Search results for: parents' perspectives
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2437

Search results for: parents' perspectives

757 A Correlational Study between Sexual Awareness, Behaviour and Sources of Sexual Knowledge among Youth in Context of Bihar

Authors: Kanika Naresh Singh, Uday Shankar

Abstract:

Background: Human behaviours are influenced by drives. Sexual drive is one of them. Education regarding sexual behaviour plays a great role in shaping one’s attitude towards it. These days after attaining the age of puberty, adolescents are confused and feel shy to talk about it. In order to get information, they refer to various types of sources and these sources play a greater role in spreading awareness in the mass adolescent population. Sometimes it also leads to the building of myths and misconceptions. Due to increasing incidences of HIV/AIDS, RTIs/STIs and teenage pregnancies, there is a rising need to impart sex education. Aim: The aim of this research was to study the level of sexual awareness among the youth of Bihar and also study their sexual behaviour and sources of influence. It also aims to study the correlation between sexual awareness, behaviour and sources of sexual knowledge among youth in Bihar. Methods: The sample size for the project was 50 youth consisting of both boys and girls, in between the age group of 18 to 23 years from urban and semi-urban areas. The purposive sampling method was used in the research. The tools used were the Sexual Awareness Questionnaire and Sexual Behavior and Sources of Influence (SBSI) scale. The sexual Awareness Questionnaire was developed by Snell, having 35 items. A socio-demographic data sheet was also used. Results: The youth had poor sexual awareness. Internet and Friends were found to be the major source for gathering information. The youth of Bihar were less inclined towards resolving their doubts with their parents. There was a positive correlation between sexual awareness, behaviour and sources of knowledge. Conclusion: The youth of Bihar has poor sexual knowledge. Internet and Friends are major sources of information. Sex Education should be promoted as suggested by various institutions like World Health Organization United Nations. Psychiatrists and psychologists have a key leadership role in introducing these potentially emotionally challenging issues to the youth with consideration of psychosocial and cultural factors.

Keywords: sexual awareness, sexual behavior, sources of influence, youths, Bihar, India

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756 The Relationship between Resilient Qualities and Health Management in Video Testimonials of Adolescents and Young Adults with Cancer

Authors: A. Sainvil, J. Mallela, L. M. Pereira

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Adolescents and young adults (AYA) diagnosed with cancer are tasked with managing their health through treatment, a time when reliance on and independence from parents may change in unexpected ways. Resilience allows patients to cope and manage their own health through treatment, promoting motivation and a healthier lifestyle. The film acts as a source of reflection through the cancer journey, which may have an impact on how patients cope. The current research investigated relationships between resilient linguistic qualities of the video narratives and attitudes toward personal health management. N=24 patients diagnosed between ages 11-18 were recruited. First, participants provided demographic information, then made a video testimonial about their cancer experience. After filming, participants then completed a questionnaire on the perceived benefits for themselves and others for making the video. Videos were transcribed and analyzed for thematic content via codebook and for linguistic qualities, indicating resilience with the use of the Linguistic Inquiry and Word Count Analysis Program (LIWC). Linear regressions were then calculated to explore relationships between resilient qualities, thematic content, and participants’ perceptions of their medical team and willingness to care for themselves. Participants who spoke with greater narrator connectedness were more likely to change their view of their medical team (β=.628 p=.034). When a participant believed that providers were likely to view their video, they were marginally more likely to want to take better care of themselves (β=.367, p=.078). Participants who spoke in depth about their health reported higher intention to take better care of themselves (β=.785, p=.033). AYAs with cancer who showcased certain resilient qualities within their narrative were more likely to consider taking better care of themselves. Additionally, the more patients reflected on their health, the more they wanted to take better care of themselves. These relationships were stronger when a patient believed that a provider would watch their video. Study findings highlight the utility of film in uncovering aspects of resilience and coping that may lead to healthier behaviors in AYAs with cancer.

Keywords: adolescents, cancer, resilience, health management

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755 Students with Hearing Impairment and Their Access to Inclusive Education in Nagpur City, India: An Exploratory Study

Authors: Avanika Gupta

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Education plays a significant and remedial role in balancing the socio-economic fabric of a country. Inclusive education is considered as the most appropriate mode of teaching students with hearing impairment (SwHI) by various national and international legislations. But inclusive education is still an evolving concept among the disability studies scholars and policy makers in India. The study aimed to examine accessibility of SwHI in mainstream schools if there are special provisions for SwHI. The study also intended to identify if the provisions are same for deaf and hard-of-hearing students. Using stratified random sampling technique, a school was selected from each of the six administrative zones of Nagpur city. All the selected schools had primary and secondary level education and were co-educational in nature. Interview with principals of these schools and focused-group- observation method showcased lack of accessibility for SwHI in attending schools. Not even a single school had a hearing impaired student, either deaf or hard-of-hearing depicting the double marginalization of SwHI. This is despite the fact that the right to education is a fundamental right in India, and national legislation on disability has special provisions for ensuring educational opportunities to SwHI. None of the schools even had an Indian Sign Language (ISL) instructor. Both observations seemed cause and effect of one another. One of the principals informed that they have seats for all students with disabilities but they usually lie vacant due to lack of awareness among the parents. One school had 2 students with locomotive impairment while another had a student with visual impairment. Principals of two special schools were also interviewed to understand the reason behind the low enrollment rate of SwHI in mainstream schools. Guardian preference, homogeneity, relatable faculty, familiar environment were some of the chief reasons mentioned. Few suggestions for the policymakers, teachers, guardians and the students are also recommended so that Indian education system could become inclusive in true sense.

Keywords: deaf, hard-of-hearing, inclusive education, India, Nagpur, students with hearing impairment

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754 Prostitution in Colonial Bengal: Autobiographical Articulations and Fictional Representations

Authors: Aparna Bandyopadhyay

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The proposed paper will examine how prostitution produced a vast corpus of literature in colonial Bengal. This corpus included autobiographical accounts by prostitutes themselves. While the authenticity of some of these has, at times, been doubted by contemporary observers, the sheer magnitude of such narrative prose demands critical attention. Many of these autobiographical narratives focused on the prostitute’s early life within respectable society and then proceeded to delineate the transgressions and the inescapable chain of circumstances that eventually rendered her a prostitute. Significantly, these serve to corroborate the findings of official investigations regarding the circumstances that led upper-caste Hindu women in Bengal to embrace prostitution in this period. The literary corpus that dwelt on prostitution also included a vast volume of fiction penned by celebrated writers. These foregrounded a prostitute as the central protagonist, telling the life-stories of prostitutes and the circumstances that made them what they were. Novels and short stories often represented the prostitute as an affective being – an individual capable of deep emotions despite her profession. She was seldom a person who had voluntarily embraced prostitution. She was always a figure of helplessness and suffering, a woman whose desire to love and be loved transcended the carnality of her livelihood. She was an outcast, but she experienced the entire repertoire of emotions experienced by her respectable counterparts. The proposed paper will examine the trends and characteristics of the available repertoire of prostitute-oriented literature in late colonial Bengal. It will begin by focusing on the existing perspectives on the origins of prostitution in late colonial Bengal. It will proceed to discuss the literary corpus supposedly penned by prostitutes themselves and then focus on the manner in which some of the stalwarts of high literature represented the prostitute in their literary creations.

Keywords: emotions, literature, prostitution, transgression

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753 Furniture Embodied Carbon Calculator for Interior Design Projects

Authors: Javkhlan Nyamjav, Simona Fischer, Lauren Garner, Veronica McCracken

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Current whole building life cycle assessments (LCA) primarily focus on structural and major architectural elements to measure building embodied carbon. Most of the interior finishes and fixtures are available on digital tools (such as Tally); however, furniture is still left unaccounted for. Due to its repeated refreshments and its complexity, furniture embodied carbon can accumulate over time, becoming comparable to structure and envelope numbers. This paper presents a method to calculate the Global Warming Potential (GWP) of furniture elements in commercial buildings. The calculator uses the quantity takeoff method with GWP averages gathered from environmental product declarations (EPD). The data was collected from EPD databases and furniture manufacturers from North America to Europe. A total of 48 GWP numbers were collected, with 16 GWP coming from alternative EPD. The finalized calculator shows the average GWP of typical commercial furniture and helps the decision-making process to reduce embodied carbon. The calculator was tested on MSR Design projects and showed furniture can account for more than half of the interior embodied carbon. The calculator highlights the importance of adding furniture to the overall conversation. However, the data collection process showed a) acquiring furniture EPD is not straightforward as other building materials; b) there are very limited furniture EPD, which can be explained from many perspectives, including the EPD price; c) the EPD themselves vary in terms of units, LCA scopes, and timeframes, which makes it hard to compare the products. Even though there are current limitations, the emerging focus on interior embodied carbon will create more demand for furniture EPD. It will allow manufacturers to represent all their efforts on reducing embodied carbon. In addition, the study concludes with recommendations on how designers can reduce furniture-embodied carbon through reuse and closed-loop systems.

Keywords: furniture, embodied carbon, calculator, tenant improvement, interior design

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752 Exploring Leadership Adaptability in the Private Healthcare Organizations in the UK in Times of Crises

Authors: Sade Ogundipe

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The private healthcare sector in the United Kingdom has experienced unprecedented challenges during times of crisis, necessitating effective leadership adaptability. This qualitative study delves into the dynamic landscape of leadership within the sector, particularly during crises, employing the lenses of complexity theory and institutional theory to unravel the intricate mechanisms at play. Through in-depth interviews with 25 various levels of leaders in the UK private healthcare sector, this research explores how leaders in UK private healthcare organizations navigate complex and often chaotic environments, shedding light on their adaptive strategies and decision-making processes during crises. Complexity theory is used to analyze the complicated, volatile nature of healthcare crises, emphasizing the need for adaptive leadership in such contexts. Institutional theory, on the other hand, provides insights into how external and internal institutional pressures influence leadership behavior. Findings from this study highlight the multifaceted nature of leadership adaptability, emphasizing the significance of leaders' abilities to embrace uncertainty, engage in sensemaking, and leverage the institutional environment to enact meaningful changes. Furthermore, this research sheds light on the challenges and opportunities that leaders face when adapting to crises within the UK private healthcare sector. The study's insights contribute to the growing body of literature on leadership in healthcare, offering practical implications for leaders, policymakers, and stakeholders within the UK private healthcare sector. By employing the dual perspectives of complexity theory and institutional theory, this research provides a holistic understanding of leadership adaptability in the face of crises, offering valuable guidance for enhancing the resilience and effectiveness of healthcare leadership within this vital sector.

Keywords: leadership, adaptability, decision-making, complexity, complexity theory, institutional theory, organizational complexity, complex adaptive system (CAS), crises, healthcare

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751 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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750 Organ Transplantation in Pakistan from an Anthropological Perspectives

Authors: Qurratulain Faheem

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The human body often serves as a reference point to analyse the notions of self and society. Situating on Merleau-Ponty and Bourdieu theories of embodiments, this research explores the notions around the human body and its influence on the ethical considerations in regards to organ transplantation among the Muslim communities in Pakistan. The context of Pakistan makes an intriguing case study as cadaveric organ transplantation is not in practise. Whereas living organ transplantation is commonly is practised between family membersonly. These contradictory practices apparently rests on the ideologies around the human body and religious beliefs as well the personal judgements and authority of healthcare professionals. This research is a year-long ethnographic study carried out as part of doctoral studies. An anthropological approach towards organ transplantation in Pakistan brought forward various socio-cultural notions around the human body and selfhood that serve as a framework around biomedical ethical issues in various societies. Further, it surface the contradictions and issues associated with organ transplantation that makes it a dilemma situated in a nexus of various socio-cultural and political factors rather seeing it as an isolated health concern. This research is a novel study on the subject of organ transplantation in the context of Pakistan but also put forward ethnographic data that could serve as a reference in other religious societies. Further, the ethnographic data bring forward experiences and stories of organ receivers, organ donors, religious leaders, healthcare professionals, and the general public, which aspire to encourage biomedical ethicists and social-scientists to consider ethnography as a research methodology and rely upon people’s lived experiences while establishing policies and practices around biomedical ethical issues.

Keywords: organ transplantation, ethics, pakistan, gender, islam, muslims, living organ donation

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749 A Case Study of Kinesthetic Intelligence Development Intervention on One Asperger Child

Authors: Chingwen Yeh, I. Chen Huang

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This paper aims to conduct a case study on kinesthetic intelligence development intervention with a child who has Asperger symptom identified by physician. First, the characteristics of Asperger were defined based on the related literature. Some Asperger's people are born with outstanding insight and are good at solving complex and difficult problems. In contrast to high-functioning autistic, Asperger children do not lose their ability to express themselves verbally. However in the cognitive function, they focus mainly on the things they are interested in instead of paying attention to the whole surrounding situation. Thus it is difficult for them not only to focus on things that they are not interesting in, but also to interact with people. Secondly, 8-weeks of kinesthetic intelligence development courses were designed within a series of physical action that including the following sections: limbs coordination, various parts of body rhythm changes, strength and space awareness and breathing practice. In classroom observations were recorded both on words and with video as the qualitative research data. Finally, in-depth interview with the case child’s teachers, parents and other in class observers were documented on a weekly base in order to examine the effectiveness of before and after the kinesthetic intelligence development course and to testify the usefulness of the lesson plan. This research found that the case child has improved significantly in terms of attention span and body movement creativity. In the beginning of intervention, the case child made less eyes contact with others. The instructor needed to face the case child to confirm the eyes contact. And the instructor also used various adjective words as guiding language for all kinds of movement sequence practice. The result can cause the case child’s attention and learning motivation. And the case child understand what to do to enhance kinesthetic intelligence. These authors hope findings of this study can contribute as reference for the further research on the related topic.

Keywords: asperger symptom, body rhythm, kinesthetic intelligence, space awareness

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748 ISO 9001:2008 Effectiveness on the Performance of Public Organizations in Oman

Authors: Said Rashid Aal Abdulsallam

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The purpose of this paper is to measure ISO 9001:2008 effectiveness and determines its impact on the performance dimensions in terms of service quality, operational performance and customer satisfaction from the perspectives of both service providers and receivers. The paper is based on an empirical study carried out on all the ISO 9001:2008 certified departments in the Ministry of Education in the Sultanate of Oman. Data were obtained from the certified departments and their equivalent clients through two structured online questionnaires. Exploratory factor analyses are applied to extract the underlying factors of the indicators of ISO 9001 objectives and performance dimensions. Multiple linear regression analyses are also applied in order to determine the impact of ISO 9001 effectiveness on the performance dimensions of the certified departments. The study sample includes all the ISO 9001 certified departments in the Ministry of Education. The study instruments used target both the service providers as well as the service receivers with the purpose of alleviating the subjective nature of the data collected from the service providers who may be biased in favour of ISO 9001 quality management system or their performance. The findings of the study verify the effectiveness of the application of ISO 9001:2008 quality management system. Additionally, the study reveals that the ISO 9001 certified departments have achieved the ISO 9001 the standard's objectives including prevention of nonconformities, continuous improvement and customer satisfaction focus at different rates. The study also proves that there is a significant relation between the achievement of the ISO 9001 standard objectives and the operational performance of the departments. Even though the operational performance service quality of the ISO 9001 certified departments has substantially improved from the perspective of the departments, the customer satisfaction has not notably increased from the perspective of the service receivers.

Keywords: iso 9001, customer satisfaction, operational performance, public organization, quality management

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747 Distributive Justice through Constitution

Authors: Rohtash

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Academically, the concept of Justice in the literature is vast, and theories are voluminous and definitions are numerous but it is very difficult to define. Through the ages, justice has been evolving and developing reasoning that how individuals and communities do the right thing that is just and fair to all in that society. Justice is a relative and dynamic concept, not absolute one. It is different in different societies based on their morality and ethics. The idea of justice cannot arise from a single morality but interaction of competing moralities and contending perspectives. Justice is the conditional and circumstantial term. Therefore, justice takes different meanings in different contexts. Justice is the application of the Laws. It is a values-based concept in order to protect the rights and liberties of the people. It is a socially created concept that has no physical reality. It exists in society on the basis of the spirit of sharing by the communities and members of society. The conception of justice in society or among communities and individuals is based on their social coordination. It can be effective only when people’s judgments are based on collective reasoning. Their behavior is shaped by social values, norms and laws. People must accept, share and respect the set of principles for delivering justice. Thus justice can be a reasonable solution to conflicts and to coordinate behavior in society. The subject matter of distributive justice is the Public Good and societal resources that should be evenly distributed among the different sections of society on the principles developed and established by the State through legislation, public policy and Executive orders. The Socioeconomic transformation of the society is adopted by the constitution within the limit of its morality and gives a new dimension to transformative justice. Therefore, both Procedural and Transformative justice is part of Distributive justice. Distributive justice is purely an economic phenomenon. It concerns the allocation of resources among the communities and individuals. The subject matter of distributive justice is the distribution of rights, responsibilities, burdens and benefits in society on the basis of the capacity and capability of individuals.

Keywords: distributive justice, constitutionalism, institutionalism, constitutional morality

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746 Perspectives on the Role of Stakeholder Engagement and Community Participation in River Basin Management in South Africa: A Study of the Hennops River

Authors: Lucien N. James, Mulala D. Simatele

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As a country that already faces hydrological and climatological challenges, South Africa’s socio-economic situation only complicates water resource management. This is observable through the state of rivers in the Gauteng Province such as the Hennops and Jukskei which are plagued by pollution from surrounding urban areas. While communities in the Hennops River basin contribute to its degradation, their potential in improved water resource management strategies is yet to be established. Therefore, the aim of this study was to investigate the myriad of ways in which stakeholder and community engagement, mobilisation, as well as participation can be harnessed in contested urban spaces to facilitate a sustainable management system for river basins. Through meetings, clean-up campaigns, and a community workshop, the community of Tembisa and several key informants were engaged. The role of communities and their perceptions on an integrated and participatory approach to solving the Hennops River basin’s current pollution crisis were therefore explored. The findings of this study suggest that meaningful participation is tied to the level of awareness within communities as well as the amount of support attributed to active involvement through the initiatives of stakeholders such as NonGovernmental Organisations. For meaningful participation to take place, more needs to be done to shift communities away from a “bystander” position to a more active role. An approach to community engagement is therefore proposed arguing for the further support of stakeholder-driven initiatives and the raising of awareness around environmental challenges in poorer communities. The findings of this study demonstrate the value of engagement with stakeholders and communities, highlighting ways through which better water management and environmental governance can be achieved in South Africa.

Keywords: community participation, integrated water resource management, river basin management, stakeholder engagement

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745 Family Firms Performance: Examining the Impact of Digital and Technological Capabilities using Partial Least Squares Structural Equation Modeling and Necessary Condition Analysis

Authors: Pedro Mota Veiga

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This study comprehensively evaluates the repercussions of innovation, digital advancements, and technological capabilities on the operational performance of companies across fifteen European Union countries following the initial wave of the COVID-19 pandemic. Drawing insights from longitudinal data sourced from the 2019 World Bank business surveys and subsequent 2020 World Bank COVID-19 follow-up business surveys, our extensive examination involves a diverse sample of 5763 family businesses. In exploring the relationships between these variables, we adopt a nuanced approach to assess the impact of innovation and digital and technological capabilities on performance. This analysis unfolds along two distinct perspectives: one rooted in necessity and the other insufficiency. The methodological framework employed integrates partial least squares structural equation modeling (PLS-SEM) with condition analysis (NCA), providing a robust foundation for drawing meaningful conclusions. The findings of the study underscore a positive influence on the performance of family firms stemming from both technological capabilities and digital advancements. Furthermore, it is pertinent to highlight the indirect contribution of innovation to enhanced performance, operating through its impact on digital capabilities. This research contributes valuable insights to the broader understanding of how innovation, coupled with digital and technological capabilities, can serve as pivotal factors in shaping the post-COVID-19 landscape for businesses across the European Union. The intricate analysis of family businesses, in particular adds depth to the comprehension of the dynamics at play in diverse economic contexts within the European Union.

Keywords: digital capabilities, technological capabilities, family firms performance, innovation, NCA, PLS-SEM

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744 Re-Visiting Rumi and Iqbal on Self-Enhancement for Social Responsibility

Authors: Javed Y. Uppal

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The background of this study is the great degree of stress that the world is experiencing today, internationally among the countries, within a community among people, and even individually within one’s own self. The significance of the study is the attempt to find a solution of this stress in the philosophy of the olden times of Jalaluddin Rumi and comparatively recently of that of Allama Iqbal. The methodology adopted in this paper is firstly exploration of the perspectives of these philosophers that are being consolidated by a number of psychic and spiritual experts of today, who are being widely read but less followed. This paper further goes on presenting brief life sketches of Rumi and Iqbal. It expounds the key concepts proposed by them and the social change that was resulted in the times of the two above mentioned metaphysical philosophers. It is further amplified that with the recent advancements, in both metaphysics and the physical sciences, the gap between the two is closing down. Both Rumi and Iqbal emphasized their common essence. The old time's concepts, postulates, and philosophies are hence once again becoming valid. The findings of this paper are that the existence of human empathy, affection and mutual social attraction among humans is still valid. The positive inner belief system that dictates our thoughts and actions is vital. As a conclusion, empathy should enable us solving our problems collectively. We need to strengthen our inner communication system, to listen to the messages that come to our inner-selves. We need to get guidance and strength from them. We need to value common needs and purposes collectively to achieve results. Spiritual energy among us is to be harnessed and utilized. Connectivity is to be recognized to unify and strengthen ties among people. Mutual bonding at small and large group levels is to be employed for the survival of the disadvantaged, and sustainability of the empowering trends. With the above guidelines, hopefully, we can define a framework towards a brave and happy new humane world.

Keywords: belief system, connectivity, human empathy, inner-self, mutual bonding, spiritual energy

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743 Homosexuality and Culture: A Case Study Depicting the Struggles of a Married Lady

Authors: Athulya Jayakumar, M. Manjula

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Though there has been a shift in the understanding of homosexuality from being a sin, crime or pathology in the medical and legal perspectives, the acceptance of homosexuality still remains very scanty in the Indian subcontinent. The present case study is a 24-year-old female who has completed a diploma in polytechnic engineering and residing in the state of Kerala. She initially presented with her husband with complaints of lack of sexual desire and non-cooperation from the index client. After an initial few sessions, the client revealed, in an individual session, about her homosexual orientation which was unknown to her family. She has had multiple short-term relations with females and never had any heterosexual orientation/interest. During her adolescence, she was wondering if she could change herself into a male. However, currently, she accepts her gender. She never wanted a heterosexual marriage; but, had to succumb to the pressure of mother, as a result of a series of unexpected incidents at home and had to agree for the marriage, also with a hope that she may change herself into a bi-sexual. The client was able to bond with the husband emotionally but the multiple attempts at sexual intercourse, at the insistence of the husband, had always been non-pleasurable and induced a sense of disgust. Currently, for several months, there has not been any sexual activity. Also, she actively avoids any chance to have a warm communication with him so that she can avoid chances of him approaching her in a sexual manner. The case study is an attempt to highlight the culture and the struggles of a homosexual individual who comes to therapy for wanting to be a ‘normal wife’ despite having knowledge of legal rights and scenario. There is a scarcity of Indian literature that has systematically investigated issues related to homosexuality. Data on prevalence, emotional problems faced and clinical services available are sparse though it is crucial for increasing understanding of sexual behaviour, orientation and difficulties faced in India.

Keywords: case study, culture, cognitive behavior therapy, female homosexuality

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742 Antecedents of MNE Performance and Managing Firm-Specific and Country-Specific Advantages: An Empirical Study of Optoelectronics Industry in Taiwan

Authors: Jyh-Yi Shih, Chie-Bein Chen, Kuang-Yi Lin, Yu-Wei Huang

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Because of the trend toward globalization, Taiwanese companies have gradually focused more on overseas market operations. Overseas market performance has gradually increased as a proportion of Taiwanese companies’ total business revenues. Existing international investment theories cannot explain numerous new phenomena in this domain. Opinions are inconsistent, and contradictory positions exist regarding the antecedents of multinational enterprise (MNE) performance. This study applied contemporary internalization theory to establish and extend approaches adopted by previous relevant studies. In the context of the overseas market, the influence that MNE investment in research and development (R&D) and marketing has on enterprise performance was investigated from the firm-specific advantages (FSAs) and country-specific advantages (CSAs) perspectives. CSAs and internationalization speed were addressed as moderators, and hypotheses regarding how internationalization and performance were achieved through MNE overseas market operation were explored to ensure the completeness of the investigation. The list of enterprises was sourced from the Taiwan Economic Journal. After examining the relevant data, the following conclusions were obtained: (a) The relationship between the level of FSAs in R&D and enterprise performance exhibited an S-shaped curve. (b) The relationship between the level of FSAs in marketing and enterprise performance displayed a U-shaped curve. (c) The extent to which potential CFAs were obtained positively moderated the relationship between enterprise investment in R&D to gain FSAs and MNE performance. (d) Internationalization speed positively moderated the relationship between MNEs and enterprise investment in R&D and marketing to gain FSAs.

Keywords: multinational corporation, firm-specific advantages, country-specific advantages, international speed

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741 Understanding the Impact of Ambience, Acoustics, and Chroma on User Experience through Different Mediums and Study Scenarios

Authors: Mushty Srividya

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Humans that inhabit a designed space consciously or unconsciously accept the spaces which have an impact on how they perceive, feel and act accordingly. Spaces that are more interactive and communicative with the human senses become more interesting. Interaction in architecture is the art of building relationships between the user and the spaces. Often spaces are form-based, function-based or aesthetically pleasing spaces but they are not interactive with the user which actually has a greater impact on how the user perceives the designed space and appreciate it. It is very necessary for a designer to understand and appreciate the human character and design accordingly, wherein the user gets the flexibility to explore and experience it for themselves rather than the designed space dictating the user how to perceive or feel in that space. In this interaction between designed spaces and the user, a designer needs to understand the spatial potential and user’s needs because the design language varies with varied situations in accordance with these factors. Designers often have the tendency to construct spaces with their perspectives, observations, and sense the space in their range of different angles rather than the users. It is, therefore, necessary to understand the potential of the space by understanding different factors and improve the quality of space with the help of creating better interactive spaces. For an interaction to occur between the user and space, there is a need for some medium. In this paper, light, color, and sound will be used as the mediums to understand and create interactions between the user and space, considering these to be the primary sources which would not require any physical touch in the space and would help in triggering the human senses. This paper involves in studying and understanding the impact of light, color and sound on different typologies of spaces on the user through different findings, articles, case studies and surveys and try to get links between these three mediums to create an interaction. This paper also deals with understanding in which medium takes an upper hand in a varied typology of spaces and identify different techniques which would create interactions between the user and space with the help of light, color, and sound.

Keywords: color, communicative spaces, human factors, interactive spaces, light, sound

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740 The Contribution of the Lomé Charter to Combating Trafficking in Arms at Sea: Nigerian and South African Legal Perspectives

Authors: Obinna Emmanuel Nkomadu

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Many illegal activities take place on the sea, including trafficking in arms, which constitutes one of the major threats to maritime security. Indeed, the dissemination of arms has hampered the peaceful settlement of many States in Africa, fuelled disputes into armed conflicts, and contributed to the prolongation of armed conflicts in many African States. The absence of international standards on the importation, exportation, and transfer of conventional arms is a contributory factor to conflict, displacement of people, crime, and terrorism on the continent of Africa, which in turn undermines peace, safety, security, stability, and sustainable development. South Africa and Nigeria have taken steps to address the illicit arms, but, despite those steps, arms trafficking at sea continues. To suppress the illicit arms and to combat a number of other threats to maritime security around the continent of Africa, the majority of AU members in 2016 adopted the African Charter on Maritime Security and Safety and Development in Africa (“the Lomé Charter”). However, the Lomé Charter is yet to come into force. This paper set out the pre-existing international legal instruments on arms to ascertain the domestic laws of South Africa and Nigeria relating to arms with the relevant provisions of the Charter in order to establish whether any legal steps are required to ensure that South Africa and Nigeria comply with its obligations under the Lomé Charter should it decide to ratify it. The legal steps include cooperating in establishing policies, as well as a regional and continental institution, and ensuring the implementation of such policies. The paper concludes ratifying the Lomé Charter is a step in the right direction in suppressing arms trafficking at sea, in addition to filling those gaps or limitations in their relevant legislation.

Keywords: cooperation against arms trafficking at sea, Lomé Charter, maritime security, Nigerian and South Africa legislation on arms

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739 Second Generation Mozambican Migrant Youth’s Identity and Sense of Belonging: The Case of Hluvukani Village in Bushbuckridge, Mpumalanga

Authors: Betty Chiyangwa

Abstract:

This is a work in progress project focused on exploring the complexities surrounding the second generation Mozambican migrant youth’s experiences to construct their identity and develop a sense of belonging in post-apartheid, Bushbuckridge in South Africa. Established in 1884, Bushbuckridge is one of the earliest districts to accommodate Mozambicans who migrated to South Africa in the 1970s. Bushbuckridge as a destination for Mozambican migrants is crucial to their search for social freedom and space to “belong to.” The action of deliberately seeking freedom is known as an act of agency. Four major objectives govern the paper. The first objective observes how second-generation Mozambican migrant youth living in South Africa negotiate and construct their own identities. Secondly, it explores second-generation Mozambican migrant youth narratives regarding their sense of belonging in South Africa. Thirdly, the study intends to understand how social processes of identity and belonging influence second-generation Mozambican migrant youth experiences and future aspirations in South Africa. The last objective examines how Sen’s Capability approach is relevant in understanding second-generation Mozambican migrant youth identity and belonging in South Africa. This is a single case study informed by data from semi-structured interviews and narratives with youth between the ages of 18 and 34 who are born and raised in South Africa to at least one former Mozambican refugee parent living in Bushbuckridge. Drawing from Crenshaw’s Intersectionality and Sen’s Capability approaches, this study significantly contributes to the existing body of knowledge on South to South migration by demonstrating how both approaches can be operationalized towards understanding complex experiences and capabilities of the disadvantaged group simultaneously. The subject of second-generation migrants is often under-researched in South African migration; thus, their perspectives have been marginalized in Social Science research.

Keywords: second-generation, Mozambican, migrant, youth, bushbuckridge

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738 Biases in Macroprudential Supervision and Their Legal Implications

Authors: Anat Keller

Abstract:

Given that macro-prudential supervision is a relatively new policy area and its empirical and analytical research are still in their infancy, its theoretical foundations are also lagging behind. This paper contributes to the developing discussion on effective legal and institutional macroprudential supervision frameworks. In the first part of the paper, it is argued that effectiveness as a key benchmark poses some challenges in the context of macroprudential supervision such as the difficulty in proving causality between supervisory actions and the achievement of the supervisor’s mission. The paper suggests that effectiveness in the macroprudential context should, therefore, be assessed at the supervisory decision-making process (to be differentiated from the supervisory outcomes). The second part of the essay examines whether insights from behavioural economics can point to biases in the macroprudential decision-making process. These biases include, inter alia, preference bias, groupthink bias and inaction bias. It is argued that these biases are exacerbated in the multilateral setting of the macroprudential supervision framework in the EU. The paper then examines how legal and institutional frameworks should be designed to acknowledge and perhaps contain these identified biases. The paper suggests that the effectiveness of macroprudential policy will largely depend on the existence of clear and robust transparency and accountability arrangements. Accountability arrangements can be used as a vehicle for identifying and addressing potential biases in the macro-prudential framework, in particular, inaction bias. Inclusiveness of the public in the supervisory process in the form of transparency and awareness of the logic behind policy decisions may assist in minimising their potential unpopularity thus promoting their effectiveness. Furthermore, a governance structure which facilitates coordination of the macroprudential supervisor with other policymakers and incorporates outside perspectives and opinions could ‘break-down’ groupthink bias as well as inaction bias.

Keywords: behavioural economics and biases, effectiveness of macroprudential supervision, legal and institutional macroprudential frameworks, macroprudential decision-making process

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737 Dependency on Social Media and Psychological Well-Being among Young Adults: Case Study of University Students in Pakistan

Authors: Ghazala Yasmeen, Zahid Yousaf

Abstract:

Frequent social media use has significantly changed people's life and communication styles during the last two decades. Social media use has multiple dimensions, and there are nuanced relationships between it and how it affects different societal subgroups. With the increased popularity and rapid growth of social networking sites, people are experiencing potential social media addiction, which causes severe mental health problems. How social media is dramatically influencing the lives and mental health of its users, and particularly of the students, creating psychological issues, e.g., isolation, depression, and anxiety, will be the primary objective of this study. This research will address the problems confronted by many students who are regular social media users and can undergo mental distress. This study aims to explore how social media use can lead to isolation, depression, and anxiety. This research will also investigate the effects of cyber-bullying on social, emotional, and psychological wellbeing. For this purpose, the researcher will use the survey technique as a method of inquiry. Ryff's theory of Psychological wellbeing will be used as a theoretical framework to explore the association between social media addiction and psychological effects among users. For data collection, the researcher will use the quantitative research method through a survey questionnaire from three universities in Pakistan from the public and private sectors. This study will imply a two-stage random sampling technique. At first, the researcher will select 20% of students from universities. In the second stage, 20% of students using different social networking sites will be chosen, and draw a representative sample from these will be. The intended study will use questionnaires comprising two portions. The first section will consist of social media engagement by the students, following impacts on their mental health and reported attitude towards psychological wellbeing. This study will spotlight the considerations of parents, educationists, and policymakers to take measures against the devastating effects of cyber-crimes on young adults.

Keywords: anxiety, depression, isolation, social media, wellbeing

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736 Second Language Development with an Intercultural Approach: A Pilot Program Applied to Higher Education Students from a Escuela Normal in Atequiza, Mexico

Authors: Frida C. Jaime Franco, C. Paulina Navarro Núñez, R. Jacob Sánchez Nájera

Abstract:

The importance of developing multi-language abilities in our global society is noteworthy. However, the necessity, interest, and consciousness of the significance that the development of another language represents, apart from the mother tongue, is not always the same in all contexts as it is in multicultural communities, especially in rural higher education institutions immersed in small communities. Leading opportunities for digital interaction among learners from Mexico and abroad partners represents scaffolding towards, not only language skills development but also intercultural communicative competences (ICC). This study leads us to consider what should be the best approach to work while applying a program of ICC integrated into the practice of EFL. While analyzing the roots of the language, it is possible to obtain the main objective of learning another language, to communicate with a functional purpose, as well as attaching social practices to the learning process, giving a result of functionality and significance to the target language. Hence, the collateral impact that collaborative learning leads to, aims to contribute to a better global understanding as well as a means of self and other cultural awareness through intercultural communication. While communicating through the target language by online collaboration among students in platforms of long-distance communication, language is used as a tool of interaction to broaden students’ perspectives reaching a substantial improvement with the help of their differences. This process should consider the application of the target language in the inquiry of sociocultural information, expecting the learners to integrate communicative skills to handle cultural differentiation at the same time they apply the knowledge of their target language in a real scenario of communication, despite being through virtual resources.

Keywords: collaborative learning, communicative approach, culture, interaction, interculturalism, target language, virtual partnership

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735 Multi-Sensory Coding as Intervention Therapy for ESL Spellers with Auditory Processing Delays: A South African Case-Study

Authors: A. Van Staden, N. Purcell

Abstract:

Spelling development is complex and multifaceted and relies on several cognitive-linguistic processes. This paper explored the spelling difficulties of English second language learners with auditory processing delays. This empirical study aims to address these issues by means of an intervention design. Specifically, the objectives are: (a) to develop and implement a multi-sensory spelling program for second language learners with auditory processing difficulties (APD) for a period of 6 months; (b) to assess the efficacy of the multi-sensory spelling program and whether this intervention could significantly improve experimental learners' spelling, phonological awareness, and processing (PA), rapid automatized naming (RAN), working memory (WM), word reading and reading comprehension; and (c) to determine the relationship (or interplay) between these cognitive and linguistic skills (mentioned above), and how they influence spelling development. Forty-four English, second language learners with APD were sampled from one primary school in the Free State province. The learners were randomly assigned to either an experimental (n=22) or control group (n=22). During the implementation of the spelling program, several visual, tactile and kinesthetic exercises, including the utilization of fingerspelling were introduced to support the experimental learners’ (N = 22) spelling development. Post-test results showed the efficacy of the multi-sensory spelling program, with the experimental group who were trained in utilising multi-sensory coding and fingerspelling outperforming learners from the control group on the cognitive-linguistic, spelling and reading measures. The results and efficacy of this multi-sensory spelling program and the utilisation of fingerspelling for hearing second language learners with APD open up innovative perspectives for the prevention and targeted remediation of spelling difficulties.

Keywords: English second language spellers, auditory processing delays, spelling difficulties, multi-sensory intervention program

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734 Feasibility and Efficacy of Matrix Model in Arabic Countries

Authors: Yasin Ibrahim, Hisham Almohandes, Chia Hsu, Regina Baronia, Jesse Worsham, Sara Abdelgawad, Mansour Shawky, Mohammed Abdelfattah, Nesif Alhemiary

Abstract:

Background: The matrix model (MM) is an evidence-based program for treating substance use disorders. Since first translated into Arabic in 2010, the MM has been gaining popularity in Arabic countries. However, there is no published data as pertains to its efficacy and feasibility in Arabic communities. Here we aimed at exploring providers’ perspectives on its feasibility and efficacy. Methods: Eight addiction treatment centers from four Arabic countries, namely Egypt, Kingdom of Saudi Arabia, the United Arab Emirates, and Iraq, were contacted via email. They were asked to fill in a 21-item questionnaire. Results: Matrix model continues to be utilized in 6 out of the 8 contacted programs. One center in Egypt has discontinued the MM as the providers felt it was not suitable for substance disorders other than stimulants, which are not common in Egypt. Baghdad University Medical Center has substituted MM with Colombo Program as there have been more training opportunities available for it. Data showed wide variability in regards to number of clients treated with the MM (from 300 to 2500). The Arabic version was utilized for training providers in 5 out of the 8 centers while the providers of the other 3 have been trained in the United States. All providers reported that MM made their job significantly easier, and seven providers believed that MM has favorably affected the relapse rate. In all of the six centers, MM is being utilized for many substance use disorders in addition to stimulant use disorders. Reported challenges included the acceptability of patients and their families, difficulty understanding some concepts, and high drop rates in some centers. Conclusion: Matrix model seems to be a valuable modality for the treatment of substance use disorders in Arabic countries. It has its own challenges and limitations that call for more culturally adapted versions.

Keywords: addiction, Arabic countries, developing countries, matrix model

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733 LAMOS - Layered Amorphous Metal Oxide Gas Sensors: New Interfaces for Gas Sensing Applications

Authors: Valentina Paolucci, Jessica De Santis, Vittorio Ricci, Giacomo Giorgi, Carlo Cantalini

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Despite their potential in gas sensing applications, the major drawback of 2D exfoliated metal dichalcogenides (MDs) is that they suffer from spontaneous oxidation in air, showing poor chemical stability under dry/wet conditions even at room temperature, limiting their practical exploitation. The aim of this work is to validate a synthesis strategy allowing microstructural and electrical stabilization of the oxides that inevitably form on the surface of 2D dichalcogenides. Taking advantage of spontaneous oxidation of MDs in air, we report on liquid phase exfoliated 2D-SnSe2 flakes annealed in static air at a temperature below the crystallization temperature of the native a-SnO2 oxide. This process yields a new class of 2D Layered Amorphous Metal Oxides Sensors (LAMOS), specifically few-layered amorphous a-SnO2, showing excellent gas sensing properties. Sensing tests were carried out at low operating temperature (i.e. 100°C) by exposing a-SnO2 to both oxidizing and reducing gases (i.e. NO2, H2S and H2) and different relative humidities ranging from 40% to 80% RH. The formation of stable nanosheets of amorphous a-SnO2 guarantees excellent reproducibility and stability of the response over one year. These results pave the way to new interesting research perspectives out considering the opportunity to synthesize homogeneous amorphous textures with no grain boundaries, no grains, no crystalline planes with different orientations, etc., following gas sensing mechanisms that likely differ from that of traditional crystalline metal oxide sensors. Moreover, the controlled annealing process could likely be extended to a large variety of Transition Metal Dichalcogenides (TMDs) and Metal Chalcogenides (MCs), where sulfur, selenium, or tellurium atoms can be easily displaced by O2 atoms (ΔG < 0), enabling the synthesis of a new family of amorphous interfaces.

Keywords: layered 2D materials, exfoliation, lamos, amorphous metal oxide sensors

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732 Multilingualism without a Dominant Language in the Preschool Age: A Case of Natural Italian-Russian-German-English Multilingualism

Authors: Legkikh Victoria

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The purpose of keeping bi/multilingualism is usually a way to let the child speak two/three languages at the same level. The main problem which normally appears is a mixed language or a domination of one language. The same level of two or more languages would be ideal but practically not easily reachable. So it was made an experiment with a girl with a natural multilingualism as an attempt to avoid a dominant language in the preschool age. The girl lives in Germany and the main languages for her are Italian, Russian and German but she also hears every day English. ‘One parent – one language’ strategy was used since the beginning so Italian and Russian were spoken to her since her birth, English was spoken between the parents and when she was 1,5 it was added German as a language of a nursery. In order to avoid a dominant language, she was always put in international groups with activity in different languages. Even if it was not possible to avoid an interference of languages in this case we can talk not only about natural multilingualism but also about balanced bilingualism in preschool time. The languages have been developing in parallel with different accents in a different period. Now at the age of 6 we can see natural horizontal multilingualism Russian/Italian/German/English. At the moment, her Russian/Italian bilingualism is balanced. German vocabulary is less but the language is active and English is receptive. We can also see a reciprocal interference of all the three languages (English is receptive so the simple phrases are normally said correctly but they are not enough to judge the level of language interference and it is not noticed any ‘English’ mistakes in other languages). After analysis of the state of every language, we can see as a positive and negative result of the experiment. As a positive result we can see that in the age of 6 the girl does not refuse any language, three languages are active, she differentiate languages and even if she says a word from another language she notifies that it is not a correct word, and the most important are the fact, that she does not have a preferred language. As a prove of the last statement it is to be noticed not only her self-identification as ‘half Russian and half Italian’ but also an answer to the question about her ‘mother tongue’: ‘I do not know, probably, when I have my own children I will speak one day Russian and one day Italian and sometimes German’. As a negative result, we can notice that not only a development of all the three languages are a little bit slower than it is supposed for her age but since she does not have a dominating language she also does not have a ‘perfect’ language and the interference is reciprocal. In any case, the experiment shows that it is possible to keep at least two languages without a preference in a pre-school multilingual space.

Keywords: balanced bilingualism, language interference, natural multilingualism, preschool multilingual education

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731 An Analysis of Eco-efficiency and GHG Emission of Olive Oil Production in Northeast of Portugal

Authors: M. Feliciano, F. Maia, A. Gonçalves

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Olive oil production sector plays an important role in Portuguese economy. It had a major growth over the last decade, increasing its weight in the overall national exports. International market penetration for Mediterranean traditional products is increasingly more demanding, especially in the Northern European markets, where consumers are looking for more sustainable products. Trying to support this growing demand this study addresses olive oil production under the environmental and eco-efficiency perspectives. The analysis considers two consecutive product life cycle stages: olive trees farming; and olive oil extraction in mills. Addressing olive farming, data collection covered two different organizations: a middle-size farm (~12ha) (F1) and a large-size farm (~100ha) (F2). Results from both farms show that olive collection activities are responsible for the largest amounts of Green House Gases (GHG) emissions. In this activities, estimate for the Carbon Footprint per olive was higher in F2 (188g CO2e/kgolive) than in F1 (148g CO2e/kgolive). Considering olive oil extraction, two different mills were considered: one using a two-phase system (2P) and other with a three-phase system (3P). Results from the study of two mills show that there is a much higher use of water in 3P. Energy intensity (EI) is similar in both mills. When evaluating the GHG generated, two conditions are evaluated: a biomass neutral condition resulting on a carbon footprint higher in 3P (184g CO2e/Lolive oil) than in 2P (92g CO2e/Lolive oil); and a non-neutral biomass condition in which 2P increase its carbon footprint to 273g CO2e/Lolive oil. When addressing the carbon footprint of possible combinations among studied subsystems, results suggest that olive harvesting is the major source for GHG.

Keywords: carbon footprint, environmental indicators, farming subsystem, industrial subsystem, olive oil

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730 Psychical Impacts of Episiotomy: First Results

Authors: Clesse C., Lighezzolo-Alnot J., De Lavergne S.

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Considered as the most common surgical procedure worldwide, episiotomy can be defined as an incision around the vulva performed to enlarge it, in the aim of preventing the traumatic rupture of the perineum during childbirth. Rather mediatized, this practice raises many questions in the field of mental health, relayed by different users and health professionals. Today, is topicality is moderately hectic since many queries about the prophylactic exercise of episiotomy are subject to a relative consensus, particularly since WHO advocated in 1996 that only 10% of childbirths should involve an episiotomy. This indicator appeared after the publication of numerous results from randomized clinical trials. Unfortunately, these papers seem mostly centered about somatic impacts of episiotomy. From the side of psychological studies, they mostly integrate a major clinical methodological bias, especially considering that every primiparous woman is identical to the others face to the experience of parturition. In the aim to fill this lack of knowledge, we developed a longitudinal research starting in the 7th month of pregnancy and ending one year after delivery. We are studying in a comparative way different possible psychological consequences inherent to the use of episiotomy. To do this, we use a standardized methodology which combines semi-structured clinical interviews (IRMAG, IRMAN ...), free clinical interviews, a projective test (Rorschach) and five questionnaires (QIC, EPDS, CPQ WOMBLSQ4, SF36). Therefore, we can comprehend with shrewdness the question of psychic impacts of episiotomy in a qualitative and quantitative way by comparing it to other obstetric interventions. In this paper, we will present the first results obtained about a population of twenty-two primiparous women by focusing on body image, sexuality, quality of life, depressive affects, post-traumatic stress disorder and investment of the maternal role. Finally, we will consider the different implications and perspectives of this research which could improve the public health policies in the field of perinatal care.

Keywords: assessment, episiotomy, mental health, psychical impacts

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729 'Explainable Artificial Intelligence' and Reasons for Judicial Decisions: Why Justifications and Not Just Explanations May Be Required

Authors: Jacquelyn Burkell, Jane Bailey

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Artificial intelligence (AI) solutions deployed within the justice system face the critical task of providing acceptable explanations for decisions or actions. These explanations must satisfy the joint criteria of public and professional accountability, taking into account the perspectives and requirements of multiple stakeholders, including judges, lawyers, parties, witnesses, and the general public. This research project analyzes and integrates two existing literature on explanations in order to propose guidelines for explainable AI in the justice system. Specifically, we review three bodies of literature: (i) explanations of the purpose and function of 'explainable AI'; (ii) the relevant case law, judicial commentary and legal literature focused on the form and function of reasons for judicial decisions; and (iii) the literature focused on the psychological and sociological functions of these reasons for judicial decisions from the perspective of the public. Our research suggests that while judicial ‘reasons’ (arguably accurate descriptions of the decision-making process and factors) do serve similar explanatory functions as those identified in the literature on 'explainable AI', they also serve an important ‘justification’ function (post hoc constructions that justify the decision that was reached). Further, members of the public are also looking for both justification and explanation in reasons for judicial decisions, and that the absence of either feature is likely to contribute to diminished public confidence in the legal system. Therefore, artificially automated judicial decision-making systems that simply attempt to document the process of decision-making are unlikely in many cases to be useful to and accepted within the justice system. Instead, these systems should focus on the post-hoc articulation of principles and precedents that support the decision or action, especially in cases where legal subjects’ fundamental rights and liberties are at stake.

Keywords: explainable AI, judicial reasons, public accountability, explanation, justification

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728 Parents, Carers and Young Persons’ Views Regarding Nursing ‘Workarounds’ Within Clinical Electronic Patient Record Systems

Authors: Patrick Nurse, Professor Neil Sebire, Polly Livermore

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The use of digital systems in healthcare is now highly prevalent. With further advancement of technology, these systems will become increasingly utilised within the healthcare sector. Therefore understanding how clinicians (for example, doctors, nurses) interact with technology and digital systems is critical to making care safer. Seven members from the Parent/Carers’ Research Advisory Group and the Young-Persons’ Research Group at a healthcare Trust in London and three staff members contributed to an engagement workshop to assess the impact of digital systems on the practice of nurses. The group also advised on the viability of a research study to investigate this further. A wide range of issues within digital system implementation in healthcare were raised, such as ‘workarounds’, system’s training, and upkeep and regulation of usage, which all emerged as early themes during the discussion. Further discussion focused on the subject of escalation of issues, ‘workarounds’, and problem solving. While challenging to implement, digital systems are hugely beneficial to healthcare providers. The workshop indicated that there is scope for investigation of the prevalence, nature, and escalation of ‘workarounds’, this was of key interest to the advisory group. An interesting concern of the group was their worry from a patient and parental perspective regarding how nurses might feel when needing to complete a ‘workaround’ during a busy shift. This is especially relevant if the reasons to complete the ‘workaround’ were outside the nurse’s control, driven by clinical need and urgency of care. This showed the level of insight that those using healthcare services have into the reality of workflows of those providing care. Additionally, it reflects the desire for patients and families to understand more about the administration and methodology of their care. Future study should be dedicated to understanding why nurses deploy ‘workarounds’, as well as their perspective and experience of them and subsequent escalation through leadership hierarchies

Keywords: patient engagement/involvement, workarounds, medication-administration, digital systems

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