Search results for: hard care

Authors: Tanja Salary

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This study uncovers a gap in the research and adds to the body of knowledge regarding medication errors in a juvenile justice facility. The study includes an introduction to data collected about medication errors in a juvenile justice facility and explores contributing factors that relate to those errors. The data represent electronic incident records of the medication errors that were documented from the years 2011 through 2019. In addition, this study reviews both current and historical research of empirical data about patient safety standards and quality care comparing traditional healthcare facilities to juvenile justice residential facilities. The theoretical/conceptual framework for the research study pertains to Bandura and Adams’s (1977) framework of self-efficacy theory of behavioral change and Mark Friedman’s results-based accountability theory (2005). Despite the lack of evidence in previous studies about addressing medication errors in juvenile justice facilities, this presenter will relay information that adds to the body of knowledge to note the importance of how assessing the potential relationship between medication errors. Implications for more research include recommendations for more education and training regarding increased communication among juvenile justice staff, including nurses, who administer medications to juveniles to ensure adherence to patient safety standards. There are several opportunities for future research concerning other characteristics about factors that may affect medication administration errors within the residential juvenile justice facility.

Keywords: juvenile justice, medication errors, psychotropic medications, behavioral health, juveniles, incarcerated youth, recidivism, patient safety

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Authors: Mario Isaza-Ruget, Claudia C. Colmenares-Mejia, Nancy Yomayusa, Camilo A. González, Andres Cely, Jossie Murcia

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Quantification of risks associated with complications development from chronic kidney disease (CKD) through accurate survival models can help with patient management. A retrospective cohort that included patients diagnosed with CKD from a primary care program and followed up between 2013 and 2018 was carried out. Time-dependent and static covariates associated with demographic, clinical, and laboratory factors were included. Deep Learning (DL) survival analyzes were developed for three CKD outcomes: CKD stage progression, >25% decrease in Estimated Glomerular Filtration Rate (eGFR), and Renal Replacement Therapy (RRT). Models were evaluated and compared with Random Survival Forest (RSF) based on concordance index (C-index) metric. 2.143 patients were included. Two models were developed for each outcome, Deep Neural Network (DNN) model reported C-index=0.9867 for CKD stage progression; C-index=0.9905 for reduction in eGFR; C-index=0.9867 for RRT. Regarding the RSF model, C-index=0.6650 was reached for CKD stage progression; decreased eGFR C-index=0.6759; RRT C-index=0.8926. DNN models applied in survival analysis context with considerations of longitudinal covariates at the start of follow-up can predict renal stage progression, a significant decrease in eGFR and RRT. The success of these survival models lies in the appropriate definition of survival times and the analysis of covariates, especially those that vary over time.

Keywords: artificial intelligence, chronic kidney disease, deep neural networks, survival analysis

Procedia PDF Downloads 134

Authors: Mohammed-Hareef Asunramu, Sana Hashemi, Raja Ohri, Luc Worthington, Nadia Zaman, Junkai Zhu

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Background: The 2012 Health and Social Care Act committed to a ‘parity of esteem between mental and physical health services. Although this investment, aimed to both increase the quality of services and ensure the retention of mental health staff, questions remained regarding its ability to prevent mental health problems. One possible solution is a focus on the social determinants of health which have been shown to impact mental health. Aim: To examine the relationship between the index of multiple deprivations (IMD) and the prevalence of common mental health disorders (CMD) for CCGs in NHS England between 2019 and 2020. Design and setting: Cross-sectional analysis of 189 CCGs in NHS England. Methods: A multivariate linear regression model was utilized with CMD as outcome variable and IMD, age and ethnicity as explanatory variables. Datasets were obtained from Public Health England and the latest UK Census. Results: CCG IMD was found to have a significantly positive relationship with CMD. For every 1-point increase in IMD, CMD increases by 0.25%. Ethnicity had a significantly positive relationship with CMD. For every 1% increase in the population that identifies as BME, there is a 0.03% increase in CMD. Age had a significantly negative relationship with CMD. For every 1% increase in the population aged 60+, there is a 0.11% decrease in CMD. Conclusion: This study demonstrates that addressing mental health issues may require a multi-pronged approach. Beyond budget increases, it is essential to prioritize health equity, with careful considerations towards ethnic minorities and different age brackets.

Keywords: deprivation, health inequality, mental health, social determinants

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Authors: Mia Bahar, Özlem Bozkurt

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Obsessive-compulsive disorder (OCD) is a typical, persistent, and long-lasting mental health condition in which a person experiences uncontrollable, recurrent thoughts (or "obsessions") and/or activities (or "compulsions") that they feel compelled to engage in repeatedly. Obsessive-compulsive disorder is both underdiagnosed and undertreated. It frequently manifests in a variety of medical settings and is persistent, expensive, and burdensome. Obsessive-compulsive neurosis was long believed to be a condition that offered valuable insight into the inner workings of the unconscious mind. Obsessive-compulsive disorder is now recognized as a prime example of a neuropsychiatric condition susceptible to particular pharmacotherapeutic and psychotherapy therapies and mediated by pathology in particular neural circuits. An obsessive-compulsive disorder which is called OCD, usually has two components, one cognitive and the other behavioral, although either can occur alone. Obsessions are often repetitive and intrusive thoughts that invade consciousness. These obsessions are incredibly hard to control or dismiss. People who have OCD often engage in rituals to reduce anxiety associated with intrusive thoughts. Once the ritual is formed, the person may feel extreme relief and be free from anxiety until the thoughts of contamination intrude once again. These thoughts are strengthened through a manifestation of negative reinforcement because they allow the person to avoid anxiety and obscurity. These thoughts are described as autogenous, meaning they most likely come from nowhere. These unwelcome thoughts are related to actions which we can describe as Thought Action Fusion. The thought becomes equated with an action, such as if they refuse to perform the ritual, something bad might happen, and so people perform the ritual to escape the intrusive thought. In almost all cases of OCD, the person's life gets extremely disturbed by compulsions and obsessions. Studies show OCD is an estimated 1.1% prevalence, making it a challenging issue with high co-morbidities with other issues like depressive episodes, panic disorders, and specific phobias. The first to reveal brain anomalies in OCD were numerous CT investigations, although the results were inconsistent. A few studies have focused on the orbitofrontal cortex (OFC), anterior cingulate gyrus (AC), and thalamus, structures also implicated in the pathophysiology of OCD by functional neuroimaging studies, but few have found consistent results. However, some studies have found abnormalities in the basal ganglion. There have also been some discussions that OCD might be genetic. OCD has been linked to families in studies of family aggregation, and findings from twin studies show that this relationship is somewhat influenced by genetic variables. Some Research has shown that OCD is a heritable, polygenic condition that can result from de novo harmful mutations as well as common and unusual variants. Numerous studies have also presented solid evidence in favor of a significant additive genetic component to OCD risk, with distinct OCD symptom dimensions showing both common and individual genetic risks.

Keywords: compulsions, obsessions, neuropsychiatric, genetic

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Authors: Haleema Sadia

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The study is aimed at exploring the identity construction of female British born Pakistani postgraduate student who shifted to Pakistan at the age of 12, stayed there for 8 years and re-shifted to UK for Higher Education. Research questions are: 1. What is the academic and socio-cultural background of the participant prior to joining the UoM as a postgrad student? 2. How the participant talk, see herself and act in relation to cultural and social norms and practices? Participant’ identity is explored through positioning theory of Holland et al. (1998), referring to the ways people understand and enact their social positions in the figured world. The research is a case study based on narrative interview of Shabana, a British-born Pakistani female postgraduate student, who has recently joined the university of Manchester. Shabana received her primary education in UK during the first twelve years of her life. She is the youngest among the three sisters, with only one brother younger to her. Her father, although not well educated is a successful entrepreneur, maintaining offices in UK and Pakistan. Her mother is a housewife with no formal education. Shabana’s elder sister got involved in a relationship with a Pakistani boy against cultural norms of arranged marriage. Resultantly the three sisters were shifted to Pakistan to be equated with socio-religious norms. Shabana termed her first year in Pakistan as disgusting and she hated her father for the decision. However after a year’s time and shifting from an orthodox city to the provincial capital Lahore, she developed liking for the Pakistani culture. She gradually developed a new socio-religious identity during her stay, which she expressed as a turning point in her life. After completing O level Shabana returned back to UK and joined the University of Hull as undergraduate Student. At Hull she remained isolated, missed the religious environment and relished the memories of Lahore. She would visit Pakistan almost three times a year. After obtaining her BSc degree from Hull she went back to Pakistan. Soon after she decided to improve her academic qualification. She came to UK to join her parents and got admission in the MSc chemistry program at UoM. Presently Shabana talks about the dominant role of male members in the family culture in decision-making. She strongly feels to struggle hard and attain equal status with males in education, employment, earning, authority and freedom. She sees herself in a position to share the authority with her (would be) husband in important family and other matters. Shabana has developed a new identity of a mix of both Pakistani and UK culture. She is appreciative of the socio-cultural values of UK while still regarding the cultural and religious values of Pakistan in high esteem.

Keywords: postgraduate students, identity construction, cultural shifts, female british pakistani student

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Authors: Huanhuan Qiang, Sijia Jin

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Population aging has become a global trend, and China has entered an aging society, implementing an active aging system focused on home and community-based care. However, most urban communities where elderly people live face issues such as monotonous planning, unappealing landscapes, and inadequate aging infrastructure, which do not meet the requirements for active aging. Intergenerational friendliness and mutual assistance are key components in China's active aging policy framework. Therefore, residential development should prioritize enhancing intergenerational friendliness. Residential and public spaces are central to community life and well-being, offering new and challenging venues to improve relationships among residents of different ages. They are crucial for developing intergenerational communities with diverse generations and non-blood relationships. This paper takes the Maigaoqiao community in Nanjing, China, as a case study, examining intergenerational interactions in public spaces. Based on Maslow's hierarchy of needs and using time geography analysis, it identifies the spatiotemporal behavior characteristics of intergenerational groups in outdoor activities. Then construct an intergenerational-friendly evaluation system and an IPA quadrant model for public spaces in residential areas. Lastly, it explores optimization strategies for public spaces to promote intergenerational friendly interactions, focusing on five aspects: accessibility, safety, functionality, a sense of belonging, and interactivity.

Keywords: intergenerational friendliness, demand theory, spatiotemporal behavior, IPA analysis, existing residential public space

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Authors: Parul Suraia, Harshit Sosan Lakra

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Indigenous communities represent some of the most marginalized populations globally, with India labeled as tribals, experiencing particularly pronounced marginalization and a concerning decline in their numbers. These communities often inhabit geographically challenging regions characterized by low population densities, posing significant challenges to providing essential infrastructure services. Jharkhand, a Schedule 5 state, is infamous for its low-level health status due to disparities in access to health care. The primary objective of this study is to investigate the spatial inequalities in healthcare accessibility among tribal populations within the state and pinpoint critical areas requiring immediate attention. Health indicators were selected based on the tribal perspective and association of Sustainable Goal 3 (Good Health and Wellbeing) with other SDGs. Focused group discussions in which tribal people and tribal experts were done in order to finalize the indicators. Employing Principal Component Analysis, two essential indices were constructed: the Tribal Health Index (THI) and the Tribal Health Intervention Index (THII). Index values were calculated based on the district-wise secondary data for Jharkhand. The bivariate spatial association technique, Moran’s I was used to assess the spatial pattern of the variables to determine if there is any clustering (positive spatial autocorrelation) or dispersion (negative spatial autocorrelation) of values across Jharkhand. The results helped in facilitating targeting policy interventions in deprived areas of Jharkhand.

Keywords: tribal health, health spatial disparities, health status, Jharkhand

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Authors: Donna-Marie Phyllis Lanton

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Sarcopenia is a well-known geriatric syndrome characterized by the progressive and generalized loss of muscle quantity or quality. The incidence of sarcopenia increases with age and is associated with adverse outcomes such as the increased risk of falls, cognitive impairment, loss of independence, diminished quality of life, increased health costs, need for care in a skilled nursing facility, and increased mortality. Physical activity, including resistance training, is the most prevalent recommendation for treating and preventing sarcopenia. Residents (N = 23) of a skilled nursing facility in East Orlando, Florida, participated in a 90-day strength training program designed using the PARIHS framework to improve measures of muscle mass, muscle strength, physical performance, and quality of life. Residents engaged in both resistance and balance exercises for 1 hour two times a week. Baseline data were collected and compared to data at Days 30, 60, and 90. T tests indicated significant gains on all measures from baseline to 90 days: muscle mass increased by 1.2 (t[22] = 2.85, p = .009), grip strength increased by 4.02 (t[22] = 8.15, p < .001), balance increased by 2.13 (t[22] = 18.64, p < .001), gait speed increased by 1.83 (t[22] = 17.84, p < .001), chair speed increased 1.87 (t[22] = 16.36, p < .001), and quality of life score increased by 17.5 (t[22] = 19.26, p < .001). For residents with sarcopenia in skilled nursing facilities, a 90-day strength training program with resistance and balance exercises may provide an option for decreasing the incidence of sarcopenia among that population

Keywords: muscle mass, muscle strength, older adults, PARIHS framework

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Authors: Taguekou Kenfack Alexie

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For a long time, refugee protection has constituted one of the main concerns of the international community as a whole and for the South African government in particular.The focus of this paper is on the challenges refugees face in accessing their rights in South Africa. In particular, it analyses the legal framework for the protection of the socio economic rights of refugees under international law, regional and domestic law and the extent to which the rights have been realized. The main hypothesis of the study centered on the fact that the social protection of refugees in South Africa is in conformity with international standards. To test this hypothesis, the qualitative research method was applied. Refugee related legal instruments were analyzed as well as academic publications, organizational reports and internet sources. The data analyzed revealed that there has been enormous progress in meeting international standards in the areas of education, emergency relief and assistance, protection of women and refugee children. The results also indicated that much remain to be desired in such areas as nutrition, shelter, health care, freedom of movement and very importantly, employment and social security. The paper also seeks to address the obstacles which prevent the proper treatment of refugees and to make recommendations as how the South African government can better regulate the treatment of refugees living in its territory.Recommendations include the amendment of the legal instruments that provide the normative framework for protection and improvement of protection policies to reflect the changing dynamics.

Keywords: international community, refugee, socioeconomic rights, social protection

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Authors: Sabry A. El Azazy

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The archaeological heritage sites are one of the most important touristic attractions worldwide. Egypt has various archaeological sites and historical locations that are classified within the list of the archaeological heritage destinations in the world, such as Cairo, Luxor, Aswan, Alexandria, and Sinai. This study focuses on how to manage the archaeological sites and provide them with all services according to the traveler's needs. Tourism management depends on strategic planning for supporting the national economy and sustainable development. Additionally, tourism management has to utilize highly effective standards of security, promotion, advertisement, sales, and marketing while taking into consideration the preservation of monuments. In Egypt, the archaeological heritage sites must be well-managed and protected, which would assist tourism management, especially in times of crisis. Recently, the monumental places and archeological heritage sites were affected by unstable conditions and were threatened. It is essential to focus on preserving our heritage. Moreover, more efforts and cooperation between the tourism organizations and ministry of archaeology have to be done in order to protect the archaeology and promote the tourism industry. Methodology: Qualitative methods have been used as the overall approach to this study. Interviews and observations have provided the researcher with the required in-depth insight to the research subject. The researcher was a lecturer of tourist guidance that allows visiting all historical sites in Egypt. Additionally, the researcher had the privilege to communicate with tourism specialists and attend meetings, conferences, and events that were focused on the research subject. Objectives: The main purpose of the research was gaining information in order to develop theoretical research on how to effectively benefit out of those historical sights both economically and culturally, and pursue further researches and scientific studies to be well-suited for tourism and hospitality sector. The researcher works hard to present further studies in a field related to tourism and archaeological heritage using previous experience. Pursing this course of study enables the researcher to acquire the necessary abilities and competencies to achieve the set goal successfully. Results: The professional tourism management focus on making Egypt one of the most important destinations in the world, and provide the heritage and archaeological sites with all services that will place those locations into the international map of tourism. Tourists interested in visiting Egypt and making tourism flourish supports and strengths Egypt's national economy and the local community, taking into consideration preserving our heritage and archaeology. Conclusions: Egypt has many tourism attractions represented in the heritage, archaeological sites, and touristic places. These places need more attention and efforts to be included in tourism programs and be opened for visitors from all over the world. These efforts will encourage both local and international tourism to see our great civilization and provide different touristic activities.

Keywords: archaeology, archaeological sites, heritage, ministry of archaeology, national economy, touristic attractions, tourism management, tourism organizations

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Authors: Surarong Chinwong, Namthip Intarakumhang Na Rachasima, Siyaporn Kuikhiew, Dujrudee Chinwong

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Irrational use of medicines is a major problem in public health. Half of all patients take medicines incorrectly. An inappropriate use of antibiotics is one of the common types of irrational medicine use; for example, patients use antibiotic for treatment of common cold or diarrhea. Objectives: This cross-sectional study aimed to investigate the behaviors on antibiotic use, using amoxicillin and norfloxacin as examples, as well as sources of received health information. Methods: An online self-administered questionnaire was used to collect data from participants in Thailand between September and December 2015. Participants were asked about their behaviors on antibiotic use. Data were analyzed using descriptive statistics. Results: Of all 405 participants, most were female (65.3 %), aged 18-30 years (49.4 %), undergraduate or lower (69.7%), and civil servant or state enterprises (31.7 %). We found inappropriate behaviors in use of amoxicillin or norfloxacin: 1) there were 201/400 participants (50.3%) taking amoxicillin right away in case of having a common cold, such as having sore throat, running nose, and cough; 2) there were 170/405 participants (42.0%) using amoxicillin for relieving inflammatory symptoms, e.g. muscle inflammation or osteoarthritis; 3) there were 71/398 participants (17.8%) using amoxicillin as a muscle relaxant; 4) there were 135/398 participants (33.9%) using norfloxacin for treating diarrhea. Sources of health information received by the participants were from the internet (78.5%), the radio and/or television (42.2%), advertising publishing (33.3 %), and word of mouth (30.1%). Conclusion: This study showed improper behaviors in antibiotic use especially amoxicillin and norfloxacin. Health care providers including pharmacists should raise the public awareness on dangers of inappropriate antibiotic use and promote the rational use of antibiotics.

Keywords: antibiotic use, amoxicillin, norfloxacin, rational drug use

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Authors: G. Raviraja Shetty, K. G. Poojitha, Pranay Kumar

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Biodiversity refers to the numbers, variety and variability of living organisms and ecosystem. The climatic and altitudinal variations, coupled with varied ecological habitats of this country, have contributed to the development of immensely rich vegetation with a unique diversity in medicinal plants which provides an important source of medicinal raw materials for traditional medicine systems as well as for pharmaceutical industries in the country and abroad. World Health Organization has listed over 21000 plant species used around the world for medicinal purpose. In India, about 2500 plant species are being used in indigenous system of medicine. The red data book lists 427 Indian Medicinal plant entries on endangered species, of which 28 are considered extinct, 124 endangered, 81 rare, and 34 insufficiently known. It is abundantly clear from the experience of all govt agencies that on their own they cannot efficiently conserve the biodiversity. Participatory Approach with the involvement of local people in conservation is found to be more effective these days. Involvement of local people reduces the cost involved in conservation. Local communities have long tradition of resource use in particular area, hold in depth knowledge and experience of plant which can be invaluable for conservation efforts.Medicinal plants occupy a vital sector of health care system in India and represent a major national resource.There is an immense need for conservation of diversity of medicinal plant wealth for the present and fore coming generations, by adapting the suitable strategy with most appropriate method of conservation.

Keywords: conservation, biodiversity, participatory, medicinal plants

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Authors: Jakub Stelina, Janina Ciechanowicz-McLean

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Fifty years of existence and development of international environmental law brought a deep disappointment with efficiency and effectiveness of traditional command and control mechanisms of environmental regulation. Agenda 21 agreed during the first Earth Summit in Rio de Janeiro 1992 was one of the first international documents, which explicitly underlined the importance of public participation in environmental protection. This participation includes also the initiatives undertaken by business corporations in the form of private environmental standards setting. Twenty years later during the Rio 20+ Earth Summit the private sector obligations undertaken during the negotiations have proven to be at least as important as the ones undertaken by the governments. The private sector has taken the leading role in environmental standard setting. Among the research methods used in the article two are crucial in the analysis. The comparative analysis of law is the instrument used in the article to analyse the practice of states and private business companies in the field of sustainable development. The article uses economic analysis of law to estimate the costs and benefits of Corporate Social Responsibility Projects in the field of environmental protection. The study is based on the four premises. First is the role of social dialogue, which is crucial for both Corporate Social Responsibility and modern environmental protection regulation. The Aarhus Convention creates a procedural environmental human right to participate in administrative procedures of law setting and environmental decisions making. The public participation in environmental impact assessment is nowadays a universal standard. Second argument is about the role of precaution as a principle of modern environmental regulation. This principle can be observed both in governmental regulatory undertakings and also private initiatives within the Corporate Social Responsibility environmental projects. Even in the jurisdictions which are relatively reluctant to use the principle of preventive action in environmental regulation, the companies often use this standard in their own private business standard setting initiatives. This is often due to the fact that soft law standards are used as the basis for private Corporate Social Responsibility regulatory initiatives. Third premise is about the role of ecological education in environmental protection. Many soft law instruments underline the importance of environmental education. Governments use environmental education only to the limited extent due to the costs of such projects and problems with effects assessment. Corporate Social Responsibility uses various means of ecological education as the basis of their actions in the field of environmental protection. Last but not least Sustainable development is a goal of both legal protection of the environment, and economic instruments of companies development. Modern environmental protection law uses to the increasing extent the Corporate Social Responsibility. This may be the consequence of the limits of hard law regulation. Corporate Social Responsibility is nowadays not only adapting to soft law regulation of environmental protection but also creates such standards by itself, showing new direction for development of international environmental law. Corporate Social Responsibility in environmental protection can be good investment in future development of the company.

Keywords: corporate social responsibility, environmental CSR, environmental justice, stakeholders dialogue

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Authors: Marwa Djebbi, Hakim Gabtni

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Gravity is a continuously advancing method that has become a mature technology for geological studies. Increasingly, it has been used to complement and constrain traditional seismic data and even used as the only tool to get information of the sub-surface. In fact, in some regions the seismic data, if available, are of poor quality and hard to be interpreted. Such is the case for the current study area. The Nefza zone is part of the Tellian fold and thrust belt domain in the north west of Tunisia. It is essentially made of a pile of allochthonous units resulting from a major Neogene tectonic event. Its tectonic and stratigraphic developments have always been subject of controversies. Considering the geological and hydrogeological importance of this area, a detailed interdisciplinary study has been conducted integrating geology, seismic and gravity techniques. The interpretation of Gravity data allowed the delimitation of the dune reservoir and the identification of the regional lineaments contouring the area. It revealed the presence of three gravity lows that correspond to the dune of Zouara and Ouchtata separated along with a positive gravity axis espousing the Ain Allega_Aroub Er Roumane axe. The Bouguer gravity map illustrated the compartmentalization of the Zouara dune into two depressions separated by a NW-SE anomaly trend. This constitution was confirmed by the vertical derivative map which showed the individualization of two depressions with slightly different anomaly values. The horizontal gravity gradient magnitude was performed in order to determine the different geological features present in the studied area. The latest indicated the presence of NE-SW parallel folds according to the major Atlasic direction. Also, NW-SE and EW trends were identified. The maxima tracing confirmed this direction by the presence of NE-SW faults, mainly the Ghardimaou_Cap Serrat accident. The quality of the available seismic sections and the absence of borehole data in the region, except few hydraulic wells that been drilled and showing the heterogeneity of the substratum of the dune, required the process of gravity modeling of this challenging area that necessitates to be modeled for the geometrical characterization of the dune reservoir and determine the different stratigraphic series underneath these deposits. For more detailed and accurate results, the scale of study will be reduced in coming research. A more concise method will be elaborated; the 4D microgravity survey. This approach is considered as an expansion of gravity method and its fourth dimension is time. It will allow a continuous and repeated monitoring of fluid movement in the subsurface according to the micro gal (μgall) scale. The gravity effect is a result of a monthly variation of the dynamic groundwater level which correlates with rainfall during different periods.

Keywords: 3D gravity modeling, dune reservoir, heterogeneous substratum, seismic interpretation

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Authors: Benyapa Thitimapong

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Teenage pregnancy and adolescent mothers have become a matter of increasing concern in Thailand. Since adolescent mothers have been a big problem for two main consequences; health outcomes and socio-economic impacts. Adolescent mothers often endure poor living conditions; limited financial resources while also experience high stress, family instability, and limited educational opportunities. These disadvantages are negative and have long-term effects on adolescent mothers, their families, and the community. The majority of pregnant students and adolescent mothers dropped out of school after becoming pregnant, and some of them return to study again after they gave birth. This research aimed to explain the meaning of adolescent mothers who had undergone with childrearing and studying simultaneously after childbirth. A phenomenological qualitative approach was undertaken to investigate this study. The participants were 20 adolescent mothers each of whom became a mother and a student concurrently within less than 2 years after giving birth to a healthy baby and had also undergone the experience of childrearing and studying in non-formal education. In-depth interview was carried out for data collection, and the data were analyzed using content analysis method. ‘Learning to move forward’ was the meaning of adolescent mothers who experienced with childrearing and studying simultaneously. Their expressions were classified into two categories 1) having more responsibility, and 2) conceding and going on. The result of this study can be used as evidence for health care providers, especially nurses to facilitate and support pregnant adolescents and adolescent mothers to continue their education. Also, it can be used to guide policy to promote in all educational system to enable these groups to remain in school for their life-long success in the future.

Keywords: adolescent mothers, childrearing, studying, teenage pregnancy

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Authors: Anita De Melo

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Today we live in a crucial time of ecological crisis, of environmental catastrophes worldwide, and this scenario is, arrogantly, overlooked by powerful economic forces and their politics. Thus, a critical pedagogy that leads to action and that fosters ecoliteracy, environment education, is now inevitable, and it must become an integral part of the school curriculum across the disciplines, including the social sciences and the humanities. One of the most important contemporary and emerging movement of today is ecopedagogy, a movement that blends theory and ethics towards a curriculum that focus on an environmental education that will promote ecological justice, respect, and care by educating students to become planetary citizens. This paper aims, first, to emphasize the need for discussions and investigations regarding ecoliteracy within our field of teaching foreign languages, which will consider, among others, the of role language in stimulating sustainability, and the role of second language proficiency in fostering positive transnational dialogues conducive to fighting our current planetary crisis. Second, this paper suggests and discusses some critical ecopedagogical practices -- in the form of project-based learning, service-learning and environmental-oriented study abroad programs – apropos to ecoliteracy. These interdisciplinary projects can and should bring students in contact with communities speaking the target language, and such encounter would facilitate cultural exchanges and promote positive language proficiency whilst it would also give students the opportunity to work with finding ideas/projects to fight our current ecological catastrophe.

Keywords: critical pedagogy, ecoliteracy, ecopedagogy, planetary crisis

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Authors: Nabil A. Albaser

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Background: There is a serious problem with adverse drug reactions (ADRs) everywhere, including Yemen. Since it helps with the detection, assessment, reporting and prevention of ADRs, pharmacovigilance (PV) is an essential part of the healthcare system. The unbiased reporting of ADRs remains the foundation of PV. Students majoring in healthcare should acquire the knowledge and skills necessary to conduct PV in a range of clinical settings. The primary objective of this study was to evaluate the understanding and attitudes of final-year Pharmacy, Nursing, and Midwifery students at Al-Razi University in Sana'a, Yemen, regarding PV and ADRs reporting. Methods: The study followed descriptive cross-sectional approach. A validated, self-administered questionnaire with three parts—demographic information, knowledge, and perceptions of Pharmacovigilance was online distributed to final-year Pharmacy, Nursing, and Midwifery students. The questionnaire was given to 175 students; 122 of them responded with a percentage (69.7%). Results: The majority of respondents were male (79.5%). More than the tow-third of the students, 68.9%, were beyond the age of 23. Although the majority of students, 80%, heard about the terms of ADRs and PV, but only 50% and 57.4% of the respondents, respectively, could define the both terms correctly. However, only 11.48 % of them, nevertheless, took a PV course. More than a half of them (56.6%) had a positive perceptions towards pharmacovigilance and ADR reporting and had a moderate degree of knowledge (68.9%). Conclusion: The study demonstrated that the participants lacked sufficient knowledge of pharmacovigilance and ADR reporting. They showed a moderate level of understanding of reporting ADRs as well as a favorable opinion of dealing with and reporting ADRs. Yemen's health care curriculum should include lessons on pharmacovigilance.

Keywords: adverse drug reaction reporting, pharmacovigilance, yemen, knowlegde

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Authors: W. Pungchompoo, A. Richardson, L. Brindle

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Background: The developing of a culturally acceptable end of life survey (the VOICES-ESRD/Thai questionnaire) is an essential instrument for evaluation health services provision of older persons with ESRD in Thailand. The focus of the questionnaire was on symptoms, symptom control and the health care needs of older people with ESRD who are managed without dialysis. Objective: The objective of this study was to develop and adapt VOICES to make it suitable for use in a population survey in Thailand. Methods: The mixed methods exploratory sequential design was focussed on modifying an instrument. Data collection: A cognitive interviewing technique was implemented, using two cycles of data collection with a sample of 10 bereaved carers and a prototype of the Thai VOICES questionnaire. Qualitative study was used to modify the developing a culturally acceptable end of life survey (the VOICES-ESRD/Thai questionnaire). Data analysis: The data were analysed by using content analysis. Results: The revisions to the prototype questionnaire were made. The results were used to adapt the VOICES questionnaire for use in a population-based survey with older ESRD patients in Thailand. Conclusions: A culturally specific questionnaire was generated during this second phase and issues with questionnaire design were rectified.

Keywords: VOICES-ESRD/Thai questionnaire, cognitive interviewing, end of life survey, health services provision, older persons with ESRD

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Authors: Nadeem Qaiser, Sherjeel Munsif Khan, Muhammad Mustafa Hussian, Vincent Tung

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One of the emerging fields in the detection of chronic diseases is based on the point-of-care (POC) early monitoring of the symptoms and thus provides a state-of-the-art personalized healthcare system. Nowadays, wearable and flexible sensors are being used for analyzing sweat, glucose, blood pressure, and other skin conditions. However, localized jaw-bone swelling called parotid-swelling caused by some viruses has never been tracked before. To track physical motion or deformations, strain sensors, especially piezoresistive ones, are widely used. This work, for the first time, reports carbon nanotubes (CNTs)-based piezoresistive sensing patch that is highly flexible and stretchable and can record muscle deformations in real-time. The developed patch offers an excellent gauge factor for in-plane stretching and spatial expansion with low hysteresis. To calibrate the volumetric muscle expansion, we fabricated the pneumatic actuator that experienced volumetric expansion and thus redefined the gauge factor. Moreover, we employ a Bluetooth-low-energy system that can send information about muscle activity in real-time to a smartphone app. We utilized COMSOL calculations to reveal the mechanical robustness of the patch. The experiments showed the sensing patch's greater cyclability, making it a patch for personal healthcare and an excellent choice for monitoring the real-time POC monitoring of the human muscle swelling.

Keywords: piezoresistive strain sensor, FEM simulations, CNTs sensor, flexible

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Authors: Yi-Fung Lin, Pei-Chen Tsai

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Background: The hospital healthcare team provides 24-hour patient care, and therefore shift-work is inevitable in the nursing field. There is an increased awareness that shift-work affecting circadian rhythms may cause various health problems, especially in poor sleep quality, which may harm the quality of life. Purposes: The purpose of this study was to investigate the influences of demographic characteristics on nurses’ sleep quality and quality of life and the relationship between these predictors of nurses’ quality of life. Methods: A cross-sectional, descriptive correlational study was conducted with purposive sampling of 520 female nurses in a medical center in north Taiwan from July to September 2014. Data were collected with structured questionnaires using Psychometric Evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) and the World Health Organization Quality of Life (WHOQOL-BREF). Outcomes: The main results include: 1) Irregular menstruation, non-regular exercisers, and more daily caffeine consumption have negative impacts on sleep quality. 2) Younger age, fewer children, low education level, low annual income, irregular menstruation, pain during menstrual cycles, non-regular exercisers, constipation, and poor sleep quality all contribute negative impacts on the quality of life. 3) The odds ratio of sleep disturbance between 12-hour shifts and 8-hour shifts was 2.26, but there was no significant difference regarding their quality of life scores. Conclusion: This study showed that there is a strong correlation between oncology nurses’ sleep quality and quality of life. Sleep quality is a significant predictor of quality of life in oncology nurses.

Keywords: oncology nurses, sleep quality, quality of life, shift-work

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Authors: Cherifi Katia, Al-Hawat Marie-Lynn, Tricou Leo-Paul, Lamontagne Stephanie, Tran Minh, Ngu Amy Ching Yie, Manrique Gabriela, Guirguis Natalie, Machuca Parra Arturo Israel, Matoori Simon

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Diabetic foot ulcers (DFUs) are a serious and prevalent complication of diabetes. Current diagnostic options are limited to macroscopic wound analysis such as wound size, depth, and infection. Molecular diagnostics promise to improve DFU diagnosis, staging, and assessment of treatment response. Here, we developed a rapid and easy-to-use fluorescent pH-sensing bandage for wound diagnostics. In a fluorescent dye screen, we identified pyranine as the lead compound due to its suitable pH-sensing properties in the clinically relevant pH range of 6 to 9. To minimize the release of this dye into the wound bed, we screened a library of ionic microparticles and found a strong adhesion of the anionic dye to a cationic polymeric microparticle. These dye-loaded microparticles showed a strong fluorescence response in the clinically relevant pH range of 6 to 9 and a dye release below 1% after one day in biological media. The dye-loaded microparticles were subsequently encapsulated in a calcium alginate hydrogel to minimize the interaction of the microparticles with the wound tissue. This pH-sensing diagnostic wound dressing was tested on full-thickness dorsal wounds of mice, and a linear fluorescence response (R2 = 0.9909) to clinically relevant pH values was observed. These findings encourage further development of this pH-sensing system for molecular diagnostics in DFUs.

Keywords: wound ph, fluorescence, diagnostics, diabetic foot ulcer, wound healing, chronic wounds, diabetes

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Authors: Olufemi Samuel Shola, Oladapo Adenike Adesola

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Inadequate dietary intake has increased the susceptibility of under five children to malnutrition and infections. This study, therefore, assessed the feeding practices of children of 0-23 months of age among mothers in urban areas of Akure, Ondo State, Nigeria. Simple random sampling technique was used to select four hundred (400) mothers out of 710 mothers from 7 primary health care centres in Akure metropolis for the study. Data were collected using modified WHO 2003 Questionnaire on child feeding practices. Data were analyzed using descriptive statistics, while chi-square was used to determine the association between variables. Results showed that 52.0% of the children were males, with 47.5% in the 6-8 months age group. More than half (57.0%) of the mothers were between the ages of 20-29 years, and 45.0% had secondary education. Majority (94.3%) of the mothers breastfed their children in the last 24 hours preceding the survey. The feeding practices history of mothers showed that 28.0% and 53.7% of the mothers initiated breastfeeding less than 30 minutes and between 30 minutes to 1 hour after delivery, respectively. Also, 52.0% of mothers practiced exclusive breastfeeding for six months, while 26.2% breastfed from 6 months up to 2 years of age. Dietary diversity of the children age 6-23 months revealed that 68.7% of the children attained the minimum dietary diversity by consuming 4 or more food groups in the last 24 hours. There was a significant association (P < 0.05) between mothers’ education (n=180), occupation(n=41) and dietary diversity (n= 150) and meal frequency (n=209). Therefore, the study concluded that the duration of breastfeeding and time of introduction of complementary food did not meet WHO recommended guidelines. There is urgent need to launching more programmes.

Keywords: breastfeeding, mothers, child feeding, urban areas, ondo state, nigeria

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Authors: Sara Mohammad Atef Sabaika

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Background: The development of factor VIII (FVIII) inhibitor and hemophilic arthropathy in patients with hemophilia A (PWHA) are a great challenge for hemophilia care. Both genetic and environmental factors led to complications in PWHA. The development of inhibitory antibodies is usually induced by the immune response. Tumor necrosis factor α (TNF-α), one of the cytokines, might contribute to its polymorphism. Aim: Study the association between tumor necrosis alpha level and genotypes in pediatric patients with hemophilia A and its relation to inhibitor development and joint status. Methods: A cross-sectional study was conducted among a sufficient number of PWHA attending the Pediatric Hematology and Oncology Unit, Pediatric department in Menoufia University hospital. The clinical parameters, FVIII, FVIII inhibitor, and serum TNF-α level were assessed. The genotyping of −380G > A TNF-α gene polymorphism was performed using real time polymerase chain reaction. Results: Among the 50 PWHA, 28 (56%) were identified as severe PWHA. The FVIII inhibitor was identified in 6/28 (21.5%) of severe PWHA. There was a significant correlation between serum TNF-α level and the development of inhibitor (p = 0:043). There was significant correlation between polymorphisms of −380G > A TNF-α gene and hemophilic arthropathy development (p = 0:645). Conclusion: The prevalence of FVIII inhibitor in severe PWHA in Menoufia was 21.5%. The frequency of replacement therapy is a risk factor for inhibitor development. Serum TNF-α level and its gene polymorphism might be used to predict inhibitor development and joint status in pediatric patients with hemophilia A.

Keywords: hemophilic arthropathy, TNF alpha., patients witb hemophilia A PWHA, inhibitor

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Authors: Nicholas Agyepong, Paul Gyan

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Inappropriate prescribing of antibiotic is a common healthcare concern globally resulted in an increased risk of adverse reactions and the emergence of antimicrobial resistance. The wrong antibiotic prescribing habits may lead to ineffective and unsafe treatment, worsening of disease condition, and thus increase in health care costs. The study was to examine the antibiotic prescribing pattern and associated risk factors at Regional Hospital in the Bono region of Ghana. A retrospective cross-sectional study was conducted to describe the current prescribing practices at the Hospital from January 2014 to December, 2021. A systematic random sampling method was used to select the participants for the study. STATA version 16 software was used for data management and analysis. Descriptive statistics and logistic regression analysis were used to analyze the data. Statistical significance set at p<0.05. Antibiotic consumption was equivalent to 11 per 1000 inhabitants consuming 1 DDD per day. Most common prescribed antibiotic was amoxicillin/clavulanic acid (14.39%) followed by erythromycin (11.44%), and ciprofloxacin (11.36%). Antibiotics prescription have been steadily increased over the past eight years (2014: n=59,280 to 2021: n=190,320). Prescribers above the age of 35 were more likely to prescribe antibiotics than those between the ages of 20 and 25 (COR=21.00; 95% CI: 1.78 – 48.10; p=0.016). Prescribers with at least 6 years of experience were also significantly more likely to prescribe antibiotics than those with at most 5 years of experience (COR=14.17; 95% CI: 2.39 – 84.07; p=0.004). Thus, the establishment of an antibiotic stewardship program in the hospitals is imperative, and further studies need to be conducted in other facilities to establish the national antibiotic prescription guideline.

Keywords: antibiotic, antimicrobial resistance, prescription, prescribers

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Authors: Nicole Brown

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This study considers the illness experience of fibromyalgia patients by using identity boxes. The results improve health care professionals' understanding of patient experiences. Additionally, the concept of the identity boxes may offer a practical solution for helping patients accept the diagnosis of fibromyalgia. Fibromyalgia research traditionally refers to pain experiences and relies on questionnaires, surveys, interviews and some narrative analysis. However, due to the variability in symptoms, symptom levels, and locations, these methods may not be best suited to provide an insight into the patient experience. On the other hand, lengthy interview processes are not easily accessible for sufferers of fibromyalgia. In addition to timelines and diary extracts, this study uses identity boxes as its main data collection method. Participants are asked to find items in response to specific questions and to arrange them in their box. The objects represent the patients' experiences holistically. Participants provide photographs of their identity box at each stage of the process and explain their chosen items. The photographs of the identity boxes and the patients' explanations of their objects and their boxes are subjected to interpretative phenomenological analysis. Despite the unique forms of the completed boxes, common experiences are described: the need for comfort, the role of spirituality and the impact of fibromyalgia on everyday life, that it plays a significant role but those patients are determined not to let it rule their lives. The work with the identity boxes has shown beneficial impact due to the reflective nature involved in the tasks. Further investigations will be needed to identify the long-term impact of identity work using such boxes.

Keywords: biographical disruption, fibromyalgia, illness experience, illness narrative

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Authors: Mustapha Abdulsalam, R. N. Ahmed

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Nauclea latifolia is one of the medicinal plants used in traditional Nigerian medicine in the treatment of various diseases such as fever, toothaches, malaria, diarrhea among several other conditions. Nauclea latifolia leaf extract acts as a capping and reducing agent in the formation of silver nanoparticles. Silver nanoparticles (AgNPs) were synthesized using a combination of aqueous extract of Nauclea latifolia and 1mM of silver nitrate (AgNO₃) solution to obtain concentrations of 100mg/ml-400mg/ml. Characterization of the particles was done by UV-Vis spectroscopy and Fourier transform infrared (FTIR). In this study, aqueous as well as ethanolic extract of leaf of Nauclea latifolia were investigated for antibacterial activity using the standard agar well diffusion technique against three clinical isolates (Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa). The Minimum Inhibitory Concentration (MIC) was achieved by microbroth dilution method and Minimum Bactericidal Concentration (MBC) was also determined by plate assay. Characterization by UV-visible spectrometry revealed peak absorbance of 0.463 at 450.0nm, while FTIR showed the presence of two functional groups. At 400mg/ml, the highest inhibitory activities were observed with S.aureus and E.coli with zones of inhibition measuring 20mm and 18mm respectively. The MIC was obtained at 400mg/ml while MBC was at a higher concentration. The data from this study indicate the potential of silver nanoparticle of Nauclea latifolia as a suitable alternative antibacterial agent for incorporation into orthodox medicine in health care delivery in Nigeria.

Keywords: agar well diffusion, antimicrobial activity, Nauclea latifolia, silver nanoparticles

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Authors: Fernanda F. Zimmermann, Beverley Burrell, Jennifer Jordan

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Introduction: Supportive care for people affected by cancer is recognised as a priority for research but yet there is little solid evidence of the effectiveness of psychological treatments for those with advanced cancer. The literature suggests that mindfulness-based interventions may be acceptable and beneficial for this population. This study aims to develop a mindfulness intervention to provide emotional support for advanced cancer population. The treatment package includes mindfulness meditation, developing an acceptance attitude and reflections on meaning in life. Methods: This study design is a one-group pre-post test with a mixed methods approach. Participants are recruited through public and private hospitals in Christchurch, NZ. Quantitative measures are the Acceptance and Action Questionnaire-II, Mindful Coping Scale and, the Meaning in Life Questionnaire. Qualitative semi-structured interviews enquire about emotional support before and after the diagnosis, participants’ thoughts about meaning in life, expectations and reflections on the mindfulness training. Qualitative data will be analysed using thematic analysis. Treatment consists of one to one 30 minutes session weekly for 4 weeks using a pre-recorded CD/podcast of the mindfulness training. This research is part of the presenter’s PhD study. Findings: This project is currently underway. The presenter will provide preliminary data on the acceptability of the mindfulness training package being delivered to participants along with the recruitment strategies. We anticipate that this novel treatment used as a self-management tool will reduce psychological distress and enable better coping for patients with advanced cancer.

Keywords: acceptance, cancer, meaning in life, mindfulness

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Authors: Munir Ashraf, Shagufta Riaz

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Personal protective equipment (PPE) and bioactive textiles are highly important for the health care of front line hospital workers, patients, and the general population to be safe from highly infectious diseases. This was even more critical in the wake of COVID-19 outbreak. Most of the medical textiles are inactive against various viruses and bacteria, hence there is a need to wash them frequently to avoid the spread of microorganisms. According to survey conducted by the world health organization, more than 500 million people get infected from hospitals, and more than 13 million died due to these hospitals’ acquired deadly diseases. The market available PPE are though effective against the penetration of pathogens and to kill bacteria but, they are not breathable and active against different viruses. Therefore, there was a great need to develop textiles that are not only effective against bacteria, fungi, and viruses but also are comfortable to the medical personnel and patients. In the present study, waterproof breathable, and biologically active textiles were developed using antiviral and antibacterial nanomaterials. These nanomaterials like TiO₂, ZnO, Cu, and Ag were immobilized at the surface of cotton fabric by using different silane coupling agents and electroless deposition that they retained their functionality even after 30 industrial laundering cycles. Afterwards, the treated fabrics were coated with a waterproof breathable film to prevent the permeation of liquid droplets, any particle or microorganisms greater than 80 nm. The developed cotton fabric was highly active against bacteria and viruses. The good durability of nanomaterials at the cotton surface after several industrial washing cycles makes this fabric an ideal candidate for bioactive textiles used in the medical field.

Keywords: antibacterial, antiviral, cotton, durable

Procedia PDF Downloads 179

Authors: Irma Nool, Katriin Saueauk, Ebe Siimson, Vlada Žukova, Elise Gertrud Vellet

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Background: Asthma is one of themostcommonchronicdiseases in children, whichcansignificantlyaffectchildren, and challengetheirfamilies. The unpredictability, frequency, and control of asthma attacks have a profound effect on the daily lives of familieswithasthmaticchildren. Thereis a growing body of researchshowingthatthequality of life of parents and childrenislinkedtothedevelopment of asthma. Theoretical and clinicalstudiesprovethat a positive and well-functioningfamilysystemhelpstocopebetterwiththediagnosis of the chronic disease. The aim of theresearchwastodescribethecopingstrategies of parents of a childwithasthmaconcerningthechild'sillness. Method: Theresearchwasanempirical, quantitative, descriptive study. Thesamplewastheparents of a child with asthma at the Tallinn Children'sHospital, whose child was in inpatienttreatmentbetween 07.04.2021 and 12.09.2021. This is a convenient sample. 59 parentsrepliedtothequestionnaire. The questionnaire “CopingInventoryforStressfulSituations” wasusedtocollectthedata, whichwastranslatedinto Estonian and Russian using a back-and-forthtranslationtechnique. Thequestionnairewasanswered on a 5-point Likert scale. Dataanalysiswasperformedusing SPSS 26.0, descriptive statistics, with mean values and standard deviation. The Mann-Whitney U test wasusedtocomparefathers and motherscopingstrategies. PermissiontoconductresearchhasbeenobtainedfromtheEthicsCommitteeforHuman Research of theInstituteforHealthDevelopment. Results: The mean age of the respondents was 40 ± 6.2 years (median 40), withtheyoungestbeing 27 yearsold and the oldest being 57 yearsold. Of the respondents, 51 (86.4%) were mothers, and 8 (13.6%) werefathers. Parentsusedthemosttask-orientedcopingstrategies (mean 3.35 ± 0.602) and theleastemotion-orientedcopingstrategies (mean 1.97 ± 0.526). Mothersusedmoretask-orientedcopingstrategies (p = 0.001) than fathers. Fathersusedemotion-orientedcopingstrategiesless (p = 0.024) than mothers. mothersplantheirtimebetter (p = 0.043), focus on the problem and look at how to solve it (p = 0.007), and makeanefforttogetthingsdone (p = 0.045). mothersblamethemselvesmorefornotknowingwhattodo (p = 0.045) and worryaboutwhattheyshoulddo (p = 0.027). mothers look more at the goods displayed in the shop windows (p = 0.018) and go for a walk (p = 0.007) compared to fathers. Conclusions: The results of theresearchshowedthatproblem-orientedcopingstrategiesare used the most and there are differences in the behavior of fathers and mothers. Thisshouldbetakenintoaccountwhenprovidingfamily-centered nursing care.

Keywords: asthma, coping strategies, parents, family

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Authors: Mila Radovanovic, Jovana Jestrovic, Ivana Mihic

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Deciding whether to have a child is a complex psychological process, and the child's birth is an everlasting change in the life of the family. Researchers from all over the world have been recognized the importance of the motivation for parenthood in latter family life, but there is no very clear picture of factors which make the difference in this motivation. One of these factors can be the method of conception and results of the earlier studies are different- some showed the differences, but the others did not. The aim of this study was to determine the type and intensity of motivation for parenting among women in Serbia and to examine whether there are differences in motivation depend on the method of conception. The total sample consisted of 94 women- 57 pregnant women who conceive naturally and the same number of women in the process of in vitro fertilization, who still haven’t known the final result of the process- are they pregnant or no. The Child Study Inventory, which estimates four types of motivation for parenthood- altruistic, instrumental, narcissistic and fatalistic-was used for this purpose. Multivariate analysis of variance was used to answer the main question of the study. The results indicate that there is no statistically significant difference between the two groups of women, while the most common is the altruistic motivation that emphasizes the psychological value of the child, and sees the motivation for parenting as a desire to give love to the child. The results are encouraging because altruistic motivation is intrinsic one and the protective factor for latter family relations and care about child and sensitivity of parents. Altruistic motivation is showed like a good predictor in developing stable emotional relationship between mother and her baby but also is correlated with the higher satisfaction with marriage.

Keywords: development of parental role, in vitro fertilization, motivation for parenthood, pregnancy

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