Search results for: Yuzawa family health plan

Authors: P. Chandhra Sekhar, R. A. Deshpande, T. Raghunatha

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The government of India has given special attention on rural electrification under Rajiv Gandhi Grameena Vidyuthikarana Yojana (RGGVY) during 10th plan and 11th plan. Government of India electrified about 107523 villages and 21164003 BPL Households. This paper briefs about various rural electrification programs initiated by government of India and status of RGGVY in India. The paper mainly describes about challenges in the rural electrification, new ideas recently implemented and suggestions for improvement in the rural electrification.

Keywords: rural electrification, RGGVY, NJY, BPL

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Authors: S. I. Mwasha, Z. Robinson, M. Musgrave

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Communities, especially in the global south, have been reported to have low adaptive capacity to cope with climate change impacts. As an attempt to improve adaptive capacity, most studies have focused on understanding the access of the household resources which can contribute to resilience against changes. However, little attention has been shown in uncovering how the household resources could be used and their implications to resilience against weather related shocks. By using a case study qualitative study, this project analyzed the trends in livelihoods practices and their implication to social equity. The study was done in three different villages within Kilimanjaro region. Each in different agro ecological zone. Two focus group discussions in two agro-ecological zones were done, one for women and another one for men except in the third zone where focus group participant were combined together (due to unforeseen circumstances). In the focus group discussion, several participatory rural appraisal tools were used to understand trend in crops and animal production and the use in which it is made: climate trends, soil fertility, trees and other livelihoods resources. Data were analyzed using thematic network analysis. Using an amalgam of magnitude (to note weather comments made were positive or negative) and descriptive coding (to note the topic), six basic themes were identified under social equity: individual ownership, family ownership, love and respect, women no education, women access to education as well as women access to loans. The results implied that despite mum and dad in the family providing labor in the agro pastoral activities, there were separations on who own what, as well as individual obligations in the family. Dad owned mostly income creating crops and mum, food crops. therefore, men controlled the economy which made some of them become arrogant and spend money to meet their interests sometimes not taking care of the family. Separation in ownership was reported to contribute to conflicts in the household as well as causing controversy on the use income is spent. Men were reported to use income to promote matriarchy system. However, as women were capacitated through access to education and loans they become closer to their husband and get access to own and plan the income together for the interest of the family. Joint ownership and planning on the household resources were reported to be important if families have to better adapt to climate change. The aim of this study is not to show women empowerment and joint ownership and planning as only remedy for low adaptive capacity. There is the need to understand other practices that either directly or indirectly impacts environmental integrity, food security and economic development for household resilience against changing climate.

Keywords: adaptive capacity, climate change, resilience, women empowerment

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Authors: Man Chung Chu

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In the dynamic family interaction, parental self-efficacy is connected with parent-child attachment. Parental self-efficacy and its corresponding behavior played an influential role in the lifespan development of the child. Recently, Mindful parenting is popularly addressed as it lightens parents’ awareness to their own thoughts feelings and behaviors by adapting a nonjudgmental attitude in the present moment being with the child. The effectiveness of mindful parent is considerably significant in enhancing parent-child relationship as well as family functioning. Parenting in early developmental stage is always challenging and essential for later growth, however, literature is rarely exploring the mediation of mindful parenting on the effect of parent self-efficacy on parent-child attachment in preschoolers’ families. The mediation effect of the research shed light on how mindful parenting should head, where parental self-efficacy training should be incorporated together with mindful family program in attempt to yield the best outcome in the family of young-aged children. Two hundred and eight (208) parents, of two to six years old children, were participated in the study and results supported the significance in the mediator effect of mindful parenting in both facets, i.e. Parent-focused - ‘Mindful Discipline’ and Child-focused – ‘Being in the moment with the child’ where parental self-efficacy is a significant predictor of mindful parenting. The implication of the result suggests that mindful parenting would be a therapeutic framework in promoting family functioning and child’s well-being, it would also be a ‘significant helping hand’ in maintaining continuous secure attachment relationship and growing their mindful children in a family.

Keywords: mediation effect, mindful parenting, parental self efficacy, parent-child attachment, preschoolers

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Authors: Damla Tas, Robert Rudolf

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Fast economic development and women empowerment in Korea have contributed to an unprecedented family and gender crisis, with Korean fertility rates at a global record low. This study explores the predictors and time trends of Korean women’s attitudes toward family formation and the household division of labor by using the Korean Longitudinal Survey of Women and Families from 2007 to 2018. Results indicate that education, age, marital status, and motherhood are significantly associated with women’s attitudes toward family formation and gender attitudes toward the intrahousehold division of labor. In addition, more educated women and those aged 26 to 45 are less likely to support traditional marriage and traditional household division of labor statements. Unmarried and divorced women are more likely to support progressive values and roles. Also, retrospective factors such as mothers’ schooling and parents’ relationship are significantly associated with gender role ideology. Our findings also indicate a downward trend in the number of Korean women stating one must have children. The study suggests that Korean families and society need to adjust to women’s changing preferences concerning their societal roles toward less traditional. Hence, a new agreement between men and women is needed on how work can be divided more equally.

Keywords: marriage, family formation, intrahousehold division of labor, gender role attitudes, Korea

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Authors: Noa Nelson, Meitar Moshe, Dana Cohen

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Work-family conflict (WFC) is a significant source of stress for contemporary employees, with research indicating its heightened severity for women. The conservation of resources theory argues that individuals experience stress when their resources fall short of demands, and attempt to reach balance by obtaining resources. Presumably then, to achieve work-family balance women would need to negotiate for resources such as spouse support, employer support and work flexibility. The current research tested the hypotheses that competent negotiation at home and at work associated with increased family and job resources and with decreased WFC, as well as with higher work, marital and life satisfaction. In the first study, 113 employed mothers, married or cohabiting, reported to what extent they conducted satisfactory negotiation with spouse over division of housework, and their actual housework load compared to spouse. They answered a WFC questionnaire, measuring how much work interferes with family (WIF) and how much family interferes with work (FIW), and finally, measurements of satisfaction. In the second study, 94 employed mothers, married or cohabiting reported to what extent they conducted satisfactory negotiation with their boss over balancing work demands with family needs. They reported the levels of three job resources: flexibility, control and family-friendly organizational culture. Finally, they answered the same WFC and satisfaction measurements from study 1. Statistical analyses –t-tests, correlations, and hierarchical linear regressions- showed that in both studies, women reported higher WIF than FIW. Negotiations associated with increased resources: support from spouse, work flexibility and control and a family-friendly culture; negotiation with spouse associated also with satisfaction measurements. However, negotiations or resources (except family-friendly culture) did not associate with reduced conflict. The studies demonstrate the role of negotiation in obtaining family and job resources. Causation cannot be determined, but the fact is that employed mothers who enjoyed more support (at both home and work), flexibility and control, were more likely to keep active interactions to increase them. This finding has theoretical and practical implications, especially in view of research on female avoidance of negotiation. It is intriguing that negotiations and resources generally did not associate with reduced WFC. This finding might reflect the severity of the conflict, especially of work interfering with family, which characterizes many contemporary jobs. It might also suggest that employed mothers have high expectations from themselves, and even under supportive circumstances, experience the challenge of balancing two significant and demanding roles. The research contributes to the fields of negotiation, gender, and work-life balance. It calls for further studies, to test its model in additional populations and validate the role employees have in actively negotiating for the balance that they need. It also calls for further research to understand the contributions of job and family resources to reducing work-family conflict, and the circumstances under which they contribute.

Keywords: sork-family conflict, work-life balance, negotiation, gender, job resources, family resources

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Authors: Binoun Chaki Hagar

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Studies have investigated grandparents' perceptions relating to their grandchildren with disabilities. Literature on grandparenthood focuses on the Western grandparents. Autism within the Arab populations has also being investigated. Moreover, the Bedouin population can also be seen in various studies related to different experiences and different perceptions about disabilities in general and among children in particular. However, as far as we know, no studies were found on grand parenting a child with autism in Bedouin society. This study combines three areas of knowledge, to create another knowledge domain. The aim of this study was to learn about the experience of grand parenting an autistic child in the Bedouin Arab society, to examine how it affects the grandparents' relationships, feelings, and functioning within the family, and as individuals, as well as to examine their coping mechanisms and their social support networks. This study is significant and as it examines autism and grandparents among the Bedouin Arab population in Israel, a population that has unique socio-demographic, cultural and traditional characteristics. The study revealed three themes concerning the meaning of grandparenthood to be associated with family continuity, how autism is perceived, and the importance of religion. It also suggests another category – the status of the elderly in the Arab-Bedouin family. It is recognized that the role of the elderly is held in high esteem, and can be affected by the grandchild’s’ autism.

Keywords: Arab–Bedouin family, autism, grandparents, family relationships

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Authors: M. C. Pardo-Ferreira, J. C. Rubio-Romero, M. Martínez-Rojas

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Resilience Engineering is a new paradigm of safety management that proposes to change the way of managing the safety to focus on the things that go well instead of the things that go wrong. Many complex and high-risk sectors such as air traffic control, health care, nuclear power plants, railways or emergencies, have applied this new vision of safety and have obtained very positive results. In the construction sector, safety management continues to be a problem as indicated by the statistics of occupational injuries worldwide. Therefore, it is important to improve safety management in this sector. For this reason, it is proposed to apply Resilience Engineering to the construction sector. The Construction Phase Health and Safety Plan emerges as a key element for the planning of safety management. One of the key tools of Resilience Engineering is the Resilience Assessment Grid that allows measuring the four essential abilities (respond, monitor, learn and anticipate) for resilient performance. The purpose of this paper is to develop a questionnaire based on the Resilience Assessment Grid, specifically on the ability to learn, to assess whether a Construction Phase Health and Safety Plans helps companies in a construction site to implement this ability. The research process was divided into four stages: (i) initial design of a questionnaire, (ii) validation of the content of the questionnaire, (iii) redesign of the questionnaire and (iii) application of the Delphi method. The questionnaire obtained could be used as a tool to help construction companies to evolve from Safety-I to Safety-II. In this way, companies could begin to develop the ability to learn, which will serve as a basis for the development of the other abilities necessary for resilient performance. The following steps in this research are intended to develop other questions that allow evaluating the rest of abilities for resilient performance such as monitoring, learning and anticipating.

Keywords: resilience engineering, construction sector, resilience assessment grid, construction phase health and safety plan

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Authors: Jeff A. Tysinger, Dawn P. Tysinger

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The aim of this paper is to theoretically apply Bowen’s understanding of triangulation and triads to school psychology intern supervision so that it can assist in the conceptualization of the dynamics of intern supervision and provide some key methods to address common issues. The school psychology internship is the capstone experience for the school psychologist in training. It involves three key participants whose relationships will determine the success of the internship.  To understand the potential effect, Bowen’s family systems theory can be applied to the supervision relationship. He describes a way to resolve stress between two people by triangulating or binging in a third person. He applies this to a nuclear family, but school psychology intern supervision requires the marriage of an intern, field supervisor, and university supervisor; thus, setting all up for possible triangulation. The consequences of triangulation can apply to standards and requirements, direct supervision, and intern evaluation. Strategies from family systems theory to decrease the negative impact of supervision triangulation.

Keywords: family systems theory, intern supervision, school psychology training, triangulation

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Authors: Abdullah I. Alkraiji, Thomas W. Jackson, Ian Murray

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The proliferation of health data standards today is somewhat overlapping and conflicting, resulting in market confusion and leading to increasing proprietary interests. The government role and support in standardization for health data are thought to be crucial in order to establish credible standards for the next decade, to maximize interoperability across the health sector, and to decrease the risks associated with the implementation of non-standard systems. The normative literature missed out the exploration of the different steps required to be undertaken by the government towards the development of national health data standards. Based on the lessons learned from a qualitative study investigating the different issues to the adoption of health data standards in the major tertiary hospitals in Saudi Arabia and the opinions and feedback from different experts in the areas of data exchange and standards and medical informatics in Saudi Arabia and UK, a list of steps required towards the development of national health data standards was constructed. Main steps are the existence of: a national formal reference for health data standards, an agreed national strategic direction for medical data exchange, a national medical information management plan and a national accreditation body, and more important is the change management at the national and organizational level. The outcome of this study can be used by academics and practitioners to develop the planning of health data standards, and in particular those in developing countries.

Keywords: interoperabilty, medical data exchange, health data standards, case study, Saudi Arabia

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Authors: Sudha Subramani, Hua Wang

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Domestic Violence (DV) against women is now recognized to be a serious and widespread problem worldwide. There is a growing concern that violence against women has a global public health impact, as well as a violation of human rights. From the existing statistical surveys, it is revealed that there exists a strong relationship between DV and health issues of women like bruising, lacerations, depression, anxiety, flashbacks, sleep disturbances, hyper-arousal, emotional distress, sexually transmitted diseases and so on. This social problem is still considered as behind the closed doors issue and stigmatized topic. Women conceal their sufferings from family and friends, as they experience a lack of trust in others, feelings of shame and embarrassment among the society. Hence, women survivors of DV experience some barriers in seeking the support of specialized services such as health care access, crisis support, and legal guidance. Fortunately, with the popularity of social media like Facebook and Twitter, people share their opinions and emotional feelings to seek the social and emotional support, for sympathetic encouragement, to show compassion and empathy among the public. Considering the DV, social media plays a predominant role in creating the awareness and promoting the support services to the public, as we live in the golden era of social media. The various professional people like the public health researchers, clinicians, psychologists, social workers, national family health organizations, lawyers, and victims or their family and friends share the unprecedentedly valuable information (personal opinions and experiences) in a single platform to improve the social welfare of the community. Though each tweet or post contains a less informational value, the consolidation of millions of messages can generate actionable knowledge and provide valuable insights about the public opinion in general. Hence, this paper reports on an exploratory analysis of the effectiveness of social media for unobtrusive assessment of attitudes and awareness towards DV. In this paper, mixed methods such as qualitative analysis and text mining approaches are used to understand the social media disclosures of DV through the lenses of opinion sharing, anonymity, and support seeking. The results of this study could be helpful to avoid the cost of wide scale surveys, while still maintaining appropriate research conditions is to leverage the abundance of data publicly available on the web. Also, this analysis with data enrichment and consolidation would be useful in assisting advocacy and national family health organizations to provide information about resources and support, raise awareness and counter common stigmatizing attitudes about DV.

Keywords: domestic violence, social media, social stigma and support, women health

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Authors: Patcharaporn Sakulpong, Wiriya Phokhwang

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Background: Banpunrug (Love Sharing House) established in 2013 provides a community-based palliative care for patients with cancer from 7 provinces in southern Thailand. These patients come to receive outpatient chemotherapy and radiotherapy at Suratthani Cancer Hospital. They are poor and uneducated; they need an accommodation during their 30-45 day course of therapy. Methods: A community-participatory action research (PAR) was employed to establish a model of palliative care for patients with cancer. The participants included health care providers, community, and patients and families. The PAR process includes problem identification and need assessment, community and team establishment, field survey, organization founding, model of care planning, action and inquiry (PDCA), outcome evaluation, and model distribution. Results: The model of care at Banpunrug involves the concepts of HHHS model, in that Banpunrug is a Home for patients; patients live in a house comfortable like in a Hotel resource; the patients are given care and living facilities similarly to those in a Hospital; the house is a School for patients to learn how to take care themselves, how to live well with cancer, and most importantly how to prepare themselves for a good death. The house is also a humanized care school for health care providers. Banpunrug’s philosophy of care is based on friendship therapy, social and spiritual support, community partnership, patient-family centeredness, Live & Love sharing house, and holistic and humanized care. With this philosophy, the house is managed as a home of the patients and everyone involved; everything is costless for all eligible patients and their family members; all facilities and living expense are donated from benevolent people, friends, and community. Everyone, including patients and family, has a sense of belonging to the house and there is no authority between health care providers and the patients in the house. The house is situated in a temple and a community and supported by many local nonprofit organizations and healthcare facilities such as a health promotion hospital at sub-disctrict level and Suratthani Cancer Hospital. Village health volunteers and multi-professional health care volunteers have contributed not only appropriate care, but also knowledge and experience to develop a distinguishing HHHS community-based palliative care model for patients with cancer. Since its opening the house has been a home for more than 400 patients and 300 family members. It is also a model for many national and international healthcare organizations and providers, who come to visit and learn about palliative care in and by community. Conclusions: The success of this palliative care model comes from community involvement, multi-professional volunteers and distributions, and concepts of HHHS model. Banpunrug promotes a consistent care across the cancer trajectory independent of prognosis in order to strengthen a full integration of palliative

Keywords: community-based palliative care, model, participatory action research, patients with cancer

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Authors: Elzbieta Sikorska-Simmons

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Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.

Keywords: advanced dementia, family caregiver, medical decision-making, symptom management

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Authors: Umesh Kumar Singh, Abhishek Raghuvanshi, Suyash Kumar Singh

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As IoT networks gain popularity, they are more susceptible to security breaches. As a result, it is crucial to analyze the IoT platform as a whole from the standpoint of core security concepts. The Internet of Things relies heavily on wireless networks, which are well-known for being susceptible to a wide variety of attacks. This article provides an analysis of many techniques that may be used to identify vulnerabilities in the software and hardware associated with the Internet of Things (IoT). In the current investigation, an experimental setup is built with the assistance of server computers, client PCs, Internet of Things development boards, sensors, and cloud subscriptions. Through the use of network host scanning methods and vulnerability scanning tools, raw data relating to IoT-based applications and devices may be collected. Shodan is a tool that is used for scanning, and it is also used for effective vulnerability discovery in IoT devices as well as penetration testing. This article presents an efficient mitigation plan for encountering vulnerabilities in the Internet of Things.

Keywords: internet of things, security, privacy, vulnerability identification, mitigation plan

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Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Ju-Jen Shie, Wen-Ju Yang, Yuann-Meei Tzeng, Chien-Ying Wang

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Background: The quality of care in intensive care units (ICUs) is crucial, especially for terminally ill patients. Shared decision-making (SDM) with families is essential to ensure appropriate care and reduce suffering. Aim: This study explores the effectiveness of an end-of-life decision support Patient Decision Aid (PDA) in an ICU setting. Methods: This study employed a cross-sectional research design conducted in an ICU from August 2020 to June 2023. Participants included family members of end-of-life patients aged 20 or older. A total of 319 participants. Family members of end-of-life patients received the PDA, and data were collected after they made medical decisions. Data collection involved providing family members with a PDA during family meetings. A post-PDA questionnaire with 17 questions assessed PDA effectiveness and anxiety levels. Statistical analysis was performed using SPSS 22.0. Results: The PDA significantly reduced anxiety levels among family members (p < 0.001). It helped them organize their thoughts, prepare for discussions with doctors, and understand critical decision factors. Most importantly, it influenced decision outcomes, with a shift towards palliative care and withdrawal of life-sustaining treatment. Conclusion: This study highlights the importance of family-centered end-of-life care in ICUs. PDAs promote informed decision-making, reduce conflicts, and enhance patient and family involvement. These tools align patient values and goals with medical recommendations, ultimately leading to decisions that prioritize comfort and quality of life. Implementing PDAs in healthcare systems can ensure that patients' care aligns with their values.

Keywords: shared decision-making, patient decision aid, end-of-life care, intensive care unit, family-centered care

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Authors: Giedre Sirvinskiene, Kastytis Smigelskas

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Quality of family relations is an important factor of child development, however, the role of joint family activities on adolescent happiness still needs investigation. The aim of this study is to analyze associations between happiness of school-aged children and parental involvement. The analysis involves Lithuanian data from the cross-sectional Health Behaviour in School Aged Children (HBSC) study. The sample comprised 5730 children aged 11–15 years. Results: The odds of happiness was 2.38 times higher if children were living together with mother (95% CI: 1.81–3.13) and 1.81 times – with father (95% CI: 1.53–2.15). However, the likelihood of happiness was 7.21 times lower if adolescent had difficulties to talk with mother (95% CI: 5.42–9.61) and 6.40 times – with father (95% CI: 4.80–8.56). The joint daily adolescents-parents activities also predict the odds for happiness: joint TV watching by 5.96 times (95% CI: 4.21–8.43), having meals together by 7.02 times (95% CI: 4.77–10.32), going for a walk together 4.30 times (95% CI: 2.96–6.26), visiting places by 6.85 times (95% CI: 4.74–9.90), visiting friends and relatives by 7.13 times (95% CI: 4.87–10.43), sporting by 2.76 (95% CI: 1.83–4.18) as well as discussing various things by 7.35 times (95% CI: 5.50–9.82). Conclusions: Joint parents-adolescents activities and communication are related with greater happiness of adolescent. Though adolescence is a period when the relationships with peers get more importance, the communication and joint activities with parents remain a significant factor of adolescent happiness.

Keywords: adolescent, family, happiness, school-age

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Authors: Ya-Hui Lee, Ching-Yi Lu

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Taiwan will become an aging society in 2018. The method to face the challenges related to the aging population has become an important topic. Purpose: This study aims to understand the future preparation of middle-age and older adults, and how they prepared themselves to face the problems of aging, and how they took actions to plan and cope with their future life. Moreover, how did they generate the process of learning action, so that they would be able to live a more active and meaningful life when they entered into their older age? Method: We conducted semi-structure interviews with 10 middle-aged and older adults who had taken actions to prepare for their future. We examined the interviewees’ consciousness and learning actions in their future preparation. Preliminary Results: 1. The triggering factors of the interviewees’ consciousness to prepare for the future included: family events, the desire to maintain active social lives after retirement, the continuation of the interviewees’ professional careers after retirement, and the aspiration for participation in volunteer services. 2. 'Health problems' and 'economic security' were issued of the utmost concern for the interviewees’ future. However, they would transform these worries to learning actions, comprising of active participation in learning, finding relevant information through learning; thus, accumulating more resources to cope with their future needs.

Keywords: middle-age and older adults, preparing for future, older adult learning

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Authors: Yassine Sadji

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Some architectural conditions required some shapes often lead to an irregular distribution of masses, rigidities, and resistances. The main object of the present study consists in estimating the influence of the irregularity both in plan and in elevation which presenting some structures on the dynamic characteristics and his influence on the behavior of this structures. To do this, it is necessary to make apply both dynamic methods proposed by the RPA99 (spectral modal method and method of analysis by accélérogramme) on certain similar prototypes and to analyze the parameters measuring the answer of these structures and to proceed to a comparison of the results.

Keywords: irregularity, seismic, response, structure, ductility

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Authors: Kristine Joy Y. Sumanga, Clarissa Mae D. Derecho

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Telemedicine is providing health care services using electronic means at a distance, including the diagnosis, treatment, and prevention of diseases as well as the research and evaluation and education of health care providers. The role of telemedicine in this time of the COVID-19 pandemic is vital, especially in the practice of medicine. General Objective: To determine the extent of knowledge, preparedness and perception of telemedicine among Family Medicine Resident Physicians in different training institutions in Cebu City during the Coronavirus Disease 19 pandemic. Methods: A descriptive, cross-sectional survey research study was conducted in four hospital training institutions in Cebu City. A total of 41 respondents gave their consent and were given the online survey questionnaire pertaining to the extent of knowledge, preparedness and perceptions on telemedicine, including respondents’ demographic data and problems encountered in Telemedicine. Results: Out of the 41 respondents, 56.10% were young adults (26 to 30 years old), mostly females (70.73%), single (68.29%), first-year residents (43.90%), employed at a government hospital (70.73%) and are in the traditional residency pathway (82.93%). On relevant experience, 82.93% experienced telemedicine during residency, with 100% on follow-up consultations, and 95% were consulted due to infections. Respondents’ extent of knowledge was average, while the extent of preparedness and perception were great. Problems with low connectivity (80.48%) were noted by most of the respondents. Conclusion: Resident physicians moderately understood the information about telemedicine but with a great extent of preparedness and perception. They are always prepared for telemedicine modality because they are fully aware of its existence and need in the delivery of health care services among their patients at the time of the pandemic. Challenges to low connectivity and handling patients’ data privacy were the major concerns met by the resident physicians in the use of telemedicine.

Keywords: telemedicine, knowledge, preparedness, perception, family medicine, residents, COVID 19

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Authors: Khalid A. Salman, Shereen Wagih, Tariq Munshi, Musaed Almalki, Safwan Zatari, Zahid Khan

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Aim: To measure exposure levels to family members and caregivers of Saudi patients treated with low dose I131 therapy, and household radiation exposure rate to predict different factors that can affect radiation exposure. Patients and methods: All adult self dependent patients with hyperthyroidism or cancer thyroid referred for low dose radioactive I131 therapy on outpatient basis are included. Radiation protection procedures are given to the participant and family members in details. TLD’s were dispensed to each participant in sufficient quantity for his/her family members living in the household. TLD’s are collected at fifth days post-dispense from patients who agreed to have a home visit during which the household is inspected and level of radiation contamination of surfaces was measured. Results: Thirty-two patients were enrolled in the current study, with a mean age of 43.1± 17.1 years Out of them 25 patients (78%) are females. I131 therapy was given in twenty patients (63%) for cancer thyroid of and for toxic goiter in the remaining twelve patients (37%), with an overall mean I131 dose of 24.1 ± 7.5mCi that is relatively higher in the former. The overall number of household family members and helpers of patients are 139, out of them77 are females (55.4%) & 62 are males (44.6%) with a mean age of 29.8± 17.6. The mean period of contact with the patient is 7.6 ±5.6hours. The cumulative radiation exposure shows that radiation exposure to all family members is below the exposure constraint (1mSv), with a range of 109 to 503uSv, and a mean value of 220.9±91 uSv. Numerical data shows a little higher exposure rate for family members of those who receive higher dose of I131 (patients with thyroid cancer) and household members who spent longer time with the patient, yet, the difference is statistically insignificant (P>0.05). Besides, no significant correlation was found between the degree of cumulative exposure of the family members to their gender, age, socioeconomic standard, educational level and residential factors. In the 21 home visits all data from bedrooms, reception areas and kitchens are below hazardous limits (0.5uSv/h) apart from bathrooms that give a slightly higher reading of 0.57±0.39 uSv/h in those with cancer thyroid who receive a higher radiation dose. A statistically significant difference was found between radiation exposure rate in bathrooms used by the patient versus those used by family members only, with a mean value of exposure rate of 0.701±0.21 uSv/h and 0.17±0.82 uSv/h respectively, with a p-value of 0.018 (<0.05). Conclusion: Family members of patients treated with low dose I131 on outpatient basis have a good compliance to radiation protection instruction if given properly with a cumulative radiation exposure rate evidently beyond the radiation exposure constraints of 1 mSv. Given I131 dose, hours spent with the patient, age, gender, socioeconomic standard, educational level and residential factors have no significant correlation with the cumulative radiation exposure. The patient bathroom exhibits more radiation exposure rate, needing more strict instructions for patient bathroom use and health hygiene.

Keywords: family members, radiation exposure, radioactive iodine therapy, radiation safety

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Authors: Tanveer Ahmed Choudhury

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Background: Bangladesh is one of the largest deltas in the world, with high population density and high rates of poverty and illiteracy. 80% of the country is on low-lying floodplains, leaving the country one of the most vulnerable to the adverse effects of climate change: sea level rise, cyclones and storms, salinity intrusion, rising temperatures and heavy monsoon downpours. Such climatic events already limit Economic Development in the country. Although Bangladesh has had little responsibility in contributing to global climatic change, it is vulnerable to both its direct and indirect impacts. Real threats include reduced agricultural production, worsening food security, increased incidence of flooding and drought, spreading disease and an increased risk of conflict over scarce land and water resources. Currently, 8.3 million Bangladeshis live in cyclone high risk areas. However, by 2050 this is expected to grow to 20.3 million people, if proper adaptive actions are not taken. Under a high emissions scenario, an additional 7.6 million people will be exposed to very high salinity by 2050 compared to current levels. It is also projected that, an average of 7.2 million people will be affected by flooding due to sea level rise every year between 2070-2100 and If global emissions decrease rapidly and adaptation interventions are taken, the population affected by flooding could be limited to only about 14,000 people. To combat the climate change adverse effects, Bangladesh government has initiated many adaptive measures specially in infrastructure and renewable energy sector. Government is investing huge money and initiated many projects which have been proved very success full. Objectives: The objective of this paper is to describe some successful measures initiated by Bangladesh government in its effort to make the country a Climate Resilient. Methodology: Review of operation plan and activities of different relevant Ministries of Bangladesh government. Result: The following initiative projects, programs and activities are considered as best practices for Climate Change adaptation successes for Bangladesh: 1. The Infrastructure Development Company Limited (IDCOL); 2. Climate Change and Health Promotion Unit (CCHPU); 3. The Climate Change Trust Fund (CCTF); 4. Community Climate Change Project (CCCP); 5. Health, Population, Nutrition Sector Development Program (HPNSDP, 2011-2016)- "Climate Change and Environmental Issues"; 6. Ministry of Health and Family Welfare, Bangladesh and WHO Collaboration; - National Adaptation Plan. -"Building adaptation to climate change in health in least developed countries through resilient WASH". 7. COP-21 “Climate and health country profile -2015 Bangladesh. Conclusion: Due to a vast coastline, low-lying land and abundance of rivers, Bangladesh is highly vulnerable to climate change. Having extensive experience with facing natural disasters, Bangladesh has developed a successful adaptation program, which led to a significant reduction in casualties from extreme weather events. In a low income country setting, Bangladesh had successfully adapted various projects and initiatives to combat future Climate Change challenges.

Keywords: climate, change, success, Bangladesh

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Authors: Xu Qian

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This abstract explores the importance of building resilience within families and offers evidence-based strategies for promoting positive parenting and enhancing emotional well-being. It emphasizes the role of effective communication, conflict resolution, and fostering a supportive environment to strengthen family bonds and promote healthy child development. Introduction: The well-being and resilience of families play a crucial role in fostering healthy child development and promoting overall emotional well-being. This abstract highlights the significance of nurturing resilient families and provides evidence-based strategies for positive parenting. By focusing on effective communication, conflict resolution, and creating a supportive environment, families can strengthen their bonds and enhance emotional well-being for both parents and children. Methods: This abstract draws upon a comprehensive review of existing research and literature on resilient families, positive parenting, and emotional well-being. The selected studies employ various methodologies, including surveys, interviews, and longitudinal observations, to investigate the factors contributing to family resilience and the strategies that promote positive parenting practices. The findings from these studies serve as the foundation for the strategies discussed in this abstract. Results: The results of the reviewed studies demonstrate that effective communication within families is a key factor in building resilience and promoting emotional well-being. Open and honest communication allows family members to express their thoughts, feelings, and concerns, fostering trust and understanding. Conflict resolution skills, such as active listening, compromise, and problem-solving, are vital in managing conflicts constructively and preventing negative consequences on family dynamics and children's well-being. Creating a supportive environment that nurtures emotional well-being is another critical aspect of promoting resilient families. This includes providing emotional support, setting clear boundaries, and promoting positive discipline strategies. Research indicates that consistent and responsive parenting approaches contribute to improved self-regulation skills, emotional intelligence, and overall mental health in children. Discussion: The discussion centers on the implications of these findings for promoting positive parenting and emotional well-being. It emphasizes the need for parents to prioritize self-care and seek support when facing challenges. Parental well-being directly influences the quality of parenting and the overall family environment. By attending to their own emotional needs, parents can better meet the needs of their children and create a nurturing atmosphere. Furthermore, the importance of fostering resilience in children is highlighted. Resilient children are better equipped to cope with adversity, adapt to change, and thrive in challenging circumstances. By cultivating resilience through supportive relationships, encouragement of independence, and providing opportunities for growth, parents can foster their children's ability to bounce back from setbacks and develop essential life skills. Conclusion: In conclusion, nurturing resilient families is crucial for positive parenting and enhancing emotional well-being. This abstract presents evidence-based strategies that emphasize effective communication, conflict resolution, and creating a supportive environment. By implementing these strategies, parents can strengthen family bonds, promote healthy child development, and enhance overall family resilience. Investing in resilient families not only benefits individual family members but also contributes to the well-being of the broader community.

Keywords: childrearing families, family education, children's mental health, positive parenting, emotional health

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Authors: Dan Richard D. Fernandez

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This study determined the perspectives of community health workers’ perspectives in the sustainability of primary health care. Eight community health workers, two community officials and a rural health midwife in a rural community in the in the Philippines were enjoined to share their perspectives in the sustainability of primary health care. The study utilized the critical research method. The critical research assumes that there are ‘dominated’ or ‘marginalized’ groups whose interests are not best served by existing societal structures. Their experiences highlighted that the challenges of their role include unkind and uncooperative patients, the lack of institutional support mechanisms and conflict of their roles with their family responsibilities. Their most revealing insight is the belief that primary health care is within their grasp. Finally, they believe that the burden to sustain primary health care rests on their shoulders alone. This study establishes that Multi-stakeholder participation is and Gender-sensitivity is integral to the sustainability of Primary Health Care. It also observed that the ingrained Expert-Novice or Top-down Management Culture and the marginalisation of BHWs within the system is a threat to PHC sustainability. This study also recommends to expand the study and to involve the local government units and academe in lobbying the integration of gender-sensitivity and multi-stake participatory approaches to health workforce policies. Finally, this study recognised that the CHWs’ role is indispensable to the sustainability of primary health care.

Keywords: community health workers, multi-stakeholder participation, sustainability, gender-sensitivity

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Authors: Oussama Derdous, Lakhdar Djemili, Hamza Bouchahed

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The consequences of a dam breach can be devastating; both in terms of lives lost and damaged infrastructure and property. Hydraulic modeling provides a clear picture of the possible consequences of partial or complete failure of a dam, which is the key to carry out emergency planning and conduct reliable risk assessments. In this paper, the MIKE11 model developed by the Danish Hydrologic Institute (DHI) was used to simulate the flood wave propagation associated with a potential failure analysis failure of Zardezas dam located in the city of Skikda in the North East of Algeria. MIKE11 results including inundation maps and the representative channel/valley cross-sections depicting flow depth and maximal flow velocities showed that Zardezas reservoir presents a significant risk to downstream areas in the event of a dam failure. These results can be used as the basis of the development of an Emergency Action Plan (EAP).The main objective of this plan is to predict the appropriate steps to avoid or at least decrease the consequences of unexpected failure of Zardezas dam.

Keywords: MIKE11, dam break, inundation maps, emergency action plan

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Authors: Alongkorn Pekalee, Rossarin Gray

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Various determinants associated with older health include socio-demographic factors and health-promoting behaviors but lack in scholars recommended what factors associated with health status in specific sub-groups of older adults. The current study aims to explore the health-promoting behaviors and to examine and compare the associations of these factors with self-rated health status among three older age cohorts in Thai traditional context. Methods: This study is based on the Survey of Older Persons in Thailand (SOPT), in 2017, conducted by the National Statistical Office (NSO) of Thailand. Participants were classified into three groups by using the Thai contextual recommendation: youngest-old cohort (60-69), old-old cohort (70-79) and oldest old cohort (80 or older). Health promoting behaviors are the behaviors which associated with the health status of older adults include alcohol consumption, smoking, diet, and physical activity. Health status was defined as a subjective measurement by using self-rated health, a simple measure of general health. The socio-demographic factors, health-promoting behaviors, and health status were explained and summarized by descriptive statistics. The binary logistic regression was performed to analyze the data and evaluate the associations between independent and dependent variables. Results: Increase of age contributes to a higher proportion of health-promoting behaviors. All variables were associated with self-reported health status as good health among three older age cohorts statistically significant (p-value = 0.000). However, the influence of income sufficiency on health status is more notable, especially in older adults who aged 60-69 and 70-79. The influence of dietary and physical activity on health status became greater as age increased. Conclusion: the results suggest that income sufficiency should be noted in a plan to promote healthy aging, and co-residence should be more concerned especially in the oldest old cohort. Moreover, the interventions or policies to promote older health behaviors like diet and physical activity should be emphasized in the oldest old cohort more than others.

Keywords: health-promoting behaviors, older adults, self- rated health, Thailand

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Authors: Mohamed Radwan

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Introduction: Polycystic ovary syndrome is becoming very common among girls from ages 14 to 21 years old, alongside women in their childbearing period. A combination of menstrual irregularities, overweight or obesity, insulin resistance (type 2 diabetes), and symptoms of virilization are characteristics of these cases. Background: A multidisciplinary team should be involved in managing these cases and may consist of A gynecologist, endocrinologist, nutritionist, and psychologist. The role of nutritionists is crucial in these cases in weight reduction and nutritional management. It is mandatory to present some questions that may help in expanding further our understanding of the nutritional management of this syndrome, such as it is not an easy process to reduce the weight of PCO patients (2) we need to know what suitable nutritional plans for these cases are. Methodology: It is not successful to use one diet plan for all patients or a specific plan, but we need to give tailored plans for each patient. We will summarize the medical, nutritional therapy and weight management in polycystic ovary patients and highlight the best eating plan and dietary composition in the treatment of these women. We will also discuss the role of dieticians in treating polycystic ovary cases and overcoming the challenges these women face. Conclusion: All diet plans would decrease the weight of Polycystic ovary cases as low calory diet, low glycemic index diet, high protein diet, as well as Dash diet, but the most suitable diet plan to improve hormones and lead to spontaneous pregnancy is the Mediterranean diet.

Keywords: obesity, PCO mediteranian diet, dash diet, high protein diet

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Authors: Florenda B. Cardinoza

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This study was conducted to determine the determinants of Grade III and grade VI pupils’ performance in the National Achievement Test in the Division of Cavite City, School Year 2011-2012. Specifically, the research aimed to: (1) describe the demographic profile of the respondents in terms of age, sex, birth order, family size, family income, and occupation of parents; (2) determine the level of attitude towards NAT; and (3) describe the degree of relationship between the following variables: school support, teachers’ support, and lastly family support for the pupils’ performance in 2012 NAT. The study used the descriptive-correlation research method to investigate the determinants of pupils’ performance in the National Achievement Test of Public Elementary Schools in the Division of Cavite City. The instrument used in data gathering was a self-structured survey. The NAT result for SY 2011-2012 provided by NETRC and DepEd Cavite City was also utilized. The statistical tools used to process and analyze the data were frequency distribution, percentage, mean, standard deviation, Kruskall Wallis, Mann-Whitney, t-test for independent samples, One-way ANOVA, and Spearman Rank Correlational Coefficient. Results revealed that there were more female students than males in the Division of Cavite City; out of 659 respondents, 345 were 11 years old and above; 390 were females; 283 were categorized as first child in the family; 371 of the respondents were from small family; 327 had Php5000 and below family income; 450 of the fathers’ respondents were non professionals; and 431 of the mothers respondents had no occupation. The attitude towards NAT, with a mean of 1.65 and SD of .485, shows that respondents considered NAT important. The school support towards NAT, with a mean of 1.89 and SD of .520, shows that respondents received school support. The pupils had a very high attitude towards teachers’ support in NAT with a mean of 1.60 and SD of .572. Family support, with t-test of 16.201 with a p-value of 0.006, shows significant at 5 percent level. Thus, the determinants of pupils’ performance in NAT in terms of family support for NAT preparation is not significant according to their family income. The grade level, with the t-test is 4.420 and a p-value of 0.000, is significant at 5 percent level. Therefore, the determinants of pupils’ performance in NAT in terms of grade level for NAT preparation vary according to their grade level. For the determinants of pupils’ performance of NAT sample test for attitude towards NAT, school support, teachers’ support, and family support were noted highly significant with a p value of 0.000.

Keywords: achievement, determinants, national, performance, public, pupils', test

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Authors: Mireya Mateo Gomez

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The purpose of this study was to examine the perceptions first-generation Mexican origin mothers living in San Diego have on postpartum depression (PPD), with a special focus on social influences and cultural beliefs towards those meanings. This study also aimed to examine possible PPD help-seeking behaviors that first-generation Mexican origin mothers can perform. The Health Belief Model (HBM) and Social Ecological Model (SEM) were the guiding theoretical frameworks for this study. Data for this study were collected from three focus groups, four in-depth interviews, and the distribution of an acculturation survey (ARSMA II). There were a total of 15 participants, in which participant’s mean age was 45, and the mean age migrated to the United States being 22. Most participants identified as being married, born in Southern or Western Mexico, and with a strong Mexican identity in relation to the ARSMA survey. Participants identified four salient PPD perceptions corresponding to the interpersonal level of SEM. These four main perceptions were: 1) PPD affecting the identity of motherhood; 2) PPD being a natural part of a mother’s experience but mitigated by networks; 3) PPD being a U.S. phenomenon due to family and community breakdown; and 4) natural remedies as a preferred PPD treatment. In regard to themes relating to help seeking behaviors, participants identified seven being: 1) seeking help from immediate family members; 2) practicing home remedies; 3) seeking help from a medical professional; 4) obtaining help from a clinic or organization; 5) seeking help from God; 6) participating in PPD support groups; and 7) talking to a friend. It was evident in this study that postpartum depression is not a well discussed topic within the Mexican immigrant population. In relation to the role culture and social influences have on PPD perceptions, most participants shared hearing or learning about PPD from their family members or friends. Participants also stated seeking help from family members if diagnosed with PPD and seeking out home remedies. This study as well provides suggestions to increase the awareness of PPD among the Mexican immigrant community.

Keywords: cultural beliefs, health belief model, Mexican origin mothers, perceptions, postpartum depression social ecological model

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Authors: Abigail Bentley, Audrey Prost, Nayreen Daruwalla, Apoorwa Gupta, David Osrin

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BACKGROUND: Intimate partner violence (IPV) can impact a woman’s physical, reproductive and mental health, including common mental disorders such as anxiety and depression. However, people other than an intimate partner may also perpetrate violence against women in the family, particularly in India. This study aims to investigate the relationship between experiences of violence perpetrated by the husband and other members of the wider household and symptoms of common mental disorders in women residing in informal settlement (slum) areas of Mumbai. METHODS: Experiences of violence were assessed through a detailed cross-sectional survey of 598 women, including questions about specific acts of emotional, economic, physical and sexual violence across different time points in the woman’s life and the main perpetrator of each act. Symptoms of common mental disorders were assessed using the 12-item General Health Questionnaire (GHQ-12). The GHQ-12 scores were divided into four groups and the relationship between experiences of each type of violence in the last 12 months and GHQ-12 score group was analyzed using ordinal logistic regression, adjusted for the woman’s age and clustering. RESULTS: 482 (81%) women consented to interview. On average, they were 28.5 years old, had completed 7 years of education and had been married 9 years. 88% were Muslim and 47% lived in joint and 53% in nuclear families. 44% of women had experienced at least one act of violence in their lifetime (33% emotional, 22% economic, 23% physical, 12% sexual). 7% had a high GHQ-12 score (6 or above). For violence experiences in the last 12 months, the odds of being in the highest GHQ-12 score group versus the lower groups combined were 13.1 for emotional violence, 6.5 for economic, 5.7 for physical and 6.3 for sexual (p<0.001 for all outcomes). DISCUSSION: The high level of violence reported across the lifetime could be due to the detailed assessment of violent acts at multiple time points and the inclusion of perpetrators within the family other than the husband. Each type of violence was associated with greater odds of a higher GHQ-12 score and therefore more symptoms of common mental disorders. Emotional violence was far more strongly associated with symptoms of common mental disorders than physical or sexual violence. However, it is not possible to attribute causal directionality to the association. Further work to investigate the relationship between differing severity of violence experiences and women’s mental health and the components of emotional violence that make it so strongly associated with symptoms of common mental disorders would be beneficial.

Keywords: common mental disorders, family violence, India, informal settlements, mental health, violence against women

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Authors: Negin Parsamanesh, Saman Ameri-Mahabadi, Ali Nikfar, Mojdeh Mansouri, Hossein Chiti, Gita Fatemi Abhari

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Duchenne muscular dystrophy (DMD) is a severe progressive X-linked neuromuscular illness that affects movement through mutations in dystrophin gene. The mutation leads to insufficient, lack of or dysfunction of dystrophin. The cause of DMD was determined in an Iranian family. Exome sequencing was carried out along with a complete physical examination of the family. In silico methods were applied to find the alteration in the protein structure. The homozygous variant in DMD gene (NM-004006.2) was defined as c.2732-2733delTT (p.Phe911CysfsX8) in exon 21. In addition, phylogenetic conservation study of the human dystrophin protein sequence revealed that phenylalanine 911 is one of the evolutionarily conserved amino acids. In conclusion, our study indicated a new deletion in the DMD gene in the affected family. This deletion with an X-linked inheritance pattern is new in Iran. These findings could facilitate genetic counseling for this family and other patients in the future.

Keywords: duchenne muscular dystrophy, whole exome sequencing, iran, metabolic syndrome

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Authors: Arundhati Devi Maibam, K. Ingocha Singh

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Cervical cancer is preventable if detected early. Determination of risk factors is essential to plan screening programmes to prevent the disease. To study the demographic risk factors of cervical cancer among Manipuri women, information on age, marital status, educational level, monthly family income and socioeconomic status were collected through a pre-tested interview schedule. In this study, 64 incident cases registered at the RT Dept, RIMS (Regional Institute of Medical Sciences), Imphal, Manipur, India during 2008-09 participated. Data were entered in Microsoft Excel and the results were expressed in percentages. Among the 64 patients with cervical cancer, 56 (88.9%) were in the age group of 40+ years. The majority of the patients were from rural areas (68.75%) and 31.25% were from urban areas. The majority of the patients were Hindus (73%), 55(85.9%) were of low educational level, 43(67.2%) were married, and 36 (56.25%) belonged to Class IV socioeconomic status. In conclusion, if detected early, cervical cancer is preventable and curable. The potential risk factors need to be identified and women in the risk group need to be motivated for screening. Affordable screening programmes and health care resources will help in lessening the burden of the disease.

Keywords: cervical cancer, Manipuri women, RIIMS, socio-demographic risk factors

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