Search results for: supervisor’s support
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7099

Search results for: supervisor’s support

5749 Machine Learning Based Digitalization of Validated Traditional Cognitive Tests and Their Integration to Multi-User Digital Support System for Alzheimer’s Patients

Authors: Ramazan Bakir, Gizem Kayar

Abstract:

It is known that Alzheimer and Dementia are the two most common types of Neurodegenerative diseases and their visibility is getting accelerated for the last couple of years. As the population sees older ages all over the world, researchers expect to see the rate of this acceleration much higher. However, unfortunately, there is no known pharmacological cure for both, although some help to reduce the rate of cognitive decline speed. This is why we encounter with non-pharmacological treatment and tracking methods more for the last five years. Many researchers, including well-known associations and hospitals, lean towards using non-pharmacological methods to support cognitive function and improve the patient’s life quality. As the dementia symptoms related to mind, learning, memory, speaking, problem-solving, social abilities and daily activities gradually worsen over the years, many researchers know that cognitive support should start from the very beginning of the symptoms in order to slow down the decline. At this point, life of a patient and caregiver can be improved with some daily activities and applications. These activities include but not limited to basic word puzzles, daily cleaning activities, taking notes. Later, these activities and their results should be observed carefully and it is only possible during patient/caregiver and M.D. in-person meetings in hospitals. These meetings can be quite time-consuming, exhausting and financially ineffective for hospitals, medical doctors, caregivers and especially for patients. On the other hand, digital support systems are showing positive results for all stakeholders of healthcare systems. This can be observed in countries that started Telemedicine systems. The biggest potential of our system is setting the inter-user communication up in the best possible way. In our project, we propose Machine Learning based digitalization of validated traditional cognitive tests (e.g. MOCA, Afazi, left-right hemisphere), their analyses for high-quality follow-up and communication systems for all stakeholders. R. Bakir and G. Kayar are with Gefeasoft, Inc, R&D – Software Development and Health Technologies company. Emails: ramazan, gizem @ gefeasoft.com This platform has a high potential not only for patient tracking but also for making all stakeholders feel safe through all stages. As the registered hospitals assign corresponding medical doctors to the system, these MDs are able to register their own patients and assign special tasks for each patient. With our integrated machine learning support, MDs are able to track the failure and success rates of each patient and also see general averages among similarly progressed patients. In addition, our platform also supports multi-player technology which helps patients play with their caregivers so that they feel much safer at any point they are uncomfortable. By also gamifying the daily household activities, the patients will be able to repeat their social tasks and we will provide non-pharmacological reminiscence therapy (RT – life review therapy). All collected data will be mined by our data scientists and analyzed meaningfully. In addition, we will also add gamification modules for caregivers based on Naomi Feil’s Validation Therapy. Both are behaving positively to the patient and keeping yourself mentally healthy is important for caregivers. We aim to provide a therapy system based on gamification for them, too. When this project accomplishes all the above-written tasks, patients will have the chance to do many tasks at home remotely and MDs will be able to follow them up very effectively. We propose a complete platform and the whole project is both time and cost-effective for supporting all stakeholders.

Keywords: alzheimer’s, dementia, cognitive functionality, cognitive tests, serious games, machine learning, artificial intelligence, digitalization, non-pharmacological, data analysis, telemedicine, e-health, health-tech, gamification

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5748 Optimum Design of Support and Care Home for the Elderly

Authors: P. Shahabi

Abstract:

The increase in average human life expectancy has led to a growing elderly population. This demographic shift has brought forth various challenges related to the mental and physical well-being of the elderly, often resulting in a lack of dignity and respect for this valuable segment of society. These emerging social issues have cast a shadow on the lives of families, prompting the need for innovative solutions to enhance the lives of the elderly. In this study, within the context of architecture, we aim to create a pleasant and nurturing environment that combines traditional Iranian and modern architectural elements to cater to the unique needs of the elderly. Our primary research objectives encompass the following: Recognizing the societal demand for nursing homes due to the increasing elderly population, addressing the need for a conducive environment that promotes physical and mental well-being among the elderly, developing spatial designs that are specifically tailored to the elderly population, ensuring their comfort and convenience. To achieve these objectives, we have undertaken a comprehensive exploration of the challenges and issues faced by the elderly. We have also laid the groundwork for the architectural design of nursing homes, culminating in the presentation of an architectural plan aimed at minimizing the difficulties faced by the elderly and enhancing their quality of life. It is noteworthy that many of the existing nursing homes in Iran lack the necessary welfare and safety conditions required for the elderly. Hence, our research aims to establish comprehensive and suitable criteria for the optimal design of nursing homes. We believe that through optimal design, we can create spaces that are not only diverse, attractive, and dynamic but also significantly improve the quality of life for the elderly. We hold the hope that these homes will serve as beacons of hope and tranquility for all individuals in their later years.

Keywords: care home, elderly, optimum design, support

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5747 Exploring the Impact of ChatGPT on the English Writing Skills of a Group of International EFL Uzbek Students: A Qualitative Case Study Conducted at a Private University College in Malaysia

Authors: Uranus Saadat

Abstract:

ChatGPT, as one of the well-known artificial intelligence (AI) tools, has recently been integrated into English language education and has had several impacts on learners. Accordingly, concerns regarding the overuse of this tool among EFL/ESL learners are rising, which could lead to several disadvantages in their writing skills development. The use of ChatGPT in facilitating writing skills is a novel concept that demands further studies in different contexts and learners. In this study, a qualitative case study is applied to investigate the impact of ChatGPT on the writing skills of a group of EFL bachelor’s students from Uzbekistan studying Teaching English as the Second Language (TESL) at a private university in Malaysia. The data was collected through the triangulation of document analysis, semi-structured interviews, classroom observations, and focus group discussions. Subsequently, the data was analyzed by using thematic analysis. Some of the emerging themes indicated that ChatGPT is helpful in engaging students by reducing their anxiety in class and providing them with constructive feedback and support. Conversely, certain emerging themes revealed excessive reliance on ChatGPT, resulting in a decrease in students’ creativity and critical thinking skills, memory span, and tolerance for ambiguity. The study suggests a number of strategies to alleviate its negative impacts, such as peer review activities, workshops for familiarizing students with AI, and gradual withdrawal of AI support activities. This study emphasizes the need for cautious AI integration into English language education to cultivate independent learners with higher-order thinking skills.

Keywords: ChatGPT, EFL/ESL learners, English writing skills, artificial intelligence tools, critical thinking skills

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5746 Topping Failure Analysis of Anti-Dip Bedding Rock Slopes Subjected to Crest Loads

Authors: Chaoyi Sun, Congxin Chen, Yun Zheng, Kaizong Xia, Wei Zhang

Abstract:

Crest loads are often encountered in hydropower, highway, open-pit and other engineering rock slopes. Toppling failure is one of the most common deformation failure types of anti-dip bedding rock slopes. Analysis on such failure of anti-dip bedding rock slopes subjected to crest loads has an important influence on engineering practice. Based on the step-by-step analysis approach proposed by Goodman and Bray, a geo-mechanical model was developed, and the related analysis approach was proposed for the toppling failure of anti-dip bedding rock slopes subjected to crest loads. Using the transfer coefficient method, a formulation was derived for calculating the residual thrust of slope toe and the support force required to meet the requirements of the slope stability under crest loads, which provided a scientific reference to design and support for such slopes. Through slope examples, the influence of crest loads on the residual thrust and sliding ratio coefficient was investigated for cases of different block widths and slope cut angles. The results show that there exists a critical block width for such slope. The influence of crest loads on the residual thrust is non-negligible when the block thickness is smaller than the critical value. Moreover, the influence of crest loads on the slope stability increases with the slope cut angle and the sliding ratio coefficient of anti-dip bedding rock slopes increases with the crest loads. Finally, the theoretical solutions and numerical simulations using Universal Distinct Element Code (UDEC) were compared, in which the consistent results show the applicability of both approaches.

Keywords: anti-dip bedding rock slope, crest loads, stability analysis, toppling failure

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5745 The Role of Sustainable Financing Models for Smallholder Tree Growers in Ghana

Authors: Raymond Awinbilla

Abstract:

The call for tree planting has long been set in motion by the government of Ghana. The Forestry Commission encourages plantation development through numerous interventions including formulating policies and enacting legislations. However, forest policies have failed and that has generated a major concern over the vast gap between the intentions of national policies and the realities established. This study addresses three objectives;1) Assessing the farmers' response and contribution to the tree planting initiative, 2) Identifying socio-economic factors hindering the development of smallholder plantations as a livelihood strategy, and 3) Determining the level of support available for smallholder tree growers and the factors influencing it. The field work was done in 12 farming communities in Ghana. The article illuminates that farmers have responded to the call for tree planting and have planted both exotic and indigenous tree species. Farmers have converted 17.2% (369.48ha) of their total land size into plantations and have no problem with land tenure. Operations and marketing constraints include lack of funds for operations, delay in payment, low price of wood, manipulation of price by buyers, documentation by buyers, and no ready market for harvesting wood products. Environmental institutions encourage tree planting; the only exception is with the Lands Commission. Support availed to farmers includes capacity building in silvicultural practices, organisation of farmers, linkage to markets and finance. Efforts by the Government of Ghana to enhance forest resources in the country could rely on the input of local populations.

Keywords: livelihood strategy, marketing constraints, environmental institutions, silvicultural practices

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5744 Patient Advocates to Improve Access to Justice in Involuntary Hospitalisation

Authors: Zuzana Durajova, Natasa Diatkova, Shreya Bhardwaj

Abstract:

This paper introduces the project START, its activities, goals, evaluation and final results. Over the past few decades, the legal discourse surrounding mental health has resulted in improvement in patient rights (in Netherlands, etc.), the appointment of Ombudspersons for psychiatric patients (in Austria, Sweden) and facilitating the participation of patients in decision-making processes. Czech legislation already recognizes the position of “patient’s advocate” as a person of trust. However, this instrument is not very widely known and rarely used in practice. In the pilot study of the project, legal training for patient advocacy is provided to persons with experience with mental health problems/psychiatric hospitalization chosen from a Czech-based NGO. These persons (patient advocates) visit patients in involuntary hospitalization in one closed ward in the chosen psychiatric institution. During visits, the patient advocates inform patients about their legal standing, their procedural rights and also offer them individual support in contacting their counsel, family members etc. To understand the effect of the intervention, qualitative interviews and participant observations are conducted with the patients, advocates, the hospital management and staff and other identifiable stakeholders, such as government officials responsible for mental health care reform. The interviews are held before, during and after the intervention (support from patient advocates in hospitals). Given the ethical quandaries arising from using psychiatric wards as a field setting, we assume a participatory approach to ensure respect for patient boundaries and dignity. Through this project, we seek to establish a profession of patient advocates based on professional standards.

Keywords: patient advocacy, involuntary hospitalization, Czech Republic, patient Rights, professionalization

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5743 Facilitating Academic Growth of Students With Autism

Authors: Jolanta Jonak

Abstract:

All students demonstrate various learning preferences and learning styles that range from visual, auditory to kinesthetic preferences. These learning preferences are further impacted by individual cognitive profiles hat characterizes itself in linguistic strengths, logical- special, inter-or intra- personal, just to name a few. Students from culturally and linguistically diverse backgrounds (CLD) have an increased risk of being misunderstood by many school systems and even medical personnel. Students with disability, specifically Autism, are faced with another layer of learning differences. Research indicates that large numbers of students are not provided the type of education and types of supports they need in order to be successful in an academic environment. Multiple research findings indicate that significant numbers of school staff self-reports that they do not feel adequately prepared to work with students with disability and different learing profiles. It is very important for the school staff to be educated about different learning needs of students with autism spectrum disorders. Having the knowledge, school staff can avoid unnecessary referrals for office referrals and avoid inaccurate decisions about restrictive learning environments. This presentation will illustrate the cognitive differences in students with autism, how to recognize them, and how to support them through Differentiated Instruction. One way to ensure successful education for students with disability is by providing Differentiated Instruction (DI). DI is quickly gaining its popularity in the Unites States as a scientific- research based instructional approach for all students. This form of support ensures that regardless of the students’ learning preferences and cognitive learning profiles, they have an opportunity to learn through approaches that are suitable to their needs. It is extremely important for the school staff, especially school psychologists who often are the first experts to be consulted by educators, to be educated about differences due to learning preference styles and differentiation needs.

Keywords: special education, autism, differentiation, differences, differentiated instruction

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5742 The Phenomena of False Cognates and Deceptive Cognates: Issues to Foreign Language Learning and Teaching Methodology Based on Set Theory

Authors: Marilei Amadeu Sabino

Abstract:

The aim of this study is to establish differences between the terms ‘false cognates’, ‘false friends’ and ‘deceptive cognates’, usually considered to be synonyms. It will be shown they are not synonyms, since they do not designate the same linguistic process or phenomenon. Despite their differences in meaning, many pairs of formally similar words in two (or more) different languages are true cognates, although they are usually known as ‘false’ cognates – such as, for instance, the English and Italian lexical items ‘assist x assistere’; ‘attend x attendere’; ‘argument x argomento’; ‘apology x apologia’; ‘camera x camera’; ‘cucumber x cocomero’; ‘fabric x fabbrica’; ‘factory x fattoria’; ‘firm x firma’; ‘journal x giornale’; ‘library x libreria’; ‘magazine x magazzino’; ‘parent x parente’; ‘preservative x preservativo’; ‘pretend x pretendere’; ‘vacancy x vacanza’, to name but a few examples. Thus, one of the theoretical objectives of this paper is firstly to elaborate definitions establishing a distinction between the words that are definitely ‘false cognates’ (derived from different etyma) and those that are just ‘deceptive cognates’ (derived from the same etymon). Secondly, based on Set Theory and on the concepts of equal sets, subsets, intersection of sets and disjoint sets, this study is intended to elaborate some theoretical and practical questions that will be useful in identifying more precisely similarities and differences between cognate words of different languages, and according to graphic interpretation of sets it will be possible to classify them and provide discernment about the processes of semantic changes. Therefore, these issues might be helpful not only to the Learning of Second and Foreign Languages, but they could also give insights into Foreign and Second Language Teaching Methodology. Acknowledgements: FAPESP – São Paulo State Research Support Foundation – the financial support offered (proc. n° 2017/02064-7).

Keywords: deceptive cognates, false cognates, foreign language learning, teaching methodology

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5741 Mandatory Wellness Assessments for Medical Students at the University of Ottawa

Authors: Haykal. Kay-Anne

Abstract:

The health and well-being of students is a priority for the Faculty of Medicine at the University of Ottawa. The demands of medical studies are extreme, and many studies confirm that the prevalence of psychological distress is very high among medical students and that it is higher than that of the general population of the same age. The main goal is to identify risk factors for mental health among medical students at the University of Ottawa. The secondary objectives are to determine the variation of these risk factors according to demographic variables, as well as to determine if there is a change in the mental health of students during the 1st and 3rd years of their study. Medical students have a mandatory first and third-year wellness check meeting. This assessment includes a questionnaire on demographic information, mental health, and risk factors such as physical health, sleep, social support, financial stress, education and career, stress and drug use and/or alcohol. Student responses were converted to numerical values and analyzed statistically. The results show that 61% of the variation in the mean of the mental health score is explained by the following risk factors (R2 = 0.61, F (9.396) = 67.197, p < 0.01): lack of sleep and fatigue (β = 0.281, p < 0.001), lack of social support (β = 0.217, p <0.001), poor study or career development (β = 0.195, p < 0.001) and an increase stress and drug and alcohol use (β = -0.239, p < 0.001). No demographic variable has a significant effect on the presence of risk factors. In addition, fixed-effects regression demonstrated significantly lower mental health (p < 0.1) among first-year students (M = 0.587, SD = 0.072) than among third-year students (M = 0.719, SD = 0.071). This preliminary study indicates the need to continue data collection and analysis to increase the significance of the study results. As risk factors are present at the beginning of medical studies, it is important to offer resources to students very early in their medical studies and to have close monitoring and supervision.

Keywords: assessment of mental health, medical students, risk factors for mental health, wellness assessment

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5740 Effectual Role of Local Level Partnership Schemes in Affordable Housing Delivery

Authors: Hala S. Mekawy

Abstract:

Affordable housing delivery for low and lower middle income families is a prominent problem in many developing countries; governments alone are unable to address this challenge due to diverse financial and regulatory constraints, and the private sector's contribution is rare and assists only middle-income households even when institutional and legal reforms are conducted to persuade it to go down market. Also, the market-enabling policy measures advocated by the World Bank since the early nineties have been strongly criticized and proven to be inappropriate to developing country contexts, where it is highly unlikely that the formal private sector can reach low income population. In addition to governments and private developers, affordable housing delivery systems involve an intricate network of relationships between diverse ranges of actors. Collaboration between them was proven to be vital, and hence, an approach towards partnership schemes for affordable housing delivery has emerged. The basic premise of this paper is that addressing housing affordability challenges in Egypt demands direct public support, as markets and market actors alone would never succeed in delivering decent affordable housing to low and lower middle income groups. It argues that this support would ideally be through local level partnership schemes, with a leading decentralized local government role, and partners being identified according to specific local conditions. It attempts to identify major attributes that would ensure the fulfilment of the goals of such schemes in the Egyptian context. This is based upon evidence from diversified worldwide experiences, in addition to the main outcomes of a questionnaire that was conducted to specialists and chief actors in the field.

Keywords: affordable housing, partnership schemes, housing, urban environments

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5739 Development and Evaluation of a Cognitive Behavioural Therapy Based Smartphone App for Low Moods and Anxiety

Authors: David Bakker, Nikki Rickard

Abstract:

Smartphone apps hold immense potential as mental health and wellbeing tools. Support can be made easily accessible and can be used in real-time while users are experiencing distress. Furthermore, data can be collected to enable machine learning and automated tailoring of support to users. While many apps have been developed for mental health purposes, few have adhered to evidence-based recommendations and even fewer have pursued experimental validation. This paper details the development and experimental evaluation of an app, MoodMission, that aims to provide support for low moods and anxiety, help prevent clinical depression and anxiety disorders, and serve as an adjunct to professional clinical supports. MoodMission was designed to deliver cognitive behavioural therapy for specifically reported problems in real-time, momentary interactions. Users report their low moods or anxious feelings to the app along with a subjective units of distress scale (SUDS) rating. MoodMission then provides a choice of 5-10 short, evidence-based mental health strategies called Missions. Users choose a Mission, complete it, and report their distress again. Automated tailoring, gamification, and in-built data collection for analysis of effectiveness was also included in the app’s design. The development process involved construction of an evidence-based behavioural plan, designing of the app, building and testing procedures, feedback-informed changes, and a public launch. A randomized controlled trial (RCT) was conducted comparing MoodMission to two other apps and a waitlist control condition. Participants completed measures of anxiety, depression, well-being, emotional self-awareness, coping self-efficacy and mental health literacy at the start of their app use and 30 days later. At the time of submission (November 2016) over 300 participants have participated in the RCT. Data analysis will begin in January 2017. At the time of this submission, MoodMission has over 4000 users. A repeated-measures ANOVA of 1390 completed Missions reveals that SUDS (0-10) ratings were significantly reduced between pre-Mission ratings (M=6.20, SD=2.39) and post-Mission ratings (M=4.93, SD=2.25), F(1,1389)=585.86, p < .001, np2=.30. This effect was consistent across both low moods and anxiety. Preliminary analyses of the data from the outcome measures surveys reveal improvements across mental health and wellbeing measures as a result of using the app over 30 days. This includes a significant increase in coping self-efficacy, F(1,22)=5.91, p=.024, np2=.21. Complete results from the RCT in which MoodMission was evaluated will be presented. Results will also be presented from the continuous outcome data being recorded by MoodMission. MoodMission was successfully developed and launched, and preliminary analysis suggest that it is an effective mental health and wellbeing tool. In addition to the clinical applications of MoodMission, the app holds promise as a research tool to conduct component analysis of psychological therapies and overcome restraints of laboratory based studies. The support provided by the app is discrete, tailored, evidence-based, and transcends barriers of stigma, geographic isolation, financial limitations, and low health literacy.

Keywords: anxiety, app, CBT, cognitive behavioural therapy, depression, eHealth, mission, mobile, mood, MoodMission

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5738 Analyzing Use of Figurativeness, Visual Elements, Allegory, Scenic Imagery as Support System in Punjabi Contemporary Theatre for Escaping Censorship

Authors: Shazia Anwer

Abstract:

This paper has discussed the unusual form of resistance in theatre against censorship board in Pakistan. The atypical approach of dramaturgy created massive space for performers and audiences to integrate and communicate. The social and religious absolutes creates suffocation in Pakistani society, strict control over all Fine and Performing Art has made art political, contemporary dramatics has started an amalgamated theatre to avoid censorship. Contemporary Punjabi theatre techniques are directly dependent on human cognition. The idea of indirect thought processing is not unique but dependent on spectators. The paper has provided an account of these techniques and their specific use for conveying specific messages across the audiences. For the Dramaturge of today, theatre space is an expression representing a linguistic formulation that includes qualities of experimental and non-traditional use of classical theatrical space in the context of fulfilling the concept of open theatre. Paper has explained the transformation of the theatrical experience into an event where the actor and the audience are co-existing and co-experiencing the dramatical experience. The denial of the existence of the 4th -Wall made two-way communication possible. This paper has elaborated that the previously marginalized genres such as naach, jugat, miras, are extensively included to counter the censorship board. Figurativeness, visual elements, allegory, scenic imagery are basic support system for contemporary Punjabi theatre. The body of the actor is used as a source for non-verbal communication, and for an escape from traditional theatrical space which by every means has every element that could be controlled and reprimanded by the controlling authority.

Keywords: communication, Punjabi theatre, figurativeness, censorship

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5737 Evaluation of Model-Based Code Generation for Embedded Systems–Mature Approach for Development in Evolution

Authors: Nikolay P. Brayanov, Anna V. Stoynova

Abstract:

Model-based development approach is gaining more support and acceptance. Its higher abstraction level brings simplification of systems’ description that allows domain experts to do their best without particular knowledge in programming. The different levels of simulation support the rapid prototyping, verifying and validating the product even before it exists physically. Nowadays model-based approach is beneficial for modelling of complex embedded systems as well as a generation of code for many different hardware platforms. Moreover, it is possible to be applied in safety-relevant industries like automotive, which brings extra automation of the expensive device certification process and especially in the software qualification. Using it, some companies report about cost savings and quality improvements, but there are others claiming no major changes or even about cost increases. This publication demonstrates the level of maturity and autonomy of model-based approach for code generation. It is based on a real live automotive seat heater (ASH) module, developed using The Mathworks, Inc. tools. The model, created with Simulink, Stateflow and Matlab is used for automatic generation of C code with Embedded Coder. To prove the maturity of the process, Code generation advisor is used for automatic configuration. All additional configuration parameters are set to auto, when applicable, leaving the generation process to function autonomously. As a result of the investigation, the publication compares the quality of generated embedded code and a manually developed one. The measurements show that generally, the code generated by automatic approach is not worse than the manual one. A deeper analysis of the technical parameters enumerates the disadvantages, part of them identified as topics for our future work.

Keywords: embedded code generation, embedded C code quality, embedded systems, model-based development

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5736 Sudan’s Approach to Knowledge Management in Disaster Management

Authors: Mohamed Abdalla Elamein Boshara, Peter Charles Woods, Nour Eldin Mohamed Elshaiekh

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Knowledge Management has become very important for Disaster Management response and planning. This paper proposes the implementation of a Knowledge Management System with a sustainable data collection mechanism for reliable and timely information management to support decision makers in making the right decisions in the timely manner.

Keywords: knowledge management, disaster management, incident tracking, web application

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5735 Service Provision in 'the Jungle': Describing Mental Health and Psychosocial Support Offered to Residents of the Calais Camp

Authors: Amy Darwin, Claire Blacklock

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Background: Existing literature about delivering evidence-based mental health and psychosocial support (MHPSS) in emergency settings is limited. It is difficult to monitor and evaluate the approach to MHPSS in informal refugee camps such as ‘The Jungle’ in Calais, where there are multiple service providers and where the majority of providers are volunteers. AIM: To identify experiences of MHPSS delivery by service providers in an informal camp environment in Calais, France and describe MHPSS barriers and opportunities in this type of setting. Method: Qualitative semi-structured interviews were conducted with 13 individuals from different organisations offering MHPSS in Calais and analysed using conventional content analysis. Results: Unsafe, uncertain and unsanitary conditions in the camp meant MHPSS was difficult to implement, and such conditions contributed to the poor mental health of the residents. The majority of MHPSS was offered by volunteers who lacked resources and training, and there was no overall official camp leadership which meant care was poorly coordinated and monitored. Strong relationships existed between volunteers and camp residents, but volunteers felt frustrated that they could not deliver the kind of MHPSS that they felt residents required. Conclusion: While long-term volunteers had built supportive relationships with camp residents, lack of central coordination and leadership of MHPSS services and limited access to trained professionals made implementation of MHPSS problematic. Similarly, the camp lacked the necessary infrastructure to meet residents’ basic needs. Formal recognition of the camp, and clear central leadership were identified as necessary steps to improving MHPSS delivery.

Keywords: calais, mental health, refugees, the jungle, MHPSS

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5734 Planning Urban Sprawl in Mining Areas in Africa: How to Ensure Coherent Development

Authors: Pascal Rey, Anaïs Weber

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Many mining projects are being developed in Africa the last decades. Due to the economic opportunities they offer, these projects result in a massive and rapid influx of migrants to the surrounding area. In areas where central government representation is low and local administration lack financial resources, urban development is often anarchical, beyond all public control. It leads to socio-spatial segregation, insecurity and the risk of social conflicts rising. Aware that their economic development is very correlated with local situation, mining companies get more and more involved in regional planning in setting up tools and Strategic Directions document. One of the commonly used tools in this regard is the “Influx Management Plan”. It consists in looking at the region’s absorption capacities in order to ensure its coherent development and by developing several urban centers than one macrocephalic city. It includes many other measures such as urban governance support, skills transfer, creation of strategic guidelines, financial support (local taxes, mining taxes, development funds etc.) local development projects. Through various examples of mining projects in Guinea, A country that is host to many large mining projects, we will look at the implications of regional and urban planning of which mining companies are key playor as well as public authorities. While their investment capacity offers advantages and accelerates development, their actions raise questions of the unilaterality of interests and local governance. By interfering in public affairs are mining companies not increasing the risk of central and local government shirking their responsibilities in terms of regional development, or even calling their legitimacy into question? Is such public-private collaboration really sustainable for the region as a whole and for all stakeholders?

Keywords: Africa, guinea, mine, urban planning

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5733 Land Use Planning Tool to Achieve Land Degradation Neutrality: Tunisia Case Study

Authors: Rafla Attia, Claudio Zucca, Bao Quang Le, Sana Dridi, Thouraya Sahli, Taoufik Hermassi

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In Tunisia, landscape change and land degradation are critical issues for landscape conservation, management, and planning. Landscapes are undergoing crucial environmental problems made evident by soil degradation and desertification. Human improper uses of land resources (e.g., unsuitable land uses, unsustainable crop intensification, and poor rangeland management) and climate change are the main factors leading to the landscape transformation and desertification affecting high proportions of the Tunisian lands. Land use planning (LUP) to achieve Land Degradation Neutrality (LDN) must be supported by methodologies and technologies that help identify best solutions and practices and design context-specific sustainable land management (SLM) strategies. Such strategies must include restoration or rehabilitation efforts in areas with high land degradation, as well as prevention of degradation that could be caused by improper land use (LU) and land management (LM). The geoinformatics Land Use Planning for LDN (LUP4LDN) tool has been designed for this purpose. Its aim is to support national and sub-national planners in i) mapping geographic patterns of current land degradation; ii) anticipating further future land degradation expected in areas that are unsustainably managed; and iii) providing an interactive procedure for developing participatory LU-LM transitional scenarios over selected regions of interest and timeframes, visualizing the related expected levels of impacts on ecosystem services via maps and graphs. The tool has been co-developed and piloted with national stakeholders in Tunisia. The piloting implementation assessed how the LUP4LDN tool fits with existing LUP processes and the benefits achieved by using the tool to support land use planning for LDN.

Keywords: land use system, land cover, sustainable land management, land use planning for land degradation neutrality

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5732 IPO Price Performance and Signaling

Authors: Chih-Hsiang Chang, I-Fan Ho

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This study examines the credibility of the signaling as explanation for IPO initial underpricing. Findings reveal the initial underpricing and the long-term underperformance of IPOs in Taiwan. However, we only find weak support for signaling as explanation of IPO underpricing.

Keywords: signaling, IPO initial underpricing, IPO long-term underperformance, Taiwan’s stock market

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5731 Benchmarking Machine Learning Approaches for Forecasting Hotel Revenue

Authors: Rachel Y. Zhang, Christopher K. Anderson

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A critical aspect of revenue management is a firm’s ability to predict demand as a function of price. Historically hotels have used simple time series models (regression and/or pick-up based models) owing to the complexities of trying to build casual models of demands. Machine learning approaches are slowly attracting attention owing to their flexibility in modeling relationships. This study provides an overview of approaches to forecasting hospitality demand – focusing on the opportunities created by machine learning approaches, including K-Nearest-Neighbors, Support vector machine, Regression Tree, and Artificial Neural Network algorithms. The out-of-sample performances of above approaches to forecasting hotel demand are illustrated by using a proprietary sample of the market level (24 properties) transactional data for Las Vegas NV. Causal predictive models can be built and evaluated owing to the availability of market level (versus firm level) data. This research also compares and contrast model accuracy of firm-level models (i.e. predictive models for hotel A only using hotel A’s data) to models using market level data (prices, review scores, location, chain scale, etc… for all hotels within the market). The prospected models will be valuable for hotel revenue prediction given the basic characters of a hotel property or can be applied in performance evaluation for an existed hotel. The findings will unveil the features that play key roles in a hotel’s revenue performance, which would have considerable potential usefulness in both revenue prediction and evaluation.

Keywords: hotel revenue, k-nearest-neighbors, machine learning, neural network, prediction model, regression tree, support vector machine

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5730 The Methanotrophic Activity in a Landfill Bio-Cover through a Subzero Winter

Authors: Parvin Berenjkar, Qiuyan Yuan, Richard Sparling, Stan Lozecznik

Abstract:

Landfills highly contribute to anthropological global warming through CH₄ emissions. Landfills are usually capped by a conventional soil cover to control the migration of gases. Methane is consumed by CH₄-oxidizing microorganisms known as methanotrophs that naturally exist in the landfill soil cover. The growth of methanotrophs can be optimized in a bio-cover that typically consists of a gas distribution layer (GDL) to homogenize landfill gas fluxes and an overlying oxidation layer composed of suitable materials that support methanotrophic populations. Materials such as mature yard waste composts can provide an inexpensive and favourable porous support for the growth and activity of methanotrophs. In areas with seasonal cold climates, it is valuable to know if methanotrophs in a bio-cover can survive in winter until the next spring, and how deep they are active in the bio-cover to mitigate CH₄. In this study, a pilot bio-cover was constructed in a closed landfill cell in Winnipeg that has a very cold climate in Canada. The bio-cover has a surface area of 2.5 m x 3.5 m and 1.5 m of depth, filled with 50 cm of gravel as a GDL and 70 cm of biosolids compost amended with yard and leaf waste compost. The observed in situ potential of methanotrophs for CH₄ oxidation was investigated at a specific period of time from December 2016 to April 2017 as well as November 2017 to April 2018, when the transition to surface frost and thawing happens in the bio-cover. Compost samples taken from different depths of the bio-cover were incubated in the laboratory under standardized conditions; an optimal air: methane atmosphere, at 22ºC, but at in situ moisture content. Results showed that the methanotrophs were alive oxidizing methane without a lag, indicating that there was the potential for methanotrophic activity at some depths of the bio-cover.

Keywords: bio-cover, global warming, landfill, methanotrophic activity

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5729 Flexural Response of Sandwiches with Micro Lattice Cores Manufactured via Selective Laser Sintering

Authors: Emre Kara, Ali Kurşun, Halil Aykul

Abstract:

The lightweight sandwiches obtained with the use of various core materials such as foams, honeycomb, lattice structures etc., which have high energy absorbing capacity and high strength to weight ratio, are suitable for several applications in transport industry (automotive, aerospace, shipbuilding industry) where saving of fuel consumption, load carrying capacity increase, safety of vehicles and decrease of emission of harmful gases are very important aspects. While the sandwich structures with foams and honeycombs have been applied for many years, there is a growing interest on a new generation sandwiches with micro lattice cores. In order to produce these core structures, various production methods were created with the development of the technology. One of these production technologies is an additive manufacturing technique called selective laser sintering/melting (SLS/SLM) which is very popular nowadays because of saving of production time and achieving the production of complex topologies. The static bending and the dynamic low velocity impact tests of the sandwiches with carbon fiber/epoxy skins and the micro lattice cores produced via SLS/SLM were already reported in just a few studies. The goal of this investigation was the analysis of the flexural response of the sandwiches consisting of glass fiber reinforced plastic (GFRP) skins and the micro lattice cores manufactured via SLS under thermo-mechanical loads in order to compare the results in terms of peak load and absorbed energy values respect to the effect of core cell size, temperature and support span length. The micro lattice cores were manufactured using SLS technology that creates the product drawn by a 3D computer aided design (CAD) software. The lattice cores which were designed as body centered cubic (BCC) model having two different cell sizes (d= 2 and 2.5 mm) with the strut diameter of 0.3 mm were produced using titanium alloy (Ti6Al4V) powder. During the production of all the core materials, the same production parameters such as laser power, laser beam diameter, building direction etc. were kept constant. Vacuum Infusion (VI) method was used to produce skin materials, made of [0°/90°] woven S-Glass prepreg laminates. The combination of the core and skins were implemented under VI. Three point bending tests were carried out by a servo-hydraulic test machine with different values of support span distances (L = 30, 45, and 60 mm) under various temperature values (T = 23, 40 and 60 °C) in order to analyze the influences of support span and temperature values. The failure mode of the collapsed sandwiches has been investigated using 3D computed tomography (CT) that allows a three-dimensional reconstruction of the analyzed object. The main results of the bending tests are: load-deflection curves, peak force and absorbed energy values. The results were compared according to the effect of cell size, support span and temperature values. The obtained results have particular importance for applications that require lightweight structures with a high capacity of energy dissipation, such as the transport industry, where problems of collision and crash have increased in the last years.

Keywords: light-weight sandwich structures, micro lattice cores, selective laser sintering, transport application

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5728 Integrated HIV Prevention and Sexual and Reproductive Health Services Among Adolescent Girls and Young Women in Rwanda: Knowledge, Attitudes, and Practices Survey.

Authors: Nsenga Bakinahe

Abstract:

Background: Adolescent girls and young women (AGYW) globally and, particularly in Rwanda, face significant challenges related to HIV prevention and sexual and reproductive health (SRH). Rwanda has a young population, with 65.3% below 30 years of age, demonstrating a need for SRH promotion and HIV prevention for this population. We aimed to determine the knowledge, attitudes, and practices (KAP) of integrated HIV prevention and SRH services among AGYW in Rwanda. Methodology: We conducted a cross-sectional survey among 384 AGYW aged 15-24 years who had ever been pregnant and currently reside in Nyagatare district, Eastern Rwanda from January to April 2023. A questionnaire was developed to collect data, participants were randomly selected and data were collected by one-on-one interviews and were analyzed using SPSS V21. The statistical relationship between variables was significant at P-Value of 0.05 and 95% confidence interval. Results: The majority (97.9%) of respondents demonstrated a good level of knowledge, (52.2%) of the respondents had positive attitudes towards integrated HIV prevention and SRH services. Looking at the practice of integrated HIV prevention and SRH services use, 51.4% of respondents have a low level of practice. The practice of integrated HIV prevention and SRH services was significantly associated with school drop-out and family status (P>0.05). Conclusion: The findings from these studies collectively emphasize the need for comprehensive education, targeted interventions, and community-based support to achieve better health outcomes regarding HIV prevention and overall sexual and reproductive health among adolescent girls and young women. Empowering adolescent girls and young women with accurate information and comprehensive support will enable them to make informed decisions, protect their health effectively, and contribute to reducing the burden of HIV and improving sexual and reproductive health outcomes.

Keywords: integrated HIV prevention, sexual and reproductive health services, among adolescentes girls, and young women

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5727 Academic Staff Identity and Emotional Labour: Exploring Pride, Motivation, and Relationships in Universities

Authors: Keith Schofield, Garry R. Prentice

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The perceptions of the work an academic does, and the environment in which they do it, contributes to the professional identity of that academic. In turn, this has implications for the level of involvement they have in their job, their satisfaction, and their work product. This research explores academic identities in British and Irish institutions and considers the complex interplay between identity, practice, and participation. Theoretical assumptions made in this paper assert that meaningful work has positive effects on work pride, organisational commitment, organisational citizenship, and motivation; when employees participate enthusiastically they are likely to be more engaged, more successful, and more satisfied. Further examination is given to the context in which this participation happens; the nature of institutional process, management, and relationships with colleagues, team members, and students is considered. The present study follows a mixed-methods approach to explore work satisfaction constructs in a number of academic contexts in the UK and Ireland. The quantitative component of this research (Convenience Sample: 155 academics, and support/ administrative staff; 36.1% male, 63.9% female; 60.8% academic staff, 39.2% support/ administration staff; across a number of universities in the UK and Ireland) was based on an established emotional labour model and was tested across gender groups, job roles, and years of service. This was complimented by qualitative semi-structured interviews (Purposive Sample: 10 academics, and 5 support/ administrative staff across the same universities in the UK and Ireland) to examine various themes including values within academia, work conditions, professional development, and transmission of knowledge to students. Experiences from both academic and support perspectives were sought in order to gain a holistic view of academia and to provide an opportunity to explore the dynamic of the academic/administrator relationship within the broader institutional context. The quantitative emotional labour model, tested via a path analysis, provided a robust description of the relationships within the data. The significant relationships found within the quantitative emotional labour model included a link between non-expression of true feelings resulting in emotional labourious work and lower levels of intrinsic motivation and higher levels of extrinsic motivation. Higher levels of intrinsic motivation also linked positively to work pride. These findings were further explored in the qualitative elements of the research where themes emerged including the disconnection between faculty management and staff, personal fulfilment and the friction between the identities of teacher, researcher/ practitioner and administrator. The implications of the research findings from this study are combined and discussed in relation to possible identity-related and emotional labour management-related interventions. Further, suggestions are made to institutions concerning the application of these findings including the development of academic practices, with specific reference to the duality of identity required to service the combined teacher/ researcher role. Broader considerations of the paper include how individuals and institutions may engage with the changing nature of students-as-consumers as well as a recommendation to centralise personal fulfillment through the development of professional academic identities.

Keywords: academic work, emotional labour, identity friction, mixed methods

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5726 Integrating the Modbus SCADA Communication Protocol with Elliptic Curve Cryptography

Authors: Despoina Chochtoula, Aristidis Ilias, Yannis Stamatiou

Abstract:

Modbus is a protocol that enables the communication among devices which are connected to the same network. This protocol is, often, deployed in connecting sensor and monitoring units to central supervisory servers in Supervisory Control and Data Acquisition, or SCADA, systems. These systems monitor critical infrastructures, such as factories, power generation stations, nuclear power reactors etc. in order to detect malfunctions and ignite alerts and corrective actions. However, due to their criticality, SCADA systems are vulnerable to attacks that range from simple eavesdropping on operation parameters, exchanged messages, and valuable infrastructure information to malicious modification of vital infrastructure data towards infliction of damage. Thus, the SCADA research community has been active over strengthening SCADA systems with suitable data protection mechanisms based, to a large extend, on cryptographic methods for data encryption, device authentication, and message integrity protection. However, due to the limited computation power of many SCADA sensor and embedded devices, the usual public key cryptographic methods are not appropriate due to their high computational requirements. As an alternative, Elliptic Curve Cryptography has been proposed, which requires smaller key sizes and, thus, less demanding cryptographic operations. Until now, however, no such implementation has been proposed in the SCADA literature, to the best of our knowledge. In order to fill this gap, our methodology was focused on integrating Modbus, a frequently used SCADA communication protocol, with Elliptic Curve based cryptography and develop a server/client application to demonstrate the proof of concept. For the implementation we deployed two C language libraries, which were suitably modify in order to be successfully integrated: libmodbus (https://github.com/stephane/libmodbus) and ecc-lib https://www.ceid.upatras.gr/webpages/faculty/zaro/software/ecc-lib/). The first library provides a C implementation of the Modbus/TCP protocol while the second one offers the functionality to develop cryptographic protocols based on Elliptic Curve Cryptography. These two libraries were combined, after suitable modifications and enhancements, in order to give a modified version of the Modbus/TCP protocol focusing on the security of the data exchanged among the devices and the supervisory servers. The mechanisms we implemented include key generation, key exchange/sharing, message authentication, data integrity check, and encryption/decryption of data. The key generation and key exchange protocols were implemented with the use of Elliptic Curve Cryptography primitives. The keys established by each device are saved in their local memory and are retained during the whole communication session and are used in encrypting and decrypting exchanged messages as well as certifying entities and the integrity of the messages. Finally, the modified library was compiled for the Android environment in order to run the server application as an Android app. The client program runs on a regular computer. The communication between these two entities is an example of the successful establishment of an Elliptic Curve Cryptography based, secure Modbus wireless communication session between a portable device acting as a supervisor station and a monitoring computer. Our first performance measurements are, also, very promising and demonstrate the feasibility of embedding Elliptic Curve Cryptography into SCADA systems, filling in a gap in the relevant scientific literature.

Keywords: elliptic curve cryptography, ICT security, modbus protocol, SCADA, TCP/IP protocol

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5725 Driving Green Public Procurement – A Framework for a Supporting Structure for Public Authorities Based on Good Practices in Europe

Authors: Pia Moschall, Kathrin Sackmann

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Considering a purchasing volume of around two trillion Euros per year, which equals about 14% of the European Union’s gross domestic product, European public authorities have significant market power. Making use of this market power by prioritizing the procurement of green products and services offers a great potential to contribute to the Green New Deal. The market demand that is created by Green Public Procurement (GPP) sets incentives for European producers to design and develop Green Products and Eco-Innovations. However, most procurement still does not consider environmental criteria. The goal of the work is to encourage the adaptation of GPP in the European Union. To this end, the drivers for the adaptation were investigated over different case studies. The paper analyzes good-practice cases from European authorities from 2010 to 2020 that were provided by the European Commission. This analysis was guided by Philipp Mayring’s method of qualitative content analysis, whereby the inductively formed categories led to the identification of nine major drivers. The most important ones are ‘use of official guidelines and standards, ‘political support and requirements as well as ‘market research and involvement.’ Further, the paper discusses mutual dependencies between several drivers and how to exploit them. A supporting infrastructure was identified as a crucial factor for the successful adaption of green public procurement. In the next step, the work aims to examine on which administrative level the single drivers can be implemented most effectively. Practical implications of this research are recommendations on how to create a supporting structure on a municipal, federal and national level, including training for the responsible staff, support tools, as well as guidelines and standards for involved stakeholders.

Keywords: content analysis, green public procurement, public authorities, sustainable procurement

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5724 Hemodynamic Effects of Magnesium Sulphate Therapy in Critically Ill Infants and Children with Wheezy Chest

Authors: Yasmin Sayed, Hala Hamdy, Hafez Bazaraa, Hanaa Rady, Sherif Elanwary

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Intravenous and inhaled magnesium sulfate (MgSO₄) had been recently used as an adjuvant therapy in cases suffering from the wheezy chest. Objective: We aimed to determine the possible change in the hemodynamic state in cases received intravenous or inhaled MgSO₄ in comparison to cases received standard treatment in critically ill infants and children with the wheezy chest. Methods: A randomized controlled trial comprised 81 patients suffering from wheezy chest divided into 3 groups. In addition to bronchodilators and systemic steroids, MgSO₄ was given by inhalation in group A, intravenously in group B, and group C didn't receive MgSO₄. The hemodynamic state was determined by assessment of blood pressure, heart rate, capillary refill time and the need for shock therapy or inotropic support just before and 24 hours after receiving treatment in 3 groups. Results: There was no significant difference in the hemodynamic state of the studied groups before and after treatment. Means of blood pressure were 102.2/63.2, 105.1/64.8 before and after inhaled MgSO₄; respectively. Means of blood pressure were 105.5/64.2, 104.1/64.9 before and after intravenous MgSO₄; respectively. Means of blood pressure were 107.4/62.8, 104.4/62.1 before and after standard treatment, respectively. There was a statistically insignificant reduction of the means of the heart rate in group A and group B after treatment rather than group C. There was no associated prolongation in capillary refill time and/or the need for inotropic support or shock therapy after treatment in the studied groups. Conclusion: MgSO₄ is a safe adjuvant therapy and not associated with significant alteration in the hemodynamic state in critically ill infants and children with the wheezy chest.

Keywords: critically ill infants and children, inhaled MgSO₄, intravenous MgSO₄, wheezy chest

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5723 Developing Serious Games to Increase Children’s Knowledge of Diet and Nutrition

Authors: N. Liu, N. Tuah, D. Ying

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This research aims to identify and test whether serious games can help children learn and pick up healthy eating habits. The practical component takes the form of digitalizing an already existing educational board game called “All you can eat” (AYCE), designed with the nutritious subject matter in mind. This time with the added features of online playability, which will widen its availability and accessibility to reach more players compared to the physical iteration. The game will be deployed alongside the conducting of theoretical research, which also involves teachers leading children to play said digital version. The research methodology utilizes two experiments, such as handing out surveys to gather feedback from both the partners and students. The research was carried out in several countries, namely Brunei, Malaysia, and Taiwan. The results are to be used for validating the concept of “serious games,” particularly when tied to the health aspect of the players, which in this case were children. As for the research outcomes, they can be applied to a variety of serious games that are related to health topics more broadly and not simply limited to healthy eating habits alone, adopting a balanced combination of practical and theoretical considerations. The study will also help other researchers in the correlated fields of serious game development and pediatrics to better comprehend the needs of children. On the theoretical side, these findings can enable further technological advancements to be made possible, a case in point being more serious games, to provide the appropriate social support precisely on the matter of health-related issues. Not just individuals but rather communities could benefit from improved health and well-being as a result of the project, which, when done right, will potentially improve their quality of life and have fun while doing it. AYCE will be demonstrated to support a wide range of health issues as a result of this research case.

Keywords: culture heritage, digital games, digitalization, traditional religious culture

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5722 “Student Veterans’ Transition to Nursing Education: Barriers and Facilitators

Authors: Bruce Hunter

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Background: The transition for student veterans from military service to higher education can be a challenging endeavor, especially for those pursuing an education in nursing. While the experiences and perspectives of each student veteran is unique, their successful integration into an academic environment can be influenced by a complex array of barriers and facilitators. This mixed-methods study aims to explore the themes and concepts that can be found in the transition experiences of student veterans in nursing education, with a focus on identifying the barriers they face and the facilitators that support their success. Methods: This study utilizes an explanatory mixed-methods approach. The research participants include student veterans enrolled in nursing programs across three academic institutions in the Southeastern United States. Quantitative Phase: A Likert scale instrument is distributed to a sample of student veterans in nursing programs. The survey assesses demographic information, academic experiences, social experiences, and perceptions of institutional support. Quantitative data is analyzed using descriptive statistics to assess demographics and to identify barriers and facilitators to the transition. Qualitative Phase: Two open-ended questions were posed to student veterans to explore their lived experiences, barriers, and facilitators during the transition to nursing education and to further explain the quantitative findings. Thematic analysis with line-by-line coding is employed to identify recurring themes and narratives that may shed light on the barriers and facilitators encountered. Results: This study found that the successful academic integration of student veterans lies in recognizing the diversity of values and attitudes among student veterans, understanding the potential challenges they face, and engaging in initiative-taking steps to create an inclusive and supportive academic environment that accommodates the unique experiences of this demographic. Addressing these academic and social integration concerns can contribute to a more understanding environment for student veterans in the BSN program. Conclusion: Providing support during this transitional period is crucial not only for retaining veterans, but also for bolstering their success in achieving the status of registered nurses. Acquiring an understanding of military culture emerges as an essential initial step for nursing faculty in student veteran retention and for successful completion of their programs. Participants found that their transition experience lacked meaningful social interactions, which could foster a positive learning environment, enhance their emotional well-being, and could contribute significantly to their overall success and satisfaction in their nursing education journey. Recognizing and promoting academic and social integration is important in helping veterans experience a smooth transition into and through the unfamiliar academic environment of nursing education.

Keywords: nursing, education, student veterans, barriers, facilitators

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5721 Care Experience of a Female Breast Cancer Patient Undergoing Modified Radical Mastectomy

Authors: Ting-I Lin

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Purpose: This article explores the care experience of a 34-year-old female breast cancer patient who was admitted to the intensive care unit after undergoing a modified radical mastectomy. The patient discovered a lump in her right breast during a self-examination and, after mammography and ultrasound-guided biopsy, was diagnosed with a malignant tumor in the right breast. The tumor measured 1.5 x 1.4 x 2 cm, and the patient underwent a modified radical mastectomy. Postoperatively, she exhibited feelings of inferiority due to changes in her appearance. Method: During the care period, we engaged in conversations, observations, and active listening, using Gordon's Eleven Functional Health Patterns for a comprehensive assessment. In collaboration with the critical care team, a psychologist, and an oncology case manager, we conducted an interdisciplinary discussion and reached a consensus on key nursing issues. These included pain related to postoperative tumor excision and disturbed body image due to changes in appearance after surgery. Result: During the care period, a private space was provided to encourage the patient to express her feelings about her altered body image. Communication was conducted through active listening and a non-judgmental approach. The patient's anxiety level, as measured by the depression and anxiety scale, decreased from moderate to mild, and she was able to sleep for 6-8 hours at night. The oncology case manager was invited to provide education on breast reconstruction using breast models and videos to both the patient and her husband. This helped rebuild the patient's confidence. With the patient's consent, a support group was arranged where a peer with a similar experience shared her journey, offering emotional support and encouragement. This helped alleviate the psychological stress and shock caused by the cancer diagnosis. Additionally, pain management was achieved through adjusting the dosage of analgesics, administering Ultracet 37.5 mg/325 mg 1# Q6H PO, along with distraction techniques and acupressure therapy. These interventions helped the patient relax and alleviate discomfort, maintaining her pain score at a manageable level of 3, indicating mild pain. Conclusion: Disturbance in body image can cause significant psychological stress for patients. Through support group discussions, encouraging patients to express their feelings, and providing appropriate education on breast reconstruction and dressing techniques, the patient's self-concept was positively reinforced, and her emotions were stabilized. This led to renewed self-worth and confidence.

Keywords: breast cancer, modified radical mastectomy, acupressure therapy, Gordon's 11 functional health patterns

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5720 The Association of Southeast Asian Nations (ASEAN) and the Dynamics of Resistance to Sovereignty Violation: The Case of East Timor (1975-1999)

Authors: Laura Southgate

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The Association of Southeast Asian Nations (ASEAN), as well as much of the scholarship on the organisation, celebrates its ability to uphold the principle of regional autonomy, understood as upholding the norm of non-intervention by external powers in regional affairs. Yet, in practice, this has been repeatedly violated. This dichotomy between rhetoric and practice suggests an interesting avenue for further study. The East Timor crisis (1975-1999) has been selected as a case-study to test the dynamics of ASEAN state resistance to sovereignty violation in two distinct timeframes: Indonesia’s initial invasion of the territory in 1975, and the ensuing humanitarian crisis in 1999 which resulted in a UN-mandated, Australian-led peacekeeping intervention force. These time-periods demonstrate variation on the dependent variable. It is necessary to observe covariation in order to derive observations in support of a causal theory. To establish covariation, my independent variable is therefore a continuous variable characterised by variation in convergence of interest. Change of this variable should change the value of the dependent variable, thus establishing causal direction. This paper investigates the history of ASEAN’s relationship to the norm of non-intervention. It offers an alternative understanding of ASEAN’s history, written in terms of the relationship between a key ASEAN state, which I call a ‘vanguard state’, and selected external powers. This paper will consider when ASEAN resistance to sovereignty violation has succeeded, and when it has failed. It will contend that variation in outcomes associated with vanguard state resistance to sovereignty violation can be best explained by levels of interest convergence between the ASEAN vanguard state and designated external actors. Evidence will be provided to support the hypothesis that in 1999, ASEAN’s failure to resist violations to the sovereignty of Indonesia was a consequence of low interest convergence between Indonesia and the external powers. Conversely, in 1975, ASEAN’s ability to resist violations to the sovereignty of Indonesia was a consequence of high interest convergence between Indonesia and the external powers. As the vanguard state, Indonesia was able to apply pressure on the ASEAN states and obtain unanimous support for Indonesia’s East Timor policy in 1975 and 1999. However, the key factor explaining the variance in outcomes in both time periods resides in the critical role played by external actors. This view represents a serious challenge to much of the existing scholarship that emphasises ASEAN’s ability to defend regional autonomy. As these cases attempt to show, ASEAN autonomy is much more contingent than portrayed in the existing literature.

Keywords: ASEAN, east timor, intervention, sovereignty

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