Search results for: national security strategy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9833

Search results for: national security strategy

233 Adaptation to Climate Change: An Anthropological Study on Changing Livelihood Strategies in South-West Coastal Bangladesh

Authors: Ashik Sarder

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Bangladesh is a disaster-prone and one of the most vulnerable countries to climate change. The country has a long coastal area which is frequently being affected by several types of natural disasters due to climate change. The disasters have impacts on the life and livelihood of different natural resources depending on communities living in the coastal areas. The Malo is a Hindu religious traditional fishing community living at Sarafpur Union of Dumuria Upazila of Khulna district of south-west coastal Bangladesh. Fishing is the only means of their livelihood and the community has been engaged in fishing practices inherently in rivers, estuaries, and sea for more than 300 years. and they are totally dependent on this traditional occupation. But, in recent year’s climate change has negative impacts on their only livelihood option. The study aims to examine the impacts of climate change on the livelihood of Malo fishing community in south-west coastal Bangladesh, identify the adaptation strategies undertaken and practiced by Malo fishing community to cope with climate change and sustain their livelihood and explore the changing adaptation strategies undertaken by Malo fishing community and others. The study has been conducted from both qualitative and quantitative perspectives. Data has been collected from both primary and secondary sources. The primary data has been collected in the participatory observation approach following both qualitative and quantitative method. The primary source of data includes village census, face-to-face interview and in-depth case studies using structured questionnaire. The secondary source of the literature includes different national and international documents, policy papers, books and articles; related websites and peer-viewed documents on climate change, vulnerability, adaptation, livelihood, and fisheries. The study has identified different practices of adaption to climate change by Malo fishing community and others in the selected area. Three types of adaption practices have been identified. Firstly, the indigenous adaptation practices by Malo fishing community to cope with climate change have been identified. These identified adaptation practices by Malo fishing community include; ensuring drinking water and sanitation facilities, planting trees to tackle impacts of cyclone, excavating dumps to preserve the valuable assets, growing vegetables and rearing domestic livestock to earn surplus money, taking loans for ensuring continuation of present livelihood and migrating to near city or towns for better livelihood options. Secondly, adaptation initiatives undertaken by the government have provided limited facility to this vulnerable fishing community and made them benefited. And thirdly, some adaptation initiatives commenced by few non-government and community-based organizations have also made the Malo fishing community as beneficiaries. The study has suggested recommendations for Malo fishing community to overcome the challenges and impacts of climate change for retaining their traditional fishing livelihood. The accumulated recommendations would be very useful for the researchers, academicians, policy-makers of Government and non-government organizations to conduct more researches and take initiatives for Malo fishing community to make them more capable to sustain their fishing livelihood.

Keywords: climate change, livelihood, adaptation, anthropology, vulnerability

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232 Bio-Nanotechnology Approach of Nano-Size Iron Particles as Promising Iron Supplements: An Exploratory Study to Combat the Problems of Iron Fortification in Children and Pregnant Women of Rural India

Authors: Roshni Raha, Kavya P., Gayathri M.

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India, with a humongous population, remains the world's poorest developing nation in terms of nutritional status, with iron deficiency anaemia (IDA) affecting the population. Despite efforts over the past decades, India's anaemia prevalence has not been reduced. Researchers are interested in developing therapies that will minimize the typical side effects of oral iron and optimize iron salts-based treatment through delivery methods based on the physiology of hepcidin regulation. However, they need to come up with iron therapies that will prevent making the infection worse. This article explores using bio-nanotechnology as the alternative, promising substitution of providing iron supplements for the treatment of diarrhoea and gut inflammation in kids and pregnant women. This article is an exploratory study using a literature survey and secondary research from review papers. In the realm of biotechnology, nanoparticles have become extremely famous due to unexpected variations in surface characteristics caused by particle size. Particle size distribution and shape exhibit unusual, enhanced characteristics when reduced to nanoscale. The article attempts to develop a model for a nanotechnology based solution in iron fortification to combat the problems of diarrhoea and gut inflammation. Certain dimensions that have been considered in the model include the size, shape, source, and biosynthesis of the iron nanoparticles. Another area of investigation addressed in the article is the cost-effective biocompatible production of these iron nanoparticles. Studies have demonstrated that a substantial reduction of metal ions to form nanoparticles from the bulk metal occurs in plants because of the presence of a wide diversity of biomolecules. Using this concept, the paper investigates the effectiveness and impact of how similar sources can be used for the biological synthesis of iron nanoparticles. Results showed that iron particles, when prepared in nano-metre size, offer potential advantages. When the particle size of the iron compound decreases and attains nano configuration, its surface area increases, which further improves its solubility in the gastric acid, leading to higher absorption, higher bioavailability, and producing the least organoleptic changes in food. It has no negative effects and possesses a safe, effective profile to reduce IDA. Considering all the parameters, it has been concluded that iron particles in nano configuration serve as alternative iron supplements for the complete treatment of IDA. Nanoparticles of ferric phosphate, ferric pyrophosphate, and iron oxide are the choices of iron supplements. From a sourcing perspective, the paper concludes green sources are the primary sources for the biological synthesis of iron nanoparticles. It will also be a cost-effective strategy since our goal is to treat the target population in rural India. Bio-nanotechnology serves as an alternative and promising substitution for iron supplements due to its low cost, excellent bioavailability, and strong organoleptic properties. One area of future research can be to explore the type of size and shape of iron nanoparticles that would be suitable for the different age groups of pregnant women and children and whether it would be influenced based on the topography in certain areas.

Keywords: anemia, bio-nanotechnology, iron-fortification, nanoparticle

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231 Malaria Menace in Pregnancy; Hard to Ignore

Authors: Nautiyal Ruchira, Nautiyal Hemant, Chaudhury Devnanda, Bhargava Surbhi, Chauhan Nidhi

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Introduction: South East Asian region contributes 2.5 million cases of malaria each year to the global burden of 300 to 500 million of which 76% is reported from India. Government of India launched a national program almost half a century ago, still malaria remains a major public health challenge. Pregnant women are more susceptible to severe malaria and its fetomaternal complications. Inadequate surveillance and under-reporting underestimates the problem. Aim: Present study aimed to analyze the clinical course and pattern of malaria during pregnancy and to study the feto-maternal outcome. Methodology: This is a prospective observational study carried out at Himalayan Institute of Medical Sciences – a tertiary care center in the sub-Himalayan state of Uttarakhand, Northern India. All the pregnant women with malaria and its complications were recruited in the study during 2009 to 2014 which included referred cases from the state of western Uttar Pradesh. A thorough history and clinical examination were carried out to assess maternal and fetal condition. Relevant investigations including haemogram, platelet count, LFT, RFT, and USG was done. Blood slides and rapid diagnostic tests were done to diagnose the type of malaria.The primary outcomes measured were the type of malaria infection, maternal complications associated with malaria, outcome of pregnancy and effect on the fetus. Results: 67 antenatal cases with malaria infection were studied. 71% patients were diagnosed with plasmodium vivax infection, 25% cases were plasmodium falciparum positive and in 3% cases mixed infection was found. 38(56%) patients were primigravida and 29(43%) were multiparous. Most of the patients had already received some treatment from their local doctors and presented with severe malaria with the complications. Thrombocytopenia was the commonest manifestation seen in 35(52%) patients, jaundice in 28%, severe anemia in 18%, and severe oligohydramnios in 10% and renal failure in 6% cases. Regarding pregnancy outcome there were 44 % preterm deliveries, 22% had IUFD and abortions in 6% cases.20% of newborn were low birth weight and 6% were IUGR. There was only one maternal death which occurred due to ARDS in falciparum malaria. Although Plasmodium vivax was the main parasite considering the severity of clinical presentation, all the patients received intensive care. As most of the patients had received chloroquine therapy hence they were treated with IV artesunate followed by oral artemesinin combination therapy. Other therapies in the form of packed RBC’s and platelet transfusions, dialysis and ventilator support were provided when required. Conclusion: Even in areas with annual parasite index (API) less than 2 like ours, malaria in pregnancy could be an alarming problem. Vivax malaria cannot be considered benign in pregnancy because of high incidence of morbidity. Prompt diagnosis and aggressive treatment can reduce morbidity and mortality significantly. Increased community level research, integrating ANC checkups with the distribution of insecticide-treated nets in areas of high endemicity, imparting education and awareness will strengthen the existing control strategies.

Keywords: severe malaria, pregnancy, plasmodium vivax, plasmodium falciparum

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230 Digital Health During a Pandemic: Critical Analysis of the COVID-19 Contact Tracing Apps

Authors: Mohanad Elemary, Imose Itua, Rajeswari B. Matam

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Virologists and public health experts have been predicting potential pandemics from coronaviruses for decades. The viruses which caused the SARS and MERS pandemics and the Nipah virus led to many lost lives, but still, the COVID-19 pandemic caused by the SARS-CoV2 virus surprised many scientific communities, experts, and governments with its ease of transmission and its pathogenicity. Governments of various countries reacted by locking down entire populations to their homes to combat the devastation caused by the virus, which led to a loss of livelihood and economic hardship to many individuals and organizations. To revive national economies and support their citizens in resuming their lives, governments focused on the development and use of contact tracing apps as a digital way to track and trace exposure. Google and Apple introduced the Exposure Notification Systems (ENS) framework. Independent organizations and countries also developed different frameworks for contact tracing apps. The efficiency, popularity, and adoption rate of these various apps have been different across countries. In this paper, we present a critical analysis of the different contact tracing apps with respect to their efficiency, adoption rate and general perception, and the governmental strategies and policies, which led to the development of the applications. When it comes to the European countries, each of them followed an individualistic approach to the same problem resulting in different realizations of a similarly functioning application with differing results of use and acceptance. The study conducted an extensive review of existing literature, policies, and reports across multiple disciplines, from which a framework was developed and then validated through interviews with six key stakeholders in the field, including founders and executives in digital health startups and corporates as well as experts from international organizations like The World Health Organization. A framework of best practices and tactics is the result of this research. The framework looks at three main questions regarding the contact tracing apps; how to develop them, how to deploy them, and how to regulate them. The findings are based on the best practices applied by governments across multiple countries, the mistakes they made, and the best practices applied in similar situations in the business world. The findings include multiple strategies when it comes to the development milestone regarding establishing frameworks for cooperation with the private sector and how to design the features and user experience of the app for a transparent, effective, and rapidly adaptable app. For the deployment section, several tactics were discussed regarding communication messages, marketing campaigns, persuasive psychology, and the initial deployment scale strategies. The paper also discusses the data privacy dilemma and how to build for a more sustainable system of health-related data processing and utilization. This is done through principles-based regulations specific for health data to allow for its avail for the public good. This framework offers insights into strategies and tactics that could be implemented as protocols for future public health crises and emergencies whether global or regional.

Keywords: contact tracing apps, COVID-19, digital health applications, exposure notification system

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229 Survey for Mango Seed Weevils and Pulp Weevil Sternochetus Species (Coleoptera:Curculionidae) on Mango, Mangifera indica in Shan State-South, Myanmar

Authors: Khin Nyunt Yee, Mu Mu Thein

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Detection survey of mango seed and Pulp weevils was undertaken at major mango production areas, Yat Sauk, Taunggyi, Nyaung Shwe and Hopong Townships, in Shan State (South) of Myanmar on two mango cultivars of Sein Ta Lone and Yinkwe from May to August 2016 to coincide with fruiting season to conduct a survey of mango seed and pulp weevils population. The total numbers of 6300 fruits of both mango cultivars were sampled. Among them, 2900 fruits from 5674 fruit bearing plants were collected for Sein Ta Lone cultivar of five well managed, one unmanaged orchards and Urban in Yatsauk Twonship, 400 fruits from only one well managed orchard in Taunggyi Township, 400 fruits from two managed orchards in Nyaung Shwe Township and 400 fruits from one managed orchard in Hopong Township from May to June. 2200 fruits were collected from 4043 fruit bearing plants for Yinkwe Cultivar of four well managed orchards, one unmanaged orchards and one wild tree only in Yat Sauk Township from July to August, 2016. Fruit sample size was 200 fruits /orchard, / wild or /volunteer trees as minimum number. The pulps of all randomly sampling fruits were longitudinal cut open into three slices on each side of fruit and seed were cut longitudinally to inspect the presence of mango weevils. The collected weevils were identified up to species level at Plant Quarantine Laboratory, Plant Protection Division, Department of Agriculture, Ministry of Agriculture, Livestock and Irrigation, Yangon, Myanmar. Mango Pulp and Seed weevils were found on Sein Ta Lone Mango Cultivar in three out of four surveyed Townships except Hopong with the level of infestation ranged from 0.0% to 3.5% of fruits per Township with 0.0% to 39.0% of fruits per orchard. The highest infestation rate per township was 3.5% of fruits (n=400 fruits) in Nyaung Shwe, then, at Yat Suak, the rate was 2.47% (n=2900 fruits). A well-managed orchard at Taung Gyi had 0.75% (n=400 fruits) whereas Hopong was free 0.0% (n=400). The weevils were also recorded on Yinkwe Mango Cultivar in Yatsauk Township where the infestation level was 12.63% of fruits (n=2200) with 0.0% to 67.0% of fruits per orchard. This high level of infestation was obtained by including an absolutely non Integrated Pest Management (non IPM) orchards in both survey with the infestation rates 63.0% of fruits (n=200) and 67.0% of fruits (n=200) respectively on Yinkwe cultivar. Two different species; mango pulp weevil, Sternochetus frigitus, and mango seed weevil Sternochetus olivieri (Faust) of family Curculionidae under the order Coleoptera were recorded. Sternochetus mangiferae was not found during these surveys. Three different developmental stages of mango seed and pulp weevils: larva, pupa and adult were first detected since the first survey in 3rd week of May and mostly were recorded as adult stages in the following surveys in June, July and August The number of Mango pulp weevil was statistically higher than that of mango seed weevils at P < 0.001%. More precise surveys should be carried out national wide to detect the mango weevils.

Keywords: mango pulp weevil, Sternochetus frigitus, mango seed weevil Sternochetus olivieri, faust, Sternochetus mangiferae, fabricius, Sein Ta Lone, Yinkwe mango cultivars, Shan State (South) Myanmar

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228 Distributed Listening in Intensive Care: Nurses’ Collective Alarm Responses Unravelled through Auditory Spatiotemporal Trajectories

Authors: Michael Sonne Kristensen, Frank Loesche, James Foster, Elif Ozcan, Judy Edworthy

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Auditory alarms play an integral role in intensive care nurses’ daily work. Most medical devices in the intensive care unit (ICU) are designed to produce alarm sounds in order to make nurses aware of immediate or prospective safety risks. The utilisation of sound as a carrier of crucial patient information is highly dependent on nurses’ presence - both physically and mentally. For ICU nurses, especially the ones who work with stationary alarm devices at the patient bed space, it is a challenge to display ‘appropriate’ alarm responses at all times as they have to navigate with great flexibility in a complex work environment. While being primarily responsible for a small number of allocated patients they are often required to engage with other nurses’ patients, relatives, and colleagues at different locations inside and outside the unit. This work explores the social strategies used by a team of nurses to comprehend and react to the information conveyed by the alarms in the ICU. Two main research questions guide the study: To what extent do alarms from a patient bed space reach the relevant responsible nurse by direct auditory exposure? By which means do responsible nurses get informed about their patients’ alarms when not directly exposed to the alarms? A comprehensive video-ethnographic field study was carried out to capture and evaluate alarm-related events in an ICU. The study involved close collaboration with four nurses who wore eye-level cameras and ear-level binaural audio recorders during several work shifts. At all time the entire unit was monitored by multiple video and audio recorders. From a data set of hundreds of hours of recorded material information about the nurses’ location, social interaction, and alarm exposure at any point in time was coded in a multi-channel replay-interface. The data shows that responsible nurses’ direct exposure and awareness of the alarms of their allocated patients vary significantly depending on work load, social relationships, and the location of the patient’s bed space. Distributed listening is deliberately employed by the nursing team as a social strategy to respond adequately to alarms, but the patterns of information flow prompted by alarm-related events are not uniform. Auditory Spatiotemporal Trajectory (AST) is proposed as a methodological label to designate the integration of temporal, spatial and auditory load information. As a mixed-method metrics it provides tangible evidence of how nurses’ individual alarm-related experiences differ from one another and from stationary points in the ICU. Furthermore, it is used to demonstrate how alarm-related information reaches the individual nurse through principles of social and distributed cognition, and how that information relates to the actual alarm event. Thereby it bridges a long-standing gap in the literature on medical alarm utilisation between, on the one hand, initiatives to measure objective data of the medical sound environment without consideration for any human experience, and, on the other hand, initiatives to study subjective experiences of the medical sound environment without detailed evidence of the objective characteristics of the environment.

Keywords: auditory spatiotemporal trajectory, medical alarms, social cognition, video-ethography

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227 Effects of the In-Situ Upgrading Project in Afghanistan: A Case Study on the Formally and Informally Developed Areas in Kabul

Authors: Maisam Rafiee, Chikashi Deguchi, Akio Odake, Minoru Matsui, Takanori Sata

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Cities in Afghanistan have been rapidly urbanized; however, many parts of these cities have been developed with no detailed land use plan or infrastructure. In other words, they have been informally developed without any government leadership. The new government started the In-situ Upgrading Project in Kabul to upgrade roads, the water supply network system, and the surface water drainage system on the existing street layout in 2002, with the financial support of international agencies. This project is an appropriate emergency improvement for living life, but not an essential improvement of living conditions and infrastructure problems because the life expectancies of the improved facilities are as short as 10–15 years, and residents cannot obtain land tenure in the unplanned areas. The Land Readjustment System (LRS) conducted in Japan has good advantages that rearrange irregularly shaped land lots and develop the infrastructure effectively. This study investigates the effects of the In-situ Upgrading Project on private investment, land prices, and residents’ satisfaction with projects in Kart-e-Char, where properties are registered, and in Afshar-e-Silo Lot 1, where properties are unregistered. These projects are located 5 km and 7 km from the CBD area of Kabul, respectively. This study discusses whether LRS should be applied to the unplanned area based on the questionnaire and interview responses of experts experienced in the In-situ Upgrading Project who have knowledge of LRS. The analysis results reveal that, in Kart-e-Char, a lot of private investment has been made in the construction of medium-rise (five- to nine-story) buildings for commercial and residential purposes. Land values have also incrementally increased since the project, and residents are commonly satisfied with the road pavement, drainage systems, and water supplies, but dissatisfied with the poor delivery of electricity as well as the lack of public facilities (e.g., parks and sport facilities). In Afshar-e-Silo Lot 1, basic infrastructures like paved roads and surface water drainage systems have improved from the project. After the project, a few four- and five-story residential buildings were built with very low-level private investments, but significant increases in land prices were not evident. The residents are satisfied with the contribution ratio, drainage system, and small increase in land price, but there is still no drinking water supply system or tenure security; moreover, there are substandard paved roads and a lack of public facilities, such as parks, sport facilities, mosques, and schools. The results of the questionnaire and interviews with the four engineers highlight the problems that remain to be solved in the unplanned areas if LRS is applied—namely, land use differences, types and conditions of the infrastructure still to be installed by the project, and time spent for positive consensus building among the residents, given the project’s budget limitation.

Keywords: in-situ upgrading, Kabul city, land readjustment, land value, planned area, private investment, residents' satisfaction, unplanned area

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226 Simulation Research of Innovative Ignition System of ASz62IR Radial Aircraft Engine

Authors: Miroslaw Wendeker, Piotr Kacejko, Mariusz Duk, Pawel Karpinski

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The research in the field of aircraft internal combustion engines is currently driven by the needs of decreasing fuel consumption and CO2 emissions, while fulfilling the level of safety. Currently, reciprocating aircraft engines are found in sports, emergency, agricultural and recreation aviation. Technically, they are most at a pre-war knowledge of the theory of operation, design and manufacturing technology, especially if compared to that high level of development of automotive engines. Typically, these engines are driven by carburetors of a quite primitive construction. At present, due to environmental requirements and dealing with a climate change, it is beneficial to develop aircraft piston engines and adopt the achievements of automotive engineering such as computer-controlled low-pressure injection, electronic ignition control and biofuels. The paper describes simulation research of the innovative power and control systems for the aircraft radial engine of high power. Installing an electronic ignition system in the radial aircraft engine is a fundamental innovative idea of this solution. Consequently, the required level of safety and better functionality as compared to the today’s plug system can be guaranteed. In this framework, this research work focuses on describing a methodology for optimizing the electronically controlled ignition system. This attempt can reduce emissions of toxic compounds as a result of lowered fuel consumption, optimized combustion and engine capability of efficient combustion of ecological fuels. New, redundant elements of the control system can improve the safety of aircraft. Consequently, the required level of safety and better functionality as compared to the today’s plug system can be guaranteed. The simulation research aimed to determine the vulnerability of the values measured (they were planned as the quantities measured by the measurement systems) to determining the optimal ignition angle (the angle of maximum torque at a given operating point). The described results covered: a) research in steady states; b) velocity ranging from 1500 to 2200 rpm (every 100 rpm); c) loading ranging from propeller power to maximum power; d) altitude ranging according to the International Standard Atmosphere from 0 to 8000 m (every 1000 m); e) fuel: automotive gasoline ES95. The three models of different types of ignition coil (different energy discharge) were studied. The analysis aimed at the optimization of the design of the innovative ignition system for an aircraft engine. The optimization involved: a) the optimization of the measurement systems; b) the optimization of actuator systems. The studies enabled the research on the vulnerability of the signals to the control of the ignition timing. Accordingly, the number and type of sensors were determined for the ignition system to achieve its optimal performance. The results confirmed the limited benefits, in terms of fuel consumption. Thus, including spark management in the optimization is mandatory to significantly decrease the fuel consumption. This work has been financed by the Polish National Centre for Research and Development, INNOLOT, under Grant Agreement No. INNOLOT/I/1/NCBR/2013.

Keywords: piston engine, radial engine, ignition system, CFD model, engine optimization

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225 Nature as a Human Health Asset: An Extensive Review

Authors: C. Sancho Salvatierra, J. M. Martinez Nieto, R. García Gonzalez-Gordon, M. I. Martinez Bellido

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Introduction: Nature could act as an asset for human health protecting against possible diseases and promoting the state of both physical and mental health. Goals: This paper aims to determine which natural elements present evidence that show positive influence on human health, on which particular aspects and how. It also aims to determine the best biomarkers to measure such influence. Method: A systematic literature review was carried out. First, a general free text search was performed in databases, such as Scopus, PubMed or PsychInfo. Secondly, a specific search was performed combining keywords in order of increasing complexity. Also the Snowballing technique was used and it was consulted in the CSIC’s (The Spanish National Research Council). Databases: Of the 130 articles obtained and reviewed, 80 referred to natural elements that influenced health. These 80 articles were classified and tabulated according to the nature elements found, the health aspects studied, the health measurement parameters used and the measurement techniques used. In this classification the results of the studies were codified according to whether they were positive, negative or neutral both for the elements of nature and for the aspects of health studied. Finally, the results of the 80 selected studies were summarized and categorized according to the elements of nature that showed the greatest positive influence on health and the biomarkers that had shown greater reliability to measure said influence. Results: Of the 80 articles studied, 24 (30.0%) were reviews and 56 (70.0%) were original research articles. Among the 24 reviews, 18 (75%) found positive results of natural elements on health, and 6 (25%) both positive and negative effects. Of the 56 original articles, 47 (83.9%) showed positive results, 3 (5.4%) both positive and negative, 4 (7.1%) negative effects, and 2 (3.6%) found no effects. The results reflect positive effects of different elements of nature on the following pathologies: diabetes, high blood pressure, stress, attention deficit hyperactivity disorder, psychotic, anxiety and affective disorders. They also show positive effects on the following areas: immune system, social interaction, recovery after illness, mood, decreased aggressiveness, concentrated attention, cognitive performance, restful sleep, vitality and sense of well-being. Among the elements of nature studied, those that show the greatest positive influence on health are forest immersion, natural views, daylight, outdoor physical activity, active transport, vegetation biodiversity, natural sounds and the green residences. As for the biomarkers used that show greater reliability to measure the effects of natural elements are the levels of cortisol (both in blood and saliva), vitamin D levels, serotonin and melatonin, blood pressure, heart rate, muscle tension and skin conductance. Conclusions: Nature is an asset for health, well-being and quality of life. Awareness programs, education and health promotion are needed based on the elements that nature brings us, which in turn generate proactive attitudes in the population towards the protection and conservation of nature. The studies related to this subject in Spain are very scarce. Aknowledgements. This study has been promoted and partially financed by the Environmental Foundation Jaime González-Gordon.

Keywords: health, green areas, nature, well-being

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224 Improving the Quality of Discussion and Documentation of Advance Care Directives in a Community-Based Resident Primary Care Clinic

Authors: Jason Ceavers, Travis Thompson, Juan Torres, Ramanakumar Anam, Alan Wong, Andrei Carvalho, Shane Quo, Shawn Alonso, Moises Cintron, Ricardo C. Carrero, German Lopez, Vamsi Garimella, German Giese

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Introduction: Advance directives (AD) are essential for patients to communicate their wishes when they are not able to. Ideally, these discussions should not occur for the first time when a patient is hospitalized with an acute life-threatening illness. There is a large number of patients who do not have clearly documented ADs, resulting in the misutilization of resources and additional patient harm. This is a nationwide issue, and the Joint Commission has it as one of its national quality metrics. Presented here is a proposed protocol to increase the number of documented AD discussions in a community-based, internal medicine residency primary care clinic in South Florida. Methods: The SMART Aim for this quality improvement project is to increase documentation of AD discussions in the outpatient setting by 25% within three months in medicare patients. A survey was sent to stakeholders (clinic attendings, residents, medical assistants, front desk staff, and clinic managers), asking them for three factors they believed contributed most to the low documentation rate of AD discussions. The two most important factors were time constraints and systems issues (such as lack of a standard method to document ADs and ADs not being uploaded to the chart) which were brought up by 25% and 21.2% of the 32 survey responders, respectively. Pre-intervention data from clinic patients in 2020-2021 revealed 17.05% of patients had clear, actionable ADs documented. To address these issues, an AD pocket card was created to give to patients. One side of the card has a brief explanation of what ADs are. The other side has a column of interventions (cardiopulmonary resuscitation, mechanical ventilation, dialysis, tracheostomy, feeding tube) with boxes patients check off if they want the intervention done, do not want the intervention, do not want to discuss the topic, or need more information. These cards are to be filled out and scanned into their electronic chart to be reviewed by the resident before their appointment. The interventions that patients want more information on will be discussed by the provider. If any changes are made, the card will be re-scanned into their chart. After three months, we will chart review the patients seen in the clinic to determine how many medicare patients have a pocket card uploaded and how many have advance directives discussions documented in a progress note or annual wellness note. If there is not enough time for an AD discussion, a follow-up appointment can be scheduled for that discussion. Discussion: ADs are a crucial part of patient care, and failure to understand a patient’s wishes leads to improper utilization of resources, avoidable litigation, and patient harm. Time constraints and systems issues were identified as two major factors contributing to the lack of advance directive discussion in our community-based resident primary care clinic. Our project aims at increasing the documentation rate for ADs through a simple pocket card intervention. These are self-explanatory, easy to read and allow the patients to clearly express what interventions they desire or what they want to discuss further with their physician.

Keywords: advance directives, community-based, pocket card, primary care clinic

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223 Health Inequalities in the Global South: Identification of Poor People with Disabilities in Cambodia to Generate Access to Healthcare

Authors: Jamie Lee Harder

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In the context of rapidly changing social and economic circumstances in the developing world, this paper analyses access to public healthcare for poor people with disabilities in Cambodia. Like other countries of South East Asia, Cambodia is developing at rapid pace. The historical past of Cambodia, however, has set former social policy structures to zero. This past forces Cambodia and its citizens to implement new public health policies to align with the needs of social care, healthcare, and urban planning. In this context, the role of people with disabilities (PwDs) is crucial as new developments should and can take into consideration their specific needs from the beginning onwards. This paper is based on qualitative research with expert interviews and focus group discussions in Cambodia. During the field work it became clear that the identification tool for the poorest households (HHs) does not count disability as a financial risk to fall into poverty neither when becoming sick nor because of higher health expenditures and/or lower income because of the disability. The social risk group of poor PwDs faces several barriers in accessing public healthcare. The urbanization, the socio-economic health status, and opportunities for education; all influence social status and have an impact on the health situation of these individuals. Cambodia has various difficulties with providing access to people with disabilities, mostly due to barriers regarding finances, geography, quality of care, poor knowledge about their rights and negative social and cultural beliefs. Shortened budgets and the lack of prioritizations lead to the need for reorientation of local communities, international and national non-governmental organizations and social policy. The poorest HHs are identified with a questionnaire, the IDPoor program, for which the Ministry of Planning is responsible. The identified HHs receive an ‘Equity Card’ which provides access free of charge to public healthcare centers and hospitals among other benefits. The dataset usually does not include information about the disability status. Four focus group discussions (FGD) with 28 participants showed various barriers in accessing public healthcare. These barriers go far beyond a missing ramp to access the healthcare center. The contents of the FGDs were ratified and repeated during the expert interviews with the local Ministries, NGOs, international organizations and private persons working in the field. The participants of the FGDs faced and continue to face high discrimination, low capacity to work and earn an own income, dependency on others and less social competence in their lives. When discussing their health situation, we identified, a huge difference between those who are identified and hold an Equity Card and those who do not. Participants reported high costs without IDPoor identification, positive experiences when going to the health center in terms of attitude and treatment, low satisfaction with specific capacities for treatments, negative rumors, and discrimination with the consequence of fear to seek treatment in many cases. The problem of accessing public healthcare by risk groups can be adapted to situations in other countries.

Keywords: access, disability, health, inequality, Cambodia

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222 Population Growth as the Elephant in the Room: Teachers' Perspectives and Willingness to Incorporate a Controversial Environmental Sustainability Issue in their Teaching

Authors: Iris Alkaher, Nurit Carmi

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It is widely agreed among scientists that population growth (PG) is a major factor that drives the global environmental crisis. Many researchers recognize that explicitly addressing the impact of PG on the environment and human quality of life through education systems worldwide could play a significant role in improving understanding regarding the links between rapid PG and environmental degradation and changing perceptions, attitudes, and behaviors concerning the necessity to reduce the fertility rate. However, the issue of PG is still rarely included in schools' curricula, mainly because of its complexity and controversiality. This study aims to explore the perspectives of teachers with an academic background in environmental and sustainability education (ESEteachers) and teachers with no such background (non-ESE teachers) regarding PG as an environmental risk. The study also explores the teachers’ willingness to include PG in their teaching and identifies what predicts their inclusion of it. In this mixed-methods research study, data were collected using questionnaires and interviews. The findings portray a complex picture concerning the debate aboutPG as a major factor that drives the global environmental crisis in the Israeli context. Consistent with other countries, we found that the deep-rooted pronatalist culture in the Israeli society, as well as a robust national pronatalist agenda and policies, have a tremendous impact on the education system. Therefore, we found that an academic background in ESE had a limited impact on teachers' perceptions concerning PG as a problem and on their willingness to include it in their teaching and discuss its controversiality. Teachers' attitudes related to PG demonstrated social, cultural, and politically oriented disavowal justification regarding the negative impacts of rapid PG, identified in the literature as population-skepticism and population-fatalism. Specifically, factors such as the ongoing Israeli-Palestinian conflict, the Jewish anxiety of destruction, and the religious command to“be fruitful and multiply”influenced the perceptions of both ESE and non-ESE teachers. While these arguments are unique to the Israeli context, pronatalist policies are international. In accordance with the pronatalist policy, we also found that the absence of PG from both school curricula and the Israeli public discourse was reported by ESE and non-ESE teachers as major reasons for their disregarding PG in their teaching. Under these circumstances, the role of the education system to bring the population question to the front stage in Israel and elsewhere is more challenging. To encourage science and social studies teachers to incorporate the controversial issue of PG in their teaching and successfully confront dominant pronatalist cultures, they need strong and ongoing scaffolding and support. In accordance with scientists' agreement regarding the role of PG as a major factor that drives the global environmental crisis, we call on stakeholders and policymakers in the education system to bring the population debate into schools' curricula, the sooner, the better. And not only as part of human efforts to mitigate environmental degradation but also to use this controversial topic as a platform for shaping critical learners and responsible and active citizens who are tolerant of different people’s opinions.

Keywords: population growth, environmental and sustainability education, controversial environmental sustainability issues, pronatalism

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221 The Late Bronze Age Archeometallurgy of Copper in Mountainous Colchis (Lechkhumi), Georgia

Authors: Nino Sulava, Brian Gilmour, Nana Rezesidze, Tamar Beridze, Rusudan Chagelishvili

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Studies of ancient metallurgy are a subject of worldwide current interest. Georgia with its famous early metalworking traditions is one of the central parts of in the Caucasus region. The aim of the present study is to introduce the results of archaeometallurgical investigations being undertaken in the mountain region of Colchis, Lechkhumi (the Tsageri Municipality of western Georgia) and establish their place in the existing archaeological context. Lechkhumi (one of the historic provinces of Georgia known from Georgian, Greek, Byzantine and Armenian written sources as Lechkhumi/Skvimnia/Takveri) is the part of the Colchian mountain area. It is one of the important but little known centres of prehistoric metallurgy in the Caucasian region and of Colchian Bronze Age culture. Reconnaissance archaeological expeditions (2011-2015) revealed significant prehistoric metallurgical sites in Lechkhumi. Sites located in the vicinity of Dogurashi Village (Tsageri Municipality) have become the target area for archaeological excavations. During archaeological excavations conducted in 2016-2018 two archaeometallurgical sites – Dogurashi I and Dogurashi II were investigated. As a result of an interdisciplinary (archaeological, geological and geophysical) survey, it has been established that at both prehistoric Dogurashi mountain sites, it was copper that was being smelted and the ore sources are likely to be of local origin. Radiocarbon dating results confirm they were operating between about the 13th and 9th century BC. More recently another similar site has been identified in this area (Dogurashi III), and this is about to undergo detailed investigation. Other prehistoric metallurgical sites are being located and investigated in the Lechkhumi region as well as chance archaeological finds (often in hoards) – copper ingots, metallurgical production debris, slag, fragments of crucibles, tuyeres (air delivery pipes), furnace wall fragments and other related waste debris. Other chance finds being investigated are the many copper, bronze and (some) iron artefacts that have been found over many years. These include copper ingots, copper, bronze and iron artefacts such as tools, jewelry, and decorative items. These show the important but little known or understood the role of Lechkhumi in the late Bronze Age culture of Colchis. It would seem that mining and metallurgical manufacture form part of the local agricultural yearly lifecycle. Colchian ceramics have been found and also evidence for artefact production, small stone mould fragments and encrusted material from the casting of a fylfot (swastika) form of Colchian bronze buckle found in the vicinities of the early settlements of Tskheta and Dekhviri. Excavation and investigation of previously unknown archaeometallurgical sites in Lechkhumi will contribute significantly to the knowledge and understanding of prehistoric Colchian metallurgy in western Georgia (Adjara, Guria, Samegrelo, and Svaneti) and will reveal the importance of this region in the study of ancient metallurgy in Georgia and the Caucasus. Acknowledgment: This work has been supported by the Shota Rustaveli National Science Foundation (grant FR # 217128).

Keywords: archaeometallurgy, Colchis, copper, Lechkhumi

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220 A Vision-Based Early Warning System to Prevent Elephant-Train Collisions

Authors: Shanaka Gunasekara, Maleen Jayasuriya, Nalin Harischandra, Lilantha Samaranayake, Gamini Dissanayake

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One serious facet of the worsening Human-Elephant conflict (HEC) in nations such as Sri Lanka involves elephant-train collisions. Endangered Asian elephants are maimed or killed during such accidents, which also often result in orphaned or disabled elephants, contributing to the phenomenon of lone elephants. These lone elephants are found to be more likely to attack villages and showcase aggressive behaviour, which further exacerbates the overall HEC. Furthermore, Railway Services incur significant financial losses and disruptions to services annually due to such accidents. Most elephant-train collisions occur due to a lack of adequate reaction time. This is due to the significant stopping distance requirements of trains, as the full braking force needs to be avoided to minimise the risk of derailment. Thus, poor driver visibility at sharp turns, nighttime operation, and poor weather conditions are often contributing factors to this problem. Initial investigations also indicate that most collisions occur in localised “hotspots” where elephant pathways/corridors intersect with railway tracks that border grazing land and watering holes. Taking these factors into consideration, this work proposes the leveraging of recent developments in Convolutional Neural Network (CNN) technology to detect elephants using an RGB/infrared capable camera around known hotspots along the railway track. The CNN was trained using a curated dataset of elephants collected on field visits to elephant sanctuaries and wildlife parks in Sri Lanka. With this vision-based detection system at its core, a prototype unit of an early warning system was designed and tested. This weatherised and waterproofed unit consists of a Reolink security camera which provides a wide field of view and range, an Nvidia Jetson Xavier computing unit, a rechargeable battery, and a solar panel for self-sufficient functioning. The prototype unit was designed to be a low-cost, low-power and small footprint device that can be mounted on infrastructures such as poles or trees. If an elephant is detected, an early warning message is communicated to the train driver using the GSM network. A mobile app for this purpose was also designed to ensure that the warning is clearly communicated. A centralized control station manages and communicates all information through the train station network to ensure coordination among important stakeholders. Initial results indicate that detection accuracy is sufficient under varying lighting situations, provided comprehensive training datasets that represent a wide range of challenging conditions are available. The overall hardware prototype was shown to be robust and reliable. We envision a network of such units may help contribute to reducing the problem of elephant-train collisions and has the potential to act as an important surveillance mechanism in dealing with the broader issue of human-elephant conflicts.

Keywords: computer vision, deep learning, human-elephant conflict, wildlife early warning technology

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219 Automated End of Sprint Detection for Force-Velocity-Power Analysis with GPS/GNSS Systems

Authors: Patrick Cormier, Cesar Meylan, Matt Jensen, Dana Agar-Newman, Chloe Werle, Ming-Chang Tsai, Marc Klimstra

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Sprint-derived horizontal force-velocity-power (FVP) profiles can be developed with adequate validity and reliability with satellite (GPS/GNSS) systems. However, FVP metrics are sensitive to small nuances in data processing procedures such that minor differences in defining the onset and end of the sprint could result in different FVP metric outcomes. Furthermore, in team-sports, there is a requirement for rapid analysis and feedback of results from multiple athletes, therefore developing standardized and automated methods to improve the speed, efficiency and reliability of this process are warranted. Thus, the purpose of this study was to compare different methods of sprint end detection on the development of FVP profiles from 10Hz GPS/GNSS data through goodness-of-fit and intertrial reliability statistics. Seventeen national team female soccer players participated in the FVP protocol which consisted of 2x40m maximal sprints performed towards the end of a soccer specific warm-up in a training session (1020 hPa, wind = 0, temperature = 30°C) on an open grass field. Each player wore a 10Hz Catapult system unit (Vector S7, Catapult Innovations) inserted in a vest in a pouch between the scapulae. All data were analyzed following common procedures. Variables computed and assessed were the model parameters, estimated maximal sprint speed (MSS) and the acceleration constant τ, in addition to horizontal relative force (F₀), velocity at zero (V₀), and relative mechanical power (Pmax). The onset of the sprints was standardized with an acceleration threshold of 0.1 m/s². The sprint end detection methods were: 1. Time when peak velocity (MSS) was achieved (zero acceleration), 2. Time after peak velocity drops by -0.4 m/s, 3. Time after peak velocity drops by -0.6 m/s, and 4. When the integrated distance from the GPS/GNSS signal achieves 40-m. Goodness-of-fit of each sprint end detection method was determined using the residual sum of squares (RSS) to demonstrate the error of the FVP modeling with the sprint data from the GPS/GNSS system. Inter-trial reliability (from 2 trials) was assessed utilizing intraclass correlation coefficients (ICC). For goodness-of-fit results, the end detection technique that used the time when peak velocity was achieved (zero acceleration) had the lowest RSS values, followed by -0.4 and -0.6 velocity decay, and 40-m end had the highest RSS values. For intertrial reliability, the end of sprint detection techniques that were defined as the time at (method 1) or shortly after (method 2 and 3) when MSS was achieved had very large to near perfect ICC and the time at the 40 m integrated distance (method 4) had large to very large ICCs. Peak velocity was reached at 29.52 ± 4.02-m. Therefore, sport scientists should implement end of sprint detection either when peak velocity is determined or shortly after to improve goodness of fit to achieve reliable between trial FVP profile metrics. Although, more robust processing and modeling procedures should be developed in future research to improve sprint model fitting. This protocol was seamlessly integrated into the usual training which shows promise for sprint monitoring in the field with this technology.

Keywords: automated, biomechanics, team-sports, sprint

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218 The Sense of Recognition of Muslim Women in Western Academia

Authors: Naima Mohammadi

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The present paper critically reports on the emergency of Iranian international students in a large public university in Italy. Although the most sizeable diaspora of Iranians dates back to the 1979 revolution, a huge wave of Iranian female students travelled abroad after the Iranian Green Movement (2009) due to the intensification of gender discrimination and Islamization. To explore the experience of Iranian female students at an Italian public university, two complementary methods were adopted: a focus group and individual interviews. Focus groups yield detailed collective conversations and provide researchers with an opportunity to observe the interaction between participants, rather than between participant and researcher, which generates data. Semi-structured interviews allow participants to share their stories in their own words and speak about personal experiences and opinions. Research participants were invited to participate through a public call in a Telegram group of Iranian students. Theoretical and purposive sampling was applied to select participants. All participants were assured that full anonymity would be ensured and they consented to take part in the research. A two-hour focus group was held in English with participants in the presence and some online. They were asked to share their motivations for studying in Italy and talk about their experiences both within and outside the university context. Each of these interviews lasted from 45 to 60 minutes and was mostly carried out online and in Farsi. The focus group consisted of 8 Iranian female post-graduate students. In analyzing the data a blended approach was adopted, with a combination of deductive and inductive coding. According to research findings, although 9/11 was the beginning of the West’s challenges against Muslims, the nuclear threats of Islamic regimes promoted the toughest international sanctions against Iranians as a nation across the world. Accordingly, carrying an Iranian identity contributes to social, political, and economic exclusion. Research findings show that geopolitical factors such as international sanctions and Islamophobia, and a lack of reciprocity in terms of recognition, have created a sense of stigmatization for veiled and unveiled Iranian female students who are the largest groups of ‘non-European Muslim international students’ enrolled in Italian universities. Participants addressed how their nationality has devalued their public image and negatively impacted their self-confidence and self-realization in academia. They highlighted the experience of an unwelcoming atmosphere by different groups of people and institutes, such as receiving marked students’ badges, rejected bank account requests, failed visa processes, secondary security screening selection, and hyper-visibility of veiled students. This study corroborates the need for institutions to pay attention to geopolitical factors and religious diversity in student recruitment and provide support mechanisms and access to basic rights. Accordingly, it is suggested that Higher Education Institutions (HEIs) have a social and moral responsibility towards the discrimination and both social and academic exclusion of Iranian students.

Keywords: Iranian diaspora, female students, recognition theory, inclusive university

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217 Factors Associated with Risky Sexual Behaviour in Adolescent Girls and Young Women in Cambodia: A Systematic Review

Authors: Farwa Rizvi, Joanne Williams, Humaira Maheen, Elizabeth Hoban

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There is an increase in risky sexual behavior and unsafe sex in adolescent girls and young women aged 15 to 24 years in Cambodia, which negatively affects their reproductive health by increasing the risk of contracting sexually transmitted infections and unintended pregnancies. Risky sexual behavior includes ‘having sex at an early age, having multiple sexual partners, having sex while under the influence of alcohol or drugs, and unprotected sexual behaviors’. A systematic review of quantitative research conducted in Cambodia was undertaken, using the theoretical framework of the Social Ecological Model to identify the personal, social and cultural factors associated with risky sexual behavior and unsafe sex in young Cambodian women. PRISMA guidelines were used to search databases including Medline Complete, PsycINFO, CINAHL Complete, Academic Search Complete, Global Health, and Social Work Abstracts. Additional searches were conducted in Science Direct, Google Scholar and in the grey literature sources. A risk-of-bias tool developed explicitly for the systematic review of cross-sectional studies was used. Summary item on the overall risk of study bias after the inter-rater response showed that the risk-of-bias was high in two studies, moderate in one study and low in one study. The search strategy included a combination of subject terms and free text terms. The medical subject headings (MeSH) terms included were; contracept* or ‘birth control’ or ‘family planning’ or pregnan* or ‘safe sex’ or ‘protected intercourse’ or ‘unprotected intercourse’ or ‘protected sex’ or ‘unprotected sex’ or ‘risky sexual behaviour*’ or ‘abort*’ or ‘planned parenthood’ or ‘unplanned pregnancy’ AND ( barrier* or obstacle* or challenge* or knowledge or attitude* or factor* or determinant* or choic* or uptake or discontinu* or acceptance or satisfaction or ‘needs assessment’ or ‘non-use’ or ‘unmet need’ or ‘decision making’ ) AND Cambodia*. Initially, 300 studies were identified by using key words and finally, four quantitative studies were selected based on the inclusion criteria. The four studies were published between 2010 and 2016. The study participants ranged in age from 10-24 years, single or married, with 3 to 10 completed years of education. The mean age at sexual debut was reported to be 18 years. Using the perspective of the Social Ecological Model, risky sexual behavior was associated with individual-level factors including young age at sexual debut, low education, unsafe sex under the influence of alcohol and substance abuse, multiple sexual partners or transactional sex. Family level factors included living away from parents, orphan status and low levels of family support. Peer and partner level factors included peer delinquency and lack of condom use. Low socioeconomic status at the society level was also associated with risky sexual behaviour. There is scant research on sexual and reproductive health of adolescent girls and young women in Cambodia. Individual, family and social factors were significantly associated with risky sexual behaviour. More research is required to inform potential preventive strategies and policies that address young women’s sexual and reproductive health.

Keywords: adolescents, high-risk sex, sexual activity, unplanned pregnancies

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216 Understanding Jordanian Women's Values and Beliefs Related to Prevention and Early Detection of Breast Cancer

Authors: Khlood F. Salman, Richard Zoucha, Hani Nawafleh

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Introduction: Jordan ranks the fourth highest breast cancer prevalence after Lebanon, Bahrain, and Kuwait. Considerable evidence showed that cultural, ethnic, and economic differences influence a woman’s practice to early detection and prevention of breast cancer. Objectives: To understand women’s health beliefs and values in relation to early detection of breast cancer; and to explore the impact of these beliefs on their decisions regarding reluctance or acceptance of early detection measures such as mammogram screening. Design: A qualitative focused ethnography was used to collect data for this study. Settings: The study was conducted in the second largest city surrounded by a large rural area in Ma’an- Jordan. Participants: A total of twenty seven women, with no history of breast cancer, between the ages of 18 and older, who had prior health experience with health providers, and were willing to share elements of personal health beliefs related to breast health within the larger cultural context. The participants were recruited using the snowball method and words of mouth. Data collection and analysis: A short questionnaire was designed to collect data related to socio demographic status (SDQ) from all participants. A Semi-structured interviews guide was used to elicit data through interviews with the informants. Nvivo10 a data manager was utilized to assist with data analysis. Leininger’s four phases of qualitative data analysis was used as a guide for the data analysis. The phases used to analyze the data included: 1) Collecting and documenting raw data, 2) Identifying of descriptors and categories according to the domains of inquiry and research questions. Emic and etic data is coded for similarities and differences, 3) Identifying patterns and contextual analysis, discover saturation of ideas and recurrent patterns, and 4) Identifying themes and theoretical formulations and recommendations. Findings: Three major themes were emerged within the cultural and religious context; 1. Fear, denial, embarrassment and lack of knowledge were common perceptions of Ma’anis’ women regarding breast health and screening mammography, 2. Health care professionals in Jordan were not quick to offer information and education about breast cancer and screening, and 3. Willingness to learn about breast health and cancer prevention. Conclusion: The study indicated the disparities between the infrastructure and resourcing in rural and urban areas of Jordan, knowledge deficit related to breast cancer, and lack of education about breast health may impact women’s decision to go for a mammogram screening. Cultural beliefs, fear, embarrassments as well as providers lack of focus on breast health were significant contributors against practicing breast health. Health providers and policy makers should provide resources for the establishment health education programs regarding breast cancer early detection and mammography screening. Nurses should play a major role in delivering health education about breast health in general and breast cancer in particular. A culturally appropriate health awareness messages can be used in creating educational programs which can be employed at the national levels.

Keywords: breast health, beliefs, cultural context, ethnography, mammogram screening

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215 Practice Based Approach to the Development of Family Medicine Residents’ Educational Environment

Authors: Lazzat M. Zhamaliyeva, Nurgul A. Abenova, Gauhar S. Dilmagambetova, Ziyash Zh. Tanbetova, Moldir B. Ahmetzhanova, Tatyana P. Ostretcova, Aliya A. Yegemberdiyeva

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Introduction: There are many reasons for the weak training of family doctors in Kazakhstan: the unified national educational program is not focused on competencies, the role of a general practitioner (GP) is not clear, poor funding for the health care and education system, outdated teaching and assessment methods, inefficient management. We highlight two issues in particular. Firstly, academic teachers of family medicine (FM) in Kazakhstan do not practice as family doctors; most of them are narrow specialists (pediatricians, therapists, surgeons, etc.); they usually hold one-time consultations; clinical mentors from practical healthcare (non-academic teachers) do not have the teaching competences, and the vast majority of them are also narrow specialists. Secondly, clinical sites (polyclinics) are unprepared for general practice and do not follow the principles of family medicine; residents do not like to be in primary health care (PHC) settings due to the chaos that is happening there, as well as due to the lack of the necessary equipment for mastering and consolidating practical skills. Aim: We present the concept of the family physicians’ training office (FPTO), which is being created as a friendly learning environment for young general practitioners and for the involvement of academic teachers of family medicine in the practical work and innovative development of PHC. Methodology: In developing the conceptual framework and identifying practical activities, we drew on literature and expert input, and interviews. Results: The goal of the FPTO is to create a favorable educational and clinical environment for the development of the FM residents’ competencies, in which the residents with academic teachers and clinical mentors could understand and accept the principles of family medicine, improve clinical knowledge and skills, and gain experience in improving the quality of their practice in scientific basis. Three main areas of office activity are providing primary care to the patients, improving educational services for FM residents and other medical workers, and promoting research in PHC and innovations. The office arranges for residents to see outpatients at least 50% of the time, and teachers of FM departments at least 1/4 of their working time conduct general medical appointments next to residents. Taking into account the educational and scientific workload, the number of attached population for one GP does not exceed 500 persons. The equipment of the office allows FPTO workers to perform invasive and other manipulations without being sent to other clinics. In the office, training for residents is focused on their needs and aimed at achieving the required level of competence. International methodologies and assessment tools are adapted to local conditions and evaluated for their effectiveness and acceptability. Residents and their faculty actively conduct research in the field of family medicine. Conclusions: We propose to change the learning environment in order to create teams of like-minded people, to unite residents and teachers even more for the development of family medicine. The offices will also invest resources in developing and maintaining young doctors' interest in family medicine.

Keywords: educational environment, family medicine residents, family physicians’ training office, primary care research

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214 Urban Slum Communities Engage in the Fight Against TB in Karnataka, South India

Authors: N. Rambabu, H. Gururaj, Reynold Washington, Oommen George

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Motivation: Under the USAID Strengthening Health Outcomes through Private Sector (SHOPS-TB) initiative, Karnataka Health Promotion Trust (KHPT) with technical support of Abt associates is implementing a TB prevention and care model in Karnataka State, South India. KHPT is the interface agency between the public and private sectors, and providers and the target community facilitating early TB case detection and enhancing treatment compliance through private health care providers (pHCP) engagement in RNTCP. The project coverage is 0.84 million urban poor from 663 slums in 12 districts of Karnataka. Problem Statement: India with the highest burden of global TB (26%) and two million cases annually, accounts for approximately one fifth of the global incidence. WHO estimates 300,000 people die from TB annually in India. India expanded the coverage of Directly Observed Treatment, Short-course chemotherapy (DOTS) to the entire country as early as 2006. However, the performance of RNTCP has not been uniform across states. While the national annual new smear-positive (NSP) case notification rate is 53, it is much lower at 47 in Karnataka. A third of TB patients in India reside in urban slums. Approach: Under SHOPS, KHPT actively engages with communities through key opinion leaders and community structures. Interpersonal communication, by Outreach workers through house-to-house visits and at aggregation points, is the primary method used for communication about TB and its management and to increase demand for sputum examination and DOTS. pHCP are mapped, trained and mentored by KHPT. ORWs also provide patient and family counseling on TB treatment, side effects and adherence, screen close contacts of index patients especially children under 6 years of age and screen co-morbidities including HIV, diabetes and malnutrition and risk factors including alcoholism, tobacco use, occupational hazards making appropriate accompanied or documented referrals. A treatment ‘buddy’ system for the patients involving close friends or family members, ICT-based support, DOTS Prerana (inspiration) groups of TB patients, family members and community, DOTS Mitra (friend) helpline services are also used for care and support services. Results: The intervention educated 39988 slum dwellers, referred 1731 chest symptomatics, tested 1061 patients and initiated 248 patients on anti-TB treatment within three months of intervention through continuous community engagement. Conclusions: The intervention’s potential to increase access to preferred health care providers, reduce patient and health system delays in diagnosis and initiation of treatment, improve health seeking behaviour and enhance compliance of pHCPs to standard treatment protocols is being monitored. Initial results are promising.

Keywords: DOTS, KHPT, health outcomes, public and private sector

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213 University Climate and Psychological Adjustment: African American Women’s Experiences at Predominantly White Institutions in the United States

Authors: Faheemah N. Mustafaa, Tamarie Macon, Tabbye Chavous

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A major concern of university leaders worldwide is how to create environments where students from diverse racial/ethnic, national, and cultural backgrounds can thrive. Over the past decade or so in the United States, African American women have done exceedingly well in terms of college enrollment, academic performance, and completion. However, the relative academic successes of African American women in higher education has in some ways overshadowed social challenges many Black women continue to encounter on college campuses in the United States. Within predominantly White institutions (PWIs) in particular, there is consistent evidence that many Black students experience racially hostile climates. However, research studies on racial climates within PWIs have mostly focused on cross-sectional comparisons of minority and majority group experiences, and few studies have examined campus racial climate in relation to short- and longer-term well-being. One longitudinal study reported that African American women’s psychological well-being was positively related to their comfort in cross-racial interactions (a concept closely related to campus climate). Thus, our primary research question was: Do African American women’s perceptions of campus climate (tension and positive association) during their freshman year predict their reports of psychological distress and well-being (self-acceptance) during their sophomore year? Participants were part of a longitudinal survey examining African American college students’ academic identity development, particularly in Science, Technology, Engineering, and Mathematics (STEM) fields. The final subsample included 134 self-identified African American/Black women enrolled in PWIs. Accounting for background characteristics (mother’s education, family income, interracial contact, and prior levels of outcomes), we employed hierarchical regression to examine relationships between campus racial climate during freshman year and psychological adjustment one year later. Both regression models significantly predicted African American women’s psychological outcomes (for distress, F(7,91)= 4.34, p < .001; and for self-acceptance, F(7,90)= 4.92, p < .001). Although none of the controls were significant predictors, perceptions of racial tension on campus were associated with both distress and self-acceptance. More perceptions of tension were related to African American women’s greater psychological distress the following year (B= 0.22, p= .01). Additionally, racial tension predicted later self-acceptance in the expected direction: Higher first-year reports of racial tension were related to less positive attitudes toward the self during the sophomore year (B= -0.16, p= .04). However, perceptions that it was normative for Black and White students to socialize on campus (or positive association scores) were unrelated to psychological distress or self-acceptance. Findings highlight the relevance of examining multiple facets of campus racial climate in relation to psychological adjustment, with possible emphasis on the import of racial tension on African American women’s psychological adjustment. Results suggest that negative dimensions of campus racial climate may have lingering effects on psychological well-being, over and above more positive aspects of climate. Thus, programs targeted toward improving student relations on campus should consider addressing cross-racial tensions.

Keywords: higher education, psychological adjustment, university climate, university students

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212 Risk Factors Associated to Low Back Pain among Active Adults: Cross-Sectional Study among Workers in Tunisian Public Hospital

Authors: Lamia Bouzgarrou, Irtyah Merchaoui, Amira Omrane, Salma Kammoun, Amine Daafa, Neila Chaari

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Backgrounds: Currently, low back pain (LBP) is one of the most prevalent public health problems, which caused severe morbidity among a large portion of the adult population. It is also associated with heavy direct and indirect costs, in particular, related to absenteeism and early retirement. Health care workers are one of most occupational groups concerned by LBP, especially because of biomechanical and psycho-organizational risk factors. Our current study aims to investigate risk factors associated with chronic low back pain among Tunisian caregivers in university-hospitals. Methods: Cross-sectional study conducted over a period of 14 months, with a representative sample of caregivers, matched according to age, sex and work department, in two university-hospitals in Tunisia. Data collection included items related to socio-professional characteristics, the evaluation of the working capacity index (WAI), the occupational stress (Karazek job strain questionnaire); the quality of life (SF12), the musculoskeletal disorders Nordic questionnaire, and the examination of the spine flexibility (distance finger-ground, sit-stand maneuver and equilibrium test). Results: Totally, 293 caregivers were included with a mean age equal to 42.64 ± 11.65 years. A body mass index (BMI) exceeding 30, was noted in 20.82% of cases. Moreover, no regular physical activity was practiced in 51.9% of cases. In contrast, domestic activity equal or exceeding 20 hours per week, was reported by 38.22%. Job strain was noted in 19.79 % of cases and the work capacity was 'low' to 'average' among 27.64% of subjects. During the 12 months previous to the investigation, 65% of caregivers complained of LBP, with pain rated as 'severe' or 'extremely severe' in 54.4% of cases and with a frequency of discomfort exceeding one episode per week in 58.52% of cases. During physical examination, the mean distance finger-ground was 7.10 ± 7.5cm. Caregivers assigned to 'high workload' services had the highest prevalence of LBP (77.4%) compared to other categories of hospital services, with no statistically significant relationship (P = 0.125). LBP prevalence was statistically correlated with female gender (p = 0.01) and impaired work capacity (p < 10⁻³). Moreover, the increase of the distance finger-ground was statistically associated with LBP (p = 0.05), advanced age (p < 10⁻³), professional seniority (p < 10⁻³) and the BMI ≥ 25 (p = 0.001). Furthermore, others physical tests of spine flexibility were underperformed among LBP suffering workers with a statistically significant difference (sit-stand maneuver (p = 0.03); equilibrium test (p = 0.01)). According to the multivariate analysis, only the domestic activity exceeding 20H/week, the degraded quality of physical life, and the presence of neck pain were significantly corelated to LBP. The final model explains 36.7% of the variability of this complaint. Conclusion: Our results highlighted the elevate prevalence of LBP among caregivers in Tunisian public hospital and identified both professional and individual predisposing factors. The preliminary analysis supports the necessity of a multidimensional approach to prevent this critical occupational and public health problem. The preventive strategy should be based both on the improvement of working conditions, and also on lifestyle modifications, and reinforcement of healthy behaviors in these active populations.

Keywords: health care workers, low back pain, prevention, risk factor

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211 Varieties of Capitalism and Small Business CSR: A Comparative Overview

Authors: Stéphanie Looser, Walter Wehrmeyer

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Given the limited research on Small and Mediumsized Enterprises’ (SMEs) contribution to Corporate Social Responsibility (CSR) and even scarcer research on Swiss SMEs, this paper helps to fill these gaps by enabling the identification of supranational SME parameters and to make a contribution to the evolving field of these topics. Thus, the paper investigates the current state of SME practices in Switzerland and across 15 other countries. Combining the degree to which SMEs demonstrate an explicit (or business case) approach or see CSR as an implicit moral activity with the assessment of their attributes for “variety of capitalism” defines the framework of this comparative analysis. According to previous studies, liberal market economies, e.g. in the United States (US) or United Kingdom (UK), are aligned with extrinsic CSR, while coordinated market systems (in Central European or Asian countries) evolve implicit CSR agendas. To outline Swiss small business CSR patterns in particular, 40 SME owner-managers were interviewed. The transcribed interviews were coded utilising MAXQDA for qualitative content analysis. A secondary data analysis of results from different countries (i.e., Australia, Austria, Chile, Cameroon, Catalonia (notably a part of Spain that seeks autonomy), China, Finland, Germany, Hong Kong (a special administrative region of China), Italy, Netherlands, Singapore, Spain, Taiwan, UK, US) lays groundwork for this comparative study on small business CSR. Applying the same coding categories (in MAXQDA) for the interview analysis as well as for the secondary data research while following grounded theory rules to refine and keep track of ideas generated testable hypotheses and comparative power on implicit (and the lower likelihood of explicit) CSR in SMEs retrospectively. The paper identifies Swiss small business CSR as deep, profound, “soul”, and an implicit part of the day-to-day business. Similar to most Central European, Mediterranean, Nordic, and Asian countries, explicit CSR is still very rare in Swiss SMEs. Astonishingly, also UK and US SMEs follow this pattern in spite of their strong and distinct liberal market economies. Though other findings show that nationality matters this research concludes that SME culture and its informal CSR agenda are strongly formative and superseding even forces of market economies, nationally cultural patterns, and language. In a world of “big business”, explicit “business case” CSR, and the mantra that “CSR must pay”, this study points to a distinctly implicit small business CSR model built on trust, physical closeness, and virtues that is largely detached from the bottom line. This pattern holds for different cultural contexts and it is concluded that SME culture is stronger than nationality leading to a supra-national, monolithic SME CSR approach. Hence, classifications of countries by their market system or capitalism, as found in the comparative capitalism literature, do not match the CSR practices in SMEs as they do not mirror the peculiarities of their business. This raises questions on the universality and generalisability of management concepts.

Keywords: CSR, comparative study, cultures of capitalism, small, medium-sized enterprises

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210 Study of the Association between Salivary Microbiological Data, Oral Health Indicators, Behavioral Factors, and Social Determinants among Post-COVID Patients Aged 7 to 12 Years in Tbilisi City

Authors: Lia Mania, Ketevan Nanobashvili

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Background: The coronavirus disease COVID-19 has become the cause of a global health crisis during the current pandemic. This study aims to fill the paucity of epidemiological studies on the impact of COVID-19 on the oral health of pediatric populations. Methods: It was conducted an observational, cross-sectional study in Georgia, in Tbilisi (capital of Georgia), among 7 to 12-year-old PCR or rapid test-confirmed post-Covid populations in all districts of Tbilisi (10 districts in total). 332 beneficiaries who were infected with Covid within one year were included in the study. The population was selected in schools of Tbilisi according to the principle of cluster selection. A simple random selection took place in the selected clusters. According to this principle, an equal number of beneficiaries were selected in all districts of Tbilisi. By July 1, 2022, according to National Center for Disease Control and Public Health data (NCDC.Ge), the number of test-confirmed cases in the population aged 0-18 in Tbilisi was 115137 children (17.7% of all confirmed cases). The number of patients to be examined was determined by the sample size. Oral screening, microbiological examination of saliva, and administration of oral health questionnaires to guardians were performed. Statistical processing of data was done with SPSS-23. Risk factors were estimated by odds ratio and logistic regression with 95% confidence interval. Results: Statistically reliable differences between the averages of oral health indicators in asymptomatic and symptomatic covid-infected groups are: for caries intensity (DMF+def) t=4.468 and p=0.000, for modified gingival index (MGI) t=3.048, p=0.002, for simplified oral hygiene index (S-OHI) t=4.853; p=0.000. Symptomatic covid-infection has a reliable effect on the oral microbiome (Staphylococcus aureus, Candida albicans, Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus epidermalis); (n=332; 77.3% vs n=332; 58.0%; OR=2.46, 95%CI: 1.318-4.617). According to the logistic regression, it was found that the severity of the covid infection has a significant effect on the frequency of pathogenic and conditionally pathogenic bacteria in the oral cavity B=0.903 AOR=2.467 (CL 1.318-4.617). Symptomatic covid-infection affects oral health indicators, regardless of the presence of other risk factors, such as parental employment status, tooth brushing behaviors, carbohydrate meal, fruit consumption. (p<0.05). Conclusion: Risk factors (parental employment status, tooth brushing behaviors, carbohydrate consumption) were associated with poorer oral health status in a post-Covid population of 7- to 12-year-old children. However, such a risk factor as symptomatic ongoing covid-infection affected the oral microbiome in terms of the abundant growth of pathogenic and conditionally pathogenic bacteria (Staphylococcus aureus, Candida albicans, Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus epidermalis) and further worsened oral health indicators. Thus, a close association was established between symptomatic covid-infection and microbiome changes in the post-covid period; also - between the variables of oral health indicators and the symptomatic course of covid-infection.

Keywords: oral microbiome, COVID-19, population based research, oral health indicators

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209 Empowering and Educating Young People Against Cybercrime by Playing: The Rayuela Method

Authors: Jose L. Diego, Antonio Berlanga, Gregorio López, Diana López

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The Rayuela method is a success story, as it is part of a project selected by the European Commission to face the challenge launched by itself for achieving a better understanding of human factors, as well as social and organisational aspects that are able to solve issues in fighting against crime. Rayuela's method specifically focuses on the drivers of cyber criminality, including approaches to prevent, investigate, and mitigate cybercriminal behavior. As the internet has become an integral part of young people’s lives, they are the key target of the Rayuela method because they (as a victim or as a perpetrator) are the most vulnerable link of the chain. Considering the increased time spent online and the control of their internet usage and the low level of awareness of cyber threats and their potential impact, it is understandable the proliferation of incidents due to human mistakes. 51% of Europeans feel not well informed about cyber threats, and 86% believe that the risk of becoming a victim of cybercrime is rapidly increasing. On the other hand, Law enforcement has noted that more and more young people are increasingly committing cybercrimes. This is an international problem that has considerable cost implications; it is estimated that crimes in cyberspace will cost the global economy $445B annually. Understanding all these phenomena drives to the necessity of a shift in focus from sanctions to deterrence and prevention. As a research project, Rayuela aims to bring together law enforcement agencies (LEAs), sociologists, psychologists, anthropologists, legal experts, computer scientists, and engineers, to develop novel methodologies that allow better understanding the factors affecting online behavior related to new ways of cyber criminality, as well as promoting the potential of these young talents for cybersecurity and technologies. Rayuela’s main goal is to better understand the drivers and human factors affecting certain relevant ways of cyber criminality, as well as empower and educate young people in the benefits, risks, and threats intrinsically linked to the use of the Internet by playing, thus preventing and mitigating cybercriminal behavior. In order to reach that goal it´s necessary an interdisciplinary consortium (formed by 17 international partners) carries out researches and actions like Profiling and case studies of cybercriminals and victims, risk assessments, studies on Internet of Things and its vulnerabilities, development of a serious gaming environment, training activities, data analysis and interpretation using Artificial intelligence, testing and piloting, etc. For facilitating the real implementation of the Rayuela method, as a community policing strategy, is crucial to count on a Police Force with a solid background in trust-building and community policing in order to do the piloting, specifically with young people. In this sense, Valencia Local Police is a pioneer Police Force working with young people in conflict solving, through providing police mediation and peer mediation services and advice. As an example, it is an official mediation institution, so agreements signed by their police mediators have once signed by the parties, the value of a judicial decision.

Keywords: fight against crime and insecurity, avert and prepare young people against aggression, ICT, serious gaming and artificial intelligence against cybercrime, conflict solving and mediation with young people

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208 Professional Working Conditions, Mental Health And Mobility In The Hungarian Social Sector Preliminary Findings From A Multi-method Study

Authors: Ágnes Győri, Éva Perpék, Zsófia Bauer, Zsuzsanna Elek

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The aim of the research (funded by Hungarian national grant, NFKI- FK 138315) is to examine the professional mobility, mental health and work environment of social workers with a complex approach. Previous international and Hungarian research has pointed out that those working in the helping professions are strongly exposed to the risk of emotional-mental-physical exhaustion due to stress. Mental and physical strain, as well as lack of coping (can) cause health problems, but its role in career change and high labor turnover has also been proven. Even though satisfaction with working conditions of those employed in the human service sector in the context of the stress burden has been researched extensively, there is a lack of large-sample international and Hungarian domestic studies exploring the effects of profession-specific conditions. Nor has it been examined how the specific features of the social profession and mental health affect the career mobility of the professionals concerned. In our research, these factors and their correlations are analyzed by means of mixed methodology, utilizing the benefits of netnographic big data analysis and a sector-specific quantitative survey. The netnographic analysis of open web content generated inside and outside the social profession offers a holistic overview of the influencing factors related to mental health and the work environment of social workers. On the one hand, the topics and topoi emerging in the external discourse concerning the sector are examined, and on the other hand, focus on mentions and streams of comments regarding the profession, burnout, stress, coping, as well as labor turnover and career changes among social professionals. The analysis focuses on new trends and changes in discourse that have emerged during and after the pandemic. In addition to the online conversation analysis, a survey of social professionals with a specific focus has been conducted. The questionnaire is based on input from the first two research phases. The applied approach underlines that the mobility paths of social professionals can only be understood if, apart from the general working conditions, the specific features of social work and the effects of certain aspects of mental health (emotional-mental-physical strain, resilience) are taken into account as well. In this paper, the preliminary results from this innovative methodological mix are presented, with the aim of highlighting new opportunities and dimensions in the research on social work. A gap in existing research is aimed to be filled both on a methodological and empirical level, and the Hungarian domestic findings can create a feasible and relevant framework for a further international investigation and cross-cultural comparative analysis. Said results can contribute to the foundation of organizational and policy-level interventions, targeted programs whereby the risk of burnout and the rate of career abandonment can be reduced. Exploring different aspects of resilience and mapping personality strengths can be a starting point for stress-management, motivation-building, and personality-development training for social professionals.

Keywords: burnout, mixed methods, netnography, professional mobility, social work

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207 Combustion Variability and Uniqueness in Cylinders of a Radial Aircraft Piston Engine

Authors: Michal Geca, Grzegorz Baranski, Ksenia Siadkowska

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The work is a part of the project which aims at developing innovative power and control systems for the high power aircraft piston engine ASz62IR. Developed electronically controlled ignition system will reduce emissions of toxic compounds as a result of lowered fuel consumption, optimized combustion and engine capability of efficient combustion of ecological fuels. The tested unit is an air-cooled four-stroke gasoline engine of 9 cylinders in a radial setup, mechanically charged by a radial compressor powered by the engine crankshaft. The total engine cubic capac-ity is 29.87 dm3, and the compression ratio is 6.4:1. The maximum take-off power is 1000 HP at 2200 rpm. The maximum fuel consumption is 280 kg/h. Engine powers aircrafts: An-2, M-18 „Dromader”, DHC-3 „OTTER”, DC-3 „Dakota”, GAF-125 „HAWK” i Y5. The main problems of the engine includes the imbalanced work of cylinders. The non-uniformity value in each cylinder results in non-uniformity of their work. In radial engine cylinders arrangement causes that the mixture movement that takes place in accordance (lower cylinder) or the opposite (upper cylinders) to the direction of gravity. Preliminary tests confirmed the presence of uneven workflow of individual cylinders. The phenomenon is most intense at low speed. The non-uniformity is visible on the waveform of cylinder pressure. Therefore two studies were conducted to determine the impact of this phenomenon on the engine performance: simulation and real tests. Simplified simulation was conducted on the element of the intake system coated with fuel film. The study shows that there is an effect of gravity on the movement of the fuel film inside the radial engine intake channels. Both in the lower and the upper inlet channels the film flows downwards. It follows from the fact that gravity assists the movement of the film in the lower cylinder channels and prevents the movement in the upper cylinder channels. Real tests on aircraft engine ASz62IR was conducted in transients condition (rapid change of the excess air in each cylinder were performed. Calculations were conducted for mass of fuel reaching the cylinders theoretically and really and on this basis, the factors of fuel evaporation “x” were determined. Therefore a simplified model of the fuel supply to cylinder was adopted. Model includes time constant of the fuel film τ, the number of engine transport cycles of non-evaporating fuel along the intake pipe γ and time between next cycles Δt. The calculation results of identification of the model parameters are presented in the form of radar graphs. The figures shows the averages declines and increases of the injection time and the average values for both types of stroke. These studies shown, that the change of the position of the cylinder will cause changes in the formation of fuel-air mixture and thus changes in the combustion process. Based on the results of the work of simulation and experiments was possible to develop individual algorithms for ignition control. This work has been financed by the Polish National Centre for Research and Development, INNOLOT, under Grant Agreement No. INNOLOT/I/1/NCBR/2013.

Keywords: radial engine, ignition system, non-uniformity, combustion process

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206 Narratives of Cultural Encounters Revisited: Moroccan Entertainers beyond Borders (1840-1920)

Authors: Lhoussain Simour

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This paper discusses the reordering and reorientation Moroccan Oossified and frozen histories in national and colonial archives. It attempts to reexamine Moroccan non-canonical voices beyond borders, their forgotten experiences and itineraries, with the aim of uncovering cultural discourses pertaining to early cultural and artistic interactions between Morocco and the western countries, namely Britain and America. In fact, less attention has been given to the presence of Moroccan entertainers beyond borders in the archives of history. Moroccan historians and cultural critics seem to have paid little critical consideration to Moroccan artistic encounters with the west, Europe and America as a case in point. They have overlooked to deal with travel performances, professional entertainments, and artistic spectacles, initiated by acrobats, as instances of visual cross-cultural encounters between Morocco and the west. The narratives of these professional artists have hardly found their ways into historiographical writing. This contribution attempts to locate the contesting beginnings of Moroccan professional entertainers in western show business in the nineteenth century which witnessed intricate artistic, discursive and cultural junctures by emphasizing connections between theatrical performances, ethnic exhibition and world fair expositions. Moroccan professional performances grew in Europe and America within a zealous context marked by the rise of a paradigmatic racial consciousness that sought to authenticate and legitimate ethnic discourses of power and exclusion. The ethnic taxonomies and racial hierarchies governed by ethnographic and anthropological documentation fueled up entertainment venues and popular theatrical performances and helped in developing a distinctive view about Self and Other paradigms. Moroccan travelers started their journeys to visit European and American countries to exhibit their acrobatics acts. They, in a certain sense, continued, albeit in varying degrees and circumstances, the whole tradition of travel initiated previously by their ancestor diplomats and ambassadors. Professional entertainers embarked on daring journeys across the Mediterranean and the Atlantic to discover new geographies and cultural spaces, and perform their spectacles beyond borders. These travelers left rich archival documents that reflect important cultural and historical moments. The routes of travel started from the margins of the empire towards metropolitan centers of nineteenth century Europe and America included Moroccan women travelers as acrobats and dancing professional artists as well. These also crossed the straits of Gibraltar and journeyed through the Atlantic Ocean to visit western countries. Moroccan women travelers took part in various Euro-American theatre performances and in circus shows as early as 1850 according to newspapers archives and passengers shipping lists. Najat Amburg, Zahar Ben Tahar, Torquia, Fadma, and many more whose names are now lost to us, moved freely in various western capital cities to entertain nineteenth century western audiences.

Keywords: archives, cultural encounters, self and other, Morocco, travel, Moroccan acrobats, Moorish dancing women

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205 Atmospheric Circulation Patterns Inducing Coastal Upwelling in the Baltic Sea

Authors: Ewa Bednorz, Marek Polrolniczak, Bartosz Czernecki, Arkadiusz Marek Tomczyk

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This study is meant as a contribution to the research of the upwelling phenomenon, which is one of the most pronounced examples of the sea-atmosphere coupling. The aim is to confirm the atmospheric forcing of the sea waters circulation and sea surface temperature along the variously oriented Baltic Sea coasts and to find out macroscale and regional circulation patterns triggering upwelling along different sections of this relatively small and semi-closed sea basin. The mean daily sea surface temperature data from the summer seasons (June–August) of the years 1982–2017 made the basis for the detection of upwelling cases. For the atmospheric part of the analysis, monthly indices of the Northern Hemisphere macroscale circulation patterns were used. Besides, in order to identify the local direction of airflow, the daily zonal and meridional regional circulation indices were constructed and introduced to the analysis. Finally, daily regional circulation patterns over the Baltic Sea region were distinguished by applying the principal component analysis to the gridded mean daily sea level pressure data. Within the Baltic Sea, upwelling is the most frequent along the zonally oriented northern coast of the Gulf of Finland, southern coasts of Sweden, and along the middle part of the western Gulf of Bothnia coast. Among the macroscale circulation patterns, the Scandinavian type (SCAND), with a primary circulation center located over Scandinavia, has the strongest impact on the horizontal flow of surface sea waters in the Baltic Sea, which triggers upwelling. An anticyclone center over Scandinavia in the positive phase of SCAND enhances the eastern airflow, which increases upwelling frequency along southeastern Baltic coasts. It was proved in the study that the zonal circulation has a stronger impact on upwelling occurrence than the meridional one, and it could increase/decrease a chance of upwelling formation by more than 70% in some coastal sections. Positive and negative phases of six distinguished regional daily circulation patterns made 12 different synoptic situations which were analyzed in the terms of their influence on the upwelling formation. Each of them revealed some impact on the frequency of upwelling in some coastal section of the Baltic Sea; however, two kinds of synoptic situations seemed to have the strongest influence, namely, the first kind representing pressure patterns enhancing the zonal flow and the second kind representing synoptic patterns with a cyclone/anticyclone centers over southern Scandinavia. Upwelling occurrence appeared to be particularly strongly reliant on the atmospheric conditions in some specific coastal sections, namely: the Gulf of Finland, the south eastern Baltic coasts (Polish and Latvian-Lithuanian section), and the western part of the Gulf of Bothnia. Concluding, it can be stated that atmospheric conditions strongly control the occurrence of upwelling within the Baltic Sea basin. Both local and macroscale circulation patterns expressed by the location of the pressure centers influence the frequency of this phenomenon; however, the impact strength varies, depending on the coastal region. Acknowledgment: This research was funded by the National Science Centre, Poland, grant number 2016/21/B/ST10/01440.

Keywords: Baltic Sea, circulation patterns, coastal upwelling, synoptic conditions

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204 Red Dawn in the Desert: A World-Systems Analysis of the Maritime Silk Road Initiative

Authors: Toufic Sarieddine

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The current debate on the hegemonic impact of China’s Belt and Road Initiative (BRI) is of two opposing strands: Resilient and absolute US hegemony on the one hand and various models of multipolar hegemony such as bifurcation on the other. Bifurcation theories illustrate an unprecedented division of hegemonic functions between China and the US, whereby Beijing becomes the world’s economic hegemon, leaving Washington the world’s military hegemon and security guarantor. While consensus points to China being the main driver of unipolarity’s rupturing, the debate among bifurcationists is on the location of the first rupture. In this regard, the Middle East and North Africa (MENA) region has seen increasing Chinese foreign direct investment in recent years while that to other regions has declined, ranking it second in 2018 as part of the financing for the Maritime Silk Road Initiative (MSRI). China has also become the top trade partner of 11 states in the MENA region, as well as its top source of machine imports, surpassing the US and achieving an overall trade surplus almost double that of Washington’s. These are among other features outlined in world-systems analysis (WSA) literature which correspond with the emergence of a new hegemon. WSA is further utilized to gauge other facets of China’s increasing involvement in MENA and assess whether bifurcation is unfolding therein. These features of hegemony include the adoption of China’s modi operandi, economic dominance in production, trade, and finance, military capacity, cultural hegemony in ideology, education, and language, and the promotion of a general interest around which to rally potential peripheries (MENA states in this case). China’s modi operandi has seen some adoption with regards to support against the United Nations Convention on the Law of the Sea, oil bonds denominated in the yuan, and financial institutions such as the Shanghai Gold Exchange enjoying increasing Arab patronage. However, recent elections in Qatar, as well as liberal reforms in Saudi Arabia, demonstrate Washington’s stronger normative influence. Meanwhile, Washington’s economic dominance is challenged by China’s sizable machine exports, increasing overall imports, and widening trade surplus, but retains some clout via dominant arms and transport exports, as well as free-trade deals across the region. Militarily, Washington bests Beijing’s arms exports, has a dominant and well-established presence in the region, and successfully blocked Beijing’s attempt to penetrate through the UAE. Culturally, Beijing enjoys higher favorability in Arab public opinion, and its broadcast networks have found some resonance with Arab audiences. In education, the West remains MENA students’ preferred destination. Further, while Mandarin has become increasingly available in schools across MENA, its usage and availability still lag far behind English. Finally, Beijing’s general interest in infrastructure provision and prioritizing economic development over social justice and democracy provides an avenue for increased incorporation between Beijing and the MENA region. The overall analysis shows solid progress towards bifurcation in MENA.

Keywords: belt and road initiative, hegemony, Middle East and North Africa, world-systems analysis

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