Search results for: gender microaggressions
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2547

Search results for: gender microaggressions

477 The Link between Corporate Governance and EU Competition Law Enforcement: A Conditional Logistic Regression Analysis of the Role of Diversity, Independence and Corporate Social Responsibility

Authors: Jeroen De Ceuster

Abstract:

This study is the first empirical analysis of the link between corporate governance and European Union competition law. Although competition law enforcement is often studied through the lens of competition law, we offer an alternative perspective by looking at a number of corporate governance factor at the level of the board of directors. We find that undertakings where the Chief Executive Officer is also chairman of the board are twice as likely to violate European Union competition law. No significant relationship was found between European Union competition law infringements and gender diversity of the board, the size of the board, the percentage of directors appointed after the Chief Executive Officer, the percentage of independent directors, or the presence of corporate social responsibility (CSR) committee. This contribution is based on a 1-1 matched peer study. Our sample includes all ultimate parent companies with a board that have been sanctioned by the European Commission for either anticompetitive agreements or abuse of dominance for the period from 2004 to 2018. These companies were matched to a company with headquarters in the same country, belongs to the same industry group, is active in the European Economic Area, and is the nearest neighbor to the infringing company in terms of revenue. Our final sample includes 121 pairs. As is common with matched peer studies, we use CLR to analyze the differences within these pairs. The only statistically significant independent variable after controlling for size and performance is CEO/Chair duality. The results indicate that companies whose Chief Executive Officer also functions as chairman of the board are twice as likely to infringe European Union competition law. This is in line with the monitoring theory of the board of directors, which states that its primary function is to monitor top management. Since competition law infringements are mostly organized by management and hidden from board directors, the results suggest that a Chief Executive Officer who is also chairman is more likely to be either complicit in the infringement or less critical towards his day-to-day colleagues and thus impedes proper detection by the board of competition law infringements.

Keywords: corporate governance, competition law, board of directors, board independence, ender diversity, corporate social responisbility

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476 From Text to Data: Sentiment Analysis of Presidential Election Political Forums

Authors: Sergio V Davalos, Alison L. Watkins

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User generated content (UGC) such as website post has data associated with it: time of the post, gender, location, type of device, and number of words. The text entered in user generated content (UGC) can provide a valuable dimension for analysis. In this research, each user post is treated as a collection of terms (words). In addition to the number of words per post, the frequency of each term is determined by post and by the sum of occurrences in all posts. This research focuses on one specific aspect of UGC: sentiment. Sentiment analysis (SA) was applied to the content (user posts) of two sets of political forums related to the US presidential elections for 2012 and 2016. Sentiment analysis results in deriving data from the text. This enables the subsequent application of data analytic methods. The SASA (SAIL/SAI Sentiment Analyzer) model was used for sentiment analysis. The application of SASA resulted with a sentiment score for each post. Based on the sentiment scores for the posts there are significant differences between the content and sentiment of the two sets for the 2012 and 2016 presidential election forums. In the 2012 forums, 38% of the forums started with positive sentiment and 16% with negative sentiment. In the 2016 forums, 29% started with positive sentiment and 15% with negative sentiment. There also were changes in sentiment over time. For both elections as the election got closer, the cumulative sentiment score became negative. The candidate who won each election was in the more posts than the losing candidates. In the case of Trump, there were more negative posts than Clinton’s highest number of posts which were positive. KNIME topic modeling was used to derive topics from the posts. There were also changes in topics and keyword emphasis over time. Initially, the political parties were the most referenced and as the election got closer the emphasis changed to the candidates. The performance of the SASA method proved to predict sentiment better than four other methods in Sentibench. The research resulted in deriving sentiment data from text. In combination with other data, the sentiment data provided insight and discovery about user sentiment in the US presidential elections for 2012 and 2016.

Keywords: sentiment analysis, text mining, user generated content, US presidential elections

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475 Understanding Childhood Sexual Abuse and Its Association with Psychological Traumatization, Re-Traumatization, and Shame in Adult South Asian Women: A Scoping Review

Authors: Manisha Massey, Mariette Berndsen, Helen McLaren

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The existing body of literature concerning the incidence, prevalence, and experiences of childhood sexual abuse (CSA) lacked cultural inclusivity, primarily reflecting Euro-centric perspectives. This study investigated and reviewed the existing literature to understand the experiences of women of color from South Asia, addressing the gap in understanding how culture and diversity impact CSA. While individualist cultures emphasize autonomy, collectivist societies prioritize interdependence. South Asia's diverse intersections, including gender, caste, religion, and class, have intensified child sexual exploitation, challenging assumed homogeneity and safety. Additionally, the power exploitation in the space of abuse and grooming supplementing with the prevalence of honor violence makes disclosures of sexual abuse for children daunting and unsafe in these cultures. This scoping review examined the connection between CSA, psychological trauma, re-traumatization, and shame among adult South Asian women from India, Pakistan, and Bangladesh. Despite distinct borders, these countries share historical, linguistic, and traditional ties. Following PRISMA guidelines, the review employed thematic analysis. Findings underscored cultural factors' influence on CSA incidence, help-seeking barriers, and treatment challenges. The pivotal role of shame (sharam) and honor (izzat) in disclosure and healing processes was highlighted. The study emphasized the need for culturally sensitive interventions while noting limited literature on re-traumatisation. Incorporating a culturally informed perspective, this research aims to decolonize trauma therapy by contributing to the CSA discourse, shedding light on its intricate interaction with trauma, shame, and healing among South Asian women.

Keywords: Childhood sexual abuse, decolonizing psychology, trauma, re-trauma, shame

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474 Effect of Blood Sugar Levels on Short Term and Working Memory Status in Type 2 Diabetics

Authors: Mythri G., Manjunath ML, Girish Babu M., Shireen Swaliha Quadri

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Background: The increase in diabetes among the elderly is of concern because in addition to the wide range of traditional diabetes complications, evidence has been growing that diabetes is associated with increased risk of cognitive decline. Aims and Objectives: To find out if there is any association between blood sugar levels and short-term and working memory status in patients of type 2 diabetes. Materials and Methods: The study was carried out in 200 individuals aged between 40-65 years consisting of 100 diagnosed cases of Type 2 Diabetes Mellitus and 100 non-diabetics from OPD of Mc Gann Hospital, Shivamogga. Rye’s Auditory Verbal Learning Test, Verbal Fluency Test and Visual Reproduction Test, Working Digit Span Test and Validation Span Test were used to assess short-term and working memory. Fasting and Post Prandial blood sugar levels were estimated. Statistical analysis was done using SPSS 21. Results: Memory test scores of type 2 diabetics were significantly reduced (p < 0.001) when compared to the memory scores of age and gender matched non-diabetics. Fasting blood sugar levels were found to have a negative correlation with memory scores for all 5 tests: AVLT (r=-0.837), VFT (r=-0.888), VRT(r=-0.787), WDST (r=-0.795) and VST (r=-0.943). Post- Prandial blood sugar levels were found to have a negative correlation with memory scores for all 5 tests: AVLT (r=-0.922), VFT (r=-0.848), VRT(r=-0.707),WDST (r=-0.729) and VST (r=-0.880) Memory scores in all 5 tests were found to be negatively correlated with the FBS and PPBS levels in diabetic patients (p < 0.001). Conclusion: The decreased memory status in diabetic patients may be due to many factors like hyperglycemia, vascular disease, insulin resistance, amyloid deposition and also some of the factor combine to produce additive effects like, type of diabetes, co-morbidities, age of onset, duration of the disease and type of therapy. These observed effects of blood sugar levels of diabetics on memory status are of potential clinical importance because even mild cognitive impairment could interfere with todays’ activities.

Keywords: diabetes, cognition, diabetes, HRV, respiratory medicine

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473 Analysis of Residents’ Travel Characteristics and Policy Improving Strategies

Authors: Zhenzhen Xu, Chunfu Shao, Shengyou Wang, Chunjiao Dong

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To improve the satisfaction of residents' travel, this paper analyzes the characteristics and influencing factors of urban residents' travel behavior. First, a Multinominal Logit Model (MNL) model is built to analyze the characteristics of residents' travel behavior, reveal the influence of individual attributes, family attributes and travel characteristics on the choice of travel mode, and identify the significant factors. Then put forward suggestions for policy improvement. Finally, Support Vector Machine (SVM) and Multi-Layer Perceptron (MLP) models are introduced to evaluate the policy effect. This paper selects Futian Street in Futian District, Shenzhen City for investigation and research. The results show that gender, age, education, income, number of cars owned, travel purpose, departure time, journey time, travel distance and times all have a significant influence on residents' choice of travel mode. Based on the above results, two policy improvement suggestions are put forward from reducing public transportation and non-motor vehicle travel time, and the policy effect is evaluated. Before the evaluation, the prediction effect of MNL, SVM and MLP models was evaluated. After parameter optimization, it was found that the prediction accuracy of the three models was 72.80%, 71.42%, and 76.42%, respectively. The MLP model with the highest prediction accuracy was selected to evaluate the effect of policy improvement. The results showed that after the implementation of the policy, the proportion of public transportation in plan 1 and plan 2 increased by 14.04% and 9.86%, respectively, while the proportion of private cars decreased by 3.47% and 2.54%, respectively. The proportion of car trips decreased obviously, while the proportion of public transport trips increased. It can be considered that the measures have a positive effect on promoting green trips and improving the satisfaction of urban residents, and can provide a reference for relevant departments to formulate transportation policies.

Keywords: neural network, travel characteristics analysis, transportation choice, travel sharing rate, traffic resource allocation

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472 A Realist Review of Interventions Targeting Maternal Health in Low- and Middle-income Countries

Authors: Julie Mariam Abraham, G. J. Melendez-Torres

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Background. Maternal mortality is disproportionately higher in low- and middle- income countries (LMICs) compared to other parts of the world. At the current pace of progress, the Sustainable Development Goals for maternal mortality rate will not be achieved by 2030. A variety of factors influence the increased risk of maternal complications in LMICs. These are exacerbated by socio-economic and political factors, including poverty, illiteracy, and gender inequality. This paper aims to use realist synthesis to identify the contexts, mechanisms, and outcomes (CMOs) of maternal health interventions conducted in LMICs to inform evidence-based practice for future maternal health interventions. Methods. In May 2022, we searched four electronic databases for systematic reviews of maternal health interventions in LMICs published in the last five years. We used open and axial coding of CMOs to develop an explanatory framework for intervention effectiveness. Results. After eligibility screening and full-text analysis, 44 papers were included. The intervention strategies and measured outcomes varied within reviews. Healthcare system level contextual factors were the most frequently reported, and infrastructural capacity was the most reported context. The most prevalent mechanism was increased knowledge and awareness. Discussion. Health system infrastructure must be considered in interventions to ensure effective implementation and sustainability. Healthcare-seeking behaviours are embedded within social and cultural norms, environmental conditions, family influences, and provider attitudes. Therefore, effective engagement with communities and families is important to create new norms surrounding pregnancy and delivery. Future research should explore community mobilisation and involvement to enable tailored interventions with optimal contextual fit.

Keywords: maternal mortality, service delivery and organisation, realist synthesis, sustainable development goals, overview of reviews

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471 The Post-Confucian Korea: Destroying Hierarchies in Kim Yong Ha's "Oppa Came Back"

Authors: Steven D. Capener

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The 1997 Asian financial crisis was a watershed event in Korea as it necessitated changes that begin an unravelling of many of the norms and traditions that had served to underpin society. Divorce skyrocketed; the era of lifetime employment was over; women came out the home to become, in many cases, the main breadwinners; competitive forces were exacerbated; and traditional sources of authority began to crumble. All of these changes weekend the power to structure human relations of the Confucian Three Bonds and Five Relationships (삼강오륜). Since then, this “de-confucianization” has only become more pronounced with women increasingly refusing to marry, partly in protest to what they perceive as entrenched gender inequality, married couples eschewing childbirth resulting in the lowest birthrate in the world, and diminishing inheritances eroding the traditionally strong sense of filial piety (효) of children toward parents. The result of all this can be seen in the continued weakening or outright crumbling of the hierarchies codified in the Three Bonds and Five Relationship, which have served as a social template in Korea for centuries. In his 2004 work “Oppa Came Back,” writer Kim Yong Ha depicts what he apparently sees as the “post-Confucian” family in a wickedly funny portrayal of what Korean society could look like if traditional bulwarks of prescriptive values suddenly collapse and are not replaced with tenable alternatives. In the short story, Kim subverts all the traditional hierarchies while leaving the desire to dominate these hierarchies intact. This produces the picture of a Korean family governed by the new values of money and physical power. After lying out what can be identified as major cultural changes in what could be called “traditional” society,” the article uses a close reading of Kim’s story for its implications regarding a possible new, dysfunctional version of Korean society. It seems apparent that Kim’s story is a cautionary tale of the pitfalls that lie athwart the late-modern Korean landscape. These changes have important implications in the areas of education and socio-political philosophy. The conclusion focuses on possible alternatives to this post-Confucian conundrum.

Keywords: post-confucian, three bonds and five relationships, traditional society, hierarchies

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470 Sibling Relationship of Adults with Intellectual Disability in China

Authors: Luyin Liang

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Although sibling relationship has been viewed as one of the most important family relationships that significantly impacted on the quality of life of both adults with Intellectual Disability (AWID) and their brothers/sisters, very few research have been done to investigate this relationship in China. This study investigated Chinese siblings of AWID’s relational motivations in sibling relationship and their determining factors. Quantitative research method has been adopted and 284 samples were recruited in this study. Siblings of AWID’s two types of relational motivations, including obligatory motivations and discretionary motivations were examined. Their emotional closeness, senses of responsibility, experiences of ID stigma, and expectancy of self-reward in sibling relationship were measured by validated scales. Personal, and familial-social demographic characteristics were also investigated. Linear correlation test and standard multiple regression analysis were the major statistical methods that have been used to analyze the data. The findings of this study showed that all the measured factors, including siblings of AWID’s emotional closeness, their senses of responsibility, experiences of ID stigma, and self-reward expectations had significant relationships with their both types of motivations. However, when these factors were grouped together to measure each type of these motivations, the prediction results were varied. The order of factors that best predict siblings of AWID’s obligatory motivations was: their senses of responsibility, emotional closeness, experiences of ID stigma, and their expectancy of self-reward, whereas the order of these factors that best determine siblings of AWID’s discretionary motivations was: their self-reward expectations, experiences of ID stigma, senses of responsibility, and emotional closeness. Among different demographic characteristics, AWID’s disability condition, their siblings’ age, gender, marital status, number of children, both siblings’ living arrangements and family financial status were found to have significant impacts on siblings of AWID’s both types of motivations in sibling relationship. The results of this study could enhance social work practitioners’ understandings about the needs and challenges of siblings of AWID. Suggestions on advocacies for policy changes and services improvements for these siblings were discussed in this study.

Keywords: sibling relationship, intellectual disability, adults, China

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469 Being Young in Times of Change: Transformative Aspects of Migration across Generations in South Wollo, Ethiopia

Authors: Adamnesh A. Bogale, Dorte Thorsen

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This paper aims to learn how children/siblings left behind due to parental migration experience care and the effects of the separation. It also aims to unpack the experiences of youth migrants in rural Ethiopia. It focuses specifically on how children and youth are affected in order to highlight in which areas intervention can enhance or inadvertently undermine the development impact of migration on young people. Based on a qualitative study in South Wollo, Ethiopia, which was undertaken in three stages in 2017-19 and involved 34 households and a number of key informants, the analysis offers insights into how migration contributes to household sustainability and, in the process, alters intergenerational relationships and dynamics. Contemporary migration in Ethiopia is complex and highly gendered. For young women, the migration corridor from Ethiopia to the Middle East is the most important, whereas young men mostly engage in local migration or travel to South Africa or Sudan. Arguing that children and youths’ experience of migration must be understood in the context of the moral, affective, and material economies, the paper distinguishes between young people’s experiences of migration as children of migrants, as siblings of a migrant, and as migrants. The material shows that children and youths demonstrate different experiences in parental migration depending on age, care arrangement, and the ability to communicate with an absent mother. Migration has a different implication for younger siblings depending on their gender. The division of work and future responsibilities post marriage combine to disadvantage female siblings while male siblings are either unaffected or reaped the benefits of investments made with remittances. Finally, migration is a mechanism to change generational power relationships. As remitters, young migrants yield better recognition in the family, though not always to the degree that they can control the use of remittances. The power to make decisions is not tied only to material resources and the household; migration facilitates social change that opens space for young women to have more influence over their own lives.

Keywords: migration, youth, Ethiopia, generations

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468 Tattooing: Personal Markings with Meaning: Themes Uncovered While Making a Video Documentary

Authors: Byrad Yyelland, Robert Bianchi

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No longer the secret mark of outlaw bikers, criminals, and sailors, tattooing has become mainstream in much of the world. The current study showcases data gathered for a video documentary on the triangulated relationship connecting tattoos as a form of body modification, cultural norms, and personal meanings. This research has revealed that some religious belief systems, Buddhism in Thailand, is one example, connect tattooing with spirituality in an intimate manner. Buddhist monks provide tattoos using traditional bamboo implements and processes, and they pray over the tattoo, infusing magic into the tattoo and consequently, into the body of the receiver. In contrast, although there is no direct mention of tattooing in the Qur’an, many Islamic scholars argue that permanent tattooing is considered haram—forbidden for Muslims. Only the temporary henna is acceptable. In fact, tattooing is illegal in Qatar. Some Indigenous belief systems in Canada adopt a similar stance on the basis that we were all created by the Creator and as such, we do not have the right to alter what the Creator has made. Still other belief systems such as Spiritism in Brazil and mainstream Christianity in the West are more inclined to regard tattooing as a matter of personal choice. It is practically impossible for any culture to resist the dual impacts of time and globalization. Long term cultural change has resulted in mainstream acceptance of tattooing in the west and increased acceptance in Japan. Short-term cultural change is seen in Qatar where tattoos are on on public display amongst expats and migrant laborers. This tolerance of tattooed individuals was clearly evident with the choice of David Beckham as ambassador for the FIFA World Cup and during the corresponding tourist celebrations. Themes uncovered in this multicultural research also include individual meanings attributed to tattoo imagery and processes, experiences of personal empowerment, devotion to family, personal philosophy, gender identity, and aesthetics.

Keywords: culture, norms, tattooing, spirituality, personal motivations and personal meanings

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467 Factors Affecting Online Tourism Services in Israel

Authors: Shlomit Hon-Snir, Shosh Shahrabai, Sharon Teitler Regev, Anabel Friedlander-Lifszyc

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Today, online travel sites account for a large share of the orders for tourism services, leading to the expectation that many traditional travel agencies will become redundant in the future. Technological changes are offering customers a wider variety and better prices, and the improved competition in the industry has increased customer well-being significantly. Therefore, the question is whether all customers can enjoy this change, specifically whether different groups in the Israeli population enjoy the changes similarly. The purpose of this study is to identify the factors that affect the collection of data and the purchase of tourism products online and in particular to identify the barriers and limitations of technology usage among the population. The results of the current research are of great importance both economically and socially. The theory of Reasoned Action assumes that actual behavior is based on intention. Volitional behavior is predicted by individuals' attitudes to that behavior and by the way they think other people will look at them. Two cognitive variables regarding the use of technology are: perceived usefulness and perceived ease-of-use. Moreover, early adopters of innovations have different characteristics than people that adopt an innovation at a later stage. In the study, we analyze four groups of factors: Customer characteristics, internet usage, technology acceptance and product characteristics. Some of the parameters are gender, age, income level, frequency and type of internet use, proficiency in English, traveler type, number of trips abroad, perceived ease of use, perceived usefulness, perceived risk, perceived trust and product type. We investigate online purchasing and online information search separately. Data will be collected using an online questionnaire distributed among a representative sample of 600 citizens in Israel. Some of the research questions will be based on previous research studies (that underwent reliability and validity testing). Those questions will be translated into Hebrew and adjusted for the tested population.

Keywords: customer characteristics, online travel sites, technology acceptance, tourism

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466 Correlation Study between Clinical and Radiological Findings in Knee Osteoarthritis

Authors: Nabil A. A. Mohamed, Alaa A. A. Balbaa, Khaled E. Ayad

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Osteoarthritis (OA) of the knee is the most common form of arthritis and leads to more activity limitations (e.g., disability in walking and stair climbing) than any other disease, especially in the elderly. Recently, impaired proprioceptive accuracy of the knee has been proposed as a local factor in the onset and progression of radiographic knee OA (ROA). Purpose: To compare the clinical and radiological findings in healthy with that of knee OA. Also, to determine if there is a correlation between the clinical and radiological findings in patients with knee OA. Subjects: Fifty one patients diagnosed as unilateral or bilateral knee OA with age ranged between 35-70 years, from both gender without any previous history of knee trauma or surgery, and twenty one normal subjects with age ranged from 35 - 68 years. METHODS: peak torque/body weight (PT/BW) was recorded from knee extensors at isokinetic isometric mode at angle of 45 degree. Also, the Absolute Angular Error was recorded at 45O and 30O to measure joint position sense (JPS). They made anteroposterior (AP) plain X-rays from standing semiflexed knee position and their average score of Timed Up and Go test(TUG) and WOMAC were recorded as a measure of knee pain, stiffness and function. Comparison between the mean values of different variables in the two groups was performed using unpaired student t test. The P value less or equal to 0.05 was considered significant. Results: There were significant differences between the studied variables between the experimental and control groups except the values of AAE at 30O. Also, there were no significant correlation between the clinical findings (pain, function, muscle strength and proprioception) and the severity of arthritic changes in X-rays. CONCLUSION: From the finding of the current study we can conclude that there were a significant difference between the both groups in all studied parameters (the WOMAC, functional level, quadriceps muscle strength and the joint proprioception). Also this study did not support the dependency on radiological findings in management of knee OA as the radiological features did not necessarily indicate the level of structural damage of patients with knee OA and we should consider the clinical features in our treatment plan.

Keywords: joint position sense, peak torque, proprioception, radiological knee osteoarthritis

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465 A Meta-Analysis of the Academic Achievement of Students With Emotional/Behavioral Disorders in Traditional Public Schools in the United States

Authors: Dana Page, Erica McClure, Kate Snider, Jenni Pollard, Tim Landrum, Jeff Valentine

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Extensive research has been conducted on students with emotional and behavioral disorders (EBD) and their rates of challenging behavior. In the past, however, less attention has been given to their academic achievement and outcomes. Recent research examining outcomes for students with EBD has indicated that these students receive lower grades, are less likely to pass classes, and experience higher rates of school dropout than students without disabilities and students with other high incidence disabilities. Given that between 2% and 20% of the school-age population is likely to have EBD (though many may not be identified as such), this is no small problem. Despite the need for increased examination of this population’s academic achievement, research on the actual performance of students with EBD has been minimal. This study reports the results of a meta-analysis of the limited research examining academic achievement of students with EBD, including effect sizes of assessment scores and discussion of moderators potentially impacting academic outcomes. Researchers conducted a thorough literature search to identify potentially relevant documents before screening studies for inclusion in the systematic review. Screening identified 35 studies that reported results of academic assessment scores for students with EBD. These studies were then coded to extract descriptive data across multiple domains, including placement of students, participant demographics, and academic assessment scores. Results indicated possible collinearity between EBD disability status and lower academic assessment scores, despite a lack of association between EBD eligibility and lower cognitive ability. Quantitative analysis of assessment results yielded effect sizes for academic achievement of student participants, indicating lower performance levels and potential moderators (e.g., race, socioeconomic status, and gender) impacting student academic performance. In addition to discussing results of the meta-analysis, implications and areas for future research, policy, and practice are discussed.

Keywords: students with emotional behavioral disorders, academic achievement, systematic review, meta-analysis

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464 Multilingual Practices in the UK: Kabyles’ Situational Language Choice in a Linguistically Diverse Setting.

Authors: Souhila Belabbas

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This paper focuses on the Kabyles’ multilingual practices in the UK, within the Kabyle/Amazigh Cultural Organisation in London, on online platforms and at home. The Kabyles have roots in northern Algeria and associate their language, Kabyle, with a pre-Arabized history of northern Africa. Drawing on ethnographic research with this community, this study brings together their post-migration language preservation activisms as well as their dynamic multilingual practices and situational language choice into a dialogue. This shows the enduring significance of the heritage language for social, cultural and historical identity. It also demonstrates that the current survival of the “mother tongue” hinges on multilingual and multi-sited language activisms, which bear the hallmarks of both new creativities and diminishing fluencies in multilingual spaces. These multilingual repertoires also included a range of ideological stances, expressed as cultural, moral, and political attitudes to the “mother tongue” and to other, potentially more dominant, languages in their lives, involving both inclusive and exclusive instances. The Kabyles in the UK practice everyday forms of multilingualism in the dynamic terms whilst making strong identity claims to an endangered heritage language. Crucially, their language contact experiences were not a post-migration novelty but part of their pre-migration lifeworlds. The participants involved in this study shared a commitment to Kabyle identity activism. They expressed this differently, varyingly foregrounding cultural, social or political issues. These differences were related to their North-African cultural background, live, gender, religious and/or political affiliation, as well as to their different migratory trajectories. Among these ethno-conscious individuals, the use of Kabyle was often particularly vibrant in informal domains of casual conversations and mixed in with French, English and often Arabic. During community events and festivals, though, many made special efforts to converse in Kabyle as if to make a point about their commitment to a shared identity.

Keywords: ethnography, language ideology, language choice, heritage language, migration trajectories, multilingual repertoires

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463 Multilingual Practices in the UK: Kabyles’ Situational Language Choice in a Linguistically Diverse Setting

Authors: Souhila Belabbas

Abstract:

This paper focuses on the Kabyles’ multilingual practices in the UK, within the Kabyle/Amazigh Cultural Organisation in London, on online platforms and at home. The Kabyles have roots in northern Algeria and associate their language, Kabyle, with a pre-Arabized history of northern Africa. Drawing on ethnographic research with this community, this study brings together their post-migration language preservation activisms as well as their dynamic multilingual practices and situational language choice into a dialogue. This shows the enduring significance of the heritage language for social, cultural and historical identity. It also demonstrates that the current survival of the “mother tongue” hinges on multilingual and multi-sited language activisms, which bear the hallmarks of both new creativities and diminishing fluencies in multilingual spaces. These multilingual repertoires also included a range of ideological stances, expressed as cultural, moral, and political attitudes to the “mother tongue” and to other, potentially more dominant, languages in their lives, involving both inclusive and exclusive instances. The Kabyles in the UK practice everyday forms of multilingualism in the dynamic terms whilst making strong identity claims to an endangered heritage language. Crucially, their language contact experiences were not a post-migration novelty but part of their pre-migration lifeworlds. The participants involved in this study shared a commitment to Kabyle identity activism. They expressed this differently, varyingly foregrounding cultural, social or political issues. These differences were related to their North-African cultural background, live, gender, religious and/or political affiliation, as well as to their different migratory trajectories. Among these ethno-conscious individuals, the use of Kabyle was often particularly vibrant in informal domains of casual conversations and mixed in with French, English and often Arabic. During community events and festivals, though, many made special efforts to converse in Kabyle as if to make a point about their commitment to a shared identity.

Keywords: ethnography, language ideology, language choice, heritage language, migration trajectories, multilingual repertoires

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462 The Hierarchical Model of Fitness Services Quality Perception in Serbia

Authors: Mirjana Ilic, Dragan Zivotic, Aleksandra Perovic, Predrag Gavrilovic

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The service quality perception depends on many factors, such as the area in which the services are provided, socioeconomic status, educational status, experience, age and gender of consumers, as well as many others. For this reason, it is not possible to apply instrument for establishing the service quality perception that is developed in other areas and in other populations. The aim of the research was to form an instrument for assessing the quality perception in the field of fitness in Serbia. After analyzing the available literature and conducting a pilot research, there were 15 isolated areas in which it was possible to observe the service quality perception. The areas included: material and technical basis, secondary facilities, coaches, programs, reliability, credibility, security, rapid response, compassion, communication, prices, satisfaction, loyalty, quality outcomes and motives. These areas were covered by a questionnaire consisted of 100 items where the number of items varied from area to area from 3 up to 11. The questionnaire was administered to 350 subjects of both genders (174 men and 176 women) aged from 18 to 68 years, being beneficiaries of fitness services for at least 1 year. In each of the areas was conducted a factor analysis in its exploratory form by principal components method. The number of significant factors has been determined in accordance with the Kaiser Guttman criterion. The initial factor solutions were simplified using the Varimax rotation. Analyses per areas have produced from 1 to 4 factors. Afterward, the factor analysis of factor scores on the first principal component of each of the respondents in each of the analyzed area was performed, and the factor structure was obtained with four latent dimensions interpreted as offer, the relationship with the coaches, the experience of quality and the initial impression. This factor structure was analysed by hierarchical analysis of Oblique factors, which in the second order space produced single factor interpreted as a general factor of the service quality perception. The resulting questionnaire represents an instrument which can serve managers in the field of fitness to optimize the centers development, raising the quality of services in line with consumers needs and expectations.

Keywords: fitness, hierarchical model, quality perception, factor analysis

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461 Evaluating the Impact of a Child Sponsorship Program on Paediatric Health and Development in Calauan, Philippines: A Retrospective Audit

Authors: Daniel Faraj, Arabella Raupach, Charlotte Hespe, Helen Wilcox, Kristie-Lee Anning

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Aim: International child sponsorship programs comprise a considerable proportion of global aid accessible to the general population. Team Philippines (TP), a healthcare and welfare initiative run in association with the University of Notre Dame Sydney since 2013, leads a holistic sponsorship program for thirty children from Calauan, Philippines. To date, empirical research has not been performed on the overall success and impact of the TP child sponsorship program. As such, this study aims to evaluate its effectiveness in improving pediatric outcomes. Methods: Study cohorts comprised thirty sponsored and twenty-nine age- and gender-matched non-sponsored children. Data were extracted from the TP Medical Director database and lifestyle questionnaires for July-November 2019. Outcome measures included anthropometry, markers of medical health, dental health, exercise, and diet. Statistical analyses were performed in SPSS. Results: Sponsorship resulted in fewer medical diagnoses and prescription medications, superior dental health, and improved diet. Further, sponsored children may show a clinically significant trend toward improved physical health. Sponsorship did not affect growth and development metrics or levels of physical activity. Conclusions: The TP child sponsorship program significantly impacts positive pediatric health outcomes in the Calauan community. The strength of the program lies in its holistic, sustainable, and community-based model, which is enabled by effective international child sponsorship. This study further supports the relationship between supporting early livelihood and improved health in the pediatric population.

Keywords: child health, public health, health status disparities, healthcare disparities, social determinants of health, morbidity, community health services, culturally competent care, medically underserved areas, population health management, Philippines

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460 Higher Education Leadership and Creating Sites of Institutional Belonging: A Global Case Study

Authors: Lisa M. Coleman

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The focus on disability, LGBTQ+, and internationalization has certainly been the subject of much research and programmatic across higher education. Many universities have entered into global partnerships with varying success and challenges across the various areas, including laws and policies. Attentiveness to the specific nuances of global inclusion, diversity, equity, belonging, and access (GIDBEA) and the leadership to support these efforts is crucial to the development of longstanding success across the programs. There have been a number of shifts related to diversification across student and alumni bodies. These shifts include but are not limited to how people identify gender, race, and sexuality (and the intersections across such identities), as well as trends across emerging and diverse disability communities. NYU is the most international campus in the United States, with the most campuses and sites outside of its county of origin and the most international students and exchange programs than any other university. As a result, the ongoing work related to GIDEBA is at the center of much of the leadership, administrative, and research efforts. Climate assessment work across NYU’s diverse global campus landscape will serve as the foundation to exemplify best practices related to data collection and dissemination, community and stakeholder engagement, and effective implementation of innovative strategies to close gap areas as identified. The data (quantitative and qualitative) and related research findings represent data collected from close to 22,000 stakeholders across the NYU campuses. The case study centers on specific methodological considerations, data integrity, stakeholder engagement from across student-faculty, staff, and alumni constituencies, and tactics to advance specific GIDBEA initiatives related to navigating shifting landscapes. Design thinking, incubation, and co-creation strategies have been employed to expand, leverage, actualize, and implement GIDBEA strategies that are – concrete, measurable, differentiated, and specific to global sites and regions and emerging trends.

Keywords: disability, LGBTQ+, DEI, research, case studies

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459 Safety Profile of Anti-Retroviral Medicine in South Africa Based on Reported Adverse Drug Reactions

Authors: Sarah Gounden, Mukesh Dheda, Boikhutso Tlou, Elizabeth Ojewole, Frasia Oosthuizen

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Background: Antiretroviral therapy (ART) has been effective in the reduction of mortality and resulted in an improvement in the prognosis of HIV-infected patients. However, treatment with antiretrovirals (ARVs) has led to the development of many adverse drug reactions (ADRs). It is, therefore, necessary to determine the safety profile of these medicines in a South African population in order to ensure safe and optimal medicine use. Objectives: The aim of this study was to quantify ADRs experienced with the different ARVs currently used in South Africa, to determine the safety profile of ARV medicine in South Africa based on reported ADRs, and to determine the ARVs with the lowest risk profile based on specific patient populations. Methodology: This was a quantitative study. Individual case safety reports for the period January 2010 – December 2013 were obtained from the National Pharmacovigilance Center; these reports contained information on ADRs, ARV medicine, and patient demographics. Data was analysed to find associations that may exist between ADRs experienced, ARV medicines used and patient demographics. Results: A total of 1916 patient reports were received of which 1534 met the inclusion criteria for the study. The ARV with the lowest risk of ADRs were found to be lamivudine (0.51%, n=12), followed by lopinavir/ritonavir combination (0.8%, n=19) and abacavir (0.64%, n=15). A higher incidence of ADRs was observed in females compared to males. The age group 31–50 years and the weight group 61–80 kg had the highest incidence of ADRs reported. Conclusion: This study found that the safest ARVs to be used in a South African population are lamivudine, abacavir, and the lopinavir/ritonavir combination. Gender differences play a significant role in the occurrence of ADRs and both anatomical and physiological differences account for this. An increased BMI (body mass index) in both men and women showed an increase in the incidence of ADRs associated with ARV therapy.

Keywords: adverse drug reaction, antiretrovirals, HIV/AIDS, pharmacovigilance, South Africa

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458 Entrepreneurial Intention and Social Entrepreneurship among Students in Malaysian Higher Education

Authors: Radin Siti Aishah Radin A Rahman, Norasmah Othman, Zaidatol Akmaliah Lope Pihie, Hariyaty Ab. Wahid

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The recent instability in economy was found to be influencing the situation in Malaysia whether directly or indirectly. Taking that into consideration, the government needs to find the best approach to balance its citizen’s socio-economic strata level urgently. Through education platform is among the efforts planned and acted upon for the purpose of balancing the effects of the influence, through the exposure of social entrepreneurial activity towards youth especially those in higher institution level. Armed with knowledge and skills that they gained, with the support by entrepreneurial culture and environment while in campus; indirectly, the students will lean more on making social entrepreneurship as a career option when they graduate. Following the issues of marketability and workability of current graduates that are becoming dire, research involving how far the willingness of student to create social innovation that contribute to the society without focusing solely on personal gain is relevant enough to be conducted. With that, this research is conducted with the purpose of identifying the level of entrepreneurial intention and social entrepreneurship among higher institution students in Malaysia. Stratified random sampling involves 355 undergraduate students from five public universities had been made as research respondents and data were collected through surveys. The data was then analyzed descriptively using min score and standard deviation. The study found that the entrepreneurial intention of higher education students are on moderate level, however it is the contrary for social entrepreneurship activities, where it was shown on a high level. This means that while the students only have moderate level of willingness to be a social entrepreneur, they are very committed to created social innovation through the social entrepreneurship activities conducted. The implication from this study can be contributed towards the higher institution authorities in prediction the tendency of student in becoming social entrepreneurs. Thus, the opportunities and facilities for realizing the courses related to social entrepreneurship must be created expansively so that the vision of creating as many social entrepreneurs as possible can be achieved.

Keywords: entrepreneurial intention, higher education institutions (HEIs), social entrepreneurship, social entrepreneurial activity, gender

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457 The Effect of Values on Social Innovativeness in Nursing and Medical Faculty Students

Authors: Betül sönmez, Fatma Azizoğlu, S. Bilge Hapçıoğlu, Aytolan Yıldırım

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Background: Social innovativeness contains the procurement of a sustainable benefit for a number of problems from working conditions to education, social development, health, and from environmental control to climate change, as well as the development of new social productions and services. Objectives: This study was conducted to determine the correlation between the social innovation tendency of nursing and medical faculty students and value types. Methods and participants: The population of this correlational study consisted of third-year students studying at a medical faculty and a nursing faculty in a public university in Istanbul. Ethics committee approval and permission from the school administrations were obtained in order to conduct the study and voluntary participation of the students in the study was ensured. 524 questionnaires were obtained with a total return rate of 57.1% (65.0% in nurse student and 52.1% in physic students). The data of the study were collected by using the Portrait Values Questionnaire and a questionnaire containing the Social Innovativeness Scale. Results: The effect of the subscale scores of Portrait Values Questionnaire on the total score of Social Innovativeness Scale was 26.6%. In the model where a significance was determined (F=37.566; p<0.01), the highest effect was observed in the subscale of universalism. The effect of subscale scores obtained from the Portrait Values Questionnaire, as well as age, gender and number of siblings was 25% on the Social Innovativeness in nursing students and 30.8% in medical faculty students. In both models where a significance was determined (p<0.01), the nursing students had the values of power, universalism and kindness, whereas the medical faculty students had the values of self-direction, stimulation, hedonism and universalism showed the highest effect in both models. Conclusions: Universalism is the value with the highest effect upon the social innovativeness in both groups, which is an expected result by the nature of professions. The effect of the values of independent thinking and self-direction, as well as openness to change involving quest for innovation (stimulation), which are observed in medical faculty students, also supports the literature of innovative behavior. These results are thought to guide educators and administrators in terms of developing socially innovative behaviors.

Keywords: social innovativeness, portrait values questionnaire, nursing students, medical faculty students

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456 A Quantitative Study Investigating Whether the Internalisation of Adolescent Femininity Ideologies Predicts Depression and Anxiety in Female Adolescents

Authors: Tondani Mudau, Sherine B. Van Wyk, Zuhayr Kafaar, Janan Dietrich

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Female adolescents residing in a patriarchal society such as South Africa are more inclined to embrace feminine ideologies. Internalizing these ideologies may expose female adolescents to mental health challenges such as depression and anxiety. This study explored whether the internalisation of adolescent femininity ideologies namely, objectified relationship with own body (ORB) and inauthentic self in relationships (ISR) predicted anxiety and depression in late female adolescents at Stellenbosch University. The sample of the study consisted of 1451 (18-24) female undergraduate and postgraduate students enrolled at Stellenbosch University. The mean age of the participants was 20 (SD=1.46), and most participants (39.7%) were first-year students. The study employed a cross-sectional quantitative research design. Data was collected through an online self-completion survey, the survey consisted of three sections, the first section asked biographical questions regarding age, gender, race and family background. The second section measured the internalisation of feminine ideologies by using the adolescent femininity ideology scale which has two subscales namely inauthentic self in relationship with others (ISR) and objectified relationship with one’s own body (ORB). The ISR scale had the Cronbach Alpha of 0.76, and the ORB scale had the Cronbach Alpha of 0.83. The third section measured mental health (depression and anxiety) by using the Hopkins Symptoms 25-checklist which had the Cronbach Alpha of 0.93. Data were analysed through multiple linear regression from IBM SPSS (Statistical Package for the Social Sciences Version 24). The overall results of the multiple linear regression showed that The AFIS combination accounted for 14% for anxiety as measured by the Hopkins Symptoms Checklist R² = .142, F (2, 682) = 56.431, p < .001. The combination also accounted for 24% for depression as measured by the Hopkins Symptoms Checklist R² = .239, F (2, 682) = 106.971, p < .0. The findings in this study affirm the objectification and feminist theory contentions that internalising femininity ideologies (ISR and ORB) predict negative mental health in female adolescents.

Keywords: adolescents, anxiety, depression, feminine ideologies, inauthentic self, mental health, self-objectification, South Africa

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455 Predictive Relationship between Motivation Strategies and Musical Creativity of Secondary School Music Students

Authors: Lucy Lugo Mawang

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Educational Psychologists have highlighted the significance of creativity in education. Likewise, a fundamental objective of music education concern the development of students’ musical creativity potential. The purpose of this study was to determine the relationship between motivation strategies and musical creativity, and establish the prediction equation of musical creativity. The study used purposive sampling and census to select 201 fourth-form music students (139 females/ 62 males), mainly from public secondary schools in Kenya. The mean age of participants was 17.24 years (SD = .78). Framed upon self- determination theory and the dichotomous model of achievement motivation, the study adopted an ex post facto research design. A self-report measure, the Achievement Goal Questionnaire-Revised (AGQ-R) was used in data collection for the independent variable. Musical creativity was based on a creative music composition task and measured by the Consensual Musical Creativity Assessment Scale (CMCAS). Data collected in two separate sessions within an interval of one month. The questionnaire was administered in the first session, lasting approximately 20 minutes. The second session was for notation of participants’ creative composition. The results indicated a positive correlation r(199) = .39, p ˂ .01 between musical creativity and intrinsic music motivation. Conversely, negative correlation r(199) = -.19, p < .01 was observed between musical creativity and extrinsic music motivation. The equation for predicting musical creativity from music motivation strategies was significant F(2, 198) = 20.8, p < .01, with R2 = .17. Motivation strategies accounted for approximately (17%) of the variance in participants’ musical creativity. Intrinsic music motivation had the highest significant predictive value (β = .38, p ˂ .01) on musical creativity. In the exploratory analysis, a significant mean difference t(118) = 4.59, p ˂ .01 in musical creativity for intrinsic and extrinsic music motivation was observed in favour of intrinsically motivated participants. Further, a significant gender difference t(93.47) = 4.31, p ˂ .01 in musical creativity was observed, with male participants scoring higher than females. However, there was no significant difference in participants’ musical creativity based on age. The study recommended that music educators should strive to enhance intrinsic music motivation among students. Specifically, schools should create conducive environments and have interventions for the development of intrinsic music motivation since it is the most facilitative motivation strategy in predicting musical creativity.

Keywords: extrinsic music motivation, intrinsic music motivation, musical creativity, music composition

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454 The Effects of Billboard Content and Visible Distance on Driver Behavior

Authors: Arsalan Hassan Pour, Mansoureh Jeihani, Samira Ahangari

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Distracted driving has been one of the most integral concerns surrounding our daily use of vehicles since the invention of the automobile. While much attention has been recently given to cell phones related distraction, commercial billboards along roads are also candidates for drivers' visual and cognitive distractions, as they may take drivers’ eyes from the road and their minds off the driving task to see, perceive and think about the billboard’s content. Using a driving simulator and a head-mounted eye-tracking system, speed change, acceleration, deceleration, throttle response, collision, lane changing, and offset from the center of the lane data along with gaze fixation duration and frequency data were collected in this study. Some 92 participants from a fairly diverse sociodemographic background drove on a simulated freeway in Baltimore, Maryland area and were exposed to three different billboards to investigate the effects of billboards on drivers’ behavior. Participants glanced at the billboards several times with different frequencies, the maximum of which occurred on the billboard with the highest cognitive load. About 74% of the participants didn’t look at billboards for more than two seconds at each glance except for the billboard with a short visible area. Analysis of variance (ANOVA) was performed to find the variations in driving behavior when they are invisible, readable, and post billboards area. The results show a slight difference in speed, throttle, brake, steering velocity, and lane changing, among different areas. Brake force and deviation from the center of the lane increased in the readable area in comparison with the visible area, and speed increased right after each billboard. The results indicated that billboards have a significant effect on driving performance and visual attention based on their content and visibility status. Generalized linear model (GLM) analysis showed no connection between participants’ age and driving experience with gaze duration. However, the visible distance of the billboard, gender, and billboard content had a significant effect on gaze duration.

Keywords: ANOVA, billboards, distracted driving, drivers' behavior, driving simulator, eye-Tracking system, GLM

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453 Women and Terrorism in Nigeria: Policy Templates for Addressing Complex Challenges in a Changing Democratic State

Authors: Godiya Pius Atsiya

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One of the most devastating impacts of terrorism on the Nigerian state is the danger it has posed on women, children and other vulnerable groups. The complexity of terrorism in Nigeria, especially in most parts of Northern Nigeria has entrenched unprecedented security challenges such as refugee crisis, kidnapping, food shortages, increase in death tolls, malnutrition, fear, rape and several other psychological factors. Of particular interest in this paper as it relates to terrorism is the high rate of Internally Displaced Persons(IDPs), with women, children and the aged being the most affected. Empirical evidence arising from recent development in Nigeria’s North-East geo-political zone shows that large numbers of refugees fleeing the Boko Haram attacks have doubled. The attendant consequences of this mass exodus of people in the affected areas are that the victims now suffer untold and unwarranted economic hardship. In another dimension, recent findings have it that most powerless women and young teenage girls have been forcefully conscripted into the Islamic extremist groups and used as shields. In some respect, these groups of people have been used as available tools for suicide bombing and other criminal tendencies, the result of which can be detrimental to social cohesion and integration. This work is a theoretical insight into terrorism discourses; hence, the paper relies on existing works of scholars in carrying out the research. The paper argues that the implications of terrorism on women gender have grounding effects on the moral psyche of women who are supposed to be home managers and custodians of morality in society. The burden of terrorism and all it tends to propagate has literally upturned social lives and hence, Nigeria is gradually being plunged into the Hobesian state of nature. As a panacea to resolving this social malaise, the paper submits that government and indeed, all stakeholders in the nation’s democratic project must expedite action to nip this trend in the bud. The paper sums up with conclusion and other alternative policy measures to mitigate the challenges of terrorism in Nigeria.

Keywords: changing democratic state, policy measures, terrorism, women

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452 Architectural Design Strategies and Visual Perception of Contemporary Spatial Design

Authors: Nora Geczy

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In today’s architectural practice, during the process of designing public, educational, healthcare and cultural space, human-centered architectural designs helping spatial orientation, safe space usage and the appropriate spatial sequence of actions are gaining increasing importance. Related to the methodology of designing public buildings, several scientific experiments in spatial recognition, spatial analysis and spatial psychology with regard to the components of space producing mental and physiological effects have been going on at the Department of Architectural Design and the Interdisciplinary Student Workshop (IDM) at the Széchenyi István University, Győr since 2013. Defining the creation of preventive, anticipated spatial design and the architectural tools of spatial comfort of public buildings and their practical usability are in the limelight of our research. In the experiments applying eye-tracking cameras, we studied the way public spaces are used, especially concentrating on the characteristics of spatial behaviour, orientation, recognition, the sequence of actions, and space usage. Along with the role of mental maps, human perception, and interaction problems in public spaces (at railway stations, galleries, and educational institutions), we analyzed the spatial situations influencing psychological and ergonomic factors. We also analyzed the eye movements of the experimental subjects in dynamic situations, in spatial procession, using stairs and corridors. We monitored both the consequences and the distorting effects of the ocular dominance of the right eye on spatial orientation; we analyzed the gender-based differences of women and men’s orientation, stress-inducing spaces, spaces affecting concentration and the spatial situation influencing territorial behaviour. Based on these observations, we collected the components of creating public interior spaces, which -according to our theory- contribute to the optimal usability of public spaces. We summed up our research in criteria for design, including 10 points. Our further goals are testing design principles needed for optimizing orientation and space usage, their discussion, refinement, and practical usage.

Keywords: architecture, eye-tracking, human-centered spatial design, public interior spaces, visual perception

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451 Teachers’ Perception of Implementing a Norm Critical Pedagogical Perspective – A Case Study of a Swedish Behavioural Science Programme

Authors: Sophia Yakhlef

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Norm-critical pedagogy is an approach originating from intersectional gender pedagogy, feminist pedagogy, queer pedagogy, and critical pedagogy. In the Swedish context, the norm critical approach is rising in popularity, and norms that are highlighted or challenged are, for example, various dimensions of power such as ’whiteness norm’, discourses of ’Swedishness’, ’middle class norm’, heteronormativity, and body functionality. Instead of seeing students as a homogenous group, intersectional pedagogy focuses on the consequences of differences and on critically paying attention to differences. The perspective encourages teachers to assess their teaching methods, material, and the course literature provided in their education. The classical sociological literature that most students encounter when studying behaviour science or sociology has, in recent years, been referred to as the sociological canon. The sociological perspectives of the classical scholars included in the canon have, in many ways, shaped how we perceive the history of sociology and theories of the modern world in general. The sociological canon has, in recent decades, been challenged by, amongst others, feminist, post-colonial, and queer theorists. This urges us to further investigate the implications that this might have on sociological and behavioural science education, as well as on pedagogical considerations and teaching methods. This qualitative case study focuses on the experiences of implementing a norm critical pedagogical perspective in an online behavioural science programme at Kristianstad University in Sweden. Interviews and informal conversations were conducted in 2022 with teachers regarding their experiences of teaching online, of implementing a student-centred learning approach, and their experiences of implementing a norm critical perspective in sociology and criminology courses. The study demonstrates the inclusion aspect of online education, the benefits of adopting a norm critical perspective, the challenges that arise when updating course literature, and the urgent need for guidance and education for teachers regarding inclusion and paying attention to power asymmetry.

Keywords: norm critical pedagogy, online-education, sociological canon, sweden

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450 Dietary Vitamin D Intake and the Bladder Cancer Risk: A Pooled Analysis of Prospective Cohort Studies

Authors: Iris W. A. Boot, Anke Wesselius, Maurice P. Zeegers

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Diet may play an essential role in the aetiology of bladder cancer (BC). Vitamin D is involved in various biological functions which have the potential to prevent BC development. Besides, vitamin D also influences the uptake of calcium and phosphorus , thereby possibly indirectly influencing the risk of BC. The aim of the present study was to investigate the relation between vitamin D intake and BC risk. Individual dietary data were pooled from three cohort studies. Food item intake was converted to daily intakes of vitamin D, calcium and phosphorus. Pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs) were obtained using Cox-regression models. Analyses were adjusted for gender, age and smoking status (Model 1), and additionally for the food groups fruit, vegetables and meat (Model 2). Dose–response relationships (Model 1) were examined using a nonparametric test for trend. In total, 2,871 cases and 522,364 non-cases were included in the analyses. The present study showed an overall increased BC risk for high dietary vitamin D intake (HR: 1.14, 95% CI: 1.03-1.26). A similar increase BC risk with high vitamin D intake was observed among women and for the non-muscle invasive BC subtype, (HR: 1.41, 95% CI: 1.15-1.72, HR: 1.13, 95% CI: 1.01-1.27, respectively). High calcium intake decreased the BC risk among women (HR: 0.81, 95% CI: 0.67-0.97). A combined inverse effect on BC risk was observed for low vitamin D intake and high calcium intake (HR: 0.67, 95% CI: 0.48-0.93), while a positive effect was observed for high vitamin D intake in combination with low, moderate and high phosphorus (HR: 1.31, 95% CI: 1.09-1.59, HR: 1.17, 95% CI: 1.01-1.36, HR: 1.16, 95% CI: 1.03-1.31, respectively). Combining all nutrients showed a decreased BC risk for low vitamin D intake, high calcium and moderate phosphor intake (HR: 0.37, 95% CI: 0.18-0.75), and an increased BC risk for moderate intake of all the nutrients (HR: 1.18, 95% CI: 1.02-1.38), for high vitamin D and low calcium and phosphor intake (HR: 1.28, 95% CI: 1.01-1.62), and for moderate vitamin D and calcium and high phosphorus intake (HR: 1.27, 95% CI: 1.01-1.59). No significant dose-response analyses were observed. The findings of this study show an increased BC risk for high dietary vitamin D intake and a decreased risk for high calcium intake. Besides, the study highlights the importance of examining the effect of a nutrient in combination with complementary nutrients for risk assessment. Future research should focus on nutrients in a wider context and in nutritional patterns.

Keywords: bladder cancer, nutritional oncology, pooled cohort analysis, vitamin D

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449 Linguistic Competencies of Students with Hearing Impairment

Authors: Khalil Ullah Khan

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Linguistic abilities in students with hearing impairment yet remain a concern for educationists. The emerging technological support and provisions in the recent era vow to have addressed the situation and claim significant contributions in terms of linguistic repertoire. Being a descriptive and quantitative paradigm of study, the purpose of this research set forth was to assess the linguistic competencies of students with hearing impairment in the English language. The goals were further broken down to identify the level of reading abilities in the subject population. The population involved students with HI studying at a higher secondary level in Lahore. A simple random sampling technique was used to choose a sample of fifty students. A purposive curriculum-based assessment was designed in line with the accelerated learning program by the Punjab Government to assess Linguistic competence among the sample. Further to it, an Informal Reading Inventory (IRI) corresponding to reading levels was also developed by researchers duly validated and piloted before the final use. Descriptive and inferential statistics were utilized to reach the findings. Spearman’s correlation was used to find out the relationship between the degree of hearing loss, grade level, gender and type of amplification device. An Independent sample t-test was used to compare means among groups. Major findings of the study revealed that students with hearing impairment exhibit significant deviation from the mean scores when compared in terms of grades, severity and amplification device. The study divulged that respective students with HI have yet failed to qualify for an independent level of reading according to their grades, as the majority fall at the frustration level of word recognition and passage comprehension. The poorer performance can be attributed to lower linguistic competence, as it is shown in the frustration levels of reading, writing and comprehension. The correlation analysis did reflect an improved performance grade. Wise. However, scores could only correspond to frustration level, and independent levels were never achieved. Reported achievements at the instructional level of the subject population may further to linguistic skills if practiced purposively.

Keywords: linguistic competence, hearing impairment, reading levels, educationist

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448 Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Tunisia: Risk and Protective Factor

Authors: Ahmed Sami Hammami, Mohamed Jellazi

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Background: The aim of the study is to evaluate the magnitude of different psychological outcomes among Tunisian health care professionals (HCP) during the COVID-19 pandemic and to identify the associated factors. Methods: HCP completed a cross-sectional questionnaire from April 4th to April, 28th 2020. The survey collected demographic information, factors that may interfere with the psychological outcomes, behavior changes and mental health measurements. The latter was assessed through 3 scales; the 7-item questions Insomnia Severity Index, the 2-item Patient Health Questionnaire and the 2-item Generalized Anxiety Disorder. Multivariable logistic regression was conducted to identify factors associated with psychological outcomes. Results: A total of 503 HCP successfully completed the survey; among those, n=493 consented to enroll in the study, 411 [83.4%] were physicians, 323 [64.2%] were women and 271 [55%] had a second-line working position. A significant proportion of HCP had anxiety 35.7%, depression 35.1% and insomnia 23.7%. Females, those with psychiatric history and those using public transport exhibited the highest proportions for overall symptoms compared to other groups e.g., depression among females vs. males: 44,9% vs. 18,2%, P=0.00. Those with a previous medical history and nurses, had more anxiety and insomnia compared to other groups e.g. anxiety among nurses vs. interns/residents vs. attending 45,1% vs 36,1% vs 27,5%; p=0.04. Multivariable logistic regression showed that female gender was a risk factor for all psychological outcomes e.g. female sex increased the odds of anxiety by 2.86; 95% confidence interval [CI], 1, 78-4, 60; P=0.00, whereas having a psychiatric history was a risk factor for both anxiety and insomnia. (e.g. for insomnia OR=2,86; 95% [CI], 1,78-4,60; P=0.00), Having protective equipment was associated with lower risk for depression (OR=0,41; 95% CI, 0,27-0,62; P=0.00) and anxiety. Physical activity was also protective against depression and anxiety (OR=0,41, 95% CI, 0,25-0,67, P=0.00). Conclusion: Psychological symptoms are usually undervalued among HCP, though the COVID-19 pandemic played a major role in exacerbating this burden. Prompt psychological support should be endorsed and simple measures such as physical activity and ensuring the necessary protection are paramount to improve mental health outcomes and the quality of care provided to patients.

Keywords: COVID-19 pandemic, health care professionals, mental health, protective factors, psychological symptoms, risk factors

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