Search results for: children cognitive
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4830

Search results for: children cognitive

90 Gendered Water Insecurity: a Structural Equation Approach for Female-Headed Households in South Africa

Authors: Saul Ngarava, Leocadia Zhou, Nomakhaya Monde

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Water crises have the fourth most significant societal impact after weapons of mass destruction, climate change, and extreme weather conditions, ahead of natural disasters. Intricacies between women and water are central to achieving the 2030 Sustainable Development Goals (SDGs). The majority of the 1.2 billion poor people worldwide, with two-thirds being women, and mostly located in Sub Sahara Africa (SSA) and South Asia, do not have access to safe and reliable sources of water. There exist gendered differences in water security based on the division of labour associating women with water. Globally, women and girls are responsible for water collection in 80% of the households which have no water on their premises. Women spend 16 million hours a day collecting water, while men and children spend 6 million and 4 million per day, respectively, which is time foregone in the pursuit of other livelihood activities. Due to their proximity and activities concerning water, women are vulnerable to water insecurity through exposures to water-borne diseases, fatigue from physically carrying water, and exposure to sexual and physical harassment, amongst others. Proximity to treated water and their wellbeing also has an effect on their sensitivity and adaptive capacity to water insecurity. The great distances, difficult terrain and heavy lifting expose women to vulnerabilities of water insecurity. However, few studies have quantified the vulnerabilities and burdens on women, with a few taking a phenomenological qualitative approach. Vulnerability studies have also been scanty in the water security realm, with most studies taking linear forms of either quantifying exposures, sensitivities or adaptive capacities in climate change studies. The current study argues for the need for a water insecurity vulnerability assessment, especially for women into research agendas as well as policy interventions, monitoring, and evaluation. The study sought to identify and provide pathways through which female-headed households were water insecure in South Africa, the 30th driest country in the world. This was through linking the drinking water decision as well as the vulnerability frameworks. Secondary data collected during the 2016 General Household Survey (GHS) was utilised, with a sample of 5928 female-headed households. Principal Component Analysis and Structural Equation Modelling were used to analyse the data. The results show dynamic relationships between water characteristics and water treatment. There were also associations between water access and wealth status of the female-headed households. Association was also found between water access and water treatment as well as between wealth status and water treatment. The study concludes that there are dynamic relationships in water insecurity (exposure, sensitivity, and adaptive capacity) for female-headed households in South Africa. The study recommends that a multi-prong approach is required in tackling exposures, sensitivities, and adaptive capacities to water insecurity. This should include capacitating and empowering women for wealth generation, improve access to water treatment equipment as well as prioritising the improvement of infrastructure that brings piped and safe water to female-headed households.

Keywords: gender, principal component analysis, structural equation modelling, vulnerability, water insecurity

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89 Exploring Empathy Through Patients’ Eyes: A Thematic Narrative Analysis of Patient Narratives in the UK

Authors: Qudsiya Baig

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Empathy yields an unparalleled therapeutic value within patient physician interactions. Medical research is inundated with evidence to support that a physician’s ability to empathise with patients leads to a greater willingness to report symptoms, an improvement in diagnostic accuracy and safety, and a better adherence and satisfaction with treatment plans. Furthermore, the Institute of Medicine states that empathy leads to a more patient-centred care, which is one of the six main goals of a 21st century health system. However, there is a paradox between the theoretical significance of empathy and its presence, or lack thereof, in clinical practice. Recent studies have reported that empathy declines amongst students and physicians over time. The three most impactful contributors to this decline are: (1) disagreements over the definitions of empathy making it difficult to implement it into practice (2) poor consideration or regulation of empathy leading to burnout and thus, abandonment altogether, and (3) the lack of diversity in the curriculum and the influence of medical culture, which prioritises science over patient experience, limiting some physicians from using ‘too much’ empathy in the fear of losing clinical objectivity. These issues were investigated by conducting a fully inductive thematic narrative analysis of patient narratives in the UK to evaluate the behaviours and attitudes that patients associate with empathy. The principal enquiries underpinning this study included uncovering the factors that affected experience of empathy within provider-patient interactions and to analyse their effects on patient care. This research contributes uniquely to this discourse by examining the phenomenon of empathy directly from patients’ experiences, which were systematically extracted from a repository of online patient narratives of care titled ‘CareOpinion UK’. Narrative analysis was specifically chosen as the methodology to examine narratives from a phenomenological lens to focus on the particularity and context of each story. By enquiring beyond the superficial who-whatwhere, the study of narratives prescribed meaning to illness by highlighting the everyday reality of patients who face the exigent life circumstances created by suffering, disability, and the threat of life. The following six themes were found to be the most impactful in influencing the experience of empathy: dismissive behaviours, judgmental attitudes, undermining patients’ pain or concerns, holistic care and failures and successes of communication or language. For each theme there were overarching themes relating to either a failure to understand the patient’s perspective or a success in taking a person-centred approach. An in-depth analysis revealed that a lack of empathy was greatly associated with an emotive-cognitive imbalance, which disengaged physicians with their patients’ emotions. This study hereby concludes that competent providers require a combination of knowledge, skills, and more importantly empathic attitudes to help create a context for effective care. The crucial elements of that context involve (a) identifying empathy clues within interactions to engage with patients’ situations, (b) attributing a perspective to the patient through perspective-taking and (c) adapting behaviour and communication according to patient’s individual needs. Empathy underpins that context, as does an appreciation of narrative, and the two are interrelated.

Keywords: empathy, narratives, person-centred, perspective, perspective-taking

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88 A Constructionist View of Projects, Social Media and Tacit Knowledge in a College Classroom: An Exploratory Study

Authors: John Zanetich

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Designing an educational activity that encourages inquiry and collaboration is key to engaging students in meaningful learning. Educational Information and Communications Technology (EICT) plays an important role in facilitating cooperative and collaborative learning in the classroom. The EICT also facilitates students’ learning and development of the critical thinking skills needed to solve real world problems. Projects and activities based on constructivism encourage students to embrace complexity as well as find relevance and joy in their learning. It also enhances the students’ capacity for creative and responsible real-world problem solving. Classroom activities based on constructivism offer students an opportunity to develop the higher–order-thinking skills of defining problems and identifying solutions. Participating in a classroom project is an activity for both acquiring experiential knowledge and applying new knowledge to practical situations. It also provides an opportunity for students to integrate new knowledge into a skill set using reflection. Classroom projects can be developed around a variety of learning objects including social media, knowledge management and learning communities. The construction of meaning through project-based learning is an approach that encourages interaction and problem-solving activities. Projects require active participation, collaboration and interaction to reach the agreed upon outcomes. Projects also serve to externalize the invisible cognitive and social processes taking place in the activity itself and in the student experience. This paper describes a classroom project designed to elicit interactions by helping students to unfreeze existing knowledge, to create new learning experiences, and then refreeze the new knowledge. Since constructivists believe that students construct their own meaning through active engagement and participation as well as interactions with others. knowledge management can be used to guide the exchange of both tacit and explicit knowledge in interpersonal interactions between students and guide the construction of meaning. This paper uses an action research approach to the development of a classroom project and describes the use of technology, social media and the active use of tacit knowledge in the college classroom. In this project, a closed group Facebook page becomes the virtual classroom where interaction is captured and measured using engagement analytics. In the virtual learning community, the principles of knowledge management are used to identify the process and components of the infrastructure of the learning process. The project identifies class member interests and measures student engagement in a learning community by analyzing regular posting on the Facebook page. These posts are used to foster and encourage interactions, reflect a student’s interest and serve as reaction points from which viewers of the post convert the explicit information in the post to implicit knowledge. The data was collected over an academic year and was provided, in part, by the Google analytic reports on Facebook and self-reports of posts by members. The results support the use of active tacit knowledge activities, knowledge management and social media to enhance the student learning experience and help create the knowledge that will be used by students to construct meaning.

Keywords: constructivism, knowledge management, tacit knowledge, social media

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87 Challenges and Lessons of Mentoring Processes for Novice Principals: An Exploratory Case Study of Induction Programs in Chile

Authors: Carolina Cuéllar, Paz González

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Research has shown that school leadership has a significant indirect effect on students’ achievements. In Chile, evidence has also revealed that this impact is stronger in vulnerable schools. With the aim of strengthening school leadership, public policy has taken up the challenge of enhancing capabilities of novice principals through the implementation of induction programs, which include a mentoring component, entrusting the task of delivering these programs to universities. The importance of using mentoring or coaching models in the preparation of novice school leaders has been emphasized in the international literature. Thus, it can be affirmed that building leadership capacity through partnership is crucial to facilitate cognitive and affective support required in the initial phase of the principal career, gain role clarification and socialization in context, stimulate reflective leadership practice, among others. In Chile, mentoring is a recent phenomenon in the field of school leadership and it is even more new in the preparation of new principals who work in public schools. This study, funded by the Chilean Ministry of Education, sought to explore the challenges and lessons arising from the design and implementation of mentoring processes which are part of the induction programs, according to the perception of the different actors involved: ministerial agents, university coordinators, mentors and novice principals. The investigation used a qualitative design, based on a study of three cases (three induction programs). The sources of information were 46 semi-structured interviews, applied in two moments (at the beginning and end of mentoring). Content analysis technique was employed. Data focused on the uniqueness of each case and the commonalities within the cases. Five main challenges and lessons emerged in the design and implementation of mentoring within the induction programs for new principals from Chilean public schools. They comprised the need of (i) developing a shared conceptual framework on mentoring among the institutions and actors involved, which helps align the expectations for the mentoring component within the induction programs, along with assisting in establishing a theory of action of mentoring that is relevant to the public school context; (ii) recognizing trough actions and decisions at different levels that the role of a mentor differs from the role of a principal, which challenge the idea that an effective principal will always be an effective mentor; iii) improving mentors’ selection and preparation processes trough the definition of common guiding criteria to ensure that a mentor takes responsibility for developing critical judgment of novice principals, which implies not limiting the mentor’s actions to assist in the compliance of prescriptive practices and standards; (iv) generating common evaluative models with goals, instruments and indicators consistent with the characteristics of mentoring processes, which helps to assess expected results and impact; and (v) including the design of a mentoring structure as an outcome of the induction programs, which helps sustain mentoring within schools as a collective professional development practice. Results showcased interwoven elements that entail continuous negotiations at different levels. Taking action will contribute to policy efforts aimed at professionalizing the leadership role in public schools.

Keywords: induction programs, mentoring, novice principals, school leadership preparation

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86 Organisational Mindfulness Case Study: A 6-Week Corporate Mindfulness Programme Significantly Enhances Organisational Well-Being

Authors: Dana Zelicha

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A 6-week mindfulness programme was launched to improve the well being and performance of 20 managers (including the supervisor) of an international corporation in London. A unique assessment methodology was customised to the organisation’s needs, measuring four parameters: prioritising skills, listening skills, mindfulness levels and happiness levels. All parameters showed significant improvements (p < 0.01) post intervention, with a remarkable increase in listening skills and mindfulness levels. Although corporate mindfulness programmes have proven to be effective, the challenge remains the low engagement levels at home and the implementation of these tools beyond the scope of the intervention. This study has offered an innovative approach to enforce home engagement levels, which yielded promising results. The programme launched with a 2-day introduction intervention, which was followed by a 6-week training course (1 day a week; 2 hours each). Participants learned all basic principles of mindfulness such as mindfulness meditations, Mindfulness Based Stress Reduction (MBSR) techniques and Mindfulness Based Cognitive Therapy (MBCT) practices to incorporate into their professional and personal lives. The programme contained experiential mindfulness meditations and innovative mindfulness tools (OWBA-MT) created by OWBA - The Well Being Agency. Exercises included Mindful Meetings, Unitasking and Mindful Feedback. All sessions concluded with guided discussions and group reflections. One fundamental element of this programme was engagement level outside of the workshop. In the office, participants connected with a mindfulness buddy - a team member in the group with whom they could find support throughout the programme. At home, participants completed online daily mindfulness forms that varied according to weekly themes. These customised forms gave participants the opportunity to reflect on whether they made time for daily mindfulness practice, and to facilitate a sense of continuity and responsibility. At the end of the programme, the most engaged team member was crowned the ‘mindful maven’ and received a special gift. The four parameters were measured using online self-reported questionnaires, including the Listening Skills Inventory (LSI), Mindfulness Attention Awareness Scale (MAAS), Time Management Behaviour Scale (TMBS) and a modified version of the Oxford Happiness Questionnaire (OHQ). Pre-intervention questionnaires were collected at the start of the programme, and post-intervention data was collected 4-weeks following completion. Quantitative analysis using paired T-tests of means showed significant improvements, with a 23% increase in listening skills, a 22% improvement in mindfulness levels, a 12% increase in prioritising skills, and an 11% improvement in happiness levels. Participant testimonials exhibited high levels of satisfaction and the overall results indicate that the mindfulness programme substantially impacted the team. These results suggest that 6-week mindfulness programmes can improve employees’ capacities to listen and work well with others, to effectively manage time and to experience enhanced satisfaction both at work and in life. Limitations noteworthy to consider include the afterglow effect and lack of generalisability, as this study was conducted on a small and fairly homogenous sample.

Keywords: corporate mindfulness, listening skills, organisational well being, prioritising skills, mindful leadership

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85 Green Building for Positive Energy Districts in European Cities

Authors: Paola Clerici Maestosi

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Positive Energy District (PED) is a rather recent concept whose aim is to contribute to the main objectives of the Energy Union strategy. It is based on an integrated multi-sectoral approach in response to Europe's most complex challenges. PED integrates energy efficiency, renewable energy production, and energy flexibility in an integrated, multi-sectoral approach at the city level. The core idea behind Positive Energy Districts (PEDs) is to establish an urban area that can generate more energy than it consumes. Additionally, it should be flexible enough to adapt to changes in the energy market. This is crucial because a PED's goal is not just to achieve an annual surplus of net energy but also to help reduce the impact on the interconnected centralized energy networks. It achieves this by providing options to increase on-site load matching and self-consumption, employing technologies for short- and long-term energy storage, and offering energy flexibility through smart control. Thus, it seems that PEDs can encompass all types of buildings in the city environment. Given this which is the added value of having green buildings being constitutive part of PEDS? The paper will present a systematic literature review identifying the role of green building in Positive Energy District to provide answer to following questions: (RQ1) the state of the art of PEDs implementation; (RQ2) penetration of green building in Positive Energy District selected case studies. Methodological approach is based on a broad holistic study of bibliographic sources according to Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) further data will be analysed, mapped and text mining through VOSviewer. Main contribution of research is a cognitive framework on Positive Energy District in Europe and a selection of case studies where green building supported the transition to PED. The inclusion of green buildings within Positive Energy Districts (PEDs) adds significant value for several reasons. Firstly, green buildings are designed and constructed with a focus on environmental sustainability, incorporating energy-efficient technologies, materials, and design principles. As integral components of PEDs, these structures contribute directly to the district's overall ability to generate more energy than it consumes. Secondly, green buildings typically incorporate renewable energy sources, such as solar panels or wind turbines, further boosting the district's capacity for energy generation. This aligns with the PED objective of achieving a surplus of net energy. Moreover, green buildings often feature advanced systems for on-site energy management, load-matching, and self-consumption. This enhances the PED's capability to respond to variations in the energy market, making the district more agile and flexible in optimizing energy use. Additionally, the environmental considerations embedded in green buildings align with the broader sustainability goals of PEDs. By reducing the ecological footprint of individual structures, PEDs with green buildings contribute to minimizing the overall impact on centralized energy networks and promote a more sustainable urban environment. In summary, the incorporation of green buildings within PEDs not only aligns with the district's energy objectives but also enhances environmental sustainability, energy efficiency, and the overall resilience of the urban environment.

Keywords: positive energy district, renewables energy production, energy flexibility, energy efficiency

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84 Chemical, Biochemical and Sensory Evaluation of a Quadrimix Complementary Food Developed from Sorghum, Groundnut, Crayfish and Pawpaw Blends

Authors: Ogechi Nzeagwu, Assumpta Osuagwu, Charlse Nkwoala

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Malnutrition in infants due to poverty, poor feeding practices, and high cost of commercial complementary foods among others is a concern in developing countries. The study evaluated the proximate, vitamin and mineral compositions, antinutrients and functional properties, biochemical, haematological and sensory evaluation of complementary food made from sorghum, groundnut, crayfish and paw-paw flour blends using standard procedures. The blends were formulated on protein requirement of infants (18 g/day) using Nutrisurvey linear programming software in ratio of sorghum(S), groundnut(G), crayfish(C) and pawpaw(P) flours as 50:25:10:15(SGCP1), 60:20:10:10 (SGCP2), 60:15:15:10 (SGCP3) and 60:10:20:10 (SGCP4). Plain-pap (fermented maize flour)(TCF) and cerelac (commercial complementary food) served as basal and control diets. Thirty weanling male albino rats aged 28-35 days weighing 33-60 g were purchased and used for the study. The rats after acclimatization were fed with gruel produced with the experimental diets and the control with water ad libitum daily for 35days. Effect of the blends on lipid profile, blood glucose, haematological (RBC, HB, PCV, MCV), liver and kidney function and weight gain of the rats were assessed. Acceptability of the gruel was conducted at the end of rat feeding on forty mothers of infants’ ≥ 6 months who gave their informed consent to participate using a 9 point hedonic scale. Data was analyzed for means and standard deviation, analysis of variance and means were separated using Duncan multiple range test and significance judged at 0.05, all using SPSS version 22.0. The results indicated that crude protein, fibre, ash and carbohydrate of the formulated diets were either comparable or higher than values in cerelac. The formulated diets (SGCP1- SGCP4) were significantly (P>0.05) higher in vitamin A and thiamin compared to cerelac. The iron content of the formulated diets SGCP1- SGCP4 (4.23-6.36 mg/100) were within the recommended iron intake of infants (0.55 mg/day). Phytate (1.56-2.55 mg/100g) and oxalate (0.23-0.35 mg/100g) contents of the formulated diets were within the permissible limits of 0-5%. In functional properties, bulk density, swelling index, % dispersibility and water absorption capacity significantly (P<0.05) increased and compared favourably with cerelac. The essential amino acids of the formulated blends were within the amino acid profile of the FAO/WHO/UNU reference protein for children 0.5 -2 years of age. Urea concentration of rats fed with SGCP1-SGCP4 (19.48 mmol/L),(23.76 mmol/L),(24.07 mmol/L),(23.65 mmol/L) respectively was significantly higher than that of rat fed cerelac (16.98 mmol/L); however, plain pap had the least value (9.15 mmol/L). Rats fed with SGCP1-SGCP4 (116 mg/dl), (119 mg/dl), (115 mg/dl), (117 mg/dl) respectively had significantly higher glucose levels those fed with cerelac (108 mg/dl). Liver function parameters (AST, ALP and ALT), lipid profile (triglyceride, HDL, LDL, VLDL) and hematological parameters of rats fed with formulated diets were within normal range. Rats fed SGCP1 gained more weight (90.45 g) than other rats fed with SGCP2-SGCP4 (71.65 g, 79.76 g, 75.68 g), TCF (20.13 g) and cerelac (59.06 g). In all the sensory attributes, the control was preferred with respect to the formulated diets. The formulated diets were generally adequate and may likely have potentials to meet nutrient requirements of infants as complementary food.

Keywords: biochemical, chemical evaluation, complementary food, quadrimix

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83 Impact of School Environment on Socio-Affective Development: A Quasi-Experimental Longitudinal Study of Urban and Suburban Gifted and Talented Programs

Authors: Rebekah Granger Ellis, Richard B. Speaker, Pat Austin

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This study used two psychological scales to examine the level of social and emotional intelligence and moral judgment of over 500 gifted and talented high school students in various academic and creative arts programs in a large metropolitan area in the southeastern United States. For decades, numerous models and programs purporting to encourage socio-affective characteristics of adolescent development have been explored in curriculum theory and design. Socio-affective merges social, emotional, and moral domains. It encompasses interpersonal relations and social behaviors; development and regulation of emotions; personal and gender identity construction; empathy development; moral development, thinking, and judgment. Examining development in these socio-affective domains can provide insight into why some gifted and talented adolescents are not successful in adulthood despite advanced IQ scores. Particularly whether nonintellectual characteristics of gifted and talented individuals, such as emotional, social and moral capabilities, are as advanced as their intellectual abilities and how these are related to each other. Unique characteristics distinguish gifted and talented individuals; these may appear as strengths, but there is the potential for problems to accompany them. Although many thrive in their school environments, some gifted students struggle rather than flourish. In the socio-affective domain, these adolescents face special intrapersonal, interpersonal, and environmental problems. Gifted individuals’ cognitive, psychological, and emotional development occurs asynchronously, in multidimensional layers at different rates and unevenly across ability levels. Therefore, it is important to examine the long-term effects of participation in various gifted and talented programs on the socio-affective development of gifted and talented adolescents. This quasi-experimental longitudinal study examined students in several gifted and talented education programs (creative arts school, urban charter schools, and suburban public schools) for (1) socio-affective development level and (2) whether a particular gifted and talented program encourages developmental growth. The following research questions guided the study: (1) How do academically and artistically talented gifted 10th and 11th grade students perform on psychometric scales of social and emotional intelligence and moral judgment? Do they differ from their age or grade normative sample? Are their gender differences among gifted students? (2) Does school environment impact 10th and 11th grade gifted and talented students’ socio-affective development? Do gifted adolescents who participate in a particular school gifted program differ in their developmental profiles of social and emotional intelligence and moral judgment? Students’ performances on psychometric instruments were compared over time and by type of program. Participants took pre-, mid-, and post-tests over the course of an academic school year with Defining Issues Test (DIT-2) assessing moral judgment and BarOn EQ-I: YV assessing social and emotional intelligence. Based on these assessments, quantitative differences in growth on psychological scales (individual and school) were examined. Change scores between schools were also compared. If a school showed change, artifacts (culture, curricula, instructional methodology) provided insight as to environmental qualities that produced this difference.

Keywords: gifted and talented education, moral development, socio-affective development, socio-affective education

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82 Somatic Delusional Disorder Subsequent to Phantogeusia: A Case Report

Authors: Pedro Felgueiras, Ana Miguel, Nélson Almeida, Raquel Silva

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Objective: Through the study of a clinical case of delusional somatic disorder secondary to phantogeusia, we aim to highlight the importance of considering psychosomatic conditions in differential diagnosis, as well as to emphasize the complexity of its comprehension, treatment, and respective impact on patients’ functioning. Methods: Bearing this in mind, we conducted a critical analysis of a case series based on patient observations, clinical data, and complementary diagnostic methods, as well as a non-systematic review of the literature on the subject. Results: A 61-year-old female patient with no history of psychiatric conditions. Family psychiatric history of mood disorder (depression), with psychotic features found in her mother. Medical history of many comorbidities affecting different organ systems (endocrine, gastrointestinal, genitourinary, ophthalmological). Documented neuroticism traits of personality. The patient’s family described a persistent concern about several physical symptoms across her life, with a continuous effort to obtain explanations about any sensation out of her normal perception. Since being subjected to endoscopy in 2018, she started complaints of persistent phantogeusia (acid taste) and developed excessive thoughts, feelings, and behaviors associated with this somatic symptom. The patient was evaluated by several medical specialties, and an extensive panel of medical exams was carried out, excluding any disease. Besides all the investigation and with no evidence of disease signs, acute anxiety, time, and energy dispended to this symptom culminated in severe psychosocial impairment. The patient was admitted to a psychiatric ward for investigation and treatment of this clinical picture, leading to the diagnosis of the delusional somatic disorder. In order to exclude the acute organic etiology of this psychotic disorder, an analytic panel was carried out with no abnormal results. In the context of a psychotic clinical picture, a CT scan was performed, which revealed a right cortical vascular lesion. Neuropsychological evaluation was made, with the description of cognitive functioning being globally normative. During treatment with an antipsychotic (pimozide), a complete remission of the somatic delusion was associated with the disappearance of gustative perception disturbance. In follow-up, a relapse of gustative sensation was documented, and her thoughts and speech were dominated by concerns about multiple somatic symptoms. Conclusion: In terms of abnormal bodily sensations, the oral cavity is one of the frequent sites of delusional disorder. Patients with these gustatory perception distortions complain about unusual sensations without corresponding abnormal findings in the oral area. Its pathophysiology has not been fully elucidated yet. In terms of its comprehensive psychopathology, this case was hypothesized as a paranoid development of a delusional somatic disorder triggered by a post-invasive procedure phantogeusia (which is described as a possible side effect of an endoscopy) in a patient with an anankastic personality. This case presents interesting psychopathology, reinforcing the complexity of psychosomatic disorders in terms of their etiopathogenesis, clinical treatment, and long-term prognosis.

Keywords: psychosomatics, delusional somatic disorder, phantogeusia, paranoid development

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81 Rabies Free Pakistan - Eliminating Rabies Through One Health Approach

Authors: Anzal Abbas Jaffari, Wajiha Javed, Naseem Salahuddin

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Rationale: Rabies, a vaccine preventable disease, continues to be a critical public health issue as it kills around 2000-5000 people annually in Pakistan. Along with the disease spread among animals, the dog population remains a victim of brutal culling practices by the local authorities, which adversely affects ecosystem (sinking of poison in the soil – affecting vegetation & contaminating water) and the disease spread. The dog population has been exponentially rising primarily because a lack of a consolidated nationwide Animal Birth Control program and awareness among the local communities in general and children in particular. This is reflected in Pakistan’s low SARE score - 1.5, which makes the country trails behind other developing countries like Bangladesh (2.5) and Philippines (3.5).According to an estimate, the province of Sindh alone is home to almost 2.5 million dogs. The clustering of dogs in Peri-Urban areas and inner cities localities leads to an increase of reported dog bite cases in these areas specifically. Objective: Rabies Free Pakistan (RFP), which is a joint venture of Getz Pharma Private Limited and Indus Hospital & Health Network (IHHN); it was established in 2018 to eliminate Rabies from Pakistan by 2030 using the One Health Approach. Methodology: The RFP team is actively working on advocacy and policy front with both the Federal & Provincial government to ensure that all stakeholders currently involved in dog culling in Pakistan have a paradigm shift towards humane methods of vaccination and ABC. Along with the federal government, RFP aims to declare Rabies as a notifiable disease. Whereas RFP closely works with the provincial government of Sindh to initiate a province wide Rabies Control Program.RFP program follows international standards and WHO approved protocols for this program in Pakistan.RFP team has achieved various milestones in the fight against Rabies after successfully scaling up project operations and has vaccinated more than 30,000 dogs and neutered around 7,000 dogs since 2018. Recommendations: Effective implementation of Rabies program (MDV and ABC) requires a concentrated effort to address a variety of structural and policy challenges. This essentially demands a massive shift in the attitude of individuals towards rabies. The two most significant challenges in implementing a standard policy at the structural level are lack of institutional capacity, shortage of vaccine, and absence of inter-departmental coordination among major stakeholders: federal government, provincial ministry of health, livestock, and local bodies (including local councils). The lack of capacity in health care workers to treat dog bite cases emerges as a critical challenge at the clinical level. Conclusion: Pakistan can learn from the successful international models of Sri Lanka and Mexico as they adopted the One Health Approach to eliminate rabies like RFP. The WHO advised One Health approach provides the policymakers with an interactive and cross-sectoral guide, which involves all the essential elements of the eco system (including animals, humans, and other components).

Keywords: animal birth control, dog population, mass dog vaccination, one health, rabies elimination

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80 Advancing Early Intervention Strategies for United States Adolescents and Young Adults with Schizophrenia in the Post-COVID-19 Era

Authors: Peggy M. Randon, Lisa Randon

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Introduction: The post-COVID-19 era has presented unique challenges for addressing complex mental health issues, particularly due to exacerbated stress, increased social isolation, and disrupted continuity of care. This article outlines relevant health disparities and policy implications within the context of the United States while maintaining international relevance. Methods: A comprehensive literature review (including studies, reports, and policy documents) was conducted to examine concerns related to childhood-onset schizophrenia and the impact on patients and their families. Qualitative and quantitative data were synthesized to provide insights into the complex etiology of schizophrenia, the effects of the pandemic, and the challenges faced by socioeconomically disadvantaged populations. Case studies were employed to illustrate real-world examples and areas requiring policy reform. Results: Early intervention in childhood is crucial for preventing or mitigating the long-term impact of complex psychotic disorders, particularly schizophrenia. A comprehensive understanding of the genetic, environmental, and physiological factors contributing to the development of schizophrenia is essential. The COVID-19 pandemic worsened symptoms and disrupted treatment for many adolescent patients with schizophrenia, emphasizing the need for adaptive interventions and the utilization of virtual platforms. Health disparities, including stigma, financial constraints, and language or cultural barriers, further limit access to care, especially for socioeconomically disadvantaged populations. Policy implications: Current US health policies inadequately support patients with schizophrenia. The limited availability of longitudinal care, insufficient resources for families, and stigmatization represent ongoing policy challenges. Addressing these issues necessitates increased research funding, improved access to affordable treatment plans, and cultural competency training for healthcare providers. Public awareness campaigns are crucial to promote knowledge, awareness, and acceptance of mental health disorders. Conclusion: The unique challenges faced by children and families in the US affected by schizophrenia and other psychotic disorders have yet to be adequately addressed on institutional and systemic levels. The relevance of findings to an international audience is emphasized by examining the complex factors contributing to the onset of psychotic disorders and their global policy implications. The broad impact of the COVID-19 pandemic on mental health underscores the need for adaptive interventions and global responses. Addressing policy challenges, improving access to care, and reducing the stigma associated with mental health disorders are crucial steps toward enhancing the lives of adolescents and young adults with schizophrenia and their family members. The implementation of virtual platforms can help overcome barriers and ensure equitable access to support and resources for all patients, enabling them to lead healthy and fulfilling lives.

Keywords: childhood, schizophrenia, policy, United, States, health, disparities

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79 Introducing, Testing, and Evaluating a Unified JavaScript Framework for Professional Online Studies

Authors: Caspar Goeke, Holger Finger, Dorena Diekamp, Peter König

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Online-based research has recently gained increasing attention from various fields of research in the cognitive sciences. Technological advances in the form of online crowdsourcing (Amazon Mechanical Turk), open data repositories (Open Science Framework), and online analysis (Ipython notebook) offer rich possibilities to improve, validate, and speed up research. However, until today there is no cross-platform integration of these subsystems. Furthermore, implementation of online studies still suffers from the complex implementation (server infrastructure, database programming, security considerations etc.). Here we propose and test a new JavaScript framework that enables researchers to conduct any kind of behavioral research in the browser without the need to program a single line of code. In particular our framework offers the possibility to manipulate and combine the experimental stimuli via a graphical editor, directly in the browser. Moreover, we included an action-event system that can be used to handle user interactions, interactively change stimuli properties or store participants’ responses. Besides traditional recordings such as reaction time, mouse and keyboard presses, the tool offers webcam based eye and face-tracking. On top of these features our framework also takes care about the participant recruitment, via crowdsourcing platforms such as Amazon Mechanical Turk. Furthermore, the build in functionality of google translate will ensure automatic text translations of the experimental content. Thereby, thousands of participants from different cultures and nationalities can be recruited literally within hours. Finally, the recorded data can be visualized and cleaned online, and then exported into the desired formats (csv, xls, sav, mat) for statistical analysis. Alternatively, the data can also be analyzed online within our framework using the integrated Ipython notebook. The framework was designed such that studies can be used interchangeably between researchers. This will support not only the idea of open data repositories but also constitutes the possibility to share and reuse the experimental designs and analyses such that the validity of the paradigms will be improved. Particularly, sharing and integrating the experimental designs and analysis will lead to an increased consistency of experimental paradigms. To demonstrate the functionality of the framework we present the results of a pilot study in the field of spatial navigation that was conducted using the framework. Specifically, we recruited over 2000 subjects with various cultural backgrounds and consequently analyzed performance difference in dependence on the factors culture, gender and age. Overall, our results demonstrate a strong influence of cultural factors in spatial cognition. Such an influence has not yet been reported before and would not have been possible to show without the massive amount of data collected via our framework. In fact, these findings shed new lights on cultural differences in spatial navigation. As a consequence we conclude that our new framework constitutes a wide range of advantages for online research and a methodological innovation, by which new insights can be revealed on the basis of massive data collection.

Keywords: cultural differences, crowdsourcing, JavaScript framework, methodological innovation, online data collection, online study, spatial cognition

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78 Illness-Related PTSD Among Type 1 Diabetes Patients

Authors: Omer Zvi Shaked, Amir Tirosh

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Type 1 Diabetes (T1DM) is an incurable chronic illness with no known preventive measures. Excess to insulin therapy can lead to hypoglycemia with neuro-glycogenic symptoms such as shakiness, nausea, sweating, irritability, fatigue, excessive thirst or hunger, weakness, seizure, and coma. Severe Hypoglycemia (SH) is also considered a most aversive event since it may put patients at risk for injury and death, which matches the criteria of a traumatic event. SH has a ranging prevalence of 20%, which makes it a primary medical Issue. One of the results of SH is an intense emotional fear reaction resembling the form of post-traumatic stress symptoms (PTS), causing many patients to avoid insulin therapy and social activities in order to avoid the possibility of hypoglycemia. As a result, they are at risk for irreversible health deterioration and medical complications. Fear of Hypoglycemia (FOH) is, therefore, a major disturbance for T1DM patients. FOH differs from prevalent post-traumatic stress reactions to other forms of traumatic events since the threat to life continuously exists in the patient's body. That is, it is highly probable that orthodox interventions may not be sufficient for helping patients after SH to regain healthy social function and proper medical treatment. Accordingly, the current presentation will demonstrate the results of a study conducted among T1DM patients after SH. The study was designed in two stages. First, a preliminary qualitative phenomenological study among ten patients after SH was conducted. Analysis revealed that after SH, patients confuse between stress symptoms and Hypoglycemia symptoms, divide life before and after the event, report a constant sense of fear, a loss of freedom, a significant decrease in social functioning, a catastrophic thinking pattern, a dichotomous split between the self and the body, and internalization of illness identity, a loss of internal locus of control, a damaged self-representation, and severe loneliness for never being understood by others. The second stage was a two steps study of intervention among five patients after SH. The first part of the intervention included three months of therapeutic 3rd wave CBT therapy. The contents of the therapeutic process were: acceptance of fear and tolerance to stress; cognitive de-fusion combined with emotional self-regulation; the adoption of an active position relying on personal values; and self-compassion. Then, the intervention included a one-week practical real-time 24/7 support by trained medical personnel, alongside a gradual exposure to increased insulin therapy in a protected environment. The results of the intervention are a decrease in stress symptoms, increased social functioning, increased well-being, and decreased avoidance of medical treatment. The presentation will discuss the unique emotional state of T1DM patients after SH. Then, the presentation will discuss the effectiveness of the intervention for patients with chronic conditions after a traumatic event. The presentation will make evident the unique situation of illness-related PTSD. The presentation will also demonstrate the requirement for multi-professional collaboration between social work and medical care for populations with chronic medical conditions. Limitations of the study and recommendations for further research will be discussed.

Keywords: type 1 diabetes, chronic illness, post-traumatic stress, illness-related PTSD

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77 A Longitudinal Exploration into Computer-Mediated Communication Use (CMC) and Relationship Change between 2005-2018

Authors: Laurie Dempsey

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Relationships are considered to be beneficial for emotional wellbeing, happiness and physical health. However, they are also complicated: individuals engage in a multitude of complex and volatile relationships during their lifetime, where the change to or ending of these dynamics can be deeply disruptive. As the internet is further integrated into everyday life and relationships are increasingly mediated, Media Studies’ and Sociology’s research interests intersect and converge. This study longitudinally explores how relationship change over time corresponds with the developing UK technological landscape between 2005-2018. Since the early 2000s, the use of computer-mediated communication (CMC) in the UK has dramatically reshaped interaction. Its use has compelled individuals to renegotiate how they consider their relationships: some argue it has allowed for vast networks to be accumulated and strengthened; others contend that it has eradicated the core values and norms associated with communication, damaging relationships. This research collaborated with UK media regulator Ofcom, utilising the longitudinal dataset from their Adult Media Lives study to explore how relationships and CMC use developed over time. This is a unique qualitative dataset covering 2005-2018, where the same 18 participants partook in annual in-home filmed depth interviews. The interviews’ raw video footage was examined year-on-year to consider how the same people changed their reported behaviour and outlooks towards their relationships, and how this coincided with CMC featuring more prominently in their everyday lives. Each interview was transcribed, thematically analysed and coded using NVivo 11 software. This study allowed for a comprehensive exploration into these individuals’ changing relationships over time, as participants grew older, experienced marriages or divorces, conceived and raised children, or lost loved ones. It found that as technology developed between 2005-2018, everyday CMC use was increasingly normalised and incorporated into relationship maintenance. It played a crucial role in altering relationship dynamics, even factoring in the breakdown of several ties. Three key relationships were identified as being shaped by CMC use: parent-child; extended family; and friendships. Over the years there were substantial instances of relationship conflict: for parents renegotiating their dynamic with their child as they tried to both restrict and encourage their child’s technology use; for estranged family members ‘forced’ together in the online sphere; and for friendships compelled to publicly display their relationship on social media, for fear of social exclusion. However, it was also evident that CMC acted as a crucial lifeline for these participants, providing opportunities to strengthen and maintain their bonds via previously unachievable means, both over time and distance. A longitudinal study of this length and nature utilising the same participants does not currently exist, thus provides crucial insight into how and why relationship dynamics alter over time. This unique and topical piece of research draws together Sociology and Media Studies, illustrating how the UK’s changing technological landscape can reshape one of the most basic human compulsions. This collaboration with Ofcom allows for insight that can be utilised in both academia and policymaking alike, making this research relevant and impactful across a range of academic fields and industries.

Keywords: computer mediated communication, longitudinal research, personal relationships, qualitative data

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76 The 5-HT1A Receptor Biased Agonists, NLX-101 and NLX-204, Elicit Rapid-Acting Antidepressant Activity in Rat Similar to Ketamine and via GABAergic Mechanisms

Authors: A. Newman-Tancredi, R. Depoortère, P. Gruca, E. Litwa, M. Lason, M. Papp

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The N-methyl-D-aspartic acid (NMDA) receptor antagonist, ketamine, can elicit rapid-acting antidepressant (RAAD) effects in treatment-resistant patients, but it requires parenteral co-administration with a classical antidepressant under medical supervision. In addition, ketamine can also produce serious side effects that limit its long-term use, and there is much interest in identifying RAADs based on ketamine’s mechanism of action but with safer profiles. Ketamine elicits GABAergic interneuron inhibition, glutamatergic neuron stimulation, and, notably, activation of serotonin 5-HT1A receptors in the prefrontal cortex (PFC). Direct activation of the latter receptor subpopulation with selective ‘biased agonists’ may therefore be a promising strategy to identify novel RAADs and, consistent with this hypothesis, the prototypical cortical biased agonist, NLX-101, exhibited robust RAAD-like activity in the chronic mild stress model of depression (CMS). The present study compared the effects of a novel, selective 5-HT1A receptor-biased agonist, NLX-204, with those of ketamine and NLX-101. Materials and methods: CMS procedure was conducted on Wistar rats; drugs were administered either intraperitoneally (i.p.) or by bilateral intracortical microinjection. Ketamine: 10 mg/kg i.p. or 10 µg/side in PFC; NLX-204 and NLX-101: 0.08 and 0.16 mg/kg i.p. or 16 µg/side in PFC. In addition, interaction studies were carried out with systemic NLX-204 or NLX-101 (each at 0.16 mg/kg i.p.) in combination with intracortical WAY-100635 (selective 5-HT1A receptor antagonist; 2 µg/side) or muscimol (GABA-A receptor agonist, 12.5 ng/side). Anhedonia was assessed by CMS-induced decrease in sucrose solution consumption; anxiety-like behavior was assessed using the Elevated Plus Maze (EPM), and cognitive impairment was assessed by the Novel Object Recognition (NOR) test. Results: A single administration of NLX-204 was sufficient to reverse the CMS-induced deficit in sucrose consumption, similarly to ketamine and NLX-101. NLX-204 also reduced CMS-induced anxiety in the EPM and abolished CMS-induced NOR deficits. These effects were maintained (EPM and NOR) or enhanced (sucrose consumption) over a subsequent 2-week period of treatment. The anti-anhedonic response of the drugs was also maintained for several weeks Following treatment discontinuation, suggesting that they had sustained effects on neuronal networks. A single PFC administration of NLX-204 reversed deficient sucrose consumption, similarly to ketamine and NLX-101. Moreover, the anti-anhedonic activities of systemic NLX-204 and NLX 101 were abolished by coadministration with intracortical WAY-100635 or muscimol. Conclusions: (i) The antidepressant-like activity of NLX-204 in the rat CMS model was as rapid as that of ketamine or NLX-101, supporting targeting cortical 5-HT1A receptors with selective, biased agonists to achieve RAAD effects. (ii)The anti-anhedonic activity of systemic NLX-204 was mimicked by local administration of the compound in the PFC, confirming the involvement of cortical circuits in its RAAD-like effects. (iii) Notably, the effects of systemic NLX-204 and NLX-101 were abolished by PFC administration of muscimol, indicating that they act by (indirectly) eliciting a reduction in cortical GABAergic neurotransmission. This is consistent with ketamine’s mechanism of action and suggests that there are converging NMDA and 5-HT1A receptor signaling cascades in PFC underlying the RAAD-like activities of ketamine and NLX-204. Acknowledgements: The study was financially supported by NCN grant no. 2019/35/B/NZ7/00787.

Keywords: depression, ketamine, serotonin, 5-HT1A receptor, chronic mild stress

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75 When It Wasn’t There: Understanding the Importance of High School Sports

Authors: Karen Chad, Louise Humbert, Kenzie Friesen, Dave Sandomirsky

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Background: The pandemic of COVID-19 presented many historical challenges to the sporting community. For organizations and individuals, sport was put on hold resulting in social, economic, physical, and mental health consequences for all involved. High school sports are seen as an effective and accessible pathway for students to receive health, social, and academic benefits. Studies examining sport cessation due to COVID-19 found substantial negative outcomes on the physical and mental well-being of participants in the high school setting. However, the pandemic afforded an opportunity to examine sport participation and the value people place upon their engagement in high school sport. Study objectives: (1) Examine the experiences of students, parents, administrators, officials, and coaches during a year without high school sports; (2) Understand why participants are involved in high school sports; and (3) Learn what supports are needed for future involvement. Methodology: A mixed method design was used, including semi-structured interviews and a survey (SurveyMonkey software), which was disseminated electronically to high school students, coaches, school administrators, parents, and officials. Results: 1222 respondents completed the survey. Findings showed: (1) 100% of students participate in high school sports to improve their mental health, with >95% said it keeps them active and healthy, helps them make friends and teaches teamwork, builds confidence and positive self-perceptions, teaches resiliency, enhances connectivity to their school, and supports academic learning; (2) Top three reasons teachers coach is their desire to make a difference in the lives of students, enjoyment, and love of the sport, and to give back. Teachers said what they enjoy most is contributing to and watching athletes develop, direct involvement with student sport success, and the competitiveatmosphere; (3) 90% of parents believe playing sports is a valuable experience for their child, 95% said it enriches student academic learning and educational experiences, and 97% encouraged their child to play school sports; (4) Officials participate because of their enjoyment and love of the sport, experience, and expertise, desire to make a difference in the lives of children, the competitive/sporting atmosphere and growing the sport. 4% of officials said it was financially motivated; (5) 100% of administrators said high school sports are important for everyone. 80% believed the pandemic will decrease teachers coaching and increase student mental health and well-being. When there was no sport, many athletes got a part-time job and tried to stay active, with limited success. Coaches, officials, and parents spent more time with family. All participants did little physical activity, were bored; and struggled with mental health and poor physical health. Respondents recommended better communication, promotion, and branding of high school sport benefits, equitable funding for all sports, athlete development, compensation and recognition for coaching, and simple processes to strengthen the high school sport model. Conclusions: High school sport is an effective vehicle for athletes, parents, coaches, administrators, and officials to derive many positive outcomes. When it is taken away, serious consequences prevail. Paying attention to important success factors will be important for the effectiveness of high school sports.

Keywords: physical activity, high school, sports, pandemic

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74 Improved Anatomy Teaching by the 3D Slicer Platform

Authors: Ahmedou Moulaye Idriss, Yahya Tfeil

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Medical imaging technology has become an indispensable tool in many branches of the biomedical, health area, and research and is vitally important for the training of professionals in these fields. It is not only about the tools, technologies, and knowledge provided but also about the community that this training project proposes. In order to be able to raise the level of anatomy teaching in the medical school of Nouakchott in Mauritania, it is necessary and even urgent to facilitate access to modern technology for African countries. The role of technology as a key driver of justifiable development has long been recognized. Anatomy is an essential discipline for the training of medical students; it is a key element for the training of medical specialists. The quality and results of the work of a young surgeon depend on his better knowledge of anatomical structures. The teaching of anatomy is difficult as the discipline is being neglected by medical students in many academic institutions. However, anatomy remains a vital part of any medical education program. When anatomy is presented in various planes medical students approve of difficulties in understanding. They do not increase their ability to visualize and mentally manipulate 3D structures. They are sometimes not able to correctly identify neighbouring or associated structures. This is the case when they have to make the identification of structures related to the caudate lobe when the liver is moved to different positions. In recent decades, some modern educational tools using digital sources tend to replace old methods. One of the main reasons for this change is the lack of cadavers in laboratories with poorly qualified staff. The emergence of increasingly sophisticated mathematical models, image processing, and visualization tools in biomedical imaging research have enabled sophisticated three-dimensional (3D) representations of anatomical structures. In this paper, we report our current experience in the Faculty of Medicine in Nouakchott Mauritania. One of our main aims is to create a local learning community in the fields of anatomy. The main technological platform used in this project is called 3D Slicer. 3D Slicer platform is an open-source application available for free for viewing, analysis, and interaction with biomedical imaging data. Using the 3D Slicer platform, we created from real medical images anatomical atlases of parts of the human body, including head, thorax, abdomen, liver, and pelvis, upper and lower limbs. Data were collected from several local hospitals and also from the website. We used MRI and CT-Scan imaging data from children and adults. Many different anatomy atlases exist, both in print and digital forms. Anatomy Atlas displays three-dimensional anatomical models, image cross-sections of labelled structures and source radiological imaging, and a text-based hierarchy of structures. Open and free online anatomical atlases developed by our anatomy laboratory team will be available to our students. This will allow pedagogical autonomy and remedy the shortcomings by responding more fully to the objectives of sustainable local development of quality education and good health at the national level. To make this work a reality, our team produced several atlases available in our faculty in the form of research projects.

Keywords: anatomy, education, medical imaging, three dimensional

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73 Relationship between Illegal Wildlife Trade and Community Conservation: A Case Study of the Chepang Community in Nepal

Authors: Vasundhara H. Krishnani, Ajay Saini, Dibesh Karmacharya, Salit Kark

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Illegal Wildlife Trade is one of the most pressing global conservation challenges. Unregulated wildlife trade can threaten biodiversity, contribute to habitat loss, limit sustainable development efforts, and expedite species declines and extinctions. In low-income and middle-income countries, such as Nepal and other countries in Asia and Africa, many of the people engaged in the early stages of illegal wildlife trade, which includes the hunting and transportation of wildlife, belong to Indigenous tribes and local communities.These countries primarily rely on punitive measures to prevent and suppress Illegal Wildlife Trade. For example, in Nepal, people involved in wildlife crimes can often be sentenced to incarceration and a hefty fine and serve up to 15 years in prison. Despite these harsh punitive measures, illegal wildlife trade remains a significant conservation challenge in many countries. The aim of this study was to examine factors affecting the participation of Indigenous communities in Illegal Wildlife Trade while recording the experiences of members of the Indigenous Chepang community, some of whom were imprisoned for their alleged involvement in rhino poaching. Chepangs, belonging to traditionally a hunter-gatherer community, are often considered an isolated and marginalized Indigenous community, some of whom live around the Chitwan National Park in Nepal. Established in 1973, Chitwan National Park is situated in the Chitwan Valley of Nepal and was one of the first regions that was declared as a protected area in Nepal, aiming to protect the one-horned rhinoceros as a flagship species. Conducted over a period of three years, this study used semi-structured interviews and focus group discussions to collect data from Illegal Wildlife Trade offenders, family members of offenders, community Elders, NGO personnel, community forest representatives, Chepang community representatives, and Government school teachers from the region surrounding Chitwan National Park. The study also examined the social, cultural, health, and financial impacts that the imprisonment of offenders had on the families of the community members, especially women and children. The results suggest that involvement of the members of the Chepang community living around Chitwan National Park in the poaching of the one-horned rhinoceros (Rhinoceros unicornis) can be attributed to a range of factors, some of which include: lack of livelihood opportunities, lack of awareness regarding wildlife rules and regulations and poverty.This work emphasises the need for raising awareness and building programs to enhance alternative livelihood training and empower indigenous and marginalised communities that provide sustainable alternatives. Furthermore, the issue needs to be addressed as a community solution which includes all community members. We suggest this multi-pronged approach can benefit wildlife conservation by reducing illegal poaching and wildlife trade, as well as community conservation in regions with similar challenges. By actively involving and empowering local communities, the communities become key stakeholders in the conservation process. This involvement contributes to protecting wildlife and natural ecosystems while simultaneously providing sustainable livelihood options for local communities.

Keywords: alternative livelihoods, chepang community, illegal wildlife trade, low-and middle-income countries, nepal, one-horned rhinoceros

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72 A Regulator's Assessment of Consumer Risk When Evaluating a User Test for an Umbrella Brand Name in an over the Counter Medicine

Authors: A. Bhatt, C. Bassi, H. Farragher, J. Musk

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Background: All medicines placed on the EU market are legally required to be accompanied by labeling and package leaflet, which provide comprehensive information, enabling its safe and appropriate use. Mock-ups with results of assessments using a target patient group must be submitted for a marketing authorisation application. Consumers need confidence in non-prescription, OTC medicines in order to manage their minor ailments and umbrella brands assist purchasing decisions by assisting easy identification within a particular therapeutic area. A number of regulatory agencies have risk management tools and guidelines to assist in developing umbrella brands for OTC medicines, however assessment and decision making is subjective and inconsistent. This study presents an evaluation in the UK following the US FDA warning concerning methaemoglobinaemia following 21 reported cases (11 children under 2 years) caused by OTC oral analgesics containing benzocaine. METHODS: A standard face to face, 25 structured task based user interview testing methodology using a standard questionnaire and rating scale in consumers aged 15-91 years, was conducted independently between June and October 2015 in their homes. Whether individuals could discriminate between the labelling, safety information and warnings on cartons and PILs between 3 different OTC medicines packs with the same umbrella name was evaluated. Each pack was presented with differing information hierarchy using, different coloured cartons, containing the 3 different active ingredients, benzocaine (oromucosal spray) and two lozenges containing 2, 4, dichlorobenzyl alcohol, amylmetacresol and hexylresorcinol respectively (for the symptomatic relief of sore throat pain). The test was designed to determine whether warnings on the carton and leaflet were prominent, accessible to alert users that one product contained benzocaine, risk of methaemoglobinaemia, and refer to the leaflet for the signs of the condition and what to do should this occur. Results: Two consumers did not locate the warnings on the side of the pack, eventually found them on the back and two suggestions to further improve accessibility of the methaemoglobinaemia warning. Using a gold pack design for the oromucosal spray, all consumers could differentiate between the 3 drugs, minimum age particulars, pharmaceutical form and the risk factor methaemoglobinaemia. The warnings for benzocaine were deemed to be clear or very clear; appearance of the 3 packs were either very well differentiated or quite well differentiated. The PIL test passed on all criteria. All consumers could use the product correctly, identify risk factors ensuring the critical information necessary for the safe use was legible and easily accessible so that confusion and errors were minimised. Conclusion: Patients with known methaemoglobinaemia are likely to be vigilant in checking for benzocaine containing products, despite similar umbrella brand names across a range of active ingredients. Despite these findings, the package design and spray format were not deemed to be sufficient to mitigate potential safety risks associated with differences in target populations and contraindications when submitted to the Regulatory Agency. Although risk management tools are increasingly being used by agencies to assist in providing objective assurance of package safety, further transparency, reduction in subjectivity and proportionate risk should be demonstrated.

Keywords: labelling, OTC, risk, user testing

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71 A Postmodern Framework for Quranic Hermeneutics

Authors: Christiane Paulus

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Post-Islamism assumes that the Quran should not be viewed in terms of what Lyotard identifies as a ‘meta-narrative'. However, its socio-ethical content can be viewed as critical of power discourse (Foucault). Practicing religion seems to be limited to rites and individual spirituality, taqwa. Alternatively, can we build on Muhammad Abduh's classic-modern reform and develop it through a postmodernist frame? This is the main question of this study. Through his general and vague remarks on the context of the Quran, Abduh was the first to refer to the historical and cultural distance of the text as an obstacle for interpretation. His application, however, corresponded to the modern absolute idea of authentic sharia. He was followed by Amin al-Khuli, who hermeneutically linked the content of the Quran to the theory of evolution. Fazlur Rahman and Nasr Hamid abu Zeid remain reluctant to go beyond the general level in terms of context. The hermeneutic circle, therefore, persists in challenging, how to get out to overcome one’s own assumptions. The insight into and the acceptance of the lasting ambivalence of understanding can be grasped as a postmodern approach; it is documented in Derrida's discovery of the shift in text meanings, difference, also in Lyotard's theory of différend. The resulting mixture of meanings (Wolfgang Welsch) can be read together with the classic ambiguity of the premodern interpreters of the Quran (Thomas Bauer). Confronting hermeneutic difficulties in general, Niklas Luhmann proves every description an attribution, tautology, i.e., remaining in the circle. ‘De-tautologization’ is possible, namely by analyzing the distinctions in the sense of objective, temporal and social information that every text contains. This could be expanded with the Kantian aesthetic dimension of reason (critique of pure judgment) corresponding to the iʽgaz of the Coran. Luhmann asks, ‘What distinction does the observer/author make?’ Quran as a speech from God to the first listeners could be seen as a discourse responding to the problems of everyday life of that time, which can be viewed as the general goal of the entire Qoran. Through reconstructing koranic Lifeworlds (Alfred Schütz) in detail, the social structure crystallizes the socio-economic differences, the enormous poverty. The koranic instruction to provide the basic needs for the neglected groups, which often intersect (old, poor, slaves, women, children), can be seen immediately in the text. First, the references to lifeworlds/social problems and discourses in longer koranic passages should be hypothesized. Subsequently, information from the classic commentaries could be extracted, the classical Tafseer, in particular, contains rich narrative material for reconstructing. By selecting and assigning suitable, specific context information, the meaning of the description becomes condensed (Clifford Geertz). In this manner, the text gets necessarily an alienation and is newly accessible. The socio-ethical implications can thus be grasped from the difference of the original problem and the revealed/improved order/procedure; this small step can be materialized as such, not as an absolute solution but as offering plausible patterns for today’s challenges as the Agenda 2030.

Keywords: postmodern hermeneutics, condensed description, sociological approach, small steps of reform

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70 Case Report: Treatment Resistant Schizophrenia in an Immigrant Adolescent

Authors: Omaymah Al-Otoom, Rajesh Mehta

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Introduction: Migration is an established risk factor in the development of schizophrenia and other forms of psychosis. The exposure to different social adversities, including social isolation, discrimination, and economic stress, is thought to contribute to elevated rates of psychosis in immigrants and their children. We present a case of resistant schizophrenia in an immigrant adolescent. Case: The patient is a 15-year-old male immigrant. In October 2021, the patient was admitted for irritability, suicidal ideations, and hallucinations. He was treated with Fluoxetine 10 mg daily for irritability. In November 2021, he presented with similar manifestations. Fluoxetine was discontinued, and Risperidone 1 mg at bedtime was started for psychotic symptoms. In March 2022, he presented with commanding auditory hallucinations (voices telling him that people were going to kill his father). Risperidone was gradually increased to 2.5 mg twice daily for hallucinations. The outpatient provider discontinued Risperidone and started Olanzapine 7.5 mg and Lurasidone 40 mg daily. In August 2022, he presented with worsening paranoia due to medication non-adherence. The patient had limited improvement on medications. In October 2022, the patient presented to the ED for visual hallucinations and aggression towards the family. His medications were Olanzapine 10 mg daily, Lurasidone 60 mg daily, and Haloperidol 2.5 mg twice daily. In the ED, he received multiple as-needed medications and was placed in seclusion for his aggressive behavior. The patient showed a positive response to a higher dose of Olanzapine and decreased dose of Lurasidone. The patient was discharged home in stable condition. Two days after discharge, he was brought for bizarre behavior, visual hallucinations, and homicidal ideations at school. Due to concerns for potential antipsychotic side effects and poor response, Lurasidone and Olanzapine were discontinued, and he was discharged home on Haloperidol 5 mg in the morning and 15 mg in the evening. Clozapine treatment was recommended on an outpatient basis. He has no family history of psychotic disorders. He has no history of substance use. A medical workup was done, the electroencephalogram was normal, and the urine toxicology was negative. Discussion: Our patient was on three antipsychotics at some point with no improvement in his psychotic symptoms, which qualifies as treatment-resistant schizophrenia (TRP). It is well recognized that migrants are at higher risk of different psychiatric disorders, including posttraumatic stress disorder, affective disorders, schizophrenia, and psychosis. This is thought to be related to higher exposure to traumatic life events compared to the general population. In addition, migrants are more likely to experience poverty, separation from family members, and discrimination which could contribute to mental health issues. In one study, they found that people who migrated before the age of 18 had twice the risk of psychotic disorders compared to the native-born population. It is unclear whether migration increases the risk of treatment resistance. In a Canadian study, neither ethnicity nor migrant status was associated with treatment resistance; however, this study was limited by its small sample size. There is a need to implement psychiatric prevention strategies and outreach programs through research to mitigate the risk of mental health disorders among immigrants.

Keywords: psychosis, immigrant, adolescent, treatment resistant schizophrenia

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69 The Healing 'Touch' of Music: A Neuro-Acoustics Approach to Understand Its Therapeutic Effect

Authors: Jagmeet S. Kanwal, Julia F. Langley

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Music can heal the body, but a mechanistic understanding of this phenomenon is lacking. This study explores the effects of music presentation on neurologic and physiologic responses leading to metabolic changes in the human body. The mind and body co-exist in a corporeal entity and within this framework, sickness ensues when the mind-body balance goes awry. It is further hypothesized that music has the capacity to directly reset this balance. Two lines of inquiry taken together can provide a mechanistic understanding of this phenomenon 1) Empirical evidence for a sound-sensitive pressure sensor system in the body, and 2) The notion of a “healing center” within the brain that is activated by specific patterns of sounds. From an acoustics perspective, music is spatially distributed as pressure waves ranging from a few cm to several meters in wavelength. These waves interact and propagate in three-dimensions in unique ways, depending on the wavelength. Furthermore, music creates dynamically changing wave-fronts. Frequencies between 200 Hz and 1 kHz generate wavelengths that range from 5'6" to 1 foot. These dimensions are in the range of the body size of most people making it plausible that these pressure waves can geometrically interact with the body surface and create distinct patterns of pressure stimulation across the skin surface. For humans, short wavelength, high frequency (> 200 Hz) sounds are best received via cochlear receptors. For low frequency (< 200 Hz), long wavelength sound vibrations, however, the whole body may act as an ideal receiver. A vast array of highly sensitive pressure receptors (Pacinian corpuscles) is present just beneath the skin surface, as well as in the tendons, bones, several organs in the abdomen, and the sexual organs. Per the available empirical evidence, these receptors contribute to music perception by allowing the whole body to function as a sound receiver, and knowledge of how they function is essential to fully understanding the therapeutic effect of music. Neuroscientific studies have established that music stimulates the limbic system that can trigger states of anxiety, arousal, fear, and other emotions. These emotional states of brain activity play a crucial role in filtering top-down feedback from thoughts and bottom-up sensory inputs to the autonomic system, which automatically regulates bodily functions. Music likely exerts its pleasurable and healing effects by enhancing functional and effective connectivity and feedback mechanisms between brain regions that mediate reward, autonomic, and cognitive processing. Stimulation of pressure receptors under the skin by low-frequency music-induced sensations can activate multiple centers in the brain, including the amygdala, the cingulate cortex, and nucleus accumbens. Melodies in music in the low (< 600 Hz) frequency range may augment auditory inputs after convergence of the pressure-sensitive inputs from the vagus nerve onto emotive processing regions within the limbic system. The integration of music-generated auditory and somato-visceral inputs may lead to a synergistic input to the brain that promotes healing. Thus, music can literally heal humans through “touch” as it energizes the brain’s autonomic system for restoring homeostasis.

Keywords: acoustics, brain, music healing, pressure receptors

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68 Sustainability in the Purchase of Airline Tickets: Analysis of Digital Communication from the Perspective of Neuroscience

Authors: Rodríguez Sánchez Carla, Sancho-Esper Franco, Guillen-Davo Marina

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Tourism is one of the most important sectors worldwide since it is an important economic engine for today's society. It is also one of the sectors that most negatively affect the environment in terms of CO₂ emissions due to this expansion. In light of this, airlines are developing Voluntary Carbon Offset (VCO). There is important evidence focused on analyzing the features of these VCO programs and their efficacy in reducing CO₂ emissions, and findings are mixed without a clear consensus. Different research approaches have centered on analyzing factors and consequences of VCO programs, such as economic modelling based on panel data, survey research based on traveler responses or experimental research analyzing customer decisions in a simulated context. This study belongs to the latter group because it tries to understand how different characteristics of an online ticket purchase website affect the willingness of a traveler to choose a sustainable one. The proposed behavioral model is based on several theories, such as the nudge theory, the dual processing ELM and the cognitive dissonance theory. This randomized experiment aims at overcoming previous studies based on self-reported measures that mainly study sustainable behavioral intention rather than actual decision-making. It also complements traditional self-reported independent variables by gathering objective information from an eye-tracking device. This experiment analyzes the influence of two characteristics of the online purchase website: i) the type of information regarding flight CO₂ emissions (quantitative vs. qualitative) and the comparison framework related to the sustainable purchase decision (negative: alternative with more emissions than the average flight of the route vs. positive: alternative with less emissions than the average flight of the route), therefore it is a 2x2 experiment with four alternative scenarios. A pretest was run before the actual experiment to refine the experiment features and to check the manipulations. Afterward, a different sample of students answered the pre-test questionnaire aimed at recruiting the cases and measuring several pre-stimulus measures. One week later, students came to the neurolab at the University setting to be part of the experiment, made their decision regarding online purchases and answered the post-test survey. A final sample of 21 students was gathered. The committee of ethics of the institution approved the experiment. The results show that qualitative information generates more sustainable decisions (less contaminant alternative) than quantitative information. Moreover, evidence shows that subjects are more willing to choose the sustainable decision to be more ecological (comparison of the average with the less contaminant alternative) rather than to be less contaminant (comparison of the average with the more contaminant alternative). There are also interesting differences in the information processing variables from the eye tracker. Both the total time to make the choice and the specific times by area of interest (AOI) differ depending on the assigned scenario. These results allow for a better understanding of the factors that condition the decision of a traveler to be part of a VCO program and provide useful information for airline managers to promote these programs to reduce environmental impact.

Keywords: voluntary carbon offset, airline, online purchase, carbon emission, sustainability, randomized experiment

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67 Guard@Lis: Birdwatching Augmented Reality Mobile Application

Authors: Jose A. C. Venancio, Alexandrino J. M. Goncalves, Anabela Marto, Nuno C. S. Rodrigues, Rita M. T. Ascenso

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Nowadays, it is common to find people who are concerned about getting away from the everyday life routine, looking forward to outcome well-being and pleasant emotions. Trying to disconnect themselves from the usual places of work and residence, they pursue different places, such as tourist destinations, aiming to have unexpected experiences. In order to make this exploration process easier, cities and tourism agencies seek new opportunities and solutions, creating routes with diverse cultural landmarks, including natural landscapes and historic buildings. These offers frequently aspire to the preservation of the local patrimony. In nature and wildlife, birdwatching is an activity that has been increasing, both in cities and in the countryside. This activity seeks to find, observe and identify the diversity of birds that live permanently or temporarily in these places, and it is usually supported by birdwatching guides. Leiria (Portugal) is a well-known city, presenting several historical and natural landmarks, like the Lis river and the castle where King D. Dinis lived in the 13th century. Along the Lis River, a conservation process was carried out and a pedestrian route was created (Polis project). This is considered an excellent spot for birdwatching, especially for the gray heron (Ardea cinerea) and for the kingfisher (Alcedo atthis). There is also a route through the city, from the riverside to the castle, which encloses a characterized variety of species, such as the barn swallow (Hirundo rustica), known for passing through different seasons of the year. Birdwatching is sometimes a difficult task since it is not always possible to see all bird species that inhabit a given place. For this reason, a need to create a technological solution was found to ease this activity. This project aims to encourage people to learn about the various species of birds that live along the Lis River and to promote the preservation of nature in a conscious way. This work is being conducted in collaboration with Leiria Municipal Council and with the Environmental Interpretation Centre. It intends to show the majesty of the Lis River, a place visited daily by several people, such as children and families, who use it for didactic and recreational activities. We are developing a mobile multi-platform application (Guard@Lis) that allows bird species to be observed along a given route, using representative digital 3D models through the integration of augmented reality technologies. Guard@Lis displays a route with points of interest for birdwatching and a list of species for each point of interest, along with scientific information, images and sounds for every species. For some birds, to ensure their observation, the user can watch them in loco, in their real and natural environment, with their mobile device by means of augmented reality, giving the sensation of presence of these birds, even if they cannot be seen in that place at that moment. The augmented reality feature is being developed with Vuforia SDK, using a hybrid approach to recognition and tracking processes, combining marks and geolocation techniques. This application proposes routes and notifies users with alerts for the possibility of viewing models of augmented reality birds. The final Guard@Lis prototype will be tested by volunteers in-situ.

Keywords: augmented reality, birdwatching route, mobile application, nature tourism, watch birds using augmented reality

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66 Memories of Lost Fathers: The Unfinished Transmission of Generational Values in Hungarian Cinema by Peter Falanga

Authors: Peter Falanga

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During the process of de-Stalinization that began in 1956 with the Twentieth Congress of the Soviet Communist Party, many filmmakers in Hungary chose to explore their country’s political discomforts by using Socialist Realism as a negative model against which they could react to the dominating ideology. A renewed national film industry and a more permissive political regime would allow filmmakers to take to task the plight of the preceding generation who had experienced the fatal political turmoil of both World Wars and the purges of Stalin. What follows is no longer the multigenerational unity found in Socialist Realism wherein both the old and the young embrace Stalin’s revolutionary optimism; instead, the protagonists are parentless, and thus their connection to the previous generation is partially severed. In these films, violent historical forces leave one generation to search for both a connection with their family’s past, and for moral guidance to direct their future. István Szabó’s Father (1966), Márta Mészáros Diary for My Children (1984), and Pál Gábor’s Angi Vera (1978) each consider the fraught relationship between successive generations through the lens of postwar youth. A characteristic each of their protagonist’s share is that they are all missing one or both parents, and cope with familial loss either through recalling memories of their parents in dream-like sequences, or, in the case of Angi Vera, through embracing the surrogate paternalism that the Communist Party promises to provide. This paper considers the argument these films present about the progress of Hungarian history, and how this topic is explored in more recent films that similarly focus on the transmission of generational values. Scholars such as László Strausz and John Cunningham have written on the continuous concern with the transmission of generational values in more recent films such as István Szabó’s Sunshine (1999), Béla Tarr’s Werckmeister Harmonies (2000), György Pálfi’s Taxidermia (2006), Ágnes Kocsis’ Pál Adrienn (2010), and Kornél Mundruczó’s Evolution (2021). These films, they argue, make intimate portrayals of the various sweeping political changes in Hungary’s history and question how these epochs or events have impacted Hungarian identities. If these films attempt to personalize historical shifts of Hungary, then what is the significance of featuring characters who have lost one or both parents? An attempt to understand this coherent trend in Hungarian cinema will profit from examining the earlier, celebrated films of Szabó, Mészáros, and Gábor, who inaugurated this preoccupation with generational values. The pervasive interplay of dreams and memory in their films invites an additional element to their argument concerning historical progression. This paper incorporates Richard Teniman’s notion of the “dialectics of memory” in which memory is in a constant process of negation and reinvention to explain why these Directors prefer to explore Hungarian identity through the disarranged form of psychological realism over the linear causality structure of historical realism.

Keywords: film theory, Eastern European Studies, film history, Eastern European History

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65 Reimagining Landscapes: Psychological Responses and Behavioral Shifts in the Aftermath of the Lytton Creek Fire

Authors: Tugba Altin

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In an era where the impacts of climate change resonate more pronouncedly than ever, communities globally grapple with events bearing both tangible and intangible ramifications. Situating this within the evolving landscapes of Psychological and Behavioral Sciences, this research probes the profound psychological and behavioral responses evoked by such events. The Lytton Creek Fire of 2021 epitomizes these challenges. While tangible destruction is immediate and evident, the intangible repercussions—emotional distress, disintegration of cultural landscapes, and disruptions in place attachment (PA)—require meticulous exploration. PA, emblematic of the emotional and cognitive affiliations individuals nurture with their environments, emerges as a cornerstone for comprehending how environmental cataclysms influence cultural identity and bonds to land. This study, harmonizing the core tenets of an interpretive phenomenological approach with a hermeneutic framework, underscores the pivotal nature of this attachment. It delves deep into the realm of individuals' experiences post the Lytton Creek Fire, unraveling the intricate dynamics of PA amidst such calamity. The study's methodology deviates from conventional paradigms. Instead of traditional interview techniques, it employs walking audio sessions and photo elicitation methods, granting participants the agency to immerse, re-experience, and vocalize their sentiments in real-time. Such techniques shed light on spatial narratives post-trauma and capture the otherwise elusive emotional nuances, offering a visually rich representation of place-based experiences. Central to this research is the voice of the affected populace, whose lived experiences and testimonies form the nucleus of the inquiry. As they renegotiate their bonds with transformed environments, their narratives reveal the indispensable role of cultural landscapes in forging place-based identities. Such revelations accentuate the necessity of integrating both tangible and intangible trauma facets into community recovery strategies, ensuring they resonate more profoundly with affected individuals. Bridging the domains of environmental psychology and behavioral sciences, this research accentuates the intertwined nature of tangible restoration with the imperative of emotional and cultural recuperation post-environmental disasters. It advocates for adaptation initiatives that are rooted in the lived realities of the affected, emphasizing a holistic approach that recognizes the profundity of human connections to landscapes. This research advocates the interdisciplinary exchange of ideas and strategies in addressing post-disaster community recovery strategies. It not only enriches the climate change discourse by emphasizing the human facets of disasters but also reiterates the significance of an interdisciplinary approach, encompassing psychological and behavioral nuances, for fostering a comprehensive understanding of climate-induced traumas. Such a perspective is indispensable for shaping more informed, empathetic, and effective adaptation strategies.

Keywords: place attachment, community recovery, disaster response, restorative landscapes, sensory response, visual methodologies

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64 Skin-to-Skin Contact Simulation: Improving Health Outcomes for Medically Fragile Newborns in the Neonatal Intensive Care Unit

Authors: Gabriella Zarlenga, Martha L. Hall

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Introduction: Premature infants are at risk for neurodevelopmental deficits and hospital readmissions, which can increase the financial burden on the health care system and families. Kangaroo care (skin-to-skin contact) is a practice that can improve preterm infant health outcomes. Preterm infants can acquire adequate body temperature, heartbeat, and breathing regulation through lying directly on the mother’s abdomen and in between her breasts. Due to some infant’s condition, kangaroo care is not a feasible intervention. The purpose of this proof-of-concept research project is to create a device which simulates skin-to-skin contact for pre-term infants not eligible for kangaroo care, with the aim of promoting baby’s health outcomes, reducing the incidence of serious neonatal and early childhood illnesses, and/or improving cognitive, social and emotional aspects of development. Methods: The study design is a proof-of-concept based on a three-phase approach; (1) observational study and data analysis of the standard of care for 2 groups of pre-term infants, (2) design and concept development of a novel device for pre-term infants not currently eligible for standard kangaroo care, and (3) prototyping, laboratory testing, and evaluation of the novel device in comparison to current assessment parameters of kangaroo care. A single center study will be conducted in an area hospital offering Level III neonatal intensive care. Eligible participants include newborns born premature (28-30 weeks of age) admitted to the NICU. The study design includes 2 groups: a control group receiving standard kangaroo care and an experimental group not eligible for kangaroo care. Based on behavioral analysis of observational video data collected in the NICU, the device will be created to simulate mother’s body using electrical components in a thermoplastic polymer housing covered in silicone. It will be designed with a microprocessor that controls simulated respiration, heartbeat, and body temperature of the 'simulated caregiver' by using a pneumatic lung, vibration sensors (heartbeat), pressure sensors (weight/position), and resistive film to measure temperature. A slight contour of the simulator surface may be integrated to help position the infant correctly. Control and monitoring of the skin-to-skin contact simulator would be performed locally by an integrated touchscreen. The unit would have built-in Wi-Fi connectivity as well as an optional Bluetooth connection in which the respiration and heart rate could be synced with a parent or caregiver. A camera would be integrated, allowing a video stream of the infant in the simulator to be streamed to a monitoring location. Findings: Expected outcomes are stabilization of respiratory and cardiac rates, thermoregulation of those infants not eligible for skin to skin contact with their mothers, and real time mother Bluetooth to the device to mimic the experience in the womb. Results of this study will benefit clinical practice by creating a new standard of care for premature neonates in the NICU that are deprived of skin to skin contact due to various health restrictions.

Keywords: kangaroo care, wearable technology, pre-term infants, medical design

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63 Developing a Methodology to Examine Psychophysiological Responses during Stress Exposure and Relaxation: An Experimental Paradigm

Authors: M. Velana, G. Rinkenauer

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Nowadays, nurses are facing unprecedented amounts of pressure due to the ongoing global health demands. Work-related stress can cause a high physical and psychological workload, which can lead, in turn, to burnout. On the physiological level, stress triggers an initial activation of the sympathetic nervous and adrenomedullary systems resulting in increases in cardiac activity. Furthermore, activation of the hypothalamus-pituitary-adrenal axis provokes endocrine and immune changes leading to the release of cortisol and cytokines in an effort to re-establish body balance. Based on the current state of the literature, it has been identified that resilience and mindfulness exercises among nurses can effectively decrease stress and improve mood. However, it is still unknown what relaxation techniques would be suitable for and to what extent would be effective to decrease psychophysiological arousal deriving from either a physiological or a psychological stressor. Moreover, although cardiac activity and cortisol are promising candidates to examine the effectiveness of relaxation to reduce stress, it still remains to shed light on the role of cytokines in this process so as to thoroughly understand the body’s response to stress and to relaxation. Therefore, the main aim of the present study is to develop a comprehensive experimental paradigm and assess different relaxation techniques, namely progressive muscle relaxation and a mindfulness exercise originating from cognitive therapy by means of biofeedback, under highly controlled laboratory conditions. An experimental between-subject design will be employed, where 120 participants will be randomized either to a physiological or a psychological stress-related experiment. Particularly, the cold pressor test refers to a procedure in which the participants have to immerse their non-dominant hands into ice water (2-3 °C) for 3 min. The participants are requested to keep their hands in the water throughout the whole duration. However, they can immediately terminate the test in case it would be barely tolerable. A pre-test anticipation phase and a post-stress period of 3 min, respectively, are planned. The Trier Social Stress Test will be employed to induce psychological stress. During this laboratory stressor, the participants are instructed to give a 5-min speech in front of a committee of communication specialists. Before the main task, there is a 10-min anticipation period. Subsequently, participants are requested to perform an unexpected arithmetic task. After stress exposure, the participants will perform one of the relaxation exercises (treatment condition) or watch a neutral video (control condition). Electrocardiography, salivary samples, and self-report will be collected at different time points. The preliminary results deriving from the pilot study showed that the aforementioned paradigm could effectively induce stress reactions and that relaxation might decrease the impact of stress exposure. It is of utmost importance to assess how the human body responds under different stressors and relaxation exercises so that an evidence-based intervention could be transferred in a clinical setting to improve nurses’ general health. Based on suggestive future laboratory findings, the research group plans to conduct a pilot-level randomized study to decrease stress and promote well-being among nurses who work in the stress-riddled environment of a hospital located in Northern Germany.

Keywords: nurses, psychophysiology, relaxation, stress

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62 Femicide in the News: Jewish and Arab Victims and Culprits in the Israeli Hebrew Media

Authors: Ina Filkobski, Eran Shor

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This article explores how newspapers cover murder of women by family members and intimate partners. Three major Israeli newspapers were compared in order to analyse the coverage of Jewish and Arab victims and culprits and to examine whether and in what ways the media contribute to the construction of symbolic boundaries between minority and dominant social groups. A sample of some 459 articles that were published between 2013 and 2015 was studied using a systematic qualitative content analysis. Our findings suggest that the treatment of murder cases by the media varies according to the ethnicity of both victims and culprits. The murder of Jews by family members or intimate partners was framed as a shocking and unusual event, a result of the individual personality or pathology of the culprit. Conversely, when Arabs were the killers, murders were often explained by focusing on the culture of the ethnic group, described as traditional, violent, and patriarchal. In two-thirds of the cases in which Arabs were involved, so-called ‘honor killing’ or other cultural explanations were proposed as the motive for the murder. This was often the case even before a suspect was detected, while police investigation was at its very early stages, and often despite forceful denials from victims’ families. In case of Jewish culprits, more than half of the articles in our sample suggested mental disorder to explain the acts and cultural explanations were almost entirely absent. Beyond the emphasis on psychological vs. cultural explanations, newspaper articles also tend to provide much more detail about Jewish culprits than about Arabs. Such detailed examinations convey a desire to make sense of the event by understanding the supposedly unique and unorthodox nature of the killer. The detailed accounts were usually absent from the reports on Arab killers. Thus, even if reports do not explicitly offer cultural motivations for the murder, the fact that reports often remain laconic leaves people to draw their own conclusions, which would then be likely based on existing cognitive scripts and previous reports on family murders among Arabs. Such treatment contributes to the notion that Arab and Muslim cultures, religions, and nationalities are essentially misogynistic and adhere to norms of honor and shame that are radically different from those of modern societies, such as the Jewish-Israeli one. Murder within the family is one of the most dramatic occurrences in the social world, and in societies that see themselves as modern it is a taboo; an ultimate signifier of danger. We suggest that representations of murder provide a valuable prism for examining the construction of group boundaries. Our analysis, therefore, contributes to the scholarly effort to understand the creation and reinforcement of symbolic boundaries between ‘society’ and its ‘others’ by systematically tracing the media constructions of ‘otherness’. While our analysis focuses on Israel, studies on the United States, Canada, and various European countries with ethnically and racially heterogeneous populations, make it clear that the stigmatisation and exclusion of visible, religious, and language minorities are not unique to the Israeli case.

Keywords: comparative study of media coverege of minority and majority groups, construction of symbolic group boundaries, murder of women by family members and intimate partners, Israel, Jews, Arabs

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61 Innovation Eco-Systems and Cities: Sustainable Innovation and Urban Form

Authors: Claudia Trillo

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Regional innovation eco-ecosystems are composed of a variety of interconnected urban innovation eco-systems, mutually reinforcing each other and making the whole territorial system successful. Combining principles drawn from the new economic growth theory and from the socio-constructivist approach to the economic growth, with the new geography of innovation emerging from the networked nature of innovation districts, this paper explores the spatial configuration of urban innovation districts, with the aim of unveiling replicable spatial patterns and transferable portfolios of urban policies. While some authors suggest that cities should be considered ideal natural clusters, supporting cross-fertilization and innovation thanks to the physical setting they provide to the construction of collective knowledge, still a considerable distance persists between regional development strategies and urban policies. Moreover, while public and private policies supporting entrepreneurship normally consider innovation as the cornerstone of any action aimed at uplifting the competitiveness and economic success of a certain area, a growing body of literature suggests that innovation is non-neutral, hence, it should be constantly assessed against equity and social inclusion. This paper draws from a robust qualitative empirical dataset gathered through 4-years research conducted in Boston to provide readers with an evidence-based set of recommendations drawn from the lessons learned through the investigation of the chosen innovation districts in the Boston area. The evaluative framework used for assessing the overall performance of the chosen case studies stems from the Habitat III Sustainable Development Goals rationale. The concept of inclusive growth has been considered essential to assess the social innovation domain in each of the chosen cases. The key success factors for the development of the Boston innovation ecosystem can be generalized as follows: 1) a quadruple helix model embedded in the physical structure of the two cities (Boston and Cambridge), in which anchor Higher Education (HE) institutions continuously nurture the Entrepreneurial Environment. 2) an entrepreneurial approach emerging from the local governments, eliciting risk-taking and bottom-up civic participation in tackling key issues in the city. 3) a networking structure of some intermediary actors supporting entrepreneurial collaboration, cross-fertilization and co-creation, which collaborate at multiple-scales thus enabling positive spillovers from the stronger to the weaker contexts. 4) awareness of the socio-economic value of the built environment as enabler of cognitive networks allowing activation of the collective intelligence. 5) creation of civic-led spaces enabling grassroot collaboration and cooperation. Evidence shows that there is not a single magic recipe for the successful implementation of place-based and social innovation-driven strategies. On the contrary, the variety of place-grounded combinations of micro and macro initiatives, embedded in the social and spatial fine grain of places and encompassing a diversity of actors, can create the conditions enabling places to thrive and local economic activities to grow in a sustainable way.

Keywords: innovation-driven sustainable Eco-systems , place-based sustainable urban development, sustainable innovation districts, social innovation, urban policie

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