Search results for: United Arab Emirates.
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1995

Search results for: United Arab Emirates.

1335 Primary Care Physicians in Urgent Care Centres of the United Kingdom

Authors: Mohammad Ansari, Ahmed Ismail, Satinder Mann

Abstract:

Overcrowding in Emergency departments (ED) of United Kingdom has become a common problem. Urgent Care centres were developed nearly a decade ago to reduce pressure on EDs. Unfortunately, the development of Urgent Care centres has failed to produce the projected effects. It was thought that nearly 40% patients attending ED would go to Urgent Care centres and these would be staffed by Primary care Physicians. Data reveals that no more than 20% patients were seen by Primary Care Physicians even when the Urgent Care Centre was based in the ED. This study was carried out at the ED of George Eliot Hospital, Nuneaton, UK where the Urgent Care centre was based in the ED and employed Primary Care Physicians with special interest in trauma for nearly one year. This was then followed by a Primary Care Physician and Advanced Nurse Practitioner. We compared the number of patients seen during these periods and the cost-effectiveness of the service.We randomly selected a week of patients seen by Primary Care Physicians with special interest in Trauma and by Primary Care Physicians and the Advanced Nurse Practitioner. We compared the number and type of patients seen during these two periods. Nearly 38% patients were seen by Primary care Physician with special interest in Trauma, whilst only 14.3% patients were seen by the Primary care Physician and Advanced Nurse Practitioner. The Primary Care Physicians with special interest in trauma were paid less. Our study confirmed that unless Primary Care Physicians are able to treat minor trauma and interpret x-rays, the urgent care service is not going to be cost effective. Numerous previous studies have shown that 15 to 20% patients attending ED can be treated by Primary Care Physicians who do not require any investigations for their management. It is advantageous to have Urgent Care Centres within the ED because if the patient deteriorates they can be transferred to ED. We recommend that the Urgent care Centres should be a part of ED. Our study shows that Urgent care Centres in the ED can be helpful and cost effective if staffed by either senior Emergency Physicians or Primary Care Physicians with special interest and experience in the management of minor trauma.

Keywords: urgent care centres, primary care physician, advanced nurse practitioner, trauma

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1334 US-China Competition in South China Sea and International Law

Authors: Mubashra Shaheen

Abstract:

The conflict over the South China Sea (SCS) is a complex imbroglio spanning over several territorial and maritime claims involving two major island groups, the Paracels and the Spratlys. It has become a major source of geopolitical competition between the United States and China. The study's overall objective is to understand China's land reclamations and assertive behavior in the South China Sea, which lies between both the Western Pacific and the Indian Ocean. Over half of global commerce passes through these waterways, which host a great amount of marine life and hydrocarbon deposits. China's sand-filling and island-building strategy in the South China Sea is motivated by its goal of privatizing all these riches as well as the routes. It would raise China to the pinnacle of world power status as well as allow it to threaten the dominance of the U.S. The study will examine China's assertive behavior and modernization plans as well as the United States' quest for supremacy through the lens of realists. While using a qualitative method of analysis, the study will examine China's nine-dash line claims and Exclusive Economic Zones (EEZs), UNCLOS, and U.S.-China divergence over international law considerations to pacify the tensions in the South China Sea. This paper is intended to explore the possible answers to the following questions: (1) Why does China’s rise necessitate the US's efforts to contain and encircle it through the lending of a hand to strategic partners and allies in the South China Sea? (2) Why South China Sea dispute is so complex imbroglio? (3) What are US-China international law considerations regarding the South China Sea? The study will further follow the bellow research procedure: 1: Comparative Legal Method: This method simply chalk-outs the follow of few steps that discarnate the positive and negative effects of the great power competitions. 2: Conceptualization: The conceptualization of the policies of containment defines and differentiates two different problems behind the persuasive means of hegemony and dominance in the strategic milieu.

Keywords: us, china, south china sea, unclos

Procedia PDF Downloads 88
1333 The Reality of Teaching Arabic for Specific Purposes in Educational Institutions

Authors: Mohammad Anwarul Kabir, Fayezul Islam

Abstract:

Language invariably is learned / taught to be used primarily as means of communications. Teaching a language for its native audience differs from teaching it to non-native audience. Moreover, teaching a language for communication only is different from teaching it for specific purposes. Arabic language is primarily regarded as the language of the Quran and the Sunnah (Prophetic tradition). Arabic is, therefore, learnt and spread all over the globe. However, Arabic is also a cultural heritage shared by all Islamic nations which has used Arabic for a long period to record the contributions of Muslim thinkers made in the field of wide spectrum of knowledge and scholarship. That is why the phenomenon of teaching Arabic by different educational institutes became quite rife, and the idea of teaching Arabic for specific purposes is heavily discussed in the academic sphere. Although the number of learners of Arabic is increasing consistently, yet their purposes vary. These include religious purpose, international trade, diplomatic purpose, better livelihood in the Arab world extra. By virtue of this high demand for learning Arabic, numerous institutes have been established all over the world including Bangladesh. This paper aims at focusing on the current status of the language institutes which has been established for learning Arabic for specific purposes in Bangladesh including teaching methodology, curriculum, and teachers’ quality. Such curricula and using its materials resulted in a lot of problems. The least, it confused teachers and students as well. Islamic educationalists have been working hard to professionally meet the need. They are following a systematic approach of stating clear and achievable goals, building suitable content, and applying new technology to present these learning experiences and evaluate them. It also suggests a model for designing instructional systems that responds to the need of non-Arabic speaking Islamic communities and provide the knowledge needed in both linguistic and cultural aspects. It also puts forward a number of suggestions for the improvement of the teaching / learning Arabic for specific purposes in Bangladesh after a detailed investigation in the following areas: curriculum, teachers’ skills, method of teaching and assessment policy.

Keywords: communication, Quran, sunnah, educational institutes, specific purposes, curriculum, method of teaching

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1332 The Representation of Women in Iraq: Gender Wage Gap and the Position of Women within Iraqi Society

Authors: Hanaa Sameen Ameen Bajilan

Abstract:

Human rights should be protected and promoted without regard to race, ethnicity, religion, political philosophy, or sexual orientation, following our firm convictions. Thus, any infringement of these rights or disdain for; any use of violence against women undermines the principles and human values of equality and endangers the entire society, including its potential to live in peace and to make growth and development. This paper represents the condition of the new Iraqi women regarding issues such as the gender wage gap, education, health, and violence against women. The study aims to determine the impact of traditions and customs on the legal position of Iraqi women. First, it seeks to assess the effects of culture as a historical agency on the legal status of Iraqi women. Second, the influence of cultural developments in the later part of the twentieth century on Iraqi women's legal standing, and third, the importance of cultural variety as a progressive cultural component in women's legal position. Finally, the study highlights the representation of women in Iraq: Gender wage Gap, Women's liberation between culture and law, and the role of women within Iraqi society based on an Iraqi novel named (Orange Light) in Arabic: برتقالو ضو. in her book, the Iraqi writer Nadia Al-Abru succeeds in portraying the post-war society's devotion to the sexual, emotional and mental marginalization of women in terms of the value of attendance. Since the study of Iraqi women's literature in Arabic-English translation is a new avenue of research that contributes to all three areas, this investigation aims to establish critical lines of engagement between contemporary Iraqi women's literature in English translation and feminist translation conceptual frameworks, and this is accomplished by first focusing on why analyzing Iraqi women writers' novels in Arabic-English translation is a timeline of inquiry that contributes to existing and emerging knowledge fields concerning Iraqi women writers' contemporary critical contexts and scholarship on Arab women's literature in Arabic-English translation.

Keywords: women in İraq, equality, violence, gender wage gap, Nadia Al-Abru, (orange light), women's liberation, İraqi women's literature,

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1331 Representation of Emotions and Characters in Turkish and Indian Series

Authors: Lienjang Zeite

Abstract:

Over the past few years, Turkish and Indian series have been distributed worldwide to countless households and have found ardent followers across different age group. The series have captured numerous hearts. Turkish and Indian series have become not only one of the best means of entertainment and relaxation but also a platform to learn and appreciate shared emotions and social messages. The popularity of the series has created a kind of interest in representing human emotions and stories like never before. The demands for such series have totally shifted the entertainment industry at a new level. The interest and vibe created by the series have had impacts on various departments spanning from technology to the fashion industry and it has also become the bridge to connect viewers across the globe. The series have amassed avid admirers who find solace in the beautiful visual representations of human relationships whether it is of lovers, family or friendship. The influence of Turkish and Indian series in many parts of the world has created a cultural phenomenon that has taken viewers beyond cultural and language differences. From China to Latin America, Arab countries and the Caucasus region, the series have been accepted and loved by millions of viewers. It has captivated audiences ranging from grandmothers to teenagers. Issues like language barrier are easily solved by means of translation or dubbing making it easier to understand and enjoy the series. Turkey and India are two different countries with their own unique culture and traditions. Both the countries are exporters of series in large scale. The series function as a platform to reveal the plots and shed lights on characters of all kinds. Both the countries produce series that are more or less similar in nature. However, there are also certain issues that are shown in different ways and light. The paper will discuss how emotions are represented in Turkish and Indian series. It will also discuss the ways the series have impacted the art of representing emotions and characters in the digital era. The representation of culture through Turkish and Indian series will be explored as well. The paper will also locate the issue of gender roles and how relationships are forged or abandoned in the series. The issue of character formation and importance of moral factors will be discussed. It will also examine the formula and ingredients of turning human emotions and characters into a much loved series.

Keywords: characters, cultural phenomenon, emotions, Turkish and Indian series

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1330 Analysing Tertiary Lecturers’ Teaching Practices and Their English Major Students’ Learning Practices with Information and Communication Technology (ICT) Utilization in Promoting Higher-Order Thinking Skills (HOTs)

Authors: Malini Ganapathy, Sarjit Kaur

Abstract:

Maximising learning with higher-order thinking skills with Information and Communications Technology (ICT) has been deep-rooted and emphasised in various developed countries such as the United Kingdom, the United States of America and Singapore. The transformation of the education curriculum in the Malaysia Education Development Plan (PPPM) 2013-2025 focuses on the concept of Higher Order Thinking (HOT) skills which aim to produce knowledgeable students who are critical and creative in their thinking and can compete at the international level. HOT skills encourage students to apply, analyse, evaluate and think creatively in and outside the classroom. In this regard, the National Education Blueprint (2013-2025) is grounded based on high-performing systems which promote a transformation of the Malaysian education system in line with the vision of Malaysia’s National Philosophy in achieving educational outcomes which are of world class status. This study was designed to investigate ESL students’ learning practices on the emphasis of promoting HOTs while using ICT in their curricula. Data were collected using a stratified random sampling where 100 participants were selected to take part in the study. These respondents were a group of undergraduate students who undertook ESL courses in a public university in Malaysia. A three-part questionnaire consisting of demographic information, students’ learning experience and ICT utilization practices was administered in the data collection process. Findings from this study provide several important insights on students’ learning experiences and ICT utilization in developing HOT skills.

Keywords: English as a second language students, critical and creative thinking, learning, information and communication technology and higher order thinking skills

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1329 A Technique for Planning the Application of Buttress Plate in the Medial Tibial Plateau Using the Preoperative CT Scan

Authors: P. Panwalkar, K. Veravalli, R. Gwynn, M. Tofighi, R. Clement, A. Mofidi

Abstract:

When operating on tibial plateau fracture especially medial tibial plateau, it has regularly been said “where do I put my thumb to reduce the fracture”. This refers to the ideal placement of the buttress device to hold the fracture till union. The aim of this study was to see if one can identify this sweet spot using a CT scan. Methods: Forty-five tibial plateau fractures with medial plateau involvement were identified and included in the study. The preoperative CT scans were analysed and the medial plateau involvement pattern was classified based on modified radiological classification by Yukata et-al of stress fracture of medial tibial plateau. The involvement of part of plateau was compared with position of buttress plate position which was classified as medial posteromedial or both. Presence and position of the buttress was compared with ability to achieve and hold the reduction of the fracture till union. Results: Thirteen fractures were type-1 fracture, 19 fractures were type-2 fracture and 13 fractures were type-3 fracture. Sixteen fractures were buttressed correctly according to the potential deformity and twenty-six fractures were not buttressed and three fractures were partly buttressed correctly. No fracture was over butressed! When the fracture was buttressed correctly the rate of the malunion was 0%. When fracture was partly buttressed 33% were anatomically united and 66% were united in the plane of buttress. When buttress was not used, 14 were malunited, one malunited in one of the two planes of deformity and eleven anatomically healed (of which 9 were non displaced!). Buttressing resulted in statistically significant lower mal-union rate (x2=7.8, p=0.0052). Conclusion: The classification based on involvement of medial condyle can identify the placement of buttress plate in the tibial plateau. The correct placement of the buttress plate results in predictably satisfactory union. There may be a correlation between injury shape of the tibial plateau and the fracture type.

Keywords: knee, tibial plateau, trauma, CT scan, surgery

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1328 The Re-Emergence of Slavery in Libya Is a Crime against Humanity That Must Be Eradicated without Delay

Authors: Vincent Jones

Abstract:

The North African country of Libya is in crisis and is currently a humanitarian disaster. The current American ‘hands off’ foreign policy appear to have contributed to this crisis. The research upon which this paper is based focused on a qualitative analysis of migration to Libya and its history with slavery, current conditions that have contributed to the re-emergence of slavery, an analysis of available resources in the effected region, and an analysis of legal remedies pursuant to international law. In addition, a qualitative analysis of American foreign policy from the Reagan Administration through the current Trump administration has been a focus of analysis. The major findings of this research are: (1) Since the removal of Muammar Gadhafi, a move that the United States played a major role in achieving, the nation of Libya has been in free fall and the rule of law has all but disappeared. As a major port stop for refugees and migrants fleeing atrocities in sub-Saharan African states, Libya has become the gate way to European ports of asylum. The problem is these migrant refugees are unwanted, caught between rival and often ineffective governments, profiteers, and inaction from the international community. (2) The outlook for these refugees is bleak: the ineffective government of Libya is ill-equipped to handle the large influx, European refugee destination states like Italy and Greece are already overburdened by the Syrian refugee crisis and are reluctant to accept more refugees, leaving the powerful and armed Libyan militia in control of a situation that is ripe for exploitation. (3) The combined intervention of the international community, led by a newly committed and engaged American foreign policy. In conclusion, a new American foreign policy approach along with the active engagement of the United Nations, EU, and the African Union can effectively resolve this humanitarian crisis.

Keywords: slavery, Libya, migrants, slave auction

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1327 A Comparative Analysis: Cultural Reflections of Mexicans in the United States and Turks in Germany

Authors: Gülşen Kocaevli

Abstract:

This paper aims to conduct a comparative analysis on the reflections of cultural elements such as language, festival, and food both in the case of Turkish immigrants in Germany and Mexican immigrants in the United States within a historical perspective. These reflections will be studied first by giving a certain background information on the migratory history of the two nations, Mexican immigration to the US, and Turkish immigration to Germany, respectively. These two cases were picked as the analytical subjects of this paper because both nations first migrated to the related country to constitute a labor force since there was a huge need for that due to several reasons such as the loss of manpower after certain wars or revolutions. At the end of this comparative study, it is speculated to be found that there are certain parallels between these two immigrant societies in the way that they reflect their cultures in the receiving country since both nations have a conventionalist nature which makes them tend more to protect their cultures and pay less effort to integrate into the society in which they are living. Even though this integration might be realized in certain fields like economic status and exogamy, it does not cover all segments nor is there any desire of the receiving government to integrate the immigrants but rather they make policies to assimilate them. This research paper will use a qualitative method which is fundamentally based on the interpretative data drawn from several sociological or ethnographic studies conducted in the related field. The primary and secondary resources of this paper will cover academic books, journal articles, particularly those reporting interviews with the immigrants, and certain governmental documents as well as publicized statistics regarding the subject of analysis. By the use of the aforementioned methodology and resources, the conventionalist nature of the two immigrant nations is aimed to be presented as the unifying factor in the way that Mexicans in the US and Turks in Germany reflect and protect their cultures in the form of language, festivals, and food.

Keywords: assimilation, culture, German-Turks, immigration, Mexican Americans

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1326 Early Childhood Education for Bilingual Children: A Cross-Cultural Examination

Authors: Dina C. Castro, Rossana Boyd, Eugenia Papadaki

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Immigration within and across continents is currently a global reality. The number of people leaving their communities in search for a better life for them and their families has increased dramatically during the last twenty years. Therefore, young children of the 21st century around the World are growing up in diverse communities, exposed to many languages and cultures. One consequence of these migration movements is the increased linguistic diversity in school settings. Depending on the linguistic history and the status of languages in the communities (i.e., minority-majority; majority-majority) the instructional approaches will differ. This session will discuss how bilingualism is addressed in early education programs in both minority-majority and majority-majority language communities, analyzing experiences in three countries with very distinct societal and demographic characteristics: Peru (South America), the United States (North America), and Italy (European Union). The ultimate goal is to identify commonalities and differences across the three experiences that could lead to a discussion of bilingualism in early education from a global perspective. From Peru, we will discuss current national language and educational policies that have lead to the design and implementation of bilingual and intercultural education for children in indigenous communities. We will also discuss how those practices are being implemented in preschool programs, the progress made and challenges encountered. From the United States, we will discuss the early education of Spanish-English bilingual preschoolers, including the national policy environment, as well as variations in language of instruction approaches currently being used with these children. From Italy, we will describe early education practices in the Bilingual School of Monza, in northern Italy, a school that has 20 years promoting bilingualism and multilingualism in education. While the presentations from Peru and the United States will discuss bilingualism in a majority-minority language environment, this presentation will lead to a discussion on the opportunities and challenges of promoting bilingualism in a majority-majority language environment. It is evident that innovative models and policies are necessary to prevent inequality of opportunities for bilingual children beginning in their earliest years. The cross-cultural examination of bilingual education experiences for young children in three part of the World will allow us to learn from our success and challenges. The session will end with a discussion of the following question: To what extent are early care and education programs being effective in promoting positive development and learning among all children, including those from diverse language, ethnic and cultural backgrounds? We expect to identify, with participants to our session, a set of recommendations for policy and program development that could ensure access to high quality early education for all bilingual children.

Keywords: early education for bilingual children, global perspectives in early education, cross-cultural, language policies

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1325 A Corpus-Linguistic Analysis of Online Iranian News Coverage on Syrian Revolution

Authors: Amaal Ali Al-Gamde

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The Syrian revolution is a major issue in the Middle East, which draws in world powers and receives a great focus in international mass media since 2011. The heavy global reliance on cyber news and digital sources plays a key role in conveying a sense of bias to a wide range of online readers. Thus, based on the assumption that media discourse possesses ideological implications, this study investigates the representation of Syrian revolution in online media. The paper explores the discursive constructions of anti and pro-government powers in Syrian revolution in 1000,000-word corpus of Fars online reports (an Iranian news agency), issued between 2013 and 2015. Taking a corpus assisted discourse analysis approach, the analysis investigates three types of lexicosemantic relations, the semantic macrostructures within which the two social actors are framed, the lexical collocations characterizing the news discourse and the discourse prosodies they tell about the two sides of the conflict. The study utilizes computer-based approaches, sketch engine and AntConc software to minimize the bias of the subjective analysis. The analysis moves from the insights of lexical frequencies and keyness scores to examine themes and the collocational patterns. The findings reveal the Fars agency’s ideological mode of representations in reporting events of Syrian revolution in two ways. The first is by stereotyping the opposition groups under the umbrella of terrorism, using words such as (law breakers, foreign-backed groups, militant groups, terrorists) to legitimize the atrocities of security forces against protesters and enhance horror among civilians. The second is through emphasizing the power of the government and depicting it as the defender of the Arab land by foregrounding the discourse of international conspiracy against Syria. The paper concludes discussing the potential importance of triangulating corpus linguistic tools with critical discourse analysis to elucidate more about discourses and reality.

Keywords: discourse prosody, ideology, keyness, semantic macrostructure

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1324 Cairo’s Inferno of Pollution: Ecocritical Reading of “The Breeze Hunter” by Egyptian Writer Mohammed Makhzangi

Authors: Mila Fantinelli

Abstract:

Cairo is the perfect modern representation of a living hell between rising temperatures and failing architecture. The works of Egyptian writer Mohamed Makhzangi may prove to add more depth to the debate that surrounds the topic of pollution in Arab literature. This Egyptian writer, who studied medicine and psychiatry before dedicating his life to writing, sheds indeed further light on the ecological condition of Cairo. In relation to this, the short story “The breeze hunter” (2018) tackles the topic of “environmental architecture”, citing the research of Hassan Fathy in “Architecture for the Poor: An Experiment in Rural Egypt” which provides examples from history of inventions to counter the effects of the hot weather. Specifically, the main character of the story is a man living in Cairo in a small apartment, which turns into a living hell in the summer season because of the high temperatures. Catastrophic urban planning, therefore, prevents the mitigation of the torrid climate but rather worsens it. Makhzangi indeed refers to the environmental issue of pollution caused by the excessive number of air conditioners, which transform Cairo into an infernal island of heat while our country becomes warmer with the passing of time. His description of the city already intersects ecocriticism and environmental issues, tackling the topic of pollution inside of cities and the impact of climate change, of which Cairo is a perfect example. History has indeed provided ways in order to reduce the heat inside houses. Yet, these have all been ignored. As a result, through the teachings of Hassan Fathy, the narrator of the story builds an opening in the house to catch the natural breeze coming from the north. He, therefore, becomes the breeze hunter of Mansoura. However, polluted waves interrupt this brief rest, thus leading to a worsening of his conditions, leading to him suffering from the effects of crowding and the consequences of climate change and pollution. Makhzangi, therefore, reflects on how architecture and urbanism affect the psychological sanity of people and how the situation is worsened by the catastrophic consequences of climate change and pollution.

Keywords: ecocriticism, Arabic literature, pollution, environmental architecture, crowding

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1323 The Development of an Agent-Based Model to Support a Science-Based Evacuation and Shelter-in-Place Planning Process within the United States

Authors: Kyle Burke Pfeiffer, Carmella Burdi, Karen Marsh

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The evacuation and shelter-in-place planning process employed by most jurisdictions within the United States is not informed by a scientifically-derived framework that is inclusive of the behavioral and policy-related indicators of public compliance with evacuation orders. While a significant body of work exists to define these indicators, the research findings have not been well-integrated nor translated into useable planning factors for public safety officials. Additionally, refinement of the planning factors alone is insufficient to support science-based evacuation planning as the behavioral elements of evacuees—even with consideration of policy-related indicators—must be examined in the context of specific regional transportation and shelter networks. To address this problem, the Federal Emergency Management Agency and Argonne National Laboratory developed an agent-based model to support regional analysis of zone-based evacuation in southeastern Georgia. In particular, this model allows public safety officials to analyze the consequences that a range of hazards may have upon a community, assess evacuation and shelter-in-place decisions in the context of specified evacuation and response plans, and predict outcomes based on community compliance with orders and the capacity of the regional (to include extra-jurisdictional) transportation and shelter networks. The intention is to use this model to aid evacuation planning and decision-making. Applications for the model include developing a science-driven risk communication strategy and, ultimately, in the case of evacuation, the shortest possible travel distance and clearance times for evacuees within the regional boundary conditions.

Keywords: agent-based modeling for evacuation, decision-support for evacuation planning, evacuation planning, human behavior in evacuation

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1322 Interaction between the Rio Conventions on Climate and Biodiversity: Analysis of the Integration of Ecosystem-Based Approaches and Nature-Based Solutions into the UNFCCC

Authors: Dieudonne Mevono Mvogo

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The Intergovernmental Platform on Biodiversity and Ecosystem Services (IPBES)-Intergovernmental Panel on Climate Change (IPCC) co-sponsored workshop report suggests that climate change and biodiversity loss are two of the most pressing issues of the Anthropocene. Research establishes the interconnection between climate change and biodiversity. On the one hand, the impact of climate change on biodiversity loss – 14 % over the past century – is projected to surpass other threats – land and sea use 34 % and direct exploitation of species 23 % – during the 21st century. Response measures to climate change also affect biodiversity negatively or positively. On the other hand, actions to halt or reverse biodiversity loss can enhance land and ocean capacity for carbon sequestration. These actions can also promote adaptation by ensuring adaptive capacity. This systemic interaction between climate change and biodiversity affects the human quality of life. The United Nations Secretariat's report entitled 'Gaps in international environmental law and environment-related instruments: towards a global pact for the environment,' released in 2018, states that cooperation and mutual support among agreements dealing with climate change, the protection of the marine environment, freshwater resources and hazardous waste are indispensable for the effective implementation of the Convention on the Biological Diversity (CBD). Since biodiversity is being lost at an alarming rate, this study aims to evaluate the cooperative framework for the coherence and coordination between climate change and biodiversity regimes to provide co-benefits for climate and biodiversity crises. It questions the potential improvement regarding integrating ecosystem-based approaches and nature-based solutions – promoted by the CBD – into the United Nations Framework Convention on Climate Change (UNFCCC).

Keywords: rio conventions, climate change, biodiversity, cooperative framework, ecosystem-based approaches, nature-based solutions

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1321 The Impact of Covid-19 on Anxiety Levels in the General Population of the United States: An Exploratory Survey

Authors: Amro Matyori, Fatimah Sherbeny, Askal Ali, Olayiwola Popoola

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Objectives: The study evaluated the impact of COVID-19 on anxiety levels in the general population in the United States. Methods: The study used an online questionnaire. It adopted the Generalized Anxiety Disorder Assessment (GAD-7) instrument. It is a self-administered scale with seven items used as a screening tool and severity measure for generalized anxiety disorder. The participants rated the frequency of anxiety symptoms in the last two weeks on a Likert scale, which ranges from 0-3. Then the item points are summed to provide the total score. Results: Thirty-two participants completed the questionnaire. Among them, 24 (83%) females and 5 (17%) males. The age range of 18-24-year-old represented the most respondents. Only one of the participants tested positive for the COVID-19, and 39% of them, one of their family members, friends, or colleagues, tested positive for the coronavirus. Moreover, 10% have lost a family member, a close friend, or a colleague because of COVID-19. Among the respondents, there were ten who scored approximately five points on the GAD-7 scale, which indicates mild anxiety. Furthermore, eight participants scored 10 to 14 points, which put them under the category of moderate anxiety, and one individual who was categorized under severe anxiety scored 15 points. Conclusions: It is identified that most of the respondents scored the points that put them under the mild anxiety category during the COVID-19 pandemic. It is also noticed that severe anxiety was the lowest among the participants, and people who tested positive and/or their family members, close friends, and colleagues were more likely to experience anxiety. Additionally, participants who lost friends or family members were also at high risk of anxiety. It is obvious the COVID-19 outcomes and too much thinking about the pandemic put people under stress which led to anxiety. Therefore, continuous assessment and monitoring of psychological outcomes during pandemics will help to establish early well-informed interventions.

Keywords: anxiety and covid-19, covid-19 and mental health outcomes, influence of covid-19 on anxiety, population and covid-19 impact on mental health

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1320 Revolutionizing Autonomous Trucking Logistics with Customer Relationship Management Cloud

Authors: Sharda Kumari, Saiman Shetty

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Autonomous trucking is just one of the numerous significant shifts impacting fleet management services. The Society of Automotive Engineers (SAE) has defined six levels of vehicle automation that have been adopted internationally, including by the United States Department of Transportation. On public highways in the United States, organizations are testing driverless vehicles with at least Level 4 automation which indicates that a human is present in the vehicle and can disable automation, which is usually done while the trucks are not engaged in highway driving. However, completely driverless vehicles are presently being tested in the state of California. While autonomous trucking can increase safety, decrease trucking costs, provide solutions to trucker shortages, and improve efficiencies, logistics, too, requires advancements to keep up with trucking innovations. Given that artificial intelligence, machine learning, and automated procedures enable people to do their duties in other sectors with fewer resources, CRM (Customer Relationship Management) can be applied to the autonomous trucking business to provide the same level of efficiency. In a society witnessing significant digital disruptions, fleet management is likewise being transformed by technology. Utilizing strategic alliances to enhance core services is an effective technique for capitalizing on innovations and delivering enhanced services. Utilizing analytics on CRM systems improves cost control of fuel strategy, fleet maintenance, driver behavior, route planning, road safety compliance, and capacity utilization. Integration of autonomous trucks with automated fleet management, yard/terminal management, and customer service is possible, thus having significant power to redraw the lines between the public and private spheres in autonomous trucking logistics.

Keywords: autonomous vehicles, customer relationship management, customer experience, autonomous trucking, digital transformation

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1319 Yield Loss Estimation Using Multiple Drought Severity Indices

Authors: Sara Tokhi Arab, Rozo Noguchi, Tofeal Ahamed

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Drought is a natural disaster that occurs in a region due to a lack of precipitation and high temperatures over a continuous period or in a single season as a consequence of climate change. Precipitation deficits and prolonged high temperatures mostly affect the agricultural sector, water resources, socioeconomics, and the environment. Consequently, it causes agricultural product loss, food shortage, famines, migration, and natural resources degradation in a region. Agriculture is the first sector affected by drought. Therefore, it is important to develop an agricultural drought risk and loss assessment to mitigate the drought impact in the agriculture sector. In this context, the main purpose of this study was to assess yield loss using composite drought indices in the drought-affected vineyards. In this study, the CDI was developed for the years 2016 to 2020 by comprising five indices: the vegetation condition index (VCI), temperature condition index (TCI), deviation of NDVI from the long-term mean (NDVI DEV), normalized difference moisture index (NDMI) and precipitation condition index (PCI). Moreover, the quantitative principal component analysis (PCA) approach was used to assign a weight for each input parameter, and then the weights of all the indices were combined into one composite drought index. Finally, Bayesian regularized artificial neural networks (BRANNs) were used to evaluate the yield variation in each affected vineyard. The composite drought index result indicated the moderate to severe droughts were observed across the Kabul Province during 2016 and 2018. Moreover, the results showed that there was no vineyard in extreme drought conditions. Therefore, we only considered the severe and moderated condition. According to the BRANNs results R=0.87 and R=0.94 in severe drought conditions for the years of 2016 and 2018 and the R= 0.85 and R=0.91 in moderate drought conditions for the years of 2016 and 2018, respectively. In the Kabul Province within the two years drought periods, there was a significate deficit in the vineyards. According to the findings, 2018 had the highest rate of loss almost -7 ton/ha. However, in 2016 the loss rates were about – 1.2 ton/ha. This research will support stakeholders to identify drought affect vineyards and support farmers during severe drought.

Keywords: grapes, composite drought index, yield loss, satellite remote sensing

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1318 Outcomes-Based Qualification Design and Vocational Subject Literacies: How Compositional Fallacy Short-Changes School-Leavers’ Literacy Development

Authors: Rose Veitch

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Learning outcomes-based qualifications have been heralded as the means to raise vocational education and training (VET) standards, meet the needs of the changing workforce, and establish equivalence with existing academic qualifications. Characterized by explicit, measurable performance statements and atomistically specified assessment criteria, the outcomes model has been adopted by many VET systems worldwide since its inception in the United Kingdom in the 1980s. Debate to date centers on how the outcomes model treats knowledge. Flaws have been identified in terms of the overemphasis of end-points, neglect of process and a failure to treat curricula coherently. However, much of this censure has evaluated the outcomes model from a theoretical perspective; to date, there has been scant empirical research to support these criticisms. Various issues therefore remain unaddressed. This study investigates how the outcomes model impacts the teaching of subject literacies. This is of particular concern for subjects on the academic-vocational boundary such as Business Studies, since many of these students progress to higher education in the United Kingdom. This study also explores the extent to which the outcomes model is compatible with borderline vocational subjects. To fully understand if this qualification model is fit for purpose in the 16-18 year-old phase, it is necessary to investigate how teachers interpret their qualification specifications in terms of curriculum, pedagogy and assessment. Of particular concern is the nature of the interaction between the outcomes model and teachers’ understandings of their subject-procedural knowledge, and how this affects their capacity to embed literacy into their teaching. This present study is part of a broader doctoral research project which seeks to understand if and how content-area, disciplinary literacy and genre approaches can be adapted to outcomes-based VET qualifications. This qualitative research investigates the ‘what’ and ‘how’ of literacy embedding from the perspective of in-service teacher development in the 16-18 phase of education. Using ethnographic approaches, it is based on fieldwork carried out in one Further Education college in the United Kingdom. Emergent findings suggest that the outcomes model is not fit for purpose in the context of borderline vocational subjects. It is argued that the outcomes model produces inferior qualifications due to compositional fallacy; the sum of a subject’s components do not add up to the whole. Findings indicate that procedural knowledge, largely unspecified by some outcomes-based qualifications, is where subject-literacies are situated, and that this often gets lost in ‘delivery’. It seems that the outcomes model provokes an atomistic treatment of knowledge amongst teachers, along with the privileging of propositional knowledge over procedural knowledge. In other words, outcomes-based VET is a hostile environment for subject-literacy embedding. It is hoped that this research will produce useful suggestions for how this problem can be ameliorated, and will provide an empirical basis for the potential reforms required to address these issues in vocational education.

Keywords: literacy, outcomes-based, qualification design, vocational education

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1317 Rescaling Global Health and International Relations: Globalization of Health in a Low Security Environment

Authors: F. Argurio, F. G. Vaccaro

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In a global environment defined by ever-increasing health issues, in spite of the progress made by modern medicine, this paper seeks to readdress the question of global health in an international relations perspective. The research hypothesis is: the lower the security environment, the higher the spread of communicable diseases. This question will be channeled by re-scaling the connotation of 'global' and 'international' dimension through the theoretical lens of glocalization, a theory by Bauman that starts its analysis from simple systems to get to the most complex ones. Glocalization theory will be operationalized by analyzing health in an armed-conflict context. In this respect, the independent variable 'low security environment' translates into the cases of Syria and Yemen, which provide a clear example of the all-encompassing nature of conflict on national health and the effects on regional development. In fact, Syria and Yemen have been affected by poliomyelitis and cholera outbreaks respectively. The dependent variable will be constructed on said communicable diseases which belong to the families of sanitation-related and vaccine-preventable diseases. The research will be both qualitative and quantitative, based on primary (interviews) and secondary (WHO and other NGO’s reports) sources. The methodology is based on the assessment of the vaccine coverage and case-analysis in time and space using epidemiological data. Moreover, local health facilities’ functioning and efficiency will be studied. The article posits that the intervention and cooperation of international organizations with the local authorities becomes crucial to provide the local populations with their primary health needs. In Yemen, the majority of fatal cholera cases were in the regions controlled by the Houthi rebels, not officially accredited by the International Community. Similarly, the polio outbreak in Syria primarily affected the areas not controlled by the Syrian Arab Republic forces, recognized as the leading interlocutor by the WHO. The jeopardized possibilities to access these countries have been pivotal to the determining the problem in controlling sanitation-related and vaccine preventable diseases. This represents a potential threat to global health.

Keywords: health in conflict-affected areas, cholera, polio, Yemen, Syria, glocalization

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1316 Trump’s COVID-19 Discourse: Downgrading the Fundamentals of the Political Fair Play

Authors: Gustavo Naranjo Maroto, Dolores Fernandez Martinez

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Context has always been essential to understand any reaction from every human being, and words, whether written or spoken, are definitely a powerful representative sample of human reaction. This study starts with an accurate breakdown of the context in which the current president of the US, Mr. Donald J. Trump is conveying his discourses in order to be able to judge them from a critical discourse analysis point of view. The present world’s scenario with a pandemic disease in form of Covid-19 that is threatening the world and certainly putting at risk the so called 'Welfare State', the role of the United States as the first superpower on earth nowadays, the very peculiar profile of President Trump not only as a politician but as a persona, and the fact of being on the verge of a very controversial presidential elections are without doubt a great and undeniable opportunity for the implementation of the critical discourse analysis methodology. Hence, this research will primarily analyze in detail some of the most interesting discourses delivered by Trump in different media since the very beginning of the outbreak of the coronavirus pandemic in the United States of America (February, 2020), sadly very often downplayed by President Trump, until the final result of the upcoming presidential election scheduled for Tuesday, November 3, 2020, where the political discourse has been dramatically downgraded to a very dangerous state, putting in jeopardy the fundamentals of the political fair play in terms of speech. Finally, the study will hopefully conclude with the final outcome of the data analyzed, allowing to picture how significant the context can be concerning linguistics on the one hand, in terms of shaping or altering the message that the issuer thought to convey in the first place, and on the other hand, generously assessing to what extend the recipients of the message are influenced by the message in terms of receptiveness.

Keywords: Covid-19, critical discourse analysis, Donald J. Trump, political discourse

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1315 From Al Capone to Silk Road: Money Laundering Regulation for Cryptocurrency on the Horizon

Authors: Chinelle van der Westhuizen

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The introduction of cryptocurrencies as an alternative payment system have placed governments in a challenging position in relation to the regulatory status of cryptocurrencies and the money laundering activities associated with it. In April 2018, the Australian government amended its Anti-Money Laundering laws to regulate digital currency exchanges in an attempt to regulate money laundering activities and the introduction of ‘know-your-customer’ policies within the digital currency sector. Part one of this paper explores the use of cryptocurrencies for money laundering purposes and its significance to money launderers. Part two studies the efficacy of the current Australian Anti-Money Laundering laws and whether more can be done on a regulatory level. This paper will, therefore, highlight recent court decisions and legislation in terms of money laundering activities within these alternative payment systems in Australia and the United Kingdom. Part three of the paper will further analyze recent case studies by the Australian Transaction Reports and Analysis Centre and the Office for Professional Body Anti-Money Laundering Supervision in the United Kingdom as the regulatory bodies for money laundering activities. The case studies and research will explore the legal disputes and future regulation concerning the use of cryptocurrencies and money laundering on a national as well as international level. This paper intends to highlight that although cryptocurrency is viewed as an innovative global phenomenon and an alternative method of payment, there are a number of legal issues associated with its use that indicate the need for regulatory reform. It is recommended in this paper that the Financial Action Task Force, International Monetary Fund as well as concerned governments have ongoing discussions on these regulatory issues and how to address it appropriately, whether through legislation or universal guidelines. Therefore, the conclusion of this paper will emphasize the benefits of a regulatory regime for money laundering activities within the cryptocurrency space and that the lack of such a regime may be detrimental to countries.

Keywords: cryptocurrency, know-your-customer policy, money laundering, regulation

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1314 Violent Conflict and the Protection of Women from Sex and Gender-Based Violence: A Third World Feminist Critique of the United Nations Women, Peace, and Security Agenda

Authors: Seember Susan Aondoakura

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This paper examines the international legal framework established to address the challenges women and girls experience in situations of violent conflict. The United Nations (UN) women, peace, and security agenda (hereafter WPS agenda, the Agenda) aspire to make wars safer for women. It recognizes women's agency in armed conflict and their victimization and formulates measures for their protection. The Agenda also acknowledges women's participation in conflict transformation and post-conflict reconstruction. It also calls for the involvement of women in conflict transformation, encourages the protection of women from sex and gender-based violence (SGBV), and provides relief and recovery from conflict-related SGBV. Using Third World Critical Feminist Theory, this paper argues that the WPS agenda overly focus on the protection of women from SGBV occurring in the less developed and conflict-ridden states in the global south, obscures the complicity of western states and economies to the problem, and silences the privileges that such states derive from war economies that continue to fuel conflict. This protectionist approach of the UN also obliterates other equally pressing problems in need of attention, like the high rates of economic degradation in conflict-ravaged societies of the global south. Prioritising protection also 'others' the problem, obliterating any sense of interconnections across geographical locations and situating women in the less developed economies of the global south as the victims and their men as the perpetrators. Prioritising protection ultimately situates western societies as saviours of Third World women with no recourse to their role in engendering and sustaining war. The paper demonstrates that this saviour mentality obliterates chances of any meaningful coalition between the local and the international in framing and addressing the issue, as solutions are formulated from a specific lens—the white hegemonic lens.

Keywords: conflict, protection, security, SGBV

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1313 Analyzing the Impact of the COVID-19 Pandemic on Clinicians’ Perceptions of Resuscitation and Escalation Decision-Making Processes: Cross-Sectional Survey of Hospital Clinicians in the United Kingdom

Authors: Michelle Hartanto, Risheka Suthantirakumar

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Introduction Staff redeployment, increased numbers of acutely unwell patients requiring resuscitation decision-making conversations, visiting restrictions, and varying guidance regarding resuscitation for patients with COVID-19 disrupted clinicians’ management of resuscitation and escalation decision-making processes. While it was generally accepted that the COVID-19 pandemic disturbed numerous aspects of the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) process in the United Kingdom, a process which establishes a patient’s CPR status and treatment escalation plans, the impact of the pandemic on clinicians’ attitudes towards these resuscitation and decision-making conversations was unknown. This was the first study to examine the impact of the COVID-19 pandemic on clinicians’ knowledge, skills, and attitudes towards the ReSPECT process. Methods A cross-sectional survey of clinicians at one acute teaching hospital in the UK was conducted. A questionnaire with a defined five-point Likert scale was distributed and clinicians were asked to recall their pre-pandemic views on ReSPECT and report their current views at the time of survey distribution (May 2020, end of the first COVID-19 wave in the UK). Responses were received from 171 clinicians, and self-reported views before and during the pandemic were compared. Results Clinicians reported they found managing ReSPECT conversations more challenging during the pandemic, especially when conducted over the telephone with relatives, and they experienced an increase in negative emotions before, during, and after conducting ReSPECT conversations. Our findings identified that due to the pandemic there was now a need for clinicians to receive training and support in conducting resuscitation and escalation decision-making conversations over the telephone with relatives and managing these processes.

Keywords: cardiopulmonary resuscitation, COVID-19 pandemic, DNACPR discussion, education, recommended summary plan for emergency care and treatment, resuscitation order

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1312 Accountability Mechanisms of Leaders and Its Impact on Performance and Value Creation: Comparative Analysis (France, Germany, United Kingdom)

Authors: Bahram Soltani, Louai Ghazieh

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The responsibility has a big importance further to the financial crisis and the various pressures, which companies face their duties. The main objective of this study is to explain the variation of mechanisms of the responsibility of the manager in the company among the advanced capitalist economies. Then we study the impact of these mechanisms on the performance and the value creation in European companies. To reach our goal, we established a final sample composed on average of 284 French, British and German companies quoted in stock exchanges with 2272 annual reports examined during the period from 2005 to 2012. We examined at first the link of causalities between the determining-mechanisms bound to the company such as the characteristics of the board of directors, the composition of the shareholding and the ethics of the company on one side and the profitability of the company on the other side. The results show that the smooth running of the board of directors and its specialist committees are very important determinants of the responsibility of the managers who impact positively the performance and the value creation in the company. Furthermore, our results confirm that the presence of a solid ethical environment within the company will be effective to increase the probability that the managers realize ethical choices in the organizational decision-making. At the second time, we studied the impact of the determining mechanisms bound to the function and to the profile of manager to know its relational links, his remuneration, his training, his age and his experiences about the performance and the value creation in the company. Our results highlight the existence of a negative relation between the relational links of the manager, his very high remuneration and the general profitability of the company. This study is a contribution to the literature on the determining mechanisms of company director's responsibility (Accountability). It establishes an empirical and comparative analysis between three influential countries of Europe, to know France, the United Kingdom and Germany.

Keywords: leaders, company’s performance, accountability mechanisms, corporate governance, value creation of firm, financial crisis

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1311 Black Masculinity, Media Stereotyping And Its Influence on Policing in the United States: A Functionalist Perspective

Authors: Jack Santiago Monell

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In America, misrepresentations of black males have been perpetuated throughout the history of popular culture. Because of these narratives, varying communities have developed biases and stereotypes about what black male masculinity represents and more importantly, how they respond to them. The researcher explored the perspectives of police officers in the following states, Maryland, Pennsylvania, and North Carolina. Because of the nature of police and community relations, and national attention to high profile cases, having officers provide context into how black males are viewed from their lens, was critical while expanding on the theoretical explanations to describe attitudes towards police confrontations. As one of the objectives was to identify specific themes relevant to why police officers may view African American males differently, hence, responding more aggressively, this proved to be the most beneficial method of initial analysis to identify themes. The following nodes (appearance, acting suspicious/ troublesome behavior, upbringing about black males, excessive force) were identified to analyze the transcripts to discern associations. The data was analyzed through NVivo 11, and several themes resulted to elaborate on the data received. In analyzing the data, four themes were identified: appearance, acting suspicious/ troublesome behavior, upbringing about black males, and excessive force. The data conveyed that continuous stereotypes about African American men will ultimately result in excessive use of force or pervasive shootings, albeit the men are armed or unarmed. African American males are consistently targeted because of their racial makeup and appearance over any other probable circumstances. As long as racial bias and stereotypical practices continue in policing, African American males will endlessly be unjustly targeted and at times, the victims of violent encounters with police officers in the United States.

Keywords: African American males, police perceptions, masculinity, popular culture

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1310 Ethics and Military Defections in Nonviolent Resistance Campaigns

Authors: Adi Levy

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Military and security personnel defections during nonviolent resistance (NVR) campaigns are recognized as an effective way of undermining the regime’s power, but they also may generate moral dilemmas that contradict the moral standing of NVR tactics. NVR campaigns have been primarily praised for their adherence to moral and legal norms, yet some of NVR tactics raise serious ethical concerns. This paper focuses on NVR tactics that seek to promote defections and disobedience within military and security personnel to sustain their campaign. Academic literature regarding NVR tactics indicates that compared to violent forms of resistance, defections are more likely to occur when security forces confront nonviolent activists. Indeed, defections play a strategically fundamental role in nonviolent campaigns, particularly against authoritarian regimes, as it enables activists to undermine the regime’s central pillars of support. This study examines the events of the Arab Spring and discusses the ethical problems that arise in nonviolent activists’ promotion of defections and disobedience. The cases of Syria and Egypt suggest that the strategic promotion of defections and disobedience was significantly effective in sustaining the campaign. Yet, while such defections enhance nonviolent activists’ resilience, how they are promoted can be morally contentious and the consequences can be dire. Defections are encouraged by social, moral and emotional appeals that use the power disparities between unarmed civilians and powerful regimes to affect soldiers and security personnel’s process of decision-making. In what is commonly referred to as dilemma action, nonviolent activists deliberately entangle security forces in a moral dilemma that compels them to follow a moral code to protect unarmed civilians. In this way, activists sustain their struggle and even gain protection. Nonviolent activists are likely to be completely defeated when confronted with armed forces. Therefore they rely on the military and security personnel’s moral conscious of convincing them to refrain from using force against them. While this is effective, it also leaves soldiers and security forces exposed to the implications and punishments that might follow their disobedience or defection. As long as they remain nonviolent, activists enjoy civilian immunity despite using morally contentious tactics. But the severe implications brought upon defectors. As a result, demand a deep examination of this tactic’s moral permissibility and a discussion that assesses culpability for the moral implications of its application.

Keywords: culpability, defections, nonviolence, permissibility

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1309 Towards a Framework for Evaluating Scientific Efficiency of World-Class Universities

Authors: Veljko Jeremic, Milica Kostic Stankovic, Aleksandar Markovic, Milan Martic

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Evaluating the efficiency of decision making units has been frequently elaborated on in numerous publications. In this paper, the theoretical framework for a novel method of Distance Based Analysis (DBA) is presented. In addition, the method is performed on a sample of the ARWU’s top 54 Universities of the United States, the findings of which clearly demonstrate that the best ranked Universities are far from also being the most efficient.

Keywords: evaluating efficiency, distance based analysis, ranking of universities, ARWU

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1308 Influence of Online Media on Governance in Nigeria: The United States-Based Sahara Reporters as a Case Study

Authors: Sheriff Folarin, Oluwafunke Folarin, Hadassah Hussaini, Victor Jubril, Olaniyi Ayodele

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Using a famous, unrestrained and fiery United States-based, Nigerian-owned Sahara Reporters as a case study, this paper examined the impact of online-based media on governance in Nigeria. The discourse is premised on the thesis that the internet has changed the face of journalism and that the mainstream but online-based media have made journalism more participatory than ever. Everyone who has something to say finds it easy to say it quickly and conveniently, unhinged or without being censored. This has made online journalism very popular and the number of online-based news platforms to be on the increase. As these platforms have given the citizens a means to interact and added to the content of the news, they have also succeeded in promoting partisanship. It thus becomes necessary to study the impact of the rabid news platform, Sahara Reporters, on governance in Africa’s biggest democracy, Nigeria. Few studies have examined the impact on governance of mainstream-online media platforms and those studies that did, have only focused on social media, such as Facebook and Twitter. This paper is a product of a bigger study, in which the research design entailed semi-structured interviews with participants from different sectors of the society and an analysis of contents from the Sahara Reporters website, from which data were collected. The findings revealed that through uncensored reporting and citizen participation on the platform of Sahara Reporters, there had been a significant people influence on governance in Nigeria, with government at two levels (national and state) sometimes shifting or yielding grounds, particularly from 2011-2016. The study also recognized the presence of counter-forces in the online community who want to discredit the information on the site. Through the lens of media dependency theory, the study concluded that the public now increasingly depends on online news media for information and the more news these media provide, the more the people depend on it, making it easy for them to influence governance.

Keywords: governance, media, online news, Sahara reporters

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1307 Dietary Patterns and Adherence to the Mediterranean Diet among Breast Cancer Female Patients in Lebanon: A Cross-Sectional Study

Authors: Yasmine Aridi, Lara Nasreddine, Maya Khalil, Arafat Tfayli, Anas Mugharbel, Farah Naja

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Breast cancer is the most commonly diagnosed cancer site among women worldwide and the second most common cause of cancer mortality. Breast cancer rates differ vastly between geographical areas, countries, and within the same country. In Lebanon, the proportion of breast cancer to all other sites of tumor is 38.2%; these rates are still lower than those observed worldwide, but remain the highest among Arab countries. Studies and evidence based reviews show a strong association between breast cancer development and prognosis and dietary habits, specifically the Mediterranean diet (MD). As such, the aim of this study is to examine dietary patterns and adherence to the MD among a sample of 182 breast cancer female patients in Beirut, Lebanon. Subjects were recruited from two major hospitals; a private medical center and a public hospital. All subjects were administered two questionnaires: socio- demographics and Mediterranean diet adherence. Five Mediterranean scores were calculated: MS, MSDPS, PMDI, PREDIMED and DDS. The mean age of the participants was 53.78 years. The overall adherence to the Mediterranean diet (MD) was low since the sample means of 3 out of the 5 calculated scores were less than the scores’ medians. Given that 4 out of the 5 Mediterranean scores significantly varied between the recruitment sites, women in the private medical center were found to adhere more to the MD. Our results also show that the majority of the sample population’s intakes are exceeding the recommendations for total and saturated fat, while meeting the requirements for fiber, EPA, DHA and Linolenic Acid. Participants in the private medical center were consuming significantly more calories, carbohydrates, fiber, sugar, Lycopene, Calcium, Iron and Folate and less fat. After conducting multivariate linear regression analyses, the following significant results were observed: positive associations between MD (CPMDI, PREDIMED) and monthly income & current state of health, while negative associations between MD (MSDPS, PREDIMED) and age & employment status. Our findings indicated a low overall adherence to the MD and identified factors associated with it; which suggests a need to address dietary habits among BC patients in Lebanon, specifically encouraging them to adhere to their traditional Mediterranean diet.

Keywords: Adherence, Breast cancer, Dietary patterns, Mediterranean diet, Nutrition

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1306 Prevalence of Sexually Transmitted Infections in Pregnancy, Preterm Birth, Low Birthweight, and the Importance of Prenatal Care: Data from the 2020 United States Birth Certificate

Authors: Anthony J. Kondracki, Bonzo Reddick, Jennifer L. Barkin

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Background: Many pregnancies in the United States are affected each year with the most common sexually transmitted infections (STIs), including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Treponema pallidum (TP, syphilis), and the rate of congenital syphilis has reached a 20-year high. We sought to estimate the prevalence of CT, NG, and TP in pregnancy and the risk of preterm birth (PTB) (<37 weeks gestation) and low birthweight (LBW) (<2500g) deliveries according to utilization of prenatal care (PNC) during the COVID-19 pandemic. Methods: This study was based on the 2020 National Center for Health Statistics (NCHS) Natality File restricted to singleton births (N=3,512,858). We estimated the prevalence of CT, NG, TP, PTBand LBW across timing and the number of prenatal care (PNC) visits attended. In multivariable logistic regression models, adjusted odds ratios of PTB and LBW were assessed according to STIs and PNC status. E-values, based on effect size estimates and the lower bound of the 95% confidence intervals (CIs) of the association, examined the potential impact of unmeasured confounding. Results: CT (1.8%) was most prevalent in pregnancy, followed by NG (0.3%) and TP (0.1%). The strongest predictors of PTB and LBW were maternal NG (12.2% and 12.1%, respectively), late initiation/no PNC (8.5% and 7.6%, respectively), and ≤10 prenatal visits (13.1% and 10.3%, respectively). The odds of PTB and LBW were 2.5- to 3-fold greater for each STI in women who received ≤10 compared to >10 prenatal visits. E-values demonstrated the minimum strength of potential unmeasured confounding necessary to explain away observed associations. Conclusions: Timely initiation and receipt of recommended number of prenatal visits benefits screening and treatment of all women for STIs, including NG to substantially reduce infant morbidity and mortality related to PTB and LBW among infants born during the COVID-19 pandemic.

Keywords: COVID-19 pandemic, sexually transmitted infections, preterm birth, low birthweight, prenatal care

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