Search results for: whole school interventions
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4866

Search results for: whole school interventions

126 The Effect of Teachers' Personal Values on the Perceptions of the Effective Principal and Student in School

Authors: Alexander Zibenberg, Rima’a Da’As

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According to the author’s knowledge, individuals are naturally inclined to classify people as leaders and followers. Individuals utilize cognitive structures or prototypes specifying the traits and abilities that characterize the effective leader (implicit leadership theories) and effective follower in an organization (implicit followership theories). Thus, the present study offers insights into understanding how teachers' personal values (self-enhancement and self-transcendence) explain the preference for styles of effective leader (i.e., principal) and assumptions about the traits and behaviors that characterize effective followers (i.e., student). Beyond the direct effect on perceptions of effective types of leader and follower, the present study argues that values may also interact with organizational and personal contexts in influencing perceptions. Thus authors suggest that teachers' managerial position may moderate the relationships between personal values and perception of the effective leader and follower. Specifically, two key questions are addressed in the present research: (1) Is there a relationship between personal values and perceptions of the effective leader and effective follower? and (2) Are these relationships stable or could they change across different contexts? Two hundred fifty-five Israeli teachers participated in this study, completing questionnaires – about the effective student and effective principal. Results of structural equations modeling (SEM) with maximum likelihood estimation showed: first: the model fit the data well. Second: researchers found a positive relationship between self-enhancement and anti-prototype of the effective principal and anti-prototype of the effective student. The relationship between self-transcendence value and both perceptions were found significant as well. Self-transcendence positively related to the way the teacher perceives the prototype of the effective principal and effective student. Besides, authors found that teachers' managerial position moderates these relationships. The article contributes to the literature both on perceptions and on personal values. Although several earlier studies explored issues of implicit leadership theories and implicit followership theories, personality characteristics (values) have garnered less attention in this matter. This study shows that personal values which are deeply rooted, abstract motivations that guide justify or explain attitudes, norms, opinions and actions explain differences in perception of the effective leader and follower. The results advance the theoretical understanding of the relationship between personal values and individuals’ perceptions in organizations. An additional contribution of this study is the application of the teacher's managerial position to explain a potential boundary condition of the translation of personal values into outcomes. The findings suggest that through the management process in the organization, teachers acquire knowledge and skills which augment their ability (beyond their personal values) to predict perceptions of ideal types of principal and student. The study elucidates the unique role of personal values in understanding an organizational thinking in organization. It seems that personal values might explain the differences in individual preferences of the organizational paradigm (mechanistic vs organic).

Keywords: implicit leadership theories, implicit followership theories, organizational paradigms, personal values

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125 Bedouin Dispersion in Israel: Between Sustainable Development and Social Non-Recognition

Authors: Tamir Michal

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The subject of Bedouin dispersion has accompanied the State of Israel from the day of its establishment. From a legal point of view, this subject has offered a launchpad for creative judicial decisions. Thus, for example, the first court decision in Israel to recognize affirmative action (Avitan), dealt with a petition submitted by a Jew appealing the refusal of the State to recognize the Petitioner’s entitlement to the long-term lease of a plot designated for Bedouins. The Supreme Court dismissed the petition, holding that there existed a public interest in assisting Bedouin to establish permanent urban settlements, an interest which justifies giving them preference by selling them plots at subsidized prices. In another case (The Forum for Coexistence in the Negev) the Supreme Court extended equitable relief for the purpose of constructing a bridge, even though the construction infringed the Law, in order to allow the children of dispersed Bedouin to reach school. Against this background, the recent verdict, delivered during the Protective Edge military campaign, which dismissed a petition aimed at forcing the State to spread out Protective Structures in Bedouin villages in the Negev against the risk of being hit from missiles launched from Gaza (Abu Afash) is disappointing. Even if, in arguendo, no selective discrimination was involved in the State’s decision not to provide such protection, the decision, and its affirmation by the Court, is problematic when examined through the prism of the Theory of Recognition. The article analyses the issue by tools of theory of Recognition, according to which people develop their identities through mutual relations of recognition in different fields. In the social context, the path to recognition is cognitive respect, which is provided by means of legal rights. By seeing other participants in Society as bearers of rights and obligations, the individual develops an understanding of his legal condition as reflected in the attitude to others. Consequently, even if the Court’s decision may be justified on strict legal grounds, the fact that Jewish settlements were protected during the military operation, whereas Bedouin villages were not, is a setback in the struggle to make the Bedouin citizens with equal rights in Israeli society. As the Court held, ‘Beyond their protective function, the Migunit [Protective Structures] may make a moral and psychological contribution that should not be undervalued’. This contribution is one that the Bedouin did not receive in the Abu Afash verdict. The basic thesis is that the Court’s verdict analyzed above clearly demonstrates that the reliance on classical liberal instruments (e.g., equality) cannot secure full appreciation of all aspects of Bedouin life, and hence it can in fact prejudice them. Therefore, elements of the recognition theory should be added, in order to find the channel for cognitive dignity, thereby advancing the Bedouins’ ability to perceive themselves as equal human beings in the Israeli society.

Keywords: bedouin dispersion, cognitive respect, recognition theory, sustainable development

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124 Trends in Conservation and Inheritance of Musical Culture of Ethnic Groups: A Case Study of the Akha Music in Chiang Rai Province, Thailand

Authors: Nutthan Inkhong, Sutthiphong Ruangchante

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Chiang Rai province is located at the northern border of Thailand. Most of the geography there is the northern continental highlands, and the population has many types of inhabitants, including Thai people, immigrants and ethnic groups such as Akha, Lahu, Lisu, Yao, etc. Most of these ethnic groups migrated from neighbouring countries such as Myanmar, Laos, China, etc. and settled in the mountains. Each ethnic group has their unique traditions, culture, and ways of life, including the musical culture that the ancestors of each ethnic group brought with them. In the present, the Akha have the largest population in the region and still live together in numerous villages in many districts. Thus, Akha musical culture still appears in the community traditions and cultural events of Chiang Rai province regularly. This article presents the situations of Akha musical culture in the present and the predictions for the future. The study method involves the analysis of music information and the related social contexts, which were collected from the fieldwork of ethnomusicological methodology by in-depth interviews, observations, audio and visual recordings, and related documents. The results found that the important persons who are related with Akha musical culture include (1) a musical instrument maker (lives in Mae Chan district) who produces various Akha musical instruments, including gourd mouth organs, Akha drums, two-way flutes, three-hole flutes, Jew’s harps (the sound of teenage love), buffalo horns (the sound symbol of hunting) and bird call instruments (the imitation of bird sounds), (2) a folk philosopher (lives in Mae Pha Luang district) who can teach music to the new generation of Akha people as well as lecture and demonstrate music to academics and tourists, and (3) a community leader (lives in Mae Chan district) who conserves Akha performances, singing and music through various activities of the students in an informal school. Because of the changes to the social contexts and ways of life of the Akha people, such as the educational system, religion, social media, etc., including the popularity of both Thai and international popular music among the new generation of Akha people, changes to and the fading away of Akha musical culture in the future may likely occur. Therefore, the conservation and inheritance of Akha music is an issue that should be resolved quickly. This primary study leads to the next step of the ethnomusicological work and plays a part in preventing or reducing the problems impacting Akha musical culture survival by the recording of Akha music in all of its dimensions, such as producing musical instruments, playing musical instruments, analysis of tuning systems, recording Akha music as musical notation using symbols, researching related social contexts, etc. and the transcription of this information to create lessons that can be returned to the Akha community.

Keywords: Akha music, Chiang Rai, ethnic music in Thailand, ethnomusicology

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123 Food Insecurity and Other Correlates of Individual Components of Metabolic Syndrome in Women Living with HIV (WLWH) in the United States

Authors: E. Wairimu Mwangi, Daniel Sarpong

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Background: Access to effective antiretroviral therapy in the United States has resulted in the rise in longevity in people living with HIV (PLHIV). Despite the progress, women living with HIV (WLWH) experience increasing rates of cardiometabolic disorders compared with their HIV-negative counterparts. Studies focusing on the predictors of metabolic disorders in this population have largely focused on the composite measure of metabolic syndrome (METs). This study seeks to identify the predictors of composite and individual METs factors in a nationally representative sample of WLWH. In particular, the study also examines the role of food security in predicting METs. Methods: The study comprised 1800 women, a subset of participants from the Women’s Interagency HIV Study (WIHS). The primary exposure variable, food security, was measured using the U.S. 10-item Household Food Security Survey Module. The outcome measures are the five metabolic syndrome indicators (elevated blood pressure [systolic BP > 130 mmHg and diastolic BP ≥ 85 mmHg], elevated fasting glucose [≥ 110 mg/dL], elevated fasting triglyceride [≥ 150 mg/dL], reduced HDL cholesterol [< 50 mg/dL], and waist circumference > 88 cm) and the composite measure - Metabolic Syndrome (METs) Status. Each metabolic syndrome indicator was coded one if yes and 0 otherwise. The values of the five indicators were summed, and participants with a total score of 3 or greater were classified as having metabolic syndrome. Participants classified as having metabolic syndrome were assigned a code of 1 and 0 otherwise for analysis. The covariates accounted for in this study fell into sociodemographic factors and behavioral and health characteristics. Results: The participants' mean (SD) age was 47.1 (9.1) years, with 71.4% Blacks and 10.9% Whites. About a third (33.1%) had less than a high school (HS) diploma, 60.4% were married, 32.8% were employed, and 53.7% were low-income. The prevalence of worst dietary diversity, low, moderate, and high food security were 24.1%, 26.6%, 17.0%, and 56.4%, respectively. The correlate profile of the five individual METs factors plus the composite measure of METs differ significantly, with METs based on HDL having the most correlates (Age, Education, Drinking Status, Low Income, Body Mass Index, and Health Perception). Additionally, metabolic syndrome based on waist circumference was the only metabolic factor where food security was significantly correlated (Food Security, Age, and Body Mass Index). Age was a significant predictor of all five individual METs factors plus the composite METs measure. Except for METs based on Fasting Triglycerides, body mass index (BMI) was a significant correlate of the various measures of metabolic syndrome. Conclusion: High-density Lipoprotein (HDL) cholesterol significantly correlated with most predictors. BMI was a significant predictor of all METs factors except Fasting Triglycerides. Food insecurity, the primary predictor, was only significantly associated with waist circumference.

Keywords: blood pressure, food insecurity, fasting glucose, fasting triglyceride, high-density lipoprotein, metabolic syndrome, waist circumference, women living with HIV

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122 Multilevel Regression Model - Evaluate Relationship Between Early Years’ Activities of Daily Living and Alzheimer’s Disease Onset Accounting for Influence of Key Sociodemographic Factors Using a Longitudinal Household Survey Data

Authors: Linyi Fan, C.J. Schumaker

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Background: Biomedical efforts to treat Alzheimer’s disease (AD) have typically produced mixed to poor results, while more lifestyle-focused treatments such as exercise may fare better than existing biomedical treatments. A few promising studies have indicated that activities of daily life (ADL) may be a useful way of predicting AD. However, the existing cross-sectional studies fail to show how functional-related issues such as ADL in early years predict AD and how social factors influence health either in addition to or in interaction with individual risk factors. This study would helpbetterscreening and early treatments for the elderly population and healthcare practice. The findings have significance academically and practically in terms of creating positive social change. Methodology: The purpose of this quantitative historical, correlational study was to examine the relationship between early years’ ADL and the development of AD in later years. The studyincluded 4,526participantsderived fromRAND HRS dataset. The Health and Retirement Study (HRS) is a longitudinal household survey data set that is available forresearchof retirement and health among the elderly in the United States. The sample was selected by the completion of survey questionnaire about AD and dementia. The variablethat indicates whether the participant has been diagnosed with AD was the dependent variable. The ADL indices and changes in ADL were the independent variables. A four-step multilevel regression model approach was utilized to address the research questions. Results: Amongst 4,526 patients who completed the AD and dementia questionnaire, 144 (3.1%) were diagnosed with AD. Of the 4,526 participants, 3,465 (76.6%) have high school and upper education degrees,4,074 (90.0%) were above poverty threshold. The model evaluatedthe effect of ADL and change in ADL on onset of AD in late years while allowing the intercept of the model to vary by level of education. The results suggested that the only significant predictor of the onset of AD was changes in early years’ ADL (b = 20.253, z = 2.761, p < .05). However, the result of the sensitivity analysis (b = 7.562, z = 1.900, p =.058), which included more control variables and increased the observation period of ADL, are not supported this finding. The model also estimated whether the variances of random effect vary by Level-2 variables. The results suggested that the variances associated with random slopes were approximately zero, suggesting that the relationship between early years’ ADL were not influenced bysociodemographic factors. Conclusion: The finding indicated that an increase in changes in ADL leads to an increase in the probability of onset AD in the future. However, this finding is not support in a broad observation period model. The study also failed to reject the hypothesis that the sociodemographic factors explained significant amounts of variance in random effect. Recommendations were then made for future research and practice based on these limitations and the significance of the findings.

Keywords: alzheimer’s disease, epidemiology, moderation, multilevel modeling

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121 Kansei Engineering Applied to the Design of Rural Primary Education Classrooms: Design-Based Learning Case

Authors: Jimena Alarcon, Andrea Llorens, Gabriel Hernandez, Maritza Palma, Lucia Navarrete

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The research has funding from the Government of Chile and is focused on defining the design of rural primary classroom that stimulates creativity. The relevance of the study consists of its capacity to define adequate educational spaces for the implementation of the design-based learning (DBL) methodology. This methodology promotes creativity and teamwork, generating a meaningful learning experience for students, based on the appreciation of their environment and the generation of projects that contribute positively to their communities; also, is an inquiry-based form of learning that is based on the integration of design thinking and the design process into the classroom. The main goal of the study is to define the design characteristics of rural primary school classrooms, associated with the implementation of the DBL methodology. Along with the change in learning strategies, it is necessary to change the educational spaces in which they develop. The hypothesis indicates that a change in the space and equipment of the classrooms based on the emotions of the students will motivate better learning results based on the implementation of a new methodology. In this case, the pedagogical dynamics require an important interaction between the participants, as well as an environment favorable to creativity. Methodologies from Kansei engineering are used to know the emotional variables associated with their definition. The study is done to 50 students between 6 and 10 years old (average age of seven years), 48% of men and 52% women. Virtual three-dimensional scale models and semantic differential tables are used. To define the semantic differential, self-applied surveys were carried out. Each survey consists of eight separate questions in two groups: question A to find desirable emotions; question B related to emotions. Both questions have a maximum of three alternatives to answer. Data were tabulated with IBM SPSS Statistics version 19. Terms referred to emotions are grouped into twenty concepts with a higher presence in surveys. To select the values obtained as part of the implementation of Semantic Differential, a number expected of 'chi-square test (x2)' frequency calculated for classroom space is considered lower limit. All terms over the N expected a cut point, are included to prepare tables for surveys to find a relation between emotion and space. Statistic contrast (Chi-Square) represents significance level ≥ 0, indicator that frequencies appeared are not random. Then, the most representative terms depend on the variable under study: a) definition of textures and color of vertical surfaces is associated with emotions such as tranquility, attention, concentration, creativity; and, b) distribution of the equipment of the rooms, with emotions associated with happiness, distraction, creativity, freedom. The main findings are linked to the generation of classrooms according to diverse DBL team dynamics. Kansei engineering is the appropriate methodology to know the emotions that students want to feel in the classroom space.

Keywords: creativity, design-based learning, education spaces, emotions

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120 Mobi-DiQ: A Pervasive Sensing System for Delirium Risk Assessment in Intensive Care Unit

Authors: Subhash Nerella, Ziyuan Guan, Azra Bihorac, Parisa Rashidi

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Intensive care units (ICUs) provide care to critically ill patients in severe and life-threatening conditions. However, patient monitoring in the ICU is limited by the time and resource constraints imposed on healthcare providers. Many critical care indices such as mobility are still manually assessed, which can be subjective, prone to human errors, and lack granularity. Other important aspects, such as environmental factors, are not monitored at all. For example, critically ill patients often experience circadian disruptions due to the absence of effective environmental “timekeepers” such as the light/dark cycle and the systemic effect of acute illness on chronobiologic markers. Although the occurrence of delirium is associated with circadian disruption risk factors, these factors are not routinely monitored in the ICU. Hence, there is a critical unmet need to develop systems for precise and real-time assessment through novel enabling technologies. We have developed the mobility and circadian disruption quantification system (Mobi-DiQ) by augmenting biomarker and clinical data with pervasive sensing data to generate mobility and circadian cues related to mobility, nightly disruptions, and light and noise exposure. We hypothesize that Mobi-DiQ can provide accurate mobility and circadian cues that correlate with bedside clinical mobility assessments and circadian biomarkers, ultimately important for delirium risk assessment and prevention. The collected multimodal dataset consists of depth images, Electromyography (EMG) data, patient extremity movement captured by accelerometers, ambient light levels, Sound Pressure Level (SPL), and indoor air quality measured by volatile organic compounds, and the equivalent CO₂ concentration. For delirium risk assessment, the system recognizes mobility cues (axial body movement features and body key points) and circadian cues, including nightly disruptions, ambient SPL, and light intensity, as well as other environmental factors such as indoor air quality. The Mobi-DiQ system consists of three major components: the pervasive sensing system, a data storage and analysis server, and a data annotation system. For data collection, six local pervasive sensing systems were deployed, including a local computer and sensors. A video recording tool with graphical user interface (GUI) developed in python was used to capture depth image frames for analyzing patient mobility. All sensor data is encrypted, then automatically uploaded to the Mobi-DiQ server through a secured VPN connection. Several data pipelines are developed to automate the data transfer, curation, and data preparation for annotation and model training. The data curation and post-processing are performed on the server. A custom secure annotation tool with GUI was developed to annotate depth activity data. The annotation tool is linked to the MongoDB database to record the data annotation and to provide summarization. Docker containers are also utilized to manage services and pipelines running on the server in an isolated manner. The processed clinical data and annotations are used to train and develop real-time pervasive sensing systems to augment clinical decision-making and promote targeted interventions. In the future, we intend to evaluate our system as a clinical implementation trial, as well as to refine and validate it by using other data sources, including neurological data obtained through continuous electroencephalography (EEG).

Keywords: deep learning, delirium, healthcare, pervasive sensing

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119 Harnessing the Power of Artificial Intelligence: Advancements and Ethical Considerations in Psychological and Behavioral Sciences

Authors: Nayer Mofidtabatabaei

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Advancements in artificial intelligence (AI) have transformed various fields, including psychology and behavioral sciences. This paper explores the diverse ways in which AI is applied to enhance research, diagnosis, therapy, and understanding of human behavior and mental health. We discuss the potential benefits and challenges associated with AI in these fields, emphasizing the ethical considerations and the need for collaboration between AI researchers and psychological and behavioral science experts. Artificial Intelligence (AI) has gained prominence in recent years, revolutionizing multiple industries, including healthcare, finance, and entertainment. One area where AI holds significant promise is the field of psychology and behavioral sciences. AI applications in this domain range from improving the accuracy of diagnosis and treatment to understanding complex human behavior patterns. This paper aims to provide an overview of the various AI applications in psychological and behavioral sciences, highlighting their potential impact, challenges, and ethical considerations. Mental Health Diagnosis AI-driven tools, such as natural language processing and sentiment analysis, can analyze large datasets of text and speech to detect signs of mental health issues. For example, chatbots and virtual therapists can provide initial assessments and support to individuals suffering from anxiety or depression. Autism Spectrum Disorder (ASD) Diagnosis AI algorithms can assist in early ASD diagnosis by analyzing video and audio recordings of children's behavior. These tools help identify subtle behavioral markers, enabling earlier intervention and treatment. Personalized Therapy AI-based therapy platforms use personalized algorithms to adapt therapeutic interventions based on an individual's progress and needs. These platforms can provide continuous support and resources for patients, making therapy more accessible and effective. Virtual Reality Therapy Virtual reality (VR) combined with AI can create immersive therapeutic environments for treating phobias, PTSD, and social anxiety. AI algorithms can adapt VR scenarios in real-time to suit the patient's progress and comfort level. Data Analysis AI aids researchers in processing vast amounts of data, including survey responses, brain imaging, and genetic information. Privacy Concerns Collecting and analyzing personal data for AI applications in psychology and behavioral sciences raise significant privacy concerns. Researchers must ensure the ethical use and protection of sensitive information. Bias and Fairness AI algorithms can inherit biases present in training data, potentially leading to biased assessments or recommendations. Efforts to mitigate bias and ensure fairness in AI applications are crucial. Transparency and Accountability AI-driven decisions in psychology and behavioral sciences should be transparent and subject to accountability. Patients and practitioners should understand how AI algorithms operate and make decisions. AI applications in psychological and behavioral sciences have the potential to transform the field by enhancing diagnosis, therapy, and research. However, these advancements come with ethical challenges that require careful consideration. Collaboration between AI researchers and psychological and behavioral science experts is essential to harness AI's full potential while upholding ethical standards and privacy protections. The future of AI in psychology and behavioral sciences holds great promise, but it must be navigated with caution and responsibility.

Keywords: artificial intelligence, psychological sciences, behavioral sciences, diagnosis and therapy, ethical considerations

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118 Closing the Loop between Building Sustainability and Stakeholder Engagement: Case Study of an Australian University

Authors: Karishma Kashyap, Subha D. Parida

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Rapid population growth and urbanization is creating pressure throughout the world. This has a dramatic effect on a lot of elements which include water, food, transportation, energy, infrastructure etc. as few of the key services. Built environment sector is growing concurrently to meet the needs of urbanization. Due to such large scale development of buildings, there is a need for them to be monitored and managed efficiently. Along with appropriate management, climate adaptation is highly crucial as well because buildings are one of the major sources of greenhouse gas emission in their operation phase. Buildings to be adaptive need to provide a triple bottom approach to sustainability i.e., being socially, environmentally and economically sustainable. Hence, in order to deliver these sustainability outcomes, there is a growing understanding and thrive towards switching to green buildings or renovating new ones as per green standards wherever possible. Academic institutions in particular have been following this trend globally. This is highly significant as universities usually have high occupancy rates because they manage a large building portfolio. Also, as universities accommodate the future generation of architects, policy makers etc., they have the potential of setting themselves as a best industry practice model for research and innovation for the rest to follow. Hence their climate adaptation, sustainable growth and performance management becomes highly crucial in order to provide the best services to users. With the objective of evaluating appropriate management mechanisms within academic institutions, a feasibility study was carried out in a recent 5-Star Green Star rated university building (housing the School of Construction) in Victoria (south-eastern state of Australia). The key aim was to understand the behavioral and social aspect of the building users, management and the impact of their relationship on overall building sustainability. A survey was used to understand the building occupant’s response and reactions in terms of their work environment and management. A report was generated based on the survey results complemented with utility and performance data which were then used to evaluate the management structure of the university. Followed by the report, interviews were scheduled with the facility and asset managers in order to understand the approach they use to manage the different buildings in their university campuses (old, new, refurbished), respective building and parameters incorporated in maintaining the Green Star performance. The results aimed at closing the communication and feedback loop within the respective institutions and assist the facility managers to deliver appropriate stakeholder engagement. For the wider design community, analysis of the data highlights the applicability and significance of prioritizing key stakeholders, integrating desired engagement policies within an institution’s management structures and frameworks and their effect on building performance

Keywords: building optimization, green building, post occupancy evaluation, stakeholder engagement

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117 A Case Report on the Course and Outcome of a Patient Diagnosed with Trichotillomania and Major Depressive Disorder

Authors: Ziara Carmelli G. Tan, Irene Carmelle S. Tan

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Background: Trichotillomania (TTM) and Major Depressive Disorder (MDD) are two psychiatric conditions that frequently co-occur, presenting a significant challenge for treatment due to their complex interplay. TTM involves repetitive hair-pulling, leading to noticeable hair loss and distress, while MDD is characterized by persistent low mood and loss of interest or pleasure, leading to dysfunctionality. This case report examines the intricate relationship between TTM and MDD in a young adult female, emphasizing the need for a comprehensive, multifaceted therapeutic approach to address both disorders effectively. Case Presentation: The patient is a 21-year-old female college student and youth church leader who presented with chronic hair-pulling and depressive symptoms. Her premorbid personality was marked by low self-esteem and a strong need for external validation. Despite her academic and social responsibilities and achievements, she struggled with managing her emotional distress, which was exacerbated by her family dynamics and her role within her church community. Her hair-pulling and mood symptoms were particularly triggered by self-esteem threats and feelings of inadequacy. She was diagnosed with Trichotillomania, Scalp and Major Depressive Disorder. Intervention/Management: The patient’s treatment plan was comprehensive, incorporating both pharmacological and non-pharmacological interventions. Initial pharmacologic management was Fluoxetine 20mg/day up, titrated to 40mg/day with no improvement; hence, shifted to Escitalopram 20mg/day and started with N-acetylcysteine 600mg/day with noted significant improvement in symptoms. Psychotherapeutic strategies played a crucial role in her treatment. These included supportive-expressive psychodynamic psychotherapy, which helped her explore and understand underlying emotional conflicts. Cognitive-behavioral techniques were employed to modify her maladaptive thoughts and behaviors. Grief processing was integrated to help her cope with significant losses. Family therapy was done to address conflicts and collaborate with the treatment process. Psychoeducation was provided to enhance her understanding of her condition and to empower her in her treatment journey. A suicide safety plan was developed to ensure her safety during critical periods. An interprofessional approach, which involved coordination with the Dermatology service for co-management, was also a key component of her treatment. Outcome: Over the course of 15 therapy sessions, the patient demonstrated significant improvement in both her depressive symptoms and hair-pulling behavior. Her active engagement in therapy, combined with pharmacological support, facilitated better emotional regulation and a more cohesive sense of self. Her adherence to the treatment plan, along with the collaborative efforts of the interprofessional team, contributed to her positive outcomes. Discussion: This case underscores the significance of addressing both TTM and its comorbid conditions to achieve effective treatment outcomes. The intricate interplay between TTM and MDD in the patient’s case highlights the importance of a comprehensive treatment plan that includes both pharmacological and psychotherapeutic approaches. Supportive-expressive psychodynamic psychotherapy, Cognitive-behavioral techniques, and Family therapy were particularly beneficial in addressing the complex emotional and behavioral aspects of her condition. The involvement of an interprofessional team, including dermatology co-management, was crucial in providing holistic care. Future practice should consider the benefits of such a multidisciplinary approach to managing complex cases like this, ensuring that both the psychological and physiological aspects of the disorders are adequately addressed.

Keywords: cognitive-behavioral therapy, interprofessional approach, major depressive disorder, psychodynamic psychotherapy, trichotillomania

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116 A Sustainable Training and Feedback Model for Developing the Teaching Capabilities of Sessional Academic Staff

Authors: Nirmani Wijenayake, Louise Lutze-Mann, Lucy Jo, John Wilson, Vivian Yeung, Dean Lovett, Kim Snepvangers

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Sessional academic staff at universities have the most influence and impact on student learning, engagement, and experience as they have the most direct contact with undergraduate students. A blended technology-enhanced program was created for the development and support of sessional staff to ensure adequate training is provided to deliver quality educational outcomes for the students. This program combines innovative mixed media educational modules, a peer-driven support forum, and face-to-face workshops to provide a comprehensive training and support package for staff. Additionally, the program encourages the development of learning communities and peer mentoring among the sessional staff to enhance their support system. In 2018, the program was piloted on 100 sessional staff in the School of Biotechnology and Biomolecular Sciences to evaluate the effectiveness of this model. As part of the program, rotoscope animations were developed to showcase ‘typical’ interactions between staff and students. These were designed around communication, confidence building, consistency in grading, feedback, diversity awareness, and mental health and wellbeing. When surveyed, 86% of sessional staff found these animations to be helpful in their teaching. An online platform (Moodle) was set up to disseminate educational resources and teaching tips, to host a discussion forum for peer-to-peer communication and to increase critical thinking and problem-solving skills through scenario-based lessons. The learning analytics from these lessons were essential in identifying difficulties faced by sessional staff to further develop supporting workshops to improve outcomes related to teaching. The face-to-face professional development workshops were run by expert guest speakers on topics such as cultural diversity, stress and anxiety, LGBTIQ and student engagement. All the attendees of the workshops found them to be useful and 88% said they felt these workshops increase interaction with their peers and built a sense of community. The final component of the program was to use an adaptive e-learning platform to gather feedback from the students on sessional staff teaching twice during the semester. The initial feedback provides sessional staff with enough time to reflect on their teaching and adjust their performance if necessary, to improve the student experience. The feedback from students and the sessional staff on this model has been extremely positive. The training equips the sessional staff with knowledge and insights which can provide students with an exceptional learning environment. This program is designed in a flexible and scalable manner so that other faculties or institutions could adapt components for their own training. It is anticipated that the training and support would help to build the next generation of educators who will directly impact the educational experience of students.

Keywords: designing effective instruction, enhancing student learning, implementing effective strategies, professional development

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115 Wadjda, a Film That Quietly Sets the Stage for a Cultural Revolution in Saudi Arabia

Authors: Anouar El Younssi

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This study seeks to shed some light on the political and social ramifications and implications of Haifaa al-Mansour’s 2012 film Wadjda. The film made international headlines following its release, and was touted as the first film ever to be shot in its entirety inside the Kingdom of Saudi Arabia, and also the first to be directed by a female (Haifaa al-Mansour). Wadjda revolves around a simple storyline: A teenage Saudi girl living in the capital city Riyadh—named Wadjda—wants to have a bicycle just like her male teenage neighbor and friend Abdullah, but her ultra-conservative Saudi society places so many constraints on its female population—including not allowing girls and women to ride bicycles. Wadjda, who displays a rebellious spirit, takes concrete steps to save money in order to realize her dream of buying a bicycle. For example, she starts making and selling sports bracelets to her school mates, and she decides to participate in a Qur’an competition in hopes of winning a sum of money that comes with the first prize. In the end, Wadjda could not beat the system on her own, but the film reverses course, and the audience gets a happy ending: Wadjda’s mother, whose husband has decided to take a second wife, defies the system and buys her daughter the very bicycle Wadjda has been dreaming of. It is quite significant that the mother takes her daughter’s side on the subject of the bicycle at the end of the film, for this shows that she finally came to the realization that she and her daughter are both oppressed by the cultural norms prevalent in Saudi society. It is no coincidence that this change of heart and action on the part of the mother takes place immediately after the wedding night celebrating her husband’s second marriage. Gender inequality is thus placed front and center in the film. Nevertheless, a major finding of this study is that the film carries out its social critique in a soft and almost covert manner. The female actors in the film never issue a direct criticism of Saudi society or government; the criticism is consistently implied and subtle throughout. It is a criticism that relies more on showing than telling. The film shows us—rather than tells us directly—what is wrong, and lets us, the audience, decide and make a judgment. In fact, showing could arguably be more powerful and impactful than telling. Regarding methodology, this study will focus on and analyze the visuals and a number of key utterances by the main actor Wadjda in order to corroborate the study’s argument about the film’s bent on critiquing patriarchy. This research will attempt to establish a link between the film as an art object and as a social text. Ultimately, Wadjda sends a message of hope, that change is possible and that it is already happening slowly inside the Kingdom. It also sends the message that an insurrectional approach regarding women’s rights in Saudi Arabia is perhaps not the right one, at least at this historical juncture.

Keywords: bicycle, gender inequality, social critique, Wadjda, women’s rights

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114 Oil-price Volatility and Economic Prosperity in Nigeria: Empirical Evidence

Authors: Yohanna Panshak

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The impact of macroeconomic instability on economic growth and prosperity has been at forefront in many discourses among researchers and policy makers and has generated a lot of controversies over the years. This has generated series of research efforts towards understanding the remote causes of this phenomenon; its nature, determinants and how it can be targeted and mitigated. While others have opined that the root cause of macroeconomic flux in Nigeria is attributed to Oil-Price volatility, others viewed the issue as resulting from some constellation of structural constraints both within and outside the shores of the country. Research works of scholars such as [Akpan (2009), Aliyu (2009), Olomola (2006), etc] argue that oil volatility can determine economic growth or has the potential of doing so. On the contrary, [Darby (1982), Cerralo (2005) etc] share the opinion that it can slow down growth. The earlier argument rest on the understanding that for a net balance of oil exporting economies, price upbeat directly increases real national income through higher export earnings, whereas, the latter allude to the case of net-oil importing countries (which experience price rises, increased input costs, reduced non-oil demand, low investment, fall in tax revenues and ultimately an increase in budget deficit which will further reduce welfare level). Therefore, assessing the precise impact of oil price volatility on virtually any economy is a function of whether it is an oil-exporting or importing nation. Research on oil price volatility and its outcome on the growth of the Nigerian economy are evolving and in a march towards resolving Nigeria’s macroeconomic instability as long as oil revenue still remain the mainstay and driver of socio-economic engineering. Recently, a major importer of Nigeria’s oil- United States made a historic breakthrough in more efficient source of energy for her economy with the capacity of serving significant part of the world. This undoubtedly suggests a threat to the exchange earnings of the country. The need to understand fluctuation in its major export commodity is critical. This paper leans on the Renaissance growth theory with greater focus on theoretical work of Lee (1998); a leading proponent of this school who makes a clear cut of difference between oil price changes and oil price volatility. Based on the above background, the research seeks to empirically examine the impact oil-price volatility on government expenditure using quarterly time series data spanning 1986:1 to 2014:4. Vector Auto Regression (VAR) econometric approach shall be used. The structural properties of the model shall be tested using Augmented Dickey-Fuller and Phillips-Perron. Relevant diagnostics tests of heteroscedasticity, serial correlation and normality shall also be carried out. Policy recommendation shall be offered on the empirical findings and believes it assist policy makers not only in Nigeria but the world-over.

Keywords: oil-price, volatility, prosperity, budget, expenditure

Procedia PDF Downloads 267
113 Assessment of Food Safety Culture in Select Restaurants and a Produce Market in Doha, Qatar

Authors: Ipek Goktepe, Israa Elnemr, Hammad Asim, Hao Feng, Mosbah Kushad, Hee Park, Sheikha Alzeyara, Mohammad Alhajri

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Food safety management in Qatar is under the shared oversight of multiple agencies in two government ministries (Ministry of Public Health and Ministry of Municipality and Environment). Despite the increasing number and diversity of the food service establishments, no systematic food surveillance system is in place in the country, which creates a gap in terms of determining the food safety attitudes and practices applied in the food service operations. Therefore, this study seeks to partially address this gap through determination of food safety knowledge among food handlers, specifically with respect to food preparation and handling practices, and sanitation methods applied in food service providers (FSPs) and a major market in Doha, Qatar. The study covered a sample of 53 FSPs randomly selected out of 200 FSPs. Face-to-face interviews with managers at participating FSPs were conducted using a 40-questions survey. Additionally, 120 produce handlers who are in direct contact with fresh produce at the major produce market in Doha were surveyed using a questionnaire containing 21 questions. A written informed consent was obtained from each survey participant. The survey data were analyzed using the chi-square test and correlation test. The significance was evaluated at p ˂ 0.05. The results from the FSPs surveys indicated that the average age of FSPs was 11 years, with the oldest and newest being established in 1982 and 2015, respectively. Most managers (66%) had college degree and 68% of them were trained on the food safety management system known as HACCP. These surveys revealed that FSP managers’ training and education level were highly correlated with the probability of their employees receiving food safety training while managers with lower education level had no formal training on food safety for themselves nor for their employees. Casual sit-in and fine dine-in restaurants consistently kept records (100%), followed by fast food (36%), and catering establishments (14%). The produce handlers’ survey results showed that none of the workers had any training on safe produce handling practices. The majority of the workers were in the age range of 31-40 years (37%) and only 38% of them had high-school degree. Over 64% of produce handlers claimed to wash their hands 4-5 times per day but field observations pointed limited handwashing as there was soap in the settings. This observation suggests potential food safety risks since a significant correlation (p ˂ 0.01) between the educational level and the hand-washing practices was determined. This assessment on food safety culture through determination of food and produce handlers' level of knowledge and practices, the first of its kind in Qatar, demonstrated that training and education are important factors which directly impact the food safety culture in FSPs and produce markets. These findings should help in identifying the need for on-site training of food handlers for effective food safety practices in food establishments in Qatar.

Keywords: food safety, food safety culture, food service providers, food handlers

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112 Improving Diagnostic Accuracy of Ankle Syndesmosis Injuries: A Comparison of Traditional Radiographic Measurements and Computed Tomography-Based Measurements

Authors: Yasar Samet Gokceoglu, Ayse Nur Incesu, Furkan Okatar, Berk Nimetoglu, Serkan Bayram, Turgut Akgul

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Ankle syndesmosis injuries pose a significant challenge in orthopedic practice due to their potential for prolonged recovery and chronic ankle dysfunction. Accurate diagnosis and management of these injuries are essential for achieving optimal patient outcomes. The use of radiological methods, such as X-ray, computed tomography (CT), and magnetic resonance imaging (MRI), plays a vital role in the accurate diagnosis of syndesmosis injuries in the context of ankle fractures. Treatment options for ankle syndesmosis injuries vary, with surgical interventions such as screw fixation and suture-button implantation being commonly employed. The choice of treatment is influenced by the severity of the injury and the presence of associated fractures. Additionally, the mechanism of injury, such as pure syndesmosis injury or specific fracture types, can impact the stability and management of syndesmosis injuries. Ankle fractures with syndesmosis injury present a complex clinical scenario, requiring accurate diagnosis, appropriate reduction, and tailored management strategies. The interplay between the mechanism of injury, associated fractures, and treatment modalities significantly influences the outcomes of these challenging injuries. The long-term outcomes and patient satisfaction following ankle fractures with syndesmosis injury are crucial considerations in the field of orthopedics. Patient-reported outcome measures, such as the Foot and Ankle Outcome Score (FAOS), provide essential information about functional recovery and quality of life after these injuries. When diagnosing syndesmosis injuries, standard measurements, such as the medial clear space, tibiofibular overlap, tibiofibular clear space, anterior tibiofibular ratio (ATFR), and the anterior-posterior tibiofibular ratio (APTF), are assessed through radiographs and computed tomography (CT) scans. These parameters are critical in evaluating the presence and severity of syndesmosis injuries, enabling clinicians to choose the most appropriate treatment approach. Despite advancements in diagnostic imaging, challenges remain in accurately diagnosing and treating ankle syndesmosis injuries. Traditional diagnostic parameters, while beneficial, may not capture the full extent of the injury or provide sufficient information to guide therapeutic decisions. This gap highlights the need for exploring additional diagnostic parameters that could enhance the accuracy of syndesmosis injury diagnoses and inform treatment strategies more effectively. The primary goal of this research is to evaluate the usefulness of traditional radiographic measurements in comparison to new CT-based measurements for diagnosing ankle syndesmosis injuries. Specifically, this study aims to assess the accuracy of conventional parameters, including medial clear space, tibiofibular overlap, tibiofibular clear space, ATFR, and APTF, in contrast with the recently proposed CT-based measurements such as the delta and gamma angles. Moreover, the study intends to explore the relationship between these diagnostic parameters and functional outcomes, as measured by the Foot and Ankle Outcome Score (FAOS). Establishing a correlation between specific diagnostic measurements and FAOS scores will enable us to identify the most reliable predictors of functional recovery following syndesmosis injuries. This comparative analysis will provide valuable insights into the accuracy and dependability of CT-based measurements in diagnosing ankle syndesmosis injuries and their potential impact on predicting patient outcomes. The results of this study could greatly influence clinical practices by refining diagnostic criteria and optimizing treatment planning for patients with ankle syndesmosis injuries.

Keywords: ankle syndesmosis injury, diagnostic accuracy, computed tomography, radiographic measurements, Tibiofibular syndesmosis distance

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111 Religious Discourses and Their Impact on Regional and Global Geopolitics: A Study of Deobandi in India, Pakistan and Afghanistan

Authors: Soumya Awasthi

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The spread of radical ideology is possible not merely through public meetings, protests, and mosques but even in schools, seminaries, and madrasas. The rhetoric created around the relationship between religion and conflict has been the primary factor for instigating global conflicts – when religion is used to achieve broader objectives. There have been numerous cases of religion-driven conflict around the world be it the Jewish revolt between 66 AD and 628 AD or the 1119 AD the Crusades revolt or during the Cold War period or the rise of right-wing politics in India. Some of the major developments which reiterate the significance of religion in the contemporary times include: (1) The emergence of theocracy in Iran in 1979 (2) Resurgence of world-wide religious beliefs in post-Soviet space. (3) Emergence of transnational terrorism shaped by twisted depiction of Islam by the self proclaimed protectors of the religion. Therefore this paper is premised in the argument that religion has always found itself on the periphery of the discipline of International Relations (IR), and has received less attention than it deserves. The focus of the topic is on the discourses of ‘Deobandi’ and its impact both on the geopolitics of the region- particularly in India, Pakistan, and Afghanistan- and also at the global level. Discourse is a mechanism in use since time immemorial and has been a key tool to mobilise masses against the ruling authority. With the help of field surveys, qualitative and analytical method of research in religion and international relations, it has been found that they are numerous madrassas that are running illegally and are unregistered. These seminaries are operating in the Khyber-Pakhtunkhwa and Federally Administered Tribal Area (FATA). During the Soviet invasion of Afghanistan in 1979, relation between religion and geopolitics was highlighted when there was a sudden spread of radical ideas, finding support from countries like Saudi Arabia (who funded the campaign) and Pakistan (which organised the Saudi funds and set up training camps, both educational and military). During this period there was a huge influence of Wahabi theology on the madrasas which started with Deoband philosophy and later became a mix of Wahabi (influenced by Ahmad Ibn Hannabal and Ibn Taimmiya) and Deobandi philosophy, tending towards fundamentalism. Later the impact of regional geopolitics had influence on the global geopolitics when the incidents like attack on the US in 2001, bomb blasts in U.K, Indonesia, Turkey, and Israel in 2000s. In the midst of all this, there were several scholars who pointed towards Deobandi Philosophy as one of the drivers in the creation of armed Islamic groups in Pakistan, Afghanistan. Hence this paper will make an attempt to understand the trend as to how Deobandi religious discourses originating from India have changed over the decades, and who the agents of such changes are. It will throw light on Deoband from pre-independence till date to create a narrative around the religious discourses and Deobandi philosophy and its spill over impact on the map of global and regional security.

Keywords: Deobandi School of Thought, radicalization, regional and global geopolitics, religious discourses, Whabi movement

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110 Implementation of International Standards in the Field of Higher Secondary Education in Kerala

Authors: Bernard Morais Joosa

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Kerala, the southern state of India, is known for its accomplishments in universal education and enrollments. Through this mission, the Government proposes comprehensive educational reforms including 1000 Government schools into international standards during the first phase. The idea is not only to improve the infrastructural facilities but also to reform the teaching and learning process to the present day needs by introducing ICT enabled learning and providing smart classrooms. There will be focus on creating educational programmes which are useful for differently abled students. It is also meant to reinforce the teaching–learning process by providing ample opportunities to each student to construct their own knowledge using modern technology tools. The mission will redefine the existing classroom learning process, coordinate resource mobilization efforts and develop ‘Janakeeya Vidyabhyasa Mathruka.' Special packages to support schools which are in existence for over 100 years will also be attempted. The implementation will enlist full involvement and partnership of the Parent Teacher Association. Kerala was the first state in the country to attain 100 percent literacy more than two and a half decades ago. Since then the State has not rested on its laurels. It has moved forward in leaps and bounds conquering targets that no other State could achieve. Now the government of Kerala is taking off towards new goal of comprehensive educational reforms. And it focuses on Betterment of educational surroundings, use of technology in education, renewal of learning method and 1000 schools will be uplifted as Smart Schools. Need to upgrade 1000 schools into international standards and turning classrooms from standard 9 to 12 in high schools and higher secondary into high-tech classrooms and a special unique package for the renovation of schools, which have completed 50 and 100 years. The government intends to focus on developing standards first to eighth standards in tune with the times by engaging the teachers, parents, and alumni to recapture the relevance of public schools. English learning will be encouraged in schools. The idea is not only to improve the infrastructure facilities but also reform the curriculum to the present day needs. Keeping in view the differently-abled friendly approach of the government, there will be focus on creating educational program which is useful for differently abled students. The idea is to address the infrastructural deficiencies being faced by such schools. There will be special emphasis on ensuring internet connectivity to promote IT-friendly existence. A task-force and a full-time chief executive will be in charge of managing the day to day affairs of the mission. Secretary of the Public Education Department will serve as the Mission Secretary and the Chairperson of Task Force. As the Task Force will stress on teacher training and the use of information technology, experts in the field, as well as Directors of SCERT, IT School, SSA, and RMSA, will also be a part of it.

Keywords: educational standards, methodology, pedagogy, technology

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109 Pedagogy of the Oppressed: Fifty Years Later. Implications for Policy and Reforms

Authors: Mohammad Ibrahim Alladin

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The Pedagogy of the Oppressed by Paulo Freire was first published in 1970. Since its publication it has become one of most cited book in the social sciences. Over a million copies have been sold worldwide. The Pedagogy of the Oppressed by Paulo Freire was published in 1970 (New York: Herder and Herder), The book has caused a “revolution” in the education world and his theory has been examined and analysed. It has influenced educational policy, curriculum development and teacher education. The revolution started half a century ago. “Paolo Freire’s Pedagogy of the Oppressed develops a theory of education fitted to the needs of the disenfranchised and marginalized members of capitalist societies. Combining educational and political philosophy, the book offers an analysis of oppression and a theory of liberation. Freire believes that traditional education serves to support the dominance of the powerful within society and thereby maintain the powerful’s social, political, and economic status quo. To overcome the oppression endemic to an exploitative society, education must be remade to inspire and enable the oppressed in their struggle for liberation. This new approach to education focuses on consciousness-raising, dialogue, and collaboration between teacher and student in the effort to achieve greater humanization for all. For Freire, education is political and functions either to preserve the current social order or to transform it. The theories of education and revolutionary action he offers in Pedagogy of the Oppressed are addressed educators committed to the struggle for liberation from oppression. Freire’s own commitment to this struggle developed through years of teaching literacy to Brazilian and Chilean peasants and laborers. His efforts at educational and political reform resulted in a brief period of imprisonment followed exile from his native Brazil for fifteen years. In Pedagogy of the Oppressed begins Freire asserts the importance of consciousness-raising, or conscientização, as the means enabling the oppressed to recognize their oppression and commit to the effort to overcome it, taking full responsibility for themselves in the struggle for liberation. He addresses the “fear of freedom,” which inhibits the oppressed from assuming this responsibility. He also cautions against the dangers of sectarianism, which can undermine the revolutionary purpose as well as serve as a refuge for the committed conservative. Freire provides an alternative view of education by attacking tradition education and knowledge. He is highly critical of how is imparted and how knowledge is structured that limits the learner’s thinking. Hence, education becomes oppressive and school functions as an institution of social control. Since its publication, education has gone through a series of reforms and in some areas total transformation. This paper addresses the following: The role of education in social transformation The teacher/learner relationship :Critical thinking The paper essentially examines what happened in the last fifty years since Freire’s book. It seeks to explain what happened to Freire’s education revolution, and what is the status of the movement that started almost fifty years ago.

Keywords: pedagogy, reform, curriculum, teacher education

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108 Psycho-Social Associates of Deliberate Self-Harm in Rural Sri Lanka

Authors: P. H. G. J. Pushpakumara, A. M. P. Adikari, S. U. B. Tennakoon, Ranil Abeysinghe, Andrew Dawson

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Introduction: Deliberate Self-harm (DSH) is a global public health problem. Since 1950, suicide rates in Sri Lanka are among the highest national rates in the world. It has become an increasingly common response to emotional distress in young adults. However, it remains unclear the reason for this occurrence. Objectives: The descriptive component of this study was conducted to identify of epidemiological pattern of DSH and suicide in Kurunegala District (KD). Assessment of association between DSH socio-cultural, economical and psychological factors were the objectives of the case control component. Methods: Prospective data collection of DSH and suicide was conducted at all (46) hospitals and all (28) police stations in the KD for thirty six months, from 1st January 2011, as the descriptive component. Case control component was conducted at T.H. Kurunegala (THK) for eighteen months duration, from 1st July 2011. Cases (n=439) were randomly selected from a block of 7 consecutively admitted consenting DSP patients using a computer program. Age, sex and residential divisional secretariat division one to one matched, individuals were randomly selected as controls from patients presented to Out Patient Department. Structured Clinical Interview for DSM-IV-TR Axis I and II Disorders was used to diagnose psychiatric disorders. Validated tools were used to measure other constructs. Results: Suicide incidences in KD were, 21.6, 20.7 and 24.3 per 100,000 population in 2011- 2013 (Male:female ratio 5.7, 4.4 and 6.4). 60% of suicides were due to poisoning. DSP incidences were 205.4, 248.3 and 202.5 per 100,000 population in 2011- 2013. Highest age standardized male DSP incidence reported in 20-24 years (769.6/100,000) and female in 15-19 years (1304.0/100,000). Bing married (age >25 years), monthly family income less than Rs.30,000, not achieving G.C.E (O/L) qualifications, a school drop-out, not in a permanent position in occupation, being a manual and an own account worker, were significantly associated with DSP. Perceiving the quality of relationship as bad or very bad with parents, spouse/ girlfriend/ boyfriend and sibling as associated with 8, 40 and 10.5 times higher risk respectively. Feeling and experiences of neglect, other emotional abuses, feeling of insecurity with the family, in child hood, and having a contact history carried an excess risk for DSP. Cases were less likely to seek help. Further, they had significantly lower scores for life skills and life skills application ability. 25.6% DSH patients had DSM TR axis-I and/or TR axis-II disorder. The presence of psychiatric disorder carried 7.7 (95% CI 4.3 – 13.8) times higher risk for DSP. Conclusion: In general, pattern of DSH and suicide is, unique, different from developed, upper and middle income and lower and middle income countries. It is a learned way of expressing emotions in difficult situations of vulnerable people.

Keywords: deliberate self-harm, help-seeking, life-skills, mental- health, psychological, social, suicide

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107 Examining the Usefulness of an ESP Textbook for Information Technology: Learner Perspectives

Authors: Yun-Husan Huang

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Many English for Specific Purposes (ESP) textbooks are distributed globally as the content development is often obliged to compromises between commercial and pedagogical demands. Therefore, the issue of regional application and usefulness of globally published ESP textbooks has received much debate. For ESP instructors, textbook selection is definitely a priority consideration for curriculum design. An appropriate ESP textbook can facilitate teaching and learning, while an inappropriate one may cause a disaster for both teachers and students. This study aims to investigate the regional application and usefulness of an ESP textbook for information technology (IT). Participants were 51 sophomores majoring in Applied Informatics and Multimedia at a university in Taiwan. As they were non-English majors, their English proficiency was mostly at elementary and elementary-to-intermediate levels. This course was offered for two semesters. The textbook selected was Oxford English for Information Technology. At class end, the students were required to complete a survey comprising five choices of Very Easy, Easy, Neutral, Difficult, and Very Difficult for each item. Based on the content design of the textbook, the survey investigated how the students viewed the difficulty of grammar, listening, speaking, reading, and writing materials of the textbook. In terms of difficulty, results reveal that only 22% of them found the grammar section difficult and very difficult. For listening, 71% responded difficult and very difficult. For general reading, 55% responded difficult and very difficult. For speaking, 56% responded difficult and very difficult. For writing, 78% responded difficult and very difficult. For advanced reading, 90% reported difficult and very difficult. These results indicate that, except the grammar section, more than half of the students found the textbook contents difficult in terms of listening, speaking, reading, and writing materials. Such contradictory results between the easy grammar section and the difficult four language skills sections imply that the textbook designers do not well understand the English learning background of regional ESP learners. For the participants, the learning contents of the grammar section were the general grammar level of junior high school, while the learning contents of the four language skills sections were more of the levels of college English majors. Implications from the findings are obtained for instructors and textbook designers. First of all, existing ESP textbooks for IT are few and thus textbook selections for instructors are insufficient. Second, existing globally published textbooks for IT cannot be applied to learners of all English proficiency levels, especially the low level. With limited textbook selections, third, instructors should modify the selected textbook contents or supplement extra ESP materials to meet the proficiency level of target learners. Fourth, local ESP publishers should collaborate with local ESP instructors who understand best the learning background of their students in order to develop appropriate ESP textbooks for local learners. Even though the instructor reduced learning contents and simplified tests in curriculum design, in conclusion, the students still found difficult. This implies that in addition to the instructor’s professional experience, there is a need to understand the usefulness of the textbook from learner perspectives.

Keywords: ESP textbooks, ESP materials, ESP textbook design, learner perspectives on ESP textbooks

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106 Preparation and Struggle of Two Generations for Future Care: A Study of Intergenerational Care Planning among Mainland Immigrant Ageing Families in Hong Kong

Authors: Xue Bai, Ranran He, Chang Liu

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Care planning before the onset of intensive care needs can benefit older adults’ psychological well-being and increases families’ ability to manage caregiving crises and cope with care transitions. Effective care planning requires collaborative ‘team-work’ in families. However, future care planning has not been substantially examined in intergenerational or family contexts, let alone among immigrant families who have to face particular challenges in parental caregiving. From a family systems perspective, this study intends to explore the extent, processes, and contents of intergenerational care planning of Mainland immigrant ageing families in Hong Kong and to examine the intergenerational congruence and discrepancies in the care planning process. Adopting a qualitative research design, semi-structured in-depth interviews were conducted with 17 adult child-older parent pairs and another 33 adult children. In total, 50 adult children who migrated to Hong Kong after the age of 18 with more than three years’ work experience in Hong Kong had at least one parent aged over 55 years old who was not a Hong Kong resident and considered his/herself as the primary caregiver of the parent were recruited. Seventeen ageing parents of the recruited adult children were invited for dyadic interviews. Scarcity of caregiving resources in the context of cross-border migration, intergenerational discrepancies in care planning stages, both generations’ struggle and ambivalence toward filial care, intergenerational transmission of care values, and facilitating role of accumulated family capital in care preparation were primary themes concluded from participants’ narratives. Compared with ageing parents, immigrant adult children generally displayed lower levels of care planning. Although with a strong awareness of parents’ future care needs, few adult children were found engaged in concrete planning activities. This is largely due to their uncertainties toward future life and career, huge work and living pressure, the relatively good health status of their parents, and restrictions of public welfare policies in the receiving society. By contrast, children’s cross-border migration encouraged ageing parents to have early and clear preparation for future care. Ageing parents mostly expressed low filial care expectations when realizing the scarcity of family caregiving resources in the cross-border context. Even though they prefer in-person support from children, most of them prepare themselves for independent ageing to prioritize the next generation’s needs or choose to utilize paid services, welfare systems, friend networks, or extended family networks in their sending society. Adult children were frequently found caught in the dilemma of desiring to provide high quality and in-person support for their parents but lacking sufficient resources. Notably, a salient pattern of intergenerational transmission in terms of family and care values and ideal care arrangement emerged from intergenerational care preparation. Moreover, the positive role of accumulated family capital generated by a reunion in care preparation and joint decision-making were also identified. The findings of the current study will enhance professionals’ and service providers’ awareness of intergenerational care planning in cross-border migration contexts, inform services to alleviate unpreparedness for elderly care and intergenerational discrepancies concerning care arrangements and broaden family services to encompass intergenerational care planning interventions. Acknowledgment: This study is supported by a General Research Grant from the Research Grants Council of the HKSAR, China (Project Number: 15603818).

Keywords: intergenerational care planning, mainland immigrants in Hong Kong, migrant family, older adults

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105 The Roles of Mandarin and Local Dialect in the Acquisition of L2 English Consonants Among Chinese Learners of English: Evidence From Suzhou Dialect Areas

Authors: Weijing Zhou, Yuting Lei, Francis Nolan

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In the domain of second language acquisition, whenever pronunciation errors or acquisition difficulties are found, researchers habitually attribute them to the negative transfer of the native language or local dialect. To what extent do Mandarin and local dialects affect English phonological acquisition for Chinese learners of English as a foreign language (EFL)? Little evidence, however, has been found via empirical research in China. To address this core issue, the present study conducted phonetic experiments to explore the roles of local dialects and Mandarin in Chinese EFL learners’ acquisition of L2 English consonants. Besides Mandarin, the sole national language in China, Suzhou dialect was selected as the target local dialect because of its distinct phonology from Mandarin. The experimental group consisted of 30 junior English majors at Yangzhou University, who were born and lived in Suzhou, acquired Suzhou Dialect since their early childhood, and were able to communicate freely and fluently with each other in Suzhou Dialect, Mandarin as well as English. The consonantal target segments were all the consonants of English, Mandarin and Suzhou Dialect in typical carrier words embedded in the carrier sentence Say again. The control group consisted of two Suzhou Dialect experts, two Mandarin radio broadcasters, and two British RP phoneticians, who served as the standard speakers of the three languages. The reading corpus was recorded and sampled in the phonetic laboratories at Yangzhou University, Soochow University and Cambridge University, respectively, then transcribed, segmented and analyzed acoustically via Praat software, and finally analyzed statistically via EXCEL and SPSS software. The main findings are as follows: First, in terms of correct acquisition rates (CARs) of all the consonants, Mandarin ranked top (92.83%), English second (74.81%) and Suzhou Dialect last (70.35%), and significant differences were found only between the CARs of Mandarin and English and between the CARs of Mandarin and Suzhou Dialect, demonstrating Mandarin was overwhelmingly more robust than English or Suzhou Dialect in subjects’ multilingual phonological ecology. Second, in terms of typical acoustic features, the average duration of all the consonants plus the voice onset time (VOT) of plosives, fricatives, and affricatives in 3 languages were much longer than those of standard speakers; the intensities of English fricatives and affricatives were higher than RP speakers but lower than Mandarin and Suzhou Dialect standard speakers; the formants of English nasals and approximants were significantly different from those of Mandarin and Suzhou Dialects, illustrating the inconsistent acoustic variations between the 3 languages. Thirdly, in terms of typical pronunciation variations or errors, there were significant interlingual interactions between the 3 consonant systems, in which Mandarin consonants were absolutely dominant, accounting for the strong transfer from L1 Mandarin to L2 English instead of from earlier-acquired L1 local dialect to L2 English. This is largely because the subjects were knowingly exposed to Mandarin since their nursery and were strictly required to speak in Mandarin through all the formal education periods from primary school to university.

Keywords: acquisition of L2 English consonants, role of Mandarin, role of local dialect, Chinese EFL learners from Suzhou Dialect areas

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104 Racial Distress in the Digital Age: A Mixed-Methods Exploration of the Effects of Social Media Exposure to Police Brutality on Black Students

Authors: Amanda M. McLeroy, Tiera Tanksley

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The 2020 movement for Black Lives, ignited by anti-Black police brutality and exemplified by the public execution of George Floyd, underscored the dual potential of social media for political activism and perilous exposure to traumatic content for Black students. This study employs Critical Race Technology Theory (CRTT) to scrutinize algorithmic anti-blackness and its impact on Black youth's lives and educational experiences. The research investigates the consequences of vicarious exposure to police brutality on social media among Black adolescents through qualitative interviews and quantitative scale data. The findings reveal an unprecedented surge in exposure to viral police killings since 2020, resulting in profound physical, socioemotional, and educational effects on Black youth. CRTT forms the theoretical basis, challenging the notion of digital technologies as post-racial and neutral, aiming to dismantle systemic biases within digital systems. Black youth, averaging over 13 hours of daily social media use, face constant exposure to graphic images of Black individuals dying. The study connects this exposure to a range of physical, socioemotional, and mental health consequences, emphasizing the urgent need for understanding and support. The research proposes questions to explore the extent of police brutality exposure and its effects on Black youth. Qualitative interviews with high school and college students and quantitative scale data from undergraduates contribute to a nuanced understanding of the impact of police brutality exposure on Black youth. Themes of unprecedented exposure to viral police killings, physical and socioemotional effects, and educational consequences emerge from the analysis. The study uncovers how vicarious experiences of negative police encounters via social media lead to mistrust, fear, and psychosomatic symptoms among Black adolescents. Implications for educators and counselors are profound, emphasizing the cultivation of empathy, provision of mental health support, integration of media literacy education, and encouragement of activism. Recognizing family and community influences is crucial for comprehensive support. Professional development opportunities in culturally responsive teaching and trauma-informed approaches are recommended for educators. In conclusion, creating a supportive educational environment that addresses the emotional impact of social media exposure to police brutality is crucial for the well-being and development of Black adolescents. Counselors, through safe spaces and collaboration, play a vital role in supporting Black youth facing the distressing effects of social media exposure to police brutality.

Keywords: black youth, mental health, police brutality, social media

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103 Assessing How Liberal Arts Colleges Can Teach Undergraduate Students about Key Issues in Migration, Immigration, and Human Rights

Authors: Hao Huang

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INTRODUCTION: The Association of American Colleges and Universities (AACU) recommends the development of ‘high-impact practices,’ in an effort to increase rates of student retention and student engagement at undergraduate institutions. To achieve these goals, the Scripps College Humanities Institute and HI Fellows Seminar not only featured distinguished academics presenting their scholarship about current immigration policy and its consequences in the USA and around the world but integrated socially significant community leaders and creative activists/artivists in public talks, student workshops and collaborative art events. Students participated in experiential learning that involved guest personal presentations and discussions, oral history interviews that applied standard oral history methodologies, detailed cultural documentation, collaborative artistic interventions, and weekly posts in Internet Digital Learning Environment Sakai collaborative course forums and regular responses to other students’ comments. Our teaching pedagogies addressed the four learning styles outlined in Kolb’s Learning Style Inventory. PROJECT DESCRIPTION: Over the academic year 2017-18, the Scripps College Humanities Institute and HI Fellows Seminar presented a Fall 2017 topic, ‘The World at Our Doorsteps: Immigration and Deportation in Los Angeles’. Our purpose was to address how current federal government anti-immigration measures have affected many students of color, some of whom are immigrants, many of whom are related to and are friends with people who are impacted by the attitudes as well as the practices of the U.S. Citizenship and Immigration Services. In Spring 2018, we followed with the topic, ‘Exclusive Nationalisms: Global Migration and Immigration’. This addresses the rise of white supremacists who have ascended to position of power worldwide, in America, Europe, Russia, and xenophobic nationalisms in China, Myanmar and the Philippines. Recent scholarship has suggested the existence of categories of refugees beyond the political or social, who fit into the more inclusive category of migrants. ASSESSMENT METHODOLOGIES: Assessment methodologies not only included qualitative student interviews and quantitative student evaluations in standard rubric format, but also Outcome Assessments, Formative Evaluations, and Outside Guest Teacher feedback. These indicated that the most effective educational practices involved collaborative inquiry in undergraduate research, community-based learning, and capstone projects. Assessments of E-portfolios, written and oral coursework, and final creative projects with associated 10-12 page analytic paper revealed that students developed their understanding of how government and social organizations work; they developed communication skills that enhanced working with others from different backgrounds; they developed their ability to thoughtfully evaluate their course performance by adopting reflective practices; they gained analytic and interpretive skills that encouraged self-confidence and self- initiative not only academically, but also with regards to independent projects. CONCLUSION: Most importantly, the Scripps Humanities Institute experiential learning project spurred on real-world actions by our students, such as a public symposium on how to cope with bigots, a student tutoring program for immigrant staff children, student negotiations with the administration to establish meaningful, sustainable diversity and inclusion programs on-campus. Activism is not only to be taught to and for our students– it has to be enacted by our students.

Keywords: immigration, migration, human rights, learning assessment

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102 Risk Factors Associated with Increased Emergency Department Visits and Hospital Admissions Among Child and Adolescent Patients

Authors: Lalanthica Yogendran, Manassa Hany, Saira Pasha, Benjamin Chaucer, Simarpreet Kaur, Christopher Janusz

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Children and adolescent patients visit the Psychiatric Emergency Department (ED) for multiple reasons. Visiting the Psychiatric ED itself can be a traumatic experience that can affect an adolescents mental well-being, regardless of a history of mental illness. Despite this, limited research exists in this domain. Prospective studies have correlated adverse psychosocial determinants among adolescents to risk factors for poor well-being and unfavorable behavior outcomes. Studies have also shown that physiological stress is a contributor in the development of health problems and an increase in substance abuse in adolescents. This study aimed to retrospectively determine which psychosocial factors are associated with an increase in psychiatric ED visits. 600 charts of patients who had a psychiatric ED and inpatient admission visit from January 2014 through December 2014 were reviewed. Sociodemographics, diagnoses, ED visits and inpatient admissions were collected. Descriptive statistics, chi-square tests and independent t-test analyses were utilized to examine differences in the sample to determine which factors affected ED visits and admissions. The sample was 50% female, 35.2% self-identified black, and had a mean age of 13 years. The majority, 85%, went to public school and 17% were in special education. Attention Deficit Hyperactivity Disorder was the most common admitting diagnosis, found in 132(23%) responders. Most patients came from single parent household 305 (53%). The mean ages of patients that were sexually active, with legal issues, and reporting marijuana substance abuse were 15, 14.35, and 15 years respectively. Patients from two biological parent households had significantly fewer ED visits (1.2 vs. 1.7, p < 0.01) and admissions (0.09 vs. 0.26, p < 0.01). Among social factors, those who reported sexual, physical or emotional abuse had a significantly greater number of ED visits (2.1 vs. 1.5, p < 0.01) and admissions (0.61 vs. 0.14, p < 0.01) than those who did not. Patients that were sexually active or had legal issues or substance abuse with marijuana had a significantly greater number of admissions (0.43 vs. 0.17, p < 0.01), (0.54 vs. .18, p < 0.01) and (0.46 vs. 0.18, p < 0.01) respectively. This data supports the theory of the stability of a two parent home. Dual parenting plays a role in creating a safe space where a child can develop; this is shown by subsequent decreases in psychiatric ED visits and admissions. This may highlight the psychological protective role of a two parent household. Abuse can exacerbate existing psychiatric illness or initiate the onset of new disease. Substance abuse and legal issues result in early induction to the criminal system. Results show that this causes an increase in frequency of visits and severity of symptoms. Only marijuana, but not other illicit substances, correlated with higher incidence of psychiatric ED visits. This may speak to the psychotropic nature of tetrahydrocannabinols and their role in mental illness. This study demonstrates the array of psychosocial factors that lead to increased ED visits and admissions in children and adolescents.

Keywords: adolescent, child psychiatry, emergency department, substance abuse

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101 Addressing Primary Care Clinician Burnout in a Value Based Care Setting During the COVID-19 Pandemic

Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar

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Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.

Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement

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100 Combating the Practice of Open Defecation through Appropriate Communication Strategies in Rural India

Authors: Santiagomani Alex Parimalam

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Lack of awareness on the consequences of open defecation and myths and misconceptions related to use of toilets have led to the continued practice of open defecation in India. Government of India initiated a multi-pronged intensive communication campaign against the practice of open defecation in the last few years. The primary vision of this communication campaign was to provide increased demand for toilets and to ensure that all have access to safe sanitation. The campaign strategy included the use of mass media, group and folk media, and interpersonal communication to expedite achieving its objectives. The campaign included the use of various media such as posters, wall writings, slides in cinema theatres, kiosks, pamphlets, newsletters, flip charts and folk media to bring behavioural changes in the communities. The author did a concurrent monitoring and process documentation of the campaigns initiated by the state of Tamilnandu, India between 2013 and 2016 commissioned by UNICEF India. The study was carried out to assess the effectiveness of the communication campaigns in combating the practice of open defecation and promote construction of toilets in the state of Tamilnadu, India. Initial findings revealed the gap in understanding the audience and the use of appropriate media. The first phase of the communication campaign by name as Chi Chi Chollapa (bringing shame concept) also revealed that use of interpersonal communication, group and community media were the most effective strategy in reaching the rural masses. The failure of various other media used especially the print media (poster, handbills, newsletter, kiosks) provides insights as to where the government needs to invest its resources in bringing health-seeking behaviour in the community. The findings shared with the government enabled to strengthen the campaign resulting in improved response. Taking cues from the study, the government understood the potency of the women, school children, youth and community leaders as the effective carriers of the message. The government narrowed down its focus and invested on the voluntary workers (village poverty reduction committee workers VPRCs) in the community. The effectiveness of interpersonal communication and peer education by the credible community worker threw light on the need for localising the content and communicator. From this study, we could derive that only community and group media are preferred by the people in the rural community. Children, youth, women, and credible local leaders are proved to be ambassadors in behaviour change communication. This study discloses the lacunae involved in the communication campaign and points out that the state should have carried out a proper communication need analysis and piloting. The study used a survey method with random sampling. The study used both quantitative and qualitative tools such as interview schedules, in-depth interviews, and focus group discussions in rural areas of Tamilnadu in phases. The findings of the study would provide directions to future campaigns to any campaign concerning health and rural development.

Keywords: appropriate, communication, combating, open defecation

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99 Validation of an Educative Manual for Patients with Breast Cancer Submitted to Radiation Therapy

Authors: Flavia Oliveira de A. M. Cruz, Edison Tostes Faria, Paula Elaine D. Reis

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When the breast is submitted to radiation therapy (RT), the most common effects are pain, skin changes, mobility restrictions, local sensory alteration, and fatigue. These effects, if not managed properly, may reduce the quality of life of cancer patients and may lead to the treatment discontinuation. Therefore, promoting knowledge and guidelines for symptom management remain a high priority for patients and a challenge for health professionals, due to the need to handle side effects in a population with a life-threatening disease. Printed materials are important strategies for supporting educative activities since they help the individual to assimilate and understand the amount of information transmitted. Nurses' behavior can be systematized through the use of an educative manual, which may be effective in promoting information regarding the treatment, self-care and how to control the effects of RT at home. In view of the importance of guaranteeing the validity of the material before its use, the objective of this research was to validate the content and appearance of an educative manual for breast cancer patients undergoing RT. The Theory of Psychometrics was used for the validation process in this descriptive methodological research. A minimum agreement rate (AR) of 80% was considered to guarantee the validity of the material. The data were collected from October to December 2017, by means of two assessments tools, constructed in the form of a Likert scale, with five levels of understanding. These instruments addressed different aspects of the evaluation, in view of two different groups of participants; 17 experts in the theme area of the educative manual, and 12 women that received RT previously to treat breast cancer. The manual was titled 'Orientation Manual: radiation therapy in breast', and was focused on breast cancer patients attended at the Department of Oncology of the Brasília University Hospital (UNACON/HUB). The research project was submitted to the Research Ethics Committee at the School of Health Sciences of the University of Brasília (CAAE: 24592213.1.0000.0030). Only two items of the assessment tool for the experts, one related to the manual's ability to promote behavioral and attitude changes and the other related to the extent of its use for other health services, obtained AR < 80% and were reformulated based on the participants' suggestions and in the literature. All other items were considered appropriate and/or complete appropriate in the three blocks proposed for the experts: objectives - 89%, structure and form - 93%, and relevance - 93%; and good and/or very good in the five blocks of analysis proposed for patients: objectives - 100%, organization - 100%, writing style - 100%, appearance - 100%, and motivation. The appearance and content validation of the educative manual proposed were attended to. The educative manual was considered relevant and pertinent and may contribute to the understanding of the therapeutic process by breast cancer patients during RT, as well as support clinical practice through the nursing consultation.

Keywords: oncology nursing, nursing care, validation studies, educational technology

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98 Artificial Intelligence in Management Simulators

Authors: Nuno Biga

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Artificial Intelligence (AI) allows machines to interpret information and learn from context analysis, giving them the ability to make predictions adjusted to each specific situation. In addition to learning by performing deterministic and probabilistic calculations, the 'artificial brain' also learns through information and data provided by those who train it, namely its users. The "Assisted-BIGAMES" version of the Accident & Emergency (A&E) simulator introduces the concept of a "Virtual Assistant" (VA) that provides users with useful suggestions, namely to pursue the following operations: a) to relocate workstations in order to shorten travelled distances and minimize the stress of those involved; b) to identify in real time the bottleneck(s) in the operations system so that it is possible to quickly act upon them; c) to identify resources that should be polyvalent so that the system can be more efficient; d) to identify in which specific processes it may be advantageous to establish partnership with other teams; and e) to assess possible solutions based on the suggested KPIs allowing action monitoring to guide the (re)definition of future strategies. This paper is built on the BIGAMES© simulator and presents the conceptual AI model developed in a pilot project. Each Virtual Assisted BIGAME is a management simulator developed by the author that guides operational and strategic decision making, providing users with useful information in the form of management recommendations that make it possible to predict the actual outcome of different alternative management strategic actions. The pilot project developed incorporates results from 12 editions of the BIGAME A&E that took place between 2017 and 2022 at AESE Business School, based on the compilation of data that allows establishing causal relationships between decisions taken and results obtained. The systemic analysis and interpretation of this information is materialised in the Assisted-BIGAMES through a computer application called "BIGAMES Virtual Assistant" that players can use during the Game. Each participant in the Virtual Assisted-BIGAMES permanently asks himself about the decisions he should make during the game in order to win the competition. To this end, the role of the VA of each team consists in guiding the players to be more effective in their decision making through presenting recommendations based on AI methods. It is important to note that the VA's suggestions for action can be accepted or rejected by the managers of each team, and as the participants gain a better understanding of the game, they will more easily dispense with the VA's recommendations and rely more on their own experience, capability, and knowledge to support their own decisions. Preliminary results show that the introduction of the VA provides a faster learning of the decision-making process. The facilitator (Serious Game Controller) is responsible for supporting the players with further analysis and the recommended action may be (or not) aligned with the previous recommendations of the VA. All the information should be jointly analysed and assessed by each player, who are expected to add “Emotional Intelligence”, a component absent from the machine learning process.

Keywords: artificial intelligence (AI), gamification, key performance indicators (KPI), machine learning, management simulators, serious games, virtual assistant

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97 Exploring the Treatment of Unmarried Female Adolescents (10-19 Years) at Health Facilities during the Maternity Period in Uganda

Authors: Peninah Agaba, Monica Magadi, Bev Orton

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Uganda is one of the countries with high maternal mortality (336/100,000) where adolescents account for 24 percent of the total maternal deaths. Research shows that use of maternal health services may prevent some of these deaths and good provider attitudes attract adolescents to use the services. However, poor health provider’s attitudes discourage adolescents from seeking the services during the maternity period. This study explores the experiences of unmarried female adolescents at the health facilities during the maternity period. The study population is unmarried adolescent girls aged 10-19 years who were pregnant or had given birth within three years before the interview. This is a special interest group that requires attention throughout this period. Most of the pregnancies among unmarried adolescents are unwanted; as a result, many of them have been abused and neglected by parents and close family members including partners who deny fatherhood of the pregnancy/child. These adolescents hope to find comfort from health providers like being listened to during counseling, not abused and judged; unfortunately this is not the case always. The research was approved by the University of Hull, School of Education and Social Sciences ethics review committee, Mildmay Uganda Research Ethics Committee and Uganda National Council of Science and Technology. The study was carried out in Bushenyi and Kibale districts in Western Uganda. Fourteen in-depth interviews and seven focus group discussions were completed in the local languages and later transcribed to English language. Thematic analysis to identify the themes was done. Adolescents were aged 16-19 years, two had become pregnant before 15 years. Most had not completed secondary education; none had tertiary education and three of the 14 IDI adolescent participants wanted to get pregnant. Analysis shows varied experiences; most adolescents were abused verbally and physically by the health providers due to their young age of pregnancy, lack of essential items during this period (maternity dresses, children clothes, delivery kit) and fear of labour pains. Another cause for abuse was these adolescents coming for antenatal care with no partners yet the implementation of a policy on increasing male involvement in reproductive health in Uganda requires them to attend antenatal care with their partners and most of these unmarried adolescents have no partners to accompany them. Despite the above challenges, the study also identified the care some of these unmarried adolescents received during the maternity visits for example they were not abused, were provided with appropriate information and supported with child care. The study identified abuse and support the unmarried adolescents received during the maternity period. Efforts to provide adolescents with adequate information including what to expect during labour by providers and provision of basic needs are essential. Health providers should have trainings on client care especially how to embrace unmarried adolescents when they come to access maternity services. More so, the policy on improving male involvement in RH issues need to be considerate of unmarried adolescents who in most cases do not have the partners to go with to access maternity care.

Keywords: abuse, maternity care, Uganda, unmarried, adolescents

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