Search results for: symptom experiences
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2876

Search results for: symptom experiences

206 Nuancing the Indentured Migration in Amitav Ghosh's Sea of Poppies

Authors: Murari Prasad

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This paper is motivated by the implications of indentured migration depicted in Amitav Ghosh’s critically acclaimed novel, Sea of Poppies (2008). Ghosh’s perspective on the experiences of North Indian indentured labourers moving from their homeland to a distant and unknown location across the seas suggests a radical attitudinal change among the migrants on board the Ibis, a schooner chartered to carry the recruits from Calcutta to Mauritius in the late 1830s. The novel unfolds the life-altering trauma of the bonded servants, including their efforts to maintain a sense of self while negotiating significant social and cultural transformations during the voyage which leads to the breakdown of familiar life-worlds. Equally, the migrants are introduced to an alternative network of relationships to ensure their survival away from land. They relinquish their entrenched beliefs and prejudices and commit themselves to a new brotherhood formed by ‘ship siblings.’ With the official abolition of direct slavery in 1833, the supply of cheap labour to the sugar plantation in British colonies as far-flung as Mauritius and Fiji to East Africa and the Caribbean sharply declined. Around the same time, China’s attempt to prohibit the illegal importation of opium from British India into China threatened the lucrative opium trade. To run the ever-profitable plantation colonies with cheap labour, Indian peasants, wrenched from their village economies, were indentured to plantations as girmitiyas (vernacularized from ‘agreement’) by the colonial government using the ploy of an optional form of recruitment. After the British conquest of the Isle of France in 1810, Mauritius became Britain’s premier sugar colony bringing waves of Indian immigrants to the island. In the articulations of their subjectivities one notices how the recruits cope with the alienating drudgery of indenture, mitigate the hardships of the voyage and forge new ties with pragmatic acts of cultural syncretism in a forward-looking autonomous community of ‘ship-siblings’ following the fracture of traditional identities. This paper tests the hypothesis that Ghosh envisions a kind of futuristic/utopian political collectivity in a hierarchically rigid, racially segregated and identity-obsessed world. In order to ground the claim and frame the complex representations of alliance and love across the boundaries of caste, religion, gender and nation, the essential methodology here is a close textual analysis of the novel. This methodology will be geared to explicate the utopian futurity that the novel gestures towards by underlining new regulations of life during voyage and dissolution of multiple differences among the indentured migrants on board the Ibis.

Keywords: indenture, colonial, opium, sugar plantation

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205 Home Environment and Self-Efficacy Beliefs among Native American, African American and Latino Adolescents

Authors: Robert H. Bradley

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Many minority adolescents in the United States live in adverse circumstances that pose long-term threats to their well-being. A strong sense of personal control and self-efficacy can help youth mitigate some of those risks and may help protect youth from influences connected with deviant peer groups. Accordingly, it is important to identify conditions that help foster feelings of efficacy in areas that seem critical for the accomplishment of developmental tasks during adolescence. The purpose of this study is to examine two aspects of the home environment (modeling and encouragement of maturity, family companionship and investment) and their relation to three components of self efficacy (self efficacy in enlisting social resources, self efficacy for engaging in independent learning, and self-efficacy for self-regulatory behavior) in three groups of minority adolescents (Native American, African American, Latino). The sample for this study included 54 Native American, 131 African American, and 159 Latino families, each with a child between 16 and 20 years old. The families were recruited from four states: Arizona, Arkansas, California, and Oklahoma. Each family was administered the Late Adolescence version of the Home Observation for Measurement of the Environment (HOME) Inventory and each adolescent completed a 30-item measure of perceived self-efficacy. Three areas of self-efficacy beliefs were examined for this study: enlisting social resources, independent learning, and self-regulation. Each of the three areas of self-efficacy was regressed on the two aspects of the home environment plus overall household risk. For Native Americans, modeling and encouragement were significant for self-efficacy pertaining to enlisting social resources and independent learning. For African Americans, companionship and investment was significant in all three models. For Latinos, modeling and encouragement was significant for self-efficacy pertaining to enlisting social resources and companionship and investment were significant for the other two areas of self-efficacy. The findings show that even as minority adolescents are becoming more individuated from their parents, the quality of experiences at home continues to be associated with their feelings of self-efficacy in areas important for adaptive functioning in adult life. Specifically, individuals can develop a sense that they are efficacious in performing key tasks relevant to work, social relationships, and management of their own behavior if they are guided in how to deal with key challenges and they have been exposed and supported by others who are competent in dealing with such challenges. The findings presented in this study would seem useful given that there is so little current research on home environmental factors connected to self-efficacy beliefs among adolescents in the three groups examined. It would seem worthwhile that personnel from health, human service and juvenile justice agencies give attention to supporting parents in communicating with adolescents, offering expectations to adolescents in mutually supportive ways, and in engaging with adolescents in productive activities. In comparison to programs for parents of young children, there are few specifically designed for parents of children in middle childhood and adolescence.

Keywords: family companionship, home environment, household income, modeling, self-efficacy

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204 Exploring the Impact of Eye Movement Desensitization and Reprocessing (EMDR) And Mindfulness for Processing Trauma and Facilitating Healing During Ayahuasca Ceremonies

Authors: J. Hash, J. Converse, L. Gibson

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Plant medicines are of growing interest for addressing mental health concerns. Ayahuasca, a traditional plant-based medicine, has established itself as a powerful way of processing trauma and precipitating healing and mood stabilization. Eye Movement Desensitization and Reprocessing (EMDR) is another treatment modality that aids in the rapid processing and resolution of trauma. We investigated group EMDR therapy, G-TEP, as a preparatory practice before Ayahuasca ceremonies to determine if the combination of these modalities supports participants in their journeys of letting go of past experiences negatively impacting mental health, thereby accentuating the healing of the plant medicine. We surveyed 96 participants (51 experimental G-TEP, 45 control grounding prior to their ceremony; age M=38.6, SD=9.1; F=57, M=34; white=39, Hispanic/Latinx=23, multiracial=11, Asian/Pacific Islander=10, other=7) in a pre-post, mixed methods design. Participants were surveyed for demographic characteristics, symptoms of PTSD and cPTSD (International Trauma Questionnaire (ITQ), depression (Beck Depression Inventory, BDI), and stress (Perceived Stress Scale, PSS) before the ceremony and at the end of the ceremony weekend. Open-ended questions also inquired about their expectations of the ceremony and results at the end. No baseline differences existed between the control and experimental participants. Overall, participants reported a decrease in meeting the threshold for PTSD symptoms (p<0.01); surprisingly, the control group reported significantly fewer thresholds met for symptoms of affective dysregulation, 2(1)=6.776, p<.01, negative self-concept, 2 (1)=7.122, p<.01, and disturbance in relationships, 2 (1)=9.804, p<.01, on subscales of the ITQ as compared to the experimental group. All participants also experienced a significant decrease in scores on the BDI, t(94)=8.995, p<.001, and PSS, t(91)=6.892, p<.001. Similar to patterns of PTSD symptoms, the control group reported significantly lower scores on the BDI, t(65.115)=-2.587, p<.01, and a trend toward lower PSS, t(90)=-1.775, p=.079 (this was significant with a one-sided test at p<.05), compared to the experimental group following the ceremony. Qualitative interviews among participants revealed a potential explanation for these relatively higher levels of depression and stress in the experimental group following the ceremony. Many participants reported needing more time to process their experience to gain an understanding of the effects of the Ayahuasca medicine. Others reported a sense of hopefulness and understanding of the sources of their trauma and the necessary steps to heal moving forward. This suggests increased introspection and openness to processing trauma, therefore making them more receptive to their emotions. The integration process of an Ayahuasca ceremony is a week- to months-long process that was not accessible in this stage of research, yet it is an integral process to understanding the full effects of the Ayahuasca medicine following the closure of a ceremony. Our future research aims to assess participants weeks into their integration process to determine the effectiveness of EMDR, and if the higher levels of depression and stress indicate the initial reaction to greater awareness of trauma and receptivity to healing.

Keywords: ayahuasca, EMDR, PTSD, mental health

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203 Multilingual Students Acting as Language Brokers in Italy: Their Points of View and Feelings towards This Activity

Authors: Federica Ceccoli

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Italy is undergoing one of its largest migratory waves, and Italian schools are reporting the highest numbers of multilingual students coming from immigrant families and speaking minority languages. For these pupils, who have not perfectly acquired their mother tongue yet, learning a second language may represent a burden on their linguistic development and may have some repercussions on their school performances and relational skills. These are some of the reasons why they have turned out to be those who have the worst grades and the highest school drop-out rates. However, despite these negative outcomes, it has been demonstrated that multilingual immigrant students frequently act as translators or language brokers for their peers or family members who do not speak Italian fluently. This activity has been defined as Child Language Brokering (hereinafter CLB) and it has become a common practice especially in minority communities as immigrants’ children often learn the host language much more quickly than their parents, thus contributing to their family life by acting as language and cultural mediators. This presentation aims to analyse the data collected by a research carried out during the school year 2014-2015 in the province of Ravenna, in the Northern Italian region of Emilia-Romagna, among 126 immigrant students attending junior high schools. The purpose of the study was to analyse by means of a structured questionnaire whether multilingualism matched with language brokering experiences or not and to examine the perspectives of those students who reported having acted as translators using their linguistic knowledge to help people understand each other. The questionnaire consisted of 34 items roughly divided into 2 sections. The first section required multilingual students to provide personal details like their date and place of birth, as well as details about their families (number of siblings, parents’ jobs). In the second section, they were asked about the languages spoken in their families as well as their language brokering experience. The in-depth questionnaire sought to investigate a wide variety of brokering issues such as frequency and purpose of the activity, where, when and which documents young language brokers translate and how they feel about this practice. The results have demonstrated that CLB is a very common practice among immigrants’ children living in Ravenna and almost all students reported positive feelings when asked about their brokering experience with their families and also at school. In line with previous studies, responses to the questionnaire item regarding the people they brokered for revealed that the category ranking first is parents. Similarly, language-brokering activities tend to occur most often at home and the documents they translate the most (either orally or in writing) are notes from teachers. Such positive feelings towards this activity together with the evidence that it occurs very often in schools have laid the foundation for further projects on how this common practice may be valued and used to strengthen the linguistic skills of these multilingual immigrant students and thus their school performances.

Keywords: immigration, language brokering, multilingualism, students' points of view

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202 Cinema Reception in a Digital World: A Study of Cinema Audiences in India

Authors: Sanjay Ranade

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Traditional film theory assumes the cinema audience in a darkened room where cinema is projected on to a white screen, and the audience suspends their sense of reality. Shifts in audiences due to changes in cultural tastes or trends have been studied for decades. In the past two decades, however, the audience, especially the youth, has shifted to digital media for the consumption of cinema. As a result, not only are audiences watching cinema on different devices, they are also consuming cinema in places and ways never imagined before. Public transport often crowded to the brim with a lot of ambient content, and a variety of workplaces have become sites for cinema viewing. Cinema is watched piecemeal and at different times of the day. Audiences use devices such as mobile phones and tablets to watch cinema. The cinema viewing experience is getting redesigned by the user. The emerging design allows the spectator to not only consume images and narratives but also produce, reproduce, and manipulate existing images and narratives, thereby participating in the process and influencing it. Spectatorship studies stress on the importance of subjectivity when dealing with the structure of the film text and the cultural and psychological implications in the engagement between the spectator and the film text. Indian cinema has been booming and contributing to global movie production significantly. In 2005 film production was 1000 films a year and doubled to 2000 by 2016. Digital technology helped push this growth in 2012. Film studies in India have had a decided Euro-American bias. The studies have chiefly analysed the content for ideological leanings or myth or as reflections of society, societal changes, or articulation of identity or presented retrospectives of directors, actors, music directors, etc. The one factor relegated to the background has been the spectator. If they have been addressed, they are treated as a collective of class or gender. India has a performative tradition going back several centuries. How Indians receive cinema is an important aspect to study with respect to film studies. This exploratory and descriptive study looked at 162 young media students studying cinema at the undergraduate and postgraduate levels. The students, speaking as many as 20 languages amongst them, were drawn from across the country’s media schools. The study looked at nine film societies registered with the Federation of Film Societies of India. A structured questionnaire was made and distributed online through media teachers for the students. The film societies were approached through the regional office of the FFSI in Mumbai. Lastly, group discussions were held in Mumbai with students and teachers of media. A group consisted of between five and twelve student participants, along with one or two teachers. All the respondents looked at themselves as spectators and shared their experiences of spectators of cinema, providing a very rich insight into Indian conditions of viewing cinema and challenges for cinema ahead.

Keywords: audience, digital, film studies, reception, reception spectatorship

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201 Bridging the Educational Gap: A Curriculum Framework for Mass Timber Construction Education and Comparative Analysis of Physical vs. Virtual Prototypes in Construction Management

Authors: Farnaz Jafari

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The surge in mass timber construction represents a pivotal moment in sustainable building practices, yet the lack of comprehensive education in construction management poses a challenge in harnessing this innovation effectively. This research endeavors to bridge this gap by developing a curriculum framework integrating mass timber construction into undergraduate and industry certificate programs. To optimize learning outcomes, the study explores the impact of two prototype formats -Virtual Reality (VR) simulations and physical mock-ups- on students' understanding and skill development. The curriculum framework aims to equip future construction managers with a holistic understanding of mass timber, covering its unique properties, construction methods, building codes, and sustainable advantages. The study adopts a mixed-methods approach, commencing with a systematic literature review and leveraging surveys and interviews with educators and industry professionals to identify existing educational gaps. The iterative development process involves incorporating stakeholder feedback into the curriculum. The evaluation of prototype impact employs pre- and post-tests administered to participants engaged in pilot programs. Through qualitative content analysis and quantitative statistical methods, the study seeks to compare the effectiveness of VR simulations and physical mock-ups in conveying knowledge and skills related to mass timber construction. The anticipated findings will illuminate the strengths and weaknesses of each approach, providing insights for future curriculum development. The curriculum's expected contribution to sustainable construction education lies in its emphasis on practical application, bridging the gap between theoretical knowledge and hands-on skills. The research also seeks to establish a standard for mass timber construction education, contributing to the field through a unique comparative analysis of VR simulations and physical mock-ups. The study's significance extends to the development of best practices and evidence-based recommendations for integrating technology and hands-on experiences in construction education. By addressing current educational gaps and offering a comparative analysis, this research aims to enrich the construction management education experience and pave the way for broader adoption of sustainable practices in the industry. The envisioned curriculum framework is designed for versatile integration, catering to undergraduate programs and industry training modules, thereby enhancing the educational landscape for aspiring construction professionals. Ultimately, this study underscores the importance of proactive educational strategies in preparing industry professionals for the evolving demands of the construction landscape, facilitating a seamless transition towards sustainable building practices.

Keywords: curriculum framework, mass timber construction, physical vs. virtual prototypes, sustainable building practices

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200 Navigating AI in Higher Education: Exploring Graduate Students’ Perspectives on Teacher-Provided AI Guidelines

Authors: Mamunur Rashid, Jialin Yan

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The current years have witnessed a rapid evolution and integration of artificial intelligence (AI) in various fields, prominently influencing the education industry. Acknowledging this transformative wave, AI tools like ChatGPT and Grammarly have undeniably introduced perspectives and skills, enriching the educational experiences of higher education students. The prevalence of AI utilization in higher education also drives an increasing number of researchers' attention in various dimensions. Departments, offices, and professors in universities also designed and released a set of policies and guidelines on using AI effectively. In regard to this, the study targets exploring and analyzing graduate students' perspectives regarding AI guidelines set by teachers. A mixed-methods study will be mainly conducted in this study, employing in-depth interviews and focus groups to investigate and collect students' perspectives. Relevant materials, such as syllabi and course instructions, will also be analyzed through the documentary analysis to facilitate understanding of the study. Surveys will also be used for data collection and students' background statistics. The integration of both interviews and surveys will provide a comprehensive array of student perspectives across various academic disciplines. The study is anchored in the theoretical framework of self-determination theory (SDT), which emphasizes and explains the students' perspective under the AI guidelines through three core needs: autonomy, competence, and relatedness. This framework is instrumental in understanding how AI guidelines influence students' intrinsic motivation and sense of empowerment in their learning environments. Through qualitative analysis, the study reveals a sense of confusion and uncertainty among students regarding the appropriate application and ethical considerations of AI tools, indicating potential challenges in meeting their needs for competence and autonomy. The quantitative data further elucidates these findings, highlighting a significant communication gap between students and educators in the formulation and implementation of AI guidelines. The critical findings of this study mainly come from two aspects: First, the majority of graduate students are uncertain and confused about relevant AI guidelines given by teachers. Second, this study also demonstrates that the design and effectiveness of course materials, such as the syllabi and instructions, also need to adapt in regard to AI policies. It indicates that certain of the existing guidelines provided by teachers lack consideration of students' perspectives, leading to a misalignment with students' needs for autonomy, competence, and relatedness. More emphasize and efforts need to be dedicated to both teacher and student training on AI policies and ethical considerations. To conclude, in this study, graduate students' perspectives on teacher-provided AI guidelines are explored and reflected upon, calling for additional training and strategies to improve how these guidelines can be better disseminated for their effective integration and adoption. Although AI guidelines provided by teachers may be helpful and provide new insights for students, educational institutions should take a more anchoring role to foster a motivating, empowering, and student-centered learning environment. The study also provides some relevant recommendations, including guidance for students on the ethical use of AI and AI policy training for teachers in higher education.

Keywords: higher education policy, graduate students’ perspectives, higher education teacher, AI guidelines, AI in education

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199 Developing Creative and Critically Reflective Digital Learning Communities

Authors: W. S. Barber, S. L. King

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This paper is a qualitative case study analysis of the development of a fully online learning community of graduate students through arts-based community building activities. With increasing numbers and types of online learning spaces, it is incumbent upon educators to continue to push the edge of what best practices look like in digital learning environments. In digital learning spaces, instructors can no longer be seen as purveyors of content knowledge to be examined at the end of a set course by a final test or exam. The rapid and fluid dissemination of information via Web 3.0 demands that we reshape our approach to teaching and learning, from one that is content-focused to one that is process-driven. Rather than having instructors as formal leaders, today’s digital learning environments require us to share expertise, as it is the collective experiences and knowledge of all students together with the instructors that help to create a very different kind of learning community. This paper focuses on innovations pursued in a 36 hour 12 week graduate course in higher education entitled “Critical and Reflective Practice”. The authors chronicle their journey to developing a fully online learning community (FOLC) by emphasizing the elements of social, cognitive, emotional and digital spaces that form a moving interplay through the community. In this way, students embrace anywhere anytime learning and often take the learning, as well as the relationships they build and skills they acquire, beyond the digital class into real world situations. We argue that in order to increase student online engagement, pedagogical approaches need to stem from two primary elements, both creativity and critical reflection, that are essential pillars upon which instructors can co-design learning environments with students. The theoretical framework for the paper is based on the interaction and interdependence of Creativity, Intuition, Critical Reflection, Social Constructivism and FOLCs. By leveraging students’ embedded familiarity with a wide variety of technologies, this case study of a graduate level course on critical reflection in education, examines how relationships, quality of work produced, and student engagement can improve by using creative and imaginative pedagogical strategies. The authors examine their professional pedagogical strategies through the lens that the teacher acts as facilitator, guide and co-designer. In a world where students can easily search for and organize information as self-directed processes, creativity and connection can at times be lost in the digitized course environment. The paper concludes by posing further questions as to how institutions of higher education may be challenged to restructure their credit granting courses into more flexible modules, and how students need to be considered an important part of assessment and evaluation strategies. By introducing creativity and critical reflection as central features of the digital learning spaces, notions of best practices in digital teaching and learning emerge.

Keywords: online, pedagogy, learning, communities

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198 'You’re Not Alone': Peer Feedback Practices for Cross-Cultural Writing Classrooms and Centers

Authors: Cassandra Branham, Danielle Farrar

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As writing instructors and writing center administrators at a large research university with a significant population of English language learners (ELLs), we are interested in how peer feedback pedagogy can be effectively translated for writing center purposes, as well as how various modes of peer feedback can enrich the learning experiences of L1 and L2 writers in these spaces. Although peer feedback is widely used in classrooms and centers, instructor, student, and researcher opinions vary in respect to its effectiveness. We argue that peer feedback - traditional and digital, synchronous and asynchronous - is an indispensable element for both classrooms and centers and emphasize that it should occur with both L1 and L2 students to further develop an array of reading and writing skills. We also believe that further understanding of the best practices of peer feedback in such cross-cultural spaces, like the classroom and center, can optimize the benefits of peer feedback. After a critical review of the literature, we implemented an embedded tutoring program in our university’s writing center in collaboration with its First-Year Composition (FYC) program and Language Institute. The embedded tutoring program matches a graduate writing consultant with L1 and L2 writers enrolled in controlled-matriculation composition courses where ELLs make up at least 50% of each class. Furthermore, this program is informed by what we argue to be some best practices of peer feedback for both classroom and center purposes, including expectation-based training through rubrics, modeling effective feedback, hybridizing traditional and digital modes of feedback, recognizing the significance the body in composition (what we call writer embodiment), and maximizing digital technologies to exploit extended cognition. After conducting surveys and follow-up interviews with students, instructors, and writing consultants in the embedded tutoring program, we found that not only did students see an increased value in peer feedback, but also instructors saw an improvement in both writing style and critical thinking skills. Our L2 participants noted improvements in language acquisition while our L1 students recognized a broadening of their worldviews. We believe that both L1 and L2 students developed self-efficacy and agency in their identities as writers because they gained confidence in their abilities to offer feedback, as well as in the legitimacy of feedback they received from peers. We also argue that these best practices situate novice writers as experts, as writers become a valued and integral part of the revision process with their own and their peers’ papers. Finally, the use of iPads in embedded tutoring recovered the importance of the body and its senses in writing; the highly sensory feedback from these multi-modal sessions that offer audio and visual input underscores the significant role both the body and mind play in compositional practices. After beginning with a brief review of the literature that sparked this research, this paper will discuss the embedded tutoring program in detail, report on the results of the pilot program, and will conclude with a discussion of the pedagogical implications that arise from this research for both classroom and center.

Keywords: English language learners, peer feedback, writing center, writing classroom

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197 Work Related Outcomes of Perceived Authentic Leadership: Moderating Role of Organizational Structures

Authors: Aisha Zubair, Anila Kamal

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Leadership styles and practices greatly influence the organizational effectiveness and productivity. It also plays an important role in employees’ experiences of positive emotions at workplace and creative work behaviors. Authentic leadership as a newly emerging concept has been found as a significant predictor of various desirable work related outcomes. However, leadership practices and its work related outcomes, to a great extent, are determined by the very nature of the organizational structures (tall and flat). Tall organizations are characterized by multiple hierarchical layers with predominant vertical communication patterns, and narrow span of control; while flat organizations are featured by few layers of management employing both horizontal and vertical communication styles, and wide span of control. Therefore, the present study was undertaken to determine the work related outcomes of perceived authentic leadership; that is work related flow and creative work behavior among employees of flat and tall organizations. Moreover, it was also intended to determine the moderating role of organizational structure (flat and tall) in the relationship between perceived authentic leadership with work related flow and creative work behavior. In this regard, two types of companies have been considered; that is, banks as a form of tall organizational structure with multiple hierarchical structures while software companies have been considered as flat organizations with minimal layers of management. Respondents (N = 1180) were full time regular employees of marketing departments of banks (600) and software companies (580) including both men and women with age range of 22-52 years (M = 33.24; SD = 7.81). Confirmatory Factor Analysis yielded factor structures of measures of work related flow and creative work behavior in accordance to the theoretical models. However, model of authentic leadership exhibited variation in terms of two items which were not included in the final measure of the perceived authentic leadership. Results showed that perceived authentic leadership was positively associated with work related flow and creative work behavior. Likewise, work related flow was positively aligned with creative work behavior. Furthermore, type of organizational structure significantly moderated the relationship of perceived authentic leadership with work related flow and creative work behavior. Results of independent sample t-test showed that employees working in flat organization reflected better perceptions of authentic leadership; higher work related flow and elevated levels of creative work behavior as compared to those working in tall organizations. It was also found that employees with extended job experience and more job duration in the same organization displayed better perceptions of authentic leadership, reported more work related flow and augmented levels of creative work behavior. Findings of the present study distinctively highlighted the similarities as well as differences in the interactions of major constructs which function differentially in the context of tall (banks) and flat (software companies) organizations. Implications of the present study for employees and management as well as future recommendations were also discussed.

Keywords: creative work behavior, organizational structure, perceived authentic leadership, work related flow

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196 Social Implementation of Information Sharing Road Safety Measure in South-East Asia

Authors: Hiroki Kikuchi, Atsushi Fukuda, Hirokazu Akahane, Satoru Kobayakawa, Tuenjai Fukuda, Takeru Miyokawa

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According to WHO reports, fatalities by road traffic accidents in many countries of South-East Asia region especially Thailand and Malaysia are increasing year by year. In order to overcome these serious problems, both governments are focusing on road safety measures. In response, the Ministry of Land, Infrastructure, Transport and Tourism (MLIT) of Japan and Japan International Cooperation Agency (JICA) have begun active support based on the experiences to reduce the number of fatalities in road accidents in Japan in the past. However, even if the successful road safety measures in Japan is adopted in South-East Asian countries, it is not sure whether it will work well or not. So, it is necessary to clarify the issues and systematize the process for the implementation of road safety measures in South-East Asia. On the basis of the above, this study examined the applicability of "information sharing traffic safety measure" which is one of the successful road safety measures in Japan to the social implementation of road safety measures in South-East Asian countries. The "Information sharing traffic safety measure" is carried out traffic safety measures by stakeholders such as residents, administration, and experts jointly. In this study, we extracted the issues of implementation of road safety measures under local context firstly. This is clarifying the particular issues with its implementation in South-East Asian cities. Secondly, we considered how to implement road safety measures for solving particular issues based on the method of "information sharing traffic safety measure". In the implementation method, the location of the occurrence of a dangerous event was extracted based on the “HIYARI-HATTO” data which were obtained from the residents. This is because it is considered that the implementation of the information sharing traffic safety measure focusing on the location where the dangerous event occurs leads to the reduction of traffic accidents. Also, the target locations for the implementation of measures differ for each city. In Penang, we targeted the intersections in the downtown, while in Suphan Buri, we targeted mainly traffic control on the intercity highway. Finally, we proposed a method for implementing traffic safety measures. For Penang, we proposed a measure to improve the signal phase and showed the effect of the measure on the micro traffic simulation. For Suphan Buri, we proposed the suitable measures for the danger points extracted by collecting the “HIYARI-HATTO” data of residents to the administration. In conclusion, in order to successfully implement the road safety measure based on the "information sharing traffic safety measure", the process for social implementation of the road safety measures should be consistent and carried out repeatedly. In particular, by clarifying specific issues based on local context in South-East Asian countries, the stakeholders, not only such as government sectors but also local citizens can share information regarding road safety and select appropriate countermeasures. Finally, we could propose this approach to the administration that had the authority.

Keywords: information sharing road safety measure, social implementation, South-East Asia, HIYARI-HATTO

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195 Psycho-Social Associates of Deliberate Self-Harm in Rural Sri Lanka

Authors: P. H. G. J. Pushpakumara, A. M. P. Adikari, S. U. B. Tennakoon, Ranil Abeysinghe, Andrew Dawson

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Introduction: Deliberate Self-harm (DSH) is a global public health problem. Since 1950, suicide rates in Sri Lanka are among the highest national rates in the world. It has become an increasingly common response to emotional distress in young adults. However, it remains unclear the reason for this occurrence. Objectives: The descriptive component of this study was conducted to identify of epidemiological pattern of DSH and suicide in Kurunegala District (KD). Assessment of association between DSH socio-cultural, economical and psychological factors were the objectives of the case control component. Methods: Prospective data collection of DSH and suicide was conducted at all (46) hospitals and all (28) police stations in the KD for thirty six months, from 1st January 2011, as the descriptive component. Case control component was conducted at T.H. Kurunegala (THK) for eighteen months duration, from 1st July 2011. Cases (n=439) were randomly selected from a block of 7 consecutively admitted consenting DSP patients using a computer program. Age, sex and residential divisional secretariat division one to one matched, individuals were randomly selected as controls from patients presented to Out Patient Department. Structured Clinical Interview for DSM-IV-TR Axis I and II Disorders was used to diagnose psychiatric disorders. Validated tools were used to measure other constructs. Results: Suicide incidences in KD were, 21.6, 20.7 and 24.3 per 100,000 population in 2011- 2013 (Male:female ratio 5.7, 4.4 and 6.4). 60% of suicides were due to poisoning. DSP incidences were 205.4, 248.3 and 202.5 per 100,000 population in 2011- 2013. Highest age standardized male DSP incidence reported in 20-24 years (769.6/100,000) and female in 15-19 years (1304.0/100,000). Bing married (age >25 years), monthly family income less than Rs.30,000, not achieving G.C.E (O/L) qualifications, a school drop-out, not in a permanent position in occupation, being a manual and an own account worker, were significantly associated with DSP. Perceiving the quality of relationship as bad or very bad with parents, spouse/ girlfriend/ boyfriend and sibling as associated with 8, 40 and 10.5 times higher risk respectively. Feeling and experiences of neglect, other emotional abuses, feeling of insecurity with the family, in child hood, and having a contact history carried an excess risk for DSP. Cases were less likely to seek help. Further, they had significantly lower scores for life skills and life skills application ability. 25.6% DSH patients had DSM TR axis-I and/or TR axis-II disorder. The presence of psychiatric disorder carried 7.7 (95% CI 4.3 – 13.8) times higher risk for DSP. Conclusion: In general, pattern of DSH and suicide is, unique, different from developed, upper and middle income and lower and middle income countries. It is a learned way of expressing emotions in difficult situations of vulnerable people.

Keywords: deliberate self-harm, help-seeking, life-skills, mental- health, psychological, social, suicide

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194 The South African Polycentric Water Resource Governance-Management Nexus: Parlaying an Institutional Agent and Structured Social Engagement

Authors: J. H. Boonzaaier, A. C. Brent

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South Africa, a water scarce country, experiences the phenomenon that its life supporting natural water resources is seriously threatened by the users that are totally dependent on it. South Africa is globally applauded to have of the best and most progressive water laws and policies. There are however growing concerns regarding natural water resource quality deterioration and a critical void in the management of natural resources and compliance to policies due to increasing institutional uncertainties and failures. These are in accordance with concerns of many South African researchers and practitioners that call for a change in paradigm from talk to practice and a more constructive, practical approach to governance challenges in the management of water resources. A qualitative theory-building case study through longitudinal action research was conducted from 2014 to 2017. The research assessed whether a strategic positioned institutional agent can be parlayed to facilitate and execute WRM on catchment level by engaging multiple stakeholders in a polycentric setting. Through a critical realist approach a distinction was made between ex ante self-deterministic human behaviour in the realist realm, and ex post governance-management in the constructivist realm. A congruence analysis, including Toulmin’s method of argumentation analysis, was utilised. The study evaluated the unique case of a self-steering local water management institution, the Impala Water Users Association (WUA) in the Pongola River catchment in the northern part of the KwaZulu-Natal Province of South Africa. Exploiting prevailing water resource threats, it expanded its ancillary functions from 20,000 to 300,000 ha. Embarking on WRM activities, it addressed natural water system quality assessments, social awareness, knowledge support, and threats, such as: soil erosion, waste and effluent into water systems, coal mining, and water security dimensions; through structured engagement with 21 different catchment stakeholders. By implementing a proposed polycentric governance-management model on a catchment scale, the WUA achieved to fill the void. It developed a foundation and capacity to protect the resilience of the natural environment that is critical for freshwater resources to ensure long-term water security of the Pongola River basin. Further work is recommended on appropriate statutory delegations, mechanisms of sustainable funding, sufficient penetration of knowledge to local levels to catalyse behaviour change, incentivised support from professionals, back-to-back expansion of WUAs to alleviate scale and cost burdens, and the creation of catchment data monitoring and compilation centres.

Keywords: institutional agent, water governance, polycentric water resource management, water resource management

Procedia PDF Downloads 113
193 Evaluating an Educational Intervention to Reduce Pesticide Exposure Among Farmers in Nigeria

Authors: Gift Udoh, Diane S. Rohlman, Benjamin Sindt

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BACKGROUND: There is concern regarding the widespread use of pesticides and impacts on public health. Farmers in Nigeria frequently apply pesticides, including organophosphate pesticides which are known neurotoxicants. They receive little guidance on how much to apply or information about safe handling practices. Pesticide poisoning is one of the major hazards that farmers face in Nigeria. Farmers continue to use highly neurotoxic pesticides for agricultural activities. Because farmers receive little or no information on safe handling and how much to apply, they continue to develop severe and mild illnesses caused by high exposures to pesticides. The project aimed to reduce pesticide exposure among rural farmers in Nigeria by identifying hazards associated with pesticide use and developing and pilot testing training to reduce exposures to pesticides utilizing the hierarchy of controls system. METHODS: Information on pesticide knowledge, behaviors, barriers to safety, and prevention methods was collected from farmers in Nigeria through workplace observations, questionnaires, and interviews. Pre and post-surveys were used to measure farmer’s knowledge before and after the delivery of pesticide safety training. Training topics included the benefits and risks of using pesticides, routes of exposure and health effects, pesticide label activity, use and selection of PPE, ways to prevent exposure and information on local resources. The training was evaluated among farmers and changes in knowledge, attitudes and behaviors were collected prior to and following the training. RESULTS: The training was administered to 60 farmers, a mean age of 35, with a range of farming experience (<1 year to > 50 years). There was an overall increase in knowledge after the training. In addition, farmers perceived a greater immediate risk from exposure to pesticides and their perception of their personal risk increased. For example, farmers believed that pesticide risk is greater to children than to adults, recognized that just because a pesticide is put on the market doesn’t mean it is safe, and they were more confident that they could get advice about handling pesticides. Also, there was greater awareness about behaviors that can increase their exposure (mixing pesticides with bare hands, eating food in the field, not washing hands before eating after applying pesticides, walking in fields recently sprayed, splashing pesticides on their clothes, pesticide storage). CONCLUSION: These results build on existing evidence from a 2022 article highlighting the need for pesticide safety training in Nigeria which suggested that pesticide safety educational programs should focus on community-based, grassroots-style, and involve a family-oriented approach. Educating farmers on agricultural safety while letting them share their experiences with their peers is an effective way of creating awareness on the dangers associated with handling pesticides. Also, for rural communities, especially in Nigeria, pesticide safety pieces of training may not be able to reach some locations, so intentional scouting of rural farming communities and delivering pesticide safety training will improve knowledge of pesticide hazards. There is a need for pesticide information centers to be situated in rural farming communities or agro supply stores, which gives rural farmers information.

Keywords: pesticide exposure, pesticide safety, nigeria, rural farming, pesticide education

Procedia PDF Downloads 141
192 Nursing Education in the Pandemic Time: Case Study

Authors: Jaana Sepp, Ulvi Kõrgemaa, Kristi Puusepp, Õie Tähtla

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COVID-19 was officially recognized as a pandemic in late 2019 by the WHO, and it has led to changes in the education sector. Educational institutions were closed, and most schools adopted distance learning. Estonia is known as a digitally well-developed country. Based on that, in the pandemic time, nursing education continued, and new technological solutions were implemented. To provide nursing education, special focus was paid on quality and flexibility. The aim of this paper is to present administrative, digital, and technological solutions which support Estonian nursing educators to continue the study process in the pandemic time and to develop a sustainable solution for nursing education for the future. This paper includes the authors’ analysis of the documents and decisions implemented in the institutions through the pandemic time. It is a case study of Estonian nursing educators. Results of the analysis show that the implementation of distance learning principles challenges the development of innovative strategies and technics for the assessment of student performance and educational outcomes and implement new strategies to encourage student engagement in the virtual classroom. Additionally, hospital internships were canceled, and the simulation approach was deeply implemented as a new opportunity to develop and assess students’ practical skills. There are many other technical and administrative changes that have also been carried out, such as students’ support and assessment systems, the designing and conducting of hybrid and blended studies, etc. All services were redesigned and made more available, individual, and flexible. Hence, the feedback system was changed, the information was collected in parallel with educational activities. Experiences of nursing education during the pandemic time are widely presented in scientific literature. However, to conclude our study, authors have found evidence that solutions implemented in Estonian nursing education allowed the students to graduate within the nominal study period without any decline in education quality. Operative information system and flexibility provided the minimum distance between the students, support, and academic staff, and likewise, the changes were implemented quickly and efficiently. Institution memberships were updated with the appropriate information, and it positively affected their satisfaction, motivation, and commitment. We recommend that the feedback process and the system should be permanently changed in the future to place all members in the same information area, redefine the hospital internship process, implement hybrid learning, as well as to improve the communication system between stakeholders inside and outside the organization. The main limitation of this study relates to the size of Estonia. Nursing education is provided by two institutions only, and similarly, the number of students is low. The result could be generated to the institutions with a similar size and administrative system. In the future, the relationship between nurses’ performance and organizational outcomes should be deeply investigated and influences of the pandemic time education analyzed at workplaces.

Keywords: hybrid learning, nursing education, nursing, COVID-19

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191 Optimizing Usability Testing with Collaborative Method in an E-Commerce Ecosystem

Authors: Markandeya Kunchi

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Usability testing (UT) is one of the vital steps in the User-centred design (UCD) process when designing a product. In an e-commerce ecosystem, UT becomes primary as new products, features, and services are launched very frequently. And, there are losses attached to the company if an unusable and inefficient product is put out to market and is rejected by customers. This paper tries to answer why UT is important in the product life-cycle of an E-commerce ecosystem. Secondary user research was conducted to find out work patterns, development methods, type of stakeholders, and technology constraints, etc. of a typical E-commerce company. Qualitative user interviews were conducted with product managers and designers to find out the structure, project planning, product management method and role of the design team in a mid-level company. The paper tries to address the usual apprehensions of the company to inculcate UT within the team. As well, it stresses upon factors like monetary resources, lack of usability expert, narrow timelines, and lack of understanding of higher management as some primary reasons. Outsourcing UT to vendors is also very prevalent with mid-level e-commerce companies, but it has its own severe repercussions like very little team involvement, huge cost, misinterpretation of the findings, elongated timelines, and lack of empathy towards the customer, etc. The shortfalls of the unavailability of a UT process in place within the team and conducting UT through vendors are bad user experiences for customers while interacting with the product, badly designed products which are neither useful and nor utilitarian. As a result, companies see dipping conversions rates in apps and websites, huge bounce rates and increased uninstall rates. Thus, there was a need for a more lean UT system in place which could solve all these issues for the company. This paper highlights on optimizing the UT process with a collaborative method. The degree of optimization and structure of collaborative method is the highlight of this paper. Collaborative method of UT is one in which the centralised design team of the company takes for conducting and analysing the UT. The UT is usually a formative kind where designers take findings into account and uses in the ideation process. The success of collaborative method of UT is due to its ability to sync with the product management method employed by the company or team. The collaborative methods focus on engaging various teams (design, marketing, product, administration, IT, etc.) each with its own defined roles and responsibility in conducting a smooth UT with users In-house. The paper finally highlights the positive results of collaborative UT method after conducting more than 100 In-lab interviews with users across the different lines of businesses. Some of which are the improvement of interaction between stakeholders and the design team, empathy towards users, improved design iteration, better sanity check of design solutions, optimization of time and money, effective and efficient design solution. The future scope of collaborative UT is to make this method leaner, by reducing the number of days to complete the entire project starting from planning between teams to publishing the UT report.

Keywords: collaborative method, e-commerce, product management method, usability testing

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190 Attitudes of Gratitude: An Analysis of 30 Cancer Patient Narratives Published by Leading U.S. Cancer Care Centers

Authors: Maria L. McLeod

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This study examines the ways in which cancer patient narratives are portrayed and framed on the websites of three leading U.S. cancer care centers –The University of Texas MD Anderson Cancer Center in Houston, Memorial Sloan Kettering Cancer Center in New York, and Seattle Cancer Care Alliance. Thirty patient stories, ten from each cancer center website blog, were analyzed using qualitative and quantitative textual analysis of unstructured data, documenting repeated use of specific metaphors and tropes while charting common themes and other elements of story structure and content. Patient narratives were coded using grounded theory as the basis for conducting emergent qualitative research. As part of a systematic, inductive approach to collecting and analyzing data, recurrent and unique themes were examined and compared in terms of positive and negative framing, patient agency, and institutional praise. All three of these cancer care centers are teaching hospitals with university affiliations, that emphasizes an evidence-based scientific approach to treatment that utilizes the latest research and cutting-edge techniques and technology. Thus, the use of anecdotal evidence presented in patient narratives could be perceived as being in conflict with this evidence-based model, as the patient stories are not an accurate representation of scientific outcomes related to developing cancer, cancer reoccurrence, or cancer outcomes. The representative patient narratives tend to exclude or downplay adverse responses to treatment, survival rates, integrative and/or complementary cancer treatments, cancer prevention and causes, and barriers to treatment, such as the limitation of insurance plans, costs of treatment, and/or other issues related to access, potentially contributing to false narratives and inaccurate notions of cancer prevention, cancer care treatment and the potential for a cure. Both quantitative and qualitative findings demonstrate that cancer patient stories featured on the blogsites of the nation’s top cancer care centers deemphasize patient agency and, instead, emphasize deference and gratitude toward the institutions where the featured patients received treatment. Along these lines, language choices reflect positive framing of the cancer experience. Accompanying portrait photos of healthy appearing subjects as well as positive-framed headlines, subheads, and pull quotes function similarly, reflecting hopeful, transformative experiences and outcomes over hardship and suffering. Although patient narratives include real, factual scientific details and descriptions of actual events, the stories lack references to more negative realities of cancer diagnosis and treatment. Instead, they emphasize the triumph of survival by which the cancer care center, in the savior/hero role, enables the patient’s success, represented as a cathartic medical journey.

Keywords: cancer framing, cancer stories, medical gaze, patient narratives

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189 Social Factors That Contribute to Promoting and Supporting Resilience in Children and Youth following Environmental Disasters: A Mixed Methods Approach

Authors: Caroline McDonald-Harker, Julie Drolet

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Abstract— In the last six years Canada In the last six years Canada has experienced two major and catastrophic environmental disasters– the 2013 Southern Alberta flood and the 2016 Fort McMurray, Alberta wildfire. These two disasters resulted in damages exceeding 12 billion dollars, the costliest disasters in Canadian history. In the aftermath of these disasters, many families faced the loss of homes, places of employment, schools, recreational facilities, and also experienced social, emotional, and psychological difficulties. Children and youth are among the most vulnerable to the devastating effects of disasters due to the physical, cognitive, and social factors related to their developmental life stage. Yet children and youth also have the capacity to be resilient and act as powerful catalyst for change in their own lives and wider communities following disaster. Little is known, particularly from a sociological perspective, about the specific factors that contribute to resilience in children and youth, and effective ways to support their overall health and well-being. This paper focuses on the voices and experiences of children and youth residing in these two disaster-affected communities in Alberta, Canada and specifically examines: 1) How children and youth’s lives are impacted by the tragedy, devastation, and upheaval of disaster; 2) Ways that children and youth demonstrate resilience when directly faced with the adversarial circumstances of disaster; and 3) The cumulative internal and external factors that contribute to bolstering and supporting resilience among children and youth post-disaster. This paper discusses the characteristics associated with high levels of resilience in 183 children and youth ages 5 to 17 based on quantitative and qualitative data obtained through a mix methods approach. Child and youth participants were administered the Children and Youth Resilience Measure (CYRM-28) in order to examine factors that influence resilience processes including: individual, caregiver, and context factors. The CYRM-28 was then supplemented with qualitative interviews with children and youth to contextualize the CYRM-28 resiliency factors and provide further insight into their overall disaster experience. Findings reveal that high levels of resilience among child and youth participants is associated with both individual factors and caregiver factors, specifically positive outlook, effective communication, peer support, and physical and psychological caregiving. Individual and caregiver factors helped mitigate the negative effects of disaster, thus bolstering resilience in children and youth. This paper discusses the implications that these findings have for understanding the specific mechanisms that support the resiliency processes and overall recovery of children and youth following disaster; the importance of bridging the gap between children and youth’s needs and the services and supports provided to them post-disaster; and the need to develop resiliency processes and practices that empower children and youth as active agents of change in their own lives following disaster. These findings contribute to furthering knowledge about pragmatic and representative changes to resources, programs, and policies surrounding disaster response, recovery, and mitigation.

Keywords: children and youth, disaster, environment, resilience

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188 Developing Digital Competencies in Aboriginal Students through University-College Partnerships

Authors: W. S. Barber, S. L. King

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This paper reports on a pilot project to develop a collaborative partnership between a community college in rural northern Ontario, Canada, and an urban university in the greater Toronto area in Oshawa, Canada. Partner institutions will collaborate to address learning needs of university applicants whose goals are to attain an undergraduate university BA in Educational Studies and Digital Technology degree, but who may not live in a geographical location that would facilitate this pathways process. The UOIT BA degree is attained through a 2+2 program, where students with a 2 year college diploma or equivalent can attain a four year undergraduate degree. The goals reported on the project are as: 1. Our aim is to expand the BA program to include an additional stream which includes serious educational games, simulations and virtual environments, 2. Develop fully (using both synchronous and asynchronous technologies) online learning modules for use by university applicants who otherwise are not geographically located close to a physical university site, 3. Assess the digital competencies of all students, including members of local, distance and Indigenous communities using a validated tool developed and tested by UOIT across numerous populations. This tool, the General Technical Competency Use and Scale (GTCU) will provide the collaborating institutions with data that will allow for analyzing how well students are prepared to succeed in fully online learning communities. Philosophically, the UOIT BA program is based on a fully online learning communities model (FOLC) that can be accessed from anywhere in the world through digital learning environments via audio video conferencing tools such as Adobe Connect. It also follows models of adult learning and mobile learning, and makes a university degree accessible to the increasing demographic of adult learners who may use mobile devices to learn anywhere anytime. The program is based on key principles of Problem Based Learning, allowing students to build their own understandings through the co-design of the learning environment in collaboration with the instructors and their peers. In this way, this degree allows students to personalize and individualize the learning based on their own culture, background and professional/personal experiences. Using modified flipped classroom strategies, students are able to interrogate video modules on their own time in preparation for one hour discussions occurring in video conferencing sessions. As a consequence of the program flexibility, students may continue to work full or part time. All of the partner institutions will co-develop four new modules, administer the GTCU and share data, while creating a new stream of the UOIT BA degree. This will increase accessibility for students to bridge from community colleges to university through a fully digital environment. We aim to work collaboratively with Indigenous elders, community members and distance education instructors to increase opportunities for more students to attain a university education.

Keywords: aboriginal, college, competencies, digital, universities

Procedia PDF Downloads 195
187 Visuospatial Perspective Taking and Theory of Mind in a Clinical Approach: Development of a Task for Adults

Authors: Britt Erni, Aldara Vazquez Fernandez, Roland Maurer

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Visuospatial perspective taking (VSPT) is a process that allows to integrate spatial information from different points of view, and to transform the mental images we have of the environment to properly orient our movements and anticipate the location of landmarks during navigation. VSPT is also related to egocentric perspective transformations (imagined rotations or translations of one's point of view) and to infer the visuospatial experiences of another person (e.g. if and how another person sees objects). This process is deeply related to a wide-ranging capacity called the theory of mind (ToM), an essential cognitive function that allows us to regulate our social behaviour by attributing mental representations to individuals in order to make behavioural predictions. VSPT is often considered in the literature as the starting point of the development of the theory of mind. VSPT and ToM include several levels of knowledge that have to be assessed by specific tasks. Unfortunately, the lack of tasks assessing these functions in clinical neuropsychology leads to underestimate, in brain-damaged patients, deficits of these functions which are essential, in everyday life, to regulate our social behaviour (ToM) and to navigate in known and unknown environments (VSPT). Therefore, this study aims to create and standardize a VSPT task in order to explore the cognitive requirements of VSPT and ToM, and to specify their relationship in healthy adults and thereafter in brain-damaged patients. Two versions of a computerized VSPT task were administered to healthy participants (M = 28.18, SD = 4.8 years). In both versions the environment was a 3D representation of 10 different geometric shapes placed on a circular base. Two sets of eight pictures were generated from this: of the environment with an avatar somewhere on its periphery (locations) and of what the avatar sees from that place (views). Two types of questions were asked: a) identify the location from the view, and b) identify the view from the location. Twenty participants completed version 1 of the task and 20 completed the second version, where the views were offset by ±15° (i.e., clockwise or counterclockwise) and participants were asked to choose the closest location or the closest view. The preliminary findings revealed that version 1 is significantly easier than version 2 for accuracy (with ceiling scores for version 1). In version 2, participants responded significantly slower when they had to infer the avatar's view from the latter's location, probably because they spent more time visually exploring the different views (responses). Furthermore, men significantly performed better than women in version 1 but not in version 2. Most importantly, a sensitive task (version 2) has been created for which the participants do not seem to easily and automatically compute what someone is looking at yet which does not involve more heavily other cognitive functions. This study is further completed by including analysis on non-clinical participants with low and high degrees of schizotypy, different socio-educational status, and with a range of older adults to examine age-related and other differences in VSPT processing.

Keywords: mental transformation, spatial cognition, theory of mind, visuospatial perspective taking

Procedia PDF Downloads 163
186 Small and Medium-Sized Enterprises, Flash Flooding and Organisational Resilience Capacity: Qualitative Findings on Implications of the Catastrophic 2017 Flash Flood Event in Mandra, Greece

Authors: Antonis Skouloudis, Georgios Deligiannakis, Panagiotis Vouros, Konstantinos Evangelinos, Loannis Nikolaou

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On November 15th, 2017, a catastrophic flash flood devastated the city of Mandra in Central Greece, resulting in 24 fatalities and extensive damages to the built environment and infrastructure. It was Greece's deadliest and most destructive flood event for the past 40 years. In this paper, we examine the consequences of this event too small and medium-sized enterprises (SMEs) operating in Mandra during the flood event, which were affected by the floodwaters to varying extents. In this context, we conducted semi-structured interviews with business owners-managers of 45 SMEs located in flood inundated areas and are still active nowadays, based on an interview guide that spanned 27 topics. The topics pertained to the disaster experience of the business and business owners-managers, knowledge and attitudes towards climate change and extreme weather, aspects of disaster preparedness and related assistance needs. Our findings reveal that the vast majority of the affected businesses experienced heavy damages in equipment and infrastructure or total destruction, which resulted in business interruption from several weeks up to several months. Assistance from relatives or friends helped for the damage repairs and business recovery, while state compensations were deemed insufficient compared to the extent of the damages. Most interviewees pinpoint flooding as one of the most critical risks, and many connect it with the climate crisis. However, they are either not willing or unable to apply property-level prevention measures in their businesses due to cost considerations or complex and cumbersome bureaucratic processes. In all cases, the business owners are fully aware of the flood hazard implications, and since the recovery from the event, they have engaged in basic mitigation measures and contingency plans in case of future flood events. Such plans include insurance contracts whenever possible (as the vast majority of the affected SMEs were uninsured at the time of the 2017 event) as well as simple relocations of critical equipment within their property. The study offers fruitful insights on latent drivers and barriers of SMEs' resilience capacity to flash flooding. In this respect, findings such as ours, highlighting tensions that underpin behavioral responses and experiences, can feed into a) bottom-up approaches for devising actionable and practical guidelines, manuals and/or standards on business preparedness to flooding, and, ultimately, b) policy-making for an enabling environment towards a flood-resilient SME sector.

Keywords: flash flood, small and medium-sized enterprises, organizational resilience capacity, disaster preparedness, qualitative study

Procedia PDF Downloads 111
185 Melancholia, Nostalgia: Bernardo Soares after Fernando Pessoa

Authors: Maria de Fátima Lambert

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Bernardo Soares is one of Fernando Pessoa' several heteronyms (and "half-heteronyms"). Perhaps the one that brought together the majority of his qualities and characters of self-identity within the famous inner-persona-alter-diversity. The Book of Disquiet by Bernardo Soares was released in 1983, consisting of ontological remarks caught by an obsessive inquiring about self-existence. The book became a highly valuable substance when focusing upon the philosophical grounds of Pessoa's aesthetics. For sure, we cannot consider a single aesthetic, admitting that each heteronym has its own particular one, developed after different principles and convictions. Regarding Bernardo Soares, his thought arises from sequenced self-clues expressing peculiar existential doubtless presented as certainties -and vice-versa. His written self-search-images are reported, molding the painful awareness of existence through the discredited tolerance of any conclusive dialogue with others. Given the nature of Soares’ [maybe] unfinished writings, it is obvious that he headed far from his self-insurance-capsule: the office, bedroom, or even the walkscapes through Lisbon. The idea of travel/journey is one of the most relevant when recognizing his profound - although undercover - anguish as melancholy and nostalgia. In Bernardo Soares, Aesthetics is taken agonizingly, grounded upon discreet poetic phraseology and terms. His poetical awareness developed compulsive titles such "Aesthetics of Indifference", "Aesthetics of Discouragement". Soares' Aesthetics emerges directly from oneself, understanding art as inner acts and living experienced issues. Art is not freed from the intellectual expression of oneself emotions. The Disquiet Book is an existential nightmare nourished by everyday life, single written thoughts, balanced by melancholia, nostalgia, and distress. One might wonder if it was dreams that guided his fictional literary persona or the narrow facts of life itself. Along with his endless disquiet writing, Pessoa’s semi-heteronymous traveled without physically going anywhere. The complexity of inner existence is fulfilled by lonely mental walks and travels, as in two texts titled The Never Accomplished Journey. Although we also can consider other fragments, these are the deepest reflections about travelling. Let’s recall that Fernando Pessoa’s ortonyms writings -poems and essays- also addressed this issue from a philosophical perspective. We believe that this theme is one of the meaningful concepts for featuring the main principles of his aesthetics. As we know, Fernando Pessoa did not travel to foreign countries (or in Portugal), except for the journey, with his family, from Lisbon to South Africa (as a child) and, some years later, the return back to Lisbon. One may wonder why the poet never undertook other journeys. Maybe due to a disbelief in moving away from his comfort zone or due to the fear of becoming addicted to endless travels and the loss of his convenient self-closeness. In The Book of Disquiet, the poet shared his internal visions of the outer world but mainly visualizing his deepest enigmas and experiences -so strongly incorporated into reality and fiction.

Keywords: aesthetic principles, Bernardo Soares, Fernando Pessoa , melancholia, nostalgia, non-accomplished travel, The Book of Disquiet

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184 Optimization of Multi-Disciplinary Expertise and Resource for End-Stage Renal Failure (ESRF) Patient Care

Authors: Mohamed Naser Zainol, P. P. Angeline Song

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Over the years, the profile of end-stage renal patients placed under The National Kidney Foundation Singapore (NKFS) dialysis program has evolved, with a gradual incline in the number of patients with behavior-related issues. With these challenging profiles, social workers and counsellors are often expected to oversee behavior management, through referrals from its partnering colleagues. Due to the segregation of tasks usually found in many hospital-based multi-disciplinary settings, social workers’ and counsellors’ interventions are often seen as an endpoint, limiting other stakeholders’ involvement that could otherwise be potentially crucial in managing such patients. While patients’ contact in local hospitals often leads to eventual discharge, NKFS patients are mostly long term. It is interesting to note that these patients are regularly seen by a team of professionals that includes doctors, nurses, dietitians, exercise specialists in NKFS. The dynamism of relationships presents an opportunity for any of these professionals to take ownership of their potentials in leading interventions that can be helpful to patients. As such, it is important to have a framework that incorporates the strength of these professionals and also channels empowerment across the multi-disciplinary team in working towards wholistic patient care. This paper would like to suggest a new framework for NKFS’s multi-disciplinary team, where the group synergy and dynamics are used to encourage ownership and promote empowerment. The social worker and counsellor use group work skills and his/her knowledge of its members’ strengths, to generate constructive solutions that are centered towards patient’s growth. Using key ideas from Karl’s Tomm Interpersonal Communications, the Communication Management of Meaning and Motivational Interviewing, the social worker and counsellor through a series of guided meeting with other colleagues, facilitates the transmission of understanding, responsibility sharing and tapping on team resources for patient care. As a result, the patient can experience personal and concerted approach and begins to flow in a direction that is helpful for him. Using seven case studies of identified patients with behavioral issues, the social worker and counsellor apply this framework for a period of six months. Patient’s overall improvement through interventions as a result of this framework are recorded using the AB single case design, with baseline measured three months before referral. Interviews with patients and their families, as well as other colleagues that are not part of the multi-disciplinary team are solicited at mid and end points to gather their experiences about patient’s progress as a by-product of this framework. Expert interviews will be conducted on each member of the multi-disciplinary team to study their observations and experience in using this new framework. Hence, this exploratory framework hopes to identify the inherent usefulness in managing patients with behavior related issues. Moreover, it would provide indicators in improving aspects of the framework when applied to a larger population.

Keywords: behavior management, end-stage renal failure, satellite dialysis, multi-disciplinary team

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183 Sustainable Transition of Universal Design for Learning-Based Teachers’ Latent Profiles from Contact to Distance Education

Authors: Alvyra Galkienė, Ona Monkevičienė

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The full participation of all pupils in the overall educational process is defined by the concept of inclusive education, which is gradually evolving in education policy and practice. It includes the full participation of all pupils in a shared learning experience and educational practices that address barriers to learning. Inclusive education applying the principles of Universal Design for Learning (UDL), which includes promoting students' involvement in learning processes, guaranteeing a deep understanding of the analysed phenomena, initiating self-directed learning, and using e-tools to create a barrier-free environment, is a prerequisite for the personal success of each pupil. However, the sustainability of quality education is affected by the transformation of education systems. This was particularly evident during the period of the forced transition from contact to distance education in the COVID-19 pandemic. Research Problem: The transformation of the educational environment from real to virtual one and the loss of traditional forms of educational support highlighted the need for new research, revealing the individual profiles of teachers using UDL-based learning and the pathways of sustainable transfer of successful practices to non-conventional learning environments. Research Methods: In order to identify individual latent teacher profiles that encompass the essential components of UDL-based inclusive teaching and direct leadership of students' learning, the quantitative analysis software Mplius was used for latent profile analysis (LPA). In order to reveal proven, i.e., sustainable, pathways for the transit of the components of UDL-based inclusive learning to distance learning, latent profile transit analysis (LPTA) via Mplius was used. An online self-reported questionnaire was used for data collection. It consisted of blocks of questions designed to reveal the experiences of subject teachers in contact and distance learning settings. 1432 Lithuanian, Latvian, and Estonian subject teachers took part in the survey. Research Results: The LPA analysis revealed eight latent teacher profiles with different characteristics of UDL-based inclusive education or traditional teaching in contact teaching conditions. Only 4.1% of the subject teachers had a profile characterised by a sustained UDL approach to teaching: promoting pupils' self-directed learning; empowering pupils' engagement, understanding, independent action, and expression; promoting pupils' e-inclusion; and reducing the teacher's direct supervision of the students. Other teacher profiles were characterised by limited UDL-based inclusive education either due to the lack of one or more of its components or to the predominance of direct teacher guidance. The LPTA analysis allowed us to highlight the following transit paths of teacher profiles in the extreme conditions of the transition from contact to distance education: teachers staying in the same profile of UDL-based inclusive education (sustainable transit) or jumping to other profiles (unsustainable transit in case of barriers), and teachers from other profiles moving to this profile (ongoing transit taking advantage of the changed new possibilities in the teaching process).

Keywords: distance education, latent teacher profiles, sustainable transit, UDL

Procedia PDF Downloads 70
182 An Unusual Manifestation of Spirituality: Kamppi Chapel of Helsinki

Authors: Emine Umran Topcu

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In both urban design and architecture, the primary goal is considered to be looking for ways in which people feel and think about space and place. Humans, in general, see a place as security and space as freedom and feel attached to place and long for space. Contemporary urban design manifests itself by addressing basic physical and psychological human needs. Not much attention is paid to transcendence. There seems to be a gap in the hierarchy of human needs. Usually, social aspects of public space are addressed through urban design. More personal and intimately scaled needs of an individual are neglected. How does built form contribute to an individual’s growth, contemplation, and exploration? In other words, a greater meaning in the immediate environment. Architects love to talk about meaning, poetics, attachment and other ethereal aspects of space that are not visible attributes of places. This paper aims at describing spirituality through built form with a personal experience of Kamppi Chapel of Helsinki. Experience covers various modes through which a person unfolds or constructs reality. Perception, sensation, emotion, and thought can be counted as for these modes. To experience is to get to know. What can be known is a construct of experience. Feelings and thoughts about space and place are very complex in human beings. They grow out of life experiences. The author had the chance of visiting Kamppi Chapel in April 2017, out of which the experience grew. The Kamppi Chapel is located on the South side of the busy Narinnka Square in central Helsinki. It offers a place to quiet down and compose oneself in a most lively urban space. With its curved wooden facade, the small building looks more like a museum than a chapel. It can be called a museum for contemplation. With its gently shaped interior, it embraces visitors and shields them from the hustle bustle of the city outside. Places of worship in all faiths signify sacred power. The author, having origins in a part of the world where domes and minarets dominate the cityscape, was impressed by the size and the architectural visibility of the Chapel. Anyone born and trained in such a tradition shares the inherent values and psychological mechanisms of spirituality, sacredness and the modest realities of their environment. Spirituality in all cultural traditions has not been analyzed and reinterpreted in new conceptual frameworks. Fundamentalists may reject this positivist attitude, but Kamppi Chapel as it stands does not look like it has a say like “I’m a model to be followed”. It just faces the task of representing a religious facility in an urban setting largely shaped by modern urban planning, which seems to the author as looking for a new definition of individual status. The quest between the established and the new is the demand for modern efficiency versus dogmatic rigidity. The architecture here has played a very promising and rewarding role for spirituality. The designers have been the translators for human desire for better life and aesthetic environment for an optimal satisfaction of local citizens and the visitors alike.

Keywords: architecture, Kamppi Chapel, spirituality, urban

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181 Elite Netball Players’ Perspectives on Long Term Athlete Development Programmes in South Africa

Authors: Petrus Louis Nolte

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University sport in South Africa is not isolated from the complexity of globalization and professionalization of sport, as it forms an integral part of the sport development environment in South Africa. In order to align their sport programmes with global and professional requirements, several universities opted to develop elite sport programmes; recruit specialized personnel such as coaches, administrators and athletes; provide expert coaching; scientific and medical services; sports testing; fitness, technical and tactical expertise; sport psychological and rehabilitation support; academic guidance and career assistance; and student-athlete accommodation. In addition, universities provide administrative support and high-quality physical resources (training facilities) for the benefit of the overall South African sport system. Although it is not compulsory for universities to develop elite sport programmes to prepare their teams for competitions, elite competitions such as the annual Varsity Sport, University Sport South Africa (USSA) and local club competitions and leagues within university international competitions where universities not only compete but also deliver players for representative national netball teams. The aim of this study is therefore to describe the perceptions of players of the university elite netball programmes they were participating in. This study adopted a descriptive design with a quantitative approach, utilizing a self-structured questionnaire as research technique. As this research formed part of a national research project for NSA with a population of 172 national and provincial netball players, a sample of 92 university netball players from the population was selected. Content validity of the self-structured questionnaire was secured through a test-retest process, with construct validity through a member of the Statistical Consultation Services (STATCON) of the University of Johannesburg that provided feedback on the structural format of the questionnaire. Reliability was measured utilising Cronbach Alpha on p<0.005 level of significance. A reliability score of 0.87 was measured. The research was approved by the Board of Netball South Africa and ethical conduct implemented according to the processes and procedures approved by the Ethics Committees of the Faculty of Health Sciences, University of Johannesburg with clearance number REC-01-30-2019. From the results it is evident that university elite netball programmes are professional, especially with regards to the employment of knowledgeable and competent coaches and technical officials such as team managers and sport sciences staff. These professionals have access to elite training facilities, support staff, and relatively large groups of elite players, all elements of an elite programme that could enhance the national federation’s (Netball South Africa) system. Universities could serve the dual purpose of serving as university netball clubs, as well as providing elite training services and facilities as performance hubs for national players.

Keywords: elite sport programmes, university netball, player experiences, Varsity Sport netball

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180 Sociocultural Influences on Men of Color’s Body Image Concerns: A Structural Equation Modeling Study

Authors: Zikun Li, Regine Talleyrand

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Negative body image is one of the most common causes of eating disorders, and it is not only happening to women. Regardless of the increasing attention that researchers and practitioners have been paying to the male population and their body image concerns, men of color have yet to be fully represented or studied. Given the consensus that the sociocultural experiences of people of color may play a significant role in their health and well-being, this study focused on assessing the mechanism through which sociocultural factors may influence men of color’s perceptions of body image. In particular, this study focused on untangling how interpersonal and media pressure, as well as ethnic-racial identities and perceptions, would impact body dissatisfaction in terms of muscularity, body fat, and height in men of color and how this mechanism is moderated across different ethnic-racial groups. The structural equation modeling approach was therefore applied to achieve the research goal. With the sample size of 181 self-identified Black, Indigenous, and People of Color male participants aged 20-50 (M=33.33, SD=6.9) through surveying on Amazon’s MTurk platform, the proposed model achieved a modestly acceptable model fit with the pooled sample, X2(836) = 1412.184, CFI = 0.900, RMSEA = 0.062 [0.056, 0.067]. And SRMR = 0.088, And it explained 89.5% of the variance in body dissatisfaction. The results showed that of all the direct effects on body dissatisfaction, interpersonal appearance pressure exhibited the strongest effect (β = 0.410***), followed by media appearance pressure (β = 0.272**) and self-hatred feeling (β = 0.245**). The ethnic-racial related factors (i.e., stereotype endorsement, ethnic-racial salience, and nationalistic assimilation) statistically influenced body dissatisfaction through the mediators of media appearance pressure and/or self-hatred feeling. Furthermore, the moderation analysis between Black/African American men and non-Black/African American men revealed the substantial differences in how ethnic/racial identity impacts one’s perception of body image, and the Black/African American men were found to be influenced by sociocultural factors at a higher level, compared with their counterparts. The impacts of demographic characteristics (i.e., SES, weight, height) on body dissatisfaction were also examined. Instead of considering interpersonal appearance pressure and media pressure as two subscales under one construct, this study considered them as two separate and distinct sociocultural factors. The good model fit to the data indicates this rationality and encourages scholars to reconsider the impacts of two sources of social pressures on body dissatisfaction. In addition, this study also provided empirical evidence of the moderation effect existing within the population of men of color, which reveals the heterogeneity existing across different ethnic-racial groups and implies the necessity to study individual ethnic-racial groups so as to better understand the mechanism of sociocultural influences on men of color’s body dissatisfaction. These findings strengthened the current understanding of the body image concerns exciting among men of color and meanwhile provided empirical evidence for practitioners to provide tailored health prevention and treatment options for this growing population in the United States.

Keywords: men of color, body image concerns, sociocultural factors, structural equation modeling

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179 Exploring the Carer Gender Support Gap: Results from Freedom of Information Requests to Adult Social Services in England

Authors: Stephen Bahooshy

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Our understanding of gender inequality has advanced in recent years. Differences in pay and societal gendered behaviour expectations have been emphasized. It is acknowledged globally that gender shapes everyone’s experiences of health and social care, including access to care, use of services and products, and the interaction with care providers. NHS Digital in England collects data from local authorities on the number of carers and people with support needs and the services they access. This data does not provide a gender breakdown. Caring can have many positive and negative impacts on carers’ health and wellbeing. For example, caring can improve physical health, provide a sense of pride and purpose, and reduced stress levels for those who undertake a caring role by choice. Negatives of caring include financial concerns, social isolation, a reduction in earnings, and not being recognized as a carer or involved and consulted by health and social care professionals. Treating male and female carers differently is by definition unequitable and precludes one gender from receiving the benefits of caring whilst potentially overburdening the other with the negatives of caring. In order to explore the issue on a preliminary basis, five local authorities who provide statutory adult social care services in England were sent Freedom of Information requests in 2019. The authorities were selected to include county councils and London boroughs. The authorities were asked to provide data on the amount of money spent on care at home packages to people over 65 years, broken down by gender and carer gender for each financial year between 2013 and 2019. Results indicated that in each financial year, female carers supporting someone over 65 years received less financial support for care at home support packages than male carers. Over the six-year period, this difference equated to a £9.5k deficit in financial support received on average per female carer when compared to male carers. An example of a London borough with the highest disparity presented an average weekly spend on care at home for people over 65 with a carer of £261.35 for male carers and £165.46 for female carers. Consequently, female carers in this borough received on average £95.89 less per week in care at home support than male carers. This highlights a real and potentially detrimental disparity in the care support received to female carers in order to support them to continue to care in parts of England. More research should be undertaken in this area to better explore this issue and to understand if these findings are unique to these social care providers or part of a wider phenomenon. NHS Digital should request local authorities collect data on gender in the same way that large employers in the United Kingdom are required by law to provide data on staff salaries by gender. People who allocate social care packages of support should consider the impact of gender when allocating support packages to people with support needs and who have carers to reduce any potential impact of gender bias on their decision-making.

Keywords: caregivers, carers, gender equality, social care

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178 The Concept of Path in Original Buddhism and the Concept of Psychotherapeutic Improvement

Authors: Beth Jacobs

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The landmark movement of Western clinical psychology in the 20th century was the development of psychotherapy. The landmark movement of clinical psychology in the 21st century will be the absorption of meditation practices from Buddhist psychology. While millions of people explore meditation and related philosophy, very few people are exposed to the materials of original Buddhism on this topic, especially to the Theravadan Abhidharma. The Abhidharma is an intricate system of lists and matrixes that were used to understand and remember Buddha’s teaching. The Abhidharma delineates the first psychological system of Buddhism, how the mind works in the universe of reality and why meditation training strengthens and purifies the experience of life. Its lists outline the psychology of mental constructions, perception, emotion and cosmological causation. While the Abhidharma is technical, elaborate and complex, its essential purpose relates to the central purpose of clinical psychology: to relieve human suffering. Like Western depth psychology, the methodology rests on understanding underlying processes of consciousness and perception. What clinical psychologists might describe as therapeutic improvement, the Abhidharma delineates as a specific pathway of purified actions of consciousness. This paper discusses the concept of 'path' as presented in aspects of the Theravadan Abhidharma and relates this to current clinical psychological views of therapy outcomes and gains. The core path in Buddhism is the Eight-Fold Path, which is the fourth noble truth and the launching of activity toward liberation. The path is not composed of eight ordinal steps; it’s eight-fold and is described as opening the way, not funneling choices. The specific path in the Abhidharma is described in many steps of development of consciousness activities. The path is not something a human moves on, but something that moments of consciousness develop within. 'Cittas' are extensively described in the Abhidharma as the atomic-level unit of a raw action of consciousness touching upon an object in a field, and there are 121 types of cittas categorized. The cittas are embedded in the mental factors, which could be described as the psychological packaging elements of our experiences of consciousness. Based on these constellations of infinitesimal, linked occurrences of consciousness, citta are categorized by dimensions of purification. A path is a chain of citta developing through causes and conditions. There are no selves, no pronouns in the Abhidharma. Instead of me walking a path, this is about a person working with conditions to cultivate a stream of consciousness that is pure, immediate, direct and generous. The same effort, in very different terms, informs the work of most psychotherapies. Depth psychology seeks to release the bound, unconscious elements of mental process into the clarity of realization. Cognitive and behavioral psychologies work on breaking down automatic thought valuations and actions, changing schemas and interpersonal dynamics. Understanding how the original Buddhist concept of positive human development relates to the clinical psychological concept of therapy weaves together two brilliant systems of thought on the development of human well being.

Keywords: Abhidharma, Buddhist path, clinical psychology, psychotherapeutic outcome

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177 Forced Migration and Access to Maternal Healthcare in Internally Displaced Persons Camps in North-Central Nigeria

Authors: Faith O. Olanrewaju

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Internal displacement and the vulnerability of women are two critical aspects of forced migration that have dominated both global and local discourses. Statistics show that in November 2021, there were over 2.1 million internally displaced persons (IDPs) in Nigeria. Literature also states that displaced women and girls are more vulnerable than displaced men. They are susceptible to adversative experiences, including various forms of sexual violence and rape. As a result, the displaced women and girls are faced with psychological and physical traumas, including HIV/AIDS as well as unexpected or poorly spaced pregnancies. In addition, the poor condition of living of internally displaced women in IDP camps affects their reproductive health, pregnancy outcomes, and maternal mortality levels. Incontrovertibly, internally displaced women constitute an imperative contributor to the ills of Nigeria's maternal health status, which is the second worse globally and the worst in Africa. World Health Organisation statistics showed that approximately 536,000 girls and women die from pregnancy-related causes globally, and Nigeria accounts for 14% of the global maternal deaths. Undeniably, this supports the claims that maternal mortality remains a challenge in Nigeria and can be exacerbated by internal displacement crises. Therefore, maternal mortality remains a critical impediment to the actualisation of the 3.1 SDG target. Owing to this, concerns arise about the quality of the policy in Nigeria’s health sector. More specifically, this study is concerned with the maternal health care services displaced women receive in IDP camps in the three states affected by internal displacement in north-central Nigeria, an understudied area. The novelty of the study also lies in its comparative investigation of maternal healthcare service delivery in three different camp structures (faith-based, government, and informal IDP camps), a pattern that is absent in literature. Therefore, this study will investigate how the camp structures affect access to maternal health services in the study areas; analyse the successes and challenges in the delivery of maternal health care services to displaced women in the various camps; and recommendation and strategies for reducing maternal healthcare disparities/gaps across IDP camps in Nigeria (should they exist). It will adopt a mixed-method approach and multi-stage sampling technique. A total of 1,152 copies of the study questionnaire will be distributed to displaced pregnant and nursing mothers (PNM); nine focus group discussions will also be held with the displaced PNM; in-depth interviews will be conducted with humanitarian actors, policymakers, and health professionals. The quantitative and qualitative data will be analysed using Statistical Package for Social Science (SPSS) 21.0 and thematic analysis, respectively. The findings of the study will be used to develop a model of care that will address the fragmentations in Nigeria's healthcare system. The findings will also inform the development of best policies and practices in the maternal health of displaced women.

Keywords: forced displacement, internally displaced women, maternal healthcare, maternal mortality

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