Search results for: health perception
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10735

Search results for: health perception

6775 Entrepreneurship Education: A Panacea for Entrepreneurial Intention of University Undergraduates in Ogun State, Nigeria

Authors: Adedayo Racheal Agbonna

Abstract:

The rising level of graduate unemployment in Nigeria has brought about the introduction of entrepreneurship education as a career option for self–reliance and self-employment. Sequel to this, it is important to have an understanding of the determining factors of entrepreneurial intention. Therefore this research empirically investigated the influence of entrepreneurship education on entrepreneurial intention of undergraduate students of selected universities in Ogun State, Nigeria. The study is significant to researchers, university policy makers, and the government. Survey research design was adopted in the study. The population consisted of 17,659 final year undergraduate students universities in Ogun State. The study adopted stratified and random sampling technique. The table of sample size determination was used to determine the sample size for this study at 95% confidence level and 5% margin error to arrive at a sample size of 1877 respondents. The elements of population were 400 level students of the selected universities. A structured questionnaire titled 'Entrepreneurship Education and students’ Entrepreneurial intention' was administered. The result of the reliability test had the following values 0.716, 0.907 and 0.949 for infrastructure, perceived university support, and entrepreneurial intention respectively. In the same vein, from the construct validity test, the following values were obtained 0.711, 0.663 and 0.759 for infrastructure, perceived university support and entrepreneurial intention respectively. Findings of this study revealed that each of the entrepreneurship education variables significantly affected intention University infrastructure B= -1.200, R²=0.679, F (₁,₁₈₇₅) = 3958.345, P < 0.05) Perceived University Support B= -1.027, R²=0.502, F(₁,₁₈₇₅) = 1924.612, P < 0.05). The perception of respondents in public university and private university on entrepreneurship education have a statistically significant difference [F(₁,₁₈₇₅) = 134.614, p < 0.05) α F(₁,₁₈₇₅) = 363.439]. The study concluded that entrepreneurship education positively influenced entrepreneurial intention of undergraduate students in Ogun State, Nigeria. Also, university infrastructure and perceived university support have negative and significant effect on entrepreneurial intention. The study recommended that to promote entrepreneurial intention of university undergraduate students, infrastructures and the university support that can arouse entrepreneurial intention of students should be put in place.

Keywords: entrepreneurship education, entrepreneurial intention, perceived university support, university infrastructure

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6774 Nutrition, Dental Status and Post-Traumatic Stress Disorder among Underage Refugees in Germany

Authors: Marios Loucas, Rafael Loucas, Oliver Muensterer

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Aim of the Study: Over the last two years, there has been a substantial rise of refugees entering Germany, of which approximately one-third are underage. Little is known about the general state of health such as nutrition, dental status and post-traumatic stress disorder among underage refugees. Our study assesses the general health status of underage refugees based on a large sample cohort. Methods: After ethics board approval, we used a structured questionnaire to collect demographic information and health-related elements in 3 large refugee accommodation centers, focusing on nutritional and dental status, as well as symptoms of posttraumatic stress disorder. Main results: A total of 461 minor refugees were included. The majority were boys (54.5%), average age was 8 years. Out of the 8 recorded countries of origin, most children came from Syria (33.6%), followed by Afghanistan (23.2%). Of the participants, 50.3% reported DSM-5 criteria of Posttraumatic stress disorder and presented mental health-related problems. The most frequently reported mental abnormalities were concentration disturbances (15.2%), sleep disorders (6.9%), unclear headaches (5.4%). The majority of the participants showed an unfavorable nutritional and dental status. According to the family, the majority of the children rarely eat healthy foods such as fruits, vegetables and fish. However, the majority of these children (over 90%) consume a large quantity of sugary foods and sweetened drinks such as soft drinks and confectionery at least daily. Caries was found in 63% of the minor children included in the study. A large proportion (47%) reported never brushing their teeth. According to the family, 78.3% of refugee children have never been evaluated by a dentist in Germany. The remainder visited a dentist mainly because of unbearable toothache. Conclusions: Minor refugees have specific psychological, nutritional and dental problems that must be considered in order to ensure appropriate medical care. Posttraumatic stress disorder is mainly caused by physical and emotional trauma suffered either during the flight or in the refugee camp in Germany. These data call for widespread screening of psychological, dental and nutritional problems in underage refugees. Dental care of this cohort is completely inadequate. Nutritional programs should focus on educating the families and providing the means to obtain healthy foods for these children.

Keywords: children, nutrition, posttraumatic stress disorder, refugee

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6773 A Review of Hypnosis Uses for Anxiety and Phobias Treatment

Authors: Fleura Shkëmbi, Sevim Mustafa, Naim Fanaj

Abstract:

Hypnosis, often known as cognitive therapy, is a sort of mind-body psychotherapy. A professional and certified hypnotist or hypnotherapist guides the patient into this extreme level of focus and relaxation during the session by utilizing verbal cues, repetition, and imagery. In recent years, hypnotherapy has gained popularity in the treatment of a variety of disorders, including anxiety and particular phobias. The term "phobia" is commonly used to define fear of a certain trigger. When faced with potentially hazardous situations, the brain naturally experiences dread. While a little dread here and there may keep us safe, phobias can drastically reduce our quality of life. In summary, persons who suffer from anxiety are considered to see particular environmental situations as dangerous, but those who do not suffer from anxiety do not. Hypnosis is essential in the treatment of anxiety disorders. Hypnosis can help patients minimize their anxiety symptoms. This broad concept has aided in the development of models and therapies for anxiety disorders such as generalized anxiety disorder, panic attacks, hypochondria, and obsessional disorders. Hypnosis techniques are supposed to be attentive and mental pictures, which is conceivable; this is why they're associated with improved working memory and visuospatial abilities. In this sense, the purpose of this study is to determine how effectively specific therapeutic methods perform in treating persons with anxiety and phobias. In addition to cognitive-behavioral therapy and other therapies, the approaches emphasized the use of therapeutic hypnosis. This study looks at the use of hypnosis and related psychotherapy procedures in the treatment of anxiety disorders. Following a discussion of the evolution of hypnosis as a therapeutic tool, neurobiological research is used to demonstrate the influence of hypnosis on the change of perception in the brain. The use of hypnosis in the treatment of phobias, stressful situations, and posttraumatic stress disorder is examined, as well as similarities between the hypnotic state and dissociative reactions to trauma. Through an extensive literature evaluation, this study will introduce hypnotherapy procedures that result in more successful anxiety and phobia treatment.

Keywords: anxiety, hypnosis, hypnotherapy, phobia, technique, state

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6772 Optimal Allocation of Oil Rents and Public Investment In Low-Income Developing Countries: A Computable General Equilibrium Analysis

Authors: Paule Olivia Akotto

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The recent literature suggests spending between 50%-85% of oil rents. However, there are not yet clear guidelines for allocating this windfall in the public investment system, while most of the resource-rich countries fail to improve their intergenerational mobility. We study a design of the optimal spending system in Senegal, a low-income developing country featuring newly discovered oil fields and low intergenerational mobility. We build a dynamic general equilibrium model in which rural and urban (Dakar and other urban centers henceforth OUC) households face different health, education, and employment opportunities based on their location, affecting their intergenerational mobility. The model captures the relationship between oil rents, public investment, and multidimensional inequality of opportunity. The government invests oil rents in three broad sectors: health and education, road and industries, and agriculture. Through endogenous productivity externality and human capital accumulation, our model generates the predominant position of Dakar and OUC households in terms of access to health, education, and employment in line with Senegal data. Rural households are worse off in all dimensions. We compute the optimal spending policy under two sets of simulation scenarios. Under the current Senegal public investment strategy, which weighs more health and education investments, we find that the reform maximizing the decline in inequality of opportunity between households, frontloads investment during the first eight years of the oil exploitation and spends the perpetual value of oil wealth thereafter. We will then identify the marginal winners and losers associated with this policy and its redistributive implications. Under our second set of scenarios, we will test whether the Senegalese economy can reach better equality of opportunity outcomes under this frontloading reform, by allowing the sectoral shares of investment to vary. The trade-off will be between cutting human capital investment in favor of agricultural and productive infrastructure or increasing the former. We will characterize the optimal policy by specifying where the higher weight should be. We expect that the optimal policy of the second set strictly dominates in terms of equality of opportunity, the optimal policy computed under the current investment strategy. Finally, we will quantify this optimal policy's aggregate and distributional effects on poverty, well-being, and gender earning gaps.

Keywords: developing countries, general equilibrium, inequality of opportunity, oil rents

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6771 The Use of Artificial Intelligence in the Prevention of Micro and Macrovascular Complications in Type Diabetic Patients in Low and Middle-Income Countries

Authors: Ebere Ellison Obisike, Justina N. Adalikwu-Obisike

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Artificial intelligence (AI) is progressively transforming health and social care. With the rapid invention of various electronic devices, machine learning, and computing systems, the use of AI istraversing many health and social care practices. In this systematic review of journal and grey literature, this study explores how the applications of AI might promote the prevention of micro and macrovascular complications in type 1 diabetic patients. This review focuses on the use of a digitized blood glucose meter and the application of insulin pumps for the effective management of type 1 diabetes in low and middle-income countries. It is projected that the applications of AI may assist individuals with type 1 diabetes to monitor and control their blood glucose level and prevent the early onset of micro and macrovascular complications.

Keywords: artificial intelligence, blood glucose meter, insulin pump, low and middle-income countries, micro and macrovascular complications, type 1 diabetes

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6770 Innovation Management in E-Health Care: The Implementation of New Technologies for Health Care in Europe and the USA

Authors: Dariusz M. Trzmielak, William Bradley Zehner, Elin Oftedal, Ilona Lipka-Matusiak

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The use of new technologies should create new value for all stakeholders in the healthcare system. The article focuses on demonstrating that technologies or products typically enable new functionality, a higher standard of service, or a higher level of knowledge and competence for clinicians. It also highlights the key benefits that can be achieved through the use of artificial intelligence, such as relieving clinicians of many tasks and enabling the expansion and greater specialisation of healthcare services. The comparative analysis allowed the authors to create a classification of new technologies in e-health according to health needs and benefits for patients, doctors, and healthcare systems, i.e., the main stakeholders in the implementation of new technologies and products in healthcare. The added value of the development of new technologies in healthcare is diagnosed. The work is both theoretical and practical in nature. The primary research methods are bibliographic analysis and analysis of research data and market potential of new solutions for healthcare organisations. The bibliographic analysis is complemented by the author's case studies of implemented technologies, mostly based on artificial intelligence or telemedicine. In the past, patients were often passive recipients, the end point of the service delivery system, rather than stakeholders in the system. One of the dangers of powerful new technologies is that patients may become even more marginalised. Healthcare will be provided and delivered in an increasingly administrative, programmed way. The doctor may also become a robot, carrying out programmed activities - using 'non-human services'. An alternative approach is to put the patient at the centre, using technologies, products, and services that allow them to design and control technologies based on their own needs. An important contribution to the discussion is to open up the different dimensions of the user (carer and patient) and to make them aware of healthcare units implementing new technologies. The authors of this article outline the importance of three types of patients in the successful implementation of new medical solutions. The impact of implemented technologies is analysed based on: 1) "Informed users", who are able to use the technology based on a better understanding of it; 2) "Engaged users" who play an active role in the broader healthcare system as a result of the technology; 3) "Innovative users" who bring their own ideas to the table based on a deeper understanding of healthcare issues. The authors' research hypothesis is that the distinction between informed, engaged, and innovative users has an impact on the perceived and actual quality of healthcare services. The analysis is based on case studies of new solutions implemented in different medical centres. In addition, based on the observations of the Polish author, who is a manager at the largest medical research institute in Poland, with analytical input from American and Norwegian partners, the added value of the implementations for patients, clinicians, and the healthcare system will be demonstrated.

Keywords: innovation, management, medicine, e-health, artificial intelligence

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6769 Early Intervention for Preschool Children of Parents with Mental Illness: The Evaluation of a Resource for Service Providers

Authors: Stella Laletas, Andrea Reupert, Melinda Goodyear, Bradley Morgan

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Background: Many people with a mental illness have young children. Research has shown that early childhood is a particularly vulnerable time for children whose parents have a mental illness. Moreover, repeated research has demonstrated the effectiveness of a multiagency approach to family focused practice for improving parental functioning and preventing adverse outcomes in children whose parents have a mental illness, particularly in the early years of a child’s life. However, there is a paucity of professional development resources for professionals who work with families where a parent has a mental illness and has young children. Significance of the study: This study will make a contribution to addressing knowledge gaps around resource development and workforce needs for early childhood and mental health professionals working with young children where a parent has a mental illness. Objective: This presentation describes a newly developed resource, 'Pathways of Care', specifically designed for early childhood educators and mental health workers, alongside pilot evaluation data regarding its effectiveness. ‘Pathways of Care’ aims to promote collaborative practice and present early identification and referral processes for workers in this sector. The resource was developed by the Children of Parents with a Mental Illness (COPMI) National Initiative which is funded by the Australian Government. Method: Using a mixed method design, the effectiveness of the training resource is also presented. Fifteen workers completed the Family Focus Mental Health Practice Questionnaire pre and post using the resource, to measure confidence and practice change; semi-structured interviews were also conducted with eight of these same workers to further explore the utility of the resource. Findings: The findings indicated the resource was effective in increasing knowledge and confidence, particularly for new and/or inexperienced staff. Examples of how the resource was used in practice by various professions emerged from the interview data. Conclusions: Collaborative practice, early identification and intervention in early childhood can potentially play a key role in altering the life trajectory of children who are at risk. This information has important implications for workforce development and staff training in both the early childhood and mental health sectors. Implications for policy and future research are discussed.

Keywords: parents with mental ilnesses, early intervention, evaluation, preschool children

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6768 Utilization of Family Planning Methods and Associated Factors among Women of Reproductive Age Group in Sunsari, Nepal

Authors: Punam Kumari Mandal, Namita Yangden, Bhumika Rai, Achala Niraula, Sabitra Subedi

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introduction: Family planning not only improves women’s health but also promotes gender equality, better child health, and improved education outcomes, including poverty reduction. The objective of this study is to assess the utilization of family planning methods and associated factors in Sunsari, Nepal. methodology: A cross-sectional analytical study was conducted among women of the reproductive age group (15-49 years) in Sunsari in 2020. Nonprobability purposive sampling was used to collect information from 212 respondents through face-to-face interviews using a Semi-structured interview schedule from ward no 1 of Barju rural municipality. Data processing was done by using SPSS “statistics for windows, version 17.0(SPSS Inc., Chicago, III.USA”). Descriptive analysis and inferential analysis (binary logistic regression) were used to find the association of the utilization of family planning methods with selected demographic variables. All the variables with P-value <0.1 in bivariate analysis were included in multivariate analysis. A P-value of <0.05 was considered to indicate statistical significance at a level of significance of 5%. results: This study showed that the mean age and standard deviation of the respondents were 26±7.03, and 91.5 % of respondent’s age at marriage was less than 20 years. Likewise, 67.5% of respondents use any methods of family planning, and 55.2% of respondents use family planning services from the government health facility. Furthermore, education (AOR 1.579, CI 1.013-2.462)., husband’s occupation (AOR 1.095, CI 0.744-1.610)., type of family (AOR 2.741, CI 1.210-6.210)., and no of living son (AOR 0.259 CI 0.077-0.872)are the factors associated with the utilization of family planning methods. conclusion: This study concludes that two-thirds of reproductive-age women utilize family planning methods. Furthermore, education, the husband’s occupation, the type of family, and no of living sons are the factors associated with the utilization of family planning methods. This reflects that awareness through mass media, including behavioral communication, is needed to increase the utilization of family planning methods.

Keywords: family planning methods, utilization. factors, women, community

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6767 Patient-Reported Adverse Reactions to Adolescent Non-Suicidal Self-Injury Disclosures and Implications for Clinical Practice

Authors: Renee Fabian, Jordan Davidson

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Current research on non-suicidal self-injury (NSSI) provides ample insights on best practices for caregivers and clinicians to address and reduce NSSI behavior among adolescents. However, the efficacy of evidenced-based NSSI interventions and their delivery from the perspective of adolescent patients does not receive significant attention, creating a gap between the efficacy of research-based NSSI interventions and adolescent perceptions of NSSI treatment and adolescent willingness to engage in NSSI interventions. To address the gap between practice and patient perspectives and inform more effective treatment outcomes, the current survey aims to identify major patient-reported adverse reactions to NSSI disclosures from caregivers, treating mental health clinicians, and medical professionals using a mixed methods survey of 2,500 people with a history of NSSI completed by editors at a consumer-facing health publication. Based on the analyzed results of the survey, a majority of adolescents with a history of NSSI found parents and caregivers ineffective at empathetically addressing NSSI, and a significant number of participants reported at least one treating mental health professional inadequately responded to NSSI behaviors, in addition to other findings of adverse reactions to NSSI disclosures that serve as a barrier to treatment. NSSI is a significant risk factor for future suicide attempts. Addressing patient-reported adverse reactions to NSSI disclosures in the adolescent population can remove barriers to the effectiveness of caregiver and clinician NSSI interventions and reduce the risk of NSSI-related harm and lower the risk of future suicide attempts or completions.

Keywords: adolescent self-injury, non-suicidal self-injury, patient perspectives, self-harm interventions

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6766 Investigating the Impact of Factors Associated with Student Academic Achievement and Expectations through the Ecosystemic Perspective in the Greek Context: The Role of the Individual, Family, School and of the Community

Authors: Olga Giovani

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In this research, Bronfenbrenner's theory will be used to investigate the individual, microsystemic, and exosystemic factors that may affect adolescents' academic achievement as well as their expectations in Greece. First, the topic of academic achievement in an adolescent developmental context will be set as the target of the proposed study while focusing on the aspects of community influences on adolescents. More specifically, the effect of available resources and the perceived sense of safety and support will be further investigated. Then the issue of family factors will be analyzed, as they are subjectively perceived by the adolescents, focusing on the perceived parental style, parental monitor, and involvement as a mesosystemic factor. In turn, the school will also be discussed with emphasis on the perceived school climate and support as well as the academic aspects of student achievement. Finally, the adolescent's individual perspective will be taken into consideration in developmental terms, examining their perceptions regarding their community/neighborhood, their family, their school, as well as their sense of self-concept and self-esteem as these are expressed through their academic performance and prosocial behavior. The aim of the proposed research is to study these associations through the prism of the systemic perspective, the relationship between aspects of educational achievement and socioeconomic background, with an emphasis on the role of the community, which has not been adequately researched in the Greek context. Community will be defined by the available community resources (recreational activities, public library, local orchestras, free entrance museums, etc.), adolescents' own perception of social support, safety, and support inside that community. These perceptions need to be investigated since they may serve as possible predictors of a child's current cognitive, developmental, and psycho-social outcomes, such as their perceived self-concept and self-esteem, as well as on their future expectations related to the entrance to university and job expectations.

Keywords: bioecological model, developmental psychology, ecosystemic approach, student achievement, microsystemic factors, mesosystemic factors, individual perceptions

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6765 Palliative Care: Optimizing the Quality of Life through Strengthening the Legal Regime of Bangladesh

Authors: Sonia Mannan, M. Jobair Alam

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The concept of palliative care in Bangladesh largely remained limited to the sympathetic caring of patients with a life-limiting illness. Quality of Life (QoL) issues are rarely practiced in Bangladesh. Furthermore, palliative medicine, in the perspective of holistic palliative care service, does not have its proper recognition in Bangladesh. Apart from those socio-medical aspects, palliative care patients face legal issues that impact their quality of life, including access to health services and social benefits and dealing with other life-transactions of the patients and their families (such as disposing of property; planning for children). This paper is an attempt to articulate these legal dimensions of the right to palliative care in the context of Bangladesh. The major focus of this paper will be founded on the doctrinal analysis of the constitutional provisions and other relevant legislation on the right to health and their judicial interpretation, which is argued to offer a meaningful space for the right to palliative care. This paper will also investigate the gaps in the said legal framework to better secure such care. In conclusion, a few recommendations are made so that the palliative care practices in Bangladesh are better aligned with international standards, and it can respond more humanely to the patients who need palliative care.

Keywords: Bangladesh, constitution, legal regime, palliative care, quality of life

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6764 Chilean Business Orientalism: The Role of Non-State Actors in the Frame of Asymmetric Bilateral Relations

Authors: Pablo Ampuero, Claudia Labarca

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The current research paper assesses how the narrative of Chilean businesspeople about China shapes a new Orientalism Analyses on the role of non-state actors in foreign policy that have hitherto theorized about Orientalism as a narrative of hegemonic power. Hence, it has been instrumental to the efforts of imperialist powers to justify their mission civilisatrice. However, such conceptualization can seldom explain new complexities of international interactions at the height of globalization. Hence, we assessed the case of Chile, a small Latin American country, and its relationship with China, its largest trading partner. Through a discourse analysis of interviews with Chilean businesspeople engaged in the Chinese market, we could determine that Chile is building an Orientalist image of China. This new business Orientalism reinforces a relation of alterity based on commercial opportunities, traditional values, and natural dispositions. Hence, the perception of the Chinese Other amongst Chilean business people frames a new set of representations as part of the essentially commercial nature of current bilateral relations. It differs from previous frames, such as the racial bias frame of the early 20th century, or the anti-communist frame in reaction to Mao’s leadership. As in every narrative of alterity, there is not only a construction of the Other but also a definition of the Self. Consequently, this analysis constitutes a relevant case of the role of non-state actors in asymmetrical bilateral relations, where the non-state actors of the minor power build and act upon an Orientalist frame, which is not representative of its national status in the relation. This study emerges as a contribution on the relation amongst non-state actors in asymmetrical relations, where the smaller power’s business class acts on a negative prejudice of its interactions with its counterpart. The research builds upon the constructivist approach to international relations, linking the idea of Nation Branding with Orientalism in the case of Chile-China relations.

Keywords: new business Orientalism, small power, framing, Chile-China relations

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6763 Feeding Patterns and Diarrhea Incidence Among Children in Bangladesh: A Study Using Data from Demographic and Health Survey, 2014

Authors: Iqbal Ahmed Chowdhury

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Diarrhea is considered to be one of the influential factors of child death in Bangladesh. While it is known that diarrhea is a water-driven disease, due to the lack of studies, little is known about the extent to which various feeding patterns contribute to such an incidence. Our paper intends to fill this gap by looking into different feeding patterns and their influence on diarrhea incidence among children in Bangladesh. Using data collected for the Demographic and Health Survey, 2014, this paper reveals that feeding patterns can influence the diarrhea incidence among this group of children to a great extent. This paper finds that the incidence of diarrhea is likely to elevate if diarrhea-affected children are fed plain water from any source and any kind of juice. However, breastfeeding, feeding soup or clear broth, prescribed baby food, and clean water from a tube well tend to help fight diarrhea incidence among children in Bangladesh. The results are found to be consistent even after controlling for sociodemographic variables, including age and sex of children, age and education qualification of the parent, and the number of children in the family. The results of this study could contribute to treating diarrhea among children in Bangladesh as well as similar other countries in the world.

Keywords: feeding patterns, diarrhea, Bangladesh, children

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6762 Men's Decision Making: The Determinant of Home Delivery among Women in Khyber Pakhtunkhwa Pakistan

Authors: Hussain Ali, Ahmad Ali, Syed Rashid Ali

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The maternal mortality is one of the basic health issues faced by rural women in Pakistan. There are various structural and socio-cultural determinants which confine women to domestic sphere. Such mobility restriction compels women for home delivery which causes high maternal mortality and morbidity. However, it is hard to find out the research findings and well-organized literature that explain the cultural factors act as determinant to home delivery among Pakhtun women. The overall objective of this research is to study men’s decision making within the household in Pakhtun society as determinant of home delivery among Pakhtun women in Khyber Pakhtunkhwa province of Pakistan. In the present study, researchers used the quantitative research design in which the data are collected through household survey technique from (n=503) ever-married women having reproductive age (15-49 years) by using interview schedule. The data are analyzed through SPSS, and binary logistic regression was applied to draw the association between home as a place of delivery and men’s decision making in the Pakhtun society. The results show that majority (76%) of the husbands are key decision makers about the home delivery due to their superior position within household. Similarly, majority (88%) Pakhtun women prefer to stay in home for their delivery due to their dependency on husband’s decision. The researcher concludes that men are key decision makers in Pakhtun society and their decisions affect women maternal health care. Similarly, the women are in subordinate position, and their limited decision making in the domestic sphere are greatly responsible for home delivery which causing high maternal mortality rate in the study area. In order to achieve Sustainable Development Goal No. 3, the study recommends empowering women in the decision making about accessing and utilizing maternal health care services and given financial autonomy to them.

Keywords: home delivery, men’s decision, Pakhtun women, subordinate position

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6761 Perceived Family Functioning 12 Months after the COVID-19 Outbreak Has Been Declared a Global Pandemic

Authors: Snezana Svetozarevic

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The aim of the research was to determine whether there were significant changes in perceptions of family functioning by families in Serbia 12 months after the coronavirus (COVID-19) outbreak has been declared a global pandemic. Above all, what has protected families in the face of the global crisis caused by COVID-19. The Self-Report Family Inventory, II version (SFI-II; Beavers and Hampson, 2013) and the Inventory of Family Protective Factors (IFPF; Gardner et al., 2008) were used to assess family functioning and protective factors. Currently, families perceive their functioning as more problematic regarding family emotional expressiveness, conflict, cohesion, and global family health/competence. Adaptive appraisal based on positive coping experiences significantly predicted values on emotional expressiveness, conflict, leadership, and global family health/competence dimensions -a higher prevalence of this factor was associated with more optimal family functioning and fewer problems. The growing problem in family functioning with the beginning of the pandemic is inevitable. However, our research confirmed that it is not enough to take into account what families do to survive. It is equally important to learn about what they do to thrive i.e., to study the family resilience.

Keywords: family, coping, resilience, pandemic, COVID-19

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6760 The People's Tribunal: Empowerment by Survivors for Survivors of Child Abuse

Authors: Alan Collins

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This study explains how The People’s Tribunal empowered survivors of child abuse. It examines how People’s tribunals can be effective mean of empowerment; the challenges of empowerment – expectation v. reality; the findings and how they reflect other inquiry findings; and the importance of listening and learning from survivors. UKCSAPT “The People’s Tribunal” was established by survivors of child sex abuse and members of civil society to investigate historic cases of institutional sex abuse. The independent inquiry, led by a panel of four judges, listened to evidence spanning four decades from survivors and experts. A common theme throughout these accounts showed that a series of institutional failures prevented abuse from being reported; and that there are clear links between children being rendered vulnerable by these failures and predatory abuse on an organised scale. It made a series of recommendations including the establishment of a permanent and open forum for victims to share experiences and give evidence, better links between mental health services and police investigations, and training for police and judiciary professionals on the effects of undisclosed sexual abuse. The main findings of the UKCSAPT report were:-There are clear links between children rendered vulnerable by institutional failures and predatory abuse on an organised scale, even if these links often remain obscure. -UK governmental institutions have failed to provide survivors with meaningful opportunities for either healing or justice. -The vital mental health needs of survivors are not being met and this undermines both their psychological recovery and access to justice. -Police and other authorities often lack the training to understand the complex reasons for the inability of survivors to immediately disclose a history of abuse. -Without far-reaching changes in institutional culture and practices, the sexual abuse of children will continue to be a significant scourge in the UK. The report also outlined a series of recommendations for improving reporting and mental health provision, and access to justice for victims were made, including: -A permanent, government-funded popular tribunal should be established to enable survivors to come forward and tell their stories. -Survivors giving evidence should be assigned an advocate to assist their access to justice. -Mental health services should be linked to police investigations to help victims disclose abuse. -Victims who fear reprisals should be provided with a channel though which to give evidence anonymously.

Keywords: empowerment, survivors, sexual, abuse

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6759 No-Fee Shot for Life: Immune Defense from Covid-19, Acute Debilitation and Untimely Death through Vaccinations for Ages 60 and Above, Protection of the Elderly and Seniors

Authors: Maeah Stephanie A. Macapaz Abadejos

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Covid-19 shook the whole world. Every person on all sides of the world was affected by the pandemic. All the nations and world leaders were searching for a variety of cures and solutions to stop the spread of the virus. In connection with this, this investigative case study aims to show a relationship between COVID-19 vaccinations to the immune system of the seniors and elderly. The seniors and elderly are one of the most vulnerable populations that show high morbidity and mortality in any illnesses and diseases. This study will show lived experiences of the senior’s immune system and health status, how it is being affected by the COVID-19 virus and its vaccines, Risk for COVID-19 Infection, Hospitalization, and Death by Age Group. Participants of this study are from 3 Cebu City Barangays and 2 from Barangays of the Cities of the Cebu Province. To conclude, this study shall serve its purpose of providing clear and concise results in strengthening the evidence of the effects of the COVID-19 virus infection, especially the free vaccinations, on the health and overall well-being of the elderly and seniors.

Keywords: gerontology nursing, vaccination, protection and immunity, seniors and the elderly

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6758 Identifying Degradation Patterns of LI-Ion Batteries from Impedance Spectroscopy Using Machine Learning

Authors: Yunwei Zhang, Qiaochu Tang, Yao Zhang, Jiabin Wang, Ulrich Stimming, Alpha Lee

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Forecasting the state of health and remaining useful life of Li-ion batteries is an unsolved challenge that limits technologies such as consumer electronics and electric vehicles. Here we build an accurate battery forecasting system by combining electrochemical impedance spectroscopy (EIS) -- a real-time, non-invasive and information-rich measurement that is hitherto underused in battery diagnosis -- with Gaussian process machine learning. We collect over 20,000 EIS spectra of commercial Li-ion batteries at different states of health, states of charge and temperatures -- the largest dataset to our knowledge of its kind. Our Gaussian process model takes the entire spectrum as input, without further feature engineering, and automatically determines which spectral features predict degradation. Our model accurately predicts the remaining useful life, even without complete knowledge of past operating conditions of the battery. Our results demonstrate the value of EIS signals in battery management systems.

Keywords: battery degradation, machine learning method, electrochemical impedance spectroscopy, battery diagnosis

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6757 Socio-Economic Inequality in Breastfeeding Patterns in India

Authors: Ankita Shukla

Abstract:

The promotion and support of breastfeeding is a global priority with benefits for maternal and infant health, especially in low income and middle-income countries where the probability of child survival is still very low. In India too it has been well established that breastfeeding increases the survival of the child. However, the breastfeeding levels are quite low in the country. Examining the socio-economic inequality in breastfeeding pattern can help to the causal pathways responsible for early breastfeeding termination. This paper tries to understand the socio-economic differential in breastfeeding patterns among Indian women. Data is used from nationally representative National Family Health Survey-3. Using Cox regression modelling techniques, the analysis found that the likelihood of having small breastfeeding duration increased with increasing household wealth status similarly education also has negative effect on breastfeeding duration. The considerable gender difference is also visible in India, likelihood of stopping breastfeeding was significantly higher among female children compared with male children. To understand the cultural factors or norms responsible for the early termination of breastfeeding more in depth/qualitative studies are needed.

Keywords: breastfeeding, India, socio-economic inequality, women education

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6756 Changes in the Demand of Waterway Passengers During COVID-19 Pandemic: Case Study of Belém-Marajó Island, in Brazil

Authors: Maisa Sales Gama Tobias, Humberto de Paiva Junior, Luciano Silva Brito, Rui António Rodrigues Ramos

Abstract:

Waterway transport in the Amazon was the first means of access and occupation in the region. For the economic and social matter of high importance, still nowadays one of the main transport modes to several places in the region. To some places, still the only transport mode. With the advent of the pandemic, transport companies that already faced management challenges began to experience unprecedented structural changes and trends in trade and global supply chains. Thus, companies need operational reorganization to maintain the sustainability of the service under the penalty of loss of demand. Allied to this fact, it was observed that the demand presented behavior changes to adapt to this new moment. However, the lack of information about these changes makes it difficult to find solutions to maintain the quality of service. This work aimed to characterize the changes in the demand of waterway passengers through an empirical study with field research involving interviews with users and crew, on-board journeys, and visits to the waterway service company. The case study is the route Belém-Camara, on Marajó Island, in the state of Pará. This line is traditionally the only means of transport for this route, besides air transport on a much smaller scale. The collected data had a descriptive and analytical statistical treatment presented in this work. As the main result, the COVID-19 pandemic has caused significant changes, mainly in trip time and motives and, in the perception itself on service quality by part of the demand, with the increase of trip time and the feeling of insecurity. In conclusion, the service operator must review cost management and business survival strategies and tactics. The viability of the service and the social guarantee of transport proved to be threatened, putting at risk the service to the riverside populations.

Keywords: demand of waterway transport passengers, data analysis, COVID-19, amazonia

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6755 Turkey in Minds: Cognitive and Social Representation of "East" and "West"

Authors: Feyzan Tuzkaya, Nihan S. Soylu, Caglar Solak, Mehmet Peker, Hilal Peker, Kemal Ozeralp, Ceren Mete, Ezgi Mehmetoglu, Mehmet Karasu, Cihan Elci, Ece Akca, Melek Goregenli

Abstract:

Perception, evaluation and representation of the environment have been the subject of many disciplines including psychology, geography and architecture. In environmental and social psychology literature there are several evidences which suggest that cognitive representations about a place consisted of not only geographic items but also social and cultural. Mental representations of residence area or a country is influenced and determined by social-demographics, the physical and social context. Thus, all mental representations of a given place are also social representations. Cognitive maps are the main and common instruments that are used to identify spatial images and the difference between physical and subjective environments. The aim of the current study is investigating the mental and social representations of Turkey in university students’ minds. Data was collected from 249 university students from different departments (i.e. psychology, geography, history, tourism departments) of Ege University. Participants were requested to reflect Turkey in their mind onto the paper drawing sketch maps. According to the results, cognitive maps showed geographic aspects of Turkey as well as the context of symbolic, cultural and political reality of Turkey. That is to say, these maps had many symbolic and verbal items related to critics on social and cultural problems, ongoing ethnic and political conflicts, and actual political agenda of Turkey. Additionally, one of main differentiations in these representations appeared in terms of the East and West side of the Turkey, and the representations of the East and West was varied correspondingly participants’ cultural background, their ethnic values, and where they have born. The results of the study were discussed in environmental and social psychological perspective considering cultural and social values of Turkey and current political circumstances of the country.

Keywords: cognitive maps, East, West, politics, social representations, Turkey

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6754 Transforming Maternity and Neonatal Services in a Middle Eastern Country

Authors: M. A. Brown, K. Hugill, D. Meredith

Abstract:

Since the establishment of midwifery, as a professional identity in its own right, in the early years of the 20th century, midwifery-led models of childbirth have prevailed in many parts of the world. However, in many locations midwives’ scope of practice remains underdeveloped or absent. In Qatar, all births take place in hospital and are under the professional jurisdiction of obstetricians, predominately supported by internationally trained nurse-midwives and obstetric nurses. The strategic vision for health services in Qatar endorsed a desire to provide women with the ‘Best Care Always’ and the introduction of midwifery was seen as a way to achieve this. In 2015 the process of recruiting postgraduate educated Clinical Midwife Specialists from international sources began. The midwives were brought together to initiate an in hospital and community service transformation plan. This plan set out a series of wide-ranging actions to transform maternity and neonatal services to make care safer and give women more health choices. Change in any organization is a complex and dynamic process. This is made even more complex when multifaceted professional and cross cultural factors are involved. This presentation reports upon the motivations and challenges that exist and the progress around introducing a multicultural midwifery model of childbirth care in the state of Qatar. The paper examines and reflects upon the drivers and unique features of childbirth in the country. Despite accomplishments, progress still needs to be made in order to fully implement sustainable changes to further improve care and ensure women and neonates get the ‘Best Care Always’. The progress within the transformation plan highlights how midwifery may coexist with competing models of maternity care to create an innovative, eclectic and culturally sensitive paradigm that can best serve women and neonatal health needs.

Keywords: culture, managing change, midwifery, neonatal, service transformation plan

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6753 The Incidence of Incomplete Abortion and the Prevalence of Abortion-Related Morbidity in South African Public Hospitals, 2018

Authors: Daphney Nozizwe Conco, Jonathan Levin, Boitumelo Komane, Sharon Fonn

Abstract:

Background: South Africa is globally renowned for its reproductive rights framework. Despite the progressive abortion legislation, evidence points to limited access to safe abortion due to stigma, provider opposition, and lack of trained providers. Consequently, women resort to informal abortion providers and later present with incomplete abortion (ICA) at public hospitals. 20 years after the passing of the Choice for Termination of Pregnancy Act (CTOPA), we hypothesized that the incidence of ICA and abortion-related morbidity would change, influenced by access to safe abortion care and the availability of medication abortion. The aim was to generate data that could be compared with the results of similar studies conducted in 1994 and 2000. Objectives: The research objectives were to determine the number of women who presented with ICA to public hospitals, to describe their characteristics, to categorize medical complications according to severity, and to describe treatment provided to them at South African public hospitals. Methods: This is a cross-sectional retrospective medical record review study. A stratified random sample of public hospitals was selected. Data was extracted from the medical records of women who presented with incomplete abortions to sampled public hospitals in 2018. Data was captured directly into a REDCap database. To estimate the national prevalence of incomplete abortions, we used population estimates for 2018 comprising 17,199,227 women aged 12-49 years and 1,200,436 live births. Results: We found 913 medical records of women who presented with ICA to the 52 sampled hospitals. The women’s mean age of 27 years, and most had a previous pregnancy. These results were similar in the three studies (2018, 2000, and 1994). A greater proportion of women admitted with a gestation between 0-12 weeks seem to be on the increase, 60.5% in 1994, 67.1% in 2000, and 73.9% in 2024. We found an ICA incidence of 362 (269-455) per 100 000 women aged 12­49 years, which was the same as the 2000 incidence of 362 (282­441) but lower than the incidence of 375 (299­451) in 1994. Signs of infection decreased over time: 79.5% in 1994, 90.1% in 2000, and 92.5% in 2018 had no signs of infection. Similarly, 95.6% in 1994, 97.1% in 2000 and 99.1% in 2018 recorded no organ failure. Conclusion: A trend of lower infection rates was observed, suggesting that women are getting safer abortions, possibly from informal providers. However, the lack of change in ICA incidence indicates that the implementation of CTOPA has failed. It is safe to conclude that the legislation has made no significant impact on women’s health and rights. The implications of such failure are profound, as South Africa has not effectively implemented the act, which has important consequences for women’s health and rights.

Keywords: incomplete abortion, abortion-related morbidity, safe-abortion, South Africa public health, sexual and reproductive health rights, women’s health

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6752 Implementing Mindfulness into Wellness Plans: Assisting Individuals with Substance Abuse and Addiction

Authors: Michele M. Mahr

Abstract:

The purpose of this study is to educate, inform, and facilitate scholarly conversation and discussion regarding the implementation of mindfulness techniques when working with individuals with substance use disorder (SUD) or addictive behaviors in mental health. Mindfulness can be recognized as the present moment, non-judgmental awareness, initiated by concentrated attention that is non-reactive and as openheartedly as possible. Individuals with SUD or addiction typically are challenged with triggers, environmental situations, cravings, or social pressures which may deter them from remaining abstinent from their drug of choice or addictive behavior. Also, mindfulness is recognized as one of the cognitive and behavioral treatment approaches and is both a physical and mental practice that encompasses individuals to become aware of internal situations and experiences with undivided attention. That said, mindfulness may be an effective strategy for individuals to employ during these experiences. This study will reveal how mental health practitioners and addiction counselors may find mindfulness to be an essential component of increasing wellness when working with individuals seeking mental health treatment. To this end, mindfulness is simply the ability individuals have to know what is actually happening as it is occurring and what they are experiencing at the moment. In the context of substance abuse and addiction, individuals may employ breathing techniques, meditation, and cognitive restructuring of the mind to become aware of present moment experiences. Furthermore, the notion of mindfulness has been directly connected to the development of neuropathways. The creation of the neural pathways then leads to creating thoughts which leads to developing new coping strategies and adaptive behaviors. Mindfulness strategies can assist individuals in connecting the mind with the body, allowing the individual to remain centered and focused. All of these mentioned above are vital components to recovery during substance abuse and addiction treatment. There are a variety of therapeutic modalities applying the key components of mindfulness, such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy for depression (MBCT). This study will provide an overview of both MBSR and MBCT in relation to treating individuals with substance abuse and addiction. The author will also provide strategies for readers to employ when working with clients. Lastly, the author will create and foster a safe space for discussion and engaging conversation among participants to ask questions, share perspectives, and be educated on the numerous benefits of mindfulness within wellness.

Keywords: mindfulness, wellness, substance abuse, mental health

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6751 Microbial Assessment of Dairy Byproducts in Albania as a Basis for Consumer Safety

Authors: Klementina Puto, Ermelinda Nexhipi, Evi Llaka

Abstract:

Dairy by-products are a fairly good environment for microorganisms due to their composition for their growth. Microbial populations have a significant impact in the production of cheese, butter, yogurt, etc. in terms of their organoleptic quality and at the same time some also cause their breakdown. In this paper, the microbiological contamination of soft cheese, butter and yogurt produced in the country (domestic) and imported is assessed, as an indicator of hygiene with impact on public health. The study was extended during September 2018-June 2019 and was divided into three periods, September-December, January-March, and April-June. During this study, a total of 120 samples were analyzed, of which 60 samples of cheese and butter locally produced, and 60 samples of imported soft cheese and butter productions. The microbial indicators analyzed are Staphylococcus aureus and E. coli. Analyzes have been conducted at the Food Safety Laboratory (FSIV) in Tirana in accordance with EU Regulation 2073/2005. Sampling was performed according to the specific international standards for these products (ISO 6887 and ISO 8261). Sampling and transport of samples were done under sterile conditions. Also, coding of samples was done to preserve the anonymity of subjects. After the analysis, the country's soft cheese products compared to imports were more contaminated with S. aureus and E. coli. Meanwhile, the imported butter samples that were analyzed, resulted within norms compared to domestic ones. Based on the results, it was concluded that the microbial quality of samples of cheese, butter and yogurt analyzed remains a real problem for hygiene in Albania. The study will also serve business operators in Albania to improve their work to ensure good hygiene on the basis of the HACCP plan and to provide a guarantee of consumer health.

Keywords: consumer, health, dairy, by-products, microbial

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6750 Observations of Conformity in the Health Professions

Authors: Tanya Beran, Michelle Drefs, Ghazwan Altabbaa, Nouf Al Harbi, Noof Al Baz, Elizabeth Oddone Paolucci

Abstract:

Although research shows that interprofessional practice has desirable effects on patient care, its implementation can present challenges to its team members. In particular, they may feel pressured to agree with or conform to other members who share information that is contrary to their own understanding. Obtaining evidence of this phenomenon is challenging, as team members may underreport their conformity behaviors due to reasons such as social desirability. In this paper, a series of studies are reviewed in which several approaches to assessing conformity in the health care professions are tested. Simulations, questionnaires, and behavior checklists were developed to measure conformity behaviors. Insights from these studies show that a significant proportion of people conform either in the presence or absence of others, express a variety of verbal and nonverbal behaviors when considering whether to conform to others, may shift between conforming and moments later not conforming (and vice versa), and may not accurately report whether they conformed. A new method of measuring conformity using the implicit bias test is also discussed. People at all levels in the healthcare system are encouraged to develop both formal and informal.

Keywords: conformity, decision-making, inter-professional teams, simulation

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6749 Ta(l)king Pictures: Development of an Educational Program (SELVEs) for Adolescents Combining Social-Emotional Learning and Photography Taking

Authors: Adi Gielgun-Katz, Alina S. Rusu

Abstract:

In the last two decades, education systems worldwide have integrated new pedagogical methods and strategies in lesson plans, such as innovative technologies, social-emotional learning (SEL), gamification, mixed learning, multiple literacies, and many others. Visual language, such as photographs, is known to transcend cultures and languages, and it is commonly used by youth to express positions and affective states in social networks. Therefore, visual language needs more educational attention as a linguistic and communicative component that can create connectedness among the students and their teachers. Nowadays, when SEL is gaining more and more space and meaning in the area of academic improvement in relation to social well-being, and taking and sharing pictures is part of the everyday life of the majority of people, it becomes natural to add the visual language to SEL approach as a reinforcement strategy for connecting education to the contemporary culture and language of the youth. This article presents a program conducted in a high school class in Israel, which combines the five SEL with photography techniques, i.e., Social-Emotional Learning Visual Empowerments (SELVEs) program (experimental group). Another class of students from the same institution represents the control group, which is participating in the SEL program without the photography component. The SEL component of the programs addresses skills such as: troubleshooting, uncertainty, personal strengths and collaboration, accepting others, control of impulses, communication, self-perception, and conflict resolution. The aim of the study is to examine the effects of programs on the level of the five SEL aspects in the two groups of high school students: Self-Awareness, Social Awareness, Self-Management, Responsible Decision Making, and Relationship Skills. The study presents a quantitative assessment of the SEL programs’ impact on the students. The main hypothesis is that the students’ questionnaires' analysis will reveal a better understanding and improvement of the five aspects of the SEL in the group of students involved in the photography-enhanced SEL program.

Keywords: social-emotional learning, photography, education program, adolescents

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6748 Daily Dietary Intake and Cognitive Functioning among Population in Malaysia

Authors: Khor Khai Ling, Vashnarekha A/P Kumarasuriar, Tan Kok Wei, Ooi Pei Boon

Abstract:

The food pyramid had been stressed for years and used to promote a healthy diet. Recently, the Ministry of Health in Malaysia has changed the food pyramid structure. They moved fruits and vegetables to the bottom layer and encouraged citizens to consume more fruits and vegetables. Past research has shown that the amount of vegetables and fruits consumption has associated with cognitive health. However, Malaysians have yet to achieve the amount of fruit and vegetable intake as per recommendation. Thus, this study aims to investigate Malaysian’s habitual diet and cognitive functioning via a cross-sectional study. One hundred and ninety-three participants will be recruited via convenient sampling. A Food Frequency Questionnaire (FFQ) measures the habitual diet, and an online cognitive test measures attention, executive functioning, and memory objectively. The collected one hundred samples to the date of abstract submission, and the data collection is still in progress. This study will provide an insight to Malaysian about the diet pattern and its relationship with cognitive performance.

Keywords: attention, cognitive, executive functioning, habitual diet, memory

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6747 Community-Based Palliative Care for Patients with Cerebral Palsy and Developmental Disabilities

Authors: Elizabeth Grier, Meg Gemmill, Mary Martin, Leora Reiter, Herman Tang, Alexandra Donaldson, Isis Lunsky, Mia Wu

Abstract:

Background: Individuals with Cerebral Palsy (CP) and/or IDD face numerous physical and mental health challenges, including difficulty accessing effective palliative care. The aim of this study is to assess the knowledge and comfort of healthcare providers in providing community-based palliative care for patients with Cerebral Palsy (CP) and severe to profound Intellectual and Developmental Disabilities (IDD). Methods: This study includes a mixed methods approach obtaining both quantitative and qualitative data. Quantitative data from palliative care practitioners was obtained through an online survey assessing comfort in symptom management, grief assessment, and goals of care discussion. This survey was distributed to physicians and allied health practitioners across Canada through the College of Family Physicians of Canada Member Interest Groups for Palliative Care and for IDD. Survey results guided the development of a semi-structured interview template, which was used to conduct a focus group on the same topic. Participants were four palliative care providers (3 physicians and one spiritual care practitioner). The focus group transcript is currently undergoing thematic analysis using NVivo 12 software. Results: 57 palliative care practitioners completed the survey. 87% of participants indicated they have provided palliative care services for persons with CP and/or IDD. Findings suggest practitioners are somewhat confident in identifying specific physical symptoms (dyspnea, pressure ulcers) but less confident in identifying physical/emotional pain, addressing grief, and prognosticating life expectancy in this population. 54% of responses indicated they had little/no training on palliating those with CP or IDD, and 45% somewhat or strongly disagree members of their profession can manage symptoms for this population. Focus group analysis is underway, and results will be available at the time of the poster presentation. Conclusion: Persons with CP and IDD are more likely to experience severe health inequities when accessing palliative care. Results of this study suggest further education is needed for palliative care professionals to address the barriers and challenges in providing palliative care to this patient population.

Keywords: palliative care, symptom management, health equity, community healthcare, intellectual and developmental disabilities

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6746 A Case Study of An Artist Diagnosed with Schizophrenia-Using the Graphic Rorschach (Digital version) “GRD”

Authors: Maiko Kiyohara, Toshiki Ito

Abstract:

In this study, we used a psychotherapy process for patient with dissociative disorder and the graphic Rorschach (Digital version) (GRD). A dissociative disorder is a type of dissociation characterized by multiple alternating personalities (also called alternate identity or another identity). "dissociation" is a state in which consciousness, memory, thinking, emotion, perception, behavior, body image, and so on are divided and experienced. Dissociation symptoms, such as lack of memory, are seen, and the repetition of blanks in daily events causes serious problems in life. Although the pathological mechanism of dissociation has not yet been fully elucidated, it is said that it is caused by childhood abuse or shocking trauma. In case of Japan, no reliable data has been reported on the number of patients and prevalence of dissociative disorders, no drug is compatible with dissociation symptoms, and no clear treatment has been established. GRD is a method that the author revised in 2017 to a Graphic Rorschach, which is a special technique for subjects to draw language responses when enforce Rorschach. GRD reduces the burden on both the subject and the examiner, reduces the complexity of organizing data, improves the simplicity of organizing data, and improves the accuracy of interpretation by introducing a tablet computer during the drawing reaction. We are conducting research for the purpose. The patient in this case is a woman in her 50s, and has multiple personalities since childhood. At present, there are about 10 personalities whose main personality is just grasped. The patients is raising her junior high school sons as single parent, but personal changes often occur at home, which makes the home environment inferior and economically oppressive, and has severely hindered daily life. In psychotherapy, while a personality different from the main personality has appeared, I have also conducted psychotherapy with her son. In this case, the psychotherapy process and the GRD were performed to understand the personality characteristics, and the possibility of therapeutic significance to personality integration is reported.

Keywords: GRD, dissociative disorder, a case study of psychotherapy process, dissociation

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