Search results for: perceived barriers
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2986

Search results for: perceived barriers

2206 Reframing Physical Activity for Health

Authors: M. Roberts

Abstract:

We Are Undefeatable - is a mass marketing behaviour change campaign that aims to support the least active people living with long term health conditions to be more active. This is an important issue to address because people with long term conditions are an historically underserved community for the sport and physical activity sector and the least active of those with long term conditions have the most to gain in health and wellbeing benefits. The campaign has generated a significant change in the way physical activity is communicated and people with long term conditions are represented in the media and marketing. The goal is to create a social norm around being active. The campaign is led by a unique partnership of organisations: the Richmond Group of Charities (made up of Age UK, Alzheimer’s Society, Asthma + Lung UK, Breast Cancer Now, British Heart Foundation, British Red Cross, Diabetes UK, Macmillan Cancer Support, Rethink Mental Illness, Royal Voluntary Service, Stroke Association, Versus Arthritis) along with Mind, MS Society, Parkinson’s UK and Sport England, with National Lottery Funding. It is underpinned by the COM-B model of behaviour change. It draws on the lived experience of people with multiple long term conditions to shape the look and feel of the campaign and all the resources available. People with long term conditions are the campaign messengers, central to the ethos of the campaign by telling their individual stories of overcoming barriers to be active with their health conditions. The central messaging is about finding a way to be active that works for the individual. We Are Undefeatable is evaluated through a multi-modal approach, including regular qualitative focus groups and a quantitative evaluation tracker undertaken three times a year. The campaign has highlighted the significant barriers to physical activity for people with long term conditions. This has changed the way our partnership talks about physical activity but has also had an impact on the wider sport and physical activity sector, prompting an increasing departure from traditional messaging and marketing approaches for this audience of people with long term conditions. The campaign has reached millions of people since its launch in 2019, through multiple marketing and partnership channels including primetime TV advertising and promotion through health professionals and in health settings. Its diverse storytellers make it relatable to its target audience and the achievable activities highlighted and inclusive messaging inspire our audience to take action as a result of seeing the campaign. The We Are Undefeatable campaign is a blueprint for physical activity campaigns; it not only addresses individual behaviour change but plays a role in addressing systemic barriers to physical activity by sharing the lived experience insight to shape policy and professional practice.

Keywords: behaviour change, long term conditions, partnership, relatable

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2205 Bundling of Transport Flows: Adoption Barriers and Opportunities

Authors: Vandenbroucke Karel, Georges Annabel, Schuurman Dimitri

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In the past years, bundling of transport flows, whether or not implemented in an intermodal process, has popped up as a promising concept in the logistics sector. Bundling of transport flows is a process where two or more shippers decide to synergize their shipped goods over a common transport lane. Promoted by the European Commission, several programs have been set up and have shown their benefits. Bundling promises both shippers and logistics service providers economic, societal and ecological benefits. By bundling transport flows and thus reducing truck (or other carrier) capacity, the problems of driver shortage, increased fuel prices, mileage charges and restricted hours of service on the road are solved. In theory, the advantages of bundled transport exceed the drawbacks, however, in practice adoption among shippers remains low. In fact, bundling is mentioned as a disruptive process in the rather traditional logistics sector. In this context, a Belgian company asked iMinds Living Labs to set up a Living Lab research project with the goal to investigate how the uptake of bundling transport flows can be accelerated and to check whether an online data sharing platform can overcome the adoption barriers. The Living Lab research was conducted in 2016 and combined quantitative and qualitative end-user and market research. Concretely, extensive desk research was conducted and combined with insights from expert interviews with four consultants active in the Belgian logistics sector and in-depth interviews with logistics professionals working for shippers (N=10) and LSP’s (N=3). In the article, we present findings which show that there are several factors slowing down the uptake of bundling transport flows. Shippers are hesitant to change how they currently work and they are hesitant to work together with other shippers. Moreover, several practical challenges impede shippers to work together. We also present some opportunities that can accelerate the adoption of bundling of transport flows. First, it seems that there is not enough support coming from governmental and commercial organizations. Secondly, there is the chicken and the egg problem: too few interested parties will lead to no or very few matching lanes. Shippers are therefore reluctant to partake in these projects because the benefits have not yet been proven. Thirdly, the incentive is not big enough for shippers. Road transport organized by the shipper individually is still seen as the easiest and cheapest solution. A solution for the abovementioned challenges might be found in the online data sharing platform of the Belgian company. The added value of this platform is showing shippers possible matching lanes, without the shippers having to invest time in negotiating and networking with other shippers and running the risk of not finding a match. The interviewed shippers and experts indicated that the online data sharing platform is a very promising concept which could accelerate the uptake of bundling of transport flows.

Keywords: adoption barriers, bundling of transport, shippers, transport optimization

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2204 The Interventions to Parents Caring Children with Attention Deficit/Hyperactivity Disorder in Hong Kong

Authors: Wing Chi Wong

Abstract:

Globally, studying parents caring for children with attention deficit/ hyperactivity disorder (ADHD) is valuable in order to design measures in supporting those parents by health care providers and government. Such parents in Hong Kong seem to encounter detrimental stress and enormous difficulties which are exacerbated by the traditional Chinese culture, exclusion from social members and fiercely competitive educational system. However, seldom studies scrutinize this issue in Hong Kong. This article aims to review the literature regarding parents caring offsprings with ADHD in Hong Kong. Criteria were set for searching among published studies listed in various databases, including MEDLINE, CINCAHL, PsycINFO, ProQuest, Embase, Cochrane Library and Springer Link. Articles with words 'Attention Deficit Hyperactivity Disorder', 'parenting', 'parent', 'family', 'father', 'mother', 'care' in titles and abstracts were identified. Articles with all types of research designs and methods, regardless in English or Chinese, were included. They were limited to years between January 2008 and September 2018. Four relevant studies have resulted. Of them, two were exploratory studies, one was a qualitative study, and one was a survey. Samples were recruited from child psychiatric clinic, Child and Adolescent Mental Health Unit, or multiple family group therapy centres. Authors proclaimed that quality of life of those parents was usually low; particularly mothers perceived a higher stress than fathers; parenting barriers existed; conflicts were commonly raised in parent-child relationship resulting in probable maltreatment to children. Previous studies generally suggested the potential negative outcomes of parents caring children with ADHD. The types and effectiveness of interventions to those parents on relieving their tortures under Hong Kong context had not been explored and systematically evaluated. The scanty studies and existing understanding could not give a promising conclusion pertaining to the appropriate family intervention to parents living with children with ADHD. A stringent research design is necessary to establish evidence on the effectiveness of interventions for those families.

Keywords: attention deficit/ hyperactivity disorder, Hong Kong, parents, interventions

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2203 Smart Energy Consumers: An Empirical Investigation on the Intention to Adopt Innovative Consumption Behaviour

Authors: Cecilia Perri, Vincenzo Corvello

Abstract:

The aim of the present study is to investigate consumers' determinants of intention toward the adoption of Smart Grid solutions and technologies. Ajzen's Theory of Planned Behaviour (TPB) model is applied and tested to explain the formation of such adoption intention. An exogenous variable, taking into account the resistance to change of individuals, was added to the basic model. The elicitation study allowed obtaining salient modal beliefs, which were used, with the support of literature, to design the questionnaire. After the screening phase, data collected from the main survey were analysed for evaluating measurement model's reliability and validity. Consistent with the theory, the results of structural equation analysis revealed that attitude, subjective norm, and perceived behavioural control positively, which affected the adoption intention. Specifically, the variable with the highest estimate loading factor was found to be the perceived behavioural control, and, the most important belief related to each construct was determined (e.g., energy saving was observed to be the most significant belief linked with attitude). Further investigation indicated that the added exogenous variable has a negative influence on intention; this finding confirmed partially the hypothesis, since this influence was indirect: such relationship was mediated by attitude. Implications and suggestions for future research are discussed.

Keywords: adoption of innovation, consumers behaviour, energy management, smart grid, theory of planned behaviour

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2202 Healthy and Smart Building Projects

Authors: Ali A. Karakhan

Abstract:

Stakeholders in the architecture, engineering, and construction (AEC) industry have been always searching for strategies to develop, design, and construct healthy and smart building projects. Healthy and smart building projects require that the building process including design and construction be altered and carefully implemented in order to bring about sustainable outcomes throughout the facility lifecycle. Healthy and smart building projects are expected to positively influence organizational success and facility performance across the project lifecycle leading to superior outcomes in terms of people, economy, and the environment. The present study aims to identify potential strategies that AEC organizations can implement to achieve healthy and smart building projects. Drivers and barriers for healthy and smart building features are also examined. The study findings indicate that there are three strategies to advance the development of healthy and smart building projects: (1) the incorporation of high-quality products and low chemical-emitting materials, (2) the integration of innovative designs, methods, and practices, and (3) the adoption of smart technology throughout the facility lifecycle. Satisfying external demands, achievement of a third-party certification, obtaining financial incentives, and a desire to fulfill professional duty are identified as the key drivers for developing healthy and smart building features; whereas, lack of knowledge and training, time/cost constrains, preference for/adherence to customary practices, and unclear business case for why healthy buildings are advantageous are recognized as the primary barriers toward a wider diffusion of healthy and smart building projects. The present study grounded in previous engineering, medical, and public health research provides valuable technical and practical recommendations for facility owners and industry professionals interested in pursuing sustainable, yet healthy and smart building projects.

Keywords: healthy buildings, smart construction, innovative designs, sustainable projects

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2201 The Roles of Parental Involvement in the Teaching-Learning Process of Students with Special Needs: Perceptions of Special Needs Education Teachers

Authors: Chassel T. Paras, Tryxzy Q. Dela Cruz, Ma. Carmela Lousie V. Goingco, Pauline L. Tolentino, Carmela S. Dizon

Abstract:

In implementing inclusive education, parental involvement is measured to be an irreplaceable contributing factor. Parental involvement is described as an indispensable aspect of the teaching-learning process and has a remarkable effect on the student's academic performance. However, there are still differences in the viewpoints, expectations, and needs of both parents and teachers that are not yet fully conveyed in their relationship; hence, the perceptions of SNED teachers are essential in their collaboration with parents. This qualitative study explored how SNED teachers perceive the roles of parental involvement in the teaching-learning process of students with special needs. To answer this question, one-on-one face-to-face semi-structured interviews with three SNED teachers in a selected public school in Angeles City, Philippines, that offer special needs education services were conducted. The gathered data are then analyzed using Interpretative Phenomenological Analysis (IPA). The results revealed four superordinate themes, which include: (1) roles of parental involvement, (2) parental involvement opportunities, (3) barriers to parental involvement, and (4) parent-teacher collaboration practices. These results indicate that SNED teachers are aware of the roles and importance of parental involvement; however, despite parent-teacher collaboration, there are still barriers that impede parental involvement. Also, SNED teachers acknowledge the big roles of parents as they serve as main figures in the teaching-learning process of their children with special needs. Lastly, these results can be used as input in developing a school-facilitated parenting involvement framework that encompasses the contribution of SNED teachers in planning, developing, and evaluating parental involvement programs, which future researchers can also use in their studies

Keywords: parental involvement, special needs education, teaching-learning process, teachers’ perceptions, special needs education teachers, interpretative phenomenological analysis

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2200 Alternative (In)Security: Using Photovoice Research Methodology to Explore Refugee Anxieties in Lebanon

Authors: Jessy Abouarab

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For more than half a century, international norms related to refugee security and protection have proliferated, yet their role in alleviating war’s negative impacts on human life remains limited. The impact of refugee-security processes often manifests asymmetrically within populations. Many issues and people get silenced due to narrow security policies that focus either on abstract threat containment and refugee control or refugee protection and humanitarian aid. (In)security practices are gendered and experienced. Examining the case study of Syrian refugees in Lebanon, this study explores the gendered impact of refugee security mechanisms on local realities. A transnational feminist approach will be used to position this research in relation to existing studies in the field of security and the refugee-protection regime, highlighting the social, cultural, legal, and political barriers to gender equality in the areas of violence, rights, and social inclusion. Through Photovoice methodology, the Syrian refugees’ (in)securities in Lebanon were given visibility by enabling local volunteers to record and reflect their realities through pictures, at the same time voice the participants’ anxieties and recommendations to reach normative policy change. This Participatory Action Research approach helped participants observe the structural barriers and lack of culturally inclusive refugee services that hinder security, increase discrimination, stigma, and poverty. The findings have implications for a shift of the refugee protection mechanisms to a community-based approach in ways that extend beyond narrow security policies that hinder women empowerment and raise vulnerabilities such as gendered exploitation, abuse, and neglect.

Keywords: gender, (in)security, Lebanon, refugee, Syrian refugees, women

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2199 Perceiving Interpersonal Conflict and the Big Five Personality Traits

Authors: Emily Rivera, Toni DiDona

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The Big Five personality traits is a hierarchical classification of personality traits that applies factor analysis to a personality survey data in order to describe human personality using five broad dimensions: Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness (Fetvadjiev & Van de Vijer, 2015). Research shows that personality constructs underline individual differences in processing conflict and interpersonal relations. (Graziano et al., 1996). This research explores the understudied correlation between the Big Five personality traits and perceived interpersonal conflict in the workplace. It revises social psychological literature on Big Five personality traits within a social context and discusses organizational development journal articles on the perceived efficacy of conflict tactics and approach to interpersonal relationships. The study also presents research undertaken on a survey group of 867 subjects over the age of 18 that were recruited by means of convenience sampling through social media, email, and text messaging. The central finding of this study is that only two of the Big Five personality traits had a significant correlation with perceiving interpersonal conflict in the workplace. Individuals who score higher on agreeableness and neuroticism, perceive more interpersonal conflict in the workplace compared to those that score lower on each dimension. The relationship between both constructs is worthy of research due to its everyday frequency and unique individual psycho-social consequences. This multimethod research associated the Big Five personality dimensions to interpersonal conflict. Its findings that can be utilized to further understand social cognition, person perception, complex social behavior and social relationships in the work environment.

Keywords: five-factor model, interpersonal conflict, personality, The Big Five personality traits

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2198 A Preliminary Study of Local Customers' Perception towards the Image of the Spa and Their Intention to Visit

Authors: Felsy J. Sandi

Abstract:

There is a potential of growth in the spa industry due to the influx of domestic and international tourist coming to Sabah, Malaysia. It is a good opportunity to venture into this industry for the country’s economic future growth, and therefore, it is essential for this area to be researched. Being one of the fastest growing industries in the world, has led to enormous challenges, which need to be addressed. Malaysia is also riding with this phenomenon. The President of the Malaysian Association of Wellness and Spa stated that the misconception about the Spa industry’s image, especially amongst the elderly is the biggest challenge faced by the industry, as they perceived the spa industry is equivalent to a prostitution center. Therefore, the objective of this study is to explore the issue by analyzing whether image can be added in the theory of planned behavior to better understand the consumer’s intention to visit, in the spa context. The Theory of Planned Behavior by Ajzen, a theory or model in predicting intention, has three constructs; such as Attitude as the first construct, the second construct is Subjective Norm and the third construct is Perceived Behavioral Control. Qualitative research is used as this is an exploratory research. The site of study will be at Jari Jari Spa, located in Kota Kinabalu, the only spa in Sabah that was awarded as the Center of Excellence (CoE) by the Ministry of Tourism and Culture in Malaysia. The findings propose to provide useful information to the relevant stakeholders on ways to approach local customers to convince them to visit the spa and for spa marketers to help them develop and design effective marketing strategies. Future investigation should consider more on the perception and loyalty of the local customers.

Keywords: consumer's perception, image, local customer, spa, visit intention

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2197 Perceived Effect of Physical Exercise on Healthy Well-Being of Pregnant Women in Imo State

Authors: Roseline Chizoba Onuoha, Rose Ngozi Uzoka

Abstract:

This study aimed at investigating perceived effect of physical exercise on healthy well-being of pregnant mothers in Imo state. The study was guided by three research questions and three null hypotheses tested at 0.05 level of significance. The study was a quasi-experimental non-equivalent control group design involving pre and post tests. A sample of 92 pregnant women drawn from a total population of 922 registered pregnant women in ten randomly selected health centers in Imo State through multistage sampling technique was used. A 41 item structured instrument titled Physical Exercise Pregnancy Test (PEPT) was used for the study. The PEPT was validated by three experts from measurement and evaluation, educational psychology and health education. Crombach Alpha method was used to determine the reliability of Physical Exercise Pregnancy Test (PEPT) and reliability index of 0.82 was obtained. Mean and standard deviation were used to answer the research questions; while Analysis of Covariance (ANCOVA) was used in analyzing the hypotheses. Findings of the study revealed that physical exercise affects physical, social and emotional wellbeing scores of pregnant women. The study also indicated that intervention using physical exercise significantly enhanced healthy well-being scores of pregnant mothers who were exposed to physical exercise than those who received conventional health talks; Location has no significant interaction effect on the mean well-being scores of pregnant women via PEPT. Among recommendations made were that pregnant women should participate in physical exercise.

Keywords: educational psychology, Imo state, Physical exercise, pregnant women

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2196 E-Book Market In Vietnam: Great Potential, Many Barriers

Authors: Zakir Hossain

Abstract:

Nowadays reading e-books on laptops, smartphones, and tablets have become a new leisure activity for Vietnamese youth. Since 2011 the copyrighted e-book market began to develop in Vietnam with the participation of five local enterprises. Over the last five years, thousands of e-books were published including the first online early education book series for children from 0 to 6 years old. Research shows that 61% Vietnamese find reading e-books is comfortable, and 45% feel convenient buying books online. More than half of the Vietnamese consider reading online far better than buying printed books, and surprisingly people over age 30 desire reading online while those under 18 prefer reading printed books. Hence with a market of more than 40 million regular internet users including 22 million smartphone users, Vietnam has ample opportunities to develop the e-book market and contribute a great deal to the diversity of the local reading culture which is essential for Building a Lifelong Learning Society, a state ambition of Vietnam by 2020. However, the e-book market in Vietnam is still in its infancy and is growing far too slowly than e-book producers had expected. All five e-book enterprises are facing numerous challenges. While the big profit that e-book technology can bring has been clearly recognised in other countries, e-books in Vietnam only make up less than 1% share of the book market. The objective of the study is to identify the difficulties and barriers to the development of the e-book market in Vietnam through an extensive literature review available in English. The study revealed that illegal e-books due to copyright infringement and an inconvenient payment system to purchase e-books are the major obstacles. The great potential of e-books in Vietnam is a reality but requires government enforcement of copyright protection laws, a new area of focus for the e-book market. Furthermore, Vietnamese readers should change their habits from using free and illegal e-books to develop the e-publishing industry in Vietnam.

Keywords: copyright, e-book, e-book reading, e-publishing, Vietnam

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2195 A Qualitative Study of Health-Related Beliefs and Practices among Vegetarians

Authors: Lorena Antonovici, Maria Nicoleta Turliuc

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The process of becoming a vegetarian involves changes in several life aspects, including health. Despite its relevance, however, little research has been carried out to analyze vegetarians' self-perceived health, and even less empirical attention has received in the Romanian population. This study aimed to assess health-related beliefs and practices among vegetarian adults in a Romanian sample. We have undertaken 20 semi-structured interviews (10 males, 10 females) based on a snowball sample with a mean age of 31 years. The interview guide was divided into three sections: causes of adopting the diet, general aspects (beliefs, practices, tensions, and conflicts) and consequences of adopting the diet (significant changes, positive aspects, and difficulties, physical and mental health). Additional anamnestic data were reported by means of a questionnaire. Data analyses were performed using Tropes text analysis software (v. 8.2) and SPSS software (v. 24.0.) Findings showed that most of the participants considered a vegetarian diet as a natural and healthy choice as opposed to meat-eating, which is not healthy, and its consumption should be moderated among omnivores. A higher proportion of participants (65%) had an average body mass index (BMI), and several women even assumed having certain affections that no longer occur after following a vegetarian diet. Moreover, participants admitted having better moods and mental health status, given their self-contentment with the dietary choice. Relatives were perceived as more skeptical about their practices than others, and especially women had this view. This study provides a valuable insight into health-related beliefs and practices and how a vegetarian diet might interact.

Keywords: beliefs, health, practices, vegetarians

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2194 Partnering With Faith-Based Entities to Improve Mental Health Awareness and Decrease Stigma in African American Communities

Authors: Bryana Woodard, Monica Mitchell, Kasey Harry, Ebony Washington, Megan Harris, Marcia Boyd, Regina Lynch, Daphene Baines, Surbi Bankar

Abstract:

Introduction: African Americans experience mental health illnesses (i.e., depression, anxiety, etc.) at higher rates than their white counterparts. Despite this, they utilize mental health resources less and have lower mental health literacy, perhaps due to cultural barriers- including but not limited to mistrust. Research acknowledges African Americans’ close ties to community networks, identifying these linkages as key to establishing comfort and trust. Similarly, the church has historically been a space that creates unity and community among African Americans. Studies show that longstanding academic-community partnerships with organizations, such as churches and faith-based entities, have the capability to effectively address health and mental health barriers and needs in African Americans. The importance of implementing faith-based approaches is supported in the literature, however few empirical studies exist. This project describes the First Ladies for Health and Cincinnati Children's Hospital Medical Center (CCHMC) Partnership (FLFH-CCHMC Partnership) and the implementation and assessment of an annual Mental Health Symposium, the overall aim of which was to increase mental health awareness and decrease stigma in African American communities. Methods: The specific goals of the FLFH Mental Health Symposium were to (1) Collaborate with trusted partners to build trust with community participants; (2) Increase mental health literacy and decrease mental health stigma; (3) Understand the barriers to improving mental health and improving trust; (4) Assess the short-term outcomes two months following the symposium. Data were collected through post-event and follow-up surveys using a mixed methods approach. Results: More than 100 participants attended each year with over 350 total participants over three years. 98.7% of participants were African American, 86.67% female, 11.6% male, and 11.6% LGBTQ+/non-binary; 10.5% of participants were teens, with the remainder aged 20 to 80 plus. The event was successful in achieving its goals: (1a) Eleven different speakers from 8 community and church organizations presented; (1b) 93% of participants rated the overall symposium as very good or excellent (2a) Mental health literacy significantly increased each year with over 90% of participants reporting improvement in their “understanding” and “awareness of mental health (2b) Participants 'personal stigma surrounding mental health illness decreased each year with 92.3% of participants reporting changes in their “willingness to talk about and share” mental health challenges; (3) Barriers to mental health care were identified and included social stigma, lack of trust, and the cost of care. Data were used to develop priorities and an action plan for the FLFH-CCHMC Mental Health Partnership; (4) Follow-up data showed that participants sustained benefits of the FLFH Symposium and took actionable steps (e.g., meditation, referrals, etc.). Additional quantitative and qualitative data will be shared. Conclusions: Lower rates of mental health literacy and higher rates of stigma among participants in this initiative demonstrate the importance of mental health providers building trust and partnerships in communities. Working with faith-based entities provides an opportunity to mitigate and address mental health equity in African American communities.

Keywords: community psychology, faith-based, african-american, culturally competent care, mental health equity

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2193 Collaborative Environmental Management: A Case Study Research of Stakeholders' Collaboration in the Nigerian Oil-Producing Region

Authors: Favour Makuochukwu Orji, Yingkui Zhao

Abstract:

A myriad of environmental issues face the Nigerian industrial region, resulting from; oil and gas production, mining, manufacturing and domestic wastes. Amidst these, much effort has been directed by stakeholders in the Nigerian oil producing regions, because of the impacts of the region on the wider Nigerian economy. Research to date has suggested that collaborative environmental management could be an effective approach in managing environmental issues; but little attention has been given to the roles and practices of stakeholders in effecting a collaborative environmental management framework for the Nigerian oil-producing region. This paper produces a framework to expand and deepen knowledge relating to stakeholders aspects of collaborative roles in managing environmental issues in the Nigeria oil-producing region. The knowledge is derived from analysis of stakeholders’ practices – studied through multiple case studies using document analysis. Selected documents of key stakeholders – Nigerian government agencies, multi-national oil companies and host communities, were analyzed. Open and selective coding was employed manually during document analysis of data collected from the offices and websites of the stakeholders. The findings showed that the stakeholders have a range of roles, practices, interests, drivers and barriers regarding their collaborative roles in managing environmental issues. While they have interests for efficient resource use, compliance to standards, sharing of responsibilities, generating of new solutions, and shared objectives; there is evidence of major barriers which includes resource allocation, disjointed policy and regulation, ineffective monitoring, diverse socio- economic interests, lack of stakeholders’ commitment and limited knowledge sharing. However, host communities hold deep concerns over the collaborative roles of stakeholders for economic interests, particularly, where government agencies and multi-national oil companies are involved. With these barriers and concerns, a genuine stakeholders’ collaboration is found to be limited, and as a result, optimal environmental management practices and policies have not been successfully implemented in the Nigeria oil-producing region. A framework is produced that describes practices that characterize collaborative environmental management might be employed to satisfy the stakeholders’ interests. The framework recommends critical factors, based on the findings, which may guide a collaborative environmental management in the oil producing regions. The recommendations are designed to re-define the practices of stakeholders in managing environmental issues in the oil producing regions, not as something wholly new, but as an approach essential for implementing a sustainable environmental policy. This research outcome may clarify areas for future research as well as to contribute to industry guidance in the area of collaborative environmental management.

Keywords: collaborative environmental management framework, case studies, document analysis, multinational oil companies, Nigerian oil producing regions, Nigerian government agencies, stakeholders analysis

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2192 Principal Creative Leadership for Teacher Learning and School Culture

Authors: Yashi Ye

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Principles play vital roles in shaping the school culture and promoting teachers' professional learning by exerting their leadership. In the changing time of the 21st century, the creative leadership of school leaders is increasingly important in cultivating the professional learning communities of teachers for eventually improving student performance in every continent. This study examines under what conditions and how principal creative leadership contributes to teachers’ professional learning and school culture. Data collected from 632 teachers in 30 primary and middle schools in the cities of Chengdu and Chongqing in mainland China are analyzed using structural equation modeling and bootstrapping tests. A moderated mediation model of principle creative leadership effects is used to analyze professional teacher learning and school culture in which the mediator will be school culture and the moderator will be power distance orientation. The results indicate that principal creative leadership has significant direct and indirect effects on teachers' professional learning. A positive correlation between principal creative leadership, professional teacher learning, and school culture is observed. Further model testing found that teacher power distance orientation moderated the significant effect of principal creative leadership on school culture. When teachers perceived higher power distance in teacher-principal relations, the effects of principal creative leadership were stronger than for those who perceived low power distance. The results indicate the “culture change” in the young generation of teachers in China, and further implications to understanding the cultural context in the field of educational leadership are discussed.

Keywords: power distance orientation, principal creative leadership, school culture, teacher professional learning

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2191 University Students’ Perceptions of the Influence of Cannabis Use on Mental Health

Authors: Konesh Navsaria, Itumeleng Ramodumo

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The study explored university students’ perceptions of cannabis use on academic life at a higher education institution (HEI) in Nelson Mandela Bay, South Africa. Cannabis is described as the most commonly-used drug by youth, especially those who are in tertiary institutions. The use of cannabis has both negative and positive effects; this is evident in different areas of human functioning. Cannabis usage has been debated upon in courts regarding its legalization and decriminalization, and on the 18th of September 2018, the South African High Court decriminalized cannabis for personal use. Cannabis use has increased in academic settings, and this has raised concerns about how it affects the mental health of students. A qualitative approach was used for the study with an explorative, descriptive design. Purposive sampling was used to select 15 participants for the study. Data were collected using focused-group interviews, following ethical clearance from the HEI. The collected data were analyzed and interpreted using thematic analysis, and cognitive behavioural theory was used as the theoretical framework. The research findings indicated both positive and negative influences of cannabis use on mental health. Most participants who expressed positive effects have used cannabis before, whereas most participants with negative perspectives of cannabis use on mental health are non-cannabis users. The findings revealed that participants perceived that the quantity of cannabis smoked determined whether there was a positive or negative effect on mental health; that is, large doses of cannabis were perceived as having negative effects. The research findings also revealed that the legalization of cannabis is very likely to increase its use and also highlighted precautionary measures users take to avoid the substance’s negative effects on mental health.

Keywords: cannabis use, mental health, university students, legalization

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2190 Factors Influencing the Uptake of Family Planning Services among Young People (18-24 Years) at Community Level in Rural Budaka District, Uganda

Authors: Mathew Nyashanu, George K. Kiggundu, Mandu S. Ekpenyong

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There is an increased number of young people engaging in early sexual relationships worldwide. Furthermore, statistics for early pregnancy among young people have also increased, especially in low and middle-income countries. This has health implications for both the parents and the baby. High uptake in family planning contraception among young people can reduce early pregnancy and subsequent negative health outcomes on the young parents and the baby. This study was set to explore the factors influencing the uptake of family planning contraceptive services among young people (18-24 years) at a community level in rural Budaka district, Uganda. The study utilised an explorative qualitative approach. The study found out that religion, partner resistance; perceived loss of libido, perceived barren, long waiting time and distance from the health facility, lack of privacy/confidentiality, excessive menstrual bleeding, cancer, and fear of having disabled babies, limited the utilisation of family planning contraceptive services while contraception as HIV prevention and child spacing encouraged young people to use family planning contraceptive services. There is a need for a culturally orientated community-based contraceptive health promotion approach to increase the uptake of family planning contraception services among young people.

Keywords: Young people, Family Planning, Contraceptives, Black sub-Sahara African

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2189 Factors of Major Depressive Disorder (MDD): Prevalence of Social Support on Stress within Parental Depression

Authors: Calvin Chiu, Samar Saade Needham

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The factors associated with the development of major depressive disorder (MDD) have been an ongoing area of concern within the field of psychopathology. Among parents, the rise in stress factors for individuals receiving less social support contributes to an increase in MDD cases. Understanding the causal aspects of MDD through the interworking of stress development within social support disparities provides critical insights into preventive measures for depressive symptoms. The present study seeks to assess the impact of social support on stress formation within MDD. Such that single parents lacking social support prompt an increase in stress formation, which proliferates the progression of MDD. Participants in this study were 450 ethnic minority mothers and fathers experiencing health inequities during pregnancy and early childhood. Perceived stress, social support, and depression are assessed by multi-item questionnaires that produce score ranges for general findings. Results indicated that lower social support scores resulted in higher depression scores, and higher perceived stress scores produced higher depression scores. Furthermore, single parents reported higher depression scores. These findings overlap with studies on paternal depression and suggest that MDD is a product of stress accumulation due to declining social support systems. Future studies may specify effective social support systems for decreasing stress accumulation in MDD formation in preventive strategies.

Keywords: major depressive disorder, stress formation, cognitive-behavioral outcomes, deficit-based behaviors

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2188 Effects of Alternative Opportunities and Compensation on Turnover Intention of Singapore PMET

Authors: Han Guan Chew, Keith Yong Ngee Ng, Shan-Wei Fan

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In Singapore, talent retention is one of the most persistent and real issue companies have to grapple with due to the tight labour market. Being resource-scarce, Singapore depends solely on its talented pool of high quality human resource to sustain its competitive advantage in the global economy. But the complex and multifaceted nature of turnover phenomenon makes the prescription of effective talent retention strategies in such a competitive labour market very challenging, especially when it comes to monetary incentives, companies struggle to answer the question of “How much is enough?” By examining the interactive effects of perceived alternative employment opportunities, annual salary and satisfaction with compensation on the turnover intention of 102 Singapore Professionals, Managers, Executives and Technicians (PMET) through correlation analyses and multiple regressions, important insights into the psyche of the Singapore talent pool can be drawn. It is found that annual salary influence turnover intention indirectly through mediation and moderation effects on PMET’s satisfaction on compensation. PMET are also found to be heavily swayed by better external opportunities. This implies that talent retention strategies should not adopt a purely monetary based blanket approach but rather a comprehensive and holistic one that considers the dynamics of prevailing market conditions.

Keywords: employee turnover, high performers, knowledge workers, perceived alternative employment opportunities salary, satisfaction on compensation, Singapore PMET, talent retention

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2187 The Attitudes towards English Relative to Other Languages in Indonesia: Discrepancies between Policy and Usage

Authors: Rani Silvia

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English has surpassed other languages to become the most widely taught and studied foreign language in Indonesia. This reflects the tendency of the Indonesian public to participate in global mainstream culture, which is longstanding but has been greatly facilitated by the widespread availability of television, the traditional media, and more recently the Internet and social media. However, despite increasing exposure and a history of teaching and study, mastery of English remains low, even as interest and perceived importance continue to increase. This along with Indonesia’s extremely complex linguistic environment has increased the status and value associated with the use of English and is changing the dynamic of language use nationwide. This study investigates the use of English in public settings in Indonesia as well as the attitudes of Indonesian speakers towards English. A case study was developed to explicate this phenomenon in a major Indonesian city. Fifty individuals, including both professionals and lay people, were interviewed about their language preferences as well as their perceptions about English as compared to other languages, such as the local language, Indonesian as the national language, and other foreign languages. Observations on the use of language in the public environment in advertising, signs, and other forms of public expression were analyzed to identify language preferences at this level and their relationship to current language policy. This study has three major findings. First, Indonesian speakers have more positive attitudes towards English than other languages; second, English has encroached on domains in which Indonesian should be used; and third, perceived awareness of the importance of Indonesian as an introduced national language seems to be declining to suggest a failure of policy. The study includes several recommendations for the future development of language planning in determining and directing language use in a public context in Indonesia.

Keywords: English, Indonesia, language attitudes, language policy

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2186 Overcoming Reading Barriers in an Inclusive Mathematics Classroom with Linguistic and Visual Support

Authors: A. Noll, J. Roth, M. Scholz

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The importance of written language in a democratic society is non-controversial. Students with physical, learning, cognitive or developmental disabilities often have difficulties in understanding information which is presented in written language only. These students suffer from obstacles in diverse domains. In order to reduce such barriers in educational as well as in out-of-school areas, access to written information must be facilitated. Readability can be enhanced by linguistic simplifications like the application of easy-to-read language. Easy-to-read language shall help people with disabilities to participate socially and politically in society. The authors state, for example, that only short simple words should be used, whereas the occurrence of complex sentences should be avoided. So far, these guidelines were not empirically proved. Another way to reduce reading barriers is the use of visual support, for example, symbols. A symbol conveys, in contrast to a photo, a single idea or concept. Little empirical data about the use of symbols to foster the readability of texts exist. Nevertheless, a positive influence can be assumed, e.g., because of the multimedia principle. It indicates that people learn better from words and pictures than from words alone. A qualitative Interview and Eye-Tracking-Study, which was conducted by the authors, gives cause for the assumption that besides the illustration of single words, the visualization of complete sentences may be helpful. Thus, the effect of photos, which illustrate the content of complete sentences, is also investigated in this study. This leads us to the main research question which was focused on: Does the use of easy-to-read language and/or enriching text with symbols or photos facilitate pupils’ comprehension of learning tasks? The sample consisted of students with learning difficulties (N = 144) and students without SEN (N = 159). The students worked on the tasks, which dealt with introducing fractions, individually. While experimental group 1 received a linguistically simplified version of the tasks, experimental group 2 worked with a variation which was linguistically simplified and furthermore, the keywords of the tasks were visualized by symbols. Experimental group 3 worked on exercises which were simplified by easy-to-read-language and the content of the whole sentences was illustrated by photos. Experimental group 4 received a not simplified version. The participants’ reading ability and their IQ was elevated beforehand to build four comparable groups. There is a significant effect of the different setting on the students’ results F(3,140) = 2,932; p = 0,036*. A post-hoc-analyses with multiple comparisons shows that this significance results from the difference between experimental group 3 and 4. The students in the group easy-to-read language plus photos worked on the exercises significantly more successfully than the students who worked in the group with no simplifications. Further results which refer, among others, to the influence of the students reading ability will be presented at the ICERI 2018.

Keywords: inclusive education, mathematics education, easy-to-read language, photos, symbols, special educational needs

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2185 Psychological Factors Affecting Breastfeeding: An Exploratory Study among Breastfeeding Moms

Authors: Marwa Abdussalam

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Breastfeeding is a unique emotional bond between a mother and their offspring. Though breastfeeding may be natural, it is not something mothers are born with; some still struggle to breastfeed their babies. Various factors can influence the breastfeeding experience, such as the mode of delivery, the mother’s health condition, proper latching, etc. In addition, psychological factors have been known to influence breastfeeding ability, duration, and milk supply. Some mothers struggle to breastfeed their babies because they perceive they have a low milk supply and or don’t have the ability to breastfeed their babies. Most of these perceptions result either from their own past experience or from the ‘comments’ of their caregivers. So, it is of utmost essential to understand such psychological factors affecting breastfeeding so that necessary steps can be taken to educate breastfeeding mothers. The study explored the role of psychological factors that affect breastfeeding. Data were collected from fifteen breastfeeding mothers using a semi-structured interview schedule. A total of 10 questions were included in the interview schedule. Questions were sequenced in a funnel pattern, beginning with open-ended questions and then moving on to close-ended questions. Data were analyzed using Braun and Clarke’s Thematic Analysis technique. This technique involves identifying the codes, generating themes, naming them, and finally reviewing them. Results indicated that breastfeeding self-efficacy perceived insufficient milk supply, and lack of knowledge were the psychological factors affecting breastfeeding. The results of this study can be used to help mothers who are struggling with breastfeeding by developing interventions aimed at improving breastfeeding self-efficacy.

Keywords: breastfeeding, breastfeeding self-efficacy, perceived insufficient milk supply, Thematic Analysis

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2184 Drivers and Barriers to the Acceptability of a Human Milk Bank Among Malaysians: A Cross Sectional Study

Authors: Kalaashini Ramachandran, Maznah Dahlui, Nik Daliana Nik Farid

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WHO recommends all babies to be exclusively breastfed and donor milk is the next best alternative in the absence of mother’s own milk. The establishment of a human milk bank (HMB) is still being debated due to religious concerns in Malaysia leading to informal milk sharing practices, but little is known on the knowledge, attitude and perception of women towards HMB and its benefits. This study hypothesizes that there is no association between knowledge and attitude and the acceptance towards the establishment of human milk bank among Malaysian women and healthcare providers. The aim of this study is to determine the drivers and barriers among Malaysian towards the acceptance of an HMB. A cross-sectional study with 367 participants was enrolled within a period of 3 months to answer an online self-administered questionnaire. Data on sociodemographic, knowledge on breastfeeding benefits, knowledge and attitude on HMB and its specific issues were analyzed in terms of frequency and then proceed to multiple logistic regression. Majority of the respondents are of Islamis religion (73.3%), have succeesfully completed their tertiary education (82.8%), and are employed (70.8%). Only 55.9% of respondents have heard of an HMB stating internet as their main source of information but a higher prevalence is agreeable to the establishment of a human milk bank (67.8%). Most respondents have a good score on knowledge of breastfeeding benefits and on HMB specific issues (70% and 54.2% respectively) while 63.8% of them have a positive attitude towards HMB. In the multivariate analysis, mothers with a good score on general knowledge of breastfeeding (AOR: 1.715) were more likely to accept the establishment of an HMB while Islamic religion was negatively associated with its establishment (AOR:0.113). This study has found a high prevalence rate of mothers who are willing to accept the establishment of an HMB. This action can be potentially shaped by educating mothers on the benefits of breastfeeding as well as addressing their religious concerns so the establishment of a religiously abiding HMB in Malaysia may be accepted without compromising their belief or the health benefit of donor milk.

Keywords: acceptability, attitude, human milk bank, knowledge

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2183 Positive Incentives to Reduce Private Car Use: A Theory-Based Critical Analysis

Authors: Rafael Alexandre Dos Reis

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Research has shown a substantial increase in the participation of Conventionally Fuelled Vehicles (CFVs) in the urban transport modal split. The reasons for this unsustainable reality are multiple, from economic interventions to individual behaviour. The development and delivery of positive incentives for the adoption of more environmental-friendly modes of transport is an emerging strategy to help in tackling the problem of excessive use of conventionally fuelled vehicles. The efficiency of this approach, like other information-based schemes, can benefit from the knowledge of their potential impacts in theoretical constructs of multiple behaviour change theories. The goal of this research is to critically analyse theories of behaviour that are relevant to transport research and the impacts of positive incentives on the theoretical determinants of behaviour, strengthening the current body of evidence about the benefits of this approach. The main method to investigate this will involve a literature review on two main topics: the current theories of behaviour that have empirical support in transport research and the past or ongoing positive incentives programs that had an impact on car use reduction. The reviewed programs of positive incentives were the following: The TravelSmart®; Spitsmijden®; Incentives for Singapore Commuters® (INSINC); COMMUTEGREENER®; MOVESMARTER®; STREETLIFE®; SUPERHUB®; SUNSET® and the EMPOWER® project. The theories analysed were the heory of Planned Behaviour (TPB); The Norm Activation Theory (NAM); Social Learning Theory (SLT); The Theory of Interpersonal Behaviour (TIB); The Goal-Setting Theory (GST) and The Value-Belief-Norm Theory (VBN). After the revisions of the theoretical constructs of each of the theories and their influence on car use, it can be concluded that positive incentives schemes impact on behaviour change in the following manners: -Changing individual’s attitudes through informational incentives; -Increasing feelings of moral obligations to reduce the use of CFVs; -Increase the perceived social pressure to engage in more sustainable mobility behaviours through the use of comparison mechanisms in social media, for example; -Increase the perceived control of behaviour through informational incentives and training incentives; -Increasing personal norms with reinforcing information; -Providing tools for self-monitoring and self-evaluation; -Providing real experiences in alternative modes to the car; -Making the observation of others’ car use reduction possible; -Informing about consequences of behaviour and emphasizing the individual’s responsibility with society and the environment; -Increasing the perception of the consequences of car use to an individual’s valued objects; -Increasing the perceived ability to reduce threats to environment; -Help establishing goals to reduce car use; - iving personalized feedback on the goal; -Increase feelings of commitment to the goal; -Reducing the perceived complexity of the use of alternatives to the car. It is notable that the emerging technique of delivering positive incentives are systematically connected to causal determinants of travel behaviour. The preliminary results of the reviewed programs evidence how positive incentives might strengthen these determinants and help in the process of behaviour change.

Keywords: positive incentives, private car use reduction, sustainable behaviour, voluntary travel behaviour change

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2182 Permeable Bio-Reactive Barriers to Tackle Petroleum Hydrocarbon Contamination in the Sub-Antarctic

Authors: Benjamin L. Freidman, Sally L. Gras, Ian Snape, Geoff W. Stevens, Kathryn A. Mumford

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Increasing transportation and storage of petroleum hydrocarbons in Antarctic and sub-Antarctic regions have resulted in frequent accidental spills. Migrating petroleum hydrocarbon spills can have a significant impact on terrestrial and marine ecosystems in cold regions, as harsh environmental conditions result in heightened sensitivity to pollution. This migration of contaminants has led to the development of Permeable Reactive Barriers (PRB) for application in cold regions. PRB’s are one of the most practical technologies for on-site or in-situ groundwater remediation in cold regions due to their minimal energy, monitoring and maintenance requirements. The Main Power House site has been used as a fuel storage and power generation area for the Macquarie Island research station since at least 1960. Soil analysis at the site has revealed Total Petroleum Hydrocarbon (TPH) (C9-C28) concentrations as high as 19,000 mg/kg soil. Groundwater TPH concentrations at this site can exceed 350 mg/L TPH. Ongoing migration of petroleum hydrocarbons into the neighbouring marine ecosystem resulted in the installation of a ‘funnel and gate’ PRB in November 2014. The ‘funnel and gate’ design successfully intercepted contaminated groundwater and analysis of TPH retention and biodegradation on PRB media are currently underway. Installation of the PRB facilitates research aimed at better understanding the contribution of particle attached biofilms to the remediation of groundwater systems. Bench-scale PRB system analysis at The University of Melbourne is currently examining the role biofilms play in petroleum hydrocarbon degradation, and how controlled release nutrient media can heighten the metabolic activity of biofilms in cold regions in the presence of low temperatures and low nutrient groundwater.

Keywords: groundwater, petroleum, Macquarie island, funnel and gate

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2181 Promoting Civic Health through Patient Voter Registration

Authors: Amit Syal, Madeline Grade, Alister Martin

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

Keywords: civic health, enfranchisement, physician, voting

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2180 The Influence of Destination Image on Tourists' Experience at Osun Osogbo World Heritage Site

Authors: Bola Adeleke, Kayode Ogunsusi

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Heritage sites have evolved to preserve culture and heritage and also to educate and entertain tourists. Tourist travel decisions and behavior are influenced by destination image and value of the experience of tourists. Perceived value is one of the important tools for securing a competitive edge in tourism destinations. The model of Ritchie and Crouch distinguished 36 attributes of competitiveness which are classified into five factors which are quality of experience, touristic attractiveness, environment and infrastructure, entertainment/outdoor activities and cultural traditions. The study extended this model with a different grouping of the determinants of destination competitiveness. The theoretical framework used for this study assumes that apart from attractions already situated in the grove, satisfaction with destination common service, and entertainment and events, can all be used in creating a positive image for/and in attracting customers (destination selection) to visit Osun Sacred Osogbo Grove during and after annual celebrations. All these will impact positively on travel experience of customers as well as their spiritual fulfillment. Destination image has a direct impact on tourists’ satisfaction which consequently impacts on tourists’ likely future behavior on whether to revisit a cultural destination or not. The study investigated the variables responsible for destination image competitiveness of the Heritage Site; assessed the factors enhancing the destination image; and evaluated the perceived value realized by tourists from their cultural experience at the grove. A complete enumeration of tourists above 18 years of age who visited the Heritage Site within the month of March and April 2017 was taken. 240 respondents, therefore, were used for the study. The structured questionnaire with 5 Likert scales was administered. Five factors comprising 63 variables were used to determine the destination image competitiveness through principal component analysis, while multiple regressions were used to evaluate perceived value of tourists at the grove. Results revealed that 11 out of the 12 variables determining the destination image competitiveness were significant in attracting tourists to the grove. From the R-value, all factors predicted tourists’ value of experience strongly (R= 0.936). The percentage variance of customer value was explained by 87.70% of the variance of destination common service, entertainment and event satisfaction, travel environment satisfaction and spiritual satisfaction, with F-value being significant at 0.00. Factors with high alpha value contributed greatly to adding value to enhancing destination and tourists’ experience. 11 variables positively predicted tourist value with significance. Managers of Osun World Heritage Site should improve on variables critical to adding values to tourists’ experience.

Keywords: competitiveness, destination image, Osun Osogbo world heritage site, tourists

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2179 Explore Customers' Perceptions of U.K. Fast Fashion Retailers' Identities

Authors: Ranis Cheng

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Corporate identity is an asset of a company that is unique, valuable and provides a source of competitive advantage. This research taking a holistic view to explore all dimensions of corporate identity and influence of each on customers’ shopping experience in the fast fashion retail sector in the U.K. Unfortunately these issues have not been explored sufficiently in the extant literature, especially in the area of the identity gap. To date, there is still a lack of empirical research on corporate identity, especially in the retail sector despite the importance of the concept to all organisations. Furthermore, although customer group is one of the essential audiences of organisations and the importance of customers in corporate identity management cannot be ignored, to date limited studies have been conducted in order to understand how customers interpret and perceive corporate identity (perceived identity). Therefore, this research investigates customers’ perceptions of corporate identity in the fast fashion retail sector. 1) To explore customers’ perceptions of fast fashion retailers’ corporate identities; 2) To uncover the important constructs of corporate identity which contribute to the U.K. fast fashion retail sector. 40 semi-structured interviews with the fast fashion consumers have been carried out to identify their perceptions of fast fashion retailers' corporate identities. Secondary research on retailers' websites and press releases have been evaluated to identify their desired corporate identities. The findings have revealed that there are significant gaps between how fast fashion retailers present their identities and how their consumers perceive them. This has posed customers' negative perceptions towards the retailers and their shopping experience as a whole. This study has studied how the corporate identity constructs could be applied in the fashion context and has helped retailers to shed lights on how to minimise the gap between desired and perceived identity.

Keywords: corporate identity, fast fashion, fashion retailing, identity gap

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2178 The Efficacy of Vestibular Rehabilitation Therapy for Mild Traumatic Brain Injury: A Systematic Review and Meta-Analysis

Authors: Ammar Aljabri, Alhussain Halawani, Alaa Ashqar, Omar Alageely

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Objective: mild Traumatic Brain Injury (mTBI) or concussion is a common yet undermanaged and underreported condition. This systematic review and meta-analysis aim to determine the efficacy of VRT as a treatment option for mTBI. Method: This review and meta-analysis was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and included RCTs and pre-VRT/post-VRT retrospective chart reviews. Records meeting the inclusion criteria were extracted from the following databases: Medline, Embase, and Cochrane Register of Controlled Trials (CENTRAL). Results: Eight articles met the inclusion criteria, and six RCTs were included in the meta-analysis. VRT demonstrated significant improvement in decreasing perceived dizziness at the end of the intervention program, as shown by DHI scores (SMD= -0.33, 95% CI -0.62 to -0.03, p=0.03, I2= 0%). However, no significant reduction in DHI was evident after two months of follow-up (SMD= 0.15, 95% CI -0.23 to 0.52, p=0.44, I2=0%). Quantitative analysis also depicts significant reduction in both VOMS (SMD=-0.40, 95% CI -0.60 to -0.20, p<0.0001, I2=0%) and PCSS (SMD= -0.39, 95% CI -0.71 to -0.07, p=0.02, I2=0%) following the intervention. Lastly, there was no significant difference between intervention groups on BESS scores (SMD= -31, 95% CI -0.71 to 0.10, p=0.14, I2=0%) and return to sport/function (95% CI 0.32 to 30.80, p=0.32, I2=82%). Conclusions: Current evidence on the efficacy of VRT for mTBI is limited. This review and analysis provide evidence that supports the role of VRT in improving perceived symptoms following concussion. There is still a need for high-quality trials evaluating the benefit of VRT using a standardized approach.

Keywords: concussion, traumatic brain injury, vestibular rehabilitation, neurorehabilitation

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2177 Perceptions and Governance of One Health in African Countries: A Workshop Report

Authors: Menouni Aziza, Chbihi Kaoutar, El Jaafari Samir

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There is strong evidence connecting epidemics with the disruption of the human-animal-environment interaction. Despite the fact that several cases of emerging and endemic zoonotic diseases indifferent parts of Africa have been documented, there is limited data regarding which specific interventions are effective in preventing and managing the associated risks using a One Health approach. The aim of this study is to better understand perceptions and ongoing research related to interventions in Africa through the implementation of suitable projects and policies. A bibliometric review of the scientific literature on one health studies with a focus on African countries was conducted, followed by a qualitative survey among stakeholders involved in fields related to One Health research or management in the Africa, including veterinary experts, public health professionals, environmentalists and policy makers, to learn about determinants of their perceptions, as well as barriers to and promoters of successful interventions and governance. The project was concluded with an international workshop in March 2023, where a broad range of topics relevant to One Health were discussed. 94% of the respondents were aware of the importance of the One Health approach and strongly endorse it within their respective countries. The top reported barriers to One Health development in Africa included paucity of data, weak linkages and institutional communication between the different departments and the lack of funding. Key areas of improvement identified were the impact evaluation of current initiatives, awareness raising campaigns among citizens targeted at behavioral changes, capacity building of relevant professionals and stakeholders, as well as the implementation of adequate policies and enforcement of national and continental regulations, allowing for better coordination on the African level. All One Health sectors in Africa require strong governance and leadership, as well as inter-ministerial, inter-sectoral, and interdisciplinary cooperation.

Keywords: one health, perceptions, governance, Africa

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