Search results for: home care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4883

Search results for: home care

1523 Radiologic Assessment of Orbital Dimensions Among Omani Subjects: Computed Tomography Imaging-Based Study

Authors: Marwa Al-Subhi, Eiman Al-Ajmi, Mallak Al-Maamari, Humood Al-Dhuhli, Srinivasa Rao

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The orbit and its contents are affected by various pathologies and craniofacial anomalies. Sound knowledge of the normal orbital dimensions is clinically essential for successful surgical outcomes and also in the field of forensic anthropology. Racial, ethnic, and regional variations in the orbital dimensions have been reported. This study sought to determine the orbital dimensions of Omani subjects who had been referred for computed tomography (CT) images at a tertiary care hospital. A total of 273 patients’ CT images were evaluated retrospectively by using an electronic medical records database. The orbital dimensions were recorded using both axial and sagittal planes of CT images. The mean orbital index (OI) was found to be 83.25±4.83 and the prevalent orbital type was categorized as mesoseme. The mean orbital index was 83.34±5.05 and 83.16±4.57 in males and females, respectively, with their difference being statistically not significant (p=0.76). A statistically significant association was observed between the right and left orbits with regard to horizontal distance (p<0.05) and vertical distance (p<0.01) of orbit and OI (p<0.05). No significant difference between the OI and age groups was observed in both males and females. The mean interorbital distance and interzygomatic distance were found to be 19.45±1.52 mm and 95.59±4.08 mm, respectively. Both of these parameters were significantly higher in males (p<0.05). Results of the present study provide reference values of orbital dimensions in Omani subjects. The prevalent orbital type of Omani subjects is mesoseme, which is a hallmark of the white race.

Keywords: orbit, orbital index, mesoseme, ethnicity, variation

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1522 Vision-Based Daily Routine Recognition for Healthcare with Transfer Learning

Authors: Bruce X. B. Yu, Yan Liu, Keith C. C. Chan

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We propose to record Activities of Daily Living (ADLs) of elderly people using a vision-based system so as to provide better assistive and personalization technologies. Current ADL-related research is based on data collected with help from non-elderly subjects in laboratory environments and the activities performed are predetermined for the sole purpose of data collection. To obtain more realistic datasets for the application, we recorded ADLs for the elderly with data collected from real-world environment involving real elderly subjects. Motivated by the need to collect data for more effective research related to elderly care, we chose to collect data in the room of an elderly person. Specifically, we installed Kinect, a vision-based sensor on the ceiling, to capture the activities that the elderly subject performs in the morning every day. Based on the data, we identified 12 morning activities that the elderly person performs daily. To recognize these activities, we created a HARELCARE framework to investigate into the effectiveness of existing Human Activity Recognition (HAR) algorithms and propose the use of a transfer learning algorithm for HAR. We compared the performance, in terms of accuracy, and training progress. Although the collected dataset is relatively small, the proposed algorithm has a good potential to be applied to all daily routine activities for healthcare purposes such as evidence-based diagnosis and treatment.

Keywords: daily activity recognition, healthcare, IoT sensors, transfer learning

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1521 Cultural Practices as a Coping Measure for Women who Terminated a Pregnancy in Adolescence: A Qualitative Study

Authors: Botshelo Rachel Sebola

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Unintended pregnancy often results in pregnancy termination. Most countries have legalised the termination of a pregnancy, and pregnant adolescents can visit designated clinics without their parents’ consent. In most African and Asian countries, certain cultural practices are performed following any form of childbirth, including abortion, and such practices are ingrained in societies. The aim of this paper was to understand how women who terminated a pregnancy during adolescence coped by embracing cultural practices. A descriptive multiple case study design was adopted for the study. In-depth, semi-structured interviews and reflective diaries were used for data collection. 13 women aged 20 to 35 years who had terminated a pregnancy in adolescence participated in the study. Three women kept their soiled sanitary pads, burned them to ash and waited for the rainy season to scatter the ash in a flowing stream. This ritual was performed to appease the ancestors, ask them for forgiveness and as a send-off for the aborted foetus. Five women secretly consulted Sangoma (traditional healers) to perform certain rituals. Three women isolated themselves to perform herbal cleansings, and the last two chose not to engage in any sexual activity for one year, which led to the loss of their partners. This study offers a unique contribution to understanding the solitary journey of women who terminate a pregnancy. The study challenges healthcare professionals who work in clinics that offer pregnancy termination services to look beyond releasing the foetus to advocating and providing women with the necessary care and support in performing cultural practices.

Keywords: adolescence, culture, case study, pregnancy

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1520 Efficacy of Opicapone and Levodopa with Different Levodopa Daily Doses in Parkinson’s Disease Patients with Early Motor Fluctuations: Findings from the Korean ADOPTION Study

Authors: Jee-Young Lee, Joaquim J. Ferreira, Hyeo-il Ma, José-Francisco Rocha, Beomseok Jeon

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The effective management of wearing-off is a key driver of medication changes for patients with Parkinson’s disease (PD) treated with levodopa (L-DOPA). While L-DOPA is well tolerated and efficacious, its clinical utility over time is often limited by the development of complications such as dyskinesia. Still, common first-line option includes adjusting the daily L-DOPA dose followed by adjunctive therapies usually counting for the L-DOPA equivalent daily dose (LEDD). The LEDD conversion formulae are a tool used to compare the equivalence of anti-PD medications. The aim of this work is to compare the effects of opicapone (OPC) 50 mg, a catechol-O-methyltransferase (COMT) inhibitor, and an additional 100 mg dose of L-DOPA in reducing the off time in PD patients with early motor fluctuations receiving different daily L-DOPA doses. OPC was found to be well tolerated and efficacious in advanced PD population. This work utilized patients' home diary data from a 4-week Phase 2 pharmacokinetics clinical study. The Korean ADOPTION study randomized (1:1) patients with PD and early motor fluctuations treated with up to 600 mg of L-DOPA given 3–4 times daily. The main endpoint was change from baseline in off time in the subgroup of patients receiving 300–400 mg/day L-DOPA at baseline plus OPC 50 mg and in the subgroup receiving >300 mg/day L-DOPA at baseline plus an additional dose of L-DOPA 100 mg. Of the 86 patients included in this subgroup analysis, 39 received OPC 50 mg and 47 L-DOPA 100 mg. At baseline, both L-DOPA total daily dose and LEDD were lower in the L-DOPA 300–400 mg/day plus OPC 50 mg group than in the L-DOPA >300 mg/day plus L-DOPA 100 mg. However, at Week 4, LEDD was similar between the two groups. The mean (±standard error) reduction in off time was approximately three-fold greater for the OPC 50 mg than for the L-DOPA 100 mg group, being -63.0 (14.6) minutes for patients treated with L-DOPA 300–400 mg/day plus OPC 50 mg, and -22.1 (9.3) minutes for those receiving L-DOPA >300 mg/day plus L-DOPA 100 mg. In conclusion, despite similar LEDD, OPC demonstrated a significantly greater reduction in off time when compared to an additional 100 mg L-DOPA dose. The effect of OPC appears to be LEDD independent, suggesting that caution should be exercised when employing LEDD to guide treatment decisions as this does not take into account the timing of each dose, onset, duration of therapeutic effect and individual responsiveness. Additionally, OPC could be used for keeping the L-DOPA dose as low as possible for as long as possible to avoid the development of motor complications which are a significant source of disability.

Keywords: opicapone, levodopa, pharmacokinetics, off-time

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1519 Novel Correlations for P-Substituted Phenols in NMR Spectroscopy

Authors: Khodzhaberdi Allaberdiev

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Substituted phenols are widely used for the synthesis of advanced polycondensation polymers. In terms of the structure regularity and practical value of obtained polymers are of special interest the p-substituted phenols. The lanthanide induced shifts (LIS) of the aromatic ring and the OH protons by addition Eu(fod)3 to various p-substituted phenols in CDCL3 solvent were measured Nuclear Magnetic Resonance spectroscopy. A linear relationship has been observed between the LIS of protons (∆=δcomplex –δsubstrate) and Eu(fod)3/substrate molar ratios. The LIS protons of the investigated phenols decreases in the following order: ОН > ortho > meta. The LIS of these protons also depends on both steric and electronic effects of p-substituents. The effect on the LIS of protons steric hindrance of substituents by way of example p-substituted alkyl phenols was studied. Alkyl phenols exhibit pronounced europium- induced shifts, their sensitivity increasing in the order: CH3 > C2H5 > sym-C5H11 > tert-C5H11 > tert-C4H9, i.e. in parallel with decreasing steric hindrance. The influence steric hindrance p-substituents of phenols on the LIS of protons in sequence following decreases: OH> meta >ortho. Contrary to the expectations, it is found that the LIS of the ortho protons an excellent linear correlation with meta-substituent constants, σm for 14 p-substituted phenols: ∆H2, 6=8.165-9.896 σm (r2=0,999). Moreover, a linear correlation between the LIS of the ortho protons and ionization constants, РКa of p-substituted phenols has been revealed. Similarly, the linear relationships for the LIS of the meta and the OH protons were obtained. Use the LIS of the phenolic hydroxyl groups for linear relationships is necessary with care, because of the signal broadening of the OH protons. New constants may be determinate with unusual case by this approach.

Keywords: novel correlations, NMR spectroscopy, phenols, shift reagent

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1518 Gains and Pitfalls of Participating on International Staff Exchange Programs: Individual Experiences of Academic Staff of Makerere University, Uganda

Authors: David Onen

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Staff exchanges amongst different work organizations are a growing international phenomenon. In higher education in particular, it is not only the staff participating on international exchange programs, but their students as well. The practice of exchanging staff is premised on the belief that participating members of staff would not only get the chance to network with colleagues from partner institutions but also gain the opportunity for knowledge sharing and skills development. As a result, it would not only benefit the participating individual staff but their institutions too. However, in practice, staff exchange programs everywhere are not all ‘a bed of roses’. In fact, some of the programs seem to be laden with unapparent source of trouble or danger for the participating staff. This paper is a report on an on-going study investigating the experiences of members of academic staff of Makerere University in Uganda who have ever participated on international staff exchange programs. The study is aimed at documenting individual experiences in order to stimulate, not only a debate, but practical ways of enriching the experiences of staff who engage on well-meant international staff exchange programs. The study has employed an exploratory survey research design in which self-administered questionnaire and interview guide are being used to collect data from university academic staff respondents selected through snow-ball and purposive sampling techniques. Data have been analysed with the use of appropriate descriptive and inferential statistics as well as content analysis techniques. Preliminary study findings reveal that the majority of the respondents (95.5%) were, to a large extent, fully satisfied with their participation on the staff exchange programs. Many attested to gaining new experience (97%), networking (75%), gaining new knowledge (94%), acquiring new skills (88%), and therefore bringing to their institutions something ‘new’ and ‘beneficial’. However, a reasonably large percentage (57%) of the participants too expressed dissatisfaction in the institutional support that Makerere University gave them during their participation on the exchange programs. Some respondents reported about the ‘unfriendly welcome’ they received upon returning ‘home’ because colleagues detested how they were chosen to participate on such programs. The researcher thus concluded that international staff exchange programs are truly beneficial to both the participating staff and their institutions though with pitfalls. The researcher thus recommended for mutual and preferably equal engagement of the participating institutions on staff exchange programs if such programs are to benefit both the participating staff and institutions. Besides, exchange programs require clear terms of cooperation including on how staff are selected, facilitated and what are expected of the sending and host institutions as well as the concerned staff.

Keywords: gains, exchange programs, higher education, pitfalls

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1517 The Language of Risk: Pregnancy and Childbirth in the COVID-19 Era

Authors: Sarah Holdren, Laura Crook, Anne Drapkin Lyerly

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Objective: The COVID-19 Pandemic has drawn new attention to long-existing bioethical questions around pregnancy, childbirth, and parenthood. Due to the increased risk of severe COVID-19, pregnant individuals may experience anxiety regarding medical decision-making. Especially in the case of hospital births, questions around the ethics of bringing healthy pregnant individuals into a high-risk environment for viral transmission illuminate gaps in the American maternal and child healthcare system. Limited research has sought to understand the experiences of those who gave birth outside hospitals during this time. This study aims to understand pregnant individuals’ conceptualization of risk during the COVID-19 pandemic. Methods: Individuals who gave birth after March 2020 were recruited through advertisements on social media. Participants completed a 1-hour semi-structured interview and a demographic questionnaire. Interviews were transcribed and coded by members of the research team using thematic narrative analysis. Results: A total of 18 participants were interviewed and completed the demographic questionnaire. The language of risk was utilized in birth narratives in three different ways, which highlighted the multileveled and nuanced ways in which risk is understood and mitigated by pregnant and birthing individuals. These included: 1. The risk of contracting COVID-19 before, during, and after birth, 2. The risk of birth complications requiring medical interventions dependent on selected birthing space (home, birthing center, hospital), and 3. The overall risk of creating life in the middle of a pandemic. The risk of contracting COVID-19 and risk of birth complications were often weighed in paradoxical ways throughout each individual’s pregnancy, while phrases such as “pandemic baby” and “apocalypse” appeared throughout narratives and highlighted the broader implications of pregnancy and childbirth during this momentous time. Conclusions: Healthcare professionals should consider the variety of ways that pregnant and birthing individuals understand the risk when counseling patients on healthcare decisions, especially during times of healthcare crisis such as COVID-19. Future work should look to understand how the language of risk fits into a broader understanding of the human experience of growing life in times of crisis.

Keywords: maternal and child health, thematic narrative analysis, COVID-19, risk mitigation

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1516 Exploring the Issue of Occult Hypoperfusion in the Pre-Hospital Setting

Authors: A. Fordham, A. Hudson

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Background: Studies have suggested 16-25% of normotensive trauma patients with no clinical signs of shock have abnormal lactate and BD readings evidencing shock; a phenomenon known as occult hypoperfusion (OH). In light of the scarce quantity of evidence currently documenting OH, this study aimed to identify the prevalence of OH in the pre-hospital setting and explore ways to improve its identification and management. Methods: A quantitative retrospective data analysis was carried out on 75 sets of patient records for trauma patients treated by Kent Surrey Sussex Air Ambulance Trust between November 2013 and October 2014. The KSS HEMS notes and subsequent ED notes were collected. Trends between patients’ SBP on the scene, whether or not they received PRBCs on the scene as well as lactate and BD readings in the ED were assessed. Patients’ KSS HEMS notes written by the HEMS crew were also reviewed and recorded. Results: -Suspected OH was identified in 7% of the patients who did not receive PRBCs in the pre-hospital phase. -SBP heavily influences the physicians’ decision of whether or not to transfuse PRBCs in the pre-hospital phase. Preliminary conclusions: OH is an under-studied and underestimated phenomenon. We suggest a prospective trial is carried out to evaluate whether detecting trauma patients’ tissue perfusion status in the pre-hospital phase using portable devices capable of measuring serum BD and/or lactate could aid more accurate detection and management of all haemorrhaging trauma patients, including patients with OH.

Keywords: occult hypoperfusion, PRBC transfusion, point of care testing, pre-hospital emergency medicine, trauma

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1515 Risk Factors and Outcome of Free Tissue Transfer at a Tertiary Care Referral Center

Authors: Majid Khan

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Introduction: In this era of microsurgery, free flap holds a remarkable spot in reconstructive surgery. A free flap is well suited for composite defects as it provides sufficient and well-vascularized tissue for coverage. We report our experience with the use of the free flaps for the reconstruction of composite defects. Methods: This is a retrospective case series (chart review) of patients who underwent reconstruction of composite defects with a free flap at Aga Khan University Hospital, Karachi (Pakistan) from January 01, 2015, to December 31, 2019. Data were collected for patient demographics, size of the defect, size of flap, recipient vessels, postoperative complications, and outcome of the free flap. Results: Over this period, 532 free flaps are included in this study. The overall success rate is 95.5%. The mean age of the patient was 44.86 years. In 532 procedures, there were 448 defects from tumor ablation of head and neck cancer. The most frequent free flap was the anterolateral thigh flap in 232 procedures. In this study, the risk factor hypertension (p=0.004) was found significant for wound dehiscence, preop radiation/chemotherapy (p=0.003), and malnutrition (p=0.005) were found significant for fistula formation. Malnutrition (p=0.02) and use of vein grafts (p=0.025) were significant factors for flap failure. Conclusion: Free tissue transfer is a reliable option for the reconstruction of large and composite defects. Hypertension, malnutrition, and preoperative radiotherapy can cause significant morbidity.

Keywords: free flap, free flap failure, risk factors for flap failure, free flap outcome

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1514 Financial Technology: The Key to Achieving Financial Inclusion in Developing Countries Post COVID-19 from an East African Perspective

Authors: Yosia Mulumba, Klaus Schmidt

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Financial Inclusion is considered a key pillar for development in most countries around the world. Access to affordable financial services in a country’s economy can be a driver to overcome poverty and reduce income inequalities, and thus increase economic growth. Nevertheless, the number of financially excluded populations in developing countries continues to be very high. This paper explores the role of Financial Technology (Fintech) as a key driver for achieving financial inclusion in developing countries post the COVID-19 pandemic with an emphasis on four East African countries: Kenya, Tanzania, Uganda, and Rwanda. The research paper is inspired by the positive disruption caused by the pandemic, which has compelled societies in East Africa to adapt and embrace the use of financial technology innovations, specifically Mobile Money Services (MMS), to access financial services. MMS has been further migrated and integrated with other financial technology innovations such as Mobile Banking, Micro Savings, and Loans, and Insurance, to mention but a few. These innovations have been adopted across key sectors such as commerce, health care, or agriculture. The research paper will highlight the Mobile Network Operators (MNOs) that are behind MMS, along with numerous innovative products and services being offered to the customers. It will also highlight the regulatory framework under which these innovations are being governed to ensure the safety of the customers' funds.

Keywords: financial inclusion, financial technology, regulatory framework, mobile money services

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1513 Soft Skills: Expectations and Needs in Tourism

Authors: Susana Silva, Dora Martins

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The recent political, economic, social technological and employment changes significantly affect the tourism organizations and consequently the changing nature of the employment experience of the tourism workforce. Such scene leads several researchers and labor analysts to reflect about what kinds of jobs, knowledge and competences are need to ensure the success to teach, to learning and to work on this sector. In recent years the competency-based approach in high education level has become of significant interest. On the one hand, this approach could leads to the forming of the key students’ competences which contribute their better preparation to the professional future and on the other hand could answer better to practical demands from tourism job market. The goals of this paper are (1) to understand the expectations of university tourism students in relation to the present and future tourism competences demands, (2) to identify the importance put on the soft skills, (3) to know the importance of high qualification to their future professional activity and (4) to explore the students perception about present and future tourist sector specificities. To this proposal, a questionnaire was designed and distributed to every students who participate on classes of Hospitality Management under degree and master from one public Portuguese university. All participants were invited, during December 2014 and September 2015, to answer the questionnaire at the moment and on presence of one researcher of this study. Fulfilled the questionnaire 202 students (72, 35,6% male and 130, 64.4% female), the mean age was 21,64 (SD=5,27), 91% (n=86) were undergraduate and 18 (9%) were master students. 80% (n=162) of our participants refers as a possibility to look for a job outside the country.42% (n=85) prefers to work in a medium-sized tourism units (with 50-249 employees). According to our participants the most valued skills in tourism are the domain of foreign languages (87.6%, n=177), the ability to work as a team (85%), the personal persistence (83%, n=168), the knowledge of the product/services provided (73.8%, n=149), and assertiveness (66.3%, n=134). 65% (n=131) refers the availability to look for a job in a home distance of 1000 kilometers and 59% (n=119) do not consider the possibility to work in another area than tourism. From the results of this study we are in the position of confirming the need for universities to maintain a better link with the professional tourism companies and to rethink some competences into their learning course model. Based on our results students, universities and companies could understand more deeply the motivations, expectations and competences need to build the future career who study and work on the tourism sector.

Keywords: human capital, employability, students’ competencies perceptions, soft skills, tourism

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1512 Experimental Study and Evaluation of Farm Environmental Monitoring System Based on the Internet of Things, Sudan

Authors: Farid Eltom A. E., Mustafa Abdul-Halim, Abdalla Markaz, Sami Atta, Mohamed Azhari, Ahmed Rashed

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Smart environment sensors integrated with ‘Internet of Things’ (IoT) technology can provide a new concept in tracking, sensing, and monitoring objects in the environment. The aim of the study is to evaluate the farm environmental monitoring system based on (IoT) and to realize the automated management of agriculture and the implementation of precision production. Until now, irrigation monitoring operations in Sudan have been carried out using traditional methods, which is a very costly and unreliable mechanism. However, by utilizing soil moisture sensors, irrigation can be conducted only when needed without fear of plant water stress. The result showed that software application allows farmers to display current and historical data on soil moisture and nutrients in the form of line charts. Design measurements of the soil factors: moisture, electrical, humidity, conductivity, temperature, pH, phosphorus, and potassium; these factors, together with a timestamp, are sent to the data server using the Lora WAN interface. It is considered scientifically agreed upon in the modern era that artificial intelligence works to arrange the necessary procedures to take care of the terrain, predict the quality and quantity of production through deep analysis of the various operations in agricultural fields, and also support monitoring of weather conditions.

Keywords: smart environment, monitoring systems, IoT, LoRa Gateway, center pivot

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1511 From Context to Text and Back Again: Teaching Toni Morrison Overseas

Authors: Helena Maragou

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Introducing Toni Morrison’s fiction to a classroom overseas entails a significant pedagogical investment, from monitoring students’ uncertain journey through Morrison’s shifty semantics to filling in the gaps of cultural knowledge and understanding for the students to be able to relate text to context. A rewarding process, as Morrison’s works present a tremendous opportunity for transnational dialogue, an opportunity that hinges upon Toni Morrison’s bringing to the fore the untold and unspeakable lives of racial ‘Others’, but also, crucially, upon her broader critique of Western ideological hegemony. This critique is a fundamental aspect of Toni Morrison’s politics and one that appeals to young readers of Toni Morrison in Greece at a time when the questioning of institutions and ideological traditions is precipitated by regional and global change. It is more or less self-evident that to help a class of international students get aboard a Morrison novel, an instructor should begin by providing them with cultural context. These days, students’ exposure to Hollywood representations of the African American past and present, as well as the use of documentaries, photography, music videos, etc., as supplementary class material, provide a starting point, a workable historical and cultural framework for textual comprehension. The true challenge, however, lies ahead: it is one thing for students to intellectually grasp the historical hardships and traumas of Morrison’s characters and to even engage in aesthetic appreciation of Morrison’s writing; quite another to relate to her works as articulations of experiences akin to their own. The great challenge, then, is in facilitating students’ discovery of the universal Morrison, the author who speaks across cultures while voicing the untold tales of her own people; this process of discovery entails, on a pedagogical level, that students be guided through the works’ historical context, to plunge into the intricacies of Morrison’s discourse, itself an elaborate linguistic booby trap, so as to be finally brought to reconsider their own historical experiences using the lens of Morrison’s fiction. The paper will be based on experience of teaching a Toni Morrison seminar to a class of Greek students at the American College of Greece and will draw from students’ exposure and responses to Toni Morrison’s “Nobel Prize Lecture,” as well as her novels Song of Solomon and Home.

Keywords: toni morrison, international classroom, pedagogy, African American literature

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1510 Assessment of Antioxidant Activities in Roots of Miswak (Salvadora persica) Plants Grown at Two Different Locations in Saudi Arabia

Authors: Mohamed M. Ibrahima, Abdul Aziz A.AL Sahli, Ibrahim A. Alaraidh, Ali A. Al-Homaidan, E.M. Mostafa, G.A. EL-Gaaly

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Traditionally, in Middle Eastern countries, many cultures use chewing sticks of arak for medicinal purposes especially, for oral cleanliness care. It was used by Muslims for the treatment of teeth and highly recommended to be used by muslims during the whole day. Therefore, the present work aimed to determine the total phenolic content and total flavonoids in two Miswak extracts obtained from arak roots collected from two different localities in Saudi Arabia. They were extracted with aqueous ethanol (80%) and used to estimate in vitro their antioxidative abilities. The new findings showed that the two tested extracts contained significantly different amounts of both total phenolic content and total flavonoids. According to the increase of total phenolic contents and total flavonoids obtained from the two extracts, Miswak collected from the southern region was found to contain more contents than those collected from the middle region. The results of antioxidant activities of Miswak root extract obtained by using different in vitro methods were varied depending on the technique used. According to the malondialdehyde (MDA) method, hydrogen peroxide (H2O2) scavenging ability and 1,1-diphenyl-2-picrylhydrazyl (DPPH) methods, the two Miswak extracts exhibited to have high to very high antioxidant activities. Mostly, the values of antioxidant activities of Southern region have been shown to be always the highest.

Keywords: Arak, antioxidant, medicinal plants, Saudi Arabia

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1509 Nutritional Status of Food Insecure Students, UWC

Authors: E. C. Swart, E. Kunneke

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Background: Disparities in food security exist between communities and households across the country, reflecting continuing social and economic inequalities. The purpose of this study was to investigate the presence of food insecurity amongst UWC students. Method: Cross-sectional study recruited 200 students via email and cellphone from an ICS generated list of randomly selected students aged 18-25. Data collection took place during the first two weeks of term 3. Individual appointments were made with consenting participants and conducted in English by trained BSc Dietetics students. Data was analysed using SPSS. The hunger scale used by Stats SA (October 2010) was used. Dietary intake was assessed using a single 24hr recall. Results: Sixty-three percent of the students reported that they do experience some food insecurity whilst 14.5% reported to go hungry due to inadequate access to food. Coping mechanisms during periods of food insecurity include: Asking a friend, neighbour, family member (40%); Borrow (15%); Steal (none); Casual jobs (12%). Anthropometric status of students did not differ statistically significantly by food security status. A statistically significantly greater proportion of Xhosa speaking students reported inadequate money for food. Students residing in residences off campus appear to be least food secure in terms of money available and limiting food intake, whilst those residing at home are less food insecure. Similar proportions of students who receive bursaries or whose parents are paying reported going hungry whilst those who supports themselves never goes hungry. Mean nutrient intake during the previous 24 hours of students who reported inadequate resources to buy food, who eat less due to inadequate resources and who goes hungry only differed statistically significantly for Vitamin B (go hungry) and for fibre (money shortage). In general the nutrient intake is lower for those who reported to eat less and go hungry except for added sugar, vitamin A and folate (go hungry), and energy, fibre, iron, riboflavin and folate (eat less). For students who reported to have inadequate money to buy food, the mean nutrient intake was higher except for calcium and thiamin. The mean body mass index of this group of students was also higher even though the difference was not statistically significant. Conclusion: Hunger is present on campus however a single 24hr recall did not confirm statistically significant lower nutrient intakes for students who reported different levels of food insecurity.

Keywords: anthropometry, dietary intake, nutritional status, students

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1508 Evaluation of the Safety and Performance of Blood Culture Practices Using BD Safety-Lokᵀᴹ Blood Collection Sets in the Emergency Room

Authors: Jeonghyun Chang, Taegeun Lee, Heungsup Sung, Yoon-Seon Lee, Youn-Jung Kim, Mi-Na Kim

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Background: Safety device has been applied to improve safety and performance of blood culture practice. BD vacutainer® Safety-Lokᵀᴹ blood collection sets with pre-attached holder (Safety-Lok) (BD, USA) was evaluated in the emergency room (ER) of a tertiary care hospital. Methods: From April to June 2017, interns and nurses in ER were surveyed for blood culture practices with a questionnaire before and after 2 or 3 weeks of experience of Safety-Lok. All of them participated in exercise workshop for 1 hour combined with video education prior to the initial survey. The blood volume, positive and contamination rates of Safety-Lok-drawn (SD) blood cultures were compared to those of overall blood cultures. Results: Eighteen interns and 30 nurses were enrolled. As a result of the initial survey, interns had higher rates of needlestick incidence (27.8%), carriage of the blood-filled syringe with needle (88.9%) and lower rates of vacutainer use (38.9%) than nurses (13.3%, 53.3%, and 60.0%). Interns preferred to use safety devices (88.9%) rather than nurses (40.0%). The number of overall blood cultures and SD blood cultures was 9,053 and 555, respectively. While the overall blood volume of aerobic bottles was 2.6±2.1 mL, those of SD blood cultures were 5.0±3.0 mL in aerobic bottles and 6.0±3.0 mL in anaerobic bottles. Positive and contamination rates were 6.5% and 0.72% with SD blood cultures and 6.2% and 0.3% with overall blood cultures. Conclusions: The introduction of the safety device would encourage healthcare workers to collect adequate blood volume as well as lead to safer practices in the ER.

Keywords: blood culture, needlestick, safety device, volume

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1507 Factors Influencing Accidental Cyberbullying on Social Media: Healthcare Industry Perspective

Authors: Iram Malik, Mahrukh Shaukat, Abeer Malik, Hafiz Mushtaq Ahmad

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There has been a lot of research on cyberbullying but there is limited research on the topic of accidental cyberbullying on social media with a special focus on healthcare industry. This study emphasizes to uncover the factors that contribute to accidental cyberbullying on social media and how it affects individuals, professionals’ and organizations in health care sector. Nowadays social media is becoming a necessary part of our daily life; there is a need to look into how it is shaping our social life and behaviors displayed online. Instances of cyber bullying can have long-term repercussions due to over-sharing of information. The study used simple random sampling and the instrument of data collection was survey. A sample size of 250 healthcare professionals was chosen from the twin cities of Rawalpindi and Islamabad, Pakistan to examine the relationship between their attitude towards internet use, psychological distress, verbal aggression, envy, frustration, self-compassion, personality traits and accidental cyberbullying on social media. The results of the study have been encouraging. The findings show that psychological distress, aggression, envy, frustration and personality traits had direct effect on accidental cyberbullying whereas compassion, altruism lessened the effect of accidental cyberbullying behavior. It is our intent that the findings of this study could help raise awareness regarding fair use of social media, help policy makers in developing appropriate policies for avoiding cyberbullying in future.

Keywords: accidental cyberbullying, aggression, cyberbullying, frustration, social media

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1506 Teachers’ Stress as a Moderator of the Impact of POMPedaSens on Preschool Children’s Social-Emotional Learning

Authors: Maryam Zarra-Nezhad, Ali Moazami-Goodarzi, Joona Muotka, Nina Sajaniemi

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This study examines the extent to which the impact of a universal intervention program, i.e., POMPedaSens, on children’s early social-emotional learning (SEL) is different depending on early childhood education (ECE) teaches stress at work. The POMPedaSens program aims to promote children’s (5–6-year-olds) SEL by supporting ECE teachers’ engagement and emotional availability. The intervention effectiveness has been monitored using an 8-month randomized controlled trial design with an intervention (IG; 26 teachers and 195 children) and a waiting control group (CG; 36 teachers and 198 children) that provided the data before and after the program implementation. The ECE teachers in the IG are trained to implement the intervention program in their early childhood education and care groups. Latent change score analysis suggests that the program increases children’s prosocial behavior in the IG when teachers show a low level of stress. No significant results were found for the IG regarding a change in antisocial behavior. However, when teachers showed a high level of stress, an increase in prosocial behavior and a decrease in antisocial behavior were only found for children in the CG. The results suggest a promising application of the POMPedaSens program for promoting prosocial behavior in early childhood when teachers have low stress. The intervention will likely need a longer time to display the moderating effect of ECE teachers’ well-being on children’s antisocial behavior change.

Keywords: early childhood, social-emotional learning, universal intervention program, professional development, teachers' stress

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1505 The Experiences of Hong Kong Chinese Divorced Wives in Facing the Cancer Death of Their Ex-Husbands

Authors: M. L. Yeung

Abstract:

With the surge of divorce rate and male cancer onset/death rates, the phenomenon of divorced wives in the facing cancer death of their ex-husbands is not uncommon in Hong Kong. Yet, there is a dearth of study on the experiences of bereaved-divorced wives in the Hong Kong cultural context. This project fills the knowledge gap by conducting a qualitative study for having interviewed four bereaved ex-wives, who returned to ex-husbands’ end-of-life caregiving and eventually grieved for the ex-spousal’s death. From the perspectives of attachment theory and disenfranchised grief in the Hong Kong cultural context, a ‘double-loss’ experience is found in which interviewees suffer from the first loss of divorce and the second loss of ex-husbands’ death. Traumatic childhood experiences, attachment needs, role ambiguity, unresolved emotions and unrecognized grief are found significant in their lived experiences which alert the ‘double-loss’ is worthy of attention. Extending a family-centered end-of-life and bereavement care services to divorced couples is called for, in which validation on the attachment needs, ex-couple reconciliation, and acknowledgement on the disenfranchised grief are essential for social work practice on this group of clienteles specifically in Hong Kong cultural context.

Keywords: changing family, disenfranchised grief, divorce, ex-spousal death, marriage

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1504 A Study of the Effects of Nurse Innovation on Service Quality and Service Experience

Authors: Rhay-Hung Weng, Ching-Yuan Huang, Wan-Ping Chen

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Recently, many hospitals have put much emphasis upon the development of nurse innovation. The present study aimed to clarify how nurse innovation is related to medical service quality and medical service experience. This study adopted questionnaire-survey method with nurses and customers of the inpatient wards from three Taiwanese hospitals as the research subjects. After pairing, there were 294 valid questionnaires. Hierarchical regression analysis was utilized to test the possible impact of nurse innovation on medical service quality and experience. In terms of the dimensions of nurse innovation, “innovation behavior” ranked the highest (3.24), followed by knowledge creation and innovation diffusion; in terms of the degree of the medical service quality, 'reliability' ranked the highest (4.35). As for the degree of the medical service experience, 'feel experience' ranked the highest (4.44). All dimensions of nurse innovation have no significant effects on medical service quality and medical service experience. Of these three dimensions of nurse innovation, the level of innovation behavior was perceived by the nurses as the highest. The study found that nurse innovation has no significant effects on medical service quality and medical service experience. Managers shall provide sufficient resources and budget for fostering innovation development and encourage their nurses to develop nursing innovation for patents. The education and training courses on “patient-centered ” shall be enhanced among hospital nurses. Health care managers shall also explore the difficulties about innovation diffusion and find the solutions for nurses.

Keywords: innovation, employee innovative behavior, service quality, service experience

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1503 Beneficial Effects of Physical Activity in Treatment with Mental Health

Authors: Aline Giardin

Abstract:

Introduction: This review addresses the relationship between physical education and mental health and its main objective is to discuss the meanings that circulate in Psychiatric Hospitalization Units and Psychosocial Care Centers (CAPS) about the presence of physical education teachers and the practices developed by Them within these services. Material and methods: It is based on the theoretical contribution of the Psychiatric Reform and is methodologically inspired by the Bibliographic Review. Objectives: The objective of this review was to identify the main scientific evidence on the effects of physical activity on the main psychological aspects associated with mental health during the hospitalization process. Results: It was observed that physical activity has beneficial effects in the psychological, social and cognitive aspects, being thus a fundamental aspect of the lifestyle in promoting a healthy and successful treatment. In studies evaluating the effects of physical activity on mental health, the most frequently evaluated outcomes include anxiety, depression, and health-related quality of life (eg, self-esteem and self-efficacy). Evidence from epistemological studies indicates that the level of physical activity is positively associated with good mental health, when mental health is defined as good mood, general well-being and decreased symptoms. Conclusion: It is necessary to intervene and a greater interest of the professionals of physical education in the treatment with the people with mental disorders so that the negative symptoms are modified, through the aid of the physical activity, by better quality of life, physical condition, nutritional state and A healthy emotional appearance.

Keywords: health mental, physical activity, benefits, treatment

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1502 Ethnobotanical Study of Medicinal Plants Used by Indigenous People of Community Forest User Groups of Parbat District, Nepal

Authors: Gokul Gaudel, Zhang Wen Hui, Dang Quang Hung, Le Thi Hien, Liang Xiao

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The community forests of Nepal serve as a major source of medicinal plants for majority of local people who are dependent on traditional health care system. This study aims to explore the ethnobotanical information of the medicinal plants used by five different community forest user groups of Parbat district of Nepal. The research was conducted during different periods of the year 2015, using semi-structured, open-ended questionnaires, formal and informal interviews, and group discussions. In total 145 different plant species within 77 families were documented, the majority of them being herb were found to be used to treat 84 different ailments. In terms of plant parts use: whole plants, barks, fruits, leaves were found to be in top priorities. Oral administration was the dominant route (57%), followed by both oral and dermal route (29%) and dermal only (14%). Females were found to have 24% more ethnobotanical knowledge than male. The knowledge of ethnobotanical medicinal plants was found excellent on age group 65-75. This study showed that community forests of Parbat district are rich in medicinal plants but the new generation was found less interested in using them. Easy access to modern medicines, lack of documentation and knowledge transfer to young generations are the major causes of diminishing utility of traditional medicinal practices.

Keywords: ailments, community forest, ethnobotany, medicinal plants, Parbat

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1501 Nurse's Professional Space: Psychiatric Outpatient Clinic of Ottawa's Montfort Hospital 1976-2002

Authors: Silvia Maria Moya

Abstract:

After the Great Depression, the number of admissions to psychiatric facilities saw a significant increase. This increase, coupled with the arrival of new antipsychotic drugs, prepared the ground to the psychiatric deinstitutionalization movement in North America. Community services became an essential part of care where the role of the nurse also became crucial in the management of patients. Looking through the archives of the Department of Psychiatry at the Ottawa Montfort Hospital, this project aims to assess the role of the nurse in a multidisciplinary team in a period of psychiatric deinstitutionalization. This research focuses on the different roles of the mental health nurse during the second half of the twentieth century. The case study, used as a methodological approach allows in-depth analysis of the journey of a female patient with long hospital course. The analysis of the document ‘psychiatric evaluation’ on the medical records of outpatient Montfort Hospital – where, on a regular basis, different health professionals of the multidisciplinary team write their notes – allow us to better understand the difficulties of the patient, their problems, their family and work relationships and the evolution of their self-esteem, but most importantly, it allows us to identify the importance of the different nurse`s roles in the team and in the mental health setting. This project therefore reveals that the nurse occupies a larger professional space than the other professionals in the multidisciplinary team and highlights the role of mental health nurses with patients and their families and their leadership role within a multidisciplinary team.

Keywords: mental health, nursing, deinstitutionalization, professional space

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1500 COVID-19: The Dark Side of an Unprecedented Social Isolation in the Elderly

Authors: L. Paulino Ferreira, M. Gomes Neto, M. Duarte, S. Serra

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Objectives: COVID-19 pandemic has caused older adults to experience a degree of social isolation and loneliness that is unprecedented. Our aim is to review state of the art regarding the consequences of social isolation due to COVID-19 in elderly people. Methods: The authors conducted a search on Medscape and PubMed with the keywords mentioned below, and the most relevant articles were selected. Results: Social isolation leads many elderlies to experience loneliness, anxiety, depression, alcohol abuse, and feelings of abandonment with a perception of being a burden on society. Thus, social isolation has increased the risk for suicide in older people. It is also noteworthy that the exacerbation of psychiatric disorders (such as depression, anxiety, and post-traumatic stress disorder) without correct treatment and follow-up also increases suicide risk. Loneliness is also associated with accelerated cognitive deterioration and dementia. Besides that, during social isolation, it could be more difficult for older people to get medication as well as proper health care. It is also noticed an increase in the risk of falls, poor nutrition, and lack of exercise. All this contributes to weakening elderlies’ immune systems leading to a higher risk of developing infections, cardiovascular events, and cancer, increasing hospitalization and morbimortality. Conclusion: Social isolation in the elderly has a significant impact on physical and mental health, as well as morbimortality and hospitalizations due to non-COVID causes. Nevertheless, further studies will be needed to assess the real dimension of the effects of social isolation due to COVID-19.

Keywords: social isolation, COVID-19, elderly, mental health

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1499 The Thoughts and Feelings of 60-72 Month Old Children about School and Teacher

Authors: Ayse Ozturk Samur, Gozde Inal Kiziltepe

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No matter what level of education it is, starting a school is an exciting process as it includes new experiences. In this process, child steps into a different environment and institution except from the family institution which he was born into and feels secure. That new environment is different from home; it is a social environment which has its own rules, and involves duties and responsibilities that should be fulfilled and new vital experiences. The children who have a positive attitude towards school and like school are more enthusiastic and eager to participate in classroom activities. Moreover, a close relationship with the teacher enables the child to have positive emotions and ideas about the teacher and school and helps children adapt to school easily. In this study, it is aimed to identify children’s perceptions of academic competence, attitudes towards school and ideas about their teachers. In accordance with the aim a mixed method that includes both qualitative and quantitative data collection methods are used. The study is supported with qualitative data after collecting quantitative data. The study group of the research consists of randomly chosen 250 children who are 60-72 month old and attending a preschool institution in a city center located West Anatolian region of Turkey. Quantitative data was collected using Feelings about School scale. The scale consists of 12 items and 4 dimensions; school, teacher, mathematic, and literacy. Reliability and validity study for the scale used in the study was conducted by the researchers with 318 children who were 60-72 months old. For content validity experts’ ideas were asked, for construct validity confirmatory factor analysis was utilized. Reliability of the scale was examined by calculating internal consistency coefficient (Cronbach alpha). At the end of the analyses it was found that FAS is a valid and reliable instrument to identify 60-72 month old children’ perception of their academic competency, attitude toward school and ideas about their teachers. For the qualitative dimension of the study, semi-structured interviews were done with 30 children aged 60-72 month. At the end of the study, it was identified that children’s’ perceptions of their academic competencies and attitudes towards school was medium-level and their ideas about their teachers were high. Based on the semi structured interviews done with children, it is identified that they have a positive perception of school and teacher. That means quantitatively gathered data is supported by qualitatively collected data.

Keywords: feelings, preschool education, school, teacher, thoughts

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1498 Syngas From Polypropylene Gasification in a Fluidized Bed

Authors: Sergio Rapagnà, Alessandro Antonio Papa, Armando Vitale, Andre Di Carlo

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In recent years the world population has enormously increased the use of plastic products for their living needs, in particular for transporting and storing consumer goods such as food and beverage. Plastics are widely used in the automotive industry, in construction of electronic equipment, clothing and home furnishings. Over the last 70 years, the annual production of plastic products has increased from 2 million tons to 460 million tons. About 20% of the last quantity is mismanaged as waste. The consequence of this mismanagement is the release of plastic waste into the terrestrial and marine environments which represents a danger to human health and the ecosystem. Recycling all plastics is difficult because they are often made with mixtures of polymers that are incompatible with each other and contain different additives. The products obtained are always of lower quality and after two/three recycling cycles they must be eliminated either by thermal treatment to produce heat or disposed of in landfill. An alternative to these current solutions is to obtain a mixture of gases rich in H₂, CO and CO₂ suitable for being profitably used for the production of chemicals with consequent savings fossil sources. Obtaining a hydrogen-rich syngas can be achieved by gasification process using the fluidized bed reactor, in presence of steam as the fluidization medium. The fluidized bed reactor allows the gasification process of plastics to be carried out at a constant temperature and allows the use of different plastics with different compositions and different grain sizes. Furthermore, during the gasification process the use of steam increase the gasification of char produced by the first pyrolysis/devolatilization process of the plastic particles. The bed inventory can be made with particles having catalytic properties such as olivine, capable to catalyse the steam reforming reactions of heavy hydrocarbons normally called tars, with a consequent increase in the quantity of gases produced. The plant is composed of a fluidized bed reactor made of AISI 310 steel, having an internal diameter of 0.1 m, containing 3 kg of olivine particles as a bed inventory. The reactor is externally heated by an oven up to 1000 °C. The hot producer gases that exit the reactor, after being cooled, are quantified using a mass flow meter. Gas analyzers are present to measure instantly the volumetric composition of H₂, CO, CO₂, CH₄ and NH₃. At the conference, the results obtained from the continuous gasification of polypropylene (PP) particles in a steam atmosphere at temperatures of 840-860 °C will be presented.

Keywords: gasification, fluidized bed, hydrogen, olivine, polypropyle

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1497 Interpreting Chopin’s Music Today: Mythologization of Art: Kitsch

Authors: Ilona Bala

Abstract:

The subject of this abstract is related to the notion of 'popular music', a notion that should be treated with extreme care, particularly when applied to Frederic Chopin, one of the greatest composers of Romanticism. By ‘popular music’, we mean a category of everyday music, set against the more intellectual kind, referred to as ‘classical’. We only need to look back to the culture of the nineteenth century to realize that this ‘popular music’ refers to the ‘music of the low’. It can be studied from a sociological viewpoint, or as sociological aesthetics. However, we cannot ignore the fact that, very quickly, this music spread to the wealthiest strata of the European society of the nineteenth century, while likewise the lowest classes often listen to the intellectual classical music, so pleasant to listen to. Further, we can observe that a sort of ‘sacralisation of kitsch’ occurs at the intersection between the classical and popular music. This process is the topic of this contribution. We will start by investigating the notion of kitsch through the study of Chopin’s popular compositions. However, before considering the popularisation of this music in today’s culture, we will have to focus on the use of the word kitsch in Chopin’s times, through his own musical aesthetics. Finally, the objective here will be to negate the theory that art is simply the intellectual definition of aesthetics. A kitsch can, obviously, only work on the emotivity of the masses, as it represents one of the features of culture-language (the words which the masses identify with). All art is transformed, becoming something outdated or even outmoded. Here, we are truly within a process of mythologization of art, through the study of the aesthetic reception of the musical work.

Keywords: F. Chopin, kitsch, musical work, mythologization of art, popular music, romantic music

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1496 “I” on the Web: Social Penetration Theory Revised

Authors: Dr. Dionysis Panos Dpt. Communication, Internet Studies Cyprus University of Technology

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The widespread use of New Media and particularly Social Media, through fixed or mobile devices, has changed in a staggering way our perception about what is “intimate" and "safe" and what is not, in interpersonal communication and social relationships. The distribution of self and identity-related information in communication now evolves under new and different conditions and contexts. Consequently, this new framework forces us to rethink processes and mechanisms, such as what "exposure" means in interpersonal communication contexts, how the distinction between the "private" and the "public" nature of information is being negotiated online, how the "audiences" we interact with are understood and constructed. Drawing from an interdisciplinary perspective that combines sociology, communication psychology, media theory, new media and social networks research, as well as from the empirical findings of a longitudinal comparative research, this work proposes an integrative model for comprehending mechanisms of personal information management in interpersonal communication, which can be applied to both types of online (Computer-Mediated) and offline (Face-To-Face) communication. The presentation is based on conclusions drawn from a longitudinal qualitative research study with 458 new media users from 24 countries for almost over a decade. Some of these main conclusions include: (1) There is a clear and evidenced shift in users’ perception about the degree of "security" and "familiarity" of the Web, between the pre- and the post- Web 2.0 era. The role of Social Media in this shift was catalytic. (2) Basic Web 2.0 applications changed dramatically the nature of the Internet itself, transforming it from a place reserved for “elite users / technical knowledge keepers" into a place of "open sociability” for anyone. (3) Web 2.0 and Social Media brought about a significant change in the concept of “audience” we address in interpersonal communication. The previous "general and unknown audience" of personal home pages, converted into an "individual & personal" audience chosen by the user under various criteria. (4) The way we negotiate the nature of 'private' and 'public' of the Personal Information, has changed in a fundamental way. (5) The different features of the mediated environment of online communication and the critical changes occurred since the Web 2.0 advance, lead to the need of reconsideration and updating the theoretical models and analysis tools we use in our effort to comprehend the mechanisms of interpersonal communication and personal information management. Therefore, is proposed here a new model for understanding the way interpersonal communication evolves, based on a revision of social penetration theory.

Keywords: new media, interpersonal communication, social penetration theory, communication exposure, private information, public information

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1495 Resort to Religious and Faith Healing Practices in the Pathway to Care for Mental Illness: A Study among Mappila Muslims of Malabar, Kerala

Authors: K. P. Farsana

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Belief in supernatural causation of mental illnesses and resort to religious and faith healing as the method of intervention still continue in many parts of the world. The proposed study intended to find out the belief and causation on health and illness and utilization of religious and faith healing, its implications, and associated socio-cultural and religious factors among Mappila Muslims of Malabar, Kerala, a southern state of India.Thangals are the endogamous community in Kerala, of Yemeni heritage who claim direct descent from the Prophet Mohammed’s family. Because of their sacrosanct status, many Thangal works as religious healers in Malabar, Northern Kerala. Using the case of one Thangal healer as an illustration of the many religious healers in Kerala who engage in the healing practices, it is intended, in this paper to illustrate the religious and ritual healing practices among Mappila Muslims of Malabar. It was found that the majority of the Mappila Muslims believed in supernatural causation on illness, and majority of them consulted religious and faith healers for various health problems before seeking professional help, and a considerable proportion continued to believe in the healing efficiency of the religious and faith healing. A significant proportion of the population found religious and faith healing practices are supportive and more acceptable within the community. Religion and belief system play an important role in the heath seeking behavior of a person.

Keywords: religious and faith healing, mental illness, Mappila Muslims, Malabar

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1494 Urban Metis Women’s Identity and Experiences with Health Services in Toronto, Ontario

Authors: Renee Monchalin

Abstract:

Métis peoples, while comprising over a third of the total Indigenous population in Canada, experience major gaps in health services that accommodate their cultural identities. This is problematic given Métis peoples experience severe disparities in health determinants and outcomes compared to the non-Indigenous Canadian population. At the same time, Métis are unlikely to engage in health services that do not value their cultural identities, often utilizing mainstream options. Given these contexts, this research aims to fill the culturally-safe health care gap for Métis peoples in Canada. It does this by engaging 56 urban Métis women who participated in a longitudinal cohort study, Our Health Counts (OHC) Toronto. Traditionally, Métis women were central to the health and well-being of their communities. However, due to decades of colonial legislation and forced land displacement, female narratives have been silenced, and Métis identities have been fractured. This has resulted in having direct implications on Métis people’s current health and access to health services. Solutions to filling the Métis health service gap may lie in the all too often unacknowledged or missing voices of Métis women. Through a conversational method, this research will explore urban Métis women’s perspectives on identity and their experiences with health services in Toronto. The goal of this research is to learn from urban Métis women on steps towards filling the health service gap. This research is currently in the data collection stage. Preliminary findings from the conversations will be disseminated. Policy recommendations for health service providers will be provided to better accommodate Métis people.

Keywords: indigenous health, Metis health, urban, health service access, identity

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