Search results for: non-traditional marketing communication strategies
Commenced in January 2007
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Paper Count: 9657

Search results for: non-traditional marketing communication strategies

507 The Language of Science in Higher Education: Related Topics and Discussions

Authors: Gurjeet Singh, Harinder Singh

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In this paper, we present "The Language of Science in Higher Education: Related Questions and Discussions". Linguists have written and researched in depth the role of language in science. On this basis, it is clear that language is not just a medium or vehicle for communicating knowledge and ideas. Nor are there mere signs of language knowledge and conversion of ideas into code. In the process of reading and writing, everyone thinks deeply and struggles to understand concepts and make sense. Linguistics play an important role in achieving concepts. In the context of such linguistic diversity, there is no straightforward and simple answer to the question of which language should be the language of advanced science and technology. Many important topics related to this issue are as follows: Involvement in practical or Deep theoretical issues. Languages for the study of science and other subjects. Language issues of science to be considered separate from the development of science, capitalism, colonial history, the worldview of the common man. The democratization of science and technology education in India is possible only by providing maximum reading/resource material in regional languages. The scientific research should be increase to chances of understanding the subject. Multilingual instead or monolingual. As far as deepening the understanding of the subject is concerned, we can shed light on it based on two or three experiences. An attempt was made to make the famous sociological journal Economic and Political Weekly Hindi almost three decades ago. There were many obstacles in this work. The original articles written in Hindi were not found, and the papers and articles of the English Journal were translated into Hindi, and a journal called Sancha was taken out. Equally important is the democratization of knowledge and the deepening of understanding of the subject. However, the question is that if higher education in science is in Hindi or other languages, then it would be a problem to get job. In fact, since independence, English has been dominant in almost every field except literature. There are historical reasons for this, which cannot be reversed. As mentioned above, due to colonial rule, even before independence, English was established as a language of communication, the language of power/status, the language of higher education, the language of administration, and the language of scholarly discourse. After independence, attempts to make Hindi or Hindustani the national language in India were unsuccessful. Given this history and current reality, higher education should be multilingual or at least bilingual. Translation limits should also be increased for those who choose the material for translation. Writing in regional languages on science, making knowledge of various international languages available in Indian languages, etc., is equally important for all to have opportunities to learn English.

Keywords: language, linguistics, literature, culture, ethnography, punjabi, gurmukhi, higher education

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506 Principles and Guidance for the Last Days of Life: Te Ara Whakapiri

Authors: Tania Chalton

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In June 2013, an independent review of the Liverpool Care Pathway (LCP) identified a number of problems with the implementation of the LCP in the UK and recommended that it be replaced by individual care plans for each patient. As a result of the UK findings, in November 2013 the Ministry of Health (MOH) commissioned the Palliative Care Council to initiate a programme of work to investigate an appropriate approach for the care of people in their last days of life in New Zealand (NZ). The Last Days of Life Working Group commenced a process to develop national consensus on the care of people in their last days of life in April 2014. In order to develop its advice for the future provision of care to people in their last days of life, the Working Group (WG) established a comprehensive work programme and as a result has developed a series of working papers. Specific areas of focus included: An analysis of the UK Independent Review findings and an assessment of these findings to the NZ context. A stocktake of services providing care to people in their last days of life, including aged residential care (ARC); hospices; hospitals; and primary care. International and NZ literature reviews of evidence and best practice. Survey of family to understand the consumer perspective on the care of people in their last days of life. Key aspects of care that required further considerations for NZ were: Terminology: clarify terminology used in the last days of life and in relation to death and dying. Evidenced based: including specific review of evidence regarding, spiritual, culturally appropriate care as well as dementia care. Diagnosis of dying: need for both guidance around the diagnosis of dying and communication with family. Workforce issues: access to an appropriate workforce after hours. Nutrition and hydration: guidance around appropriate approaches to nutrition and hydration. Symptom and pain management: guidance around symptom management. Documentation: documentation of the person’s care which is robust enough for data collection and auditing requirements, not ‘tick box’ approach to care. Education and training: improved consistency and access to appropriate education and training. Leadership: A dedicated team or person to support and coordinate the introduction and implementation of any last days of life model of care. Quality indicators and data collection: model of care to enable auditing and regular reviews to ensure on-going quality improvement. Cultural and spiritual: address and incorporate any cultural and spiritual aspects. A final document was developed incorporating all the evidence which provides guidance to the health sector on best practice for people at end of life: “Principles and guidance for the last days of life: Te Ara Whakapiri”.

Keywords: end of life, guidelines, New Zealand, palliative care

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505 L2 Anxiety, Proficiency, and L2 Willingness to Communicate in the Classroom, Outside the Classroom, and in Digital Setting: Insights from Ethiopian Preparatory Schools

Authors: Merih Welay Welesilassie, Marianne Nikolov

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Research into second and foreign language (L2) acquisitions has demonstrated that L2 anxiety, perceived proficiency, and L2 willingness to communicate (L2WTC) profoundly impact language learning outcomes. However, the complex interplay between these variables has yet to be fully explored, as these factors are dynamic and context-specific and can vary across different learners and learning environments. This study, therefore, utilized a cross-sectional quantitative survey research design to scrutinise the causal relationships between L2 anxiety, English proficiency, and L2WTC of 609 Ethiopian preparatory school students. The model for the L2WTC, both inside and outside the classroom, has been expanded to include an additional sub-scale known as the L2WTC in a digital setting. Moreover, in contrast to the commonly recognised debilitative-focused L2 anxiety, the construct of L2 anxiety has been divided into facilitative and debilitative anxiety. This method allows to measure not only the presence or absence of anxiety but also evaluate if anxiety helps or hinders the L2 learning experience. A self-assessment proficiency measure was also developed specifically for Ethiopian high school students. The study treated facilitative and debilitative anxiety as independent variables while considering self-assessed English proficiency and L2WTC in the classroom, outside the classroom, and in digital settings as dependent variables. Additionally, self-assessed English proficiency was used as an independent variable to predict L2WTC in these three settings. The proposed model, including these variables, was tested using structural equation modelling (SEM). According to the descriptive analysis, the mean scores of L2WTC in the three settings were generally low, ranging from 2.30 to 2.84. Debilitative anxiety casts a shadow on the positive aspects of anxiety. Self-assessed English proficiency was also too low. According to SEM, debilitative anxiety displayed a statistically significant negative impact on L2WTC inside the classroom, outside the classroom, in digital settings, and in self-assessed levels of English proficiency. In contrast, facilitative anxiety was found to positively contribute to L2WTC outside the classroom, in digital settings, and in self-assessed English proficiency. Self-assessed English proficiency made a statistically significant and positive contribution to L2WTC within the classroom, outside the classroom, and in digital contexts. L2WTC inside the classroom was found to positively contribute to L2WTC outside the classrooms and in digital contexts. The findings were systematically compared with existing studies, and the pedagogical implications, limitations, and potential avenues for future research were elucidated. The outcomes of the study have the potential to significantly contribute to the advancement of theoretical and empirical knowledge about improving English education, learning, and communication not only in Ethiopia but also in similar EFL contexts, thereby providing valuable insights for educators, researchers, and policymakers.

Keywords: debilitative anxiety, facilitative anxiety, L2 willingness to communicate, self-assessed English proficiency

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504 An Investigation on Opportunities and Obstacles on Implementation of Building Information Modelling for Pre-fabrication in Small and Medium Sized Construction Companies in Germany: A Practical Approach

Authors: Nijanthan Mohan, Rolf Gross, Fabian Theis

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The conventional method used in the construction industries often resulted in significant rework since most of the decisions were taken onsite under the pressure of project deadlines and also due to the improper information flow, which results in ineffective coordination. However, today’s architecture, engineering, and construction (AEC) stakeholders demand faster and accurate deliverables, efficient buildings, and smart processes, which turns out to be a tall order. Hence, the building information modelling (BIM) concept was developed as a solution to fulfill the above-mentioned necessities. Even though BIM is successfully implemented in most of the world, it is still in the early stages in Germany, since the stakeholders are sceptical of its reliability and efficiency. Due to the huge capital requirement, the small and medium-sized construction companies are still reluctant to implement BIM workflow in their projects. The purpose of this paper is to analyse the opportunities and obstacles to implementing BIM for prefabrication. Among all other advantages of BIM, pre-fabrication is chosen for this paper because it plays a vital role in creating an impact on time as well as cost factors of a construction project. The positive impact of prefabrication can be explicitly observed by the project stakeholders and participants, which enables the breakthrough of the skepticism factor among the small scale construction companies. The analysis consists of the development of a process workflow for implementing prefabrication in building construction, followed by a practical approach, which was executed with two case studies. The first case study represents on-site prefabrication, and the second was done for off-site prefabrication. It was planned in such a way that the first case study gives a first-hand experience for the workers at the site on the BIM model so that they can make much use of the created BIM model, which is a better representation compared to the traditional 2D plan. The main aim of the first case study is to create a belief in the implementation of BIM models, which was succeeded by the execution of offshore prefabrication in the second case study. Based on the case studies, the cost and time analysis was made, and it is inferred that the implementation of BIM for prefabrication can reduce construction time, ensures minimal or no wastes, better accuracy, less problem-solving at the construction site. It is also observed that this process requires more planning time, better communication, and coordination between different disciplines such as mechanical, electrical, plumbing, architecture, etc., which was the major obstacle for successful implementation. This paper was carried out in the perspective of small and medium-sized mechanical contracting companies for the private building sector in Germany.

Keywords: building information modelling, construction wastes, pre-fabrication, small and medium sized company

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503 Nanoparticle Supported, Magnetically Separable Metalloporphyrin as an Efficient Retrievable Heterogeneous Nanocatalyst in Oxidation Reactions

Authors: Anahita Mortazavi Manesh, Mojtaba Bagherzadeh

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Metalloporphyrins are well known to mimic the activity of monooxygenase enzymes. In this regard, metalloporphyrin complexes have been largely employed as valuable biomimetic catalysts, owing to the critical roles they play in oxygen transfer processes in catalytic oxidation reactions. Investigating in this area is based on different strategies to design selective, stable and high turnover catalytic systems. Immobilization of expensive metalloporphyrin catalysts onto supports appears to be a good way to improve their stability, selectivity and the catalytic performance because of the support environment and other advantages with respect to recovery, reuse. In other words, supporting metalloporphyrins provides a physical separation of active sites, thus minimizing catalyst self-destruction and dimerization of unhindered metalloporphyrins. Furthermore, heterogeneous catalytic oxidations have become an important target since their process are used in industry, helping to minimize the problems of industrial waste treatment. Hence, the immobilization of these biomimetic catalysts is much desired. An attractive approach is the preparation of the heterogeneous catalyst involves immobilization of complexes on silica coated magnetic nano-particles. Fe3O4@SiO2 magnetic nanoparticles have been studied extensively due to their superparamagnetism property, large surface area to volume ratio and easy functionalization. Using heterogenized homogeneous catalysts is an attractive option to facile separation of catalyst, simplified product work-up and continuity of catalytic system. Homogeneous catalysts immobilized on magnetic nanoparticles (MNPs) surface occupy a unique position due to combining the advantages of both homogeneous and heterogeneous catalysts. In addition, superparamagnetic nature of MNPs enable very simple separation of the immobilized catalysts from the reaction mixture using an external magnet. In the present work, an efficient heterogeneous catalyst was prepared by immobilizing manganese porphyrin on functionalized magnetic nanoparticles through the amino propyl linkage. The prepared catalyst was characterized by elemental analysis, FT-IR spectroscopy, X-ray powder diffraction, atomic absorption spectroscopy, UV-Vis spectroscopy, and scanning electron microscopy. Application of immobilized metalloporphyrin in the oxidation of various organic substrates was explored using Gas chromatographic (GC) analyses. The results showed that the supported Mn-porphyrin catalyst (Fe3O4@SiO2-NH2@MnPor) is an efficient and reusable catalyst in oxidation reactions. Our catalytic system exhibits high catalytic activity in terms of turnover number (TON) and reaction conditions. Leaching and recycling experiments revealed that nanocatalyst can be recovered several times without loss of activity and magnetic properties. The most important advantage of this heterogenized catalytic system is the simplicity of the catalyst separation in which the catalyst can be separated from the reaction mixture by applying a magnet. Furthermore, the separation and reuse of the magnetic Fe3O4 nanoparticles were very effective and economical.

Keywords: Fe3O4 nanoparticle, immobilized metalloporphyrin, magnetically separable nanocatalyst, oxidation reactions

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502 Exploring Antifragility Principles in Humanitarian Supply Chain: The key Role of Information Systems

Authors: Sylvie Michel, Sylvie Gerbaix, Marc Bidan

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The COVID-19 pandemic has been a major and global disruption that has affected all supply chains on a worldwide scale. Consequently, the question posed by this communication is to understand how - in the face of such disruptions - supply chains, including their actors, management tools, and processes, react, survive, adapt, and even improve. To do so, the concepts of resilience and antifragility applied to a supply chain have been leveraged. This article proposes to perceive resilience as a step to surpass in moving towards antifragility. The research objective is to propose an analytical framework to measure and compare resilience and antifragility, with antifragility seen as a property of a system that improves when subjected to disruptions rather than merely resisting these disruptions, as is the case with resilience. A unique case study was studied - MSF logistics (France) - using a qualitative methodology. Semi-structured interviews were conducted in person and remotely in multiple phases: during and immediately after the COVID crisis (8 interviews from March 2020 to April 2021), followed by a new round from September to November 2023. A Delphi method was employed. The interviews were analyzed using coding and a thematic framework. One of the theoretical contributions is consolidating the field of supply chain resilience research by precisely characterizing the dimensions of resilience for a humanitarian supply chain (Reorganization, Collaboration mediated by IS, Humanitarian culture). In this regard, a managerial contribution of this study is providing a guide for managers to identify the four dimensions and sub-dimensions of supply chain resilience. This enables managers to focus their decisions and actions on dimensions that will enhance resilience. Most importantly, another contribution is comparing the concepts of resilience and antifragility and proposing an analytical framework for antifragility—namely, the mechanisms on which MSF logistics relied to capitalize on uncertainties, contingencies, and shocks rather than simply enduring them. For MSF Logistics, antifragility manifested through the ability to identify opportunities hidden behind the uncertainties and shocks of COVID-19, reducing vulnerability, and fostering a culture that encourages innovation and the testing of new ideas. Logistics, particularly in the humanitarian domain, must be able to adapt to environmental disruptions. In this sense, this study identifies and characterizes the dimensions of resilience implemented by humanitarian logistics. Moreover, this research goes beyond the concept of resilience to propose an analytical framework for the concept of antifragility. The organization studied emerged stronger from the COVID-19 crisis due to the mechanisms we identified, allowing us to characterize antifragility. Finally, the results show that the information system plays a key role in antifragility.

Keywords: antifragility, humanitarian supply chain, information systems, qualitative research, resilience.

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501 Encouraging the Uptake of Entrepreneurship by Graduates of Higher Education Institutions in South Africa

Authors: Chux Gervase Iwu, Simon Nsengimane

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Entrepreneurship stimulates socio-economic development in many countries, if not all. It creates jobs and decreases unemployment and inequality. There are other benefits that are accruable from entrepreneurship, namely the empowerment of women and the promotion of better livelihoods. Innovation has become a weapon for business competition, growth, and sustainability. Paradoxically, it is a threat to businesses because products can be duplicated; new products may decrease the market share of existing ones or delete them from the market. This creates a constant competitive environment that calls for updates, innovation, and the invention of new products and services. Thus, the importance of higher education in instilling a good entrepreneurial mindset in students has become even more critical. It can be argued that the business environment is under enormous pressure from several factors, including the fourth industrial revolution, which calls for the adoption and use of information and communication technology, which is the catalyst for many innovations and organisational changes. Therefore, it is crucial that higher education students are equipped with relevant knowledge and skills to respond effectively to the needs of the business environment and create a vibrant entrepreneurship ecosystem. In South Africa, entrepreneurship education or some form of it has been a privilege for economic and management fields of study, leaving behind other fields. Entrepreneurship should not be limited to business faculties but rather extended to other fields of study. This is perhaps the reason for low levels of entrepreneurship uptake among South African graduates if they are compared with the graduates in other countries. There may be other reasons for the low entrepreneurship uptake. Some of these have been documented in extant literature to include (1) not enough time was spent teaching entrepreneurship in the business faculties, (2) the skills components in the curricula are insufficient, and (3) the overall attitudes/mindsets necessary to establish and run sustainable enterprises seem absent. Therefore, four important areas are recognised as crucial for the effective implementation of entrepreneurship education: policy, private sector engagement, curriculum development, and teacher development. The purpose of this research is to better comprehend the views, aspirations, and expectations of students and faculty members to design an entrepreneurial teaching model for higher education institutions. A qualitative method will be used to conduct a purposive interview with undergraduate and graduate students in select higher institutions. Members of faculty will also be included in the sample as well as, where possible, two or more government personnel responsible for higher education policy development. At present, interpretative analysis is proposed for the analysis of the interviews with the support of Atlas Ti. It is hoped that an entrepreneurship education model in the South African context is realised through this study.

Keywords: entrepreneurship education, higher education institution, graduate unemployment, curriculum development

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500 Advancing Trustworthy Human-robot Collaboration: Challenges and Opportunities in Diverse European Industrial Settings

Authors: Margarida Porfírio Tomás, Paula Pereira, José Manuel Palma Oliveira

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The decline in employment rates across sectors like industry and construction is exacerbated by an aging workforce. This has far-reaching implications for the economy, including skills gaps, labour shortages, productivity challenges due to physical limitations, and workplace safety concerns. To sustain the workforce and pension systems, technology plays a pivotal role. Robots provide valuable support to human workers, and effective human-robot interaction is essential. FORTIS, a Horizon project, aims to address these challenges by creating a comprehensive Human-Robot Interaction (HRI) solution. This solution focuses on multi-modal communication and multi-aspect interaction, with a primary goal of maintaining a human-centric approach. By meeting the needs of both human workers and robots, FORTIS aims to facilitate efficient and safe collaboration. The project encompasses three key activities: 1) A Human-Centric Approach involving data collection, annotation, understanding human behavioural cognition, and contextual human-robot information exchange. 2) A Robotic-Centric Focus addressing the unique requirements of robots during the perception and evaluation of human behaviour. 3) Ensuring Human-Robot Trustworthiness through measures such as human-robot digital twins, safety protocols, and resource allocation. Factor Social, a project partner, will analyse psycho-physiological signals that influence human factors, particularly in hazardous working conditions. The analysis will be conducted using a combination of case studies, structured interviews, questionnaires, and a comprehensive literature review. However, the adoption of novel technologies, particularly those involving human-robot interaction, often faces hurdles related to acceptance. To address this challenge, FORTIS will draw upon insights from Social Sciences and Humanities (SSH), including risk perception and technology acceptance models. Throughout its lifecycle, FORTIS will uphold a human-centric approach, leveraging SSH methodologies to inform the design and development of solutions. This project received funding from European Union’s Horizon 2020/Horizon Europe research and innovation program under grant agreement No 101135707 (FORTIS).

Keywords: skills gaps, productivity challenges, workplace safety, human-robot interaction, human-centric approach, social sciences and humanities, risk perception

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499 Phospholipid Cationic and Zwitterionic Compounds as Potential Non-Toxic Antifouling Agents: A Study of Biofilm Formation Assessed by Micro-titer Assays with Marine Bacteria and Eco-toxicological Effect on Marine Microalgae

Authors: D. Malouch, M. Berchel, C. Dreanno, S. Stachowski-Haberkorn, P-A. Jaffres

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Biofouling is a complex natural phenomenon that involves biological, physical and chemical properties related to the environment, the submerged surface and the living organisms involved. Bio-colonization of artificial structures can cause various economic and environmental impacts. The increase in costs associated with the over-consumption of fuel from biocolonized vessels has been widely studied. Measurement drifts from submerged sensors, as well as obstructions in heat exchangers, and deterioration of offshore structures are major difficulties that industries are dealing with. Therefore, surfaces that inhibit biocolonization are required in different areas (water treatment, marine paints, etc.) and many efforts have been devoted to produce efficient and eco-compatible antifouling agents. The different steps of surface fouling are widely described in literature. Studying the biofilm and its stages provides a better understanding of how to elaborate more efficient antifouling strategies. Several approaches are currently applied, such as the use of biocide anti-fouling paint (mainly with copper derivatives) and super-hydrophobic coatings. While these two processes are proving to be the most effective, they are not entirely satisfactory, especially in a context of a changing legislation. Nowadays, the challenge is to prevent biofouling with non-biocide compounds, offering a cost effective solution, but with no toxic effects on marine organisms. Since the micro-fouling phase plays an important role in the regulation of the following steps of biofilm formation, it is desired to reduce or delate biofouling of a given surface by inhibiting the micro-fouling at its early stages. In our recent works, we reported that some amphiphilic compounds exhibited bacteriostatic or bactericidal properties at a concentration that did not affect mammalian eukaryotic cells. These remarkable properties invited us to assess this type of bio-inspired phospholipids to prevent the colonization of surfaces by marine bacteria. Of note, other studies reported that amphiphilic compounds interacted with bacteria leading to a reduction of their development. An amphiphilic compound is a molecule consisting of a hydrophobic domain and a polar head (ionic or non-ionic). These compounds appear to have interesting antifouling properties: some ionic compounds have shown antimicrobial activity, and zwitterions can reduce nonspecific adsorption of proteins. Herein, we investigate the potential of amphiphilic compounds as inhibitors of bacterial growth and marine biofilm formation. The aim of this study is to compare the efficacy of four synthetic phospholipids that features a cationic charge or a zwitterionic polar-head group to prevent microfouling with marine bacteria. Toxicity of these compounds was also studied in order to identify the most promising compounds that inhibit biofilm development and show low cytotoxicity on two links representative of coastal marine food webs: phytoplankton and oyster larvae.

Keywords: amphiphilic phospholipids, biofilm, marine fouling, non-toxique assays

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498 Deep Learning in Chest Computed Tomography to Differentiate COVID-19 from Influenza

Authors: Hongmei Wang, Ziyun Xiang, Ying liu, Li Yu, Dongsheng Yue

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Intro: The COVID-19 (Corona Virus Disease 2019) has greatly changed the global economic, political and financial ecology. The mutation of the coronavirus in the UK in December 2020 has brought new panic to the world. Deep learning was performed on Chest Computed tomography (CT) of COVID-19 and Influenza and describes their characteristics. The predominant features of COVID-19 pneumonia was ground-glass opacification, followed by consolidation. Lesion density: most lesions appear as ground-glass shadows, and some lesions coexist with solid lesions. Lesion distribution: the focus is mainly on the dorsal side of the periphery of the lung, with the lower lobe of the lungs as the focus, and it is often close to the pleura. Other features it has are grid-like shadows in ground glass lesions, thickening signs of diseased vessels, air bronchi signs and halo signs. The severe disease involves whole bilateral lungs, showing white lung signs, air bronchograms can be seen, and there can be a small amount of pleural effusion in the bilateral chest cavity. At the same time, this year's flu season could be near its peak after surging throughout the United States for months. Chest CT for Influenza infection is characterized by focal ground glass shadows in the lungs, with or without patchy consolidation, and bronchiole air bronchograms are visible in the concentration. There are patchy ground-glass shadows, consolidation, air bronchus signs, mosaic lung perfusion, etc. The lesions are mostly fused, which is prominent near the hilar and two lungs. Grid-like shadows and small patchy ground-glass shadows are visible. Deep neural networks have great potential in image analysis and diagnosis that traditional machine learning algorithms do not. Method: Aiming at the two major infectious diseases COVID-19 and influenza, which are currently circulating in the world, the chest CT of patients with two infectious diseases is classified and diagnosed using deep learning algorithms. The residual network is proposed to solve the problem of network degradation when there are too many hidden layers in a deep neural network (DNN). The proposed deep residual system (ResNet) is a milestone in the history of the Convolutional neural network (CNN) images, which solves the problem of difficult training of deep CNN models. Many visual tasks can get excellent results through fine-tuning ResNet. The pre-trained convolutional neural network ResNet is introduced as a feature extractor, eliminating the need to design complex models and time-consuming training. Fastai is based on Pytorch, packaging best practices for in-depth learning strategies, and finding the best way to handle diagnoses issues. Based on the one-cycle approach of the Fastai algorithm, the classification diagnosis of lung CT for two infectious diseases is realized, and a higher recognition rate is obtained. Results: A deep learning model was developed to efficiently identify the differences between COVID-19 and influenza using chest CT.

Keywords: COVID-19, Fastai, influenza, transfer network

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497 Evaluation of Biological and Confinement Properties of a Bone Substitute to in Situ Preparation Based on Demineralized Bone Matrix for Bone Tissue Regeneration

Authors: Aura Maria Lopera Echavarria, Angela Maria Lema Perez, Daniela Medrano David, Pedronel Araque Marin, Marta Elena Londoño Lopez

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Bone regeneration is the process by which the formation of new bone is stimulated. Bone fractures can originate at any time due to trauma, infections, tumors, congenital malformations or skeletal diseases. Currently there are different strategies to treat bone defects that in some cases, regeneration does not occur on its own. That is why they are treated with bone substitutes, which provide a necessary environment for the cells to synthesize new bone. The Demineralized Bone Matrix (DBM) is widely used as a bone implant due to its good properties, such as osteoinduction and bioactivity. However, the use of DBM is limited, because its presentation is powder, which is difficult to implant with precision and is susceptible to migrating to other sites through blood flow. That is why the DBM is commonly incorporated into a variety of vehicles or carriers. The objective of this project is to evaluate the bioactive and confinement properties of a bone substitute based on demineralized bone matrix (DBM). Also, structural and morphological properties were evaluated. Bone substitute was obtained from EIA Biomaterials Laboratory of EIA University and the DBM was facilitated by Tissue Bank Foundation. Morphological and structural properties were evaluated by scanning electron microscopy (SEM), X-ray diffraction (DRX) and Fourier transform infrared spectroscopy with total attenuated reflection (FTIR-ATR). Water absorption capacity and degradation were also evaluated during three months. The cytotoxicity was evaluated by the MTT test. The bioactivity of the bone substitute was evaluated through immersion of the samples in simulated body fluid during four weeks. Confinement tests were performed on tibial fragments of a human donor with bone defects of determined size, to ensure that the substitute remains in the defect despite the continuous flow of fluid. According of the knowledge of the authors, the methodology for evaluating samples in a confined environment has not been evaluated before in real human bones. The morphology of the samples showed irregular surface and presented some porosity. DRX confirmed a semi-crystalline structure. The FTIR-ATR determined the organic and inorganic phase of the sample. The degradation and absorption measurements stablished a loss of 3% and 150% in one month respectively. The MTT showed that the system is not cytotoxic. Apatite clusters formed from the first week were visualized by SEM and confirmed by EDS. These calcium phosphates are necessary to stimulate bone regeneration and thanks to the porosity of the developed material, osteinduction and osteoconduction are possible. The results of the in vitro evaluation of the confinement of the material showed that the migration of the bone filling to other sites is negligible, although the samples were subjected to the passage of simulated body fluid. The bone substitute, putty type, showed stability, is bioactive, non-cytotoxic and has handling properties for specialists at the time of implantation. The obtained system allows to maintain the osteoinductive properties of DBM and it can fill completely fractures in any way; however, it does not provide a structural support, that is, it should only be used to treat fractures without requiring a mechanical load.

Keywords: bone regeneration, cytotoxicity, demineralized bone matrix, hydrogel

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496 A Novel Concept of Optical Immunosensor Based on High-Affinity Recombinant Protein Binders for Tailored Target-Specific Detection

Authors: Alena Semeradtova, Marcel Stofik, Lucie Mareckova, Petr Maly, Ondrej Stanek, Jan Maly

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Recently, novel strategies based on so-called molecular evolution were shown to be effective for the production of various peptide ligand libraries with high affinities to molecular targets of interest comparable or even better than monoclonal antibodies. The major advantage of these peptide scaffolds is mainly their prevailing low molecular weight and simple structure. This study describes a new high-affinity binding molecules based immunesensor using a simple optical system for human serum albumin (HSA) detection as a model molecule. We present a comparison of two variants of recombinant binders based on albumin binding domain of the protein G (ABD) performed on micropatterned glass chip. Binding domains may be tailored to any specific target of interest by molecular evolution. Micropatterened glass chips were prepared using UV-photolithography on chromium sputtered glasses. Glass surface was modified by (3-aminopropyl)trietoxysilane and biotin-PEG-acid using EDC/NHS chemistry. Two variants of high-affinity binding molecules were used to detect target molecule. Firstly, a variant is based on ABD domain fused with TolA chain. This molecule is in vivo biotinylated and each molecule contains one molecule of biotin and one ABD domain. Secondly, the variant is ABD domain based on streptavidin molecule and contains four gaps for biotin and four ABD domains. These high-affinity molecules were immobilized to the chip surface via biotin-streptavidin chemistry. To eliminate nonspecific binding 1% bovine serum albumin (BSA) or 6% fetal bovine serum (FBS) were used in every step. For both variants range of measured concentrations of fluorescently labelled HSA was 0 – 30 µg/ml. As a control, we performed a simultaneous assay without high-affinity binding molecules. Fluorescent signal was measured using inverse fluorescent microscope Olympus IX 70 with COOL LED pE 4000 as a light source, related filters, and camera Retiga 2000R as a detector. The fluorescent signal from non-modified areas was substracted from the signal of the fluorescent areas. Results were presented in graphs showing the dependence of measured grayscale value on the log-scale of HSA concentration. For the TolA variant the limit of detection (LOD) of the optical immunosensor proposed in this study is calculated to be 0,20 µg/ml for HSA detection in 1% BSA and 0,24 µg/ml in 6% FBS. In the case of streptavidin-based molecule, it was 0,04 µg/ml and 0,07 µg/ml respectively. The dynamical range of the immunosensor was possible to estimate just in the case of TolA variant and it was calculated to be 0,49 – 3,75 µg/ml and 0,73-1,88 µg/ml respectively. In the case of the streptavidin-based the variant we didn´t reach the surface saturation even with the 480 ug/ml concentration and the upper value of dynamical range was not estimated. Lower value was calculated to be 0,14 µg/ml and 0,17 µg/ml respectively. Based on the obtained results, it´s clear that both variants are useful for creating the bio-recognizing layer on immunosensors. For this particular system, it is obvious that the variant based on streptavidin molecule is more useful for biosensing on glass planar surfaces. Immunosensors based on this variant would exhibit better limit of detection and wide dynamical range.

Keywords: high affinity binding molecules, human serum albumin, optical immunosensor, protein G, UV-photolitography

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495 The Impact of Information and Communications Technology (ICT)-Enabled Service Adaptation on Quality of Life: Insights from Taiwan

Authors: Chiahsu Yang, Peiling Wu, Ted Ho

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From emphasizing economic development to stressing public happiness, the international community mainly hopes to be able to understand whether the quality of life for the public is becoming better. The Better Life Index (BLI) constructed by OECD uses living conditions and quality of life as starting points to cover 11 areas of life and to convey the state of the general public’s well-being. In light of the BLI framework, the Directorate General of Budget, Accounting and Statistics (DGBAS) of the Executive Yuan instituted the Gross National Happiness Index to understand the needs of the general public and to measure the progress of the aforementioned conditions in residents across the island. Whereas living conditions consist of income and wealth, jobs and earnings, and housing conditions, health status, work and life balance, education and skills, social connections, civic engagement and governance, environmental quality, personal security. The ICT area consists of health care, living environment, ICT-enabled communication, transportation, government, education, pleasure, purchasing, job & employment. In the wake of further science and technology development, rapid formation of information societies, and closer integration between lifestyles and information societies, the public’s well-being within information societies has indeed become a noteworthy topic. the Board of Science and Technology of the Executive Yuan use the OECD’s BLI as a reference in the establishment of the Taiwan-specific ICT-Enabled Better Life Index. Using this index, the government plans to examine whether the public’s quality of life is improving as well as measure the public’s satisfaction with current digital quality of life. This understanding will enable the government to gauge the degree of influence and impact that each dimension of digital services has on digital life happiness while also serving as an important reference for promoting digital service development. The content of the ICT Enabled Better Life Index. Information and communications technology (ICT) has been affecting people’s living styles, and further impact people’s quality of life (QoL). Even studies have shown that ICT access and usage have both positive and negative impact on life satisfaction and well-beings, many governments continue to invest in e-government programs to initiate their path to information society. This research is the few attempts to link the e-government benchmark to the subjective well-being perception, and further address the gap between user’s perception and existing hard data assessment, then propose a model to trace measurement results back to the original public policy in order for policy makers to justify their future proposals.

Keywords: information and communications technology, quality of life, satisfaction, well-being

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494 Evaluation of Regional Anaesthesia Practice in Plastic Surgery: A Retrospective Cross-Sectional Study

Authors: Samar Mousa, Ryan Kerstein, Mohanad Adam

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Regional anaesthesia has been associated with favourable outcomes in patients undergoing a wide range of surgeries. Beneficial effects have been demonstrated in terms of postoperative respiratory and cardiovascular endpoints, 7-day survival, time to ambulation and hospital discharge, and postoperative analgesia. Our project aimed at assessing the regional anaesthesia practice in the plastic surgery department of Buckinghamshire trust and finding out ways to improve the service in collaboration with the anaesthesia team. It is a retrospective study associated with a questionnaire filled out by plastic surgeons and anaesthetists to get the full picture behind the numbers. The study period was between 1/3/2022 and 23/5/2022 (12 weeks). The operative notes of all patients who had an operation under plastic surgery, whether emergency or elective, were reviewed. The criteria of suitable candidates for the regional block were put by the consultant anaesthetists as follows: age above 16, single surgical site (arm, forearm, leg, foot), no drug allergy, no pre-existing neuropathy, no bleeding disorders, not on ant-coagulation, no infection to the site of the block. For 12 weeks, 1061 operations were performed by plastic surgeons. Local cases were excluded leaving 319 cases. Of the 319, 102 patients were suitable candidates for regional block after applying the previously mentioned criteria. However, only seven patients had their operations under the regional block, and the rest had general anaesthesia that could have been easily avoided. An online questionnaire was filled out by both plastic surgeons and anaesthetists of different training levels to find out the reasons behind the obvious preference for general over regional anaesthesia, even if this was against the patients’ interest. The questionnaire included the following points: training level, time taken to give GA or RA, factors that influence the decision, percentage of RA candidates that had GA, reasons behind this percentage, recommendations. Forty-four clinicians filled out the questionnaire, among which were 23 plastic surgeons and 21 anaesthetists. As regards the training level, there were 21 consultants, 4 associate specialists, 9 registrars, and 10 senior house officers. The actual percentage of patients who were good candidates for RA but had GA instead is 93%. The replies estimated this percentage as between 10-30%. 29% of the respondents thought that this percentage is because of surgeons’ preference to have GA rather than RA for their operations without medical support for the decision. 37% of the replies thought that anaesthetists prefer giving GA even if the patient is a suitable candidate for RA. 22.6% of the replies thought that patients refused to have RA, and 11.3% had other causes. The recommendations were in 5 main accesses, which are protocols and pathways for regional blocks, more training opportunities for anaesthetists on regional blocks, providing a separate block room in the hospital, better communication between surgeons and anaesthetists, patient education about the benefits of regional blocks.

Keywords: regional anaesthesia, regional block, plastic surgery, general anaesthesia

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493 Human Rights on Digital Platforms

Authors: Niina Meriläinen

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Digital platforms are arenas for dialogue, various kinds of political debates, information and news gathering, policymaking, and social change processes. Human rights serve as examples of social and political issues that are universally noted as principles and yet often violated on digital platforms as well as in the analog world. Digital platforms in this study are different Internet sites, blogs, discussion platforms, social media apps, and gaming. Various actors, from human rights activists and non-governmental organizations to individual people, governments, and corporations, use digital platforms along with analog arenas to discuss and defend human rights, while violators can find new victims and continue violating rights on the same platforms. Digital platforms create opportunities for various women and minorities to empower themselves and others and to be active in various arenas of society and policymaking. At the same time, digital platforms pose threats to human rights globally, especially to women, girls, and minorities. The results of this meta-study of n=120 academic case studies indicate that more research is needed to determine the framework of human rights and human rights on digital platforms. A broad discussion must be had on what human rights require in the digital realm and how ICTs may enhance or threaten our ability to respect, protect, and fulfill a wide variety of human rights while various digital platforms pose multiple threats to human rights. This relates to the willingness of political decision-makers to act upon various crimes committed on and with online platforms. More research is needed to determine the framework of digital human rights and human rights on digital platforms in relation to political communication and decision-making. It is important to develop a framework in which these are defined. It must be discussed who participates in this process: those whose rights are violated, companies that profit by selling our personal data, activists, governments, and some unknown actors. In the end, the question comes back to who has the power to define what we talk about, when, and where. This use of power plays a big role. Digital platforms illustrate the darker side of technological progress, which, on the one hand, has given various people the possibility to engage in society, empower themselves, and take ownership of their rights globally. At the same time, the platforms enable others to use the same platforms to find victims, abuse them, and exploit them. Bullying, harassment, and violence are rampant on various digital platforms, where minorities and people with limited support are victims. There is indeed a need for a discussion of normative values in the era of fake news, the power of influencers, Trumpism, and institutionalized disregard for human rights, gender equality, and the elimination of gender-based violence online. Attention and obligations must be placed on politicians and internet architecture, such as corporations, and their roles in human rights and their violations online.

Keywords: human rights, digital platforms, violations, internet, social media

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492 Mobile Technology Use by People with Learning Disabilities: A Qualitative Study

Authors: Peter Williams

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Mobile digital technology, in the form of smart phones, tablets, laptops and their accompanying functionality/apps etc., is becoming ever more used by people with Learning Disabilities (LD) - for entertainment, to communicate and socialize, and enjoy self-expression. Despite this, there has been very little research into the experiences of such technology by this cohort, it’s role in articulating personal identity and self-advocacy and the barriers encountered in negotiating technology in everyday life. The proposed talk describes research funded by the British Academy addressing these issues. It aims to explore: i) the experiences of people with LD in using mobile technology in their everyday lives – the benefits, in terms of entertainment, self-expression and socialising, and possible greater autonomy; and the barriers, such as accessibility or usability issues, privacy or vulnerability concerns etc. ii) how the technology, and in particular the software/apps and interfaces, can be improved to enable the greater access to entertainment, information, communication and other benefits it can offer. It is also hoped that results will inform parents, carers and other supporters regarding how they can use the technology with their charges. Rather than the project simply following the standard research procedure of gathering and analysing ‘data’ to which individual ‘research subjects’ have no access, people with Learning Disabilities (and their supporters) will help co-produce an accessible, annotated and hyperlinked living e-archive of their experiences. Involving people with LD as informants, contributors and, in effect, co-researchers will facilitate digital inclusion and empowerment. The project is working with approximately 80 adults of all ages who have ‘mild’ learning disabilities (people who are able to read basic texts and write simple sentences). A variety of methods is being used. Small groups of participants have engaged in simple discussions or storytelling about some aspect of technology (such as ‘when my phone saved me’ or ‘my digital photos’ etc.). Some individuals have been ‘interviewed’ at a PC, laptop or with a mobile device etc., and asked to demonstrate their usage and interests. Social media users have shown their Facebook pages, Pinterest uploads or other material – giving them an additional focus they have used to discuss their ‘digital’ lives. During these sessions, participants have recorded (or employed the researcher to record) their observations on to the e-archive. Parents, carers and other supporters are also being interviewed to explore their experiences of using mobile technology with the cohort, including any difficulties they have observed their charges having. The archive is supplemented with these observations. The presentation will outline the methods described above, highlighting some of the special considerations required when working inclusively with people with LD. It will describe some of the preliminary findings and demonstrate the e-archive with a commentary on the pages shown.

Keywords: inclusive research, learning disabilities, methods, technology

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491 Evaluation: Developing An Appropriate Survey Instrument For E-Learning

Authors: Brenda Ravenscroft, Ulemu Luhanga, Bev King

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A comprehensive evaluation of online learning needs to include a blend of educational design, technology use, and online instructional practices that integrate technology appropriately for developing and delivering quality online courses. Research shows that classroom-based evaluation tools do not adequately capture the dynamic relationships between content, pedagogy, and technology in online courses. Furthermore, studies suggest that using classroom evaluations for online courses yields lower than normal scores for instructors, and may affect faculty negatively in terms of administrative decisions. In 2014, the Faculty of Arts and Science at Queen’s University responded to this evidence by seeking an alternative to the university-mandated evaluation tool, which is designed for classroom learning. The Faculty is deeply engaged in e-learning, offering large variety of online courses and programs in the sciences, social sciences, humanities and arts. This paper describes the process by which a new student survey instrument for online courses was developed and piloted, the methods used to analyze the data, and the ways in which the instrument was subsequently adapted based on the results. It concludes with a critical reflection on the challenges of evaluating e-learning. The Student Evaluation of Online Teaching Effectiveness (SEOTE), developed by Arthur W. Bangert in 2004 to assess constructivist-compatible online teaching practices, provided the starting point. Modifications were made in order to allow the instrument to serve the two functions required by the university: student survey results provide the instructor with feedback to enhance their teaching, and also provide the institution with evidence of teaching quality in personnel processes. Changes were therefore made to the SEOTE to distinguish more clearly between evaluation of the instructor’s teaching and evaluation of the course design, since, in the online environment, the instructor is not necessarily the course designer. After the first pilot phase, involving 35 courses, the results were analyzed using Stobart's validity framework as a guide. This process included statistical analyses of the data to test for reliability and validity, student and instructor focus groups to ascertain the tool’s usefulness in terms of the feedback it provided, and an assessment of the utility of the results by the Faculty’s e-learning unit responsible for supporting online course design. A set of recommendations led to further modifications to the survey instrument prior to a second pilot phase involving 19 courses. Following the second pilot, statistical analyses were repeated, and more focus groups were used, this time involving deans and other decision makers to determine the usefulness of the survey results in personnel processes. As a result of this inclusive process and robust analysis, the modified SEOTE instrument is currently being considered for adoption as the standard evaluation tool for all online courses at the university. Audience members at this presentation will be stimulated to consider factors that differentiate effective evaluation of online courses from classroom-based teaching. They will gain insight into strategies for introducing a new evaluation tool in a unionized institutional environment, and methodologies for evaluating the tool itself.

Keywords: evaluation, online courses, student survey, teaching effectiveness

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490 Toward the Decarbonisation of EU Transport Sector: Impacts and Challenges of the Diffusion of Electric Vehicles

Authors: Francesca Fermi, Paola Astegiano, Angelo Martino, Stephanie Heitel, Michael Krail

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In order to achieve the targeted emission reductions for the decarbonisation of the European economy by 2050, fundamental contributions are required from both energy and transport sectors. The objective of this paper is to analyse the impacts of a largescale diffusion of e-vehicles, either battery-based or fuel cells, together with the implementation of transport policies aiming at decreasing the use of motorised private modes in order to achieve greenhouse gas emission reduction goals, in the context of a future high share of renewable energy. The analysis of the impacts and challenges of future scenarios on transport sector is performed with the ASTRA (ASsessment of TRAnsport Strategies) model. ASTRA is a strategic system-dynamic model at European scale (EU28 countries, Switzerland and Norway), consisting of different sub-modules related to specific aspects: the transport system (e.g. passenger trips, tonnes moved), the vehicle fleet (composition and evolution of technologies), the demographic system, the economic system, the environmental system (energy consumption, emissions). A key feature of ASTRA is that the modules are linked together: changes in one system are transmitted to other systems and can feed-back to the original source of variation. Thanks to its multidimensional structure, ASTRA is capable to simulate a wide range of impacts stemming from the application of transport policy measures: the model addresses direct impacts as well as second-level and third-level impacts. The simulation of the different scenarios is performed within the REFLEX project, where the ASTRA model is employed in combination with several energy models in a comprehensive Modelling System. From the transport sector perspective, some of the impacts are driven by the trend of electricity price estimated from the energy modelling system. Nevertheless, the major drivers to a low carbon transport sector are policies related to increased fuel efficiency of conventional drivetrain technologies, improvement of demand management (e.g. increase of public transport and car sharing services/usage) and diffusion of environmentally friendly vehicles (e.g. electric vehicles). The final modelling results of the REFLEX project will be available from October 2018. The analysis of the impacts and challenges of future scenarios is performed in terms of transport, environmental and social indicators. The diffusion of e-vehicles produces a consistent reduction of future greenhouse gas emissions, although the decarbonisation target can be achieved only with the contribution of complementary transport policies on demand management and supporting the deployment of low-emission alternative energy for non-road transport modes. The paper explores the implications through time of transport policy measures on mobility and environment, underlying to what extent they can contribute to a decarbonisation of the transport sector. Acknowledgements: The results refer to the REFLEX project which has received grants from the European Union’s Horizon 2020 research and innovation program under Grant Agreement No. 691685.

Keywords: decarbonisation, greenhouse gas emissions, e-mobility, transport policies, energy

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489 Comparative Research on Culture-Led Regeneration across Cities in China

Authors: Fang Bin Guo, Emma Roberts, Haibin Du, Yonggang Wang, Yu Chen, Xiuli Ge

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This paper explores the findings so far from a major externally-funded project which operates internationally in China, Germany and the UK. The research team is working in the context of the redevelopment of post-industrial sites in China and how these might be platforms for creative enterprises and thereby, the economy and welfare to flourish. Results from the project are anticipated to inform urban design policies in China and possibly farther afield. The research has utilised ethnographic studies and participatory design methods to investigate alternative strategies for sustainable urban renewal of China’s post-industrial areas. Additionally, it has undertaken comparative studies of successful examples of European and Chinese urban regeneration cases. The international cross-disciplinary team has been seeking different opportunities for developing relevant creative industries whilst retaining cultural and industrial heritage. This paper will explore the research conducted so far by the team and offer initial findings. Findings point out the development challenges of cities respecting the protection of local culture/heritages, history of the industries and transformation of the local economies. The preliminary results and pilot analysis of the current research have demonstrated that local government policyholders, business investors/developers and creative industry practitioners are the three major stakeholders that will impact city revitalisations. These groups are expected to work together with asynchronous vision in order for redevelopments to be successful. Meanwhile, local geography, history, culture, politics, economy and ethnography have been identified as important factors that impact on project design and development during urban transformations. Data is being processed from the team’s research conducted across the focal Western and Chinese cities. This has provided theoretical guidance and practical support to the development of significant experimental projects. Many were re-examined with a more international perspective, and adjustments have been based on the conclusions of the research. The observations and research are already generating design solutions in terms of ascertaining essential site components, layouts, visual design and practical facilities for regenerated sites. Two significant projects undertaken by this project team have been nominated by the central Chinese government as the most successful exemplars. They have been listed as outstanding national industry heritage projects; in particular, one of them was nominated by ArchDaily as Building of the Year 2019, and so this project outcome has made a substantial contribution to research and innovation. In summary, this paper will outline the funded project, discuss the work conducted so far, and pinpoint the initial discoveries. It will detail the future steps and indicate how these will impact on national and local governments in China, designers, local citizens and building users.

Keywords: cultural & industrial heritages, ethnographic research, participatory design, regeneration of post-industrial sites, sustainable

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488 Socio-Political Crisis in the North West and South West Regions of Cameroon and the Emergence of New Cultures

Authors: Doreen Mekunda

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This paper is built on the premise that the current socio-political crisis in the two restive regions of Cameroon, though enveloped with destructive and devastating trends (effects) on both property and human lives, is not without its strengths and merits. It is incontestable that many cultures, to a greater extent, are going to be destroyed as people forcibly move from war-stricken habitats to non-violent places. Many cultural potentials, traditional shrines, artifacts, art, and crafts, etc., are unknowingly or knowingly disfigured, and many other ugly things will, by the end of the crisis, affect the cultures of these two regions under siege and of the receiving population. A plethora of other problems like the persecution of Internally Displaced Persons (IDPs) for being displaced and blamed for increased crime rates and the existence of cultural and ethnic differences that produce both inter-tribal and interpersonal conflicts and conflicts between communities will abound. However, there is the emergence of rapid literature, and other forms of cultural productions, whether written or oral, is visible, thereby precipitating a rich cultural diversity due to the coming together of a variety of cultures of both the IDPs and the receiving populations, rapid urbanization, improvement of health-related issues, the rebirth of indigenous cultural practices, the development of social and lingua-cultural competences, dependence on alternative religions, faith and spirituality. Even financial and economic dependence, though a burden to others by IDPs, has its own merits as it improves the living standards of the IDPs. To be able to obtain plausible results, cultural materialism, which is a literary theory that hinges on the empirical study of socio-cultural systems within a materialist infrastructure-super-structure framework, is employed together with the postcolonial theory. Postcolonial theory because the study deals with postcolonial experiences/tenets of migration, hybridity, ethnicity, indignity, language, double consciousness, migration, center/margin binaries, and identity, amongst others. The study reveals that the involuntary movement of persons from their habitual homes brings about movement in cultures, thus, the emergence of new cultures. The movement of people who hold fast to their cultural heritage can only influence new forms of literature, the development of new communication competences, the rise of alternative religion, faith and spirituality, the re-emergence of customary and traditional legal systems that might have been abandoned for the new judicial systems, and above all the revitalization of traditional health care systems.

Keywords: alternative religion, emergence, socio-political crisis, spirituality, lingua-cultural competences

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487 Household Perspectives and Resistance to Preventive Relocation in Flood Prone Areas: A Case Study in the Polwatta River Basin, Southern Sri Lanka

Authors: Ishara Madusanka, So Morikawa

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Natural disasters, particularly floods, pose severe challenges globally, affecting both developed and developing countries. In many regions, especially Asia, riverine floods are prevalent and devastating. Integrated flood management incorporates structural and non-structural measures, with preventive relocation emerging as a cost-effective and proactive strategy for areas repeatedly impacted by severe flooding. However, preventive relocation is often hindered by economic, psychological, social, and institutional barriers. This study investigates the factors influencing resistance to preventive relocation and evaluates the role of flood risk information in shaping relocation decisions through risk perception. A conceptual model was developed, incorporating variables such as Flood Risk Information (FRI), Place Attachment (PA), Good Living Conditions (GLC), and Adaptation to Flooding (ATF), with Flood Risk Perception (FRP) serving as a mediating variable. The research was conducted in Welipitiya in the Polwatta river basin, Matara district, Sri Lanka, a region experiencing recurrent flood damage. For this study, an experimental design involving a structured questionnaire survey was utilized, with 185 households participating. The treatment group received flood risk information, including flood risk maps and historical data, while the control group did not. Data were collected in 2023 and analyzed using independent sample t-tests and Partial Least Squares Structural Equation Modeling (PLS-SEM). PLS-SEM was chosen for its ability to model latent variables, handle complex relationships, and suitability for exploratory research. Multi-group Analysis (MGA) assessed variations across different flood risk areas. Findings indicate that flood risk information had a limited impact on flood risk perception and relocation decisions, though its effect was significant in specific high-risk areas. Place attachment was a significant factor influencing relocation decisions across the sample. One potential reason for the limited impact of flood risk information on relocation decisions could be the lack of specificity in the information provided. The results suggest that while flood risk information alone may not significantly influence relocation decisions, it is crucial in specific contexts. Future studies and practitioners should focus on providing more detailed risk information and addressing psychological factors like place attachments to enhance preventive relocation efforts.

Keywords: flood risk communication, flood risk perception, place attachment, preventive relocation, structural equation modeling

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486 Identification and Characterization of Small Peptides Encoded by Small Open Reading Frames using Mass Spectrometry and Bioinformatics

Authors: Su Mon Saw, Joe Rothnagel

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Short open reading frames (sORFs) located in 5’UTR of mRNAs are known as uORFs. Characterization of uORF-encoded peptides (uPEPs) i.e., a subset of short open reading frame encoded peptides (sPEPs) and their translation regulation lead to understanding of causes of genetic disease, proteome complexity and development of treatments. Existence of uORFs within cellular proteome could be detected by LC-MS/MS. The ability of uORF to be translated into uPEP and achievement of uPEP identification will allow uPEP’s characterization, structures, functions, subcellular localization, evolutionary maintenance (conservation in human and other species) and abundance in cells. It is hypothesized that a subset of sORFs are translatable and that their encoded sPEPs are functional and are endogenously expressed contributing to the eukaryotic cellular proteome complexity. This project aimed to investigate whether sORFs encode functional peptides. Liquid chromatography-mass spectrometry (LC-MS) and bioinformatics were thus employed. Due to probable low abundance of sPEPs and small in sizes, the need for efficient peptide enrichment strategies for enriching small proteins and depleting the sub-proteome of large and abundant proteins is crucial for identifying sPEPs. Low molecular weight proteins were extracted using SDS-PAGE from Human Embryonic Kidney (HEK293) cells and Strong Cation Exchange Chromatography (SCX) from secreted HEK293 cells. Extracted proteins were digested by trypsin to peptides, which were detected by LC-MS/MS. The MS/MS data obtained was searched against Swiss-Prot using MASCOT version 2.4 to filter out known proteins, and all unmatched spectra were re-searched against human RefSeq database. ProteinPilot v5.0.1 was used to identify sPEPs by searching against human RefSeq, Vanderperre and Human Alternative Open Reading Frame (HaltORF) databases. Potential sPEPs were analyzed by bioinformatics. Since SDS PAGE electrophoresis could not separate proteins <20kDa, this could not identify sPEPs. All MASCOT-identified peptide fragments were parts of main open reading frame (mORF) by ORF Finder search and blastp search. No sPEP was detected and existence of sPEPs could not be identified in this study. 13 translated sORFs in HEK293 cells by mass spectrometry in previous studies were characterized by bioinformatics. Identified sPEPs from previous studies were <100 amino acids and <15 kDa. Bioinformatics results showed that sORFs are translated to sPEPs and contribute to proteome complexity. uPEP translated from uORF of SLC35A4 was strongly conserved in human and mouse while uPEP translated from uORF of MKKS was strongly conserved in human and Rhesus monkey. Cross-species conserved uORFs in association with protein translation strongly suggest evolutionary maintenance of coding sequence and indicate probable functional expression of peptides encoded within these uORFs. Translation of sORFs was confirmed by mass spectrometry and sPEPs were characterized with bioinformatics.

Keywords: bioinformatics, HEK293 cells, liquid chromatography-mass spectrometry, ProteinPilot, Strong Cation Exchange Chromatography, SDS-PAGE, sPEPs

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485 Effect of Renin Angiotensin Pathway Inhibition on the Efficacy of Anti-programmed Cell Death (PD-1/L-1) Inhibitors in Advanced Non-small Cell Lung Cancer Patients- Comparison of Single Hospital Retrospective Assessment to the Published Literature

Authors: Esther Friedlander, Philip Friedlander

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The use of immunotherapy that inhibits programmed death-1 (PD-1) or its ligand PD-L1 confers survival benefits in patients with non-small cell lung cancer (NSCLC). However, approximately 45% of patients experience primary treatment resistance, necessitating the development of strategies to improve efficacy. While the renin-angiotensin system (RAS) has systemic hemodynamic effects, tissue-specific regulation exists along with modulation of immune activity in part through regulation of myeloid cell activity, leading to the hypothesis that RAS inhibition may improve anti-PD-1/L-1 efficacy. A retrospective analysis was conducted that included 173 advanced solid tumor cancer patients treated at Valley Hospital, a community Hospital in New Jersey, USA, who were treated with a PD-1/L-1 inhibitor in a defined time period showing a statistically significant relationship between RAS pathway inhibition (RASi through concomitant treatment with an ACE inhibitor or angiotensin receptor blocker) and positive efficacy to the immunotherapy that was independent of age, gender and cancer type. Subset analysis revealed strong numerical benefit for efficacy in both patients with squamous and nonsquamous NSCLC as determined by documented clinician assessment of efficacy and by duration of therapy. A PUBMED literature search was now conducted to identify studies assessing the effect of RAS pathway inhibition on anti-PD-1/L1 efficacy in advanced solid tumor patients and compare these findings to those seen in the Valley Hospital retrospective study with a focus on NSCLC specifically. A total of 11 articles were identified assessing the effects of RAS pathway inhibition on the efficacy of checkpoint inhibitor immunotherapy in advanced cancer patients. Of the 11 studies, 10 assessed the effect on survival of RASi in the context of treatment with anti-PD-1/PD-L1, while one assessed the effect on CTLA-4 inhibition. Eight of the studies included patients with NSCLC, while the remaining 2 were specific to genitourinary malignancies. Of the 8 studies, two were specific to NSCLC patients, with the remaining 6 studies including a range of cancer types, of which NSCLC was one. Of these 6 studies, only 2 reported specific survival data for the NSCLC subpopulation. Patient characteristics, multivariate analysis data and efficacy data seen in the 2 NSLCLC specific studies and in the 2 basket studies, which provided data on the NSCLC subpopulation, were compared to that seen in the Valley Hospital retrospective study supporting a broader effect of RASi on anti-PD-1/L1 efficacy in advanced NSLCLC with the majority of studies showing statistically significant benefit or strong statistical trends but with one study demonstrating worsened outcomes. This comparison of studies extends published findings to the community hospital setting and supports prospective assessment through randomized clinical trials of efficacy in NSCLC patients with pharmacodynamic components to determine the effect on immune cell activity in tumors and on the composition of the tumor microenvironment.

Keywords: immunotherapy, cancer, angiotensin, efficacy, PD-1, lung cancer, NSCLC

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484 Evaluation of Wheat Varieties for Water Use Efficiency under Staggering Sowing Times and Variable Irrigation Regimes under Timely and Late Sown Conditions

Authors: Vaibhav Baliyan, S. S. Parihar

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With the rise in temperature during reproductive phase and moisture stress, winter wheat yields are likely to decrease because of limited plant growth, higher rate of night respiration, higher spikelet sterility or number of grains per spike and restricted embryo development thereby reducing grain number. Crop management practices play a pivotal role in minimizing adverse effects of terminal heat stress on wheat production. Amongst various agronomic management practices, adjusting sowing date, crop cultivars and irrigation scheduling have been realized to be simple yet powerful, implementable and eco-friendly mitigation strategies to sustain yields under elevated temperature conditions. Taking into account, large variability in wheat production in space and time, a study was conducted to identify the suitable wheat varieties under both early and late planting with suitable irrigation schedule for minimizing terminal heat stress effect and thereby improving wheat production. Experiments were conducted at research farms of Indian Agricultural Research Institute, New Delhi, India, separately for timely and late sown conditions with suitable varieties with staggering dates of sowing from 1st November to 30th November in case of timely sown and from 1st December to 31st December for late sown condition. The irrigation schedule followed for both the experiments were 100% of ETc (evapotranspiration of crop), 80% of ETc and 60% of ETc. Results of the timely sown experiment indicated that 1st November sowing resulted in higher grain yield followed by 10th November. However, delay in sowing thereafter resulted in gradual decrease in yield and the maximum reduction was noticed under 30th November sowing. Amongst the varieties, HD3086 produced higher grain yield compared to other varieties. Irrigation applied based on 100% of ETc gave higher yield comparable to 80% of ETc but both were significantly higher than 60% of ETc. It was further observed that even liberal irrigation under 100% of ETc could not compensate the yield under delayed sowing suggesting that rise in temperature beyond January adversely affected the growth and development of crop as well as forced maturity resulting in significant reduction of yield attributing characters due to terminal heat stress. Similar observations were recorded under late sown experiment too. Planting on 1st December along with 100% ETc of irrigation schedule resulted in significantly higher grain yield as compared to other dates and irrigation regimes. Further, it was observed that reduction in yield under late sown conditions was significantly large than the timely sown conditions irrespective of the variety grown and irrigation schedule followed. Delayed sowing resulted in reducing crop growth period and forced maturity in turn led to significant deterioration in all the yield attributing characters and there by reduction in yield suggesting that terminal heat stress had greater impact on yield under late sown crop than timely sown due to temperature rise coinciding with reproductive phase of the crop.

Keywords: climate, irrigation, mitigation, wheat

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483 Supporting a Moral Growth Mindset Among College Students

Authors: Kate Allman, Heather Maranges, Elise Dykhuis

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Moral Growth Mindset (MGM) is the belief that one has the capacity to become a more moral person, as opposed to a fixed conception of one’s moral ability and capacity (Han et al., 2018). Building from Dweck’s work in incremental implicit theories of intelligence (2008), Moral Growth Mindset (Han et al., 2020) extends growth mindsets into the moral dimension. The concept of MGM has the potential to help researchers understand how both mindsets and interventions can impact character development, and it has even been shown to have connections to voluntary service engagement (Han et al., 2018). Understanding the contexts in which MGM might be cultivated could help to promote the further cultivation of character, in addition to prosocial behaviors like service engagement, which may, in turn, promote larger scale engagement in social justice-oriented thoughts, feelings, and behaviors. In particular, college may be a place to intentionally cultivate a growth mindset toward moral capacities, given the unique developmental and maturational components of the college experience, including contextual opportunity (Lapsley & Narvaez, 2006) and independence requiring the constant consideration, revision, and internalization of personal values (Lapsley & Woodbury, 2016). In a semester-long, quasi-experimental study, we examined the impact of a pedagogical approach designed to cultivate college student character development on participants’ MGM. With an intervention (n=69) and a control group (n=97; Pre-course: 27% Men; 66% Women; 68% White; 18% Asian; 2% Black; <1% Hispanic/Latino), we investigated whether college courses that intentionally incorporate character education pedagogy (Lamb, Brant, Brooks, 2021) affect a variety of psychosocial variables associated with moral thoughts, feelings, identity, and behavior (e.g. moral growth mindset, honesty, compassion, etc.). The intervention group consisted of 69 undergraduate students (Pre-course: 40% Men; 52% Women; 68% White; 10.5% Black; 7.4% Asian; 4.2% Hispanic/Latino) that voluntarily enrolled in five undergraduate courses that encouraged students to engage with key concepts and methods of character development through the application of research-based strategies and personal reflection on goals and experiences. Moral Growth Mindset was measured using the four-item Moral Growth Mindset scale (Han et al., 2020), with items such as You can improve your basic morals and character considerably on a six-point Likert scale from 1 (strongly disagree) to 6 (strongly agree). Higher scores of MGM indicate a stronger belief that one can become a more moral person with personal effort. Reliability at Time 1 was Cronbach’s ɑ= .833, and at Time 2 Cronbach’s ɑ= .772. An Analysis of Covariance (ANCOVA) was conducted to explore whether post-course MGM scores were different between the intervention and control when controlling for pre-course MGM scores. The ANCOVA indicated significant differences in MGM between groups post-course, F(1,163) = 8.073, p = .005, R² = .11, where descriptive statistics indicate that intervention scores were higher than the control group at post-course. Results indicate that intentional character development pedagogy can be leveraged to support the development of Moral Growth Mindset and related capacities in undergraduate settings.

Keywords: moral personality, character education, incremental theories of personality, growth mindset

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482 Well-being of Parents of Children with Autism Spectrum Disorder or Developmental Coordination Disorder: Cross-Cultural and Cross-disorder Comparative Studies

Authors: Léa Chawki, Émilie Cappe

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Context: Nowadays, supporting parents of children with autism spectrum disorder (ASD) and helping them adjust to their child’s condition represents a core clinical and scientific necessity and is encouraged by the French National Strategy for Autism (2018). In France, ASD remains a challenging condition, causing distress, segregation and social stigma to concerned family members concerned by this handicap. The literature highlights that neurodevelopmental disorders in children, such as ASD, influence parental well-being. This impact could be different according to parents’ culture and the child’s particular disorder manifestation, such as developmental coordination disorder (DCC), for instance. Objectives: This present study aims to explore parental stress, anxiety and depressive symptoms, as well as the quality of life in parents of children with ASD or DCD, as well as the explicit individual, psychosocial and cultural factors of parental well-being. Methods: Participants will be recruited through diagnostic centers, child and specialized adolescent units, and organizations representing families with ASD and DCD. Our sample will include five groups of 150 parents: four groups of parents having children with ASD – one living in France, one in the US, one in Canada and the other in Lebanon – and one group of French parents of children with DCD. Self-evaluation measures will be filled directly by parents in order to measure parental stress, anxiety and depressive symptoms, quality of life, coping and emotional regulation strategies, internalized stigma, perceived social support, the child’s problem behaviors severity, as well as motor coordination deficits in children with ASD and DCD. A sociodemographic questionnaire will help collect additional useful data regarding participants and their children. Individual and semi-structured research interviews will be conducted to complete quantitative data by further exploring participants’ distinct experiences related to parenting a child with a neurodevelopmental disorder. An interview grid, specially designed for the needs of this study, will strengthen the comparison between the experiences of parents of children with ASD with those of parents of children with DCD. It will also help investigate cultural differences regarding parent support policies in the context of raising a child with ASD. Moreover, interviews will help clarify the link between certain research variables (behavioral differences between ASD and DCD, family leisure activities, family and children’s extracurricular life, etc.) and parental well-being. Research perspectives: Results of this study will provide a more holistic understanding of the roles of individual, psychosocial and cultural variables related to parental well-being. Thus, this study will help direct the implementation of support services offered to families of children with neurodevelopmental disorders (ASD and DCD). Also, the implications of this study are essential in order to guide families through changes related to public policies assisting neurodevelopmental disorders and other disabilities. The between-group comparison (ASD and DCD) is also expected to help clarify the origins of all the different challenges encountered by those families. Hence, it will be interesting to investigate whether complications perceived by parents are more likely to arise from child-symptom severity, or from the lack of support obtained from health and educational systems.

Keywords: Autism spectrum disorder, cross-cultural, cross-disorder, developmental coordination delay, well-being

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481 Overcoming the Challenges of Subjective Truths in the Post-Truth Age Through a Critical-Ethical English Pedagogy

Authors: Farah Vierra

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Following the 2016 US presidential election and the advancement of the Brexit referendum, the concept of “post-truth,” defined by the Oxford Dictionary as “relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief,” came into prominent use in public, political and educational circles. What this essentially entails is that in this age, individuals are increasingly confronted with subjective perpetuations of truth in their discourse spheres that are informed by beliefs and opinions as opposed to any form of coherence to the reality of those to who this truth claims concern. In principle, a subjective delineation of truth is progressive and liberating – especially considering its potential to provide marginalised groups in the diverse communities of our globalised world with the voice to articulate truths that are representative of themselves and their experiences. However, any form of human flourishing that seems to be promised here collapses as the tenets of subjective truths initially in place to liberate have been distorted through post-truth to allow individuals to purport selective and individualistic truth claims that further oppress and silence certain groups within society without due accountability. The evidence of this is prevalent through the conception of terms such as "alternative facts" and "fake news" that we observe individuals declare when their problematic truth claims are being questioned. Considering the pervasiveness of post-truth and the ethical issues that accompany it, educators and scholars alike have increasingly noted the need to adapt educational practices and pedagogies to account for the diminishing objectivity of truth in the twenty-first century, especially because students, as digital natives, find themselves in the firing line of post-truth; engulfed in digital societies that proliferate post-truth through the surge of truth claims allowed in various media sites. In an attempt to equip students with the vital skills to navigate the post-truth age and oppose its proliferation of social injustices, English educators find themselves having to contend with a complex question: how can the teaching of English equip students with the ability to critically and ethically scrutinise truth claims whilst also mediating the subjectivity of truth in a manner that does not undermine the voices of diverse communities. In order to address this question, this paper will first examine the challenges that confront students as a result of post-truth. Following this, the paper will elucidate the role English education can play in helping students overcome the complex demands of the post-truth age. Scholars have consistently touted the affordances of literary texts in providing students with imagined spaces to explore societal issues through a critical discernment of language and an ethical engagement with its narrative developments. Therefore, this paper will explain and demonstrate how literary texts, when used alongside a critical-ethical post-truth pedagogy that equips students with interpretive strategies informed by literary traditions such as literary and ethical criticism, can be effective in helping students develop the pertinent skills to comprehensively examine truth claims and overcome the challenges of the post-truth age.

Keywords: post-truth, pedagogy, ethics, english, education

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480 The Effectiveness of Prenatal Breastfeeding Education on Breastfeeding Uptake Postpartum: A Systematic Review

Authors: Jennifer Kehinde, Claire O’Donnell, Annmarie Grealish

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Introduction: Breastfeeding has been shown to provide numerous health benefits for both infants and mothers. The decision to breastfeed is influenced by physiological, psychological, and emotional factors. However, the importance of equipping mothers with the necessary knowledge for successful breastfeeding practice cannot be ruled out. The decline in global breastfeeding rate can be linked to a lack of adequate breastfeeding education during the prenatal stage. This systematic review examined the effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum. Method: This review was undertaken and reported in conformity with the Preferred Reporting Items for Systemic Reviews and Meta-Analysis statement (PRISMA) and was registered on the international prospective register for systematic reviews (PROSPERO: CRD42020213853). A PICO analysis (population, intervention, comparison, outcome) was undertaken to inform the choice of keywords in the search strategy to formulate the review question, which was aimed at determining the effectiveness of prenatal breastfeeding educational programs in improving breastfeeding uptake following birth. A systematic search of five databases (Cumulative Index to Nursing and Allied Health Literature, Medline, Psych INFO, and Applied Social Sciences Index and Abstracts) was searched between January 2014 until July 2021 to identify eligible studies. Quality assessment and narrative synthesis were subsequently undertaken. Results: Fourteen studies were included. All 14 studies used different types of breastfeeding programs; eight used a combination of curriculum-based breastfeeding education programs, group prenatal breastfeeding counselling, and one-to-one breastfeeding educational programs, which were all delivered in person; four studies used web-based learning platforms to deliver breastfeeding education prenatally which were both delivered online and face to face over a period of 3 weeks to 2 months with follow-up periods ranging from 3 weeks to 6 months; one study delivered breastfeeding educational intervention using mother-to-mother breastfeeding support groups in promoting exclusive breastfeeding, and one study disseminated breastfeeding education to participants based on the theory of planned behaviour. The most effective interventions were those that included both theory and hands-on demonstrations. Results showed an increase in breastfeeding uptake, breastfeeding knowledge, an increase in a positive attitude to breastfeeding, and an increase in maternal breastfeeding self-efficacy among mothers who participated in breastfeeding educational programs during prenatal care. Conclusion: Prenatal breastfeeding education increases women’s knowledge of breastfeeding. Mothers who are knowledgeable about breastfeeding and hold a positive approach towards breastfeeding have the tendency to initiate breastfeeding and continue for a lengthened period. Findings demonstrate a general correlation between prenatal breastfeeding education and increased breastfeeding uptake postpartum. The high level of positive breastfeeding outcomes inherent in all the studies can be attributed to prenatal breastfeeding education. This review provides rigorous contemporary evidence that healthcare professionals and policymakers can apply when developing effective strategies to improve breastfeeding rates and ultimately improve the health outcomes of mothers and infants.

Keywords: breastfeeding, breastfeeding programs, breastfeeding self-efficacy, prenatal breastfeeding education

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479 Comparative Analysis on the Evolution of Chlorinated Solvents Pollution in Granular Aquifers and Transition Zones to Aquitards

Authors: José M. Carmona, Diana Puigserver, Jofre Herrero

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Chlorinated solvents belong to the group of nonaqueous phase liquids (DNAPL) and have been involved in many contamination episodes. They are carcinogenic and recalcitrant pollutants that may be found in granular aquifers as: i) pools accumulated on low hydraulic conductivity layers; ii) immobile residual phase retained at the pore-scale by capillary forces; iii) dissolved phase in groundwater; iv) sorbed by particulate organic matter; and v) stored into the matrix of low hydraulic conductivity layers where they penetrated by molecular diffusion. The transition zone between granular aquifers and basal aquitards constitute the lowermost part of the aquifer and presents numerous fine-grained interbedded layers that give rise to significant textural contrasts. These layers condition the transport and fate of contaminants and lead to differences from the rest of the aquifer, given that: i) hydraulic conductivity of these layers is lower; ii) DNAPL tends to accumulate on them; iii) groundwater flow is slower in the transition zone and consequently pool dissolution is much slower; iv) sorbed concentrations are higher in the fine-grained layers because of their higher content in organic matter; v) a significant mass of pollutant penetrates into the matrix of these layers; and vi) this contaminant mass back-diffuses after remediation and the aquifer becomes contaminated again. Thus, contamination sources of chlorinated solvents are extremely more recalcitrant in transition zones, which has far-reaching implications for the environment. The aim of this study is to analyze the spatial and temporal differences in the evolution of biogeochemical processes in the transition zone and in the rest of the aquifer. For this, an unconfined aquifer with a transition zone in the lower part was selected at Vilafant (NE Spain). This aquifer was contaminated by perchloroethylene (PCE) in the 80’s. Distribution of PCE and other chloroethenes in groundwater and porewater was analyzed in: a) conventional piezometers along the plume and in two multilevel wells at the source of contamination; and b) porewater of fine grained materials from cores recovered when drilled the two multilevel wells. Currently, the highest concentrations continue to be recorded in the source area in the transition zone. By contrast, the lowest concentrations in this area correspond to the central part of the aquifer, where flow velocities are higher and a greater washing of the residual phase initially retained has occurred. The major findings of the study were: i) PCE metabolites were detected in the transition zone, where conditions were more reducing than in the rest of the aquifer; ii) however, reductive dechlorination was partial since only the formation of cis-dicholoroethylene (DCE) was reached; iii) In the central part of the aquifer, where conditions were predominantly oxidizing, the presence of nitrate significantly hindered the reductive declination of PCE. The remediation strategies to be implemented should be directed to enhance dissolution of the source, especially in the transition zone, where it is more recalcitrant. For example, by combining chemical and bioremediation methods, already tested at the laboratory scale with groundwater and sediments of this site.

Keywords: chlorinated solvents, chloroethenes, DNAPL, partial reductive dechlorination, PCE, transition zone to basal aquitard

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478 Where do Pregnant Women Miss Out on Nutrition? Analysis of Survey Data from 22 Countries

Authors: Alexis D'Agostino, Celeste Sununtunasuk, Jack Fiedler

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Background: Iron-folic acid (IFA) supplementation during antenatal care (ANC) has existed in many countries for decades. Despite this, low national coverage persists and women do not often consume appropriate amounts during pregnancy. USAID’s SPRING Project investigated pregnant women’s access to, and consumption of, IFA tablets through ANC. Cross-country analysis provided a global picture of the state of IFA-supplementation, while country-specific results noted key contextual issues, including geography, wealth, and ANC attendance. The analysis can help countries prioritize strategies for systematic performance improvements within one of the most common micronutrient supplementation programs aimed at reducing maternal anemia. Methodology: Using falter point analysis on Demographic and Health Survey (DHS) data collected from 162,958 women across 22 countries, SPRING identified four sequential falter points (ANC attendance, IFA receipt or purchase, IFA consumption, and number of tablets taken) where pregnant women fell out of the IFA distribution structure. SPRING analyzed data on IFA intake from DHS surveys with women of reproductive age. SPRING disaggregated these data by ANC participation during the most recent pregnancy, residency, and women’s socio-economic status. Results: Average sufficient IFA tablet use across all countries was only eight percent. Even in the best performing countries, only about one-third of pregnant women consumed 180 or more IFA tablets during their most recent pregnancy. ANC attendance was an important falter point for a quarter of women across all countries (with highest falter rates in Democratic Republic of the Congo, Nigeria, and Niger). Further analysis reveals patterns, with some countries having high ANC coverage but low IFA provision during ANC (DRC and Haiti), others having high ANC coverage and IFA provision but few women taking any tablets (Nigeria and Liberia), and countries that perform well in ANC, supplies, and initial consumption but where very few women consume the recommended 180 tablets (Malawi and Cambodia). Country-level analysis identifies further patterns of supplementation. In Indonesia, for example, only 62% of women in the poorest quintile took even one IFA tablet, while 86% of the wealthiest women did. This association between socioeconomic status and IFA intake held across nearly all countries where these data are available and was also visible in rural/urban comparisons. Analysis of ANC attendance data also suggests that higher numbers of ANC visits are associated with higher tablet intake. Conclusions: While it is difficult to disentangle which specific aspects of supply or demand cause the low rates of consumption, this tool allows policy-makers to identify major bottlenecks to scaling-up IFA supplementation during ANC. In turn, each falter point provides possible explanations of program performance and helps strategically identify areas for improved IFA supplementation. For example, improving the delivery of IFA supplementation in Ethiopia relies on increasing access to ANC, but also on identifying and addressing program gaps in IFA supply management and health workers’ practices in order to provide quality ANC services. While every country requires a customized approach to improving IFA supplementation, the multi-country analysis conducted by SPRING is a helpful first step in identifying country bottlenecks and prioritizing interventions.

Keywords: iron and folic acid, supplementation, antenatal care, micronutrient

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