Search results for: family medicine residents

Authors: Maria Luz Macasinag

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This study aims to determine and to examine critically successful family-owned higher educational institutions towards identifying the attributes and practices that may likely have led to their success. This research is confined to private, non-sectarian, family-owned higher institutions of learning that have been operating for more than fifty years, had only one founder and had at least two transitions in terms of generation. The criteria for selecting family-owned universities to be part of the cases under investigation include institutions (1) with increasing enrollment over the past five years, with level III accreditation status, (3) with good performance in the Board examinations in most of its programs and (4) with high employability of graduates. The study uses the multiple case study method. A model based on the cross-case analysis of the attributes and practices of all the case studies of successful family- owned higher institutions of learning is the output. The paper provides insights to current and future school owners and administrators in the management of their institutions for competitiveness, sustainability and advancement. This research encourages the evaluation of how the ideas that may lead to the success of schools owned by families in developing a sense of community, a reciprocal relationship among colleagues, the students and other stakeholders will result to the attainment of the vision and mission of the school. The study is beneficial to entrepreneurs and to business students whose know-how may provide insights that would be helpful in guiding prospective school owners. The commission on higher education and the Department of Education stand to benefit from this academic paper for the guidance that they provide to family-owned educational institutions. Banks and other financial institutions may find valuable ideas from this academic paper for the purpose of providing financial assistance to colleges and universities that are family-owned. Researchers in the field of educational management and administration may be able to extract from this study related topics for future research.

Keywords: administration practices, attributes, family-owned schools, success factors

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Authors: Shan Jiang

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Child aggression represents a significant global issue, with its familial determinants being crucial. Family is a vital context for child development, but prior research on the impact of parental assortative mating on child aggression is limited. This study investigates the effects of assortative mating on child aggression, elucidating the mediating mechanisms involved and examining gender-specific responses, within a substantial sample of 10,570 parents and their children, grades 1-6, in Hangzhou City, Zhejiang Province, China. The findings indicate that children exhibit a significant increase in aggressive behaviors when maternal income surpasses paternal income, contrasted with families where the father's income is higher. The study identifies family communication, co-parenting quality, and parental problem-solving strategies as significant mediators in the relationship between parental income/education differences and child aggression. This research contributes to understanding the parental influence on child behavior within the family system and offers valuable implications for child protection policy and intervention strategies.

Keywords: assortative mating, aggression, children, family

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Authors: A. Hoppe, T. Kagele, B. Hall, A. Nichols, B. Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to members of Spokane, Washington, experiencing homelessness. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to the underserved homeless population. In this analysis, clinical charts from street and shelter encounters made by the Spokane Street Medicine Program in early 2021 were reviewed in order to better understand the healthcare inequities prevalent among people experiencing homelessness in Spokane, WA. Pain, wound-care, and follow-up efforts were predominant concerns among the homeless population. More than half of the conditions addressed were acute, and almost a quarter of all chief complaints involved chronic unmanaged conditions. This analysis gives reason for the priorities of the SSM Program to be focused on pain, wound-care, and follow-up efforts. Understanding the specific medical needs of this population will allow for better resource allocation and improved health outcomes among people experiencing homelessness.

Keywords: equity issues in public health, health disparities, health services accessibility, medical public health, street medicine

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Authors: K. Fyad, A. Cheriti, Y. Bourmita, N. Belboukhari

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Many industries are involved by using essential oils such as food, flavour, and beverage, pharmaceutical, cosmetic and fragrance. Apiaceae species are usually herbs, rarely schrubs characterized particularly by its inflorescence typical umbel. Many species of this family have been widely used in folk medicine throughout the world. The most characteristic natural compounds in this family are the essential oils secreted in schizogenous canals in all organs with remarkable variability chemical composition. As a part of our investigation into medicinal plants growing in Algerian Sahara. In this study, we investigate the chemical composition of the essential oils extracted from two Apiaceae species: Foeniculum vulgare Miller and Carum carvi L cultivated in the Sahara. The plants were selected on the basis of their use by local people to treat infectious diseases as determined in our previous ethnopharmacological study. Wild samples of Foeniculum vulgare Miller and Carum carvi L cultivated in an experimental field at the university. The harvest was made during the year 2011 according to the growth cycle stage of the plants. The essential oils of different fresh aerial parts, obtained by hydrodistillation were analysed by GC. The results showed that the essential oils yields are not uniform among the different cycle stage. The percentage of components is significantly affected by the harvesting period of the plant material.

Keywords: essential oils, Apiaceae, growth cycle, Sahara, GC

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Authors: Szu-Yi Chang, Jiin-Ru Rong

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This paper discussed a case involving a young female patient with schizophrenia. The patient's condition was deteriorating, and she was becoming increasingly reliant on her family to take care of her, and as her father did not understand the illness well and was afraid that others will learn about the presence of a mentally ill individual in their family, he and the patient's mother were thus unable to cope with the patient's deteriorating condition, which in turn caused her to suffer from a lack of self-confidence and low self-esteem. The patient received nursing care from July 26th to October 25th, 2017, during which counseling, family visits, and phone interviews were carried out, and her condition was monitored. By referring to the practical ability indicators for community psychiatric mental health nursing that were developed by the psychiatric mental health nurses' association of the Republic of China, defining categories such as 'self-construction,' 'self-management,' 'disease management,' and 'family nursing,' and incorporating indicators for empowerment and various skills into the steps and strategies used for nursing care, we will able to help the patient to construct her own identity, raise her self-esteem, improve her ability to independently perform activities of daily living, strengthen her disease management ability, and gradually build up her life management skills. The patient's family was also encouraged to communicate more among themselves, so as to align them with the nursing care objectives of improving the patient's ability to adapt to community life and her disease. The results indicated that the patient was able to maintain her mental stability within her community. By implementing effective self-management and maintaining a routine life, the patient was able to continue her active participation in community work and rehabilitation activities. Improvements were also achieved with respect to family role issues by establishing mutual understanding among the patient's family members and gaining their support. It is recommended that mental health nurses can leverage their community mental health nursing skills and the related strategies to promote adaptation to community life among mental life patients.

Keywords: community psychiatric mental health nursing, family nursing, schizophrenia, self-management

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Authors: Mahnaz Seyedoshohadaee

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Background and Aims: Hospitalization of one of the family members in the hospital, especially in the emergency department, causes anxiety and psychological problems in family members and others. The way nurses interact with patients and their companions can play an important role in controlling and managing their anxiety. This study aims to determine the relationship between the anxiety of family members of patients referring to emergency departments and their views on the communication skills of nurses. Materials and Methods: The current research was a descriptive-correlation cross-sectional study on 263 family members of patients referred to the department. The emergency of two selected medical training centers affiliated with Iran University of Medical Sciences was performed. The samples were selected continuously in 2018 based on the inclusion criteria. Information was collected using the Health Communication Questionnaire (HCCQ) and Beck Anxiety Questionnaire (BAI). To analyze the data, Pearson's correlation coefficient, independent t-tests, analysis of variance, and Kruskal-Wallis were used at a significance level of 0.05. The data was analyzed using SPSS version 16 statistical software. Results: The mean score of communication skills of emergency department nurses from the point of view of patients' companions was at a low level (74.36 with a standard deviation of 3.7). 3.75% of patients' companions had anxiety at a mild level. There was no statistically significant correlation between the anxieties of the patient's companions. The anxiety of the patient's companions had a statistically significant relationship with the educational level (P=0.039), economic status (P=0.033), and family relationship with the patient (P=0.001). Also, the average anxiety score in children was significantly higher than that of patients' wives (P=0.008). The triage level of the patient also had a statistically significant relationship with the anxiety of the patient's companions (P>0.001). Conclusion: Most of the family members of the patients referred to the emergency room experienced mild anxiety. Also, from their point of view, the communication skills of emergency nurses were at a weak level. Despite the fact that there was no statistically significant relationship between the patient's family member's anxiety and their opinion about nurses' communication skills in this study, it seems that the weak communication skills of nurses from the patient's family member's point of view need special attention. The results of the present study can provide the necessary grounds for planning to improve the communication skills of nurses and also control the anxiety of patient caregivers through in-service training or other incentive mechanisms.

Keywords: anxiety, family, emergency department, communication skills, nurse

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Authors: Dina Hadad

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Women empowerment in the Arab world remains a central issue in the context of development and human rights. Akin to many societies around the globe, gender equality is yet to be achieved. This research will provide an introduction into the current legal stand of some Arab countries in terms of gender equality and women rights in the context of family law. It will look specifically into the recent family law in Kuwait and why many women consider it a positive step towards affirming their rights and their needs. Depending on comparative material from the area, the research argues that whilst some countries made efforts to promote women’s empowerment as a concept and practice throughout its policies, others have indeed some unique journeys that reflect organic and from within evolutions. Nonetheless, these efforts are yet to reflect a comprehensive structure that addresses women legal and political empowerment let alone social status. A contradiction in the realities of different Arab states is nothing new since the lack of comprehensive rights-based policy making in Arab countries has contributed to the disconnect between economic growth and development challenges.

Keywords: women empowerment, cultural challenges, gender equality, Islamic law, international standards, family law

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Authors: Gizachew Assefa Tessema, Mohammad Afzal Mahmood, Judith Streak Gomersall, Caroline O. Laurence

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Introduction: Improving access to quality family planning services is the key to improving health of women and children. However, there is currently little evidence on the quality and scope of family planning services provided by private facilities, and this compares to the services provided in public facilities in Ethiopia. This is important, particularly in determining whether the government should further expand the roles of the private sector in the delivery of family planning facility. Methods: This study used the 2014 Ethiopian Services Provision Assessment Plus (ESPA+) survey dataset for comparing the structural aspects of quality of care in family planning services. The present analysis used a weighted sample of 1093 primary health care facilities (955 public and 138 private). This study employed logistic regression analysis to compare key structural variables between public and private facilities. While taking the structural variables as an outcome for comparison, the facility type (public vs private) were used as the key exposure of interest. Results: When comparing availability of basic amenities (infrastructure), public facilities were less likely to have functional cell phones (AOR=0.12; 95% CI: 0.07-0.21), and water supply (AOR=0.29; 95% CI: 0.15-0.58) than private facilities. However, public facilities were more likely to have staff available 24 hours in the facility (AOR=0.12; 95% CI: 0.07-0.21), providers having family planning related training in the past 24 months (AOR=4.4; 95% CI: 2.51, 7.64) and possessing guidelines/protocols (AOR= 3.1 95% CI: 1.87, 5.24) than private facilities. Moreover, comparing the availability of equipment, public facilities had higher odds of having pelvic model for IUD demonstration (AOR=2.60; 95% CI: 1.35, 5.01) and penile model for condom demonstration (AOR=2.51; 95% CI: 1.32, 4.78) than private facilities. Conclusion: The present study suggests that Ethiopian government needs to provide emphasis towards the private sector in terms of providing family planning guidelines and training on family planning services for their staff. It is also worthwhile for the public health facilities to allocate funding for improving the availability of basic amenities. Implications for policy and/ or practice: This study calls policy makers to design appropriate strategies in providing opportunities for training a health care providers working in private health facility.

Keywords: quality of care, family planning, public-private, Ethiopia

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Authors: Sascha Kraus, Wolfgang Hora, Philipp Stieg, Thomas Niemand, Ferdinand Thies, Matthias Filser

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In most countries, small and medium-sized enterprises (SME) are the backbone of the economy due to their impact on job creation, innovation and wealth creation. Moreover, the ongoing globalization makes it inevitable – even for SME that traditionally focused on their domestic markets – to internationalize their business activities to realize further growth and survive in international markets. Thus, internationalization has become one of the most common growth strategies for SME and has received increasing scholarly attention over the last two decades. One the downside internationalization can be also regarded as the most complex strategy that a firm can undertake. Particularly for family firms, that are often characterized by limited financial capital, a risk-averse nature and limited growth aspirations, it could be argued that family firms are more likely to face greater challenges when taking the pathway to internationalization. Especially the triangulation of family, ownership, and management (so-called ‘familiness’) manifests in a unique behavior and decision-making process which is often characterized by the importance given to noneconomic goals and distinguishes a family firm from other businesses. Taking this into account, the concept of socio-emotional wealth (SEW) has been evolved to describe the behavior of family firms. In order to investigate how different internal and external firm characteristics shape internationalization success of family firms, we drew on a sample consisting of 297 small and medium-sized family firms from Germany, Austria, Switzerland, and Liechtenstein. Thus, we include SEW as essential family firm characteristic and added the two major intra-organizational characteristics, entrepreneurial orientation (EO), absorptive capacity (AC) as well as collaboration intensity (CI) and relational knowledge (RK) as two major external network characteristics. Based on previous research we assume that these characteristics are important to explain internationalization success of family firm SME. Regarding the data analysis, we applied a Fuzzy Set Qualitative Comparative Analysis (fsQCA), an approach that allows identifying configurations of firm characteristics, specifically used to study complex causal relationships where traditional regression techniques reach their limits. Results indicate that several combinations of these family firm characteristics can lead to international success, with no permanently required key characteristic. Instead, there are many roads to walk down for family firms to achieve internationalization success. Consequently, our data states that family owned SME are heterogeneous and internationalization is a complex and dynamic process. Results further show that network related characteristics occur in all sets, thus represent an essential element in the internationalization process of family owned SME. The contribution of our study is twofold, as we investigate different forms of international expansion for family firms and how to improve them. First, we are able to broaden the understanding of the intersection between family firm and SME internationalization with respect to major intra-organizational and network-related variables. Second, from a practical perspective, we offer family firm owners a basis for setting up internal capabilities to achieve international success.

Keywords: entrepreneurial orientation, family firm, fsQCA, internationalization, socio-emotional wealth

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Authors: Michel T. Leger, Shawn Martin

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Leading an ecologically responsible lifestyle represents a difficult challenge. Though research in environmental education does point to an increase in the intention to act more responsibly towards the environment, this intent does not seem to translate to concrete ecological action. This mixed methods collective case study explores the adoption of ecological actions in the family, a context of socio-ecological transformation rarely examined in the scientific literature. More specifically, it takes into account the popular use of social media today to explore the potential role social media, namely Facebook, in promoting environmental action. In other words, for families who are intent on adopting an ecologically friendly lifestyle, could the use of Facebook positively affect the way family members relate to the environment and bring about real change in their daily household actions? To answer this question, twenty-one families living in an urban setting were recruited and then divided them into two distinct groups. The first group of families attempted to lower their household electrical bill as part of a private Facebook group, while the other aimed to do the same, but without the directed use of social media. For both groups, we recorded the amount of kilowatt-hours used during the project as well as the amount used for the same months the previous year, adjusting for temperature variations. Exit interviews were also conducted with each family in order to try to understand the processes of eco-citizenship development in the context of family. Results seem to suggest that both virtual social networks and one-on-one support can help to increase environmental awareness in participating family. Interestingly, families from the Facebook group seemed to demonstrate a higher degree of environmental engagement, and younger family members in this group were more active in the processes of collective behavioral change.

Keywords: environmental education, family-based eco-citizenship, social media, case study

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Authors: Lemi Tolu

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Background: Postpartum family planning (PPFP) focuses on the prevention of unintended and closely spaced pregnancies through the first 12 months following childbirth. Objective: This study assesses the barriers to uptake of long-term and permanent family planning methods among immediate post-partum mothers at Saint Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia. Methodology: An institution-based cross-sectional study was conducted from January 1 to June 30, 2017. The six months of study were used as strata, and systematic sampling used to select participants in each month. Post-partum mothers were interviewed using pretested structured questionnaires. Data entry and analysis were done using SPSS version 17. Bivariate and multivariable logistic regressions were fitted to identify determinants of post-partum family planning uptake. An OR with 95% CIs was calculated, and p values set at 005 were used to determine the statistical significance of associations. Results: Four hundred and twenty-two post-partum women were interviewed. Two hundred sixty-eight (63%) women received counselling on family planning, and 241 (66.8 %) got information about contraception. One hundred and fifty-two (45%) of the women accepted long-term and permanent contraception on their immediate postpartum period before discharge. Contraceptive counselling (OR = 2.13, 95% CI 1.004-3.331), getting information from the health facility (OR = 15.15, 95% CI 1.848-19.242), and partner support (OR = 1.367, 95% CI 1.175-2.771) were significantly associated with long-term and permanent contraception uptake. Conclusion: Postpartum counselling on family planning and provision of contraception information improve immediate postpartum FP acceptance, and, hence postpartum programs need to strengthen such services.

Keywords: contraception, immediate postpartum, long-term family planning, post-partum family planning

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Authors: Marie Oslène Honorat

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Porto Belo is a neighborhood in the city of Foz do Iguaçu / PR, located in the Vila C region of Brazil. It is a project that addresses the question of the dirt generated by the neighborhood community about how they dispose and recycle domestic waste. This project aimed at raising awareness among residents, on how important it is to preserve the environment and take care, especially of the space in which we are located. Living this way manages to minimize the exploitation of natural resources, soil and water pollution. After collecting information about what one saw, we questioned some people in the neighborhood to find out about selective collection, recycling, and the separation and final destination of garbage. From the study, it was possible to verify the importance of placing more trash cans on neighborhood streets, where garbage is discarded, and the importance of promoting environmental education to improve the environment and quality of life. The methodology used in this research was a qualitative methodology that seeks the principle of transforming reality through investigation.

Keywords: awareness, recycling, selective collection, waste disposal

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Authors: Burcin Basyazici

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The history of urban regeneration in Istanbul dates to the 1980s and has been generated by various reasons, from political state-based decisions to cultural migrations and/or translocations and economical private sector-based reasons. However, one of the latest regeneration areas in Fikirtepe that have been still under construction for ten years becomes dissimilar to other regeneration areas in Istanbul. The region is located very close to Kadıkoy's downtown area but was still considered a slum due to its inhabitants -who mostly belong to lower-income immigrants. The process begun in 2011 with the decision of the government, and the settlement has been emptied and demolished also by the government -together with the investors and construction companies. Although there has been much research on the process of deconstruction and the relocation of landlords, there hasn’t been any research on what happened after the regeneration. While many high-rise luxurious gated communities were constructed and inhabited in five years, many constructions have stopped due to the latest economic devastation in Turkey. Then the region stayed as an unfinished construction area with its new upper-income and upper-middle-income residents and old low-income landlords. This situation has also changed the commercial activities in Fikirtepe. While some new retail facilities have been offered for new residents, some of the oldest ones have also survived in new-Fikirtepe. This study aims to investigate the urban everyday life of Fikirtepe with relation to its retail-based regeneration with the help of the theories of Bourdieu called cultural capital and cultural omnivorousness. To achieve this aim, after presenting the historical background of urban regeneration in Istanbul, Bourdieu’s conceptualism of cultural capital, habitus, and the consumption tendencies related to those are introduced and discussed within the scope of the Fikirtepe case. To represent the retail-based regeneration in the area, the current situation of retail premises is mapped by comparing to its pre-situation before urban gentrification. To better understand the change of cultural capital and the consumption tendencies of the new residents, eighteen semi-structured in-depth interviews have been conducted with twelve inhabitants from three different luxurious gated communities and six shop owners containing the new ones after regeneration and old ones before it. The interview questions have been structured to understand the motivation of change and/or inhibition of retail premises and the consumption tendencies of the new residents. In conclusion, the study shows that even though the cultural capital has been changed in Fikirtepe, the new residents also tend to act as culturally omnivorous by referring to Bourdieu's theories on multi-cultural tendencies of the upper-class and upper-middle-class societies, that should be questioned regarding the cultural regeneration in in-town urban regeneration areas in metropoles.

Keywords: bourdieu, cultural omnivorousness, fikirtepe, urban regeneration in istanbul

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Authors: Yu-Yu Wang, Shih-Hua Hsieh, Ru-Shian Hsieh

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Wishes and choices being respected, and the right to be supported rather than coerced, have been internationally recognized as the human rights of persons with mental illness. In Taiwan, ‘coerced hospitalization’ has become difficult since the revision of the mental health legislation in 2007. Despite trend towards human rights, the real problem families face when their family members are in mental health crisis is the lack of alternative services. This study aims to explore: 1) When is hospitalization seen as the only solution by family members? 2) What are the barriers for arranging hospitalization, and how are they managed? 3) What have family carers learned, in their experiences of caring for their family members with mental illness? To answer these questions, qualitative approach was adopted, and focus group interviews were taken to collect data. This study includes 24 family carers. The main findings of this research include: First, hospital is the last resort for carers in helplessness. Family carers tend to do everything they could to provide care at home for their family members with mental illness. Carers seek hospitalization only when a patient’s behavior is too violent, weird, and/or abnormal, and beyond their ability to manage. Hospitalization, nevertheless, is never an easy choice. Obstacles emanate from the attitudes of the medical doctors, the restricted areas of ambulance service, and insufficient information from the carers’ part. On the other hand, with some professionals’ proactive assistance, access to medical care while in crisis becomes possible. Some family carers obtained help from the medical doctor, nurse, therapist and social workers. Some experienced good help from policemen, taxi drivers, and security guards at the hospital. The difficulty in accessing medical care prompts carers to work harder on assisting their family members with mental illness to stay in stable states. Carers found different ways of helping the ‘person’ to get along with the ‘illness’ and have better quality of life. Taking back ‘the right to control’ in utilizing medication, from passiveness to negotiating with medical doctors and seeking alternative therapies, are seen in many carers’ efforts. Besides, trying to maintain regular activities in daily life and play normal family roles are also experienced as important. Furthermore, talking with the patient as a person is also important. The authors conclude that in order to protect the human rights of persons with mental illness, it is crucial to make the medical care system more flexible and to make the services more humane: sufficient information should be provided and communicated, and efforts should be made to maintain the person’s social roles and to support the family.

Keywords: family carers, independent living, mental health crisis, persons with mental illness

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Authors: John Ibanga

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Since May 1999, when Nigeria returned to uninterrupted democratic rule, there have been various attempts by successive governments at committing themselves to democratic ideals. Such efforts include a revision of communication policies after repeated calls by civil society organisations, development partners, researchers, and academics to allow not only the commencement of campus radio broadcasting but also the takeoff of community radio broadcasting. Thus, in 2015, operating licenses were granted to several communities spread across the six geopolitical zones in the country for the establishment of community radio stations culminating in the establishment of the first community radio in Nigeria on July 17, 2015. And, since citizens’ involvement in policy matters and governance is one of the tenets of participatory democracy, it becomes imperative to investigate how the emerging community radio sector in Nigeria is facilitating participatory democracy among Nigerians, even in the face of attempts by the present government to silence all dissenting voices. This study, therefore, examines how residents in Ondo State, Southwest Nigeria, are utilising programmes on Ejule Nen and Kakaaki community radio stations in Ondo State, Nigeria, to deepen participatory democracy. Much of the existing studies on the role of community radio in participatory democracy and citizens' engagement efforts miss out on Nigeria because of the delayed implementation of community radio policy in Nigeria being Africa’s most populous nation as well as a major player in the affairs of the African continent. While the participatory communication and communication infrastructure theories were used as framework, data were collected from in-depth interviews with staff of the community radio station and community leaders, focus group discussions with the community residents, and qualitative content analysis of programmes on the station. The residents used the community radio stations as platforms for demanding accountability from government, mobilising resources for the execution of a number of community projects, promoting credible electoral practices, and influencing the implementation of free education policy in their communities. Hence the community radio stations became the reliable and authoritative voices of residents for participating in the public sphere and, generally, the democratic process.

Keywords: community, community radio, democracy, participatory democracy

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Authors: Denver E. Severt, Cynthia Mejia

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With a grey wave sweeping across the world and people living longer than ever, more individuals will reside in retirement communities in unprecedented numbers. Enhancing the resident stay within these communities is imperative to reduce past stigmas associated with senior communities. This exploratory quantitative investigation examined interview contents of employees and residents to see if empathy was observed. The results showed the employees across all ranges had a much better grasp of affective empathy, yet with greater experience and age, it was clear that cognitive empathy had to be used with affective empathy in order to gain better trust across the community of residents. Outcomes from the study suggest that future training programs for employees are operationalized to include both affective and cognitive empathy practices. This study is unique in that two scales of empathy were transformed into qualitative questions, and in-depth employee and resident interviews were conducted. The study answers many calls of research to provide more specific studies in senior living communities.

Keywords: senior living community, transformational service research, qualitative research

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Authors: Ashok Kumar, Anjali Sharma

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As cities grow and expand spatially, redevelopment in urban India is beginning to emerge as a new mode of urban expansion sweeping low-income informal settlements. This paper examines the extent and nature of expanding urban frontier before examining implications for the families living in these settlements. Displacement of these families may appear to be an obvious consequence. However, we have conducted ethnographic studies over the past several months in a Delhi slum named Kathputli Colony, Delhi. In depth analysis of the study for this slum appears to present a variegated set of consequences for the residents of informal settlements including loss of livelihoods, dismantling of family ties, and general anxiety arising out of uncertainty about resettlement. Apart from Delhi case study, we also compare and contrast another redevelopment case from Mumbai located at Bhendi Bazar. These examples from the two mega cities of Mumbai and Delhi are analysed to understand and explore expanding urban frontiers and their consequences for informing future public policy.

Keywords: informal settlements, policy, redevelopment, urban

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Authors: Nachawit Tikul

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This study aimed to determine low-income housing adaptations for flooding, which causes living problems and housing damage, and the results from improvement. Three low-income settlements in Chiang Mai which experienced different flood types, i.e. flash floods in Samukeepattana, drainage floods in Bansanku, and river floods in Kampangam, were chosen for the study. Almost all of the residents improved their houses to protect the property from flood damage by changing building materials to flood damage resistant materials for walls, floors, and other parts of the structure that were below the base of annual flood elevation. They could only build some parts of their own homes, so hiring skilled workers or contractors was still important. Building materials which have no need for any special tools and are easy to access and use for construction, as well as low cost, are selected for construction. The residents in the three slums faced living problems for only a short time and were able to cope with them. This may be due to the location of the three slums near the city where assistance is readily available. But the housing and the existence in the slums can endure only the regular floods and residence still have problems in unusual floods, which have been experienced 1-2 times during the past 10 years. The residents accept the need for evacuations and prepare for them. When faced with extreme floods, residence have evacuated to the nearest safe place such as schools and public building, and come back to repair the houses after the flood. These are the distinguishing characteristics of low-income living which can withstand serious situations due to the simple lifestyle. Therefore, preparation of living areas for use during severe floods and encouraging production of affordable flood resistant materials should be areas of concern when formulating disaster assistance policies for low income people.

Keywords: flooding, low-income settlement, housing, adaptation

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Authors: Kathryn McMillan

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A recent study of 8500 adult Australians aged 16 and over revealed 62% had experienced childhood maltreatment. In response to multiple recommendations by bodies such as the Australian Law Reform Commission, parliamentary reports and stakeholder input, a number of key initiatives have been developed to grapple with the difficulties of a federal-state system and to screen and triage high-risk families navigating their way through the court system. The Lighthouse Project (LHP) is a world-first initiative of the Federal Circuit and Family Courts in Australia (FCFOCA) to screen family law litigants for major risk factors, including family violence, child abuse, alcohol or substance abuse and mental ill-health at the point of filing in all applications that seek parenting orders. It commenced on 7 December 2020 on a pilot basis but has now been expanded to 15 registries across the country. A specialist risk screen, Family DOORS, Triage has been developed – focused on improving the safety and wellbeing of families involved in the family law system safety planning and service referral, and ¬ differentiated case management based on risk level, with the Evatt List specifically designed to manage the highest risk cases. Early signs are that this approach is meeting the needs of families with multiple risks moving through the Court system. Before the LHP, there was no data available about the prevalence of risk factors experienced by litigants entering the family courts and it was often assumed that it was the litigation process that was fueling family violence and other risks such as suicidality. Data from the 2022 FCFCOA annual report indicated that in parenting proceedings, 70% alleged a child had been or was at risk of abuse, 80% alleged a party had experienced Family Violence, 74 % of children had been exposed to Family Violence, 53% alleged through substance misuse by party children had caused or was at risk of causing harm to children and 58% of matters allege mental health issues of a party had caused or placed a child at risk of harm. Those figures reveal the significant overlap between child protection and family violence, both of which are under the responsibility of state and territory governments. Since 2020, a further key initiative has been the co-location of child protection and police officials amongst a number of registries of the FCFOCA. The ability to access in a time-effective way details of family violence or child protection orders, weapons licenses, criminal convictions or proceedings is key to managing issues across the state and federal divide. It ensures a more cohesive and effective response to family law, family violence and child protection systems.

Keywords: child protection, family violence, parenting, risk screening, triage.

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Authors: K. Masingboon, S. Duangpaeng, N. Chaiwong

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Acute myocardial infarction (AMI) is the most common cause of death among Thai with coronary heart disease (CHD). Thai AMI survivors are most likely to have impaired health-related quality of life (HRQoL) due to their lifestyle, functional, and psychological problems. Guided by the Individual and Family Self-Management Theory, this study aimed to explore HRQoL and identify its predictors among Thai AMI survivors. 155 Thai AMI survivors were recruited by stratified random sampling from three hospitals located in eastern region of Thailand. HRQol was measured using the Short Form -12 Health Survey (SF-12). The Center for Epidemiologic studies Depression Scale (CES-D) was utilized to assess the presence of depression, and the Family Support questionnaire was administered to examine family support. Results revealed that 92 percent of Thai AMI survivors reported a generally high level of HRQoL and 80 percent of them reported higher level of HRQoL in physical health and mental health dimension. Depression and family support were significantly predicted HRQoL among Thai AMI survivors and accounted for 28.5 percent of variance (p < .001). Interestingly, depression was the most significant predictors of HRQoL (β = -.65, p < .001) In conclusion, depression is a significant predictor of HRQoL in Thai AMI survivors. Increasing awareness of depression among these survivors is important. Depressive symptoms in should be routinely assessed. In addition, intervention to improve HRQoL among Thai AMI survivors should be addressed through depressive symptom management and family collaboration.

Keywords: health-related quality of life, AMI survivors, predictors, collaboration

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Authors: Amir Ashraf

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Homoeopathy is an alternative system of medicine discovered by German physician Samuel Hahnemann in 1796. It has been used by several people for various health conditions globally for more than last 200 years. In India, homoeopathy is considered as a major system of alternative medicine. Homoeopathy is found effective in various medical conditions including Pyuria. Pyuria is the condition in which pus cells are found in urine. Homoeopathy is very useful for reducing pus cells, and homeopathically potentized Conium Mac (Hemlock) is an important remedy commonly used for reducing pyuria. Aim: To reduce the amount pus cells found in urine using Conium Mac 200C. Methods: Design. Small N Design. Samples: Purposive Sampling with 5 cases diagnosed as pyuria. Tools: Personal Data Schedule and ICD-10 Criteria for Pyuria. Techniques: Potentized homoeopathic medicine, Conium Mac 200th potency is used. Statistical Analysis: The statistical analyses were done using non-parametric tests. Results: There is significant pre/post difference has been identified. Conclusion: Homoeopathic potency, Conium Mac 200 C is effective in reducing the increased level of pus cells found in urine samples.

Keywords: homoeopathy, alternative medicine, Pyuria, Conim Mac, small N design, non-parametric tests, homeopathic physician, Ashirvad Hospital, Kannur

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Authors: Esabella Yuan

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This study explored the recollections of young carers who lived with and cared for their mentally ill parent and how they managed life difficulties in Taiwan. 19 former young carers took part in the study, conducted from July to October 2021. The findings provided the unique view that all the participants acknowledged being taught by the mainstream culture to honour family value and prioritize the needs of parents over their own ones, they stepped in to care for the ill parent out of love and out of necessity through there having no-one to turn to, they were willing to assume long-term caring responsibilities, strikingly, a much more common experience was that the participants hided parental illness and young carer identity in the community through the fear of social discrimination attached to mental illness. As a result, these former young carers stayed in hidden circumstances and coped alone with caring challenges. The findings suggest that there needs multi-disciplinary services working together to recognize the needs of young carers and provide appropriate intervention to young carers based on a family-focus approach and ensure to serve the best interests of young carers and their families. It is to be hope that young carers can grow up safely and healthily within the community.

Keywords: young carers, family well-being, mental health, parental mental illness

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Authors: Eisa Al-Balhan

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This study explores the effects of parents’ personality and family variables on aggressive behavior in children from the State of Kuwait. The sample of 117children aged between 6 and 10 years (M=7.79 years, SD =1.4 years),117 fathers, and 117mothers from Kuwait. The following tools were used: a) the Aggressive Behavior Scale for Children (ABSC), b) the Personality Scales Inventory (PSI), and c) the Family Climate Scale (FCS). The results show that there were significant differences between children with highly aggressive behavior and those with low aggressive behavior for most of the personality traits of the father and mother, as well as most of the family climate and its different dimensions according to the father’s knowledge and the mother’s knowledge. Furthermore, there was a significant difference between males and females in the total score of aggressive behavior, verbal aggression, physical aggression, self-aggression, and aggression toward others, with higher scores occurring among males. Most of the correlations of the children’s aggressive behavior were with the personality traits of the father. The personality traits of the mother, family climate, and most of its different dimensions according to the father's and mother's knowledge had significant negative correlations with the child's aggression. There was no effect of the mother's and father's education levels on their child’s aggressive behavior. There was a significant difference between normal families and separated families in the total score of aggressive behavior, verbal aggression, and self-aggression, with a higher score occurring among separated families, and there was no significant difference between the two groups in physical aggression and aggression towards others.

Keywords: aggressive behavior, personality traits of parents, family variables, parents

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Authors: Farzad Jalilian, Mehdi Mirzaei Alavijeh, Fazel Zinat Motlagh

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Social support is an important benchmark of health for people in avoidance conditions. The main goal of this study was to determine the three kinds of social support (family, friend and other significant) to drug cessation among male addicts, in Kermanshah, the west of Iran. This cross-sectional study was conducted among 132 addicts, randomly selected to participate voluntarily in the study. Data were collected from conduct interviews based on standard questionnaire and analyzed by using SPSS-18 at 95% significance level. The majority of addicts were young (Mean: 30.4 years), and with little education. Opium (36.4%), Crack (21.2%), and Methamphetamine (12.9%) were the predominant drugs. Inabilities to reject the offer and having addict friends are the most often reasons for drug usage. Almost, 18.9% reported history of drug injection. 43.2% of the participants already did drug cessation at least once. Logistic regression showed the family support (OR = 1.110), age (OR = 1.106) and drug use initiation age (OR = 0.918) was predicting drug cessation. Our result showed; family support is a more important effect among types of social support in drug cessation. It seems that providing educational program to addict’s families for more support of patients at drug cessation can be beneficial.

Keywords: drug cessation, family support, drug use, initiation age

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Authors: Ling-Lang Huang

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Research Background: Historically, the evolution of medicine has not only aimed to extend life but has also inadvertently introduced suffering in the process of maintaining life, presenting a contemporary challenge. We must carefully assess the conflict between the length of life and the quality of living. Evidence-Based Medicine (EBM) exists primarily to ensure the quality of cures. However, EBM alone does not fulfill our ultimate medical goals; we must also evaluate Value-Based Medicine (VBM) to find the best treatment for patients. Research Methodology: We can attempt to integrate EBM with VBM. Within the five steps of EBM, the first three steps (Ask—Acquire—Appraise) focus on the physical aspect of humans. However, in the fourth and fifth steps (Apply—Assess), the focus shifts from the physical to applying evidence-based treatment to the patient and assessing its effectiveness, considering a holistic approach to the individual. To consider VBM for patients, we can divide the process into three steps: The first step is "awareness," recognizing that each patient inhabits a different life-world and possesses unique differences. The second step is "integration," akin to the hermeneutic concept of the Fusion of Horizons. This means being aware of differences and also understanding the origins of these patient differences. The third step is "respect," which involves setting aside our adherence to medical objectivity and scientific rigor to respect the ultimate healthcare decisions made by individuals regarding their lives. Discussion and Conclusion: After completing these three steps of VBM, we can return to the fifth step of EBM: Assess. Our assessment can now transcend the physical treatment focus of the initial steps to align with a holistic care philosophy.

Keywords: shared decision-making, evidence-based medicine, values-based medicine, holistic healthcare

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Authors: Policarpio Jr. Joves

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Physicians in most teaching hospitals are commonly promoted into managerial roles, yet their training is mostly in clinical and scientific skills but not in leadership competencies. When they shift into roles of physician leadership, the majority hold on to their primary identity of physicians. These conflicting roles affect their identity and eventually their work. The physician leaders also face additional challenges related to academics which include incorporation of new knowledge into the existing curriculum, use of technology in the delivery of teaching, the need to train medical students outside of hospital wards, etc. The study aims to explore how physician leaders in teaching hospitals of private medical schools enact their leadership roles and how they face the challenges as physician leaders. The study setting shall be teaching hospitals of three private medical schools situated in the National Capital Region, Philippines. A multiple case study design shall be adopted in this research. Physicians shall be eligible to participate in the study if they are practicing clinicians limited to the five major clinical specialty: Internal Medicine, Pediatrics, Family Medicine, Surgery, Obstetrics and Gynecology. They must be teaching in the College of Medicine prior to their appointments as physician leaders in both medical school and teaching hospital. Semi-structured face-to-face interviews shall be utilized as a means of data collection, with open-ended questions, enabling physician leaders to present narratives about their identity, role enactment, conflicts, reaction of colleagues, and the challenges encountered in their day-to-day work as physician leaders. Interviews shall be combined with observations and review of records to gain more insights into how the physician leaders are 'doing' management. Within-case analysis shall be done initially followed by a thematic analysis across the cases, referred to as cross–case analysis or cross-case synthesis.

Keywords: academic leaders, academic managers, physician leaders, physician managers

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Authors: Bui Duc Sinh

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Ecotourism in national parks seemed to be one of the options in the conservation of the natural resources and to improve the living condition of local communities. However, ecotourism development will be useless if it lacks the perception and support of local communities and appropriate ecotourism strategies. The aims of this study were to measure residents’ perception and satisfaction towards ecotourism impacts and their attitudes for ecotourism development in Cuc Phuong National Park; to assess the current ecotourism strategies based on ecotourism criteria and then to provide recommendations on ecotourism development strategies. The primary data were collected through personal observations, in-depth interviews with residents and national park staffs, and from surveys on households in all of the five communes in the Cuc Phuong National Park. The results depicted that local communities were aware of ecotourism impacts and had positive attitudes toward ecotourism development, and were satisfied of ecotourism development. However, higher perception rate was found on specific groups such as the young, the high income and educated, and those with jobs related to ecotourism. The study revealed the issues of concerns about the current ecotourism development strategies in Cuc Phuong National Park. The major hindrances for ecotourism development were lack of local participation and unattractive ecotourism services. It was also suggested that Cuc Phuong National Park should use ecotourism criteria to implement ecotourism activities sustainably and to harmonize the sharing of benefits amongst the stakeholders. The approaches proposed were to: create local employment through reengineering, improve the ecotourism quality, appropriate tourism benefits to the stakeholders, and carry out education and training programs. Furthermore, the results of the study helped tour operators and tourism promoters aware the real concerns, issues on current ecotourism activities in Cuc Phuong National Park.

Keywords: ecotourism, ecotourism impact, local community, national park

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Authors: Shuenn-Yih Chang, Chiu-LI Huang, Ngoc-Cuong Tran

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A new family of structure-dependent integration methods, whose coefficients of the difference equation for displacement increment are functions of the initial structural properties and the step size for time integration, is proposed in this work. This family method can simultaneously integrate the controllable numerical dissipation, explicit formulation and unconditional stability together. In general, its numerical dissipation can be continuously controlled by a parameter and it is possible to achieve zero damping. In addition, it can have high-frequency damping to suppress or even remove the spurious oscillations high frequency modes. Whereas, the low frequency modes can be very accurately integrated due to the almost zero damping for these low frequency modes. It is shown herein that the proposed family method can have exactly the same numerical properties as those of HHT-α method for linear elastic systems. In addition, it still preserves the most important property of a structure-dependent integration method, which is an explicit formulation for each time step. Consequently, it can save a huge computational efforts in solving inertial problems when compared to the HHT-α method. In fact, it is revealed by numerical experiments that the CPU time consumed by the proposed family method is only about 1.6% of that consumed by the HHT-α method for the 125-DOF system while it reduces to be 0.16% for the 1000-DOF system. Apparently, the saving of computational efforts is very significant.

Keywords: structure-dependent integration method, nonlinear dynamic analysis, unconditional stability, numerical dissipation, accuracy

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Authors: Ambika Roy Bardhan

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Kolkata, the City of Joy, is a greying metropolis not only in respect of its concrete jungle but also because of the largest population of 60-plus residents that it shelters among all other cities in India. Declining birth and death rates and a negative growth of population indicate that the city has reached the last stage of demographic transition. Thus, the obvious consequence has been the ageing of its population. With this background, the present paper attempts to study the demographic and socio-economic status of the elderly population in Kolkata. Analysis and findings have been based on secondary data obtained from Census of India of various years, Sample Registration System Reports and reports by HelpAge India. Findings show that the elderly population is increasing continuously. With respect to gender, the male elderly outnumbers the female elderly population. The percentage of households having one elderly member is more in the city due to the emergence of the nuclear families and erosion of joint family system. With respect to socio-economic status, those elderly who are the heads of the family are lower in percentages than those in the other age groups. Also, male elderly as head of the family are greater in percentage than female elderly. Elderly in the category of currently married records the highest percentage followed by widowed, never married and lastly, separated or divorced. Male elderly outnumber the female elderly as currently married, while female elderly outnumbers the male elderly in the category of widowed. In terms of living status, the percentage of elderly who are living alone is highest in Kolkata and the reason for staying alone as no support from children also happens to be highest in this city. The literacy rate and higher level of education is higher among the male than female elderly. Higher percentages of female elderly have been found to be with disability. Disability in movement and multiple disabilities have been found to be more common among the elderly population in Kolkata. Percentages of male literate pensioners are highest than other categories. Also, in terms of levels of education male elderly who are graduate and above other than technical degree are the highest receivers of pension. Also, in terms of working status, elderly as non-workers are higher in percentages with the population of elderly females outnumbering the males. The old age dependency ratio in the city is increasing continuously and the ratio is higher among females than male. Thus, it can be stated that Kolkata is witnessing continuous and rapid ageing of its population. Increasing dependency ratio is likely to create pressure on the working population, available civic, social and health amenities. This requires intervention in the form of planning, formulation and implementation of laws, policies, programs and measures to safeguard and improve the conditions of the elderly in Kolkata.

Keywords: demographic, elderly, population, socio-economic

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Authors: Rajae Tahri, Omar Chokairi, Asmae Saadi, Souad Chaouir

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Background: The factors motivating students to choose a medical career is a long-standing topic of publication and discussion. To our knowledge, no national study on the motivation for choosing medical studies has been published to date. Population and methods: This is an observational, descriptive, and cross-sectional study of first-year medical students at the Faculty of Medicine and Pharmacy of Rabat. An anonymous questionnaire comprising 16 questions was developed and distributed to students during Embryology tutorials. The students were free to fill it in or not. The number of students who consented to participate in the survey was 266. The variables studied are the socio-demographic variables of the students and the reasons for choosing medical studies. Results: The most strongly and frequently chosen reasons for choice by our students were saving lives (64.9%), helping others (62.1%), love of medicine (57%), and reducing suffering (56.5%). The comparison of the results according to gender showed a significant difference between the degree of self-motivation of girls compared to that of boys (p <0.001). The reason that stood out the most for them was teamwork. The presence of a health professional in the family was associated with strong extrinsic motivation (p = 0.005). Conclusion: Understanding medical student career choices would improve our knowledge of the factors that influence medical student learning and performance. This knowledge will make it possible to adapt the educational strategies to maintain the motivation of the students throughout their course as well as during their exercise.

Keywords: motivation, motivational profiles, medical studies, Morocco

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