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Search results for: tracking of participants’ editing

642 Validation of a Placebo Method with Potential for Blinding in Ultrasound-Guided Dry Needling

Authors: Johnson C. Y. Pang, Bo Peng, Kara K. L. Reeves, Allan C. L. Fud

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Objective: Dry needling (DN) has long been used as a treatment method for various musculoskeletal pain conditions. However, the evidence level of the studies was low due to the limitations of the methodology. Lack of randomization and inappropriate blinding is potentially the main sources of bias. A method that can differentiate clinical results due to the targeted experimental procedure from its placebo effect is needed to enhance the validity of the trial. Therefore, this study aimed to validate the method as a placebo ultrasound(US)-guided DN for patients with knee osteoarthritis (KOA). Design: This is a randomized controlled trial (RCT). Ninety subjects (25 males and 65 females) aged between 51 and 80 (61.26 ± 5.57) with radiological KOA were recruited and randomly assigned into three groups with a computer program. Group 1 (G1) received real US-guided DN, Group 2 (G2) received placebo US-guided DN, and Group 3 (G3) was the control group. Both G1 and G2 subjects received the same procedure of US-guided DN, except the US monitor was turned off in G2, blinding the G2 subjects to the incorporation of faux US guidance. This arrangement created the placebo effect intended to permit comparison of their results to those who received actual US-guided DN. Outcome measures, including the visual analog scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) subscales of pain, symptoms, and quality of life (QOL), were analyzed by repeated measures analysis of covariance (ANCOVA) for time effects and group effects. The data regarding the perception of receiving real US-guided DN or placebo US-guided DN were analyzed by the chi-squared test. The missing data were analyzed with the intention-to-treat (ITT) approach if more than 5% of the data were missing. Results: The placebo US-guided DN (G2) subjects had the same perceptions as the use of real US guidance in the advancement of DN (p<0.128). G1 had significantly higher pain reduction (VAS and KOOS-pain) than G2 and G3 at 8 weeks (both p<0.05) only. There was no significant difference between G2 and G3 at 8 weeks (both p>0.05). Conclusion: The method with the US monitor turned off during the application of DN is credible for blinding the participants and allowing researchers to incorporate faux US guidance. The validated placebo US-guided DN technique can aid in investigations of the effects of US-guided DN with short-term effects of pain reduction for patients with KOA. Acknowledgment: This work was supported by the Caritas Institute of Higher Education [grant number IDG200101].

Keywords: ultrasound-guided dry needling, dry needling, knee osteoarthritis, physiotheraphy

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641 Barriers of the Development and Implementation of Health Information Systems in Iran

Authors: Abbas Sheikhtaheri, Nasim Hashemi

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Health information systems have great benefits for clinical and managerial processes of health care organizations. However, identifying and removing constraints and barriers of implementing and using health information systems before any implementation is essential. Physicians are one of the main users of health information systems, therefore, identifying the causes of their resistance and concerns about the barriers of the implementation of these systems is very important. So the purpose of this study was to determine the barriers of the development and implementation of health information systems in terms of the Iranian physicians’ perspectives. In this study conducted in 8 selected hospitals affiliated to Tehran and Iran Universities of Medical Sciences, Tehran, Iran in 2014, physicians (GPs, residents, interns, specialists) in these hospitals were surveyed. In order to collect data, a research made questionnaire was used (Cronbach’s α = 0.95). The instrument included 25 about organizational (9), personal (4), moral and legal (3) and technical barriers (9). Participants were asked to answer the questions using 5 point scale Likert (completely disagree=1 to completely agree=5). By using a simple random sampling method, 200 physicians (from 600) were invited to study that eventually 163 questionnaires were returned. We used mean score and t-test and ANOVA to analyze the data using SPSS software version 17. 52.1% of respondents were female. The mean age was 30.18 ± 7.29. The work experience years for most of them were between 1 to 5 years (80.4 percent). The most important barriers were organizational ones (3.4 ± 0.89), followed by ethical (3.18 ± 0.98), technical (3.06 ± 0.8) and personal (3.04 ± 1.2). Lack of easy access to a fast Internet (3.67±1.91) and the lack of exchanging information (3.61±1.2) were the most important technical barriers. Among organizational barriers, the lack of efficient planning for the development and implementation systems (3.56±1.32) and was the most important ones. Lack of awareness and knowledge of health care providers about the health information systems features (3.33±1.28) and the lack of physician participation in planning phase (3.27±1.2) as well as concerns regarding the security and confidentiality of health information (3.15 ± 1.31) were the most important personal and ethical barriers, respectively. Women (P = 0.02) and those with less experience (P = 0.002) were more concerned about personal barriers. GPs also were more concerned about technical barriers (P = 0.02). According to the study, technical and ethics barriers were considered as the most important barriers however, lack of awareness in target population is also considered as one of the main barriers. Ignoring issues such as personal and ethical barriers, even if the necessary infrastructure and technical requirements were provided, may result in failure. Therefore, along with the creating infrastructure and resolving organizational barriers, special attention to education and awareness of physicians and providing solution for ethics concerns are necessary.

Keywords: barriers, development health information systems, implementation, physicians

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640 An Evaluation of the Relationship between the Anthropometric Measurements and Blood Lipid Profiles in Adolescents

Authors: Nalan Hakime Nogay

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Childhood obesity is a significant health issue that is currently on the rise all over the world. In recent years, the relationship between childhood obesity and cardiovascular disease risk has been pointed out. The purpose of this study is to evaluate the relationship between some of the anthropometric indicators and blood lipid levels in adolescents. The present study has been conducted on a total of 252 adolescents -200 girls and 52 boys- within an age group of 12 to 18 years. Blood was drawn from each participant in the morning -after having fasted for 10 hours from the day before- to analyze their total cholesterol, HDL, LDL and triglyceride levels. Their body weight, height, waist circumference, subscapular skinfold thicknesses and triceps skinfold thicknesses measurements were taken and their individual waist/height ratios, BMI and body fat ratios were calculated. The blood lipid levels of the participants were categorized as acceptable, borderline and high in accordance with the 2011 Expert Panel Integrated Guidelines. The body fat ratios, total blood cholesterol and HDL levels of the girls were significantly higher than the boys whereas their waist circumference values were lower. The triglyceride levels, total cholesterol/HDL, LDL/HDL, triglyceride/HDL ratios of the group with the BMI ≥ 95 percentile ratio (the obese group) were higher than the groups that were considered to be overweight and normal weight as per their respective BMI values, while the HDL level of the obese group was lower; a fact that was found to be statistically significant. No significant relationship could be established, however, between the total blood cholesterol and LDL levels with their anthropometric measurements. The BMI, waist circumference, waist/height ratio, body fat ratio and triglyceride level of the group with the higher triglyceride level ( ≥ 130mg/dl) were found to be significantly higher compared to borderline (90-129 mg/dl) and the normal group (< 90 mg/dl). The BMI, waist circumference, waist/height ratio values of the group with the lower HDL level ( < 40 mg/dl) were significantly higher than the normal ( > 45 mg/dl) and borderline (40-45 mg/dl) groups. All of the anthropometric measurements of the group with the higher triglyceride/HDL ratio ( ≥ 3) were found to be significantly higher than that of the group with the lower ratio (< 3). Having a high BMI, waist/height ratio and waist circumference is related to low HDL and high blood triglyceride and triglyceride/HDL ratio. A high body fat ratio, on the other hand, is associated with a low HDL and high triglyceride/HDL ratio. Tackling childhood and adolescent obesity are important in terms of preventing cardiovascular diseases.

Keywords: adolescent, body fat, body mass index, lipid profile

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639 Critical Understanding on Equity and Access in Higher Education Engaging with Adult Learners and International Student in the Context of Globalisation

Authors: Jin-Hee Kim

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The way that globalization distinguishes itself from the previous changes is scope and intensity of changes, which together affect many parts of a nation’s system. In this way, globalization has its relation with the concept of ‘internationalization’ in that a nation state formulates a set of strategies in many areas of its governance to actively react to it. In short, globalization is a ‘catalyst,’ and internationalization is a ‘response’. In this regard, the field of higher education is one of the representative cases that globalization has several consequences that change the terrain of national policy-making. Started and been dominated mainly by the Western world, it has now been expanded to the ‘late movers,’ such as Asia-Pacific countries. The case of internationalization of Korean higher education is, therefore, located in a unique place in this arena. Yet Korea still is one of the major countries of sending its students to the so-called, ‘first world.’ On the other hand, it has started its effort to recruit international students from the world to its higher education system. After new Millennium, particularly, internationalization of higher education has been launched in its full-scale and gradually been one of the important global policy agenda, striving in both ways by opening its turf to foreign educational service providers and recruiting prospective students from other countries. Particularly the latter, recruiting international students, has been highlighted under the government project named ‘Study Korea,’ launched in 2004. Not only global, but also local issues and motivations were based to launch this nationwide project. Bringing international students means various desirable economic outcomes such as reducing educational deficit as well as utilizing them in Korean industry after the completion of their study, to name a few. In addition, in a similar vein, Korea's higher education institutes have started to have a new comers of adult learners. When it comes to the questions regarding the quality and access of this new learning agency, the answer is quite tricky. This study will investigate the different dimension of education provision and learning process to empower diverse group regardless of nationality, race, class and gender in Korea. Listening to the voices of international students and adult learning as non-traditional participants in a changing Korean higher educational space not only benefit students themselves, but Korean stakeholders who should try to accommodate more comprehensive and fair educational provisions for more and more diversifying groups of learners.

Keywords: education equity, access, globalisation, international students, adult learning, learning support

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638 Factors Affecting Cesarean Section among Women in Qatar Using Multiple Indicator Cluster Survey Database

Authors: Sahar Elsaleh, Ghada Farhat, Shaikha Al-Derham, Fasih Alam

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Background: Cesarean section (CS) delivery is one of the major concerns both in developing and developed countries. The rate of CS deliveries are on the rise globally, and especially in Qatar. Many socio-economic, demographic, clinical and institutional factors play an important role for cesarean sections. This study aims to investigate factors affecting the prevalence of CS among women in Qatar using the UNICEF’s Multiple Indicator Cluster Survey (MICS) 2012 database. Methods: The study has focused on the women’s questionnaire of the MICS, which was successfully distributed to 5699 participants. Following study inclusion and exclusion criteria, a final sample of 761 women aged 19- 49 years who had at least one delivery of giving birth in their lifetime before the survey were included. A number of socio-economic, demographic, clinical and institutional factors, identified through literature review and available in the data, were considered for the analyses. Bivariate and multivariate logistic regression models, along with a multi-level modeling to investigate clustering effect, were undertaken to identify the factors that affect CS prevalence in Qatar. Results: From the bivariate analyses the study has shown that, a number of categorical factors are statistically significantly associated with the dependent variable (CS). When identifying the factors from a multivariate logistic regression, the study found that only three categorical factors -‘age of women’, ‘place at delivery’ and ‘baby weight’ appeared to be significantly affecting the CS among women in Qatar. Although the MICS dataset is based on a cluster survey, an exploratory multi-level analysis did not show any clustering effect, i.e. no significant variation in results at higher level (households), suggesting that all analyses at lower level (individual respondent) are valid without any significant bias in results. Conclusion: The study found a statistically significant association between the dependent variable (CS delivery) and age of women, frequency of TV watching, assistance at birth and place of birth. These results need to be interpreted cautiously; however, it can be used as evidence-base for further research on cesarean section delivery in Qatar.

Keywords: cesarean section, factors, multiple indicator cluster survey, MICS database, Qatar

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637 The Structure of Financial Regulation: The Regulators Perspective

Authors: Mohamed Aljarallah, Mohamed Nurullah, George Saridakis

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This paper aims and objectives are to investigate how the structural change of the financial regulatory bodies affect the financial supervision and how the regulators can design such a structure with taking into account; the Central Bank, the conduct of business and the prudential regulators, it will also consider looking at the structure of the international regulatory bodies and what barriers are found. There will be five questions to be answered; should conduct of business and prudential regulation be separated? Should the financial supervision and financial stability be separated? Should the financial supervision be under the Central Bank? To what extent the politician should intervene in changing the regulatory and supervisory structure? What should be the regulatory and supervisory structure when there is financial conglomerate? Semi structure interview design will be applied. This research sample selection contains a collective of financial regulators and supervisors from the emerged and emerging countries. Moreover, financial regulators and supervisors must be at a senior level at their organisations. Additionally, senior financial regulators and supervisors would come from different authorities and from around the world. For instance, one of the participants comes from the International Bank Settlements, others come from European Central Bank, and an additional one will come from Hong Kong Monetary Authority and others. Such a variety aims to fulfil the aims and objectives of the research and cover the research questions. The analysis process starts with transcription of the interview, using Nvivo software for coding, applying thematic interview to generate the main themes. The major findings of the study are as follow. First, organisational structure changes quite frequently if the mandates are not clear. Second, measuring structural change is difficult, which makes the whole process unclear. Third, effective coordination and communication are what regulators looking for when they change the structure and that requires; openness, trust, and incentive. In addition to that, issues appear during the event of crisis tend to be the reason why the structure change. Also, the development of the market sometime causes a change in the regulatory structure. And, some structural change occurs simply because of the international trend, fashion, or other countries' experiences. Furthermore, when the top management change the structure tends to change. Moreover, the structure change due to the political change, or politicians try to show they are doing something. Finally, fear of being blamed can be a driver of structural change. In conclusion, this research aims to provide an insight from the senior regulators and supervisors from fifty different countries to have a clear understanding of why the regulatory structure keeps changing from time to time through a qualitative approach, namely, semi-structure interview.

Keywords: financial regulation bodies, financial regulatory structure, global financial regulation, financial crisis

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636 Capacity Building and Training of Health Personals for Disaster Preparedness in North East India

Authors: U. K. Tamuli

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Introduction: North East India is graced with natural beauty and hazards. This area is prone to major earthquakes, floods, landslides, accidents, terrorist activities etc. Academy of Trauma (AOT), an NGO of Doctors, conducts training programs, mock drills, field trials amongst the doctors and paramedics in North East India. The present study is to evaluate the efficacy of such training in terms of sensitivity, awareness, and delivery systems of the products. Here the health care delivery system for disaster management is inadequate. Clear guideline of mass casualty management is unavailable. AOT has initiated steps to increase the awareness and handling of mass casualty management to improve the emergency health care delivery system. Method: AOT has conducted training programmes on emergency health management, mass casualty management and hospital preparedness amongst 800 doctors and 1200 paramedics in twenty-two districts of Assam in Northeast India. The training module consists of lectures, hands-on workshop using manikins, mock drills, distribution of manuals, emergency management exercises, periodic exchange of experience and debriefings. AOT evaluates the impact of these trainings by conducting pre and post tests of delegates, trainer’s evaluation, delegate’s satisfaction and confidence level and their suggestions. Results: The module, training, hands-on workshops, mock drills were highly appreciated. There is significant improvement in scores on the post-training tests. The confidence level of the participants has risen to deal with emergency medical situation Conclusion: These kinds of trainings increase the awareness of the medical members to handle mass casualties in different situations. One such training actually sensitises the delegates. Repetition of such training, TOT (Training-of-Trainers) programs, and individual efforts of delegates are extremely important for sustenance and success of health care delivery service during disasters in the developing countries. Further collaboration, assistance, networking, suggestions from established global agencies in this field will be highly appreciated.

Keywords: capacity building, North East India, non-governmental organization, trauma

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635 Lexico-semantic and Morphosyntactic Analyses of Student-generated Paraphrased Academic Texts

Authors: Hazel P. Atilano

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In this age of AI-assisted teaching and learning, there seems to be a dearth of research literature on the linguistic analysis of English as a Second Language (ESL) student-generated paraphrased academic texts. This study sought to examine the lexico-semantic, morphosyntactic features of paraphrased academic texts generated by ESL students. Employing a descriptive qualitative design, specifically linguistic analysis, the study involved a total of 85 students from senior high school, college, and graduate school enrolled in research courses. Data collection consisted of a 60-minute real-time, on-site paraphrasing practice exercise using excerpts from discipline-specific literature reviews of 150 to 200 words. A focus group discussion (FGD) was conducted to probe into the challenges experienced by the participants. The writing exercise yielded a total of 516 paraphrase pairs. A total of 176 paraphrase units (PUs) and 340 non-paraphrase pairs (NPPs) were detected. Findings from the linguistic analysis of PUs reveal that the modifications made to the original texts are predominantly syntax-based (Diathesis Alterations and Coordination Changes) and a combination of Miscellaneous Changes (Change of Order, Change of Format, and Addition/Deletion). Results of the analysis of paraphrase extremes (PE) show that Identical Structures resulting from the use of synonymous substitutions, with no significant change in the structural features of the original, is the most frequently occurring instance of PE. The analysis of paraphrase errors reveals that synonymous substitutions resulting in identical structures are the most frequently occurring error that leads to PE. Another type of paraphrasing error involves semantic and content loss resulting from the deletion or addition of meaning-altering content. Three major themes emerged from the FGD: (1) The Challenge of Preserving Semantic Content and Fidelity; (2) The Best Words in the Best Order: Grappling with the Lexico-semantic and Morphosyntactic Demands of Paraphrasing; and (3) Contending with Limited Vocabulary, Poor Comprehension, and Lack of Practice. A pedagogical paradigm was designed based on the major findings of the study for a sustainable instructional intervention.

Keywords: academic text, lexico-semantic analysis, linguistic analysis, morphosyntactic analysis, paraphrasing

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634 Numerical Board Game for Low-Income Preschoolers

Authors: Gozde Inal Kiziltepe, Ozgun Uyanik

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There is growing evidence that socioeconomic (SES)-related differences in mathematical knowledge primarily start in early childhood period. Preschoolers from low-income families are likely to perform substantially worse in mathematical knowledge than their counterparts from middle and higher income families. The differences are seen on a wide range of recognizing written numerals, counting, adding and subtracting, and comparing numerical magnitudes. Early differences in numerical knowledge have a permanent effect childrens’ mathematical knowledge in other grades. In this respect, analyzing the effect of number board game on the number knowledge of 48-60 month-old children from disadvantaged low-income families constitutes the main objective of the study. Participants were the 71 preschoolers from a childcare center which served low-income urban families. Children were randomly assigned to the number board condition or to the color board condition. The number board condition included 35 children and the color board game condition included 36 children. Both board games were 50 cm long and 30 cm high; had ‘The Great Race’ written across the top; and included 11 horizontally arranged, different colored squares of equal sizes with the leftmost square labeled ‘Start’. The numerical board had the numbers 1–10 in the rightmost 10 squares; the color board had different colors in those squares. A rabbit or a bear token were presented to children for selecting, and on each trial spun a spinner to determine whether the token would move one or two spaces. The number condition spinner had a ‘1’ half and a ‘2’ half; the color condition spinner had colors that matched the colors of the squares on the board. Children met one-on-one with an experimenter for four 15- to 20-min sessions within a 2-week period. In the first and fourth sessions, children were administered identical pretest and posttest measures of numerical knowledge. All children were presented three numerical tasks and one subtest presented in the following order: counting, numerical magnitude comparison, numerical identification and Count Objects – Circle Number Probe subtest of Early Numeracy Assessment. In addition, same numerical tasks and subtest were given as a follow-up test four weeks after the post-test administration. Findings obtained from the study; showed that there was a meaningful difference between scores of children who played a color board game in favor of children who played number board game.

Keywords: low income, numerical board game, numerical knowledge, preschool education

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633 Barriers and Facilitators of Community Based Mental Health Intervention (CMHI) in Rural Bangladesh: Findings from a Descriptive Study

Authors: Rubina Jahan, Mohammad Zayeed Bin Alam, Sazzad Chowdhury, Sadia Chowdhury

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Access to mental health services in Bangladesh is a tale of urban privilege and rural struggle. Mental health services in the country are primarily centered in urban medical hospitals, with only 260 psychiatrists for a population of more than 162 million, while rural populations face far more severe and daunting challenges. In alignment with the World Health Organization's perspective on mental health as a basic human right and a crucial component for personal, community, and socioeconomic development; SAJIDA Foundation a value driven non-government organization in Bangladesh has introduced a Community Based Mental Health (CMHI) program to fill critical gaps in mental health care, providing accessible and affordable community-based services to protect and promote mental health, offering support for those grappling with mental health conditions. The CMHI programme is being implemented in 3 districts in Bangladesh, 2 of them are remote and most climate vulnerable areas targeting total 6,797 individual. The intervention plan involves a screening of all participants using a 10-point vulnerability assessment tool to identify vulnerable individuals. The assumption underlying this is that individuals assessed as vulnerable is primarily due to biological, psychological, social and economic factors and they are at an increased risk of developing common mental health issues. Those identified as vulnerable with high risk and emergency conditions will receive Mental Health First Aid (MHFA) and undergo further screening with GHQ-12 to be identified as cases and non-cases. The identified cases are then referred to community lay counsellors with basic training and knowledge in providing 4-6 sessions on problem solving or behavior activation. In situations where no improvement occurs post lay counselling or for individuals with severe mental health conditions, a referral process will be initiated, directing individuals to ensure appropriate mental health care. In our presentation, it will present the findings from 6-month pilot implementation focusing on the community-based screening versus outcome of the lay counseling session and barriers and facilitators of implementing community based mental health care in a resource constraint country like Bangladesh.

Keywords: community-based mental health, lay counseling, rural bangladesh, treatment gap

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632 Identifying and Understand Pragmatic Failures in Portuguese Foreign Language by Chinese Learners in Macau

Authors: Carla Lopes

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It is clear nowadays that the proper performance of different speech acts is one of the most difficult obstacles that a foreign language learner has to overcome to be considered communicatively competent. This communication presents the results of an investigation on the pragmatic performance of Portuguese Language students at the University of Macau. The research discussed herein is based on a survey consisting of fourteen speaking situations to which the participants must respond in writing, and that includes different types of speech acts: apology, response to a compliment, refusal, complaint, disagreement and the understanding of the illocutionary force of indirect speech acts. The responses were classified in a five levels Likert scale (quantified from 1 to 5) according to their suitability for the particular situation. In general terms, we can summarize that about 45% of the respondents' answers were pragmatically competent, 10 % were acceptable and 45 % showed weaknesses at socio-pragmatic competence level. Given that the linguistic deviations were not taken into account, we can conclude that the faults are of cultural origin. It is natural that in the presence of orthogonal cultures, such as Chinese and Portuguese, there are failures of this type, barely solved in the four years of the undergraduate program. The target population, native speakers of Cantonese or Mandarin, make their first contact with the English language before joining the Bachelor of Portuguese Language. An analysis of the socio - pragmatic failures in the respondents’ answers suggests the conclusion that many of them are due to the lack of cultural knowledge. They try to compensate for this either using their native culture or resorting to a Western culture that they consider close to the Portuguese, that is the English or US culture, previously studied, and also widely present in the media and on the internet. This phenomenon, known as 'pragmatic transfer', can result in a linguistic behavior that may be considered inauthentic or pragmatically awkward. The resulting speech act is grammatically correct but is not pragmatically feasible, since it is not suitable to the culture of the target language, either because it does not exist or because the conditions of its use are in fact different. Analysis of the responses also supports the conclusion that these students present large deviations from the expected and stereotyped behavior of Chinese students. We can speculate while this linguistic behavior is the consequence of the Macao globalization that culturally casts the students, makes them more open, and distinguishes them from the typical Chinese students.

Keywords: Portuguese foreign language, pragmatic failures, pragmatic transfer, pragmatic competence

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631 Teachers Influence on Encouraging Physical Activity and Recreation in Township Schools in the City of Tshwane

Authors: Rapuane Eric Jan Pule

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Sport participation plays a significant role in learners’ well-being and lifestyle. Learners spend most of their time in the school environment, where they are monitored, guided and advised by teachers. Teachers have a good relationship with the learners, therefore they can play a major role in promoting and influencing learners to participate in physical activities, both competitive and recreational purposes. Their influence and involvement could assist in increasing the number learners' involvement in physical activities, sport and recreation at Township schools. The national sport and recreation plan in South Africa, recommends that promotion of sport and physical activities at primary and secondary schools should play an important role in helping learners commit to a live-long participation in sport, recreational and physical activities. Schoolteachers could play an influential role in ensuring that learners spent their leisure time productively through physical and recreational activities. However, the role and the influence of teachers in promoting physical and recreational activities have been previously overlooked in the literature. Part of this study focuses on the in-depth challenges encountered by primary and secondary school teachers at Township schools in promoting and influencing learners’ involvement in sport, recreation and physical activities. 109 primary and secondary teachers at Township schools agreed to participate in the study through the provision of informed consent. The participants consisted of 49 primary school teachers and 60 secondary school teachers. Quantitative approach was followed using validated structured questionnaire comprising 12 close-ended items were used. Findings indicated that teachers' can play a significant role in influencing and encouraging learners to participate in sport, recreation or physical activities. Teachers view physical activity as an important developmental component for learners. Primary school teachers believe that they have a significant role to play in encouraging and promoting physical activities, sport and recreation, as compared to the secondary school teachers. Both group of teachers at primary and secondary schools, believe that infrastructure development, financial support, and extra incentives could motivate them to promote physical, recreational and sporting activities at schools. Teachers also acknowledge that schools are facing challenges in implementing and coordinating physical activities and recreational programmes as required by the Department of sport and recreation South Africa. It is recommended that the Department of Basic Education and Sport and Recreation South Africa revise their policies regarding the role of teachers in promoting and administering physical and recreational activities at schools.

Keywords: township, physical activities, sport and recreation participation, learners, teachers, primary and secondary schools, physical education

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630 Functional Impairment in South African Children with ADHD: Design, Implementation and Evaluation of a Targeted Intervention

Authors: Mareli Fischer, Kevin G. F. Thomas

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Although Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent childhood neurobehavioural disorders, little empirical research has been published on its clinical presentation in Africa, and, globally, few studies evaluate ADHD intervention programs that emphasize parent training. Hence, Stage 1 of this research programme aimed to describe the functional impairment of South African children with ADHD, and also sought to investigate the influence of sociodemographic variables (e.g., sex, age, socioeconomic status, family environment) and clinical variables (e.g., ADHD subtype and comorbidity) on the degree of that impairment. We used the Mini International Neuropsychiatric Interview for Children and Adolescents as a diagnostic tool, and the Child Behavior Checklist, the Strengths and Difficulties Questionnaire, and the Impairment Rating Scale as measures of functional impairment. Results from this stage of the research indicated that South African children and adolescents who meet diagnostic criteria for ADHD experience most functional impairment in the school domain, as well as in the area of social functioning. None of the measured sociodemographic variables had a significant detrimental or protective effect on how ADHD symptoms impacted on functioning. In terms of comorbidity, the presence of Major Depressive Disorder, Conduct Disorder, and Oppositional Defiant Disorder were all associated with significantly impaired overall functioning. Stage 2 of the research programme aimed to design, implement, and evaluate a child-specific intervention that targeted the primary areas of impairment identified in Stage 1. Existing literature suggests that a positive parent-training programme, in the group format, is one of the best options for cost-effective and successful ADHD intervention. Hence, the intervention took that form. Parents were taught basic behaviour analysis concepts within a supportive group context. Evaluation of the intervention’s efficacy used many of the same measures as in Stage 1, but also featured semi-structured interviews with participants and naturalistic observation of parent-child interaction. We will discuss preliminary results of that evaluation. Studying functional impairment and designing intervention plans in this way will pave the way for evidence-based treatment plans for children and adolescents diagnosed with ADHD.

Keywords: attention deficit/hyperactivity disorder, children, intervention, parenting groups

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629 Sensitivity to Misusing Verb Inflections in Both Finite and Non-Finite Clauses in Native and Non-Native Russian: A Self-Paced Reading Investigation

Authors: Yang Cao

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Analyzing the oral production of Chinese-speaking learners of English as a second language (L2), we can find a large variety of verb inflections – Why does it seem so hard for them to use consistent correct past morphologies in obligatory past contexts? Failed Functional Features Hypothesis (FFFH) attributes the rather non-target-like performance to the absence of [±past] feature in their L1 Chinese, arguing that for post puberty learners, new features in L2 are no more accessible. By contrast, Missing Surface Inflection Hypothesis (MSIH) tends to believe that all features are actually acquirable for late L2 learners, while due to the mapping difficulties from features to forms, it is hard for them to realize the consistent past morphologies on the surface. However, most of the studies are limited to the verb morphologies in finite clauses and few studies have ever attempted to figure out these learners’ performance in non-finite clauses. Additionally, it has been discussed that Chinese learners may be able to tell the finite/infinite distinction (i.e. the [±finite] feature might be selected in Chinese, even though the existence of [±past] is denied). Therefore, adopting a self-paced reading task (SPR), the current study aims to analyze the processing patterns of Chinese-speaking learners of L2 Russian, in order to find out if they are sensitive to misuse of tense morphologies in both finite and non-finite clauses and whether they are sensitive to the finite/infinite distinction presented in Russian. The study targets L2 Russian due to its systematic morphologies in both present and past tenses. A native Russian group, as well as a group of English-speaking learners of Russian, whose L1 has definitely selected both [±finite] and [±past] features, will also be involved. By comparing and contrasting performance of the three language groups, the study is going to further examine and discuss the two theories, FFFH and MSIH. Preliminary hypotheses are: a) Russian native speakers are expected to spend longer time reading the verb forms which violate the grammar; b) it is expected that Chinese participants are, at least, sensitive to the misuse of inflected verbs in non-finite clauses, although no sensitivity to the misuse of infinitives in finite clauses might be found. Therefore, an interaction of finite and grammaticality is expected to be found, which indicate that these learners are able to tell the finite/infinite distinction; and c) having selected [±finite] and [±past], English-speaking learners of Russian are expected to behave target-likely, supporting L1 transfer.

Keywords: features, finite clauses, morphosyntax, non-finite clauses, past morphologies, present morphologies, Second Language Acquisition, self-paced reading task, verb inflections

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628 Changes in Skin Microbiome Diversity According to the Age of Xian Women

Authors: Hanbyul Kim, Hye-Jin Kin, Taehun Park, Woo Jun Sul, Susun An

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Skin is the largest organ of the human body and can provide the diverse habitat for various microorganisms. The ecology of the skin surface selects distinctive sets of microorganisms and is influenced by both endogenous intrinsic factors and exogenous environmental factors. The diversity of the bacterial community in the skin also depends on multiple host factors: gender, age, health status, location. Among them, age-related changes in skin structure and function are attributable to combinations of endogenous intrinsic factors and exogenous environmental factors. Skin aging is characterized by a decrease in sweat, sebum and the immune functions thus resulting in significant alterations in skin surface physiology including pH, lipid composition, and sebum secretion. The present study gives a comprehensive clue on the variation of skin microbiota and the correlations between ages by analyzing and comparing the metagenome of skin microbiome using Next Generation Sequencing method. Skin bacterial diversity and composition were characterized and compared between two different age groups: younger (20 – 30y) and older (60 - 70y) Xian, Chinese women. A total of 73 healthy women meet two conditions: (I) living in Xian, China; (II) maintaining healthy skin status during the period of this study. Based on Ribosomal Database Project (RDP) database, skin samples of 73 participants were enclosed with ten most abundant genera: Chryseobacterium, Propionibacterium, Enhydrobacter, Staphylococcus and so on. Although these genera are the most predominant genus overall, each genus showed different proportion in each group. The most dominant genus, Chryseobacterium was more present relatively in Young group than in an old group. Similarly, Propionibacterium and Enhydrobacter occupied a higher proportion of skin bacterial composition of the young group. Staphylococcus, in contrast, inhabited more in the old group. The beta diversity that represents the ratio between regional and local species diversity showed significantly different between two age groups. Likewise, The Principal Coordinate Analysis (PCoA) values representing each phylogenetic distance in the two-dimensional framework using the OTU (Operational taxonomic unit) values of the samples also showed differences between the two groups. Thus, our data suggested that the composition and diversification of skin microbiomes in adult women were largely affected by chronological and physiological skin aging.

Keywords: next generation sequencing, age, Xian, skin microbiome

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627 Farmers’ Perception, Willingness and Capacity in Utilization of Household Sewage Sludge as Organic Resources for Peri-Urban Agriculture around Jos Nigeria

Authors: C. C. Alamanjo, A. O. Adepoju, H. Martin, R. N. Baines

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Peri-urban agriculture in Jos Nigeria serves as a major means of livelihood for both urban and peri-urban poor, and constitutes huge commercial inclination with a target market that has spanned beyond Plateau State. Yet, the sustainability of this sector is threatened by intensive application of urban refuse ash contaminated with heavy metals, as a result of the highly heterogeneous materials used in ash production. Hence, this research aimed to understand the current fertilizer employed by farmers, their perception and acceptability in utilization of household sewage sludge for agricultural purposes and their capacity in mitigating risks associated with such practice. Mixed methods approach was adopted, and data collection tools used include survey questionnaire, focus group discussion with farmers, participants and field observation. The study identified that farmers maintain a complex mixture of organic and chemical fertilizers, with mixture composition that is dependent on fertilizer availability and affordability. Also, farmers have decreased the rate of utilization of urban refuse ash due to labor and increased logistic cost and are keen to utilize household sewage sludge for soil fertility improvement but are mainly constrained by accessibility of this waste product. Nevertheless, farmers near to sewage disposal points have commenced utilization of household sewage sludge for improving soil fertility. Farmers were knowledgeable on composting but find their strategic method of dewatering and sun drying more convenient. Irrigation farmers were not enthusiastic for treatment, as they desired both water and sludge. Secondly, household sewage sludge observed in the field is heterogeneous due to nearness between its disposal point and that of urban refuse, which raises concern for possible cross-contamination of pollutants and also portrays lack of extension guidance as regards to treatment and management of household sewage sludge for agricultural purposes. Hence, farmers concerns need to be addressed, particularly in providing extension advice and establishment of decentralized household sewage sludge collection centers, for continuous availability of liquid and concentrated sludge. Urgent need is also required for the Federal Government of Nigeria to increase commitment towards empowering her subsidiaries for efficient discharge of corporate responsibilities.

Keywords: ash, farmers, household, peri-urban, refuse, sewage, sludge, urban

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626 Level of Caregiver Burden: A Study of Caregivers of Stroke Survivors at CRP in Bangladesh

Authors: Yeasir Arafat Alve, Nazmun Nahar, Salma BeguM

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Introduction / Rationale: Caregivers of stroke survivors have experienced financial, emotional, physical and mental anxiety and have influence of family bonding and social customs, where 80% of caregivers were women and majority of the patients were cared for by immediate family members for example a spouse, son/daughter, son-in-law, daughter-in-law, siblings and they are significantly feel burden as a caregiver. In Bangladeshi context, there has a limitation of knowledge about the level of caregiver burden. This study could be suggested the health professional to focus on the care giving stress to provide a better support to them and also it will be advisable to provide equivalent services for caregivers and their families. Objectives: The study finds out the socio-demographic image of caregivers of stroke survivors in Bangladesh as well as discovers the level of burden of caregiver of stroke survivor in relation to general strain, isolation, disappointment, emotional involvement and environment. The study will find out the association between level of burden among caregivers and onset of stroke of survivors & duration of care giving. As well as to determine the association between level of burden among caregivers and caregiver’s age, gender, occupation and caregiver’s relationship with stroke survivors. Method / Approach: The study is a non experimental cross-sectional study design where 151 participants were selected through purposive comprehensive sampling. Data were selected from occupational therapy outdoor and stroke rehab unit, CRP (Savar & Mirpur) where using the Caregiver Burden Scale (a structured questionnaire) with face to face interview. Results: Most of the caregivers (78.8%) of stroke survivors faced moderate level of burden in general strain (37.7%), isolation (27.2%) but in case of disappointment (60.3%) feel higher burden and lower burden in emotional involvement (9.9%) and environment (0.7%). Caregiver burden level was significantly associated with caregivers’ age (P=0.006), sex (P=0.002), occupation (p= 0.04), relationship with stroke survivors (P=0.02), care giving duration (P=0.000), care giving hours (P=0.009), and onset of stroke (P=0.000) of stroke survivors. Conclusion: The study findings revealed that most of the caregivers faced moderate burden where no environmental burden for them, this is possibly in case of Bangladeshi culture where people hospitable. Through this study, it was also found that there is a possibility to have the higher burden. Finally, it is being also suggested that appropriate advice and support may preserve care giving which eventually enables the survivors to live a longer and more fulfilling life in the community.

Keywords: caregiver, level of caregiver burden, stroke survivor, stroke rehab unit

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625 Humanistic Psychology Workshop to Increase Psychological Well-Being

Authors: Nidia Thalia Alva Rangel, Ferran Padros Blazquez, Ma. Ines Gomez Del Campo Del Paso

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Happiness has been since antiquity a concept of interest around the world. Positive psychology is the science that begins to study happiness in a more precise and controlled way, obtaining wide amount of research which can be applied. One of the central constructs of Positive Psychology is Carol Ryff’s psychological well-being model as eudaimonic happiness, which comprehends six dimensions: autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. Humanistic psychology is a clear precedent of Positive Psychology, which has studied human development topics and it features a great variety of intervention techniques nevertheless has little evidence with controlled research. Therefore, the present research had the aim to evaluate the efficacy of a humanistic intervention program to increase psychological well-being in healthy adults through a mixed methods study. Before and after the intervention, it was applied Carol Ryff’s psychological well-being scale (PWBS) and the Symptom Check List 90 as pretest and posttest. In addition, a questionnaire of five open questions was applied after each session. The intervention program was designed in experiential workshop format, based on the foundational attitudes defined by Carl Rogers: congruence, unconditional positive regard and empathy, integrating humanistic intervention strategies from gestalt, psychodrama, logotherapy and psychological body therapy, with the aim to strengthen skills in the six dimensions of psychological well-being model. The workshop was applied to six volunteer adults in 12 sessions of 2 hours each. Finally, quantitative data were analyzed with Wilcoxon statistic test through the SPSS program, obtaining as results differences statistically significant in pathology symptoms between prettest and postest, also levels of dimensions of psychological well-being were increased, on the other hand for qualitative strand, by open questionnaires it showed how the participants were experiencing the techniques and changing through the sessions. Thus, the humanistic psychology program was effective to increase psychological well-being. Working to promote well-being prompts to be an effective way to reduce pathological symptoms as a secondary gain. Experiential workshops are a useful tool for small groups. There exists the need for research to count with more evidence of humanistic psychology interventions in different contexts and impulse the application of Positive Psychology knowledge.

Keywords: happiness, humanistic psychology, positive psychology, psychological well-being, workshop

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624 The Effect of Realizing Emotional Synchrony with Teachers or Peers on Children’s Linguistic Proficiency: The Case Study of Uji Elementary School

Authors: Reiko Yamamoto

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This paper reports on a joint research project in which a researcher in applied linguistics and elementary school teachers in Japan explored new ways to realize emotional synchrony in a classroom in childhood education. The primary purpose of this project was to develop a cross-curriculum of the first language (L1) and second language (L2) based on the concept of plurilingualism. This concept is common in Europe, and can-do statements are used in forming the standard of linguistic proficiency in any language; these are attributed to the action-oriented approach in the Common European Framework of Reference for Languages (CEFR). CEFR has a basic tenet of language education: improving communicative competence. Can-do statements are classified into five categories based on the tenet: reading, writing, listening, speaking/ interaction, and speaking/ speech. The first approach of this research was to specify the linguistic proficiency of the children, who are still developing their L1. Elementary school teachers brainstormed and specified the linguistic proficiency of the children as the competency needed to synchronize with others – teachers or peers – physically and mentally. The teachers formed original can-do statements in language proficiency on the basis of the idea that emotional synchrony leads to understanding others in communication. The research objectives are to determine the effect of language education based on the newly developed curriculum and can-do statements. The participants of the experiment were 72 third-graders in Uji Elementary School, Japan. For the experiment, 17 items were developed from the can-do statements formed by the teachers and divided into the same five categories as those of CEFR. A can-do checklist consisting of the items was created. The experiment consisted of three steps: first, the students evaluated themselves using the can-do checklist at the beginning of the school year. Second, one year of instruction was given to the students in Japanese and English classes (six periods a week). Third, the students evaluated themselves using the same can-do checklist at the end of the school year. The results of statistical analysis showed an enhancement of linguistic proficiency of the students. The average results of the post-check exceeded that of the pre-check in 12 out of the 17 items. Moreover, significant differences were shown in four items, three of which belonged to the same category: speaking/ interaction. It is concluded that children can get to understand others’ minds through physical and emotional synchrony. In particular, emotional synchrony is what teachers should aim at in childhood education.

Keywords: elementary school education, emotional synchrony, language proficiency, sympathy with others

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623 Individual Differences in Affective Neuroscience Personality Traits Predict Several Dimensions of Psychological Wellbeing. A Cross-Sectional Study in Healthy Subjects

Authors: Valentina Colonnello, Paolo Maria Russo

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Decades of cross-species affective neuroscience research by Panksepp and others have identified basic evolutionarily preserved subcortical emotional systems that humans share with mammals and many vertebrates. These primary emotional systems encode unconditional affective responses and contribute to the development of personality traits throughout ontogenesis and interactions with the environment. The Affective Neuroscience Personality Scale (ANPS) measures individual differences in affective personality traits associated with the basic emotional systems of CARE, PLAY, SEEKING, SADNESS, FEAR, and ANGER, along with Spirituality, which is a more cognitively and socially refined expression of affectivity. Though the ANPS’s power to predict human psychological distress has been documented, to the best of our knowledge, its predictive power for psychological wellbeing has not been explored. This study therefore investigates the relationship between affective neuroscience traits and psychological wellbeing facets. Because the emotional systems are thought to influence cognitively-mediated mental processes about the self and the world, understanding the relationship between affective traits and psychological wellbeing is particularly relevant to understanding the affective dimensions of health. In a cross-sectional study, healthy participants (n = 402) completed the ANPS and the Psychological Wellbeing scale. Multiple regressions revealed that each facet of wellbeing was explained by two to four affective traits, and each trait was significantly related to at least one aspect of wellbeing. Specifically, SEEKING predicted all the wellbeing facets, except for positive relations; CARE predicted personal growth, positive relations, purpose in life, and self-acceptance; PLAY and, inversely, ANGER predicted positive relations; SADNESS inversely predicted autonomy, while FEAR inversely predicted purpose in life. SADNESS and FEAR inversely predicted environmental mastery and self-acceptance. Finally, Spirituality predicted personal growth, positive relations, and self-acceptance. These findings are the first to show the relationship between affective neuroscience personality traits and psychological wellbeing. They also call attention to the distinctive role of FEAR and PANIC traits in psychological wellbeing facets, thereby complementing or even overcoming the traditional personality approach to neuroticism as a global trait.

Keywords: affective neuroscience, individual differences, personality, wellbeing

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622 An Assessment of the Role of Actors in the Medical Waste Management Policy-Making Process of Bangladesh

Authors: Md Monirul Islam, Shahaduz Zaman, Mosarraf H. Sarker

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Context: Medical waste management (MWM) is a critical sector in Bangladesh due to its impact on human health and the environment. There is a need to assess the current policies and identify the role of policy actors in the policy formulation and implementation process. Research Aim: The study aimed to evaluate the role of policy actors in the medical waste management policy-making process in Bangladesh, identify policy gaps, and provide actionable recommendations for improvement. Methodology: The study adopted a qualitative research method and conducted key informant interviews. The data collected were analyzed using the thematic coding approach through Atlas.ti software. Findings: The study found that policies are formulated at higher administrative levels and implemented in a top-down approach. Higher-level institutions predominantly contribute to policy development, while lower-level institutions focus on implementation. However, due to negligence, ignorance, and lack of coordination, medical waste management receives insufficient attention from the actors. The study recommends the need for immediate strategies, a comprehensive action plan, regular policy updates, and inter-ministerial meetings to enhance medical waste management practices and interventions. Theoretical Importance: The research contributes to evaluating the role of policy actors in medical waste management policymaking and implementation in Bangladesh. It identifies policy gaps and provides actionable recommendations for improvement. Data Collection: The study used key informant interviews as the data collection method. Thirty-six participants were interviewed, including influential policymakers and representatives of various administrative spheres. Analysis Procedures: The data collected was analyzed using the inductive thematic analysis approach. Question Addressed: The study aimed to assess the role of policy actors in medical waste management policymaking and implementation in Bangladesh. Conclusion: In conclusion, the study provides insights into the current medical waste management policy in Bangladesh, the role of policy actors in policy formulation and implementation, and the need for improved strategies and policy updates. The findings of this study can guide future policy-making efforts to enhance medical waste management practices and interventions in Bangladesh.

Keywords: key informant, medical waste management, policy maker, qualitative study

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621 Cooperative Learning Promotes Successful Learning. A Qualitative Study to Analyze Factors that Promote Interaction and Cooperation among Students in Blended Learning Environments

Authors: Pia Kastl

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Potentials of blended learning are the flexibility of learning and the possibility to get in touch with lecturers and fellow students on site. By combining face-to-face sessions with digital self-learning units, the learning process can be optimized, and learning success increased. To examine wether blended learning outperforms online and face-to-face teaching, a theory-based questionnaire survey was conducted. The results show that the interaction and cooperation among students is poorly provided in blended learning, and face-to-face teaching performs better in this respect. The aim of this article is to identify concrete suggestions students have for improving cooperation and interaction in blended learning courses. For this purpose, interviews were conducted with students from various academic disciplines in face-to-face, online, or blended learning courses (N= 60). The questions referred to opinions and suggestions for improvement regarding the course design of the respective learning environment. The analysis was carried out by qualitative content analysis. The results show that students perceive the interaction as beneficial to their learning. They verbalize their knowledge and are exposed to different perspectives. In addition, emotional support is particularly important in exam phases. Interaction and cooperation were primarily enabled in the face-to-face component of the courses studied, while there was very limited contact with fellow students in the asynchronous component. Forums offered were hardly used or not used at all because the barrier to asking a question publicly is too high, and students prefer private channels for communication. This is accompanied by the disadvantage that the interaction occurs only among people who already know each other. Creating contacts is not fostered in the blended learning courses. Students consider optimization possibilities as a task of the lecturers in the face-to-face sessions: Here, interaction and cooperation should be encouraged through get-to-know-you rounds or group work. It is important here to group the participants randomly to establish contact with new people. In addition, sufficient time for interaction is desired in the lecture, e.g., in the context of discussions or partner work. In the digital component, students prefer synchronous exchange at a fixed time, for example, in breakout rooms or an MS Teams channel. The results provide an overview of how interaction and cooperation can be implemented in blended learning courses. Positive design possibilities are partly dependent on subject area and course. Future studies could tie in here with a course-specific analysis.

Keywords: blended learning, higher education, hybrid teaching, qualitative research, student learning

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620 The Thoughts and Feelings Associated with Goal Achievement

Authors: Lindsay Foreman

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Introduction: Goals have become synonymous with the quest for the good life and the pursuit of happiness, with coaching and positive psychology gaining popularity as an approach in recent decades. And yet mental health is on the rise and the leading cause of disability, wellbeing is on the decline, stress is leading to 50-60% of workday absences and the need for action is indisputable and urgent. Purpose: The purpose of this study is to better understand two things we cannot see, but that play the most significant role in these outcomes - what we think and how we feel. With many working on the assumption that positive thinking and an optimistic outlook are necessary or valuable components of goal pursuit, this study uncovers the reality of the ‘inner-game’ from the coachee's perspective. Method: With a mixed methods design using a Q Method study of subjectivity to ‘make the unseen seen’. First, a wide-ranging universe of subjective thoughts and feelings experienced during goal pursuit are explored. These are generated from literature and a Qualtrics survey to create a Q-Set of 40 statements. Then 19 participants in professional and organisational settings offer their perspectives on these 40 Q-Set statements. Each rank them in a semi-forced distribution from ‘most like me’ to ‘least like me’ using Q-Sort software. From these individual perspectives, clusters of perspectives are identified using factor analysis and four distinct viewpoints have emerged. Findings: These Goal Pursuit Viewpoints offer insight into the states and self-talk experienced by coachees and may not reflect the assumption of positive thinking associated with achieving goals. The four Viewpoints are 1) the Optimistic View, 2) the Realistic View 3) The Dreamer View and 4) The Conflicted View. With only a quarter of the Dreamer View, and a third of the Optimistic view going on to achieve their goals, these assumptions need review. And with all the Realistic Views going on to achieve their goals, the role of self-doubt, overwhelm and anxiousness in goal achievement cannot be overlooked. Contribution: This study offers greater insight and understanding of people's inner experiences as they pursue goals and highlights the necessary and normal negative states associated with goal achievement. It also offers a practical tool of the Q-set statements to help coaches and coachees explore the current state and help navigate the journey towards goal achievement. It calls into question whether goals should always be part of coaching and if values, identity, and purpose may play a greater role than goals.

Keywords: coaching, goals, positive psychology, mindset, leadership, mental health, beliefs, cognition, emotional intelligence

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619 Challenges influencing Nurse Initiated Management of Retroviral Therapy (NIMART) Implementation in Ngaka Modiri Molema District, North West Province, South Africa

Authors: Sheillah Hlamalani Mboweni, Lufuno Makhado

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Background: The increasing number of people who tested HIV positive and who demand antiretroviral therapy (ART) prompted the National Department of Health to adopt WHO recommendations of task shifting where Professional Nurses(PNs) initiate ART rather than doctors in the hospital. This resulted in the decentralization of services to primary health care(PHC), generating a need to capacitate PNs on NIMART. After years of training, the impact of NIMART was assessed where it was established that even though there was an increased number who accessed ART, the quality of care is of serious concern. The study aims to answer the following question: What are the challenges influencing NIMART implementation in primary health care. Objectives: This study explores challenges influencing NIMART training and implementation and makes recommendations to improve patient and HIV program outcomes. Methods: A qualitative explorative program evaluation research design. The study was conducted in the rural districts of North West province. Purposive sampling was used to sample PNs trained on NIMART. FGDs were used to collect data with 6-9 participants and data was analysed using ATLAS ti. Results: Five FGDs, n=28 PNs and three program managers were interviewed. The study results revealed two themes: inadequacy in NIMART training and the health care system challenges. Conclusion: The deficiency in NIMART training and health care system challenges is a public health concern as it compromises the quality of HIV management resulting in poor patients’ outcomes and retard the goal of ending the HIV epidemic. These should be dealt with decisively by all stakeholders. Recommendations: The national department of health should improve NIMART training and HIV management: standardization of NIMART training curriculum through the involvement of all relevant stakeholders skilled facilitators, the introduction of pre-service NIMART training in institutions of higher learning, support of PNs by district and program managers, plan on how to deal with the shortage of staff, negative attitude to ensure compliance to guidelines. There is a need to develop a conceptual framework that provides guidance and strengthens NIMART implementation in PHC facilities.

Keywords: antiretroviral therapy, nurse initiated management of retroviral therapy, primary health care, professional nurses

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618 Exploring Barriers to Social Innovation: Swedish Experiences from Nine Research Circles

Authors: Claes Gunnarsson, Karin Fröding, Nina Hasche

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Innovation is a necessity for the evolution of societies and it is also a driving force in human life that leverages value creation among cross-sector participants in various network arrangements. Social innovations can be characterized as the creation and implementation of a new solution to a social problem, which is more effective and sustainable than existing solutions in terms of improvement of society’s conditions and in particular social inclusion processes. However, barriers exist which may restrict the potential of social innovations to live up to its promise as a societal welfare promoting driving force. The literature points at difficulties in tackling social problems primarily related to problem complexity, access to networks, and lack of financial muscles. Further research is warranted at detailed at detail clarification of these barriers, also connected to recognition of the interplay between institutional logics on the development of cross-sector collaborations in networks and the organizing processes to achieve innovation barrier break-through. There is also a need to further elaborate how obstacles that spur a difference between the actual and desired state of innovative value creating service systems can be overcome. The purpose of this paper is to illustrate barriers to social innovations, based on qualitative content analysis of 36 dialogue-based seminars (i.e. research circles) with nine Swedish focus groups including more than 90 individuals representing civil society organizations, private business, municipal offices, and politicians; and analyze patterns that reveal constituents of barriers to social innovations. The paper draws on central aspects of innovation barriers as discussed in the literature and analyze barriers basically related to internal/external and tangible/intangible characteristics. The findings of this study are that existing institutional structures highly influence the transformative potential of social innovations, as well as networking conditions in terms of building a competence-propelled strategy, which serves as an offspring for overcoming barriers of competence extension. Both theoretical and practical knowledge will contribute to how policy-makers and SI-practitioners can facilitate and support social innovation processes to be contextually adapted and implemented across areas and sectors.

Keywords: barriers, research circles, social innovation, service systems

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617 Learning Gains and Constraints Resulting from Haptic Sensory Feedback among Preschoolers' Engagement during Science Experimentation

Authors: Marios Papaevripidou, Yvoni Pavlou, Zacharias Zacharia

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Embodied cognition and additional (touch) sensory channel theories indicate that physical manipulation is crucial to learning since it provides, among others, touch sensory input, which is needed for constructing knowledge. Given these theories, the use of Physical Manipulatives (PM) becomes a prerequisite for learning. On the other hand, empirical research on Virtual Manipulatives (VM) (e.g., simulations) learning has provided evidence showing that the use of PM, and thus haptic sensory input, is not always a prerequisite for learning. In order to investigate which means of experimentation, PM or VM, are required for enhancing student science learning at the kindergarten level, an empirical study was conducted that sought to investigate the impact of haptic feedback on the conceptual understanding of pre-school students (n=44, age mean=5,7) in three science domains: beam balance (D1), sinking/floating (D2) and springs (D3). The participants were equally divided in two groups according to the type of manipulatives used (PM: presence of haptic feedback, VM: absence of haptic feedback) during a semi-structured interview for each of the domains. All interviews followed the Predict-Observe-Explain (POE) strategy and consisted of three phases: initial evaluation, experimentation, final evaluation. The data collected through the interviews were analyzed qualitatively (open-coding for identifying students’ ideas in each domain) and quantitatively (use of non-parametric tests). Findings revealed that the haptic feedback enabled students to distinguish heavier to lighter objects when held in hands during experimentation. In D1 the haptic feedback did not differentiate PM and VM students' conceptual understanding of the function of the beam as a mean to compare the mass of objects. In D2 the haptic feedback appeared to have a negative impact on PM students’ learning. Feeling the weight of an object strengthen PM students’ misconception that heavier objects always sink, whereas the scientifically correct idea that the material of an object determines its sinking/floating behavior in the water was found to be significantly higher among the VM students than the PM ones. In D3 the PM students outperformed significantly the VM students with regard to the idea that the heavier an object is the more the spring will expand, indicating that the haptic input experienced by the PM students served as an advantage to their learning. These findings point to the fact that PMs, and thus touch sensory input, might not always be a requirement for science learning and that VMs could be considered, under certain circumstances, as a viable means for experimentation.

Keywords: haptic feedback, physical and virtual manipulatives, pre-school science learning, science experimentation

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616 Cultural Competence and Healthcare Challenges of Migrants in South Wales United Kingdom

Authors: Qirat Naz, Abasiokpon Udoakah

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In developed countries, global migration is diversifying. The minority ethnic population, including refugees and asylum seekers who, fled their home countries due to war, terrorism, oppression, or natural disasters, and returning home is dangerous for them. They need sanctuary and peaceful environment in host countries. They begin the process of acculturation, in which a person adopts the social mores and behavioral patterns of the dominant culture, yet they still have unique multicultural needs that the dominant society fails to address. The aim of this research is to provide a holistic understanding of the living experiences of a minority population, particularly migrants, including asylum seekers and refugees, in the health and social care system of South Wales. The purpose of this study is to investigate three research objectives: the multicultural health care needs of minorities, as well as the barriers to seeking health and social care facilities. There are Welsh policies for promoting cultural competence in the health and social care sectors; this research will explore the implications and impact of these policies on the target population. This research study will be conducted using qualitative research methods, tools, and techniques. This research is an inductive approach to coming up with a grounded theory. The sample will be divided into two groups: migrants and professionals providing any kind of services to migrants; each group will contain 30 participants. Interpretive phenomenological analysis would be utilized during the process of coding and developing the main themes of this research. The positionality of the researcher would be minimized by unloaded and open-ended questions, researcher’s work experience in research, continuous evaluation of her positionality, daily base reflection of fieldwork and seeking the help of male and female gatekeepers. The research findings would be based on emic perspective, and by documenting the emic perspective of minorities, this research will contribute to the knowledge of appropriate channels, including organizations, academics, and policymakers, to discover possible solutions and coping mechanisms to deal with the challenges and meet the multicultural demands of minorities. This research will provide a more in-depth understanding of minorities and will help to promote the diversity of health and social care in South Wales.

Keywords: migration, migrants, cultural competence, cultural barriers, healthcare challenges

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615 Lived Experiences of Parents in Disciplining Their Children

Authors: Bernardino Vinoya, Cassandra D. Batton, Samantha Gayle M. Bonavente, Johnson O. Canoza, Lhea Flynn B. Capones, Camille S. Dispo, Johanna Neilvin T. Dontogan, Louise Angelica C. Lipana, Charlene Pearl P. Navalta, Rechelle Vhen W. Payo-os, Mary Reyna D. Ridao, Rushnol Jade P. Tupac, Pauline B. Sol

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Parenting is preparing children for life as productive adults and discipline strategies are needed to achieve it like non-aggressive, psychologically aggressive and physical discipline. The effects of disciplinary strategies on children are well explored as evidenced by existing studies, local and international laws and active international organizations which are all brimmed towards child protection but status quo shows a profound scarcity of studies engaged in the effects of disciplining the child on the parent. To know the deeper unexplored reasons and untold stories of the parent, mainly the lived experiences of parents in disciplining their children. Design is descriptive phenomelogical. Participants were chosen using snowball purposive sampling. Data were collected through interview with the general question, “Ano ang mga karanasan ninyo sa pagdidisiplina ng inyong anak (What are your experiences when disciplining your child?)”, followed with unstructured questions. Collaizi method was used in analyzing data. Data collected was verified through focused group discussion. Results show three main themes: Reason, Disciplinary Strategy, and Aftermath. The use of disciplinary strategy is influenced by the experiences of the parent, the triggers like the child’s misbehavior and parental desires or wishes for the child. Disciplinary strategy can either be physical punishment or verbal. Parent’s generally used both when children disrespects or disobeys. Parents also experience both positive and negative effects on their physical, social, emotional aspects after disciplining their children. As a result, parents use coping mechanisms to maintain ego stability. Disciplining a child is a cyclical process. Parents, just like the child will also experience both positive and negative outcomes after using different disciplinary strategies. Future researchers can replicate study or use triangulation in multi-site qualitative and quantitative studies, professors can teach findings on parents in the concepts of pediatric nursing and apply the findings in the clinical area particularly when dealing with families.

Keywords: parents, disciplinary strategy, parental effects, pediatric nursing

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614 Neurophysiology of Domain Specific Execution Costs of Grasping in Working Memory Phases

Authors: Rumeysa Gunduz, Dirk Koester, Thomas Schack

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Previous behavioral studies have shown that working memory (WM) and manual actions share limited capacity cognitive resources, which in turn results in execution costs of manual actions in WM. However, to the best of our knowledge, there is no study investigating the neurophysiology of execution costs. The current study aims to fill this research gap investigating the neurophysiology of execution costs of grasping in WM phases (encoding, maintenance, retrieval) considering verbal and visuospatial domains of WM. A WM-grasping dual task paradigm was implemented to examine execution costs. Baseline single task required performing verbal or visuospatial version of a WM task. Dual task required performing the WM task embedded in a high precision grasp to place task. 30 participants were tested in a 2 (single vs. dual task) x 2 (visuo-spatial vs. verbal WM) within subject design. Event related potentials (ERPs) were extracted for each WM phase separately in the single and dual tasks. Memory performance for visuospatial WM, but not for verbal WM, was significantly lower in the dual task compared to the single task. Encoding related ERPs in the single task revealed different ERPs of verbal WM and visuospatial WM at bilateral anterior sites and right posterior site. In the dual task, bilateral anterior difference disappeared due to bilaterally increased anterior negativities for visuospatial WM. Maintenance related ERPs in the dual task revealed different ERPs of verbal WM and visuospatial WM at bilateral posterior sites. There was also anterior negativity for visuospatial WM. Retrieval related ERPs in the single task revealed different ERPs of verbal WM and visuospatial WM at bilateral posterior sites. In the dual task, there was no difference between verbal WM and visuospatial WM. Behavioral and ERP findings suggest that execution of grasping shares cognitive resources only with visuospatial WM, which in turn results in domain specific execution costs. Moreover, ERP findings suggest unique patterns of costs in each WM phase, which supports the idea that each WM phase reflects a separate cognitive process. This study not only contributes to the understanding of cognitive principles of manual action control, but also contributes to the understanding of WM as an entity consisting of separate modalities and cognitive processes.

Keywords: dual task, grasping execution, neurophysiology, working memory domains, working memory phases

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613 Educational Framework for Coaches on Injury Prevention in Adolescent Team Sports

Authors: Chantell Gouws, Lourens Millard, Anne Naude, Jan-Wessel Meyer, Brandon Stuwart Shaw, Ina Shaw

Abstract:

Background: Millions of South African youths participate in team sports, with netball and rugby being two of the largest worldwide. This increased participation and professionalism have resulted in an increase in the number of musculoskeletal injuries. Objective: This study examined the extent to which sport coaching knowledge translates to the injuries and prevention of injuries in adolescents participating in netball and rugby. Methods: Thirty-four South African sports coaches participated in the study. Eighteen netball coaches and 16 rugby coaches with varying levels of coaching experience were selected to participate. An adapted version of Nash and Sproule’s questionnaire was used to investigate the coaches’ knowledge with regards to sport-specific common injuries, injury prevention, fitness/conditioning, individual technique development, training programs, mental training, and preparation of players. The analysis of data was carried out using a number of different techniques outlined by Nash and Sproule (2012). These techniques were determined by the type of data. Descriptive data was used to provide statistical analysis. Quantitative data was used to determine the educational framework and knowledge of sports coaches on injury prevention. Numerical data was obtained through questions on sports injuries, as well as coaches’ sports knowledge levels. Participants’ knowledge was measured using a standardized scoring system. Results: For the 0-4 years of netball coaching experience, 76.4% of the coaches had knowledge and experience and 33.3% appropriate first aid knowledge, while for the 9-12 years and 13-16 years, 100% of the coaches had knowledge and experience and first aid knowledge. For the 0-4 years in rugby coaching experience, 59.1% had knowledge and experience and 71% the appropriate first aid knowledge; for the 17-20 years, 100% had knowledge and experience and first aid, while for higher or equal to 25 years, 45.5% had knowledge and experience. In netball, 90% of injuries consisted of ankle injuries, followed by 70% for knee, 50% for shoulder, 20% for lower leg, and 15% for finger injuries. In rugby, 81% of the injuries occurred at the knee, followed by 50% for the shoulder, 40% for the ankle, 31% for the head and neck, and 25% for hamstring injuries. Six hours of training resulted in a 13% chance of injuries in netball and a 32% chance in rugby. For 10 hours of training, the injury prevalence was 10% in netball and 17% in rugby, while 15 hours resulted in an injury incidence of 58% in netball players and a 25% chance in rugby players. Conclusion: This study highlights the need for coaches to improve their knowledge in relation to injuries and injury prevention, along with factors that act as a preventative measure and promotes players’ well-being.

Keywords: musculoskeletal injury, sport coaching, sport trauma

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