Search results for: urban experience

Authors: Justin Durham, Chanda Rooney, Robert Mather, Mickie Vanhoy

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The psychological construct of empathy is to understand a person’s cognitive perspective and experience the other person’s emotional state. Deciphering emotional states is conducive for interpreting vicarious pain. Observing others' physical pain activates neural networks related to the actual experience of pain itself. The study addresses empathy as a nonlinear dynamic process of simulation for individuals to understand the mental states of others and experience vicarious pain, exhibiting self-organized criticality. Such criticality follows from a combination of neural networks with an excitatory feedback loop generating bistability to resonate permutated empathy. Cortical networks exhibit diverse patterns of activity, including oscillations, synchrony and waves, however, the temporal dynamics of neurophysiological activities underlying empathic processes remain poorly understood. Mu rhythms are EEG oscillations with dominant frequencies of 8-13 Hz becoming synchronized when the body is relaxed with eyes open and when the sensorimotor system is in idle, thus, mu rhythm synchrony is expected to be highest in baseline conditions. When the sensorimotor system is activated either by performing or simulating action, mu rhythms become suppressed or desynchronize, thus, should be suppressed while observing video clips of painful injuries if previous research on mirror system activation holds. Twelve undergraduates contributed EEG data and survey responses to empathy and psychopathy scales in addition to watching consecutive video clips of sports injuries. Participants watched a blank, black image on a computer monitor before and after observing a video of consecutive sports injuries incidents. Each video condition lasted five-minutes long. A BIOPAC MP150 recorded EEG signals from sensorimotor and thalamocortical regions related to a complex neural network called the ‘pain matrix’. Physical and social pain are activated in this network to resonate vicarious pain responses to processing empathy. Five EEG single electrode locations were applied to regions measuring sensorimotor electrical activity in microvolts (μV) to monitor mu rhythms. EEG signals were sampled at a rate of 200 Hz. Mu rhythm desynchronization was measured via 8-13 Hz at electrode sites (F3 & F4). Data for each participant’s mu rhythms were analyzed via Fast Fourier Transformation (FFT) and multifractal time series analysis.

Keywords: desynchronization, dynamical systems theory, electroencephalography (EEG), empathy, multifractal time series analysis, mu waveform, neurophysiology, pain simulation, social cognition

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Authors: Sajjad Shukur Ullah, Syed Shujaa Safdar Gardezi

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Road infrastructure plays a vital role in the economic activities of any economy. Besides derived benefits from these facilities, the utilization of extensive energy resources, fuels, and materials results in a negative impact on the environment in terms of carbon footprint; carbon footprint is the overall amount of greenhouse gas (GHG) generated from any action. However, this aspect of environmental impact from road structure is not seriously considered during such developments, thus undermining a critical factor of sustainable development, which usually remains unaddressed, especially in developing countries. The current work investigates the carbon footprint impact of a small road project (0.8 km, dual carriageway) initiated for traffic management in an urban centre. Life cycle assessment (LCA) with boundary conditions of cradle to the site has been adopted. The only construction phase of the life cycle has been assessed at this stage. An impact of 10 ktons-CO2 (6260 ton-CO2/km) has been assessed. The rigid pavement dominated the contributions as compared to a flexible component. Among the structural elements, the underpass works shared the major portion. Among the materials, the concrete and steel utilized for various structural elements resulted in more than 90% of the impact. The earth-moving equipment was dominant in operational carbon. The results have highlighted that road infrastructure projects pose serious threats to the environment during their construction and which need to be considered during the approval stages. This work provides a guideline for supporting sustainable development that could only be ensured when such endeavours are properly assessed by industry professionals and decide various alternative environmental conscious solutions for the future.

Keywords: construction waste management, kiloton, life cycle assessment, rigid pavement

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Authors: Sacha Joseph-Mathews, Leili Javadpour

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In the tourism industry, hoteliers spend millions annually on marketing and positioning efforts for their respective hotels, all in an effort to create a specific image in the minds of the consumer. Yet despite extensive efforts to seduce potential hotel guests with sophisticated advertising messages generated by hotel entities, consumers continue to mistrust corporate branding, preferring instead to place their trust in the reviews of their consumer peers. In today’s complex and cluttered marketplace, online reviews can serve as a mediator for consumers who do not have actual knowledge and experiences with the brand, but are in the process of deciding whether or not to engage in a consumption exercise. Traditionally, consumers have used online reviews as a source of comfort and confirmation of a product/service’s positioning. But today, very few customers make any purchase decisions without first researching existing user reviews, making reviews more of a necessity, rather than a luxury in the purchase decision process. The influence of user generated content (UGC) is amplified in the tourism industry; as more than a third of potential hotel guests will not book a room without first reading a review. As corporate branding becomes less relevant and online reviews become more important, how much of the consumer’s stay expectations are being dictated by existing UGC? Moreover, as hotel guest experience a hotel through the lens of an existing review, how much of their stay and in turn their review, would have been influenced by those reviews that they read? Ultimately, there is the potential for UGC to dictate what potential guests will be most critical about, and or most focused on during their stay. If UGC is a stronger influencer in the purchase decision process than corporate branding, doesn’t it have the potential to dictate, the entire stay experience by influencing the expectations of the guest prior to them arriving on the property? For example, if a hotel is an eco-destination and they focus their branding on their website around sustainability and the retreat nature of the hotel. Yet, guest reviews constantly discuss how dissatisfactory the service and food was with no mention of nature or sustainability, will future reviews then focus primarily on the food? Using text analysis software to examine over 25,000 online reviews, we explore the extent to which new reviews are influenced by wording used in previous reviews for a hotel property, versus content generated by corporate positioning. Additionally, we investigate how distinct hotel related UGC is across different types of tourism destinations. Our findings suggest that UGC can have a greater impact on future reviews, than corporate branding and there is more cohesiveness across UGC of different types of hotel properties than anticipated. A model of User Generated Content Influence is presented and the managerial impact of the power of online reviews to trump corporate branding and shape future user experiences is discussed.

Keywords: user generated content, UGC, corporate branding, online reviews, hotels and tourism

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Authors: Nayomi Ranathunga, Priyantha Perera, Sumal Nandasena, Nalini Sathiakumar, Anuradhini Kasthuriratne, Rajitha Wikremasinghe

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Solid fuel combustion is an important source of indoor air pollution (IAP) in developing countries that has adverse health impacts particularly in children. This study was conducted to determine the effect of IAP due to solid fuel combustion on physical growth of children under five in a Sri Lankan setting. A prospective study was conducted in a mixed population comprising urban and semi urban residents. The study included 240 children under 5 who were permanent residents of the area. Physical growth was assessed by measuring anthropometric indices based on the World Health Organization (WHO) guidelines and standards. Exposure levels were defined according to the main type of fuel used for cooking at home: children residing in households using biomass fuel or kerosene as the main type of fuel for cooking were classified as the “high exposure” group and children resident in households using liquefied petroleum gas (LPG) or electricity for cooking were classified as the “low exposure” group. Sixty percent of the children were classified as from the “high” exposure group and 40% of the children were classified as from the “low” exposure group; 54% of the children were male. At baseline, the prevalence of wasting was 17.1% and the prevalence of stunting was 10.4%; the mean z-score for weight for height was - 0.85, weight for age was - 0.46 and height for age was -0.38. At baseline, children from the “high” exposure group had a significantly lower mean weight for height z-score (p=0.02) and a mean height for age z-score (p=0.001) as compared to children from the “low” exposure group after adjusting for confounding factors such as father’s education, mother’s education and family income. Poor maternal education was significantly associated with lower height for age z-scores (p=0.04) after adjusting for exposure status. IAP due to combustion of biomass fuel leads to chronic malnutrition.

Keywords: children, growth, indoor air pollution, solid fuel

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Authors: Adeleye Johnson Adelagunayeja

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The concept of making cities, communities, and neighborhoods smart, intelligent, and responsive is relatively new to Africa and its urban renewal agencies. Efforts must be made by relevant agencies to begin a holistic review of the implementation of infrastructural facilities and urban renewal methodologies that will revolve around the appreciation and application of artificial intelligence. The propagation of the ideals and benefits of the smart city concept are key factors that can encourage governments of African nations, the African Union, and other regional organizations in Africa to embrace the ideology. The ability of this smart city concept to curb insecurities – armed robbery, assassination, terrorism, and civil disorder – is one major reason, amongst others, why African governments must speedily embrace this contemporary developmental concept whose time has come! The seamlessness to access information and virtually cross-pollinate ideas with people living in already established smart cities, when combined with the great efficiency that the emergence of smart cities brings with it, are other reasons why Africa must come up with action plans that can enable the existing cities to metamorphose into smart cities. Innovations will be required to enable Africa to develop a smart city concept that will be compatible with the basic patterns of livelihood because the essence of the smart city evolution is to make life better for people to co-exist, to be productive and to enjoy standard infrastructural facilities. This research paper enumerates the multifaceted adaptive factors that have the potentials of making the adoption of smartcity concept in Africa seamless. It also proffers solutions to potential bottlenecks capable of undermining the execution of the smart city concept in Africa.

Keywords: smartcity compactibility innovation Africa government evolution, Africa as global village member, evolution in Africa, ways to make Africa adopt smartcity, localizing smartcity concept in Africa, bottleneck to smartcity developmet in Africa

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Authors: Giselle Martinez Negrette

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Language and culture mutually shape and reflect the human experience. In the learning process, this connection creates and sustains the shared world of learners and educators. Dual Language (DL) programs exemplify this relationship by placing language and culture at the center of their educational approach. These programs, originally conceived to advance social justice in education, aim to foster bilingualism, biliteracy, academic development and sociocultural competence, emphasizing the inseparability of linguistic and cultural growth. Furthermore, because DL programs serve children from diverse cultural, ethnic, and socioeconomic backgrounds, they operate as spaces where linguistic skills and sociocultural understandings are actively cultivated, negotiated, and celebrated. Against this background, this paper examines how two DL teachers see language and culture shaping and reflecting the educational experience, and how their understandings of the relationship influence their mediation of sociocultural competence in their classrooms. This qualitative study employs critical discourse analysis to study in detail participants’ narratives seeking to uncover their perspectives on the “politics” surrounding language use and cultural understandings in their school contexts. Our findings show that these educators are not only keenly aware of the pivotal role that language and culture play in multilingual students’ learning journeys, but they have identified the sociolinguistic “games” taking place in their classrooms. We contend these understandings are pivotal for the critical development of sociocultural competence in DL programs. This study provides DL educators with important conceptual and pedagogical insights regarding the intersection between language and culture in their classrooms and seeks to encourage them to analyze their roles as supporters or opponents of transformative rupture opportunities to contest inequities in education

Keywords: sociocultural competence, critical discourse analysis, dual language programs, language, culture

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Authors: Denise Levy, Helen J. Khoury

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Nuclear technology is a controversial issue among a great share of the Brazilian population. Misinformation and common wrong beliefs confuse public’s perceptions and the scientific community is expected to offer a wider perspective on the benefits and risks resulting from ionizing radiation in everyday life. Attentive to the need of new approaches between science and society, the Nuclear Energy Museum, in northeast Brazil, is an initiative created to communicate the growing impact of the beneficial applications of nuclear technology in medicine, industry, agriculture and electric power generation. Providing accessible scientific information, the museum offers a rich learning environment, making use of different educational strategies, such as films, interactive panels and multimedia learning tools, which not only increase the enjoyment of visitors, but also maximize their learning potential. Developed according to modern active learning instructional strategies, multimedia materials are designed to present the increasingly role of nuclear science in modern life, transforming science education into a meaningful learning experience. In year 2016, nine different interactive computer-based activities were developed, presenting curiosities about ionizing radiation in different landmarks around the world, such as radiocarbon dating works in Egypt, nuclear power generation in France and X-radiography of famous paintings in Italy. Feedback surveys have reported a high level of visitors’ satisfaction, proving the high quality experience in learning nuclear science at the museum. The Nuclear Energy Museum is the first and, up to the present time, the only permanent museum in Brazil devoted entirely to nuclear science.

Keywords: nuclear technology, multimedia learning tools, science museum, society and education

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Authors: Mary-Ellen Hooper, Graeme Browne, Anthony Paul O'Brien

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Background: It has been reported that the experience of the organisational workplace culture for new graduate mental health nurses plays an important role in their attraction and retention to the discipline. Additionally, other research indicates that a negative workplace culture contributes to their dissatisfaction and attrition rate. Method: An ethnographic research design was applied to explore the subcultural experiences of new graduate nurses as they encounter mental health nursing. Data was collected between April and September 2017 across 6 separate Australian, NSW, mental health units. Data comprised of semi-structured interviews (n=24) and 31 episodes of field observation (62 hours). A total number of 26 new graduate and recent graduate nurses participated in the study – 14 new graduate nurses and 12 recently graduated nurses. Results: A key finding from this study was the New Graduate difficulty in articulating the role the of mental health nurse. Participants described a dichotomy between their ideological view of the mental health nurse and the reality of clinical practice. The participants’ ideological view of the mental health nurse involved providing holistic and individualised care within a flexible framework. Participants, however, described feeling powerless to change the recovery practices within the mental health service(s) because of their low status within the hierarchy. Resulting in participants choosing to fit into the existing culture, or considering leaving the field altogether. Conclusion: An incongruence between the values and ideals of an organisational culture and the reality shock of practice are shown to contribute to role ambiguity within its members. New graduate nurses entering the culture of mental health nursing describe role ambiguity resulting in dissatisfaction with practice. The culture and philosophy inherent to a service are posited to be crucial in creating positive experiences for graduate nurses.

Keywords: culture, mental health nurse, mental health nursing role, new graduate nurse

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Authors: Zhilong Xie, Jinwen Huang, Guofang Zeng

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The existing body of research on bilingualism has consistently linked the use of multiple languages to enhanced cognitive control. Numerous studies have demonstrated that bilingual individuals exhibit advantages in non-linguistic tasks demanding cognitive control. However, recent investigations have challenged these findings, leading to a debate regarding the extent and nature of bilingual advantages. The adaptive control hypothesis posits that variations in bilingual experiences hold the key to resolving these controversies. This study aims to contribute to this discussion by exploring the impact of second language (L2) listening experience on cognitive control among young Chinese-English bilinguals. By examining this specific aspect of bilingualism, the study offers a perspective on the origins of bilingual advantages. This study employed a range of cognitive tasks, including the Flanker task, Wisconsin Card Sorting Test (WCST), Operation Span Task (OSPAN), and a second language listening comprehension test. After controlling for potential confounding variables such as intelligence, socioeconomic status, and overall language proficiency, independent sample t-test analysis revealed significant differences in performance between groups with high and low L2 listening proficiency in the Flanker task and OSPAN. However, no significant differences emerged between the two groups in the WCST. These findings suggest that L2 listening proficiency has a significant impact on inhibitory control and working memory but not on conflict monitoring or mental set shifting. These specific findings provide a more nuanced understanding of the origins of bilingual advantages within a specific bilingual context, highlighting the importance of considering the nature of bilingual experience when exploring cognitive benefits.

Keywords: bilingual advantage, inhibitory control, L2 listening, working memory

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Authors: Getaneh Berie Tarekegn

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A precise localization system is crucial for many artificial intelligence Internet of Things (AI-IoT) applications in the era of smart cities. Their applications include traffic monitoring, emergency alarming, environmental monitoring, location-based advertising, intelligent transportation, and smart health care. The most common method for providing continuous positioning services in outdoor environments is by using a global navigation satellite system (GNSS). Due to nonline-of-sight, multipath, and weather conditions, GNSS systems do not perform well in dense urban, urban, and suburban areas.This paper proposes a generative AI-based positioning scheme for large-scale wireless settings using fingerprinting techniques. In this article, we presented a semi-supervised deep convolutional generative adversarial network (S-DCGAN)-based radio map construction method for real-time device localization. It also employed a reliable signal fingerprint feature extraction method with t-distributed stochastic neighbor embedding (t-SNE), which extracts dominant features while eliminating noise from hybrid WLAN and long-term evolution (LTE) fingerprints. The proposed scheme reduced the workload of site surveying required to build the fingerprint database by up to 78.5% and significantly improved positioning accuracy. The results show that the average positioning error of GAILoc is less than 0.39 m, and more than 90% of the errors are less than 0.82 m. According to numerical results, SRCLoc improves positioning performance and reduces radio map construction costs significantly compared to traditional methods.

Keywords: location-aware services, feature extraction technique, generative adversarial network, long short-term memory, support vector machine

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Authors: Irena Balaban Cakirpaloglu, Karla Hrbackova

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This paper focuses on the issue of intercultural competencies of university students who are preparing to work in assisting professions. In recent years, the Czech Republic has become a major destination for many people from different cultural environments, and there is a growing need for workers in assisting professions to be able to respond flexibly and adequately to the changing living conditions of multicultural coexistence. The main objective of this study is to analyse the preparedness of students in assisting professions in relation to intercultural competencies. Intercultural competences include several essential skills for working successfully with diversity. Taking into account the main objective of this research, a pilot study was conducted among students of Social Pedagogy at the Faculty of Humanities at Tomas Bata University in Zlin in the academic year 2017/2018. The research sample consisted of 116 students. To obtain the data, we used the Cross-Cultural Adaptability Inventory (CCAI) by Kelley and Meyers. The inventory maps strengths and weaknesses in 4 skill areas: Emotional Resilience, Flexibility/Openness, Perceptual Acuity and Personal Autonomy. This inventory also examines individual ability to succeed in intercultural interaction and communication. The results obtained from the survey were statistically processed and analysed using the relevant statistical methods. The results of the survey point to the fact that students of social pedagogy achieve average to below average results in individual skill areas. At the same time, significant differences have been detected among the students with work experience in multicultural environment and those with no experience.

Keywords: cross–cultural adaptability inventory, diversity, intercultural competences, students of social pedagogy

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Authors: Maha Atout, Pippa Hemingway, Jane Seymour

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A preliminary systematic review shows that health professionals experience a tension when communicating with the parents and family members of children with life-threatening and life-limiting conditions. On the one hand, they want to promote open and honest communication, while on the other, they are apprehensive about fostering an unrealistic sense of hope. Defining the boundaries between information that might offer reasonable hope versus that which results in false reassurance is challenging. Some healthcare providers worry that instilling a false sense of hope could motivate parents to seek continued aggressive treatment for their child, which in turn might cause the patient further unnecessary suffering. To date, there has been a lack of research in the Middle East regarding how healthcare providers do or should communicate bad news; in particular, the issue of hope in the field of paediatric palliative care has not been researched thoroughly. This study aims to explore, from the perspective of patients’ mothers, physicians, and nurses, the experience of communicating and receiving bad news in the care of children with palliative care needs. Data were collected using a collective qualitative case study approach across three paediatric units in a Jordanian hospital. Two data collection methods were employed: participant observation and semi-structured interviews. The overall number of cases was 15, with a total of 56 interviews with mothers (n=24), physicians (n=12), and nurses (n=20) completed, as well as 197 observational hours logged. The findings demonstrate that mothers wanted their doctors to provide them with hopeful information about the future progression of their child’s illness. Although some mothers asked their doctors to provide them with honest information regarding the condition of their child, they still considered a sense of hope to be essential for coping with caring for their child. According to mothers, hope was critical to treatment as it helped them to stay committed to the treatment and protected them to some extent from the extreme emotional suffering that would occur if they lost hope. The health professionals agreed with the mothers on the importance of hope, so long as it was congruent with the stage and severity of each patient’s disease. The findings of this study conclude that while parents typically insist on knowing all relevant information when their child is diagnosed with a severe illness, they considered hope to be an essential part of life, and they found it very difficult to handle suffering without any glimmer of it. This study finds that using negative terms has extremely adverse effects on the parents’ emotions. Hence, although the mothers asked the doctors to be as honest as they could, they still wanted the physicians to provide them with a positive message by communicating this information in a sensitive manner including hope.

Keywords: health professionals, children, communication, hope, information, mothers, palliative care

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Authors: Anna Mirczak

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Introduction: In connection with the aging of the population and the increase in the number of people with chronic illnesses, the priority objective for public health has become not only lengthening life, but also improving quality of life in older persons, as well as maintenance of their relative independence and active participation in social life. The most important determinant of a person’s quality of life is health. According to the literature, older people with chronic illness who live in rural settings are at greater risk for poor outcomes than their urban counterparts. Furthermore research characterizes the rural elderly as having a higher incidence of sickness, dysfunction, disability, restricted mobility, and acute and chronic conditions than their urban citizens. It is dictated by the overlapping certain specific socio-economic factors typical for rural areas which include: social and geography exclusion, limited access to health care centers, and low socioeconomic status. Aim of the study: The objective of this study was to recognize health status and needs of older people living in selected rural areas in Poland and evaluate the impacts of working in the farm on their health status. Material and methods: The study was performed personally, using interviews based on the structural questionnaires, during the period from March 2011 to October 2012. The group of respondents consisted 203 people aged 65 years and over living in selected rural areas in Poland. The analysis of collected research material was performed using the statistical package SPSS 19 for Windows. The level of significance for the tested the hypotheses assumed value of 0.05. Results: The mean age of participants was 75,5 years (SD=5,7) range from 65 to 94 years. Most of the interviewees had children (89.2%) and grandchildren (83.7) and lived mainly with family members (75.9%) mostly in double (46.8%) and triple (20.8%) household. The majority of respondents (71,9%) were physical working on the farm. At the time of interview, each of the respondents reported that they had been diagnosed with at least one chronic diseases by their GP. The most common were: hypertension (67,5%), osteoarthritis (44,8%), atherosclerosis (43,3%), cataract (40,4%), arrhythmia (28,6%), diabetes mellitus (19,7%) and stomach or duodenum ulcer diseases (17,2%).The number of diseases occurring of the sample was dependent on gender and age. Significant associations were observed between working on the farm and frequency of occurrence cardiovascular diseases, the gastrointestinal tract dysfunction and sensory disorders. Conclusions: The most common causes of disability among older citizens were: chronic diseases, malnutrition and complaints about access to health services (especially to cardiologist and an ophthalmologist). Health care access and health status are a particular concern in rural areas where the population is older, has lower education and income levels, and is more likely to be living in medically underserved areas than is the case in urban areas.

Keywords: ageing, health status, older people, rural

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Authors: Jibran Abbasy, Rizwan Sultan, Ammar Humayun, Tabish Chawla

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Background: Hydatid disease caused by Echinococcus Granulosus affects liver in 70-90% of cases. Dogs are the definitive host while humans are the accidental host. Modalities used for its treatment are especially important for our population as the disease is endemic in many Asian countries. The aim of the study was to perform an audit of the various modalities used for treatment of hydatid disease of liver and the response to each modality in tertiary care center of Pakistan. Materials and Methods: Retrospective audit of patients diagnosed and treated for Hydatid disease of the liver at Aga Khan University Hospital from 1st January 2007 to 31st December 2014 was completed. All patients aged 16 and above were included. Patients who had extra hepatic disease and missing records were excluded. Outcome measures were morbidity, mortality and recurrence of the disease. Results: During the study period 56 patients were treated for isolated hepatic hydatid disease and were included. Mean age was 39 years with 48% being females and 52% males. Most common presenting complaint was abdominal pain seen in 53% of patients(n=41). Duration of symptoms was less than 6 months in 74% (n=38). Mostly right lobe was involved in 69% (n=38).Most common treatment modality used was surgery in 34 patients followed by PAIR in 14 patients while 8 patients were treated medically. At a median follow up of 34 months recurrence was seen in 2 patients treated with PAIR while no patient treated with surgery had recurrence with the median follow up of 20 months. While no morbidity and mortality were observed in PAIR, but in surgery 5 patients had morbidity while 1 patient had mortality. Conclusion: Our data is comparative to other studies in terms of morbidity, mortality, and recurrence. We had adequate follow up. In our study PAIR and surgery both are effective and have less complications and recurrence rate. Surgery is still the gold standard in terms of recurrence.

Keywords: echinococcous granulosus, puncture aspiration irrigation reaspiration (PAIR), surgery, hydatid disease

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Authors: Delband Yekta Moazami

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Background: For proper care and treatment of HIV patients and drug users, the medical staff and physicians must have a correct and positive attitude and knowledge towards such patients. We aimed to assess the attitudes in a sample of health care workers (HCW) working in different hospitals and clinics and medical students in Georgia towards HIV infected people and drug users in Tbilisi. Method: We conducted a cross-sectional study to assess attitudes of health care workers towards people living with HIV and drug users in hospitals and clinics in Tbilisi. The study was carried out from 1st of May 2020 till 30th of September 2020. Data were collected using a self-administered structured online questionnaire. With this tool we evaluated four facets of attitudes: Discrimination, Acceptance of HIV/AIDS patients, Acceptance of drug users and Fear. All data were imported and analyzed with the software SPSS 22 for windows. Results: In total data was collected from168 respondents, that among them 107 (65%) were women and majority of the participants were medical doctors. Women had more acceptance attitudes rather than men towards drug abusers. We found significant differences regarding expressing negative attitudes among HCW who were more than 50 years old comparing with other age groups in all four aspects. Medical doctors expressed more acceptances towards people with HIV and drug users comparing two other groups. Also our study revealed that the group with working experience 21 years and more, showed more discriminatory attitudes comparing other groups. Conclusion: Based on our study findings, there are significant differences regarding respondent’s attitudes based on gender, medical specialty and working experience in health care system. People struggling with HIV and drug use need nonjudgmental and positive behaviors from health care workers and physicians in order to help them for harm reduction and receiving appropriate treatment.

Keywords: hiv, addiction, attitudes, healthcare workers

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Authors: Daphne Fietz

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This paper builds on a reflection on an autobiographical experience of uncanniness during fieldwork in the white Afrikaner settlement Orania in South Africa. Drawing on Kristeva’s theory of abjection to establish a theory of Whiteness which is based on boundary threats, it is argued that the uncanny experience as the emergence of the abject points to a moment of crisis of the author’s Whiteness. The emanating abject directs the author to her closeness or convergence with Orania's inhabitants, that is a reciprocity based on mutual Whiteness. The experienced confluence appeals to the author’s White complicity to racism. With recourse to Butler’s theory of subjectivation, the abject, White complicity, inhabits both the outside of a discourse on racism, and of the 'self', as 'I' establish myself in relation to discourse. In this view, the qualities of the experienced abject are linked to the abject of discourse on racism, or, in other words, its frames of intelligibility. It then becomes clear, that discourse on (overt) racism functions as a necessary counter-image through which White morality is established instead of questioned, because here, by White reasoning, the abject of complicity to racism is successfully repressed, curbed, as completely impossible in the binary construction. Hence, such discourse endangers a preservation of racism in its pre-discursive and structural forms as long as its critique does not encompass its own location and performance in discourse. Discourse on overt racism is indispensable to White ignorance as it covers underlying racism and pre-empts further critique. This understanding directs us towards a form of critique which does necessitate self-reflection, uncertainty, and vigilance, which will be referred to as a discourse of relationality. Such a discourse diverges from the presumption of a detached author as a point of reference, and instead departs from attachment, dependence, mutuality and embraces the visceral as a resource of knowledge of relationality. A discourse of relationality points to another possibility of White engagement with Whiteness and racism and further promotes a conception of responsibility, which allows for and highlights dispossession and relationality in contrast to single agency and guilt.

Keywords: abjection, discourse, relationality, the visceral, whiteness

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Authors: Marzieh Ahmadi, Ruhullah Alikhan Gorgani

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The usual methods of measuring regional inequalities can not reflect the internal changes of the country in terms of their displacement in different development groups, and the indicators of inequalities are not effective in demonstrating the dynamics of the distribution of inequality. For this purpose, this paper examines the dynamics of the urban inertial transport in the country during the period of 2006-2016 using the CIRD multidimensional index and stochastic kernel density method. it firstly selects 25 indicators in five dimensions including macroeconomic conditions, science and innovation, environmental sustainability, human capital and public facilities, and two-stage Principal Component Analysis methodology are developed to create a composite index of inequality. Then, in the second stage, using a nonparametric analytical approach to internal distribution dynamics and a stochastic kernel density method, the convergence hypothesis of the CIRD index of the Iranian provinces center is tested, and then, based on the ergodic density, long-run equilibrium is shown. Also, at this stage, for the purpose of adopting accurate regional policies, the distribution dynamics and process of convergence or divergence of the Iranian provinces for each of the five. According to the results of the first Stage, in 2006 & 2016, the highest level of development is related to Tehran and zahedan is at the lowest level of development. The results show that the central cities of the country are at the highest level of development due to the effects of Tehran's knowledge spillover and the country's lower cities are at the lowest level of development. The main reason for this may be the lack of access to markets in the border provinces. Based on the results of the second stage, which examines the dynamics of regional inequality transmission in the country during 2006-2016, the first year (2006) is not multifaceted and according to the kernel density graph, the CIRD index of about 70% of the cities. The value is between -1.1 and -0.1. The rest of the sequence on the right is distributed at a level higher than -0.1. In the kernel distribution, a convergence process is observed and the graph points to a single peak. Tends to be a small peak at about 3 but the main peak at about-0.6. According to the chart in the final year (2016), the multidimensional pattern remains and there is no mobility in the lower level groups, but at the higher level, the CIRD index accounts for about 45% of the provinces at about -0.4 Take it. That this year clearly faces the twin density pattern, which indicates that the cities tend to be closely related to each other in terms of development, so that the cities are low in terms of development. Also, according to the distribution dynamics results, the provinces of Iran follow the single-density density pattern in 2006 and the double-peak density pattern in 2016 at low and moderate inequality index levels and also in the development index. The country diverges during the years 2006 to 2016.

Keywords: Urban Disparity, CIRD Index, Convergence, Distribution Dynamics, Random Kernel Density

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Authors: E. Xavier, B. Nandita

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Rohingyas are an ethnic and religious minority that resides in the Rakhine State of Myanmar. Post the military coup in 1962, Rohingyas have not been recognized as one of the ethnic tribes of Burma under the legislation. They have lost citizenship, education, health care rights, and instantly became illegal immigrants. While the historicization of this conflict is crucial, this paper wants to humanize the Rohingya population’s embodiment of violence on three different levels – individual, social, and political. In addition, the study focuses on their liminal existence in refugee camps in Bangladesh and in other parts of the world, such as Malaysia and the United States of America. A multi-medium study, it includes first-hand interviews with the Rohingya community in Wisconsin and Chicago, second-hand interviews from documentaries and past ethnographies from scholars to draw meaningful conclusions about their experience as a community. In the end, it focuses on the group of Rohingyas who have managed to resettle in another country and their transitioning experience. Rohingyas embody violence on their individual, social, and political bodies in different ways. Along with rape, murder, and physical harm, the community also encounters sexually transmitted infections, post-traumatic stress disorder symptoms, and poor mental health. On a social level, they encounter heightened gender discrimination, work industry shifting, and immense, shared emotional pain. As for their political body, the news media and journalism industry uses their bodies for purposes that benefit both parties and flirts with a tone of sensationalism in their reporting. In addition, the Rohingya community fluctuates with the concept of nationality, patriotism, citizenship, and refugee when they think about the future. This study provides a framework that future aid or health programs can use to determine the type of community need and its significance in the Rohingya community.

Keywords: embodiment, liminal, refugee, Rohingya

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Authors: Huang Wei-Yi

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Objective: This article explores the intensive care nursing experience of a terminal lung cancer patient who received palliative care after tracheal intubation. The patient was nearing death, and the family experienced sadness and grief as they faced the patient’s deteriorating condition and impending death. Methods: The patient was diagnosed with lung cancer in 2018 and received chemotherapy and radiation therapy with regular outpatient follow-ups. Due to brain metastasis and recent poor pain control and treatment outcomes, the patient was admitted to the intensive care unit (ICU), where the tracheal tube was removed, and palliative care was initiated. During the care period, a holistic assessment was conducted, addressing the physical, psychological, social, and spiritual aspects of care. Medical records were reviewed, interviews and family meetings were held, and a comprehensive assessment was carried out by the critical care team in collaboration with the palliative care team. The primary nursing issues identified included pain, ineffective breathing patterns, fear of death, and altered tissue perfusion. Results: Throughout the care process, the palliative care nurse, along with the family, utilized listening, caring, companionship, pain management, essential oil massage, distraction, and comfortable positioning to alleviate the patient’s pain and breathing difficulties. The use of Morphine 6mg in 0.9% N/S 50ml IV drip q6h reduced the FLACC pain score from 6 to 3. The patient’s respiratory rate improved from 28 breaths/min to 18-22 breaths/min, and sleep duration increased from 4 to 7 uninterrupted hours. The holistic palliative care approach, coupled with the involvement of the palliative care team, facilitated expressions of gratitude, apologies, and love between the patient and family. Visiting hours were extended, and with the nurse’s assistance, these moments were recorded and shared with the patient’s consent, providing cherished memories for the family. The patient’s end-of-life experience was thus improved, and the family was able to find peace. This case also served to promote the concept of palliative care, ensuring that more patients and families receive high-quality nursing care. Conclusion: When caring for terminal patients, collaboration with the palliative care team, including social workers, clergy, psychologists, and nutritionists, is essential. Involving the family in decision-making and providing opportunities for closeness and expressions of gratitude improve personalized care and enhance the patient's quality of life. Upon transferring to the ward, the patient’s hemodynamic stability was maintained, including SBP 110-130 mmHg, respiratory rate 20-22 breaths/min, and pain score <3. The patient was later discharged and transitioned to home hospice care for ongoing support.

Keywords: intensive care, lung cancer, palliative care, ICU

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Authors: Vaidehi Raipat

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A city is an expression of coexistence between its users and built environment. The way in which its spaces are animated signify the quality of this coexistence. Urban sustainability is the ability of a city to respond efficiently towards its people, culture, environment, visual image, history, visions and identity. The quality of built environment determines the quality of our lifestyles, but poor ability of the built environment to adapt and sustain itself through the changes leads to degradation of cities. Ranchi was created in November 2000, as the capital of the newly formed state Jharkhand, located on eastern side of India. Before this Ranchi was known as summer capital of Bihar and was a little larger than a town in terms of development. But since then it has been vigorously expanding in size, infrastructure as well as population. This sudden expansion has created a stress on existing built environment. The large forest covers, agricultural land, diverse culture and pleasant climatic conditions have degraded and decreased to a large extent. Narrow roads and old buildings are unable to bear the load of the changing requirements, fast improving technology and growing population. The built environment has hence been rendered unsustainable and unadaptable through fastidious changes of present era. Some of the common hazards that can be easily spotted in the built environment are half-finished built forms, pedestrians and vehicles moving on the same part of the road. Unpaved areas on street edges. Over-sized, bright and randomly placed hoardings. Negligible trees or green spaces. The old buildings have been poorly maintained and the new ones are being constructed over them. Roads are too narrow to cater to the increasing traffic, both pedestrian and vehicular. The streets have a large variety of activities taking place on them, but haphazardly. Trees are being cut down for road widening and new constructions. There is no space for greenery in the commercial as well as old residential areas. The old infrastructure is deteriorating because of poor maintenance and the economic limitations. Pseudo understanding of functionality as well as aesthetics drive the new infrastructure. It is hence necessary to evaluate the extent of sustainability of existing built environment of the city and create or regenerate the existing built environment into a more sustainable and adaptable one. For this purpose, research titled “Sustainability of the Built Environment of Ranchi District” has been carried out. In this research the condition of the built environment of Ranchi are explored so as to figure out the problems and shortcomings existing in the city and provide for design strategies that can make the existing built-environment sustainable. The built environment of Ranchi that include its outdoor spaces like streets, parks, other open areas, its built forms as well as its users, has been analyzed in terms of various urban design parameters. Based on which strategies have been suggested to make the city environmentally, socially, culturally and economically sustainable.

Keywords: adaptable, built-environment, sustainability, urban

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Authors: K. S. Sivakumaran, T. Thanga, B. Halabieh

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The end panels of a large rectangular industrial duct, which experience significant internal pressures, also experience considerable transverse shear due to transfer of gravity loads to the supports. The current design practice of such thin plate panels for shear load is based on methods used for the design of plate girder webs. The structural arrangements, the loadings and the resulting behavior associated with the industrial duct end panels are, however, significantly different than those of the web of a plate girder. The large aspect ratio of the end panels gives rise to multiple bands of tension fields, whereas the plate girder web design is based on one tension field. In addition to shear, the industrial end panels are subjected to internal pressure which in turn produces significant membrane action. This paper reports a study which was undertaken to review the current industrial analysis and design methods and to propose a comprehensive method of designing industrial duct end panels for shear resistance. In this investigation, a nonlinear finite element model was developed to simulate the behavior of industrial duct end panel subjected to transverse shear and internal pressures. The model considered the geometric imperfections and constitutive relations for steels. Six scale independent dimensionless parameters that govern the behavior of such end panel were identified and were then used in an extensive parametric study. It was concluded that the plate slenderness dominates the shear strength of stockier end panels, and whereas, the aspect ratio and plate slenderness influence the shear strength of slender end panels. Based on these studies, this paper proposes design aids for estimating the shear strength of rectangular duct end panels.

Keywords: thin plate, transverse shear, tension field, finite element analysis, parametric study, design

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Authors: Maria Angela Bedini, Fabio Bronzini

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The Italian experiences, positive and negative, of the post-earthquake are conditioned by long times and structural bureaucratic constraints, also motivated by the attempt to contain mafia infiltration and corruption. The transition from the operational phase of the emergency to the planning phase of the reconstruction project is thus hampered by a series of inefficiencies and delays, incompatible with the need for rapid recovery of the territories in crisis. In fact, intervening in areas affected by seismic events means at the same time associating the reconstruction plan with an urban and territorial rehabilitation project based on strategies and tools in which prevention and safety play a leading role in the regeneration of territories in crisis and the return of the population. On the contrary, the earthquakes that took place in Italy have instead further deprived the territories affected of the minimum requirements for habitability, in terms of accessibility and services, accentuating the depopulation process, already underway before the earthquake. The objective of this work is to address with implementing and programmatic tools the procedures and strategies to be put in place, today and in the future, in Italy and abroad, to face the challenge of the reconstruction of activities, sociality, services, risk mitigation: a protocol of operational intentions and firm points, open to a continuous updating and implementation. The methodology followed is that of the comparison in a synthetic form between the different Italian experiences of the post-earthquake, based on facts and not on intentions, to highlight elements of excellence or, on the contrary, damage. The main results obtained can be summarized in technical comparison cards on good and bad practices. With this comparison, we intend to make a concrete contribution to the reconstruction process, certainly not only related to the reconstruction of buildings but privileging the primary social and economic needs. In this context, the recent instrument applied in Italy of the strategic urban and territorial SUM (Minimal Urban Structure) and the strategic monitoring process become dynamic tools for supporting reconstruction. The conclusions establish, by points, a protocol of interventions, the priorities for integrated socio-economic strategies, multisectoral and multicultural, and highlight the innovative aspects of 'inversion' of priorities in the reconstruction process, favoring the take-off of 'accelerator' interventions social and economic and a more updated system of coexistence with risks. In this perspective, reconstruction as a necessary response to the calamitous event can and must become a unique opportunity to raise the level of protection from risks and rehabilitation and development of the most fragile places in Italy and abroad.

Keywords: an operational protocol for reconstruction, operational priorities for coexistence with seismic risk, social and economic interventions accelerators of building reconstruction, the difficult post-earthquake reconstruction in Italy

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Authors: Wahiba Boudraa, Farah Chettibbi, Meriem Aberkane, Fatma Djamaa, Moussa Houhamdi

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The intensity of human activities in regions surrounding the Mediterranean Sea always has a strong long-term environmental impact resulting in coastal and marine degradation, as well as an aggravated risk of more serious damage. The available data on water quality show that most water resources in Algeria are polluted by uncontrolled discharges from municipal sewage and untreated industrial effluents. Annaba is a coastal town in Algeria; The Gulf of Annaba, responds to these changes as it receives the continental inputs and urban waste, industrial without prior treatment of a highly industrialized and urbanized city, subject to the same environmental problems that know the rest of the Algerian coast. In later year, the beaches of bacterial enumeration process waters showed relatively high levels of bacterial indicators of fecal contamination (group D streptococci, total and fecal coliforms), which reflect the risks to people attending these beaches. During the twelve months of our study, we isolated from three beaches in the city of Annaba (St. Cloud, El-Kettara, and Djenane El Bey) a number of pathogenic microorganisms considered, namely: Salmonella, Aeromonas, Citrobacter, Yersinia, Enterococcus, and E.coli. The microbial count revealed elevated levels of coliform bacteria, fecal coliforms and fecal streptococci quite high especially in urban beaches (St. Cloud and El-Kettara). They are widely popular during the summer by many vacationers. For the physico-chemical parameters, there exist some weak values which increase during the pluvial period, hivernal and festival saison. These values remain, nevertheless, weak to be able to cause an organic or metallic pollution.

Keywords: quality microbiology, pollution of water, fecal contamination, physico-chemistry, beaches of Annaba city, Algeria.

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Authors: Anupama A. P.

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The Malayalam film industry, known as Mollywood, has a rich tradition of storytelling and cultural significance within Indian cinema. Middlebrow films have emerged as a distinct influential category, particularly in the 1980s, with directors like K.G. George, who engaged with female subjectivity and drew inspiration from the ‘women’s cinema’ of the 1950s and 1960s. In recent decades, particularly post-2010, the industry has transformed significantly with a new generation of filmmakers diverging from melodrama and new wave of the past, incorporating advanced technology and modern content. This study examines the evolution and impact of Malayalam middlebrow cinema in the 21st century, focusing on post-2000 films and their influence on contemporary spectator experiences. These films appeal to a wide range of audiences without compromising on their artistic integrity, tackling social issues and personal dramas with thematic and narrative complexity. Historically, middlebrow films in Malayalam cinema have portrayed realism and addressed the socio-political climate of Kerala, blending realism with reflexivity and moving away from traditional sentimentality. This shift is evident in the new generation of Malayalam films, which present a global representation of characters and a modern treatment of individuals. To provide a comprehensive understanding of this evolution, the study analyzes a diverse selection of films such as Kerala Varma Pazhassi Raja (2009), Drishyam (2013), Maheshinte Prathikaaram (2016), Take Off (2017), and Thondimuthalum Driksakshiyum (2017) and Virus (2019) illustrating the broad thematic range and innovative narrative techniques characteristic of this genre. These films exemplify how middlebrow cinema continues to evolve, adapting to changing societal contexts and audience expectations. This research employs a theoretical methodology, drawing on cultural studies and audience reception theory, utilizing frameworks such as Bordwell’s narrative theory, Deleuze’s concept of deterritorialization, and Hall’s encoding/decoding model to analyze the changes in Malayalam middlebrow cinema and interpret the storytelling methods, spectator experience, and audience reception of these films. The findings indicate that Malayalam middlebrow cinema post-2010 offers a spectator experience that is both intellectually stimulating and broadly appealing. This study highlights the critical role of middlebrow cinema in reflecting and shaping societal values, making it a significant cultural artefact within the broader context of Indian and global cinema. By bridging entertainment with thought-provoking narratives, these films engage audiences and contribute to wider cultural discourse, making them pivotal in contemporary cinematic landscapes. To conclude, this study highlights the importance of Malayalam middle-brow cinema in influencing contemporary cinematic tastes. The nuanced and approachable narratives of post-2010 films are posited to assume an increasingly pivotal role in the future of Malayalam cinema. By providing a deeper understanding of Malayalam middlebrow cinema and its societal implications, this study enriches theoretical discourse, promotes regional cinema, and offers valuable insights into contemporary spectator experiences and the future trajectory of Malayalam cinema.

Keywords: Malayalam cinema, middlebrow cinema, spectator experience, audience reception, deterritorialization

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Authors: Paul Longley Arthur

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This paper reports on an Australian Research Council-funded project utilising the Australian digital research infrastructure the ‘Time-Layered Cultural Map of Australia’ (TLCMap) (https://www.tlcmap.org/) [1]. This resource has been developed to help researchers create digital maps from cultural, textual, and historical data, layered with datasets registered on the platform. TLCMap is a set of online tools that allows humanities researchers to compile humanities data using spatio-temporal coordinates – to upload, gather, analyse and visualise data. It is the only purpose-designed, Australian-developed research tool for humanities and social science researchers to identify geographical clusters and parallel journeys by sight. This presentation discusses a series of Aboriginal mapping and visualisation experiments using TLCMap to show how Indigenous knowledge can reconfigure contemporary understandings of space including the urbanised landscape [2, 3]. The research data being generated – investigating the historical movements of Aboriginal people, the distribution of networks, and their relation to land – lends itself to mapping and geo-spatial visualisation and analysis. TLCMap allows researchers to create layers on a 3D map which pinpoint locations with accompanying information, and this has enabled our research team to plot out traditional historical journeys undertaken by Aboriginal people as well as to compile a gazetteer of Aboriginal place names, many of which have largely been undocumented until now [4]. The documented journeys intersect with and overlay many of today’s urban formations including main roads, municipal boundaries, and state borders. The paper questions how such data can be incorporated into a more culturally and ethically responsive understanding of contemporary urban spaces and as well as natural environments [5].

Keywords: spatio-temporal mapping, visualisation, Indigenous knowledge, mobility and migration, research infrastructure

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

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

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

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Authors: Omer Livvarcin, Mary Kay Park, Michael Miles

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The current literature includes a few studies that mention the impact of relations between teams, the business environment, and experiences from previous projects. There is, however, limited research that treats the phenomenon of project atmosphere (PA) as a whole. This is especially true of research identifying parameters and sub-parameters, which allow project management (PM) teams to build a project culture that ultimately imbues project success. This study’s findings identify a number of key project atmosphere parameters and sub-parameters that affect project management success. One key parameter identified in the study is a cluster related to cultural concurrence, including artifacts such as policies and mores, values, perceptions, and assumptions. A second cluster centers on motivational concurrence, including such elements as project goals and team-member expectations, moods, morale, motivation, and organizational support. A third parameter cluster relates to experiential concurrence, with a focus on project and organizational memory, previous internal PM experience, and external environmental PM history and experience). A final cluster of parameters is comprised of those falling in the area of relational concurrence, including inter/intragroup relationships, role conflicts, and trust. International and intercultural project management data was collected and analyzed from the following countries: Canada, China, Nigeria, South Korea and Turkey. The cross-cultural nature of the data set suggests increased confidence that the findings will be generalizable across cultures and thus applicable for future international project management success. The intent of the identification of project atmosphere as a critical project management element is that a clear understanding of the dynamics of its sub-parameters upon projects may significantly improve the odds of success of future international and intercultural projects.

Keywords: project management, project atmosphere, cultural concurrence, motivational concurrence, relational concurrence

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Authors: Scholastic Nangila Adeli, Francisca Mbutitia Ngithi

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Stigma is commonly associated with mental health patients and may act as a barrier to individuals who may seek or engage in treatment services. Stigmatization among university students is common whether they know someone with a mental health problem, or have a good knowledge and experience of mental health issues. The objective of this study was to establish the various barriers that prevent university students who have mental health challenges from seeking treatment and care. The study was a descriptive in nature where 320 respondents helped to establish the barriers to treatment or participation in mental health care among university students. A questionnaire was used to help establish the barriers and attitude towards mental illness among the respondents. Results from this study revealed that mental illnesses are common among university students and they are manifested in different forms like; anxiety and panic attacks, mood and eating disorders, Impulse control leading to gambling, alcohol and drug addictions, anger and depression leading to loneliness. Mental stigma (both social and self) was the major barrier with 62% of the respondents stating that social stigma was worse than self-stigma. This is because of the social discrimination towards the victim of mental challenges. On issues of attitude, 71% of the respondents said that they can never admit that they have a mental issue and would rather secretly seek clinical or psychological help for fear of being discriminated or excluded by peers. This view is informed by the societal belief that people with mental health challenges were dangerous (associating them with criminal behavior) and hard to socialize with or help. From the findings of this study, it is concluded that mental health problems are real among university students in Kenya and it is important for the university environment to minimize or eradicate stigma within the social circles. Stigma can be minimized or eradicated by creating awareness among university students and fostering social inclusion so that the students who have mental health challenges can experience a sense of belonging and acceptance hence build their self-esteem.

Keywords: disorders, impulse control, mental health problems, stigma

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Authors: Susan Evans, Janna Gordon-Elliott, Katarzyna Wyka, Virginia Mutch

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During the rise of the COVID-19 pandemic, healthcare workers needed an intervention that could address their profound acute stress. Mindfulness-based stress reduction (MBSR) is a program that has long established effectiveness for mental and physical health outcomes. In recent years, MBSR has been modified such that the duration of both class time and number of sessions has been abbreviated, and its delivery has been adapted for online dissemination, thus increasing the likelihood that individuals who could most benefit from the program would do so. We sought to investigate whether a brief, online version of MBSR could be feasible and acceptable for health care workers (HCW) in acute stress in response to the COVID-19 pandemic. Participants were recruited via an email sent to all hospital employees, which spans residents, physicians, nurses, housekeeping, lab technicians, administrators, and others. Participating HCW were asked about their previous experience with mindfulness and asked to commit to a minimum of 3 sessions. They were then provided with four weekly 1-hour sessions online that included the major mindfulness exercises taught during traditional MBSR programs (i.e., body scan, sitting meditation, mindful eating, and yoga). Participants were provided with supporting slides, videos, demonstrations and asked to track their practice. Hospital staff enrolled in the program; by the end of the first day of recruitment, 40 had applied; by the start date, about 100 were enrolled, and n attended a minimum of 3 sessions, supporting feasibility. Hospital staff also participated and practiced the mindfulness exercises (n=42), thus supporting acceptability. Participants reported that the program was logical, successful, and worth recommending both before starting the program and after completing it (M= 22.02 and M=21.76, respectively, possible range 0-27). There was a slight decline in the belief in improvement in health and well-being due to the program (ES=.37, p=.021). Secondary hypotheses regarding participants’ self-reported stress and levels of mindfulness were also supported, such that participants reported improvements in perceived stress (ES=.45, p=.006), compassion satisfaction, burnout, and secondary traumatic stress (ES=.41, ES=.31, ES=.35, respectively, p<.05). Participants reported significant improvements in the describing facet of mindfulness (ES=.49, p=.004), while all other facets (observing, acting with awareness, nonjudging of inner experience, nonreactivity to inner experience) remained unchanged pre- to post-program. Results from this study suggest that an abridged, online version of MBSR is feasible and accessible to health care workers in acute stress and provides benefits expected from traditional MBSR programs. The lack of a randomized control group limits generalizability. We intend to provide a structure, framework, and lessons learned to hospital administrators and clinical staff seeking to support their employees in acute stress.

Keywords: acute stress, health care workers, mindfulness, online interventions

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Authors: C. Peeper McDonald

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Despite the multiracial population growing exponentially in the world and especially in the U.S., there continues to be a lack of culturally responsive research addressing the unique experiences and needs of this population, especially within counseling and counselor education settings. It is evident that their unique racial microaggressive experiences need to be better understood within the field of professional counseling to not only underscore competent training and practice but also culturally responsive training and practice. The participants of this study were 13 (n=13) individuals from the United States who identified as multiracial and said they had a microaggressive experience with either their counselor or counseling professor. Data were gathered through one-on-one, semi-structured interviews. The analysis employed phenomenological methods based on the transcendental approach, resulting in themes that encapsulated the core of the participants' experiences, including multiracial microaggressions that are derogatory and perpetuate privilege/oppression; counselors and their training programs should embody safety, support, attentiveness, inter-personal sensitivity, and awareness of the impact on others; microaggressions negatively affect the counseling relationship and outcomes; awareness surrounding the emotional impact of microaggressions; strength-based responses and future responses to microaggressions; and advocacy and suggestions for counselors and counselor educators. These themes are discussed in detail, and recommendations for researchers, counselor educators, and professional counselors to improve training and practice are provided. This U.S. study's insights into the Multiracial experience of microaggressions within the mental health profession can inform global mental health practices by highlighting the need for culturally responsive counseling that recognizes and addresses racial nuances. Such knowledge is transferable to international settings where multiracial populations may also encounter similar challenges, aiding in the development of global standards for culturally competent counseling practices.

Keywords: culturally responsive training and practice, mental health, microaggressions, multiracial

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