Search results for: women’s socio-economic empowerment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3896

Search results for: women’s socio-economic empowerment

1526 Association of Alcohol Consumption with Active Tuberculosis in Taiwanese Adults: A Nationwide Population-Based Cohort Study

Authors: Yung-Feng Yen, Yun-Ju Lai

Abstract:

Background: Animal studies have shown that alcohol exposure may cause immunosuppression and increase the susceptibility to tuberculosis (TB) infection. However, the temporality of alcohol consumption with subsequent TB development remains unclear. This nationwide population-based cohort study aimed to investigate the impact of alcohol exposure on TB development in Taiwanese adults. Methods: We included 46 196 adult participants from three rounds (2001, 2005, 2009) of the Taiwan National Health Interview Survey. Alcohol consumption was classified into heavy, regular, social, or never alcohol use. Heavy alcohol consumption was defined as intoxication at least once/week. Alcohol consumption and other covariates were collected by in-person interviews at baseline. Incident cases of active TB were identified from the National Health Insurance database. Multivariate logistic regression was used to estimate the association between alcohol consumption and active TB, with adjustment for age, sex, smoking, socioeconomic status, and other covariates. Results: A total of 279 new cases of active TB occurred during the study follow-up period. Heavy (adjusted odds ratio [AOR], 5.21; 95% confident interval [CI], 2.41-11.26) and regular alcohol use (AOR, 1.73; 95% CI, 1.26-2.38) were associated with higher risks of incident TB after adjusting for the subject demographics and comorbidities. Moreover, a strong dose-response effect was observed between increasing alcohol consumption and incident TB (AOR, 2.26; 95% CI, 1.59-3.21; P <.001). Conclusion: Heavy and regular alcohol consumption were associated with higher risks of active TB. Future TB control programs should consider strategies to lower the overall level of alcohol consumption to reduce the TB disease burden.

Keywords: alcohol consumption, tuberculosis, risk factor, cohort study

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1525 Problems and Challenges in Social Economic Research after COVID-19: The Case Study of Province Sindh

Authors: Waleed Baloch

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This paper investigates the problems and challenges in social-economic research in the case study of the province of Sindh after the COVID-19 pandemic; the pandemic has significantly impacted various aspects of society and the economy, necessitating a thorough examination of the resulting implications. The study also investigates potential strategies and solutions to mitigate these challenges, ensuring the continuation of robust social and economic research in the region. Through an in-depth analysis of data and interviews with key stakeholders, the study reveals several significant findings. Firstly, researchers encountered difficulties in accessing primary data due to disruptions caused by the pandemic, leading to limitations in the scope and accuracy of their studies. Secondly, the study highlights the challenges faced in conducting fieldwork, such as restrictions on travel and face-to-face interactions, which impacted the ability to gather reliable data. Lastly, the research identifies the need for innovative research methodologies and digital tools to adapt to the new research landscape brought about by the pandemic. The study concludes by proposing recommendations to address these challenges, including utilizing remote data collection methods, leveraging digital technologies for data analysis, and establishing collaborations among researchers to overcome resource constraints. By addressing these issues, researchers in the social economic field can effectively navigate the post-COVID-19 research landscape, facilitating a deeper understanding of the socioeconomic impacts and facilitating evidence-based policy interventions.

Keywords: social economic, sociology, developing economies, COVID-19

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1524 Addressing Coastal Community Vulnerabilities with Alternative Marine Energy Projects

Authors: Danielle Preziuso, Kamila Kazimierczuk, Annalise Stein, Bethel Tarekegne

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Coastal communities experience a variety of distinct socioeconomic, technical, and environmental vulnerabilities, all of which accrue heightened risk with increasingly frequent and severe climate change impacts. Marine renewable energy (MRE) offers a potential solution for mitigating coastal community vulnerabilities, especially water-energy dependencies while delivering promising co-benefits such as increased resilience and more sustainable energy outcomes. This paper explores coastal community vulnerabilities and service dependencies based on the local drivers that create them, with attention to climate change impacts and how they catalyze water-energy unmet needs in these communities. We examine the vulnerabilities through the lens of coastal Tribal communities (i.e., the Makah Tribe, the Kenaitze Tribe, Quinault Nation), as indigenous communities often face compounded impacts of technical, economic, and environmental vulnerabilities due to their underlying socio-demographic inequalities. We offer an environmental and energy justice indicators framework to understand how these vulnerabilities disproportionately manifest and impact the most vulnerable community members, and we subsequently utilize the framework to inform a weighted decision matrix tool that compares the viability of MRE-based alternative energy futures in addressing these vulnerabilities. The framework and complementary tool highlight opportunities for future MRE research and pilot demonstrations that directly respond to the vulnerabilities of coastal communities.

Keywords: coastal communities, decision matrix, energy equity, energy vulnerability, marine energy, service dependency

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1523 An Ethnographic View of Elementary School English Language Policy Implementation

Authors: Peter Ferguson

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In 2018, Japan’s Ministry of Education revised the public elementary school curriculum. As part of widespread reforms, the recent Course of Study established English as an academic subject in Grades 5 and 6 plus lowered the starting age of 'foreign language activities' to Grade 3. These changes were implemented in April 2020. This presentation will examine the process and effects that policy implementation had on schools and teachers. A critical analysis of the 2018 Course of Study policy documents revealed several discourses were expressed concerning not only English education and foreign language acquisition, but that larger political and socioeconomic ideological beliefs on globalization, language, nation, culture, and identity were also articulated. Using excerpts from document analysis, the presenter will demonstrate how competing discourses were expressed in policy texts. Data from interviews with national policymakers also exposed several challenges policymakers faced as they tried to balance competing discourses and articulate important pedagogical concepts while having their voices heard. Findings show that some stakeholders were marginalized during the processes of policy creation, transmission, and implementation. This presentation is part of a larger multiple case study that utilized ethnography of language policy and critical analysis of discourse to examine how English education language policy was implemented into the national elementary school curriculum in Japan, and how stakeholders at the various educational levels contended with the creation, interpretation, and appropriation of the language policy.

Keywords: ethnography of language policy, elementary school EFL, language ideologies, discourse analysis

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1522 Application of Raman Spectroscopy for Ovarian Cancer Detection: Comparative Analysis of Fresh, Formalin-Fixed, and Paraffin-Embedded Samples

Authors: Zeinab Farhat, Nicolas Errien, Romuald Wernert, Véronique Verriele, Frédéric Amiard, Philippe Daniel

Abstract:

Ovarian cancer, also known as the silent killer, is the fifth most common cancer among women worldwide, and its death rate is higher than that of other gynecological cancers. The low survival rate of women with high-grade serous ovarian carcinoma highlights the critical need for the development of new methods for early detection and diagnosis of the disease. The aim of this study was to evaluate if Raman spectroscopy combined with chemometric methods such as Principal Component Analysis (PCA) could differentiate between cancerous and normal tissues from different types of samples, such as paraffin embedding, chemical deparaffinized, formalin-fixed and fresh samples of the same normal and malignant ovarian tissue. The method was applied specifically to two critical spectral regions: the signature region (860-1000 〖cm〗^(-1)) and the high-frequency region (2800-3100 〖cm〗^(-1) ). The mean spectra of paraffin-embedded in normal and malignant tissues showed almost similar intensity. On the other hand, the mean spectra of normal and cancer tissues from chemical deparaffinized, formalin-fixed, and fresh samples show significant intensity differences. These spectral differences reflect variations in the molecular composition of the tissues, particularly lipids and proteins. PCA, which was applied to distinguish between cancer and normal tissues, was performed on whole spectra and on selected regions—the PCA score plot of paraffin-embedded shows considerable overlap between the two groups. However, the PCA score of chemicals deparaffinized, formalin-fixed, and fresh samples showed a good discrimination of tissue types. Our findings were validated by analyses of a set of samples whose status (normal and cancerous) was not previously known. The results of this study suggest that Raman Spectroscopy associated with PCA methods has the capacity to provide clinically significant differentiation between normal and cancerous ovarian tissues.

Keywords: Raman spectroscopy, ovarian cancer, signal processing, Principal Component Analysis, classification

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1521 Longitudinal Examination of Depressive Symptoms among U.S. Parents who Gave Birth During the COVID-19 Pandemic

Authors: Amy Claridge, Tishra Beeson

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Background: Maternal depression is a serious health concern impacting between 10-16% of birthing persons. It is associated with difficulty in emotional interaction and the formation of attachment bonds between parent and infant. Longitudinally, maternal depression can have severe, lasting impacts on both parent and child, increasing the risk for mental, social, and physical health issues. Rates of prenatal depression have been higher among individuals who were pregnant during the first year of the COVID-19 pandemic. Pregnant persons are considered a high-risk group for poor clinical outcomes from COVID-19 infection and may also have faced or continue to face additional stressors such as financial burdens, loss of income or employment, and the benefits accompanying employment, especially among those in the United States (U.S.). It is less clear whether individuals who gave birth during the pandemic continue to experience high levels of depressive symptoms or whether symptoms have been reduced as a pandemic response has shifted. The current study examined longitudinal reports of depressive symptoms among individuals in the U.S. who gave birth between March 2020 and September 2021. Methods: This mixed-method study involved surveys and interviews with birthing persons (18-45 years old) in their third trimester of pregnancy and at 8 weeks postpartum. Participants also completed a follow-up survey at 12-18 months postpartum. Participants were recruited using convenience methods via an online survey. Survey participants included 242 U.S. women who self-reported depressive symptoms (10-item Edinburgh Postnatal Depression Scale) at each data collection wave. A subset of 23 women participated in semi-structured prenatal and 8-week postpartum qualitative interviews. Follow-up interviews are currently underway and will be integrated into the presentation. Preliminary Results: Prenatal depressive symptoms were significantly positively correlated to 8-week and 12-18-month postpartum depressive symptoms. Participants who reported clinical levels of depression prenatally were 3.29 times (SE = .32, p < .001) more likely to report clinical levels of depression at 18 months postpartum. Those who reported clinical depression at 8-weeks postpartum were 6.52 times (SE = .41, p < .001) more likely to report clinical levels of depression at 18 months postpartum. Participants who gave birth earlier in the pandemic reported significantly higher prenatal (t(103) = 2.84, p < .01) and 8-week postpartum depressive symptoms (t(126) = 3.31, p < .001). Data from qualitative interviews contextualize the findings. Participants reported negative emotions during pregnancy, including sadness, grief, and anxiety. They attributed this in part to their experiences of pregnancy during the pandemic and uncertainty related to the birth experience and postpartum period. Postpartum interviews revealed some stressors specific to childbirth during the COVID-19 pandemic; however, most women reflected on positive experiences of birth and postpartum. Conclusions: Taken together, findings reveal a pattern of persistent depressive symptoms among U.S. parents who gave birth during the pandemic. Depressive symptoms are of significant concern for the health of parents and children, and the findings of this study suggest a need for continued mental health intervention for parents who gave birth during the pandemic. Policy and practice implications will be discussed.

Keywords: maternal mental health, perinatal depression, postpartum depression, covid-19 pandemic

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1520 Sand Dollars: Sex Tourism and Coloniality of Power in the Dominican Republic

Authors: Fernando Valerio-Holguin

Abstract:

Over the recent three decades, the tourism industry in the Dominican Republic has had an enormous impact on the country’s culture. The arrival of tourists from Germany, France, Italy, Russia and the United States has rewritten Dominican cultural identity and created a cultural palimpsest in the areas of language, gastronomy, habits, fashion, values, and gender relations. As a consequence of tourism, a prostitution network has flourished across the country. In the film Sand Dollars (2015) directed by Laura Amelia Guzmán and Israel Cárdenas, Noelí (Janet Mojica), a young mulatto woman, altogether with her boyfriend (Ricardo Ariel Toribio), strips tourists of dollars and euro through prostitution. One of her frequent clients is Anne, a mature French woman (Geraldine Chaplin). While Noeli’s goal is to get all the euros she can, Anne falls in love with her and tries to bring her to France. Both the content of the film and its cinematographic languages are analyzed in light of theory of coloniality. This concept shows how European and American tourism, through the power of money, perpetuates colonial discourse, i. e., how race and ethnocentrism permeate cultural activities in their former colonies. Moreover, in the content analysis of the film the concepts of exchange value and fetishism are crucial to understanding how the colonial body becomes sexual commodity. They facilitate grasping the film’s inequity in terms of power in the relationship between the two women: the white old European woman and the young, poor, third-world mulatta. Even though the film attempts to break away from compulsory heterosexuality, the power relation between the two women persists due to the presence of the axis of race, ethnicity, age and gender. Both the novel Les dollars des sables written by Jean-Noel Pancrazi, and the film Sand Dollars offer an interesting insight into sex tourism and coloniality and shed additional light on the power relations between the former colonizers and its colonies.

Keywords: coloniality, ethnocentrism, exchange value, Europe, fetishism, money, power, prostitution, sex tourism, United States of America

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1519 An Assessment of Female Representation in Philippine Cinema in Comparison to American Cinema (1975 to 2020)

Authors: Amanda Julia Binay, Patricia Elise Suarez

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Female representation in media is an important subject in the discussion of gender equality, especially in impactful and influential media like film. As the Filipino film industry continues to grow and evolve, the need for analysis on Filipino female representation on screen is imperative. Additionally, there has been limited research made on female representation in the Philippine film scene. Thus, the paper aims to analyze the presence and evolution of female representation in Philippine cinema and compare the findings with that of American films to see how Filipino filmmakers hold their own against the standards of international movements that call for more and better female representation, especially in Hollywood. The participants selected were Filipino and American films released within the years 1975 to 2020 in five (5) year intervals. Twenty (20) critically acclaimed and highest-grossing Filipino films and twenty (20) critically acclaimed and highest-grossing Hollywood films were then subject to the Bechdel and Peirce tests to obtain statistical measures of their female representation. The findings of the study reveal that the presence of female representation in Philippine film history has been consistent and has continued to grow and evolve throughout the years, with strong female leads with vibrant characteristics and diverse stories. However, analysis of female representation regarding American films has shown an extreme lack thereof with more misogynistic, sexist, and limiting ideals. Thus, the study concludes that the state of female representation in Philippine cinema and film industry holds its own when compared to American cinema and film industry and even outperforms it in many aspects of female representation, such as consistent inclusion and depiction of multi-dimensional female leads and female relationships. Hence, the study implies that women’s consistent presence in Philippine cinema mirrors Filipino women’s prominent role in Philippine society and that American cinema must continue to make efforts to change their portrayals of female characters, leads, and relationships to make them more grounded in reality.

Keywords: female representation, gender studies, feminism, philippine cinema, American cinema, bechdel test, peirce test, comparative analysis

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1518 The Mashishing Marking Memories Project: A Culture-Centered Approach to Participation

Authors: Nongcebo Ngcobo

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This research explores the importance of including a multitude of voices in the cultural heritage narrative, particularly in South Africa. The Mashishing project is an extension of and builds on the existing ‘Biesje Poort project’ which is a rock art project that was funded by the National Heritage Council in 2010 - 2013. Hence, the Mashishing marking memories project applies comparable Biesje Poort project objectives, though in a different geographical area. The wider project objectives are to transfer skills, promote social cohesion and empowerment, and lastly to add to the knowledge base of the Mashishing region and the repository of the local museum in the Lydenburg museum. This study is located in the Mashishing area, in Mpumalanga, South Africa. In this area, there were no present multi-vocal heritage projects. This research assesses the Mashishing marking memories project through the culture-centered approach for communication for social change, which examines the impact that the diverse participants have on the operations of the Mashishing project and also investigates whether the culturally diverse participants facilitates or hinders effective participation within the project. Key findings of this research uncovered the significance of participation and diverse voices in the cultural heritage field. Furthermore, this study highlights how unequal power relations affect effective participation. As a result, this study encourages the importance of bringing the researcher and the participant in a safe space to facilitate mutual learning. It also encourages an exchange of roles, where the researcher shifts from being an authoritarian figure to being in the role of a listener.

Keywords: culture, heritage, participation, social change

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1517 Improving Breastfeeding Practices and Infants’ Growth through Promoting for “Feed Your Baby like a Baby’’

Authors: Ammal M. Metwally, Walaa A. Basha, Ghada A. Abdel-Latif, Amira S. El Rifay

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Introduction: Improving breastfeeding practices does not always link to interventions relying on improving nutrition awareness and education alone but needs cultural and behavioral insights. Aim: Our study provided educational intervention through the use of the social marketing (SM) approach, which was respectable to societal norms allowing more conscious choices by mothers to achieve the maximum potential of physical growth of their infants. This study evaluated the effectiveness of the used approach for improving breastfeeding practices and the physical growth of infants aged up to 2 years. Methodology: A quasi-experimental intervention design with a posttest-only control design was done over three years duration to motivate mothers’ voluntary behavioral change toward breastfeeding promotion using SM principles: product, price, place, and promotion. The interventions targeted 464 pregnant women in their last trimester, mothers of children up to 2 years, and 1454 women in their childbearing period. Results: Most mothers showed increased awareness about the benefits of breastfeeding and became interested in breastfeeding their children outside the house using the breastfeeding cover (Gawn). Breastfeeding initiation, exclusive breastfeeding under six months, frequency of breastfeeding per day, and percentage of children who continued breastfeeding till two years were significantly increased (from 30%, 23 %, 56%, and 32% to 62 %, 47.3 %, 69 %, and 43.5 %). With the attention of the nutritional educational sessions three or more times, the majority of indicators had the most significant improvement. The females who recorded underweight results over males during the first two years of life significantly improved after the intervention (from 53.8 % to 15.4%, respectively). At the same time, females that were found to be obese before the intervention (7.7 %) became no longer obese. Conclusions: Nutritional interventions that are based on the use SM approach showed improvement for the majority of the key performance indicators. Although they doubled their value before the intervention, the majority were still modest (below 50 %). With sustained use of the SM approach, infants will achieve their maximum potential for physical growth by providing economically disadvantaged mothers with breastfeeding support.

Keywords: social marketing approach, early breastfeeding initiation, exclusive breastfeeding, responsiveness to cues of hunger and satiety, physical growth of infants

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1516 Materiality of Gender Roles in Gede City State

Authors: David Maina Muthegethi

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For decades, archaeological work of Swahili Civilization has mainly concentrated on exploration of economic and political dynamics of City states. This paper moves further and explore how gender roles were formed, maintained, negotiated and re-negotiated through time and space in Gede City. Unlike other Swahili city states, Gede was located around two miles away from the shores of Indian Ocean. Nonetheless, the city was characterized by security walls, stone houses, mosques and tombs typical of Swahili City states such as Kilwa. The study employed several methods of data collection namely: archival research, survey, re-examination of collected materials and excavation of Gede archaeological site. Since, the study aimed to examine gender roles across different social class, a total of three houses were excavated based on their social hierarchy. Thus, the houses were roughly categorized as belonging to elites, middle class and lower class. The house were located in the inner wall, second inner wall and the outer wall of Gede City respectively. Key findings shows that gender roles differed considerably along classes in Gede archaeological site. For instance, the women of the elite and middle class were active participants in Gede international trade through production and consumption of imported goods. This participation corresponded with commercialization of Gede households especially in elite’ areas where they hosted international traders. On the other hand, the middle class houses, women concentrated on running of light industries aimed at supplying goods for the urban community. Thus, they were able to afford exotic goods as their elites counterparts. Lastly, the gender roles of lower class entailed subsistence gender roles with little participation in Gede formal commerce. Interestingly, gender roles in Gede were dynamic in nature and response to cultural diffusion, spread of Islam, intensification of trade, diversification of subsistence patterns and urbanization. Therefore, this findings, demonstrate centrality of gender in reconstruction of social lives of Swahili Civilization.

Keywords: gender roles, Islam, Swahili civilization, urbanization

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1515 Analysis of Productivity and Poverty Status among Users of Improved Sorghum Varieties in Kano State, Nigeria

Authors: Temitope Adefunsho Olatoye, Julius Olabode Elega

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Raising agricultural productivity is an important policy goal for governments and development agencies, and this is central to growth, income distribution, improved food security, and poverty alleviation among practitioners. This study analyzed the productivity and poverty status among users of improved sorghum varieties in Kano State, Nigeria. A multistage sampling technique was adopted in the selection of 131 sorghum farmers who were users of improved sorghum varieties. Data collected were analyzed using both descriptive (frequency distribution and percentage) and inferential (productivity index and FGT model) statistics. The result of the socioeconomic characteristics of the sorghum farmers showed a mean age of 40 years, with about 93.13% of the sorghum farmers being male. Also, as indicated by the result, the majority (82.44%) of the farmers were married, with most of them having qur’anic education with a mean farm size of 3.6 ha, as reported in the study area. Furthermore, the result showed that the mean farming experience of the sorghum farmers in the study area was 19 years, with an average monthly income of about ₦48,794, as reported in the study area. The result of the productivity index showed a ratio of 192,977kg/ha, while the result of poverty status shows that 62.88% were in the non-poor category, 21.21% were poor, and 15.91% were very poor, respectively. The result also showed that the incidence of poverty for sorghum farmers was 16%, indicating that the incidence of poverty was prevalent in the study area. Based on the findings of this study, it was therefore recommended that seed companies should facilitate the spread of improved sorghum varieties as it has an impact on the productivity and poverty status of sorghum farmers in the study area.

Keywords: Foster Greer Thorbecke model, improved sorghum varieties, productivity, poverty status

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1514 Phenotype of Cutaneous Squamous Cell Carcinoma in a Brazilian City with a Tropical Climate

Authors: Julia V. F. Cortes, Maria E. V. Amarante, Carolina L. Cerdeira, Roberta B. V. Silva

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Nonmelanoma skin cancer is more commonly diagnosed than all other malignancies combined. In that group, cutaneous squamous cell carcinoma stands out for having the highest probability of metastasis and recurrence after treatment, in addition to being the second most prevalent form of skin cancer. Its main risk factors include exposure to carcinogens, such as ultraviolet radiation related to sunlight exposure, smoking, alcohol consumption, and human papillomavirus (HPV) infection. Considering the increased risk of skin cancer in the Brazilian population, caused by the high incidence of solar radiation, and the importance of identifying risk phenotypes for the accomplishment of public health actions, an epidemiological study was conducted in a city with a tropical climate located in southeastern Brazil, aiming to identify the target population and assist in primary and secondary prevention. This study describes the profile of patients with cutaneous squamous cell cancer, correlating the variables, sex, age, and differentiation. The study used as primary data source the results of anatomopathological exams delivered from January 2015 to December 2019 for patients registered at one pathology service, which analyzes the results of biopsies, Thus, 66 patients with cutaneous squamous cell carcinoma were analyzed. The most affected age group was 60 years or older (78.79%), emphasizing that moderately differentiated (79.49%) and well-differentiated forms (66.67%) are prevalent in this age group, resulting in a difference of 12.82 percentage points between them. In addition, the predominant sex was male (58%), and it was found that half of the women and 65.79% of men had a moderately differentiated type, whereas the well-differentiated type was slightly more frequent in women. It is worth noting that the moderately differentiated subtype has a 59.20% prevalence among all cases. Thus, it was concluded that the most affected age group was 60 years or older and that men were more affected. As for the subtype, the moderately differentiated one, which is recognized for presenting the second-highest risk for metastasis, was prevalent in this study, affecting 6.6% more men and predominating in the elderly.

Keywords: cutaneous squamous cell carcinoma, epidemiology, skin cancer, spinal cell cancer

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1513 Application of Gamma Frailty Model in Survival of Liver Cirrhosis Patients

Authors: Elnaz Saeedi, Jamileh Abolaghasemi, Mohsen Nasiri Tousi, Saeedeh Khosravi

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Goals and Objectives: A typical analysis of survival data involves the modeling of time-to-event data, such as the time till death. A frailty model is a random effect model for time-to-event data, where the random effect has a multiplicative influence on the baseline hazard function. This article aims to investigate the use of gamma frailty model with concomitant variable in order to individualize the prognostic factors that influence the liver cirrhosis patients’ survival times. Methods: During the one-year study period (May 2008-May 2009), data have been used from the recorded information of patients with liver cirrhosis who were scheduled for liver transplantation and were followed up for at least seven years in Imam Khomeini Hospital in Iran. In order to determine the effective factors for cirrhotic patients’ survival in the presence of latent variables, the gamma frailty distribution has been applied. In this article, it was considering the parametric model, such as Exponential and Weibull distributions for survival time. Data analysis is performed using R software, and the error level of 0.05 was considered for all tests. Results: 305 patients with liver cirrhosis including 180 (59%) men and 125 (41%) women were studied. The age average of patients was 39.8 years. At the end of the study, 82 (26%) patients died, among them 48 (58%) were men and 34 (42%) women. The main cause of liver cirrhosis was found hepatitis 'B' with 23%, followed by cryptogenic with 22.6% were identified as the second factor. Generally, 7-year’s survival was 28.44 months, for dead patients and for censoring was 19.33 and 31.79 months, respectively. Using multi-parametric survival models of progressive and regressive, Exponential and Weibull models with regard to the gamma frailty distribution were fitted to the cirrhosis data. In both models, factors including, age, bilirubin serum, albumin serum, and encephalopathy had a significant effect on survival time of cirrhotic patients. Conclusion: To investigate the effective factors for the time of patients’ death with liver cirrhosis in the presence of latent variables, gamma frailty model with parametric distributions seems desirable.

Keywords: frailty model, latent variables, liver cirrhosis, parametric distribution

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1512 Association between a Serotonin Re-Uptake Transporter Gene Polymorphism and Mucosal Serotonin Level in Women Patients with Irritable Bowel Syndrome and Healthy Control: A Pilot Study from Northern India

Authors: Sunil Kumar, Uday C. Ghoshal

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Background and aims: Serotonin (5-hydroxtryptamine, 5-HT) is an important factor in gut function, playing key roles in intestinal peristalsis and secretion, and in sensory signaling in the brain-gut axis. Removal from its sites of action is mediated by a specific protein called the serotonin reuptake transporter (SERT). Polymorphisms in the promoter region of the SERT gene have effects on transcriptional activity, resulting in altered 5-HT reuptake efficiency. Functional polymorphisms may underlie disturbance in gut function in individuals suffering with disorders such as irritable bowel syndrome (IBS). The aim of this study was to assess the potential association between SERT polymorphisms and the diarrhea predominant IBS (D-IBS) phenotype Subjects: A total of 36 northern Indian female patients and 55 female northern Indian healthy controls (HC) were subjected to genotyping. Methods: Leucocyte DNA of all subjects was analyzed by polymerase chain reaction based technologies for SERT polymorphisms, specifically the insertion/deletion polymorphism in the promoter (SERT-P). Statistical analysis was performed to assess association of SERT polymorphism allele with the D-IBS phenotype. Results: The frequency of distribution of SERT-P gene was comparable between female patients with IBS and HC (p = 0.086). However, frequency of SERT-P deletion/deletion genotype was significantly higher in female patients with D-IBS compared to C-IBS and A-IBS [17/19 (89.5%) vs. 4/12 (33.3%) vs. 1/5 (20%), p=0.001, respectively]. The mucosal level of serotonin was higher in D-IBS compared to C-IBS and A-IBS [Median, range (159.26, 98.78–212.1) vs. 110.4, 67.87–143.53 vs. 92.34, 78.8–166.3 pmol/mL, p=0.001, respectively]. The mucosal level of serotonin was higher in female patients with IBS with SERT-P deletion/deletion genotype compared deletion/insertion and insertion/insertion [157.65, 67.87–212.1 vs. 110.4, 78.1–143.32 vs. 100.5, 69.1–132.03 pmol/mL, p=0.001, respectively]. Patients with D-IBS with deletion/deletion genotype more often reported symptoms of abdominal pain, discomfort (p=0.025) and bloating (p=0.039). Symptoms development following lactose ingestion was strongly associated with D-IBS and SERT-P deletion/deletion genotype (p=0.004). Conclusions: Significant association was observed between D-IBS and the SERT-P deletion/deletion genotype, suggesting that the serotonin transporter is a potential candidate gene for D-IBS in women.

Keywords: serotonin, SERT, inflammatory bowel disease, genetic polymorphism

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1511 Women's Religiosity as a Factor in the Persistence of Religious Traditions: Kazakhstan, the XX Century

Authors: G. Nadirova, B. Aktaulova

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The main question of the research is- how did the Kazakhs manage to keep their religious thinking in the period of active propaganda of Soviet atheism, for seventy years of struggle against religion with the involvement of the scientific worldview as the primary means of proving the absence of the divine nature and materiality of the world? Our hypothesis is that In case of Kazakhstan the conservative female religious consciousness seems to have been a factor that helped to preserve the “everyday” religiousness of Kazakhs, which was far from deep theological contents of Islam, but able to revive in a short time after the decennia of proclaimed atheism.

Keywords: woman, religious thinking, Kazakhstan, soviet ideology, rituals, family

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1510 Revitalization of Sign Language through Deaf Theatre: A Linguistic Analysis of an Art Form Which Combines Physical Theatre, Poetry, and Sign Language

Authors: Gal Belsitzman, Rose Stamp, Atay Citron, Wendy Sandler

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Sign languages are considered endangered. The vitality of sign languages is compromised by its unique sociolinguistic situation, in which hearing parents that give birth to deaf children usually decide to cochlear implant their child. Therefore, these children don’t acquire their natural language – Sign Language. Despite this, many sign languages, such as Israeli Sign Language (ISL) are thriving. The continued survival of similar languages under threat has been associated with the remarkable resilience of the language community. In particular, deaf literary traditions are central in reminding the community of the importance of the language. One example of a deaf literary tradition which has received increased popularity in recent years is deaf theatre. The Ebisu Sign Language Theatre Laboratory, developed as part of the multidisciplinary Grammar of the Body Research Project, is the first deaf theatre company in Israel. Ebisu Theatre combines physical theatre and sign language research, to allow for a natural laboratory to analyze the creative use of the body. In this presentation, we focus on the recent theatre production called ‘Their language’ which tells of the struggle faced by the deaf community to use their own natural language in the education system. A thorough analysis unravels how linguistic properties are integrated with the use of poetic devices and physical theatre techniques in this performance, enabling wider access by both deaf and hearing audiences, without interpretation. Interviews with the audience illustrate the significance of this art form which serves a dual purpose, both as empowering for the deaf community and educational for the hearing and deaf audiences, by raising awareness of community-related issues.

Keywords: deaf theatre, empowerment, language revitalization, sign language

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1509 Profiling of Mother Child Behaviors during Free Play: A South Indian Scenario

Authors: Jayashree S. Bhat, Megha Mohan

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Play is any activity spontaneously chosen, inherently motivated, and personally directed. There is a wide range of literature and research supporting the concept of play in promoting healthy development in young children. Modern children are experiencing nurture that has more structure and adult involvement than previous generations and free, unstructured, and child directed play is under peril. Play behaviors serve as a reflection of a child’s cultural and ethnic background and can be an index of a child’s development. The influence and impact of culture in children’s play is diverse. The culturally variable dimensions of play includes the choice of objects, the involvement of specific play partners, the amount of child initiations of social pretend play with caregivers along with its the components, and sequences and specific themes involved during play. India is a country well known for its cultural diversity. In this study, a cross sectional study design with convenient sampling was adopted. The mother child free play interaction was video clipped at their residence among typically developing children between 12 to 24 months in an urban city from South India. It was ascertained that all the children were first born and mothers were unemployed belonging to middle socioeconomic status. The video clippings were coded and analysed using SPSS software version 17. The results revealed interesting behaviors demonstrated by the mother as well as the child during the play interaction. The results high light the need for focusing on the play behaviors of children during their developmental assessment, especially so for children with challenges.

Keywords: culture, free play, interaction, typically developing

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1508 The Effect of Female Access to Healthcare and Educational Attainment on Nigerian Agricultural Productivity Level

Authors: Esther M. Folarin, Evans Osabuohien, Ademola Onabote

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Agriculture constitutes an important part of development and poverty mitigation in lower-middle-income countries, like Nigeria. The level of agricultural productivity in the Nigerian economy in line with the level of demand necessary to meet the desired expectation of the Nigerian populace is threatening to meeting the standard of the United Nations (UN) Sustainable Development Goals (SDGs); This includes the SDG-2 (achieve food security through agricultural productivity). The overall objective of the study is to reveal the performance of the interaction variable in the model among other factors that help in the achievement of greater Nigerian agricultural productivity. The study makes use of Wave 4 (2018/2019) of the Living Standard Measurement Studies, Integrated Survey on Agriculture (LSMS-ISA). Qualitative analysis of the information was also used to provide complimentary answers to the quantitative analysis done in the study. The study employed human capital theory and Grossman’s theory of health Demand in explaining the relationships that exist between the variables within the model of the study. The study engages the Instrumental Variable Regression technique in achieving the broad objectives among other techniques for the other specific objectives. The estimation results show that there exists a positive relationship between female healthcare and the level of female agricultural productivity in Nigeria. In conclusion, the study emphasises the need for more provision and empowerment for greater female access to healthcare and educational attainment levels that aids higher female agricultural productivity and consequently an improvement in the total agricultural productivity of the Nigerian economy.

Keywords: agricultural productivity, education, female, healthcare, investment

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1507 Exploring the Knowledge from the Public on Technical and Vocational Education Training (TVET) in Ghana

Authors: Abubakar-Zagoon Adams, Emmanuel Intsiful, Haruna Zagoon-Sayeed

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Within the Ghanaian context, the promotion of Technical and Vocational Education and Training (TVET) has been faced with many obstacles which are of great concern to national development. One of the obstacles that have been identified as having some negative impact on TVET promotion is the poor public perception of TVET. Poor public perception, as identified in the sub-sectors report in a number of Ghana Education Service reports, has received little attention in both research and the government’s effort to address the poor performance of the TVET sub-sector. This study investigated TVET stakeholders in the Ayawaso-West Municipality in the Greater Accra Region of Ghana to ascertain knowledge of technical and vocational education in Ghana. This study explored parents’ and students’ views and knowledge about technical and vocational education. The study adopted an exploratory research design and a qualitative research approach. Thirty-six (36) participants were selected by employing a purposive sampling technique. Twelve (ten parents and two school personnel) out of the total sample were engaged in key informant interviews, whereas three focus group discussions were conducted with students, eight in each group. The study found that the public has fair knowledge (positive) about TVET, and the other side of the coin knows that TVET is only meant for school dropouts, underprivileged students, and weak academic students. The study recommended that the government should intensify public education on TVET, deliberate investment should be made in TVET infrastructure, as well as proper regulation of the sub-sector.

Keywords: public perception, TVET promotion, socioeconomic, self-employment

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1506 Leave or Remain Silent: A Study of Parents’ Views on Social-Emotional Learning in Chinese Schools

Authors: Pei Wang

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The concept of social-emotional learning (SEL) is becoming increasingly popular in both research and practical applications worldwide. However, there is a lack of empirical studies and implementation of SEL in China, particularly from the perspective of parents. This qualitative study examined how Chinese parents perceived SEL, how their views on SEL were shaped, and how these views affected their decisions regarding their children’s education programs. Using the Collaborative for Academic Social and Emotional Learning Interactive Wheel framework and Bronfenbrenner's bioecological theory, the study conducted interviews with eight parents whose children attended public, international, and private schools in China. All collected data were conducted a thematic analysis involving three coding phases. The findings revealed that interviewees perceived SEL as significant to children’s development but held diverse understandings and perspectives on SEL at school depending on the amount and the quality of SEL resources available in their children’s schools. Additionally, parents’ attitudes towards the exam-oriented education system and Chinese culture influenced their views on SEL in school. Nevertheless, their socioeconomic status (SES) was the most significant factor in their perspectives on SEL, which significantly impacted their choices in their children's educational programs. High-SES families had more options to pursue SEL resources by sending their children to international schools or Western countries, while lower middle-class SES families had limited SEL resources in public schools. This highlighted educational inequality in China and emphasized the need for greater attention and investment in SEL programs in Chinese public schools.

Keywords: Chinese, inequality, parent, school, social-emotional learning

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1505 The Influence of Contextual Factors on Long-Term Contraceptive Use in East Java

Authors: Ni'mal Baroya, Andrei Ramani, Irma Prasetyowati

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The access to reproduction health services, including with safe and effective contraception were human rights regardless of social stratum and residence. In addition to individual factors, family and contextual factors were also believed to be the cause in the use of contraceptive methods. This study aimed to assess the determinants of long-term contraceptive methods (LTCM) by considering all the factors at either the individual level or contextual level. Thereby, this study could provide basic information for program development of prevalence enhancement of MKJP in East Java. The research, which used cross-sectional design, utilized Riskesdas 2013 data, particularly in East Java Province for further analysis about multilevel modeling of MKJP application. The sample of this study consisted of 20.601 married women who were not in pregnant that were drawn by using probability sampling following the sampling technique of Riskesdas 2013. Variables in this study were including the independent variables at the individual level that consisted of education, age, occupation, access to family planning services (KB), economic status and residence. As independent variables in district level were the Human Development Index (HDI, henceforth as IPM) in each districts of East Java Province, the ratio of field officers, the ratio of midwives, the ratio of community health centers and the ratio of doctors. As for the dependent variable was the use of Long-Term Contraceptive Method (LTCM or MKJP). The data were analyzed by using chi-square test and Pearson product moment correlation. The multivariable analysis was using multilevel logistic regression with 95% of Confidence Interval (CI) at the significance level of p < 0.05 and 80% of strength test. The results showed a low CPR LTCM was concentrated in districts in Madura Island and the north coast. The women which were 25 to 35 or more than 35 years old, at least high school education, working, and middle-class social status were more likely to use LTCM or MKJP. The IPM and low PLKB ratio had implications for poor CPR LTCM / MKJP.

Keywords: multilevel, long-term contraceptive methods, east java, contextual factor

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1504 Identification of Indices to Quantify Gentrification

Authors: Sophy Ann Xavier, Lakshmi A

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Gentrification is the process of altering a neighborhood's character through the influx of wealthier people and establishments. This idea has subsequently been expanded to encompass brand-new, high-status construction projects that involve regenerating brownfield sites or demolishing and rebuilding residential neighborhoods. Inequality is made worse by Gentrification in ways that go beyond socioeconomic position. The elderly, members of racial and ethnic minorities, individuals with disabilities, and mental health all suffer disproportionately when they are displaced. Cities must cultivate openness, diversity, and inclusion in their collaborations, as well as cooperation on objectives and results. The papers compiled in this issue concentrate on the new gentrification discussions, the rising residential allure of central cities, and the indices to measure this process according to its various varieties. The study makes an effort to fill the research gap in the area of gentrification studies, which is the absence of a set of indices for measuring Gentrification in a specific area. Studies on Gentrification that contain maps of historical change highlight trends that will aid in the production of displacement risk maps, which will guide future interventions by allowing residents and policymakers to extrapolate into the future. Additionally, these maps give locals a glimpse into the future of their communities and serve as a political call to action in areas where residents are expected to be displaced. This study intends to pinpoint metrics and approaches for measuring Gentrification that can then be applied to create a spatiotemporal map of a region and tactics for its inclusive planning. An understanding of various approaches will enable planners and policymakers to select the best approach and create the appropriate plans.

Keywords: gentrification, indices, methods, quantification

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1503 KAP Study on Breast Cancer Among Women in Nirmala Educational Institutions-A Prospective Observational Study

Authors: Shaik Asha Begum, S. Joshna Rani, Shaik Abdul Rahaman

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INTRODUCTION: Breast cancer is a disease that creates in breast cells. "KAP" study estimates the Knowledge, Attitude, and Practices of a local area. More than 1.5 million ladies (25% of all ladies with malignancy) are determined to have bosom disease consistently all through the world. Understanding the degrees of Knowledge, Attitude and Practice will empower a more effective cycle of mindfulness creation as it will permit the program to be custom-made all the more properly to the necessities of the local area. OBJECTIVES: The objective of this study is to assess the knowledge on signs and symptoms, risk factors, provide awareness on the practicing of the early detection techniques of breast cancer and provide knowledge on the overall breast cancer including preventive techniques. METHODOLOGY: This is an expressive cross-sectional investigation. This investigation of KAP was done in the Nirmala Educational Institutions from January to April 2021. A total of 300 participants are included from women students in pharmacy graduates & lecturers, and also from graduates other than the pharmacy. The examiners are taken from the BCAM (Breast Cancer Awareness Measure), tool compartment (Version 2). RESULT: According to the findings of the study, the majority of the participants were not well informed about breast cancer. A lump in the breast was the most commonly mentioned sign of breast cancer, followed by pain in the breast or nipple. The percentage of knowledge related to the breast cancer risk factors was also very less. The correct answers for breast cancer risk factors were radiation exposure (58.20 percent), a positive family history (47.6 percent), obesity (46.9 percent), a lack of physical activity (43.6 percent), and smoking (43.2 percent). Breast cancer screening, on the other hand, was uncommon (only 30 and 11.3 percent practiced clinical breast examination and mammography respectively). CONCLUSION: In this study, the knowledge on the signs and symptoms, risk factors of breast cancer - pharmacy graduates have more knowledge than the non-pharmacy graduates but in the preventive techniques and early detective tools of breast cancer -had poor knowledge in the pharmacy and non-pharmacy graduate. After the awareness program, pharmacy and non-pharmacy graduates got supportive knowledge on the preventive techniques and also practiced the early detective techniques of breast cancer.

Keywords: breast cancer, mammography, KAP study, early detection

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1502 Rapid Situation Assessment of Family Planning in Pakistan: Exploring Barriers and Realizing Opportunities

Authors: Waqas Abrar

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Background: Pakistan is confronted with a formidable challenge to increase uptake of modern contraceptive methods. USAID, through its flagship Maternal and Child Survival Program (MCSP), in Pakistan is determined to support provincial Departments of Health and Population Welfare to increase the country's contraceptive prevalence rates (CPR) in Sindh, Punjab and Balochistan to achieve FP2020 goals. To inform program design and planning, a Rapid Situation Assessment (RSA) of family planning was carried out in Rawalpindi and Lahore districts in Punjab and Karachi district in Sindh. Methodology: The methodology consisted of comprehensive desk review of available literature and used a qualitative approach comprising of in-depth interviews (IDIs) and focus group discussions (FGDs). FGDs were conducted with community women, men, and mothers-in-law whereas IDIs were conducted with health facility in-charges/chiefs, healthcare providers, and community health workers. Results: Some of the oft-quoted reasons captured during desk review included poor quality of care at public sector facilities, affordability and accessibility in rural communities and providers' technical incompetence. Moreover, providers had inadequate knowledge of contraceptive methods and lacked counseling techniques; thereby, leading to dissatisfied clients and hence, discontinuation of contraceptive methods. These dissatisfied clients spread the myths and misconceptions about contraceptives in their respective communities which seriously damages community-level family planning efforts. Private providers were found reluctant to insert Intrauterine Contraceptive Devices (IUCDs) due to inadequate knowledge vis-à-vis post insertion issues/side effects. FGDs and IDIs unveiled multi-faceted reasons for poor contraceptives uptake. It was found that low education and socio-economic levels lead to low contraceptives uptake and mostly uneducated women rely on condoms provided by Lady Health Workers (LHWs). Providers had little or no knowledge about postpartum family planning or lactational amenorrhea. At community level family planning counseling sessions organized by LHWs and Male Mobilizers do not sensitize community men on permissibility of contraception in Islam. Many women attributed their physical ailments to the use of contraceptives. Lack of in-service training, job-aids and Information, Education and Communications (IEC) materials at facilities seriously comprise the quality of care in effective family planning service delivery. This is further compounded by frequent stock-outs of contraceptives at public healthcare facilities, poor data quality, false reporting, lack of data verification systems and follow-up. Conclusions: Some key conclusions from this assessment included capacity building of healthcare providers on long acting reversible contraceptives (LARCs) which give women contraception for a longer period. Secondly, capacity building of healthcare providers on postpartum family planning is an enormous challenge that can be best addressed through institutionalization. Thirdly, Providers should be equipped with counseling skills and techniques including inculcation of pros and cons of all contraceptive methods. Fourthly, printed materials such as job-aids and Information, Education and Communications (IEC) materials should be disseminated among healthcare providers and clients. These concluding statements helped MCSP to make informed decisions with regard to setting broad objectives of project and were duly approved by USAID.

Keywords: capacity building, contraceptive prevalence rate, family planning, Institutionalization, Pakistan, postpartum care, postpartum family planning services

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1501 Transnational Migration of Sports Workers from Africa to Foreign Countries: The Impact of their Assistance to the Domestic Community Through their Socioeconomic Choices of Action

Authors: Ernest Yeboah Acheampong, Malek Bouhaouala, Michel Raspaud

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Studies on African sport workers’ migration have given less attention to examining the extent to which the individual (sports workers) contributes to a socio-economic development of their domestic communities. The decision to support or not to support can also have a debilitating effect on the domestic communities. This article therefore, analyses the choices of action of these actors with an exact focus on footballers to the domestic community. This exploratory survey focuses on 13 UEFA countries leagues of footballers from 43 African countries, including seventeen interviews and four autobiographies of the players. Max Weber theory of individual subjectivity can underpin their decisions making processes to either offer assistance or not to their locales. This study revealed some players closed relationships, particularly those raised in the typical locales as they often provide support via projects like building hospitals, schools, sporting facilities, health centres, and scholarship schemes among others. While others shown commitment and readiness to offer assistance, touch livelihood, and promote social development based on their lived experiences abroad. With many lamenting against lack of support from local and national authorities as disincentive to do more yet committed to the cause of the society. This article can conclude that football athletes logics of action depend on the individual values and conceptions from evidence of their socio-economic projects, as well as social embeddedness in the locality

Keywords: choices of action, domestic development, footballers, transnational migration

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1500 Knowledge, Attitudes and Practices of Female Students regarding Emergency Contraception at Midlands State University, Zimbabwe

Authors: P. Mambanga, T. G. Tshitangano, H. Akinsola

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Background: Unintended pregnancies constitute a most serious public health challenge to women to an extent that they sometimes end in illegal abortions resulting in adverse consequences. However, the introduction of emergency contraception has served as the last chance for women to avoid unintended pregnancies, though, in countries like Zimbabwe the cause for underutilisation of emergency contraception has been hardly investigated. Purpose: The main purpose of this study was to assess the knowledge, attitude and practice of female students regarding emergency contraception among in preventing unintended pregnancy. Methodology: A quantitative approach using descriptive cross-sectional survey design was conducted among 319 stratified random sampled female university students of Midland State University, Zimbabwe. Self-administered close-ended questionnaire was used to collect the data. To ensure validity, the development of the instrument was guided by a wide range of literature and the inputs of experts. The instrument was retested for reliability and the responses will be comparing using Cronbach’s alpha which yielded high reliability alpha (α) value of 0.84. Data was coded and entered into a computer using Microsoft Excel 2010 and analysed using Statistical Package for Social Scientists (SPSS) version 22.0. Descriptive statistics were used to analyse data in the form of cross tabulation and the results were presented in table, graphs and pie charts. Results: The results indicated that apart from all sources of information about EC, mass media has shown to be the most famous. Although female students knows about EC, the knowledge about effective level and correct use of EC poor. The attitudes of female students at MSU are unfavourable for EC as they gave reasons like EC promotes promiscuity and it can pose risk. The practice of EC at MSU is low with only 47% of respondents said they have once use EC. Conclusion and recommendation: The study concluded the lack of actual knowledge about EC which has directly influenced attitudes and practices. The study concluded that there MSU female students has fair knowledge about EC which has resulted in negative and attitudes towards EC with few EC practices. The study, therefore, recommends the adoption and use of Health Belief Model approach in promoting the young to use EC to prevent unwanted pregnancies.

Keywords: emergency contraception, knowledge, attitude, practice, female students

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1499 Narratives of Cultural Encounters Revisited: Moroccan Entertainers beyond Borders (1840-1920)

Authors: Lhoussain Simour

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This paper discusses the reordering and reorientation Moroccan Oossified and frozen histories in national and colonial archives. It attempts to reexamine Moroccan non-canonical voices beyond borders, their forgotten experiences and itineraries, with the aim of uncovering cultural discourses pertaining to early cultural and artistic interactions between Morocco and the western countries, namely Britain and America. In fact, less attention has been given to the presence of Moroccan entertainers beyond borders in the archives of history. Moroccan historians and cultural critics seem to have paid little critical consideration to Moroccan artistic encounters with the west, Europe and America as a case in point. They have overlooked to deal with travel performances, professional entertainments, and artistic spectacles, initiated by acrobats, as instances of visual cross-cultural encounters between Morocco and the west. The narratives of these professional artists have hardly found their ways into historiographical writing. This contribution attempts to locate the contesting beginnings of Moroccan professional entertainers in western show business in the nineteenth century which witnessed intricate artistic, discursive and cultural junctures by emphasizing connections between theatrical performances, ethnic exhibition and world fair expositions. Moroccan professional performances grew in Europe and America within a zealous context marked by the rise of a paradigmatic racial consciousness that sought to authenticate and legitimate ethnic discourses of power and exclusion. The ethnic taxonomies and racial hierarchies governed by ethnographic and anthropological documentation fueled up entertainment venues and popular theatrical performances and helped in developing a distinctive view about Self and Other paradigms. Moroccan travelers started their journeys to visit European and American countries to exhibit their acrobatics acts. They, in a certain sense, continued, albeit in varying degrees and circumstances, the whole tradition of travel initiated previously by their ancestor diplomats and ambassadors. Professional entertainers embarked on daring journeys across the Mediterranean and the Atlantic to discover new geographies and cultural spaces, and perform their spectacles beyond borders. These travelers left rich archival documents that reflect important cultural and historical moments. The routes of travel started from the margins of the empire towards metropolitan centers of nineteenth century Europe and America included Moroccan women travelers as acrobats and dancing professional artists as well. These also crossed the straits of Gibraltar and journeyed through the Atlantic Ocean to visit western countries. Moroccan women travelers took part in various Euro-American theatre performances and in circus shows as early as 1850 according to newspapers archives and passengers shipping lists. Najat Amburg, Zahar Ben Tahar, Torquia, Fadma, and many more whose names are now lost to us, moved freely in various western capital cities to entertain nineteenth century western audiences.

Keywords: archives, cultural encounters, self and other, Morocco, travel, Moroccan acrobats, Moorish dancing women

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1498 Opinions and Perceptions of Clinical Staff towards Caring for Obese Patients: A Qualitative Research Study in a Cardiac Centre in Bahrain

Authors: Catherine Mary Abou-Zaid, Sandra Goodwin

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This study was conducted in a cardiac center in Bahrain. The rise in the amount of obese patients’ both men and women, being admitted for surgical procedures has become an issue to the nurses and doctors as these patients pose a high risk of major complications arising from their problem. The cessation of obesity in the country is very high and obesity-related diseases has been the cause of concern among men and women, also related individual diseases such as cardiovascular, diabetes and chronic respiratory diseases are rising dramatically within Bahrain in the last 10 years. Rationale for the Study: The ontological approach will help to understand and assess the true nature of the social world and how the world looks at obesity. Obesity has to be looked at as being a realistic ongoing issue. The epistemological approach will look at the theory of the origins of the nature of knowledge, set the rule of validating and learning in the social world of what can be done to curb this concept and how this can help prevent otherwise preventable diseases. Design Methodology: The qualitative design methodology took the form of an ontological/epistemological approach using phenomenology as a framework. The study was based on a social research issue, therefore, ontological ‘realism and idealism’ will feature as the nature of the world from a social and natural context. Epistemological positions of the study will be how we as researchers will find the actual social world and the limiting of that knowledge. The one-to-one interviews will be transcribed and the taped verbatim will be coded and charted giving the thematic analytic results. Recommendations: The significance of the research brought many recommendations. These recommendations were taken from the themes and sub-themes and were presented to the centers management and the necessary arrangements for updating knowledge and attitudes towards obesity in cardiac patients was then presented to the in-service education department. Workshops and training sessions on promoting health education were organized and put into the educational calendar for the next academic year. These sessions would look at patient autonomy, the patients’ rights, healthy eating for patients and families and the risks associated with obesity in cardiac disease processes.

Keywords: cardiac patients, diabetes, education & training, obesity cessation, qualitative

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1497 Assessing the Quality of Maternity Care in Sub-Saharan Africa Using the Donabedian Quality of Care Framework: A Systematic Scoping Review

Authors: Bernice Boafoaa Gyapong, Anne Jones, Sam Bassett, Janet Anderson

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Background: Maternal mortality and morbidity are global concerns, especially in sub-Saharan Africa (SSA). Most maternal mortalities occur at the time of birth. Quality intrapartum care is essential for improving maternal and newborn health outcomes. This scoping review aimed to assess and describe the quality of care during childbirth in SSA to provide an overview of the regional trend of the quality of intrapartum care, the challenges to quality care provision, and identify research gaps. Methods: A scoping review based on Arksey and O’Malley’s scoping review framework was conducted. Medline, CINAHL, PsycINFO, and maternal-infant databases were searched to identify the relevant studies for this review. A narrative summary was presented using themes based on the Donabedian structure, process, and outcome quality of care model. Results: A total of five hundred and forty-seven (547) publications were identified. Fifty-six (56) studies conducted in twenty (20) countries were included in the review. Thirty-four (34) were quantitative, sixteen (16) were qualitative, and six (6) were mixed methods. Most of the studies were related to the process component of quality of care. The provision of emergency obstetric care services, infrastructure, and availability of essential staff and equipment for perinatal care was inadequate in many facilities, particularly rural and peripheral health facilities. Many women experienced disrespectful care during childbirth. Routine care during labour and delivery was observed to be sub-optimal, yet some women reported high satisfaction with care. The use of health facilities for delivery was lower in health centres compared to hospitals. Conclusion: There are variations in the quality of maternity care provided in SSA. Intrapartum care quality is generally deficient in SSA, particularly in peripheral health facilities, health centres, and community clinics. Many of the quality-of-care issues identified are related to the structure component. Stakeholders must develop interventions that comprehensively address these interrelated issues to improve maternal healthcare quality, especially in primary healthcare facilities.

Keywords: quality of care, maternity health, Sub-Saharan Africa, intrapartum

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