Search results for: intervention measures

Authors: James D. Beauchemin

Abstract:

Introduction: The incarceration of people with mental illness and substance use disorders is a major public health issue with social, clinical, and economic implications. Yoga participation has been associated with numerous psychological benefits; however, there is a paucity of research examining impacts of yoga with incarcerated populations. The purpose of this study was to evaluate effectiveness of a six-week yoga intervention on several mental health-related variables, including emotion regulation, body awareness, and warnings of substance relapse among incarcerated females. Methods: This study utilized a pre-post, three-arm design, with participants assigned to intervention, therapeutic community, or general population groups. A between-group analysis of covariance (ANCOVA) was conducted across groups to assess intervention effectiveness using the Difficulties in Emotion Regulation Scale (DERS), Scale of Body Connection (SBC), and Warnings of Relapse (AWARE) Questionnaire. Results: ANCOVA results for warnings of relapse (AWARE) revealed significant between-group differences F(2, 80) = 7.15, p = .001; np2 = .152), with significant pairwise comparisons between the intervention group and both the therapeutic community (p = .001) and the general population (p = .005) groups. Similarly, significant differences were found for emotional regulation (DERS) F(2, 83) = 10.521, p = .000; np2 = .278). Pairwise comparisons indicated a significant difference between the intervention and general population (p = .01). Finally, significant differences between the intervention and control groups were found for body awareness (SBC) F(2, 84) = 3.69, p = .029; np2 = .081). Between-group differences were clarified via pairwise comparisons, indicating significant differences between the intervention group and both the therapeutic community (p = .028) and general population groups (p = .020). Implications: Study results suggest that yoga may be an effective addition to integrative mental health and substance use treatment for incarcerated women and contributes to increasing evidence that holistic interventions may be an important component for treatment with this population. Specifically, given the prevalence of mental health and substance use disorders, findings revealed that changes in body awareness and emotion regulation might be particularly beneficial for incarcerated populations with substance use challenges as a result of yoga participation. From a systemic perspective, this proactive approach may have long-term implications for both physical and psychological well-being for the incarcerated population as a whole, thereby decreasing the need for traditional treatment. By integrating a more holistic, salutogenic model that emphasizes prevention, interventions like yoga may work to improve the wellness of this population while providing an alternative or complementary treatment option for those with current symptoms.

Keywords: wellness, solution-focused coaching, college students, prevention

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Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

Abstract:

In Canada, as prevalence rates and severity of illness have increased among patients suffering from eating disorders, wait times have grown substantially. Patients in Canada often face wait times in excess of 12 months. It is known that delaying treatment for eating disorders contributes to poor patient outcomes and higher rates of symptom relapse. Improving interim services for adult patients awaiting outpatient treatment is a priority for an outpatient eating disorders clinic in Ontario, Canada. The clinical setting currently provides care for adults diagnosed with anorexia nervosa, bulimia nervosa and binge eating disorder. At present, the only support provided while patients are on the waitlist consists of communication with primary care providers regarding parameters for medical monitoring. The significance of this study will be to test the feasibility, acceptability and efficacy of an intervention to support adult patients awaiting outpatient eating disorder treatment for anorexia nervosa, bulimia nervosa and binge eating disorder. Methods: An intervention including psychoeducation, supportive resources, self-monitoring, and auxiliary referral will be pilot-tested with a group of patients in the summer of 2022 and detailed using a prospective cohort case study research design. The team will host patient focus groups in May 2022 to gather input informing the content of the intervention. The intervention will be pilot tested with newly-referred patients in June and July 2022. Patients who participate in the intervention will be asked to complete a survey evaluating the utility of the intervention and for suggestions, they may have for improvement. Preliminary findings describing the existing literature pertaining to waitlist interventions for patients with eating disorders, data gathered from the focus groups and early pilot testing results will be presented. Data analysis will continue throughout 2022 and early 2023 for follow-up publication and presentation in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to providing interim support to those patients waiting for treatment for eating disorders and, by extension, to improve outcomes for this population.

Keywords: eating disorders, waitlist management, intervention study, pilot test

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Authors: Khadija Al-Hosni, Moon Fai Chan, Mohammed Al-Azri

Abstract:

Background: Several studies suggest that most school-age adolescents are poorly informed on cancer warning signs and risk factors. Providing adolescents with sufficient knowledge would increase their awareness in adulthood and improve seeking behaviors later. Significant: The results will provide a clear vision in assisting key decision-makers in formulating policies on the students' awareness programs towards cancer. So, the likelihood of avoiding cancer in the future will be increased or even promote early diagnosis. Objectives: to evaluate the effectiveness of an education program designed to increase awareness of cancer signs and symptoms risk factors, improve the behavior of seeking help among school students in Oman, and address the barriers to obtaining medical help. Methods: A randomized controlled trial with two groups was conducted in Oman. A total of 1716 students (n=886/control, n= 830/education), aged 15-17 years, at 10th and 11th grade from 12 governmental schools 3 in governorates from 20-February-2022 to 12-May-2022. Basic demographic data were collected, and the Cancer Awareness Measure (CAM) was used as the primary outcome. Data were collected at baseline (T0) and 4 weeks after (T1). The intervention group received an education program about cancer's cause and its signs and symptoms. In contrast, the control group did not receive any education related to this issue during the study period. Non-parametric tests were used to compare the outcomes between groups. Results: At T0, the lamp was the most recognized cancer warning sign in control (55.0%) and intervention (55.2%) groups. However, there were no significant changes at T1 for all signs in the control group. In contrast, all sign outcomes were improved significantly (p<0.001) in the intervention group, the highest response was unexplained pain (93.3%). Smoking was the most recognized risk factor in both groups: (82.8% for control; 84.1% for intervention) at T0. However, there was no significant change in T1 for the control group, but there was for the intervention group (p<0.001), the highest identification was smoking cigarettes (96.5%). Too scared was the largest barrier to seeking medical help by students in the control group at T0 (63.0%) and T1 (62.8%). However, there were no significant changes in all barriers in this group. Otherwise, being too embarrassed (60.2%) was the largest barrier to seeking medical help for students in the intervention group at T0 and too scared (58.6%) at T1. Although there were reductions in all barriers, significant differences were found in six of ten only (p<0.001). Conclusion: The intervention was effective in improving students' awareness of cancer symptoms, warning signs (p<0.001), and risk factors (p<0.001 reduced the most addressed barriers to seeking medical help (p<0.001) in comparison to the control group. The Ministry of Education in Oman could integrate awareness of cancer within the curriculum, and more interventions are needed on the sociological part to overcome the barriers that interfere with seeking medical help.

Keywords: adolescents, awareness, cancer, education, intervention, student

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Authors: Jia Guo, Qinyuan Huang, Qinyi Zhong, Yanjing Zeng, Yimeng Li, James Wiley, Kin Cheung, Jyu-Lin Chen

Abstract:

Context: Mothers with abdominal obesity, particularly in China, face challenges in managing their health due to family responsibilities. Existing diabetes prevention programs do not cater specifically to this demographic. Research Aim: To assess the feasibility, acceptability, and efficacy of an mHealth-based diabetes prevention program tailored for Chinese mothers with abdominal obesity in reducing weight-related variables and diabetes risk. Methodology: A randomized controlled trial was conducted in Changsha, China, where the mHealth group received personalized modules and health messages, while the control group received general health education. Data were collected at baseline, 3 months, and 6 months. Findings: The mHealth intervention significantly improved waist circumference, modifiable diabetes risk scores, daily steps, self-efficacy for physical activity, social support for physical activity, and physical health satisfaction compared to the control group. However, no differences were found in BMI and certain other variables. Theoretical Importance: The study demonstrates the feasibility and efficacy of a tailored mHealth intervention for Chinese mothers with abdominal obesity, emphasizing the potential for such programs to improve health outcomes in this population. Data Collection: Data on various variables including weight-related measures, diabetes risk scores, behavioral and psychological factors were collected at baseline, 3 months, and 6 months from participants in the mHealth and control groups. Analysis Procedures: Generalized estimating equations were used to analyze the data collected from the mHealth and control groups at different time points during the study period. Question Addressed: The study addressed the effectiveness of an mHealth-based diabetes prevention program tailored for Chinese mothers with abdominal obesity in improving various health outcomes compared to traditional general health education approaches. Conclusion: The tailored mHealth intervention proved to be feasible and effective in improving weight-related variables, physical activity, and physical health satisfaction among Chinese mothers with abdominal obesity, highlighting its potential for delivering diabetes prevention programs to this population.

Keywords: type 2 diabetes, mHealth, obesity, prevention, mothers

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Authors: Ratih Andaruni Widhiantari

Abstract:

The combination of the expanding population of aid agencies and the act of politicization in humanitarian intervention blurred the distinction between what humanitarianism accept as universal human rights in theory and their practices in humanitarian intervention. Humanitarian organizations were now venturing into the formerly taboo territory of politics that place individuals at risk, for examples, cooperating and coordinating with the intervening states, considering moments of destruction as opportunities for political change and even taking on functions that had once been the exclusive preserve of government. Hence, aid agencies were becoming involved in matters of local or even international politics. This study focuses on the comparison between Oxfam and Médecins Sans Frontières (MSF) or Doctor without Borders different attitudes against political influences in humanitarian aid. It aims to untangle the bewilderment whether the contradictory approach to politics will becoming a barrier to performing their principles as humanitarian actors and also the consequences of taking that one particular position. The analysis of quantitative data and qualitative literature analysis are presented. The findings indicated Oxfam is actively engaged with politics. It welcomed government and private sector to shared cooperation to reach its goals to alleviate global inequalities. On the other hand, MSF has always taken a strong position to refuse any politics influence within their aid programmes. With no financial assistance from any government, MSF is free from any direct politics intervention. Hence, it can work efficiently with a clear objective to respond the demand side pressures from the people in needs. It is still publicly against politic involvement in the humanitarian activity, but practically, it has been moving forward to politicization in its own definition.

Keywords: humanitarian agencies, humanitarian intervention, humanitarian principles, politicization of humanitarianism

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Authors: Phornchanok Motantasut, Torkamol Hunsawong, Lugkana Mato, Wanida Donpunha

Abstract:

Identifying abnormal foot posture is important for prescribing appropriate management in patients with lower limb disorders and chronic non-specific low back pain. The normalized navicular height truncated (NNHt) and the foot posture index-6 (FPI-6) have been recommended as the common, simple, valid, and reliable static measures for clinical application. The NNHt is a single plane measure while the FPI-6 is a triple plane measure. At present, there is inadequate information about the correlation between the NNHt and the FPI-6 for categorizing foot posture that leads to a difficulty of choosing the appropriate assessment. Therefore, the present study aimed to determine the correlation between the NNHt and the FPI-6 measures in adult participants with asymptomatic feet. Methods: A cross-sectional descriptive study was conducted in 47 asymptomatic individuals (23 males and 24 females) aged 28.89 ± 7.67 years with body mass index 21.73 ± 1.76 kg/m². The right foot was measured twice by the experienced rater using the NNHt and the FPI-6. A sequence of the measures was randomly arranged for each participant with a 10-minute rest between the tests. The Pearson’s correlation coefficient (r) was used to determine the relationship between the measures. Results: The mean NNHt score was 0.23 ± 0.04 (ranged from 0.15 to 0.36) and the mean FPI-6 score was 4.42 ± 4.36 (ranged from -6 to +11). The Pearson’s correlation coefficient among the NNHt score and the FPI-6 score was -0.872 (p < 0.01). Conclusion: The present finding demonstrates the strong correlation between the NNHt and FPI-6 in adult feet and implies that both measures could be substituted for each other in identifying foot posture.

Keywords: foot posture index, foot type, measurement of foot posture, navicular height

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Authors: Sarah Majid Ansari, Serjosha Wulf, Matthias Goerke

Abstract:

In times of global warming and the increasing shortage of resources, sustainable production is becoming more and more inevitable. Companies cannot only heighten their competitiveness but also contribute positively to environmental protection through efficient energy and resource consumption. Regarding this, technical solutions are often preferred during production, although organizational and process-related approaches also offer great potential. This project focuses on reducing resource usage, with a special emphasis on the human factor. It is the aspiration to develop a methodology that systematically implements and embeds suitable and individual measures and methods regarding resource efficiency throughout the entire production. The measures and methods established help employees handle resources and energy more sensitively. With this in mind, this paper also deals with the difficulties that can occur during the sensitization of employees and the implementation of these measures and methods. In addition, recommendations are given on how to avoid such difficulties.

Keywords: implementation, human factors, production plants, resource efficiency

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Authors: Yungtai Lo

Abstract:

The current study follows an educational intervention on bottle-weaning to simultaneously evaluate the effect of the bottle-weaning intervention on reducing bottle use, daily milk intake from bottles, and daily energy intake in toddlers aged 11 to 13 months. A shared parameter model and a random effects model are used to jointly model bottle use, daily milk intake from bottles, and daily energy intake. We show in the two joint models that the bottle-weaning intervention promotes bottleweaning, and reduces daily milk intake from bottles in toddlers not off bottles and daily energy intake. We also show that the odds of drinking from a bottle were positively associated with the amount of milk intake from bottles and increased daily milk intake from bottles was associated with increased daily energy intake. The effect of bottle use on daily energy intake is through its effect on increasing daily milk intake from bottles that in turn increases daily energy intake.

Keywords: two-part model, semi-continuous variable, joint model, gamma regression, shared parameter model, random effects model

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Authors: Saeed M. Al Qahtani, Alaa Eldin A. Ayoub

Abstract:

The study aimed to develop a battery of measures to assessment gifted initiatives in Saudi Arabia. The battery consisted of 17 measures developed in light of Saudi Arabia's future vision objectives for gifted education. A battery was applied to 193 gifted students who benefit from gifted initiatives and programs, 42 teachers of gifted as well as, 40 experts of gifted. Samples were taken from three main regions: Riyadh, Sharqia, Gharbia in Saudi Arabia. The results indicated that battery measures have a reliability and stability index ranging from 0.6 to 0.87. Besides that, results showed that the educational environment lacks many basic components such as facilities, laboratories, and activities that may stimulate creativity and innovation. Furthermore, results showed that there is a weakness in private sector involvement in the construction of educational buildings, special centers for gifted people and the provision of certain facilities that support talented programs. The recommendations of the study indicate the need for the private sector participation in the provision of services and projects for the care of gifted students in Saudi Arabia.

Keywords: battery of measures, gifted care initiatives, Saudi future vision, gifted student

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Authors: Opeyemi Awau Adepoju

Abstract:

The task of nation-building for Nigeria, like other developing nations, has continued to be riddled with audacious challenges that kept threatening to consume the state itself. Among the destabilizing factors that are sometimes mutually reinforcing are poverty and insecurity. Nigeria has been bedeviled with poverty since the onset of the 1980s when the country metamorphosed from an agricultural to an oil-based economy coupled with unbridled political corruption and wasteful management of resources by successive governments. The crippling poverty started manifesting in the scourge of criminalities and a general state of insecurity. Poverty gradually becomes the breeder of insecurity and threats to human life in Nigeria. Interestingly, successive governments tended to recognize the destructive tendencies of poverty and took several interventionist initiatives towards abating or slowing down the spate of poverty so as to reverse the trend of insecurity, but none of those initiatives can be adjudged good or enduring legacies. The emergence of the Buhari administration in 2015 provided a new opportunity to tackle poverty and, in turn, insecurity that had permeated every aspect of national life before that year’s presidential elections. Expectedly, the government took ambitious steps through its innovative ideas of intervention through its National Social Intervention Programmes (NSIP). Therefore, this paper is an assessment of the Buhari administration’s initiatives in poverty eradication in Nigeria as one of its strategies to fight insecurity, and the paper adopted a qualitative approach. The theoretical arguments put up by this paper are with respect to the connection between poverty and insecurity sourced from the theory of Relative Deprivation. The paper found that the Buhari administration has done better than any government since 1999 in inventing a social intervention program and that the poverty of the people has been addressed to a notable extent. However, the problem of politicization of intervention programs has continued to be the practice under the administration, and if this is not abated, the post-Buhari era may as well be like the eras before it. The paper recommends legislation that can make poverty ameliorating programs permanent, at least for some years to come, so as to avoid the usual policy summersault at every instance of political transition, which has limited the sustainability of public policies and indeed hindered nation-building efforts in Nigeria.

Keywords: insecurity, poverty alleviation, public policies, social intervention

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Authors: Richard Harrison

Abstract:

Developing competency in mathematics and related critical thinking skills is essential to the education of undergraduate students of Science, Technology, Engineering and Mathematics (STEM). Recently, the HE sector has been impacted by a seemingly widening disconnect between the mathematical competency of incoming first-year STEM students and their entrance qualification tariffs. Despite relatively high grades in A-Level Mathematics, students may initially lack fundamental skills in key areas such as algebraic manipulation and have limited capacity to apply problem solving strategies. Compounded by compensatory measures applied to entrance qualifications during the pandemic, there has been an associated decline in student performance on introductory university mathematics modules. In the UK, a number of online resources have been developed to help scaffold the transition to university mathematics. However, in general, these do not offer a structured learning journey focused on individual developmental needs, nor do they offer an experience coherent with the teaching and learning characteristics of the destination institution. In order to address some of these issues, a bespoke framework has been designed and implemented on our VLE in the Faculty of Engineering & Physical Sciences (FEPS) at the University of Surrey. Called the FEPS Maths Support Framework, it was conceived to scaffold the mathematical development of individuals prior to entering the university and during the early stages of their transition to undergraduate studies. More than 90% of our incoming STEM students voluntarily participate in the process. Students complete a set of initial diagnostic questions in the late summer. Based on their performance and feedback on these questions, they are subsequently guided to self-select specific mathematical topic areas for review using our proprietary resources. This further assists students in preparing for discipline related diagnostic tests. The framework helps to identify students who are mathematically weak and facilitates early intervention to support students according to their specific developmental needs. This paper presents a summary of results from a rich data set captured from the framework over a 3-year period. Quantitative data provides evidence that students have engaged and developed during the process. This is further supported by process evaluation feedback from the students. Ranked performance data associated with seven key mathematical topic areas and eight engineering and science discipline areas reveals interesting patterns which can be used to identify more generic relative capabilities of the discipline area cohorts. In turn, this facilitates evidence based management of the mathematical development of the new cohort, informing any associated adjustments to teaching and learning at a more holistic level. Evidence is presented establishing our framework as an effective early intervention strategy for addressing the sector-wide issue of supporting the mathematical development of STEM students transitioning to HE

Keywords: competency, development, intervention, scaffolding

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Authors: Sonia David, Uma Warrier

Abstract:

Background: Film therapy is the use of commercial or non-commercial films to enhance healing for therapeutic purposes. Objectives: The mixed-method study aims to evaluate the effect of film-based counseling on body image dissatisfaction among adolescents to precisely ascertain the cause of the alteration in body image dissatisfaction due to the said intervention. Method: The one group pre-test post-test research design study using inferential statistics and thematic analysis is based on a pre-test post-test design conducted on 44 school-going adolescents between 13 and 17. The Body Shape Questionnaire (BSQ- 34) was used as a pre-test and post-test measure. The film-based counseling intervention model was used through individual counseling sessions. The analysis involved paired sample t-test used to examine the data quantitatively, and thematic analysis was used to evaluate qualitative data. Findings: The results indicated that there is a significant difference between the pre-test and post-test means. Since t(44)= 9.042 is significant at a 99% confidence level, it is ascertained that film-based counseling intervention reduces body image dissatisfaction. The five distinct themes from the thematic analysis are “acceptance, awareness, empowered to change, empathy, and reflective.” Novelty: The paper originally contributes to the repertoire of research on film therapy as a successful counseling intervention for addressing the challenges of body image dissatisfaction. This study also opens avenues for considering alteration of teaching pedagogy to include video-based learning in various subjects.

Keywords: body image dissatisfaction, adolescents, film-based counselling, film therapy, acceptance and commitment therapy

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Authors: Omer Zvi Shaked, Amir Tirosh

Abstract:

Type 1 Diabetes (T1DM) is an incurable chronic illness with no known preventive measures. Excess to insulin therapy can lead to hypoglycemia with neuro-glycogenic symptoms such as shakiness, nausea, sweating, irritability, fatigue, excessive thirst or hunger, weakness, seizure, and coma. Severe Hypoglycemia (SH) is also considered a most aversive event since it may put patients at risk for injury and death, which matches the criteria of a traumatic event. SH has a ranging prevalence of 20%, which makes it a primary medical Issue. One of the results of SH is an intense emotional fear reaction resembling the form of post-traumatic stress symptoms (PTS), causing many patients to avoid insulin therapy and social activities in order to avoid the possibility of hypoglycemia. As a result, they are at risk for irreversible health deterioration and medical complications. Fear of Hypoglycemia (FOH) is, therefore, a major disturbance for T1DM patients. FOH differs from prevalent post-traumatic stress reactions to other forms of traumatic events since the threat to life continuously exists in the patient's body. That is, it is highly probable that orthodox interventions may not be sufficient for helping patients after SH to regain healthy social function and proper medical treatment. Accordingly, the current presentation will demonstrate the results of a study conducted among T1DM patients after SH. The study was designed in two stages. First, a preliminary qualitative phenomenological study among ten patients after SH was conducted. Analysis revealed that after SH, patients confuse between stress symptoms and Hypoglycemia symptoms, divide life before and after the event, report a constant sense of fear, a loss of freedom, a significant decrease in social functioning, a catastrophic thinking pattern, a dichotomous split between the self and the body, and internalization of illness identity, a loss of internal locus of control, a damaged self-representation, and severe loneliness for never being understood by others. The second stage was a two steps study of intervention among five patients after SH. The first part of the intervention included three months of therapeutic 3rd wave CBT therapy. The contents of the therapeutic process were: acceptance of fear and tolerance to stress; cognitive de-fusion combined with emotional self-regulation; the adoption of an active position relying on personal values; and self-compassion. Then, the intervention included a one-week practical real-time 24/7 support by trained medical personnel, alongside a gradual exposure to increased insulin therapy in a protected environment. The results of the intervention are a decrease in stress symptoms, increased social functioning, increased well-being, and decreased avoidance of medical treatment. The presentation will discuss the unique emotional state of T1DM patients after SH. Then, the presentation will discuss the effectiveness of the intervention for patients with chronic conditions after a traumatic event. The presentation will make evident the unique situation of illness-related PTSD. The presentation will also demonstrate the requirement for multi-professional collaboration between social work and medical care for populations with chronic medical conditions. Limitations of the study and recommendations for further research will be discussed.

Keywords: type 1 diabetes, chronic illness, post-traumatic stress, illness-related PTSD

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Authors: Evagelia Makri, Maria Tsourela, Dimitris Paschaloudis, Dafni M. Nerantzaki

Abstract:

One of the biggest financial and social problems, which at the same time constitute one of the greater challenges that Greek society faces today, is the illegal avoidance of tax payments. Tax evasion may negate financial data and community budgets, as well as breed financial chaos. This research seeks to reflect Greek reality concerning tax measures. Also, there will be an effort to record the factors surrounding tax evasion. Greek tax system’s data will be rendered in financial terms. Questionnaires will be handed out to tax payers, and interviews will be conducted to taxmen. The quantitative analysis of the questionnaire answers will define the tax payers’ opinion towards the existence of tax evasion. The qualitative analysis of the interviews will reveal the main reason that boosts tax evasion. At the end, there will be some realistic proposals about how to better collect taxes, through the creation of a strong regulatory mechanism.

Keywords: tax evasion, tax collection measures, insurance recovery measures, Greek tax system

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Authors: Khadija Al-Hosni, Moon Fai Chan, Mohammed Al-Azri

Abstract:

Background: Several studies suggest that most school-age adolescents are poorly informed on cancer warning signs and risk factors. Providing adolescents with sufficient knowledge would increase their awareness in adulthood and improve seeking behaviors later. Significant: The results will provide a clear vision in assisting key decision-makers in formulating policies on the students' awareness programs towards cancer. So, the likelihood of avoiding cancer in the future will be increased or even promote early diagnosis. Objectives: to evaluate the effectiveness of an education program designed to increase awareness of cancer signs and symptoms risk factors, improve the behavior of seeking help among school students in Oman, and address the barriers to obtaining medical help. Methods: A randomized controlled trial with two groups was conducted in Oman. A total of 1716 students (n=886/control, n= 830/education), aged 15-17 years, at 10th and 11th grade from 12 governmental schools 3 in governorates from 20-February-2022 to 12-May-2022. Basic demographic data were collected, and the Cancer Awareness Measure (CAM) was used as the primary outcome. Data were collected at baseline (T0) and 4 weeks after (T1). The intervention group received an education program about cancer's cause and its signs and symptoms. In contrast, the control group did not receive any education related to this issue during the study period. Non-parametric tests were used to compare the outcomes between groups. Results: At T0, the lamp was the most recognized cancer warning sign in the control (55.0%) and intervention (55.2%) groups. However, there were no significant changes at T1 for all signs in the control group. In contrast, all sign outcomes were improved significantly (p<0.001) in the intervention group, and the highest response was unexplained pain (93.3%). Smoking was the most recognized risk factor in both groups: (82.8% for control; 84.1% for intervention) at T0. However, there was no significant change in T1 for the control group, but there was for the intervention group (p<0.001), the highest identification was smoking cigarettes (96.5%). Too scared was the largest barrier to seeking medical help by students in the control group at T0 (63.0%) and T1 (62.8%). However, there were no significant changes in all barriers in this group. Otherwise, being too embarrassed (60.2%) was the largest barrier to seeking medical help for students in the intervention group at T0 and too scared (58.6%) at T1. Although there were reductions in all barriers, significant differences were found in six of ten only (p<0.001). Conclusion: The intervention was effective in improving students' awareness of cancer symptoms, warning signs (p<0.001), and risk factors (p<0.001 reduced the most addressed barriers to seeking medical help (p<0.001) in comparison to the control group. The Ministry of Education in Oman could integrate awareness of cancer within the curriculum, and more interventions are needed on the sociological part to overcome the barriers that interfere with seeking medical help.

Keywords: adolescents, awareness, cancer, education, intervention, student

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Authors: M. Rojo, M. Blanco, T. Lacruz, S. Solano, L. Beltran, M. Graell, A. R. Sepulveda.

Abstract:

There is an association between an early accumulation of Stressful Life Events (SLE) during childhood and various physical and psychological health complications. However, there are only a few studies on this topic in children and adolescents with overweight or obesity. The general aim of the study was to evaluate the accumulation and type of SLE in 200 children from 8 to 12 years old and analyze the relationship with their emotional well-being and weight status (obesity, overweight and normal weight). The children and their families completed an interview. The evaluated variables that are included in this study are sociodemographic measures, medical/psychological history, anthropometric measures (BMI, z-BMI), and psychological variables (children's clinical interview K-SADS-PL(Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version) and battery of questionnaires). Results: Children with overweight and obesity accumulate more stressful events from an early age and have a significantly higher percentage of psychiatric diagnoses, compared to their peers with normal weight. Presenting a child psychiatric disorder is related to greater z-BMI and the total number of SLE (p < 0.001). A higher z-BMI is also related to a greater number of stressful events during childhood. There is also a positive and significant relationship between the total number of SLE and worse emotional well-being (higher levels of anxious and depressive symptoms and low self-esteem of children) (p < 0.01). Conclusion: Children with overweight and obesity grow up in a family, school, and social context where more stressors are accumulated. This is also directly associated with worse emotional well-being. It is necessary to implement multidisciplinary prevention and intervention strategies in different changes (school, family, and health). This study is included in a project funded by the Ministry of Innovation and Science (PSI2011-23127).

Keywords: childhood obesity, emotional well-being, psychopathology, stressful life events

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Authors: Kumudini Achchi

Abstract:

India, being known for its rich cultural values has given a special place to women who are also been victims of humiliation, torture, and exploitation. The major share of Human Trafficking goes to sex trafficking which is recognised as world’s second most huge social evil. The original form of sex trafficking in India is prostitution with and without religious sanction. Today the situation of such women reached as an issue of human rights where they rights are denied severely. This situation demanded intervention to protect them from the exploitative situation. NGO are the proactive initiatives which offer support to the exploited women in sex trade. To understand the intervention programs of NGOs in South India, a study was conducted covering four states and a union territory considering 32 NGOs based on their preparedness to participate in the research study. Descriptive and diagnostic research design was adopted along with interview schedule as a tool for collecting data. The study reveals that these NGOs believes in the possibility of mainstreaming commercially sexually exploited women and found adopted seven different programs in the process such as rescue, rehabilitation, reintegration, prevention, developmental, advocacy and research. Each area involves different programs to reach and prepare the exploited women towards mainstreamed society which has been discussed in the paper. Implementation of these programs is not an easy task for the organizations rather they are facing hardships in the areas such as social, legal, financial, political which are hindering the successful operations. Rescue, advocacy, and research are the least adopted areas by the NGOs because of lack of support as well as knowledge in the area. Rehabilitation stands as the most adopted area in implementation. The paper further deals with the challenges in the implementation of the programs as well as the remedial measures in social work point of view having Indian cultural background.

Keywords: NGOs, commercially sexually exploited women, programmes, South India

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Authors: Omer Zvi Shaked

Abstract:

Intimate Partner Violence (IPV) is a widespread social problem. Since the 1970's, and due to political changes resulting from the feminist movement, western society has been changing its attitude towards the phenomenon and has been taking an active approach to reduce its magnitude. Enterprises in the form of legislation, awareness and prevention campaigns, women's shelters, and community intervention programs became more prevalent as years progressed. Although many initiatives were found to be productive, the effectiveness of one, however, remained questionable throughout the years: intervention programs for men's intimate violence. Surveys outline two main intervention models for men's intimate violence. The first is the Duluth model, which argued that men are socialized to be dominant - while women are socialized to be subordinate - and men are therefore required by social imperative to enforce, physically if necessary, their dominance. The Duluth model became the chief authorized intervention program, and some states in the US even regulated it as the standard criminal justice program for men's intimate violence. However, meta-analysis findings demonstrated that based on a partner's reports, Duluth treatment completers have 44% recidivism rate, and between 40% and 85% dropout range. The second model is the Cognitive-Behavioral Model (CBT), which is a highly accepted intervention worldwide. The model argues that cognitive misrepresentations of intimate situations precede violent behaviors frequently when anger predisposition exists. Since anger dysregulation mediates between one's cognitive schemes and violent response, anger regulation became the chief purpose of the intervention. Yet, a meta-analysis found only a 56% risk reduction for CBT interventions. It is, therefore, crucial to understand the background behind the domination of both the Duluth model and CBT interventions. This presentation will discuss the ways in which theoretical conceptualizations of men's intimate violence, as well as ideologies, had contributed to the above-mentioned interventions' wide acceptance, despite known lack of scientific and evidential support. First, the presentation will review the prominent interventions for male intimate violence, the Duluth model, and CBT. Second, the presentation will review the prominent theoretical models explaining men's intimate violence: The Patriarchal model, the Abusive Personality model, and the Post-Traumatic Stress model. Third, the presentation will discuss the interrelation between theory and practice, and the nature of affinity between research and practice regarding men's intimate violence. Finally, the presentation will set new directions for further research, aiming to improve intervention's efficiency with men's intimate violence and advance social work practice in the field.

Keywords: intimate partner violence, theory and practice relationship, Duluth, CBT, abusive personality, post-traumatic stress

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Authors: S. Yesmin, N. F.Rahman, R. Akther, T. Begum, T. Tahmid, T. Chowdury, S. Afrin, J. D. Hamadani

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Abstract: Maternal depression is one of the risk factors of developmental delay in young children in low-income countries. Maternal depressions during pregnancy are rarely reported in Bangladesh. Objectives: The purpose of the present study was to examine the efficacy of a community based psychosocial intervention on women with mild to moderate depressive illness during the perinatal period and on their children from birth to 12 months on mothers’ mental status and their infants’ growth and development. Methodology: The study followed a prospective longitudinal approach with a randomized controlled design. Total 250 pregnant women aged between 15 and 40 years were enrolled in their third trimester of pregnancy of which 125 women were in the intervention group and 125 in the control group. Women in the intervention group received the “Thinking Healthy (CBT based) program” at their home setting, from their last month of pregnancy till 10 months after delivery. Their children received psychosocial stimulation from birth till 12 months. The following instruments were applied to get the outcome information- Bangla version of Edinburgh Postnatal Depression Scale (BEPDS), Prenatal Attachment Inventory (PAI), Maternal Attachment Inventory (MAI), Bayley Scale of Infant Development-Third version (Bayley–III) and Family Care Indicator (FCI). In addition, sever morbidity; breastfeeding, immunization, socio-economic and demographic information were collected. Data were collected at three time points viz. baseline, midline (6 months after delivery) and endline (12 months after delivery). Results: There was no significant difference between any of the socioeconomic and demographic variables at baseline. A very preliminary analysis of the data shows an intervention effect on Socioemotional behaviour of children at endline (p<0.001), motor development at midline (p=0.016) and at endline (p=0.065), language development at midline (p=0.004) and at endline (p=0.023), cognitive development at midline (p=0.008) and at endline (p=0.002), and quality of psychosocial stimulation at midline (p=0.023) and at endline (p=0.010). EPDS at baseline was not different between the groups (p=0.419), but there was a significant improvement at midline (p=0.027) and at endline (p=0.024) between the groups following the intervention. Conclusion: Psychosocial intervention is found effective in reducing women’s low and moderate depressive illness to cope with mental health problem and improving development of young children in Bangladesh.

Keywords: mental health, maternal depression, infant development, CBT, EPDS

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Authors: Endri Yuliati, Siti Helmyati, Narendra Yoga Hendarta, Moh. Darussalam, Maharani Jibbriella, Fauziah Oktavira Hayati Fakhruddin, Faisal Hanin

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Background: Both of iron and zinc has vital role in growth. The prebiotics fermentation by probiotics lower the acidity of intestine thus increase mineral absorption. Objective: To know the effect of double fortification of synbiotic fermented milk on growth. Methods: An Indonesian local isolate, Lactobacillus plantarum Dad-13 and Fructo-oligosaccharides (FOS) were used in making synbiotic fermented milk. It, then was double fortified with 100 ppm Fe and 50 ppm Zn. A total of 15 Wistar rats were divided into 3 groups and given: synbiotic fermented milk (CO), synbiotic fermented milk with NaFeEDTA and Zn acetate (NZ) and synbiotic fermented milk with Fe gluconate and Zn acetate (FZ) every day for one month. Body weight and body length were measured before, every week and after intervention. Results: Body weight and body length were similar at baseline among three groups (p > 0.05). All groups showed similar growth after intervention, from 62,40 + 6,1 to 109,0 + 9,0; 62,0 + 7,9 to 110,3 + 14,2; and 64,40 + 4,7 to 115,1 + 7,7 g for CO, NZ, and FZ, respectively (p > 0.05). The body length after intervention was also similar (p > 0.05). Conclusion: Fortification of iron and zinc did not modify effect of synbiotic fermented milk on growth.

Keywords: probiotics, prebiotics, iron, zinc, growth

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Authors: Si Jack Chong, Chew Theng Yap, Wan Loong James Mok

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Introduction: Regional burn centres face the spectra of introduced multi-drug resistant organisms (MDRO) from transfer patients resident in MDRO endemic countries. MDRO can cause severe nosocomial infection, which in massive burn patients, will lead to greater morbidity and mortality and strain the institution financially. We aim to highlight 4 key measures that have effectively prevented transmission of imported MDRO. Methods: A case of Candida auris (C. auris) from a massive burn patient transferred from an MDRO endemic country is used to illustrate the measures. C. auris is a globally emerging multi-drug resistant fungal pathogen causing nosocomial transmission. Results: Infection control measures used to mitigate the risk of outbreak from transfer cases are: (1) Multidisciplinary team approach involving Infection Control and Infectious Disease specialists early to ensure appropriate antibiotics use and implementation of barrier measures, (2) aseptic procedures for dressing change with strict isolation and donning of personal protective equipment in the ward, (3) early screening of massive burn patient from MDRO endemic region, (4) hydrogen peroxide vaporization terminal cleaning for operating theatres and rooms. Conclusion: The prevalence of air travel and international transfer to regional burn centres will need effective infection control measures to reduce the risk of transmission from imported massive burn patients. In our centre, we have effectively implemented 4 measures which have reduced the risks of local contamination. We share a recent case report to illustrate successful management of a potential MDRO outbreak resulting from transfer of massive burn patient resident in an MDRO endemic area.

Keywords: burns, burn unit, cross infection, infection control

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Authors: Hadi O. Tohme

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This study is a review on the effectiveness of new physiotherapy techniques with external sensory stimulus compared to standard physiotherapy in the daily activities of patients with Parkinson's disease. Twenty studies from 1996 to 2015 were analyzed and discussed in this review, using the rehabilitation strategy with external sensory stimulus evaluating walking, freezing episodes, balance, transfers, and daily activities of parkinsonian patients. The study highlights the effectiveness of the variety of rehabilitation with cueing strategy used in the treatment of Parkinson's disease. Based on the literature review completed, there is a need for more specific trials with better treatment strategies to support the most appropriate choice of physiotherapy intervention using external sensory stimulus to the type and frequency of this stimulus. In addition, no trials examined the long-term benefits of the physiotherapy intervention with the external sensory stimulus. In order to determine if, or how long the improvements due to the external sensory stimulus physiotherapy intervention can last, long-term follow-up should be performed.

Keywords: cueing strategy, external sensory stimulus, parkinson disease, rehabilitation for parkinson, sensory attention focused exercises, sensory strategy reeducation

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Authors: Sarwat Sultan, Muhammad Saleem, Frasat Kanwal

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Adolescence is a transition period of life that brings physical and psychological changes and always results in several challenges for an adolescent. An adolescent must learn life skills for a healthy transition from adolescence period to adulthood. Therefore this study was planned to examine the effects of life skill education on adolescents' mental health and academic benefits. A random sample of 720 school students aged between 13-17 years was categorized into two groups; experimental (n=360) and control (n=360). Life skill education was given to the students of the intervention group with repeated assessments of mental health and academic benefits at pre-intervention (T1) and post-intervention (T2) for both groups. Both groups were compared on scores of mental health and academic benefits across two times T1 and T2 by employing a mixed between-within-subjects analysis of variance. Findings showed the main effect of time suggesting the largest changes in mental health and academic benefits over time. Interaction effects between time and both groups were also found significant indicating the largest changes across time between both groups. Results of between-group comparisons showed significant values for Wilks’ Lambda and partial eta squared for students of the intervention group who scored higher on mental health and academic benefits after receiving life skills training than the students of the control group. Results of the present study determined the efficacy of life skill education and have implications for both teachers and psychotherapists to improve the students’ mental health and academic performance.

Keywords: academic benefits, life skills, mental health, adolescents

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Authors: Stephen V. Crowder, Jonathan W. Lane

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With short production development times, there is an increased need to demonstrate product reliability relatively quickly with minimal testing. In such cases there may be few if any observed failures. Thus it may be difficult to assess reliability using the traditional reliability test plans that measure only time (or cycles) to failure. For many components, degradation measures will contain important information about performance and reliability. These measures can be used to design a minimal test plan, in terms of number of units placed on test and duration of the test, necessary to demonstrate a reliability goal. In this work we present a case study involving an electronic component subject to degradation. The data, consisting of 42 degradation paths of cycles to failure, are first used to estimate a reliability function. Bootstrapping techniques are then used to perform power studies and develop a minimal reliability test plan for future production of this component.

Keywords: degradation measure, time to failure distribution, bootstrap, computational science

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Authors: Mohsen Goodarzi, George Berghorn

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Despite the rapid growth in the number of green building and community development projects, the long-term performance of these projects has not yet been sufficiently evaluated from the users’ points of view. This is partially due to the lack of post-occupancy evaluation tools available for this type of project. In this study, a post-construction evaluation model is developed to evaluate the relationship between the perceived performance and satisfaction of residents in LEED-certified residential buildings and communities. To develop this evaluation model, a primary five-factor model was developed based on the existing models and residential satisfaction theories. Each factor of the model included several measures that were adopted from LEED certification systems such as LEED-BD+C New Construction, LEED-BD+C Multifamily Midrise, LEED-ND, as well as the UC Berkeley’s Center for the Built Environment survey tool. The model included four predictor variables (factors), including perceived building performance (8 measures), perceived infrastructure performance (9 measures), perceived neighborhood design (6 measures), and perceived economic performance (4 measures), and one dependent variable (factor), which was residential satisfaction (6 measures). An online survey was then conducted to collect the data from the residents of LEED-certified residential communities (n=192) and the validity of the model was tested through Confirmatory Factor Analysis (CFA). After modifying the CFA model, 26 measures, out of the initial 33 measures, were retained to enter into a Structural Equation Model (SEM) and to find the relationships between the perceived buildings performance, infrastructure performance, neighborhood design, economic performance and residential Satisfaction. The results of the SEM showed that the perceived building performance was the most influential factor in determining residential satisfaction in LEED-certified communities, followed by the perceived neighborhood design. On the other hand, perceived infrastructure performance and perceived economic performance did not show any significant relationship with residential satisfaction in these communities. This study can benefit green building researchers by providing a model for the evaluation of the long-term performance of these projects. It can also provide opportunities for green building practitioners to determine priorities for future residential development projects.

Keywords: green building, residential satisfaction, perceived performance, confirmatory factor analysis, structural equation modeling

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Authors: John Njikem

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Attention Deficit Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed behavioral disorders in children, associated with this disorder are core symptoms of inattention, hyperactivity and impulsivity. This study was purposely to enlighten and inform teachers, policy makers and other professionals concern in the education of this group of learners in inclusive schools in Buea, Cameroon. The major purpose of this study was to identify children with ADHD in elementary schools practicing inclusive education and to investigate the effect of classroom based intervention on their academic performance. The research problem stems from the fact that majority of children with ADHD in our school mostly have problems with classroom tasks like paying attention, easily distracted, and difficulties in organization and very little has been done to manage this numerous conditions, therefore it was necessary for the researcher to identify them and implement some inclusive strategies that teachers can better use in managing the behavior of this group of learners. There were four research questions and the study; the sample population used for the study was 27 pupils (3-7years old) formally identified with key symptoms of ADHD from primary 3-6 from four primary inclusive schools in Buea. Two sub-types of ADHD children were identified by using the recent DSM-IV behavioral checklist in recording their behavior after teacher and peer nomination they were later subjected to three groups for classroom intervention. Data collection was done by using interviews and other supportive methods such as document consultation, field notes and informal talks as additional sources was also used to gather information. Classroom Intervention techniques were carried out by the teachers themselves for 8 weeks under the supervision of the researcher, results were recorded for the 27 children's academic performance in the areas of math’s, writing and reading. Descriptive Statistics was applied in analyzing the data in percentages while tables and diagrams were used to represent the results. Findings obtained indicated that there was significant increase in the level of attention and organization on classroom tasks in the areas of reading, writing and mathematics. Finding also show that there was a more significant improvement made on their academic performance using the combined intervention approach which was proven to be the most effective intervention technique for pupils with ADHD in the study. Therefore it is necessary that teachers in inclusive primary schools in Buea understand the needs of these children and learn how to identify them and also use this intervention approaches to accommodate them in classroom task in order to encourage inclusive educational classroom practices in the country. Recommendations were based on each research objective and suggestions for further studies centered on other methods of classroom intervention for ADHD children in inclusive settings.

Keywords: attention deficit hyperactivity disorder, inclusive classrooms, academic performance, impulsivity

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Authors: Anetta Caplanova, Eva Sirakovova, Estera Szakadatova

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Non-payment of taxes and fees represents a problem, which occurs at national and local government levels in many countries. An effective tax collection is key for generating government and local government budget revenues to finance public services and infrastructure; thus, there is the need to address this problem. The standard approach considers as a solution raising taxes/fees to boost public revenues, which may be politically challenging and time-consuming to implement. An alternative approach is related to using behavioral interventions. These can be usually implemented relatively quickly, and in most cases, they are associated with low cost. In the paper, we present the results of the behavioral experiment focused on raising the level of compliance with the payment of garbage collection fees in a selected municipality in the Slovak Republic. The experiment was implemented using the leaflets sent to residential households together with the invoice for the garbage collection in the municipality Hlohovec, Western Slovakia, in Spring 2021. The sample of about 10000 households was divided into three random groups, a control group and two intervention groups. Households in intervention group 1 were sent a leaflet using the social norm nudge, while households in intervention group 2 were sent a leaflet using the deterrence nudge. The social norm framing leaflet pointed out that in the municipality, the prevailing majority of people paid the garbage collection fee and encouraged recipients to join this majority. The deterrent leaflet reminded the recipients that if they did not pay the fee on time, enforcement proceedings would follow. This was aimed to increase the subjective perception of citizens of the enforcement proceedings in case of noncompliance. In the paper, we present and discuss the results from the experiment and formulate relevant generalizations for other municipalities.

Keywords: municipal governments, garbage fee collection, behavioural intervention, social norm, deterrence nudge

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Authors: Felix Olajide Ibikunle

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Introductory Statement: Sustainable participation of teenagers in sport requires deliberate and concerted plan and managerial policy rooted in the “philosophy of catch them young”. At risk, teenagers need proper integration into societal aspiration: This direction will go a long way to streamline them into the security breach and attractive nuisance free lifestyles. Basic Methodology: The population consists of children within 13-19 years old. A proportionate sampling size technique of 60% was adopted to select seven zones out of 11 geo-political zones in the Ibadan metropolis. Qualitative information and interview were used to collect needed information. Majority of the teenagers were out of school, street hawkers, motor pack, touts, and unserious vocation apprentices. These groups have the potentials of security breaches in the metropolis and beyond. Five hundred and thirty-four (534) respondents were used for the study. They were drawn from Ojoo, Akingbile, and Moniya axis = 72, Agbowo, Ajibode, and Apete axis = 74; Akobo, Basorun, and Idi-ape axis 79; Wofun, Monatan, and Iyana-Church axis = 78; Molete, Oke-ado and Oke-Bola axis = 75; Beere, Odinjo, Elekuro axis = 77; Eleyele, Ologuneru, and Alesinloye axis = 79. Major Findings: Multiple regression was used to analyze the independent variables and percentage. The respondents average age was 15.6 years old, and with 100% male. The instrument(questionnaire) used yielded; sport preference (r = 0.72); intervention (r = 0.68) and the sustainable participation (r = 0.70).The relative contributions of sport preference on participation of at risk teenagers was (F-ratio = 1.067); Intervention contribution of sport on participation of at risk teenagers = produced (F-ratio of 12.095) was significant while sustainable participation of at risk teenager produced (F-ratio = 1.062) was significant. Closing Statement: The respondents’ sport preference stimulated their participation in sport. The intervention exposed at risk-teenagers to coaching, which activated their interest and participation in sport. While sustainable participation contributed positively to evolve at risk teenagers participation in their preferred sport.

Keywords: sport, preference, intervention, teenagers, sustainable, participation and risk teenagers

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Authors: Marwa Mamdouh Shaban, Nagat Saied Habib, Shireen Ezz El-Din Taha, Eman Mahmoud Seif El-Naser

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Background: Dental nurses and dentists were constantly exposed to a number of specific work related health risk factors which develop and intensify with years. Awareness regarding these work-related health risk factors and implementation of preventive health care measures could provide a safe work environment for all dental nurses and dentists. Aim of the study: to assess the work-related health risk factors among dental nurses and dentists and preventive health care measures applied among dental nurses and dentists. Research design: A descriptive design was utilized. Sample: Convenience sample of 50 dental nurses and 150 dentists were included in the current study. Setting: This study was conducted at the dental clinics at faculty of oral and dental medicine, Al-Kasr Al Ainy Hospital. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a-Socio-demographic data sheet, b-Work-related health risk factors questionnaire, and c-structured observational checklist. Results: The most common work risk factors prevailing among dental nurses were emotional exhaustion (82%), low back pain (76%) and latex allergy (62%) and the most common work risk factors prevailing among dentists were percutaneous exposure incident (100%), emotional exhaustion (100%) and low back pain (93.3%). Also, statistically significant negative correlation (r=-0.274, at p = 0.045) between the incidence of chemical health risk factors and application of chemical preventive measures among dental nurses. A statistically significant negative correlation (r=-0.177, at p = 0.030) between the incidences of mechanical health risk factors among dentists and application of mechanical preventive measures. Conclusion: The studied dental nurses and dentists exposed to many work related health risk factors as latex allergy, percutaneous exposure incidents, low back pain and emotional exhaustion related to inappropriate application of preventive health care measures. Recommendation: Raise awareness of dental nurses and dentists about work-related health risk factors, design and implement health education program for preventive health care measures.

Keywords: work-related risk factors, preventive measures, nurses, dentists

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Authors: Nazli Ustunes Demirhan

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Norms of any nature are subject to pressures of change throughout their lifespans, as they are interpreted and re-interpreted every time they are used rhetorically or practically by international actors. The inevitable contestation of different interpretations may lead to an erosion of the norm, as well as to its strengthening. This paper aims to question the role of formal legality on the change of norm strength, using a norm contestation framework and a multidimensional norm strength conceptualization. It argues that the role of legality is not necessarily linked to the formal legal characteristics of a norm, but is about the legality of the contestation processes. In order to demonstrate this argument, the paper examines the evolutionary path of the humanitarian intervention norm as a case study. Humanitarian intervention, as a norm of very low formal legal characteristics, has been subject to numerous cycles of contestation, demonstrating a fluctuating pattern of norm strength. With the purpose of examining the existence and role of legality in the selected contestation periods from 1999 to 2017, this paper uses process tracing method with a detailed document analysis on the Security Council documents; including decisions, resolutions, meeting minutes, press releases as well as individual country statements. Through the empirical analysis, it is demonstrated that the legality of the contestation processes has a positive effect at least on the authoritativeness dimension of norm strength. This study tries to contribute to the developing dialogue between international relations (IR) and internal law (IL) disciplines with its better-tuned understanding of legality. It connects to further questions in IR/IL nexus, relating to the value added of norm legality, and politics of legalization as well as better international policies for norm reinforcement.

Keywords: humanitarian intervention, legality, norm contestation, norm dynamics, responsibility to protect

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