Search results for: perspectives
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1340

Search results for: perspectives

410 Clinicians’ Experiences with IT Systems in a UK District General Hospital: A Qualitative Analysis

Authors: Sunny Deo, Eve Barnes, Peter Arnold-Smith

Abstract:

Introduction: Healthcare technology is a rapidly expanding field in healthcare, with enthusiasts suggesting a revolution in the quality and efficiency of healthcare delivery based on the utilisation of better e-healthcare, including the move to paperless healthcare. The role and use of computers and programmes for healthcare have been increasing over the past 50 years. Despite this, there is no standardised method of assessing the quality of hardware and software utilised by frontline healthcare workers. Methods and subjects: Based on standard Patient Related Outcome Measures, a questionnaire was devised with the aim of providing quantitative and qualitative data on clinicians’ perspectives of their hospital’s Information Technology (IT). The survey was distributed via the Institution’s Intranet to all contracted doctors, and the survey's qualitative results were analysed. Qualitative opinions were grouped as positive, neutral, or negative and further sub-grouped into speed/usability, software/hardware, integration, IT staffing, clinical risk, and wellbeing. Analysis was undertaken on the basis of doctor seniority and by specialty. Results: There were 196 responses, with 51% from senior doctors (consultant grades) and the rest from junior grades, with the largest group of respondents 52% coming from medicine specialties. Differences in the proportion of principle and sub-groups were noted by seniority and specialty. Negative themes were by far the commonest stated opinion type, occurring in almost 2/3’s of responses (63%), while positive comments occurred less than 1 in 10 (8%). Conclusions: This survey confirms strongly negative attitudes to the current state of electronic documentation and IT in a large single-centre cohort of hospital-based frontline physicians after two decades of so-called progress to a paperless healthcare system. Greater use would provide further insights and potentially optimise the focus of development and delivery to improve the quality and effectiveness of IT for clinicians and their patients.

Keywords: information technology, electronic patient records, digitisation, paperless healthcare

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409 An Investigation of Allied Health and Medical Clinician’s Viewpoint on Prosthetic Rehabilitation and Cognition

Authors: Erinn Dawes, Vida Bliokas, Lyndel Hewitt, Val Wilson

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Background: In a population where adapting to new devices is often necessary post-surgery, this can pose significant challenges. This study aimed to explore the factors that influence clinicians (occupational therapists, physiotherapists, vascular surgeons, and rehabilitation medicine physicians) when prescribing prosthetic rehabilitation. Additionally, the study aimed to gain insight into clinicians’ perspectives regarding the role of patient cognition in prosthetic rehabilitation. Method: This research constitutes one segment of a broader action research study. A combination of group and individual interviews, as well as surveys to engage key clinicians who are involved in the amputation and prosthetic rehabilitation pathway within a local health district in Australia, were conducted. Major findings: Several factors emerged as essential considerations when prescribing prosthetic rehabilitation. These included patient’s goals, medical history, quality of life, cognitive abilities, and the support available on discharge. Cognition has a far-reaching impact on prosthetic rehabilitation and should be considered at every stage of the amputation journey, from obtaining pre-operative consent to fitting prosthetics, ensuring patient safety upon discharge, and ongoing rehabilitation. This study also revealed variations in opinions among different disciplines concerning prosthetic rehabilitation. The biggest variance was seen between the opinions of vascular surgeons and those in allied health on the appropriateness of prosthetic prescription with patients, with vascular surgery believing most should not receive prosthetics and allied health believing that most should have an attempt with a prosthetic. Conclusion: The complex area of care and journey for clinicians has been made much more approachable by the identification of key areas for consideration when prescribing prosthetic rehabilitation. Should clinicians wish, these could be made into a framework to guide pertinent conversations regarding prosthetic rehabilitation and are closely linked with the patients' cognition. Whilst discipline specific differences existed on prosthetic rehabilitation appropriateness, there was a desire to build a consensus around a shared approach of identification for patients and clinicians.

Keywords: aging, cognition, multidisciplinary, prosthetic rehabilitation

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408 Organisational Change: The Impact on Employees and Organisational Development

Authors: Maureen Royce, Joshi Jariwala, Sally Kah

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Change is inevitable, but the change process is progressive. Organisational change is the process in which an organisation changes strategies, operational methods, systems, culture, and structure to affect something different in the organisation. This process can be continuous or developed over a period and driven by internal and external factors. Organisational change is essential if organisations are to survive in dynamic and uncertain environments. However, evidence from research shows that many change initiatives fail, leading to severe consequences for organisations and their resources. The complex models of third sector organisations, i.e., social enterprise, compounds the levels of change in these organisations. Interestingly, innovation is associated with a change in social enterprises due to the hybridity of product and service development. Furthermore, the creation of social intervention has offered a new process and outcomes to the lifecycle of change. Therefore, different forms of organisational innovation are developed, i.e., total, evolutionary, expansionary, and developmental, which affect the interventions of social enterprises. This raises both theoretical and business concerns on how the competing hybrid nature of social enterprises change, how change is managed, and the impact on these organisations. These perspectives present critical questions for further investigation. In this study, we investigate the impact of organisational change on employees and organisational development at DaDaFest –a disability arts organisation with a social focus based in Liverpool. The three main objectives are to explore the drivers of change and the implementation process; to examine the impact of organisational change on employees and; to identify barriers to organisation change and development. To address the preceding research objectives, qualitative research design is adopted using semi-structured interviews. Data is analysed using a six-step thematic analysis framework, which enables the study to develop themes depicting the impact of change on employees and organisational development. This study presents theoretical and practical contributions for academics and practitioners. The knowledge contributions encapsulate the evolution of change and the change cycle in a social enterprise. However, practical implications provide critical insights into the change management process and the impact of change on employees and organisational development.

Keywords: organisational change, change management, organisational change system, social enterprise

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407 The Characteristics of Withhold Resuscitation in Out-Of-Hospital Cardiac Arrest

Authors: An-Yi Wang, Wei-Fong Kao, Shin-Han Tsai

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Introduction: Information as patient characteristics, resuscitation scene, resuscitation provider perspectives and families wish affects on resuscitation decision-making for out-of-hospital cardiac arrest (OHCA). There is no consistency consensus on how families and emergency physicians approach this decision. The main purpose of our study is to evaluate the characteristics of withholding resuscitation efforts arrival at the hospital. Methods: We retrospectively analyzed patients with OHCA without pre-hospital return-of-spontaneous circulation (ROSC) who was sent to our emergency department (ED) between January 2014 and December 2015. Baseline characteristics, pre-hospital course, and causes of the cardiopulmonary arrest among patients were compared. Results: In 2 years, total 155 arrest patients without pre-hospital ROSC was included. 33(21.3%) patients withhold the resuscitation efforts in ED with mean resuscitation duration 4.45 ± 7.04 minutes after ED arrival. In withholding group, the initial rhythm of arrests was all non-shockable. 9 of them received endotracheal intubation before decision-making. None of the patients in withhold resuscitation group survived to discharge. There was no significant difference among gender, underlying cardiovascular disease, malignancy, chronic renal disease, nor witness collapse between withhold and continue resuscitation groups. Univariate analysis showed there was lower percentage of bystander resuscitation (32.3% vs. 50.4%, p=0.071), and the lower percentage of transport via emergency medical service (EMS) (78.8% vs. 91.8%, p=0.054) in withholding group. Multivariate analysis showed old age (adjusted odds ratio=1.06, 95% C.I.=[1.02-1.11], p<0.05), with underlying respiratory insufficiency (adjusted odds ratio=12.16, 95% C.I.=[3.34-44.29], p<0.05), living at home compared with nursing home (adjusted odds ratio=37.75, 95% C.I.=[1.09-1110.70], p<0.05) were more likely to withhold resuscitation. Transport via EMS was more likely to continue resuscitation (adjusted odds ratio=0.11, 95% C.I.=[0.02-0.71], p<0.05). Conclusion: The decision-making for families and emergency physicians to withhold or continue resuscitation for out-of-hospital cardiac arrest is complex and multi-factorial. Continue resuscitation efforts in nursing home residents is high, and further study among this population is warranted.

Keywords: cardiopulmonary resuscitation, out-of-hospital cardiac arrest, termination resuscitation, withhold resuscitation

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406 The Role of Home Composting in Waste Management Cost Reduction

Authors: Nahid Hassanshahi, Ayoub Karimi-Jashni, Nasser Talebbeydokhti

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Due to the economic and environmental benefits of producing less waste, the US Environmental Protection Agency (EPA) introduces source reduction as one of the most important means to deal with the problems caused by increased landfills and pollution. Waste reduction involves all waste management methods, including source reduction, recycling, and composting, which reduce waste flow to landfills or other disposal facilities. Source reduction of waste can be studied from two perspectives: avoiding waste production, or reducing per capita waste production, and waste deviation that indicates the reduction of waste transfer to landfills. The present paper has investigated home composting as a managerial solution for reduction of waste transfer to landfills. Home composting has many benefits. The use of household waste for the production of compost will result in a much smaller amount of waste being sent to landfills, which in turn will reduce the costs of waste collection, transportation and burial. Reducing the volume of waste for disposal and using them for the production of compost and plant fertilizer might help to recycle the material in a shorter time and to use them effectively in order to preserve the environment and reduce contamination. Producing compost in a home-based manner requires very small piece of land for preparation and recycling compared with other methods. The final product of home-made compost is valuable and helps to grow crops and garden plants. It is also used for modifying the soil structure and maintaining its moisture. The food that is transferred to landfills will spoil and produce leachate after a while. It will also release methane and greenhouse gases. But, composting these materials at home is the best way to manage degradable materials, use them efficiently and reduce environmental pollution. Studies have shown that the benefits of the sale of produced compost and the reduced costs of collecting, transporting, and burying waste can well be responsive to the costs of purchasing home compost machine and the cost of related trainings. Moreover, the process of producing home compost may be profitable within 4 to 5 years and as a result, it will have a major role in reducing waste management.

Keywords: compost, home compost, reducing waste, waste management

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405 Molecular Interactions between Vicia Faba L. Cultivars and Plant Growth Promoting Rhizobacteria (PGPR), Utilized as Yield Enhancing 'Plant Probiotics'

Authors: Eleni Stefanidou, Nikolaos Katsenios, Ioanna Karamichali, Aspasia Efthimiadou, Panagiotis Madesis

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The excessive use of pesticides and fertilizers has significant environmental and human health-related negative effects. In the frame of the development of sustainable agriculture practices, especially in the context of extreme environmental changes (climate change), it is important to develop alternative practices to increase productivity and biotic and abiotic stress tolerance. Beneficial bacteria, such as symbiotic bacteria in legumes (rhizobia) and symbiotic or free-living Plant Growth Promoting Rhizobacteria (PGPR), which could act as "plant probiotics", can promote plant growth and significantly increase the resistance of crops under adverse environmental conditions. In this study, we explored the symbiotic relationships between Faba bean (Vicia faba L.) cultivars with different PGPR bacteria, aiming to identify the possible influence on yield and biotic-abiotic phytoprotection benefits. Transcriptomic analysis of root and whole plant samples was executed for two Vicia faba L. cultivars (Polikarpi and Solon) treated with selected PGPR bacteria (6 treatments: B. subtilis + Rhizobium-mixture, A. chroococcum + Rhizobium-mixture, B. subtilis, A. chroococcum and Rhizobium-mixture). Preliminary results indicate a significant yield (Seed weight and Total number of pods) increase in both varieties, ranging around 25%, in comparison to the control, especially for the Solon cultivar. The increase was observed for all treatments, with the B. subtilis + Rhizobium-mixture treatment being the highest performing. The correlation of the physiological and morphological data with the transcriptome analysis revealed molecular mechanisms and molecular targets underlying the observed yield increase, opening perspectives for the use of nitrogen-fixing bacteria as a natural, more ecological enhancer of legume crop productivity.

Keywords: plant probiotics, PGPR, legumes, sustainable agriculture

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404 Digitalising the Instruction: Between Technology Integration and Instrumental Use

Authors: H. Zouar, I. Kassous, F. Benzert

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The relentless pace of technology development in the last two decades has pervaded much of the recent educational discourse on a nation-wide scale. The rippling echoes of the buzz that account for the myriad of advantages the new technologies bring to the pedagogical activity has inevitably transcended from the western world to the Algerian educational contexts. Attempts have been made by Algerian practitioners to heed this digital advancement and push their instructional practices forward. However, due to the still largely existing first-order barriers as exemplified in the forms of deficient institutional infrastructure and unavailability of sufficient digital materials, the results of those attempts have polarised the views of Algerian academics regarding technology integration within higher education context. Hence, this study aims at measuring the possibility of integrating technology in our classrooms in a way that conforms to the philosophy of hybrid education. It also attempts to re-consider teachers’ understanding of technology integration in our context. Furthermore, the purpose of this research is also to reveal the level of teachers’ awareness regarding the distinction between technology integration and instrumental use. In view of the nature of these aims, a mixed-methods mode of investigation has been adopted to collect both qualitative and quantitative data from different perspectives. The data collection tools comprise of an observation as well as students’ and teachers’ questionnaires. The findings show that despite the fact that the examined context is not without its technological limitations, technology integration can be successfully incorporated contingent on teachers' level of knowledge and agency. Technology integration in Algerian universities does not proceed as the bedrock theory of it entails due to issues within teachers' general understanding of utilizing technology in class. It seems that technology is a means to an end, depending on the teachers who make use of it in order to deliver lessons (PowerPoint presentation) and issue commands (Facebook posting). Teachers' ability to clearly discern between integrating technology in their practices versus employing it as an instrument of instruction needs further consideration in order to establish a solid understanding of technology integration within higher education context.

Keywords: technology integration, hybrid education, teachers' understanding, teachers' awareness, instrumental use

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403 Derivation of Human NK Cells from T Cell-Derived Induced Pluripotent Stem Cells Using Xenogeneic Serum-Free and Feeder Cell-Free Culture System

Authors: Aliya Sekenova, Vyacheslav Ogay

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The derivation of human induced pluripotent stem cells (iPSCs) from somatic cells by direct reprogramming opens wide perspectives in the regenerative medicine. It means the possibility to develop the personal and, consequently, any immunologically compatible cells for applications in cell-based therapy. The purpose of our study was to develop the technology for the production of NK cells from T cell-derived induced pluripotent stem cells (TiPSCs) for subsequent application in adoptive cancer immunotherapy. Methods: In this study iPSCs were derived from peripheral blood T cells using Sendai virus vectors expressing Oct4, Sox2, Klf4 and c-Myc. Pluripotent characteristics of TiPSCs were examined and confirmed with alkaline phosphatase staining, immunocytochemistry and RT-PCR analysis. For NK cell differentiation, embryoid bodies (EB) formed from (TiPSCs) were cultured in xenogeneic serum-free medium containing human serum, IL-3, IL-7, IL-15, SCF, FLT3L without using M210-B4 and AFT-024 stromal feeder cells. After differentiation, NK cells were characterized with immunofluorescence analysis, flow cytometry and cytotoxicity assay. Results: Here, we for the first time demonstrate that TiPSCs can effectively differentiate into functionally active NK cells without M210-B4 and AFT-024 xenogeneic stroma cells. Immunofluorescence and flow cytometry analysis showed that EB-derived cells can differentiate into a homogeneous population of NK cell expressing high levels of CD56, CD45 and CD16 specific markers. Moreover, these cells significantly express killing activation receptors such as NKp44 and NKp46. In the comparative analysis, we observed that NK cells derived using feeder-free culture system have more high killing activity against K-562 tumor cells, than NK cells derived by feeder-dependent method. Thus, we think that our obtained data will be useful for the development of large-scale production of NK cells for translation into cancer immunotherapy.

Keywords: induced pluripotent stem cells, NK cells, T cells, cell diffentiation, feeder cell-free culture system

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402 “Chasing Hope”: Parents’ Perspectives on Complementary and Alternative Interventions for Autism Spectrum Disorder Children in Kazakhstan

Authors: Sofiya An, Akbota Kanderzhanova, Assel Akhmetova, Faye Foster, Chee K. Chan

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Healthcare, education and social support for children with autism in Kazakhstan has been evolving and transforming over the last three decades. There is still limited knowledge of the use of complementary and alternative medicine by families caring for autistic children in this post-Soviet region. An exploratory qualitative focus group study of Kazakhstani families was carried out to capture and understand their experiences of using complementary and alternative (CAM) medicine. A total of six focus groups were conducted in five cities across the country including Nur-Sultan, Almaty, Kyzylorda, Karaganda and Taraz. The perceived factors driving the availability, choice, and use of complementary and alternative medicine by families of autistic children in the country were distilled and evaluated. The data collected was analyzed using a framework analysis and themes and subthemes were developed. Two major themes stood out. The first was the “unmet needs”, which relates to the predisposing factors that motivate parents to CAM uptake, and the second was the “chasing hope”, which relates to the enabling factors that facilitate parents’ uptake of CAM. Fear of missing out (FOMO) is a latent underlying motivation underscoring these two themes as well. Parents of autism spectrum disorder (ASD) children in Kazakhstan have to deal with many challenges when seeking treatment for their children with ASD. They are prepared and resort to try out whatever CAM interventions available. The motivation and rationale of choice of use is driven by the lack of options and the hope of any potential positive outcome rather than from rational decisions based on efficacy or the evidence-based data of CAM. Parents get desperate and are willing to try CAM regardless of and independent of their cultural and belief systems and they do not want to miss out just in case it might work. This study also gives an international and cross-cultural perspective on the motives, choice and practice of parents with ASD children using CAM in Kazakhstan, a Central Asian country.

Keywords: autism spectrum disorder, Central Asia, complementary and alternative medicine, cross-cultural perspective, qualitative research

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401 School Administrators’ Perspectives on Child Neglect and Abuse and Intervention Methods

Authors: Eylem G. Cengiz, Ersin Çilek, Gözde Başkaya, Havva Nur Taş

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It is possible to define the abuse and neglect of the child as a social problem. Such adverse experiences of the child are witnessed by wider social circles as well as his or her immediate environment. The most effective institution among these social circles is the school. The awareness of teachers, administrators, and even auxiliary personnel on this issue can act as a protective and preventive buffer because teachers have the opportunity to be with children every day and constantly observe them; therefore, they can notice the physical and mental changes in students. Furthermore, school administrators have an undeniable role in recognizing and responding to the risk of neglect and abuse. This study aims to evaluate the awareness of school administrators on the risk factors, clues, and ways of intervention towards abuse and neglect through the scenarios given to them. Data were collected from 37 primary, secondary, and high school administrators working in various provinces of Turkey through descriptive and scenario-based questions to determine their general knowledge of the concepts of neglect and abuse and their general tendencies towards practice. Descriptive questions were evaluated with content analysis, and scenario-based questions were evaluated with numerical qualitative data analysis. Concepts and themes were tried to be reached by content analysis from the descriptive data collected. When the results are evaluated in general, it is striking that the concept of child abuse means only sexual abuse for some school administrators. There is an important uncertainty for school administrators in the content of the idea of neglect. When the views on the causes of neglect and abuse are examined, the family factor was seen as the primary source of both neglect and abuse. In addition, among the prevention strategies applied by school administrators, intervention for the family -interviewing and informing- was recommended by only 9 (29%) out of 31 administrators. When the responses to the physical, emotional, and sexual abuse scenarios are examined, it is revealed that the administrators generally realize the abuse but fail to develop an appropriate/whole intervention method. The research results show that school administrators' awareness should be increased. Although administrators have sensitivity towards children, they should be empowered to recognize all types of neglect and abuse and develop appropriate intervention tools.

Keywords: assessment child abuse and neglect, child abuse, child neglect, school administrators

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400 Effectiveness of the Community Health Assist Scheme in Reducing Market Failure in Singapore’s Healthcare Sector

Authors: Matthew Scott Lau

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This study addresses the research question: How effective has the Community Health Assist Scheme (CHAS) been in reducing market failure in Singapore’s healthcare sector? The CHAS policy, introduced in 2012 in Singapore, aims to improve accessibility and affordability of healthcare by offering subsidies to low and middle-income groups and elderly individuals for general practice consultations and healthcare. The investigation was undertaken by acquiring and analysing primary and secondary research data from 3 main sources, including handwritten survey responses of 334 individuals who were valid CHAS subsidy recipients (CHAS cardholders) from 5 different locations in Singapore, interview responses from two established general practitioner doctors with working knowledge of the scheme, and information from literature available online. Survey responses were analysed to determine how CHAS has affected the affordability and consumption of healthcare, and other benefits or drawbacks for CHAS users. The interview responses were used to explain the benefits of healthcare consumption and provide different perspectives on the impacts of CHAS on the various parties involved. Online sources provided useful information on changes in healthcare consumerism and Singapore’s government policies. The study revealed that CHAS has been largely effective in reducing market failure as the subsidies granted to consumers have improved the consumption of healthcare. This has allowed for the external benefits of healthcare consumption to be realized, thus reducing market failure. However, the study also revealed that CHAS cannot be fully effective in reducing market failure as the scope of CHAS prevents healthcare consumption from fully reaching the socially optimal level. Hence, the study concluded that CHAS has been effective to a large extent in reducing market failure in Singapore’s healthcare sector, albeit with some benefits to third parties yet to be realised. There are certain elements of the investigation, which may limit the validity of the conclusion, such as the means used to determine the socially optimal level of healthcare consumption, and the survey sample size.

Keywords: healthcare consumption, health economics, market failure, subsidies

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399 Animal-Assisted Therapy: A Perspective From Singapore

Authors: Julia Wong, Hua Beng Lim, Petrina Goh, Johanna Foo, Caleb Ng, Nurul ‘Aqilah Bte Mohd Taufek

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Animal-assisted therapy (AAT) utilizes human-animal interaction to achieve specific therapeutic goals, and its efficacy has been demonstrated across various settings overseas. The use of AAT in Singapore, however, is still limited. Ang Mo Kio-Thye Hua Kwan (AMKH) is one of the first community hospitals in Singapore to use AAT to complement its occupational therapy services with elderly patients. This study explored the perspectives of AMKH’s occupational therapists (OTs) in relation to AAT to understand barriers and enablers in implementing and practising AAT. We also examined how OTs at-large across practice settings perceive AAT. A mixed method design was used. 64 OTs at-large participated in on online survey, and 7 AMKH OTs were interviewed individually via Zoom. Survey results were analysed with descriptive and Mann-Whitney U tests. Interviews were thematically analysed. AMKH OTs perceived various benefits of AAT articulated in overseas studies in domains such as motivation and participation, emotional, social interaction, sensory tactile stimulation, and cognition. Interestingly, this perception was also supported by 67% of OTs who had responded to the survey, even though most of the OTs who had participated in the survey had no experience in AAT. Despite the perceived benefits of AAT, both OTs from AMKH and those at-large articulated concerns on risks pertaining to AAT (e.g., allergies, unexpected animal behaviour, infections, etc). However, AMKH OTs shared several ways to mitigate these risks, demonstrating their ability to develop a safe program. For e.g., volunteers and their dogs must meet specific recruitment criteria, stringent protocols are used to screen and match dogs with patients, and there are strict exclusion criteria for patients participating in AAT. AMKH OTs’ experience suggests that additional skills and knowledge are required to implement AAT, therefore, healthcare institutions should first consider improving their staff training and risk mitigation knowledge before implementing AAT. They can also refer to AMKH’s AAT protocols and those found in overseas studies, but institutions must adapt the protocols to fit their institutional settings and patients’ profiles.

Keywords: animal-assisted therapy, dog-assisted therapy, occupational therapy, complementary therapy

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398 Speech Community and Social Language Codes: A Sociolinguistic Study of Mampruli-English Codeswitching in Nalerigu, Ghana

Authors: Gertrude Yidanpoa Grumah

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Ghana boasts of a rich linguistic diversity, with around eighty-seven indigenous languages coexisting with English, the official language. Within this multilingual environment, speech communities adopt bilingual code choices as a common practice, as people seamlessly switch between Ghanaian languages and English. Extensive research has delved into this phenomenon from various perspectives, including the role of bilingual code choices in teaching, its implications for language policy, and its significance in multilingual communities. Yet, a noticeable gap in the literature persists, with most studies focusing on codeswitching between English and the major southern Ghanaian languages like Twi, Ga, and Ewe. The intricate dynamics of codeswitching with minority indigenous languages, such as Mampruli spoken in northern Ghana, remain largely unexplored. This thesis embarks on an investigation into Mampruli-English codeswitching, delving into the linguistic practices of educated Mampruli speakers. The data collection methods encompass interviews, recorded radio programs, and ethnographic observation. The analytical framework employed draws upon the Ethnography of Communication, with observation notes and transcribed interviews thoughtfully classified into discernible themes. The research findings suggest that a bilingual's tendency to switch from Mampruli to English is significantly influenced by factors such as the level of education, age, gender, perceptions of language prestige, and religious beliefs. In essence, this study represents a pioneering endeavor, marking the first comprehensive study on codeswitching practices within the Mampruli-English context and making a significant contribution to our understanding of Mampruli linguistics, covering the social language codes reflecting the speech community. In a region where such research has been scarce for the past four decades, this study addresses a critical knowledge gap, shedding light on the intricate dynamics of language use in northern Ghana.

Keywords: codeswitching, English, ethnography of communication, Mampruli, sociolinguistics

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397 Embodied Spirituality in Gestalt Therapy

Authors: Silvia Alaimo

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This lecture brings to our attention the theme of spirituality within Gestalt therapy’s theoretical and clinical perspectives and which is closely connected to the fertile emptiness and creative indifference’ experiences. First of all, the premise that must be done is the overcoming traditional western culture’s philosophical and religious misunderstandings, such as the dicotomy between spirituality and pratical/material daily life, as well as the widespread secular perspective of classic psychology. Even fullness and emptiness have traditionally been associated with the concepts of being and not being. "There is only one way through which we can contact the deepest layers of our existence, rejuvenate our thinking and reach intuition (the harmony of thought and being): inner silence" (Perls) *. Therefore, "fertile void" doesn't mean empty in itself, but rather an useful condition of every creative and responsible act, making room for a deeper dimension close to spirituality. Spirituality concerns questions about the meaning of existence, which lays beyond the concrete and literal dimension, looking for the essence of things, and looking at the value of personal experience. Looking at fundamentals of Gestalt epistemology, phenomenology, aesthetics, and the relationship, we can reach the heart of a therapeutic work that takes spiritual contours and which are based on an embodied (incarnate size), through the relational aesthetic knowledge (Spagnuolo Lobb ), the deep contact with each other, the role of compassion and responsibility, as the patient's recognition criteria (Orange, 2013) rooted in the body. The aesthetic dimension, like the spiritual dimension to which it is often associated, is a subtle dimension: it is the dimension of the essence of things, of their "soul." In clinical practice, it implies that the relationship between therapist and patient is "in the absence of judgment," also called "zero point of creative indifference," expressed by ‘therapeutic mentality’. It consists in following with interest and authentic curiosity where the patient wants to go and support him in his intentionality of contact. It’s a condition of pure and simple awareness, of the full acceptance of "what is," a moment of detachment from one's own life in which one does not take oneself too seriously, a starting point for finding a center of balance and integration that brings to the creative act, to growth, and, as Perls would say, to the excitement and adventure of living.

Keywords: spirituality, bodily, embodied aesthetics, phenomenology, relationship

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396 The Experience of Middle Grade Teachers in a Culture of Collaboration

Authors: Tamara Tallman

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Collaboration is a powerful tool for professional development and central for creating opportunities for teachers to reflect on their practice. However, school districts continue to have difficulty both implementing and sustaining collaboration. The purpose of this research was to investigate the experience of the teacher in a creative, instructional collaboration. The teachers in this study found that teacher-initiated collaboration offered them trust and they were more open with their partners. An interpretative phenomenological analysis was used for this study as it told the story of the teacher’s experience. Interpretative Phenomenological Analysis was chosen for this study to capture the complex and contextual nature of the teacher experience from a creative, instructional collaborative experience. This study sought to answer the question of how teachers in a private, faith-based school experience collaboration. In particular, the researcher engaged the study’s participants in interviews where they shared their unique perspectives on their experiences in relation to this phenomenon. Through the use of interpretative phenomenological analysis, the researcher interpreted the experiences of each participant in an attempt to gain deeper insight into how teachers made sense of their understanding of collaboration. In addition to the researcher’s interpreting the meaning of this construct for each research participant, this study gave a voice to the individual experiences and positionality of each participant at the research site. Moreover, the key findings presented in this study shed light on how teachers within this particular context participated in and made sense of their experience of creating an instructional collaborative. The research presented the findings that speak to the meaning that each research participant experienced in their relation to participating in building a collaborative culture and its effect on professional and personal growth. The researcher provided recommendations for future practice and research possibilities. The research findings demonstrated the unique experiences of each participant as well as a connection to the literature within the field of teacher professional development. The results also supported the claim that teacher collaboration can facilitate school reform. Participating teachers felt less isolation and developed more teacher knowledge.

Keywords: collaboration, personal grwoth, professional development, teachers

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395 Urban Renewal, Social Housing, Relocation, and Violence in Algiers

Authors: Kahina Amal Djiar, Mouna Gharbi, Maha Messaoudene, Oumelkheir Chareb

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Over the last decade, Algerian authorities have implemented an ambitious program of urban renewal, which includes important relocation operations. The objectives behind such strategic interventions are on the one hand, to carry out an incremental approach aiming at eradicating precarious housing and on the other hand, to diversify alternative housing options for families requiring better living spaces. It is precisely for these same purposes that the Djenan el-Hassan and Carrières Jaubert estates, which are both located in Algiers, have undergone major urban transformations. These dwelling sites were built as part of the famous "Battle of Housing", which was launched by French colonial administration in the 1950s just before the independence of Algeria in 1962. Today, the Djenan el-Hassan estate is almost entirely demolished following the relocation of 171 families. The Carrières Jaubert estate, for its part, has seen two kinds of operations. The first has been shaped by a process of urban requalification and redevelopment, which allowed some of the residents to stay on site after the transformation of most housing cells into larger apartments. The second operation has required the relocation of over 300 families to entirely newly built dwellings. Such projects of urban renewal are supposed to create new opportunities, not only in terms of local urban development, but also in terms of social perspectives for those families who are involved, either directly or indirectly, in the process of relocation. In fact, the percentage of urban violence in Algiers has increased instead. Recent events in the newly built estates show that residents are repeatedly experiencing and even instigating episodes of brutality, hostility and aggression. The objective of this paper is to examine the causes that have engendered such rise in urban violence in newly built housing estates in Algiers. This paper aims to present the findings of a recent qualitative research and highlight the way that poorly designed neighbourhood, combined with a relocation process that leaves little room for community participation, create inevitably severe social tensions.

Keywords: relocation, social housing, violence, Algiers

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394 Building Care Networks for Patients with Life-Limiting Illnesses: Perspectives from Health Care and Social Service Providers

Authors: Lindy Van Vliet, Saloni Phadke, Anthea Nelson, Ann Gallant

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Comprehensive and compassionate palliative care and support requires an integrated system of care that draws on formal health and social service providers working together with community and informal networks to ensure that patients and families have access to the care they need. The objective of this study is to further explore and understand the community supports, services, and informal networks that health care professionals and social service providers rely on to allow their patients to die in their homes and communities. Drawing on an interpretivist, exploratory, qualitative design, our multidisciplinary research team (medicine, nursing and social work) conducted interviews with 15 health care and social service providers in the Ottawa region. Interview data was audio-recorded, transcribed and analyzed using a reflexive thematic analysis approach. The data deepens our understandings of the facilitators and barriers that arise as health care and social service providers attempt to build networks of care for patients with life limiting illnesses and families. Three main findings emerged: First, the variability that arises due to systemic barriers in accessing and providing care; second, the exceptionally challenging workload that providers are facing as they work to address complex social care needs (housing, disability, food security), along with escalating palliative care needs; and, finally, the lack of structural support that providers and informal care networks receive. Conclusion: These findings will facilitate and build stronger person-centred/relationship-centred principles and practices between providers, patients, community, and informal care networks by highlighting the systemic barriers to accessing and providing person-centred care. Further, they will have important implications for future partnerships in integrated care delivery programs and initiatives, community policies, education programs, and provincial and national palliative care strategies.

Keywords: public health palliative care, palliative care nursing, care networks, informal care, integrated health care

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393 An Integral Sustainable Design Evaluation of the 15-Minute City and the Processes of Transferability to Cities of the Global South

Authors: Chitsanzo Isaac

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Across the world, the ongoing Covid-19 pandemic has challenged urban systems and policy frameworks, highlighting societal vulnerabilities and systemic inequities among many communities. Measures of confinement and social distancing to contain the Covid-19 virus have fragmented the physical and social fabric of cities. This has caused urban dwellers to reassess how they engage with their urban surroundings and maintain social ties. Urbanists have presented strategies that would allow communities to survive and even thrive, in extraordinary times of crisis like the pandemic. Tactical Urbanism, particularly the 15-Minute City, has gained popularity. It is considered a resilient approach in the global north, however, it’s transferability to the global south has been called into question. To this end, this paper poses the question: to what extent is the 15-Minute City framework integral sustainable design, and are there processes that make it adoptable by cities in the global south? This paper explores four issues using secondary quantitative data analysis and convergence analysis in the Paris and Blantyre urban regions. First, it questions how the 15-Minute City has been defined and measured, and how it impacts urban dwellers. Second, it examines the extent to which the 15-minute city performs under the lens of frameworks such as Wilber’s integral theory and Fleming’s integral sustainable design theory. Thirdly this work examines the processes that can be transferred to developing cities which foster community resilience through the perspectives of experience, behaviors, cultures, and systems. Finally, it reviews the principal ways in which a multi-perspective reality can be the basis for resilient community design and sustainable urban development. This work will shed a light on the importance of a multi-perspective reality as a means of achieving sustainable urban design goals in developing urban areas.

Keywords: 15-minute city, developing cities, global south, community resilience, integral sustainable design, systems thinking, complexity, tactical urbanism

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392 Subsidiary Entrepreneurial Orientation, Trust in Headquarters and Performance: The Mediating Role of Autonomy

Authors: Zhang Qingzhong

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Though there exists an increasing number of research studies on the headquarters-subsidiary relationship, and within this context, there is a focus on subsidiaries' contributory role to multinational corporations (MNC), subsidiary autonomy, and the conditions under which autonomy exerts an effect on subsidiary performance still constitute a subject of debate in the literature. The objective of this research is to study the MNC subsidiary autonomy and performance relationship and the effect of subsidiary entrepreneurial orientation and trust on subsidiary autonomy in the China environment, a phenomenon that has not yet been studied. The research addresses the following three questions: (i) Is subsidiary autonomy associated with MNC subsidiary performance in the China environment? (ii) How do subsidiary entrepreneurship and its trust in headquarters affect the level of subsidiary autonomy and its relationship with subsidiary performance? (iii) Does subsidiary autonomy have a mediating effect on subsidiary performance with subsidiary’s entrepreneurship and trust in headquarters? In the present study, we have reviewed literature and conducted semi-structured interviews with multinational corporation (MNC) subsidiary senior executives in China. Building on our insights from the interviews and taking perspectives from four theories, namely the resource-based view (RBV), resource dependency theory, integration-responsiveness framework, and social exchange theory, as well as the extant articles on subsidiary autonomy, entrepreneurial orientation, trust, and subsidiary performance, we have developed a model and have explored the direct and mediating effects of subsidiary autonomy on subsidiary performance within the framework of the MNC. To test the model, we collected and analyzed data based on cross-industry two waves of an online survey from 102 subsidiaries of MNCs in China. We used structural equation modeling to test measurement, direct effect model, and conceptual framework with hypotheses. Our findings confirm that (a) subsidiary autonomy is positively related to subsidiary performance; (b) subsidiary entrepreneurial orientation is positively related to subsidiary autonomy; (c) subsidiary’s trust in headquarters has a positive effect on subsidiary autonomy; (d) subsidiary autonomy mediates the relationship between entrepreneurial orientation and subsidiary performance; (e) subsidiary autonomy mediates the relationship between trust and subsidiary performance. Our study highlights the important role of subsidiary autonomy in leveraging the resource of subsidiary entrepreneurial orientation and its trust relationship with headquarters to achieve high performance. We discuss the theoretical and managerial implications of the findings and propose directions for future research.

Keywords: subsidiary entrepreneurial orientation, trust, subsidiary autonomy, subsidiary performance

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391 Lessons from Seven Years of Teaching Mindfulness to Children Living in a Context of Vulnerability

Authors: Annie Devault

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Mindfulness-based interventions (MBI) can be beneficial for the well-being of children. MBIs offered for children in contexts of vulnerability (poverty, neglect) report positive results in terms of emotion regulation and cognitive flexibility. Anxiety is a common issue for children living in a vulnerable context. It has a negative impact on children’s attention span, emotional regulation and self-esteem. The MBI (12 weeks) associated with this research has been developed for a total of 30 children suffering from anxiety (7 to 9 years old) and receiving services from a community center over the last seven years. The first objective is to describe in details the content of the mindfulness-based intervention. The second purpose is to document what helps and what hinders the practice of mindfulness for children living in a context of vulnerability. A special attention will be given to the importance of the way that the intervention is offered and the principles that are followed by the practitioners. Perceived effects of the intervention on children were collected through an individual semi-structured interview with each child at the end of the program. Parents were also interviewed to have their point of view on the effect of their children’s participation in the group. Anxiety was measure with the Beck youth pre-post and at follow up (2 months). Qualitative analysis of the interviews with children showed that most of them mentioned that the program helped them become calmer, more confident, less scared and more able to deal with difficult emotions. Almost all of them reported having used the material provided to them to practice at home. This result has been confirmed by parents. They reported that their child had gained confidence and were better at verbalizing emotions. Children also grew calmer, even though all anxiety was not gone. They would have liked more material to practice at home. The quantitative instrument used to measure anxiety did not corroborate the qualitative interviews about anxiety. Discussion will question the use of this questionnaire for children who have important cognitive limitations. Discussion will also report the importance of the personalized contact with children, along with other consideration, to enhance the adherence of children and parents. The MBI seems to have benefited children in different ways, which is corroborated by most parents. Since the sample was limited, we will need to continue documenting its effects with more children and parents. The major strength of this research is to have reported the subjective perspectives of children on their experience of mindfulness.

Keywords: anxiety, mindfulness, children, best practices

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390 Understanding Childhood Sexual Abuse and Its Association with Psychological Traumatization, Re-Traumatization, and Shame in Adult South Asian Women: A Scoping Review

Authors: Manisha Massey, Mariette Berndsen, Helen McLaren

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The existing body of literature concerning the incidence, prevalence, and experiences of childhood sexual abuse (CSA) lacked cultural inclusivity, primarily reflecting Euro-centric perspectives. This study investigated and reviewed the existing literature to understand the experiences of women of color from South Asia, addressing the gap in understanding how culture and diversity impact CSA. While individualist cultures emphasize autonomy, collectivist societies prioritize interdependence. South Asia's diverse intersections, including gender, caste, religion, and class, have intensified child sexual exploitation, challenging assumed homogeneity and safety. Additionally, the power exploitation in the space of abuse and grooming supplementing with the prevalence of honor violence makes disclosures of sexual abuse for children daunting and unsafe in these cultures. This scoping review examined the connection between CSA, psychological trauma, re-traumatization, and shame among adult South Asian women from India, Pakistan, and Bangladesh. Despite distinct borders, these countries share historical, linguistic, and traditional ties. Following PRISMA guidelines, the review employed thematic analysis. Findings underscored cultural factors' influence on CSA incidence, help-seeking barriers, and treatment challenges. The pivotal role of shame (sharam) and honor (izzat) in disclosure and healing processes was highlighted. The study emphasized the need for culturally sensitive interventions while noting limited literature on re-traumatisation. Incorporating a culturally informed perspective, this research aims to decolonize trauma therapy by contributing to the CSA discourse, shedding light on its intricate interaction with trauma, shame, and healing among South Asian women.

Keywords: Childhood sexual abuse, decolonizing psychology, trauma, re-trauma, shame

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389 Peer Bullying and Mentalization from the Perspective of Pupils

Authors: Anna Siegler

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Bullying among peers is not uncommon; however, adults can notice only a fragment of the cases of harassment during everyday life. The systemic approaches of bullying investigation put the whole school community in the focus of attention and propose that the solution should emerge from the culture of the school. Bystanders are essential in the prevention and intervention processes as an active agent rather than passive. For combating exclusion, stigmatization and harassment, it is important that the bystanders have to realize they have the power to take action. To prevent the escalation of violence, victims must believe that students and teachers will help them and their environment is able to provide safety. The study based on scientific narrative psychological approach, and focuses on the examination of the different perspectives of students, how peers are mentalizing with each other in case of bullying. The data collection contained responses of students (N = 138) from three schools in Hungary, and from three different area of the country (Budapest, Martfű and Barcs). The test battery include Bullying Prevalence Questionnaire, Interpersonal Reactivity Index and an instruction to get narratives about bullying, which effectiveness was tested during a pilot test. The obtained results are in line with the findings of previous bullying research: the victims are mentalizing less with their peers and experience greater personal distress when they are in identity threatening situations, thus focusing on their own difficulties rather than social signals. This isolation is an adaptive response in short-term although it seems to lead to a deficit in social skills later in life and makes it difficult for students to become socially integrated to society. In addition the results also show that students use more mental state attribution when they report verbal bullying than in case of physical abuse. Those who witness physical harassment also witness concrete answers to the problem from teachers, in contrast verbal abuse often stays without consequences. According to the results students mentalizing more in these stories because they have less normative explanation to what happened. To expanding bullying literature, this research helps to find ways to reduce school violence through community development.

Keywords: bullying, mentalization, narrative, school culture

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388 Applying Computer Simulation Methods to a Molecular Understanding of Flaviviruses Proteins towards Differential Serological Diagnostics and Therapeutic Intervention

Authors: Sergio Alejandro Cuevas, Catherine Etchebest, Fernando Luis Barroso Da Silva

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The flavivirus genus has several organisms responsible for generating various diseases in humans. Special in Brazil, Zika (ZIKV), Dengue (DENV) and Yellow Fever (YFV) viruses have raised great health concerns due to the high number of cases affecting the area during the last years. Diagnostic is still a difficult issue since the clinical symptoms are highly similar. The understanding of their common structural/dynamical and biomolecular interactions features and differences might suggest alternative strategies towards differential serological diagnostics and therapeutic intervention. Due to their immunogenicity, the primary focus of this study was on the ZIKV, DENV and YFV non-structural proteins 1 (NS1) protein. By means of computational studies, we calculated the main physical chemical properties of this protein from different strains that are directly responsible for the biomolecular interactions and, therefore, can be related to the differential infectivity of the strains. We also mapped the electrostatic differences at both the sequence and structural levels for the strains from Uganda to Brazil that could suggest possible molecular mechanisms for the increase of the virulence of ZIKV. It is interesting to note that despite the small changes in the protein sequence due to the high sequence identity among the studied strains, the electrostatic properties are strongly impacted by the pH which also impact on their biomolecular interactions with partners and, consequently, the molecular viral biology. African and Asian strains are distinguishable. Exploring the interfaces used by NS1 to self-associate in different oligomeric states, and to interact with membranes and the antibody, we could map the strategy used by the ZIKV during its evolutionary process. This indicates possible molecular mechanisms that can explain the different immunological response. By the comparison with the known antibody structure available for the West Nile virus, we demonstrated that the antibody would have difficulties to neutralize the NS1 from the Brazilian strain. The present study also opens up perspectives to computationally design high specificity antibodies.

Keywords: zika, biomolecular interactions, electrostatic interactions, molecular mechanisms

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387 A Methodology for Developing New Technology Ideas to Avoid Patent Infringement: F-Term Based Patent Analysis

Authors: Kisik Song, Sungjoo Lee

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With the growing importance of intangible assets recently, the impact of patent infringement on the business of a company has become more evident. Accordingly, it is essential for firms to estimate the risk of patent infringement risk before developing a technology and create new technology ideas to avoid the risk. Recognizing the needs, several attempts have been made to help develop new technology opportunities and most of them have focused on identifying emerging vacant technologies from patent analysis. In these studies, the IPC (International Patent Classification) system or keywords from text-mining application to patent documents was generally used to define vacant technologies. Unlike those studies, this study adopted F-term, which classifies patent documents according to the technical features of the inventions described in them. Since the technical features are analyzed by various perspectives by F-term, F-term provides more detailed information about technologies compared to IPC while more systematic information compared to keywords. Therefore, if well utilized, it can be a useful guideline to create a new technology idea. Recognizing the potential of F-term, this paper aims to suggest a novel approach to developing new technology ideas to avoid patent infringement based on F-term. For this purpose, we firstly collected data about F-term and then applied text-mining to the descriptions about classification criteria and attributes. From the text-mining results, we could identify other technologies with similar technical features of the existing one, the patented technology. Finally, we compare the technologies and extract the technical features that are commonly used in other technologies but have not been used in the existing one. These features are presented in terms of “purpose”, “function”, “structure”, “material”, “method”, “processing and operation procedure” and “control means” and so are useful for creating new technology ideas that help avoid infringing patent rights of other companies. Theoretically, this is one of the earliest attempts to adopt F-term to patent analysis; the proposed methodology can show how to best take advantage of F-term with the wealth of technical information. In practice, the proposed methodology can be valuable in the ideation process for successful product and service innovation without infringing the patents of other companies.

Keywords: patent infringement, new technology ideas, patent analysis, F-term

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386 Understanding Co-Living Experience through University Residential Halls - A Pilot Study

Authors: Michelle W. T. Cheng, Yau Y.

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Hong Kong continues to be ranked as the least affordable housing market in the world, making co-living a feasible alternative in this high-density city. Although the number of co-living residences has increased in Hong Kong, co-living as a housing typology is still a new concept for many. Little research has been conducted on this new housing typology, let alone the co-living experience. To address this gap, this study targeted student residents in university residential halls as it is a more controlled environment (e.g., with established rules and guidelines regarding the use of communal facilitates and housing management) for studying co-living experiences in Hong Kong. To date, no research study has systematically identified anti-social behavior (ASB) in co-living spaces. Since ASB can be influenced by factors such as social norms and individual interpretation, it has an elastic definition that results in different levels of acceptance. Unlike other types of housing, co-living spaces can be potentially more influenced by the neighborhood as residents share more time and space. As a pilot study, this research targeted one university residential hall to examine student co-living experiences. To clarify, the research question is focused on identifying the social factors that impact the residential satisfaction of those who co-living in residential halls. Quantitative data (n=100) were collected via a structured questionnaire to measure the residential environment, including ASB, social neighboring, community attachment, and perceived hall management efficacy. The survey was distributed at the end of the academic year to ensure that respondents had at least one year of first-hand experience living in a co-living space. To gather qualitative data, follow-up focus group interviews were conducted with 16 participants who completed the survey. The semi-structured interviews aimed to elicit the participants' perspectives on their co-living experience. Through analyzing their co-living experiences, the researcher identified factors that affected their residential satisfaction and provided recommendations to enhance their co-living experience.

Keywords: co-living, university residential hall, anti-social behabiour, neighbour relationship, community attachement

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385 Usage of Visual Tools for Light Exploring with Children in the Geographical Istria Region Kindergartens in Republic of Croatia and Republic of Slovenia

Authors: Urianni Merlin, Đeni Zuliani Blašković

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Inspired by the Reggio Pedagogy approach that explores light from physical, mathematical, artistic, and natural perspectives, emphasizes the value of visual tools in light exploring that opens up a wide area of experiential discovery and knowledge, especially if used in kindergartens with children. While there is some literature evidence of visual tool usage for light exploring in kindergartens in the Republic of Slovenia, in the Republic of Croatia there are few researches, and those published are focused at shadow exploring, exploring of physical characteristics and teatrical play of light and shadow. The objectives of this research are to assess how much visual tools are used for light exploring by preschool teachers from geographical Istria kindergartens as part of the activities offered to children and if the usage of the visual tool for light exploring it’s different regarding the work environment (Slovenian and Croatian Istria kindergartens; city vs. village kindergartens; preschool teachers age and length of service). One hundred one preschool teachers from Croatian Istria Region and 70 preschool teachers from Slovenian Istria Region responded to a self-made questionnaire regarding visual tool usage habits in their work. As predicted, results show significant differences in visual tool usage regarding preschool teachers' work environment, length of service, and age. Preschool teachers from Slovenian Istria that work in kindergartens located in the city that have from 15 to 19 years of service and are more than 30 years of age use significantly more visual tools for light exploring. The results highlight the differences in visual tools usage for light exploring in the small Istria peninsula that can be attributed to different University art curricula in Slovenia and Croatia or lifelong education offered in Slovenia that is more open to Italian reggio pedagogy influence and are further used by older preschool teachers with more service experience. Considering the small number of researches, this research significantly contributes to science and motivates preschool teachers and scientists to implement the use of light tools in the preschool and university curriculum, especially in Croatia.

Keywords: activities with light, light exploring, preschool children, visual tools

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384 The Integration and Practice of Indigenous Knowledge System and Sustainable Environmental Education Concept

Authors: Shih-Tsung Chen, Yenchin Hsiao

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Evergreen Lily is a newly-built school after Morakot Typhoon took place. The school is located on Majia farm, which is surrounded by mountains. The fund in the construction of the school is solely sponsored by Chang Yung-Fa Foundation. There are 483 permanent houses near the school belonging to three tribes, Dashe, Majia, and Haocha. Due to the most ancient heritages of Paiwan and Rukai in these three tribes, the school is full of cultural atmosphere. From modern and traditional perspectives, Evergreen Lily strives to establish and develop a long-lasting educational model to meet the expectation of the tribes, parents, and the public. This study is a case study of how to develop indigenous education in newly established schools after the Morakot Hurricane disaster to meet the concept of environmental education. The systematic curriculum construction of education and cultural integration and the systematic practice of curriculum practice will be discussed, and the concept and practice of tribal education curriculum and sustainable environmental education will be understood. This study found that this school integrates the spirit of natural philosophy, democratic education, ethnic and experimental education, and constructs a knowledge system that includes three levels of spiritual culture, institutional culture, and material culture, as well as six dimensions of life philosophy, natural ecology, organizational system, tribal literature and history, song and dance, and technical and artistic methods. Adhering to the concept of harmonious education and the sustainable common good, the development of school-based tribal academic courses accounts for about one-third of the total number of teaching sessions, and there are different cultural themes in grades one to six, and there are clear teaching modules to effectively enhance students' potential inspiration. The complete curriculum implementation model can be described as a model for the development of indigenous schools to sustainable environmental education.

Keywords: environmental education, indigenous education, sustainable development, school-based curriculum

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383 Challenges of Skill Training among Women with Intellectual Disability: Stakeholders' Perspective

Authors: Jayanti Pujari

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The present study attempts to find out the barriers faced by adult women with an Intellectual disability during their training at vocational training centres offered by rehabilitation institutes. As economic independence is the ultimate aim of rehabilitation, this study tries to focus on the barriers which restrict the adult women with intellectual disability in equipping themselves in required skill which can really empower them and help them in independent living. The objectives of the study are (1) To find out the barriers perceived by job coaches during training given to women with intellectual disability (2) To find out the barriers perceived by the parents of women with intellectual disability who are undergoing vocational training and (3) To find out the barriers perceived by the women with intellectual disabilities during the vocational training. The barriers have been operationalised in the present study from three perspectives such as behavioural barriers, competency related barriers and accessibility barriers. For the present study three groups of participants(N=60) have been selected through purposive nonprobability sampling procedure to generate the data. They are( 20) job coaches who are working at vocational centres, (20) parents of women with intellectual disabilities, (20) adult women with intellectual disabilities. The study followed a descriptive research design and data are generated through self developed questionnaire. Three sets of self-developed and face validated questionnaires were used as the tool to gather the data from the three categories of sample. The questionnaire has 30 close ended questions and the respondents have to answer on a three point scale (yes, no, need help). Both qualitative and quantitative analysis was conducted to test the hypothesis. The major findings of the study depict that the 87% of the women with intellectual disability perceived highest barriers related to competency whereas barriers related to behaviour and accessibility are perceived lowest. 92% of job coaches perceived barriers related to competencies and accessibility are highest which hinder the effectiveness of skill development of women with intellectual disability and 74% of the parents of adult women with intellectual disability also opines that the barriers related to competencies and accessibility are highest. In conclusion, it is stressed that there is need to create awareness among the stakeholders about the training and management strategies of skill training and positive behaviour support which will surely enable the adult women with intellectual disability to utilise their residual skill and acquire training to become economically independent.

Keywords: economic independence, intellectual disability, skill development, training barrier

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382 Adopting a Stakeholder Perspective to Profile Successful Sustainable Circular Business Approaches: A Single Case Study

Authors: Charleen von Kolpinski, Karina Cagarman, Alina Blaute

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The circular economy concept is often framed by politicians, scientists and practitioners as being the solution to sustainability problems of our times. However, the focus of these discussions and publications is very often set on environmental and economic aspects. In contrast, the social dimension of sustainability has been neglected and only a few recent and mostly conceptual studies targeted the inclusion of social aspects and the SDGs into circular economy research. All stakeholders of this new circular system have to be included to represent a truly sustainable solution to all the environmental, economic and social challenges caused by the linear economic system. Hence, this empirical research aims to analyse, next to the environmental and economic dimension, also explicitly the social dimension of a sustainable circular business model. This inductive and explorative approach applies the single case study method. A multi-stakeholder view is adopted to shed light on social aspects of the circular business model. Different stakeholder views, tensions between stakeholders and conflicts of interest are detected. In semi-structured interviews with different stakeholders of the company, this study compares the different stakeholder views to profile the success factors of its business model in terms of sustainability implementation and to detect its shortcomings. These findings result in the development of propositions which cover different social aspects of sustainable circular business model implementation. This study is an answer to calls for future empirical research about the social dimension of the circular economy and contributes to sustainable business model thinking in entrepreneurial contexts of the circular economy. It helps identifying all relevant stakeholders and their needs to successfully and inclusively implement a sustainable circular business model. The method of a single case study has some limitations by nature as it only covers one enterprise with its special business model. Therefore, more empirical studies are needed to research sustainable circular business models from multiple stakeholder perspectives, in different countries and industries. Future research can build upon the developed propositions of this study and develop hypotheses to be tested.

Keywords: circular economy, single case study, social dimension, sustainable circular business model

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381 Clinicians’ Perspectives on Child Language Brokering

Authors: Carmen Pena-Díaz

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Linguistic and cultural difficulties regarding the access and use of public services, as well as facilitating communication at all levels, are problems which have not yet been tackled by authorities in Spain. In fact, linguistic and cultural issues are often not recognised as an integral part of migratory movements or social integration. While professionals of interlinguistic and intercultural communication (translators, interpreters, mediators) know that language and culture are key components to achieve immigrant integration and consolidate a truly multilingual society, policymakers at local, national, or supranational levels do not always seem aware of the risks and costs of not providing interpreting and translation services, particularly those affecting the health of users. Regarding the services currently used to cover the communication-related needs between the non-Spanish speaking population and healthcare professionals, evidence proves that there are no effective provisions for communication problems at present in Spanish hospitals. An example that suggests the poor management of the situation in relation to the migrants’ access to public healthcare is the fact that relying on a family member (often a minor) in medical consultations is one of the main practices that affects communication. At present, most medical professionals will explain that in their consultations with migrants who do not speak Spanish, they ask them to bring along a family member or friend who speaks Spanish. In fact, an abundant body of literature describes situations in which family members, children, friends, or anyone who speaks or understands a language helps to break language barriers in hospitals, not only in Spain. It is not difficult to see the problems this may cause, from ethical issues to comprehension problems and misunderstandings. This paper will present the results of Narrative Inquiry from a sample of eight clinicians about their perceptions and experiences using child language brokers in their appointments with non-Spanish speaking families. The main aim is to collect information about child language brokering as recalled and perceived by clinicians who present CLB as a routine practice and express their concerns and worries about using children to convey negative news to their parents or family members.

Keywords: child language brokering, community interpreting, healthcare, PSIT

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