Search results for: barriers
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1208

Search results for: barriers

908 Adobe Attenuation Coefficient Determination and Its Comparison with Other Shielding Materials for Energies Found in Common X-Rays Procedures

Authors: Camarena Rodriguez C. S., Portocarrero Bonifaz A., Palma Esparza R., Romero Carlos N. A.

Abstract:

Adobe is a construction material that fulfills the same function as a conventional brick. Widely used since ancient times, it is present in an appreciable percentage of buildings in Latin America. Adobe is a mixture of clay and sand. The interest in the study of the properties of this material arises due to its presence in the infrastructure of hospital´s radiological services, located in places with low economic resources, for the attenuation of radiation. Some materials such as lead and concrete are the most used for shielding and are widely studied in the literature. The present study will determine the mass attenuation coefficient of Adobe. The minimum required thicknesses for the primary and secondary barriers will be estimated for the shielding of radiological facilities where conventional and dental X-rays are performed. For the experimental procedure, an X-ray source emitted direct radiation towards different thicknesses of an Adobe barrier, and a detector was placed on the other side. For this purpose, an UNFORS Xi solid state detector was used, which collected information on the difference of radiation intensity. The initial parameters of the exposure started at 45 kV; and then the tube tension was varied in increments of 5 kV, reaching a maximum of 125 kV. The X-Ray tube was positioned at a distance of 0.5 m from the surface of the Adobe bricks, and the collimation of the radiation beam was set for an area of 0.15 m x 0.15 m. Finally, mathematical methods were applied to determine the mass attenuation coefficient for different energy ranges. In conclusion, the mass attenuation coefficient for Adobe was determined and the approximate thicknesses of the most common Adobe barriers in the hospital buildings were calculated for their later application in the radiological protection.

Keywords: Adobe, attenuation coefficient, radiological protection, shielding, x-rays

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907 Translation and Adaptation of Computer Assisted ASPIRA Smoking Prevention Program in Romania

Authors: Z. Abram, V. Nadasan, J. Balint, J. L. Ferencz

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Introduction: Online smoking prevention programs became popular in the last time. In order to extend the use of such programs, existing applications can be adapted and translated in the native languages of the target groups. It is the first time that in Romania such a software was implemented. Our goal was to provide a computer-aided intervention with attractive content targeting high school students who are familiar with information and communication technology. Material and methods: ASPIRA is the Romanian/Hungarian adapted version of a smoking prevention program created in USA. Prior to apply the questionnaire and ASPIRA online program which contains five modules that include tests, videos and interactive games, the program was tested in some IT laboratories on a group of schoolchildren and students. The pilot study questionnaires were completed considering the opinions of young people and the functionality of the software. Results: Above 90% of participants reported a good or very good impression about the ASPIRA program. Only a small minority found that the program included some parts which were too long or reported the existence of any technical problems regarding the functionality of the software. 76% of the participants had little or very little difficulty in understanding the messages presented by the English speaking characters. Only 7.5% of the participants thought that the program included content that was not appropriate for the local culture. Conclusions: The vast majority of students reported favorite impressions about ASPIRA online program. High school students and boys were more critical. Language and cultural barriers did not have the potential to reduce in a significant manner the effectiveness of the tested program.

Keywords: smoking prevention, ASPIRA online program, youth opinions, language/cultural barriers

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906 To Assess Variables Related to Self-Efficacy for Increasing Physical Activity in Advanced-Stage Cancer Patients

Authors: S. Nikpour, S. Vahidi, H. Haghani

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Introduction: Exercise has mental and physical health benefits for patients with advanced stage cancer who actively receive chemotherapy, yet little is known about patients’ levels of interest in becoming more active or their confidence in increasing their activity level. Methods and materials: A convenience sample of 200 patients with advanced-stage cancer who were receiving chemotherapy completed self-report measures assessing physical activity level, mood, and quality-of-life variables. Qualitative data on patient-perceived benefits of, and barriers to, physical activity also were collected, coded by independent raters, and organized by predominant themes. Results: Current physical activity level, physical activity outcome expectations, and positive mood were significantly associated with self-efficacy. Fatigue was the most frequently listed barrier to physical activity; improved physical strength and health were the most commonly listed benefits. Participants identified benefits related to both general health and cancer-symptom management that were related to exercise. 59.5% of participants reported that they were seriously planning to increase or maintain their physical activity level, and over 40% reported having interest in receiving an intervention to become more active. Conclusion: These results suggested that many advanced-stage cancer patients who receive chemotherapy are interested in maintaining or increasing their physical activity level and in receiving professional support for exercise. In addition, these individuals identified general health and cancer-specific benefits of, and barriers to, physical activity. Future research will investigate how these findings may be incorporated into physical activity interventions for advanced-stage oncology patients receiving medical treatment.

Keywords: physical activity, cancer, self-efficacy

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905 Analysis of Rockfall Hazard along Himalayan Road Cut Slopes

Authors: Sarada Prasad Pradhan, Vikram Vishal, Tariq Siddique

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With a vast area of India comprising of hilly terrain and road cut slopes, landslides and rockfalls are a common phenomenon. However, while landslide studies have received much attention in the past in India, very little literature and analysis is available regarding rockfall hazard of many rockfall prone areas, specifically in Uttarakhand Himalaya, India. The subsequent lack of knowledge and understanding of the rockfall phenomenon as well as frequent incidences of rockfall led fatalities urge the necessity of conducting site-specific rockfall studies to highlight the importance of addressing this issue as well as to provide data for safe design of preventive structures. The present study has been conducted across 10 rockfall prone road cut slopes for a distance of 15 km starting from Devprayag, India along National Highway 58 (NH-58). In order to make a qualitative assessment of Rockfall Hazard posed by these slopes, Rockfall Hazard Rating using standards for Indian Rockmass has been conducted at 10 locations under different slope conditions. Moreover, to accurately predict the characteristics of the possible rockfall phenomenon, numerical simulation was carried out to calculate the maximum bounce heights, total kinetic energies, translational velocities and trajectories of the falling rockmass blocks when simulated on each of these slopes according to real-life conditions. As it was observed that varying slope geometry had more fatal impacts on Rockfall hazard than size of rock masses, several optimizations have been suggested for each slope regarding location of barriers and modification of slope geometries in order to minimize damage by falling rocks. This study can be extremely useful in emphasizing the significance of rockfall studies and construction of mitigative barriers and structures along NH-58 around Devprayag.

Keywords: rockfall, slope stability, rockmass, hazard

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904 Opportunities in Self-care Abortion and Telemedicine: Findings from a Study in Colombia

Authors: Paola Montenegro, Maria de los Angeles Balaguera Villa

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In February 2022 Colombia achieved a historic milestone in ensuring universal access to abortion rights with ruling C-055 of 2022 decriminalising abortion up to 24 weeks of gestation. In the context of this triumph and the expansion of telemedicine services in the wake of the COVID-19 pandemic, this research studied the acceptability of self-care abortion in young people (13 - 28 years) through a telemedicine service and also explored the primary needs that should be the focus of such care. The results shine light on a more comprehensive understanding of opportunities and challenges of teleabortion practices in a context that combines overall higher access to technology and low access to reliable information of safe abortion, stigma, and scarcity especially felt by transnational migrants, racialised people, trans men and non-binary people. Through a mixed methods approach, this study collected 5.736 responses to a virtual survey disseminated nationwide in Colombia and 47 in-person interviews (24 of them with people who were assigned female at birth and 21 with local key stakeholders in the abortion ecosystem). Quantitative data was analyzed using Stata SE Version 16.0 and qualitative analysis was completed through NVivo using thematic analysis. Key findings of the research suggest that self-care abortion is practice with growing acceptability among young people, but important adjustments must be made to meet quality of care expectations of users. Elements like quick responses from providers, lower costs, and accessible information were defined by users as decisive factors to choose over the abortion service provider. In general, the narratives in participants about quality care were centred on the promotion of autonomy and the provision of accompaniment and care practices, also perceived as transformative and currently absent of most health care services. The most staggering findings from the investigation are related to current barriers faced by young people in abortion contexts even when the legal barriers have: high rates of scepticism and distrust associated with pitfalls of telehealth and structural challenges associated with lacking communications infrastructure, among a few of them. Other important barriers to safe self-care abortion identified by participants surfaced like lack of privacy and confidentiality (especially in rural areas of the country), difficulties accessing reliable information, high costs of procedures and expenses related to travel costs or having to cease economic activities, waiting times, and stigma are among the primary barriers to abortion identified by participants. Especially in a scenario marked by unprecedented social, political and economic disruptions due to the COVID-19 pandemic, the commitment to design better care services that can be adapted to the identities, experiences, social contexts and possibilities of the user population is more necessary than ever. In this sense, the possibility of expanding access to services through telemedicine brings us closer to the opportunity to rethink the role of health care models in transforming the role of individuals and communities to make autonomous, safe and informed decisions about their own health and well-being.

Keywords: contraception, family planning, premarital fertility, unplanned pregnancy

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903 Overcoming Open Innovation Challenges with Technology Intelligence: Case of Medium-Sized Enterprises

Authors: Akhatjon Nasullaev, Raffaella Manzini, Vincent Frigant

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The prior research largely discussed open innovation practices both in large and small and medium-sized enterprises (SMEs). Open Innovation compels firms to observe and analyze the external environment in order to tap new opportunities for inbound and/or outbound flows of knowledge, ideas, work in progress innovations. As SMEs are different from their larger counterparts, they face several limitations in utilizing open innovation activities, such as resource scarcity, unstructured innovation processes and underdeveloped innovation capabilities. Technology intelligence – the process of systematic acquisition, assessment and communication of information about technological trends, opportunities and threats can mitigate this limitation by enabling SMEs to identify technological and market opportunities in timely manner and undertake sound decisions, as well as to realize a ‘first mover advantage’. Several studies highlighted firm-level barriers to successful implementation of open innovation practices in SMEs, namely challenges in partner selection, intellectual property rights and trust, absorptive capacity. This paper aims to investigate the question how technology intelligence can be useful for SMEs to overcome the barriers to effective open innovation. For this, we conduct a case study in four Estonian life-sciences SMEs. Our findings revealed that technology intelligence can support SMEs not only in inbound open innovation (taking into account inclination of most firms toward technology exploration aspects of open innovation) but also outbound open innovation. Furthermore, the results of this study state that, although SMEs conduct technology intelligence in unsystematic and uncoordinated manner, it helped them to increase their innovative performance.

Keywords: technology intelligence, open innovation, SMEs, life sciences

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902 Temperature and Substrate Orientation Effects on the Thermal Stability of Graphene Sheet Attached on the Si Surface

Authors: Wen-Jay Lee, Kuo-Ning Chiang

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The graphene binding with silicon substrate has apparently Schottky barriers property, which can be used in the application of solar cell and light source. Because graphene has only one atom layer, the atomistic structure of graphene binding with the silicon surface plays an important role to affect the properties of graphene. In this work, temperature effect on the morphology of graphene sheet attached on different crystal planes of silicon substrates are investigated by Molecular dynamics (MD) (LAMMPS, developed by Sandia National Laboratories). The results show that the covered graphene sheet would cause the structural deformation of the surface Si atoms of stubtrate. To achieve a stable state in the binding process, the surface Si atoms would adjust their position and fit the honeycomb structure of graphene after the graphene attaches to the Si surface. The height contour of graphene on different plane of silicon surfaces presents different pattern, leading the local residual stress at the interface. Due to the high density of dangling bond on the Si (111)7x7 surface, the surface of Si(111)7x7 is not matching with the graphene so well in contrast with Si(100)2x1and Si(111)2x1. Si(111)7x7 is found that only partial silicon adatoms are rearranged on surface after the attachment when the temperature is lower than 200K, As the temperature gradually increases, the deformation of surface structure becomes significant, as well as the residue stress. With increasing temperature till the 815K, the graphene sheet begins to destroy and mixes with the silicon atoms. For the Si(100)2x1 and Si(111)2x1, the silicon surface structure keep its structural arrangement with a higher temperature. With increasing temperature, the residual stress gradually decrease till a critical temperatures. When the temperature is higher than the critical temperature, the residual stress gradually increases and the structural deformation is found on the surface of the Si substrates.

Keywords: molecular dynamics, graphene, silicon, Schottky barriers, interface

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901 Academic Staff Perspective of Adoption of Augmented Reality in Teaching Practice to Support Students Learning Remotely in a Crisis Time in Higher

Authors: Ebtisam Alqahtani

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The purpose of this study is to investigate academic staff perspectives on using Augmented Reality in teaching practice to support students learning remotely during the COVID pandemic. the study adopted the DTPB theoretical model to guide the identification of key potential factors that could motivate academic staff to use or not use AR in teaching practices. A mixing method design was adopted for a better understanding of the study problem. A survey was completed by 851 academic staff, and this was followed by interviews with 20 academic staff. Statistical analyses were used to assess the survey data, and thematic analysis was used to assess the interview data. The study finding indicates that 75% of academic staff were aware of AR as a pedagogical tool, and they agreed on the potential benefits of AR in teaching and learning practices. However, 36% of academic staff use it in teaching and learning practice, and most of them agree with most of the potential barriers to adopting AR in educational environments. In addition, the study results indicate that 91% of them are planning to use it in the future. The most important factors that motivated them to use it in the future are the COVID pandemic factor, hedonic motivation factor, and academic staff attitude factor. The perceptions of academic staff differed according to the universities they attended, the faculties they worked in, and their gender. This study offers further empirical support for the DTPB model, as well as recommendations to help higher education implement technology in its educational environment based on the findings of the study. It is unprecedented the study the necessity of the use of AR technologies in the time of Covid-19. Therefore, the contribution is both theoretical and practice

Keywords: higher education, academic staff, AR technology as pedological tools, teaching and learning practice, benefits of AR, barriers of adopting AR, and motivating factors to adopt AR

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900 Breastfeeding Experiences of Nutritionist who are Mothers in Quito- Ecuador

Authors: Maria Jose Mendoza Gordillo

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Introduction: Research regarding breastfeeding is devoted to how essential breastfeeding is to guarantee wellbeing for the mother and the baby from a medical standpoint relegating the cultural, material and social barriers for breastfeeding. Consequently, worldwide breastfeeding rates are low, and Ecuador is not the exception, especially among working mothers. Worldwide, health care providers have low rates of breastfeeding due to several barriers to lactation, such as the work schedule, a lack of private places for pumping while at work, and negative emotions. Goals and Methods: This study aimed to explore how do Ecuadorian women embrace their identities as nutritionists and mothers within their breastfeeding experience. The primary data come from 20 synchronous semi-structured interviews, which follow a topic guide. The interviews were recorded and transcribed verbatim. The data analysis followed the Phronetic Iterative Approach. Results: Women shifted the preconceived idea of the ideal breastfeeding that came from the medicalized discourse of breastfeeding, and that was constructed in their training as nutritionists. Although these women believe that breast milk and breastfeeding is the best way to feed a baby, the internalized ideal of breastfeeding shifted through the experience of motherhood. When these women developed their identity as mothers, they understood that the ideal breastfeeding is different from the medicalized discourse. Although they have that clash between the ideal and the external reality, they continued breastfeeding their babies and those experiences made them improve their professional practice. Conclusions: The narratives that women shared illustrate how complex it was to manage the different roles and identities that they wanted to fulfill to keep their identity of a good mother who breastfeeds her baby and, at the same time, a good healthcare provider identity. The process of breastfeeding for this group of women who are mothers and healthcare professionals appears to be a unique relational and identity negotiation process.

Keywords: breastfeeding, identity, nutritionist, qualitative

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899 The Impact of Generative AI Illustrations on Aesthetic Symbol Consumption among Consumers: A Case Study of Japanese Anime Style

Authors: Han-Yu Cheng

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This study aims to explore the impact of AI-generated illustration works on the aesthetic symbol consumption of consumers in Taiwan. The advancement of artificial intelligence drawing has lowered the barriers to entry, enabling more individuals to easily enter the field of illustration. Using Japanese anime style as an example, with the development of Generative Artificial Intelligence (Generative AI), an increasing number of illustration works are being generated by machines, sparking discussions about aesthetics and art consumption. Through surveys and the analysis of consumer perspectives, this research investigates how this influences consumers' aesthetic experiences and the resulting changes in the traditional art market and among creators. The study reveals that among consumers in Taiwan, particularly those interested in Japanese anime style, there is a pronounced interest and curiosity surrounding the emergence of Generative AI. This curiosity is particularly notable among individuals interested in this style but lacking the technical skills required for creating such artworks. These works, rooted in elements of Japanese anime style, find ready acceptance among enthusiasts of this style due to their stylistic alignment. Consequently, they have garnered a substantial following. Furthermore, with the reduction in entry barriers, more individuals interested in this style but lacking traditional drawing skills have been able to participate in producing such works. Against the backdrop of ongoing debates about artistic value since the advent of artificial intelligence (AI), Generative AI-generated illustration works, while not entirely displacing traditional art, to a certain extent, fulfill the aesthetic demands of this consumer group, providing a similar or analogous aesthetic consumption experience. Additionally, this research underscores the advantages and limitations of Generative AI-generated illustration works within this consumption environment.

Keywords: generative AI, anime aesthetics, Japanese anime illustration, art consumption

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898 Analyzing the Implementation of Education for Sustainability: Focusing on Leadership Skills in Secondary School in Côte d'Ivoire

Authors: Elysee Guy Yohou

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Côte d'Ivoire established a National Commission for Sustainable Development with a view to implementing the ESD. This study aims to understand the knowledge, attitude and practice about education for sustainability of teachers, students, principals, and staff in secondary schools in Côte d’Ivoire while exploring the barriers, levers and examines the leadership skills needed to help carrying out ESD. The data collection took place in October and December 2015. Questionnaires were administered to 400 participants, which involved teachers, students, principals and staff in 25 public and private secondary schools in four regional offices of education. 297 questionnaires were collected producing a collection-rate of 74.25%. Descriptive statistics, independent t-test, dependent sample t-test, One way ANOVA, Pearson correlation were used to analyze the data. Thereupon, knowledge, attitudes about education for sustainability of teachers, principals and staff in secondary school are better than students. However, there is little practice of ESD. 68.3% of participants are not familiar with the Decade of Education for Sustainable Development. In addition, 92.8% of schools do not have a school Agenda 21. The major barriers that prevent the teaching of education for sustainability are lack of access to technical tools, insufficient funding and lack of information. The main levers are teacher and staff training, financing, awareness of students, and public engagement. Principals do possess good human and technical skills but limited conceptual skills. The study showed that conceptual and human skills are convenient assets which rhyme more with education for sustainability. Thereupon, if schools’ principal need to improve education for sustainability through practice, they need more conceptual skills.

Keywords: Côte d'Ivoire, education for sustainability, leadership skills, secondary school

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897 Person-Centered Approaches in Face-to-Face Interventions to Support Enrolment in Cardiac Rehabilitation: A Scoping Review Study

Authors: Birgit Rasmussen, Thomas Maribo, Bente S. Toft

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BACKGROUND: Cardiac rehabilitation is the standard treatment for ischemic heart disease. Cardiac rehabilitation improves quality of life, reduces mortality and the risk of readmission, and provides patients with valuable knowledge and encouragement from peers and staff. Still, less than half of eligible patients enroll. Face-to-face interventions have the potential to support patients' decision-making and increase enrolment in cardiac rehabilitation. However, we lack knowledge of the content and characteristics of interventions. AIM: The aim was to outline and evaluate the content and characteristics of studies that have reported on face-to-face interventions to encourage enrolment in cardiac rehabilitation in patients with ischemic heart disease. METHOD: This scoping review followed the Joanne Briggs Institute methodology. Based on an a-priori protocol that defined the systematic search criteria, six databases were searched for studies published between 2001 and 2023. Two reviewers independently screened and selected studies. All authors discussed the summarized data prior to the narrative presentation. RESULTS: After screening and full text review of 5583 records, 20 studies of heterogeneous design and content were included. Four studies described the key contents in face-to-face interventions to be education, support of autonomy, addressing reasons for change, and emotional and cognitive support while showing understanding. Two studies used motivational interviewing to target patients' experiences and address worries and anticipated difficulties. Four quantitative studies found associations between enrolment and intention to attend, cardiac rehabilitation barriers, exercise self-efficacy, and perceived control. When patients asked questions, enrolment rates were higher, while providing reassurance and optimism could lead to non-attendance if patients had a high degree of worry. In qualitative studies, support to overcome barriers and knowledge about health benefits from participation in cardiac rehabilitation facilitated enrolment. Feeling reassured that the cardiac condition was good could lead to non-attendance. DISCUSSION AND CONCLUSION: To support patients' enrolment in cardiac rehabilitation, it is recommended that interventions integrate a person-centered dialogue. Individual worries and barriers to cardiac rehabilitation should be jointly explored. When talking with patients for whom worries predominate, the recommendation is to focus on the patients' perspectives and avoid too much focus on reassurance and problem-solving. The patients' perspectives, the mechanisms of change, and the process evaluation of the intervention including person-centeredness are relevant to include in future studies.

Keywords: ischemic heart disease, cardiac rehabilitation, enrolment, person-centered, in-hospital interventions

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896 Reframing Physical Activity for Health

Authors: M. Roberts

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We Are Undefeatable - is a mass marketing behaviour change campaign that aims to support the least active people living with long term health conditions to be more active. This is an important issue to address because people with long term conditions are an historically underserved community for the sport and physical activity sector and the least active of those with long term conditions have the most to gain in health and wellbeing benefits. The campaign has generated a significant change in the way physical activity is communicated and people with long term conditions are represented in the media and marketing. The goal is to create a social norm around being active. The campaign is led by a unique partnership of organisations: the Richmond Group of Charities (made up of Age UK, Alzheimer’s Society, Asthma + Lung UK, Breast Cancer Now, British Heart Foundation, British Red Cross, Diabetes UK, Macmillan Cancer Support, Rethink Mental Illness, Royal Voluntary Service, Stroke Association, Versus Arthritis) along with Mind, MS Society, Parkinson’s UK and Sport England, with National Lottery Funding. It is underpinned by the COM-B model of behaviour change. It draws on the lived experience of people with multiple long term conditions to shape the look and feel of the campaign and all the resources available. People with long term conditions are the campaign messengers, central to the ethos of the campaign by telling their individual stories of overcoming barriers to be active with their health conditions. The central messaging is about finding a way to be active that works for the individual. We Are Undefeatable is evaluated through a multi-modal approach, including regular qualitative focus groups and a quantitative evaluation tracker undertaken three times a year. The campaign has highlighted the significant barriers to physical activity for people with long term conditions. This has changed the way our partnership talks about physical activity but has also had an impact on the wider sport and physical activity sector, prompting an increasing departure from traditional messaging and marketing approaches for this audience of people with long term conditions. The campaign has reached millions of people since its launch in 2019, through multiple marketing and partnership channels including primetime TV advertising and promotion through health professionals and in health settings. Its diverse storytellers make it relatable to its target audience and the achievable activities highlighted and inclusive messaging inspire our audience to take action as a result of seeing the campaign. The We Are Undefeatable campaign is a blueprint for physical activity campaigns; it not only addresses individual behaviour change but plays a role in addressing systemic barriers to physical activity by sharing the lived experience insight to shape policy and professional practice.

Keywords: behaviour change, long term conditions, partnership, relatable

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895 Bundling of Transport Flows: Adoption Barriers and Opportunities

Authors: Vandenbroucke Karel, Georges Annabel, Schuurman Dimitri

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In the past years, bundling of transport flows, whether or not implemented in an intermodal process, has popped up as a promising concept in the logistics sector. Bundling of transport flows is a process where two or more shippers decide to synergize their shipped goods over a common transport lane. Promoted by the European Commission, several programs have been set up and have shown their benefits. Bundling promises both shippers and logistics service providers economic, societal and ecological benefits. By bundling transport flows and thus reducing truck (or other carrier) capacity, the problems of driver shortage, increased fuel prices, mileage charges and restricted hours of service on the road are solved. In theory, the advantages of bundled transport exceed the drawbacks, however, in practice adoption among shippers remains low. In fact, bundling is mentioned as a disruptive process in the rather traditional logistics sector. In this context, a Belgian company asked iMinds Living Labs to set up a Living Lab research project with the goal to investigate how the uptake of bundling transport flows can be accelerated and to check whether an online data sharing platform can overcome the adoption barriers. The Living Lab research was conducted in 2016 and combined quantitative and qualitative end-user and market research. Concretely, extensive desk research was conducted and combined with insights from expert interviews with four consultants active in the Belgian logistics sector and in-depth interviews with logistics professionals working for shippers (N=10) and LSP’s (N=3). In the article, we present findings which show that there are several factors slowing down the uptake of bundling transport flows. Shippers are hesitant to change how they currently work and they are hesitant to work together with other shippers. Moreover, several practical challenges impede shippers to work together. We also present some opportunities that can accelerate the adoption of bundling of transport flows. First, it seems that there is not enough support coming from governmental and commercial organizations. Secondly, there is the chicken and the egg problem: too few interested parties will lead to no or very few matching lanes. Shippers are therefore reluctant to partake in these projects because the benefits have not yet been proven. Thirdly, the incentive is not big enough for shippers. Road transport organized by the shipper individually is still seen as the easiest and cheapest solution. A solution for the abovementioned challenges might be found in the online data sharing platform of the Belgian company. The added value of this platform is showing shippers possible matching lanes, without the shippers having to invest time in negotiating and networking with other shippers and running the risk of not finding a match. The interviewed shippers and experts indicated that the online data sharing platform is a very promising concept which could accelerate the uptake of bundling of transport flows.

Keywords: adoption barriers, bundling of transport, shippers, transport optimization

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894 Healthy and Smart Building Projects

Authors: Ali A. Karakhan

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Stakeholders in the architecture, engineering, and construction (AEC) industry have been always searching for strategies to develop, design, and construct healthy and smart building projects. Healthy and smart building projects require that the building process including design and construction be altered and carefully implemented in order to bring about sustainable outcomes throughout the facility lifecycle. Healthy and smart building projects are expected to positively influence organizational success and facility performance across the project lifecycle leading to superior outcomes in terms of people, economy, and the environment. The present study aims to identify potential strategies that AEC organizations can implement to achieve healthy and smart building projects. Drivers and barriers for healthy and smart building features are also examined. The study findings indicate that there are three strategies to advance the development of healthy and smart building projects: (1) the incorporation of high-quality products and low chemical-emitting materials, (2) the integration of innovative designs, methods, and practices, and (3) the adoption of smart technology throughout the facility lifecycle. Satisfying external demands, achievement of a third-party certification, obtaining financial incentives, and a desire to fulfill professional duty are identified as the key drivers for developing healthy and smart building features; whereas, lack of knowledge and training, time/cost constrains, preference for/adherence to customary practices, and unclear business case for why healthy buildings are advantageous are recognized as the primary barriers toward a wider diffusion of healthy and smart building projects. The present study grounded in previous engineering, medical, and public health research provides valuable technical and practical recommendations for facility owners and industry professionals interested in pursuing sustainable, yet healthy and smart building projects.

Keywords: healthy buildings, smart construction, innovative designs, sustainable projects

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893 The Roles of Parental Involvement in the Teaching-Learning Process of Students with Special Needs: Perceptions of Special Needs Education Teachers

Authors: Chassel T. Paras, Tryxzy Q. Dela Cruz, Ma. Carmela Lousie V. Goingco, Pauline L. Tolentino, Carmela S. Dizon

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In implementing inclusive education, parental involvement is measured to be an irreplaceable contributing factor. Parental involvement is described as an indispensable aspect of the teaching-learning process and has a remarkable effect on the student's academic performance. However, there are still differences in the viewpoints, expectations, and needs of both parents and teachers that are not yet fully conveyed in their relationship; hence, the perceptions of SNED teachers are essential in their collaboration with parents. This qualitative study explored how SNED teachers perceive the roles of parental involvement in the teaching-learning process of students with special needs. To answer this question, one-on-one face-to-face semi-structured interviews with three SNED teachers in a selected public school in Angeles City, Philippines, that offer special needs education services were conducted. The gathered data are then analyzed using Interpretative Phenomenological Analysis (IPA). The results revealed four superordinate themes, which include: (1) roles of parental involvement, (2) parental involvement opportunities, (3) barriers to parental involvement, and (4) parent-teacher collaboration practices. These results indicate that SNED teachers are aware of the roles and importance of parental involvement; however, despite parent-teacher collaboration, there are still barriers that impede parental involvement. Also, SNED teachers acknowledge the big roles of parents as they serve as main figures in the teaching-learning process of their children with special needs. Lastly, these results can be used as input in developing a school-facilitated parenting involvement framework that encompasses the contribution of SNED teachers in planning, developing, and evaluating parental involvement programs, which future researchers can also use in their studies

Keywords: parental involvement, special needs education, teaching-learning process, teachers’ perceptions, special needs education teachers, interpretative phenomenological analysis

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892 Alternative (In)Security: Using Photovoice Research Methodology to Explore Refugee Anxieties in Lebanon

Authors: Jessy Abouarab

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For more than half a century, international norms related to refugee security and protection have proliferated, yet their role in alleviating war’s negative impacts on human life remains limited. The impact of refugee-security processes often manifests asymmetrically within populations. Many issues and people get silenced due to narrow security policies that focus either on abstract threat containment and refugee control or refugee protection and humanitarian aid. (In)security practices are gendered and experienced. Examining the case study of Syrian refugees in Lebanon, this study explores the gendered impact of refugee security mechanisms on local realities. A transnational feminist approach will be used to position this research in relation to existing studies in the field of security and the refugee-protection regime, highlighting the social, cultural, legal, and political barriers to gender equality in the areas of violence, rights, and social inclusion. Through Photovoice methodology, the Syrian refugees’ (in)securities in Lebanon were given visibility by enabling local volunteers to record and reflect their realities through pictures, at the same time voice the participants’ anxieties and recommendations to reach normative policy change. This Participatory Action Research approach helped participants observe the structural barriers and lack of culturally inclusive refugee services that hinder security, increase discrimination, stigma, and poverty. The findings have implications for a shift of the refugee protection mechanisms to a community-based approach in ways that extend beyond narrow security policies that hinder women empowerment and raise vulnerabilities such as gendered exploitation, abuse, and neglect.

Keywords: gender, (in)security, Lebanon, refugee, Syrian refugees, women

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891 Factors Influencing the General Public Intention to Be Vaccinated: A Case of Botswana

Authors: Meng Qing Feng, Otsile Morake

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Background: Successful implementation of the COVID-19 vaccination ensures the prevention of virus infection. Postponement and refusal of the vaccination will threaten public health, which is now common among the general public across the world. In addition, an acceptance of the COVID-19 vaccine appears as a decisive factor in controlling the COVID-19 pandemic. Purpose: This study's objective is to explore the factors influencing the public intention to be vaccinated (ITBV). Design/methodology/approach: The web-based survey included socio-demographics and questions related to the theory of planned behavior (TPB) and the health belief model (HBM). An online survey was administered using Google Form to collect data from participants of Botswana. The sample included 339 participants, half-half of the participants were female. Data analysis was run using the Statistical Package for the Social Sciences (SPSS). Findings: The study results highlight that perceived severity, perceived barriers, health motivation, and attitude have a positive and significant effect on ITBV, while perceived susceptibility, benefits, subjective norms, and perceived behavior control do not affect ITBV. Among all of the predictors, perceived barriers have the most significant influence on ITBV. Conclusion: Theoretically, this research stated that both HBM and TPB are effective in predicting and explaining the general public ITBV. Practically, this study offers insights to the government and health departments to arrange and launch health awareness programs and provide a better guide to vaccination so that doubts about vaccine confidence and the level of uncertainty can be decreased.

Keywords: COVID-19, Omicron, intention to be COVID-19 vaccine, health behavior model, theory of planned behavior, Botswana

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890 E-Book Market In Vietnam: Great Potential, Many Barriers

Authors: Zakir Hossain

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Nowadays reading e-books on laptops, smartphones, and tablets have become a new leisure activity for Vietnamese youth. Since 2011 the copyrighted e-book market began to develop in Vietnam with the participation of five local enterprises. Over the last five years, thousands of e-books were published including the first online early education book series for children from 0 to 6 years old. Research shows that 61% Vietnamese find reading e-books is comfortable, and 45% feel convenient buying books online. More than half of the Vietnamese consider reading online far better than buying printed books, and surprisingly people over age 30 desire reading online while those under 18 prefer reading printed books. Hence with a market of more than 40 million regular internet users including 22 million smartphone users, Vietnam has ample opportunities to develop the e-book market and contribute a great deal to the diversity of the local reading culture which is essential for Building a Lifelong Learning Society, a state ambition of Vietnam by 2020. However, the e-book market in Vietnam is still in its infancy and is growing far too slowly than e-book producers had expected. All five e-book enterprises are facing numerous challenges. While the big profit that e-book technology can bring has been clearly recognised in other countries, e-books in Vietnam only make up less than 1% share of the book market. The objective of the study is to identify the difficulties and barriers to the development of the e-book market in Vietnam through an extensive literature review available in English. The study revealed that illegal e-books due to copyright infringement and an inconvenient payment system to purchase e-books are the major obstacles. The great potential of e-books in Vietnam is a reality but requires government enforcement of copyright protection laws, a new area of focus for the e-book market. Furthermore, Vietnamese readers should change their habits from using free and illegal e-books to develop the e-publishing industry in Vietnam.

Keywords: copyright, e-book, e-book reading, e-publishing, Vietnam

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889 Collaborative Environmental Management: A Case Study Research of Stakeholders' Collaboration in the Nigerian Oil-Producing Region

Authors: Favour Makuochukwu Orji, Yingkui Zhao

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A myriad of environmental issues face the Nigerian industrial region, resulting from; oil and gas production, mining, manufacturing and domestic wastes. Amidst these, much effort has been directed by stakeholders in the Nigerian oil producing regions, because of the impacts of the region on the wider Nigerian economy. Research to date has suggested that collaborative environmental management could be an effective approach in managing environmental issues; but little attention has been given to the roles and practices of stakeholders in effecting a collaborative environmental management framework for the Nigerian oil-producing region. This paper produces a framework to expand and deepen knowledge relating to stakeholders aspects of collaborative roles in managing environmental issues in the Nigeria oil-producing region. The knowledge is derived from analysis of stakeholders’ practices – studied through multiple case studies using document analysis. Selected documents of key stakeholders – Nigerian government agencies, multi-national oil companies and host communities, were analyzed. Open and selective coding was employed manually during document analysis of data collected from the offices and websites of the stakeholders. The findings showed that the stakeholders have a range of roles, practices, interests, drivers and barriers regarding their collaborative roles in managing environmental issues. While they have interests for efficient resource use, compliance to standards, sharing of responsibilities, generating of new solutions, and shared objectives; there is evidence of major barriers which includes resource allocation, disjointed policy and regulation, ineffective monitoring, diverse socio- economic interests, lack of stakeholders’ commitment and limited knowledge sharing. However, host communities hold deep concerns over the collaborative roles of stakeholders for economic interests, particularly, where government agencies and multi-national oil companies are involved. With these barriers and concerns, a genuine stakeholders’ collaboration is found to be limited, and as a result, optimal environmental management practices and policies have not been successfully implemented in the Nigeria oil-producing region. A framework is produced that describes practices that characterize collaborative environmental management might be employed to satisfy the stakeholders’ interests. The framework recommends critical factors, based on the findings, which may guide a collaborative environmental management in the oil producing regions. The recommendations are designed to re-define the practices of stakeholders in managing environmental issues in the oil producing regions, not as something wholly new, but as an approach essential for implementing a sustainable environmental policy. This research outcome may clarify areas for future research as well as to contribute to industry guidance in the area of collaborative environmental management.

Keywords: collaborative environmental management framework, case studies, document analysis, multinational oil companies, Nigerian oil producing regions, Nigerian government agencies, stakeholders analysis

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888 Overcoming Reading Barriers in an Inclusive Mathematics Classroom with Linguistic and Visual Support

Authors: A. Noll, J. Roth, M. Scholz

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The importance of written language in a democratic society is non-controversial. Students with physical, learning, cognitive or developmental disabilities often have difficulties in understanding information which is presented in written language only. These students suffer from obstacles in diverse domains. In order to reduce such barriers in educational as well as in out-of-school areas, access to written information must be facilitated. Readability can be enhanced by linguistic simplifications like the application of easy-to-read language. Easy-to-read language shall help people with disabilities to participate socially and politically in society. The authors state, for example, that only short simple words should be used, whereas the occurrence of complex sentences should be avoided. So far, these guidelines were not empirically proved. Another way to reduce reading barriers is the use of visual support, for example, symbols. A symbol conveys, in contrast to a photo, a single idea or concept. Little empirical data about the use of symbols to foster the readability of texts exist. Nevertheless, a positive influence can be assumed, e.g., because of the multimedia principle. It indicates that people learn better from words and pictures than from words alone. A qualitative Interview and Eye-Tracking-Study, which was conducted by the authors, gives cause for the assumption that besides the illustration of single words, the visualization of complete sentences may be helpful. Thus, the effect of photos, which illustrate the content of complete sentences, is also investigated in this study. This leads us to the main research question which was focused on: Does the use of easy-to-read language and/or enriching text with symbols or photos facilitate pupils’ comprehension of learning tasks? The sample consisted of students with learning difficulties (N = 144) and students without SEN (N = 159). The students worked on the tasks, which dealt with introducing fractions, individually. While experimental group 1 received a linguistically simplified version of the tasks, experimental group 2 worked with a variation which was linguistically simplified and furthermore, the keywords of the tasks were visualized by symbols. Experimental group 3 worked on exercises which were simplified by easy-to-read-language and the content of the whole sentences was illustrated by photos. Experimental group 4 received a not simplified version. The participants’ reading ability and their IQ was elevated beforehand to build four comparable groups. There is a significant effect of the different setting on the students’ results F(3,140) = 2,932; p = 0,036*. A post-hoc-analyses with multiple comparisons shows that this significance results from the difference between experimental group 3 and 4. The students in the group easy-to-read language plus photos worked on the exercises significantly more successfully than the students who worked in the group with no simplifications. Further results which refer, among others, to the influence of the students reading ability will be presented at the ICERI 2018.

Keywords: inclusive education, mathematics education, easy-to-read language, photos, symbols, special educational needs

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887 Leisure Time Physical Activity during Pregnancy and the Associated Factors Based on Health Belief Model: A Cross Sectional Study

Authors: Xin Chen, Xiao Yang, Rongrong Han, Lu Chen, Lingling Gao

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Background: Leisure time physical activity (LTPA) benefits both pregnant women and their fetuses. The guidelines recommended that pregnant women should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week. The aim of this study was to investigate the rate of LTPA participation among Chinese pregnant women and to identify its predictors based on the health belief model. Methods: A cross-sectional study was conducted from June 2019 to September 2019 in Changchun, China. A total of 225 pregnant women aged 18 years or older with no severe physical or mental disease were recruited in the obstetric clinic. Self-administered questionnaires were used to collect data. LTPA was assessed by a pregnant physical activity questionnaire (PPAQ). A revised pregnancy physical activity health belief scale and social-demographic and perinatal characteristics factors were collected and used to predict LTPA participation. Data were analyzed using descriptive statistics and multivariate logistic regression. Results: The participants had a high level of perceived susceptibility, perceived severity, perceived benefits, and action clues, with mean item scores above 3.5. The predictors of LTPA in Chinese pregnant women were pre-pregnancy exercise habits [OR 3.236 (95% CI:1.632, 6.416)], perceived susceptibility score [OR 2.083 (95% CI:1.002, 4.331)], and perceived barriers score [OR 3.113 (95%CI:1.462, 6.626)]. Conclusions: The results of this study will lead to better identification of pregnant women who may not participate in LTPA. Healthcare professionals should be cognizant of issues that may affect LTPA participation among pregnant women, including pre-pregnancy exercise habits, perceived susceptibility, and perceived barriers.

Keywords: pregnancy, health belief model., leisure time physical activity, factors

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886 Bahrain Experience in Supporting Small and Medium Enterprises by the Utilization of E-Government

Authors: Najla Alhkalaf

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The focus of this study is answering the following question: How do e-government services in Bahrain support the productivity of SMEs? This study examines the current E-government function in enhancing SME productivity in Bahrain through analysing the efficiency of e- government by viewing its facilitators and barriers from the perspective of different stakeholders. The study aims to identify and develop best practice guidelines with the end-goal of creating a standardised channel of communication between e-government and SMEs that fulfil the requirement of SME owners, and thus achieve the prime objective of e-government. E-government services for SMEs have been offered in Bahrain since 2005. However, the current services lack the required mechanism for SMEs to fully take advantage of these services because of lagging communication between service provider and end-user. E-government employees believe that a lack of awareness and trust are the main stumbling block, whereas the SME owners believe that there is a lack of sufficiency in the content and efficiency provided through e- services. A questionnaire has been created based on a pilot study that highlighted the main indicators of e-government efficiency and SMEs productivity as well as previous studies conducted on this subject. This allowed for quantitative data to be extracted. Also interviews were conducted with SME owners and government employees from both case studies, which formed the qualitative data for this study. The findings portray that both the service provider and service receiver largely agree on the existence of most of the technical and administrative barriers. However, the data reflects a level of dissatisfaction from the SME side, which contradicts with the perceived level of satisfaction from the government employees. Therefore, the data supports the argument that assures the existence of a communication gap between stakeholders. To this effect, this research would help build channels of communication between stakeholders, and then induces a plan unlocking the potential of e-government application. The conclusions of this study will help devise an optimised E-government strategy for Bahrain.

Keywords: e-government, SME, e-services, G2B, government employees' perspective, entrepreneurs' perspective, enterprise

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885 Drivers and Barriers to the Acceptability of a Human Milk Bank Among Malaysians: A Cross Sectional Study

Authors: Kalaashini Ramachandran, Maznah Dahlui, Nik Daliana Nik Farid

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WHO recommends all babies to be exclusively breastfed and donor milk is the next best alternative in the absence of mother’s own milk. The establishment of a human milk bank (HMB) is still being debated due to religious concerns in Malaysia leading to informal milk sharing practices, but little is known on the knowledge, attitude and perception of women towards HMB and its benefits. This study hypothesizes that there is no association between knowledge and attitude and the acceptance towards the establishment of human milk bank among Malaysian women and healthcare providers. The aim of this study is to determine the drivers and barriers among Malaysian towards the acceptance of an HMB. A cross-sectional study with 367 participants was enrolled within a period of 3 months to answer an online self-administered questionnaire. Data on sociodemographic, knowledge on breastfeeding benefits, knowledge and attitude on HMB and its specific issues were analyzed in terms of frequency and then proceed to multiple logistic regression. Majority of the respondents are of Islamis religion (73.3%), have succeesfully completed their tertiary education (82.8%), and are employed (70.8%). Only 55.9% of respondents have heard of an HMB stating internet as their main source of information but a higher prevalence is agreeable to the establishment of a human milk bank (67.8%). Most respondents have a good score on knowledge of breastfeeding benefits and on HMB specific issues (70% and 54.2% respectively) while 63.8% of them have a positive attitude towards HMB. In the multivariate analysis, mothers with a good score on general knowledge of breastfeeding (AOR: 1.715) were more likely to accept the establishment of an HMB while Islamic religion was negatively associated with its establishment (AOR:0.113). This study has found a high prevalence rate of mothers who are willing to accept the establishment of an HMB. This action can be potentially shaped by educating mothers on the benefits of breastfeeding as well as addressing their religious concerns so the establishment of a religiously abiding HMB in Malaysia may be accepted without compromising their belief or the health benefit of donor milk.

Keywords: acceptability, attitude, human milk bank, knowledge

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884 Permeable Bio-Reactive Barriers to Tackle Petroleum Hydrocarbon Contamination in the Sub-Antarctic

Authors: Benjamin L. Freidman, Sally L. Gras, Ian Snape, Geoff W. Stevens, Kathryn A. Mumford

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Increasing transportation and storage of petroleum hydrocarbons in Antarctic and sub-Antarctic regions have resulted in frequent accidental spills. Migrating petroleum hydrocarbon spills can have a significant impact on terrestrial and marine ecosystems in cold regions, as harsh environmental conditions result in heightened sensitivity to pollution. This migration of contaminants has led to the development of Permeable Reactive Barriers (PRB) for application in cold regions. PRB’s are one of the most practical technologies for on-site or in-situ groundwater remediation in cold regions due to their minimal energy, monitoring and maintenance requirements. The Main Power House site has been used as a fuel storage and power generation area for the Macquarie Island research station since at least 1960. Soil analysis at the site has revealed Total Petroleum Hydrocarbon (TPH) (C9-C28) concentrations as high as 19,000 mg/kg soil. Groundwater TPH concentrations at this site can exceed 350 mg/L TPH. Ongoing migration of petroleum hydrocarbons into the neighbouring marine ecosystem resulted in the installation of a ‘funnel and gate’ PRB in November 2014. The ‘funnel and gate’ design successfully intercepted contaminated groundwater and analysis of TPH retention and biodegradation on PRB media are currently underway. Installation of the PRB facilitates research aimed at better understanding the contribution of particle attached biofilms to the remediation of groundwater systems. Bench-scale PRB system analysis at The University of Melbourne is currently examining the role biofilms play in petroleum hydrocarbon degradation, and how controlled release nutrient media can heighten the metabolic activity of biofilms in cold regions in the presence of low temperatures and low nutrient groundwater.

Keywords: groundwater, petroleum, Macquarie island, funnel and gate

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883 Promoting Civic Health through Patient Voter Registration

Authors: Amit Syal, Madeline Grade, Alister Martin

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Background: Cross-sectional and longitudinal studies demonstrate an association between health and voting. Furthermore, voting enables populations to support policies that impact their health via social determinants like income, education, housing, and healthcare access. Unfortunately, many barriers exist which disproportionately affect the civic participation of certain minority groups. Health professionals have an important role to play in addressing the civic health of all patients and empowering underrepresented communities. Description: Vot-ER is a non-partisan, nonprofit organization that aims to reduce barriers to civic participation by helping patients register to vote while in healthcare settings. The initial approach involved iPad-based kiosks in the emergency department waiting rooms, allowing patients to register themselves while waiting. After the COVID-19 pandemic began, Vot-ER expanded its touchless digital approaches. Vot-ER provides healthcare workers across the country with “Healthy Democracy Kits” consisting of badge backers, posters, discharge paperwork, and other resources. These contain QR and text codes that direct users to an online platform for registering to vote or requesting a mail-in ballot, available in English or Spanish. Outcomes: From May to November 2020, Vot-ER helped prepare 46,320 people to vote. 13,192 individual healthcare providers across all 50 states signed up for and received Healthy Democracy Kits. 80 medical schools participated in the Healthy Democracy Campaign competition. Over 500 institutions ordered site-based materials. Conclusions: A healthy democracy is one in which all individuals in a community have equal and fair opportunities for their voices to be heard. Healthcare settings, such as hospitals, are appropriate and effective venues for increasing both voter registration and education.

Keywords: civic health, enfranchisement, physician, voting

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882 A Qualitative Exploration of the Sexual and Reproductive Health Practices of Adolescent Mothers from Indigenous Populations in Ratanak Kiri Province, Cambodia

Authors: Bridget J. Kenny, Elizabeth Hoban, Jo Williams

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Adolescent pregnancy presents a significant public health challenge for Cambodia. Despite declines in the overall fertility rate, the adolescent fertility rate is increasing. Adolescent pregnancy is particularly problematic in the Northeast provinces of Ratanak Kiri and Mondul Kiri where 34 percent of girls aged between 15 and 19 have begun childbearing; this is almost three times Cambodia’s national average of 12 percent. Language, cultural and geographic barriers have restricted qualitative exploration of the sexual and reproductive health (SRH) challenges that face indigenous adolescents in Northeast Cambodia. The current study sought to address this gap by exploring the SRH practices of adolescent mothers from indigenous populations in Ratanak Kiri Province. Twenty-two adolescent mothers, aged between 15 and 19, were recruited from seven indigenous villages in Ratanak Kiri Province and asked to participate in a combined body mapping exercise and semi-structured interview. Participants were given a large piece of paper (59.4 x 84.1 cm) with the outline of a female body and asked to draw the female reproductive organs onto the ‘body map’. Participants were encouraged to explain what they had drawn with the purpose of evoking conversation about their reproductive bodies. Adolescent mothers were then invited to participate in a semi-structured interview to further expand on topics of SRH. The qualitative approach offered an excellent avenue to explore the unique SRH challenges that face indigenous adolescents in rural Cambodia. In particular, the use of visual data collection methods reduced the language and cultural barriers that have previously restricted or prevented qualitative exploration of this population group. Thematic analysis yielded six major themes: (1) understanding of the female reproductive body, (2) contraceptive knowledge, (3) contraceptive use, (4) barriers to contraceptive use, (5) sexual practices, (6) contact with healthcare facilities. Participants could name several modern contraceptive methods and knew where they could access family planning services. However, adolescent mothers explained that they gained this knowledge during antenatal care visits and consequently participants had limited SRH knowledge, including contraceptive awareness, at the time of sexual initiation. Fear of the perceived side effects of modern contraception, including infertility, provided an additional barrier to contraceptive use for indigenous adolescents. Participants did not cite cost or geographic isolation as barriers to accessing SRH services. Child marriage and early sexual initiation were also identified as important factors contributing to the high prevalence of adolescent pregnancy in this population group. The findings support the Ministry of Education, Youth and Sports' (MoEYS) recent introduction of SRH education into the primary and secondary school curriculum but suggest indigenous girls in rural Cambodia require additional sources of SRH information. Results indicate adolescent girls’ first point of contact with healthcare facilities occurs after they become pregnant. Promotion of an effective continuum of care by increasing access to healthcare services during the pre-pregnancy period is suggested as a means of providing adolescents girls with an additional avenue to acquire SRH information.

Keywords: adolescent pregnancy, contraceptive use, family planning, sexual and reproductive health

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881 Women’s Perceptions of DMPA-SC Self-Injection in Malawi

Authors: Mandayachepa C. Nyando, Lauren Suchman, Innocencia Mtalimanja, Address Malata, Tamanda Jumbe, Martha Kamanga, Peter Waiswa

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Background: Subcutaneous depot medroxyprogesterone acetate (DMPA-SC) is a new innovation in contraceptive methods that allow users to inject themselves with a hormonal contraceptive in their own homes. Self-injection (SI) of DMPA-SC has the potential to improve the accessibility of family planning to women who want it and who are capable of injecting themselves. Malawi started implementing this new innovation in 2018. SI was incorporated into the DMPA-SC delivery strategy from its outset. Methodology: This study involved two districts in Malawi where DMPA-SC SI was rolled out: Mulanje and Ntchisi. We used a qualitative cross-sectional study design where 60 in-depth interviews were conducted with women of reproductive age group stratified as 15-45 age band. These included women who were SI users, non-users, and any woman who was on any contraceptive methods. The women participants were tape-recorded, and data were transcribed and then analysed using Dedoose software, where themes were categorised into mother and child themes. Results: Women perceived DMPA SC SI as uniquely private, convenient, and less painful when self-injected. In terms of privacy, women in Mulanje and Ntchisi especially appreciated that self-injecting allowed them to use covertly from partners. Some men do not allow their spouses to use modern contraceptive methods; hence women prefer to use them covertly. “… but I first reach out to men because the strongest power is answered by men (MJ015).” In addition, women reported that SI offers privacy from family/community and less contact with healthcare providers. These aspects of privacy were especially valued in areas where there is a high degree of mistrust around family planning and among those who feel judged or antagonized purchasing contraception, such as young unmarried women. Women also valued the convenience SI provided in terms of their ability to save time by injecting themselves at home rather than visiting a healthcare provider and having more reliable access to contraception, particularly in the face of stockouts. SI allows for stocking up on doses to accommodate shifting work schedules in case of future stockouts or hard times, such as the period of COVID-19, where there was a limitation in the movement of the people. Conclusion: Our findings suggest that SI may meet the needs of many women in Malawi as long as the barriers are eliminated. The barriers women mentioned include fear of self-inject and proper storage of the DMPA SC SI, and these barriers can be eliminated by proper training. The findings also set the scene for policy revision and direction at a national level and integrate the approach with national family planning strategies in Malawi. Findings provide insights that may guide future implementation strategies, strengthen non-clinic family planning access programs and stimulate continued research.

Keywords: family planning, Malawi, Sayana press, self-injection

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880 Perceptions and Governance of One Health in African Countries: A Workshop Report

Authors: Menouni Aziza, Chbihi Kaoutar, El Jaafari Samir

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There is strong evidence connecting epidemics with the disruption of the human-animal-environment interaction. Despite the fact that several cases of emerging and endemic zoonotic diseases indifferent parts of Africa have been documented, there is limited data regarding which specific interventions are effective in preventing and managing the associated risks using a One Health approach. The aim of this study is to better understand perceptions and ongoing research related to interventions in Africa through the implementation of suitable projects and policies. A bibliometric review of the scientific literature on one health studies with a focus on African countries was conducted, followed by a qualitative survey among stakeholders involved in fields related to One Health research or management in the Africa, including veterinary experts, public health professionals, environmentalists and policy makers, to learn about determinants of their perceptions, as well as barriers to and promoters of successful interventions and governance. The project was concluded with an international workshop in March 2023, where a broad range of topics relevant to One Health were discussed. 94% of the respondents were aware of the importance of the One Health approach and strongly endorse it within their respective countries. The top reported barriers to One Health development in Africa included paucity of data, weak linkages and institutional communication between the different departments and the lack of funding. Key areas of improvement identified were the impact evaluation of current initiatives, awareness raising campaigns among citizens targeted at behavioral changes, capacity building of relevant professionals and stakeholders, as well as the implementation of adequate policies and enforcement of national and continental regulations, allowing for better coordination on the African level. All One Health sectors in Africa require strong governance and leadership, as well as inter-ministerial, inter-sectoral, and interdisciplinary cooperation.

Keywords: one health, perceptions, governance, Africa

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879 Robot-Assisted Laparoscopic Surgeries: Current Use in Pediatric Urology Patients

Authors: Rimel Mwamba, Mohan Gundeti

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Introduction: The use of robot-assisted laparoscopic surgeries (RALS) has largely increased in recent years, offering faster and safer treatment options for pediatric patients. In the field of urology, RALS has shown a significant advantage over laparoscopic and open surgeries but continues to be controversial in pediatric cases due to limited comprehensive data on its use. Methods: In this review, we aim to summarize the factors associated with RALS use in pediatric cases involving pyeloplasty, ureteral reimplantation, heminephrectomy, and lower urinary tract reconstruction. We used PubMed, EMBASE, and the Cochrane Database of Systematic Reviews to systematically search for literature on the topic. We then critically assessed and compiled data on RALS outcomes, complications, and associated factors. Results: To date, numerous comparative studies have been conducted on pediatric RALS, with only one randomized control trial investigating the nuances of robotic use against standard of care treatments. These robotic approaches have shown promise in post-surgical outcomes for pediatric patients undergoing upper and lower urinary tract reconstruction. Barriers to use still persist, however, showcasing a need to increase access to the technology, refine instruments for pediatric use, address cost barriers, and provide proper training for surgeons. Conclusion: RALS providesan opportunity to improve pediatric patient outcomes for numerous urologic complications. Additional studies are required to better compare the use of RALS with current standard practices. Due to the difficult nature of conducting randomized control trials, additional prospective observational studies are needed.

Keywords: pediatric urology, robot-assisted laparoscopic surgeries (RALS), pyeloplasty, ureteral reimplantation, heminephrectomy, and lower urinary tract reconstruction

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