Search results for: perception of burden
Commenced in January 2007
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Edition: International
Paper Count: 2779

Search results for: perception of burden

529 Turkey in Minds: Cognitive and Social Representation of "East" and "West"

Authors: Feyzan Tuzkaya, Nihan S. Soylu, Caglar Solak, Mehmet Peker, Hilal Peker, Kemal Ozeralp, Ceren Mete, Ezgi Mehmetoglu, Mehmet Karasu, Cihan Elci, Ece Akca, Melek Goregenli

Abstract:

Perception, evaluation and representation of the environment have been the subject of many disciplines including psychology, geography and architecture. In environmental and social psychology literature there are several evidences which suggest that cognitive representations about a place consisted of not only geographic items but also social and cultural. Mental representations of residence area or a country is influenced and determined by social-demographics, the physical and social context. Thus, all mental representations of a given place are also social representations. Cognitive maps are the main and common instruments that are used to identify spatial images and the difference between physical and subjective environments. The aim of the current study is investigating the mental and social representations of Turkey in university students’ minds. Data was collected from 249 university students from different departments (i.e. psychology, geography, history, tourism departments) of Ege University. Participants were requested to reflect Turkey in their mind onto the paper drawing sketch maps. According to the results, cognitive maps showed geographic aspects of Turkey as well as the context of symbolic, cultural and political reality of Turkey. That is to say, these maps had many symbolic and verbal items related to critics on social and cultural problems, ongoing ethnic and political conflicts, and actual political agenda of Turkey. Additionally, one of main differentiations in these representations appeared in terms of the East and West side of the Turkey, and the representations of the East and West was varied correspondingly participants’ cultural background, their ethnic values, and where they have born. The results of the study were discussed in environmental and social psychological perspective considering cultural and social values of Turkey and current political circumstances of the country.

Keywords: cognitive maps, East, West, politics, social representations, Turkey

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528 Ta(l)king Pictures: Development of an Educational Program (SELVEs) for Adolescents Combining Social-Emotional Learning and Photography Taking

Authors: Adi Gielgun-Katz, Alina S. Rusu

Abstract:

In the last two decades, education systems worldwide have integrated new pedagogical methods and strategies in lesson plans, such as innovative technologies, social-emotional learning (SEL), gamification, mixed learning, multiple literacies, and many others. Visual language, such as photographs, is known to transcend cultures and languages, and it is commonly used by youth to express positions and affective states in social networks. Therefore, visual language needs more educational attention as a linguistic and communicative component that can create connectedness among the students and their teachers. Nowadays, when SEL is gaining more and more space and meaning in the area of academic improvement in relation to social well-being, and taking and sharing pictures is part of the everyday life of the majority of people, it becomes natural to add the visual language to SEL approach as a reinforcement strategy for connecting education to the contemporary culture and language of the youth. This article presents a program conducted in a high school class in Israel, which combines the five SEL with photography techniques, i.e., Social-Emotional Learning Visual Empowerments (SELVEs) program (experimental group). Another class of students from the same institution represents the control group, which is participating in the SEL program without the photography component. The SEL component of the programs addresses skills such as: troubleshooting, uncertainty, personal strengths and collaboration, accepting others, control of impulses, communication, self-perception, and conflict resolution. The aim of the study is to examine the effects of programs on the level of the five SEL aspects in the two groups of high school students: Self-Awareness, Social Awareness, Self-Management, Responsible Decision Making, and Relationship Skills. The study presents a quantitative assessment of the SEL programs’ impact on the students. The main hypothesis is that the students’ questionnaires' analysis will reveal a better understanding and improvement of the five aspects of the SEL in the group of students involved in the photography-enhanced SEL program.

Keywords: social-emotional learning, photography, education program, adolescents

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527 Comparison of Incidence and Risk Factors of Early Onset and Late Onset Preeclampsia: A Population Based Cohort Study

Authors: Sadia Munir, Diana White, Aya Albahri, Pratiwi Hastania, Eltahir Mohamed, Mahmood Khan, Fathima Mohamed, Ayat Kadhi, Haila Saleem

Abstract:

Preeclampsia is a major complication of pregnancy. Prediction and management of preeclampsia is a challenge for obstetricians. To our knowledge, no major progress has been achieved in the prevention and early detection of preeclampsia. There is very little known about the clear treatment path of this disorder. Preeclampsia puts both mother and baby at risk of several short term- and long term-health problems later in life. There is huge health service cost burden in the health care system associated with preeclampsia and its complications. Preeclampsia is divided into two different types. Early onset preeclampsia develops before 34 weeks of gestation, and late onset develops at or after 34 weeks of gestation. Different genetic and environmental factors, prognosis, heritability, biochemical and clinical features are associated with early and late onset preeclampsia. Prevalence of preeclampsia greatly varies all over the world and is dependent on ethnicity of the population and geographic region. To authors best knowledge, no published data on preeclampsia exist in Qatar. In this study, we are reporting the incidence of preeclampsia in Qatar. The purpose of this study is to compare the incidence and risk factors of both early onset and late onset preeclampsia in Qatar. This retrospective longitudinal cohort study was conducted using data from the hospital record of Women’s Hospital, Hamad Medical Corporation (HMC), from May 2014-May 2016. Data collection tool, which was approved by HMC, was a researcher made extraction sheet that included information such as blood pressure during admission, socio demographic characteristics, delivery mode, and new born details. A total of 1929 patients’ files were identified by the hospital information management when they apply codes of preeclampsia. Out of 1929 files, 878 had significant gestational hypertension without proteinuria, 365 had preeclampsia, 364 had severe preeclampsia, and 188 had preexisting hypertension with superimposed proteinuria. In this study, 78% of the data was obtained by hospital electronic system (Cerner) and the remaining 22% was from patient’s paper records. We have gone through detail data extraction from 560 files. Initial data analysis has revealed that 15.02% of pregnancies were complicated with preeclampsia from May 2014-May 2016. We have analyzed difference in the two different disease entities in the ethnicity, maternal age, severity of hypertension, mode of delivery and infant birth weight. We have identified promising differences in the risk factors of early onset and late onset preeclampsia. The data from clinical findings of preeclampsia will contribute to increased knowledge about two different disease entities, their etiology, and similarities/differences. The findings of this study can also be used in predicting health challenges, improving health care system, setting up guidelines, and providing the best care for women suffering from preeclampsia.

Keywords: preeclampsia, incidence, risk factors, maternal

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526 China Pakistan Economic Corridor: An Unfolding Fiasco in World Economy

Authors: Debarpita Pande

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On 22nd May 2013 Chinese Premier Li Keqiang on his visit to Pakistan tabled a proposal for connecting Kashgar in China’s Xinjiang Uygur Autonomous Region with the south-western Pakistani seaport of Gwadar via the China Pakistan Economic Corridor (hereinafter referred to as CPEC). The project, popularly termed as 'One Belt One Road' will encompass within it a connectivity component including a 3000-kilometre road, railways and oil pipeline from Kashgar to Gwadar port along with an international airport and a deep sea port. Superficially, this may look like a 'game changer' for Pakistan and other countries of South Asia but this article by doctrinal method of research will unearth some serious flaws in it, which may change the entire economic system of this region heavily affecting the socio-economic conditions of South Asia, further complicating the complete geopolitical situation of the region disturbing the world economic stability. The paper besets with a logical analyzation of the socio-economic issues arising out of this project with an emphasis on its impact on the Pakistani and Indian economy due to Chinese dominance, serious tension in international relations, security issues, arms race, political and provincial concerns. The research paper further aims to study the impact of huge burden of loan given by China towards this project where Pakistan already suffers from persistent debts in the face of declining foreign currency reserves along with that the sovereignty of Pakistan will also be at stake as the entire economy of the country will be held hostage by China. The author compares this situation with the fallout from projects in Sri Lanka, Tajikistan, and several countries of Africa, all of which are now facing huge debt risks brought by Chinese investments. The entire economic balance will be muddled by the increment in Pakistan’s demand of raw materials resulting to the import of the same from China, which will lead to exorbitant price-hike and limited availability. CPEC will also create Chinese dominance over the international movement of goods that will take place between the Atlantic and the Pacific oceans and hence jeopardising the entire economic balance of South Asia along with Middle Eastern countries like Dubai. Moreover, the paper also analyses the impact of CPEC in the context of international unrest and arms race between Pakistan and India as well as India and China due to border disputes and Chinese surveillance. The paper also examines the global change in economic dynamics in international trade that CPEC will create in the light of U.S.-China relationship. The article thus reflects the grave consequences of CPEC on the international economy, security and bilateral relations, which surpasses the positive impacts of it. The author lastly suggests for more transparency and proper diplomatic planning in the execution of this mega project, which can be a cause of economic complexity in international trade in near future.

Keywords: China, CPEC, international trade, Pakistan

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525 The Benefits of a Totally Autologous Breast Reconstruction Technique Using Extended Latissimus Dorsi Flap with Lipo-Modelling: A Seven Years United Kingdom Tertiary Breast Unit Results

Authors: Wisam Ismail, Brendan Wooler, Penelope McManus

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Introduction: The public perception of implants has been damaged in the wake of recent negative publicity and increasingly we are finding patients wanting to avoid them. Planned lipo-modelling to enhance the volume of a Latissimus dorsi flap is a viable alternative to silicone implants and maintains a Totally Autologous Technique (TAT). Here we demonstrate that when compared to an Implant Assisted Technique (IAT), a TAT offers patients many benefits that offset the requirement of more operations initially, with reduced short and long term complications, reduced symmetrisation surgery and reduced revision rates. Methods. Data was collected prospectively over 7 years. The minimum follows up was 3 years. The technique was generally standardized in the hand of one surgeon. All flaps were extended LD flaps (ELD). Lipo-modelling was performed using standard techniques. Outcome measures were unplanned secondary procedures, complication rates, and contralateral symmetrisation surgery rates. Key Results Were: Lower complication rates in the TAT group (18.5% vs. 33.3%), despite higher radiotherapy rates (TAT=49%, IAT=36.8%), TAT was associated with lower subsequent symmetrisation rates (30.6% vs. 50.9%), IAT had a relative risk of 3.1 for subsequent unplanned procedure, Autologous patients required an average of 1.76 sessions of lipo-modelling, Conclusions: Using lipo-modelling to enable totally autologous LD reconstruction offers significant advantages over an implant assisted technique. We have shown a lower subsequent unplanned procedure rate, lower revision surgery, and less contralateral symmetrisation surgery. We anticipate that a TAT will be supported by patient satisfaction surveys and long-term patient-reported cosmetic outcome data and intended to study this.

Keywords: breast, Latissimus dorsi, lipomodelling, reconstruction

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524 Prevalence, Antimicrobial Susceptibility Pattern and Public Health Significance for Staphylococcus Aureus of Isolated from Raw Red Meat at Butchery and Abattoir House in Mekelle, Northern Ethiopia

Authors: Haftay Abraha Tadesse

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Background: Staphylococcus is a genus of worldwide distributed bacteria correlated to several infectious of different sites in humans and animals. They are among the most important causes of infection that are associated with the consumption of contaminated food. Objective: The objective of this study was to determine the isolates, antimicrobial susceptibility patterns and Public Health Significance of Staphylococcus aureus in raw meat from butchery and abattoir houses of Mekelle, Northern Ethiopia. Methodology: A cross-sectional study was conducted from April to October 2019. Socio-demographic data and Public Health Significance were collected using a predesigned questionnaire. The raw meat samples were collected aseptically in the butchery and abattoir houses and transported using an ice box to Mekelle University, College of Veterinary Sciences, for isolating and identification of Staphylococcus aureus. Antimicrobial susceptibility tests were determined by the disc diffusion method. Data obtained were cleaned and entered into STATA 22.0 and a logistic regression model with odds ratio was calculated to assess the association of risk factors with bacterial contamination. A P-value < 0.05 was considered statistically significant. Results: In the present study, 88 out of 250 (35.2%) were found to be contaminated with Staphylococcus aureus. Among the raw meat specimens, the positivity rate of Staphylococcus aureus was 37.6% (n=47) and (32.8% (n=41), butchery and abattoir houses, respectively. Among the associated risks, factories not using gloves reduces risk was found to (AOR=0.222; 95% CI: 0.104-0.473), Strict Separation b/n clean & dirty (AOR= 1.37; 95% CI: 0.66-2.86) and poor habit of hand washing (AOR=1.08; 95%CI: 0.35 3.35) was found to be statistically significant and have associated with Staphylococcus aureus contamination. All isolates of thirty-seven of Staphylococcus aureus were checked and displayed (100%) sensitive to doxycycline, trimethoprim, gentamicin, sulphamethoxazole, amikacin, CN, Co trimoxazole and nitrofurantoi. Whereas the showed resistance to cefotaxime (100%), ampicillin (87.5%), Penicillin (75%), B (75%), and nalidixic acid (50%) from butchery houses. On the other hand, all isolates of Staphylococcus aureus isolate 100% (n= 10) showed sensitive chloramphenicol, gentamicin and nitrofurantoin, whereas they showed 100% resistance of Penicillin, B, AMX, ceftriaxone, ampicillin and cefotaxime from abattoirs houses. The overall multi-drug resistance pattern for Staphylococcus aureus was 90% and 100% of butchery and abattoir houses, respectively. Conclusion: 35.3% Staphylococcus aureus isolated were recovered from the raw meat samples collected from the butchery and abattoirs houses. More has to be done in the development of hand washing behavior and availability of safe water in the butchery houses to reduce the burden of bacterial contamination. The results of the present finding highlight the need to implement protective measures against the levels of food contamination and alternative drug options. The development of antimicrobial resistance is nearly always a result of repeated therapeutic and/or indiscriminate use of them. Regular antimicrobial sensitivity testing helps to select effective antibiotics and to reduce the problems of drug resistance development towards commonly used antibiotics.

Keywords: abattoir house, AMR, butchery house, S. aureus

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523 Fact-checking and Political Polarization in an Emerging Democracy

Authors: Eric Agyekum, Dominic Asitanga

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Ghana is widely considered asa beacon of democracy in sub-Saharan Africa. With a relatively free media, the country was ranked30thin the world and third in Africaon the 2021 Press Freedom Index. Despite the democratic gains, itis one of the most politically polarized nations in the world. Ghana’spolitical division is evident in the current hunglegislature, where each of the two dominant political parties has 137 members, with an independent member occupying the remaining one seat. Misinformation and fake newsthrive in systems with acuteideological and political differences(Imelda et al, 2021; Azzimonti&Fernandes, 2018; Spohr, 2017) and Ghana is no exception. The information disorder problem has been exacerbatedby the COVID-19 pandemic, with its attendant conspiracy theories and speculations, making it difficult for the media and fact-checking organizations to verifyall claims and flag false information. In Ghana, fact-checking agencies like Ghana Fact, Dubawa Ghana, and some mainstream news media organizations have been fact-checking political claims, COVID-19 conspiracy theories, and many others. However, it is not clear if the audience consumeand attach prominence to these fact-checked stories or even visit the websites of the fact-checking agencies to read the content. Nekmat (2020) opine that though the literature on fact-checking suggest that fact-checked stories can alter readers’ beliefs, very few studies have investigated the patronage and the potential of fact-checks to deter users from sharing false news with others, particularly on social media. In response to Nekmat, this study has been initiated to examine the perception and attitude of the audience in Ghana towards fact-checks. Anchored on the principles of the nudge theory, this study will investigate how fact-checked stories alters readers’ behavioural patterns. A survey will be conducted to collect data from sampled members of the Ghanaian society.

Keywords: fact-checking, information disorder, nudge theory, political polarization

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522 Effect of Preconception Picture-Based Nutrition Education on Knowledge and Adherence to Iron-Folic Acid Supplementation Among Women Planning to Be Pregnant in Ethiopia

Authors: Anteneh Berhane Yeyi, Tefera Belachew

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Any woman who could become pregnant is at risk of having a baby with neural tube defects (NTDs). A spontaneous aborted women with immediately preceding pregnancy may have an increased risk of develop NTDs. Ethiopia has one of the highest rates of micronutrient deficiencies, including folate and iron deficiency. Currently, in Ethiopia, NTDs is emerged as a public health concern. Even if Ethiopia, has implement different strategies for reducing maternal and neonatal mortality and morbidity, there is no room in the health care system and lack of integration for preventing the risk of NTDs for those women who aborted spontaneously and women who discontinue long acting contraception to become pregnant. The purpose of this study was to evaluate the effect of preconception picture-based nutrition education on knowledge and adherence to iron-folic acid supplement (IFAS) intake to reduce the risk of developing neural tube defects (NTDs) and iron deficiency anemia (IDA) among women who had a planned to pregnancy in Ethiopia, a country with a high burden of NTDs. Methodology: This study was conducted in Eastern Ethiopia. A double blinded parallel randomized controlled trial design was employed among women in the age group of 18-45 years who requested to interrupt modern contraceptive who have an intention to be pregnant and women with spontaneous abortion who refused to take a contraceptive. The interventional arm (n=122) received a preconception picture-based nutrition education with iron-folic acid supplement, and the control arm (n=122) received only preconception IFAS. In this study male partners were participated. Result: After three months of intervention the proportion of adherence to IFAS was 23% (n=56). With regard to adherence within the groups, 42.6% (n=52) in the intervention group and 3.3% (n=4) in the control group and the intervention group were significantly higher than in control group. In the intervention group the proportion of adherence to IFAS intake among participants increased by 40.1% and there were statistically difference (P<0.0001). The difference in difference between the two groups of adherence to IFAS intake was 37.6% and there were a statistical significance (P<0.0001). Level of knowledge between the groups did differ before and after intervention (P= 0.87 Vs P<0.0001). The overall the mean change in knowledge Mean (+SE) between group was 0.9 (+3.04 SE) and there were significant differences between two groups (P<0.001). Conclusion: In general this intervention is effective toward adherence to IFAS and a critical milestone to improve maternal health and reduce the neonate mortality due to NTDs and other advert effect of pregnancy and birth outcomes. This intervention is very short, simple, and cost effective and has potential for adaptation, feasible development to large-scale implementation in the existing health care system. Furthermore, this type of interventional approach has the potential to reduce the country's ANC program dropout rates and increase male partner’s participation on reproductive health.

Keywords: NTDs, IFAS, WRA, Ethiopia

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521 Perceptions and Experiences of Learners on the Banning of Corporal Punishment in South African Schools

Authors: Londeka Ngubane

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The use of corporal punishment is not a new phenomenon in the South African education system as it was, for a long time, recognised as a fitting form of punishment for ill-disciplined and disobedient children. The growing recognition that corporal punishment is an act of violence against children has resulted in the abolishment of this form of punishment in society and particularly in schools. However, regardless of criminalising corporal punishment, it appears to be a disciplinary measure that is persistently used by some educators. Historically and currently, the intimate connection between corporal punishment and discipline has not merely been a convention of human thinking, as this practice is given recognition in various definitions in dictionaries. ‘To discipline’ is habitually stated to mean ‘to punish’. The notion of ‘disciplining children’ also comes from entrenched common conceptions about children and their relationship with adults. Corporal punishment has, for a long time, been associated with the rearing and education of children, and this practice thus pervades schooling across nations. In many societies, punishment is a term that is closely linked with the self-perception of teachers who feel that they must be ‘in control’ and have ‘the upper hand’ in order to be respected. This impression of control is evident in the widespread conception of education which is to ‘socialize’ children in ‘desirable ways’ of ‘sitting in a formal classroom’, ‘behaving’ in school, ‘following instructions’ from the teacher, talking only when asked to, and finishing tasks on time. It was against this backdrop that a comprehensive review of relevant literature was undertaken and that individual interviews were conducted with fifty learners from four schools (two junior secondary and two senior secondary schools) in a selected township area in KwaZulu-Natal Province. The main aim of the study was to explore and thus understand learners’ views on the administration of corporal punishment regardless of the fact that it was legally abolished. It was envisaged that the interviews with the learners would elicit rich data that would enhance the researcher’s insight into their perceptions of the persistent use of corporal punishment as a disciplinary measure in their schools. The study was thus premised on the assumption, which had been strengthened by anecdotal and media evidence, that corporal punishment was still administered in some schools in South Africa and in schools in the study area in particular.

Keywords: corporal punishment, ban, school learners, South Africa

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520 Functioning of a Temporarily Single Parent Family System Due to Migration from the Perspective of Adolescents with Cerebral Palsy

Authors: A. Gagat-Matuła

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There is a definite lack – in Poland, as well as around the world – of empirical studies of families raising handicapped child, in which one parent migrates. In diagnostics of the functioning of such families emphasis should be placed not only on the difficulties, but most of all it should be indicated what possibilities are there for the family and how it overcomes the difficulties. Migration of a parent on the one hand is a chance to improve the family’s material situation. In certain circumstances this may only be an “escape” into work from the issues associated with the upbringing and rehabilitation of a handicapped child. The aim of the study was to learn the functioning of a temporarily single parent family system as a result of migration of a parent from the perspective of adolescents with cerebral palsy. The study was conducted in the year 2013 in the area of Eastern Poland. It involved an analysis of 70 persons (with cerebral palsy in an intellectual capacity) from families in which at least one of the parents migrates. The study incorporated the diagnostic survey method. These tools were used: Family Evaluation Scales (SOR) adapted for Poland by Andrzej Margasiński. The explorations in this study indicate, that 47% of studied temporarily single parent families are balanced models. This is evidence of the resources at the disposal of the family which, despite the disability of the child and temporary separation, is able to function properly. The conducted studies show, that 37% of temporarily single parent families are imbalanced models in the perception of adolescents with cerebral palsy. These families experience functional difficulties and require psychological and pedagogical support. There is a need for building skills related to effective coping with family stress. Especially considering, that families of an imbalanced type do not use the internal and external resources of the family system. Such a situation may deepen the disarrangement of family life. In intermediate families (16%) there are also temporary difficulties in functioning. Separation anxiety experienced by mothers may disrupt relations and introduce additional stress factors. For that reason it is important to provide support for women with difficulties coping with the emotions associated with raising handicapped adolescents and migratory separation.

Keywords: child with cerebral palsy, family, migration, parents

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519 Preliminary Study of the Cost-Effectiveness of Green Walls: Analyzing Cases from the Perspective of Life Cycle

Authors: Jyun-Huei Huang, Ting-I Lee

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Urban heat island effect is derived from the reduction of vegetative cover by urban development. Because plants can improve air quality and microclimate, green walls have been applied as a sustainable design approach to cool building temperature. By using plants to green vertical surfaces, they decrease room temperature and, as a result, decrease the energy use for air conditioning. Based on their structures, green walls can be divided into two categories, green façades and living walls. A green façade uses the climbing ability of a plant itself, while a living wall assembles planter modules. The latter one is widely adopted in public space, as it is time-effective and less limited. Although a living wall saves energy spent on cooling, it is not necessarily cost-effective from the perspective of a lifecycle analysis. The Italian study shows that the overall benefit of a living wall is only greater than its costs after 47 years of its establishment. In Taiwan, urban greening policies encourage establishment of green walls by referring to their benefits of energy saving while neglecting their low performance on cost-effectiveness. Thus, this research aims at understanding the perception of appliers and consumers on the cost-effectiveness of their living wall products from the lifecycle viewpoint. It adopts semi-structured interviews and field observations on the maintenance of the products. By comparing the two results, it generates insights for sustainable urban greening policies. The preliminary finding shows that stakeholders do not have a holistic sense of lifecycle or cost-effectiveness. Most importantly, a living wall well maintained is often with high input due to the availability of its maintenance budget, and thus less sustainable. In conclusion, without a comprehensive sense of cost-effectiveness throughout a product’s lifecycle, it is very difficult for suppliers and consumers to maintain a living wall system while achieve sustainability.

Keywords: case study, maintenance, post-occupancy evaluation, vertical greening

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518 An Empirical Study of the Moderation Effects of Commitment, Trust, and Relationship Value in the Relation of Goods and Services Related to Business to Business Brand Images on Customer Loyalty

Authors: Jorge Luis Morales Romero, Enrique Murillo Othón

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Business to business (B2B) relationships generally go beyond a purely profit-based result, with firms seeking to maintain a relationship for many years because a breakup or getting a new supplier can be very costly. Therefore, identifying the factors which determine a successful relationship in the long term is of great interest to companies. That is why their reputation and the brand image that customers have of them are among the main factors that can achieve a successful relationship; Because of the positive effect which is driven by the client’s loyalty. Additionally, the perception that a customer may have about a brand is different when it is related to goods or to services. Thereby, they create in their minds their own brand image of it based on the past experiences they have had; Thus, a positive relationship is established between goods-related brand image, service-related brand image, and customer loyalty. The present investigation examines the boundary conditions of said relationship by testing the moderating effects of trust, commitment, and relationship value in a B2B environment. All the variables were tested independently as moderators for service-related brand image/loyalty and for goods-related brand image/loyalty, as they are assumed to be separate variables. Survey data was collected through interviews with customers that have both a product-buying relationship and a service relationship with a global B2B brand of healthcare equipment operating in the Mexican healthcare market. Interviewed respondents were either the user or the purchasing manager and/or the responsible for the equipment maintenance for the customer organization. Hence, they were appropriate informants regarding the B2B relationship with this healthcare brand. The moderation models were estimated using the PROCESS macro for the Statistical Package for the Social Sciences Software (SPSS). Results show statistical evidence that both Relationship Value and Trust are significant moderators for the service-related brand image/loyalty relation but not significant for the goods-related brand/loyalty relation. On the other hand, Commitment results in a significant moderator for the goods-related brand/loyalty relation but is not significant for the service-related brand image/loyalty relation.

Keywords: commitment, trust, relationship value, loyalty, B2B, moderator

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517 Making Haste Slowly: South Africa's Transition from a Medical to a Social Model regarding Persons with Disabilities

Authors: Leoni Van Der Merwe

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Historically, in South Africa, disability has been viewed as a dilemma of the individual. The discourse surrounding the definition of disability and applicable theories are as fluid as the differing needs of persons with disabilities within society. In 1997, the Office of the Deputy President published the White Paper on the Integrated National Disability Strategy (WPINDS) which sought to integrate disability issues in all governmental development strategies, planning and programs as well as to solidify the South African government’s stance that disability was to be considered according to the social model and not the, previously utilized, medical model of disability. The models of disability are conceptual frameworks for understanding disability and can provide some insight into why certain attitudes exist and how they are reinforced in society. Although the WPINDS was regarded as a critical milestone in the history of the disability rights struggle in South Africa; it has taken approximately twenty years for the publication of a similar document taking into account South Africa’s changing social, economic, political and technological dispensation. December 2015 marked the approval of the White Paper on the Rights of Persons with Disabilities (WPRPD) which seeks to update the WPINDS, integrate principles contained in international law instruments and endorse a mainstreaming trajectory for realizing the rights of persons with disabilities. While the WPINDS and the WPRPD were published two decades apart, both documents contain an emphasis on a transition from the medical model to the social model. Whereas, the medical model presupposes that disability is mainly a health and welfare matter and is focused on an individualistic and dependency-based approach; the social model requires a paradigm shift in the manner in which disability is constructed so as to highlight the shortcomings of society in respect of disability and to bring to the fore the capabilities of persons with disabilities. The social model has led to unmatched success in changing the perceptions surrounding disability. This article seeks to investigate the progress made in the implementation of the social model in South Africa by taking into account the effect of the diverse political and cultural landscape in promoting the historically entrenched medical model and the rise of disability activism prior to the new democratic dispensation as well as legislation, case law, policy documents and barriers in respect of persons with disabilities that are pervasive in South African society. The research paper will conclude that although numerous interventions have been identified and implemented to promote the consideration of disability within a social construct in South Africa, such interventions require increased national and international collaboration, resources and pace to ensure that the efforts made lead to sustainable results. For persons with disabilities, what remains to be seen is whether the proliferation of activism by interest groups, social awareness as well as the development of policy documents, legislation and case law will serve as the impetus to dissipate the view that disability is burden to be carried solely on the shoulders of the person with the disability.

Keywords: disability, medical model, social model, societal barriers, South Africa

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516 Impact of Social Media in Shaping Perceptions on Filipino Muslim Identity

Authors: Anna Rhodora A. Solar, Jan Emil N. Langomez

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Social Media plays a crucial role in influencing Philippine public opinion with regard to a variety of socio-political issues. This became evident in the massacre of 44 members of the Special Action Force (SAF 44) tasked by the Philippine government to capture one of the US Federal Bureau of Investigation’s most wanted terrorists. The incident was said to be perpetrated by members of the Moro Islamic Liberation Front and the Bangsamoro Islamic Freedom Fighters. Part of the online discourse within Philippine cyberspace sparked intense debates on Filipino Muslim identity, with several Facebook viral posts linking Islam as a factor to the tragic event. Facebook is considered to be the most popular social media platform in the Philippines. As such, this begs the question of the extent to which social media, specifically Facebook, shape the perceptions of Filipinos on Filipino Muslims. This study utilizes Habermas’ theory of communicative action as it offers an explanation on how public sphere such as social media could be a network for communicating information and points of view through free and open dialogue among equal citizens to come to an understanding or common perception. However, the paper argues that communicative action which is aimed at reaching understanding free from force, and strategic action which is aimed at convincing someone through argumentation may not necessarily be mutually exclusive since reaching an understanding can also be considered as a result of convincing someone through argumentation. Moreover, actors may clash one another in their ideas before reaching common understanding, hence the presence of force. Utilizing content analysis on the Facebook posts with Islamic component that went viral after the massacre of the SAF 44, this paper argues that framing the image of Filipino Muslims through Facebook reflects both communicative and strategic actions. Moreover, comment threads on viral posts manifest force albeit implicit.

Keywords: communication, Muslim, Philippines, social media

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515 Learning at Workplace: Competences and Contexts in Sensory Evaluation

Authors: Ulriikka Savela-Huovinen, Hanni Muukkonen, Auli Toom

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The development of workplace as a learning environment has been emphasized in research field of workplace learning. The prior literature on sensory performance emphasized the individual’s competences as assessor, while the competences in the collaborative interactional and knowledge creation practices as workplace learning method are not often mentioned. In the present study aims to find out what kinds of competences and contexts are central when assessor conducts food sensory evaluation in authentic professional context. The aim was to answer the following questions: first, what kinds of competences does sensory evaluation require according to assessors? And second, what kinds of contexts for sensory evaluation do assessors report? Altogether thirteen assessors from three Finnish food companies were interviewed by using semi-structural thematic interviews to map practices and development intentions as well as to explicate already established practices. The qualitative data were analyzed by following the principles of abductive and inductive content analysis. Analysis phases were combined and their results were considered together as a cross-analysis. When evaluated independently required competences were perception, knowledge of specific domains and methods and cognitive skills e.g. memory. Altogether, 42% of analysis units described individual evaluation contexts, 53% of analysis units described collaborative interactional contexts, and 5% of analysis units described collaborative knowledge creation contexts. Related to collaboration, analysis reviewed learning, sharing and reviewing both external and in-house consumer feedback, developing methods to moderate small-panel evaluation and developing product vocabulary collectively between the assessors. Knowledge creation contexts individualized from daily practices especially in cases product defects were sought and discussed. The study findings contribute to the explanation that sensory assessors learn extensively from one another in the collaborative interactional and knowledge creation context. Assessors learning and abilities to work collaboratively in the interactional and knowledge creation contexts need to be ensured in the development of the expertise.

Keywords: assessor, collaboration, competences, contexts, learning and practices, sensory evaluation

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514 Defence Industry in the Political Economy of State and Business Relations

Authors: Hatice Idil Gorgen

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Turkey has been investing in its national defence industrial base since the 1980s. State’s role in defence industry showed differences in Turkey. Parallel with this, ruling group’s attitude toward companies in defence sector varied. These changes in policies and behaviors of the state have occurred throughout such milestones as political and economic turmoil in domestic and international level. Hence, it is argued that state’s role, relations with private companies in defense sector and its policies towards the defense industry has shown differences due to the international system, political institutions, ideas and political coalitions in Turkey since the 1980s. Therefore, in order to see changes in the role of the state in defence sector, this paper aims to indicate first, history of state’s role in production and defence industry in the post-1980s era. Secondly, to comprehend the changes in the state’s role in defence industry, Stephan Haggard’s sources of policy change will be provided in the theoretical ground. Thirdly, state cooperated, and joint venture defence firms, state’s actions toward them will be observed. The remaining part will explore the underlying reasons for the changes in the role of the state in defence industry, and it implicitly or explicitly impacts on state business relations. Major findings illustrate that targeted idea of self-sufficient or autarky Turkey to attract domestic audience and to raise the prestige through defence system; ruling elites can regard defence industry and involved business groups as a mean for their ends. State dominant value, sensitive perception which has been ever since Ottoman Empire, prioritizes business groups in defence industry compared to others and push the ruling elites to pursue hard power in defence sectors. Through the globally structural transformation in defence industry, integration of Turkey to liberal bloc deepened and widened interdependence among states. Although it is a qualitative study, it involves the numerated data and descriptive statistics. Data will be collected by searching secondary sources from the literature, examining official documents of ministry of defence, and other appropriate ministries.

Keywords: defense industry, state and business relations, public private relations, arm industry

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513 Pattern of Anisometropia, Management and Outcome of Anisometropic Amblyopia

Authors: Husain Rajib, T. H. Sheikh, D. G. Jewel

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Background: Amblyopia is a frequent cause of monocular blindness in children. It can be unilateral or bilateral reduction of best corrected visual acuity associated with decrement in visual processing, accomodation, motility, spatial perception or spatial projection. Anisometropia is an important risk factor for amblyopia that develops when unequal refractive error causes the image to be blurred in the critical developmental period and central inhibition of the visual signal originating from the affected eye associated with significant visual problems including anisokonia, strabismus, and reduced stereopsis. Methods: It is a prospective hospital based study of newly diagnosed of amblyopia seen at the pediatric clinic of Chittagong Eye Infirmary & Training Complex. There were 50 anisometropic amblyopia subjects were examined & questionnaire was piloted. Included were all patients diagnosed with refractive amblyopia between 3 to 13 years, without previous amblyopia treatment, and whose parents were interested to participate in the study. Patients diagnosed with strabismic amblyopia were excluded. Patients were first corrected with the best correction for a month. When the VA in the amblyopic eye did not improve over month, then occlusion treatment was started. Occlusion was done daily for 6-8 hours (full time) together with vision therapy. The occlusion was carried out for 3 months. Results: In this study about 8% subjects had anisometropia from myopia, 18% from hyperopia, 74% from astigmatism. The initial mean visual acuity was 0.74 ± 0.39 Log MAR and after intervention of amblyopia therapy with active vision therapy mean visual acuity was 0.34 ± 0.26 Log MAR. About 94% of subjects were improving at least two lines. The depth of amblyopia associated with type of anisometropic refractive error and magnitude of Anisometropia (p<0.005). By doing this study 10% mild amblyopia, 64% moderate and 26% severe amblyopia were found. Binocular function also decreases with magnitude of Anisometropia. Conclusion: Anisometropic amblyopia is a most important factor in pediatric age group because it can lead to visual impairment. Occlusion therapy with at least one instructed hour of active visual activity practiced out of school hours was effective in anisometropic amblyopes who were diagnosed at the age of 8 years and older, and the patients complied well with the treatment.

Keywords: refractive error, anisometropia, amblyopia, strabismic amblyopia

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512 Nabokov’s Lolita: Externalization of Contemporary Mind in the Configuration of Hedonistic Aesthetics

Authors: Saima Murtaza

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Ethics and aesthetics have invariably remained the two closely integrated artistic appurtenances for the production of any work of art. These artistic devices configure themselves into a complex synthesis in our contemporary literature. The labyrinthine integration of ethics and aesthetics, operating in the lives of human characters, to the extent of transcending all limits has resulted in an artistic puzzle for the readers. Art, no doubt, is an extrinsic expression of the intrinsic life of man. The use of aesthetics in literature pertaining to human existence; aesthetic solipsism, has resulted in the artistic objectification of these characters. The practice of the like aestheticism deprives the characters of their souls, rendering them as mere objects of aesthetic gaze at the hands of their artists-creators. Artists orchestrate their lives founding it on a plot which deviates from normal social and ethical standards. Their perverse attitude can be seen in dealing with characters, their feelings and the incidents of their lives. Morality is made to appear not as a religious construct but as an individual’s private affair. Furthermore, the idea of beauty incarnated, in other words hedonistic aesthetic does not placate a true aesthete. Ethics and aesthetics are the two most recurring motifs of our contemporary literature, especially of Nabokov’s world. The purpose of this study is to peruse these aforementioned motifs in Nabokov’s most enigmatic novel Lolita, a story of pedophilia, which is in fact reflective of our complex individual psychic and societal patterns. The narrative subverts all the traditional and hitherto known notions of aesthetics and ethics. When applied to literature, aesthetic does not simply mean ‘beautiful’ in the text. It refers to an intricate relationship between feelings and perception and also incorporates within its range wide-ranging emotional reactions to text. The term aesthetics in literature is connected with the readers whose critical responses to the text determine the merit of any work to be really a piece of art. Aestheticism is the child of ethics. Morality sets the grounds for the production of any work and the idea of aesthetics gives it transcendence.

Keywords: ethics, aesthetics and hedonistic aesthetic, nymphet syndrome, pedophilia

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511 Right of the City and Urban Boundaries: An Analytical Study of the Settlements in the Border of the River ‘Riachuelo’ on the Urban Agglomeration of Buenos Aires, Argentina

Authors: Mitchell De Sousa

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The city of Buenos Aires and its agglomeration concentrates more than the thirty percent of the Argentine population. Historically, the political governments (essentially during the neoliberal ones) focused all the equipment, investment, progress on the north of the city since it is the place where all the financial, core services, and the main country harbor is. The south part of the town and all the cities around the south portion of it is has been, historically, where are concentrated the more vital unfulfilled needs of this population. The river that cross over the urban agglomeration of Buenos Aires, the Matanza-Riachuelo, has been historically a place of urban segregation since it is located south of the main town. From the post-colonial times, the river has been officially a place that separates the jurisdiction of the city of Buenos Aires with some of the towns that were built around the urban agglomeration. Since its place has never been treated as a whole and has always been treated as a boundary, there is always been a focus for factories to dispose its waste and an attractive place for a large portion of the underclasses to settled down there, occupying illegally the previous terrains that were once from the railway, now abandoned. Regarding those issues and adding a one more problematic one, those who lives beyond the boundary has few access to enter the main capital city. A few bridges connect some portions of it over the Matanza Riachuelo River, which there is also a limited accessibility to the main city from the south. Because of such, the main entrances to the town are always collapsed by all the services that the urban agglomeration offer (from buses to trains and individual cars). Beyond all the enlisted problems, the contamination of the river makes it one of the most contaminated rivers on the entire world. Those who lives in the settlements are in there for themselves, so the fight from them to their right of the city and their claims to the state for intervention in the urban coast is one of the most promising discussions surrounding this place of this urban agglomeration. The study focuses on the perception of those who lives in this boundary through interviews and collective experiences and is a part of a more developed project in the University of Buenos Aires study called ‘Urban landscape and a sustainable study through the interdisciplinary. Urban strategies on city borders’.

Keywords: Buenos Aires, landscape, mobility, popular sectors, urban segregation

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510 Fostering Positive Mindset: Grounded Theory Study of Self-Awareness in Emerging Adults

Authors: Maha Ben Salem

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The transformative aspect of emerging adulthood brings about a development of self-processes, including changes in self-esteem and personal goals. Success in this life stage entails the emotional growth necessary to navigate the demands and challenges of college life. Understanding the concept of self-awareness within this particular age group sheds light on emerging adults’ internal world and the transformative aspect of their emotional growth. Uncovering the thoughts' processes that foster or hinder self-awareness is important to the understanding of how emerging adults learn to make themselves positive or negative. However, existing research in self-awareness has explored this phenomenon mostly using quantitative research methodology or through tying an individual’s level of self-awareness to specific actions or outcomes. Little is known about the process of how college students emerging adults notice and monitor their inner thoughts and emotions. Methodology and theoretical orientation: A grounded theory study using in-depth semi-structured interview was utilized. Nine interviews have been conducted. A constructionist framework was employed to generate a theory as for how self-awareness facilitates specific patterns of thinking in emerging adults. The choice of grounded theory emanates from a lack of knowledge regarding underlying thinking procedures and internal states that emerging adult college students navigate in an attempt to make meaning out of the new academic experience and life stage. Findings: Initial data analysis generated the following categories of the theory: (a) a non-judgmental perception of negative thinking and negative emotions that allow for a better understanding of the self; (b) negative state of mind is easy to overcome when it is accepted and acknowledged; (c) knowledge of the actual and desired self-generates an intentional decision to shift to a positive mindset. Preliminary findings indicate that college academic and social environment foster a new understanding of the self that yield a change in mindset and in self-knowledge.

Keywords: college environment, emergent adults, grounded theory, positive mindset, self-awareness

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509 The Effect of a Multidisciplinary Spine Clinic on Treatment Rates and Lead Times to Care

Authors: Ishan Naidu, Jessica Ryvlin, Devin Videlefsky

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Introduction: Back pain is a leading cause of years lived with disability and economic burden, exceeding over $20 billion in healthcare costs not including indirect costs such as absence from work and caregiving. The multifactorial nature of back pain leads to treatment modalities administered by a variety of specialists, which are often disjointed. Multiple studies have found that patients receiving delayed physical therapy for lower back pain had higher medical-related costs from increased health service utilization as well as a reduced improvement in pain severity compared to early management. Uncoordinated health care delivery can exacerbate the physical and economic toll of the chronic condition, thus improvements in interdisciplinary, shared decision-making may improve outcomes. Objective: To assess whether a multidisciplinary spine clinic (MSC), consisting of orthopedic surgery, neurosurgery, pain medicine, and physiatry, alters interventional and non-interventional planning and treatment compared to a traditional unidisciplinary spine clinic (USC) including only orthopedic surgery. Methods: We conducted a retrospective cohort study with patients initially presenting for spine care to orthopedic surgeons between July 1, 2018 to June 30, 2019. Time to treatment recommendation, time to treatment and rates of treatment recommendations were assessed, including physical therapy, injections and surgery. Treatment rates were compared between MSC and USC using Pearson’s chi-square test logistic regression. Time to treatment recommendation and time to treatment were compared using log-rank test and Cox proportional hazard regression. All analyses were repeated for the propensity score (PS) matched subsample. Results: This study included 1,764 patients, with 692 at MSC and 1,072 at USC. Patients in MSC were more likely to be recommended injection when compared to USC (8.5% vs. 5.4%, p=0.01). When adjusted for confounders, the likelihood of injection recommendation remained greater in MSC than USC (Odds ratio [OR]=2.22, 95% CI: (1.39, 3.53), p=0.001). MSC was also associated with a shorter time to receiving injection recommendation versus USC (median: 21 vs. 32 days, log-rank: p<0.001; hazard ratio [HR]=1.90, 95% CI: (1.25, 2.90), p=0.003). MSC was associated with a higher likelihood of injection treatment (OR=2.27, 95% CI: (1.39, 3.73), p=0.001) and shorter lead time (HR=1.98, 95% CI: (1.27, 3.09), p=0.003). PS-matched analyses yielded similar conclusions. Conclusions: Care delivered at a multidisciplinary spine clinic was associated with a higher likelihood of recommending injection and a shorter lead time to injection administration when compared to a traditional unidisciplinary spine surgery clinic. Multidisciplinary clinics may facilitate coordinated care amongst different specialties resulting in increased utilization of less invasive treatment modalities while also improving care efficiency. The multidisciplinary clinic model is an important advancement in care delivery and communication, which can be used as a powerful method of improving patient outcomes as treatment guidelines evolve.

Keywords: coordinated care, epidural steroid injection, multi-disciplinary, non-invasive

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508 Leveraging Automated and Connected Vehicles with Deep Learning for Smart Transportation Network Optimization

Authors: Taha Benarbia

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The advent of automated and connected vehicles has revolutionized the transportation industry, presenting new opportunities for enhancing the efficiency, safety, and sustainability of our transportation networks. This paper explores the integration of automated and connected vehicles into a smart transportation framework, leveraging the power of deep learning techniques to optimize the overall network performance. The first aspect addressed in this paper is the deployment of automated vehicles (AVs) within the transportation system. AVs offer numerous advantages, such as reduced congestion, improved fuel efficiency, and increased safety through advanced sensing and decisionmaking capabilities. The paper delves into the technical aspects of AVs, including their perception, planning, and control systems, highlighting the role of deep learning algorithms in enabling intelligent and reliable AV operations. Furthermore, the paper investigates the potential of connected vehicles (CVs) in creating a seamless communication network between vehicles, infrastructure, and traffic management systems. By harnessing real-time data exchange, CVs enable proactive traffic management, adaptive signal control, and effective route planning. Deep learning techniques play a pivotal role in extracting meaningful insights from the vast amount of data generated by CVs, empowering transportation authorities to make informed decisions for optimizing network performance. The integration of deep learning with automated and connected vehicles paves the way for advanced transportation network optimization. Deep learning algorithms can analyze complex transportation data, including traffic patterns, demand forecasting, and dynamic congestion scenarios, to optimize routing, reduce travel times, and enhance overall system efficiency. The paper presents case studies and simulations demonstrating the effectiveness of deep learning-based approaches in achieving significant improvements in network performance metrics

Keywords: automated vehicles, connected vehicles, deep learning, smart transportation network

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507 Electroencephalography Correlates of Memorability While Viewing Advertising Content

Authors: Victor N. Anisimov, Igor E. Serov, Ksenia M. Kolkova, Natalia V. Galkina

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The problem of memorability of the advertising content is closely connected with the key issues of neuromarketing. The memorability of the advertising content contributes to the marketing effectiveness of the promoted product. Significant directions of studying the phenomenon of memorability are the memorability of the brand (detected through the memorability of the logo) and the memorability of the product offer (detected through the memorization of dynamic audiovisual advertising content - commercial). The aim of this work is to reveal the predictors of memorization of static and dynamic audiovisual stimuli (logos and commercials). An important direction of the research was revealing differences in psychophysiological correlates of memorability between static and dynamic audiovisual stimuli. We assumed that static and dynamic images are perceived in different ways and may have a difference in the memorization process. Objective methods of recording psychophysiological parameters while watching static and dynamic audiovisual materials are well suited to achieve the aim. The electroencephalography (EEG) method was performed with the aim of identifying correlates of the memorability of various stimuli in the electrical activity of the cerebral cortex. All stimuli (in the groups of statics and dynamics separately) were divided into 2 groups – remembered and not remembered based on the results of the questioning method. The questionnaires were filled out by survey participants after viewing the stimuli not immediately, but after a time interval (for detecting stimuli recorded through long-term memorization). Using statistical method, we developed the classifier (statistical model) that predicts which group (remembered or not remembered) stimuli gets, based on psychophysiological perception. The result of the statistical model was compared with the results of the questionnaire. Conclusions: Predictors of the memorability of static and dynamic stimuli have been identified, which allows prediction of which stimuli will have a higher probability of remembering. Further developments of this study will be the creation of stimulus memory model with the possibility of recognizing the stimulus as previously seen or new. Thus, in the process of remembering the stimulus, it is planned to take into account the stimulus recognition factor, which is one of the most important tasks for neuromarketing.

Keywords: memory, commercials, neuromarketing, EEG, branding

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506 Kidney Supportive Care in Canada: A Constructivist Grounded Theory of Dialysis Nurses’ Practice Engagement

Authors: Jovina Concepcion Bachynski, Lenora Duhn, Idevania G. Costa, Pilar Camargo-Plazas

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Kidney failure is a life-limiting condition for which treatment, such as dialysis (hemodialysis and peritoneal dialysis), can exact a tremendously high physical and psychosocial symptom burden. Kidney failure can be severe enough to require a palliative approach to care. The term supportive care can be used in lieu of palliative care to avoid the misunderstanding that palliative care is synonymous with end-of-life or hospice care. Kidney supportive care, encompassing advance care planning, is an approach to care that improves the quality of life for people receiving dialysis through early identification and treatment of symptoms throughout the disease trajectory. Advanced care planning involves ongoing conversations about the values, goals, and preferences for future care between individuals and their healthcare teams. Kidney supportive care is underutilized and often initiated late in this population. There is evidence to indicate nurses are not providing the necessary elements of supportive kidney care. Dialysis nurses’ delay or lack of engagement in supportive care until close to the end of life may result in people dying without receiving optimal palliative care services. Using Charmaz’s constructivist grounded theory, the purpose of this doctoral study is to develop a substantive theory that explains the process of engagement in supportive care by nurses working in dialysis settings in Canada. Through initial purposeful and subsequent theoretical sampling, 23 nurses with current or recent work experience in outpatient hemodialysis, home hemodialysis, and peritoneal dialysis settings drawn from across Canada were recruited to participate in two intensive interviews using the Zoom© teleconferencing platform. Concurrent data collection and data analysis, constant comparative analysis of initial and focused codes until the attainment of theoretical saturation, and memo-writing, as well as researcher reflexivity, have been undertaken to aid the emergence of concepts, categories, and, ultimately, the constructed theory. At the time of abstract submission, data analysis is currently at the second level of coding (i.e., focused coding stage) of the research study. Preliminary categories include: (a) focusing on biomedical care; (b) multi-dimensional challenges to having the conversation; (c) connecting and setting boundaries with patients; (d) difficulty articulating kidney-supportive care; and (e) unwittingly practising kidney-supportive care. For the conference, the resulting theory will be presented. Nurses working in dialysis are well-positioned to ensure the delivery of quality kidney-supportive care. This study will help to determine the process and the factors enabling and impeding nurse engagement in supportive care in dialysis to effect change for normalizing advance care planning conversations in the clinical setting. This improved practice will have substantive beneficial implications for the many individuals living with kidney failure and their supporting loved ones.

Keywords: dialysis, kidney failure, nursing, supportive care

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505 The Social Justice of Movement: Undocumented Immigrant Coalitions in the United States

Authors: Libia Jiménez Chávez

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This is a study of freedom riders and their courageous journey for civil rights, but the year was not 1961. It was 2003. This paper chronicles the emergence of a new civil rights movement for immigrant rights through an oral history of the 2003 U.S. Immigrant Workers Freedom Ride (IWFR). During the height of the post-9/11 immigrant repression, a bloc of organizations inspired by the Civil Rights Movement of the 1960s mobilized 900 multinational immigrants and their allies in the fight for legal status, labor protections, family reunification, and civil rights. The activists visited over 100 U.S. cities, met with Congressional leaders in the nation’s capital, and led a rally of over 50,000 people in New York City. This unified effort set the groundwork for the national May Day immigration protests of 2006. Movements can be characterized in two distinct ways: physical movement and social movements. In the past, historians have considered immigrants both as people and as participants in social movements. In contrast, studies of recent migrants tend to say little about their involvement in immigrant political mobilizations. The dominant literature on immigration portrays immigrants as objects of exclusion, border enforcement, detention, and deportation instead of strategic political actors. This paper aims to change this perception. It considers the Freedom Riders both as immigrants who were literally on the move and as participants in a social movement. Through interviews with participants and archival video footage housed at the University of California Los Angeles, it is possible to study this mobile protest as a movement. This contemporary immigrant struggle is an opportunity to explore the makeup and development of a heterogenous immigrant coalition and consider the relationship between population movements and social justice. In addition to oral histories and archival research, the study will utilize social movement literature, U.S. immigration and labor history, and Undocumented Critical Theory to expand the historiography of immigrant social movements in America.

Keywords: civil rights, immigrant social movements, undocumented communities, undocumented critical theory

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504 Perceived Effects of Alcohol Abuse on Ordinary Level Students at Gatsi Secondary School

Authors: Chimeri Muzano Leonard

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The study was carried out to investigate the perceptions of male and female Ordinary Level students on the effects of alcohol abuse at Gatsi Secondary School. The study showed that alcohol abuse has academic, social, psychological and health effects on Ordinary Level students. The negative effects comprises of death, dropping out, poor grades, poor concentration, risky behaviors, impairment of the brain and central nervous system , risky behaviors and Impairment of reproductive functioning Only students who enrolled for Ordinary Level in the 2014 academic year participated in this study. Fifty students (25 males and 25 females) were randomly selected to participate in the study. A formal survey questionnaire was used to collect data. The respondents were asked to use a scale of 0 (totally disagree) to 10 (completely agree) to indicate the extent to which they agreed with each perception. The Statistical Package for Social Sciences (SPSS) version 19.0 was used for data analysis. The Mann Whitney U test was used to test for the significance of differences in the perceptions of male and female students. No statistically significant differences were detected between males and females in most of their perceptions regarding the effects of alcohol abuse on Ordinary Level students. However, there were three perceptions found to be significantly different between male and female. They comprises of “Peers influence one to drink alcohol”, “Alcohol abuse is a major problem among male students compared to their female peers” and “ Female students should not drink beer”.It was evident from this study that Gatsi Secondary School needs to implement more effective interventions that combat alcohol abuse. A deeper analysis of the issues that predispose Ordinary Level students to alcohol abuse should inform the interventions. Consequently, unravelling the problem of negative effects of alcohol abuse was desirable because of its potential usefulness in developing strategies that might help curb the problem and presumably improve the performance of Ordinary Level students and above all the quality of education at Gatsi Secondary School.

Keywords: perceived effects, alcohol, Gatsi Secondary School, alcohol abuse

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503 Academic Literacy: Semantic-Discursive Resource and the Relationship with the Constitution of Genre for the Development of Writing

Authors: Lucia Rottava

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The present study focuses on academic literacy and addresses the impact of semantic-discursive resources on the constitution of genres that are produced in such context. The research considers the development of writing in the academic context in Portuguese. Researches that address academic literacy and the characteristics of the texts produced in this context are rare, mainly with focus on the development of writing, considering three variables: the constitution of the writer, the perception of the reader/interlocutor and the organization of the informational text flow. The research aims to map the semantic-discursive resources of the written register in texts of several genres and produced by students in the first semester of the undergraduate course in letters. The hypothesis raised is that writing in the academic environment is not a recurrent literacy practice for these learners and can be explained by the ontogenetic and phylogenetic nature of language development. Qualitative in nature, the present research has as empirical data texts produced in a half-yearly course of Reading and Textual Production; these data result from the proposition of four different writing proposals, in a total of 600 texts. The corpus is analyzed based on semantic-discursive resources, seeking to contemplate relevant aspects of language (grammar, discourse and social context) that reveal the choices made in the reader/writer interrelationship and the organizational flow of the text. Among the semantic-discursive resources, the analysis includes three resources, including (a) appraisal and negotiation to understand the attitudes negotiated (roles of the participants of the discourse and their relationship with the other); (b) ideation to explain the construction of the experience (activities performed and participants); and (c) periodicity to outline the flow of information in the organization of the text according to the genre it instantiates. The results indicate the organizational difficulties of the flow of the text information. Cartography contributes to the understanding of the way writers use language in an effort to present themselves, evaluate someone else’s work, and communicate with readers.

Keywords: academic writing, portuguese mother tongue, semantic-discursive resources, sistemic funcional linguistic

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502 Tobacco Taxation and the Heterogeneity of Smokers' Responses to Price Increases

Authors: Simone Tedeschi, Francesco Crespi, Paolo Liberati, Massimo Paradiso, Antonio Sciala

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This paper aims at contributing to the understanding of smokers’ responses to cigarette prices increases with a focus on heterogeneity, both across individuals and price levels. To do this, a stated preference quasi-experimental design grounded in a random utility framework is proposed to evaluate the effect on smokers’ utility of the price level and variation, along with social conditioning and health impact perception. The analysis is based on individual-level data drawn from a unique survey gathering very detailed information on Italian smokers’ habits. In particular, qualitative information on the individual reactions triggered by changes in prices of different magnitude and composition are exploited. The main findings stemming from the analysis are the following; the average price elasticity of cigarette consumption is comparable with previous estimates for advanced economies (-.32). However, the decomposition of this result across five latent-classes of smokers, reveals extreme heterogeneity in terms of price responsiveness, implying a potential price elasticity that ranges between 0.05 to almost 1. Such heterogeneity is in part explained by observable characteristics such as age, income, gender, education as well as (current and lagged) smoking intensity. Moreover, price responsiveness is far from being independent from the size of the prospected price increase. Finally, by comparing even and uneven price variations, it is shown that uniform across-brand price increases are able to limit the scope of product substitutions and downgrade. Estimated price-response heterogeneity has significant implications for tax policy. Among them, first, it provides evidence and a rationale for why the aggregate price elasticity is likely to follow a strictly increasing pattern as a function of the experienced price variation. This information is crucial for forecasting the effect of a given tax-driven price change on tax revenue. Second, it provides some guidance on how to design excise tax reforms to balance public health and revenue goals.

Keywords: smoking behaviour, preference heterogeneity, price responsiveness, cigarette taxation, random utility models

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501 Transformation of Traditional Marketplaces in an Urban Context: Case of Chalai Market, Thiruvananthapuram

Authors: Aswathy Vijayan, Sharath Sunder Rajeev

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Trade has been fundamental in the footprint of human civilization since ancient time. In most of the historic cities, city development was along trading routes, where marketplaces are the major entrance to a city and hence a major element of the urban fabric. Marketplaces are where the commercial activities flourish, people, having a sense of belonging to the place, where they easily fit in. Acknowledging the built environment in and around the market in a way, creating a sense of place is an important factor in the success of public spaces. Local markets are developed in an organic manner, which adds on to the people experience and perception of urban space. With the city development, the commercial needs within the city increase, hence marketplaces flourish, irrespective of the functional segregation within. The work-live culture in the marketplaces diminishes as the commercial expansion washes away the residential patches within it. Real estate flourishes as the newer infills are without considering the carrying capacity of the place. Chalai market is a prominent business center serving the regional level of Thiruvananthapuram city. The transformation trend of marketplaces in city cores are understood from case study on Fatimid Cairo Marketplace. The parameters that led to transformation of marketplaces in a global context is considered for the analysis of the Chalai market. The structure of the marketplace over the years is analyzed in terms of transformation in location, transformation in the land- use, change in commodity, and transformation in movement and activity. The aim of the research is to emphasize the need to understand the transformation trend, in creating a suitable development pattern for the city. The unregulated transformation within the city core has led to tremendous transformation in the user group and user pattern and eventually to the commercial trend. With the change in lifestyle and need for new amenities have led to addition of new infills leading to the degradation of the native commerce. Hence addressing the transformation of marketplaces are crucial to maintaining the locational significance and cultural importance and heritage of the place.

Keywords: bazaar, market centers, marketplaces, traditional city, traditional market, urban fabric

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500 Healthcare Utilization and Costs of Specific Obesity Related Health Conditions in Alberta, Canada

Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

Abstract:

Obesity-related health conditions impose a substantial economic burden on payers due to increased healthcare use. Estimates of healthcare resource use and costs associated with obesity-related comorbidities are needed to inform policies and interventions targeting these conditions. Methods: Adults living with obesity were identified (a procedure-related body mass index code for class 2/3 obesity between 2012 and 2019 in Alberta, Canada; excluding those with bariatric surgery), and outcomes were compared over 1-year (2019/2020) between those who had and did not have specific obesity-related comorbidities. The probability of using a healthcare service (based on the odds ratio of a zero [OR-zero] cost) was compared; 95% confidence intervals (CI) were reported. Logistic regression and a generalized linear model with log link and gamma distribution were used for total healthcare cost comparisons ($CDN); cost ratios and estimated cost differences (95% CI) were reported. Potential socio-demographic and clinical confounders were adjusted for, and incremental cost differences were representative of a referent case. Results: A total of 220,190 adults living with obesity were included; 44% had hypertension, 25% had osteoarthritis, 24% had type-2 diabetes, 17% had cardiovascular disease, 12% had insulin resistance, 9% had chronic back pain, and 4% of females had polycystic ovarian syndrome (PCOS). The probability of hospitalization, ED visit, and ambulatory care was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (hospitalization: 1.8-times [OR-zero: 0.57 [0.55/0.59]] / ED visit: 1.9-times [OR-zero: 0.54 [0.53/0.56]] / ambulatory care visit: 2.4-times [OR-zero: 0.41 [0.40/0.43]]), cardiovascular disease (2.7-times [OR-zero: 0.37 [0.36/0.38]] / 1.9-times [OR-zero: 0.52 [0.51/0.53]] / 2.8-times [OR-zero: 0.36 [0.35/0.36]]), osteoarthritis (2.0-times [OR-zero: 0.51 [0.50/0.53]] / 1.4-times [OR-zero: 0.74 [0.73/0.76]] / 2.5-times [OR-zero: 0.40 [0.40/0.41]]), type-2 diabetes (1.9-times [OR-zero: 0.54 [0.52/0.55]] / 1.4-times [OR-zero: 0.72 [0.70/0.73]] / 2.1-times [OR-zero: 0.47 [0.46/0.47]]), hypertension (1.8-times [OR-zero: 0.56 [0.54/0.57]] / 1.3-times [OR-zero: 0.79 [0.77/0.80]] / 2.2-times [OR-zero: 0.46 [0.45/0.47]]), PCOS (not significant / 1.2-times [OR-zero: 0.83 [0.79/0.88]] / not significant), and insulin resistance (1.1-times [OR-zero: 0.88 [0.84/0.91]] / 1.1-times [OR-zero: 0.92 [0.89/0.94]] / 1.8-times [OR-zero: 0.56 [0.54/0.57]]). After fully adjusting for potential confounders, the total healthcare cost ratio was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (1.54-times [1.51/1.56]), cardiovascular disease (1.45-times [1.43/1.47]), osteoarthritis (1.36-times [1.35/1.38]), type-2 diabetes (1.30-times [1.28/1.31]), hypertension (1.27-times [1.26/1.28]), PCOS (1.08-times [1.05/1.11]), and insulin resistance (1.03-times [1.01/1.04]). Conclusions: Adults with obesity who have specific disease-related health conditions have a higher probability of healthcare use and incur greater costs than those without specific comorbidities; incremental costs are larger when other obesity-related health conditions are not adjusted for. In a specific referent case, hypertension was costliest (44% had this condition with an additional annual cost of $715 [$678/$753]). If these findings hold for the Canadian population, hypertension in persons with obesity represents an estimated additional annual healthcare cost of $2.5 billion among adults living with obesity (based on an adult obesity rate of 26%). Results of this study can inform decision making on investment in interventions that are effective in treating obesity and its complications.

Keywords: administrative data, healthcare cost, obesity-related comorbidities, real world evidence

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