Search results for: United States foreign policy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7886

Search results for: United States foreign policy

806 Energy Consumption and Economic Growth Nexus: a Sustainability Understanding from the BRICS Economies

Authors: Smart E. Amanfo

Abstract:

Although the exact functional relationship between energy consumption and economic growth and development remains a complex social science, there is a sustained growing of agreement among energy economists and the likes on direct or indirect role of energy use in the development process, and as sustenance for many of societal achieved socio-economic and environmental developments in any economy. According to OECD, the world economy will double by 2050 in which the two members of BRICS (Brazil, Russia, India, China and South Africa) countries: China and India lead. There is a global apprehension that if countries constituting the epicenter of the present and future economic growth follow the same trajectory as during and after Industrial Revolution, involving higher energy throughputs, especially fossil fuels, the already known and models predicted threats of climate change and global warming could be exacerbated, especially in the developing economies. The international community’s challenge is how to address the trilemma of economic growth, social development, poverty eradication and stability of the ecological systems. This paper aims at providing the estimates of economic growth, energy consumption, and carbon dioxide emissions using BRICS members’ panel data from 1980 to 2017. The preliminary results based on fixed effect econometric model show positive significant relationship between energy consumption and economic growth. The paper further identified a strong relationship between economic growth and CO2 emissions which suggests that the global agenda of low-carbon-led growth and development is not a straight forward achievable The study therefore highlights the need for BRICS member states to intensify low-emissions-based production and consumption policies, increase renewables in order to avoid further deterioration of climate change impacts.

Keywords: BRICS, sustainability, sustainable development, energy consumption, economic growth

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805 The Dynamic Nexus of Public Health and Journalism in Informed Societies

Authors: Ali Raza

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The dynamic landscape of communication has brought about significant advancements that intersect with the realms of public health and journalism. This abstract explores the evolving synergy between these fields, highlighting how their intersection has contributed to informed societies and improved public health outcomes. In the digital age, communication plays a pivotal role in shaping public perception, policy formulation, and collective action. Public health, concerned with safeguarding and improving community well-being, relies on effective communication to disseminate information, encourage healthy behaviors, and mitigate health risks. Simultaneously, journalism, with its commitment to accurate and timely reporting, serves as the conduit through which health information reaches the masses. Advancements in communication technologies have revolutionized the ways in which public health information is both generated and shared. The advent of social media platforms, mobile applications, and online forums has democratized the dissemination of health-related news and insights. This democratization, however, brings challenges, such as the rapid spread of misinformation and the need for nuanced strategies to engage diverse audiences. Effective collaboration between public health professionals and journalists is pivotal in countering these challenges, ensuring that accurate information prevails. The synergy between public health and journalism is most evident during public health crises. The COVID-19 pandemic underscored the pivotal role of journalism in providing accurate and up-to-date information to the public. However, it also highlighted the importance of responsible reporting, as sensationalism and misinformation could exacerbate the crisis. Collaborative efforts between public health experts and journalists led to the amplification of preventive measures, the debunking of myths, and the promotion of evidence-based interventions. Moreover, the accessibility of information in the digital era necessitates a strategic approach to health communication. Behavioral economics and data analytics offer insights into human decision-making and allow tailored health messages to resonate more effectively with specific audiences. This approach, when integrated into journalism, enables the crafting of narratives that not only inform but also influence positive health behaviors. Ethical considerations emerge prominently in this alliance. The responsibility to balance the public's right to know with the potential consequences of sensational reporting underscores the significance of ethical journalism. Health journalists must meticulously source information from reputable experts and institutions to maintain credibility, thus fortifying the bridge between public health and the public. As both public health and journalism undergo transformative shifts, fostering collaboration between these domains becomes essential. Training programs that familiarize journalists with public health concepts and practices can enhance their capacity to report accurately and comprehensively on health issues. Likewise, public health professionals can gain insights into effective communication strategies from seasoned journalists, ensuring that health information reaches a wider audience. In conclusion, the convergence of public health and journalism, facilitated by communication advancements, is a cornerstone of informed societies. Effective communication strategies, driven by collaboration, ensure the accurate dissemination of health information and foster positive behavior change. As the world navigates complex health challenges, the continued evolution of this synergy holds the promise of healthier communities and a more engaged and educated public.

Keywords: public awareness, journalism ethics, health promotion, media influence, health literacy

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804 Promoting Civic Health through Patient Voter Registration

Authors: Amit Syal, Madeline Grade, Alister Martin

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Background: Cross-sectional and longitudinal studies demonstrate an association between health and voting. Furthermore, voting enables populations to support policies that impact their health via social determinants like income, education, housing, and healthcare access. Unfortunately, many barriers exist which disproportionately affect the civic participation of certain minority groups. Health professionals have an important role to play in addressing the civic health of all patients and empowering underrepresented communities. Description: Vot-ER is a non-partisan, nonprofit organization that aims to reduce barriers to civic participation by helping patients register to vote while in healthcare settings. The initial approach involved iPad-based kiosks in the emergency department waiting rooms, allowing patients to register themselves while waiting. After the COVID-19 pandemic began, Vot-ER expanded its touchless digital approaches. Vot-ER provides healthcare workers across the country with “Healthy Democracy Kits” consisting of badge backers, posters, discharge paperwork, and other resources. These contain QR and text codes that direct users to an online platform for registering to vote or requesting a mail-in ballot, available in English or Spanish. Outcomes: From May to November 2020, Vot-ER helped prepare 46,320 people to vote. 13,192 individual healthcare providers across all 50 states signed up for and received Healthy Democracy Kits. 80 medical schools participated in the Healthy Democracy Campaign competition. Over 500 institutions ordered site-based materials. Conclusions: A healthy democracy is one in which all individuals in a community have equal and fair opportunities for their voices to be heard. Healthcare settings, such as hospitals, are appropriate and effective venues for increasing both voter registration and education.

Keywords: civic health, enfranchisement, physician, voting

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803 Psychological Capital as Pathways to Social Well-Being Among International Faculty in UAE: A Mediated-Moderated Study

Authors: Ejoke U. P., Smitha Dev., Madwuke Ann, DuPlessis E. D.

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The study examines the relationship between psychological capital (PsyCap) and social well-being among international faculty members in the United Arab Emirates (UAE). The UAE has become a significant destination for global academic talent, yet challenges related to social integration, acceptance, and overall well-being persist among its international faculty. The study focuses on the predictive role of PsyCap, encompassing hope, efficacy, resilience, and optimism, in determining various dimensions of social well-being, including social integration, acceptance, contribution, actualization, and coherence. Additionally, the research investigates the potential moderating or mediating effects of institutional support and Faculty Job-Status position on the relationship between PsyCap and social well-being. Through structural equation modeling, we found that institutional support mediated the positive relationship between PsyCap and SWB and the permanent Faculty job-status position type strengthens the relationship between PsyCap and SWB. Our findings uncover the pathways through which PsyCap influences the social well-being outcomes of international faculty in the UAE. The findings will contribute to the development of tailored interventions and support systems aimed at enhancing the integration experiences and overall well-being of international faculty within the UAE academic community. Thus, fostering a more inclusive and thriving academic environment in the UAE.

Keywords: faculty job-status, institutional-faculty, psychological capital, social well-being, UAE

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802 Investigation of Tourism and Development in Santo Domingo City

Authors: Mary Cruz

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Founded from 1496 to 1502, Santo Domingo is the oldest European settlement in the Americas, inhabited without any discontinuity and was the first seat of Spanish power in the new world. Capital of the country since 1932.In this text, we discover Santo Domingo as an international tourist center, Urban Structure, Eco-tourism, Contamination and other issues related to tourism and development of this city. Founded from 1496 to 1502, Santo Domingo is the oldest European settlement in the Americas, inhabited without any discontinuity and was the first seat of Spanish power in the new world. Capital of the country since 1932. Encouraged by the United Nations and the World Bank, many Caribbean governments have encouraged tourism from the 1950s to boost their Third World economies. In this text, we discover Santo Domingo as an international tourist center, Urban Structure, Eco-tourism, Contamination and challenges of the first tourist destination in the Caribbean.

Keywords: eco-tourism, urban structure, contamination, development

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801 Deconstructing the Niger-Delta Crises: In Esiaba Irobi's Cemetery Road and Hangmen Also Die

Authors: Chukwukelue Uzodinma Umenyilorah

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The history of the crises in Niger-Delta is readily traceable to the post-colonial oil boom of the early 70s. Prior to this time, it was widely believed that the people of Niger-Delta; especially those in the present day Rivers, Delta and Bayelsa States enjoyed a peaceful coexistence pretty much as the rest of Nigerians. In the early 70s however, crude oil was discovered in commercial quantities in these areas and tranquility has become a far cry over the years ever since then. First, a number of multi-national oil explorers moved into the Niger-Delta for business, and then certain conditions resulted in sundry instances of oil spillage, which caused a lot of environmental damage, destroying nearly all of the people’s sources of livelihood. The result was a multiple chain reaction ranging from incessant agitations from the natives to institutionalized dialogue between the oil business owners, the natives and the government, and then to a proposition of compensation packages for the affected communities. The said compensation, which was meant to bring peace seem to have brought even more crises instead. Corruption and greed crept in, money changed hands, suffering increased and so was the agitation from the people. The whole turn of events gradually snowballed into the formation of various militant groups who are now fingered as responsible for the sundry cases of violence in the Niger-Delta. The oil boom can, therefore, be said to be the immediate cause of the Niger-Delta crises, but there are other remote causes as well; including poverty, neglect and illiteracy to mention but a few. This study is therefore aimed at examining the various reasons behind the seemingly unending crises in the Niger-Delta. It will also take a critical look at the roles played by the various parties in the Niger-Delta crises from the 70s to date; as well as the various human and environmental devastations done in the area with a view to making informed suggestions on how to stop further damage and start fixing that, which is already done. Esiaba Irobi’s Cemetery Road and Hangmen Also Die seem to vividly capture the realities of the Niger-Delta situation, and shall, therefore, be reviewed in this study.

Keywords: corruption, Niger-delta, oil boom, post-colonial

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800 Modelling Impacts of Global Financial Crises on Stock Volatility of Nigeria Banks

Authors: Maruf Ariyo Raheem, Patrick Oseloka Ezepue

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This research aimed at determining most appropriate heteroskedastic model to predicting volatility of 10 major Nigerian banks: Access, United Bank for Africa (UBA), Guaranty Trust, Skye, Diamond, Fidelity, Sterling, Union, ETI and Zenith banks using daily closing stock prices of each of the banks from 2004 to 2014. The models employed include ARCH (1), GARCH (1, 1), EGARCH (1, 1) and TARCH (1, 1). The results show that all the banks returns are highly leptokurtic, significantly skewed and thus non-normal across the four periods except for Fidelity bank during financial crises; findings similar to those of other global markets. There is also strong evidence for the presence of heteroscedasticity, and that volatility persistence during crisis is higher than before the crisis across the 10 banks, with that of UBA taking the lead, about 11 times higher during the crisis. Findings further revealed that Asymmetric GARCH models became dominant especially during financial crises and post crises when the second reforms were introduced into the banking industry by the Central Bank of Nigeria (CBN). Generally, one could say that Nigerian banks returns are volatility persistent during and after the crises, and characterised by leverage effects of negative and positive shocks during these periods

Keywords: global financial crisis, leverage effect, persistence, volatility clustering

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799 Design and Implementation of an Affordable Electronic Medical Records in a Rural Healthcare Setting: A Qualitative Intrinsic Phenomenon Case Study

Authors: Nitika Sharma, Yogesh Jain

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Introduction: An efficient Information System helps in improving the service delivery as well provides the foundation for policy and regulation of other building blocks of Health System. Health care organizations require an integrated working of its various sub-systems. An efficient EMR software boosts the teamwork amongst the various sub-systems thereby resulting in improved service delivery. Although there has been a huge impetus to EMR under the Digital India initiative, it has still not been mandated in India. It is generally implemented in huge funded public or private healthcare organizations only. Objective: The study was conducted to understand the factors that lead to the successful adoption of an affordable EMR in the low level healthcare organization. It intended to understand the design of the EMR and address the solutions to the challenges faced in adoption of the EMR. Methodology: The study was conducted in a non-profit registered Healthcare organization that has been providing healthcare facilities to more than 2500 villages including certain areas that are difficult to access. The data was collected with help of field notes, in-depth interviews and participant observation. A total of 16 participants using the EMR from different departments were enrolled via purposive sampling technique. The participants included in the study were working in the organization before the implementation of the EMR system. The study was conducted in one month period from 25 June-20 July 2018. The Ethical approval was taken from the institute along with prior approval of the participants. Data analysis: A word document of more than 4000 words was obtained after transcribing and translating the answers of respondents. It was further analyzed by focused coding, a line by line review of the transcripts, underlining words, phrases or sentences that might suggest themes to do thematic narrative analysis. Results: Based on the answers the results were thematically grouped under four headings: 1. governance of organization, 2. architecture and design of the software, 3. features of the software, 4. challenges faced in adoption and the solutions to address them. It was inferred that the successful implementation was attributed to the easy and comprehensive design of the system which has facilitated not only easy data storage and retrieval but contributes in constructing a decision support system for the staff. Portability has lead to increased acceptance by physicians. The proper division of labor, increased efficiency of staff, incorporation of auto-correction features and facilitation of task shifting has lead to increased acceptance amongst the users of various departments. Geographical inhibitions, low computer literacy and high patient load were the major challenges faced during its implementation. Despite of dual efforts made both by the architects and administrators to combat these challenges, there are still certain ongoing challenges faced by organization. Conclusion: Whenever any new technology is adopted there are certain innovators, early adopters, late adopters and laggards. The same pattern was followed in adoption of this software. He challenges were overcome with joint efforts of organization administrators and users as well. Thereby this case study provides a framework of implementing similar systems in public sector of countries that are struggling for digitizing the healthcare in presence of crunch of human and financial resources.

Keywords: EMR, healthcare technology, e-health, EHR

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798 Exploration of Environmental Parameters on the Evolution of Vernacular Building Techniques in East Austria

Authors: Hubert Feiglstorfer

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Due to its location in a transition zone from the Pannonian to the pre-Alpine region, the east of Austria shows a small-scale diversity in the regional development of certain vernacular building techniques. In this article the relationship between natural building material resources, topography and climate will be examined. Besides environmental preconditions, social and economic historical factors have developed different construction techniques within certain regions in the Weinviertel and Burgenland, the two eastern federal states of Austria. But even within these regions, varying building techniques were found, due to the locally different use of raw materials like wood, stone, clay, lime, or organic fibres. Within these small-scale regions, building traditions were adapted over the course of time due to changes in the use of the building material, for example from wood to brick or from wood to earth. The processing of the raw materials varies from region to region, for example as rammed earth, cob, log, or brick construction. Environmental preconditions cross national borders. For that reason, developments in the neighbouring countries, the Czech Republic, Slovakia, Hungary and Slovenia are included in this analysis. As an outcome of this research a map was drawn which shows the interrelation between locally available building materials, topography, climate and local building techniques? As a result of this study, which covers the last 300 years, one can see how the local population used natural resources very sensitively adapted to local environmental preconditions. In the case of clay, for example, changes of proportions of lime and particular minerals cause structural changes that differ from region to region. Based on material analyses in the field of clay mineralogy, on ethnographic research, literature and archive research, explanations for certain local structural developments will be given for the first time over the region of East Austria.

Keywords: European crafts, material culture, architectural history, earthen architecture, earth building history

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797 The Status of the Actio Popularis under International Environmental Law in Cases of Damage to Global Commons

Authors: Aimite Jorge, Leenekela Usebiu

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In recent years the International Community has seen a rise of what can be termed as ‘actio popularis”;that is to say lawsuits brought by third parties in the interest of the public or the world community as a whole, such as in cases of genocide and terrorism prosecutions under international law. It is equally clear that under current globalized world the effect of multinational activities on the environment is often felt beyond the borders of the territories where they operate. Equally true is the fact that the correspondence of citizens self-determination with national government is increasingly upset by the increasing willingness of states to share some ‘sovereign powers’ in order to address new economic, environmental and security interdependencies. The ‘unbundling’ of functional governance from fixed territories sees continuously citizens give up their formal approval of key decisions in exchange for a more remote, indirect say in supra-national or international decision-making bodies. The efforts to address a growing transnational flow of ecological harm are at the forefront of such indirect transformations, as evidenced by a proliferation of multilateral environmental agreements (MEAs) over the past three decades. However, unlike the defence of the global commons in cases of terrorism and genocide, there is still to be a clear application of action popularis in the case of environment, despite acknowledgement that the effect of the activities of several multinationals on the environment is as destructive to the global commons as genocide or terrorism are. Thus, this paper looking at specific cases of harmful degradation of the environment by certain multinationals transcending national boundaries, argues that it is high-time for a serious consideration of the application of the actio-popularis to environmental concerns. Although it is acknowledged that in international environmental law the challenge to reach a “critical mass” of recognition and support for an ‘actio-popularis’ for environment damage is particularly demanding, it is worth the try.

Keywords: actio popularis in environment law, global commons, transnational environmental damage, law and environment

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796 Ethnic Andean Concepts of Health and Illness in the Post-Colombian World and Its Relevance Today

Authors: Elizabeth J. Currie, Fernando Ortega Perez

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—‘MEDICINE’ is a new project funded under the EC Horizon 2020 Marie-Sklodowska Curie Actions, to determine concepts of health and healing from a culturally specific indigenous context, using a framework of interdisciplinary methods which integrates archaeological-historical, ethnographic and modern health sciences approaches. The study will generate new theoretical and methodological approaches to model how peoples survive and adapt their traditional belief systems in a context of alien cultural impacts. In the immediate wake of the conquest of Peru by invading Spanish armies and ideology, native Andeans responded by forming the Taki Onkoy millenarian movement, which rejected European philosophical and ontological teachings, claiming “you make us sick”. The study explores how people’s experience of their world and their health beliefs within it, is fundamentally shaped by their inherent beliefs about the nature of being and identity in relation to the wider cosmos. Cultural and health belief systems and related rituals or behaviors sustain a people’s sense of identity, wellbeing and integrity. In the event of dislocation and persecution these may change into devolved forms, which eventually inter-relate with ‘modern’ biomedical systems of health in as yet unidentified ways. The development of new conceptual frameworks that model this process will greatly expand our understanding of how people survive and adapt in response to cultural trauma. It will also demonstrate the continuing role, relevance and use of TM in present-day indigenous communities. Studies will first be made of relevant pre-Colombian material culture, and then of early colonial period ethnohistorical texts which document the health beliefs and ritual practices still employed by indigenous Andean societies at the advent of the 17th century Jesuit campaigns of persecution - ‘Extirpación de las Idolatrías’. Core beliefs drawn from these baseline studies will then be used to construct a questionnaire about current health beliefs and practices to be taken into the study population of indigenous Quechua peoples in the northern Andean region of Ecuador. Their current systems of knowledge and medicine have evolved within complex historical contexts of both the conquest by invading Inca armies in the late 15th century, followed a generation later by Spain, into new forms. A new model will be developed of contemporary  Andean concepts of health, illness and healing demonstrating  the way these have changed through time. With this, a ‘policy tool’ will be constructed as a bridhging facility into contemporary global scenarios relevant to other Indigenous, First Nations, and migrant peoples to provide a means through which their traditional health beliefs and current needs may be more appropriately understood and met. This paper presents findings from the first analytical phases of the work based upon the study of the literature and the archaeological records. The study offers a novel perspective and methods in the development policies sensitive to indigenous and minority people’s health needs.

Keywords: Andean ethnomedicine, Andean health beliefs, health beliefs models, traditional medicine

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795 A Temporal Analysis on the Legal Status of the Turkish Straits in the Scope of National and International Legislation

Authors: Gizem Kodak, Birsen Koldemir

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The Turkish Straits are at the crossroads of Europe and Asia continents and are unique waterways connecting the Black Sea countries to the rest of the world. Because of the geostrategic value of the location, passage of trade and war ships through the Turkish Straits has become a vital attraction and importance for the great powers and the riparian states throughout the history. This study contains a temporal analysis of the legal measures implemented in the Turkish Straits System. In this context, the historical alternation of the Turkish Straits has been examined, taking into account the relevant national and international regulations. In other words, relevant national and international regulations have been examined in this study according to historical time schedules. Parallel to the main concept mentioned above, the first chapter focuses on international regulations. These arrangements are organized according to date order and in three subheadings: Sèvres Treaty (1920), Lausanne Treaty (1923) and Montreux Convention (1936). Another topic, the national regulations, has been examined under five subheadings. These; (1982), Port Regulations of Canakkale (1982), Marine Traffic Regulations of the Turkish Straits and Marmara Region (1994) and Maritime Traffic Regulations for the Turkish Straits (1998). In doing so, the aim was to identify the differences in legal arrangements throughout the time regarding the navigation through the Turkish Straits. The current situation of the Turkish Straits has been presented in detail in the last part of the work, taking Montreux Convention into consideration. In this context, the articles of the Convention which regulate the passage of trade vessels have been examined from two perspectives; Peace time and war time. As for the measures that can be implemented in time of war, three options put forward depending on Turkey's stance: ‘Turkey not being belligerent’, ‘Turkey being belligerent’ and ‘situation in which Turkey considers herself threatened with imminent danger of war’.

Keywords: temporal analysis, maritime law, Turkish straits, maritime accidents

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794 Dynamics of Soil Fertility Management in India: An Empirical Analysis

Authors: B. Suresh Reddy

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The over dependence on chemical fertilizers for nutrient management in crop production for the last few decades has led to several problems affecting soil health, environment and farmers themselves. Based on the field work done in 2012-13 with 1080 farmers of different size-classes in semi-arid regions of Uttar Pradesh, Jharkhand and Madhya Pradesh states of India, this paper reveals that the farmers in semi-arid regions of India are actively managing soil fertility and other soil properties through a wide range of practices that are based on local resources and knowledge. It also highlights the socio-economic web woven around these soil fertility management practices. This study highlights the contribution of organic matter by traditional soil fertility management practices in maintaining the soil health. Livestock has profound influence on the soil fertility enhancement through supply of organic manure. Empirical data of this study has clearly revealed how farmers’ soil fertility management options are being undermined by government policies that give more priority to chemical fertiliser-based strategies. Based on the findings it is argued that there should be a 'level playing field' for both organic and inorganic soil fertility management methods by promoting and supporting farmers in using organic methods. There is a need to provide credit to farmers for adopting his choice of soil fertility management methods which suits his socio-economic conditions and that best suits the long term productivity of soils. The study suggests that the government policies related to soil fertility management must be enabling, creating the conditions for development based more on locally available resources and local skills and knowledge. This will not only keep Indian soils in healthy condition but also support the livelihoods of millions of people, especially the small and marginal farmers.

Keywords: livestock, organic matter, small farmers, soil fertility

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793 Seismic Fragility Assessment of Strongback Steel Braced Frames Subjected to Near-Field Earthquakes

Authors: Mohammadreza Salek Faramarzi, Touraj Taghikhany

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In this paper, seismic fragility assessment of a recently developed hybrid structural system, known as the strongback system (SBS) is investigated. In this system, to mitigate the occurrence of the soft-story mechanism and improve the distribution of story drifts over the height of the structure, an elastic vertical truss is formed. The strengthened members of the braced span are designed to remain substantially elastic during levels of excitation where soft-story mechanisms are likely to occur and impose a nearly uniform story drift distribution. Due to the distinctive characteristics of near-field ground motions, it seems to be necessary to study the effect of these records on seismic performance of the SBS. To this end, a set of 56 near-field ground motion records suggested by FEMA P695 methodology is used. For fragility assessment, nonlinear dynamic analyses are carried out in OpenSEES based on the recommended procedure in HAZUS technical manual. Four damage states including slight, moderate, extensive, and complete damage (collapse) are considered. To evaluate each damage state, inter-story drift ratio and floor acceleration are implemented as engineering demand parameters. Further, to extend the evaluation of the collapse state of the system, a different collapse criterion suggested in FEMA P695 is applied. It is concluded that SBS can significantly increase the collapse capacity and consequently decrease the collapse risk of the structure during its life time. Comparing the observing mean annual frequency (MAF) of exceedance of each damage state against the allowable values presented in performance-based design methods, it is found that using the elastic vertical truss, improves the structural response effectively.

Keywords: IDA, near-fault, probabilistic performance assessment, seismic fragility, strongback system, uncertainty

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792 Developing Primal Teachers beyond the Classroom: The Quadrant Intelligence (Q-I) Model

Authors: Alexander K. Edwards

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Introduction: The moral dimension of teacher education globally has assumed a new paradigm of thinking based on the public gain (return-on-investments), value-creation (quality), professionalism (practice), and business strategies (innovations). Abundant literature reveals an interesting revolutionary trend in complimenting the raising of teachers and academic performances. Because of the global competition in the knowledge-creation and service areas, the C21st teacher at all levels is expected to be resourceful, strategic thinker, socially intelligent, relationship aptitude, and entrepreneur astute. This study is a significant contribution to practice and innovations to raise exemplary or primal teachers. In this study, the qualities needed were considered as ‘Quadrant Intelligence (Q-i)’ model for a primal teacher leadership beyond the classroom. The researcher started by examining the issue of the majority of teachers in Ghana Education Services (GES) in need of this Q-i to be effective and efficient. The conceptual framing became determinants of such Q-i. This is significant for global employability and versatility in teacher education to create premium and primal teacher leadership, which are again gaining high attention in scholarship due to failing schools. The moral aspect of teachers failing learners is a highly important discussion. In GES, some schools score zero percent at the basic education certificate examination (BECE). The question is what will make any professional teacher highly productive, marketable, and an entrepreneur? What will give teachers the moral consciousness of doing the best to succeed? Method: This study set out to develop a model for primal teachers in GES as an innovative way to highlight a premium development for the C21st business-education acumen through desk reviews. The study is conceptually framed by examining certain skill sets such as strategic thinking, social intelligence, relational and emotional intelligence and entrepreneurship to answer three main burning questions and other hypotheses. Then the study applied the causal comparative methodology with a purposive sampling technique (N=500) from CoE, GES, NTVI, and other teachers associations. Participants responded to a 30-items, researcher-developed questionnaire. Data is analyzed on the quadrant constructs and reported as ex post facto analyses of multi-variances and regressions. Multiple associations were established for statistical significance (p=0.05). Causes and effects are postulated for scientific discussions. Findings: It was found out that these quadrants are very significant in teacher development. There were significant variations in the demographic groups. However, most teachers lack considerable skills in entrepreneurship, leadership in teaching and learning, and business thinking strategies. These have significant effect on practices and outcomes. Conclusion and Recommendations: It is quite conclusive therefore that in GES teachers may need further instructions in innovations and creativity to transform knowledge-creation into business venture. In service training (INSET) has to be comprehensive. Teacher education curricula at Colleges may have to be re-visited. Teachers have the potential to raise their social capital, to be entrepreneur, and to exhibit professionalism beyond their community services. Their primal leadership focus will benefit many clienteles including students and social circles. Recommendations examined the policy implications for curriculum design, practice, innovations and educational leadership.

Keywords: emotional intelligence, entrepreneurship, leadership, quadrant intelligence (q-i), primal teacher leadership, strategic thinking, social intelligence

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791 Dwindling the Stability of DNA Sequence by Base Substitution at Intersection of COMT and MIR4761 Gene

Authors: Srishty Gulati, Anju Singh, Shrikant Kukreti

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The manifestation of structural polymorphism in DNA depends on the sequence and surrounding environment. Ample of folded DNA structures have been found in the cellular system out of which DNA hairpins are very common, however, are indispensable due to their role in the replication initiation sites, recombination, transcription regulation, and protein recognition. We enumerate this approach in our study, where the two base substitutions and change in temperature embark destabilization of DNA structure and misbalance the equilibrium between two structures of a sequence present at the overlapping region of the human COMT gene and MIR4761 gene. COMT and MIR4761 gene encodes for catechol-O-methyltransferase (COMT) enzyme and microRNAs (miRNAs), respectively. Environmental changes and errors during cell division lead to genetic abnormalities. The COMT gene entailed in dopamine regulation fosters neurological diseases like Parkinson's disease, schizophrenia, velocardiofacial syndrome, etc. A 19-mer deoxyoligonucleotide sequence 5'-AGGACAAGGTGTGCATGCC-3' (COMT19) is located at exon-4 on chromosome 22 and band q11.2 at the intersection of COMT and MIR4761 gene. Bioinformatics studies suggest that this sequence is conserved in humans and few other organisms and is involved in recognition of transcription factors in the vicinity of 3'-end. Non-denaturating gel electrophoresis and CD spectroscopy of COMT sequences indicate the formation of hairpin type DNA structures. Temperature-dependent CD studies revealed an unusual shift in the slipped DNA-Hairpin DNA equilibrium with the change in temperature. Also, UV-thermal melting techniques suggest that the two base substitutions on the complementary strand of COMT19 did not affect the structure but reduces the stability of duplex. This study gives insight about the possibility of existing structurally polymorphic transient states within DNA segments present at the intersection of COMT and MIR4761 gene.

Keywords: base-substitution, catechol-o-methyltransferase (COMT), hairpin-DNA, structural polymorphism

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790 Enhanced Exchange Bias in Poly-crystalline Compounds through Oxygen Vacancy and B-site Disorder

Authors: Koustav Pal, Indranil Das

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In recent times, perovskite and double perovskite (DP) systems attracts lot of interest as they provide a rich material platform for studying emergent functionalities like near-room-temperature ferromagnetic (FM) insulators, exchange bias (EB), magnetocaloric effects, colossal magnetoresistance, anisotropy, etc. These interesting phenomena emerge because of complex couplings between spin, charge, orbital, and lattice degrees of freedom in these systems. Various magnetic phenomena such as exchange bias, spin glass, memory effect, colossal magneto-resistance, etc. can be modified and controlled through antisite (B-site) disorder or controlling oxygen concentration of the material. By controlling oxygen concentration in SrFe0.5Co0.5O3 – δ (SFCO) (δ ∼ 0.3), we achieve intrinsic exchange bias effect with a large exchange bias field (∼1.482 Tesla) and giant coercive field (∼1.454 Tesla). Now we modified the B-site by introducing 10% iridium in the system. This modification give rise to the exchange bias field as high as 1.865 tesla and coercive field 1.863 tesla. Our work aims to investigate the effect of oxygen deficiency and B-site effect on exchange bias in oxide materials for potential technological applications. Structural characterization techniques including X-ray diffraction, scanning tunneling microscopy, and transmission electron microscopy were utilized to determine crystal structure and particle size. X-ray photoelectron spectroscopy was used to identify valence states of the ions. Magnetic analysis revealed that oxygen deficiency resulted in a large exchange bias due to a significant number of ionic mixtures. Iridium doping was found to break interaction paths, resulting in various antiferromagnetic and ferromagnetic surfaces that enhance exchange bias.

Keywords: coercive field, disorder, exchange bias, spin glass

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789 Two-Way Reminder Systems to Support Activities of Daily Living for Adults with Cognitive Impairments: A Scoping Review

Authors: Julia Brudzinski, Ashley Croswell, Jade Mardin, Hannah Shilling, Jennifer Berg-Carnegie

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Adults with brain injuries and mental illnesses commonly experience cognitive impairments that interfere with their participation in activities of daily living (ADLs). Prior research states that electronic reminder systems can support adults with cognitive impairments; however, previous studies focus primarily on one-way reminder systems. Research on adults with chronic diseases reported that two-way reminder systems yield better health outcomes and disease self-management compared to one-way reminder systems. Literature was identified through systematically searching 7 databases and hand-searching relevant reference lists. Retrieved studies were independently screened and reviewed by at least two members of the research team. Data was extracted on study design, participant characteristics, intervention details, study objectives, outcome measures, and important results. 574 articles were screened and reviewed. Nine articles met all inclusion criteria and were included. The literature focused on three main areas: system feasibility (n=8), stakeholder satisfaction (n=6), and efficacy of the two-way reminder systems (n=6). Participants in eight of the studies had brain injuries, with participants in only one study having a mental illness (i.e., schizophrenia). Two-way reminder systems were used to support participation in a wide range of ADLs. The current literature on two-way reminder systems to support ADLs for adults with cognitive impairments focuses on feasibility, stakeholder satisfaction, and system efficacy. Future research should focus on addressing the barriers to accessing and implementing two-way reminder systems and identifying specific client characteristics that would benefit most from using these systems.

Keywords: brain injury, digital health, occupational therapy, activities of daily living, two-way reminder systems

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788 Culture and Mental Health in Nigeria: A Qualitative Study of Berom, Hausa, Yoruba and Igbo Cultural Beliefs

Authors: Dung Jidong, Rachel Tribe, Poul Rohlerder, Aneta Tunariu

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Cultural understandings of mental health problems are frequently overshadowed by the western conceptualizations. Research on culture and mental health in the Nigerian context seems to be lacking. This study examined the linguistic understandings and cultural beliefs that have implications for mental health among the Berom, Hausa, Yoruba and Igbo people of Nigeria. A purposive sample of 53 participants underwent semi-structured interviews that lasted approximately 55 minutes each. Of the N=53 participants, n=26 were psychology-aligned practitioners and n=27 ‘laypersons’. Participants were recruited from four states in Nigeria, Plateau, Kaduna, Ekiti, and Enugu. All participants were self-identified as members of their ethnic groups who speak and understand their native-languages, cultural beliefs, and also are domiciled within their ethnic communities. Thematic analysis using socio-constructionism from a critical-realist position was employed to explore the participants’ beliefs about mental health, and the clash between western trained practitioners’ views and the cultural beliefs of the ‘laypersons’. Data analysis found three main themes that re-emerged across the four ethnic samples: (i) beliefs about mental health problems as a spiritual curse (ii) traditional and religious healing are used more often than western mental health care (iii) low levels of mental health awareness. In addition, the Nigerian traditional and religious healing are also revealed to be helpful as the practice gives prominence to the native-languages, religious and cultural values. However, participants described the role of ‘false’ traditional or religious healers in communities as being potentially harmful. Finally, due to the current lack of knowledge about mental health problems, awareness creation and re-orientation may be beneficial for both rural and urban Nigerian communities.

Keywords: beliefs cultures, health mental, languages religions, values

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787 Filling the Gaps with Representation: Netflix’s Anne with an E as a Way to Reveal What the Text Hid

Authors: Arkadiusz Adam Gardaś

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In his theory of gaps, Wolfgang Iser states that literary texts often lack direct messages. Instead of using straightforward descriptions, authors leave the gaps or blanks, i.e., the spaces within the text that come into existence only when readers fill them with their understanding and experiences. This paper’s aim is to present Iser’s literary theory in an intersectional way by comparing it to the idea of intersemiotic translation. To be more precise, the author uses the example of Netflix’s adaption of Lucy Maud Montgomery’s Anne of Green Gables as a form of rendering a book into a film in such a way that certain textual gaps are filled with film images. Intersemiotic translation is a rendition in which signs of one kind of media are translated into the signs of the other media. Film adaptions are the most common, but not the only, type of intersemiotic translation. In this case, the role of the translator is taken by a screenwriter. A screenwriter’s role can reach beyond the direct meaning presented by the author, and instead, it can delve into the source material (here – a novel) in a deeper way. When it happens, a screenwriter is able to spot the gaps in the text and fill them with images that can later be presented to the viewers. Anne with an E, the Netflix adaption of Montgomery’s novel, may be used as a highly meaningful example of such a rendition. It is due to the fact that the 2017 series was broadcasted more than a hundred years after the first edition of the novel was published. This means that what the author might not have been able to show in her text can now be presented in a more open way. The screenwriter decided to use this opportunity to represent certain groups in the film, i.e., racial and sexual minorities, and women. Nonetheless, the series does not alter the novel; in fact, it adds to it by filling the blanks with more direct images. In the paper, fragments of the first season of Anne with an E are analysed in comparison to its source, the novel by Montgomery. The main purpose of that is to show how intersemiotic translation connected with the Iser’s literary theory can enrich the understanding of works of art, culture, media, and literature.

Keywords: intersemiotic translation, film, literary gaps, representation

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786 Horizontal Cooperative Game Theory in Hotel Revenue Management

Authors: Ririh Rahma Ratinghayu, Jayu Pramudya, Nur Aini Masruroh, Shi-Woei Lin

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This research studies pricing strategy in cooperative setting of hotel duopoly selling perishable product under fixed capacity constraint by using the perspective of managers. In hotel revenue management, competitor’s average room rate and occupancy rate should be taken into manager’s consideration in determining pricing strategy to generate optimum revenue. This information is not provided by business intelligence or available in competitor’s website. Thus, Information Sharing (IS) among players might result in improved performance of pricing strategy. IS is widely adopted in the logistics industry, but IS within hospitality industry has not been well-studied. This research put IS as one of cooperative game schemes, besides Mutual Price Setting (MPS) scheme. In off-peak season, hotel manager arranges pricing strategy to offer promotion package and various kinds of discounts up to 60% of full-price to attract customers. Competitor selling homogenous product will react the same, then triggers a price war. Price war which generates lower revenue may be avoided by creating collaboration in pricing strategy to optimize payoff for both players. In MPS cooperative game, players collaborate to set a room rate applied for both players. Cooperative game may avoid unfavorable players’ payoff caused by price war. Researches on horizontal cooperative game in logistics show better performance and payoff for the players, however, horizontal cooperative game in hotel revenue management has not been demonstrated. This paper aims to develop hotel revenue management models under duopoly cooperative schemes (IS & MPS), which are compared to models under non-cooperative scheme too. Each scheme has five models, Capacity Allocation Model; Demand Model; Revenue Model; Optimal Price Model; and Equilibrium Price Model. Capacity Allocation Model and Demand Model employs self-hotel and competitor’s full and discount price as predictors under non-linear relation. Optimal price is obtained by assuming revenue maximization motive. Equilibrium price is observed by interacting self-hotel’s and competitor’s optimal price under reaction equation. Equilibrium is analyzed using game theory approach. The sequence applies for three schemes. MPS Scheme differently aims to optimize total players’ payoff. The case study in which theoretical models are applied observes two hotels offering homogenous product in Indonesia during a year. The Capacity Allocation, Demand, and Revenue Models are built using multiple regression and statistically tested for validation. Case study data confirms that price behaves within demand model in a non-linear manner. IS Models can represent the actual demand and revenue data better than Non-IS Models. Furthermore, IS enables hotels to earn significantly higher revenue. Thus, duopoly hotel players in general, might have reasonable incentives to share information horizontally. During off-peak season, MPS Models are able to predict the optimal equal price for both hotels. However, Nash equilibrium may not always exist depending on actual payoff of adhering or betraying mutual agreement. To optimize performance, horizontal cooperative game may be chosen over non-cooperative game. Mathematical models can be used to detect collusion among business players. Empirical testing can be used as policy input for market regulator in preventing unethical business practices potentially harming society welfare.

Keywords: horizontal cooperative game theory, hotel revenue management, information sharing, mutual price setting

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785 Corporate Governance and Performance of Islamic Banks in GCC Countries

Authors: Samir Srairi

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This paper investigates the impact of the internal corporate governance on bank performance by constructing a corporate governance index (CGI) for 27 Islamic banks operating in five Arab Gulf countries. Using content analysis on the banks’ annual reports for 3 years (2011-2013), the index construction uses information on six important corporate governance mechanisms, namely board structure, risk management, transparency and disclosure, audit committee, Sharia supervisory board and investment account holders. The results demonstrate that Islamic banks adhere to 54% of the attributes addressed in the CGI. The most frequently reported and disclosed elements are Sharia supervisory board followed by board structure and risk management. The findings related to countries revealed that only two countries, the United Arab Emirates and Bahrain, possess a higher level of CGI. Our regression results provide evidence that Islamic banks with higher levels of corporate governance report high operating performance measured by return on assets and net interest margin. Finally, as of the effect of internal and external factors, we identified four variables that were associated with bank performance, namely size, equity, risk and concentration.

Keywords: governance mechanisms, corporate governance index, bank performance, Islamic banks, GCC countries

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784 Spherical Organic Particle (SOP) Emissions from Fixed-Bed Residential Coal-Burning Devices

Authors: Tafadzwa Makonese, Harold Annegarn, Patricia Forbes

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Residential coal combustion is one of the largest sources of carbonaceous aerosols in the Highveld region of South Africa, significantly affecting the local and regional climate. In this study, we investigated single coal burning particles emitted when using different fire-ignition techniques (top-lit up-draft vs bottom-lit up-draft) and air ventilation rates (defined by the number of air holes above and below the fire grate) in selected informal braziers. Aerosol samples were collected on nucleopore filters at the SeTAR Centre Laboratory, University of Johannesburg. Individual particles (~700) were investigated using a scanning electron microscope equipped with an energy-dispersive X-ray spectroscopy (EDS). Two distinct forms of spherical organic particles (SOPs) were identified, one less oxidized than the other. The particles were further classified into "electronically" dark and bright, according to China et al. [2014]. EDS analysis showed that 70% of the dark spherical organic particles balls had higher (~60%) relative oxygen content than in the bright SOPs. We quantify the morphology of spherical organic particles and classify them into four categories: ~50% are bare single particles; ~35% particles are aggregated and form diffusion accretion chains; 10% have inclusions; and 5% are deformed due to impaction on filter material during sampling. We conclude that there are two distinct kinds of coal burning spherical organic particles and that dark SOPs are less volatile than bright SOPs. We also show that these spherical organic particles are similar in nature and characteristics to tar balls observed in biomass combustion, and that they have the potential to absorb sunlight thereby affecting the earth’s radiative budget and climate. This study provides insights on the mixing states, morphology, and possible formation mechanisms of these organic particles from residential coal combustion in informal stoves.

Keywords: spherical organic particles, residential coal combustion, fixed-bed, aerosols, morphology, stoves

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783 Computational Aided Approach for Strut and Tie Model for Non-Flexural Elements

Authors: Mihaja Razafimbelo, Guillaume Herve-Secourgeon, Fabrice Gatuingt, Marina Bottoni, Tulio Honorio-De-Faria

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The challenge of the research is to provide engineering with a robust, semi-automatic method for calculating optimal reinforcement for massive structural elements. In the absence of such a digital post-processing tool, design office engineers make intensive use of plate modelling, for which automatic post-processing is available. Plate models in massive areas, on the other hand, produce conservative results. In addition, the theoretical foundations of automatic post-processing tools for reinforcement are those of reinforced concrete beam sections. As long as there is no suitable alternative for automatic post-processing of plates, optimal modelling and a significant improvement of the constructability of massive areas cannot be expected. A method called strut-and-tie is commonly used in civil engineering, but the result itself remains very subjective to the calculation engineer. The tool developed will facilitate the work of supporting the engineers in their choice of structure. The method implemented consists of defining a ground-structure built on the basis of the main constraints resulting from an elastic analysis of the structure and then to start an optimization of this structure according to the fully stressed design method. The first results allow to obtain a coherent return in the first network of connecting struts and ties, compared to the cases encountered in the literature. The evolution of the tool will then make it possible to adapt the obtained latticework in relation to the cracking states resulting from the loads applied during the life of the structure, cyclic or dynamic loads. In addition, with the constructability constraint, a final result of reinforcement with an orthogonal arrangement with a regulated spacing will be implemented in the tool.

Keywords: strut and tie, optimization, reinforcement, massive structure

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782 Genetic Association and Functional Significance of Matrix Metalloproteinase-14 Promoter Variants rs1004030 and rs1003349 in Gallbladder Cancer Pathogenesis

Authors: J. Vinay , Kusumbati Besra, Niharika Pattnaik, Shivaram Prasad Singh, Manjusha Dixit

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Gallbladder cancer (GBC) is rare but highly malignant cancer; its prevalence is more in certain geographical regions and ethnic groups, which include the Northern and Eastern states of India. Previous studies in India have reported genetic predisposition as one of the risk factors in GBC pathogenesis. Although the matrix metalloproteinase-14 (MMP14) is a well-known modulator of the tumor microenvironment and tumorigenesis and TCGA data also suggests its upregulation yet, its role in the genetic predisposition for GBC is completely unknown. We elucidated the role of MMP14 promoter variants as genetic risk factors and their implications in expression modulation. We screened MMP14 promoter variants association with GBC using Sanger’s sequencing in approximately 300 GBC and 300 control subjects and 26 GBC tissue samples of Indian ethnicity. The immunohistochemistry was used to check the MMP14 protein expression in GBC tissue samples. The role of promoter variants on expression levels was elucidated using a luciferase reporter assay. The variants rs1004030 (p-value = 0.0001) and rs1003349 (p-value = 0.0008) were significantly associated with gallbladder cancer. The luciferase assay in two different cell lines, HEK-293 (p = 0.0006) and TGBC1TKB (p = 0.0036) showed a significant increase in relative luciferase activity in the presence of risk alleles for both the single nucleotide polymorphisms (SNPs). Similarly, genotype-phenotype correlation in patients samples confirmed that the presence of risk alleles at rs1004030 and rs1003349 increased MMP14 expression. Overall, this study unravels the genetic association of MMP14 promoter variants with gallbladder cancer, which may contribute to pathogenesis by increasing its expression.

Keywords: gallbladder cancer, matrix metalloproteinase-14, single nucleotide polymorphism, case control study, genetic association study

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781 Determinants of Market Entry Modes Used by Universities to Expand Internationally

Authors: Ali Bhayani

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The article analyses determinants of the market entry modes used by corporate firms to expand internationally and explore whether higher education institutions uses the same determinants to decide on mode adopted to enter the market. Determinants like transaction costs, location advantage, idiosyncratic capabilities, isomorphic pressure to mimic, psychic distance, uncertainty, risks, the control over academic process, previous internationalisation experience and entry to homogenous markets are considered with regards to universities. A sample consisting of 40+ branch campuses from United Arab Emirates (UAE), host to highest number of branch campuses, is selected to study the determinants of the entry modes adopted. The aim of this article is not to prescribe or offer a solution for the best-available model of market entry that can be adopted by universities but rather to act as a trigger for a critical check up on universities planning to internationalize their offering. Determinants like idiosyncratic capabilities, isomorphic pressure and control over the academic process were found to be most prevalent. However, determinants like transaction cost efficiency, internationalisation experience, psychic distance, uncertainty and risks are not significant factors.

Keywords: higher education, UAE, internationalisation, market entry, international branch campuses

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780 The Rapid Industrialization Model

Authors: Fredrick Etyang

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This paper presents a Rapid Industrialization Model (RIM) designed to support existing industrialization policies, strategies and industrial development plans at National, Regional and Constituent level in Africa. The model will reinforce efforts to attainment of inclusive and sustainable industrialization of Africa by state and non-state actors. The overall objective of this model is to serve as a framework for rapid industrialization in developing economies and the specific objectives range from supporting rapid industrialization development to promoting a structural change in the economy, a balanced regional industrial growth, achievement of local, regional and international competitiveness in areas of clear comparative advantage in industrial exports and ultimately, the RIM will serve as a step-by-step guideline for the industrialization of African Economies. This model is a product of a scientific research process underpinned by desk research through the review of African countries development plans, strategies, datasets, industrialization efforts and consultation with key informants. The rigorous research process unearthed multi-directional and renewed efforts towards industrialization of Africa premised on collective commitment of individual states, regional economic communities and the African union commission among other strategic stakeholders. It was further, established that the inputs into industrialization of Africa outshine the levels of industrial development on the continent. The RIM comes in handy to serve as step-by-step framework for African countries to follow in their industrial development efforts of transforming inputs into tangible outputs and outcomes in the short, intermediate and long-run. This model postulates three stages of industrialization and three phases toward rapid industrialization of African economies, the model is simple to understand, easily implementable and contextualizable with high return on investment for each unit invested into industrialization supported by the model. Therefore, effective implementation of the model will result into inclusive and sustainable rapid industrialization of Africa.

Keywords: economic development, industrialization, economic efficiency, exports and imports

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779 Load Transfer of Steel Pipe Piles in Warming Permafrost

Authors: S. Amirhossein Tabatabaei, Abdulghader A. Aldaeef, Mohammad T. Rayhani

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As the permafrost continues to melt in the northern regions due to global warming, a soil-water mixture is left behind with drastically lower strength; a phenomenon that directly impacts the resilience of existing structures and infrastructure systems. The frozen soil-structure interaction, which in ice-poor soils is controlled by both interface shear and ice-bonding, changes its nature into a sole frictional state. Adfreeze, the controlling mechanism in frozen soil-structure interaction, diminishes as the ground temperature approaches zero. The main purpose of this paper is to capture the altered behaviour of frozen interface with respect to rising temperature, especially near melting states. A series of pull-out tests are conducted on model piles inside a cold room to study how the strength parameters are influenced by the phase change in ice-poor soils. Steel model piles, embedded in artificially frozen cohesionless soil, are subjected to both sustained pull-out forces and constant rates of displacement to observe the creep behaviour and acquire load-deformation curves, respectively. Temperature, as the main variable of interest, is increased from a lower limit of -10°C up to the point of melting. During different stages of the temperature rise, both skin deformations and temperatures are recorded at various depths along the pile shaft. Significant reduction of pullout capacity and accelerated creep behaviour is found to be the primary consequences of rising temperature. By investigating the different pull-out capacities and deformations measured during step-wise temperature change, characteristics of the transition from frozen to unfrozen soil-structure interaction are studied.

Keywords: Adfreeze, frozen soil-structure interface, ice-poor soils, pull-out capacity, warming permafrost

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778 Culture and Health Equity: Unpacking the Sociocultural Determinants of Eye Health for Indigenous Australian Diabetics

Authors: Aryati Yashadhana, Ted Fields Jnr., Wendy Fernando, Kelvin Brown, Godfrey Blitner, Francis Hayes, Ruby Stanley, Brian Donnelly, Bridgette Jerrard, Anthea Burnett, Anthony B. Zwi

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Indigenous Australians experience some of the worst health outcomes globally, with life expectancy being significantly poorer than those of non-Indigenous Australians. This is largely attributed to preventable diseases such as diabetes (prevalence 39% in Indigenous Australian adults > 55 years), which is attributed to a raised risk of diabetic visual impairment and cataract among Indigenous adults. Our study aims to explore the interface between structural and sociocultural determinants and human agency, in order to understand how they impact (1) accessibility of eye health and chronic disease services and (2) the potential for Indigenous patients to achieve positive clinical eye health outcomes. We used Participatory Action Research methods, and aimed to privilege the voices of Indigenous people through community collaboration. Semi-structured interviews (n=82) and patient focus groups (n=8) were conducted by Indigenous Community-Based Researchers (CBRs) with diabetic Indigenous adults (> 40 years) in four remote communities in Australia. Interviews (n=25) and focus groups (n=4) with primary health care clinicians in each community were also conducted. Data were audio recorded, transcribed verbatim, and analysed thematically using grounded theory, comparative analysis and Nvivo 10. Preliminary analysis occurred in tandem with data collection to determine theoretical saturation. The principal investigator (AY) led analysis sessions with CBRs, fostering cultural and contextual appropriateness to interpreting responses, knowledge exchange and capacity building. Identified themes were conceptualised into three spheres of influence: structural (health services, government), sociocultural (Indigenous cultural values, distrust of the health system, ongoing effects of colonialism and dispossession) and individual (health beliefs/perceptions, patient phenomenology). Permeating these spheres of influence were three core determinants: economic disadvantage, health literacy/education, and cultural marginalisation. These core determinants affected accessibility of services, and the potential for patients to achieve positive clinical outcomes at every level of care (primary, secondary, tertiary). Our findings highlight the clinical realities of institutionalised and structural inequities, illustrated through the lived experiences of Indigenous patients and primary care clinicians in the four sampled communities. The complex determinants surrounding inequity in health for Indigenous Australians, are entrenched through a longstanding experience of cultural discrimination and ostracism. Secure and long term funding of Aboriginal Community Controlled Health Services will be valuable, but are insufficient to address issues of inequity. Rather, working collaboratively with communities to build trust, and identify needs and solutions at the grassroots level, while leveraging community voices to drive change at the systemic/policy level are recommended.

Keywords: indigenous, Australia, culture, public health, eye health, diabetes, social determinants of health, sociology, anthropology, health equity, aboriginal and Torres strait islander, primary care

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777 A Multicenter Assessment on Psychological Well-Being Status among Medical Residents in the United Arab Emirates

Authors: Mahera Abdulrahman

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Objective: Healthcare transformation from traditional to modern in the country recently prompted the need to address career choices, accreditation perception and satisfaction among medical residents. However, a concerted nationwide study to understand and address burnout in the medical residency program has not been conducted in the UAE and the region. Methods: A nationwide, multicenter, cross-sectional study was designed to evaluate professional burnout and depression among medical residents in order to address the gap. Results: Our results indicate that 75.5% (216/286) of UAE medical residents had moderate to high emotional exhaustion, 84% (249/298) had high depersonalization, and 74% (216/291) had a low sense of personal accomplishment. In aggregate, 70% (212/302) of medical residents were considered to be experiencing at least one symptom of burnout based on a high emotional exhaustion score or a high depersonalization score. Depression ranging from 6-22%, depending on the specialty was also striking given the fact the Arab culture lays high emphasis on family bonding. Interestingly 83% (40/48) of medical residents who had high scores for depression also reported burnout. Conclusion: Our data indicate that burnout and depression among medical residents is epidemic. There is an immediate need to address burnout through effective interventions at both the individual and institutional levels. It is imperative to reconfigure the approach to medical training for the well-being of the next generation of physicians in the Arab world.

Keywords: mental health, Gulf, Arab, residency training, burnout, depression

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