Search results for: social health insurance
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 16884

Search results for: social health insurance

11784 Beyond Recognition: Beliefs, Attitudes, and Help-Seeking for Depression and Schizophrenia in Ghana

Authors: Peter Adu

Abstract:

Background: There is a paucity of mental health research in Ghana. Little is known about the beliefs and attitudes regarding specific mental disorders in Ghana. Method: A vignette study was conducted to examine the relationship between causal attributions, help-seeking, and stigma towards depression and schizophrenia using lay Ghanaians (N = 410). This adapted questionnaire presented two unlabelled vignettes about a hypothetical person with the above disorders for participants to provide their impressions. Next, participants answered questions on beliefs and attitudes regarding this person. Results: The results showed that causal beliefs about mental disorders were related to treatment options and stigma: spiritual causal attributions associated positively with spiritual help-seeking and perceived stigma for the mental disorders, whilst biological and psychosocial causal attribution of the mental disorders was positively related with professional help-seeking. Finally, contrary to previous literature, belonging to a particular religious group did not negatively associate with professional help-seeking for mental disorders. Conclusion: In conclusion, results suggest that Ghanaians may benefit from exposure to corrective information about depression and schizophrenia. Our findings have implications for mental health literacy and anti-stigma campaigns in Ghana and other developing countries in the region.

Keywords: stigma, mental health literacy, depression, schizophrenia, spirituality, religion

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11783 Comprehensive Care and the Right to Autonomy of Children and Adolescents with Cancer

Authors: Sandra Soca Lozano, Teresa Isabel Lozano Pérez, Germain Weber

Abstract:

Cancer is a chronic disease of high prevalence in children and adolescents. Medical care in Cuba is carried out by a multidisciplinary team and family is the mediator between this team and the patient. Around this disease, there are interwoven many stereotypes and taboos by its relation to death. In this research report, we describe the work paradigm of psychological care to patients suffering from these diseases in the University Pediatric Hospital Juan Manuel Márquez of Havana, Cuba. We present the psychosocial factors that must be taken into account to provide comprehensive care and ensuring the quality of life of patients and their families. We also present the factors related to the health team and the management of information done with the patient. This is a descriptive proposal from the working experience accumulated in the named institution and in the review of the literature. As a result of this report we make a proposal of teamwork and the aspects in which psychological intervention should be continue performing in terms of increasing the quality of the care made by the health team. We conclude that it is necessary to continue improving the information management of children and adolescents with theses health problems and took into account their right to autonomy.

Keywords: comprehensive care, management of information, psychosocial factors, right to autonomy

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11782 The Role of Risk Attitudes and Networks on the Migration Decision: Empirical Evidence from the United States

Authors: Tamanna Rimi

Abstract:

A large body of literature has discussed the determinants of migration decision. However, the potential role of individual risk attitudes on migration decision has so far been overlooked. The research on migration literature has studied how the expected income differential influences migration flows for a risk neutral individual. However, migration takes place when there is no expected income differential or even the variability of income appears as lower than in the current location. This migration puzzle motivates a recent trend in the literature that analyzes how attitudes towards risk influence the decision to migrate. However, the significance of risk attitudes on migration decision has been addressed mostly in a theoretical perspective in the mainstream migration literature. The efficient outcome of labor market and overall economy are largely influenced by migration in many countries. Therefore, attitudes towards risk as a determinant of migration should get more attention in empirical studies. To author’s best knowledge, this is the first study that has examined the relationship between relative risk aversion and migration decision in US market. This paper considers movement across United States as a means of migration. In addition, this paper also explores the network effect due to the increasing size of one’s own ethnic group to a source location on the migration decision and how attitudes towards risk vary with network effect. Two ethnic groups (i.e. Asian and Hispanic) have been considered in this regard. For the empirical estimation, this paper uses two sources of data: 1) U.S. census data for social, economic, and health research, 2010 (IPUMPS) and 2) University of Michigan Health and Retirement Study, 2010 (HRS). In order to measure relative risk aversion, this study uses the ‘Two Sample Two-Stage Instrumental Variable (TS2SIV)’ technique. This is a similar method of Angrist (1990) and Angrist and Kruegers’ (1992) ‘Two Sample Instrumental Variable (TSIV)’ technique. Using a probit model, the empirical investigation yields the following results: (i) risk attitude has a significantly large impact on migration decision where more risk averse people are less likely to migrate; (ii) the impact of risk attitude on migration varies by other demographic characteristics such as age and sex; (iii) people with higher concentration of same ethnic households living in a particular place are expected to migrate less from their current place; (iv) the risk attitudes on migration vary with network effect. The overall findings of this paper relating risk attitude, migration decision and network effect can be a significant contribution addressing the gap between migration theory and empirical study in migration literature.

Keywords: migration, network effect, risk attitude, U.S. market

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11781 Adaptation and Validation of the Program Sustainability Assessment Tool

Authors: Henok Metaferia Gebremariam

Abstract:

Worldwide, considerable resources are spent implementing public health interventions that are interrupted soon after the initial funding ends. However, ambiguity remains as to how health programs can be effectively sustained over time because of the diversity of perspectives, definitions, study methods, outcomes measures and timeframes. From all the above-mentioned research challenges, standardized measures of sustainability should ultimately become a key research issue. To resolve this key challenge, the objective of the study was to adapt a tool for measuring the program’s capacity for sustainability and evaluating its reliability and validity. To adapt and validate the tool, a cross-sectional and cohort study design was conducted at 26 programs in Addis Ababa between September 2014 and May 2015. An adapted version of the tool after the pilot test was administered to 220 staff. The tool was analyzed for reliability and validity. Results show that a 40-item PSAT tool had been adapted into the Amharic version with good internal consistency (Cronbach’s alpha= 0.80), test-retest reliability(r=0.916) and construct validity. Factor analysis resulted in 7 components explaining 56.67 % of the variance. In conclusion, it was found that the Amharic version of PAST was a reliable and valid tool for measuring the program’s capacity for sustainability.

Keywords: program sustainability, public health interventions, reliability, validity

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11780 The Structure of the Intangible Capital

Authors: Kolesnikova Julia, Fakhrutdinova Elena, Zagidullina Venera, Kamasheva Anastasia

Abstract:

The article deals with the structure of intangible capital. A significant share of intangible capital is associated with a person as such and can be considered as human capital, which in turn also has a complex structure, including intellectual, social, organizational, client, reputational capital. We have allocated a separate category of intangible capital - unidentifiable capital, including a variety of synergistic interaction effects, etc. the structure of intangible capital. A significant share of intangible capital is associated with a person as such and can be considered as human capital, which in turn also has a complex structure, including intellectual, social, organizational, client, reputational capital. We have allocated unidentifiable capital as a separate category of intangible capital, including a variety of synergistic interaction effects and other.

Keywords: intangible capital, intangible property, object of intangible property, reputation capital

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11779 Attitude and Perception of Non-emergency Vehicle Drivers on Roads Towards Medical Emergency Vehicles: The Role of Empathy and Pro-Social Skills

Authors: Purnima K Bajre, Rujula Talloo

Abstract:

A variety of vehicles are driven on roads such as private vehicles, commercial vehicles, public vehicles, and emergency service vehicles (EMV). Drivers driving different vehicles can have attitude differences towards emergency service vehicles which in turn affects their likelihood to give way to them. The present review aims to understand the factors that mediate this yielding behavior of drivers towards EMVs. Through extensive review of available literature, factors such as effects of lights and sirens, cognitive load, age of the driver, driving general experience, traffic load, drivers’ experience and training with EMVs and drivers’ attitude towards EMV drivers, have emerged as mediating factors. Whereas cognitive load is the most researched area and is observed to be associated negatively with on road drivers’ attitudes towards EMVs, there is a paucity of research to understand the relationships between empathy, pro-social skills, and on road drivers’ attitude towards EMVs.

Keywords: cognitive load, emergency service vehicle, empathy, traffic load

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11778 Challenges of Teaching Physical Education to Students With Special Needs in Regular School Settings

Authors: Christine Okello

Abstract:

Physical Education (PE) curriculum provides school age students to explore issues that are likely to impact on health, safety, and well-being. The current curriculum includes the physical activity component, intended to improve physical fitness, social skills as well as building confidence. While this viewpoint is vital, there are challenges and stigma attached when specific issues are either ignored, inadequately addressed, or not seen to be important. The department stipulates that students attend a school that is closest to their home, to access available government transportation to and from school. Equivalently, parents of students with a disability decide where their children attend school. A choice between a regular classroom, mainstream Special Unit classroom, or a School for Specific Purposes (SSP). Parents who take their children to regular schools may be oblivious of the details of the curriculum. Physical Education outcomes does not stipulate the extent to which a student must perform or expected to perform. It is therefore due to the classroom teacher to adjust their teaching goals or outcomes to suit all students in their classroom. A student who can run a hundred meters race in 20 seconds may belong in the same classroom as a student in a wheelchair. While these students are challenged because of a lack of performance, teachers are challenged to effectively teach successful PE lessons, and on the other hand students without a disability may not be able to attain their optimum. This paper will identify areas of need, address the challenges, and explore a possible solution.

Keywords: special needs, disability, challenges, physical education

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11777 Influence of Urban Fabric on Child’s Upbringing: A Comparative Analysis between Modern and Traditional City

Authors: Mohamed A. Tantawy, Nourelhoda A. Hussein, Moataz A. Mahrous

Abstract:

New planning and city design theories are continuously debated and optimized for seeking efficiency and adequacy in economic and life quality aspects. Here, we examine the children-city relationship, to reflect on how modern and traditional cities affect the social climate. We adopt children as a proper caliber for urbanism, as for their very young age, they are independent and attached to family. Their fragility offers a chance to gauge how various urban settings directly affect their feeling of safety, containment, and their perception of belonging for home territory. The importance of street play for the child development process is discussed thoroughly. The authority they have on their play (when and what to play) pushes us to our conclusion. A mediocre built environment characterized by spontaneity and human-scale semi-private urban spaces, is irreplaceable by a perfectly designed far away playgrounds. Street play has a huge role in empowering children for a gradual engagement with grown-ups’ urban flow.

Keywords: child's psychology, social activity, street play, urban fabric

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11776 Improving the Management of Delirium of Surgical Inpatients

Authors: Shammael Selorfia

Abstract:

The Quality improvement project aimed to improve junior doctors and nurses’ knowledge and confidence in diagnosing and managing delirium on inpatient surgical wards in a tertiary hospital. The study aimed to develop a standardised assessment and management checklist for all staff working with patients who were presenting with signs of delirium. The aim of the study was to increase confidence of staff at dealing with delirium and improve the quality of referrals that were being sent to the Mental Health Liaison team over a 6-month period. A significant proportion of time was being spent by the Mental Health Liaison triage nurses on referrals for delirium. Data showed 28% of all delirium referrals from surgical teams were being closed at triage reflecting a poor standard of quality of those referrals. A qualitative survey of junior doctors in 6 surgical specialties in a UK tertiary hospital was conducted. These specialties include general surgery, vascular, plastic, urology, neurosurgery, and orthopaedics. The standardised checklist was distributed to all surgical wards. A comparison was made between the Mental health team caseload of delirium before intervention was compared and after. A Qualitative survey at end of 3-month cycle and compare overall caseload on Mental Health Liaison team to pre-QIP data with aim to improve quality of referrals and reduce workload on Mental Health Liaison team. At the end of the project cycle, we demonstrated an improvement in the quality of referrals with a decrease in the percentage of referrals being closed at triage by 8%. Our surveys also indicated an increase in the knowledge of official trust delirium guidelines and confidence at managing the patients. This project highlights that a new approach to delirium using multi-component interventions is needed, where the diagnosis of delirium is shared amongst medical and nursing staff, and everyone plays role in management. The key is improving awareness of delirium and encouraging the use of recognized diagnostic tools and official guidelines. Recommendations were made to the trust on how to implement a long-lasting change.

Keywords: delirium, surgery, quality, improvement

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11775 Transitioning Teacher Identity during COVID-19: An Australian Early Childhood Education Perspective

Authors: J. Jebunnesa, Y. Budd, T. Mason

Abstract:

COVID-19 changed the pedagogical expectations of early childhood education as many teachers across Australia had to quickly adapt to new teaching practices such as remote teaching. An important factor in the successful implementation of any new teaching and learning approach is teacher preparation, however, due to the pandemic, the transformation to remote teaching was immediate. A timely question to be asked is how early childhood teachers managed the transition from face-to-face teaching to remote teaching and what was learned through this time. This study explores the experiences of early childhood educators in Australia during COVID-19 lockdowns. Data were collected from an online survey conducted through the official Facebook forum of “Early Childhood Education and Care Australia,” and a constructivist grounded theory methodology was used to analyse the data. Initial research results suggest changing expectations of teachers’ roles and responsibilities during the lockdown, with a significant category related to transitioning teacher identities emerging. The concept of transitioning represents the shift from the role of early childhood educator to educational innovator, essential worker, social worker, and health officer. The findings illustrate the complexity of early childhood educators’ roles during the pandemic.

Keywords: changing role of teachers, constructivist grounded theory, lessons learned, teaching during COVID-19

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11774 The Knowledge and Beliefs Concerning Attention Deficit Hyperactivity Disorder Held by Parents of Children With Attention Deficit Hyperactivity Disorder in Saudi Arabia

Authors: Mohaned G. Abed

Abstract:

Attention Deficit Hyperactivity Disorder (ADHD) is considered one of the most frequently diagnosed psychiatric childhood disorders. It has an effect on 3–5% of school-aged children, and brings about difficulties in academic and social interaction. This study explored the knowledge and beliefs of parents in Saudi Arabia about children with ADHD. The Knowledge about Attention Deficit Disorder Questionnaire (KADD-Q) was administered to a sample of parents, followed by interviews with a subset of the total respondents. The results indicated that the parents knew more about the characteristics of ADHD than they knew about its related causes and treatment. Overall, the findings indicated that these parents had some knowledge about general characteristics of ADHD, but they had little understanding of causes and possible interventions. These results suggest an important need for more formal parents training regarding all aspects of ADHD in school age children.

Keywords: attention deficit hyperactivity disorder, childhood disorders, school-aged children, difficulties in academic, social interaction

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11773 [Keynote Talk]: Computer-Assisted Language Learning (CALL) for Teaching English to Speakers of Other Languages (TESOL/ESOL) as a Foreign Language (TEFL/EFL), Second Language (TESL/ESL), or Additional Language (TEAL/EAL)

Authors: Andrew Laghos

Abstract:

Computer-assisted language learning (CALL) is defined as the use of computers to help learn languages. In this study we look at several different types of CALL tools and applications and how they can assist Adults and Young Learners in learning the English language as a foreign, second or additional language. It is important to identify the roles of the teacher and the learners, and what the learners’ motivations are for learning the language. Audio, video, interactive multimedia games, online translation services, conferencing, chat rooms, discussion forums, social networks, social media, email communication, songs and music video clips are just some of the many ways computers are currently being used to enhance language learning. CALL may be used for classroom teaching as well as for online and mobile learning. Advantages and disadvantages of CALL are discussed and the study ends with future predictions of CALL.

Keywords: computer-assisted language learning (CALL), teaching English as a foreign language (TEFL/EFL), adult learners, young learners

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11772 Habituation on Children Mental Retardation through Practice of Behaviour Therapy in Great Aceh, Aceh Province

Authors: Marini Kristina Situmeang, Siti Hazar Sitorus, Mukhammad Fatkhullah, Arfan Fadli

Abstract:

This study aims to identify and explain how forms of treatment and community action include parents who have children with mental retardation while undergoing behavioral therapy that leads to habituation processes. Based on observations made there is inappropriate treatment such as labeling that child mental retardation is considered ‘crazy’ by some people in Aceh Besar region. Reflecting on the phenomenon of discriminatory treatment, the existence of children with mental retardation should be realized in concrete actions that can encourage the development of cognitive abilities, language, motor, and social, one of them through behavioral. The purpose of this research is to find out and explain how the social practices of children with mental retardation when undergoing behavioral therapy that leads to habituation process. This study focuses on families or parents who have children with mental retardation and do therapy of behavioral therapy at home or at physiotherapy clinics in Aceh Besar. The research method is qualitative with case study approach. Data collection techniques are conducted with in-depth interviews and Focus Group Discussion (FGD). The results showed that habituation process which is conducted by parents at home and in fisotherapy clinic have a positive effect on the development of children behavior of mental retardation, especially when dealing with the environment of the community around the residence. Habituation processes conducted through behavioral therapy practices are influenced by Habitus (Gestational and childcare at therapy) and Reinforcement (in this case family and social support). Habituation process is done in the form of habituation, the creation of the situation, and strengthening the character. For example, when a child's mental retardation commits a wrong act (disgraceful or inappropriate behavior) then the child gets punishment in accordance with the form of punishment in a normal child generally, and when he performs a good deed, then he is given a prize such as praise or a thing he likes. Through some of these actions, the child with mental retardation can behave in accordance with the character formed and expected by the community. The process of habituation done by parents accompanied by continuous support of physiotherapy can be one of the alternative booster of cognitive and social development of children mental retardation to then out of the ‘crazy’ label that has been given.

Keywords: behaviour therapy, habituation, habitus, mental retardation

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11771 ‘Call Before, Save Lives’: Reducing Emergency Department Visits through Effective Communication

Authors: Sandra Cardoso, Gaspar Pais, Judite Neves, Sandra Cavaca, Fernando Araújo

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In 2021, Portugal has 63 emergency department (ED) visits per 100 people annually, the highest numbers in Europe. While EDs provide a critical service, high use is indicative of inappropriate and inefficient healthcare. In Portugal, all ED have the Manchester Triage System (MTS), a clinical risk management tool to enable that patients are seen in order of clinical priority. In 2023, more than 40% of the ED visits were of non-urgent conditions (blue and green), that could be better managed in primary health care (PHC), meaning wrong use of resources and lack of health literacy. From 2017, the country has a phone line, SNS24 (Contact Centre of the National Health Service), for triage, counseling, and referral service, 24 hours/7 days a week. The pilot project ‘Call before, save lives’ was implemented in the municipalities of Póvoa de Varzim and Vila do Conde (around 150.000 residents), in May 2023, by the executive board of the Portuguese Health Service, with the support of the Shared Services of the Ministry of Health, and local authorities. This geographical area has short travel times, 99% of the population a family doctor and the region is organized in a health local unit (HLU), integrating PHC and the local hospital. The purposes of this project included to increase awareness to contact SNS 24, before going to an ED, and non-urgent conditions oriented to a family doctor, reducing ED visits. The implementation of the project involved two phases, beginning with: i) development of campaigns using local influencers (fishmonger, model, fireman) through local institutions and media; ii) provision of telephone installed on site to contact SNS24; iii) establishment of open consultation in PHC; iv) promotion of the use of SNS24; v) creation of acute consultations at the hospital for complex chronic patients; and vi) direct referral for home hospitalization by PHC. The results of this project showed an excellent level of access to SNS24, an increase in the number of users referred to ED, with great satisfaction of users and professionals. The second phase, initiated in January 2024, for access to the ED, the need for prior referral was established as an admission rule, except for certain situations, as trauma patients. If the patient refuses, their registration in the ED and subsequent screening in accordance with the MTS must be ensured. When the patient is non-urgent, shall not be observed in the ED, provided that, according to his clinical condition, is guaranteed to be referred to PHC or to consultation/day hospital, through effective scheduling of an appointment for the same or the following day. In terms of results, 8 weeks after beginning of phase 2, we assist of a decrease in self-reported patients to ED from 59% to 15%, and a reduction of around 7% of ED visits. The key for this success was an effective public campaign that increases the knowledge of the right use of the health system, and capable of changing behaviors.

Keywords: contact centre of the national health service, emergency department visits, public campaign, health literacy, SNS24

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11770 Providing Health Promotion Information by Digital Animation to International Visitors in Japan: A Factorial Design View of Nurses

Authors: Mariko Nishikawa, Masaaki Yamanaka, Ayami Kondo

Abstract:

Background: International visitors to Japan are at a risk of travel-related illnesses or injury that could result in hospitalization in a country where the language and customs are unique. Over twelve million international visitors came to Japan in 2015, and more are expected leading up to the Tokyo Olympics. One aspect of this is the potentially greater demand on healthcare services by foreign visitors. Nurses who take care of them have anxieties and concerns of their knowledge of the Japanese health system. Objectives: An effective distribution of travel-health information is vital for facilitating care for international visitors. Our research investigates whether a four-minute digital animation (Mari Info Japan), designed and developed by the authors and applied to a survey of 513 nurses who take care of foreigners daily, could clarify travel health procedures, reduce anxieties, while making it enjoyable to learn. Methodology: Respondents to a survey were divided into two groups. The intervention group watched Mari Info Japan. The control group read a standard guidebook. The participants were requested to fill a two-page questionnaire called Mari Meter-X, STAI-Y in English and mark a face scale, before and after the interventions. The questions dealt with knowledge of health promotion, the Japanese healthcare system, cultural concerns, anxieties, and attitudes in Japan. Data were collected from an intervention group (n=83) and control group (n=83) of nurses in a hospital, Japan for foreigners from February to March, 2016. We analyzed the data using Text Mining Studio for open-ended questions and JMP for statistical significance. Results: We found that the intervention group displayed more confidence and less anxiety to take care of foreign patients compared to the control group. The intervention group indicated a greater comfort after watching the animation. However, both groups were most likely to be concerned about language, the cost of medical expenses, informed consent, and choice of hospital. Conclusions: From the viewpoint of nurses, the provision of travel-health information by digital animation to international visitors to Japan was more effective than traditional methods as it helped them be better prepared to treat travel-related diseases and injury among international visitors. This study was registered number UMIN000020867. Funding: Grant–in-Aid for Challenging Exploratory Research 2010-2012 & 2014-16, Japanese Government.

Keywords: digital animation, health promotion, international visitor, Japan, nurse

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11769 Implementation of Nutritional Awareness Programme on Eating Habits of Primary School Children

Authors: Gulcin Satir, Ahmet Yildirim

Abstract:

Globally, including Turkey, health problems associated with malnutrition and nutrient deficiencies in childhood will remain major public health problems in future. Nutrition is a major environmental influence on physical and mental growth and development in early life. Many studies support the fact that nutritional knowledge makes contribution to wellbeing of children and their school performance. The purpose of this study was to examine nutritional knowledge and eating habits of primary school children and to investigate differences in these variables by socioeconomic status. A quasi-experimental one group pretest/posttest design study was conducted in five primary schools totaling 200 children aging 9-10 years in grade 4 to determine the effect of nutritional awareness programme on eating habits of primary school children. The schools were chosen according to parents’ social and demographic characteristics. The implemented nutritional awareness education programme focused on healthy lifestyle such as beneficial foods, eating habits, personal hygiene, physical activity and the programme consisted of eight lessons. The teaching approaches used included interactive teaching, role-playing, demonstration, small group discussions, questioning, and feedback. The lessons were given twice a week for four weeks totaling eight lessons. All lessons lasted 45-60 minutes and first 5 minutes of this was pre-assessment and last 5 minutes post assessment evaluation. The obtained data were analyzed for normality, and the distribution of the variables was tested by the Kolmogorov-Smirnov test. Paired t-test was used to evaluate the effectiveness of education programme and to compare the above-mentioned variables in each school separately before and after the lessons. The result of the paired t-test conducted separately for each school showed that on average after eight lessons, there was a 25-32% increase in nutritional knowledge of students regardless of the school they attend to and this rate was significant (P < 0.01). This shows that increase in nutritional awareness in these five schools having different socio-economic status was similar to each other. This study suggests that having children involved directly in lessons help to achieve nutritional awareness leading to healthy eating habits. It is concluded that nutritional awareness is a valuable tool to change eating habits. Study findings will provide information for developing nutrition education programmes for the healthy life and obesity prevention in children.

Keywords: children, nutritional awareness, obesity, socioeconomic status

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11768 Metabolic Pathway Analysis of Microbes using the Artificial Bee Colony Algorithm

Authors: Serena Gomez, Raeesa Tanseen, Netra Shaligram, Nithin Francis, Sandesh B. J.

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The human gut consists of a community of microbes which has a lot of effects on human health disease. Metabolic modeling can help to predict relative populations of stable microbes and their effect on health disease. In order to study and visualize microbes in the human gut, we developed a tool that offers the following modules: Build a tool that can be used to perform Flux Balance Analysis for microbes in the human gut using the Artificial Bee Colony optimization algorithm. Run simulations for an individual microbe in different conditions, such as aerobic and anaerobic and visualize the results of these simulations.

Keywords: microbes, metabolic modeling, flux balance analysis, artificial bee colony

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11767 Teaching Entrepreneurship in Light of the Triple Bottom Line

Authors: Sherry Robinson, Hans Anton Stubberud

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Entrepreneurship can take many forms. Traditional entrepreneurs seek profits and growth for the businesses they start themselves. Intrapreneurs act entrepreneurially within a business they do not own. Social entrepreneurs have goals other than (but not excluding) profit and growth as they seek to solve social problems or protect the environment. This type of entrepreneur often focuses on the triple bottom line, which includes a concern for people and the planet as well as profit. Ecopreneurs in particular are driven by their desire to create and promote environmentally sustainable products and processes. All of these entrepreneurs need an entrepreneurial orientation in order to survive and thrive. The three most common elements of an entrepreneurial orientation are (1) creativity and innovation, (2) the willingness to take risks and (3) the proactiveness to put ideas into action. This study describes an interdisciplinary entrepreneurship course integrating topics regarding the triple bottom line with those relevant to an entrepreneurial orientation. The results show that students significantly increased their skill levels in many areas, including soft skills such as communicating and working in teams, as well as designing innovative products and taking calculated risk.

Keywords: creativity, entrepreneurship education, sustainability, triple bottom line

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11766 The Right to Family Reunification of Immigrants in Spain

Authors: María José Benitez Jimenez

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This study seeks to make clear the importance of family reunification in order to establish consolidated habits of coexistence of immigrants, directly favoring the relationship of the family nucleus and indirectly the social integration of foreigners. In addition to the theoretical analysis of the subject, information has been reviewed by the National Institute of Statistics and Reports of Spanish organizations that compile data on immigrants and specifically on family reunification. The Spanish regulations on foreigners include the right of foreigners legally residing in Spain to regroup their families. The general conditions required to exercise this right are having legally resided in Spain for one year and having obtained authorization to reside for one more year. There are exceptions to the requirement of having resided for one year in our country. Article 39 of the Spanish Constitution, although it does not express what is to be understood as a family, does refer to the fact that ‘the public authorities ensure the social, economic and legal protection of the family’. Therefore for the Spanish State, the family institution, in a broad sense, enjoys a privileged treatment that is revealed in the Supreme Norm and that reflects the interest of our society to address the relationships that subjects have in their immediate environment. Although we are aware of the reluctant position of the Spanish Constitutional Court to consider as a fundamental right the right to family life despite being enshrined in Article 8 of the European Convention on Human Rights, it is questionable whether access to authorization for family reunification should be more uniform in terms of requirements related to nationality, employment or training of applicants in order to have an egalitarian character. The requirement of having resided one year in Spain to be able to request successful family reunification seems dispensable because if foreigners can obviate this requirement by having a certain status, its abolition would be feasible by equating all situations and benefiting foreigners in general. The achievement of this proposal would help to strengthen the family life of immigrants from the beginning of their life in Spain.

Keywords: family, immigrants, social integration, reunification

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11765 New Knowledge Co-Creation in Mobile Learning: A Classroom Action Research with Multiple Case Studies Using Mobile Instant Messaging

Authors: Genevieve Lim, Arthur Shelley, Dongcheol Heo

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Abstract—Mobile technologies can enhance the learning process as it enables social engagement around concepts beyond the classroom and the curriculum. Early results in this ongoing research is showing that when learning interventions are designed specifically to generate new insights, mobile devices support regulated learning and encourage learners to collaborate, socialize and co-create new knowledge. As students navigate across the space and time boundaries, the fundamental social nature of learning transforms into mobile computer supported collaborative learning (mCSCL). The metacognitive interaction in mCSCL via mobile applications reflects the regulation of learning among the students. These metacognitive experiences whether self-, co- or shared-regulated are significant to the learning outcomes. Despite some insightful empirical studies, there has not yet been significant research that investigates the actual practice and processes of the new knowledge co-creation. This leads to question as to whether mobile learning provides a new channel to leverage learning? Alternatively, does mobile interaction create new types of learning experiences and how do these experiences co-create new knowledge. The purpose of this research is to explore these questions and seek evidence to support one or the other. This paper addresses these questions from the students’ perspective to understand how students interact when constructing knowledge in mCSCL and how students’ self-regulated learning (SRL) strategies support the co-creation of new knowledge in mCSCL. A pilot study has been conducted among international undergraduates to understand students’ perspective of mobile learning and concurrently develops a definition in an appropriate context. Using classroom action research (CAR) with multiple case studies, this study is being carried out in a private university in Thailand to narrow the research gaps in mCSCL and SRL. The findings will allow teachers to see the importance of social interaction for meaningful student engagement and envisage learning outcomes from a knowledge management perspective and what role mobile devices can play in these. The findings will signify important indicators for academics to rethink what is to be learned and how it should be learned. Ultimately, the study will bring new light into the co-creation of new knowledge in a social interactive learning environment and challenges teachers to embrace the 21st century of learning with mobile technologies to deepen and extend learning opportunities.

Keywords: mobile computer supported collaborative learning, mobile instant messaging, mobile learning, new knowledge co-creation, self-regulated learning

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11764 Remodeling of Gut Microbiome of Pakistani Expats in China After Intermittent Fasting/Ramadan Fasting

Authors: Hafiz Arbab Sakandar

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Time-restricted intermittent fasting (TRIF) impacts host’s physiology and health. Plenty of health benefits have been reported for TRIF in animal models. However, limited studies have been conducted on humans especially in underdeveloped economies. Here, we designed a study to investigate the impact of TRIF/Ramadan fasting (16:8) on the modulation of gut-microbiome structure, metabolic pathways, and predicted metabolites and explored the correlation among them at different time points (during and after the month of Ramadan) in Pakistani Expats living in China. We observed different trends of Shannon-Wiener index in different subjects; however, all subjects showed substantial change in bacterial diversity with the progression of TRIF. Moreover, the changes in gut microbial structure by the end of TRIF were higher vis-a-vis in the beginning, significant difference was observed among individuals. Additionally, metabolic pathways analysis revealed that amino acid, carbohydrate and energy metabolism, glycan biosynthesis metabolism of cofactors and vitamins were significantly affected by TRIF. Pyridoxamine, glutamate, citrulline, arachidonic acid, and short chain fatty acid showed substantial difference at different time points based on the predicted metabolism. In conclusion, these results contribute to further our understanding about the key relationship among, dietary intervention (TRIF), gut microbiome structure and function. The preliminary results from study demonstrate significant potential for elucidating the mechanisms underlying gut microbiome stability and enhancing the effectiveness of microbiome-tailored interventions among the Pakistani populace. Nonetheless, extensive, and rigorous large-scale research on the Pakistani population is necessary to expound on the association between diet, gut microbiome, and overall health.

Keywords: gut microbiome, health, fasting, functionality

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11763 Polarization as a Proxy of Misinformation Spreading

Authors: Michela Del Vicario, Walter Quattrociocchi, Antonio Scala, Ana Lucía Schmidt, Fabiana Zollo

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Information, rumors, and debates may shape and impact public opinion heavily. In the latest years, several concerns have been expressed about social influence on the Internet and the outcome that online debates might have on real-world processes. Indeed, on online social networks users tend to select information that is coherent to their system of beliefs and to form groups of like-minded people –i.e., echo chambers– where they reinforce and polarize their opinions. In this way, the potential benefits coming from the exposure to different points of view may be reduced dramatically, and individuals' views may become more and more extreme. Such a context fosters misinformation spreading, which has always represented a socio-political and economic risk. The persistence of unsubstantiated rumors –e.g., the hypothetical and hazardous link between vaccines and autism– suggests that social media do have the power to misinform, manipulate, or control public opinion. As an example, current approaches such as debunking efforts or algorithmic-driven solutions based on the reputation of the source seem to prove ineffective against collective superstition. Indeed, experimental evidence shows that confirmatory information gets accepted even when containing deliberately false claims while dissenting information is mainly ignored, influences users’ emotions negatively and may even increase group polarization. Moreover, confirmation bias has been shown to play a pivotal role in information cascades, posing serious warnings about the efficacy of current debunking efforts. Nevertheless, mitigation strategies have to be adopted. To generalize the problem and to better understand social dynamics behind information spreading, in this work we rely on a tight quantitative analysis to investigate the behavior of more than 300M users w.r.t. news consumption on Facebook over a time span of six years (2010-2015). Through a massive analysis on 920 news outlets pages, we are able to characterize the anatomy of news consumption on a global and international scale. We show that users tend to focus on a limited set of pages (selective exposure) eliciting a sharp and polarized community structure among news outlets. Moreover, we find similar patterns around the Brexit –the British referendum to leave the European Union– debate, where we observe the spontaneous emergence of two well segregated and polarized groups of users around news outlets. Our findings provide interesting insights into the determinants of polarization and the evolution of core narratives on online debating. Our main aim is to understand and map the information space on online social media by identifying non-trivial proxies for the early detection of massive informational cascades. Furthermore, by combining users traces, we are finally able to draft the main concepts and beliefs of the core narrative of an echo chamber and its related perceptions.

Keywords: information spreading, misinformation, narratives, online social networks, polarization

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11762 Development of Personal and Social Identity in Immigrant Deaf Adolescents

Authors: Marialuisa Gennari, Giancarlo Tamanza, Ilaria Montanari

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Identity development in adolescence is characterized by many risks and challenges, and becomes even more complex by the situation of migration and deafness. In particular, the condition of the second generation of migrant adolescents involves the comparison between the family context in which everybody speaks a language and deals with a specific culture (usually parents’ and relatives’ original culture), the social context (school, peer groups, sports groups), where a foreign language is spoken and a new culture is faced, and finally in the context of the “deaf” world. It is a dialectic involving unsolved differences that have to be treated in a discontinuous process, which will give complex outcomes and chances depending on the process of elaboration of the themes of growth and development, culture and deafness. This paper aims to underline the problems and opportunities for each issue which immigrant deaf adolescents must deal with. In particular, it will highlight the importance of a multifactorial approach for the analysis of personal resources (both intra-psychic and relational); the level of integration of the family of origin in the migration context; the elaboration of the migration event, and finally, the tractability of the condition of deafness. Some psycho-educational support objectives will be also highlighted for the identity development of deaf immigrant adolescents, with particular emphasis on the construction of the adolescents’ useful abilities to decode complex emotions, to develop self-esteem and to get critical thoughts about the inevitable attempts to build their identity. Remarkably, and of importance, the construction of flexible settings which support adolescents in a supple, “decentralized” way in order to avoid the regressive defenses that do not allow for the development of an authentic self.

Keywords: immigrant deaf adolescents, identity development, personal and social challenges, psycho-educational support

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11761 Living in the Edge: Crisis in Indian Tea Industry and Social Deprivation of Tea Garden Workers in Dooars Region of India

Authors: Saraswati Kerketta

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Tea industry is one of the oldest organised sector of India. It employs roughly 1.5 million people directly. Since the last decade Indian tea industry, especially in the northern region is experiencing worst crisis in the post-independence period. Due to many reason the prices of tea show steady decline. The workers are paid one of the lowest wage in tea industry in the world (1.5$ a day) below the UN's $2 a day for extreme poverty. The workers rely on addition benefits from plantation which includes food, housing and medical facilities. These have been effective means of enslavement of generations of labourers by the owners. There is hardly any change in the tea estates where the owners determine the fate of workers. When the tea garden is abandoned or is closed all the facilities disappear immediately. The workers are the descendants of tribes from central India also known as 'tea tribes'. Alienated from their native place, the geographical and social isolation compounded their vulnerability of these people. The economy of the region being totally dependent on tea has resulted in absolute unemployment for the workers of these tea gardens. With no other livelihood and no land to grow food, thousands of workers faced hunger and starvation. The Plantation Labour Act which ensures the decent working and living condition is violated continuously. The labours are forced to migrate and are also exposed to the risk of human trafficking. Those who are left behind suffers from starvation, malnutrition and disease. The condition in the sick tea plantation is no better. Wage are not paid regularly, subsidised food, fuel are also not supplied properly. Health care facilities are in very bad shape. Objectives: • To study the socio-cultural and demographic characteristics of the tea garden labourers in the study area. • To examine the social situation of workers in sick estates in dooars region. • To assess the magnitude of deprivation the impact of economic crisis on abandoned and closed tea estates in the region. Data Base: The study is based on data collected from field survey. Methods: Quantative: Cross-Tabulation, Regression analysis. Qualitative: Household Survey, Focussed Group Discussion, In-depth interview of key informants. Findings: Purchasing power parity has declined since in last three decades. There has been many fold increase in migration. Males migrates long distance towards central and west and south India. Females and children migrates both long and short distance. No one has reported to migrate back to the place of origin of their ancestors. Migrant males work mostly as construction labourers and as factory workers whereas females and children work as domestic help and construction labourers. In about 37 cases either they haven't contacted their families in last six months or are not traceable. The families with single earning members are more likely to migrate. Burden of disease and the duration of sickness, abandonment and closure of plantation are closely related. Death tolls are likely to rise 1.5 times in sick tea gardens and three times in closed tea estates. Sixty percent of the people are malnourished in the sick tea gardens and more than eighty five per cent in abandoned and sick tea gardens.

Keywords: migration, trafficking, starvation death, tea garden workers

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11760 The Effectiveness of Prenatal Breastfeeding Education on Breastfeeding Uptake Postpartum: A Systematic Review

Authors: Jennifer Kehinde, Claire O’Donnell, Annmarie Grealish

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Introduction: Breastfeeding has been shown to provide numerous health benefits for both infants and mothers. The decision to breastfeed is influenced by physiological, psychological, and emotional factors. However, the importance of equipping mothers with the necessary knowledge for successful breastfeeding practice cannot be ruled out. The decline in global breastfeeding rate can be linked to a lack of adequate breastfeeding education during the prenatal stage. This systematic review examined the effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum. Method: This review was undertaken and reported in conformity with the Preferred Reporting Items for Systemic Reviews and Meta-Analysis statement (PRISMA) and was registered on the international prospective register for systematic reviews (PROSPERO: CRD42020213853). A PICO analysis (population, intervention, comparison, outcome) was undertaken to inform the choice of keywords in the search strategy to formulate the review question, which was aimed at determining the effectiveness of prenatal breastfeeding educational programs in improving breastfeeding uptake following birth. A systematic search of five databases (Cumulative Index to Nursing and Allied Health Literature, Medline, Psych INFO, and Applied Social Sciences Index and Abstracts) was searched between January 2014 until July 2021 to identify eligible studies. Quality assessment and narrative synthesis were subsequently undertaken. Results: Fourteen studies were included. All 14 studies used different types of breastfeeding programs; eight used a combination of curriculum-based breastfeeding education programs, group prenatal breastfeeding counselling, and one-to-one breastfeeding educational programs, which were all delivered in person; four studies used web-based learning platforms to deliver breastfeeding education prenatally which were both delivered online and face to face over a period of 3 weeks to 2 months with follow-up periods ranging from 3 weeks to 6 months; one study delivered breastfeeding educational intervention using mother-to-mother breastfeeding support groups in promoting exclusive breastfeeding, and one study disseminated breastfeeding education to participants based on the theory of planned behaviour. The most effective interventions were those that included both theory and hands-on demonstrations. Results showed an increase in breastfeeding uptake, breastfeeding knowledge, an increase in a positive attitude to breastfeeding, and an increase in maternal breastfeeding self-efficacy among mothers who participated in breastfeeding educational programs during prenatal care. Conclusion: Prenatal breastfeeding education increases women’s knowledge of breastfeeding. Mothers who are knowledgeable about breastfeeding and hold a positive approach towards breastfeeding have the tendency to initiate breastfeeding and continue for a lengthened period. Findings demonstrate a general correlation between prenatal breastfeeding education and increased breastfeeding uptake postpartum. The high level of positive breastfeeding outcomes inherent in all the studies can be attributed to prenatal breastfeeding education. This review provides rigorous contemporary evidence that healthcare professionals and policymakers can apply when developing effective strategies to improve breastfeeding rates and ultimately improve the health outcomes of mothers and infants.

Keywords: breastfeeding, breastfeeding programs, breastfeeding self-efficacy, prenatal breastfeeding education

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11759 Graph Neural Network-Based Classification for Disease Prediction in Health Care Heterogeneous Data Structures of Electronic Health Record

Authors: Raghavi C. Janaswamy

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In the healthcare sector, heterogenous data elements such as patients, diagnosis, symptoms, conditions, observation text from physician notes, and prescriptions form the essentials of the Electronic Health Record (EHR). The data in the form of clear text and images are stored or processed in a relational format in most systems. However, the intrinsic structure restrictions and complex joins of relational databases limit the widespread utility. In this regard, the design and development of realistic mapping and deep connections as real-time objects offer unparallel advantages. Herein, a graph neural network-based classification of EHR data has been developed. The patient conditions have been predicted as a node classification task using a graph-based open source EHR data, Synthea Database, stored in Tigergraph. The Synthea DB dataset is leveraged due to its closer representation of the real-time data and being voluminous. The graph model is built from the EHR heterogeneous data using python modules, namely, pyTigerGraph to get nodes and edges from the Tigergraph database, PyTorch to tensorize the nodes and edges, PyTorch-Geometric (PyG) to train the Graph Neural Network (GNN) and adopt the self-supervised learning techniques with the AutoEncoders to generate the node embeddings and eventually perform the node classifications using the node embeddings. The model predicts patient conditions ranging from common to rare situations. The outcome is deemed to open up opportunities for data querying toward better predictions and accuracy.

Keywords: electronic health record, graph neural network, heterogeneous data, prediction

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11758 Evaluation of Collect Tree Protocol for Structural Health Monitoring System Using Wireless Sensor Networks

Authors: Amira Zrelli, Tahar Ezzedine

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Routing protocol may enhance the lifetime of sensor network, it has a highly importance, especially in wireless sensor network (WSN). Therefore, routing protocol has a big effect in these networks, thus the choice of routing protocol must be studied before setting up our network. In this work, we implement the routing protocol collect tree protocol (CTP) which is one of the hierarchic protocols used in structural health monitoring (SHM). Therefore, to evaluate the performance of this protocol, we choice to work with Contiki system and Cooja simulator. By throughput and RSSI evaluation of each node, we will deduce about the utility of CTP in structural monitoring system.

Keywords: CTP, WSN, SHM, routing protocol

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11757 Creating Standards to Define the Role of Employment Specialists: A Case Study

Authors: Joseph Ippolito, David Megenhardt

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In the United States, displaced workers, the unemployed and those seeking to build additional work skills are provided employment training and job placement services through a system of One-Stop Career Centers that are sponsored by the country’s 593 local Workforce Boards. During the period 2010-2015, these centers served roughly 8 million individuals each year. The quality of services provided at these centers rests upon professional employment specialists who work closely with clients to identify their job interests, to connect them to appropriate training opportunities, to match them with needed supportive social services and to guide them to eventual employment. Despite the crucial role these Employment Specialists play, currently there are no broadly accepted standards that establish what these individuals are expected to do in the workplace, nor are there indicators to assess how well an individual performs these responsibilities. Education Development Center (EDC) and the United Labor Agency (ULA) have partnered to create a foundation upon which curriculum can be developed that addresses the skills, knowledge and behaviors that Employment Specialists must master in order to serve their clients effectively. EDC is a non-profit, education research and development organization that designs, implements, and evaluates programs to improve education, health and economic opportunity worldwide. ULA is the social action arm of organized labor in Greater Cleveland, Ohio. ULA currently operates One-Stop Career Centers in both Cleveland and Pittsburgh, Pennsylvania. This case study outlines efforts taken to create standards that define the work of Employment Specialists and to establish indicators that can guide assessment of work performance. The methodology involved in the study has engaged a panel of expert Employment Specialists in rigorous, structured dialogues that analyze and identify the characteristics that enable them to be effective in their jobs. It has also drawn upon and integrated reviews of the panel’s work by more than 100 other Employment Specialists across the country. The results of this process are two documents that provide resources for developing training curriculum for future Employment Specialists, namely: an occupational profile of an Employment Specialist that offers a detailed articulation of the skills, knowledge and behaviors that enable individuals to be successful at this job, and; a collection of performance based indicators, aligned to the profile, which illustrate what the work responsibilities of an Employment Specialist 'look like' a four levels of effectiveness ranging from novice to expert. The method of occupational analysis used by the study has application across a broad number of fields.

Keywords: assessment, employability, job standards, workforce development

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11756 Applying Epistemology to Artificial Intelligence in the Social Arena: Exploring Fundamental Considerations

Authors: Gianni Jacucci

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Epistemology traditionally finds its place within human research philosophies and methodologies. Artificial intelligence methods pose challenges, particularly given the unresolved relationship between AI and pivotal concepts in social arenas such as hermeneutics and accountability. We begin by examining the essential criteria governing scientific rigor in the human sciences. We revisit the three foundational philosophies underpinning qualitative research methods: empiricism, hermeneutics, and phenomenology. We elucidate the distinct attributes, merits, and vulnerabilities inherent in the methodologies they inspire. The integration of AI, e.g., deep learning algorithms, sparks an interest in evaluating these criteria against the diverse forms of AI architectures. For instance, Interpreted AI could be viewed as a hermeneutic approach, relying on a priori interpretations, while straight AI may be perceived as a descriptive phenomenological approach, processing original and uncontaminated data. This paper serves as groundwork for such explorations, offering preliminary reflections to lay the foundation and outline the initial landscape.

Keywords: artificial intelligence, deep learning, epistemology, qualitative research, methodology, hermeneutics, accountability

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11755 Interprofessional School-Based Mental Health Services for Rural Adolescents in South Australia

Authors: Garreth Kestell, Lukah Dykes, Danielle Zerk, Kyla Trewartha, Rhianon Marshall, Elena Rudnik

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Adolescent mental health is an international priority and the impact of innovative service models must be evaluated. Secondary school-based mental health services (SBMHS) involving private general practitioners and psychologists are a model of care being trialed in South Australia. Measures of depression, anxiety, and stress are routinely collected throughout psychotherapy sessions. This research set out to quantify the impact of psychotherapy for rural adolescents in a school setting and explore the importance of session frequency. Methods: Demographics, session date and DASS21 scores from students (n=65) seen in 2016 by three psychologists working at the SBMHS were recorded. Students were aged 13-18 years (M=15.43, SD= 1.24), mostly female (F=51, M=14), attended between 1 and 23 sessions with a median of 6 sessions (MAD 5.93) in one-year. The treating psychologist collected self-administered DASS21 scores. A mixed model analysis was used with age, sex, treating psychologist, months from first session, and session number as fixed effects, with response variables of DASS depression, anxiety, and stress scores. Results: 71.5% were classified as having extreme or severe anxiety and half had extreme or severe depression and/or stress scores. On average males had a greater increase in DASS scores over time but males attending more sessions benefited most from therapy. Discussion: Psychologists are treating rural adolescents in schools for severe anxiety, depression, and stress. This pilot study indicates that a predictive model combining demographics, session frequency, and DASS scores may help identify who is most likely to benefit from individual psychotherapy. Variations in DAS scores of individuals over time indicate the need for the collection of information such as living situation and exposure to alcohol. A larger sample size and additional data are currently being collected to allow for a more robust analysis.

Keywords: adolescent health, psychotherapy, school based mental health services, DAS21

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