Search results for: cyber ethics
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 882

Search results for: cyber ethics

252 Pneumoperitoneum Creation Assisted with Optical Coherence Tomography and Automatic Identification

Authors: Eric Yi-Hsiu Huang, Meng-Chun Kao, Wen-Chuan Kuo

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For every laparoscopic surgery, a safe pneumoperitoneumcreation (gaining access to the peritoneal cavity) is the first and essential step. However, closed pneumoperitoneum is usually obtained by blind insertion of a Veress needle into the peritoneal cavity, which may carry potential risks suchas bowel and vascular injury.Until now, there remains no definite measure to visually confirm the position of the needle tip inside the peritoneal cavity. Therefore, this study established an image-guided Veress needle method by combining a fiber probe with optical coherence tomography (OCT). An algorithm was also proposed for determining the exact location of the needle tip through the acquisition of OCT images. Our method not only generates a series of “live” two-dimensional (2D) images during the needle puncture toward the peritoneal cavity but also can eliminate operator variation in image judgment, thus improving peritoneal access safety. This study was approved by the Ethics Committee of Taipei Veterans General Hospital (Taipei VGH IACUC 2020-144). A total of 2400 in vivo OCT images, independent of each other, were acquired from experiments of forty peritoneal punctures on two piglets. Characteristic OCT image patterns could be observed during the puncturing process. The ROC curve demonstrates the discrimination capability of these quantitative image features of the classifier, showing the accuracy of the classifier for determining the inside vs. outside of the peritoneal was 98% (AUC=0.98). In summary, the present study demonstrates the ability of the combination of our proposed automatic identification method and OCT imaging for automatically and objectively identifying the location of the needle tip. OCT images translate the blind closed technique of peritoneal access into a visualized procedure, thus improving peritoneal access safety.

Keywords: pneumoperitoneum, optical coherence tomography, automatic identification, veress needle

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251 Cadmium Levels in Patients with Type 2 Diabetes Mellitus in Thasala Southern Thailand

Authors: Supabhorn Yimthiang, Wiyada Khanwian

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Cadmium is a heavy metal that is important in the environment because it is highly toxic. The incidence and severity of type 2 diabetes mellitus are known to be associated with cadmium. The purpose of this study was to investigate the cadmium levels in patients with type 2 diabetes mellitus at diabetes mellitus clinic, Thasala hospital, Nakhon Si Thummarat, Thailand. The study population was composed of forty five subjects. Among them, twenty two were diabetic patients and twenty three were apparently healthy non-diabetic individual subjects. After an overnight fasting, blood and morning urine samples were collected from each subject to determine fasting blood sugar and cadmium levels in urine, respectively. Systolic and diastolic blood pressure values were measured by aneroid sphygmomanometer. Study approval was taken from the human subject ethics committee of Walailak University. Verbal and written informed consent was taken from all participants. In the study samples, there were 31.8% males and 68.2% females with mean age of 47+10.53 years. The geometric mean of urine cadmium was significantly higher in diabetic patients (1.015 + 0.79 µg/g creatinine) when compared with the healthy subjects (0.395 + 0.53 µg/g creatinine) (P<0.05). This result also showed that urine cadmium excretion in diabetic patients was higher than in healthy subjects by 2.6 times. Moreover, fasting blood sugar (153+47.86 μg/dl) and systolic blood pressure (183.26+17.15 mmHg) of diabetic patients was significantly different when compared with healthy subjects (79+5.38 μg/dl and 112.78+11.32 mmHg, respectively) (P<0.05). Meanwhile, the concentration of cadmium in urine showed positive correlation with fasting plasma glucose (r=0.616) and systolic blood pressure (r=0.487). This preliminary study showed that cadmium might play an important role in the development and pathogenesis of diabetes mellitus in general population. However, these findings require confirmation through additional epidemiological and biological research.

Keywords: blood pressure, cadmium, fasting blood sugar, type 2 diabetes mellitus

Procedia PDF Downloads 220
250 An Investigation into the Ideological Facets Involved in Western Interpretations of the History of Communism

Authors: Anna Stoutenburg

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With the rise of the so-called 'new left' within the United States, marked by social democratic figures such as Bernie Sanders and Alexandria Ocasio-Cortez, significant questions have been raised in response to those who would identify with the term 'socialist'. These queries typically revolve around the negatively perceived legacy of past and present countries that share the term in question, with the stark conclusion that not only is socialism a structure that does not work economically, but that it also tends to inflict more harm on those living under it that would be endured in a country functioning under capitalism. In order to examine these claims, the goal of this paper is to examine the legacy of anti-communist historiography in a western context, with the Union of Soviet Socialist Republics, China, and modern Venezuela used as case studies for how this phenomenon operates. Not only will key portions of each nation’s history be re-examined, but there will also be a critical analysis of source cultivation and usage among western historians. The intent of this paper is not merely to deride previous attempts at historicizing and reporting on the events of the nations, but rather to attempt to glean a clearer picture that is free from anti-communist sentiments. Theoretical works that will be consulted in order to define this project are 'The Historiography of Communism' by Michael Brown, as well as 'Beyond Philosophy: Ethics, History, Marxism, and Liberation Theology' by Enrique Dussel. The latter will provide insights concerning why these questions are relevant in a larger context, namely by articulating how the means of liberation understood through an analectic method can be achieved structurally. For a majority of leftists, this question is integral, and by using history as a tool, the ways that political organizing can be used can be better understood, bridging the gap between the common assumption that the communist legacy is a dire one and the idea that it is something which needs to be completely lauded.

Keywords: anti-communism, history, ideology, Marxism

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249 The Road Ahead: Merging Human Cyber Security Expertise with Generative AI

Authors: Brennan Lodge

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Amidst a complex regulatory landscape, Retrieval Augmented Generation (RAG) emerges as a transformative tool for Governance Risk and Compliance (GRC) officers. This paper details the application of RAG in synthesizing Large Language Models (LLMs) with external knowledge bases, offering GRC professionals an advanced means to adapt to rapid changes in compliance requirements. While the development for standalone LLM’s (Large Language Models) is exciting, such models do have their downsides. LLM’s cannot easily expand or revise their memory, and they can’t straightforwardly provide insight into their predictions, and may produce “hallucinations.” Leveraging a pre-trained seq2seq transformer and a dense vector index of domain-specific data, this approach integrates real-time data retrieval into the generative process, enabling gap analysis and the dynamic generation of compliance and risk management content. We delve into the mechanics of RAG, focusing on its dual structure that pairs parametric knowledge contained within the transformer model with non-parametric data extracted from an updatable corpus. This hybrid model enhances decision-making through context-rich insights, drawing from the most current and relevant information, thereby enabling GRC officers to maintain a proactive compliance stance. Our methodology aligns with the latest advances in neural network fine-tuning, providing a granular, token-level application of retrieved information to inform and generate compliance narratives. By employing RAG, we exhibit a scalable solution that can adapt to novel regulatory challenges and cybersecurity threats, offering GRC officers a robust, predictive tool that augments their expertise. The granular application of RAG’s dual structure not only improves compliance and risk management protocols but also informs the development of compliance narratives with pinpoint accuracy. It underscores AI’s emerging role in strategic risk mitigation and proactive policy formation, positioning GRC officers to anticipate and navigate the complexities of regulatory evolution confidently.

Keywords: cybersecurity, gen AI, retrieval augmented generation, cybersecurity defense strategies

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248 Supportive Group Therapy: Its Effects on Depression, Self-Esteem and Quality of Life Among Institutionalized Elderly

Authors: Hannah Patricia S., Louise Margarrette R., Josking Oliver L., Denisse Katrina C., Justine Kali O.

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Aims: In the Philippines, there has been an astronomical increase in the population of elderly sent to nursing home facilities which has been studied to induce despair and loss of self-worth. Nurses in institutionalized facilities generally care for the elderly. Although supportive group therapy has been explored to mend this psychological disparity, nursing research has limited published studies about this in the institutionalized setting. Hence, the study determined the effectiveness of supportive group therapy in depression, self-esteem and quality of life among institutionalized elderly. Methodology: A one-group pre-test-post-test design was conducted among 20-purposively selected institutionalized elderly after the Ethics Research Board approval. All eligible participants underwent the supportive group therapy after being subdivided into session groups. The Geriatric Depression Scale, which has a Cronbach’s alpha coefficient of 0.90; the Rosenberg Self-Esteem, which has a Cronbach’s alpha coefficient = 0.84; and the Older People Quality of Life, which has a Cronbach’s alpha coefficient =0.88, were utilized to measure depression, self-esteem, and quality of life, respectively. Descriptive statistics and Repeated Measures-Multivariate Analysis of Variance (RM-MANOVA) analyzed gathered data. Results: Results showed that the supportive group therapy significantly decreased post-test depression scores (F(1,19)=78.69,p=0.0001,partial η2=0.805), significantly improved post-test self-esteem score (F(1,19)=28.07,p=0.0001,partial η2=0.596), and significantly increased the post-test quality of life (F(1,19)=79.73,p=0.0001,partial η2=0.808) after the intervention has been rendered. Conclusion: Supportive group therapy is effective in alleviating depression and in improving self-esteem and quality of life among institutionalized elderly and can be utilized by nursing homes as an intervention to improve the over-all psychosocial status of elderly patients.

Keywords: supportive group therapy, institutionalized elderly, depression, self-esteem, quality of life

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247 A Critical Reflection of Ableist Methodologies: Approaching Interviews and Go-Along Interviews

Authors: Hana Porkertová, Pavel Doboš

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Based on a research project studying the experience of visually disabled people with urban space in the Czech Republic, the conference contribution discusses the limits of social-science methodologies used in sociology and human geography. It draws on actor-network theory, assuming that science does not describe reality but produces it. Methodology connects theory, research questions, ways to answer them (methods), and results. A research design utilizing ableist methodologies can produce ableist realities. Therefore, it was necessary to adjust the methods so that they could mediate blind experience to the scientific community without reproducing ableism. The researchers faced multiple challenges, ranging from questionable validity to how to research experience that differs from that of the researchers who are able-bodied. Finding a suitable theory that could be used as an analytical tool that would demonstrate space and blind experience as multiple, dynamic, and mutually constructed was the first step that could offer a range of potentially productive methods and research questions, as well as bring critically reflected results. Poststructural theory, mainly Deleuze-Guattarian philosophy, was chosen, and two methods were used: interviews and go-along interviews that had to be adjusted to be able to explore blind experience. In spite of a thorough preparation of these methods, new difficulties kept emerging, which exposed the ableist character of scientific knowledge. From the beginning of data collecting, there was an agreement to work in teams with slightly different roles of each of the researchers, which was significant especially during go-along interviews. In some cases, the anticipations of the researchers and participants differed, which led to unexpected and potentially dangerous situations. These were not caused only by the differences between scientific and lay communities but also between able-bodied and disabled people. Researchers were sometimes assigned to the assistants’ roles, and this new position – doing research together – required further negotiations, which also opened various ethical questions.

Keywords: ableist methodology, blind experience, go-along interviews, research ethics, scientific knowledge

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246 Digital Transformation and Digitalization of Public Administration

Authors: Govind Kumar

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The concept of ‘e-governance’ that was brought about by the new wave of reforms, namely ‘LPG’ in the early 1990s, has been enabling governments across the globe to digitally transform themselves. Digital transformation is leading the governments with qualitative decisions, optimization in rational use of resources, facilitation of cost-benefit analyses, and elimination of redundancy and corruption with the help of ICT-based applications interface. ICT-based applications/technologies have enormous potential for impacting positive change in the social lives of the global citizenry. Supercomputers test and analyze millions of drug molecules for developing candidate vaccines to combat the global pandemic. Further, e-commerce portals help distribute and supply household items and medicines, while videoconferencing tools provide a visual interface between the clients and hosts. Besides, crop yields are being maximized with the help of drones and machine learning, whereas satellite data, artificial intelligence, and cloud computing help governments with the detection of illegal mining, tackling deforestation, and managing freshwater resources. Such e-applications have the potential to take governance an extra mile by achieving 5 Es (effective, efficient, easy, empower, and equity) of e-governance and six Rs (reduce, reuse, recycle, recover, redesign and remanufacture) of sustainable development. If such digital transformation gains traction within the government framework, it will replace the traditional administration with the digitalization of public administration. On the other hand, it has brought in a new set of challenges, like the digital divide, e-illiteracy, technological divide, etc., and problems like handling e-waste, technological obsolescence, cyber terrorism, e-fraud, hacking, phishing, etc. before the governments. Therefore, it would be essential to bring in a rightful mixture of technological and humanistic interventions for addressing the above issues. This is on account of the reason that technology lacks an emotional quotient, and the administration does not work like technology. Both are self-effacing unless a blend of technology and a humane face are brought in into the administration. The paper will empirically analyze the significance of the technological framework of digital transformation within the government set up for the digitalization of public administration on the basis of the synthesis of two case studies undertaken from two diverse fields of administration and present a future framework of the study.

Keywords: digital transformation, electronic governance, public administration, knowledge framework

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245 Evaluation of the Level of Knowledge about Probiotics amongst Community Pharmacy Staff in Jordan

Authors: Feras Darwish Elhajji, Alberto Berardi, Manal Ayyash, Iman Basheti

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The concept of the use of probiotics for humans now has been known for decades however, their intake by the Jordanian population seems to be less common when compared to population in the developed countries. Community pharmacy is the main supplier of probiotics, however, after conducting an extensive literature review, not any published research article could be found talking about the role, knowledge, and practice of the pharmacists in the area of probiotics. The main aim of this study was to evaluate the level of knowledge about probiotics and their dispensing practice in community pharmacies in Jordan. Community pharmacy staff (pharmacists and technicians) in Amman and north of Jordan were randomly selected to complete an anonymous questionnaire that had been pre-tested and validated. Ethical approval was obtained from the university ethics committee. The questionnaire included the following sections: demographics, knowledge and perceptions about probiotics, and role of the pharmacist Pharmacists and technicians were visited and interviewed in 281 community pharmacies. Asking about probiotics, 90.4% of them said that they know what probiotics are, although only 29.5% agreed that pharmacy staff in Jordan have good knowledge about probiotics, and 88.3% agreed that pharmacy staff in Jordan need more training and knowledge about probiotics. Variables that were significantly related to knowledge about probiotics were being a pharmacist (ρ= 0.012), area of the community pharmacy (ρ= 0.019), and female staff (ρ= 0.031) after conducting logistic regression statistical analysis. More than two-thirds of the participants thought that probiotics are classified as dietary supplements by Jordan Food and Drug Administration (JFDA). Of those who knew probiotics, the majority of them – 76.8% and 91.7% – agreed that probiotics are effective and safe, respectively. Believing in efficacy of the probiotics was significantly associated with answering their use to be with or after antibiotic administration and to increase normal flora gut population (ρ= 0.007). Efficacy was also significantly associated with recommending probiotics to consumers by the pharmacist (ρ< 0.001) and by the doctor (ρ= 0.041). At the same time, the concept of safety was mainly associated with their use for flatulence and gases (ρ= 0.048). Level of knowledge about probiotics and their uses, efficacy and safety amongst community pharmacy staff in Jordan is found to be good. However, this level can be raised in the future, especially knowledge about uses of probiotics.

Keywords: community pharmacy, Jordan, prebiotics, probiotics

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244 Service Users’ Opinions and Experiences of Health Care Practitioners’ Right to Conscientiously Object to Abortion: A Liberal Feminist Approach

Authors: B. Self, V. Fleming, C. Maxwell

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The fourth clause of the UK 1967 Abortion Act allows individuals (including health care practitioners) to conscientiously object to participating in an abortion. Individuals are able to object if they consider that participating is incompatible with their religious, moral, philosophical, ethical, or personal beliefs. Currently, there is no research on service users’ opinions and understandings of conscientious objection or the impact of conscientious objection from the UK service users’ perspective. This perspective is imperative in understanding the real-world consequences and impact of conscientious objection and essential when creating policy and guidelines. This qualitative research took a liberal feminist approach. It provided a platform for service users to share their experiences of abortion and conscientious objection, as well as their opinions and understandings of conscientious objection. The method employed was semi-structured interviews. Findings indicated that conscientious objection could work in practice. However, it is currently failing some individuals, as health care practitioners are not always referring and informing service users. Participants didn’t experience burdens such as long waiting times and were still able to access legal abortion. However, participants did experience negative emotional effects, as they were often left feeling scared, angry, and hopeless when they were not referred. Moreover, participants’ opinions on conscientious objection in the UK varied greatly. The majority supported the most common approach within the literature and in practice, whereby health care practitioners are able to object so long as they refer and inform the service user. However, the opinion that health care practitioners should not be allowed to object or should be able to object without referring and informing was also present. Without this research, the impact that conscientious objection is having on service users in the UK and service users’ opinions on conscientious objection wouldn’t be known. These findings will be used to inform national policy and guidelines, making access to abortion fairer and safer for all.

Keywords: conscientious objection, abortion, medical ethics, reproductive justice

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243 A Unified Approach for Digital Forensics Analysis

Authors: Ali Alshumrani, Nathan Clarke, Bogdan Ghite, Stavros Shiaeles

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Digital forensics has become an essential tool in the investigation of cyber and computer-assisted crime. Arguably, given the prevalence of technology and the subsequent digital footprints that exist, it could have a significant role across almost all crimes. However, the variety of technology platforms (such as computers, mobiles, Closed-Circuit Television (CCTV), Internet of Things (IoT), databases, drones, cloud computing services), heterogeneity and volume of data, forensic tool capability, and the investigative cost make investigations both technically challenging and prohibitively expensive. Forensic tools also tend to be siloed into specific technologies, e.g., File System Forensic Analysis Tools (FS-FAT) and Network Forensic Analysis Tools (N-FAT), and a good deal of data sources has little to no specialist forensic tools. Increasingly it also becomes essential to compare and correlate evidence across data sources and to do so in an efficient and effective manner enabling an investigator to answer high-level questions of the data in a timely manner without having to trawl through data and perform the correlation manually. This paper proposes a Unified Forensic Analysis Tool (U-FAT), which aims to establish a common language for electronic information and permit multi-source forensic analysis. Core to this approach is the identification and development of forensic analyses that automate complex data correlations, enabling investigators to investigate cases more efficiently. The paper presents a systematic analysis of major crime categories and identifies what forensic analyses could be used. For example, in a child abduction, an investigation team might have evidence from a range of sources including computing devices (mobile phone, PC), CCTV (potentially a large number), ISP records, and mobile network cell tower data, in addition to third party databases such as the National Sex Offender registry and tax records, with the desire to auto-correlate and across sources and visualize in a cognitively effective manner. U-FAT provides a holistic, flexible, and extensible approach to providing digital forensics in technology, application, and data-agnostic manner, providing powerful and automated forensic analysis.

Keywords: digital forensics, evidence correlation, heterogeneous data, forensics tool

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242 Descriptive Analysis of the Relationship between State and Civil Society in Hegel's Political Thought

Authors: Garineh Keshishyan Siraki

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Civil society is one of the most important concepts of the twentieth century and even so far. Modern and postmodern thinkers have provided different definitions of civil society. Of course, the concept of civil society has undergone many changes over time. The relationship between government and civil society is one of the relationships that attracted the attention of many contemporary thinkers. Hegel, the thinker we discussed in this article also explores the relationship between these concepts and emphasizing the dialectical method, he has drawn three lines between family, state, and civil society. In Hegel's view, the creation of civil society will lead to a reduction of social conflict and increased social cohesion. The importance of the issue is due to the study of social cohesion and the ways to increase it. The importance of the issue is due to the study of social cohesion and the ways to increase it. This paper, which uses a descriptive-analytic method to examine Hegel's dialectical theory of civil society, after examining the relationship between the family and the state and finding the concept of civil society as the interface and the interconnected circle of these two, investigates tripartite economic, legal, and pluralistic systems. In this article, after examining the concepts of the market, the right and duty, the individual interests and the development of the exchange economy, Hegel's view is to examine the concept of freedom and its relation with civil society. The results of this survey show that, in Hegel's thought, the separation between the political system and the social system is a natural and necessary thing. In Hegel's view, because of those who are in society, they have selfish features; the community is in tension and contradiction. Therefore, the social realms within which conflicts emerge must be identified and controlled by specific mechanisms. It can also be concluded that the government can act to reduce social conflicts by legislating, using force or forming trade unions. The bottom line is that Hegel wants to reconcile between the individual, the state and civil society and it is not possible to rely on ethics.

Keywords: civil society, cohesion system, economic system, family, the legal system, state

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241 Democratising Rivers: Local River Conflicts in Rajasthan

Authors: Renu Sisodia

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This paper attempted to explore and explain the local level river water conflicts in the larger context of state - society relations. This study also covered causes of local level river water conflicts in the catchment area of Bandi and Arvari river of Rajasthan. The focus of the study was on the emergence of community driven, decentralised management of river water bodies and strategies used by local communities to protect and manage river water conflicts. The research is conducted through the process of designing a framework based on essential theoretical and practical findings supported by primary and secondary data. Two in depth case study is conducted to understand the phenomenon in depth. The first field site is Bandi River of Pali district, which is about the struggle between textile industries, community and the State government in which water pollution is said to be one of the driving force of the conflict. Finding shows that the state is supporting textile industries in Pali district have not been adherent to the environmental ethics. Present legal infrastructure and local institutions fail to resolve the serious problem of water pollution in Bandi River and its adverse impact on the local community as a result local community resistance against the local administration and the state government. The second case illustrates the plight of Arvari River in Alwar district. Tussle for the ownership of fisheries between local community, the private fish contractor and State government has been the main bone of contestation. To resolve this conflict local community formed conflict management mechanism named as Arvari Parliament. Arvari Parliament has its own principle and rules to resolve water conflicts related to ownership of the river and use of the river water. The research findings also highlight the co-existence between conventional and modern practices in resolving conflicts.

Keywords: water, water pollution, water conflicts, water scarcity, conflict resolution, local community

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240 Concept Analysis of Professionalism in Teachers and Faculty Members

Authors: Taiebe Shokri, Shahram Yazdani, Leila Afshar, Soleiman Ahmadi

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Introduction: The importance of professionalism in higher education not only determines the appropriate and inappropriate behaviors and guides faculty members in the implementation of professional responsibilities, but also guarantees faculty members' adherence to professional principles and values, ensures the quality of teaching and facilitator will be the teaching-learning process in universities and will increase the commitment to meet the needs of students as well as the development of an ethical culture based on ethics. Therefore, considering the important role of medical education teachers to prepare teachers and students in the future, the need to determine the concept of professional teacher and teacher, and the characteristics of teacher professionalism, we have explained the concept of professionalism in teachers in this study. Methods: The concept analysis method used in this study was Walker and Avant method which has eight steps. Walker and Avant state the purpose of concept analysis as follows: The process of distinguishing between the defining features of a concept and its unrelated features. The process of concept analysis includes selecting a concept, determining the purpose of the analysis, identifying the uses of the concept, determining the defining features of the concept, identifying a model, identifying boundary and adversarial items, identifying the precedents and consequences of the concept, and defining empirical references. is. Results: Professionalism in its general sense, requires deep knowledge, insight, creating a healthy and safe environment, honesty and trust, impartiality, commitment to the profession and continuous improvement, punctuality, criticism, professional competence, responsibility, and Individual accountability, especially in social interactions, is an effort for continuous improvement, the acquisition of these characteristics is not easily possible and requires education, especially continuous learning. Professionalism is a set of values, behaviors, and relationships that underpin public trust in teachers.

Keywords: concept analysis, medical education, professionalism, faculty members

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239 Analysis of NMDA Receptor 2B Subunit Gene (GRIN2B) mRNA Expression in the Peripheral Blood Mononuclear Cells of Alzheimer's Disease Patients

Authors: Ali̇ Bayram, Semih Dalkilic, Remzi Yigiter

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N-methyl-D-aspartate (NMDA) receptor is a subtype of glutamate receptor and plays a pivotal role in learning, memory, neuronal plasticity, neurotoxicity and synaptic mechanisms. Animal experiments were suggested that glutamate-induced excitotoxic injuriy and NMDA receptor blockage lead to amnesia and other neurodegenerative diseases including Alzheimer’s disease (AD), Huntington’s disease, amyotrophic lateral sclerosis. Aim of this study is to investigate association between NMDA receptor coding gene GRIN2B expression level and Alzheimer disease. The study was approved by the local ethics committees, and it was conducted according to the principles of the Declaration of Helsinki and guidelines for the Good Clinical Practice. Peripheral blood was collected 50 patients who diagnosed AD and 49 healthy control individuals. Total RNA was isolated with RNeasy midi kit (Qiagen) according to manufacturer’s instructions. After checked RNA quality and quantity with spectrophotometer, GRIN2B expression levels were detected by quantitative real time PCR (QRT-PCR). Statistical analyses were performed, variance between two groups were compared with Mann Whitney U test in GraphpadInstat algorithm with 95 % confidence interval and p < 0.05. After statistical analyses, we have determined that GRIN2B expression levels were down regulated in AD patients group with respect to control group. But expression level of this gene in each group was showed high variability. İn this study, we have determined that NMDA receptor coding gene GRIN2B expression level was down regulated in AD patients when compared with healthy control individuals. According to our results, we have speculated that GRIN2B expression level was associated with AD. But it is necessary to validate these results with bigger sample size.

Keywords: Alzheimer’s disease, N-methyl-d-aspartate receptor, NR2B, GRIN2B, mRNA expression, RT-PCR

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238 Emerging Social Media Presence of International Organisations - Challenges and Opportunities

Authors: Laura Hervai

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One of the most significant phenomena of the 2000s was the emergence of social media sites and web 2.0 that revolutionized communication processes. Social networking platforms have fundamentally changed social and political participation of the public, which require organisations in the public and non-profit sector not only to adapt to these new trends but also to actively engage their audiences. Opportunity for interaction, freer expression of opinion and the proliferation of user generated content are major changes brought by web 2.0 technologies. Furthermore, due to the wide penetration of mobile technologies, social media sites are capable of connecting underdeveloped regions to the global flow of information. Taking advantage of these characteristics, organisations have the opportunity to engage much wider audiences, exploit new ways to raise awareness or reach out to regions that are difficult to access. The early adopters of these new communication tools soon recognized the need of developing social media guidelines for their organisations as well as the increased workload that they require. While ten years ago communication officers could handle their organisation’s social media presence, today it is a separate profession. International organisations face several challenges related to their social media presence. Early adopters have contributed to the development of best practices among which the ethics of social media usage still remained problematic. Another challenge for international organisations is to adapt to country-specific social media trends while they have to comply with the requirements of their parent organisation as well. However in the 21st century social media presence can be crucial to the successful operation of international organisations, their importance is still not taken seriously enough. The measurement of the effects and influence of social networking on the organisations’ productivity is an unsolved problem thus further research should focus on this matter. Research methods included primary research of major IGOs’ and NGOs’ social media presence and guidelines along with secondary research of social media statistics and scientific articles in the topic.

Keywords: international organisations, non-profit sector, NGO, social media, social network

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237 New Advanced Medical Software Technology Challenges and Evolution of the Regulatory Framework in Expert Software, Artificial Intelligence, and Machine Learning

Authors: Umamaheswari Shanmugam, Silvia Ronchi, Radu Vornicu

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that are able to use the large amount and variety of data generated during healthcare services every day. As we read the news, over 500 machine learning or other artificial intelligence medical devices have now received FDA clearance or approval, the first ones even preceding the year 2000. One of the big advantages of these new technologies is the ability to get experience and knowledge from real-world use and to continuously improve their performance. Healthcare systems and institutions can have a great benefit because the use of advanced technologies improves the same time efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and also to protect patients’ safety. The evolution and the continuous improvement of software used in healthcare must take into consideration the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device approval, but they are necessary to ensure performance, quality, and safety, and at the same time, they can be a business opportunity if the manufacturer is able to define in advance the appropriate regulatory strategy. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems.

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236 Learning through Reflective Practice of Nursing Students in the Delivery Room: A Qualitative Research

Authors: Peeranan Wisanskoonwong, Sumitta Sawangtook

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Practicum in Midwifery II is the subject that affects most students to be stressed and anxious because they lack of experiences and self-confidence in delivery baby. This study is a qualitative research. That research objectives were (1) to study learning through reflective practice of nursing students (2) to explain the effects of learning through reflective practice of nursing students in the delivery room. The selected key informant method was criterion-based selection. Thirty-two of fourth-year nursing students in Kuakarun Faculty of nursing who practiced in Delivery room at Taksin Hospital in academic year 2014 were selected. Data collection was data triangulation which consisted of in-depth interview, group discussion and reading students’ reflective practice journal. The research instruments were students’ reflective practice journal, semi-structured questionnaires for in-depth interview, group discussion. Data analysis was thematic analysis. The research result found that: The learning method through reflective practice of nursing students in the delivery room were (1) reflective practice journal (2) dialogue (3) critical thinking and problem solving (4) incident analysis (5) self-criticism (6) observation and evaluation of practice. There were eight issues that students learned through their reflective practice were that (1) students' ethics and morality. (2) students' knowledge and comprehension (3) creative thinking of students (4) communications and collaboration (5) experiential learning of students (6) students’memories and impressions (7) students’experience in delivery baby (8) self-learning of students. Learning through reflective practice supported students’ awareness in improving knowledge and learning continuously and systematically. It helped to adjust the attitude to learning and leadership to be careful which help develop their skills, including critical thinking and understand themselves and understand others. Recommendation for applying research results: midwifery and nursing lecturers can apply these results to be a guide for development their clinical teaching in delivery rooms and other wards.

Keywords: learning, reflection, birth, qualitative research

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235 Reliability of Movement Assessment Battery for Children-2 Age Band 3 Using Multiple Testers

Authors: Jernice S. Y. Tan

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Introduction: Reliability within and between testers is vital to ensure the accuracy of any motor assessment instrument. However, reliability checks of the Movement Assessment Battery for Children-2 (MABC-2) age band 3 using multiple testers assigned to different MABC-2 tasks for the same group of participants are uncommon. Multiple testers were not stated as a choice in the MABC-2 manual. Therefore, the purpose of this study was to determine the inter- and intra-tester reliability for using multiple testers to administer the test protocols of MABC-2 age band 3. Methods: Thirty volunteered adolescents (n = 30; 15 males, 15 females; age range: 13 – 16 years) performed the eight tasks in a randomised sequence at three different test stations for the MABC-2 task components (Manual Dexterity, Aiming and Catching, Balance). Ethics approval and parental consent were obtained. The participants were videotaped while performing the test protocols of MABC-2 age band 3. Five testers were involved in the data collection process. They were Sports Science graduating students doing their final year project and were supervised by experienced motor assessor. Inter- and intra-tester reliability checks using intra-class coefficient (ICC) were carried out using the videotaped data. Results: The inter-tester reliability between the five testers for the eight tasks ranged from rᵢcc = 0.705 to rᵢcc = 0.995. This suggests that the average agreement between them was considered good to excellent. With the exception of one tester who had rᵢcc = 0.687 for one of the eight tasks (i.e. zip-zap hopping), the intra-tester reliability within each tester ranged from rᵢcc = 0.728 to rᵢcc = 1.000, and this also suggested good to excellent consistency within testers. Discussion: The use of multiple testers with good intra-tester reliability for different test stations is feasible. This method allows several participants to be assessed concurrently at different test stations and saves overall data collection time. Therefore, it is recommended that the administering of MABC-2 with multiple testers should be extended to other age bands ensuring the feasibility of such method for other age bands.

Keywords: adolescents, MABC, motor assessment, motor skills, reliability

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234 Outcome at the Extreme of Viability: A Single-Centre Experience

Authors: Antonia Harold-Barry, Eugene Dempsey

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Background: The objective is to examine the survival and outcome of infants born under 26 weeks gestation in an Irish tertiary maternity hospital from 2007-2016 and to describe the survival and neurodevelopmental outcomes of these extremely preterm infants. Method: The population is 132 infants born at 23, 24, and 25 weeks in Cork University Maternity Hospital from 2007 to 2016. Ethical approval was granted by the Cork Clinical Research Ethics Committee. Patient details were obtained from the Vermont Oxford and Badger Networks. Survival rates and Bayley scores were calculated to assess neurodevelopmental outcomes. Statistical analysis with SPSS included frequencies, distributions, and comparisons between data from 2007-2011 and 2012-2016. Results: Overall survival rate was 63%. Of the surviving babies, 61% had Bayley scores calculated. Survival stood at 39% for delivery at 23 weeks, 50% at 24 weeks, and 83% at 25 weeks. The 2012 to 2016 cohort has shown further increases in survival, with 50% of babies at 23 weeks, 58% at 24 weeks, and 89% at 25 weeks. Corresponding figures for 2007-2011 are 20%, 39%, and 75%. Gestational age and incidence of periventricular leukomalacia were statistically significant, with a p-value of 0.022. Gestational age and delivery room deaths had a p-value of 0.025, as did gestational age and birth weight. A comparison of the two cohorts (2007-2011 and 2012-2016) with the administration of antenatal steroids showed a statistically significant p-value of 0.044. Conclusion: There is less morbidity and mortality in infants born at 25 than at 23 or 24 weeks. Survival of extremely premature infants has increased significantly over the past ten years. Survival rates with normal neurodevelopmental outcomes are comparable with international standards and reflect positive changes in attitude and practices in neonatal intensive care. This study will inform parents about the potential outcomes of extreme prematurity and policy regarding the management of extreme prematurity.

Keywords: extreme of viability, neurodevelopmental outcome, periventricular leukomalacia, prematurity

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

Authors: Awotidebe Taofeek, Oyinsuyi Oluwafunmbi

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

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

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

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

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

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

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

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

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

Keywords: HIV, children, India, disclosure

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

Authors: Bahram Soltani, Louai Ghazieh

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

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

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

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

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

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

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

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

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

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

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

Authors: Muhammed Shahriar Haque

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

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

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

Authors: Ying-Lun Tseng Chiu-Ying Chen

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

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

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225 Using Digital Innovations to Increase Awareness and Intent to Use Depo-Medroxy Progesterone Acetate-Subcutaneous Contraception among Women of Reproductive Age in Nigeria, Uganda, and Malawi

Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Introduction: Digital innovations have been useful in supporting a client’s contraceptive user journey from awareness to method initiation. The concept of contraceptive self-care is being promoted globally as a means for achieving universal access to quality contraceptive care; however, information about this approach is limited. An important determinant of the scale of awareness is the message construct, choice of information channel, and an understanding of the socio-epidemiological dynamics within the target audience. Significant gains have been made recently in expanding the awareness base of DMPA-SC -a relatively new entrant into the family planning method mix. The cornerstone of this success is a multichannel promotion campaign themed Discover your Power (DYP). The DYP campaign combines content marketing across select social media platforms, chatbots, Cyber-IPC, Interactive Voice Response (IVR), and radio campaigns. Methodology: During implementation, the project monitored predefined metrics of awareness and intent, such as the number of persons reached with the messages, the number of impressions, and meaningful engagement (link-clicks). Metrics/indicators are extracted through native insight/analytics tools across the various platforms. The project also enlists community mobilizers (CMs) who go door-to-door and engage WRA to advertise DISC’s online presence and support them to engage with IVR, digital companion (chatbot), Facebook page, and DiscoverYourPower website. Results: The result showed that the digital platforms recorded 242 million impressions and reached 82 million users with key DMPA-SC self-injection messaging in the three countries. As many as 3.4 million persons engaged (liked, clicked, shared, or reposted) digital posts -an indication of intention. Conclusion: Digital solutions and innovations are gradually becoming the archetype for the advancement of the self-care agenda. Digital innovations can also be used to increase awareness and normalize contraceptive self-care behavior amongst women of reproductive age if they are made an integral part of reproductive health programming.

Keywords: digital transformation, health systems, DMPA-SC, family planning, self-care

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224 Corporate Governance and Corporate Social Responsibility: Research on the Interconnection of Both Concepts and Its Impact on Non-Profit Organizations

Authors: Helene Eller

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The aim of non-profit organizations (NPO) is to provide services and goods for its clientele, with profit being a minor objective. By having this definition as the basic purpose of doing business, it is obvious that the goal of an organisation is to serve several bottom lines and not only the financial one. This approach is underpinned by the non-distribution constraint which means that NPO are allowed to make profits to a certain extent, but not to distribute them. The advantage is that there are no single shareholders who might have an interest in the prosperity of the organisation: there is no pie to divide. The gained profits remain within the organisation and will be reinvested in purposeful projects. Good governance is mandatory to support the aim of NPOs. Looking for a measure of good governance the principals of corporate governance (CG) will come in mind. The purpose of CG is direction and control, and in the field of NPO, CG is enlarged to consider the relationship to all important stakeholders who have an impact on the organisation. The recognition of more relevant parties than the shareholder is the link to corporate social responsibility (CSR). It supports a broader view of the bottom line: It is no longer enough to know how profits are used but rather how they are made. Besides, CSR addresses the responsibility of organisations for their impact on society. When transferring the concept of CSR to the non-profit area it will become obvious that CSR with its distinctive features will match the aims of NPOs. As a consequence, NPOs who apply CG apply also CSR to a certain extent. The research is designed as a comprehensive theoretical and empirical analysis. First, the investigation focuses on the theoretical basis of both concepts. Second, the similarities and differences are outlined and as a result the interconnection of both concepts will show up. The contribution of this research is manifold: The interconnection of both concepts when applied to NPOs has not got any attention in science yet. CSR and governance as integrated concept provides a lot of advantages for NPOs compared to for-profit organisations which are in a steady justification to show the impact they might have on the society. NPOs, however, integrate economic and social aspects as starting point. For NPOs CG is not a mere concept of compliance but rather an enhanced concept integrating a lot of aspects of CSR. There is no “either-nor” between the concepts for NPOs.

Keywords: business ethics, corporate governance, corporate social responsibility, non-profit organisations

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223 Identification of Information War in Lithuania

Authors: Vitalijus Leibenka

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After 2014 the world of Russia’s actions in annexing Crimea has seen a hybrid war that has helped Russia achieve its goals. The world and NATO nations have pointed out that hybrid action can help achieve not only military but also economic and political goals. One of the weapons of action in hybrid warfare is information warfare tools, the use of which helps to carry out actions in the context of hybrid warfare as a whole. In addition, information war tools can be used alone, over time and for long-term purposes. Although forms of information war, such as propaganda and disinformation, have been used in the past, in old conflicts and wars, new forms of information war have emerged as a result of technological development, making the dissemination of information faster and more efficient. The world understands that information is becoming a weapon, but not everyone understands that both information war and information warfare differ in their essence and full content. In addition, the damage and impact of the use of information war, which may have worse consequences than a brief military conflict, is underestimated. Lithuania is also facing various interpretations of the information war. Some believe that the information attack is an information war and the understanding of the information war is limited to a false message in the press. Others, however, deepen and explain the essence of the information war. Society has formed in such a way that not all people are able to assess the threats of information war, to separate information war from information attack. Recently, the Lithuanian government has been taking measures in the context of the information war, making decisions that allow the development of the activities of the state and state institutions in order to create defense mechanisms in the information war. However, this is happening rather slowly and incompletely. Every military conflict, related to Lithuania in one way or another, forces Lithuanian politicians to take up the theme of information warfare again. As a result, a national cyber security center is being set up, and Russian channels spreading lies are banned. However, there is no consistent development and continuous improvement of action against information threats. Although a sufficiently influential part of society (not a political part) helps to stop the spread of obscure information by creating social projects such as “Demaskuok” and “Laikykis ten su Andriumi tapinu”, it goes without saying that it will not become a key tool in the fight against information threats. Therefore, in order to achieve clean dissemination of information in Lithuania, full-fledged and substantial political decisions are necessary, the adoption of which would change the public perception of the information war, its damage, impact and actions that would allow to combat the spread. Political decisions should cover the educational, military, economic and political areas, which are one of the main and most important in the state, which would allow to fundamentally change the situation against the background of information war.

Keywords: information war, information warfare, hybrid war, hybrid warfare, NATO, Lithuania, Russia

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