Search results for: experience marketing
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5714

Search results for: experience marketing

974 Educational Sport and Quality of Life for Children and Teenagers from Brazilian Northeast

Authors: Ricardo Hugo Gonzalez, Amanda Figueiredo Vasconcelos, Francisco Loureiro Neto Monteiro, Yara Luiza Freitas Silva, Ana Cristina Lindsay, Márcia Maria Tavares Machado

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The use of sport as an integration mean is a very important tool regarding the social involvement of children and teenagers in a vulnerability situation. This study aims to report the experiences of a multidisciplinary program that intends to improve the quality of life of children and teenagers in Fortaleza, in the Northeast of Brazil. More than 400 children and teenagers aging 11 and 16 years participated in this study. Poor communities experience many particular difficulties in the urban centers such as violence, poor housing conditions, unemployment, lack in health care and deficient physical education in school. Physical education, physiotherapy, odontology, medicine and pharmacy students are responsible for the activities in the project supervised by a general coordinator and a counselor teacher of each academic unit. There are classes about team sports like basketball and soccer. Lectures about sexual behavior and sexually transmitted diseases are ministered beside the ones about oral health education, basic life support education, first aids, use and care with pharmaceuticals and orientations about healthy nutrition. In order to get the children’s family closer, monthly informative lectures are ministered. There is also the concern about reflecting the actions and producing academic paperwork such as graduation final projects and books. The number of participants has oscillated lately, and one of the causes is the lack of practicing physical activities and sports regularly. However, 250 teenagers have participated regularly for at least two years. These teenagers have shown a healthier lifestyle and a better physical fitness profile. The resources for maintaining the project come from the Pro-Reitoria of Extension, Federal University of Ceara, as well as from the PROEXT/MEC, Federal Government. Actions of this nature need to be done thinking for long periods so the effects results can become effective. Public and private investments are needed due to low socioeconomic families who are most vulnerable and have fewer opportunities to enhance to health prevention services.

Keywords: children and teenagers, health, multidisciplinary program, quality of life

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973 A Sense of Belonging: Music Learning and School Connectedness

Authors: Johanna Gamboa-Kroesen

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School connectedness, or the sense of belonging at school, is a critical factor in adolescent health, academic achievement, and socioemotional well-being. In educational research, the construct of the psychological sense of school membership is often referred to as school engagement, school bonding, or school attachment. While current research recognizes school connectedness as integral to a child’s mental health and academic success, many schools have yet to develop adequate interventions to promote a child’s overall sense of belonging at school. However, prior researches in music education indicates that, among other benefits, music classrooms may provide an environment where students feel they belong. While studies indicates that music learning environments, specifically performing ensemble learning environments, instill a sense of school connectedness and, more broadly, contribute to a student’s socio-emotional development, there has been inadequate research on how the actions of music teachers contribute to this phenomenon. The purpose of this study was to examine the relationship between school connectedness and music learning environments with middle school music students enrolled in a school-based music ensemble. In addition, the study aimed to provide a descriptive analysis of the instructional practices that music teachers use to promote an inclusive environment in their classrooms and an overall sense of belonging in their students. Using 191 student surveys of school membership, student reflective writings, 5 teacher interviews, and 10 classroom observations, this study examined the relationship between 7th and 8th-grade student-reported levels of connectedness within their school-based music ensemble and teacher instructional practice. The study found that students reported high levels of positive school membership within their music classes. Students who participate in school-based orchestra ensembles reported a positive change in emotional state during music instruction. In addition, evidence in this study found that music teachers use instructional practices to build connectedness through de-emphasizing competition and strengthening a student’s sense of relational value within their music learning experience. The findings offer implications for future music teacher instruction to create environments of inclusion, strengthen student-teacher relationships, and promote strategies that enhance student connection to school.

Keywords: music education, belonging, instructional practice, school connectedness

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972 Community Engagement Strategies to Assist with the Development of an RCT Among People Living with HIV

Authors: Joyce K. Anastasi, Bernadette Capili

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Community Engagement Strategies to Assist with the Development of an RCT Among People Living with HIV Our research team focuses on developing and testing protocols to manage chronic symptoms. For many years, our team designed and implemented symptom management studies for people living with HIV (PLWH). We identify symptoms that are not curative and are not adequately controlled by conventional therapies. As an exemplar, we describe how we successfully engaged PLWH in developing and refining our research feasibility protocol for distal sensory peripheral neuropathy (DSP) associated with HIV. With input from PLWH with DSP, our research received National Institutes of Health (NIH) research funding support. Significance: DSP is one of the most common neurologic complications in HIV. It is estimated that DSP affects 21% to 50% of PLWH. The pathogenesis of DSP in HIV is complex and unclear. Proposed mechanisms include cytokine dysregulation, viral protein-produced neurotoxicity, and mitochondrial dysfunction associated with antiretroviral medications. There are no FDA-approved treatments for DSP in HIV. Purpose: Aims: 1) to explore the impact of DSP on the lives of PLWH, 2) to identify patients’ perspectives on successful treatments for DSP, 3) to identify interventions considered feasible and sensitive to the needs of PLWH with DSP, and 4) to obtain participant input for protocol/study design. Description of Process: We conducted a needs assessment with PLWH with DSP. From our needs assessment, we learned from the patients’ perspective detailed descriptions of their symptoms; physical functioning with DSP; self-care remedies tried, and desired interventions. We also asked about protocol scheduling, instrument clarity, study compensation, study-related burdens, and willingness to participate in a randomized controlled trial (RCT) with a placebo and a waitlist group. Implications: We incorporated many of the suggestions learned from the need assessment. We developed and completed a feasibility study that provided us with invaluable information that informed subsequent NIH-funded studies. In addition to our extensive clinical and research experience working with PLWH, learning from the patient perspective helped in developing our protocol and promoting a successful plan for recruitment and retention of study participants.

Keywords: clinical trial development, peripheral neuropathy, traditional medicine, HIV, AIDS

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971 Noise Barrier Technique as a Way to Improve the Sonic Urban Environment along Existing Roadways Assessment: El-Gish Road Street, Alexandria, Egypt

Authors: Nihal Atif Salim

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To improve the quality of life in cities, a variety of interventions are used. Noise is a substantial and important sort of pollution that has a negative impact on the urban environment and human health. According to the complaint survey, it ranks second among environmental contamination complaints (conducted by EEAA in 2019). The most significant source of noise in the city is traffic noise. In order to improve the sound urban environment, many physical techniques are applied. In the local area, noise barriers are considered as one of the most appropriate physical techniques along existing traffic routes. Alexandria is Egypt's second-largest city after Cairo. It is located along the Mediterranean Sea, and El- Gish Road is one of the city's main arteries. It impacts the waterfront promenade that extends along with the city by a high level of traffic noise. The purpose of this paper is to clarify the design considerations for the most appropriate noise barrier type along with the promenade, with the goal of improving the Quality of Life (QOL) and the sonic urban environment specifically. The proposed methodology focuses on how noise affects human perception and the environment. Then it delves into the various physical noise control approaches. After that, the paper discusses sustainable design decisions making. Finally, look into the importance of incorporating sustainability into design decisions making. Three stages will be followed in the case study. The first stage involves doing a site inspection and using specific sound measurement equipment (a noise level meter) to measure the noise level along the promenade at many sites, and the findings will be shown on a noise map. The second step is to inquire about the site's user experience. The third step is to investigate the various types of noise barriers and their effects on QOL along existing routes in order to select the most appropriate type. The goal of this research is to evaluate the suitable design of noise barriers that fulfill environmental and social perceptions while maintaining a balanced approach to the noise issue in order to improve QOL along existing roadways in the local area.

Keywords: noise pollution, sonic urban environment, traffic noise, noise barrier, acoustic sustainability, noise reduction techniques

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970 An Adaptive Conversational AI Approach for Self-Learning

Authors: Airy Huang, Fuji Foo, Aries Prasetya Wibowo

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In recent years, the focus of Natural Language Processing (NLP) development has been gradually shifting from the semantics-based approach to deep learning one, which performs faster with fewer resources. Although it performs well in many applications, the deep learning approach, due to the lack of semantics understanding, has difficulties in noticing and expressing a novel business case with a pre-defined scope. In order to meet the requirements of specific robotic services, deep learning approach is very labor-intensive and time consuming. It is very difficult to improve the capabilities of conversational AI in a short time, and it is even more difficult to self-learn from experiences to deliver the same service in a better way. In this paper, we present an adaptive conversational AI algorithm that combines both semantic knowledge and deep learning to address this issue by learning new business cases through conversations. After self-learning from experience, the robot adapts to the business cases originally out of scope. The idea is to build new or extended robotic services in a systematic and fast-training manner with self-configured programs and constructed dialog flows. For every cycle in which a chat bot (conversational AI) delivers a given set of business cases, it is trapped to self-measure its performance and rethink every unknown dialog flows to improve the service by retraining with those new business cases. If the training process reaches a bottleneck and incurs some difficulties, human personnel will be informed of further instructions. He or she may retrain the chat bot with newly configured programs, or new dialog flows for new services. One approach employs semantics analysis to learn the dialogues for new business cases and then establish the necessary ontology for the new service. With the newly learned programs, it completes the understanding of the reaction behavior and finally uses dialog flows to connect all the understanding results and programs, achieving the goal of self-learning process. We have developed a chat bot service mounted on a kiosk, with a camera for facial recognition and a directional microphone array for voice capture. The chat bot serves as a concierge with polite conversation for visitors. As a proof of concept. We have demonstrated to complete 90% of reception services with limited self-learning capability.

Keywords: conversational AI, chatbot, dialog management, semantic analysis

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969 AI-based Digital Healthcare Application to Assess and Reduce Fall Risks in Residents of Nursing Homes in Germany

Authors: Knol Hester, Müller Swantje, Danchenko Natalya

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Objective: Falls in older people cause an autonomy loss and result in an economic burden. LCare is an AI-based application to manage fall risks. The study's aim was to assess the effect of LCare use on patient outcomes in nursing homes in Germany. Methods: LCare identifies and monitors fall risks through a 3D-gait analysis and a digital questionnaire, resulting in tailored recommendations on fall prevention. A study was conducted with AOK Baden-Württemberg (01.09.2019- 31.05.2021) in 16 care facilities. Assessments at baseline and follow-up included: a fall risk score; falls (baseline: fall history in the past 12 months; follow-up: a fall record since the last analysis); fall-related injuries and hospitalizations; gait speed; fear of falling; psychological stress; nurses experience on app use. Results: 94 seniors were aged 65-99 years at the initial analysis (average 84±7 years); 566 mobility analyses were carried out in total. On average, the fall risk was reduced by 17.8 % as compared to the baseline (p<0.05). The risk of falling decreased across all subgroups, including a trend in dementia patients (p=0.06), constituting 43% of analyzed patients, and patients with walking aids (p<0.05), constituting 76% of analyzed patients. There was a trend (p<0.1) towards fewer falls and fall-related injuries and hospitalizations (baseline: 23 seniors who fell, 13 injury consequences, 9 hospitalizations; follow-up: 14 seniors who fell, 2 injury consequences, 0 hospitalizations). There was a 16% improvement in gait speed (p<0.05). Residents reported less fear of falling and psychological stress by 38% in both outcomes (p<0.05). 81% of nurses found LCare effective. Conclusions: In the presented study, the use of LCare app was associated with a reduction of fall risk among nursing home residents, improvement of health-related outcomes, and a trend toward reduction in injuries and hospitalizations. LCare may help to improve senior resident care and save healthcare costs.

Keywords: falls, digital healthcare, falls prevention, nursing homes, seniors, AI, digital assessment

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968 Re-Examining the Distinction between Odour Nuisance and Health Impact: A Community’s Campaign against Landfill Gas Exposure in Shongweni, South Africa

Authors: Colin David La Grange, Lisa Frost Ramsay

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Hydrogen sulphide (H2S) is a minor component of landfill gas, but significant in its distinct odorous quality and its association with landfill-related community complaints. The World Health Organisation (WHO) provides two guidelines for H2S: a health guideline at 150 µg/m3 on a 24-hour average, and a nuisance guideline at 7 µg/m3 on a 30-minute average. Albeit a practical distinction for impact assessment, this paper highlights the danger of the apparent dualism between nuisance and health impact, particularly when it is used to dismiss community concerns of perceived health impacts at low concentrations of H2S, as in the case of a community battle against the impacts of a landfill in Shongweni, KwaZulu-Natal, South Africa. Here community members reported, using a community developed mobile phone application, a range of health symptoms that coincided with, or occurred subsequent to, odour events and localised H2S peaks. Local doctors also documented increased visits for symptoms of respiratory distress, eye and skin irritation, and stress after such odour events. Objectively measured H2S and other pollutant concentrations during these events, however, remained below WHO health guidelines. This case study highlights the importance of the physiological link between the experience of environmental nuisance and overall health and wellbeing, showing these to be less distinct than the WHO guidelines would suggest. The potential mechanisms of impact of an odorous plume, with key constituents at concentrations below traditional health thresholds, on psychologically and/or physiologically sensitised individuals are described. In the case of psychological sensitisation, previously documented mechanisms such as aversive conditioning and odour-triggered panic are relevant. Physiological sensitisation to environmental pollutants, evident as a seemingly disproportionate physical (allergy-type) response to either low concentrations or a short duration exposure of a toxin or toxins, remains extensively examined but still not well understood. The links between a heightened sensitivity to toxic compounds, accumulation of some compounds in the body, and a pre-existing or associated immunological stress disorder are presented as a possible explanation.

Keywords: immunological stress disorder, landfill odour, odour nuisance, odour sensitisation, toxin accumulation

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967 Evaluating and Supporting Student Engagement in Online Learning

Authors: Maria Hopkins

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Research on student engagement is founded on a desire to improve the quality of online instruction in both course design and delivery. A high level of student engagement is associated with a wide range of educational practices including purposeful student-faculty contact, peer to peer contact, active and collaborative learning, and positive factors such as student satisfaction, persistence, achievement, and learning. By encouraging student engagement, institutions of higher education can have a positive impact on student success that leads to retention and degree completion. The current research presents the results of an online student engagement survey which support faculty teaching practices to maximize the learning experience for online students. The ‘Indicators of Engaged Learning Online’ provide a framework that measures level of student engagement. Social constructivism and collaborative learning form the theoretical basis of the framework. Social constructivist pedagogy acknowledges the social nature of knowledge and its creation in the minds of individual learners. Some important themes that flow from social constructivism involve the importance of collaboration among instructors and students, active learning vs passive consumption of information, a learning environment that is learner and learning centered, which promotes multiple perspectives, and the use of social tools in the online environment to construct knowledge. The results of the survey indicated themes that emphasized the importance of: Interaction among peers and faculty (collaboration); Timely feedback on assignment/assessments; Faculty participation and visibility; Relevance and real-world application (in terms of assignments, activities, and assessments); and Motivation/interest (the need for faculty to motivate students especially those that may not have an interest in the coursework per se). The qualitative aspect of this student engagement study revealed what instructors did well that made students feel engaged in the course, but also what instructors did not do well, which could inform recommendations to faculty when expectations for teaching a course are reviewed. Furthermore, this research provides evidence for the connection between higher student engagement and persistence and retention in online programs, which supports our rationale for encouraging student engagement, especially in the online environment because attrition rates are higher than in the face-to-face environment.

Keywords: instructional design, learning effectiveness, online learning, student engagement

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966 Nursing-Related Barriers to Children’s Pain Management at Selected Hospitals in Ghana: A Descriptive Qualitative Study

Authors: Abigail Kusi Amponsah, Evans Frimpong Kyei, John Bright Agyemang, Hanson Boakye, Joana Kyei-Dompim, Collins Kwadwo Ahoto, Evans Oduro

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Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children’s pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children’s pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children’s pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n =24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses’ inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children’s pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children’s pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain management

Keywords: Nursing-Related Barriers, Children, Pain Management, Ghana

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965 Effects of a Brisk-Walking Program on Anxiety, Depression and Self-Concept in Adolescents: A Time-Series Design

Authors: Ming Yi Hsu, Hui Jung Chao

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The anxiety and depression adolescents in Taiwan experience can cause suicide attempts and result in unfortunate deaths. An effective method for relieving anxiety and depression is brisk walking; a moderate and low intensity aerobic exercise, which uses large muscle groups rhythmically. The research purpose was to investigate the effects of a 12-week, school-based, brisk-walking program in decreasing anxiety and depression, and in improving self-concept among high school students living in central Taiwan. A quasi-experiment using the time series design (T1 T2 X T3 T4) was conducted. The Beck Youth Inventories 2 (BYI-II) Chinese version was given four times: the first time T1 was in the 4th week prior to intervention, T2 was in the intervention week, T3 was in the 6th week after the start of the intervention period and T4 was in the 12th week post intervention. The baseline phase of the time series constituted T1 and T2. The intervention phase constituted T2, T3, and T4. The amounts of brisk walking were recorded by self-report The Generalized Estimating Equation (GEE) was used to examine the effects of brisk walking on anxiety, depression, and self-concept. The independent t-test was used to compare mean scores on three dependent variables between brisk walking over and less than 90-minutes per week. Findings revealed that levels of anxiety and self-concept had nonsignificant change during the baseline phase, while the level of depression increased significantly. In contrast, the study demonstrated significant decreases in anxiety and depression as well as increases in positive self-concept (p=.001, p<.001, p=.017) during the intervention phase. Furthermore, a subgroup analysis was completed on participants who demonstrated elevated anxiety (23.4%), and depression (29.7%), and below average self-concept (18.6%) at baseline (T2). The subgroup of anxious, depressed, or low self-concept participants who received the brisk-walking intervention demonstrated significant decreases in anxiety and depression, and significant increases in self-concept scores. Participants who engaged in brisk walking over 90 minutes per week reported decreased mean scores on anxiety (t=-2.395, p=.035) and depression (t=-2.142, p=.036) in contrast with those who engaged in brisk-walking time less than 90 minutes per week. Regarding the effects on participants whose anxiety, scores were within the normal range at baseline, there was demonstrated significant decrease in the level of anxiety when they increased their time on brisk walking before each term examination. Overall, the brisk-walking program was effective and feasible to promote adolescents’ mental health by decreasing anxiety and depression as well as elevating self-concept. It also helped adolescents from anxiety before term examinations.

Keywords: adolescents, anxiety, depression, self-concept

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964 Factors Influencing Telehealth Services for Diabetes Care in Nepal: A Mixed Method Study

Authors: Sumitra Sharma, Christina Parker, Kathleen Finlayson, Clint Douglas, Niall Higgins

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Background: Telehealth services have potential to increase accessibility, utilization, and effectiveness of healthcare services. As the telehealth services are yet to integrate within regular hospital services in Nepal, the use of the telehealth services among adults with diabetes is scarce. Prior to implementation of telehealth services for adults with diabetes, it is necessary to examine influencing factors of telehealth services. Objective: This study aimed to investigate factors influencing telehealth services for diabetes care in Nepal. Methods: This study used a mixed-method study design which included a cross-sectional survey among adults with diabetes and semi-structured interviews among key healthcare professionals of Nepal. The study was conducted in a medical out-patient department of a tertiary hospital of Nepal. The survey adapted a previously validated questionnaire, while semi-structured questions for interviews were developed from literature review and experts consultation. All interviews were audio-recorded, and inductive content analysis was used to code transcripts and develop themes. For a survey, a descriptive analysis, chi-square test, and Mann Whitney U test were used to analyze the data. Results: One hundred adults with diabetes were participated in a survey, and seven healthcare professionals were recruited for interviews. In a survey, just over half of the participants (53%) were male, and others were female. Almost all participants (98%) owned a mobile phone, and 67% of them had a computer with internet access at home. Majority of participants had experience in using Facebook messenger (95%), followed by Viber (60%) and Zoom (26%). Almost all of the participants (96%) were willing to use telehealth services. There were significant associations between female sex and participants living 10 km away from the hospital with their willingness to use telehealth services. There was a significant association between participants' self-perception of good health status with their willingness to use video-conference calls and phone calls to use telehealth services. Seven themes were developed from interview data which are related to predisposing, reinforcing, and enabling factors influencing telehealth services for diabetes care in Nepal. Conclusion: In summary, several factors were found to influence the use of telehealth services for diabetes care in Nepal. For effective implementation of a sustainable telehealth services for adults with diabetes in Nepal, these factors need to be considered.

Keywords: contributing factors, diabetes mellitus, developing countries, telemedicine, telecare

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963 The Role of Parents in Special Education in the Maldives: Teachers' Voice

Authors: Fathimath Warda, Mariyam Nihaadh

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Students with Special Education Needs (SEN) are increasing in the Maldives, like anywhere else in the world, due to the changes in lifestyle of the people and ease of being diagnosed with advancements in medical health. With the growth in the population of these students, the demand for professionals in various fields is unmet. Thus, with the introduction of the Inclusive Education Policy in 2013, all students are educated in the same classroom by the regular teacher. This poses problems as the teachers are not well trained and qualified to meet the varying needs of the students, given the limited time and the large number of students in the classroom. This is a major concern for all stakeholders in the education sector and research has been conducted by various local scholars in this area. However, studies on the role of parents of such students is an area that remains yet to be explored in the Maldives, which makes a study of this nature crucial. The main aim of this study is to determine the ways in which the education provided to Special Needs Students can be maximized for a better outcome. Therefore, the study intends to understand the involvement of parents in providing education to special needs students from the teachers' perspectives. The basis for this study is the Parent Development Theory developed by Mowder, which was initially known as Parent Role Development Theory. A qualitative research has thus been utilised for the purpose of the study as it requires to find the beliefs and attitudes of teachers, along with relevant justifications regarding the role of parents in educating students with special needs. Data was gathered using one-to-one interviews, as it is one of the most reliable ways of getting meaningful and in-depth data. The study employs a total of 8 participants who are teachers teaching in inclusive classes where students with special needs are included. Emphasis was paid to select teachers who have the experience of teaching students with different disorders commonly found in the Maldives, namely in the four areas, Autism Spectrum Disorder, Down Syndrome, Attention Deficit Hyperactive Disorder and speech impairment. Hence, purposive sampling will be used to select the participants. Data analysis has been done using thematic coding. The findings revealed that teachers highlighted that parents' involvement was a key factor in ensuring success of education in children with special needs. Thus, the study concludes that the role of parents as a necessary input for the proper development of children and in educating children with special needs, suggesting that extra measures have to be taken develop a positive relationship between teachers and parents in order to strengthen this aspect.

Keywords: involvement, parents' role, special education needs, teachers' voice

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962 Leveraging Community Partnerships for Social Impact

Authors: T. Moody, E. Mitchell, T. Dang, A. Barry, T. Proshan, S. Andrisse, V. Odero-Marah

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Women’s prison and reentry programs are focused primarily on reducing recidivism but neglect how an individual’s intersecting identities influence their risk of violence and ways that histories of gender-based violence (GBV) must be addressed for these women to recover from traumas. Light To Life (LTL) and From Prison Cells to Ph.D. (P2P) Womxn’s Cohort program recognizes this need; providing national gender-responsive programming (GRP), and trauma-informed programming to justice-impacted survivors through digital resources, leadership opportunities, educational workshops, and healing justice approaches for positive health outcomes. Through the support of a community-university partnership (CUP), a comparative evaluation study is being conducted among intimate-partner violence (IPV) survivors with histories of incarceration who have or have not participated in the cohort. The objectives of the partnership are to provide mutually beneficial training and consultation for evaluating GRP through a rigorously tested research methodology. This collaborative applies a rigorous methodology of semi-structured interviews with an intervention and control group to evaluate the impact of LTL’s programming in the P2P Womxn’s Cohort. The CUP is essential to achieve the expected results of the project. It will measure primary outcomes, including participants' level of engagement and satisfaction with programming, reduction in attitudes that accept violence in relationships, and increase in interpersonal and intrapersonal skills that lead to healthy relationships. This community-based approach will provide opportunities to evaluate the effectiveness of the program. The results addressed in the hypothesis will provide learning lessons to improve this program, to scale it up, and apply it to other similarly affected populations. The partnership experience and anticipated outcomes contribute to the knowledge in women’s health and criminal justice by fostering public awareness on the importance of developing new partnerships and fostering CUP to establish a framework to the leveraging of partnerships for social impact available to academic institutions.

Keywords: Community-university partnership, gender-responsive programming, incarceration, intimate-partner violence, POC, women

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961 Effect of Psychosocial, Behavioural and Disease Characteristics on Health-Related Quality of Life after Breast Cancer Surgery: A Cross-Sectional Study of a Regional Australian Population

Authors: Lakmali Anthony, Madeline Gillies

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Background Breast cancer (BC) is usually managed with surgical resection. Many outcomes traditionally used to define successful operative management, such as resection margin, do not adequately reflect patients’ experience. Patient-reported outcomes (PRO) such as Health-Related Quality of life (HRQoL) provide a means by which the impact of surgery for cancer can be reported in a patient-centered way. This exploratory cross-sectional study aims to; (1) describe postoperative HRQoL in patients who underwent primary resection in a regional Australian hospital; (2) describe the prevalence of anxiety, depression and clinically significant fear of cancer recurrence (FCR) in this population; and (3) identify demographic, psychosocial, disease and treatment factors associated with poorer self-reported HRQoL. Methods Patients who had resection of BC in a regional Australian hospital between 2015 and 2022 were eligible. Participants were asked to complete a survey designed to assess HRQoL, as well as validated instruments that assess several other psychosocial PROs hypothesized to be associated with HRQoL; emotional distress, fear of cancer recurrence, social support, dispositional optimism, body image and spirituality. Results Forty-six patients completed the survey. Clinically significant levels of FCR and emotional distress were present in this group. Many domains of HRQoL were significantly worse than an Australian reference population for BC. Demographic and disease factors associated with poor HRQoL included smoking and ongoing adjuvant systemic therapy. The primary operation was not associated with HRQoL for breast cancer. All psychosocial factors measured were associated with HRQoL. Conclusion HRQoL is an important outcome in surgery for both research and clinical practice. This study provides an overview of the quality of life in a regional Australian population of postoperative breast cancer patients and the factors that affect it. Understanding HRQoL and awareness of patients particularly vulnerable to poor outcomes should be used to aid the informed consent and shared decision-making process between surgeon and patient.

Keywords: breast cancer, surgery, quality of life, regional population

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960 Split Health System for Diabetes Care in Urban Area: Experience from an Action Research Project in an Urban Poor Neighborhood in Bengaluru

Authors: T. S. Beerenahally, S. Amruthavalli, C. M. Munegowda, Leelavathi, Nagarathna

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Introduction: In majority of urban India, the health system is split between different authorities being responsible for the health care of urban population. We believe that, apart from poor awareness and financial barriers to care, there are other health system barriers which affect quality and access to care for people with diabetes. In this paper, we attempted to identify health system complexity that determines access to public health system for diabetes care in KG Halli, a poor urban neighborhood in Bengaluru. The KG Halli has been a locus of a health systems research from 2009 to 2015. Methodology: The source of data is from the observational field-notes written by research team as part of urban health action research project (UHARP). Field notes included data from the community and the public primary care center. The data was generated by the community health assistants and the other research team members during regular home visits and interaction with individuals who self-reported to be diabetic over four years as part of UHARP. Results: It emerged during data analysis that the patients were not keen on utilizing primary public health center for many reasons. Patient has felt that the service provided at the center was not integrated. There was lack of availability of medicines, with a regular stock out of medicines in a year and laboratory service for investigation was limited. Many of them said that the time given by the providers was not sufficient and there was also a feeling of providers not listening to them attentively. The power dynamics played a huge role in communication. Only the consultation was available for free of cost at the public primary care center. The patient had to spend for the investigations and the major portion for medicine. Conclusion: Diabetes is a chronic disease that poses an important emerging public health concern. Most of the financial burden is borne by the family as the public facilities have failed to provide free care in India. Our study indicated various factors including individual beliefs, stigma and financial constraints affecting compliance to diabetes care.

Keywords: diabetes care, disintegrated health system, quality of care, urban health

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959 Experimental Evaluation of Contact Interface Stiffness and Damping to Sustain Transients and Resonances

Authors: Krystof Kryniski, Asa Kassman Rudolphi, Su Zhao, Per Lindholm

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ABB offers range of turbochargers from 500 kW to 80+ MW diesel and gas engines. Those operate on ships, power stations, generator-sets, diesel locomotives and large, off-highway vehicles. The units need to sustain harsh operating conditions, exposure to high speeds, temperatures and varying loads. They are expected to work at over-critical speeds damping effectively any transients and encountered resonances. Components are often connected via friction joints. Designs of those interfaces need to account for surface roughness, texture, pre-stress, etc. to sustain against fretting fatigue. The experience from field contributed with valuable input on components performance in hash sea environment and their exposure to high temperature, speed and load conditions. Study of tribological interactions of oxide formations provided an insight into dynamic activities occurring between the surfaces. Oxidation was recognized as the dominant factor of a wear. Microscopic inspections of fatigue cracks on turbine indicated insufficient damping and unrestrained structural stress leading to catastrophic failure, if not prevented in time. The contact interface exhibits strongly non-linear mechanism and to describe it the piecewise approach was used. Set of samples representing the combinations of materials, texture, surface and heat treatment were tested on a friction rig under range of loads, frequencies and excitation amplitudes. Developed numerical technique extracted the friction coefficient, tangential contact stiffness and damping. Vast amount of experimental data was processed with the multi-harmonics balance (MHB) method to categorize the components subjected to the periodic excitations. At the pre-defined excitation level both force and displacement formed semi-elliptical hysteresis curves having the same area and secant as the actual ones. By cross-correlating the terms remaining in the phase and out of the phase, respectively it was possible to separate an elastic energy from dissipation and derive the stiffness and damping characteristics.

Keywords: contact interface, fatigue, rotor-dynamics, torsional resonances

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958 Self-Care and Risk Behaviors in Primary Caregiver of Cancer Patients

Authors: Ivonne N. Pérez-Sánchez. María L. Rascón- Gasca, Angélica Riveros-Rosas, Rebeca Robles García

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Introduction: Primary caregivers of cancer patients have health problems related to their lack of time, stress, and fiscal strain. Their health problems could affect their patients’ health and also increase the expenses in public health. Aim: To describe self-care and risk behaviors in a sample of Mexican primary caregiver and the relation of these behaviors with emotional distress (caregiver burden, anxiety and depression symptoms), coping and sociodemographic variables. Method: Participated in this study 173 caregivers of a third level reference medical facility (age: M=49.4, SD=13.5) females 78%, males 22%, 57.5% were caregivers of patients with terminal cancer (CPTC), and 40.5% were caregivers of patients on oncology treatment (CPOT). Results: The 75.7% of caregivers reported to have had health problem in last six months as well as several symptoms which were related to emotional distress, these symptoms were more frequently between CPTC and female caregivers. A half (47.3%) of sample reported have had difficulties in caring their health; these difficulties were related to emotional distress and lower coping, more affected caregivers were who attend male patients and CPTC. The 76.8% of caregivers had health problems in last six months, but 26.5% of them waited to search medical care until they were very sick, and 11% didn't do it. Also, more than a half of sample (56.1%) admitted to have risk behaviors as drink alcohol, smoke or overeating for feeling well, these caregivers showed high emotional distress and lower coping. About caregivers healthy behaviors, 80% of them had a hobby; 27.2% do exercise usually and between 12% to 60% did medical checkups (glucose tests, blood pressure and cholesterol tests, eye exams and watched their weight), these caregivers had lower emotional distress and high coping, some variables related health behaviors were: care only one patient or a female patient and be a CPOT, social support, high educational level and experience as a caregiver in past. The half of caregivers were worrying to develop cancer in the future; this idea was 2.5 times more frequent in caregiver with problems to care their health. Conclusions: The results showed a big proportion of caregivers with medical problems. High emotional distress and low coping were related to physical symptoms, risk behaviors, and low self-care; poor self-care was frequently even in caregiver who have chronic illness.

Keywords: cancer, primary caregiver, risk behaviors, self-care

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957 The Application of Sensory Integration Techniques in Science Teaching Students with Autism

Authors: Joanna Estkowska

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The Sensory Integration Method is aimed primarily at children with learning disabilities. It can also be used as a complementary method in treatment of children with cerebral palsy, autistic, mentally handicapped, blind and deaf. Autism is holistic development disorder that manifests itself in the specific functioning of a child. The most characteristic are: disorders in communication, difficulties in social relations, rigid patterns of behavior and impairment in sensory processing. In addition to these disorders may occur abnormal intellectual development, attention deficit disorders, perceptual disorders and others. This study was focused on the application sensory integration techniques in science education of autistic students. The lack of proper sensory integration causes problems with complicated processes such as motor coordination, movement planning, visual or auditory perception, speech, writing, reading or counting. Good functioning and cooperation of proprioceptive, tactile and vestibular sense affect the child’s mastery of skills that require coordination of both sides of the body and synchronization of the cerebral hemispheres. These include, for example, all sports activities, precise manual skills such writing, as well as, reading and counting skills. All this takes place in stages. Achieving skills from the first stage determines the development of fitness from the next level. Any deficit in the scope of the first three stages can affect the development of new skills. This ultimately reflects on the achievements at school and in further professional and personal life. After careful analysis symptoms from the emotional and social spheres appear to be secondary to deficits of sensory integration. During our research, the students gained knowledge and skills in the classroom of experience by learning biology, chemistry and physics with application sensory integration techniques. Sensory integration therapy aims to teach the child an adequate response to stimuli coming to him from both the outside world and the body. Thanks to properly selected exercises, a child can improve perception and interpretation skills, motor skills, coordination of movements, attention and concentration or self-awareness, as well as social and emotional functioning.

Keywords: autism spectrum disorder, science education, sensory integration, special educational needs

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956 Analysis of Structural Modeling on Digital English Learning Strategy Use

Authors: Gyoomi Kim, Jiyoung Bae

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The purpose of this study was to propose a framework that verifies the structural relationships among students’ use of digital English learning strategy (DELS), affective domains, and their individual variables. The study developed a hypothetical model based on previous studies on language learning strategy use as well as digital language learning. The participants were 720 Korean high school students and 430 university students. The instrument was a self-response questionnaire that contained 70 question items based on Oxford’s SILL (Strategy Inventory for Language Learning) as well as the previous studies on language learning strategies in digital learning environment in order to measure DELS and affective domains. The collected data were analyzed through structural equation modeling (SEM). This study used quantitative data analysis procedures: Explanatory factor analysis (EFA) and confirmatory factor analysis (CFA). Firstly, the EFA was conducted in order to verify the hypothetical model; the factor analysis was conducted preferentially to identify the underlying relationships between measured variables of DELS and the affective domain in the EFA process. The hypothetical model was established with six indicators of learning strategies (memory, cognitive, compensation, metacognitive, affective, and social strategies) under the latent variable of the use of DELS. In addition, the model included four indicators (self-confidence, interests, self-regulation, and attitude toward digital learning) under the latent variable of learners’ affective domain. Secondly, the CFA was used to determine the suitability of data and research models, so all data from the present study was used to assess model fits. Lastly, the model also included individual learner factors as covariates and five constructs selected were learners’ gender, the level of English proficiency, the duration of English learning, the period of using digital devices, and previous experience of digital English learning. The results verified from SEM analysis proposed a theoretical model that showed the structural relationships between Korean students’ use of DELS and their affective domains. Therefore, the results of this study help ESL/EFL teachers understand how learners use and develop appropriate learning strategies in digital learning contexts. The pedagogical implication and suggestions for the further study will be also presented.

Keywords: Digital English Learning Strategy, DELS, individual variables, learners' affective domains, Structural Equation Modeling, SEM

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955 Effective Thermal Retrofitting Methods to Improve Energy Efficiency of Existing Dwellings in Sydney

Authors: Claire Far, Sara Wilkinson, Deborah Ascher Barnstone

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Energy issues have been a growing concern in current decades. Limited energy resources and increasing energy consumption from one side and environmental pollution and waste of resources from the other side have substantially affected the future of human life. Around 40 percent of total energy consumption of Australian buildings goes to heating and cooling due to the low thermal performance of the buildings. Thermal performance of buildings determines the amount of energy used for heating and cooling of the buildings which profoundly influences energy efficiency. Therefore, employing sustainable design principles and effective use of construction materials for building envelope can play crucial role in the improvement of energy efficiency of existing dwellings and enhancement of thermal comfort of the occupants. The energy consumption for heating and cooling normally is determined by the quality of the building envelope. Building envelope is the part of building which separates the habitable areas from exterior environment. Building envelope consists of external walls, external doors, windows, roof, ground and the internal walls that separate conditioned spaces from non-condition spaces. The energy loss from the building envelope is the key factor. Heat loss through conduction, convection and radiation from building envelope. Thermal performance of the building envelope can be improved by using different methods of retrofitting depending on the climate conditions and construction materials. Based on the available studies, the importance of employing sustainable design principles has been highlighted among the Australian building professionals. However, the residential building sector still suffers from a lack of having the best practice examples and experience for effective use of construction materials for building envelope. As a result, this study investigates the effectiveness of different energy retrofitting techniques and examines the impact of employing those methods on energy consumption of existing dwellings in Sydney, the most populated city in Australia. Based on the research findings, the best thermal retrofitting methods for increasing thermal comfort and energy efficiency of existing residential dwellings as well as reducing their environmental impact and footprint have been identified and proposed.

Keywords: thermal comfort, energy consumption, residential dwellings, sustainable design principles, thermal retrofit

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954 Visualising Charles Bonnet Syndrome: Digital Co-Creation of Pseudohallucinations

Authors: Victoria H. Hamilton

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Charles Bonnet Syndrome (CBS) is when a person experiences pseudohallucinations that fill in visual information from any type of sight loss. CBS arises from an epiphenomenal process, with the physical actions of sight resulting in the mental formations of images. These pseudohallucinations—referred to as visions by the CBS community—manifest in a wide range of forms, from complex scenes to simple geometric shapes. To share these unique visual experiences, a remote co-creation website was created where CBS participants communicated their lived experiences. This created a reflexive process, and we worked to produce true representations of these interesting and little-known phenomena. Digital reconstruction of the visions is utilised as it echoes the vivid, experiential movie-like nature of what is being perceived. This paper critically analyses co-creation as a method for making digital assets. The implications of the participants' vision impairments and the application of ethical safeguards are examined in this context. Important to note, this research is of a medical syndrome for a non-medical, practice-based design. CBS research to date is primarily conducted by the ophthalmic, neurological, and psychiatric fields and approached with the primary concerns of these specialties. This research contributes a distinct approach incorporating practice-based digital design, autoethnography, and phenomenology. Autoethnography and phenomenology combine as a foundation, with the first bringing understanding and insights, balanced by the second philosophical, bigger picture, and established approach. With further refining, it is anticipated that the research may be applied to other conditions. Conditions where articulating internal experiences proves challenging and the use of digital methods could aid communication. Both the research and CBS communities will benefit from the insights regarding the relationship between cognitive perceptions and the vision process. This research combines the digital visualising of visions with interest in the link between metaphor, embodied cognition, and image. The argument for a link between CBS visions and metaphor may appear evident due to the cross-category mapping of images that is necessary for comprehension. They both are— CBS visions and metaphors—the experience of picturing images, often with lateral connections and imaginative associations.

Keywords: Charles Bonnet Syndrome, digital design, visual hallucinations, visual perception

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953 [Keynote Speech]: Risk Management during the Rendition Process: Use of Screen-Voice Recordings in Translator Training

Authors: Maggie Hui

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Risk management is not a new concept; however, it is an uncharted area as applied to the translation process and translator training. Serving as one of the self-discovery activities in their practicum course, a two-cycle experiment was carried out with a class of 13 MA translation students with an attempt to explore their risk management while translating in a simulated setting that involves translator-client relations. To test the effects of the main variable of translators’ interaction with the simulated clients, the researcher employed control-group translators and two experiment groups (with Group A being the translator in Cycle 1 and the client in Cycle 2, and Group B on the client position in Cycle 1 and the translator position in Cycle 2). Experiment cycle 1 aims to explore if there would be any behavioral difference in risk management between translators with interaction with the simulated clients, i.e. experiment group A, and their counterparts without such interaction, i.e. control group. Design of Cycle 2 concerns the order of playing different roles of the translator and client in the experiment, and provides information to compare behavior of translators of the two experiment groups. Since this is process-oriented research, it is necessary to hypothesize what was happening in the translators’ minds. The researcher made use of a user-friendly screen-voice recording freeware to record subjects’ screen activities, including every word the translator typed and every change they made to the rendition, the websites they browsed and the reference tools they used, in addition to the verbalization of their thoughts throughout the process. The research observes the translation procedures subjects considered and finally adopted, and looks into the justifications for their procedures, in order to interpret their risk management. The qualitative and quantitative results of this study have some implications for translator training: (a) the experience of being a client seems to reinforce the translator’s risk aversion; (b) the use of role-playing simulation can empower students’ learning by enhancing their attitudinal or psycho-physiological competence, interpersonal competence and strategic competence; and (c) the screen-voice recordings serve as a helpful tool for learners to reflect on their rendition processes, i.e. what they performed satisfactorily and unsatisfactorily while translating and what they could do for improvement in future translation tasks.

Keywords: risk management, screen-voice recordings, simulated translator-client relations, translation pedagogy, translation process-oriented research

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952 Attention Deficit Hyperactivity Disorder and Criminality: A Psychological Profile of Convicts Serving Prison Sentences

Authors: Agnieszka Nowogrodzka

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Objectives: ADHD is a neurodevelopmental disorder in which symptoms are most prominent throughout childhood. In the longer term, these symptoms, as well as the behaviour of the child, the experiences arising from the response of the community to the child's symptoms, as well as the functioning of the community itself, all contribute to the onset of secondary symptoms and subsequent outcomes of the disorder, such as crime or mental disorders. The purpose of this study is to estimate the prevalence of ADHD among Polish convicts serving a prison sentence. To that end, the study will focus on the relationship between the severity of ADHD and early childhood trauma, family relations, maladaptive cognitive schemas, as well as mental disorders. It is an attempt to assess the interdependence between ADHD, childhood experiences, and secondary outcomes. Methods: The study enrolled two groups of first-time convicts and repeat offenders aged between 21 and 65 –each of the study groups comprised 120 participants; 240 participants in total took part in the study. Participants were recruited in semi-open penal institutions in Poland (Poznań Custody Suite, Wronki Penal Institution, Iława Penal Institution). The control group comprised 110 men without criminal records aged 21 to 65. The DIVA 5.0 questionnaire was employed to identify the severity of ADHD symptoms. Other questionnaires employed in the course of the study included the Childhood Trauma Questionnaire (CTQ), The Family Adaptability and Cohesion Scale IV (FACES-IV), Young Schema Questionnaire (YSQ), and the General Health Questionnaire (GHQ-30). Results: The findings of the study in question are currently still being compiled and will be shared during the conference. The findings of a pilot study involving two cohorts of convicts (each numbering 20 men) and a control group (20 men with no criminal records) indicate a significant correlation between ADHD and the experience of early childhood trauma. The severity of ADHD also shows a correlation with the assessment of the functioning of the family, with the subjects assessing the relationships in their families more negatively than the control group. Furthermore, the severity of ADHD is also correlated with maladaptive emotional schemas manifesting in the participants. The findings also show a correlation between selected dimensions and the severity of offenses.

Keywords: ADHD, social impairments, mental disorders, early childhood traumas, criminality

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951 Enhancing French Vocabulary Acquisition: The Impact of Explicit Instruction on Productive Non-Cognate Suffixes for Beginner Learners

Authors: Deborah Idowu

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This research delves into the effectiveness of explicitly teaching productive non-cognate French suffixes to English beginner learners of the French language. It is widely accepted that cognates, especially orthographic ones, can be inferred by learners from their first language (in this case, English). The same is the case for derived French words with cognate suffixes, provided the learner is familiar with the lemma, which can either be cognate or non-cognate. However, the same cannot be said for derived French words with non-cognate suffixes. These suffixes often pose challenges to learners, even when the base word is familiar to them. The primary goal of this research is to enhance the vocabulary comprehension and expansion of English-speaking beginners in French by focusing on the recognition of derived French words that may not align with their L1 knowledge. The methodology employed in this study of derivational morphology involves an experimental group receiving explicit instruction on productive non-cognate suffixes, while a control group does not. By utilizing confidence ratings and other analytical tools, the analysis aims to measure the impact of this targeted instruction on the learners' ability to understand and incorporate non-cognate suffixes into their French vocabulary. Through this experimental approach, the research seeks to provide valuable insights into how explicit instruction on non-cognate suffixes can benefit beginner French learners, ultimately aiding them in navigating the intricacies of French derivational morphology. The objectives of this research are as follows: i. to investigate the impact of explicitly teaching productive non-cognate suffixes on the vocabulary comprehension and expansion of beginner learners of the French language; ii. to assess the effectiveness of targeted instruction on non-cognate suffixes in aiding English-speaking learners in recognizing and understanding derived French words that may not align with their native language knowledge, iii. to compare the vocabulary acquisition and retention of beginner French learners who receive explicit instruction on non-cognate suffixes with those who do not to determine the effectiveness of this instructional approach, iv. to analyze the confidence ratings and other analytical methods to gauge the learners' ability to integrate non-cognate suffixes into their French vocabulary and comprehend the meaning of derived words more effectively, v. to contribute insights into how explicit instruction on non-cognate suffixes can enhance the overall language learning experience for beginner learners of French, particularly in the area of French derivational morphology.

Keywords: suffixes, derivational morphology, non-cognates, vocabulary acquisition, French language learners

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950 A Qualitative Review and Meta-Analyses of Published Literature Exploring Rates and Reasons Behind the Choice of Elective Caesarean Section in Pregnant Women With No Contraindication to Trial of Labor After One Previous Caesarean Section

Authors: Risheka Suthantirakumar, Eilish Pearson, Jacqueline Woodman

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Background: Previous research has found a variety of rates and reasons for choosing medically unindicated elective repeat cesarean section (ERCS). Understanding the frequency and reasoning of ERCS, especially when unwarranted, could help healthcare professionals better tailor their advice and service. Therefore, our study conducted meta-analyses and qualitative analyses to identify the reasons and rates worldwide for choosing this procedure over the trial of labor after cesarean (TOLAC), also referred to in published literature as vaginal birth after cesarean (VBAC). Methods: We conducted a systematic review of published literature available on PubMed, EMBASE, and science.gov and conducted a blinded peer review process to assess eligibility. Search terms were created in collaboration with experts in the field. An inclusion and exclusion criteria were established prior to reviewing the articles. Included studies were limited to those published in English due to author constraints, although no international boundaries were used in the search. No time limit for the search was used in order to portray changes over time. Results: Our qualitative analyses found five consistent themes across international studies, which were socioeconomic and cultural differences, previous cesarean experience, perceptions of risk with vaginal birth, patients’ perceptions of future benefits, and medical advice and information. Our meta-analyses found variable rates of ERCS across international borders and within national populations. The average rate across all studies was 44% (CI 95% 36-51). Discussion: The studies included in our qualitative analysis demonstrated similar repetitive themes, which give validity to the findings across the studies included. We consider the rate variation across and within national populations to be partially a result of differing inclusion and eligibility assessment between different studies and argue that a proforma be utilized for future research to be comparable.

Keywords: elective cesarean section, VBAC, TOLAC, maternal choice

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949 Hyperthyroidism in a Private Medical Services Center, Addis Ababa: A 5-Year Experience

Authors: Ersumo Tessema, Bogale Girmaye Tamrat, Mohammed Burka

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Background: Hyperthyroidism is a common thyroid disorder especially in women and characterized by increased thyroid hormone synthesis and secretion. The disorder manifests predominantly as Graves’ disease in iodine-sufficient areas and has increasing prevalence in iodine-deficient countries in patients with nodular thyroid disease and following iodine fortification. In Ethiopia, the magnitude of the disorder is unknown and, in Africa, due to scarcity of resources, its management remains suboptimal. Objective: The aim of this study was to analyze the pattern and management of patients with hyperthyroidism at the United Vision Medical Services Center, Addis Ababa between August 30, 2013, and February 1, 2018. Patients and methods: The study was a retrospective analysis of medical records of all patients with hyperthyroidism at the United Vision Private Medical Services Center, Addis Ababa. A questionnaire was filled out; the collected data entered into a computer and statistically analyzed using the SPSS package. The results were tabulated and discussed with literature review. Results: A total of 589 patients were included in this study. The median age was 40 years, and the male to female ratio was 1.0:7.9. Most patients (93%) presented with goiter and the associated features of toxic goiter except weight loss, sweating and tachycardia were uncommon. Majority of patients presented more than two years after the onset of their presenting symptoms. The most common physical finding (91%), as well as diagnosis, was toxic nodular goiter. The most frequent (83%) derangement in the thyroid function tests was a low thyroid-stimulating hormone, and the most commonly (94%) used antithyroid drug was a propylthiouracil. The most common (96%) surgical procedure in 213 patients was a near-total thyroidectomy with a postoperative course without incident in 92% of all the patients. Conclusion: The incidence and prevalence of hyperthyroidism are apparently on the increase in Addis Ababa, which may be related to the existing severe iodine-deficiency and or the salt iodation program (iodine-induced hyperthyroidism). Hyperthyroidism predominantly affects women and, in surgical services, toxic nodular goiter is more common than diffuse goiter, and the treatment of choice in experienced hands is a near-total thyroidectomy.

Keywords: Ethiopia, grave’s disease, hyperthyroidism, toxic nodular goiter

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948 Atmospheres, Ghosts and Shells to Reform our Memorial Cultures

Authors: Tomas Macsotay

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If monument removal and monument effacement may call to mind a Nietzschean proposal for vitalist disregard of conventional morality, it remains the case that it is often only by a willingness to go “beyond good and evil” in inherited monument politics that truthful, be it unexpected aspects of our co-existence with monuments can finally start to rise into fuller consciousness. A series of urgent questions press themselves in the panorama created by the affirmative idea that we can, as a community, make crucial decisions with regard to monumental preservation or discontinuation. Memorials are not the core concern for decolonial and racial dignity movements like Black Lives Matter (BLM), which have repeatedly shown they regard these actions as a welcome, albeit complementary, part of a reckoning with a past of racial violence and injustice, slavery, and colonial subaltern existence. As such, the iconoclastic issue of “rights and prohibitions of images” only tangentially touches on a cultural movement that seems rather question dominant ideas of history, pertinence, and the long life of the class, gender, and racial conflict through ossified memorial cultures. In the recent monument insurrection, we face a rare case of a new negotiation of rights of existence for this particular tract of material culture. This engenders a debate on how and why we accord rights to objects in public dominion ― indeed, how such rights impinge upon the rights of subjects who inhabit the public sphere. Incidentally, the possibility of taking away from monuments such imagined or adjoined rights has made it possible to tease open a sphere of emotionality that could not be expressed in patrimonial thinking: the reality of atmospheres as settings, often dependent on pseudo-objects and half-conscious situations, that situate individuals involuntarily in a pathic aesthetics. In this way, the unique moment we now witness ― full of the possibility of going “beyond good and evil” of monument preservation ― starts to look more like a moment of involuntary awaking: an awakening to the encrypted gaze of the monument and the enigma that the same monument or memorial site can carry day-to-day habits of life for some bystanders, while racialized and disenfranchised communities experience discomfort and erosion of subjective life in the same sites.

Keywords: monument, memorial, atmosphere, racial justice, decolonialism

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947 Assessing the Impact of Adopting Climate Smart Agriculture on Food Security and Multidimensional Poverty: Case of Rural Farm Households in the Central Rift Valley of Ethiopia

Authors: Hussien Ali, Mesfin Menza, Fitsum Hagos, Amare Haileslassie

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Climate change has perverse effects on agricultural productivity and natural resource base, negatively affecting the well-being of the households and communities. The government and NGOs promote climate smart agricultural (CSA) practices to help farmers adapt to and mitigate the negative effects of climate change. This study aims to identify widely available CSA practices and examine their impacts on food security and multi-dimensional poverty of rural farm households in the Central Rift Valley, Ethiopia. Using three-stage proportional to size sampling procedure, the study randomly selected 278 households from two kebeles from four districts each. A cross-sectional data of 2020/21 cropping season was collected using structured and pretested survey questionnaire. Food consumption score, dietary diversity score, food insecurity experience scale, and multidimensional poverty index were calculated to measure households’ welfare indicators. Multinomial endogenous switching regression model was used to assess average treatment effects of CSA on these outcome indicators on adopter and non-adopter households. The results indicate that the widely adopted CSA practices in the area are conservation agriculture, soil fertility management, crop diversification, and small-scale irrigation. Adopter households have, on average, statistically higher food consumption score, dietary diversity score and lower food insecurity access scale than non-adopters. Moreover, adopter households, on average, have lower deprivation score in multidimensional poverty compared to non-adopter households. Up scaling the adoption of CSA practices through the improvement of households’ implementation capacity and better information, technical advice, and innovative financing mechanisms is advised. Up scaling CSA practices can further promote achieving global goals such as SDG 1, SDG 2, and SDG 13 targets, aimed to end poverty and hunger and mitigate the adverse impacts of climate change, respectively.

Keywords: climate-smart agriculture, food security, multidimensional poverty, upscaling CSA, Ethiopia

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946 Being Authentic is the New “Pieces”: A Mixed Methods Study on Authenticity among African Christian Millennials

Authors: Victor Counted

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Staying true to self is complicated. In most cases, we might not fully come to terms with this realities. Just like any journey, a self-discovery experience with the ‘self’, is like a rollercoaster ride. The researcher attempts to engage the reader in an empirical study on authenticity tendencies of African Christian Millennials. Hence, attempting the all-important question: What does it actually mean to be true to self for the African youth? A comprehensive, yet an unfinished business that applies the authenticity theory in its exploratory navigations to uncover the “lived world” of the participants who were part of this study. Using a mixed methods approach, the researcher will exhaustively give account to the authenticity tendencies and experiences of the respondents in the study by providing the reader with a unique narrative for understanding what it means to be true to oneself in Africa. At the quantitative study, the participants recorded higher scores on the Authenticity Scale (AS) authentic living, while showing a significant correlation within the subscales. Hypotheses were tested at the quantitative phase, which statistically supported gender and church affiliation as possible predictors for the authenticity orientations of the participants, while being a Christian native and race/ethnicity were not impact factors statistically. The results helped the researcher to develop the objectives behind the qualitative study, where only fifteen AS-authentic living participants were interviewed to understand why they scored high on authentic living, in order to understand what it means to be authentic. The hallmark of the qualitative case study exploration was the common coping mechanism of splitting adopted by the respondents to deal with their self-crisis as they tried to remain authentic to self, whilst self-regulating and self-investing the self to discover ‘self’. Specifically, the researcher observed the concurrent utilization of some kind of the religious-self by the respondents to regulate their self crisis, as they relate with self fragmenting through different splitting stages in hope for some kind of redemption. It was an explanation that led to the conclusion that being authentic is the new pieces. Authenticity is in fragments. This proposition led the researcher to introduce a hermeneutical support-system that will enable future researchers engage more critically and responsibly with their “living human documents” in order to inspire timely solutions that resolve the concerns of authenticity and wellbeing among Millennials in Africa.

Keywords: authenticity, self, identity, self-fragmentation, weak self integration, postmodern self, splitting

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945 Rural Population Participation in Minsu Industry as the Method for Rural Revitalization in China

Authors: Xiaoxin Zhao

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Because of the long-time dual structure development in urban and rural areas, the rapid urbanization in China devours the rural resources and causes the unbalanced development of cities and the countryside. On one side, the urban sprawl is swallowing the villages in the peripheral area of cities and forms the ‘urban village’. On the other side, people from traditional and vernacular villages immigrate to the metropolis that their homeland becomes the ‘hollowed village’. In 2005, the national state council noticed the significance of rural development and promoted the ‘beautiful countryside’ project when Minsu was rising. In the 19th National Congress of the Communist Party of China (2017), president Xi Jinping announces the importance of ‘rural revitalization’ and states that the relationship between urban and rural areas should be an integrated development model. However, most Minsu projects in China was invested and managed by individual or group investors and focused on the profits but not the vernacular culture and rural development, and enhanced the urban-rural distinction. This paper introduces two Minsu projects in China designed by star-architects and advertised by social network media as case studies through photos and public comments collections. Architects as the servant to the investors, designed fancy houses, brings the urban life mode but expelled the real vernacular lifestyle as a cultural experience in rural areas. Moreover, to advertise the Minsu hotel, the social media propagates a distorted value that ‘luxury is good taste’ and motivates the vanity of people. Lastly, to maximize the profits, the investors set a high price that caused another unbalanced development in rural area since the price for one night in the Minsu hotel may exceed the monthly income of a local inhabitant. With these material, the author discusses the problems in Chinese Minsu industry and argues that the media, architects and investors play the negative role in the separation between Minsu cultural tourism and rural population. As a result, the author points out the significance of rural population participation that sharing the profits with them if we take Minsu industry as a method for rural revitalization in China.

Keywords: Minsu, vernacular, rural development, rural population participation

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