Search results for: global ethics
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5653

Search results for: global ethics

4183 Spatiotemporal Evaluation of Climate Bulk Materials Production in Atmospheric Aerosol Loading

Authors: Mehri Sadat Alavinasab Ashgezari, Gholam Reza Nabi Bidhendi, Fatemeh Sadat Alavinasab Ashkezari

Abstract:

Atmospheric aerosol loading (AAL) from anthropogenic sources is an evidence in industrial development. The accelerated trends in material consumption at the global scale in recent years demonstrate consumption paradigms sensible to the planetary boundaries (PB). This paper is a statistical approach on recognizing the path of climate-relevant bulk materials production (CBMP) of steel, cement and plastics to AAL via an updated and validated spatiotemporal distribution. The methodology of statistical analysis used the most updated regional or global databases or instrumental technologies. This corresponded to a selection of processes and areas capable for tracking AAL within the last decade, analyzing the most validated data while leading to explore the behavior functions or models. The results also represented a correlation within socio economic metabolism idea between the materials specified as macronutrients of society and AAL as a PB with an unknown threshold. The selected country contributors of China, India, US and the sample country of Iran show comparable cumulative AAL values vs to the bulk materials domestic extraction and production rate in the study period of 2012 to 2022. Generally, there is a tendency towards gradual descend in the worldwide and regional aerosol concentration after 2015. As of our evaluation, a considerable share of human role, equivalent 20% from CBMP, is for the main anthropogenic species of aerosols, including sulfate, black carbon and organic particulate matters too. This study, in an innovative approach, also explores the potential role of AAL control mechanisms from the economy sectors where ordered and smoothing loading trends are accredited through the disordered phenomena of CBMP and aerosol precursor emissions. The equilibrium states envisioned is an approval to the well-established theory of Spin Glasses applicable in physical system like the Earth and here to AAL.

Keywords: atmospheric aeroso loading, material flows, climate bulk materials, industrial ecology

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4182 Television Commercial Ideation: Considerations for the Future

Authors: Rashid Farooq, Moazzam Naseer, Rehan Hasan

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Increasing challenges posed to the creativity in the discipline of advertising during time’s movement towards the maturity of The Third Wave – a concept of change by Toffler, have to be the major theme of this study. Creative concepts for the changing media landscape are becoming a challenge for the creative industry as Stein says that the usefulness is a dimension no creative work could avoid. Furthermore, Spencer points out that the global capitalist society provides a base for the development of digital technologies. Innovation within the discipline of creativity is reshaping this process. In this review article, the role of creativity and innovation in the development and delivery of the message has to be examined.

Keywords: advertising, creativity, ideation, new media

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4181 The Relationship between Mobile Phone Usage and Secondary School Students’ Academic Performance: Work Experience at an International School

Authors: L. N. P. Wedikandage, Mohamed Razmi Zahir

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Technology is a global imperative because of its contributions to human existence and because it has improved global socioeconomic relations. As a result, the mobile phone has become the most important mode of communication today. Smartphones, Internet-enabled devices with built-in computer software and applications, are one of the most significant inventions of the twenty-first century. Technology is advantageous to many people, especially those involved in education. It is an important learning tool for today's schoolchildren. It enables students to access online learning platforms and course resources and interact digitally. Senior secondary students, in particular, have some of the most expensive and sophisticated mobile phones, tablets, and iPads capable of connecting to the internet and various social media platforms, other websites, and so on. At present, the use of mobile phones' potential for effective teaching and learning is growing. This is due to the benefits of mobile learning, including the ability to share knowledge without any limits in space or Time and the capacity to facilitate the development of critical thinking, participatory learning, problem-solving, and the development of lifelong communication skills. However, it is yet unclear how mobile devices may affect education and how they may affect opportunities for learning. As a result, the purpose of this research was to ascertain the relationship between mobile phone usage and the academic Performance of secondary-level students at an international school in Sri Lanka. The study's sample consisted of 523 secondary-level students from an international school, ranging from Form 1 to Upper 6. For the study, a survey research design and questionnaires were used. Google Forms was used to create the students' survey. There were three hypotheses tested to find out the relationship between mobile phone usage and academic preference. The findings show that there is a positive relationship between mobile phone usage and academic performance among secondary school students (the number of students obtaining simple passes is significantly higher when mobile phones are being used for more than 7 hours), no relationship between mobile phone usage and academic performance among secondary school students of different parents' occupations, and a relationship between the frequency of mobile phone usage and academic performance among secondary school students.

Keywords: mobile phone, academic performance, secondary level, international schools

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4180 Sports and Exercise Medicine: A Public Health Tool in Combating and Preventing the Side Effects of a Sedentary Lifestyle

Authors: Shireen Ibish

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Physical inactivity and unhealthy diets have contributed to a global burden of disease with increased relation to non-communicable diseases, increased risk of colon and breast cancer, high prevalence of depression, reduced quality of life and early death. The World Health Organisation’s facts on Obesity show a tripling in prevalence across the European Region since the 1980s. This has lead to a huge public health burden, being responsible for and 10-13% of deaths (fourth largest cause of global mortality) and 2-8% of health costs in the Region. In the UK alone, the present cost of physical inactivity has been estimated to be £8.2 billion. In 2002 a paper published in the International Journal of Epidemiology on ‘sedentary’ lifestyle, put into figures the increasingly worrying statistics across European countries. “Percentages of sedentary lifestyles across European countries ranged between 43.3% (Sweden) and 87.8% (Portugal)”. This was especially so amongst obese subjects, less- educated people, and smokers. While in the UK’s “50% of adult population in the UK is predicted to be obese by 2050.” Sports and Exercise Medicine, as a specialty, has a lot to offer in targeting this globally increasing epidemic. The worrying figures and the increasing knowledge of combating and preventing this issue have lead to increased awareness amongst the medical profession and more targeted interventions to reduce the burden of disease. “The public health element of the specialty is critical – this is not simply a specialty for the management of elite athletes’ medical conditions – it is central to the promotion of exercise as a means of disease prevention, to enhance well-being and in the management of disease.” WHO advised on creating National policies, encouraging and providing opportunities for greater physical activity, and improve the affordability, availability and accessibility of healthy foods. In the UK various different movements have been established to target this problem. The Motivate2Move, Move Eat Treat and guidelines advising specialties on targeting and encouraging exercise in the population (Sport and Exercise Medicine A Fresh Approach).

Keywords: sedentary lifestyle, obesity, public health burden, medicine

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4179 Energy Security and Sustainable Development: Challenges and Prospects

Authors: Abhimanyu Behera

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Over the past few years, energy security and sustainable development have moved rapidly into the global agenda. There are two main reasons: first, the impact of high and often volatile energy prices; second, concerns over environmental sustainability particularly about the global climate. Both issues are critically important in which impressive economic growth has boosted the demand for energy and put corresponding strains on the environment. Energy security is a broad concept that focuses on energy availability and pricing. Specifically, it refers to the ability of the energy supply system i.e. suppliers, transporters, distributors and regulatory, financial and R&D institutions to deliver the amount of competitively priced energy that customers demand, within accepted standards of reliability, timeliness, quality, safety. Traditionally, energy security has been defined in the context of the geopolitical risks to external oil supplies but today it is encompassing all energy forms, all the external and internal links bringing the energy to the final consumer, and all the many ways energy supplies can be disrupted including equipment malfunctions, system design flaws, operator errors, malicious computer activities, deficient market and regulatory frameworks, corporate financial problems, labour actions, severe weather and natural events, aggressive acts (e.g. war, terrorism and sabotage), and geopolitical disruptions. In practice, the most challenging disruptions are those linked to: 1) extreme weather events; 2) mismatched electricity supply and demand; 3) regulatory failures; and 4) concentration of oil and gas resources in certain regions of the world. However, insecure energy supplies inhibit development by raising energy costs and imposing expensive cuts in services when disruptions actually occur. The energy supply sector can best advance sustainable development by producing and delivering secure and environmentally-friendly sources of energy and by increasing the efficiency of energy use. With this objective, this paper seeks to highlight the significance of energy security and sustainable development in today’s world. Moreover, it critically overhauls the major challenges towards sustainability of energy security and what are the major policies are taken to overcome these challenges by Government is lucidly explicated in this paper.

Keywords: energy, policies, security, sustainability

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4178 Influence of Psychosocial Factors on Physical Activity Level among Individuals with Asthma

Authors: Awotidebe Taofeek, Oyinsuyi Oluwafunmbi

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Psychosocial factors play a significant role in physical activity participation in diseased conditions and the general population. However, little is known about the role of exercise self-efficacy (ESE), exercise perceived barriers (EPB), and social support (SOS) in patients with asthma. This study investigated the influence of psychosocial factors on physical activity participation in patients with asthma in ile-ife. This cross-sectional study involved 130 patients with asthma. They were recruited from the Chest Clinic of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-ife using purposive sampling technique. Ethical approval was obtained from the Ethics and Research Committee of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-ife, Nigeria. Socio-demographic characteristics of respondents were recorded. Information on ESE, EPB, and SOS were obtained using Exercise Self-Efficacy, Exercise Benefit, and Barrier and Medical Outcome Social Support Scales respectively. Physical activity level was assessed in the last 7 days using international physical activity questionnaire. Descriptive and inferential statistics were used to analyze the data. Alpha level was set at p<0.5. The mean age of the respondents was 25.15 ± 9.38, and a majority, 110 (84.60%), engaged in low physical activity, 69(53%) had low exercise self-efficacy. However, less than two-third 80 (62.20%) reported high social support, with the majority of 95 (73.10%) reported high exercise perceived barriers. The means of ESE for male and femalerespondents were 29.01 ± 20.62 and 24.35 ± 17.36, respectively. The means of SOS formale and female respondents were 49.52 ± 22.22 and 61.87 ± 22.66, respectively. Themeans of EPB for male and female respondents were 53.37 ± 10.23 and 57.43 ± 9.65, respectively. The respondents were comparable in exercise self-efficacy and physicalactivity level (p>0.05). However, there were significant differences in social support (t=-2.791; p=0.006) and exercise perceived barriers (t=-2.108, p=0.037).Theresultsshowthattherewasasignificantrelationshipbetweenexerciseperceivedbarriersandlowphysicalactivitylevel(r=-0.216;p=0.023).TherewasasignificantassociationbetweenExerciseself-efficacyandmarried individuals(OR=0.967;95%CI=0.936-0.998;p= 0.037). Similarly, However,thereweresignificantassociationsbetweensocialsupport Andagegroup35-54years(OR=1.036;95%CI=1.007-1.067;p=0.014),females(OR= 1.024;95%CI=1.006;p=0.009)andmarriedindividuals(OR=1.049;95%CI=1.020-1.079. p=0.001).Therewasasignificantassociationbetweenexerciseperceivedbarriersand females(OR=1.043;95%CI=1.002-1.085;p=0.040).However, thereweresignificant associationsbetweenexerciseperceivedbarriersandoccupationgroup;civilservants (OR=1.092;95%CI=1.009-1.182;p=0.028),retiree(OR=1.092;95%CI=1.040-1.469;p= 0.016)andstudents(OR=1.110;95%CI=1.040;p=0.002). Inconclusion,agreaterpercentageofpatientswithasthmahadlowphysicalactivityleveland it was associatedwithhighexerciseperceivedbarriers,whileexerciseself-efficacyandsocialsupportwerenot.

Keywords: asthma, psychosocial factors, physical activity, physical fitness

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4177 Mathematical and Numerical Analysis of a Nonlinear Cross Diffusion System

Authors: Hassan Al Salman

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We consider a nonlinear parabolic cross diffusion model arising in applied mathematics. A fully practical piecewise linear finite element approximation of the model is studied. By using entropy-type inequalities and compactness arguments, existence of a global weak solution is proved. Providing further regularity of the solution of the model, some uniqueness results and error estimates are established. Finally, some numerical experiments are performed.

Keywords: cross diffusion model, entropy-type inequality, finite element approximation, numerical analysis

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4176 Bridging Binaries: Exploring Students' Conceptions of Good Teaching within Teacher-Centered and Learner-Centered Pedagogies of Their Teachers in Disadvantaged Public Schools in the Philippines

Authors: Julie Lucille H. Del Valle

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To improve its public school education, the Philippines took a radical curriculum reform in 2012, by launching the K-to-12 program which not only added two years to its basic education but also mandated for a replacement of traditional teaching with learner-centered pedagogy, an instruction whose western underpinnings suggest improving student achievement, thus, making pedagogies in the country more or less similar with those in Europe and USA. This policy, however, placed learner-centered pedagogy in a binary opposition against teacher-centered instruction, creating a simplistic dichotomy between good and bad teaching. It is in this dichotomy that this study seeks to explore, using Critical Pedagogy of the Place as the lens, in understanding what constitutes good teaching across a range of learner-centered and teacher-centered pedagogies in the context of public schools in disadvantaged communities. Furthermore, this paper examines how pedagogical homogeneity, arguably influenced by dominant global imperatives with economic agenda – often referred as economisation of education – not only thins out local identities as structures of global schooling become increasingly similar but also limits the concept of good teaching to student outcomes and corporate employability. This paper draws from qualitative research on students, thus addressing the gap created by studies on good teaching which looked mainly into the perceptions of teachers and administrators, while overlooking those of students whose voices must be considered in the formulation of inclusive policies that advocate for true education reform. Using ethnographic methods including student focus groups, classroom observations, and teacher interviews, responses from students of disadvantaged schools reveal that good teaching includes both learner-centered and teacher-centered practices that incorporate ‘academic caring’ which sustains their motivation to achieve in school despite the challenging learning environments. The combination of these two pedagogies equips students with life-long skills necessary to gain equal access to sustainable economic opportunities in their local communities.

Keywords: critical pedagogy of the place, good teaching, learner-centered pedagogy, placed-based instruction

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4175 Comparison of Effects over the Autonomic Nervous System When Using Force Training and Interval Training in Indoor Cycling with University Students

Authors: Daniel Botero, Oscar Rubiano, Pedro P. Barragan, Jaime Baron, Leonardo Rodriguez Perdomo, Jaime Rodriguez

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In the last decade interval training (IT) has gained importance when is compare with strength training (ST). However, there are few studies analyzing the impact of these training over the autonomic nervous system (ANS). This work has aimed to compare the activity of the autonomic nervous system, when is expose to an IT or ST indoor cycling mode. After approval by the ethics committee, a cross-over clinical trial with 22 healthy participants (age 21 ± 3 years) was implemented. The selection of participants for the groups with sequence force-interval (F-I) and interval-force (I-F) was made randomly with assignation of 11 participants for each group. The temporal series of heart rate was obtained before and after each training using the POLAR TEAM® heart monitor. The evaluation of the ANS was performed with spectral analysis of the heart rate variability (HRV) using the fast Fourier transform (Kubios software). A training of 8 weeks in each sequence (4 weeks with each training) with an intermediate period of two weeks of washout was implemented for each group. The power parameter of the HRV in the low frequency band (LF = 0.04-0.15Hz related to the sympathetic nervous system), high frequency (HF = 0.15-0.4Hz, related to the parasympathetic) and LF/HF (with reference to a modulation of parasympathetic over the sympathetic), were calculated. Afterward, the difference between the parameters before and after was realized. Then, to evaluate statistical differences between each training was implemented the method of Wellek (Wellek and Blettner, 2012, Medicine, 109 (15), 276-81). To determine the difference of effect over parasympathetic when FT and IT are used, the T test is implemented obtaining a T value of 0.73 with p-value ≤ 0.1. For the sympathetic was obtained a T of 0.33 with p ≤ 0.1 and for LF/HF the T was 1.44 with a p ≥ 0.1. Then, the carry over effect was evaluated and was not present. Significant changes over autonomic activity with strength or interval training were not observed. However, a modulation of the parasympathetic over the sympathetic can be observed. Probably, these findings should be explained because the sample is little and/or the time of training was insufficient to generate changes.

Keywords: autonomic nervous, force training, indoor cycling, interval training

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4174 Deploying a Transformative Learning Model in Technological University Dublin to Assess Transversal Skills

Authors: Sandra Thompson, Paul Dervan

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Ireland’s first Technological University (TU Dublin) was established on 1st January 2019, and its creation is an exciting new milestone in Irish Higher Education. TU Dublin is now Ireland’s biggest University supporting 29,000 students across three campuses with 3,500 staff. The University aspires to create work-ready graduates who are socially responsible, open-minded global thinkers who are ambitious to change the world for the better. As graduates, they will be enterprising and daring in all their endeavors, ready to play their part in transforming the future. Feedback from Irish employers and students coupled with evidence from other authoritative sources such as the World Economic Forum points to a need for greater focus on the development of students’ employability skills as they prepare for today’s work environment. Moreover, with an increased focus on Universal Design for Learning (UDL) and inclusiveness, there is recognition that students are more than a numeric grade value. Robust grading systems have been developed to track a student’s performance around discipline knowledge but there is little or no global consensus on a definition of transversal skills nor on a unified framework to assess transversal skills. Education and industry sectors are often assessing one or two skills, and some are developing their own frameworks to capture the learner’s achievement in this area. Technological University Dublin (TU Dublin) have discovered and implemented a framework to allow students to develop, assess and record their transversal skills using transformative learning theory. The model implemented is an adaptation of Student Transformative Learning Record - STLR which originated in the University of Central Oklahoma (UCO). The purpose of this paper therefore, is to examine the views of students, staff and employers in the context of deploying a Transformative Learning model within the University to assess transversal skills. It will examine the initial impact the transformative learning model is having socially, personally and on the University as an organization. Crucially also, to identify lessons learned from the deployment in order to assist other Universities and Higher Education Institutes who may be considering a focused adoption of Transformative Learning to meet the challenge of preparing students for today’s work environment.

Keywords: assessing transversal skills, higher education, transformative learning, students

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4173 Performance Demonstration of Extendable NSPO Space-Borne GPS Receiver

Authors: Hung-Yuan Chang, Wen-Lung Chiang, Kuo-Liang Wu, Chen-Tsung Lin

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National Space Organization (NSPO) has completed in 2014 the development of a space-borne GPS receiver, including design, manufacture, comprehensive functional test, environmental qualification test and so on. The main performance of this receiver include 8-meter positioning accuracy, 0.05 m/sec speed-accuracy, the longest 90 seconds of cold start time, and up to 15g high dynamic scenario. The receiver will be integrated in the autonomous FORMOSAT-7 NSPO-Built satellite scheduled to be launched in 2019 to execute pre-defined scientific missions. The flight model of this receiver manufactured in early 2015 will pass comprehensive functional tests and environmental acceptance tests, etc., which are expected to be completed by the end of 2015. The space-borne GPS receiver is a pure software design in which all GPS baseband signal processing are executed by a digital signal processor (DSP), currently only 50% of its throughput being used. In response to the booming global navigation satellite systems, NSPO will gradually expand this receiver to become a multi-mode, multi-band, high-precision navigation receiver, and even a science payload, such as the reflectometry receiver of a global navigation satellite system. The fundamental purpose of this extension study is to port some software algorithms such as signal acquisition and correlation, reused code and large amount of computation load to the FPGA whose processor is responsible for operational control, navigation solution, and orbit propagation and so on. Due to the development and evolution of the FPGA is pretty fast, the new system architecture upgraded via an FPGA should be able to achieve the goal of being a multi-mode, multi-band high-precision navigation receiver, or scientific receiver. Finally, the results of tests show that the new system architecture not only retains the original overall performance, but also sets aside more resources available for future expansion possibility. This paper will explain the detailed DSP/FPGA architecture, development, test results, and the goals of next development stage of this receiver.

Keywords: space-borne, GPS receiver, DSP, FPGA, multi-mode multi-band

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4172 Relaxing Convergence Constraints in Local Priority Hysteresis Switching Logic

Authors: Mubarak Alhajri

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This paper addresses certain inherent limitations of local priority hysteresis switching logic. Our main result establishes that under persistent excitation assumption, it is possible to relax constraints requiring strict positivity of local priority and hysteresis switching constants. Relaxing these constraints allows the adaptive system to reach optimality which implies the performance improvement. The unconstrained local priority hysteresis switching logic is examined and conditions for global convergence are derived.

Keywords: adaptive control, convergence, hysteresis constant, hysteresis switching

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4171 Comparing Community Health Agents, Physicians and Nurses in Brazil's Family Health Strategy

Authors: Rahbel Rahman, Rogério Meireles Pinto, Margareth Santos Zanchetta

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Background: Existing shortcomings of current health-service delivery include poor teamwork, competencies that do not address consumer needs, and episodic rather than continuous care. Brazil’s Sistema Único de Saúde (Unified Health System, UHS) is acknowledged worldwide as a model for delivering community-based care through Estratégia Saúde da Família (FHS; Family Health Strategy) interdisciplinary teams, comprised of Community Health Agents (in Portuguese, Agentes Comunitário de Saude, ACS), nurses, and physicians. FHS teams are mandated to collectively offer clinical care, disease prevention services, vector control, health surveillance and social services. Our study compares medical providers (nurses and physicians) and community-based providers (ACS) on their perceptions of work environment, professional skills, cognitive capacities and job context. Global health administrators and policy makers can leverage on similarities and differences across care providers to develop interprofessional training for community-based primary care. Methods: Cross-sectional data were collected from 168 ACS, 62 nurses and 32 physicians in Brazil. We compared providers’ demographic characteristics (age, race, and gender) and job context variables (caseload, work experience, work proximity to community, the length of commute, and familiarity with the community). Providers perceptions were compared to their work environment (work conditions and work resources), professional skills (consumer-input, interdisciplinary collaboration, efficacy of FHS teams, work-methods and decision-making autonomy), and cognitive capacities (knowledge and skills, skill variety, confidence and perseverance). Descriptive and bi-variate analysis, such as Pearson Chi-square and Analysis of Variance (ANOVA) F-tests, were performed to draw comparisons across providers. Results: Majority of participants were ACS (64%); 24% nurses; and 12% physicians. Majority of nurses and ACS identified as mixed races (ACS, n=85; nurses, n=27); most physicians identified as males (n=16; 52%), and white (n=18; 58%). Physicians were less likely to incorporate consumer-input and demonstrated greater decision-making autonomy than nurses and ACS. ACS reported the highest levels of knowledge and skills but the least confidence compared to nurses and physicians. ACS, nurses, and physicians were efficacious that FHS teams improved the quality of health in their catchment areas, though nurses tend to disagree that interdisciplinary collaboration facilitated their work. Conclusion: To our knowledge, there has been no study comparing key demographic and cognitive variables across ACS, nurses and physicians in the context of their work environment and professional training. We suggest that global health systems can leverage upon the diverse perspectives of providers to implement a community-based primary care model grounded in interprofessional training. Our study underscores the need for in-service trainings to instill reflective skills of providers, improve communication skills of medical providers and curative skills of ACS. Greater autonomy needs to be extended to community based providers to offer care integral to addressing consumer and community needs.

Keywords: global health systems, interdisciplinary health teams, community health agents, community-based care

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4170 Climate Related Financial Risk on Automobile Industry and the Impact to the Financial Institutions

Authors: Mahalakshmi Vivekanandan S.

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As per the recent changes happening in the global policies, climate-related changes and the impact it causes across every sector are viewed as green swan events – in essence, climate-related changes can often happen and lead to risk and a lot of uncertainty, but needs to be mitigated instead of considering them as black swan events. This brings about a question on how this risk can be computed so that the financial institutions can plan to mitigate it. Climate-related changes impact all risk types – credit risk, market risk, operational risk, liquidity risk, reputational risk and other risk types. And the models required to compute this has to consider the different industrial needs of the counterparty, as well as the factors that are contributing to this – be it in the form of different risk drivers, or the different transmission channels or the different approaches and the granular form of data availability. This brings out the suggestion that the climate-related changes, though it affects Pillar I risks, will be a Pillar II risk. This has to be modeled specifically based on the financial institution’s actual exposure to different industries instead of generalizing the risk charge. And this will have to be considered as the additional capital to be met by the financial institution in addition to their Pillar I risks, as well as the existing Pillar II risks. In this paper, the author presents a risk assessment framework to model and assess climate change risks - for both credit and market risks. This framework helps in assessing the different scenarios and how the different transition risks affect the risk associated with the different parties. This research paper delves into the topic of the increase in the concentration of greenhouse gases that in turn cause global warming. It then considers the various scenarios of having the different risk drivers impacting the Credit and market risk of an institution by understanding the transmission channels and also considering the transition risk. The paper then focuses on the industry that’s fast seeing a disruption: the automobile industry. The paper uses the framework to show how the climate changes and the change to the relevant policies have impacted the entire financial institution. Appropriate statistical models for forecasting, anomaly detection and scenario modeling are built to demonstrate how the framework can be used by the relevant agencies to understand their financial risks. The paper also focuses on the climate risk calculation for the Pillar II Capital calculations and how it will make sense for the bank to maintain this in addition to their regular Pillar I and Pillar II capital.

Keywords: capital calculation, climate risk, credit risk, pillar ii risk, scenario modeling

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4169 Caregiver’s Perception Regarding Diagnosis Disclosure to Children Living with Human Immunodeficiency Virus in Resource-Limited Settings: Observational Study from India

Authors: Ramesh Chand Chauhan, Sanjay Kumar Rai, Shashi kant, Rakesh Lodha, Nand Kumar

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Background: With a better understanding of HIV pathogenesis and availability of antiretroviral therapy more children are growing and entering in teenage group; informing children of their own HIV status has become an important aspect of long-term disease management. There is little evidence of how and when this type of disclosure takes place in a resource-limited setting. Methods: A cross-sectional study was conducted from June 2010 to May 2011 among a dyads of 156 HIV-infected children and their caregivers, those were visiting pediatric clinic at a tertiary care hospital in Delhi, India. The study protocol was approved by the Institute Ethics Committee. After taking written informed consent; pretested structured questionnaire was administered to caregivers during routine clinic visits. Information regarding socio-demographic characteristics, awareness of HIV infection status among children and their perception regarding disclosure was collected. Mean and frequencies were calculated and chi-square and logistic regression test were applied. Results: The mean age of children was 8.4 ±3.45 years. Among them 73.7% were male and 39.1% were orphans. Among 156 enrolled children, 74.4% (n=116) were of ≥ 6 years and were assessed for disclosure. Only 18.1% (n=21) children had been informed of their HIV status. Of those under 9 years, 6.4% knew their status, whereas 18.4% of 9-11 years and 35.5% of 12-14 years children knew they had HIV. Awareness among males (23.3%) was higher than females (3.3%). Both age and sex of child were significantly (p<0.01) associated with disclosure status. Other factors favoring disclosure were orphan-hood, non-perinatal mode of transmission (OR = 4.32; 95% CI 1.01-7.12), ART initiation (OR = 4.21; 95% CI 1.03-6.98), and caregiver educated beyond primary level (OR = 1.89; 95% CI 1.03-3.26). Repeated enquiry regarding the visit to clinic was the most common reason (66.6%) for disclosure. In 52.4% children disclosure was done with the involvement of other family members. 82.5% caregivers felt the age of > 10 years is appropriate for disclosing the HIV infection status to the child. Conclusion: Detailed guidelines on disclosure are required focusing on children of school-going age with perinatal infection who are not on ART and with caregivers of low educational status.

Keywords: HIV, children, India, disclosure

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4168 Firefighting Means in Food Industries

Authors: Racim Rifaat Ferdjani, Zineddine Chetoui

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The goal of our work is to provide a tool that helps control and ensures a global view of the means of firefighting (MLCI) in a food production plant (for example Hamoud Boualem plant). We divided the site into 4 zones, then we identified the firefighting means (MLCI) present in each zone, taking into account their type, weight, location, and fire class as well as their compliance with respect to the regulations in force while assigning them an alphanumeric reference which makes it possible to deduce everything. Thus, the use of a tool in the form of an Excel table was made concrete, and an average compliance rate of 45% was therefore obtained.

Keywords: MLCI, firefighting means, Hamoud, Boualem

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4167 Effectiveness of Mobile Health Augmented Cardiac Rehabilitation (MCard) on Health-Related Quality of Life among Post-Acute Coronary Syndrome Patients: A Randomized Controlled Trial

Authors: Aliya Hisam, Zia Ul Haq, Sohail Aziz, Patrick Doherty, Jill Pell

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Objective: To determine the effectiveness of Mobile health augmented Cardiac rehabilitation (MCard) on health-related quality of life (HRQoL) among post-acute coronary syndrome(post-ACS) patients. Methodology: In a randomized controlled trial, post-ACS patients were randomly allocated (1:1) to an intervention group (received MCard; counseling, empowering with self-monitoring devices, short text messages, in addition to standard post-ACS care) or control group (standard post-ACS care). HRQoL was assessed by generic Short Form-12 and MacNew quality of life myocardial infarction (QLMI) tools. Participants were followed for 24 weeks with data collection and analysis at three-time points (baseline, 12 weeks and 24 weeks). Result: At baseline, 160 patients (80 in each group; mean age 52.66+8.46 years; 126 males, 78.75%) were recruited, of which 121(75.62%) continued and were analyzed at 12-weeks and 119(74.37%) at 24-weeks. The mean SF-12 physical component score significantly improved in the MCard group at 12 weeks follow-up (48.93 vs. control 43.87, p<.001) and 24 weeks (53.52 vs. 46.82 p<.001). The mean SF-12 mental component scores also improved significantly in the MCard group at 12 weeks follow-up (44.84 vs. control 41.40, p<.001) and 24 weeks follow-up (48.95 vs 40.12, p<.001). At 12-and 24-week follow-up, all domains of MacNew QLMI (social, emotional, physical and global) were also statistically significant (p<.001) improved in the MCard group, unlike the control group. Conclusion: MCard is feasible and effective at improving all domains of HRQoL. There was an improvement in physical, mental, social, emotional and global domains among the MCard group in comparison to the control group. The addition of MCard programs to post-ACS standard care may improve patient outcomes and reduce the burden on the health care setting.

Keywords: acute coronary syndrome, mobile health augmented cardiac rehabilitation (MCard), cardiovascular diseases, cardiac rehabilitation, health-related quality of life, short form 12, MacNew QLMI

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4166 Bank Liquidity Creation in a Dual Banking System: An Empirical Investigation

Authors: Lianne M. Q. Lee, Mohammed Sharaf Shaiban

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The importance of bank liquidity management took center stage as policy makers promoted a more resilient global banking system after the market turmoil of 2007. The growing recognition of Islamic banks’ function of intermediating funds in the economy warrants the need to investigate its balance sheet structure which is distinct from its conventional counterparts. Given that asymmetric risk, transformation is inevitable; Islamic banks need to identify the liquidity risk within their distinctive balance sheet structure. Thus, there is a strong need to quantify and assess the liquidity position to ensure proper functioning of a financial institution. It is vital to measure bank liquidity because liquid banks face less liquidity risk. We examine this issue by using two alternative quantitative measures of liquidity creation “cat fat” and “cat nonfat” constructed by Berger and Bouwman (2009). “Cat fat” measures all on balance sheet items including off balance sheet, whilst the latter measures only on balance sheet items. Liquidity creation is measured over the period 2007-2014 in 14 countries where Islamic and conventional commercial banks coexist. Also, separately by bank size class as empirical studies have shown that liquidity creation varies by bank size. An interesting and important finding shows that all size class of Islamic banks, on average have increased creation of aggregate liquidity in real dollar terms over the years for both liquidity creation measures especially for large banks indicating that Islamic banks actually generates more liquidity to the economy compared to its conventional counterparts, including from off-balance sheet items. The liquidity creation for off-balance sheets by conventional banks may have been affected by the global financial crisis when derivatives markets were severely hit. The results also suggest that Islamic banks have the higher volume of assets and deposits and that borrowing/issues of bonds are less in Islamic banks compared to conventional banks because most products are interest-based. As Islamic banks appear to create more liquidity than conventional banks under both measures, it translates that the development of Islamic banking is significant over the decades since its inception. This finding is encouraging as, despite Islamic banking’s overall size, it represents growth opportunities for these countries.

Keywords: financial institution, liquidity creation, liquidity risk, policy and regulation

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4165 Gas Tungsten Arc Welded Joints of Cast Al-Mg-Sc Alloy

Authors: K. Subbaiah, C. V. Jeyakumar, S. R. Koteswara Rao

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Cast Aluminum-Magnesium-Scandium alloy was Gas Tungsten Arc (GTA) welded, and the microstructure and mechanical properties of the joint and its component parts were examined and analyzed. The global joint fractured in the base metal, and thus possessed slightly greater tensile strength than the base metal. These results clearly show that Gas Tungsten Arc welding is an optimum / suitable welding process for cast Aluminum-Magnesium-Scandium alloys.

Keywords: cast Al-Mg-Sc alloy, GTAW, microstructure, mechanical properties

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4164 Voluntary Disclosure Of Sustainability Information In Malaysian Federal-level Statutory Bodies

Authors: Siti Zabedah Saidin, Aidi Ahmi, Azharudin Ali, Wan Norhayati Wan Ahmad

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In today's increasingly complex and interconnected world, the concept of sustainability has transcended mere corporate social responsibility, evolving into a fundamental driver of organizational behaviour and disclosure. This content analysis study delves into the Malaysian federal-level statutory bodies’ annual report for the year 2021, aiming to elucidate the extent of sustainability disclosures within the non-financial sections of these reports. The escalating global emphasis on sustainability has prompted organizations to embrace transparency as a means to demonstrate their commitment to environmental, social, and governance (ESG) considerations. Voluntary sustainability disclosure has emerged as a crucial channel through which organizations communicate their efforts, initiatives, and impacts in these areas, thereby fostering trust and accountability with stakeholders. The study aims to identify and examine the types of sustainability information disclosed voluntarily by the federal-level statutory bodies, concentrating on the non-financial sections of the annual reports. To achieve this, the study adopts a simplified disclosure index, a pragmatic tool that quantifies the extent of sustainability reporting in a standardized manner. Using convenience sampling, the study selects a sample of annual reports from the federal-level statutory bodies in Malaysia, as provided on their respective websites. The content analysis is centred on the non-financial sections of these reports, allowing for an in-depth exploration of sustainability disclosures. The findings of the study present the extent to which Malaysian federal-level statutory bodies embrace sustainability reporting. Through thorough content analysis, the study uncovered diverse dimensions of sustainability information, encompassing environmental impact assessments, social engagement endeavours, and governance frameworks. This reveals a deliberate effort by these bodies to encapsulate their holistic organizational contributions and challenges, transcending traditional financial metrics. This research contributes to the existing literature by providing insights into the evolving landscape of sustainability disclosure practices among Malaysian federal-level statutory bodies. The findings underline the proactive nature of these bodies in voluntarily sharing sustainability-related information, reflecting their recognition of the interconnectedness between organizational success and societal well-being. Furthermore, the study underscores the potential influence of regulatory guidelines and societal expectations in shaping the extent and nature of voluntary sustainability disclosures. Organizations are not merely responding to regulatory mandates but are actively aligning with global sustainability goals and stakeholder expectations. As organizations continue to navigate the intricate web of stakeholder expectations and sustainability imperatives, this study enriches the discourse surrounding transparency and sustainability reporting. The analysis emphasizes the important role of non-financial disclosures in portraying a holistic organizational narrative. In an era where stakeholders demand accountability, and the interconnectedness of global challenges necessitates collaborative action, the voluntary disclosure of sustainability information stands as a testament to the commitment of Malaysian federal-level statutory bodies in shaping a more sustainable future.

Keywords: voluntary disclosure, sustainability information, annual report, federal-level statutory body

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4163 Accountability Mechanisms of Leaders and Its Impact on Performance and Value Creation: Comparative Analysis (France, Germany, United Kingdom)

Authors: Bahram Soltani, Louai Ghazieh

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The responsibility has a big importance further to the financial crisis and the various pressures, which companies face their duties. The main objective of this study is to explain the variation of mechanisms of the responsibility of the manager in the company among the advanced capitalist economies. Then we study the impact of these mechanisms on the performance and the value creation in European companies. To reach our goal, we established a final sample composed on average of 284 French, British and German companies quoted in stock exchanges with 2272 annual reports examined during the period from 2005 to 2012. We examined at first the link of causalities between the determining-mechanisms bound to the company such as the characteristics of the board of directors, the composition of the shareholding and the ethics of the company on one side and the profitability of the company on the other side. The results show that the smooth running of the board of directors and its specialist committees are very important determinants of the responsibility of the managers who impact positively the performance and the value creation in the company. Furthermore, our results confirm that the presence of a solid ethical environment within the company will be effective to increase the probability that the managers realize ethical choices in the organizational decision-making. At the second time, we studied the impact of the determining mechanisms bound to the function and to the profile of manager to know its relational links, his remuneration, his training, his age and his experiences about the performance and the value creation in the company. Our results highlight the existence of a negative relation between the relational links of the manager, his very high remuneration and the general profitability of the company. This study is a contribution to the literature on the determining mechanisms of company director's responsibility (Accountability). It establishes an empirical and comparative analysis between three influential countries of Europe, to know France, the United Kingdom and Germany.

Keywords: leaders, company’s performance, accountability mechanisms, corporate governance, value creation of firm, financial crisis

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4162 To Include or Not to Include: Resolving Ethical Concerns over the 20% High Quality Cassava Flour Inclusion in Wheat Flour Policy in Nigeria

Authors: Popoola I. Olayinka, Alamu E. Oladeji, B. Maziya-Dixon

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Cassava, an indigenous crop grown locally by subsistence farmers in Nigeria has potential to bring economic benefits to the country. Consumption of bread and other confectionaries has been on the rise due to lifestyle changes of Nigerian consumers. However, wheat, being the major ingredient for bread and confectionery production does not thrive well under Nigerian climate hence the huge spending on wheat importation. To reduce spending on wheat importation, the Federal Government of Nigeria intends passing into law mandatory inclusion of 20% high-quality cassava flour (HQCF) in wheat flour. While the proposed policy may reduce post harvest loss of cassava, and also increase food security and domestic agricultural productivity, there are downsides to the policy which include reduction in nutritional quality and low sensory appeal of cassava-wheat bread, reluctance of flour millers to use HQCF, technology and processing challenges among others. The policy thus presents an ethical dilemma which must be resolved for its successful implementation. While inclusion of HQCF to wheat flour in bread and confectionery is a topic that may have been well addressed, resolving the ethical dilemma resulting from the act has not received much attention. This paper attempts to resolve this dilemma using various approaches in food ethics (cost benefits, utilitarianism, deontological and deliberative). The Cost-benefit approach did not provide adequate resolution of the dilemma as all the costs and benefits of the policy could not be stated in the quantitative term. The utilitarianism approach suggests that the policy delivers greatest good to the greatest number while the deontological approach suggests that the act (inclusion of HQCF to wheat flour) is right hence the policy is not utterly wrong. The deliberative approach suggests a win-win situation through deliberation with the parties involved.

Keywords: HQCF, ethical dilemma, food security, composite flour, cassava bread

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4161 A Method To Assess Collaboration Using Perception of Risk from the Architectural Engineering Construction Industry

Authors: Sujesh F. Sujan, Steve W. Jones, Arto Kiviniemi

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The use of Building Information Modelling (BIM) in the Architectural-Engineering-Construction (AEC) industry is a form of systemic innovation. Unlike incremental innovation, (such as the technological development of CAD from hand based drawings to 2D electronically printed drawings) any form of systemic innovation in Project-Based Inter-Organisational Networks requires complete collaboration and results in numerous benefits if adopted and utilised properly. Proper use of BIM involves people collaborating with the use of interoperable BIM compliant tools. The AEC industry globally has been known for its adversarial and fragmented nature where firms take advantage of one another to increase their own profitability. Due to the industry’s nature, getting people to collaborate by unifying their goals is critical to successful BIM adoption. However, this form of innovation is often being forced artificially in the old ways of working which do not suit collaboration. This may be one of the reasons for its low global use even though the technology was developed more than 20 years ago. Therefore, there is a need to develop a metric/method to support and allow industry players to gain confidence in their investment into BIM software and workflow methods. This paper departs from defining systemic risk as a risk that affects all the project participants at a given stage of a project and defines categories of systemic risks. The need to generalise is to allow method applicability to any industry where the category will be the same, but the example of the risk will depend on the industry the study is done in. The method proposed seeks to use individual perception of an example of systemic risk as a key parameter. The significance of this study lies in relating the variance of individual perception of systemic risk to how much the team is collaborating. The method bases its notions on the claim that a more unified range of individual perceptions would mean a higher probability that the team is collaborating better. Since contracts and procurement devise how a project team operates, the method could also break the methodological barrier of highly subjective findings that case studies inflict, which has limited the possibility of generalising between global industries. Since human nature applies in all industries, the authors’ intuition is that perception can be a valuable parameter to study collaboration which is essential especially in projects that utilise systemic innovation such as BIM.

Keywords: building information modelling, perception of risk, systemic innovation, team collaboration

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4160 Xerostomia and Caries Incidence in Relation to Metabolic Control in Children and Adolescents with Type 1 Diabetes

Authors: Eftychia Pappa, Heleni Vastardis, Christos Rahiotis, Andriani Vazaiou

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The aim of this study was to evaluate the prevalence of dry-mouth symptoms (xerostomia) and compare it with alterations in salivary characteristics of children and adolescents with type 1 diabetes (DM1), as measured with the use of chair-side saliva tests. This study also investigated the possible association between salivary dysfunction and incidence of caries, in relation to the level of metabolic control. A cross-sectional study was performed on young patients (6-18 years old) allocated among 3 groups: 40 patients poorly-controlled (DM1-A, HbA1c>8%), 40 well-controlled (DM1-B, HbA1c≤8%) and 40 age- and sex-matched healthy controls. The study was approved by the Research Ethics Committee of University of Athens and the parents signed written informed consent. All subjects were examined for dental caries, oral hygiene and salivary factors. Assessments of salivary function included self-reported xerostomia, quantification of resting and stimulated whole saliva flow rates, pH values, buffering capacity and saliva’s viscosity. Salivary characteristics were evaluated with the use of GC Saliva Check Buffer (3Μ ESPE). Data were analysed by chi-square and Kruskal-Wallis tests. Subjects with diabetes reported xerostomia more frequently than healthy controls (p<0.05). Unstimulated salivary flow rate and pH values remained significantly lower in DM1-A compared to DM1-B and controls. Low values of resting salivary flow rate were associated with a higher prevalence of dental caries in children and adolescents with poorly-controlled DM1 (p<0.05). The results suggested that diabetes-induced alterations in salivary characteristics are indicative of higher caries susceptibility of diabetics and chair-side saliva tests are a useful tool for the evaluation of caries risk assessment.

Keywords: caries risk assessment, saliva diagnostic tests, type 1 diabetes, xerostomia

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4159 Solar Photovoltaic Driven Air-Conditioning for Commercial Buildings: A Case of Botswana

Authors: Taboka Motlhabane, Pradeep Sahoo

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The global demand for cooling has grown exponentially over the past century to meet economic development and social needs, accounting for approximately 10% of the global electricity consumption. As global temperatures continue to rise, the demand for cooling and heating, ventilation and air-conditioning (HVAC) equipment is set to rise with it. The increased use of HVAC equipment has significantly contributed to the growth of greenhouse gas (GHG) emissions which aid the climate crisis- one of the biggest challenges faced by the current generation. The need to address emissions caused directly by HVAC equipment and electricity generated to meet the cooling or heating demand is ever more pressing. Currently, developed countries account for the largest cooling and heating demand, however developing countries are anticipated to experience a huge increase in population growth in 10 years, resulting in a shift in energy demand. Developing countries, which are projected to account for nearly 60% of the world's GDP by 2030, are rapidly building infrastructure and economies to meet their growing needs and meet these projections. Cooling, a very energy-intensive process that can account for 20 % to 75% of a building's energy, depending on the building's use. Solar photovoltaic (PV) driven air-conditioning offers a great cost-effective alternative for adoption in both residential and non-residential buildings to offset grid electricity, particularly in countries with high irradiation, such as Botswana. This research paper explores the potential of a grid-connected solar photovoltaic vapor-compression air-conditioning system for the Peter-Smith herbarium at the Okavango Research Institute (ORI) University of Botswana campus in Maun, Botswana. The herbarium plays a critical role in the collection and preservation of botanical data, dating back over 100 years, with pristine collection from the Okavango Delta, a UNESCO world heritage site and serves as a reference and research site. Due to the herbarium’s specific needs, it operates throughout the day and year in an attempt to maintain a constant herbarium temperature of 16°?. The herbarium model studied simulates a variable-air-volume HVAC system with a system rating of 30 kW. Simulation results show that the HVAC system accounts for 68.9% of the building's total electricity at 296 509.60 kWh annually. To offset the grid electricity, a 175.1 kWp nominal power rated PV system requiring 416 modules to match the required power, covering an area of 928 m2 is used to meet the HVAC system annual needs. An economic assessment using PVsyst found that for an installation priced with average solar PV prices in Botswana totalled to be 787 090.00 BWP, with annual operating costs of 30 500 BWP/year. With self-project financing, the project is estimated to have recouped its initial investment within 6.7 years. At an estimated project lifetime of 20 years, the Net Present Value is projected at 1 565 687.00 BWP with a ROI of 198.9%, with 74 070.67 tons of CO2 saved at the end of the project lifetime. This study investigates the performance of the HVAC system to meet the indoor air comfort requirements, the annual PV system performance, and the building model has been simulated using DesignBuilder Software.

Keywords: vapor compression refrigeration, solar cooling, renewable energy, herbarium

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4158 Discursive (Re/De)Construction of Objectivity-Subjectivity: Critiquing Rape/Flesh Trade-Documentaries

Authors: Muhammed Shahriar Haque

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As an offshoot of journalistic discourse, the documentary should be objective in nature without harbouring any preconceived notion to foster ulterior motifs. When it comes to a social issue like rape in South Asian countries, as media in recent times is inundated with this violent act in India, Pakistan, Myanmar, Bangladesh, how does one document it in terms of objectivity and subjectivity? The objective of this study is twofold: to document the history of documentaries, and to critically analyze South Asian rape/flesh trade-documentaries. The overall goal is to trace the (re/de)construction of objectivity-subjectivity in documentaries. This paper adopts a qualitative approach to documentarist discourse through the lens of critical discourse analysis (CDA). Data was gathered for 10 documentaries on the theme of rape and/or flesh trade from eight South Asian countries, predominantly the South Asian Association of Regional Cooperation (SAARC) region. The documentaries were primarily categorised by using three frameworks based on six modes, six subgenres, and four basic approaches of documentary. Subsequently, the findings were critiqued from CDA perspective. The outcome suggests that there a two schools of thoughts regarding documentaries. According to journalistic ethics, news and/or documentaries should be objective in orientation and focus on informing the audience and/common people. The empirical findings tend to challenge ethical parameters of objectivity. At times, it seems that journalistic discourse is discursively (re)constructed to give an augmented simulation of objectivity. Based on the findings it may be recommended that if documentaries steer away from empirical facts and indulge in poetic naivety, their credibility could be questioned. A research of this nature is significant as it raises questions with regard to ethical and moral conscience of documentary filmmakers. Furthermore, it looks at whether they uphold journalistic integrity or succumb to their bias, and thereby depict subjective views, which could be tainted with political and/or propagandist ulterior motifs.

Keywords: discursive (re/de)construction, documentaries, journalistic integrity, rape/flesh trade

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4157 Insight into Enhancement of CO2 Capture by Clay Minerals

Authors: Mardin Abdalqadir, Paul Adzakro, Tannaz Pak, Sina Rezaei Gomari

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Climate change and global warming recently became significant concerns due to the massive emissions of greenhouse gases into the atmosphere, predominantly CO2 gases. Therefore, it is necessary to find sustainable and inexpensive methods to capture the greenhouse gasses and protect the environment for live species. The application of naturally available and cheap adsorbents of carbon such as clay minerals became a great interest. However, the minerals prone to low storage capacity despite their high affinity to adsorb carbon. This paper aims to explore ways to improve the pore volume and surface area of two selected clay minerals, ‘montmorillonite and kaolinite’ by acid treatment to overcome their low storage capacity. Montmorillonite and kaolinite samples were treated with different sulfuric acid concentrations (0.5, 1.2 and 2.5 M) at 40 °C for 8 hours to achieve the above aim. The grain size distribution and morphology of clay minerals before and after acid treatment were explored with Scanning Electron Microscope to evaluate surface area improvement. The ImageJ software was used to find the porosity and pore volume of treated and untreated clay samples. The structure of the clay minerals was also analyzed using an X-ray Diffraction machine. The results showed that the pore volume and surface area were increased substantially through acid treatment, which speeded up the rate of carbon dioxide adsorption. XRD pattern of kaolinite did not change after sulfuric acid treatment, which indicates that acid treatment would not affect the structure of kaolinite. It was also discovered that kaolinite had a higher pore volume and porosity than montmorillonite before and after acid treatment. For example, the pore volume of untreated kaolinite was equal to 30.498 um3 with a porosity of 23.49%. Raising the concentration of acid from 0.5 M to 2.5 M in 8 hours’ time reaction led to increased pore volume from 30.498 um3 to 34.73 um3. The pore volume of raw montmorillonite was equal to 15.610 um3 with a porosity of 12.7%. When the acid concentration was raised from 0.5 M to 2.5 M for the same reaction time, pore volume also increased from 15.610 um3 to 20.538 um3. However, montmorillonite had a higher specific surface area than kaolinite. This study concludes that clay minerals are inexpensive and available material sources to model the realistic conditions and apply the results of carbon capture to prevent global warming, which is one of the most critical and urgent problems in the world.

Keywords: acid treatment, kaolinite, montmorillonite, pore volume, porosity, surface area

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4156 The Right of Taiwanese Individuals with Mental Illnesses to Participate in Medical Decision-Making

Authors: Ying-Lun Tseng Chiu-Ying Chen

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Taiwan's Mental Health Act was amended at the end of 2022; they added regulations regarding refusing compulsory treatment by patients with mental illnesses. In addition, not only by an examination committee, the judge must also assess the patient's need for compulsory treatment. Additionally, the maximum of compulsory hospitalization has been reduced from an unlimited period to a maximum of 60 days. They aim to promote the healthcare autonomy of individuals with mental illnesses in Taiwan and prevent their silenced voice in medical decision-making while they still possess rationality. Furthermore, they plan to use community support and social care networks to replace the current practice of compulsory treatment in Taiwan. This study uses qualitative research methodology, utilizing interview guidelines to inquire about the experiences of Taiwanese who have undergone compulsory hospitalization, compulsory community treatment, and compulsory medical care. The interviews aimed to explore their feelings when they were subjected to compulsory medical intervention, the inside of their illness, their opinions after treatments, and whether alternative medical interventions proposed by them were considered. Additionally, participants also asked about their personal life history and their support networks in their lives. We collected 12 Taiwanese who had experienced compulsory medical interventions and were interviewed 14 times. The findings indicated that participants still possessed rationality during the onset of their illness. However, when they have other treatments to replace compulsory medical, they sometimes diverge from those of the doctors and their families. Finally, doctors prefer their professional judgment and patients' families' option. Therefore, Taiwanese mental health patients' power of decision-making still needs to improve. Because this research uses qualitative research, so difficult to find participants, and the sample size rate was smaller than Taiwan's population, it may have biases in the analysis. So, Taiwan still has significant progress in enhancing the decision-making rights of participants in the study.

Keywords: medical decision making, compulsory treatment, medical ethics, mental health act

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4155 The Implementation of Sexual and Reproductive Health Education Policy in Schools in Asia and Africa: A Scoping Review

Authors: Rhea Khosla, Victoria Tzortziou-Brown

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Introduction: Adolescent SRH has been neglected since the start of the millennium. Adolescents comprise 16% of the global population, with the largest proportion living in Asia (650 million). By late adolescence, individuals in these regions are likely to become sexually active, and thus they must understand their SRH rights. Many lack knowledge of SRH, using unreliable sources for such information. Sex education is necessary to standardize and inform sexual knowledge, which empowers adolescents to make informed SRH decisions. School is an appropriate environment for this, however, SRH education requires effective policy to enforce. Nonetheless, this issue remains of low political priority in Asia and Africa. Current literature on sex education policy in schools in these regions is scarce and tends to have broad aims. Thus, a scoping review was necessary. Methods: Literature searches were conducted in February 2023 using six databases, including grey literature databases (PubMed, Scopus, Embase, Web of Science, Google Scholar, Global Index Medicus), returning a total of 1537 unique articles. After screening titles, abstracts and full text, 17 articles remained. References of included articles were additionally searched, producing a further 7 articles, which then underwent thematic analysis Results: Most countries in Africa and Asia did not have studies on this topic. Studies derived data from interviews with key stakeholders and quantitative methods quantified questionnaire responses. Barriers were: policy/curriculum issues, societal opinions, teaching discomfort, and lack of educator training. Limitations were insufficient timing, inconsistent implementation, insufficient hours dedicated to teaching, education received late into schooling, and discrepancies between teachers, schools, and students about whether policies were being implemented. Discussion: Based on the existing limited evidence, a cultural shift to reduce stigma seems necessary, alongside teacher and student involvement in policy formulation with effective implementation monitoring and educator training.

Keywords: adolescent, Africa, Asia, education, sexual and reproductive health, policy

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4154 Nurse-Led Codes: Practical Application in the Emergency Department during a Global Pandemic

Authors: F. DelGaudio, H. Gill

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Resuscitation during cardiopulmonary (CPA) arrest is dynamic, high stress, high acuity situation, which can easily lead to communication breakdown, and errors. The care of these high acuity patients has also been shown to increase physiologic stress and task saturation of providers, which can negatively impact the care being provided. These difficulties are further complicated during a global pandemic and pose a significant safety risk to bedside providers. Nurse-led codes are a relatively new concept that may be a potential solution for alleviating some of these difficulties. An experienced nurse who has completed advanced cardiac life support (ACLS), and additional training, assumed the responsibility of directing the mechanics of the appropriate ACLS algorithm. This was done in conjunction with a physician who also acted as a physician leader. The additional nurse-led code training included a multi-disciplinary in situ simulation of a CPA on a suspected COVID-19 patient. During the CPA, the nurse leader’s responsibilities include: ensuring adequate compression depth and rate, minimizing interruptions in chest compressions, the timing of rhythm/pulse checks, and appropriate medication administration. In addition, the nurse leader also functions as a last line safety check for appropriate personal protective equipment and limiting exposure of staff. The use of nurse-led codes for CPA has shown to decrease the cognitive overload and task saturation for the physician, as well as limiting the number of staff being exposed to a potentially infectious patient. The real-world application has allowed physicians to perform and oversee high-risk procedures such as intubation, line placement, and point of care ultrasound, without sacrificing the integrity of the resuscitation. Nurse-led codes have also given the physician the bandwidth to review pertinent medical history, advanced directives, determine reversible causes, and have the end of life conversations with family. While there is a paucity of research on the effectiveness of nurse-led codes, there are many potentially significant benefits. In addition to its value during a pandemic, it may also be beneficial during complex circumstances such as extracorporeal cardiopulmonary resuscitation.

Keywords: cardiopulmonary arrest, COVID-19, nurse-led code, task saturation

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