Search results for: social determinants of oral health
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 18126

Search results for: social determinants of oral health

10656 The Analgesic Impact of Adding Intrathecal Ketamine to Spinal Anaesthesia for Hip or Knee Arthroplasty: A Clinical Audit

Authors: Carl Ashworth, Matthys Campher

Abstract:

Spinal anaesthesia has been identified as the “gold standard” for primary elective total hip and knee arthroplasty, which is most commonly performed using longer-acting local anaesthetics, such as hyperbaric bupivacaine, to prolong the duration of anaesthesia and analgesia suitable for these procedures. Ketamine is known to have local anaesthetic effects with potent analgesic properties and has been evaluated as a sole anaesthetic agent via intrathecal administration; however, the use of intrathecal ketamine as an adjunct to intrathecal hyperbaric bupivacaine, morphine, and fentanyl has not been extensively studied. The objective of this study was to identify the potential analgesic effects of the addition of intrathecal ketamine to spinal anaesthesia and to compare the efficacy and safety of adding intrathecal ketamine to spinal anaesthesia for hip- or knee arthroplasty with spinal anaesthesia for hip- or knee arthroplasty without intrathecal ketamine. The medical records of patients who underwent elective hip- or knee arthroplasty under spinal anaesthesia performed by an individual anaesthetist with either intrathecal hyperbaric bupivacaine, morphine and fentanyl or intrathecal hyperbaric bupivacaine, morphine, fentanyl and ketamine between June 4, 2020, and June 4, 2022, were retrospectively reviewed. These encounters were reviewed and analyzed from a perioperative pain perspective, with the primary outcome measure as the oral morphine equivalent (OME) usage in the 48 hours post-spinal anaesthesia, and secondary outcome measures including time to breakthrough analgesia, self-reported pain scores at rest and during movement at 24 and 48 hours after surgery, adverse effects of analgesia, complications, and length of stay. There were 26 patients identified who underwent TKR between June 4, 2020, and June 4, 2022, and 25 patients who underwent THR with the same conditions. It was identified that patients who underwent traditional spinal anaesthesia with the addition of ketamine for elective hip- or knee arthroplasty had a lower mean total OME in the 48 hours immediately post-spinal anaesthesia yet had a shorter time to breakthrough analgesia administration. The proposed mechanism of action for intrathecal ketamine as an additive to traditional spinal anaesthesia for elective hip- or knee arthroplasty is that it may prolong and attenuate the analgesic effect of traditional spinal anaesthesia. There were no significant differences identified in comparing the efficacy and safety of adding intrathecal ketamine to spinal anaesthesia for hip- or knee arthroplasty with spinal anaesthesia for hip- or knee arthroplasty without intrathecal ketamine.

Keywords: anaesthesia, spinal, intra-thecal, ketamine, spinal-morphine, bupivacaine

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10655 Place-Based Practice: A New Zealand Rural Nursing Study

Authors: Jean Ross

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Rural nursing is not an identified professional identity in the UK, unlike the USA, Canada, and Australia which recognizes rural nursing as a specialty scope of practice. In New Zealand rural nursing is an underrepresented aspect of nursing practice, is misunderstood and does not fit easily within the wider nursing profession and policies governing practice. This study situated within the New Zealand context adds to the international studies’ aligned with rural nursing practice. The study addresses a gap in the literature by striving to identify and strengthen the awareness of and increase rural nurses’ understanding and articulation of their changing and adapting identity and furthermore an opportunity to appreciate their contribution to the delivery of rural health care. In addition, this study adds to the growing global rural nursing knowledge and theoretical base. This research is a continuation of the author’s academic involvement and ongoing relationships with the rural nursing sector, national policy analysts and health care planners since the 1990s. These relationships have led to awareness, that despite rural nurses’ efforts to explain the particular nuances which make up their practice, there has been little recognition by profession to establish rural nursing as a specialty. The research explored why nurses’ who practiced in the rural Otago region of New Zealand, between the 1990s and early 2000s moved away from the traditional identity as a district, practice or public health nurse and looked towards a more appropriate identity which reflected their emerging practice. This qualitative research situated within the interpretive paradigm embeds this retrospective study within the discipline of nursing and engages with the concepts of place and governmentality. National key informant and Otago regional rural nurse interviews generated data and were analyzed using thematic analysis. Stemming from the analyses, an analytical diagrammatic matrix was developed demonstrating rural nursing as a ‘place–based practice’ governed both from within and beyond location presenting how the nurse aligns the self in the rural community as a meaningful provider of health care. Promoting this matrix may encourage a focal discussion point within the international spectrum of nursing and likewise between rural and non-rural nurses which it is hoped will generate further debate in relation to the different nuances aligned with rural nursing practice. Further, insights from this paper may capture key aspects and issues related to identity formation in respect to rural nurses, from the UK, New Zealand, Canada, USA, and Australia.

Keywords: matrix, place, nursing, rural

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10654 Patient Advocates to Improve Access to Justice in Involuntary Hospitalisation

Authors: Zuzana Durajova, Natasa Diatkova, Shreya Bhardwaj

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This paper introduces the project START, its activities, goals, evaluation and final results. Over the past few decades, the legal discourse surrounding mental health has resulted in improvement in patient rights (in Netherlands, etc.), the appointment of Ombudspersons for psychiatric patients (in Austria, Sweden) and facilitating the participation of patients in decision-making processes. Czech legislation already recognizes the position of “patient’s advocate” as a person of trust. However, this instrument is not very widely known and rarely used in practice. In the pilot study of the project, legal training for patient advocacy is provided to persons with experience with mental health problems/psychiatric hospitalization chosen from a Czech-based NGO. These persons (patient advocates) visit patients in involuntary hospitalization in one closed ward in the chosen psychiatric institution. During visits, the patient advocates inform patients about their legal standing, their procedural rights and also offer them individual support in contacting their counsel, family members etc. To understand the effect of the intervention, qualitative interviews and participant observations are conducted with the patients, advocates, the hospital management and staff and other identifiable stakeholders, such as government officials responsible for mental health care reform. The interviews are held before, during and after the intervention (support from patient advocates in hospitals). Given the ethical quandaries arising from using psychiatric wards as a field setting, we assume a participatory approach to ensure respect for patient boundaries and dignity. Through this project, we seek to establish a profession of patient advocates based on professional standards.

Keywords: patient advocacy, involuntary hospitalization, Czech Republic, patient Rights, professionalization

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10653 The Strategies and Mediating Processes of Learning the Inflectional Morphology in English: A Case Study for Taiwanese English Learners

Authors: Hsiu-Ling Hsu, En-Minh (John) Lan

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Pronunciation has received more and more language researchers’ and teachers’ attention because it is important for effective or even successful communication. How to consistently and correctly orally produce verbal morphology, such as English regular past tense inflection, has been a big challenge and troublesome for FL learners. The research aims to explore EFL (English as a foreign language) learners’ developmental trajectory of the inflectional morphology, that is, what mediating processes and strategies EFL learners use, to attain native-like prosodic structure of inflectional morphemes (e.g., –ed and –s suffixes) by comparing the differences among EFL learners at different English levels. This research adopted a self-repair analysis and Prosodic Transfer Hypothesis with three developmental stages as a theoretical framework. To answer the research questions, we conducted two experiments, grammatical tense test written production (Experiment 1) and read-aloud oral production (Experiment 2), and recruited 30 participants who were divided into three groups, low-, middle-, and advanced EFL learners. Experiment 1 was conducted to ensure that participants had learned the knowledge of forming the English regular past tense rules and Experiment 2 was carried out to compare the data across FL English learner groups at different English levels. The EFL learners’ self-repair data showed at least four interesting findings. First, low achievers were more sensitive to the plural suffix -s than the past tense suffix -ed. Middle achievers exhibited a greater responsiveness to the past tense suffix, while high achievers demonstrated equal sensitivity to both suffixes. Additionally, two strategies used by EFL English learners to produce verbs and nouns with inflectional morphemes were to delete internal syllable and to divide a four-syllable verb (e.g., ‘graduated’) into two prosodic structures (e.g., ‘gradu’ and ‘ated’ or ‘gradua’ and ‘ted’). Third, true vowel epenthesis was found only in the low EFL achievers. Moreover fortition (native-like sound) was observed in the low and middle EFL achievers. These findings and self-repair data disclosed mediating processes between the developmental stages and provided insight on how Taiwan EFL learners attained the adjunction prosodic structures of inflectional Morphemes in English.

Keywords: inflectional morphology, prosodic structure, developmental trajectory, strategies and mediating processes, English as a foreign language

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10652 The Current Importance of the Rules of Civil Procedure in the Portuguese Legal Order: Between Legalism and Adequation

Authors: Guilherme Gomes, Jose Lebre de Freitas

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The rules of Civil Procedure that are defined in the Portuguese Civil Procedure Code of 2013 particularly their articles 552 to 626- represent the model that the legislator thought that would be more suitable for national civil litigation, from the moment the action is brought by the plaintiff to the moment when the sentence is issued. However, procedural legalism is no longer a reality in the Portuguese Civil Procedural Law. According to the article 547 of the code of 2013, the civil judge has a duty to adopt the procedure that better suits the circumstances of the case, whether or not it is the one defined by law. The main goal of our paper is to answer the question whether the formal adequation imposed by this article diminishes the importance of the Portuguese rules of Civil Procedure and their daily application by national civil judges. We will start by explaining the appearance of the abovementioned rules in the Civil Procedure Code of 2013. Then we will analyse, using specific examples that were obtained by the books we read, how the legal procedure defined in the abovementioned code does not suit the circumstances of some specific cases and is totally inefficient in some situations. After that, we will, by using the data obtained in the practical research that we are conducting in the Portuguese civil courts within the scope of our Ph.D. thesis (until now, we have been able to consult 150 civil lawsuits), verify whether and how judges and parties make the procedure more efficient and effective in the case sub judice. In the scope of our research, we have already reached some preliminary findings: 1) despite the fact that the legal procedure does not suit the circumstances of some civil lawsuits, there are only two situations of frequent use of formal adequation (the judge allowing the plaintiff to respond to the procedural exceptions deduced in the written defense and the exemption from prior hearing for the judges who never summon it), 2) the other aspects of procedural adequation (anticipation of the production of expert evidence, waiving of oral argument at the final hearing, written allegations, dismissal of the dispatch on the controversial facts and the examination of witnesses at the domicile of one of the lawyers) are still little used and 3) formal adequation tends to happen by initiative of the judge, as plaintiffs and defendants are afraid of celebrating procedural agreements in most situations. In short, we can say that, in the Portuguese legal order of the 21st century, the flexibility of the legal procedure, as it is defined in the law and applied by procedural subjects, does not affect the importance of the rules of Civil Procedure of the code of 2013.

Keywords: casuistic adequation, civil procedure code of 2013, procedural subjects, rules of civil procedure

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10651 Effect on Occupational Health Safety and Environment at Work from Metal Handicraft Using Rattanakosin Local Wisdom

Authors: Witthaya Mekhum, Waleerak Sittisom

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This research investigated the effect on occupational health safety and environment at work from metal handicraft using Rattanakosin local wisdom focusing on pollution, accidents, and injuries from work. The sample group in this study included 48 metal handicraft workers in 5 communities by using questionnaires and interview to collect data. The evaluation form TISI 18001 was used to analyze job safety analysis (JSA). The results showed that risk at work reduced after applying the developed model. Banbu Community produces alloy bowl rubbed with stone. The high risk process is melting and hitting process. Before the application, the work risk was 82.71%. After the application of the developed model, the work risk was reduced to 50.61%. Banbart Community produces monk’s food bowl. The high risk process is blow pipe welding. Before the application, the work risk was 93.59%. After the application of the developed model, the work risk was reduced to 48.14%. Bannoen Community produces circle gong. The high risk process is milling process. Before the application, the work risk was 85.18%. After the application of the developed model, the work risk was reduced to 46.91%. Teethong Community produces gold leaf. The high risk process is hitting and spreading process. Before the application, the work risk was 86.42%. After the application of the developed model, the work risk was reduced to 64.19%. Ban Changthong Community produces gold ornament. The high risk process is gold melting process. Before the application, the work risk was 67.90%. After the application of the developed model, the work risk was reduced to 37.03%. It can be concluded that with the application of the developed model, the work risk of 5 communities was reduced in the 3 main groups: (1) Work illness reduced by 16.77%; (2) Pollution from work reduced by 10.31%; (3) Accidents and injuries from work reduced by 15.62%.

Keywords: occupational health, safety, local wisdom, Rattanakosin

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10650 Poetics of Labor: A Study of Selected Contemporary Australian Aboriginal and Immigrant Poets

Authors: Nabeel Mohammed Ali

Abstract:

Background and significance of the study: This study focuses on the experiences, perspectives, and issues of the working-class Aboriginals and immigrants in Australia. In addition to dealing with their lives, struggles, and aspirations of working-class people, poetry of labor presents an insight into a neglected literary writing that goes beyond the social discourse of class distinction. In this contemporary context, it explores a broader spectrum of challenges and experiences, such as the complexities of modern labor, immigration, indigenous rights, social justice, multiculturalism, economic inequality, advocating for workers' rights and labor movements, the impact of globalization on local industries, and the evolution of labor in the digital age. Aims of the Study: The study will try to answer the following questions: What insights does poetics of labor provide to affect the literary creation of poetry at the time, as well as whether it can create a change in the social fabric of Australian diversity? What are the main themes and issues that Aboriginal and immigrant poets address in their works? How do they reflect the realities and challenges of working-class people in Australia? How do they use language, form, and style to convey their messages and emotions? How do the poets engage with and critique the dominant narratives and ideologies of Australian society and culture? How do they challenge or resist the stereotypes, prejudices, and discrimination that they face? And how do they show solidarity or empathy with others who share similar struggles or aspirations? Methodology: The study will utilize traditional Marxist paradigms to analyze the poetry of the selected poets in the context of the evolving sociopolitical landscape of the 21st century. The Neo-Marxist literary criticism is used as a theoretical tool to analyze the texts. The concept of Power dynamics to analyze the intersectionality of race, labor and class. Findings: The poetry of contemporary Australian Aboriginal and immigrant poets labor, represents a critical, yet under-explored, discussion of the intersection of labor, class, and a multicultural identity. The study will deal with the poetry of the Aboriginal poet Ali Cobby Eckermann (1963- ) and the immigrant Chinese poet Ouyang Yu ( 1955- ).

Keywords: aboriginals, immigrants, Australia, working-class, Ali eckermann, ouyang Yu

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10649 The Potential Role of Industrialized Building Systems in Malaysian Sustainable Construction: Awareness and Barriers

Authors: Aawag Mohsen Al-Awag, Wesam Salah Alaloul, M. S. Liew

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Industrialized building system (IBS) is a method of construction with concentrated practices consisting of techniques, products, and a set of linked elements which operate collectively to accomplish objectives. The Industrialised Building System (IBS) has been recognised as a viable method for improving overall construction performance in terms of quality, cost, safety and health, waste reduction, and productivity. The Malaysian construction industry is considered one of the contributors to the development of the country. The acceptance level of IBS is still below government expectations. Thus, the Malaysian government has been continuously encouraging the industry to use and implement IBS. Conventional systems have several drawbacks, including project delays, low economic efficiency, excess inventory, and poor product quality. When it comes to implementing IBS, construction companies still face several obstacles and problems, notably in terms of contractual and procurement concerns, which leads to the low adoption of IBS in Malaysia. There are barriers to the acceptance of IBS technology, focused on awareness of historical failure and risks connected to IBS practices to provide enhanced performance. Therefore, the transformation from the existing conventional building systems to the industrialized building systems (IBS) is needed more than ever. The flexibility of IBS in Malaysia’s construction industry is very low due to numerous shortcomings and obstacles. Due to its environmental, economic, and social benefits, IBS could play a significant role in the Malaysian construction industry in the future. This paper concentrates on the potential role of IBS in sustainable construction practices in Malaysia. It also highlights the awareness, barriers, advantages, and disadvantages of IBS in the construction sector. The study concludes with recommendations for Malaysian construction stakeholders to encourage and increase the utilization of industrialised building systems.

Keywords: construction industry, industrialized building system, barriers, advantages and disadvantages, construction, sustainability, Malaysia

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10648 Chronic Renal Failure Associated with Heavy Metal Contamination of Drinking Water in Hail, Kingdom of Saudi Arabia

Authors: Elsayed A. M. Shokr, A. Alhazemi, T. Naser, Talal A. Zuhair, Adel A. Zuhair, Ahmed N. Alshamary, Thamer A. Alanazi, Hosam A. Alanazi

Abstract:

The main threats to human health from heavy metals are associated with exposure to Pb, Cd, Cu, Mo, Zn, Ni, Mn Co and Cr. is mainly via intake of drinking water being the most important source in most populations. These metals have been extensively studied and their effects on human health regularly reviewed by international bodies such as the WHO. Heavy metals have been used by humans for thousands of years. Although several adverse health effects of heavy metals have been known for a long time, exposure to heavy metals continues, and is even increasing in some parts of the world, in particular in less developed countries, though emissions have declined in most developed countries over the last 100 years. A strong relationship between contaminated drinking water with heavy metals from some of the stations of water shopping in Hail, KSA and chronic diseases such as renal failure, liver cirrhosis, and chronic anemia has been identified in this study. These diseases are apparently related to contaminant drinking water with heavy metals such as Pb, Cd, Cu, Mo, Zn, Ni, Mn Co and Cr. Renal failure is related to contaminate drinking water with lead and cadmium, liver cirrhosis to copper and molybdenum, and chronic anemia to copper and cadmium. Recent data indicate that adverse health effects of cadmium exposure may occur at lower exposure levels than previously anticipated, primarily in the form of kidney damage but possibly also bone effects and fractures. The general population is primarily exposed to mercury via drinking water being a major source of methyl mercury exposure, and dental amalgam. During the last century lead, cadmium, zinc, iron and arsenic is mainly via intake of drinking water being the most important source in most populations. Long-term exposure to lead, cadmium, zinc, iron and arsenic in drinking-water is mainly related to primarily in the form of kidney damage. Studies of these diseases suggest that abnormal incidence in specific areas is related to toxic materials in the groundwater and thereby led to the contamination of drinking water in these areas.

Keywords: heavy metals, liver functions, kidney functions and chronic renal failure, hail, renal, water

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10647 Departing beyond the Orthodoxy: An Integrative Review and Future Research Avenues of Human Capital Resources Theory

Authors: Long Zhang, Ian Hampson, Loretta O' Donnell

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Practitioners in various industries, especially in the finance industry that conventionally benefit from financial capital and resources, appear to be increasingly aware of the importance of human capital resources (HCR) after the 2008 Global Financial Crisis. Scholars from diverse fields have conducted extensive and fruitful research on HCR within their own disciplines. This review suggests that the mainstream of pure quantitative research alone is insufficient to provide precise or comprehensive understanding of HCR. The complex relationships and interactions in HCR call for more integrative and cross-disciplinary research to more holistically understand complex and intricate HCRs. The complex nature of HCR requires deep qualitative exploration based on in-depth data to capture the everydayness of organizational activities and to register its individuality and variety. Despite previous efforts, a systematic and holistic integration of HCR research among multiple disciplines is lacking. Using a retrospective analysis of articles published in the field of economics, finance and management, including psychology, human resources management (HRM), organizational behaviour (OB), industrial and organizational psychology (I-O psychology), organizational theory, and strategy literatures, this study summaries and compares the major perspectives, theories, and findings on HCR research. A careful examination of the progress of the debates of HCR definitions and measurements in distinct disciplines enables an identification of the limitations and gaps in existing research. It enables an analysis of the interplay of these concepts, as well as that of the related concepts of intellectual capital, social capital, and Chinese guanxi, and how they provide a broader perspective on the HCR-related influences on firms’ competitive advantage. The study also introduces the themes of Environmental, Social and Governance, or ESG based investing, as the burgeoning body of ESG studies illustrates the rising importance of human and non-financial capital in investment process. The ESG literature locates HCR into a broader research context of the value of non-financial capital in explaining firm performance. The study concludes with a discussion of new directions for future research that may help advance our knowledge of HCR.

Keywords: human capital resources, social capital, Chinese guanxi, human resources management

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10646 Patterns of Problem Behavior of Out-Of-School Adolescents and Gender Difference in South Korea

Authors: Jaeyoung Lee, Minji Je

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Objectives: The adolescents not attending school are named out-of-school adolescents. They are more vulnerable to health management and are likely to be exposed to a number of risk factors. This study was conducted to investigate the problem behavior of out-of-school adolescents and analyze the difference caused by gender. Methods: In this study, the problem behaviors of out-of-school adolescents, the vulnerable class, were defined in 8 types and based on this definition, the survey on run away from home, drop out, prostitution, violence, internet game addiction, theft, drug addiction, and smoking was conducted. The study was conducted in a total of 507 out-of-school adolescents, including 342 males, and 165 females. The type, frequency and start time of the 8 problem behaviors were identified. The collected data were analyzed with chi-square test and t-test using SPSS statistics 22. Results: Among the problem behaviors of the subjects, violence ( =17.41, p < .001), internet game addiction ( =16.14, p < .001), theft ( =22.48, p < .001), drug addiction ( =4.17, p=.041), and smoking ( =3.90, p=.048) were more significantly high in male out-of-school adolescents than female out-of-school adolescents. In addition, the frequency of the problem behavior was higher in male out-of-school adolescents with statistical significance than in female out-of-school adolescents (t=5.08, p= < .001). In terms of the start time of the problem behavior, only internet game addiction was higher in male out-of-school adolescents with the statistical significance than in female out-of-school adolescents ( =6.22, p=.032). No statistically significant difference was found in other problem behaviors (p > .05). Conclusions: In this study, it was found that gender difference in problem behaviors of out-of-school adolescents exists, and its frequency and difference of types were identified. When the social countermeasures were provided for those adolescents, a distinguished approach is required depending on the patterns of problem behavior and gender. When preparing policy alternatives and interventions for out-of-school adolescents, it is required to reflect the results of this study.

Keywords: addictive behavior, adolescent, gender, problem behavior

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10645 Motives for Reshoring from China to Europe: A Hierarchical Classification of Companies

Authors: Fabienne Fel, Eric Griette

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Reshoring, whether concerning back-reshoring or near-reshoring, is a quite recent phenomenon. Despite the economic and political interest of this topic, academic research questioning determinants of reshoring remains rare. Our paper aims at contributing to fill this gap. In order to better understand the reasons for reshoring, we conducted a study among 280 French firms during spring 2016, three-quarters of which sourced, or source, in China. 105 firms in the sample have reshored all or part of their Chinese production or supply in recent years, and we aimed to establish a typology of the motives that drove them to this decision. We asked our respondents about the history of their Chinese supplies, their current reshoring strategies, and their motivations. Statistical analysis was performed with SPSS 22 and SPAD 8. Our results show that change in commercial and financial terms with China is the first motive explaining the current reshoring movement from this country (it applies to 54% of our respondents). A change in corporate strategy is the second motive (30% of our respondents); the reshoring decision follows a change in companies’ strategies (upgrading, implementation of a CSR policy, or a 'lean management' strategy). The third motive (14% of our sample) is a mere correction of the initial offshoring decision, considered as a mistake (under-estimation of hidden costs, non-quality and non-responsiveness problems). Some authors emphasize that developing a short supply chain, involving geographic proximity between design and production, gives a competitive advantage to companies wishing to offer innovative products. Admittedly 40% of our respondents indicate that this motive could have played a part in their decision to reshore, but this reason was not enough for any of them and is not an intrinsic motive leading to leaving Chinese suppliers. Having questioned our respondents about the importance given to various problems leading them to reshore, we then performed a Principal Components Analysis (PCA), associated with an Ascending Hierarchical Classification (AHC), based on Ward criterion, so as to point out more specific motivations. Three main classes of companies should be distinguished: -The 'Cost Killers' (23% of the sample), which reshore their supplies from China only because of higher procurement costs and so as to find lower costs elsewhere. -The 'Realists' (50% of the sample), giving equal weight or importance to increasing procurement costs in China and to the quality of their supplies (to a large extend). Companies being part of this class tend to take advantage of this changing environment to change their procurement strategy, seeking suppliers offering better quality and responsiveness. - The 'Voluntarists' (26% of the sample), which choose to reshore their Chinese supplies regardless of higher Chinese costs, to obtain better quality and greater responsiveness. We emphasize that if the main driver for reshoring from China is indeed higher local costs, it is should not be regarded as an exclusive motivation; 77% of the companies in the sample, are also seeking, sometimes exclusively, more reactive suppliers, liable to quality, respect for the environment and intellectual property.

Keywords: China, procurement, reshoring, strategy, supplies

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10644 A Comparison of Ethical Perceptions of Business Students In MINA

Authors: Leonie Jooste

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The main purpose of this article is to explore the ethical values of accounting students at Universities and Business Managers. Financial fraud (earnings management) is continuing to exist and published in literature and social media. However, irrespective of extensive publication, and academic research, financial fraud is still happening or still being committed. The student of today may be the manager in the future. In a study by Bruns and Merchant, the authors found that the morality of short-term earnings management was of little concern to researchers and accounting practitioners. However, in the light of increased financial frauds and failures, new and increased emphasis has been placed on the importance of the concepts of earnings quality, earnings management practices, and the inclusion of business ethics in accounting syllabi. This study uses a quantitative analysis related to the Bruns and Merchant survey of accounting students. 59 accounting students in the MENA area were surveyed in 2022 to measure their ethical values regarding earning management practices in organisations. The results of this survey were compared the surveys in 2013 to determine if courses in business ethics offered at the university influenced the perceptions of students on unethical behaviour in business practices. For the data analysis, the mean values and significant differences were calculated and compared. Overall, the results showed that there was hardly any significant difference between the two surveys.

Keywords: ethics, earnings management, corporate social responsibility, business courses.

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10643 Analyzing the Critical Factors Influencing Employees' Tacit and Explicit Knowledge Sharing Intentions for Sustainable Competitive Advantage: A Systematic Review and a Conceptual Framework

Authors: Made Ayu Aristyana Dewi

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Due to the importance of knowledge in today’s competitive world, an understanding of how to enhance employee knowledge sharing has become critical. This study discerning employees’ knowledge sharing intentions according to the type of knowledge to be shared, whether tacit or explicit. This study provides a critical and systematic review of the current literature on knowledge sharing, with a particular focus on the most critical factors influencing employees’ tacit and explicit knowledge sharing intentions. The extant literature was identified through four electronic databases, from 2006 to 2016. The findings of this review reveal that most of the previous studies only focus on individual and social factors as the antecedents of knowledge sharing intention. Therefore, those previous studies did not consider some other potential factors, like organizational and technological factors that may hinder the progress of knowledge sharing processes. Based on the findings of the critical review, a conceptual framework is proposed, which presents the antecedents of employees’ tacit and explicit knowledge sharing intentions and its impact on innovation and sustainable competitive advantage.

Keywords: antecedents, explicit knowledge, individual factors, innovation, intentions, knowledge sharing, organizational factors, social factors, sustainable competitive advantage, tacit knowledge, technological factors

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10642 Child Abuse: Emotional, Physical, Neglect, Sexual and the Psychological Effects: A Case Scenario in Lagos State

Authors: Aminu Ololade Matilda

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Child abuse is a significant issue worldwide, affecting the socio-development and mental and physical health of young individuals. It is the maltreatment of a child by an adult or a child. This paper focuses on child abuse in Communities in Lagos State. The aim of this study is to investigate the extent of child abuse and its impact on the mood, social activities, self-worth, concentration, and academic performance of children in Communities in Lagos State. The primary research instrument used in this study was the interview (Forensic), which consisted of two sections. The first section gathered data on the details of the child and the forms and impacts of abuse experienced, while the second section focused on parental style. The study found that children who experienced various forms of abuse, such as emotional, neglect, physical, or sexual abuse, were hesitant to report it out of fear of threats or even death from the abuser. These abused children displayed withdrawn behaviour, depression, and low self-worth and underperformed academically compared to their peers who did not experience abuse. The findings align with socio-learning and intergenerational transmission of violence theories, which suggest that parents and caregivers who engage in child abuse often do so because they themselves experienced or witnessed abuse as children, thereby normalizing violence. The study highlights the prevalent issue of child abuse in Lagos State and emphasizes the need for advocacy programs and capacity building to raise awareness about child abuse and prevention. The distribution of the Child’s Rights Act in various sectors is also recommended to underscore the importance of protecting the rights of children. Additionally, the inclusion of courses on child abuse in the school curriculum is proposed to ensure children are educated on recognizing and reporting abuse.

Keywords: abuse, child, awareness, effects, emotional, neglect, physical, psychological, sexual, recognize, reporting, right

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10641 Knowledge, Attitude and Associated Factors of Practice towards Post Exposure Prophylaxis of HIV Infection among Health Professionals in Yeka and Kazanchis Health Center

Authors: Semira Zeru Haileslassie

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Lack of awareness and practices of PEP treatment were observed among respondents, but they had a better attitude towards PEP. To this end, a formal training for all respondents regarding PEP for HIV prior to their clinical attachments is of utmost importance. The training ought to incorporate a brief clarification with respect to the unpleasant impact of non-adherence that essentially incorporate destitute treatment result and most prominent hazard of resistance and few given as a major cause for non-compliance to PEP, common transient side-effects of PEP and its administrations ought to be cloister educated healthcare specialists to diminish its effect on adherence. Besides, the propensity of detailing needle adhere harm was destitute that needs endeavors to progress. Progressing the culture of detailing and making the detailing handle simple is very necessary. In reality, announcing such wounds as early as conceivable will educate others not to commit same issue once more and, for the most part, will empower stakeholders to intercede the issue sometime prior to it re-occur. At long last, as distant as get up and go utilize has cleared out with so numerous bothers, risk decrease is the foremost choice. With this, taking the increased significance of protective barriers so as to decrease the hazard of exposure to HIV, distinctive stakeholders (the healing center hardware supply chain director, the HIV/ Helps clinic, the clinic chief, hardware and supply quality confirmation group, and other authoritative bodies) ought to work together in co-ordination to secure the supply and guarantee the quality of those crucial protective barriers and to advance demand health laborers to continuously wear protective barriers when exposed to HIV hazard components as well as to dispose appropriately once done. At long last, we prescribe future examiners to conduct planned multicenter studies with extra goals (counting indicator investigation) for way better generalization and result. In spite of satisfactory information and favorable state of mind towards PEP for HIV in most of the respondents, this study uncovered that there were delays in starting, low utilization, and fragmented use of the prescribed PEP. So, health care staff need to progress their practice on PEP of HIV through diverse training program related to PEP of HIV.

Keywords: HIV infection, prophylaxis, knowledge, attitude

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10640 Self-Stigma Regarding Mental Illness: An Empirical Study

Authors: Linta Koka

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Aim: The way people with severe mental disorders deal with self-stigma and how it affects their self-esteem is a problem that has gained much attention in recent years. The primary aim of this study was to empirically explore the link between self-stigma and self-esteem of individuals with the presence of a mental illness, offering a novel perspective by exploring the same variables amongst a sample without a mental illness. Methods: This study utilized a cross-sectional study. Participants with (N=85) and without (N=75) a mental health issue were included from Darlingdon's Mind organization. Participants completed two scales, one of Self-Stigma of Mental Illness Scale and one of Self-Esteem, following some demographics questions. Results: According to the primary hypothesis, self-stigma significantly correlates with self-esteem in the clinical population. Furthermore, gender and ethnicity, above all the demographics, positively correlates to the relationship of self-stigma with self-esteem in people who endure a mental health issue. Limitations: A significant limitation is that of the size of the sample of participants conducted in this study. The clinical population was limited to 85 participants, and the control group consisted of 76 participants. Since the sample was not representative. The small size used did not allow any comparisons between the group with mental illness and the control group. There was a restricted time to approach the participants since the online survey was released by the end of May. Conclusions: Individuals suffering from mental illnesses may internalize stigmatizing stereotypes on an explicit level. Efforts should be made to lessen the harmful impact stigma may have on mentally ill people, such as worsening symptoms or delays in receiving care. Further study is needed within this small research topic to improve awareness and regulate mental health among the general population. Undoubtedly, people with mental disorders are stigmatized; therefore, more research is required to explore all factors contributing to mentally ill patients' devaluation.

Keywords: self-stigma, mental illness, self-esteem, clinical population, non-clinical population

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10639 Sustainable Investing and Corporate Performance: Evidence from Shariah Compliant Companies in Southeast Asia

Authors: Norashikin Ismail, Nadia Anridho

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Sustainable investing is a responsible investment that focuses on Environmental, Social, and Governance (ESG) elements. ESG integration is essential in the investment process as it provides a positive contribution to the corporate performance for stakeholders, specifically investors. Sustainable investing is in line with the objectives of Shariah (Maqasid of Shariah), such as social inclusion as well as environmental preservation. This study attempts to evaluate the impact of ESG elements to the corporate financial performance among Shariah compliant stocks listed in two countries, namely Malaysia and Indonesia. The motivation of this study is to provide a further understanding in corporate sustainability for two different Islamic capital markets. The existence of the FTSE4Good Asean Index has played a vital role for ESG practices and eventually encouraged specific index for ESG and Shariah Compliant stocks. Our sample consists of 60 companies over the period 2010-2020 from two Southeast countries. We employ System Generalized Method of Moments (GMM) to reduce bias and more specific parameter estimation. Shariah Compliant companies tend to have higher ESG scores and are positively correlated to corporate financial performance. ESG integration with Shariah based investing would provide higher returns and lower risks for Muslim investors. Essentially, integrating ESG and Shariah, compliant companies lead to better financial performance.

Keywords: shariah compliant, southeast asia, corporate performance, sustainable investing

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10638 Development of a Framework for Family Therapy for Adolescent Substance Abuse: A Perspective from India

Authors: Tanya Anand, Arun Kandasamy, L. N. Suman

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Family based therapy for adolescent substance abuse has been studied to be effective in the West. Whereas, based on literature review, family therapy and interventions for adolescent substance abuse is still in its nascent stages in India. A multidimensional perspective to treatment has been indicated consistently in the Indian literature, but standardized therapy which addresses early substance abuse, from a social-ecological perspective has not been developed and studied for Indian population. While numerous researches have been conducted in India on the need of engaging the family in therapy for the purpose of symptom reduction, long-term maintenance of gains, and reducing family burnout, distress and dysfunction; a family based model in the Indian context has not been developed and tried, to the best of our knowledge. Hence, from the aim of building a model to treat adolescent substance abuse within the family context, experts in the area of mental health and deaddiction were interviewed to inform upon the clinical difficulties, challenges, uniqueness that Indian families present with. The integration of indigenous techniques that would be helpful in engaging families of young individuals with difficulties were also explored. Eight experts' who were interviewed, have 10-30 years of experience in working with families and substance users. An open-ended interview was conducted with the experts individually and audio-recorded. The interviews were then transcribed and subjected to qualitative analysis for building a framework and treatment guideline. Additionally, interviews with patients and their parents were conducted to elicit ‘felt needs’. The results of the analysis revealed culture-specific issues widely experienced within Indian families by adolescents and young adults, centering around the theme of Individuation versus collective identity and living. Substance abuse, in this framework, was found to be perceived as one of the maladaptive ways of the youth to disengage from the family and attempt at individuation and the responsibilities that are considered entitlements in the culture. On the other hand, interviews with family members revealed them to be engaging in inconsistent patterns of care and parenting. This was experienced and observed in terms of fostering interdependence within the family, sometimes within adverse socio-economic and societal conditions, where enacted and perceived stigma kept the individual and family members in a vicious loop of maladaptive coping patterns, dysfunctional family arrangements, and often leading to burnout with poor help seeking. The paper inform upon a framework that lays down the foundation for assessments, planning, case management and therapist competencies, required to address alcohol and drug issues in an Indian family context with such etiological factors at its heart. This paper will cover qualitative results of the interviews and present a model that may guide mental health professionals for treatment of adolescent substance use and family therapy.

Keywords: Indian families, family therapy, de-addiction, adolescent, youth, substance abuse, behavioral issues, felt needs, culture, etiology, model building, framework development, interviews

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10637 The Role of Artificial Intelligence in Concrete Constructions

Authors: Ardalan Tofighi Soleimandarabi

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Artificial intelligence has revolutionized the concrete construction industry and improved processes by increasing efficiency, accuracy, and sustainability. This article examines the applications of artificial intelligence in predicting the compressive strength of concrete, optimizing mixing plans, and improving structural health monitoring systems. Artificial intelligence-based models, such as artificial neural networks (ANN) and combined machine learning techniques, have shown better performance than traditional methods in predicting concrete properties. In addition, artificial intelligence systems have made it possible to improve quality control and real-time monitoring of structures, which helps in preventive maintenance and increases the life of infrastructure. Also, the use of artificial intelligence plays an effective role in sustainable construction by optimizing material consumption and reducing waste. Although the implementation of artificial intelligence is associated with challenges such as high initial costs and the need for specialized training, it will create a smarter, more sustainable, and more affordable future for concrete structures.

Keywords: artificial intelligence, concrete construction, compressive strength prediction, structural health monitoring, stability

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10636 Exploring the Risks and Vulnerabilities of Child Trafficking in West Java, Indonesia

Authors: B. Rusyidi, D. Mariana

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Although reforms in trafficking regulations have taken place since 2007, Indonesia is still struggling to fight child trafficking. This study aimed to identify and assess risk factors and vulnerabilities in the life of trafficked children prior to, during, and after being trafficked in order to inform the child protection system and its policies. The study was qualitative and utilized in-depth interviews to collect data. Data were gathered in 2014 and 2015 from 15 trafficked and sexually exploited girls aged 14 to 17 years originating from West Java. Social workers, safe home personnel and parents were also included as informants. Data analysis was guided by the ecological perspective and theme analyses. The study found that risks and vulnerabilities of the victims were associated with conditions at various levels of the environment. At the micro level, risk factors and vulnerabilities included young age, family conflict/violence, involvement with the “wrong” circle of friends/peers, family poverty, lack of social and economic support for the victim’s family, and psychological damages due to trafficking experiences. At the mezzo level, the lack of structured activities after school, economic inequality, stigma towards victims, lack of services for victims, and minimum public education on human trafficking were among the community hazards that increased the vulnerability and risks. Gender inequality, consumerism, the view of children as assets, corruption, weak law enforcement, the lack of institutional support, and community-wide ignorance regarding trafficking were found as factors that increased risks and vulnerabilities at the macro level. The findings from the study underline the necessity to reduce risk factors and promote protective factors at the individual, family, community and societal levels. Shifting the current focus from tertiary to primary/prevention policies and improving institutional efforts are pressing needs in the context of reducing child trafficking in Indonesia. The roles of human service providers including social work also should be promoted.

Keywords: child trafficking, child sexual exploitation, ecological perspective, risks and vulnerabilities

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10635 Content Analysis of Images Shared on Twitter during 2017 Iranian Protests

Authors: Maryam Esfandiari, Bohdan Fridrich

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On December 28, 2017, a wave of protests erupted in several Iranian cities. Protesters demonstrated against the president, Hasan Rohani, and theocratical nature of the regime. Iran has a recent history with protest movements, such as Green Movement responsible for demonstrations after 2009 Iranian presidential election. However, the 2017/2018 protests differ from the previous ones in terms of organization and agenda. The events show little to no central organization and seem as being sparked by grass root movements and by citizens’ fatigue of government corruption, authoritarianism, and economic problems of the country. Social media has played important role in communicating the protests to the outside world and also in general coordination. By using content analyses, this paper analyzes the visual content of Twitter posts published during the protests. It aims to find the correlation between their decentralized nature and nature of the tweets – either emotionally arousing or efficiency-elicit. Pictures are searched by hashtags and coded by their content, such as ‘crowds,’ ‘protest activities,’ ‘symbols of unity,’ ‘violence,’ ‘iconic figures,’ etc. The study determines what type of content prevails and what type is the most impactful in terms of reach. This study contributes to understanding the role of social media both as a tool and a space in protest organization and portrayal in countries with limited Internet access.

Keywords: twitter, Iran, collective action, protest

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10634 Traveling Abroad and the Construction of British Identity and Culture in Selected Women Writers: Lady Elizabeth Craven's A Journey Through the Crimea to Constantinople (1789) and Lady Mary Wortley Montagu's Embassy Letters (1716-1718)

Authors: Raja Al-Khalili

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Traveling abroad for British citizens in the eighteenth century was usually performed for two reasons. The first major form was for administering the expanding realm of the British Empire and its need for officials in governing the natives and facilitating the work of business companies. The other form of travel was for pleasure and involved a manifestation of wealth. This form of travel was a prelude for the modern industry of tourism and usually involved a tour of Europe and the Mediterranean. In both forms of travel the British encountered a myriad of cultures. Travel had fostered a sense of pride and confirmed an ethnocentric view of British superiority, but it also brought a critical self-examination of belonging to a colonial empire that thrives on the weaknesses of other nations. Women writers in particular have sought in the travels a kind of self-exploration of the nature of social patriarchy in a diversity of cultures. Both Lady Elizabeth Craven in A Journey through the Crimea to Constantinople (1789) and Lady Mary Wortley Montagu in Embassy Letters (1716-1718) have observed the culture of the Ottomans and then pursued to reflect on the social role of women in England.

Keywords: travel writing, Elizabeth Craven, Lady Mary Wortley, patriarchy

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10633 Investigation of the Psychological and Sociological Consequences of Facebook Usage towards Saudi Arabia University Students

Authors: Abdullah Alassiri

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Prompted by the widespread saturation of Facebook usage in Saudi Arabia, among university students to socialize with online members, this study investigated the usage, self-presentation, psychological and sociological consequences of the Facebook social networking site among undergraduate students in Saudi Arabia. The problem statement of this study was addressed by answering the following questions: 1) What motivation do undergraduate students have for joining Facebook? 2) How do undergraduate students consume Facebook? 3) In what condition do undergraduate students need Facebook? 4) How do undergraduate students manage their self-presentation via Facebook? 5) What are the experiences obtained by the undergraduate students from Facebook psychologically? 6) What are the experiences obtained by the undergraduate students from Facebook sociologically? 7) How have Facebook activities affected the lifestyle of the undergraduate students?. These questions were answered by analyzing in-depth interview data collected from twenty male undergraduate students between the ages of 18 and 24 years selected from King Saud University (KSU) and King Khalid University (KKU) Saudi Arabia. Using thematic analysis, informants data were coded ‘R1 to R20’, validated and was transcribed to minimize error from translating into the study items from Arabic back to the English Language. Using purposive sampling method, informant perspective within the research context were explored. Data collection was confined to students’ motivations for engaging in online activities, self-presentation, psychological and sociological consequences to their everyday life was investigated based on the theoretical and philosophical perspective underpinnings media and gratification paradigm and social influence theory. The findings contributed to the development of important study themes that supported the development of a new research framework. Based on the analysis, all the study questions were answered. The findings of this study showed that the students use Facebook for the purpose of interacting with others, getting information and as knowledge sources. In terms of self-presentation, this study revealed that the students portray themselves in the real and not fake image while socializing with others. Psychological and sociological consequences from the usage of Facebook are recorded ranging from cheerful to stress and from loneliness to having many friends. As a conclusion, this study conclusively drew that Facebook is a very persuasive medium of communication among the University students in Saudi Arabia that bridges across socio-cultural boundaries and unite students to interact as a community.

Keywords: Saudi Arabia, Facebook, undergraduate students, social network

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10632 Microalgae Hydrothermal Liquefaction Process Optimization and Comprehension to Produce High Quality Biofuel

Authors: Lucie Matricon, Anne Roubaud, Geert Haarlemmer, Christophe Geantet

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Introduction: This case discusses the management of two floor of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. Case Report: A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Discussion: Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk, and second primary cancer development.

Keywords: microalgae, biofuels, hydrothermal liquefaction, biomass

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10631 Circumstantial Loneliness and Existential Isolation in the Works of Flutura Açka

Authors: Elvira Lumi, Hans Jazxhi

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In the works of the writer Flutura Açka, the play with these questions is acute, and in almost each of them, the act of loneliness and isolation builds in a completely involuntary way unique and frequent conceptual spaces. Because the object of study is too broad to grasp all the works, this study lays out a rapid paradox of our access to three of the novels in the line of numerous authorial works. The novel "Woman Loneliness" (2001), also marked as the first work in prose by the author, declares in the title the paradigm of what she has decided to confess. The gender segregation proclaimed in the title will be revealed step by step in the work as conventional human segregation without gender. In this novel, the analysis of the state of "loneliness" will require a contemplation beyond man, when the role of the environment and the distance from the center of the narrative base will be extremely visible in the work. The novel "Cross of Oblivion" (2004) has another form of perception of loneliness, which, unlike the one built by the characters themselves in the novel "Woman Loneliness," is imposed and obligatory to live by the circumstances. Its characters are trapped in loneliness, as loneliness that comes from impossibility, from the past, from dependence on fate, from fear of change, and from the obligation to accept it. At the heart of the novel, the plot of the novel game is dictated by the Kanun and its rules and the loneliness of the basis of life in unbroken waves towards the periphery of the event, a periphery that has very large geography and is played in today's Europe. The novel "Where are you?" (2009) has a completely different form of constructing the concept of loneliness and isolation that comes under conditions of repression and political pressure. The loneliness in this novel takes the form of the protective element from the circumstances that actually require a social inclusion; it is personal loneliness that ensures relative mental health of the characters, up to a new trap created by the circumstances, thus building life fragmentary “healthy” in the order of a mentally ill and socially ill society.

Keywords: loneliness, existential, isolation, woman, prose

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10630 On Being a Fugitive from the State-Sponsored Witch Hunt of Homosexuals in Egypt's Media Discourse

Authors: Mahitab A. A. Mahmoud

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Despite the international community’s galvanized efforts to achieve gender equality, the Arab world still lags behind for their sustained suppression of diversity and freedoms. In Egypt, homosexuals are defamed and hunted not only by authorities but also by politicized religious institutions and media platforms. The resultant state-sponsored homophobia is reflected in media. This paper offers a critical discourse analysis of the representation of LGBTQs in Egypt’s local news articles and movies in an attempt to investigate the underlying ideology. The results reveal a clichéd portrayal of homosexuals as a social parasite that requires cleansing by the government. LGBTQs are depicted as an outcome of debauchery, unhappy marriage, sexual deviancy, deficiency of masculinity/femininity, absence of the mother and/or father figure(s), abject poverty, excessive wealth, psychiatric disorder, debased instincts, childhood sexual molestation, immorality, deviation from religion, chaos, treason, conspiracy against the regime, to name only a few. This image, which is imposed and sustained by the state, exposes homosexuals to a violation of their human rights by both the police and the society, endangers their lives, breeds intolerance, social inequality and violence, prevents healthy coexistence; and deprives them of living a normal life.

Keywords: critical discourse analysis, gender studies, homophobia, homosexuality, ideology, media studies

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10629 The Application of Sensory Integration Techniques in Science Teaching Students with Autism

Authors: Joanna Estkowska

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The Sensory Integration Method is aimed primarily at children with learning disabilities. It can also be used as a complementary method in treatment of children with cerebral palsy, autistic, mentally handicapped, blind and deaf. Autism is holistic development disorder that manifests itself in the specific functioning of a child. The most characteristic are: disorders in communication, difficulties in social relations, rigid patterns of behavior and impairment in sensory processing. In addition to these disorders may occur abnormal intellectual development, attention deficit disorders, perceptual disorders and others. This study was focused on the application sensory integration techniques in science education of autistic students. The lack of proper sensory integration causes problems with complicated processes such as motor coordination, movement planning, visual or auditory perception, speech, writing, reading or counting. Good functioning and cooperation of proprioceptive, tactile and vestibular sense affect the child’s mastery of skills that require coordination of both sides of the body and synchronization of the cerebral hemispheres. These include, for example, all sports activities, precise manual skills such writing, as well as, reading and counting skills. All this takes place in stages. Achieving skills from the first stage determines the development of fitness from the next level. Any deficit in the scope of the first three stages can affect the development of new skills. This ultimately reflects on the achievements at school and in further professional and personal life. After careful analysis symptoms from the emotional and social spheres appear to be secondary to deficits of sensory integration. During our research, the students gained knowledge and skills in the classroom of experience by learning biology, chemistry and physics with application sensory integration techniques. Sensory integration therapy aims to teach the child an adequate response to stimuli coming to him from both the outside world and the body. Thanks to properly selected exercises, a child can improve perception and interpretation skills, motor skills, coordination of movements, attention and concentration or self-awareness, as well as social and emotional functioning.

Keywords: autism spectrum disorder, science education, sensory integration, special educational needs

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10628 Effects of Nicotine on Symptoms Associated with Attention Deficit Hyperactivity Disorder: A Systematic Literature Review

Authors: Daniella Hirwa

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Attention Deficit Hyperactivity Disorder (ADHD) is associated with several risk-taking behaviors, including drug use and smoking. Such risk-taking behaviors are often a result of an attempt to self-manage symptoms associated with ADHD. The present review investigates the effects of nicotine on symptoms associated with ADHD. This systematic literature review was conducted for 2017-2024 using keywords associated with ADHD, smoking, and nicotine. The results indicate that individuals with ADHD start smoking earlier than those without ADHD, and it is believed that this prevalence and the higher rates of smoking are due to improvements in cognitive and executive function, attention, and impulsivity due to the effect that nicotine has on dopamine release. Longitudinal studies with larger sample sizes and comprehensive health history and cognitive testing are required to gain more insight into the ways that nicotine affects ADHD symptoms and the context by which smoking is used as a method of self-treatment to help aid the development of nicotine-based treatment options that do not pose the same health risks as smoking.

Keywords: ADHD, nicotine, risk-taking behaviors, smoking

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10627 The GRIT Study: Getting Global Rare Disease Insights Through Technology Study

Authors: Aneal Khan, Elleine Allapitan, Desmond Koo, Katherine-Ann Piedalue, Shaneel Pathak, Utkarsh Subnis

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Background: Disease management of metabolic, genetic disorders is long-term and can be cumbersome to patients and caregivers. Patient-Reported Outcome Measures (PROMs) have been a useful tool in capturing patient perspectives to help enhance treatment compliance and engagement with health care providers, reduce utilization of emergency services, and increase satisfaction with their treatment choices. Currently, however, PROMs are collected during infrequent and decontextualized clinic visits, which makes translation of patient experiences challenging over time. The GRIT study aims to evaluate a digital health journal application called Zamplo that provides a personalized health diary to record self-reported health outcomes accurately and efficiently in patients with metabolic, genetic disorders. Methods: This is a randomized controlled trial (RCT) (1:1) that assesses the efficacy of Zamplo to increase patient activation (primary outcome), improve healthcare satisfaction and confidence to manage medications (secondary outcomes), and reduce costs to the healthcare system (exploratory). Using standardized online surveys, assessments will be collected at baseline, 1 month, 3 months, 6 months, and 12 months. Outcomes will be compared between patients who were given access to the application versus those with no access. Results: Seventy-seven patients were recruited as of November 30, 2021. Recruitment for the study commenced in November 2020 with a target of n=150 patients. The accrual rate was 50% from those eligible and invited for the study, with the majority of patients having Fabry disease (n=48) and the remaining having Pompe disease and mitochondrial disease. Real-time clinical responses, such as pain, are being measured and correlated to disease-modifying therapies, supportive treatments like pain medications, and lifestyle interventions. Engagement with the application, along with compliance metrics of surveys and journal entries, are being analyzed. An interim analysis of the engagement data along with preliminary findings from this pilot RCT, and qualitative patient feedback will be presented. Conclusions: The digital self-care journal provides a unique approach to disease management, allowing patients direct access to their progress and actively participating in their care. Findings from the study can help serve the virtual care needs of patients with metabolic, genetic disorders in North America and the world over.

Keywords: eHealth, mobile health, rare disease, patient outcomes, quality of life (QoL), pain, Fabry disease, Pompe disease

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