevailing risk. In the present study, the objective was to assess the coping strategies and vulnerability of small landholders. So that a professional suggestion could be made to cope with the vulnerability factor of small farmers. The cross-sectional research design was used with the intervention of quantitative approach. The study was conducted in the Khanewal district, of Punjab, Pakistan. 120 small farmers were interviewed after randomized sampling from the population of respective area. All respondents were above the age of 15 years. A questionnaire was developed after keen observation of facts in the respective area. Content and face validity of the instrument was assessed with SPSS and experts in the field. Data were analyzed through SPSS using descriptive statistics. From the sample of 120, 81.67% of the respondents claimed that the environment is getting warmer and not fit for their present agricultural practices. 84.17% of the sample expressed serious concern that they are disturbed due to change in rainfall pattern and vulnerability towards the climatic effects. On the other hand, they expressed that they are not good at tackling the effects of climate change. Adaptation of coping strategies like change in cropping pattern, use of resistant varieties, varieties with minimum water requirement, intercropping and tree planting was low by more than half of the sample. From the sample 63.33% small farmers said that the coping strategies they adopt are not effective enough. The present study showed that subsistence farming, lack of marketing and overall infrastructure, lack of access to social security networks, limited access to agriculture extension services, inappropriate access to agrometeorological system, unawareness and access to scientific development and low crop yield are the prominent factors which are responsible for the vulnerability of small farmers. A comprehensive study should be conducted at national level so that a national policy could be formulated to cope with the dilemma in future with relevance to climate change. Mainstreaming and collaboration among the researchers and academicians could prove beneficiary in this regard the interest of national leaders’ does matter. Proper policies to avoid the vulnerability factors should be the top priority. The world is taking up this issue with full responsibility as should we, keeping in view the local situation.

Keywords: adaptation, coping strategies, climate change, Pakistan, small farmers, vulnerability

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352 Home Garden: A Food-Based Strategy to Achieve Sustainable Impact on Household Nutrition of Resource-Poor Families in Nepal

Authors: Purushottam P. Khatiwada, Bikash Paudel, Ram B. Rana, Parshuram Biswakarma, Roshan Pudasaini

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Nepal has been putting its efforts into securing food and nutrition security for its citizens adopting different models and approaches. Home Garden approach, that integrates vegetables, fruits, small livestock, poultry along with other components like fish, honeybee, mushroom, spices for the promotion of nutritional security of resource-poor and disadvantaged groups was implemented during March 2009 to July 2013 spreading over 16 districts of Nepal covering 115 farmers groups, directly working with 3500 households. Sustained long-term impact of development interventions targeted to the resource-poor and disadvantaged groups has been a recurrent issue for donors, policymakers and practitioners alike. Considering the issue, a post-project evaluation was carried out in a selected project group (Dangibari of Jhapa) after four years of project completion in 2017 in order to evaluate the impact and understand the factors associated with its success. Qualitative information was collected through focus group discussion with group members and associated local institutions. For quantitative information, a quick survey was carried out to the same group members only selecting few indicators. The results are compared with the data obtained from the baseline study conducted by the project in March 2009. The impact of project intervention was evident as compared to the benchmarks established during the baseline, even after four years of project completion. The area under home garden is increased to 729 m² from 386 m² and average food self-sufficiency months increased to 10.22 from 8.11. Seven to eleven fruit species are maintained in the home gardens. An average number of vegetable species grown increased to 15.85 from 9.86. It has resulted in an increase in vegetables self-sufficient month to 8.74 from 4.74 and a huge increase in cash income NPR 6142.8 (USD 59.6) from NPR 385.7 (USD 3.9) from the sale of surplus vegetables. Coaching and mentoring including nutrition sensitization by the project staff at the beginning, inputs and technical support during the project implementation phase and projects effort on the institutional building of disadvantaged farmers were the key drivers of home garden sustainability and expansion. Specifically, package of home garden management trainings provided by the project staff, availability of group funds for buying inputs even after the project, uniting home garden group members in a cooperative, resource leveraging by local institutions through group lobbying, farmers innovations for maintaining home garden diversity and continuous backstopping support by few active members as local resource persons to other members are some additional factors contributing to sustain and/or improve the home garden status by the resource-poor and disadvantaged group.

Keywords: food-based nutrition, home garden, resource-poor and disadvantaged group, sustained impact

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351 Challenging Weak Central Coherence: An Exploration of Neurological Evidence from Visual Processing and Linguistic Studies in Autism Spectrum Disorder

Authors: Jessica Scher Lisa, Eric Shyman

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Autism spectrum disorder (ASD) is a neuro-developmental disorder that is characterized by persistent deficits in social communication and social interaction (i.e. deficits in social-emotional reciprocity, nonverbal communicative behaviors, and establishing/maintaining social relationships), as well as by the presence of repetitive behaviors and perseverative areas of interest (i.e. stereotyped or receptive motor movements, use of objects, or speech, rigidity, restricted interests, and hypo or hyperactivity to sensory input or unusual interest in sensory aspects of the environment). Additionally, diagnoses of ASD require the presentation of symptoms in the early developmental period, marked impairments in adaptive functioning, and a lack of explanation by general intellectual impairment or global developmental delay (although these conditions may be co-occurring). Over the past several decades, many theories have been developed in an effort to explain the root cause of ASD in terms of atypical central cognitive processes. The field of neuroscience is increasingly finding structural and functional differences between autistic and neurotypical individuals using neuro-imaging technology. One main area this research has focused upon is in visuospatial processing, with specific attention to the notion of ‘weak central coherence’ (WCC). This paper offers an analysis of findings from selected studies in order to explore research that challenges the ‘deficit’ characterization of a weak central coherence theory as opposed to a ‘superiority’ characterization of strong local coherence. The weak central coherence theory has long been both supported and refuted in the ASD literature and has most recently been increasingly challenged by advances in neuroscience. The selected studies lend evidence to the notion of amplified localized perception rather than deficient global perception. In other words, WCC may represent superiority in ‘local processing’ rather than a deficit in global processing. Additionally, the right hemisphere and the specific area of the extrastriate appear to be key in both the visual and lexicosemantic process. Overactivity in the striate region seems to suggest inaccuracy in semantic language, which lends itself to support for the link between the striate region and the atypical organization of the lexicosemantic system in ASD.

Keywords: autism spectrum disorder, neurology, visual processing, weak coherence

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