Search results for: disability discrimination
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1265

Search results for: disability discrimination

155 Migration, Labour Market, Capital Formation, and Social Security: A Study of Livelihoods of the Urban Poor in Two Different Cities of West Bengal in India

Authors: Arup Pramanik

Abstract:

Most of the cities in the developing countries like Siliguri Municipal Corporation Area (SMCA) and Raiganj Municipality (RM) in West Bengal, India are changing typically in terms of demographic, economic and social relationship due to rapid pace of urbanization. The mushrooming growth of slums in SMCA and RM is the direct consequence of urbanization and migration due to regional imbalance, unbalanced growth process which is posing a serious threat to sustainable development of the country. Almost all the slums happen to be a breeding ground for poverty, negligence, and disease. Unpredictable growth of slums and poverty alleviation has now become a serious challenge to the global and national policy makers for the development of the slum dwellers. The ethical dimension of the poor in the cities like SMCA and RM stands on equal opportunities, inclusive and harmonious living without discrimination of any kind. But, the migrant slum dwellers in SMCA and RM do not possess high skill or education to enable them to find well paid employment in the formal sector and the surplus urban labour force is compelled to generate its own means of employment and survival in the informal sector. The survey data of the households has been analysedin terms of percentage, descriptive statistics which includes mean, Standard Deviation (SD), ANOVA (Mean Difference) etc., to analyse the socio economic variables of the households. The study shows that the migrant labour forces living in the slums are derived from the social security measures in both the municipal areas of SMCA and RM. The urban poor in the cities of SMCA and RM rely heavily on social capital amongst all the capital assets to help them ‘get by’ and ‘get ahead’. Despite, the slum dwellers in the study areas are vulnerable with respect to other determinants of capital assets. It is noteworthy that Indian plans of anti-poverty programmes was in a proper place even after the neo-liberal regime, where the basic idea behind the massive shift of various welfare and service oriented strategy to poverty reduction strategy for the benefit of the urban poor with the trickle down effects. But, the overall impact of the trickledown effect was unsatisfactory. The objective of the Paper is to assess the magnitude of migration and absorption in the urban labour market. Issues relating to capital formation, social security measures and the support of the Welfare State in order to meet 'Sustainable Development Goals'. This study also highlights the quality of life of urban poor migrants in terms of capital formation and livelihoods.

Keywords: migration, slums, labour market, capital formation, social security

Procedia PDF Downloads 93
154 Self-Inflicted Major Trauma: Inpatient Mental Health Management and Patient Outcomes

Authors: M. Walmsley, S. Elmatarri, S. Mannion

Abstract:

Introduction: Self-inflicted injury is a recognised cause of major trauma in adults and is an independent indicator of a reduced functional outcome compared to non-intentional major trauma. There is little literature available on the inpatient mental health (MH) management of this vulnerable group. A retrospective review was conducted of inpatient MH management of major trauma patients admitted to a UK regional Major Trauma Centre (MTC). Their outcomes were compared to all major trauma patients. This group of patients required multiple MH interventions whilst on the Major Trauma Ward (MTW) and a had worse functional outcome compared to non-intentional trauma. Method: The national TARN (Trauma Audit and Research Network) database was used to identify patients admitted to a regional MTC over a 2-year period from June 2018 to July 2020. Patients with an ISS (Injury Severity Score) of greater than 15 with a mechanism of either self-harm or high-risk behavior were included for further analysis. Inpatient medical notes were reviewed for MH interventions on the MTW. Further outcomes, including mortality, length of stay (LOS) and Glasgow Outcome Score (GOS) were compared with all major trauma patients for the same time period. Results: A total of 60 patients were identified in the time period and of those, 27 spent time on the MTW. A total of 23 (85%) had a prior MH diagnosis, with 11 (41%) under the care of secondary MH services. Adequate inpatient records for review were available for 24 patients. During their inpatient stay, 8 (33%) were reviewed on the ward by the inpatient MH team. There were 10 interventions required for 6 (25%) patients on the MTW including, sections under the Mental Health Act, transfer to specialist MH facility, pharmacological sedation and security being called to the MTW. When compared to all major trauma patients, those admitted due to self-harm or high-risk behavior had a statistically significantly higher ISS (31.43 vs 24.22, p=0.0001) and LOS (23.51d vs 16.06d, p=0.002). Functional outcomes using the GOS were reduced in this group of patients, GOS 5 (low disability) (51.66% vs. 61.01%) and they additionally had a higher level of mortality, GOS 1 (15.00% vs 11.67%). Discussion: Intentional self-harm is a recognised cause of major trauma in adults and this patient group sustains more severe injuries, requiring a longer hospital stay with worse outcomes compared to all major trauma patients. Inpatient MH interventions are required for a significant proportion of these patients and therefore, there needs to be a close relationship with MH services. There is limited available evidence for how this patient group is best managed as an inpatient to aid their recovery and further work is needed on how outcomes in this vulnerable group can be improved.

Keywords: adult major trauma, attempted suicide, self-inflicted major trauma, inpatient management

Procedia PDF Downloads 154
153 Harrison’s Stolen: Addressing Aboriginal and Indigenous Islanders Human Rights

Authors: M. Shukry

Abstract:

According to the United Nations Declaration of Human Rights in 1948, every human being is entitled to rights in life that should be respected by others and protected by the state and community. Such rights are inherent regardless of colour, ethnicity, gender, religion or otherwise, and it is expected that all humans alike have the right to live without discrimination of any sort. However, that has not been the case with Aborigines in Australia. Over a long period of time, the governments of the State and the Territories and the Australian Commonwealth denied the Aboriginal and Indigenous inhabitants of the Torres Strait Islands such rights. Past Australian governments set policies and laws that enabled them to forcefully remove Indigenous children from their parents, which resulted in creating lost generations living the trauma of the loss of cultural identity, alienation and even their own selfhood. Intending to reduce that population of natives and their Aboriginal culture while, on the other hand, assimilate them into mainstream society, they gave themselves the right to remove them from their families with no hope of return. That practice has led to tragic consequences due to the trauma that has affected those children, an experience that is depicted by Jane Harrison in her play Stolen. The drama is the outcome of a six-year project on lost children and which was first performed in 1997 in Melbourne. Five actors only appear on the stage, playing the role of all the different characters, whether the main protagonists or the remaining cast, present or non-present ones as voices. The play outlines the life of five children who have been taken from their parents at an early age, entailing a disastrous negative impact that differs from one to the other. Unknown to each other, what connects between them is being put in a children’s home. The purpose of this paper is to analyse the play’s text in light of the 1948 Declaration of Human Rights, using it as a lens that reflects the atrocities practiced against the Aborigines. It highlights how such practices formed an outrageous violation of those natives’ rights as human beings. Harrison’s dramatic technique in conveying the children’s experiences is through a non-linear structure, fluctuating between past and present that are linked together within each of the five characters, reflecting their suffering and pain to create an emotional link between them and the audience. Her dramatic handling of the issue by fusing tragedy with humour as well as symbolism is a successful technique in revealing the traumatic memory of those children and their present life. The play has made a difference in commencing to address the problem of the right of all children to be with their families, which renders the real meaning of having a home and an identity as people.

Keywords: aboriginal, audience, Australia, children, culture, drama, home, human rights, identity, Indigenous, Jane Harrison, memory, scenic effects, setting, stage, stage directions, Stolen, trauma

Procedia PDF Downloads 275
152 Item-Trait Pattern Recognition of Replenished Items in Multidimensional Computerized Adaptive Testing

Authors: Jianan Sun, Ziwen Ye

Abstract:

Multidimensional computerized adaptive testing (MCAT) is a popular research topic in psychometrics. It is important for practitioners to clearly know the item-trait patterns of administered items when a test like MCAT is operated. Item-trait pattern recognition refers to detecting which latent traits in a psychological test are measured by each of the specified items. If the item-trait patterns of the replenished items in MCAT item pool are well detected, the interpretability of the items can be improved, which can further promote the abilities of the examinees who attending the MCAT to be accurately estimated. This research explores to solve the item-trait pattern recognition problem of the replenished items in MCAT item pool from the perspective of statistical variable selection. The popular multidimensional item response theory model, multidimensional two-parameter logistic model, is assumed to fit the response data of MCAT. The proposed method uses the least absolute shrinkage and selection operator (LASSO) to detect item-trait patterns of replenished items based on the essential information of item responses and ability estimates of examinees collected from a designed MCAT procedure. Several advantages of the proposed method are outlined. First, the proposed method does not strictly depend on the relative order between the replenished items and the selected operational items, so it allows the replenished items to be mixed into the operational items in reasonable order such as considering content constraints or other test requirements. Second, the LASSO used in this research improves the interpretability of the multidimensional replenished items in MCAT. Third, the proposed method can exert the advantage of shrinkage method idea for variable selection, so it can help to check item quality and key dimension features of replenished items and saves more costs of time and labors in response data collection than traditional factor analysis method. Moreover, the proposed method makes sure the dimensions of replenished items are recognized to be consistent with the dimensions of operational items in MCAT item pool. Simulation studies are conducted to investigate the performance of the proposed method under different conditions for varying dimensionality of item pool, latent trait correlation, item discrimination, test lengths and item selection criteria in MCAT. Results show that the proposed method can accurately detect the item-trait patterns of the replenished items in the two-dimensional and the three-dimensional item pool. Selecting enough operational items from the item pool consisting of high discriminating items by Bayesian A-optimality in MCAT can improve the recognition accuracy of item-trait patterns of replenished items for the proposed method. The pattern recognition accuracy for the conditions with correlated traits is better than those with independent traits especially for the item pool consisting of comparatively low discriminating items. To sum up, the proposed data-driven method based on the LASSO can accurately and efficiently detect the item-trait patterns of replenished items in MCAT.

Keywords: item-trait pattern recognition, least absolute shrinkage and selection operator, multidimensional computerized adaptive testing, variable selection

Procedia PDF Downloads 99
151 X-Ray Detector Technology Optimization In CT Imaging

Authors: Aziz Ikhlef

Abstract:

Most of multi-slices CT scanners are built with detectors composed of scintillator - photodiodes arrays. The photodiodes arrays are mainly based on front-illuminated technology for detectors under 64 slices and on back-illuminated photodiode for systems of 64 slices or more. The designs based on back-illuminated photodiodes were being investigated for CT machines to overcome the challenge of the higher number of runs and connection required in front-illuminated diodes. In backlit diodes, the electronic noise has already been improved because of the reduction of the load capacitance due to the routing reduction. This translated by a better image quality in low signal application, improving low dose imaging in large patient population. With the fast development of multi-detector-rows CT (MDCT) scanners and the increasing number of examinations, the clinical community has raised significant concerns on radiation dose received by the patient in both medical and regulatory community. In order to reduce individual exposure and in response to the recommendations of the International Commission on Radiological Protection (ICRP) which suggests that all exposures should be kept as low as reasonably achievable (ALARA), every manufacturer is trying to implement strategies and solutions to optimize dose efficiency and image quality based on x-ray emission and scanning parameters. The added demands on the CT detector performance also comes from the increased utilization of spectral CT or dual-energy CT in which projection data of two different tube potentials are collected. One of the approaches utilizes a technology called fast-kVp switching in which the tube voltage is switched between 80kVp and 140kVp in fraction of a millisecond. To reduce the cross-contamination of signals, the scintillator based detector temporal response has to be extremely fast to minimize the residual signal from previous samples. In addition, this paper will present an overview of detector technologies and image chain improvement which have been investigated in the last few years to improve the signal-noise ratio and the dose efficiency CT scanners in regular examinations and in energy discrimination techniques. Several parameters of the image chain in general and in the detector technology contribute in the optimization of the final image quality. We will go through the properties of the post-patient collimation to improve the scatter-to-primary ratio, the scintillator material properties such as light output, afterglow, primary speed, crosstalk to improve the spectral imaging, the photodiode design characteristics and the data acquisition system (DAS) to optimize for crosstalk, noise and temporal/spatial resolution.

Keywords: computed tomography, X-ray detector, medical imaging, image quality, artifacts

Procedia PDF Downloads 236
150 A Qualitative Study on Cyberbullying and Traditional Bullying among Taiwanese High School Students

Authors: Chia-Wen Wang, Patou Masika Musumari, Teeranee Techasrivichien, S. Pilar Suguimoto, Chang-Chuan Chan, Masako Ono-Kihara, Masahiro Kihara

Abstract:

Background: In recent years, a particular form of bullying, referred to as 'cyberbullying' has emerged along with the rapid expansion of the Internet, social network services (SNSs) and smart phones. Many Asian countries, including Taiwan, are faced with both the cyberbullying and the traditional form of bullying. This study aims to explore Taiwanese adolescents’ experiences, perceptions and opinions regarding cyberbullying and traditional bullying through the perspective of victim, perpetrator, or witness. Method: This is a qualitative study using face-to-face in-depth interviews guided by a semi-structured questionnaire among high school students -aged 16 to 18 years- in Taipei, Taiwan. The participants were recruited through convenience sampling from five high schools between June and November 2016. Interviews were digitally recorded, transcribed, and analyzed using the thematic analysis approach. Results: Forty-eight participants were recruited, of which, 14 (29.2%) reported had ever experienced bullying. Specifically, 7 participants (14.6%) reported had ever been victims of cyberbullying, 1 (2%) had been victims of traditional bullying, and 6 (12.5%) had been victims of both cyber and traditional bullying. The majority (70.8%) reported had ever witnessed acts of bullying; however, none of the participants recognized had ever been a perpetrator of bullying. Cyberbullying mostly happens on social media (Facebook and Instagram) or LINE instant messaging application, and included upload and sharing of degrading pictures and videos of victims, as well as gossip and mean messages by the perpetrators. The anonymous and public nature of social media groups in schools made it easier to perpetrate bullying. The victim of traditional bullying reported being the target of verbal attack because of his physical appearance. Regardless of the type of bullying, victims reported feeling bad, angry, or depressed as a result of being bullied. Witnesses of both cyber- and traditional bullying cited physical appearance (e.g. having the big/flat bust or big butt, or overweight or obese) and disability as the most reasons of being a bullying victim. Conclusion: Both cyberbullying and traditional bullying had negative emotional and psychological impacts on victims. This study warrants further research to assess the extent of this phenomenon and understand the characteristics of perpetrators, victims, and witnesses to inform the design of tailored interventions using appropriate channels of dissemination.

Keywords: cyberbullying, traditional bullying, social media, adolescents

Procedia PDF Downloads 318
149 School and Family Impairment Associated with Childhood Anxiety Disorders: Examining Differences in Parent and Child Report

Authors: Melissa K. Hord, Stephen P. Whiteside

Abstract:

Impairment in functioning is a requirement for diagnosing psychopathology, identifying individuals in need of treatment, and documenting improvement with treatment. Further, identifying different types of functional impairment can guide educators and treatment providers. However, most assessment tools focus on symptom severity and few measures assess impairment associated with childhood anxiety disorders. The child- and parent-report versions of the Child Sheehan Disability Scale (CSDS) are measures that may provide useful information regarding impairment. The purpose of the present study is to examine whether children diagnosed with different anxiety disorders have greater impairment in school or home functioning based on self or parent report. The sample consisted of 844 children ages 5 to 19 years of age (mean 13.43, 61% female, 90.9% Caucasian), including 281 children diagnosed with obsessive compulsive disorder (OCD), 200 with generalized anxiety disorder (GAD), 176 with social phobia, 83 with separation anxiety, 61 with anxiety not otherwise specified (NOS), 30 with panic disorder, and 13 with panic with agoraphobia. To assess whether children and parents reported greater impairment in school or home functioning, a multivariate analysis of variance was conducted. (The assumptions of independence and homogeneity of variance were checked and met). A significant difference was found, Pillai's trace = .143, F (4, 28) = 4.19, p < .001, partial eta squared = .04. Post hoc comparisons using the Tukey HSD test indicated that children report significantly greater impairment in school with panic disorder (M=5.18, SD=3.28), social phobia (M=4.95, SD=3.20), and OCD (M=4.62, SD=3.32) compared to other diagnoses; whereas parents endorse significantly greater school impairment when their child has a social phobia (M=5.70, SD=3.39) diagnosis. Interestingly, both children and parents reported greater impairment in family functioning for an OCD (child report M=5.37, SD=3.20; parent report M=5.59, SD=3.38) diagnosis compared to other anxiety diagnoses. (Additional findings for the anxiety disorders associated with less impairment will also be presented). The results of the current study have important implications for educators and treatment providers who are working with anxious children. First, understanding that differences exist in how children and parents view impairment related to childhood anxiety can help those working with these families to be more sensitive during interactions. Second, evidence suggests that difficulties in one environment do not necessarily translate to another environment, thus caregivers may benefit from careful explanation of observations obtained by educators. Third, results support the use of the CSDS measure by treatment providers to identify impairment across environments in order to more effectively target interventions.

Keywords: anxiety, childhood, impairment, school functioning

Procedia PDF Downloads 254
148 “Divorced Women are Like Second-Hand Clothes” - Hate Language in Media Discourse

Authors: Sopio Totibadze

Abstract:

Although the legal framework of Georgia reflects the main principles of gender equality and is in line with the international situation, Georgia remains a male-dominated society. This means that men prevail in many areas of social, economic, and political life, which frequently gives women a subordinate status in society and the family. According to the latest studies, “violence against women and girls in Georgia is also recognized as a public problem, and it is necessary to focus on it”. Moreover, the Public Defender's report (2019) reveals that “in the last five years, 151 women were killed in Georgia due to gender and family violence”. Unfortunately, there are frequent cases of crimes based on gender-based oppression in Georgia, which pose a threat not only to women but also to people of any gender whose desires and aspirations do not correspond to the gender norms and roles prevailing in society. It is well-known that language is often used as a tool for gender oppression. Therefore, feminist and gender studies in linguistics ultimately serve to represent the problem, reflect on it, and propose ways to solve it. Together with technical advancement in communication, a new form of discrimination has arisen- hate language against women in electronic media discourse. Due to the nature of social media and the internet, messages containing hate language can spread in seconds and reach millions of people. However, only a few know about the detrimental effects they may have on the addressee and society. This paper aims to analyse the hateful comments directed at women on various media platforms to determine the linguistic strategies used while attacking women and the reasons why women may fall victim to this type of hate language. The data have been collected over six months, and overall, 500 comments will be examined for the paper. Qualitative and quantitative analysis was chosen for the methodology of the study. The comments posted on various media platforms have been selected manually due to several reasons, the most important being the problem of identifying hate speech as it can disguise itself in different ways- humour, memes, etc. The comments on the articles, posts, pictures, and videos selected for sociolinguistic analysis depict a woman, a taboo topic, or a scandalous event centred on a woman that triggered hate language towards the person to whom the post/article was dedicated. The study has revealed that a woman can become a victim of hatred directed at them if they do something considered to be a deviation from a societal norm, namely, get a divorce, be sexually active, be vocal about feministic values, and talk about taboos. Interestingly, people who utilize hate language are not only men trying to “normalize” the prejudiced patriarchal values but also women who are equally active in bringing down a "strong" woman. The paper also aims to raise awareness about the hate language directed at women, as being knowledgeable about the issue at hand is the first step to tackling it.

Keywords: femicide, hate language, media discourse, sociolinguistics

Procedia PDF Downloads 62
147 X-Ray Detector Technology Optimization in Computed Tomography

Authors: Aziz Ikhlef

Abstract:

Most of multi-slices Computed Tomography (CT) scanners are built with detectors composed of scintillator - photodiodes arrays. The photodiodes arrays are mainly based on front-illuminated technology for detectors under 64 slices and on back-illuminated photodiode for systems of 64 slices or more. The designs based on back-illuminated photodiodes were being investigated for CT machines to overcome the challenge of the higher number of runs and connection required in front-illuminated diodes. In backlit diodes, the electronic noise has already been improved because of the reduction of the load capacitance due to the routing reduction. This is translated by a better image quality in low signal application, improving low dose imaging in large patient population. With the fast development of multi-detector-rows CT (MDCT) scanners and the increasing number of examinations, the clinical community has raised significant concerns on radiation dose received by the patient in both medical and regulatory community. In order to reduce individual exposure and in response to the recommendations of the International Commission on Radiological Protection (ICRP) which suggests that all exposures should be kept as low as reasonably achievable (ALARA), every manufacturer is trying to implement strategies and solutions to optimize dose efficiency and image quality based on x-ray emission and scanning parameters. The added demands on the CT detector performance also comes from the increased utilization of spectral CT or dual-energy CT in which projection data of two different tube potentials are collected. One of the approaches utilizes a technology called fast-kVp switching in which the tube voltage is switched between 80 kVp and 140 kVp in fraction of a millisecond. To reduce the cross-contamination of signals, the scintillator based detector temporal response has to be extremely fast to minimize the residual signal from previous samples. In addition, this paper will present an overview of detector technologies and image chain improvement which have been investigated in the last few years to improve the signal-noise ratio and the dose efficiency CT scanners in regular examinations and in energy discrimination techniques. Several parameters of the image chain in general and in the detector technology contribute in the optimization of the final image quality. We will go through the properties of the post-patient collimation to improve the scatter-to-primary ratio, the scintillator material properties such as light output, afterglow, primary speed, crosstalk to improve the spectral imaging, the photodiode design characteristics and the data acquisition system (DAS) to optimize for crosstalk, noise and temporal/spatial resolution.

Keywords: computed tomography, X-ray detector, medical imaging, image quality, artifacts

Procedia PDF Downloads 173
146 Barriers to Participation in Sport for Children without Disability: A Systematic Review

Authors: S. Somerset, D. J. Hoare

Abstract:

Participation in sport is linked to better mental and physical health in children and adults. Studies have shown children who participate in sports benefit from improved social skills, self-confidence, communication skills and a better quality of life. Children who participate in sports from a young age are also more likely to continue to have active lifestyles during adulthood. This is an important consideration with a nation where physical activity levels are declining and the incidences of obesity are rising. Getting children active and keeping them active can provide long term health benefits to the individual but also a potential reduction in health costs in the future. This systematic review aims to identify the barriers to participation in sport for children aged up to 18 years and encompasses both qualitative and quantitative studies. The bibliographic databases, EMBASE, Medline, CINAHL and SportDiscus were searched. Additional hand searches were carried out on review articles found in the searches to identify any studies that may have been missed. Studies involving children up to 18 years without additional needs focusing on barriers to participation in sport were included. Randomised control trials, policy guidelines, studies with sport as an intervention, studies focusing on the female athlete triad, tobacco abuse, alcohol abuse, drug abuse, pre exercise testing, and cardiovascular disease were excluded. Abstract review, full paper review and quality appraisal were conducted by two researchers. A consensus meeting took place to resolve any differences at the abstract, full text and data extraction / quality appraisal stages. The CASP qualitative studies appraisal tool and the CASP cohort studies tool (excluding question 3 and 4 which refer to interventions) were used for quality appraisal in this review. The review identified several salient barriers to participation in sport for children. These barriers ranged from the uniform worn during school physical education lessons to the weather during participation in sport. The most commonly identified barriers in the review include parental support, time allocation, location of the activity and the cost of the activity. Therefore, it would be beneficial for a greater provision to be made within the school environment for children to participate sport. This can reduce the cost and time commitment required from parents to encourage participation. This would help to increase activity levels of children, which ultimately can only be a good thing.

Keywords: barrier, children, participation, sport

Procedia PDF Downloads 334
145 Effect of Cognitive Rehabilitation in Pediatric Population with Acquired Brain Injury: A Pilot Study

Authors: Carolina Beltran, Carlos De Los Reyes

Abstract:

Acquired brain injury (ABI) is any physical and functional injury secondary to events that affect the brain tissue. It is one of the biggest causes of disability in the world and it has a high annual incidence in the pediatric population. There are several causes of ABI such as traumatic brain injury, central nervous system infection, stroke, hypoxia, tumors and others. The consequences can be cognitive, behavioral, emotional and functional. The cognitive rehabilitation is necessary to achieve the best outcomes for pediatric people with ABI. Cognitive orientation to daily occupational performance (CO-OP) is an individualized client-centered, performance-based, problem-solving approach that focuses on the strategy used to support the acquisition of three client-chosen goals. It has demonstrated improvements in the pediatric population with other neurological disorder but not in Spanish speakers with ABI. Aim: The main objective of this study was to determine the efficacy of cognitive orientation to daily occupational performances (CO-OP) adapted to Spanish speakers, in the level of independence and behavior in a pediatric population with ABI. Methods: Case studies with measure pre/post-treatment were used in three children with ABI, sustained at least before 6 months assessment, in school, aged 8 to 16 years, age ABI after 6 years old and above average intellectual ability. Twelve sessions of CO-OP adapted to Spanish speakers were used and videotaped. The outcomes were based on cognitive, behavior and functional independence measurements such as Child Behavior Checklist (CBCL), Behavior Rating Inventory of Executive Function (BRIEF), The Vineland Adaptive Behavior Scales (VINELAND, Social Support Scale (MOS-SSS) and others neuropsychological measures. This study was approved by the ethics committee of Universidad del Norte in Colombia. Informed parental written consent was obtained for all participants. Results: children were able to identify three goals and use the global strategy ‘goal-plan-do-check’ during each session. Verbal self-instruction was used by all children. CO-OP showed a clinically significant improvement in goals regarding with independence level and behavior according to parents and teachers. Conclusion: The results indicated that CO-OP and the use of a global strategy such as ‘goal-plan-do-check’ can be used in children with ABI in order to improve their specific goals. This is a preliminary version of a big study carrying in Colombia as part of the experimental design.

Keywords: cognitive rehabilitation, acquired brain injury, pediatric population, cognitive orientation to daily occupational performance

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144 The 4th Critical R: Conceptualising the Development of Resilience as an Addition to the 3 Rs of the Essential Education Curricula

Authors: Akhentoolove Corbin, Leta De Jonge, Charmaine De Jonge

Abstract:

Introduction: Various writers have promoted the adoption of the 4th R in the education curricula (relationships, respect, reasoning, religion, computing, science, art, conflict management, music) and the 5th R (responsibility). They argue that the traditional 3 Rs are not adequate for the modern environment and the requirements for students to become functional citizens in society. In particular, the developing countries of the anglophone Caribbean (most of which are tiny islands) are susceptible to the dangers and complexities of climate change and global economic volatility. These proposed additions to the 3Rs do have some justification, but this research considers Resilience as even more important and relevant in a world that is faced with the negative prospects of climate change, poverty, discrimination, and economic volatility. It is argued that the foundation for resilient citizens, workers, and workplaces, must be built in the elementary and secondary/middle schools and then through the tertiary level, to achieve an outcome of more resilient students. Government, business, and society require widespread resilience to be capable of ‘bouncing back’ and be more adaptable, transformational, and sustainable. Methodology: The paper utilises a mixed-methods approach incorporating a questionnaire and interviews to determine participants’ opinions on the importance and relevance of resilience in the schools’ curricula and to government, business, and society. The target groups are as follows: educators at all levels, education administrators, members of the business sector, public sector, and 3rd sector. The research specifically targets the anglophone Caribbean developing countries (Barbados, Guyana, Jamaica, Trinidad, St. Lucia, and St Vincent, and the Grenadines). The research utilises SPSS for data analysis. Major Findings: The preliminary findings suggest that the majority of participants support the adoption of resilience as a 4th R in the curricula of the elementary, secondary/middle schools, and tertiary level in the anglophone Caribbean. The final results will allow the researchers to reveal more specific details on any variations among the islands in the sample andto engage in an in-depth discussion of the relevance and importance of resilience as the 4th R. Conclusion: Results seem to suggest that the education system should adopt the 4th R of resilience so that educators working in collaboration with the family and community/village can develop young citizens who are more resilient and capable of manifesting the behaviours and attitudes associated with ‘bouncing back,’ adaptability, transformation, and sustainability. These findings may be useful for education decision-makers and governments in these Caribbean islands, who have the authority and responsibility for the development of education policy, laws, and regulations.

Keywords: education, resilient students, adaptable, transformational, resilient citizens, workplaces, government

Procedia PDF Downloads 44
143 An Ethnographic Study of Workforce Integration of Health Care Workers with Refugee Backgrounds in Ageing Citizens in Germany

Authors: A. Ham, A. Kuckert-Wostheinrich

Abstract:

Demographic changes, like the ageing population in European countries and shortage of nursing staff, the increasing number of people with severe cognitive impairment, and elderly socially isolated people raise important questions about who will provide long-term care for ageing citizens. Due to the so-called refugee crisis in 2015, some health care institutions for ageing citizens in Europe invited first generation immigrants to start a nursing career and providing them language skills, nursing training, and internships. The aim of this ethnographic research was to explore the social processes affecting workforce integration and how newcomers enact good care in ageing citizens in a German nursing home. By ethnographic fieldwork, 200 hours of participant observations, 25 in-depth interviews with immigrants and established staff, 2 focus groups with 6 immigrants, and 6 established staff members, data were analysed. The health care institution provided the newcomers a nursing program on psychogeriatric theory and nursing skills in the psychogeriatric field and professional oriented language skills. Courses of health prevention and theater plays accompanied the training. The knowledge learned in education could be applied in internships on the wards. Additionally, diversity and inclusivity courses were given to established personal for cultural awareness and sensitivity. They learned to develop a collegial attitude of respect and appreciation, regardless of gender, nationality, ethnicity, religion or belief, age sexual orientation, or disability and identity. The qualitative data has shown that social processes affected workforce integration, like organizational constraints, staff shortages, and a demanding workload. However, zooming in on the interactions between newcomers and residents, we noticed how they tinkered to enact good care by embodied caring, playing games, singing and dancing. By situational acting and practical wisdom in nursing care, the newcomers could meet the needs of ageing residents. Thus, when health care institutions open up nursing programs for newcomers with refugees’ backgrounds and focus on talent instead of shortcomings, we might as well stimulate the unknown competencies, attitudes, skills, and expertise of newcomers and create excellent nurses for excellent care.

Keywords: established staff, Germany, nursing, refugees

Procedia PDF Downloads 76
142 The Diverse Experiences of Men Living with Disabilities Participating in Violence Prevention Interventions in Africa and Asia: Men as Victims; Men as Perpetrators

Authors: Ingrid van der Heijden, Kristen Dunkle, Rachel Jewkes

Abstract:

Background: Emerging literature on prevalence shows that men with disabilities are four more times likely than men without disabilities to experience sexual violence during their lifetime. However, compared to women with disabilities, men with disabilities still have lesser experiences of violence. While empirical evidence on the prevalence of victimization of men with disabilities is emerging, there is scarcer evidence highlighting disabled men’s perpetration of different forms of violence, particularly intimate partner violence. We can assume that men are likely to be both perpetrators and victims of violence, making more complex the causes and risks of violence. Gender norms and disability stigma play important roles in men’s experiences of violence. Men may be stigmatized because of their inability to attain hegemonic masculine ideals of strength, control over women and sexual conquest, which makes them more susceptible to emotional, physical and sexual abuse. Little to no evidence exists of men with disabilities’ experiences of perpetration of intimate partner violence, family violence or community violence. So far studies on male victimization do not succeed to offer contextual evidence that would highlight why and how men with disabilities perpetrate and/or are victims of sexual or other forms of violence. Objective: The overall aim to highlight men with disabilities’ experiences of both victimization and perpetration, and how living up to normative and hegemonic ideals of masculinity and ‘ability’ shape their experiences. It will include: identifying how gender and impairments intersect and shape their experiences of violence; identifying the contexts of and risks for violence; identifying the impacts and consequences of violence on their lives (including mental health impacts), and identifying obstacles and enablers to support and interventions to prevent violence. Methodology: In-depth qualitative interviews with 20 men with disabilities participating in interventions conducted by the What Works Global Programme for violence prevention (DIFD) in Africa and Asia. Men with a range of disabilities will be invited to share their lifetime experiences of violence. Implications for Practice: The data from this study will be used to start thinking about strategies to include men with disabilities in violence prevention strategies for both men and women. Limitations: Because men will be participating in interventions, it is assumed that they will not have severe impairments that hamper their cognitive or physical ability to participate in the intervention activities - and therefore will be able to participate in the in-depth interviews. Of course, this is a limitation of the study as it does not include those men with severe disabilities – measured by the World Health Organization’s International Classification of Functioning - who may be more vulnerable and at higher risk of experiencing violence, and who are less likely to be able to access services and interventions.

Keywords: gender, men with disabilities, perpetration of violence, victimization

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141 Confessors in Im Sun-dŭk’s Short Stories: Interiority of Korean Women under the End of Japanese Colonial Rule

Authors: Min Koo Choi

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The paper will examine Im Sun-dŭk’s two short stories, 'Iryoil' (Sunday, 1937) and 'Nazuoya' (A Godmother, 1942), which illuminate the subjects of Korean intellectuals going through the later period of a harsh and oppressive Japanese colonial rule. When Japan went to war against China in 1937, Korea, a colony of Japan since 1910, became an outpost for Japanese expansionism into China, and the Korean people were mobilized into the war effort. Nationalist movements and radical ideas that posed a threat and opposition to Japanese colonial rule in Korea and its colonial expansionism were ruthlessly suppressed, and Koreans were forcibly assimilated into becoming Japanese citizens without political rights. Racial discrimination between Koreans and Japanese was prevalent. Im Sun-dŭk, who participated in the Socialist movement in the 1930s, had his debut as a literary writer and a critic in the late 1930s, when Korean literary society was reincorporated in order to collaborate with the Japanese war effort through writing and public speech. Sun-duk's writing illuminates the unique internal landscape of a female subject who strives to live on while preserving her commitment and dignity under the circumstances that force Korean intellectuals either to collaborate with or acquiesce to Japanese colonial rule. 'Iryoil' (Sunday, 1937) foregrounds an educated intellectual, Hyeyŏng, who supplies her fiancé in prison for political involvement in resistance against Japan. On Sundays, she turns down her friends’ suggestion for enjoying holidays outside, due to her indebtedness to her fiancé. Her fiancé's imprisonment indicates the social conscience that still remains, and she seeks to share the commitment and suffering with her fiancé. The short story 'Nazuoya' (A Godmother, 1942), written in Japanese due to the suppression of Korean language publications at the time, also problematizes Japanese policy that forces Koreans to change their names into Japanese. Through the narrator I, who struggles to find a meaningful name for her cousin brother’s baby, she highlights how meaningful one’s name is for one’s life and identity. What makes her two stories unique is that her writing draws other people’s confessions into its own narrative through fragmentary forms, such as part of letter or reflection. The voices of others are intersected with the main character in 'Iryoil' (Sunday, 1937) and a narrator in 'Nazuoya' (A Godmother, 1942). In many ways, the narrator and main character provide the confessional voices who display the characters' gloomy interiorities. Even though these confessional voices do not share the commitment and values, both the main character and I in the stories reveal a more open set of viewpoints to them. In this way, they seek to form bonds and encouragement and acquire a more resilient sensibility that embraces those who strive to survive and endure in the gloomy days of the later period of Japanese colonial rule.

Keywords: Im Sun-dŭk, Japanese colonial rule, Korean literature, socialist movement

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140 Socioeconomic Burden of a Diagnosis of Cervical Cancer in Women in Rural Uganda: Findings from a Phenomenological Study

Authors: Germans Natuhwera, Peter Ellis, Acuda Wilson, Anne Merriman, Martha Rabwoni

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Objective: The aim of the study was to diagnose the socio-economic burden and impact of a diagnosis of cervical cancer (CC) in rural women in the context of low-resourced country Uganda, using a phenomenological enquiry. Methods: This was a multi-site phenomenological inquiry, conducted at three hospice settings; Mobile Hospice Mbarara in southwestern, Little Hospice Hoima in Western, and Hospice Africa Uganda Kampala in central Uganda. A purposive sample of women with a histologically confirmed diagnosis of CC was recruited. Data was collected using open-ended audio-recorded interviews conducted in the native languages of participants. Interviews were transcribed verbatim in English, and Braun and Clarke’s (2019) framework of thematic analysis was used. Results: 13 women with a mean age of 49.2 and age range 29-71 participated in the study. All participants were of low socioeconomic status. The majority (84.6%) had advanced disease at diagnosis. A fuller reading of transcripts produced four major themes clustered under; (1) socioeconomic characteristics of women, (2) impact of CC on women’s relationships, (3) disrupted and impaired activities of daily living (ADLs), and (4) economic disruptions. Conclusions: A diagnosis of CC introduces significant socio-economic disruptions in a woman’s and her family’s life. CC causes disability, impairs the woman and her family’s productivity hence exacerbating levels of poverty in the home. High and expensive out-of-pocket expenditure on treatment, investigations, and transport costs further compound the socio-economic burden. Decentralizing cancer care services to regional centers, scaling up screening services, subsidizing costs of cancer care services, or making cervical cancer care treatment free of charge, strengthening monitoring mechanisms in public facilities to curb the vice of healthcare workers soliciting bribes from patients, increased mass awareness campaigns about cancer, training more healthcare professionals in cancer investigation and management, and palliative care, and introducing an introductory course on gynecologic cancers into all health training institutions are recommended.

Keywords: activities of daily living, cervical cancer, out-of-pocket, expenditure, phenomenology, socioeconomic

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139 Dyadic Effect of Emotional Focused Psycho Educational Intervention on Spousal Emotional Abuse and Marital Satisfaction among Elderly Couples

Authors: Maryam Hazrati, Tengku Aizan Hamid, Rahimah Ibrahim, Siti Aishah Hassan, Farkhondeh Sharif, Zahra Bagheri

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Background: Emotional abuse is the most common type of spousal abuse. In a long-term marriage which lasts several decades, the couple will be faced with greater vulnerability due to illness, disability, and dependence. Emotional abuse can have a devastating impact on victims, leading to low self-esteem, depression, anxiety, and post-traumatic stress disorder. Research Aim: The aim of this study was to investigate the effects of an emotional-focused psychoeducational intervention (EFPEI) on emotional abuse and marital satisfaction among older adults couples and also to examine the dyadic effects of each partner’s emotional abuse behaviors (EAB) on his/her marital satisfaction (MS) in Shiraz-Iran. Methodology: The study was a randomized controlled trial (RCT). A total of 57 eligible couples were randomly assigned to either the experimental group or the control group. The experimental group received EFPEI, which consisted of 12 sessions, each lasting 90 minutes. The control group did not receive any intervention. Data were collected using demographic questionnaire, Multidimensional Measure of Emotional Abuse (MMEAQ), and Marital Satisfaction Questionnaire for Older People (MSQFOP). The data was analyzed using a variety of statistical methods, including repeated measures ANOVA, path analysis, and correlational analyses. Findings: The results of the study showed that the EFPEI was effective in reducing emotional abuse and increasing marital satisfaction among older adults couples. Specifically, the mean scores for emotional abuse and marital satisfaction were significantly lower in the experimental group than in the control group at the end of the intervention. These effects were maintained at a 3-month follow-up. Moreover, the dyadic analysis revealed that husbands’ EAB had no significant effects on his own marital satisfaction but a significant negative partner effect, while wives’ EAB had significant negative actor and partner effects. Conclusion: The findings of this study provide support for the use of EFPEI as an effective intervention for decreasing emotional abuse and improving marital dissatisfaction among older adults. EFPEI is a short-term, evidence-based intervention that can be delivered by trained professionals. The intervention focuses on helping couples to improve their communication skills, resolve conflict, and build a stronger emotional connection.

Keywords: spouse abuse, emotion, aged, satisfaction, dyadic effect

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138 Cinematic Transgression and Sexuality: A Study of Rituparno Ghosh's ‘Queer Trilogy’

Authors: Sudipta Garai

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Films as a cultural, social practice remains a dominant space for creation and destruction of ideologies and practices which make the sociological viewing, analysis, and interpretation of the same a complex affair. It remains the doorway between the interpretations and understanding of the writer/director and the reader/viewer. India, being a multi-linguistic culture, the media plays a much intriguing role than that of newspaper, books, stories, novels or any other medium of expression. Known to be the largest democracy, the State seem to guarantee and safeguard people’s choices and life of dignity through its Fundamental Rights and Directives. However, the laws contradict themselves when it comes to IPC 377 criminalizing anything except penovaginal sexual intercourse restricting alternative sexual preferences and practices questioning its sense of ‘democracy.' In this context, the issue of homosexuality came up in bits and pieces through various representations in ‘popular’ cinema mostly with sudden references of mockery and laughter where the explicit narratives of ‘queer’ seemed missing. Rituparno Ghosh, an eminent film maker of Bengal, came up as the ‘queer’ face in Kolkata specifically through his ‘queer’ trilogy (Memories in March, 2010; Arekti Premer Golpo, 2010; Chitrangada: A Crowning Wish, 2012) coming out of his own closet and speaking about his own sexual choices not only through the explicit narratives in films but also in person which made these films an important point of departure in Bengali film history. A sociological reading of these films through a discourse analysis is being done with the critical questions of ‘choice,' ’freedom,' ‘love and marriage’ and most importantly the ‘change.' This study not only focuses on the films and its analysis of content but also to engage with its audience, queer and not in order to extend beyond the art form into the actual vulnerabilities of life and experiences through informal interviews, focused group discussions and engaging with the real life narratives. A research of this kind is always looked upon as a medium of change hoping for a better world wiping away the discrimination and ‘shame’ the ‘queer’ faces in their everyday life, but a social science research is limited but its ‘time’ and academic boundary where the hope of change might be initiated but not fulfilled. The experiences and reflections of the ‘queer’ not only redefined the narratives of the films but also me as a researcher. The perspectives of the ‘hetero-normative’ informants gave a broader picture of the study and the socio-cultural complications that are intrigued with the ideas of resistance and change. The issues on subjectivity, power, and position couldn’t be wiped out in a study of this kind as both politics and aesthetics become integrated with each other in the creation of any art form be it films or a study of research.

Keywords: cinema, alternative sexualities, narratives, sexual choices, state and society

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137 Irradion: Portable Small Animal Imaging and Irradiation Unit

Authors: Josef Uher, Jana Boháčová, Richard Kadeřábek

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In this paper, we present a multi-robot imaging and irradiation research platform referred to as Irradion, with full capabilities of portable arbitrary path computed tomography (CT). Irradion is an imaging and irradiation unit entirely based on robotic arms for research on cancer treatment with ion beams on small animals (mice or rats). The platform comprises two subsystems that combine several imaging modalities, such as 2D X-ray imaging, CT, and particle tracking, with precise positioning of a small animal for imaging and irradiation. Computed Tomography: The CT subsystem of the Irradion platform is equipped with two 6-joint robotic arms that position a photon counting detector and an X-ray tube independently and freely around the scanned specimen and allow image acquisition utilizing computed tomography. Irradiation measures nearly all conventional 2D and 3D trajectories of X-ray imaging with precisely calibrated and repeatable geometrical accuracy leading to a spatial resolution of up to 50 µm. In addition, the photon counting detectors allow X-ray photon energy discrimination, which can suppress scattered radiation, thus improving image contrast. It can also measure absorption spectra and recognize different materials (tissue) types. X-ray video recording and real-time imaging options can be applied for studies of dynamic processes, including in vivo specimens. Moreover, Irradion opens the door to exploring new 2D and 3D X-ray imaging approaches. We demonstrate in this publication various novel scan trajectories and their benefits. Proton Imaging and Particle Tracking: The Irradion platform allows combining several imaging modules with any required number of robots. The proton tracking module comprises another two robots, each holding particle tracking detectors with position, energy, and time-sensitive sensors Timepix3. Timepix3 detectors can track particles entering and exiting the specimen and allow accurate guiding of photon/ion beams for irradiation. In addition, quantifying the energy losses before and after the specimen brings essential information for precise irradiation planning and verification. Work on the small animal research platform Irradion involved advanced software and hardware development that will offer researchers a novel way to investigate new approaches in (i) radiotherapy, (ii) spectral CT, (iii) arbitrary path CT, (iv) particle tracking. The robotic platform for imaging and radiation research developed for the project is an entirely new product on the market. Preclinical research systems with precision robotic irradiation with photon/ion beams combined with multimodality high-resolution imaging do not exist currently. The researched technology can potentially cause a significant leap forward compared to the current, first-generation primary devices.

Keywords: arbitrary path CT, robotic CT, modular, multi-robot, small animal imaging

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136 A Qualitative Study of Unmet Needs of Families of Children with Cerebral Palsy in Bangladesh

Authors: Reshma Parvin Nuri, Heather Michelle Aldersey, Setareh Ghahari

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Objectives: Worldwide, it is well known that taking care of children with disabilities (CWD) can have a significant impact on the entire family unit. Over the last few decades, an increased number of studies have been conducted on families of CWD in higher income countries, and much of this research has identified family needs and strategies to meet those needs. However, family needs are incredibly under-studied in developing countries. Therefore, the aims of this study were to: (a) explore the needs of families of children with cerebral palsy (CP) in Bangladesh; (b) investigate how some of the family needs have been met and (c) identify the sources of supports that might help the families to meet their needs in the future. Methods: A face to face, semi-structured in-depth interview was conducted with 20 family members (12 mothers, 4 fathers, 1 sister, 2 grandmothers, and 1 aunt) who visited the Centre for the Rehabilitation of the Paralysed (CRP), Bangladesh between June and August 2016. Constant comparison method of grounded theory approach within the broader spectrum of qualitative study was used to analyze the data. Results: Participants identified five categories of needs: (a) financial needs, (b) access to disability-related services, (c) family and community cohesion, (d) informational needs, and (e) emotional needs. Participants overwhelmingly reported that financial need is their greatest family need. Participants noted that families encountered additional financial expenses for a child with CP, beyond what they would typically pay for their other children. Participants were seeing education as their non-primary need as they had no hope that their children would be physically able to go to school. Some participants also shared their needs for social inclusion and participation and receiving emotional support. Participants further expressed needs to receive information related to the child’s health condition and availability/accessibility of governmental support programs. Besides unmet needs, participants also highlighted that some of their needs have been met through formal and informal support systems. Formal support systems were mainly institution-based and run by non-governmental organizations, whereas participants identified informal support coming from family, friends and community members. Participants overwhelmingly reported that they receive little to no support from the government. However, participants identified the government as the key stakeholder who can play vital role in meeting their unmet needs. Conclusions: In the next phase of this research, the plan is to understand how the Government of the People’s Republic of Bangladesh is working to meet the needs of families of CWD. There is also need for further study on needs of families of children with conditions other than CP and those who live in the community and do not have access to the CRP Services. There is clear need to investigate ways to enable children with CP have better access to education in Bangladesh.

Keywords: Bangladesh, children with cerebral palsy, family needs, support

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135 Aspiring to Achieve a Fairer Society

Authors: Bintou Jobe

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Background: The research is focused on the concept of equality, diversity, and inclusion (EDI) and the need to achieve equity by treating individuals according to their circumstances and needs. The research is rooted in the UK Equality Act 2010, which emphasizes the importance of equal opportunities for all individuals regardless of their background and social life. However, inequality persists in society, particularly for those from minority backgrounds who face discrimination. Research Aim: The aim of this research is to promote equality, diversity, and inclusion by encouraging the regeneration of minds and the eradication of stereotypes. The focus is on promoting good Equality, Diversity and Inclusion practices in various settings, including schools, colleges, universities, and workplaces, to create environments where every individual feels a sense of belonging. Methodology: The research utilises a literature review approach to gather information on promoting inclusivity, diversity, and inclusion. Findings: The research highlights the significance of promoting equality, diversity, and inclusion practices to ensure that individuals receive the respect and dignity they deserve. It emphasises the importance of treating individuals based on their unique circumstances and needs rather than relying on stereotypes. The research also emphasises the benefits of diversity and inclusion in enhancing innovation, creativity, and productivity. The theoretical importance of this research is to raise awareness about the importance of regenerating minds, challenging stereotypes, and promoting equality, diversity, and inclusion. The emphasis is on treating individuals based on their circumstances and needs rather than relying on generalizations. Diversity and inclusion are beneficial in different settings, as highlighted by the research. By raising awareness about the importance of mind regeneration, eradicating stereotypes, and promoting equality, diversity, and inclusion, this research makes a significant contribution to the subject area. It emphasizes the necessity of treating individuals based on their unique circumstances instead of relying on generalizations. However, the methodology could be strengthened by incorporating primary research to complement the literature review approach. Data Collection and Analysis Procedures: The research utilised a literature review approach to gather relevant information on promoting inclusivity, diversity, and inclusion. NVivo software application was used to analysed and synthesize the findings to identify themes and support the research aim and objectives. Question Addressed: This research addresses the question of how to promote inclusivity, diversity, and inclusion and reduce the prevalence of stereotypes and prejudice. It explores the need to treat individuals based on their unique circumstances and needs rather than relying on generic assumptions. Encourage individuals to adopt a more inclusive approach. Provide managers with responsibility and training that helps them understand the importance of their roles in shaping the workplace culture. Have an equality, diversity, and inclusion manager from a majority background at the senior level who can speak up for underrepresented groups and flag any issues that need addressing. Conclusion: The research emphasizes the importance of promoting equality, diversity, and inclusion practices to create a fairer society. It highlights the need to challenge stereotypes, treat individuals according to their circumstances and needs, and promote a culture of respect and dignity.

Keywords: equality, fairer society, inclusion, diversity

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134 Role of Grey Scale Ultrasound Including Elastography in Grading the Severity of Carpal Tunnel Syndrome - A Comparative Cross-sectional Study

Authors: Arjun Prakash, Vinutha H., Karthik N.

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BACKGROUND: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy with an estimated prevalence of 0.6 - 5.8% in the general adult population. It is caused by compression of the Median Nerve (MN) at the wrist as it passes through a narrow osteofibrous canal. Presently, the diagnosis is established by the clinical symptoms and physical examination and Nerve conduction study (NCS) is used to assess its severity. However, it is considered to be painful, time consuming and expensive, with a false-negative rate between 16 - 34%. Ultrasonography (USG) is now increasingly used as a diagnostic tool in CTS due to its non-invasive nature, increased accessibility and relatively low cost. Elastography is a newer modality in USG which helps to assess stiffness of tissues. However, there is limited available literature about its applications in peripheral nerves. OBJECTIVES: Our objectives were to measure the Cross-Sectional Area (CSA) and elasticity of MN at the carpal tunnel using Grey scale Ultrasonography (USG), Strain Elastography (SE) and Shear Wave Elastography (SWE). We also made an attempt to independently evaluate the role of Gray scale USG, SE and SWE in grading the severity of CTS, keeping NCS as the gold standard. MATERIALS AND METHODS: After approval from the Institutional Ethics Review Board, we conducted a comparative cross sectional study for a period of 18 months. The participants were divided into two groups. Group A consisted of 54 patients with clinically diagnosed CTS who underwent NCS, and Group B consisted of 50 controls without any clinical symptoms of CTS. All Ultrasound examinations were performed on SAMSUNG RS 80 EVO Ultrasound machine with 2 - 9 Mega Hertz linear probe. In both groups, CSA of the MN was measured on Grey scale USG, and its elasticity was measured at the carpal tunnel (in terms of Strain ratio and Shear Modulus). The variables were compared between both groups by using ‘Independent t test’, and subgroup analyses were performed using one-way analysis of variance. Receiver operating characteristic curves were used to evaluate the diagnostic performance of each variable. RESULTS: The mean CSA of the MN was 13.60 + 3.201 mm2 and 9.17 + 1.665 mm2 in Group A and Group B, respectively (p < 0.001). The mean SWE was 30.65 + 12.996 kPa and 17.33 + 2.919 kPa in Group A and Group B, respectively (p < 0.001), and the mean Strain ratio was 7.545 + 2.017 and 5.802 + 1.153 in Group A and Group B respectively (p < 0.001). CONCLUSION: The combined use of Gray scale USG, SE and SWE is extremely useful in grading the severity of CTS and can be used as a painless and cost-effective alternative to NCS. Early diagnosis and grading of CTS and effective treatment is essential to avoid permanent nerve damage and functional disability.

Keywords: carpal tunnel, ultrasound, elastography, nerve conduction study

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133 Nurture Early for Optimal Nutrition: A Community-Based Randomized Controlled Trial to Improve Infant Feeding and Care Practices Using Participatory Learning and Actions Approach

Authors: Priyanka Patil, Logan Manikam

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Background: The first 1000 days of life are a critical window and can result in adverse health consequences due to inadequate nutrition. South-Asian (SA) communities face significant health disparities, particularly in maternal and child health. Community-based interventions, often employing Participatory-Learning and Action (PLA) approaches, have effectively addressed health inequalities in lower-income nations. The aim of this study was to assess the feasibility of implementing a PLA intervention to improve infant feeding and care practices in SA communities living in London. Methods: Comprehensive analyses were conducted to assess the feasibility/fidelity of this pilot randomized controlled trial. Summary statistics were computed to compare key metrics, including participant consent rates, attendance, retention, intervention support, and perceived effectiveness, against predefined progression rules guiding toward a definitive trial. Secondary outcomes were analyzed, drawing insights from multiple sources, such as The Children’s-Eating-Behaviour Questionnaire (CEBQ), Parental-Feeding-Style Questionnaires (PFSQ), Food-diary, and the Equality-Impact-Assessment (EIA) tool. A video analysis of children's mealtime behavior trends was conducted. Feedback interviews were collected from study participants. Results: Process-outcome measures met predefined progression rules for a definitive trial, which deemed the intervention as feasible and acceptable. The secondary outcomes analysis revealed no significant changes in children's BMI z-scores. This could be attributed to the abbreviated follow-up period of 6 months, reduced from 12 months, due to COVID-19-related delays. CEBQ analysis showed increased food responsiveness, along with decreased emotional over/undereating. A similar trend was observed in PFSQ. The EIA tool found no potential discrimination areas, and video analysis revealed a decrease in force-feeding practices. Participant feedback revealed improved awareness and knowledge sharing. Conclusion: This study demonstrates that a co-adapted PLA intervention is feasible and well-received in optimizing infant-care practices among South-Asian community members in a high-income country. These findings highlight the potential of community-based interventions to enhance health outcomes, promoting health equity.

Keywords: child health, childhood obesity, community-based, infant nutrition

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132 Antenatal Monitoring of Pre-Eclampsia in a Low Resource Setting

Authors: Alina Rahim, Joanne Moffatt, Jessica Taylor, Joseph Hartland, Tamer Abdelrazik

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Background: In 2011, 15% of maternal deaths in Uganda were due to hypertensive disorders (pre-eclampsia and eclampsia). The majority of these deaths are avoidable with optimum antenatal care. The aim of the study was to evaluate how antenatal monitoring of pre-eclampsia was carried out in a low resource setting and to identify barriers to best practice as recommended by the World Health Organisation (WHO) as part of a 4th year medical student External Student Selected component field trip. Method: Women admitted to hospital with pre-eclampsia in rural Uganda (Villa Maria and Kitovu Hospitals) over a year-long period were identified using the maternity register and antenatal record book. It was not possible to obtain notes for all cases identified on the maternity register. Therefore a total of thirty sets of notes were reviewed. The management was recorded and compared to Ugandan National Guidelines and WHO recommendations. Additional qualitative information on routine practice was established by interviewing staff members from the obstetric and midwifery teams. Results: From the records available, all patients in this sample were managed according to WHO recommendations during labour. The rate of Caesarean section as a mode of delivery was noted to be high in this group of patients; 56% at Villa Maria and 46% at Kitovu. Antenatally two WHO recommendations were not routinely met: aspirin prophylaxis and calcium supplementation. This was due to lack of resources, and lack of attendance at antenatal clinic leading to poor detection of high-risk patients. Medical management of pre-eclampsia varied between individual patients, overall 93.3% complied with Ugandan national guidelines. Two patients were treated with diuretics, which is against WHO guidance. Discussion: Antenatal monitoring of pre-eclampsia is important in reducing severe morbidity, long-term disability and mortality amongst mothers and their babies 2 . Poor attendance at antenatal clinic is a barrier to healthcare in low-income countries. Increasing awareness of the importance of these visits for women should be encouraged. The majority of cases reviewed in this sample of women were treated according to Ugandan National Guidelines. It is recommended to commence the use of aspirin prophylaxis for women at high-risk of developing pre-eclampsia and the creation of detailed guidelines for Uganda which would allow for standardisation of care county-wide.

Keywords: antenatal monitoring, low resource setting, pre-eclampsia, Uganda

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131 Assessment of Climate Induced Hazards in Coastal Zone of Bangladesh: A Case Study of Koyra Upazilla under Khulna District and Shyamnagar Upazilla under Satkhira District

Authors: Kazi Ashief Mahmood

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Geographically Bangladesh is located in a natural hazard prone area. Compared to the rest of the areas, the coastal sub-districts are more vulnerable to climate variability and change. However, the hydro-geophysical reality of the sub-districts predominantly determines their contexts of vulnerability and its nature differs accordingly. Intriguingly enough, the poorest of the areas appear to be the most cornered among the different vulnerable sectors. Among of these deprived segments; however, the women, the persons with disability and the minorities are generally more vulnerable and they face a high risk of marginalized. The most threatening hydro-geophysical climate vulnerability have been created by prolonged dry season as observed at Koyra Upazilla in Khulna districts and Shyamnagar in Satkhira districts. The prolonged dry season creates severe surface salinity by which farmers cannot produce or use their to cultivate. The absence of land-based production and employment in the area has led to severe food insecurity. As a result, farmers tend to change their livelihood option and many of them are forced to migrate to the other areas of the country in search of livelihood. Besides salinity intrusion, water logging, drought and different climate change induced hazards are endangering safe drinking water sources and putting small-holders out of agriculture-based livelihoods in the Koyra and Shyamnagar Upazilla. A sizeable fraction of small-holders are still trying to hold on to their small scale shrimp production, despite being under pressure to sell off their cultivating lands to their influential shrimp merchants. While their desperate effort to take advantage of the increasing salinity is somewhat successful, their families still face a greater risk of health hazards owing to the lack of safe drinking water. Unless the issues of salinity in drinking water cannot be redressed, the state of the affected people will be in great jeopardy. Most of the inhabitants of oKyra and Shyamnagar Upazilla are living under the poverty line. Thus, poverty is a major factor that intensifies the vulnerability caused by hydro-geophysical climatic conditions. The government and different NGOs are trying to improve the present scenario by implementing different disaster risk reduction projects along with poverty reduction for community empowerment.

Keywords: assessment, climate change, climate induced hazards, coastal zone

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130 Study on the Focus of Attention of Special Education Students in Primary School

Authors: Tung-Kuang Wu, Hsing-Pei Hsieh, Ying-Ru Meng

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Special Education in Taiwan has been facing difficulties including shortage of teachers and lack in resources. Some students need to receive special education are thus not identified or admitted. Fortunately, information technologies can be applied to relieve some of the difficulties. For example, on-line multimedia courseware can be used to assist the learning of special education students and take pretty much workload from special education teachers. However, there may exist cognitive variations between students in special or regular educations, which suggests the design of online courseware requires different considerations. This study aims to investigate the difference in focus of attention (FOA) between special and regular education students of primary school in viewing the computer screen. The study is essential as it helps courseware developers in determining where to put learning elements that matter the most on the right position of screen. It may also assist special education specialists to better understand the subtle differences among various subtypes of learning disabilities. This study involves 76 special education students (among them, 39 are students with mental retardation, MR, and 37 are students with learning disabilities, LDs) and 42 regular education students. The participants were asked to view a computer screen showing a picture partitioned into 3 × 3 areas with each area filled with text or icon. The subjects were then instructed to mark on the prior given paper sheets, which are also partitioned into 3 × 3 grids, the areas corresponding to the pictures on the computer screen that they first set their eyes on. The data are then collected and analyzed. Major findings are listed: 1. In both text and icon scenario, significant differences exist in the first preferred FOA between special and regular education students. The first FOA for the former is mainly on area 1 (upper left area, 53.8% / 51.3% for MR / LDs students in text scenario; and 53.8% / 56.8% for MR / LDs students in icons scenario), while the latter on area 5 (middle area, 50.0% and 57.1% in text and icons scenarios). 2. The second most preferred area in text scenario for students with MR and LDs are area 2 (upper-middle, 20.5%) and 5 (middle area, 24.3%). In icons scenario, the results are similar, but lesser in percentage. 3. Students with LDs that show similar preference (either in text or icons scenarios) in FOA to regular education students tend to be of some specific sub-type of learning disabilities. For instance, students with LDs that chose area 5 (middle area, either in text or icon scenario) as their FOA are mostly ones that have reading or writing disability. Also, three (out of 13) subjects in this category, after going through the rediagnosis process, were excluded from being learning disabilities. In summary, the findings suggest when designing multimedia courseware for students with MR and LDs, the essential learning elements should be placed on area 1, 2 and 5. In addition, FOV preference may also potentially be used as an indicator for diagnosing students with LDs.

Keywords: focus of attention, learning disabilities, mental retardation, on-line multimedia courseware, special education

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129 Pricing Effects on Equitable Distribution of Forest Products and Livelihood Improvement in Nepalese Community Forestry

Authors: Laxuman Thakuri

Abstract:

Despite the large number of in-depth case studies focused on policy analysis, institutional arrangement, and collective action of common property resource management; how the local institutions take the pricing decision of forest products in community forest management and what kinds of effects produce it, the answers of these questions are largely silent among the policy-makers and researchers alike. The study examined how the local institutions take the pricing decision of forest products in the lowland community forestry of Nepal and how the decisions affect to equitable distribution of benefits and livelihood improvement which are also objectives of Nepalese community forestry. The study assumes that forest products pricing decisions have multiple effects on equitable distribution and livelihood improvement in the areas having heterogeneous socio-economic conditions. The dissertation was carried out at four community forests of lowland, Nepal that has characteristics of high value species, matured-experience of community forest management and better record-keeping system of forest products production, pricing and distribution. The questionnaire survey, individual to group discussions and direct field observation were applied for data collection from the field, and Lorenz curve, gini-coefficient, χ²-text, and SWOT (Strong, Weak, Opportunity, and Threat) analysis were performed for data analysis and results interpretation. The dissertation demonstrates that the low pricing strategy of high-value forest products was supposed crucial to increase the access of socio-economically weak households, and to and control over the important forest products such as timber, but found counter productive as the strategy increased the access of socio-economically better-off households at higher rate. In addition, the strategy contradicts to collect a large-scale community fund and carry out livelihood improvement activities as per the community forestry objectives. The crucial part of the study is despite the fact of low pricing strategy; the timber alone contributed large part of community fund collection. The results revealed close relation between pricing decisions and livelihood objectives. The action research result shows that positive price discrimination can slightly reduce the prevailing inequality and increase the fund. However, it lacks to harness the full price of forest products and collects a large-scale community fund. For broader outcomes of common property resource management in terms of resource sustainability, equity, and livelihood opportunity, the study suggests local institutions to harness the full price of resource products with respect to the local market.

Keywords: community, equitable, forest, livelihood, socioeconomic, Nepal

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128 Mothers’ Experiences of Continuing Their Pregnancy after Prenatally Receiving a Diagnosis of Down Syndrome

Authors: Sevinj Asgarova

Abstract:

Within the last few decades, major advances in the field of prenatal testing have transpired yet little research regarding the experiences of mothers who chose to continue their pregnancies after prenatally receiving a diagnosis of Down Syndrome (DS) has been undertaken. Using social constructionism and interpretive description, this retrospective research study explores this topic from the point of view of the mothers involved and provides insight as to how the experience could be improved. Using purposive sampling, 23 mothers were recruited from British Columbia (n=11) and Ontario (n=12) in Canada. Data retrieved through semi-structured in-depth interviews were analyzed using inductive, constant comparative analysis, the major analytical techniques of interpretive description. Four primary phases emerged from the data analysis 1) healthcare professional-mothers communications, 2) initial emotional response, 3) subsequent decision-making and 4) an adjustment and reorganization of lifestyle to the preparation for the birth of the child. This study validates the individualized and contextualized nature of mothers’ decisions as influenced by multiple factors, with moral values/spiritual beliefs being significant. The mothers’ ability to cope was affected by the information communicated to them about their unborn baby’s diagnosis and the manner in which that information was delivered to them. Mothers used emotional coping strategies, dependent upon support from partners, family, and friends, as well as from other families who have children with DS. Additionally, they employed practical coping strategies, such as engaging in healthcare planning, seeking relevant information, and reimagining and reorganizing their lifestyle. Over time many families gained a sense of control over their situation and readjusted to the preparation for the birth of the child. Many mothers expressed the importance of maintaining positivity and hopefulness with respect to positive outcomes and opportunities for their children. The comprehensive information generated through this study will also provide healthcare professionals with relevant information to assist them in understanding the informational and emotional needs of these mothers. This should lead to an improvement in their practice and enhance their ability to intervene appropriately and effectively, better offering improved support to parents dealing with a diagnosis of DS for their child.

Keywords: continuing affected pregnancy, decision making, disability, down syndrome, eugenic social attitudes, inequalities, life change events, prenatal care, prenatal testing, qualitative research, social change, social justice

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127 An Exploration of the Emergency Staff’s Perceptions and Experiences of Teamwork and the Skills Required in the Emergency Department in Saudi Arabia

Authors: Sami Alanazi

Abstract:

Teamwork practices have been recognized as a significant strategy to improve patient safety, quality of care, and staff and patient satisfaction in healthcare settings, particularly within the emergency department (ED). The EDs depend heavily on teams of interdisciplinary healthcare staff to carry out their operational goals and core business of providing care to the serious illness and injured. The ED is also recognized as a high-risk area in relation to service demand and the potential for human error. Few studies have considered the perceptions and experiences of the ED staff (physicians, nurses, allied health professionals, and administration staff) about the practice of teamwork, especially in Saudi Arabia (SA), and no studies have been conducted to explore the practices of teamwork in the EDs. Aim: To explore the practices of teamwork from the perspectives and experiences of staff (physicians, nurses, allied health professionals, and administration staff) when interacting with each other in the admission areas in the ED of a public hospital in the Northern Border region of SA. Method: A qualitative case study design was utilized, drawing on two methods for the data collection, comprising of semi-structured interviews (n=22) with physicians (6), nurses (10), allied health professionals (3), and administrative members (3) working in the ED of a hospital in the Northern Border region of SA. The second method is non-participant direct observation. All data were analyzed using thematic analysis. Findings: The main themes that emerged from the analysis were as follows: the meaningful of teamwork, reasons of teamwork, the ED environmental factors, the organizational factors, the value of communication, leadership, teamwork skills in the ED, team members' behaviors, multicultural teamwork, and patients and families behaviors theme. Discussion: Working in the ED environment played a major role in affecting work performance as well as team dynamics. However, Communication, time management, fast-paced performance, multitasking, motivation, leadership, and stress management were highlighted by the participants as fundamental skills that have a major impact on team members and patients in the ED. It was found that the behaviors of the team members impacted the team dynamics as well as ED health services. Behaviors such as disputes among team members, conflict, cooperation, uncooperative members, neglect, and emotions of the members. Besides that, the behaviors of the patients and their accompanies had a direct impact on the team and the quality of the services. In addition, the differences in the cultures have separated the team members and created undesirable gaps such the gender segregation, national origin discrimination, and similarity and different in interests. Conclusion: Effective teamwork, in the context of the emergency department, was recognized as an essential element to obtain the quality of care as well as improve staff satisfaction.

Keywords: teamwork, barrier, facilitator, emergencydepartment

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126 White Individuals' Perception On Whiteness

Authors: Sebastian Del Corral Winder, Kiriana Sanchez, Mixalis Poulakis, Samantha Gray

Abstract:

This paper seeks to explore White privilege and Whiteness. Being White in the U.S. is often perceived as the norm and it brings significant social, economic, educational, and health privileges that often are hidden in social interactions. One quality of Whiteness has been its invisibility given its intrinsic impact on the system, which becomes only visible when paying close attention to White identity and culture and during cross-cultural interactions. The cross-cultural interaction provides an emphasis on differences between the participants and people of color are often viewed as “the other.” These interactions may promote an increased opportunity for discrimination and negative stereotypes against a person of color. Given the recent increase of violence against culturally diverse groups, there has been an increased sense of otherness and division in the country. Furthermore, the accent prestige theory has found that individuals who speak English with a foreign accent are perceived as less educated, competent, friendly, and trustworthy by White individuals in the United States. Using the consensual qualitative research (CQR) methodology, this study explored the cross-cultural dyad from the White individual’s perspective focusing on the psychotherapeutic relationship. The participants were presented with an audio recording of a conversation between a psychotherapist with a Hispanic accent and a patient with an American English accent. Then, the participants completed an interview regarding their perceptions of race, culture, and cross-cultural interactions. The preliminary results suggested that the Hispanic accent alone was enough for the participants to assign stereotypical ethnic and cultural characteristics to the individual with the Hispanic accent. Given the quality of the responses, the authors completed a secondary analysis to explore Whiteness and White privilege in more depth. Participants were found to be on a continuum in their understanding and acknowledgment of systemic racism; while some participants listed examples of inequality, other participants noted: “all people are treated equally.” Most participants noted their feelings of discomfort in discussing topics of cultural diversity and systemic racism by fearing to “say the ‘wrong thing.” Most participants placed the responsibility of discussing cultural differences with the person of color, which has been observed to create further alienation and otherness for culturally diverse individuals. The results indicate the importance of examining racial and cultural biases from White individuals to promote an anti-racist stance. The results emphasize the need for greater systemic changes in education, policies, and individual awareness regarding cultural identity. The results suggest the importance for White individuals to take ownership of their own cultural biases in order to promote equity and engage in cultural humility in a multicultural world. Future research should continue exploring the role of White ethnic identity and education as they appear to moderate White individuals’ attitudes and beliefs regarding other races and cultures.

Keywords: culture, qualitative research, whiteness, white privilege

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