Search results for: literary gaps
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1190

Search results for: literary gaps

320 Environmental Performance Measurement for Network-Level Pavement Management

Authors: Jessica Achebe, Susan Tighe

Abstract:

The recent Canadian infrastructure report card reveals the unhealthy state of municipal infrastructure intensified challenged faced by municipalities to maintain adequate infrastructure performance thresholds and meet user’s required service levels. For a road agency, huge funding gap issue is inflated by growing concerns of the environmental repercussion of road construction, operation and maintenance activities. As the reduction of material consumption and greenhouse gas emission when maintain and rehabilitating road networks can achieve added benefits including improved life cycle performance of pavements, reduced climate change impacts and human health effect due to less air pollution, improved productivity due to optimal allocation of resources and reduced road user cost. Incorporating environmental sustainability measure into pavement management is solution widely cited and studied. However measuring the environmental performance of road network is still a far-fetched practice in road network management, more so an ostensive agency-wide environmental sustainability or sustainable maintenance specifications is missing. To address this challenge, this present research focuses on the environmental sustainability performance of network-level pavement management. The ultimate goal is to develop a framework to incorporate environmental sustainability in pavement management systems for network-level maintenance programming. In order to achieve this goal, this study reviewed previous studies that employed environmental performance measures, as well as the suitability of environmental performance indicators for the evaluation of the sustainability of network-level pavement maintenance strategies. Through an industry practice survey, this paper provides a brief forward regarding the pavement manager motivations and barriers to making more sustainable decisions, and data needed to support the network-level environmental sustainability. The trends in network-level sustainable pavement management are also presented, existing gaps are highlighted, and ideas are proposed for sustainable network-level pavement management.

Keywords: pavement management, sustainability, network-level evaluation, environment measures

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319 Pediatric Health Nursing Research in Jordan: Evaluating the State of Knowledge and Determining Future Research Direction

Authors: Inaam Khalaf, Nadin M. Abdel Razeq, Hamza Alduraidi, Suhaila Halasa, Omayyah S. Nassar, Eman Al-Horani, Jumana Shehadeh, Anna Talal

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Background: Nursing researchers are responsible for generating knowledge that corresponds to national and global research priorities in order to promote, restore, and maintain the health of individuals and societies. The objectives of this scoping review of Jordanian literature are to assess the existing research on pediatric nursing in terms of evolution, authorship and collaborations, funding sources, methodologies, topics of research, and pediatric subjects' age groups so as to identify gaps in research. Methodology: A search was conducted using related keywords obtained from national and international databases. The reviewed literature included pediatric health articles published through December 2019 in English and Arabic, authored by nursing researchers. The investigators assessed the retrieved studies and extracted data using a data-mining checklist. Results: The review included 265 articles authored by Jordanian nursing researchers concerning children's health, published between 1987 and 2019; 95% were published between 2009 and 2019. The most commonly applied research methodology was the descriptive non-experimental method (76%). The main generic topics were health promotion and disease prevention (23%), chronic physical conditions (19%), mental health, behavioral disorders, and forensic issues (16%). Conclusion: The review findings identified a grave shortage of evidence concerning nursing care issues for children below five years of age, especially those between ages two and five years. The research priorities identified in this review resonate with those identified in international reports. Implications: Nursing researchers are encouraged to conduct more research targeting topics of national-level importance in collaboration with clinically involved nurses and international scholars.

Keywords: Jordan, scoping review, children health nursing, pediatric, adolescents

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318 The Role of Group Dynamics in Creativity: A Study Case from Italy

Authors: Sofya Komarova, Frashia Ndungu, Alessia Gavazzoli, Roberta Mineo

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Modern society requires people to be flexible and to develop innovative solutions to unexpected situations. Creativity refers to the “interaction among aptitude, process, and the environment by which an individual or group produces a perceptible product that is both novel and useful as defined within a social context”. It allows humans to produce novel ideas, generate new solutions, and express themselves uniquely. Only a few scientific studies have examined group dynamics' influence on individuals' creativity. There exist some gaps in the research on creative thinking, such as the fact that collaborative effort frequently results in the enhanced production of new information and knowledge. Therefore, it is critical to evaluate creativity via social settings. The study aimed at exploring the group dynamics of young adults in small group settings and the influence of these dynamics on their creativity. The study included 30 participants aged 20 to 25 who were attending university after completing a bachelor's degree. The participants were divided into groups of three, in gender homogenous and heterogeneous groups. The groups’ creative task was tied to the Lego mosaic created for the Scintillae laboratory at the Reggio Children Foundation. Group dynamics were operationalized into patterns of behaviors classified into three major categories: 1) Social Interactions, 2) Play, and 3) Distraction. Data were collected through audio and video recording and observation. The qualitative data were converted into quantitative data using the observational coding system; then, they were analyzed, revealing correlations between behaviors using median points and averages. For each participant and group, the percentages of represented behavior signals were computed. The findings revealed a link between social interaction, creative thinking, and creative activities. Other findings revealed that the more intense the social interaction, the lower the amount of creativity demonstrated. This study bridges the research gap between group dynamics and creativity. The approach calls for further research on the relationship between creativity and social interaction.

Keywords: group dynamics, creative thinking, creative action, social interactions, group play

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317 Alternate Approaches to Quality Measurement: An Exploratory Study in Differentiation of “Quality” Characteristics in Services and Supports

Authors: Caitlin Bailey, Marian Frattarola Saulino, Beth Steinberg

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Today, virtually all programs offered to people with intellectual and developmental disabilities tout themselves as person-centered, community-based and inclusive, yet there is a vast range in type and quality of services that use these similar descriptors. The issue is exacerbated by the fields’ measurement practices around quality, inclusion, independent living, choice and person-centered outcomes. For instance, community inclusion for people with disabilities is often measured by the number of times person steps into his or her community. These measurement approaches set standards for quality too low so that agencies supporting group home residents to go bowling every week can report the same outcomes as an agency that supports one person to join a book club that includes people based on their literary interests rather than disability labels. Ultimately, lack of delineation in measurement contributes to the confusion between face value “quality” and true quality services and supports for many people with disabilities and their families. This exploratory study adopts alternative approaches to quality measurement including co-production methods and systems theoretical framework in order to identify the factors that 1) lead to high-quality supports and, 2) differentiate high-quality services. Project researchers have partnered with community practitioners who are all committed to providing quality services and supports but vary in the degree to which they are actually able to provide them. The study includes two parts; first, an online survey distributed to more than 500 agencies that have demonstrated commitment to providing high-quality services; and second, four in-depth case studies with agencies in three United States and Israel providing a variety of supports to children and adults with disabilities. Results from both the survey and in-depth case studies were thematically analyzed and coded. Results show that there are specific factors that differentiate service quality; however meaningful quality measurement practices also require that researchers explore the contextual factors that contribute to quality. These not only include direct services and interactions, but also characteristics of service users, their environments as well as organizations providing services, such as management and funding structures, culture and leadership. Findings from this study challenge researchers, policy makers and practitioners to examine existing quality service standards and measurements and to adopt alternate methodologies and solutions to differentiate and scale up evidence-based quality practices so that all people with disabilities have access to services that support them to live, work, and enjoy where and with whom they choose.

Keywords: co-production, inclusion, independent living, quality measurement, quality supports

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316 Modern Pilgrimage Narratives and India’s Heterogeneity

Authors: Alan Johnson

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This paper focuses on modern pilgrimage narratives about sites affiliated with Indian religious expressions located both within and outside India. The paper uses a multidisciplinary approach to examine poetry, personal essays, and online attestations of pilgrimage to illustrate how non-religious ideas coexist with outwardly religious ones, exemplifying a characteristically Indian form of syncretism that pre-dates Western ideas of pluralism. The paper argues that the syncretism on display in these modern creative works refutes the current exclusionary vision of India as a primordially Hindu-nationalist realm. A crucial premise of this argument is that the narrative’s intrinsic heteroglossia, so evident in India’s historically rich variety of stories and symbols, belies this reactionary version of Hindu nationalism. Equally important to this argument, therefore, is the vibrancy of Hindu sites outside India, such as the Batu Caves temple complex in Kuala Lumpur, Malaysia. The literary texts examined in this paper include, first, Arun Kolatkar’s famous 1976 collection of poems, titled Jejuri, about a visit to the pilgrimage site of the same name in Maharashtra. Here, the modern, secularized visitor from Bombay (Mumbai) contemplates the effect of the temple complex on himself and on the other, more worshipful visitors. Kolatkar’s modernist poems reflect the narrator’s typically modern-Indian ambivalence for holy ruins, for although they do not evoke a conventionally religious feeling in him, they nevertheless possess an aura of timelessness that questions the narrator’s time-conscious sensibility. The paper bookends Kolatkar’s Jejuri with considerations of an early-twentieth-century text, online accounts by visitors to the Batu Caves, and a recent, more conventional Hindu account of pilgrimage. For example, the pioneering graphic artist Mukul Chandra Dey published in 1917, My Pilgrimages to Ajanta and Bagh, in which he devotes an entire chapter to the life of the Buddha as a means of illustrating the layering of stories that is a characteristic feature of sacred sites in India. In a different but still syncretic register, Jawaharlal Nehru, India’s first prime minister, and a committed secularist proffers India’s ancient pilgrimage network as a template for national unity in his classic 1946 autobiography The Discovery of India. Narrative is the perfect vehicle for highlighting this layering of sensibilities, for a single text can juxtapose the pilgrim-narrator’s description with that of a far older pilgrimage, a juxtaposition that establishes an imaginative connection between otherwise distanced actors, and between them and the reader.

Keywords: India, literature, narrative, syncretism

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315 Best Practices in Designing a Mentoring Programme for Soft Skills Development

Authors: D Kokt, TF Dreyer

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The main objective of the study was to design a mentoring programme aimed at developing the soft skills of mentors. The mentors are all employed by a multinational corporation. The company had a mentoring plan in place that it did not yield the required results, especially related to the development of soft skills. This prompted the researchers to conduct an extensive literature review followed by a mixed methods approach to ascertain the best practices in developing the soft skills of mentors. The outcomes of the study led to the development of a structured mentoring programme using 25 modules to be completed by mentors. The design incorporated a blended modular approach using both face-to-face teaching and teaching supported by Information Communication Technology (ICT). Blended learning was ideal as the ICT component helped to minimise instructor-mentor physical contact as part of the health measures during the Covid-19 pandemic. The blended learning approach also allowed instructors and mentors an online or offline mode, so that mentors could have more time for creative and cooperative exercises. A range of delivery methodologies were spread out across the different modules to ensure mentor engagement and accelerate mentor development. This included: concept development through in-person instructor-led training sessions, concept development through virtual instructor-led training sessions, simulations and case studies, e-learning, role plays and interactive learning using mentoring toolkits; and experiential learning through application. The mentor development journey included formal modular competency assessments. All modules contained post-competency assessment consisting of 10 questions (comprising of a combination of explanatory questions and multiple-choice questions) to ensure understanding and deal with identified competency gaps. The minimum pass mark for all modular competency assessments was 80%. Mentors were allowed retake the assessment if they scored less than 80%, until they demonstrated understanding at the required level.

Keywords: mentor, mentee, soft skills, mentor development, blended learning, modular approach

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314 Metamorphosis of Teaching-Learning During COVID-19 Crisis and Challenges of Education in India

Authors: Saroj Pandey

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COVID-19, declared by the World Health Organization a pandemic (WHO,2020), has created an unprecedented crisis world over endangering the human survival itself. Corona induced lockdowns forced approximately 140 million students of 190 countries at various levels of education from preprimary to higher education to remain confined to their homes. In India, approximately 360 million students were affected by the forced shut down of schools due to the countrywide lockdown in March 2020 and resultant disruption of education. After the initial shock and anxiety the Indian polity and education system bounced back with a number of initiatives, and online education came as a major rescuer for the education system of the country. The distance and online mode of learning that was treated as the poor cousin of conventional mode and often criticized for its quality became the major crusader overnight changing the entire ecosystem of traditional teaching -leaning towards the virtual mode. Teachers who were averse to technology were forced to remodel their educational pedagogies and reorient themselves overnight to use various online platforms such as Zoom, Google meet, and other such platforms to reach the learners. This metamorphosis through ensured students was meaningfully engaged in their studies during the lockdown period but it has its own set of challenges. This paper deals with the government initiatives, and teachers' self-efforts to keep the channel of teaching learning on providing academic and socio emotional support to students during the most difficult period of their life as well as the digital divide between the rich and poor, rural and urban, and boys and girls in India and resultant challenges. It also provides an overview of few significant self-initiatives of teachers to reach their students during the crisis period, who did not have internet and smartphone facilities as well as the initiatives being taken at the government level to address the learning needs and mitigate the learning gaps of learners, bridge the digital divide, strategic planning and upskilling of teachers to overcome the effect of COVID-19 crisis.

Keywords: COVID-19, online education, initiatives, challenges

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313 Social Protection Reforms in Indonesia: Towards a Life Cycle Based Social Protection System

Authors: Dyah Larasati, Karishma Alize Huda, Sri Kusumastuti Rahayu, Martin Daniel Siyaranamual

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Indonesia continues to reform its social protection system to provide the needed protection for its citizen. Indonesia Social Protection consisted of social assistance programs (non-contributory/tax-financed) specifically targeted for the poor and at-risk and social security/insurance program (contributory system). The social assistance programs have mostly been implemented since 1998. The national health insurance has been implemented since 2014 and the employment social insurance since 2015. One major reform implemented has been improving the targeting performance of its major social assistance portfolios including (1) Food Assistance for the poor families (Rastra and BPNT/noncash foods assistance); (2) Education Assistance for poor children; (3) Conditional Cash Transfer for poor families (PKH); and (4) Subsidized beneficiaries of National Health Insurance (JKN-PBI) for the poor and at-risk individuals. For the Social Insurance (through BPJS Employment program), several initiatives have been implemented to expand the program contributing members, although it mostly benefits the formal sector workers. However, major gaps still exist especially for the emerging middle-income groups who typically work at the informal sectors. They have yet to get the protection needed to sustain their social and economic growth. Since 2017, TNP2K (the National Team for Poverty Reduction) under the Vice President office has led the social protection discourse as the government understands the need to address vulnerabilities across the lifecycle and prioritize support to the most at-risk population particularly the elderly, young children and people with disabilities. Discussion and advocacy to recommend for more investment is continuing in order for the government to establish a comprehensive social protection system in the near future (2020-2024) that protects children through an inclusive child benefit program; build a system to benefit more working-age adults (including individuals with disabilities) and a three-tier elderly protection as they reach 65 years.

Keywords: poverty reduction, social assistance, social insurance, social protection

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312 Ethical 'Spaces': A Critical Analysis of the Medical, Ethical and Legal Complexities in the Treatment and Care of Unidentified and Critically Incapacitated Victims Following a Disaster

Authors: D. Osborn, L. Easthope

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The increasing threat of ‘marauding terror,' utilising improvised explosive devices and firearms, has focused the attention of policy makers and emergency responders once again on the treatment of the critically injured patient in a highly volatile scenario. Whilst there have been significant improvements made in the response and lessons learned from recent disasters in the international disaster community there still remain areas of uncertainty and a lack of clarity in the care of the critically injured. This innovative, longitudinal study has at its heart the aim of using ethnographic methods to ‘slow down’ the journey such patients will take and make visible the ethical complexities that 2017 technologies, expectations and over a decade of improved combat medicine techniques have brought. The primary researcher, previously employed in the hospital emergency management environment, has closely followed responders as they managed casualties with life-threatening injuries. Ethnographic observation of Exercise Unified Response in March 2016, exposed the ethical and legal 'vacuums' within a mass casualty and fatality setting, specifically the extrication, treatment and care of critically injured patients from crushed and overturned train carriages. This article highlights a gap in the debate, evaluation, planning and response to an incident of this nature specifically the incapacitated, unidentified patients and the ethics of submitting them to the invasive ‘Disaster Victim Identification’ process. Using a qualitative ethnographic analysis, triangulating observation, interviews and documentation, this analysis explores the gaps and highlights the next stages in the researcher’s pathway as she continues to explore with emergency practitioners some of this century’s most difficult questions in relation to the medico-legal and ethical challenges faced by emergency services in the wake of new and emerging threats and medical treatment expectations.

Keywords: ethics, disaster, Disaster Victim Identification (DVI), legality, unidentified

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311 Just Not Seeing It: Exploring the Relationship between Inattention Blindness and Banner Blindness

Authors: Carie Cunningham, Krsiten Lynch

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Despite a viewer’s thought that they may be paying attention, many times they are missing out on their surrounds-- a phenomenon referred to as inattentional blindness. Inattention blindness refers to the failure of an individual to orient their attention to a particular item in their visual field. This well-defined in the psychology literature. Similarly, this phenomenon has been evaluated in media types in advertising. In advertising, not comprehending/remembering items in one’s field of vision is known as banner blindness. On the other hand, banner blindness is a phenomenon that occurs when individuals habitually see a banner in a specific area on a webpage, and thus condition themselves to ignore those habitual areas. Another reason that individuals avoid these habitual areas (usually on the top or sides of a webpage) is due to the lack of personal relevance or pertinent information to the viewer. Banner blindness, while a web-based concept, may also relate this inattention blindness. This paper is proposing an analysis of the true similarities and differences between these concepts bridging the two dimensions of thinking together. Forty participants participated in an eye-tracking and post-survey experiment to test attention and memory measures in both a banner blindness and inattention blindness condition. The two conditions were conducted between subjects semi-randomized order. Half of participants were told to search through the content ignoring the advertising banners; the other half of participants were first told to search through the content ignoring the distractor icon. These groups were switched after 5 trials and then 5 more trials were completed. In review of the literature, sustainability communication was found to have many inconsistencies with message production and viewer awareness. For the purpose of this study, we used advertising materials as stimuli. Results suggest that there are gaps between the two concepts and that more research should be done testing these effects in a real world setting versus an online environment. This contributes to theory by exploring the overlapping concepts—inattention blindness and banner blindness and providing the advertising industry with support that viewers can still fall victim to ignoring items in their field of view even if not consciously, which will impact message development.

Keywords: attention, banner blindness, eye movement, inattention blindness

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310 The Role of Lifetime Stress in the Relation between Socioeconomic Status and Health-Risk Behaviors

Authors: Teresa Smith, Farrah Jacquez

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Health-risk behaviors (e.g., smoking, poor diet) directly increase the risk for chronic disease and morbidity. There is substantial evidence of a negative association between socioeconomic status (SES) and engagement in health-risk behaviors. However, due to the complexity of SES, researchers have suggested looking beyond this factor to fully understand the mechanisms that underlie engagement in health-risk behaviors. Stress is one plausible mechanism through which SES impacts health-risk behaviors. Currently, it remains unclear how stress occurring across the life course might impact health behaviors and explain the association between SES and these behaviors. To address the gaps in the literature, 172 adults between the ages of 18-49 were surveyed about their lifetime stress exposure, sociodemographic variables, and health-risk behaviors via an online recruitment portal, Prolific. Five major findings emerged from the current study. First, SES was negatively associated with engagement in health-risk behaviors and lifetime stress above and beyond current stress and other relevant demographics. Second, lifetime stress was significantly associated with health-risk behaviors above and beyond current stress and relevant demographic variables. Third, lifetime stress fully mediated the association between SES and health-risk behaviors above and beyond current stress and other demographics. Fourth, the severity of stress experienced emerged as the most significant lifetime stress variable that explains the relation between SES and health-risk behaviors. Fifth and finally, lower SES and experiencing financial and legal/crime stressors increased the likelihood of engaging in health-risk behaviors. The current study results align with previous research and suggest that stress occurring over the lifespan impacts the relation between SES and health-risk behaviors, which are in turn known to impact health outcomes. However, our findings move the current literature forward by providing a more nuanced understanding of the specific aspects of stress that influence this association. Specifically, the severity of stress experienced across the entire lifespan was the most important aspect of stress when examining the association between SES and health-risk behaviors. Further, individuals most at risk for engaging in health-risk behaviors are those of the lowest SES and experience financial and legal/crime stressors. These findings have the potential to inform interventions and policies aimed at addressing health-risk behaviors by providing a more sophisticated understanding of the impact of stress.

Keywords: stress, health behaviors, socioeconomic status, health

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309 The Development of the First Inter-Agency Residential Rehabilitation Service for Gambling Disorder with Complex Clinical Needs

Authors: Dragos Dragomir-Stanciu, Leon Marsh

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Background As a response to the gaps identified in recent research in the provision of residential care to address co-occurring health needs, including mental health problems and complexities Gamble Aware has facilitated the possibility to provide a new service which would extend the NGTS provision of residential rehabilitation for gambling disorder with complex and co-morbid presentation. Gordon Moody, together with Adferiad have been successful in securing the tender for this service and this presentation aims to introduce FOLD, the resulting model of treatment developed for the delivery of the service. Setting As a partnership, we have come together to coproduce a model which allows us to share our clinical and industry knowledge and build on our reputations as trusted treatment providers. The presentation will outline our expertise share in development of a unified approach to recovery-oriented models of care, clinical governance, risk assessment and management and aftercare and continuous recovery. We will also introduce our innovative specialist referral portal which will offer referring partners the ability to include the service user in planning their own recovery journey. Outcomes Our collaboration has resulted in the development of the FOLD model which includes three agile and flexible treatment packages aimed at offering the most enhanced and comprehensive treatment in UK, to date, for those most affected by gambling harm. The paper will offer insight into each treatment package and all recovery model stages involved, as well as into the partnership work with NGST providers, local mental health and social care providers and lived experience organisation that will enable us to offer support to more 100 people a year who would otherwise get “lost in the system”. Conclusion FOLD offers a great opportunity to develop, implement and evaluate a new, much needed, whole-person and whole-system approach to counter gambling related harms.

Keywords: gambling treatment, partnership working, integrated care pathways, NGTS, complex needs

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308 Strengthening Islamic Banking Customer Behavioral Intention through Value and Commitment

Authors: Mornay Roberts-Lombard

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Consumers’ perceptions of value are crucial to ensuring their future commitment and behavioral intentions. As a result, service providers, such as Islamic banks, must provide their customers with products and services that are regarded as valuable, stimulating, collaborative, and competent. Therefore, the value provided to customers must meet or surpass their expectations, which can drive customers’ commitment (affective and calculative) and eventually favorably impact their future behavioral intentions. Consequently, Islamic banks in South Africa, as a growing African market, need to obtain a better understanding of the variables that impact Islamic banking customers’ value perceptions and how these impact their future behavioral intentions. Furthermore, it is necessary to investigate how customers’ perceived value perceptions impact their affective and calculative commitment and how the latter impact their future behavioral intentions. The purpose of this study is to bridge these gaps in knowledge, as the competitiveness of the Islamic banking industry in South Africa requires a deeper understanding of the aforementioned relationships. The study was exploratory and quantitative in nature, and data was collected from 250 Islamic banking customers using self-administered questionnaires. These banking customers resided in the Gauteng province of South Africa. Exploratory factor analysis, Pearson’s coefficient analysis, and multiple regression analysis were applied to measure the proposed hypotheses developed for the study. This research will aid Islamic banks in the country in potentially strengthening customers’ future commitment (affective and calculative) and positively impact their future behavioral intentions. The findings of the study established that service quality has a significant and positive impact on perceived value. Moreover, it was determined that perceived value has a favorable and considerable impact on affective and calculative commitment, while calculative commitment has a beneficial impact on behavioral intention. The research informs Islamic banks of the importance of service engagement in driving customer perceived value, which stimulates the future affective and calculative commitment of Islamic bank customers in an emerging market context. Finally, the study proposes guidelines for Islamic banks to develop an enhanced understanding of the factors that impact the perceived value-commitment-behavioral intention link in a competitive Islamic banking market in South Africa.

Keywords: perceived value, affective commitment, calculative commitment, behavioural intention

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307 Rethinking the Role of Small States in the Hybrid Era: Shifts in the Cypriot Foreign and Defence Policies, 2004-2019

Authors: Constantinos Adamides, Petros Petrikkos

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In the era of growing hybrid threats, small states find themselves in need to re-evaluate existing foreign and defense policies. The pressure to establishing or maintain a status of a reliable partner in the community in which they belong to, vis-à-vis their multilateral relations with other organisations and entities, small states may need to shift their policies in the field to accommodate security needs that are not only pertinent to their security, but also to that of the organisations (bloc) in which they interact. Unlike potential shortcomings in a small state’s mainstream security and defence framework where the threat would be limited to the state itself, in more contemporary times with dominating hybrid threats, the small states’ security shortcomings may also become a security problem for the bloc in which these states belong to. An indicative example is small states like Cyprus and Malta, which belong and 'interact' in the European Union. As a result, the nature of hybrid threats can be utilised to hurt bigger states in a bloc by exploiting the small states’ vulnerabilities and security gaps. Inevitably, both the defensive and foreign policy collaborations of small states with bigger states have been and are constantly re-evaluated to tackle and prevent such problems. In essence, the goal of this ‘re-evaluation’ aims to achieve a twofold goal: The first is the small states’ quest to appear as a reliable partner within the bloc, while the second is to avoid being the weakest security link in the bloc’s defence against hybrid threats. Indeed, the hybrid arena is a security area where they can excel in the bloc, despite the potential and expected conventional military deficiencies. This new environment prompts us to think security from the perspective of small states differently and in relation to their role as members or big organisations. The paper focuses on the case of Cyprus following its accession to the European Union and examines how a country that has had a very focused security orientation –not least due to its ongoing security problems– altered its foreign and defence policies within the European Union to ensure compliance with the rest of the bloc, while at the same time maximizing its role as a security player. Specifically, it examines the methods through which the country shifted its policies as well as the challenges and opportunities that emerged from these security shifts.

Keywords: Cyprus, defence, foreign policy, hybrid threats, ontological security, small states

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306 Fijian Women’s Role in Disaster Risk Management: Climate Change

Authors: Priyatma Singh, Manpreet Kaur

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Climate change is progressively being identified as a global crisis and this has immediate repercussions for Fiji Islands due to its geographical location being prone to natural disasters. In the Pacific, it is common to find significant differences between men and women, in terms of their roles and responsibilities. In the pursuit of prudent preparedness before disasters, Fijian women’s engagement is constrained due to socially constructed roles and expectation of women here in Fiji. This vulnerability is aggravated by viewing women as victims, rather than as key people who have vital information of their society, economy, and environment, as well as useful skills, which, when recognized and used, can be effective in disaster risk reduction. The focus of this study on disaster management is to outline ways in which Fijian women can be actively engaged in disaster risk management, articulating in decision-making, negating the perceived ideology of women’s constricted roles in Fiji and unveiling social constraints that limit women’s access to practical disaster management strategic plan. This paper outlines the importance of gender mainstreaming in disaster risk reduction and the ways of mainstreaming gender based on a literature review. It analyses theoretical study of academic literature as well as papers and reports produced by various national and international institutions and explores ways to better inform and engage women for climate change per ser disaster management in Fiji. The empowerment of women is believed to be a critical element in constructing disaster resilience as women are often considered to be the designers of community resilience at the local level. Gender mainstreaming as a way of bringing a gender perspective into climate related disasters can be applied to distinguish the varying needs and capacities of women, and integrate them into climate change adaptation strategies. This study will advocate women articulation in disaster risk management, thus giving equal standing to females in Fiji and also identify the gaps and inform national and local Disaster Risk Management authorities to implement processes that enhance gender equality and women’s empowerment towards a more equitable and effective disaster practice.

Keywords: disaster risk management, climate change, gender mainstreaming, women empowerment

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305 Challenges in Environmental Governance: A Case Study of Risk Perceptions of Environmental Agencies Involved in Flood Management in the Hawkesbury-Nepean Region, Australia

Authors: S. Masud, J. Merson, D. F. Robinson

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The management of environmental resources requires engagement of a range of stakeholders including public/private agencies and different community groups to implement sustainable conservation practices. The challenge which is often ignored is the analysis of agencies involved and their power relations. One of the barriers identified is the difference in risk perceptions among the agencies involved that leads to disjointed efforts of assessing and managing risks. Wood et al 2012, explains that it is important to have an integrated approach to risk management where decision makers address stakeholder perspectives. This is critical for an effective risk management policy. This abstract is part of a PhD research that looks into barriers to flood management under a changing climate and intends to identify bottlenecks that create maladaptation. Experiences are drawn from international practices in the UK and examined in the context of Australia through exploring the flood governance in a highly flood-prone region in Australia: the Hawkesbury Ne-pean catchment as a case study. In this research study several aspects of governance and management are explored: (i) the complexities created by the way different agencies are involved in assessing flood risks (ii) different perceptions on acceptable flood risk level; (iii) perceptions on community engagement in defining acceptable flood risk level; (iv) Views on a holistic flood risk management approach; and, (v) challenges of centralised information system. The study concludes that the complexity of managing a large catchment is exacerbated by the difference in the way professionals perceive the problem. This has led to: (a) different standards for acceptable risks; (b) inconsistent attempt to set-up a regional scale flood management plan beyond the jurisdictional boundaries: (c) absence of a regional scale agency with license to share and update information (d) Lack of forums for dialogue with insurance companies to ensure an integrated approach to flood management. The research takes the Hawkesbury-Nepean catchment as case example and draws from literary evidence from around the world. In addition, conclusions were extrapolated from eighteen semi-structured interviews from agencies involved in flood risk management in the Hawkesbury-Nepean catchment of NSW, Australia. The outcome of this research is to provide a better understanding of complexity in assessing risks against a rapidly changing climate and contribute towards developing effective risk communication strategies thus enabling better management of floods and achieving increased level of support from insurance companies, real-estate agencies, state and regional risk managers and the affected communities.

Keywords: adaptive governance, flood management, flood risk communication, stakeholder risk perceptions

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304 Impact of COVID-19 on Antenatal Care Provision at Public Hospitals in Ethiopia: A Mixed Method Study

Authors: Zemenu Yohannes

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Introduction: The pandemic overstretched the weak health systems in developing countries, including Ethiopia. This study aims to assess and explore the effect of COVID-19 on antenatal care (ANC) provision. Methods: A concurrent mixed methods study was applied. An interrupted time series design was applied for the quantitative study, and in-depth interviews were implemented for the qualitative research to explore maternity care providers' perceptions of ANC provision during COVID-19. We used routine monthly collected data from the health management information system (HMIS) in fifteen hospitals in the Sidama region, Ethiopia, from March 2019 to February 2020 (12 months) before COVID-19 and from March to August 2020 (6 months) during COVID-19. We imported data into STATA V.17 for analysis. ANC provision's mean monthly incidence rate ratio (IRR) was calculated using Poisson regression with a 95% confidence interval. The qualitative data were analysed using thematic analysis. Findings from quantitative and qualitative elements were integrated with a contiguous approach. Results: Our findings indicate the rate of ANC provision significantly decreased in the first six months of COVID-19. This study has three identified main themes: barriers to ANC provision, inadequate COVID-19 prevention approach, and delay in providing ANC. Conclusion and recommendation: Based on our findings, the pandemic affected ANC provision in the study area. The health bureau and stakeholders should take a novel and sustainable approach to prevent future pandemics. The health bureau and hospital administrators should establish a task force that relies on financial self-reliance to close gaps in future pandemics of medical supply shortages. Pregnant women should receive their care promptly from maternity care providers. In order to foster contact and avoid discrimination the future pandemics, hospital administrators should set up a platform for community members and maternity care providers.

Keywords: ANC provision, COVID-19, mixed methods study, Ethiopia

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303 Method for Identification of Through Defects of Polymer Films Applied onto Metal Parts

Authors: Yu A. Pluttsova , O. V. Vakhnina , K. B. Zhogova

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Nowadays, many devices operate under conditions of enhanced humidity, temperature drops, fog, and vibration. To ensure long-term and uninterruptable equipment operation under adverse conditions, one applies moisture-proof films on products and electronics components, which helps to prevent corrosion, short circuit, allowing a significant increase in device lifecycle. The reliability of such moisture-proof films is mainly determined by their coating uniformity without gaps and cracks. Unprotected product edges, as well as pores in films, can cause device failure during operation. The work objective was to develop an effective, affordable, and profit-proved method for determining the presence of through defects of protective polymer films on the surface of parts made of iron and its alloys. As a diagnostic reagent, one proposed water solution of potassium ferricyanide (III) in hydrochloric acid, this changes the color from yellow to blue according to the reactions; Feº → Fe²⁺ and 4Fe²⁺ + 3[Fe³⁺(CN)₆]³⁻ → Fe ³⁺4[Fe²⁺(CN)₆]₃. There was developed the principle scheme of technological process for determining the presence of polymer films through defects on the surface of parts made of iron and its alloys. There were studied solutions with different diagnostic reagent compositions in water: from 0,1 to 25 mass fractions, %, of potassium ferricyanide (III), and from 5 to 25 mass fractions, %, of hydrochloride acid. The optimal component ratio was chosen. The developed method consists in submerging a part covered with a film into a vessel with a diagnostic reagent. In the polymer film through defect zone, the part material (ferrum) interacts with potassium ferricyanide (III), the color changes to blue. Pilot samples were tested by the developed method for the presence of through defects in the moisture-proof coating. It was revealed that all the studied parts had through defects of the polymer film coating. Thus, the claimed method efficiently reveals polymer film coating through defects on parts made of iron or its alloys, being affordable and profit-proved.

Keywords: diagnostic reagent, metal parts, polimer films, through defects

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302 Redeeming the Self-Settling Scores with the Nazis by the Means of Poetics

Authors: Liliane Steiner

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Beyond the testimonial act, that sheds light on the feminine experience in the Holocaust, the survivors' writing voices first and foremost the abjection of the feminine self brutally inflicted by the Nazis in the Holocaust, and in the same movement redeems the self by the means of poetics, and brings it to an existential state of being a subject. This study aims to stress the poetics of this writing in order to promote the Holocaust literature from the margins to the mainstream and to contribute to the commemoration of the Holocaust in the next generations. Methodology: The study of the survivors' redeeming of self is based on Julia Kristeva's theory of the abject: the self-throws out everything that threatens its existence and Liliane Steiner's theory of the post- abjection of hell: the belated act of vomiting the abject experiences settles cores with the author of the abject to redeem the self. The research will focus on Ruth Sender's trilogy The Cage, To Life and The Holocaust Lady as a case study. Findings: The binary mode that characterizes this writing reflects the experience of Jewish women, who were subject(s), were treated violently as object(s), debased, defeminized and, eventually turned into abject by the Nazis. In a tour de force, this writing re-enacts the postponed resistance, that vomited the abject imposed on the feminine self by the very act of narration, which denounces the real abject, the perpetrators. The post-abjection of self is acted out in constructs of abject, relating the abject experience of the Holocaust as well as the rehabilitation of the surviving self (subject). The transcription of abject surfaces in deconstructing the abject through self- characterization, and in the elusive rendering of bad memories, having recourse to literary figures. The narrative 'I' selects, obstructs, mends and tells the past events from an active standpoint, as would a subject in control of its (narrative) fate. In a compensatory movement, the narrating I tells itself by reconstructing the subject and proving time and again that I is other. Moreover, in the belated endeavor to revenge, testify and narrate the abject, the narrative I defies itself, and represents itself as a dialectical I, splitting and multiplying itself in a deconstructing way. The dialectical I is never (one) I. It voices not only the unvoiced but also and mainly the other silenced 'I's. Drawing its nature and construct from traumatic memories, the dialectical I transgresses boundaries to narrate her story, and in the same breath, the story of Jewish women doomed to silence. In this narrative feat, the dialectical I stresses its essential dialectical existence with the past, never to be (one) again. Conclusion: The pattern of I is other generates patterns of subject(s) that defy, transgress and repudiate the abject and its repercussions on the feminine I. The feminine I writes itself as a survivor that defies the abject (Nazis) and takes revenge. The paradigm of metamorphosis that accompanies the journey of the Holocaust memoirist engenders life and surviving as well as a narration that defies stagnation and death.

Keywords: abject, feminine writing, holocaust, post-abjection

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301 Improving Cleanability by Changing Fish Processing Equipment Design

Authors: Lars A. L. Giske, Ola J. Mork, Emil Bjoerlykhaug

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The design of fish processing equipment greatly impacts how easy the cleaning process for the equipment is. This is a critical issue in fish processing, as cleaning of fish processing equipment is a task that is both costly and time consuming, in addition to being very important with regards to product quality. Even more, poorly cleaned equipment could in the worst case lead to contaminated product from which consumers could get ill. This paper will elucidate how equipment design changes could improve the work for the cleaners and saving money for the fish processing facilities by looking at a case for product design improvements. The design of fish processing equipment largely determines how easy it is to clean. “Design for cleaning” is the new hype in the industry and equipment where the ease of cleaning is prioritized gets a competitive advantage over equipment in which design for cleaning has not been prioritized. Design for cleaning is an important research area for equipment manufacturers. SeaSide AS is doing continuously improvements in the design of their products in order to gain a competitive advantage. The focus in this paper will be conveyors for internal logistic and a product called the “electro stunner” will be studied with regards to “Design for cleaning”. Often together with SeaSide’s customers, ideas for new products or product improvements are sketched out, 3D-modelled, discussed, revised, built and delivered. Feedback from the customers is taken into consideration, and the product design is revised once again. This loop was repeated multiple times, and led to new product designs. The new designs sometimes also cause the manufacturing processes to change (as in going from bolted to welded connections). Customers report back that the concrete changes applied to products by SeaSide has resulted in overall more easily cleaned equipment. These changes include, but are not limited to; welded connections (opposed to bolted connections), gaps between contact faces, opening up structures to allow cleaning “inside” equipment, and generally avoiding areas in which humidity and water may gather and build up. This is important, as there will always be bacteria in the water which will grow if the area never dries up. The work of creating more cleanable design is still ongoing, and will “never” be finished as new designs and new equipment will have their own challenges.

Keywords: cleaning, design, equipment, fish processing, innovation

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300 The Impact of Speech Style on the Production of Spanish Vowels by Spanish-English Bilinguals and Spanish Monolinguals

Authors: Vivian Franco

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There has been a great deal of research about vowel production of second language learners of Spanish, vowel variation across Spanish dialects, and more recently, research related to Spanish heritage speakers’ vowel production based on speech style. However, there is little investigation reported on Spanish heritage speakers’ vowel production in regard to task modality by incorporating own comparison groups of monolinguals and late bilinguals. Thus, the present study investigates the influence of speech style on Spanish heritage speakers’ vowel production by comparing Spanish-English early and late bilinguals and Spanish monolinguals. The study was guided by the following research question: How do early bilinguals (heritage speakers) differ/relate to advanced L2 speakers of Spanish (late bilinguals) and Spanish monolinguals in their vowel quality (acoustic distribution) and quantity (duration) based on speech style? The participants were a total of 11 speakers of Spanish: 7 early Spanish-English bilinguals with a similar linguistic background (simultaneous bilinguals of the second generation); 2 advanced L2 speakers of Spanish; and 2 Spanish monolinguals from Mexico. The study consisted of two tasks. The first one adopted a semi-spontaneous style by a solicited narration of life experiences and a description of a favorite movie with the purpose to collect spontaneous speech. The second task was a reading activity in which the participants read two paragraphs of a Mexican literary essay 'La nuez.' This task aimed to obtain a more controlled speech style. From this study, it can be concluded that early bilinguals and monolinguals show a smaller formant vowel space overall compared to the late bilinguals in both speech styles. In terms of formant values by stress, the early bilinguals and the late bilinguals resembled in the semi-spontaneous speech style as their unstressed vowel space overlapped with that of the unstressed vowels different from the monolinguals who displayed a slightly reduced unstressed vowel space. For the controlled data, the early bilinguals were similar to the monolinguals as their stressed and unstressed vowel spaces overlapped in comparison to the late bilinguals who showed a more clear reduction of unstressed vowel space. In regard to stress, the monolinguals revealed longer vowel duration overall. However, findings of duration by stress showed that the early bilinguals and the monolinguals remained stable with shorter values of unstressed vowels in the semi-spontaneous data and longer duration in the controlled data when compared to the late bilinguals who displayed opposite results. These findings suggest an implication for Spanish heritage speakers and L2 Spanish vowels research as it has been frequently argued that Spanish bilinguals differ from the Spanish monolinguals by their vowel reduction and centralized vowel space influenced by English. However, some Spanish varieties are characterized by vowel reduction especially in certain phonetic contexts so that some vowels present more weakening than others. Consequently, it would not be conclusive to affirm an English influence on the Spanish of these bilinguals.

Keywords: Spanish-English bilinguals, Spanish monolinguals, spontaneous and controlled speech, vowel production.

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299 [Keynote Talk]: Mental Health Challenges among Women in Dubai, Mental Health Needs Assessment for Dubai (2015), Public Health and Safety Department - Dubai Health Authority (DHA)

Authors: Kadhim Alabady

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Purpose: Mental health problems affect women and men equally, but some are more common among women. To Provide a baseline of the current picture of major mental health challenges among women in Dubai. which can then be used to measure the impact of interventions or service development. Method: We have used mixed methods evaluation approaches. This was used to increase the validity of findings by using a variety of data collection techniques. We have integrated qualitative and quantitative methods in this piece of work. Conducting the two approaches is to explore issues that might not be highlighted enough through one method. Results: The key findings are: The prevalence of people who suffer from different types of mental disorders remains largely unknown, many women are unwilling to seek professional help because of lack of awareness or the stigma attached to it. -It is estimated there were around 2,928–4,392 mothers in Dubai (2014) suffering from postnatal depression of which 858–1,287, early intervention can be effective. -The system for managing health care for women with mental illness is fragmented and contains gaps and duplications. -It is estimated 1,029 girl aged 13–19 years affected with anorexia nervosa and there would be an estimated 1,029 girl aged 13–19 years affected with anorexia nervosa. Recommendations: -Work is required with primary health care in order to identify women with undiagnosed mental illnesses. Further work is undertaken within primary health care to assess disease registries with the aim of helping GP practices to improve their disease registers. -It is important to conduct local psychiatric morbidity surveys in Dubai to obtain data and assess the prevalence of essential mental health symptoms and conditions that are not routinely collected to get a clear sense of what is needed and to assist decision and policy making in getting a complete picture on what services are required. -Emergency Mental Health Care – there is a need for a crisis response team to respond to emergencies in the community. -Continuum of care – a significant gap in the services for women once they diagnosed with mental disorder.

Keywords: mental health, depression, schizophrenia, women

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298 Informing, Enabling and Inspiring Social Innovation by Geographic Systems Mapping: A Case Study in Workforce Development

Authors: Cassandra A. Skinner, Linda R. Chamberlain

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The nonprofit and public sectors are increasingly turning to Geographic Information Systems for data visualizations which can better inform programmatic and policy decisions. Additionally, the private and nonprofit sectors are turning to systems mapping to better understand the ecosystems within which they operate. This study explores the potential which combining these data visualization methods—a method which is called geographic systems mapping—to create an exhaustive and comprehensive understanding of a social problem’s ecosystem may have in social innovation efforts. Researchers with Grand Valley State University collaborated with Talent 2025 of West Michigan to conduct a mixed-methods research study to paint a comprehensive picture of the workforce development ecosystem in West Michigan. Using semi-structured interviewing, observation, secondary research, and quantitative analysis, data were compiled on workforce development organizations’ locations, programming, metrics for success, partnerships, funding sources, and service language. To best visualize and disseminate the data, a geographic system map was created which identifies programmatic, operational, and geographic gaps in workforce development services of West Michigan. By combining geographic and systems mapping methods, the geographic system map provides insight into the cross-sector relationships, collaboration, and competition which exists among and between workforce development organizations. These insights identify opportunities for and constraints around cross-sectoral social innovation in the West Michigan workforce development ecosystem. This paper will discuss the process utilized to prepare the geographic systems map, explain the results and outcomes, and demonstrate how geographic systems mapping illuminated the needs of the community and opportunities for social innovation. As complicated social problems like unemployment often require cross-sectoral and multi-stakeholder solutions, there is potential for geographic systems mapping to be a tool which informs, enables, and inspires these solutions.

Keywords: cross-sector collaboration, data visualization, geographic systems mapping, social innovation, workforce development

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297 Imposing Personal Liability on Shareholder's/Partner's in a Corporate Entity; Implementation of UK’s Personal Liability Institutions in Georgian Corporate Law: Content and Outcomes

Authors: Gvantsa Magradze

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The paper examines the grounds for the imposition of a personal liability on shareholder/partner, mainly under Georgian and UK law’s comparative analysis. The general emphasis was made on personal responsibility grounds adaptation in practice and presents the analyze of court decisions. On this base, reader will be capable to find a difference between the dogmatic and practical grounds for imposition personal liability. The first chapter presents the general information about discussed issue and notion of personal liability. The second chapter is devoted to an explanation the concept – ‘the head of the corporation’ to make it clear who is the subject of responsibility in the article and not to remain individuals beyond the attention, who do not hold the position of director but are participating in governing activities and, therefore, have to have fiduciury duties. After short comparative analysis of personal responsibility, the Georgian Corporate law reality is further discussed. Here, the problem of determining personal liability is a problematic issue, thus a separate chapter is devoted to the issue, which explains the grounds for personal liability imposition in details. Within the paper is discussed the content and the purpose of personal liability institutions under UK’s corporate law and an attempt to implement them, and especially ‘Alter Ego’ doctrine in Georgian corporate Law reality and the outcomes of the experiment. For the research purposes will be examined national case law in regard to personal liability imposition, as well as UK’s experience in that regard. Comparative analyze will make it clear, wherein the Georgian statute, are gaps and how to fill them up. The articles major finding as stated, is that Georgian Corporate law does not provide any legally consolidated grounds for personal liability imposition, which in fact, leads to unfaithful, unlawful actions on partners’/shareholders’ behalf. In order to make business market fair, advancement of a national statute is inevitable, and for that, the experience sharing from developed countries is an irreplaceable gift. Overall, the article analyses, how discussed amendments might influence case law and if such amendments were made years ago, how the judgments could look like (before and after amendments).

Keywords: alter ego doctrine, case law, corporate law, good faith, personal liability

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296 War and Peace in the Hands of the Media: Review of Global Media Reports and Their Influencing Factors on the Foreign and Security Policy Opinions of the Population

Authors: Ismahane Emma Karima Bessi

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Military sociology is largely avoided. Discussing the military as a societal phenomenon and the social dimensions of war and peace is now considered a disgraceful and neglected province of social science that has a major impact on global populations. The first official press war began with William Howard Russell in the mid-19th century. The media are crucial to war and peace. Even Gaius Julius Caesar, with his "commentarii bello gallico", was a media tool to influence his warfare. Napoleon Bonaparte also knew how important the press was for his actions. This shows how important history is for crisis and war journalism. The one-sided media coverage that every country is confronted with ultimately prevents people from having a certain interest in the truth and from gross knowledge gaps in order to get an accurate picture of reality. There is a need to examine the relationship between the military, war, and the media to look at the modality in which the media is involved in military conflicts, in this case, as an adjunct, i.e., war because of the media. These are promoted or initiated by the following factors: photos intended for the visual manipulation of the population, the pressure from politicians and parties who are urging and exerting their influence on the global media to share the same pattern of opinion, and, most importantly, the media profiting from the war by listening to popular reactions and passing them on promoting with new visuals. These influence political elections. The media occupies a huge and ubiquitous part of the population. These have the ability to make a country that is in constant crisis and war mode appear in a brilliant light of peace. An article or photograph taken by one journalist has a tremendous impact as it can control the minds of millions of people. Most wars currently have state-political reasons. The parties, therefore, want to have their (potential) voters on their side, who are inflated by the media. The military is loathed or loved. Thinking must be created that a well-trained military in the instances of natural sciences, history, and sociology can save or protect the lives of many people. Theoretical methods for this are defined and evaluated in more detail in this paper.

Keywords: war, history, military, science, journalism, crisis

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295 Efficacy of Crystalline Admixtures in Self-Healing Capacity of Fibre Reinforced Concrete

Authors: Evangelia Tsampali, Evangelos Yfantidis, Andreas Ioakim, Maria Stefanidou

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The purpose of this paper is the characterization of the effects of crystalline admixtures on concrete. Crystallites, aided by the presence of humidity, form idiomorphic crystals that block cracks and pores resulting in reduced porosity. In this project, two types of crystallines have been employed. The hydrophilic nature of crystalline admixtures helps the components to react with water and cement particles in the concrete to form calcium silicate hydrates and pore-blocking precipitates in the existing micro-cracks and capillaries. The underlying mechanism relies on the formation of calcium silicate hydrates and the resulting deposits of these crystals become integrally bound with the hydrated cement paste. The crystalline admixtures continue to activate throughout the life of the composite material when in the presence of moisture entering the concrete through hairline cracks, sealing additional gaps. The resulting concrete exhibits significantly increased resistance to water penetration under stress. Admixtures of calcium aluminates can also contribute to this healing mechanism in the same manner. However, this contribution is negligible compared to the calcium silicate hydrates due to the abundance of the latter. These crystalline deposits occur throughout the concrete volume and are a permanent part of the concrete mass. High-performance fibre reinforced cementitious composite (HPFRCC) were produced in the laboratory. The specimens were exposed in three healing conditions: water immersion until testing at 15 °C, sea water immersion until testing at 15 °C, and wet/dry cycles (immersion in tap water for 3 days and drying for 4 days). Specimens were pre-cracked at 28 days, and the achieved cracks width were in the range of 0.10–0.50 mm. Furthermore, microstructure observations and Ultrasonic Pulse Velocity tests have been conducted. Based on the outcomes, self-healing related indicators have also been defined. The results show almost perfect healing capability for specimens healed under seawater, better than for specimens healed in water while inadequate for the wet/dry exposure in both of the crystalline types.

Keywords: autogenous self-healing, concrete, crystalline admixtures, ultrasonic pulse velocity test

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294 Alteration of Placental Development and Vascular Dysfunction in Gestational Diabetes Mellitus Has Impact on Maternal and Infant Health

Authors: Sadia Munir

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The aim of this study is to investigate changes in placental development and vascular dysfunction which subsequently affect feto-maternal health in pregnancies complicated by gestational diabetes mellitus (GDM). Fetal and postnatal adverse health outcomes of GDM are shown to be associated with disturbances in placental structure and function. Children of women with GDM are more likely to be obese and diabetic in childhood and adulthood. GDM also increases the risk of adverse pregnancy outcomes, including preeclampsia, birth injuries, macrosomia and neonatal hypoglycemia, respiratory distress syndrome, neonatal cardiac dysfunction and stillbirth. Incidences of type 2 diabetes in the MENA region are growing at an alarming rate which is estimated to become more than double by 2030. Five of the top 10 countries for diabetes prevalence in 2010 were in the Gulf region. GDM also increases the risk of development of type 2 diabetes. Interestingly, more than half of the women with GDM develop diabetes later in their life. The human placenta is a temporary organ located at the interface between mother and fetal blood circulation. Placenta has a central role as both a producer as well as a target of several molecules that are involved in placental development and function. We have investigated performed a Pubmed search with key words placenta, GDM, placental villi, vascularization, cytokines, growth factors, inflammation, hypoxia, oxidative stress and pathophysiology. We have investigated differences in the development and vascularization of placenta, their underlying causes and impact on feto-maternal health through literature review. We have also identified gaps in the literature and research questions that need to be answered to completely understand the central role of placenta in the GDM. This study is important in understanding the pathophysiology of placenta due to changes in the vascularization of villi, surface area and diameter of villous capillaries in pregnancies complicated by GDM. It is necessary to understand these mechanisms in order to develop treatments to reverse their effects on placental malfunctioning, which in turn, will result in improved mother and child health.

Keywords: gestational diabetes mellitus, placenta, vasculature, villi

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293 Drug and Poison Information Centers: An Emergent Need of Health Care Professionals in Pakistan

Authors: Asif Khaliq, Sayeeda A. Sayed

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The drug information centers provide drug related information to the requesters that include physicians, pharmacist, nurses and other allied health care professionals. The International Pharmacist Federation (FIP) describes basic functions of a drug and poison information centers as drug evaluation, therapeutic counseling, pharmaceutical advice, research, pharmaco-vigilence and toxicology. Continuous advancement in the field of medicine has expanded the medical literature, which has increased demand of a drug and poison information center for the guidance, support and facilitation of physicians. The objective of the study is to determine the need of drug and poison information centers in public and private hospitals of Karachi, Pakistan. A cross sectional study was conducted during July 2013 to April 2014 using a self-administered, multi-itemed questionnaire. Non Probability Convenient sampling was used to select the study participants. A total of 307 physicians from public and private hospitals of Karachi participated in the study. The need for 24/7 Drug and poison information center was highlighted by 92 % of physicians and 67% physicians suggested opening a drug information center at the hospital. It was reported that 70% physicians take at least 15 minutes for searching the information about the drug while managing a case. Regarding the poisoning case management, 52% physicians complaint about the unavailability of medicines in hospitals; and mentioned the importance of medicines for safe and timely management of patients. Although 73% physicians attended continued medical education (CME) sessions, 92 % physicians insisted on the need of 24/7 Drug and poison information center. The scarcity of organized channel for obtaining the information about drug and poisons is one of the most crucial problems for healthcare workers in Pakistan. The drug and poison information center is an advisory body that assists health care professional and patients in provision of appropriate drug and hazardous substance information. Drug and poison information center is one of the integral needs for running an effective health care system. Provision of a 24 /7 drug information centers with specialized staff offer multiple benefits to the hospitals while reducing treatment delays, addressing awareness gaps of all stakeholders and ensuring provision of quality health care.

Keywords: drug and poison information centers, Pakistan, physicians, public and private hospitals

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292 Quantitative and Qualitative Analysis of Randomized Controlled Trials in Physiotherapy from India

Authors: K. Hariohm, V. Prakash, J. Saravana Kumar

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Introduction and Rationale: Increased scope of Physiotherapy (PT) practice also has contributed to research in the field of PT. It is essential to determine the production and quality of the clinical trials from India since, it may reflect the scientific growth of the profession. These trends can be taken as a baseline to measure our performance and also can be used as a guideline for the future trials. Objective: To quantify and analyze qualitatively the RCT’s from India from the period 2000-2013’ May, and classify data for the information process. Methods: Studies were searched in the Medline database using the key terms “India”, “Indian”, “Physiotherapy”. Clinical trials only with PT authors were included. Trials out of scope of PT practice and on animals were excluded. Retrieved valid articles were analyzed for published year, type of participants, area of study, PEDro score, outcome measure domains of impairment, activity, participation; ‘a priori’ sample size calculation, region, and explanation of the intervention. Result: 45 valid articles were retrieved from the year 2000-2013’ May. The majority of articles were done on symptomatic participants (81%). The frequencies of conditions repeated more were low back pain (n-7) and diabetes (n-4). PEDro score with mode 5 and upper limit of 8 and lower limit 4 was found. 97.2% of studies measure the outcome at the impairment level, 34% in activity level, and 27.8% in participation level. 29.7% of studies did ‘a priori’ sample size calculation. Correlation of year trend and PEDro score found to be not significant (p>.05). Individual PEDro item analysis showed, randomization (100%), concealment (33%) baseline (76%), blinding-subject, therapist, assessor (9.1%, 0%, 10%), follow-up (89%) ITT (15%), statistics between groups (100%), measures of variance (88 %). Conclusion: The trend shows an upward slope in terms of RCTs published from India which is a good indicator. The qualitative analysis showed some gaps in the clinical trial design, which can be expected to be, fulfilled by the future researchers.

Keywords: RCT, PEDro, physical therapy, rehabilitation

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291 Perceptions of Mothers on Their Role in the Prevention of the Spread of Human Immunodeficiency Virus to Their Children and Childcare Received in the Healthcare Facility in a Rural Area

Authors: Sibusiso Buthelezi, Rugira Regis Marie-Modeste, Deliwe Rene Phetlhu

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Introduction: Mother-to-child transmission persists owing to inadequate implementation of prevention of mother-to-child transmission programmes, particularly in rural areas. To achieve a target of zero new HIV infection in children born from women living with HIV, the involvement of mothers and caregivers is undeniable. Therefore, there is a need to explore the views of the mothers because of the role they play in their own right when it comes to preventing their children from contracting HIV by consistently adhering to the guidelines of the prevention of mother-to-child transmission programme. Thus, this study sought to explore and describe the perceptions of mothers on their role in the prevention of HIV to their children exposed to HIV and further explore their perceptions of the childcare received in the healthcare facility. Methods: The study was conducted in November-December 2019 in Ngaka Modiri Molema in North West Province in South Africa. A qualitative exploratory, descriptive research design was used. Purposive sampling was used to select the mothers of children exposed to HIV during the mother`s clinic attendance. Data collection was done through semi-structured individual interviews with mothers of children exposed to HIV. Colaizzi`s method of data analysis was used to analyse data in this study. Results: Seven themes emerged from data analysis, namely: health benefits from coming to the healthcare facility, communication, information needs, attitude of healthcare workers, healthcare administration system, the role of a mother, and disclosure of HIV status. Conclusion: This study revealed systematic gaps that exist in the programme, which hinder the childcare services of children exposed to HIV and socio-economically related hindrances. Mothers’ roles, such as exclusive breastfeeding, taking their own medication, and child follow-up visits, remain inadequate. The study findings show that there is a need to develop a contextual-tailored intervention strategy that would improve the implementation of prevention of mother-to-child transmission in rural areas.

Keywords: children exposed to HIV, mothers’ role to prevent MTCT, mothers’ perceptions on childcare, PMTCT in rural areas

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