Search results for: trust in vaccines
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 844

Search results for: trust in vaccines

124 Experiences and Challenges of Community Participation in Urban Renewal Projects: A Case Study of Bhendi Bazzar, Mumbai, India

Authors: Madhura Yadav

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Urban redevelopment planning initiatives in developing countries have been largely criticised due to top-down planning approach and lack of involvement of the targeted beneficiaries which have led to a challenging situation which is contrary to the perceived needs of beneficiaries. Urban renewal projects improve the lives of people and meaningful participation of community plays a pivotal role. Public perceptions on satisfaction and participation have been given less priority in the investigation, which hinders effective planning and implementation of urban renewal projects. Moreover, challenges of community participation in urban renewal projects are less documented, particularly in relation to public participation and satisfaction. There is a need for new paradigm shift focusing on community participatory approach in urban renewal projects. The over 125-year-old Bhendi Bazar in Mumbai, India is the country’s first ever cluster redevelopment project, popularly known as Bhendi Bazaar redevelopment and it will be one of the largest projects for urban rejuvenation of one of Mumbai’s oldest and dying inner city areas. The project is led by the community trust, inputs were taken from various stakeholders, including residents, commercial tenants and expert consultants to shape the master plan and design of the project. The project started in 2016 but there is a significant delay in implementing the project. The study aimed at studying and assessing public perceptions on satisfaction and the relationship between community participation and community satisfaction in Bhendi Bazaar of Mumbai, India. Furthermore, the study will outline the challenges and problems of community participation in urban renewal projects and it suggests recommendations for the future. The qualitative and quantitative methods such as reconnaissance survey, key informant interviews, focus group discussions, walking interviews, a narrative inquiry is used for analysis of data. Preliminary findings revealed that all tenants are satisfied for the redevelopment of an area but the willingness of residential tenants to move in transit accommodation has made the projects successful and reductant of some residential and commercial tenants, regulatory provisions rising to face challenges in implementation. Experiences from the case study can help to understand dynamics behind public participation and government. At the same time, they serve as an inspiration and learning opportunity for future projects to ensure that they are sustainable not only from an economic standpoint but also, a social perspective.

Keywords: urban renewal, Bhendi Bazaar, community participation, satisfaction, social perspective

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123 Unifying RSV Evolutionary Dynamics and Epidemiology Through Phylodynamic Analyses

Authors: Lydia Tan, Philippe Lemey, Lieselot Houspie, Marco Viveen, Darren Martin, Frank Coenjaerts

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Introduction: Human respiratory syncytial virus (hRSV) is the leading cause of severe respiratory tract infections in infants under the age of two. Genomic substitutions and related evolutionary dynamics of hRSV are of great influence on virus transmission behavior. The evolutionary patterns formed are due to a precarious interplay between the host immune response and RSV, thereby selecting the most viable and less immunogenic strains. Studying genomic profiles can teach us which genes and consequent proteins play an important role in RSV survival and transmission dynamics. Study design: In this study, genetic diversity and evolutionary rate analysis were conducted on 36 RSV subgroup B whole genome sequences and 37 subgroup A genome sequences. Clinical RSV isolates were obtained from nasopharyngeal aspirates and swabs of children between 2 weeks and 5 years old of age. These strains, collected during epidemic seasons from 2001 to 2011 in the Netherlands and Belgium by either conventional or 454-sequencing. Sequences were analyzed for genetic diversity, recombination events, synonymous/non-synonymous substitution ratios, epistasis, and translational consequences of mutations were mapped to known 3D protein structures. We used Bayesian statistical inference to estimate the rate of RSV genome evolution and the rate of variability across the genome. Results: The A and B profiles were described in detail and compared to each other. Overall, the majority of the whole RSV genome is highly conserved among all strains. The attachment protein G was the most variable protein and its gene had, similar to the non-coding regions in RSV, more elevated (two-fold) substitution rates than other genes. In addition, the G gene has been identified as the major target for diversifying selection. Overall, less gene and protein variability was found within RSV-B compared to RSV-A and most protein variation between the subgroups was found in the F, G, SH and M2-2 proteins. For the F protein mutations and correlated amino acid changes are largely located in the F2 ligand-binding domain. The small hydrophobic phosphoprotein and nucleoprotein are the most conserved proteins. The evolutionary rates were similar in both subgroups (A: 6.47E-04, B: 7.76E-04 substitution/site/yr), but estimates of the time to the most recent common ancestor were much lower for RSV-B (B: 19, A: 46.8 yrs), indicating that there is more turnover in this subgroup. Conclusion: This study provides a detailed description of whole RSV genome mutations, the effect on translation products and the first estimate of the RSV genome evolution tempo. The immunogenic G protein seems to require high substitution rates in order to select less immunogenic strains and other conserved proteins are most likely essential to preserve RSV viability. The resulting G gene variability makes its protein a less interesting target for RSV intervention methods. The more conserved RSV F protein with less antigenic epitope shedding is, therefore, more suitable for developing therapeutic strategies or vaccines.

Keywords: drug target selection, epidemiology, respiratory syncytial virus, RSV

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122 Prescription of Maintenance Fluids in the Emergency Department

Authors: Adrian Craig, Jonathan Easaw, Rose Jordan, Ben Hall

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The prescription of intravenous fluids is a fundamental component of inpatient management, but it is one which usually lacks thought. Fluids are a drug, which like any other can cause harm when prescribed inappropriately or wrongly. However, it is well recognised that it is poorly done, especially in the acute portals. The National Institute for Health and Care Excellence (NICE) recommends 1mmol/kg of potassium, sodium, and chloride per day. With various options of fluids, clinicians tend to face difficulty in choosing the most appropriate maintenance fluid, and there is a reluctance to prescribe potassium as part of an intravenous maintenance fluid regime. The aim was to prospectively audit the prescription of the first bag of intravenous maintenance fluids, the use of urea and electrolytes results to guide the choice of fluid and the use of fluid prescription charts, in a busy emergency department of a major trauma centre in Stoke-on-Trent, United Kingdom. This was undertaken over a week in early November 2016. Of those prescribed maintenance fluid only 8.9% were prescribed a fluid which was most appropriate for their daily electrolyte requirements. This audit has helped to highlight further the issues that are faced in busy Emergency Departments within hospitals that are stretched and lack capacity for prompt transfer to a ward. It has supported the findings of NICE, that emergency admission portals such as Emergency Departments poorly prescribed intravenous fluid therapy. The findings have enabled simple steps to be taken to educate clinicians about their fluid of choice. This has included: posters to remind clinicians to consider the urea and electrolyte values before prescription, suggesting the inclusion of a suggested intravenous fluid of choice in the prescription chart of the trust and the inclusion of a session within the introduction programme revising intravenous fluid therapy and daily electrolyte requirements. Moving forward, once the interventions have been implemented then, the data will be reaudited in six months to note any improvement in maintenance fluid choice. Alongside this, an audit of the rate of intravenous maintenance fluid therapy would be proposed to further increase patient safety by avoiding unintentional fluid overload which may cause unnecessary harm to patients within the hospital. In conclusion, prescription of maintenance fluid therapy was poor within the Emergency Department, and there is a great deal of opportunity for improvement. Therefore, the measures listed above will be implemented and the data reaudited.

Keywords: chloride, electrolyte, emergency department, emergency medicine, fluid, fluid therapy, intravenous, maintenance, major trauma, potassium, sodium, trauma

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121 Culture Dimensions of Information Systems Security in Saudi Arabia National Health Services

Authors: Saleh Alumaran, Giampaolo Bella, Feng Chen

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The study of organisations’ information security cultures has attracted scholars as well as healthcare services industry to research the topic and find appropriate tools and approaches to develop a positive culture. The vast majority of studies in Saudi national health services are on the use of technology to protect and secure health services information. On the other hand, there is a lack of research on the role and impact of an organisation’s cultural dimensions on information security. This research investigated and analysed the role and impact of cultural dimensions on information security in Saudi Arabia health service. Hypotheses were tested and two surveys were carried out in order to collect data and information from three major hospitals in Saudi Arabia (SA). The first survey identified the main cultural-dimension problems in SA health services and developed an initial information security culture framework model. The second survey evaluated and tested the developed framework model to test its usefulness, reliability and applicability. The model is based on human behaviour theory, where the individual’s attitude is the key element of the individual’s intention to behave as well as of his or her actual behaviour. The research identified six cultural dimensions: Saudi national culture, Saudi health service leadership, employees’ trust, technology, multicultural interactions and employees’ job roles. The research also identified a set of cultural sub-dimensions. These include working values and norms, tribe values and norms, attitudes towards women, power sharing, vision, social interaction, respect and understanding, hospital intra-net, hospital employees’ language(s) used, multi-national culture, communication system, employees’ job satisfaction and job security. The research identified that (a) the human behaviour towards medical information in SA is one of the main threats to information security and one of the main challenges to SA health authority, (b) The current situation of SA hospitals’ IS cultures is falling short in protecting medical information due to the current value and norms towards information security, (c) Saudi national culture and employees’ job role are the main dimensions playing major roles in the employees’ attitude, and technology is the least important dimension playing a role in the employees’ attitudes.

Keywords: cultural dimension, electronic health record, information security, privacy

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120 Safeguarding the Cloud: The Crucial Role of Technical Project Managers in Security Management for Cloud Environments

Authors: Samuel Owoade, Zainab Idowu, Idris Ajibade, Abel Uzoka

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Cloud computing adoption continues to soar, with 83% of enterprise workloads estimated to be in the cloud by 2022. However, this rapid migration raises security concerns, needing strong security management solutions to safeguard sensitive data and essential applications. This paper investigates the critical role of technical project managers in orchestrating security management initiatives for cloud environments, evaluating their responsibilities, challenges, and best practices for assuring the resilience and integrity of cloud infrastructures. Drawing from a comprehensive review of industry reports and interviews with cloud security experts, this research highlights the multifaceted landscape of security management in cloud environments. Despite the rapid adoption of cloud services, only 25% of organizations have matured their cloud security practices, indicating a pressing need for effective management strategies. This paper proposes a strategy framework adapted to the demands of technical project managers, outlining the important components of effective cloud security management. Notably, 76% of firms identify misconfiguration as a major source of cloud security incidents, underlining the significance of proactive risk assessment and constant monitoring. Furthermore, the study emphasizes the importance of technical project managers in facilitating cross-functional collaboration, bridging the gap between cybersecurity professionals, cloud architects, compliance officers, and IT operations teams. With 68% of firms seeing difficulties integrating security policies into their cloud systems, effective communication and collaboration are critical to success. Case studies from industry leaders illustrate the practical use of security management projects in cloud settings. These examples demonstrate the importance of technical project managers in using their expertise to address obstacles and generate meaningful outcomes, with 92% of firms reporting improved security practices after implementing proactive security management tactics. In conclusion, this research underscores the critical role of technical project managers in safeguarding cloud environments against evolving threats. By embracing their role as guardians of the cloud realm, project managers can mitigate risks, optimize resource utilization, and uphold the trust and integrity of cloud infrastructures in an era of digital transformation.

Keywords: cloud security, security management, technical project management, cybersecurity, cloud infrastructure, risk management, compliance

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119 Institutional Legitimacy and Professional Boundary: Western Medicine-Trained Doctors' Attitudes and Behaviors toward Traditional Chinese Medicine

Authors: Xiaoli Tian

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The recent growing interest in and use of complementary and alternative medicine is a global phenomenon. In many regions, traditional Chinese medicine (TCM), an important type of complementary and alternative medicine, has been formally integrated into the healthcare system. Consequently, today’s doctors face increasing requests and questions from patients regarding TCM. However, studies of TCM focus either on patients’ approaches to TCM and Western medicine (WM) or on the politics involved in the institutionalization of TCM. To our knowledge, sociological studies on doctors’ attitudes toward TCM are rare. This paper compares the receptivity of WM-trained Chinese doctors to TCM in Hong Kong and mainland China, in order to evaluate the interplay between professional training and dominant medical paradigms, on the one hand, and institutional legitimacy and government and client pressures to accept TCM, on the other. Based on survey and in-depth interviews with Western-medicine doctors in Hong Kong and mainland China, this research finds that: there is major difference between Western-medicine doctors’ attitude toward traditional Chinese medicine (TCM) in Hong Kong and mainland China. Doctors in Hong Kong are still suspicious toward TCM, no matter if they have exposure to TCM or not. Even some doctors who have much knowledge about TCM, such as got a diploma or certificate in TCM or tried TCM themselves, are still suspicious. This is because they hold up to the ideal of 'evidence-based medicine' and emphasize the kind of evidence based on randomized controlled trial (RCT). To Western medicine doctors in Hong Kong, this is the most reliable type of evidence for any medical practice, but it is lacking in TCM. This is the major reason why they do not trust TCM and would not refer patients to TCM in clinical practices. In contrast, western medicine doctors in mainland China also know about randomized controlled trial (RCT) and believe that’s the most reliable evidence, but they tend to think experience-based evidence is also reliable. On this basis, they think TCM also has clinical effectiveness. Research findings reveal that legitimacy based on institutional arrangements is a relevant factor, but how doctors understand their professional boundaries also play an important role. Doctors in Hong Kong are more serious about a strict professional boundary between Western medicine and TCM because they benefited from it, such as a very prestigious status and high income. Doctors in mainland China tend to be flexible about professional boundaries because they never benefited from a well-defined strict professional boundary. This is related to a long history of the lack of professionalism in China but is also aggravated by the increasing state support of TCM.

Keywords: evidence-based decision-making, institutional legitimacy, professional behavior, traditional Chinese medicine

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118 At the Intersection of Race and Gender in Social Work Education

Authors: LaShawnda N. Fields, Valandra

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There remains much to learn about the experiences of Black women within social work education. Higher education, in general, has a strained relationship with this demographic and while social work has espoused a code of ethics and core values, Black women report inequitable experiences similar to those in other disciplines. Research-intensive (R-1) Carnegie-designated institutions typically have lower representation of those with historically marginalized identities; this study focuses on Black women in these schools of social work. This study presents qualitative findings from 9 in-depth interviews with Black women faculty members as well as interviews with 11 Black women doctoral students at R-1 universities. Many of the poor professional outcomes for Black women in academia are a result of their experiences with imposter syndrome and feeling as though they cannot present their authentic selves. The finding of this study highlighted the many ways imposter syndrome manifests within these study participants, from an inability to be productive to overproducing in an effort to win the respect and support of colleagues. Being scrutinized and seen as unprofessional when being authentic has led to some Black women isolating themselves and struggling to remain in academia. Other Black women have decided that regardless of the backlash they may receive, they will proudly present their authentic selves and allow their work to speak for itself rather than conform to the dominant White culture. These semi-structured, in-depth interviews shined a spotlight on the ways Black women doctoral students were denied inclusion throughout their programs. These students often believed both faculty members and peers seemed to actively work to ensure discomfort in these women. In response to these negative experiences and a lack of support, many of these Black women doctoral students created their own networks of support. These networks of support often included faculty members within social work but also beyond their discipline and outside of the academy at large. The faculty members who offered support to this demographic typically shared their race and gender identities. Both Black women faculty members and doctoral students historically have been forced to prioritize surviving, not thriving as a result of toxic environments within their schools of social work. This has negatively impacted their mental health and their levels of productivity. It is necessary for these institutions to build trust with these women by respecting their diverse backgrounds, supporting their race-related research interests, and honoring the rigor in a range of methodologies if substantial, sustainable change is to be achieved.

Keywords: education, equity, inclusion, intersectionality

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117 Comprehensive Geriatric Assessments: An Audit into Assessing and Improving Uptake on Geriatric Wards at King’s College Hospital, London

Authors: Michael Adebayo, Saheed Lawal

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The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.

Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality

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116 Intergenerational Succession within Family Businesses: The Role of Sharing and Creation Knowledge

Authors: Wissal Ben Arfi, Jean-Michel Sahut

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The purpose of this paper is to provide a deeper understanding of the succession process from a knowledge management perspective. By doing that, succession process in family businesses, as an environment for creating and sharing knowledge, was explored. Design/Methodology/Approach: To support our reasoning, we collected qualitative data through 16 in-depth interviews conducted with all decision makers involved in the family businesses succession process in France. These open-ended responses were subsequently exposed to thematic discourse analysis. Findings: Central to this exhibit is the nature and magnitude of knowledge creation and sharing among the actors within the family succession context and how can tacit knowledge sharing facilitate the succession process. We also identified factors that inhibit down the knowledge creation and sharing processes. The sharing and creation of knowledge among members of a family business appear to be a complex process that must be part of a strategy for change. This implies that it requests trust and takes a certain amount of time because it requires organizational change and a clear and coherent strategic vision that is accepted and assimilated by all the members. Professional and leadership skills are of particular importance in knowledge sharing and creation processes. In most cases, tacit knowledge is crucial when it is shared and accumulated collectively. Our findings reveal that managers should find ways of implementing knowledge sharing and creation processes while acknowledging the succession process within family firms. This study highlights the importance of generating knowledge strategies in order to enhance the performance and the success of intergenerational succession. The empirical outcomes contribute to enrich the field of succession management process and enhance the role of knowledge in shaping family performance and longevity. To a large extent, the lessons learned from the study of succession processes in family-owned businesses are that when there is a deliberate effort to introduce a knowledge-based approach, this action becomes a seminal event in the life of the organization. Originality/Value: The paper contributes to the deep understanding of interactions among actors by examining the knowledge creation and sharing processes since current researches in family succession focused on aspects such as personal development of potential, intra-family succession intention, decision-making processes in family businesses. Besides, as succession is one of the key factors that determine the longevity and the performance of family businesses, it also contributes to literature by examining how tacit knowledge is transferred, shared and created in family businesses and how this can facilitate the intergenerational succession process.

Keywords: family-owned businesses, succession process, knowledge, performance

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115 Evolution of Antimicrobial Resistance in Shigella since the Turn of 21st Century, India

Authors: Neelam Taneja, Abhishek Mewara, Ajay Kumar

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Multidrug resistant shigellae have emerged as a therapeutic challenge in India. At our 2000 bed tertiary care referral centre in Chandigarh, North India, which caters to a large population of 7 neighboring states, antibiotic resistance in Shigella is being constantly monitored. Shigellae are isolated from 3 to 5% of all stool samples. In 1990 nalidixic acid was the drug of choice as 82%, and 63% of shigellae were resistant to ampicillin and cotrimoxazole respectively. Nalidixic acid resistance emerged in 1992 and rapidly increased from 6% during 1994-98 to 86% by the turn of 21st century. In the 1990s, the WHO recommended ciprofloxacin as the drug of choice for empiric treatment of shigellosis in view of the existing high level resistance to agents like chloramphenicol, ampicillin, cotrimoxazole and nalidixic acid. First resistance to ciprofloxacin in S. flexneri at our centre appeared in 2000 and rapidly rose to 46% in 2007 (MIC>4mg/L). In between we had an outbreak of ciprofloxacin resistant S.dysenteriae serotype 1 in 2003. Therapeutic failures with ciprofloxacin occurred with both ciprofloxacin-resistant S. dysenteriae and ciprofloxacin-resistant S. flexneri. The severity of illness was more with ciprofloxacin-resistant strains. Till 2000, elsewhere in the world ciprofloxacin resistance in S. flexneri was sporadic and uncommon, though resistance to co-trimoxazole and ampicillin was common and in some areas resistance to nalidixic acid had also emerged. Fluoroquinolones due to extensive use and misuse for many other illnesses in our region are thus no longer the preferred group of drugs for managing shigellosis in India. WHO presently recommends ceftriaxone and azithromycin as alternative drugs to fluoroquinolone-resistant shigellae, however, overreliance on this group of drugs also seems to soon become questionable considering the emerging cephalosporin-resistant shigellae. We found 15.1% of S. flexneri isolates collected over a period of 9 years (2000-2009) resistant to at least one of the third-generation cephalosporins (ceftriaxone/cefotaxime). The first isolate showing ceftriaxone resistance was obtained in 2001, and we have observed an increase in number of isolates resistant to third generation cephalosporins in S. flexneri 2005 onwards. This situation has now become a therapeutic challenge in our region. The MIC values for Shigella isolates revealed a worrisome rise for ceftriaxone (MIC90:12 mg/L) and cefepime (MIC90:8 mg/L). MIC values for S. dysenteriae remained below 1 mg/L for ceftriaxone, however for cefepime, the MIC90 has raised to 4 mg/L. These infections caused by ceftriaxone-resistant S. flexneri isolates were successfully treated by azithromycin at our center. Most worrisome development in the present has been the emergence of DSA(Decreased susceptibility to azithromycin) which surfaced in 2001 and has increased from 4.3% till 2011 to 34% thereafter. We suspect plasmid-mediated resistance as we detected qnrS1-positive Shigella for the first time from the Indian subcontinent in 2 strains from 2010, indicating a relatively new appearance of this PMQR determinant among Shigella in India. This calls for a continuous and strong surveillance of antibiotic resistance across the country. The prevention of shigellosis by developing cost-effective vaccines is desirable as it will substantially reduce the morbidity associated with diarrhoea in the country

Keywords: Shigella, antimicrobial, resistance, India

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114 Impacts of Public Insurance on Health Access and Outcomes: Evidence from India

Authors: Titir Bhattacharya, Tanika Chakraborty, Prabal K. De

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Maternal and child health continue to be a significant policy focus in developing countries, including India. An emerging model in health care is the creation of public and private partnerships. Since the construction of physical infrastructure is costly, governments at various levels have tried to implement social health insurance schemes where a trust calculates insurance premiums and medical payments. Typically, qualifying families get full subsidization of the premium and get access to private hospitals, in addition to low cost public hospitals, for their tertiary care needs. We analyze one such pioneering social insurance scheme in the Indian state of Andhra Pradesh (AP). The Rajiv Aarogyasri program (RA) was introduced by the Government of AP on a pilot basis in 2007 and implemented in 2008. In this paper, we first examine the extent to which access to reproductive health care changed. For example, the RA scheme reimburses hospital deliveries leading us to expect an increase in institutional deliveries, particularly in private hospitals. Second, we expect an increase in institutional deliveries to also improve child health outcomes. Hence, we estimate if the program improved infant and child mortality. We use District Level Health Survey data to create annual birth cohorts from 2000-2015. Since AP was the only state in which such a state insurance program was implemented, the neighboring states constituted a plausible control group. Combined with the policy timing, and the year of birth, we employ a difference-indifference strategy to identify the effects of RA on the residents of AP. We perform several checks against threats to identification, including testing for pre-treatment trends between the treatment and control states. We find that the policy significantly lowered infant and child mortality in AP. We also find that deliveries in private hospitals increased, and government hospitals decreased, showing a substitution effect of the relative price change. Finally, as expected, out-of-pocket costs declined for the treatment group. However, we do not find any significant effects for usual preventive care such as vaccination, showing that benefits of insurance schemes targeted at the tertiary level may not trickle down to the primary care level.

Keywords: public health insurance, maternal and child health, public-private choice

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113 COVID-19: Potential Effects of Nutritional Factors on Inflammation Relief

Authors: Maryam Nazari

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COVID-19 is a respiratory disease triggered by the novel coronavirus, SARS-CoV-2, that has reached pandemic status today. Acute inflammation and immune cells infiltration into lung injuries result in multi-organ failure. The presence of other non-communicable diseases (NCDs) with systemic inflammation derived from COVID-19 may exacerbate the patient's situation and increase the risk for adverse effects and mortality. This pandemic is a novel situation and the scientific community at this time is looking for vaccines or drugs to treat the pathology. One of the biggest challenges is focused on reducing inflammation without compromising the correct immune response of the patient. In this regard, addressing the nutritional factors should not be overlooked not only as a matter of avoiding the presence of NCDs with severe infections but also as an adjunctive way to modulate the inflammatory status of the patients. Despite the pivotal role of nutrition in modifying immune response, due to the novelty of the COVID-19 disease, information about the effects of specific dietary agents is limited in this area. From the macronutrients point of view, protein deficiency (quantity or quality) has negative effects on the number of functional immunoglobulins and gut-associated lymphoid tissue (GALT). High biological value proteins or some amino acids like arginine and glutamine are well known for their ability to augment the immune system. Among lipids, fish oil has the ability to inactivate enveloped viruses, suppress pro-inflammatory prostaglandin production and block platelet-activating factors and their receptors. In addition, protectin D1, which is an Omega-3 PUFAs derivation, is a novel antiviral drug. So it seems that these fatty acids can reduce the severity and/or improve recovery of patients with COVID-19. Carbohydrates with lower glycemic index and fibers are associated with lower levels of inflammatory cytokines (CRP, TNF-α, and IL-6). Short-Chain Fatty acids not only exert a direct anti-inflammatory effect but also provide appropriate gut microbial, which is important in gastrointestinal issues related to COVID-19. From the micronutrients point of view, Vitamins A, C, D, E, iron, magnesium, zinc, selenium and copper play a vital role in the maintenance of immune function. Inadequate status in these nutrients may result in decreased resistance against COVID-19 infection. There are specific bioactive compounds in the diet that interact with the ACE2 receptor, which is the gateway for SARS and SARS-CoV-2, and thus controls the viral infection. Regarding this, the potential benefits of probiotics, resveratrol (a polyphenol found in grape), oleoylethanolamide (derived from oleic acid), and natural peroxisome proliferator-activated receptor γ agonists in foodstuffs (like curcumin, pomegranate, hot pepper) are suggested. Yet, it should be pointed out that most of these results have been reported in animal models and further human studies are needed to be verified.

Keywords: Covid-19, inflammation, nutrition, dietary agents

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112 Clinical Validation of an Automated Natural Language Processing Algorithm for Finding COVID-19 Symptoms and Complications in Patient Notes

Authors: Karolina Wieczorek, Sophie Wiliams

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Introduction: Patient data is often collected in Electronic Health Record Systems (EHR) for purposes such as providing care as well as reporting data. This information can be re-used to validate data models in clinical trials or in epidemiological studies. Manual validation of automated tools is vital to pick up errors in processing and to provide confidence in the output. Mentioning a disease in a discharge letter does not necessarily mean that a patient suffers from this disease. Many of them discuss a diagnostic process, different tests, or discuss whether a patient has a certain disease. The COVID-19 dataset in this study used natural language processing (NLP), an automated algorithm which extracts information related to COVID-19 symptoms, complications, and medications prescribed within the hospital. Free-text patient clinical patient notes are rich sources of information which contain patient data not captured in a structured form, hence the use of named entity recognition (NER) to capture additional information. Methods: Patient data (discharge summary letters) were exported and screened by an algorithm to pick up relevant terms related to COVID-19. Manual validation of automated tools is vital to pick up errors in processing and to provide confidence in the output. A list of 124 Systematized Nomenclature of Medicine (SNOMED) Clinical Terms has been provided in Excel with corresponding IDs. Two independent medical student researchers were provided with a dictionary of SNOMED list of terms to refer to when screening the notes. They worked on two separate datasets called "A” and "B”, respectively. Notes were screened to check if the correct term had been picked-up by the algorithm to ensure that negated terms were not picked up. Results: Its implementation in the hospital began on March 31, 2020, and the first EHR-derived extract was generated for use in an audit study on June 04, 2020. The dataset has contributed to large, priority clinical trials (including International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) by bulk upload to REDcap research databases) and local research and audit studies. Successful sharing of EHR-extracted datasets requires communicating the provenance and quality, including completeness and accuracy of this data. The results of the validation of the algorithm were the following: precision (0.907), recall (0.416), and F-score test (0.570). Percentage enhancement with NLP extracted terms compared to regular data extraction alone was low (0.3%) for relatively well-documented data such as previous medical history but higher (16.6%, 29.53%, 30.3%, 45.1%) for complications, presenting illness, chronic procedures, acute procedures respectively. Conclusions: This automated NLP algorithm is shown to be useful in facilitating patient data analysis and has the potential to be used in more large-scale clinical trials to assess potential study exclusion criteria for participants in the development of vaccines.

Keywords: automated, algorithm, NLP, COVID-19

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111 Graduates Construction of Knowledge and Ability to Act on Employable Opportunities

Authors: Martabolette Stecher

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Introductory: How is knowledge and ability to act on employable opportunities constructed among students and graduates at higher educations? This question have been drawn much attention by researchers, governments and universities in Denmark, since there has been an increases in the rate of unemployment among graduates from higher education. The fact that more than ten thousand graduates from higher education without the opportunity to get a job in these years has a tremendous impact upon the social economy in Denmark. Every time a student graduate from higher education and become unemployed, it is possible to trace upon the person´s chances to get a job many years ahead. This means that the tremendous rate of graduate unemployment implies a decrease in employment and lost prosperity in Denmark within a billion Danish Kroner scale. Basic methodologies: The present study investigates the construction of knowledge and ability to act upon employable opportunities among students and graduates at higher educations in Denmark in a literature review as well as a preliminary study of students from Aarhus University. 15 students from the candidate of drama have been engaging in an introductory program at the beginning of their candidate study, which included three workshops focusing upon the more personal matters of their studies and life. They have reflected upon this process during the intervention and afterwards in a semi-structured interview. Concurrently a thorough literature review has delivered key concepts for the exploration of the research question. Major findings of the study: It is difficult to find one definition of what employability encompasses, hence the overall picture of how to incorporate the concept is difficult. The present theory of employability has been focusing upon the competencies, which students and graduates are going to develop in order to become employable. In recent years there has been an emphasis upon the mechanism which supports graduates to trust themselves and to develop their self-efficacy in terms of getting a sustainable job. However, there has been little or no focus in the literature upon the idea of how students and graduates from higher education construct knowledge about and ability to act upon employable opportunities involving network of actors both material and immaterial network and meaningful relations for students and graduates in developing their enterprising behavior to achieve employment. The Act-network-theory combined with theory of entrepreneurship education suggests an alternative strategy to focus upon when explaining sustainable ways of creating employability among graduates. The preliminary study also supports this theory suggesting that it is difficult to emphasize a single or several factors of importance rather highlighting the effect of a multitude network. Concluding statement: This study is the first step of a ph.d.-study investigating this problem in Denmark and the USA in the period 2015 – 2019.

Keywords: employablity, graduates, action, opportunities

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110 Ecolabelling : Normative Power or Corporate Strategy? : A Study Case of Textile Company in Indonesia

Authors: Suci Lestari Yuana, Shofi Fatihatun Sholihah, Derarika Ensta Jesse

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Textile is one of buyer-driven industry which rely on label trust from the consumers. Most of textile manufacturers produce textile and textile products based on consumer demands. The company’s policy is highly depend on the dynamic evolution of consumers behavior. Recently, ecofriendly has become one of the most important factor of western consumers to purchase the textile and textile product (TPT) from the company. In that sense, companies from developing countries are encouraged to follow western consumers values. Some examples of ecolabel certificate are ISO (International Standard Organisation), Lembaga Ekolabel Indonesia (Indonesian Ecolabel Instution) and Global Ecolabel Network (GEN). The submission of national company to international standard raised a critical question whether this is a reflection towards the legitimation of global norms into national policy or it is actually a practical strategy of the company to gain global consumer. By observing one of the prominent textile company in Indonesia, this research is aimed to discuss what kind of impetus factors that cause a company to use ecolabel and what is the meaning behind it. Whether it comes from normative power or the strategy of the company. This is a qualitative research that choose a company in Sukoharjo, Central Java, Indonesia as a case study in explaining the pratice of ecolabelling by textitle company. Some deep interview is conducted with the company in order to get to know the ecolabelling process. In addition, this research also collected some document which related to company’s ecolabelling process and its impact to company’s value. The finding of the project reflected issues that concerned several issues: (1) role of media as consumer information (2) role of government and non-government actors as normative agency (3) role of company in social responsibility (4) the ecofriendly consciousness as a value of the company. As we know that environmental norms that has been admitted internationally has changed the global industrial process. This environmental norms also pushed the companies around the world, especially the company in Sukoharjo, Central Java, Indonesia to follow the norm. The neglection toward the global norms will remained the company in isolated and unsustained market that will harm the continuity of the company. So, in buyer-driven industry, the characteristic of company-consumer relations has brought a fast dynamic evolution of norms and values. The creation of global norms and values is circulated by passing national territories or identities.

Keywords: ecolabeling, waste management, CSR, normative power

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109 Social Business Evaluation in Brazil: Analysis of Entrepreneurship and Investor Practices

Authors: Erica Siqueira, Adriana Bin, Rachel Stefanuto

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The paper aims to identify and to discuss the impact and results of ex-ante, mid-term and ex-post evaluation initiatives in Brazilian Social Enterprises from the point of view of the entrepreneurs and investors, highlighting the processes involved in these activities and their aftereffects. The study was conducted using a descriptive methodology, primarily qualitative. A multiple-case study was used, and, for that, semi-structured interviews were conducted with ten entrepreneurs in the (i) social finance, (ii) education, (iii) health, (iv) citizenship and (v) green tech fields, as well as three representatives of various impact investments, which are (i) venture capital, (ii) loan and (iii) equity interest areas. Convenience (non-probabilistic) sampling was adopted to select both businesses and investors, who voluntarily contributed to the research. The evaluation is still incipient in most of the studied business cases. Some stand out by adopting well-known methodologies like Global Impact Investing Report System (GIIRS), but still, have a lot to improve in several aspects. Most of these enterprises use nonexperimental research conducted by their own employees, which is ordinarily not understood as 'golden standard' to some authors in the area. Nevertheless, from the entrepreneur point of view, it is possible to identify that most of them including those routines in some extent in their day-by-day activities, despite the difficulty they have of the business in general. In turn, the investors do not have overall directions to establish evaluation initiatives in respective enterprises; they are funding. There is a mechanism of trust, and this is, usually, enough to prove the impact for all stakeholders. The work concludes that there is a large gap between what the literature states in regard to what should be the best practices in these businesses and what the enterprises really do. The evaluation initiatives must be included in some extension in all enterprises in order to confirm social impact that they realize. Here it is recommended the development and adoption of more flexible evaluation mechanisms that consider the complexity involved in these businesses’ routines. The reflections of the research also suggest important implications for the field of Social Enterprises, whose practices are far from what the theory preaches. It highlights the risk of the legitimacy of these enterprises that identify themselves as 'social impact', sometimes without the proper proof based on causality data. Consequently, this makes the field of social entrepreneurship fragile and susceptible to questioning, weakening the ecosystem as a whole. In this way, the top priorities of these enterprises must be handled together with the results and impact measurement activities. Likewise, it is recommended to perform further investigations that consider the trade-offs between impact versus profit. In addition, research about gender, the entrepreneur motivation to call themselves as Social Enterprises, and the possible unintended consequences from these businesses also should be investigated.

Keywords: evaluation practices, impact, results, social enterprise, social entrepreneurship ecosystem

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108 21st Century Business Dynamics: Acting Local and Thinking Global through Extensive Business Reporting Language (XBRL)

Authors: Samuel Faboyede, Obiamaka Nwobu, Samuel Fakile, Dickson Mukoro

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In the present dynamic business environment of corporate governance and regulations, financial reporting is an inevitable and extremely significant process for every business enterprise. Several financial elements such as Annual Reports, Quarterly Reports, ad-hoc filing, and other statutory/regulatory reports provide vital information to the investors and regulators, and establish trust and rapport between the internal and external stakeholders of an organization. Investors today are very demanding, and emphasize greatly on authenticity, accuracy, and reliability of financial data. For many companies, the Internet plays a key role in communicating business information, internally to management and externally to stakeholders. Despite high prominence being attached to external reporting, it is disconnected in most companies, who generate their external financial documents manually, resulting in high degree of errors and prolonged cycle times. Chief Executive Officers and Chief Financial Officers are increasingly susceptible to endorsing error-laden reports, late filing of reports, and non-compliance with regulatory acts. There is a lack of common platform to manage the sensitive information – internally and externally – in financial reports. The Internet financial reporting language known as eXtensible Business Reporting Language (XBRL) continues to develop in the face of challenges and has now reached the point where much of its promised benefits are available. This paper looks at the emergence of this revolutionary twenty-first century language of digital reporting. It posits that today, the world is on the brink of an Internet revolution that will redefine the ‘business reporting’ paradigm. The new Internet technology, eXtensible Business Reporting Language (XBRL), is already being deployed and used across the world. It finds that XBRL is an eXtensible Markup Language (XML) based information format that places self-describing tags around discrete pieces of business information. Once tags are assigned, it is possible to extract only desired information, rather than having to download or print an entire document. XBRL is platform-independent and it will work on any current or recent-year operating system, or any computer and interface with virtually any software. The paper concludes that corporate stakeholders and the government cannot afford to ignore the XBRL. It therefore recommends that all must act locally and think globally now via the adoption of XBRL that is changing the face of worldwide business reporting.

Keywords: XBRL, financial reporting, internet, internal and external reports

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107 Polarization as a Proxy of Misinformation Spreading

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

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

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

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106 Health Communication and the Diabetes Narratives of Key Social Media Influencers in the UK

Authors: Z. Sun

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Health communication is essential in promoting healthy lifestyles, managing disease conditions, and eventually reducing health disparities. The key elements of successful health communication always include the development of communication strategies to engage people in thinking about their health, inform them about healthy choices, persuade them to adopt safe and healthy behaviours, and eventually achieve public health objectives. The use of 'Narrative' is recognised as a kind of health communication strategy to enhance personal and public health due to its potential persuasive effect in motivating and supporting individuals change their beliefs and behaviours by inviting them into a narrative world, breaking down their cognitive and emotional resistance and enhance their acceptance of the ideas portrayed in narratives. Meanwhile, the popularity of social media has provided a novel means of communication for both healthcare stakeholders, and a special group of active social media users (influencers) have started playing a pivotal role in providing health ‘solutions’. Such individuals are often referred to as ‘influencers’ because of their central position in the online communication system and the persuasive effect their actions may have on audiences. They may have established a positive rapport with their audience, earned trust and credibility in a specific area, and thus, their audience considers the information they delivered to be authentic and influential. To our best knowledge, to date, there is no published research that examines the effect of diabetes narratives presented by social media influencers and their impacts on health-related outcomes. The primary aim of this study is to investigate the diabetes narratives presented by social media influencers in the UK because of the new dimension they bring to health communication and the potential impact they may have on audiences' health outcomes. This study is situated within the interpretivist and narrative paradigms. A mixed methodology combining both quantitative and qualitative approaches has been adopted. Qualitative data has been derived to provide a better understanding of influencers’ personal experiences and how they construct meanings and make sense of their world, while quantitative data has been accumulated to identify key social media influencers in the UK and measure the impact of diabetes narratives on audiences. Twitter has been chosen as the social media platform to initially identify key influencers. Two groups of participants are the top 10 key social media influencers in the UK and 100 audiences of each influencer, which means a total of 1000 audiences have been invited. This paper is going to discuss, first of all, the background of the research under the context of health communication; Secondly, the necessity and contribution of this research; then, the major research questions being explored; and finally, the methods to be used.

Keywords: diabetes, health communication, narratives, social media influencers

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105 Collaboration versus Cooperation: Grassroots Activism in Divided Cities and Communication Networks

Authors: R. Barbour

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Peace-building organisations act as a network of information for communities. Through fieldwork, it was highlighted that grassroots organisations and activists may cooperate with each other in their actions of peace-building; however, they would not collaborate. Within two divided societies; Nicosia in Cyprus and Jerusalem in Israel, there is a distinction made by organisations and activists with regards to activities being more ‘co-operative’ than ‘collaborative’. This theme became apparent when having informal conversations and semi-structured interviews with various members of the activist communities. This idea needs further exploration as these distinctions could impact upon the efficiency of peacebuilding activities within divided societies. Civil societies within divided landscapes, both physically and socially, play an important role in conflict resolution. How organisations and activists interact with each other has the possibility to be very influential with regards to peacebuilding activities. Working together sets a positive example for divided communities. Cooperation may be considered a primary level of interaction between CSOs. Therefore, at the beginning of a working relationship, organisations cooperate over basic agendas, parallel power structures and focus, which led to the same objective. Over time, in some instances, due to varying factors such as funding, more trust and understanding within the relationship, it could be seen that processes progressed to more collaborative ways. It is evident to see that NGOs and activist groups are highly independent and focus on their own agendas before coming together over shared issues. At this time, there appears to be more collaboration in Nicosia among CSOs and activists than Jerusalem. The aims and objectives of agendas also influence how organisations work together. In recent years, Nicosia, and Cyprus in general, have perhaps changed their focus from peace-building initiatives to more environmental issues which have become new-age reconciliation topics. Civil society does not automatically indicate like-minded organisations however solidarity within social groups can create ties that bring people and resources together. In unequal societies, such as those in Nicosia and Jerusalem, it is these ties that cut across groups and are essential for social cohesion. Societies are a collection of social groups; individuals who have come together over common beliefs. These groups in turn shape the identities and determine the values and structures within societies. At many different levels and stages, social groups work together through cooperation and collaboration. These structures in turn have the capabilities to open up networks to less powerful or excluded groups, with the aim to produce social cohesion which may contribute social stability and economic welfare over any extended period.

Keywords: collaboration, cooperation, grassroots activism, networks of communication

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104 Phenolic Acids of Plant Origin as Promising Compounds for Elaboration of Antiviral Drugs against Influenza

Authors: Vladimir Berezin, Aizhan Turmagambetova, Andrey Bogoyavlenskiy, Pavel Alexyuk, Madina Alexyuk, Irina Zaitceva, Nadezhda Sokolova

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Introduction: Influenza viruses could infect approximately 5% to 10% of the global human population annually, resulting in serious social and economic damage. Vaccination and etiotropic antiviral drugs are used for the prevention and treatment of influenza. Vaccination is important; however, antiviral drugs represent the second line of defense against new emerging influenza virus strains for which vaccines may be unsuccessful. However, the significant drawback of commercial synthetic anti-flu drugs is the appearance of drug-resistant influenza virus strains. Therefore, the search and development of new anti-flu drugs efficient against drug-resistant strains is an important medical problem for today. The aim of this work was a study of four phenolic acids of plant origin (Gallic, Syringic, Vanillic, and Protocatechuic acids) as a possible tool for treatment against influenza virus. Methods: Phenolic acids; gallic, syringic, vanillic, and protocatechuic have been prepared by extraction from plant tissues and purified using high-performance liquid chromatography fractionation. Avian influenza virus, strain A/Tern/South Africa/1/1961 (H5N3) and human epidemic influenza virus, strain A/Almaty/8/98 (H3N2) resistant to commercial anti-flu drugs (Rimantadine, Oseltamivir) were used for testing antiviral activity. Viruses were grown in the allantoic cavity of 10 days old chicken embryos. The chemotherapeutic index (CTI), determined as the ratio of an average toxic concentration of the tested compound (TC₅₀) to the average effective virus-inhibition concentration (EC₅₀), has been used as a criteria of specific antiviral action. Results: The results of study have shown that the structure of phenolic acids significantly affected their ability to suppress the reproduction of tested influenza virus strains. The highest antiviral activity among tested phenolic acids was detected for gallic acid, which contains three hydroxyl groups in the molecule at C3, C4, and C5 positions. Antiviral activity of gallic acid against A/H5N3 and A/H3N2 influenza virus strains was higher than antiviral activity of Oseltamivir and Rimantadine. gallic acid inhibited almost 100% of the infection activity of both tested viruses. Protocatechuic acid, which possesses 2 hydroxyl groups (C3 and C4) have shown weaker antiviral activity in comparison with gallic acid and inhibited less than 10% of virus infection activity. Syringic acid, which contains two hydroxyl groups (C3 and C5), was able to suppress up to 12% of infection activity. Substitution of two hydroxyl groups by methoxy groups resulted in the complete loss of antiviral activity. Vanillic acid, which is different from protocatechuic acid by replacing of C3 hydroxyl group to methoxy group, was able to suppress about 30% of infection activity of tested influenza viruses. Conclusion: For pronounced antiviral activity, the molecular of phenolic acid must have at least two hydroxyl groups. Replacement of hydroxyl groups to methoxy group leads to a reduction of antiviral properties. Gallic acid demonstrated high antiviral activity against influenza viruses, including Rimantadine and Oseltamivir resistant strains, and could be used as a potential candidate for the development of antiviral drug against influenza virus.

Keywords: antiviral activity, influenza virus, drug resistance, phenolic acids

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103 Social Mentoring: Towards Formal and Informal Deployment in the Structures of the Social and Solidarity Economy

Authors: Vanessa Casadella, Mourad Chouki, Agnès Ceccarelli, Sofiane Tahi

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Mentoring is positioned in an interpersonal and intergenerational perspective, serving the transmission of interpersonal skills and organizational culture. It echoes orientation, project, self-actualization, guidance, transmission, and filiation. It is available using a formal or informal approach. The formal dimension refers to a privileged relationship between a senior and a junior. Informal mentoring is unplanned and emerges naturally between two people who choose each other. However, it remains more difficult to understand. To study the link between formal and informal mentoring and to define the notion of “social” mentoring, we conducted a qualitative study of an exploratory nature with around ten SSE organizations located in the southeast region of Tunisia. The wealth of this territory has pushed residents to found SSE organizations with a view to creating jobs but also to preserving traditions and preserving nature. These organizations developed spontaneously to solve various local problems, such as the revitalization of deserted rural areas, environmental degradation, and the reskilling and professional reintegration of people marginalized in the labor market. This research, based on semi-structured interviews in order to obtain exhaustive and sensitive data, involves an interview guide with few questions mobilized to let the respondents, leaders of the different structures, express themselves freely. The guide includes questions on activities, methods of sharing knowledge, and difficulties in understanding between stakeholders. The interviews, lasting 30 to 60 minutes, were recorded using a dictaphone and then transcribed in full. The results are as follows: 1. We see two iterative mentoring loops. A first loop can be considered a type of formal mentoring. It highlights the support organized (in the form of training) by social enterprises with the aim of developing the autonomy, know-how, and interpersonal skills of members. A second loop concerns informal mentoring. This is non-formalized support provided by members or with other members of the entourage. This informal mentoring is mainly based on the observation of good practices and learning by doing. 2. We notice an intersection between the two loops. If the first loop is not done, the second will not take place. The knowledge acquired in the first loop is used to feed the second. 3. We note a form of reluctance on the part of some members to share their knowledge for reasons of competition. Ultimately, we retain the notion of “social” mentoring as a hybridization of formal and informal mentoring while dimensioning the “social” perspective by emphasizing the reciprocal character, solidarity, confidence, and trust between the mentor and the mentee.

Keywords: social innovation, social mentoring, social and solidarity economy, informal mentoring

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102 Intervention To Prevent Infections And Reinfections With Intestinal Parasites In People Living With Human Immunodeficiency Virus In Some Parts Of Eastern Cape, South Africa

Authors: Ifeoma Anozie, Teka Apalata, Dominic Abaver

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Introduction: Despite use of Anti-retroviral therapy to reduce the incidence of opportunistic infections among HIV/AIDS patients, rapid episodes of re-infection after deworming are still common occurrences because pharmaceutical intervention alone does not prevent reinfection. Unsafe water and inadequate personal hygiene and parasitic infections are widely expected to accelerate the progression of HIV infection. This is because the chronic immunosuppression of HIV infection encourages susceptibility to opportunistic (including parasitic) infections which is linked to CD4+ cell count of <200 cells/μl. Intestinal parasites such as G. intestinalis and Entamoeba spp are ubiquitous protozoa that remain infectious over a long time in an environment and show resistance to standard disinfection. To control re-infection, the social factors that underpin the prevention need to be controlled. This study aims at prevention of intestinal parasites in people living with HIV/AIDS by using a treatment, hygiene education and sanitation (THEdS) bundle approach. Methods: This study was conducted in four clinics (Ngangelizwe health centre, Tsolo gateway clinic, Idutywa health centre and Nqamakwe health centre) across the seven districts in Eastern cape, South Africa. The four clinics were divided in two: experimental and control, for the purpose of intervention. Data was collected from March 2019 to February 2020. Six hundred participants were screened for intestinal parasitic infections. Stool samples were collected and analysed twice: before (Pre-test infection screening) and after (Post-test re-infection) THEdS bundle intervention. The experimental clinics received full intervention package, which include therapeutic treatment, health education on personal hygiene and sanitation training, while the control clinics received only therapeutic treatment for those found with intestinal parasitic infections. Results: Baseline prevalence of Intestinal Parasites isolated shows 12 intestinal parasites with overall frequency of 65, with Ascaris lumbricoides having most frequency (44.6%). The intervention had a cure rate of 60%, with odd ratio of 1.42, which indicates that the intervention group is 1.42 times more likely of parasite clearing as compared to the control group. The relative risk ratio of 1.17 signifies that there is 1.17 times more likelihood to clear intestinal parasite if there no intervention. Discussion and conclusion: Infection with multiple parasites can cause health defects, especially among HIV/AIDS patients. Efficiency of some HIV vaccines in HIV/AIDS patients is affected because treatment of re-infection amplifies drug resistance, affects the efficacy of the front-line drugs, and still permits transmission. In South Africa, treatment of intestinal parasites is usually offered to clinic attending HIV/AIDS patients upon suspicion but not as a mandate for patients being initiated into Antiretroviral (ART) program. The effectiveness of THEdS bundle advocates for inclusiveness of mandatory screening for intestinal parasitic infections among attendees of HIV/Aids clinics on regular basis.

Keywords: cure rate, , HIV/AIDS patients, intestinal parasites, intervention studies, reinfection rate

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101 Evolution of Web Development Progress in Modern Information Technology

Authors: Abdul Basit Kiani

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Web development, the art of creating and maintaining websites, has witnessed remarkable advancements. The aim is to provide an overview of some of the cutting-edge developments in the field. Firstly, the rise of responsive web design has revolutionized user experiences across devices. With the increasing prevalence of smartphones and tablets, web developers have adapted to ensure seamless browsing experiences, regardless of screen size. This progress has greatly enhanced accessibility and usability, catering to the diverse needs of users worldwide. Additionally, the evolution of web frameworks and libraries has significantly streamlined the development process. Tools such as React, Angular, and Vue.js have empowered developers to build dynamic and interactive web applications with ease. These frameworks not only enhance efficiency but also bolster scalability, allowing for the creation of complex and feature-rich web solutions. Furthermore, the emergence of progressive web applications (PWAs) has bridged the gap between native mobile apps and web development. PWAs leverage modern web technologies to deliver app-like experiences, including offline functionality, push notifications, and seamless installation. This innovation has transformed the way users interact with websites, blurring the boundaries between traditional web and mobile applications. Moreover, the integration of artificial intelligence (AI) and machine learning (ML) has opened new horizons in web development. Chatbots, intelligent recommendation systems, and personalization algorithms have become integral components of modern websites. These AI-powered features enhance user engagement, provide personalized experiences, and streamline customer support processes, revolutionizing the way businesses interact with their audiences. Lastly, the emphasis on web security and privacy has been a pivotal area of progress. With the increasing incidents of cyber threats, web developers have implemented robust security measures to safeguard user data and ensure secure transactions. Innovations such as HTTPS protocol, two-factor authentication, and advanced encryption techniques have bolstered the overall security of web applications, fostering trust and confidence among users. Hence, recent progress in web development has propelled the industry forward, enabling developers to craft innovative and immersive digital experiences. From responsive design to AI integration and enhanced security, the landscape of web development continues to evolve, promising a future filled with endless possibilities.

Keywords: progressive web applications (PWAs), web security, machine learning (ML), web frameworks, advancement responsive web design

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100 Autonomy in Pregnancy and Childbirth: The Next Frontier of Maternal Health Rights Advocacy

Authors: Alejandra Cardenas, Ona Flores, Fabiola Gretzinger

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Since the 1990s, legal strategies for the promotion and protection of maternal health rights have achieved significant gains. Successful litigation in courts around the world have shown that these rights can be judicially enforceable. Governments and international organizations have acknowledged the importance of a human rights-based approach to maternal mortality and morbidity, and obstetric violence has been recognized as a human rights issue. Despite the progress made, maternal mortality has worsened in some regions of the world, while progress has stagnated elsewhere, and mistreatment in maternal care is reported almost universally. In this context, issues of maternal autonomy and decision-making during pregnancy, labor, and delivery as a critical barrier to access quality maternal health have been largely overlooked. Indeed, despite the principles of autonomy and informed consent in medical interventions being well-established in international and regional norms, how they are applied particularly during childbirth and pregnancy remains underdeveloped. National and global legal standards and decisions related to maternal health were reviewed and analyzed to determine how maternal autonomy and decision-making during pregnancy, labor, and delivery have been protected (or not) by international and national courts. The results of this legal research and analysis lead to the conclusion that a few standards have been set by courts regarding pregnant people’s rights to make choices during pregnancy and birth; however, most undermine the agency of pregnant people. These decisions recognize obstetric violence and gender-based discrimination, but fail to protect pregnant people’s autonomy, privacy, and their right to informed consent. As current human rights standards stand today, maternal health is the only field in medicine and law in which informed consent can be overridden, and patients can be forced to submit to treatments against their will. Unconsented treatment and loss of agency during pregnancy and childbirth can have long-term physical and mental impacts, reduce satisfaction and trust in health systems, and may deter future health-seeking behaviors. This research proposes a path forward that focuses on the pregnant person as an independent agent, relying on the doctrine of self-determination during pregnancy and childbirth, which includes access to the necessary conditions to enable autonomy and choice throughout pregnancy and childbirth as a critical step towards our approaches to reduce maternal mortality, morbidity, and mistreatment, and realize the promise of access to quality maternal health as a human right.

Keywords: autonomy in childbirth and pregnancy, choice, informed consent, jurisprudential analysis

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99 Criteria to Access Justice in Remote Criminal Trial Implementation

Authors: Inga Žukovaitė

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This work aims to present postdoc research on remote criminal proceedings in court in order to streamline the proceedings and, at the same time, ensure the effective participation of the parties in criminal proceedings and the court's obligation to administer substantive and procedural justice. This study tests the hypothesis that remote criminal proceedings do not in themselves violate the fundamental principles of criminal procedure; however, their implementation must ensure the right of the parties to effective legal remedies and a fair trial and, only then, must address the issues of procedural economy, speed and flexibility/functionality of the application of technologies. In order to ensure that changes in the regulation of criminal proceedings are in line with fair trial standards, this research will provide answers to the questions of what conditions -first of all, legal and only then organisational- are required for remote criminal proceedings to ensure respect for the parties and enable their effective participation in public proceedings, to create conditions for quality legal defence and its accessibility, to give a correct impression to the party that they are heard and that the court is impartial and fair. It also seeks to present the results of empirical research in the courts of Lithuania that was made by using the interview method. The research will serve as a basis for developing a theoretical model for remote criminal proceedings in the EU to ensure a balance between the intention to have innovative, cost-effective, and flexible criminal proceedings and the positive obligation of the State to ensure the rights of participants in proceedings to just and fair criminal proceedings. Moreover, developments in criminal proceedings also keep changing the image of the court itself; therefore, in the paper will create preconditions for future research on the impact of remote criminal proceedings on the trust in courts. The study aims at laying down the fundamentals for theoretical models of a remote hearing in criminal proceedings and at making recommendations for the safeguarding of human rights, in particular the rights of the accused, in such proceedings. The following criteria are relevant for the remote form of criminal proceedings: the purpose of judicial instance, the legal position of participants in proceedings, their vulnerability, and the nature of required legal protection. The content of the study consists of: 1. Identification of the factual and legal prerequisites for a decision to organise the entire criminal proceedings by remote means or to carry out one or several procedural actions by remote means 2. After analysing the legal regulation and practice concerning the application of the elements of remote criminal proceedings, distinguish the main legal safeguards for protection of the rights of the accused to ensure: (a) the right of effective participation in a court hearing; (b) the right of confidential consultation with the defence counsel; (c) the right of participation in the examination of evidence, in particular material evidence, as well as the right to question witnesses; and (d) the right to a public trial.

Keywords: remote criminal proceedings, fair trial, right to defence, technology progress

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98 A Conceptual Model of the Factors Affecting Saudi Citizens' Use of Social Media to Communicate with the Government

Authors: Reemiah Alotaibi, Muthu Ramachandran, Ah-Lian Kor, Amin Hosseinian-Far

Abstract:

In the past decade, developers of Web 2.0 technologies have shown increasing interest in the topic of e-government. There has been a rapid growth in social media technology because of its significant role in backing up some essential social needs. Its importance and power is derived from its capacity to support two-way communication. Governments are curious to get engaged in these websites, hoping to benefit from the new forms of communication and interaction offered by such technology. Greater participation by the public can be viewed as a chief indicator of effective government communication. Yet, the level of public participation in government 2.0 is not quite satisfactory. In general, it is still at the early stage in most developing countries, including Saudi Arabia. Although it is a fact that Saudi people are among the most active in using social media, the number of people who use social media to communicate with the public institutions is not high. Furthermore, most of the governmental organisations are not using social media tools to communicate with the public. They use these platforms to disseminate information. Our study focuses on the factors affecting citizens’ adoption of social media in Saudi Arabia. Our research question is: what are the factors affecting Saudi citizens’ use of social media to communicate with the government? To answer this research question, the research aims to validate the UTAUT model for examining social media tools from the citizen perspective. An amendment will be proposed to fit the adoption of social media platforms as a communication channel in government by using a developed conceptual model which integrates constructs from the UTAUT model and others external variables based on the literature review. The set of potential factors that affect these citizens' decisions to adopt social media to communicate with their government has been identified as perceived encouragement, trust and cultural influence. The connection between the above-mentioned constructs from the basis for the research hypothesis will be examined in the light of a quantitative methodology. Data collection will be performed through a survey targeting a number of Saudi citizens who are social media users. The data collected from the primary survey will later be analysed by using statistical methods. The outcomes of this research project are argued to have potential contributions to the fields of social media and e-Government adoption, both on the theoretical and practical levels. It is believed that this research project is the first of its type that attempts to identify the factors that affect citizens’ adoption of social media to communicate with the government. The importance of identifying these factors stems from the potential use of them to enhance the government’s implementation of social media and help in making more accurate decisions and strategies based on comprehending the most important factors that affect citizens’ decisions.

Keywords: social media, adoption, citizen, UTAUT model

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97 Genetically Engineered Crops: Solution for Biotic and Abiotic Stresses in Crop Production

Authors: Deepak Loura

Abstract:

Production and productivity of several crops in the country continue to be adversely affected by biotic (e.g., Insect-pests and diseases) and abiotic (e.g., water temperature and salinity) stresses. Over-dependence on pesticides and other chemicals is economically non-viable for the resource-poor farmers of our country. Further, pesticides can potentially affect human and environmental safety. While traditional breeding techniques and proper- management strategies continue to play a vital role in crop improvement, we need to judiciously use biotechnology approaches for the development of genetically modified crops addressing critical problems in the improvement of crop plants for sustainable agriculture. Modern biotechnology can help to increase crop production, reduce farming costs, and improve food quality and the safety of the environment. Genetic engineering is a new technology which allows plant breeders to produce plants with new gene combinations by genetic transformation of crop plants for improvement of agronomic traits. Advances in recombinant DNA technology have made it possible to have genes between widely divergent species to develop genetically modified or genetically engineered plants. Plant genetic engineering provides the strength to harness useful genes and alleles from indigenous microorganisms to enrich the gene pool for developing genetically modified (GM) crops that will have inbuilt (inherent) resistance to insect pests, diseases, and abiotic stresses. Plant biotechnology has made significant contributions in the past 20 years in the development of genetically engineered or genetically modified crops with multiple benefits. A variety of traits have been introduced in genetically engineered crops which include (i) herbicide resistance. (ii) pest resistance, (iii) viral resistance, (iv) slow ripening of fruits and vegetables, (v) fungal and bacterial resistance, (vi) abiotic stress tolerance (drought, salinity, temperature, flooding, etc.). (vii) quality improvement (starch, protein, and oil), (viii) value addition (vitamins, micro, and macro elements), (ix) pharmaceutical and therapeutic proteins, and (x) edible vaccines, etc. Multiple genes in transgenic crops can be useful in developing durable disease resistance and a broad insect-control spectrum and could lead to potential cost-saving advantages for farmers. The development of transgenic to produce high-value pharmaceuticals and the edible vaccine is also under progress, which requires much more research and development work before commercially viable products will be available. In addition, molecular-aided selection (MAS) is now routinely used to enhance the speed and precision of plant breeding. Newer technologies need to be developed and deployed for enhancing and sustaining agricultural productivity. There is a need to optimize the use of biotechnology in conjunction with conventional technologies to achieve higher productivity with fewer resources. Therefore, genetic modification/ engineering of crop plants assumes greater importance, which demands the development and adoption of newer technology for the genetic improvement of crops for increasing crop productivity.

Keywords: biotechnology, plant genetic engineering, genetically modified, biotic, abiotic, disease resistance

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96 Telepsychiatry for Asian Americans

Authors: Jami Wang, Brian Kao, Davin Agustines

Abstract:

COVID-19 highlighted the active discrimination against the Asian American population easily seen through media, social tension, and increased crimes against the specific population. It is well known that long-term racism can also have a large impact on both emotional and psychological well-being. However, the healthcare disparity during this time also revealed how the Asian American community lacked the research data, political support, and medical infrastructure for this particular population. During a time when Asian American fear for safety with decreasing mental health, telepsychiatry is particularly promising. COVID-19 demonstrated how well psychiatry could integrate with telemedicine, with psychiatry being the second most utilized telemedicine visits. However, the Asian American community did not utilize the telepsychiatry resources as much as other groups. Because of this, we wanted to understand why the patient population who was affected the most by COVID-19 mentally did not seek out care. To do this, we decided to study the top top telepsychiatry platforms. The current top telepsychiatry companies in the United States include Teladoc and BetterHelp. In the Teladoc mental health sector, they only had 4 available languages (English, Spanish, French, and Danis,) with none of them being an Asian language. In a similar manner, Teladoc’s top competitor in the telepsychiatry space, BetterHelp, only listed a total of 3 Asian languages, including Mandarin, Japanese, and Malaysian. However, this is still a short list considering they have over 20 languages available. The shortage of available physicians that speak multiple languages is concerning, as it could be difficult for the Asian American community to relate with. There are limited mental health resources that cater to their likely cultural needs, further exacerbating the structural racism and institutional barriers to appropriate care. It is important to note that these companies do provide interpreters to comply with the nondiscrimination and language assistance federal law. However, interactions with an interpreter are not only more time-consuming but also less personal than talking directly with a physician. Psychiatry is the field that emphasizes interpersonal relationships. The trust between a physician and the patient is critical in developing patient rapport to guide in better understanding the clinical picture and treating the patient appropriately. The language barrier creates an additional barrier between the physician and patient. Because Asian Americans are one of the largest growing patient population bases, these telehealth companies have much to gain by catering to the Asian American market. Without providing adequate access to bilingual and bicultural physicians, the current system will only further exacerbate the growing disparity. The healthcare community and telehealth companies need to recognize that the Asian American population is a severely underserved population in mental health and has much to gain from telepsychiatry. The lack of language is one of many reasons why there is a disparity for Asian Americans in the mental health space.

Keywords: telemedicine, psychiatry, Asian American, disparity

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95 The Management of Company Directors Conflicts of Interest in Large Corporations and the Issue of Public Interest

Authors: Opemiposi Adegbulu

Abstract:

The research investigates the existence of a public interest consideration or rationale for the management of directors’ conflicts of interest within large public corporations. This is conducted through extensive literature review and theories on the definition of conflicts of interest, the firm and purposes of the fiduciary duty of loyalty under which the management of these conflicts of interest find their foundation. Conflicts of interest is an elusive, diverse and engaging subject, a cross-cutting problem of governance which involves all levels of governance, ranging from local to global, public to corporate or financial sectors. It is a common issue that affects corporate governance and corporate culture, having a negative impact on the reputation of corporations and their trustworthiness. It is clear that addressing this issue is imperative for good governance of corporations as they are increasingly becoming and are powerful global economies with significant power and influence in the society. Similarly, the bargaining power of these powerful corporations has been recognised by international organisations such as the UN and the OECD. This is made evident by the increasing calls and push for greater responsibility of these corporations for environmental and social disasters caused by their corporate activities and their impact in various parts of the world. Equally, in the US, the Sarbanes-Oxley Act like other legislation and regulatory efforts made to manage conflicts of interest linked to corporate governance, in many countries indicates that there is a (global) public interest in the maintenance of the orderly functioning of commerce. Consequently, the governance of these corporations is tremendously pivotal to the society as it touches upon a key aspect of the good functioning of society. This is because corporations, particularly large international corporations can be said to be the plumbing of the global economy. This study will employ theoretical, doctrinal and comparative methods. The research will make use largely of theory-guided methodology and theoretical framework – theories of the firm, public interest, regulation, conflicts of interest in general, directors’ conflicts of interest and corporate governance. Although, the research is intended to be narrowed down to the topic of conflicts of interest in corporate governance, the subject of company directors’ duty of loyalty and the management of conflicts of interest, an examination of the history, origin and typology of conflicts of interest in general will be carried out in order to identify some specific challenges to understanding and identifying these conflicts of interest; origin, diverging theories, psychological barrier to definition, similarities with public sector conflicts of interest due to the notions of corrosion of trust, the effect on decision-making and judgment, “being in a particular kind of situation”, etc. The result of this research will be useful and relevant in the identification of the rationale for the management of directors’ conflicts of interest, contributing to the understanding of conflicts of interest in the private sector and the significance of public interest in corporate governance of large corporations.

Keywords: conflicts of interest, corporate governance, corporate law, directors duty of loyalty, public interest

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