Search results for: frequent English writing errors
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4140

Search results for: frequent English writing errors

120 Perception of Health Care Providers: A Need to Introduce Screening of Maternal Mental Health at Primary Health Care in Nepal

Authors: Manisha Singh, Padam Simkhada

Abstract:

Background: Although mental health policy has been adapted in Nepal since 1997, the implementation of the policy framework is yet to happen. The fact that mental health services are largely concentrated in urban areas more specific to treatment only provides a clear picture of the scarcity of mental health services in the country. The shreds of evidence from around the world, along with WHO’s (World Health Organization) Mental Health Gap Action Program (mhGAP) suggest that effective mental health services can be provided from Primary Health Care (PHC) centers through community-based programs without having to place a specialized health worker. However, the country is still facing the same challenges to date with very few psychiatrists and psychologists, but they are largely based in cities. Objectives: The main objectives of this study are; (a) to understand the perception of health workers at PHC on maternal mental health, and (b) to assess the availability of the mental health services at PHC to address maternal mental health. Methods: This study used a qualitative approach where an in-depth interview was conducted with the health workers at the primary level. “Mayadevi” rural municipality in Rupendehi District that comprised of 13 small villages, was chosen as the study site. A total 8 health institutions which covered all 13 sites were included where either the health post in- charge or health worker working in maternal and child health care was interviewed for the study. All the health posts in the study area were included in the study. The interviews were conducted in Nepali; later, they were translated in English, transcribed, and triangulated. NViVO was used for the analysis. Results: The findings show that most of the health workers understood what maternal mental health was and deemed it as a public health issue. They could explain the symptoms and knew what medication to prescribe if need be. However, the majority of them failed to name the screening tools in place for maternal mental health. Moreover, they hadn’t even seen one. None of the health care centers had any provision for screening mental health status. However, one of the centers prescribed medication when the patients displayed symptoms of depression. But they believed there were a significant number of hidden cases in the community due to the stigma around mental health and being a woman with mental health problem makes the situation even difficult. Nonetheless, the health workers understood the importance of having screening tools and acknowledged the need of training and support in order to provide the services from PHC. Conclusion: Community health workers can identify cases with mental health problems and prevent them from deteriorating further. But there is a need for robust training and support to build the capacity of the health workers. The screening tools on mental health needs to be encouraged to be used in the PHC levels. Furthermore, community-based culture-sensitive programs need to be initiated and implemented to mitigate the stigma related issues around mental health.

Keywords: maternal mental health, health care providers, screening, Nepal

Procedia PDF Downloads 117
119 Clinico-pathological Study of Xeroderma Pigmentosa: A Case Series of Eight Cases

Authors: Kakali Roy, Sahana P. Raju, Subhra Dhar, Sandipan Dhar

Abstract:

Introduction: Xeroderma pigmentosa (XP) is a rare inherited (autosomal recessive) disease resulting from impairment in DNA repair that involves recognition and repair of ultraviolet radiation (UVR) induced DNA damage in the nucleotide excision repair pathway. Which results in increased photosensitivity, UVR induced damage to skin and eye, increased susceptibility of skin and ocular cancer, and progressive neurodegeneration in some patients. XP is present worldwide, with higher incidence in areas having frequent consanguinity. Being extremely rare, there is limited literature on XP and associated complications. Here, the clinico-pathological experience (spectrum of clinical presentation, histopathological findings of malignant skin lesions, and progression) of managing 8 cases of XP is presented. Methodology: A retrospective study was conducted in a pediatric tertiary care hospital in eastern India during a ten-year period from 2013 to 2022. A clinical diagnosis was made based on severe sun burn or premature photo-aging and/or onset of cutaneous malignancies at early age (1st decade) in background of consanguinity and autosomal recessive inheritance pattern in family. Results: The mean age of presentation was 1.2 years (range of 7month-3years), while three children presented during their infancy. Male to female ratio was 5:3, and all were born of consanguineous marriage. They presented with dermatological manifestations (100%) followed by ophthalmic (75%) and/or neurological symptoms (25%). Patients had normal skin at birth but soon developed extreme sensitivity to UVR in the form of exaggerated sun tanning, burning, and blistering on minimal sun exposure, followed by abnormal skin pigmentation like freckles and lentiginosis. Subsequently, over time there was progressive xerosis, atrophy, wrinkling, and poikiloderma. Six patients had varied degree of ocular involvement, while three of them had severe manifestation, including madarosis, tylosis, ectropion, Lagopthalmos, Pthysis bulbi, clouding and scarring of the cornea with complete or partial loss of vision, and ophthalmic malignancies. 50% (n=4) cases had skin and ocular pre-malignant (actinic keratosis) and malignant lesions, including melanoma and non melanoma skin cancer (NMSC) like squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) in their early childhood. One patient had simultaneous occurrence of multiple malignancies together (SCC, BCC, and melanoma). Subnormal intelligence was noticed as neurological feature, and none had sensory neural hearing loss, microcephaly, neuroregression, or neurdeficit. All the patients had been being managed by a multidisciplinary team of pediatricians, dermatologists, ophthalmologists, neurologists and psychiatrists. Conclusion: Although till date there is no complete cure for XP and the disease is ultimately fatal. But increased awareness, early diagnosis followed by persistent vigorous protection from UVR, and regular screening for early detection of malignancies along with psychological support can drastically improve patients’ quality of life and life expectancy. Further research is required on formulating optimal management of XP, specifically the role and possibilities of gene therapy in XP.

Keywords: childhood malignancies, dermato-pathological findings, eastern India, Xeroderma pigmentosa

Procedia PDF Downloads 67
118 Improving the Accuracy of Stress Intensity Factors Obtained by Scaled Boundary Finite Element Method on Hybrid Quadtree Meshes

Authors: Adrian W. Egger, Savvas P. Triantafyllou, Eleni N. Chatzi

Abstract:

The scaled boundary finite element method (SBFEM) is a semi-analytical numerical method, which introduces a scaling center in each element’s domain, thus transitioning from a Cartesian reference frame to one resembling polar coordinates. Consequently, an analytical solution is achieved in radial direction, implying that only the boundary need be discretized. The only limitation imposed on the resulting polygonal elements is that they remain star-convex. Further arbitrary p- or h-refinement may be applied locally in a mesh. The polygonal nature of SBFEM elements has been exploited in quadtree meshes to alleviate all issues conventionally associated with hanging nodes. Furthermore, since in 2D this results in only 16 possible cell configurations, these are precomputed in order to accelerate the forward analysis significantly. Any cells, which are clipped to accommodate the domain geometry, must be computed conventionally. However, since SBFEM permits polygonal elements, significantly coarser meshes at comparable accuracy levels are obtained when compared with conventional quadtree analysis, further increasing the computational efficiency of this scheme. The generalized stress intensity factors (gSIFs) are computed by exploiting the semi-analytical solution in radial direction. This is initiated by placing the scaling center of the element containing the crack at the crack tip. Taking an analytical limit of this element’s stress field as it approaches the crack tip, delivers an expression for the singular stress field. By applying the problem specific boundary conditions, the geometry correction factor is obtained, and the gSIFs are then evaluated based on their formal definition. Since the SBFEM solution is constructed as a power series, not unlike mode superposition in FEM, the two modes contributing to the singular response of the element can be easily identified in post-processing. Compared to the extended finite element method (XFEM) this approach is highly convenient, since neither enrichment terms nor a priori knowledge of the singularity is required. Computation of the gSIFs by SBFEM permits exceptional accuracy, however, when combined with hybrid quadtrees employing linear elements, this does not always hold. Nevertheless, it has been shown that crack propagation schemes are highly effective even given very coarse discretization since they only rely on the ratio of mode one to mode two gSIFs. The absolute values of the gSIFs may still be subject to large errors. Hence, we propose a post-processing scheme, which minimizes the error resulting from the approximation space of the cracked element, thus limiting the error in the gSIFs to the discretization error of the quadtree mesh. This is achieved by h- and/or p-refinement of the cracked element, which elevates the amount of modes present in the solution. The resulting numerical description of the element is highly accurate, with the main error source now stemming from its boundary displacement solution. Numerical examples show that this post-processing procedure can significantly improve the accuracy of the computed gSIFs with negligible computational cost even on coarse meshes resulting from hybrid quadtrees.

Keywords: linear elastic fracture mechanics, generalized stress intensity factors, scaled finite element method, hybrid quadtrees

Procedia PDF Downloads 130
117 The Process of Irony Comprehension in Young Children: Evidence from Monolingual and Bilingual Preschoolers

Authors: Natalia Banasik

Abstract:

Comprehension of verbal irony is an example of pragmatic competence in understanding figurative language. The knowledge of how it develops may shed new light on the understanding of social and communicative competence that is crucial for one's effective functioning in the society. Researchers agree it is a competence that develops late in a child’s development. One of the abilities that seems crucial for irony comprehension is theory of mind (ToM), that is the ability to understand that others may have beliefs, desires and intentions different from one’s own. Although both theory of mind and irony comprehension require the ability to understand the figurative use of the false description of the reality, the exact relationship between them is still unknown. Also, even though irony comprehension in children has been studied for over thirty years, the results of the studies are inconsistent as to the age when this competence are acquired. The presented study aimed to answer questions about the developmental trajectories of irony comprehension and ascribing function to ironic utterances by preschool children. Specifically, we were interested in how it is related to the development of ToM and how comprehension of the function of irony changes with age. Data was collected from over 150 monolingual, Polish-speaking children and (so far) thirty bilingual children speaking Polish and English who live in the US. Four-, five- and six-year-olds were presented with a story comprehension task in the form of audio and visual stimuli programmed in the E-prime software (pre-recorded narrated stories, some of which included ironic utterances, and pictures accompanying the stories displayed on a touch screen). Following the presentation, the children were then asked to answer a series of questions. The questions checked the children’s understanding of the intended utterance meaning, evaluation of the degree to which it was funny and evaluation of how nice the speaker was. The children responded by touching the screen, which made it possible to measure reaction times. Additionally, the children were asked to explain why the speaker had uttered the ironic statement. Both quantitive and qualitative analyses were applied. The results of our study indicate that for irony recognition there is a significant difference among the three age groups, but what is new is that children as young as four do understand the real meaning behind the ironic statement as long as the utterance is not grammtically or lexically complex also, there is a clear correlation of ToM and irony comprehension. Although four-year olds and six-year olds understand the real meaning of the ironic utterance, it is not earlier than at the age of six when children start to explain the reason of using this marked form of expression. They talk about the speaker's intention to tell a joke, be funny, or to protect the listener's emotions. There are also some metalinguistic references, such as "mommy sometimes says things that don't make sense and this is called a metaphor".

Keywords: child's pragmatics, figurative speech, irony comprehension in children, theory of mind and irony

Procedia PDF Downloads 300
116 Deconstructing and Reconstructing the Definition of Inhuman Treatment in International Law

Authors: Sonia Boulos

Abstract:

The prohibition on ‘inhuman treatment’ constitutes one of the central tenets of modern international human rights law. It is incorporated in principal international human rights instruments including Article 5 of the Universal Declaration of Human Rights, and Article 7 of the International Covenant on Civil and Political Rights. However, in the absence of any legislative definition of the term ‘inhuman’, its interpretation becomes challenging. The aim of this article is to critically analyze the interpretation of the term ‘inhuman’ in international human rights law and to suggest a new approach to construct its meaning. The article is composed of two central parts. The first part is a critical appraisal of the interpretation of the term ‘inhuman’ by supra-national human rights law institutions. It highlights the failure of supra-national institutions to provide an independent definition for the term ‘inhuman’. In fact, those institutions consistently fail to distinguish the term ‘inhuman’ from its other kin terms, i.e. ‘cruel’ and ‘degrading.’ Very often, they refer to these three prohibitions as ‘CIDT’, as if they were one collective. They were primarily preoccupied with distinguishing ‘CIDT’ from ‘torture.’ By blurring the conceptual differences between these three terms, supra-national institutions supplemented them with a long list of specific and purely descriptive subsidiary rules. In most cases, those subsidiary rules were announced in the absence of sufficient legal reasoning explaining how they were derived from abstract and evaluative standards embodied in the prohibitions collectively referred to as ‘CIDT.’ By opting for this option, supra-national institutions have created the risk for the development of an incoherent body of jurisprudence on those terms at the international level. They also have failed to provide guidance for domestic courts on how to enforce these prohibitions. While blurring the differences between the terms ‘cruel,’ ‘inhuman,’ and ‘degrading’ has consequences for the three, the term ‘inhuman’ remains the most impoverished one. It is easy to link the term ‘cruel’ to the clause on ‘cruel and unusual punishment’ originating from the English Bill of Rights of 1689. It is also easy to see that the term ‘degrading’ reflects a dignatarian ideal. However, when we turn to the term ‘inhuman’, we are left without any interpretative clue. The second part of the article suggests that the ordinary meaning of the word ‘inhuman’ should be our first clue. However, regaining the conceptual independence of the term ‘inhuman’ requires more than a mere reflection on the word-meaning of the term. Thus, the second part introduces philosophical concepts related to the understanding of what it means to be human. It focuses on ‘the capabilities approach’ and the notion of ‘human functioning’, introduced by Amartya Sen and further explored by Martha Nussbaum. Nussbaum’s work on the basic human capabilities is particularly helpful or even vital for understanding the moral and legal substance of the prohibition on ‘inhuman’ treatment.

Keywords: inhuman treatment, capabilities approach, human functioning, supra-national institutions

Procedia PDF Downloads 267
115 A Bilingual Didactic Sequence about Biological Control to Develop the Scientific Literacy on High School Students

Authors: André Melo Franco Lorena De Barros, Elida Geralda Campos

Abstract:

The bilingual education has just started in Brazils public schools. This paper is a didactic sequence of biology bilingual lessons about biologic control in the Brazilian Savana. This sequence has been applied in the first year of a bilingual education program in the only public English and Portuguese bilingual high school in Brazil. The aim of this work is to develop and apply a didactic sequence capable of developing the scientific literacy through the bilingual education associated with Problem Based Learning. This didactic sequence was applied in a class of 30 students. It was divided in three lessons. In the first lesson the students were divided in groups and received a fiction Letter from a mayor explaining the problem and asking students for help. The organic soy plantation of the mayor’s is been attacked by caterpillars. The students read the text then raised hypothesis of how they could solve the problem. In the second lesson the students searched online to verify if theirs hypothesis were correct and to find answers for the question proposed. In the third lesson the groups got together and discussed about their results and wrote a final essay with the answers for the problem proposed. The tools used to acquire information about the didactic sequence were: researcher’s diary, survey, interview and essay developed by the students. Most of the initial hypothesis couldn’t answer the problem properly. By the second lesson most of the students could answer properly. During the third lesson all the groups figured out suitable answers. The forms of biological control, birds habits and transgenic were deeply studied by the students. This methodology was successful for developing the scientific literacy with most of the students and also concluded that the quality of learning is directly associated with the effort of each student during the process. [ARAÚJO, Denise Lino de. O que é (e como se faz) sequência didática. Entrepalavras, Fortaleza, v. 3, n. 3, p.322-334, jul. 2013.] [FRANCO, Aline Aparecida et al. Preferência alimentar de Anticarsia gemmatalis Hübner (Lepidoptera: Noctuidae) por cultivares de soja. Científica: Revista de Ciências Agrárias, Jaboticabal, v. 1, n. 42, p.32-38, 29 jan. 2014.] [RIBEIRO, Luis Roberto de Camargo. Aprendizagem baseada em problemas (PBL): Uma experiência no ensino superior. São Carlos: Editora da Universidade Federal de São Carlos Ribeiro, 2008. 151 p.] [TRIVELATO, Sílvia L. Frateschi; TONIDANDEL, Sandra M. Rudella. Ensino Por Investigação: Eixos Organizadores Para Sequências De Ensino De Biologia. Ensaio Pesquisa em Educação em Ciências, Belo Horizonte, v. 17, n. especial, p.97-114, nov. 2015.].

Keywords: Bilingual Education, Environmental Education, Problem Based Learning, Science education

Procedia PDF Downloads 173
114 Architecture, Politics and Religion Synthesis: Political Legitimacy in Early Islamic Iran

Authors: Fahimeh Ghorbani, Alam Saleh

Abstract:

Ideology, politics and art have always been omnipresent patterns of Islam since its early age. The Islamic empire, expanded from China to Andalusia, has instrumentalized art and architecture to enhance political legitimacy of different dynasties or states throughout its history. Quranic verses utilized to convey ideological messages in the major mosques and mausoleums. Iranians had already been employing art and architecture to propagate their political legitimacy prior to Islam. The land of Iran and its art with strong civilizational pre-Islamic history has been profoundly politicized since the rise of Islam in the region. Early Islamic period in Iran has witnessed introduction of a new architectural language, new formulas for spatial configuration in built spaces, as well as new system of architectural decoration. Studying Iran’s Early Islamic architecture helps in better understanding the process of socio-political identity making of Iranian-Islamic culture, and thus art and architecture. This period also set the stage for formation of glorious architectural movements through Persianate world in later periods. During the Early Islamic period in Iran, the innovative combination of Islamic ideology and Iranian Architecture created formidable ideological tools in politicizing art in the region and beyond. As such, this paper aims to investigate the political history and architectural legacy from late Sassanid to Early Islamic period, delves into the ways in which Early Islamic architecture played role in transforming Persian concepts of kingship, administration, and social organization. In so doing, the study focuses on the Perso-Islamic architectural synthesis under the Samanids and Seljuk dynasty as case studies. The paper also explores how the newly introduced Islamic architecture has been employed to address the question of political legitimacy and to propagate states’ political agenda in early Islamic Iran (650-1250). As for the existing literature, despite its uniqueness and significance, Early Islamic architecture of Iran has received little scholarly attention. However, there exists a sizeable body of scholarship on socio-historic condition of the land of Iran during Early Islamic period which provide a solid base for the project. Methodologically speaking, the authors look into the subject through various lenses. They will conduct historic and archival research in libraries, private collections, and archives in Iran and the related neighbouring countries in Persian, Arabic and English. The methods of visual and formal analysis are applied to examine architectural features of the period. There are also a high number of intriguing, yet poorly examined, published and unpublished documents, old plans, drawings and photos of monuments preserved in Cultural Heritage of Iran Organization which will be consulted.

Keywords: Iran, Islamic architecture, early Islamic Iran, early Islamic architecture, politicized art, political legitimacy, propaganda, aesthetics

Procedia PDF Downloads 109
113 An Examination of Crisis Communication in Sport: Lessons from Sport Organizations Responding to Coronavirus Disease Outbreak

Authors: Geumchan Hwang

Abstract:

Professional sport leagues in Europe and North America are shut down due to novel coronavirus disease (COVID-19) outbreak. Football leagues in Europe (e.g., La Liga, English Premier League, Bundesliga, Serie A, and Ligue 1) and big four professional sport leagues in North America (e.g., National Football League, Major League Baseball, National Basketball Association, and National Hockey League) are indefinitely suspended or delayed. COVID-19 outbreak has a growing negative impact on economics of sport leagues. For example, loss of revenue in Europe’s top five leagues due to the COVID-19 pandemic was estimated at € 4 billion and loss of revenue in the NBA was estimated at $650 million as of March 2020. In the unprecedented difficult situation, sport teams and leagues try to communicate with sport fans through diverse media platforms. In sport, however, very few studies have been done regarding how sport organizations effectively communicate with sport fans during pandemics, such as COVID-19 outbreak. Understanding sport organizations’ crisis communication is important to develop effective crisis management strategies for sport organizations. Therefore, the purpose of the study is to examine how sport organizations communicate with sport fans via online platforms in COVID-19 outbreak and how sport fans evaluate their communication strategies. 9 official sport league sites (i.e., five major football leagues in Europe and four major sport leagues in North America) and COVID-19 news articles published between January and June in 2020 will be analyzed in terms of coronavirus information, teams and players’ live update, fan interaction, fan support, and community engagement. In addition, comments posted on social media sites (i.e., Facebook and Twitter) of major sport leagues will be also analyzed to examine how sport fans perceive online messages provided by sport leagues as an effective communication strategy. To measure the effectiveness of crisis communication performance, five components (i.e., prompt, compassionate, honest, informative, and interactive) of crisis communication will be collected from leagues’ official websites information and social media posts. Upon completing data collection, content analysis method will be used to evaluate effectiveness of crisis communication among 9 professional sport leagues. The results of the study will provide athletic directors, administrators, and public relations managers in sport organizations with practical information regarding how athlete celebrities and sport organizations should interact with their fans in pandemic situations. In particular, this study will contribute to developing specific crisis management plan for sport organizations. For instance, football teams and leagues in Europe will be able to create standard manuals to minimize damages caused by disease outbreak, such as COVID-19 outbreak.

Keywords: COVID-19, communication, sport leagues, fans

Procedia PDF Downloads 127
112 Review on Recent Dynamics and Constraints of Affordable Housing Provision in Nigeria: A Case of Growing Economic Precarity

Authors: Ikenna Stephen Ezennia, Sebnem Onal Hoscara

Abstract:

Successive governments in Nigeria are faced with the pressing problem of how to house an ever-expanding urban population, usually low-income earners. The question of housing and affordability presents a complex challenge for these governments, as the commodification of housing links it inextricably to markets and capital flows. Therefore, placing it as at the center of the government’s agenda. However, the provision of decent and affordable housing for average Nigerians has remained an illusion, despite copious schemes, policies and programs initiated and carried out by various successive governments. Similarly, this phenomenon has also been observed in many countries of Africa, which is largely a result of economic unpredictability, lack of housing finance and insecurity, among other factors peculiar to a struggling economy. This study reviews recent dynamics and factors challenging the provision and development of affordable housing for the low income urban populace of Nigeria. Thus, the aim of the study is to present a comprehensive approach for understanding recent trends in the provision of affordable housing for Nigerians. The approach is based on a new paradigm of research: transdisciplinarity; a form of inquiry that crosses the boundaries of different disciplines. Therefore, the review takes a retrospective gaze at the various housing development programs/schemes/policies taken by successive governments of Nigeria within the last few decades and exams recent efforts geared towards eradicating the problems of housing delivery. Sources of data included relevant English language articles and the results of literature search of Elsevier Science Direct, ISI Web of Knowledge, Pro Quest Central, Scopus, and Google Scholar. The findings reveal that factors such as; rapid urbanization, inadequate planning and land use control, lack of adequate and favorable finance, high prices of land, high prices of building material, youth/touts harassment of developers, poor urban infrastructure, multiple taxation, and risk share are the major factors posing as a hindrance to adequate housing delivery. The results show that the majority of Nigeria’s affordable housing schemes, programs and policies are in most cases poorly implemented and abandoned without proper coordination. Consequently, the study concludes that the affordable housing delivery strategies in Nigeria are an epitome of lip service politics by successive governments; and the current trend of leaving housing provision to the vagaries of market forces cannot be expected to support affordable housing especially for the low income urban populace.

Keywords: affordable housing, housing delivery, national housing policy, urban poor

Procedia PDF Downloads 202
111 IN-SEAN: The Pace of Economic Cooperation between India and ASEAN

Authors: Eumsin Payan

Abstract:

The article desires the Association of Southeast Asian Nations (ASEAN) to take interest in the policies and give importance to India over other powerful countries in the World, including powerful countries in Asia, comprising of: People’s Republic of China (PRC), Russia, and India countries with the ability to drive the Asian continent, specifically, the ASEAN Economic Community (AEC). (Japan was incapable of stepping up to become the leader of ASEAN due to the fact that Japan has created “wounds” from military history with too many countries in Asia, including wounds from the Greater East Asia War, combining with economic problems Japan is currently facing and also several natural disasters, therefore Japan is not considered a good option of our era.) China appears to be an option that stands out, which could be seen through countless published articles in the general public. However, this article desires to propose India as an option to develop and drive the relationship between ASEAN countries in the future development of Computer Science Technology and allow India to be the leader in driving the Asian Economy in place of China and the United States. As for Russia, its location is distant and apart from South East Asia. Moreover, Russia does not give as much importance to ASEAN. In this light, the author perceives that India already has the “Look East” policy. Therefore, it would be simple for ASEAN to look back at India by simply starting cooperation through policies related to collaboration in the areas of computer science. In effect, this will continuously adjust and improve the relationship towards cooperation in the areas of economics, society, and culture. Referring to the above, the author suggests a word that could be used to call the relationship between India and ASEAN, INSEAN or IN-SEAN. Hereinafter, the author hopes that Thailand, in the position of one in the five founders of ASEAN, could become the leader or be the entity that pushes forward the ASEAN policies that will increase the importance of looking towards India. India is an emerging giant that has the ability to step up in Asia. With the proficient use of English, India is able to pass on the knowledge and drive the ASEAN’s Economic relationship better than China or Russia, as faced with higher language barriers. Moreover, India has cultivated democratic civilization from the colonization of the British Empire, similar to other nations of Southeast Asia, which are familiar with various heritage cultures that the British has brought them. The most important aspect in the author’s perspective is the fact that India is not aggressive and that they have courtesy. Through developing policies of the East through the “Look East” policy, it enabled India to establish a more smooth relationship with Asian countries comparing to China. China has imposed harsh policies towards democracy to the land above the South China Sea, which directly affect the ASEAN countries. From the above reasons, India, therefore, is an appropriate option in the establishment of a closer relationship with ASEAN, as the author has proposed relationship as INSEAN or IN-SEAN.

Keywords: IN-SEAN, INSEAN, look west policy, look east policy, ASEAN, India

Procedia PDF Downloads 632
110 Teacher’s Role in the Process of Identity Construction in Language Learners

Authors: Gaston Bacquet

Abstract:

The purpose of this research is to explore how language and culture shape a learner’s identity as they immerse themselves in the world of second language learning and how teachers can assist in the process of identity construction within a classroom setting. The study will be conducted as an in-classroom ethnography, using a qualitative methods approach and analyzing students’ experiences as language learners, their degree of investment, inclusion/exclusion, and attitudes, both towards themselves and their social context; the research question the study will attempt to answer is: What kind of pedagogical interventions are needed to help language learners in the process of identity construction so they can offset unequal conditions of power and gain further social inclusion? The following methods will be used for data collection: i) Questionnaires to investigate learners’ attitudes and feelings in different areas divided into four strands: themselves, their classroom, learning English and their social context. ii) Participant observations, conducted in a naturalistic manner. iii) Journals, which will be used in two different ways: on the one hand, learners will keep semi-structured, solicited diaries to record specific events as requested by the researcher (event-contingent). On the other, the researcher will keep his journal to maintain a record of events and situations as they happen to reduce the risk of inaccuracies. iv) Person-centered interviews, which will be conducted at the end of the study to unearth data that might have been occluded or be unclear from the methods above. The interviews will aim at gaining further data on experiences, behaviors, values, opinions, feelings, knowledge and sensory, background and demographic information. This research seeks to understand issues of socio-cultural identities and thus make a significant contribution to knowledge in this area by investigating the type of pedagogical interventions needed to assist language learners in the process of identity construction to achieve further social inclusion. It will also have applied relevance for those working with diverse student groups, especially taking our present social context into consideration: we live in a highly mobile world, with migrants relocating to wealthier, more developed countries that pose their own particular set of challenges for these communities. This point is relevant because an individual’s insight and understanding of their own identity shape their relationship with the world and their ability to continue constructing this relationship. At the same time, because a relationship is influenced by power, the goal of this study is to help learners feel and become more empowered by increasing their linguistic capital, which we hope might result in a greater ability to integrate themselves socially. Exactly how this help will be provided will vary as data is unearthed through questionnaires, focus groups and the actual participant observations being carried out.

Keywords: identity construction, second-language learning, investment, second-language culture, social inclusion

Procedia PDF Downloads 95
109 Underage Internal Migration from Rural to Urban Areas of Ethiopia: The Perspective of Social Marketing in Controlling Child Labor

Authors: Belaynesh Tefera, Ahmed Mohammed, Zelalem Bayisa

Abstract:

This study focuses on the issue of underage internal migration from rural to urban areas in Ethiopia, specifically in the context of child labor. It addresses the significant disparities in living standards between rural and urban areas, which motivate individuals from rural areas to migrate to urban areas in search of better economic opportunities. The study was conducted in Addis Ababa, where there is a high prevalence of underage internal migrants engaged in child labor due to extreme poverty in rural parts of the country. The aim of this study is to explore the life experiences of shoe-makers who have migrated from rural areas of Ethiopia to Addis Ababa. The focus is on understanding the factors that push these underage individuals to migrate, the challenges they face, and the implications for child labor. This study adopts a qualitative approach, using semistructured face-to-face interviews with underage migrants. A total of 27 interviews were conducted in Addis Ababa, Ethiopia, until the point of data saturation. The criteria for selecting interviewees include working as shoemakers and migrating to Addis Ababa underage, below 16 years old. The interviews were audio-taped, transcribed into Amharic, and then translated into English for analysis. The study reveals that the major push factors for underage internal migration are socioeconomic and environmental factors. Despite improvements in living standards for underage migrants and their families, there is a high prevalence of child labor and lack of access to education among them. Most interviewees migrated without the accompaniment of their family members and faced various challenges, including sleeping on the streets. This study highlights the role of social marketing in addressing the issues of underage internal migration and child labor. It suggests that social marketing can be an effective strategy to protect children from abuse, loneliness, and harassment during their migration process. The data collection involved conducting in-depth interviews with the underage migrants. The interviews were transcribed and translated for analysis. The analysis focused on identifying common themes and patterns within the interview data. The study addresses the factors contributing to underage internal migration, the challenges faced by underage migrants, the prevalence of child labor, and the potential role of social marketing in addressing these issues. The study concludes that although Ethiopia has policies against child internal migration, it is difficult to protect underage laborers who migrate from rural to urban areas due to the voluntary nature of their migration. The study suggests that social marketing can serve as a solution to protect children from abuse and other challenges faced during migration.

Keywords: underage, internal migration, social marketing, child labor, Ethiopia

Procedia PDF Downloads 62
108 The Physiological Effects of Thyriod Disorders During the Gestatory Period on Fetal Neurological Development: A Descriptive Review

Authors: Vanessa Bennemann, Gabriela Laste, Márcia Inês Goettert

Abstract:

The gestational period is a phase in which the pregnant woman undergoes constant physiological and hormonal changes, which are part of the woman’s biological cycle, the development of the fetus, childbirth, and lactation. These are factors of response to the immunological adaptation of the human reproductive process that is directly related to the pregnancy’s well-being and development. Although most pregnancies occur without complications, about 15% of pregnant women will develop potentially fatal complications, implying maternal and fetal risk. Therefore, requiring specialized care for high-risk pregnant women (HRPW) with obstetric interventions for the survival of the mother and/or fetus. Among the risk factors that characterize HRPW are the women's age, gestational diabetes mellitus (GDM), autoimmune diseases, infectious diseases such as syphilis and HIV, hypertension (SAH), preeclampsia, eclampsia, HELLP syndrome, uterine contraction abnormalities, and premature placental detachment (PPD), thyroid disorders, among others. Thus, pregnancy has an impact on the thyroid gland causing changes in the functioning of the mother's thyroid gland, altering the thyroid hormone (TH) profiles and production as pregnancy progresses. Considering, throughout the gestational period, the interpretation of the results of the tests to evaluate the thyroid functioning depends on the stage in which the pregnancy is. Thyroid disorders are directly related to adverse obstetric outcomes and in child development. Therefore, the adequate release of TH is important for a pregnancy without complications and optimal fetal growth and development. Objective: Investigate the physiological effects caused by thyroid disorders in the gestational period. Methods: A search for articles indexed in PubMed, Scielo, and MDPI databases, was performed using the term “AND”, with the descriptors: Pregnancy, Thyroid. With several combinations that included: Melatonin, Thyroidopathy, Inflammatory processes, Cytokines, Anti-inflammatory, Antioxidant, High-risk pregnancy. Subsequently, the screening was performed through the analysis of titles and/or abstracts. The criteria were: including clinical studies in general, randomized or not, in the period of 10 years prior to the research, in the English literature; excluded: experimental studies, case reports, research in the development phase. Results: In the preliminary results, a total of studies (n=183) were found, (n=57) excluded, such as studies of cancer, diabetes, obesity, and skin diseases. Conclusion: To date, it has been identified that thyroid diseases can impair the fetus’s brain development. Further research is suggested on this matter to identify new substances that may have a potential therapeutic effect to aid the gestational period with thyroid diseases.

Keywords: pregnancy, thyroid, melatonin, high-risk pregnancy

Procedia PDF Downloads 124
107 Thematic Analysis of Ramayana Narrative Scroll Paintings: A Need for Knowledge Preservation

Authors: Shatarupa Thakurta Roy

Abstract:

Along the limelight of mainstream academic practices in Indian art, exist a significant lot of habitual art practices that are mutually susceptible in their contemporary forms. Narrative folk paintings of regional India has successfully dispersed to its audience social messages through pulsating pictures and orations. The paper consists of images from narrative scroll paintings on ‘Ramayana’ theme from various neighboring states as well as districts in India, describing their subtle differences in style of execution, method, and use of material. Despite sharing commonness in the choice of subject matter, habitual and ceremonial Indian folk art in its formative phase thrived within isolated locations to yield in remarkable variety in the art styles. The differences in style took place district wise, cast wise and even gender wise. An open flow is only evident in the contemporary expressions as a result of substantial changes in social structures, mode of communicative devices, cross-cultural exposures and multimedia interactivities. To decipher the complex nature of popular cultural taste of contemporary India it is important to categorically identify its root in vernacular symbolism. The realization of modernity through European primitivism was rather elevated as a perplexed identity in Indian cultural margin in the light of nationalist and postcolonial ideology. To trace the guiding factor that has still managed to obtain ‘Indianness’ in today’s Indian art, researchers need evidences from the past that are yet to be listed in most instances. They are commonly created on ephemeral foundations. The artworks are also found in endangered state and hence, not counted much friendly for frequent handling. The museums are in dearth of proper technological guidelines to preserve them. Even though restoration activities are emerging in the country, the existing withered and damaged artworks are in threat to perish. An immediacy of digital achieving is therefore envisioned as an alternative to save this cultural legacy. The method of this study is, two folded. It primarily justifies the richness of the evidences by conducting categorical aesthetic analysis. The study is supported by comments on the stylistic variants, thematic aspects, and iconographic identities alongside its anthropological and anthropomorphic significance. Further, it explores the possible ways of cultural preservation to ensure cultural sustainability that includes technological intervention in the form of digital transformation as an altered paradigm for better accessibility to the available recourses. The study duly emphasizes on visual description in order to culturally interpret and judge the rare visual evidences following Feldman’s four-stepped method of formal analysis combined with thematic explanation. A habitual design that emerges and thrives within complex social circumstances may experience change placing its principle philosophy at risk by shuffling and altering with time. A tradition that respires in the modern setup struggles to maintain timeless values that operate its creative flow. Thus, the paper hypothesizes the survival and further growth of this practice within the dynamics of time and concludes in realization of the urgency to transform the implicitness of its knowledge into explicit records.

Keywords: aesthetic, identity, implicitness, paradigm

Procedia PDF Downloads 354
106 Survival Analysis after a First Ischaemic Stroke Event: A Case-Control Study in the Adult Population of England.

Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski

Abstract:

Stroke is associated with a significant risk of morbidity and mortality. There is scarcity of research on the long-term survival after first-ever ischaemic stroke (IS) events in England with regards to effects of different medical therapies and comorbidities. The objective of this study was to model the all-cause mortality after an IS diagnosis in the adult population of England. Using a retrospective case-control design, we extracted the electronic medical records of patients born prior to or in year 1960 in England with a first-ever ischaemic stroke diagnosis from January 1986 to January 2017 within the Health and Improvement Network (THIN) database. Participants with a history of ischaemic stroke were matched to 3 controls by sex and age at diagnosis and general practice. The primary outcome was the all-cause mortality. The hazards of the all-cause mortality were estimated using a Weibull-Cox survival model which included both scale and shape effects and a shared random effect of general practice. The model included sex, birth cohort, socio-economic status, comorbidities and medical therapies. 20,250 patients with a history of IS (cases) and 55,519 controls were followed up to 30 years. From 2008 to 2015, the one-year all-cause mortality for the IS patients declined with an absolute change of -0.5%. Preventive treatments to cases increased considerably over time. These included prescriptions of statins and antihypertensives. However, prescriptions for antiplatelet drugs decreased in the routine general practice since 2010. The survival model revealed a survival benefit of antiplatelet treatment to stroke survivors with hazard ratio (HR) of 0.92 (0.90 – 0.94). IS diagnosis had significant interactions with gender and age at entry and hypertension diagnosis. IS diagnosis was associated with high risk of all-cause mortality with HR= 3.39 (3.05-3.72) for cases compared to controls. Hypertension was associated with poor survival with HR = 4.79 (4.49 - 5.09) for hypertensive cases relative to non-hypertensive controls, though the detrimental effect of hypertension has not reached significance for hypertensive controls, HR = 1.19(0.82-1.56). This study of English primary care data showed that between 2008 and 2015, the rates of prescriptions of stroke preventive treatments increased, and a short-term all-cause mortality after IS stroke declined. However, stroke resulted in poor long-term survival. Hypertension, a modifiable risk factor, was found to be associated with poor survival outcomes in IS patients. Antiplatelet drugs were found to be protective to survival. Better efforts are required to reduce the burden of stroke through health service development and primary prevention.

Keywords: general practice, hazard ratio, health improvement network (THIN), ischaemic stroke, multiple imputation, Weibull-Cox model.

Procedia PDF Downloads 169
105 Obesity and Lifestyle of Students in Roumanian Southeastern Region

Authors: Mariana Stuparu-Cretu, Doina-Carina Voinescu, Rodica-Mihaela Dinica, Daniela Borda, Camelia Vizireanu, Gabriela Iordachescu, Camelia Busila

Abstract:

Obesity is involved in the etiology or acceleration of progression of important non-communicable diseases, such as: metabolic, cardiovascular, rheumatological, oncological and depression. It is a need to prevent the obesity occurrence, like a key link in disease management. From this point of view, the best approach is to early educate youngsters upon the need for a healthy nutrition lifestyle associated with constant physical activities. The objective of the study was to assess correlations between weight condition, physical activities and food preferences of students from South East Romania. Questionnaires were applied on high school students in Galati: 1006 girls and 880 boys, aged between 14 and 19 years (being approved by Local School Inspectorate and the Ethics Committee of the 'Dunarea de Jos' University of Galati). The collected answers have been statistically processed by using the multivariate regression method (PLS2) by Unscramble X program (Camo, Norway). Multiple variables such as age group, body mass index, nutritional habits and physical activities were separately analysed, depending on gender and general mathematical models were proposed to explain the obesity trend at an early age. The study results show that overweight and obesity are present in less than a fifth of the adolescents who were surveyed. With a very small variation and a strong correlation of over 86% for 99% of the cases, a general preference for sweet foods, nocturnal eating associated with computer work and a reduced period of physical activity is noticed for girls. In addition, the overweight girls consume sweet juices and alcohol, although a percentage of them also practice the gym. There is also a percentage of the normoponderal girls that consume high caloric foods which predispose this group to turn into overweight cases in time. Within the studied group, statistics for the boys show a positive correlation of almost 87% for over 96% of cases. They prefer high calories foods, fast food, and sweet juices, and perform medium physical activities. Both overweight and underweight boys are more sedentary. Over 15% of girls and over a quarter of boys consume alcohol. All these bad eating habits seem to increase with age, for both sexes. To conclude, obesity and overweight assessed in adolescents in S-E Romania reveal nonsignificant percentage differences between boys and girls. However, young people in this area of the country are sedentary in general; a significant percentage prefers sweets / sweet juices / fast-food and practice computer nourishing. The authors consider that at this age, it is very useful to adapt nutritional education by new methods of food processing and market supply. This would require an early understanding of the difference among foods and nutrients and the benefits of physical activities integrated into the healthy current lifestyle, as a measure for preventing and managing non-communicable chronic diseases related to nutritional errors and sedentarism. Acknowledgment— This study has been partial founded by the Francophone University Agency, Project Réseau régional dans le domaine de la santé, la nutrition et la sécurité alimentaire (SaIN), no.21899/ 06.09.2017.

Keywords: adolescents, body mass index, nutritional habits, obesity, physical activity

Procedia PDF Downloads 248
104 A Cross-Cultural Validation of the Simple Measure of Impact of Lupus Erythematosus in Youngsters (Smiley) among Filipino Pediatric Lupus Patients

Authors: Jemely M. Punzalan, Christine B. Bernal, Beatrice B. Canonigo, Maria Rosario F. Cabansag, Dennis S. Flores, Paul Joseph T. Galutira, Remedios D. Chan

Abstract:

Background: Systemic lupus erythematosus (SLE) is one of the most common autoimmune disorders predominates in women of childbearing age. Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY) is the only health specific quality of life tool for pediatric SLE, which has been translated to different languages except in Filipino. Objective: The primary objective of this study was to develop a Filipino translation of the SMILEY and to examine the validity and reliability of this translation. Methodology: The SMILEY was translated into Filipino by a bilingual individual and back-translated by another bilingual individual blinded from the original English version. The translation was evaluated for content validity by a panel of experts and subjected to pilot testing. The pilot-tested translation was used in the validity and reliability testing proper. The SMILEY, together with the previously validated PEDSQL 4.0 Generic Core Scale was administered to lupus pediatric patients and their parent at two separate occasions: a baseline and a re-test seven to fourteen days apart. Tests for convergent validity, internal consistency, and test-retest reliability were performed. Results: A total of fifty children and their parent were recruited. The mean age was 15.38±2.62 years (range 8-18 years), mean education at high school level. The mean duration of SLE was 28 months (range 1-81 months). Subjects found the questionnaires to be relevant, easy to understand and answer. The validity of the SMILEY was demonstrated in terms of content validity, convergent validity, internal consistency, and test-retest reliability. Age, socioeconomic status and educational attainment did not show a significant effect on the scores. The difference between scores of child and parent report was showed to be significant with SMILEY total (p=0.0214), effect on social life (p=0.0000), and PEDSQL physical function (p=0.0460). Child reports showed higher scores for the following domains compared to their parent. Conclusion: SMILEY is a brief, easy to understand, valid and reliable tool for assessing pediatric SLE specific HRQOL. It will be useful in providing better care, understanding and may offer critical information regarding the effect of SLE in the quality of life of our pediatric lupus patients. It will help physician understands the needs of their patient not only on treatment of the specific disease but as well as the impact of the treatment on their daily lives.

Keywords: systemic lupus erythematosus, pediatrics, quality of life, Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY)

Procedia PDF Downloads 428
103 Spatial Setting in Translation: A Comparative Evaluation of translations from Pre-Islamic Poetry

Authors: Raja Lahiani

Abstract:

This study is concerned with scrutinising translations into English and French of references to locations in the desert of pre-Islamic Arabia. These references are used in the Source Text (ST) within a poetic image. Reference is made to the names of three different mountains in Arabia, namely Qatan, Sitar, and Yadhbul. As these mountains are referred to in the context of the poet’s description of the density and expansion of the clouds, it is crucial to know that while Sitar and Yadhbul are close to each other, Qatan is far away from them. This distance was functional for the poet to describe the expansion of the clouds. This reflects the spacious place (desert) he handled, and the fact that it was possible for him to physically see what he described. The purpose of this image is for the poet to communicate the vastness of the space he managed to see as he was in a moment of contemplation. Thus, knowledge of this characteristic about the setting is capital for the receiver to understand the communicative function of the verse. A corpus of eighteen translations is gathered. These vary between verse and prose renderings. The methodology adopted in this research work is comparative. Comparison is conducted at both the synchronic and diachronic levels; every translation shall be compared to the ST and then to previous translations. The comparative work will prove at the end that the translators who target historical facts do not necessarily succeed in preserving the image of the ST. It also proves that the more recent the translation is, the deeper the translator’s awareness is the link between imagery, setting, and point of view. Since the late eighteenth century and until nowadays, pre-Islamic poetry has been translated into Western languages. Translators differ as to motives, sources, priorities and intellectual backgrounds. A translator's skopoi undoubtedly affect the way s/he handles aspects of the ST. When it comes to culture-specific aspects and details related to setting, the problem is even more complex. Setting is a very important factor that reveals a great deal of the culture of pre-Islamic Arabia as this is remote in place, historical framework and literary tradition from its translators. History is present in pre-Islamic poetry, which justifies the important literature that has been written to extract information and data from it. These are imbedded not only by signalling given facts, events, and meditations but also by means of references to specific locations and landmarks that used to exist at the time. Spatial setting is an integral part of a literary text as it places it within its historical context. The importance of the translator’s awareness of spatial anthropological data before indulging in the process of translation is tested. This is also crucial in measuring the effect of setting loss and setting gain in translation. The findings of this research would ultimately evaluate the extent to which a comparative methodology is reliable in investigating the role of spatial setting awareness in translation.

Keywords: historical context, translation, comparative literature, spatial setting

Procedia PDF Downloads 238
102 Study on Health Status and Health Promotion Models for Prevention of Cardiovascular Disease in Asylum Seekers at Asylum Seekers Center, Kupang-Indonesia

Authors: Era Dorihi Kale, Sabina Gero, Uly Agustine

Abstract:

Asylum seekers are people who come to other countries to get asylum. In line with that, they also carry the culture and health behavior of their country, which is very different from the new country they currently live in. This situation raises problems, also in the health sector. The approach taken must also be a culturally sensitive approach, where the culture and habits of the refugee's home area are also valued so that the health services provided can be right on target. Some risk factors that already exist in this group are lack of activity, consumption of fast food, smoking, and stress levels that are quite high. Overall this condition will increase the risk of an increased incidence of cardiovascular disease. This research is a descriptive and experimental study. The purpose of this study is to identify health status and develop a culturally sensitive health promotion model, especially related to the risk of cardiovascular disease for asylum seekers in detention homes in the city of Kupang. This research was carried out in 3 stages, stage 1 was conducting a survey of health problems and the risk of asylum seeker cardiovascular disease, Stage 2 developed a health promotion model, and stage 3 conducted a testing model of health promotion carried out. There were 81 respondents involved in this study. The variables measured were: health status, risk of cardiovascular disease and, health promotion models. Method of data collection: Instruments (questionnaires) were distributed to respondents answered for anamnese health status; then, cardiovascular risk measurements were taken. After that, the preparation of information needs and the compilation of booklets on the prevention of cardiovascular disease is carried out. The compiled booklet was then translated into Farsi. After that, the booklet was tested. Respondent characteristics: average lived in Indonesia for 4.38 years, the majority were male (90.1%), and most were aged 15-34 years (90.1%). There are several diseases that are often suffered by asylum seekers, namely: gastritis, headaches, diarrhea, acute respiratory infections, skin allergies, sore throat, cough, and depression. The level of risk for asylum seekers experiencing cardiovascular problems is 4 high risk people, 6 moderate risk people, and 71 low risk people. This condition needs special attention because the number of people at risk is quite high when compared to the age group of refugees. This is very related to the level of stress experienced by the refugees. The health promotion model that can be used is the transactional stress and coping model, using Persian (oral) and English for written information. It is recommended for health practitioners who care for refugees to always pay attention to aspects of culture (especially language) as well as the psychological condition of asylum seekers to make it easier to conduct health care and promotion. As well for further research, it is recommended to conduct research, especially relating to the effect of psychological stress on the risk of cardiovascular disease in asylum seekers.

Keywords: asylum seekers, health status, cardiovascular disease, health promotion

Procedia PDF Downloads 85
101 Factors Affecting the Success of Premarital Screening Services in Middle Eastern Countries

Authors: Wafa Al Jabri

Abstract:

Background: In Middle Eastern Countries (MECs), there is a high prevalence of genetic blood disorders (GBDs), particularly sickle cell disease and thalassemia. The GBDs are considered a major public health concern that place a huge burden to individuals, families, communities, and health care systems. The high rates of consanguineous marriages, along with the unacceptable termination of at-risk pregnancy in MECs, reduce the possible solutions to control the high prevalence of GBDs. Since the early 1970s, most of MECs have started introducing premarital screening services (PSS) as a preventive measure to identify the asymptomatic carriers of GBDs and to provide genetic counseling to help couples plan for healthy families; yet, the success rate of PSS is very low. Purpose: This paper aims to highlight the factors that affect the success of PSS in MECs. Methods: An integrative review of articles located in CINAHL, PubMed, SCOPUS, and MedLine was carried out using the following terms: “premarital screening,” “success,” “effectiveness,” and “ genetic blood disorders”. Second, a hand search of the reference lists and Google searches were conducted to find studies that did not exist in the primary database searches. Only studies which are conducted in MECs and published after 2010 were included. Studies that were not published in English were excluded. Results: Eighteen articles were included in the review. The results showed that PSS in most of the MECs was successful in achieving its objective of identifying high-risk marriages; however, the service failed to meet its ultimate goal of reducing the prevalence of GBDs. Various factors seem to hinder the success of PSS, including poor public awareness, late timing of the screening, culture and social stigma, lack of prenatal diagnosis services and therapeutic abortion, emotional factors, religious beliefs, and lack of genetic counseling services. However, poor public awareness, late timing of the screening, religious misbeliefs, and the lack of adequate counseling services were the most common barriers identified. Conclusion and Implications: The review help in providing a framework for an effective preventive measure to reduce the prevalence of GBDs in MECS. This framework focuses primarily in overcoming the identified barriers by providing effective health education programs in collaboration with religious leaders, offering the screening test to young adults at an earlier stage, and tailoring the genetic counseling to consider people’s values, beliefs, and preferences.

Keywords: premarital screening, middle east, genetic blood disorders, factors

Procedia PDF Downloads 70
100 Amniotic Fluid Mesenchymal Stem Cells Selected for Neural Specificity Ameliorates Chemotherapy Induced Hearing Loss and Pain Perception

Authors: Jan F. Talts, Amit Saxena, Kåre Engkilde

Abstract:

Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most frequent side effects caused by anti-neoplastic agents, with a prevalence from 19 % to 85 %. Clinically, CIPN is a mostly sensory neuropathy leading to pain and to motor and autonomic changes. Due to its high prevalence among cancer patients, CIPN constitutes a major problem for both cancer patients and survivors, especially because currently, there is no single effective method of preventing CIPN. Hearing loss is the most common form of sensory impairment in humans and can be caused by ototoxic chemical compounds such as chemotherapy (platinum-based antineoplastic agents).In rodents, single or repeated cisplatin injections induce peripheral neuropathy and hearing impairment mimicking human disorder, allowing studying the efficacy of new pharmacological candidates in chemotherapy-induced hearing loss and peripheral neuropathy. RNA sequencing data from full term amniotic fluid (TAF) mesenchymal stemcell (MSC) clones was used to identify neural-specific markers present on TAF-MSC. Several prospective neural markers were tested by flow cytometry on cultured TAF-MSC. One of these markers was used for cell-sorting using Tyto MACSQuant cell sorter, and the neural marker positive cell population was expanded for several passages to the final therapeutic product stage. Peripheral neuropathy and hearing loss was induced in mice by administration of cisplatin in three week-long cycles. The efficacy of neural-specific TAF-MSC in treating hearing loss and pain perception was evaluated by administration of three injections of 3 million cells/kg by intravenous route or three injections of 3 million cells/kg by intra-arterial route after each cisplatin cycle treatment. Auditory brainstem responses (ABR) are electric potentials recorded from scalp electrodes, and the first ABR wave represents the summed activity of the auditory nerve fibers contacting the inner hair cells. For ABR studies, mice were anesthetized, then earphones were placed in the left ear of each mouse, an active electrode was placed in the vertex of the skull, a reference electrode under the skin of the mastoid bone, and a ground electrode in the neck skin. The stimuli consisted of tone pips of five frequencies (2, 4, 6, 12, 16, and 24 kHz) at various sound levels (from 0 to 90 dB) ranging to cover the mouse auditory frequency range. The von Frey test was used to assess the onset and maintenance of mechanical allodynia over time. Mice were placed in clear plexiglass cages on an elevated mesh floor and tested after 30 min of habituation. Mechanical paw withdrawal threshold was examined using an electronic von Frey anesthesiometer. Cisplatin groups treated with three injections of 3 million cells/kg by intravenous route and three injections of 3 million cells/kg by intra-arterial route after each cisplatin cycle treatment presented, a significant increase of hearing acuity characterized by a decrease of ABR threshold and a decrease of neuropathic pain characterized by an increase of von Frey paw withdrawal threshold compared to controls only receiving cisplatin. This study shows that treatment with MSCselected for neural specificity presents significant positive efficacy on the chemotherapy-induced neuropathic pain and the chemotherapy-induced hearing loss.

Keywords: mesenchymal stem cell, peripheral neuropathy, amniotic fluid, regenerative medicine

Procedia PDF Downloads 152
99 The Use of Platelet-rich Plasma in the Treatment of Diabetic Foot Ulcers: A Scoping Review

Authors: Kiran Sharma, Viktor Kunder, Zerha Rizvi, Ricardo Soubelet

Abstract:

Platelet rich plasma (PRP) has been recognized as a method of treatment in medicine since the 1980s. It primarily functions by releasing cytokines and growth factors that promote wound healing; these growth promoting factors released by PRP enact new processes such as angiogenesis, collagen deposition, and tissue formation that can change wound healing outcomes. Many studies recognize that PRP aids in chronic wound healing, which is advantageous for patients who suffer from chronic diabetic foot ulcers (DFUs). This scoping review aims to examine literature to identify the efficacy of PRP use in the healing of DFUs. Following PRISMA guidelines, we searched randomized-controlled trials involving PRP use in diabetic patients with foot ulcers using PubMed, Medline, CINAHL Complete, and Cochrane Database of Systematic Reviews. We restricted the search to articles published during 2005-2022, full texts in the English language, articles involving patients aged 19 years or older, articles that used PRP on specifically DFUs, articles that included a control group, articles on human subjects. The initial search yielded 119 articles after removing duplicates. Final analysis for relevance yielded 8 articles. In all cases except one, the PRP group showed either faster healing, more complete healing, or a larger percentage of healed participants. There were no situations in the included studies where the control group had a higher rate of healing or decreased wound size as compared to a group with isolated PRP-only use. Only one study did not show conclusive evidence that PRP caused accelerated healing in DFUs, and this study did not have an isolated PRP variable group. Application styles of PRP for treatment were shown to influence the level of healing in patients, with injected PRP appearing to achieve the best results as compared to topical PRP application. However, this was not conclusive due to the involvement of several other variables. Two studies additionally found PRP to be useful in healing refractory DFUs, and one study found that PRP use in patients with additional comorbidities was still more effective in healing DFUs than the standard control groups. The findings of this review suggest that PRP is a useful tool in reducing healing times and improving rates of complete wound healing in DFUs. There is room for further research in the application styles of PRP before conclusive statements can be made on the efficacy of injected versus topical PRP healing based on the findings in this study. The results of this review provide a baseline for further research in PRP use in diabetic patients and can be used by both physicians and public health experts to guide future treatment options for DFUs.

Keywords: diabetic foot ulcer, DFU, platelet rich plasma, PRP

Procedia PDF Downloads 65
98 Debriefing Practices and Models: An Integrative Review

Authors: Judson P. LaGrone

Abstract:

Simulation-based education in curricula was once a luxurious component of nursing programs but now serves as a vital element of an individual’s learning experience. A debriefing occurs after the simulation scenario or clinical experience is completed to allow the instructor(s) or trained professional(s) to act as a debriefer to guide a reflection with a purpose of acknowledging, assessing, and synthesizing the thought process, decision-making process, and actions/behaviors performed during the scenario or clinical experience. Debriefing is a vital component of the simulation process and educational experience to allow the learner(s) to progressively build upon past experiences and current scenarios within a safe and welcoming environment with a guided dialog to enhance future practice. The aim of this integrative review was to assess current practices of debriefing models in simulation-based education for health care professionals and students. The following databases were utilized for the search: CINAHL Plus, Cochrane Database of Systemic Reviews, EBSCO (ERIC), PsycINFO (Ovid), and Google Scholar. The advanced search option was useful to narrow down the search of articles (full text, Boolean operators, English language, peer-reviewed, published in the past five years). Key terms included debrief, debriefing, debriefing model, debriefing intervention, psychological debriefing, simulation, simulation-based education, simulation pedagogy, health care professional, nursing student, and learning process. Included studies focus on debriefing after clinical scenarios of nursing students, medical students, and interprofessional teams conducted between 2015 and 2020. Common themes were identified after the analysis of articles matching the search criteria. Several debriefing models are addressed in the literature with similarities of effectiveness for participants in clinical simulation-based pedagogy. Themes identified included (a) importance of debriefing in simulation-based pedagogy, (b) environment for which debriefing takes place is an important consideration, (c) individuals who should conduct the debrief, (d) length of debrief, and (e) methodology of the debrief. Debriefing models supported by theoretical frameworks and facilitated by trained staff are vital for a successful debriefing experience. Models differed from self-debriefing, facilitator-led debriefing, video-assisted debriefing, rapid cycle deliberate practice, and reflective debriefing. A reoccurring finding was centered around the emphasis of continued research for systematic tool development and analysis of the validity and effectiveness of current debriefing practices. There is a lack of consistency of debriefing models among nursing curriculum with an increasing rate of ill-prepared faculty to facilitate the debriefing phase of the simulation.

Keywords: debriefing model, debriefing intervention, health care professional, simulation-based education

Procedia PDF Downloads 137
97 Early Childhood Education for Bilingual Children: A Cross-Cultural Examination

Authors: Dina C. Castro, Rossana Boyd, Eugenia Papadaki

Abstract:

Immigration within and across continents is currently a global reality. The number of people leaving their communities in search for a better life for them and their families has increased dramatically during the last twenty years. Therefore, young children of the 21st century around the World are growing up in diverse communities, exposed to many languages and cultures. One consequence of these migration movements is the increased linguistic diversity in school settings. Depending on the linguistic history and the status of languages in the communities (i.e., minority-majority; majority-majority) the instructional approaches will differ. This session will discuss how bilingualism is addressed in early education programs in both minority-majority and majority-majority language communities, analyzing experiences in three countries with very distinct societal and demographic characteristics: Peru (South America), the United States (North America), and Italy (European Union). The ultimate goal is to identify commonalities and differences across the three experiences that could lead to a discussion of bilingualism in early education from a global perspective. From Peru, we will discuss current national language and educational policies that have lead to the design and implementation of bilingual and intercultural education for children in indigenous communities. We will also discuss how those practices are being implemented in preschool programs, the progress made and challenges encountered. From the United States, we will discuss the early education of Spanish-English bilingual preschoolers, including the national policy environment, as well as variations in language of instruction approaches currently being used with these children. From Italy, we will describe early education practices in the Bilingual School of Monza, in northern Italy, a school that has 20 years promoting bilingualism and multilingualism in education. While the presentations from Peru and the United States will discuss bilingualism in a majority-minority language environment, this presentation will lead to a discussion on the opportunities and challenges of promoting bilingualism in a majority-majority language environment. It is evident that innovative models and policies are necessary to prevent inequality of opportunities for bilingual children beginning in their earliest years. The cross-cultural examination of bilingual education experiences for young children in three part of the World will allow us to learn from our success and challenges. The session will end with a discussion of the following question: To what extent are early care and education programs being effective in promoting positive development and learning among all children, including those from diverse language, ethnic and cultural backgrounds? We expect to identify, with participants to our session, a set of recommendations for policy and program development that could ensure access to high quality early education for all bilingual children.

Keywords: early education for bilingual children, global perspectives in early education, cross-cultural, language policies

Procedia PDF Downloads 291
96 Observing Teaching Practices Through the Lenses of Self-Regulated Learning: A Study Within the String Instrument Individual Context

Authors: Marija Mihajlovic Pereira

Abstract:

Teaching and learning a musical instrument is challenging for both teachers and students. Teachers generally use diverse strategies to resolve students' particular issues in a one-to-one context. Considering individual sessions as a supportive educational context, the teacher can play a decisive role in stimulating and promoting self-regulated learning strategies, especially with beginning learners. The teachers who promote self-controlling behaviors, strategic monitoring, and regulation of actions toward goals could expect their students to practice more qualitatively and consciously. When encouraged to adopt self-regulation habits, students' could benefit from greater productivity on a longer path. Founded on Bary Zimmerman's cyclical model that comprehends three phases - forethought, performance, and self-reflection, this work aims to articulate self-regulated and music learning. Self-regulated learning appeals to the individual's attitude in planning, controlling, and reflecting on their performance. Furthermore, this study aimed to present an observation grid for perceiving teaching instructions that encourage students' controlling cognitive behaviors in light of the belief that conscious promotion of self-regulation may motivate strategic actions toward goals in musical performance. The participants, two teachers, and two students have been involved in the social inclusion project in Lisbon (Portugal). The author and one independent inter-observer analyzed six video-recorded string instrument lessons. The data correspond to three sessions per teacher lectured to one (different) student. Violin (f) and violoncello (m) teachers hold a Master's degree in music education and approximately five years of experience. In their second year of learning an instrument, students have acquired reasonable skills in musical reading, posture, and sound quality until then. The students also manifest positive learning behaviors, interest in learning a musical instrument, although their study habits are still inconsistent. According to the grid's four categories (parent codes), in-class rehearsal frames were coded using MaxQda software, version 20, according to the grid's four categories (parent codes): self-regulated learning, teaching verbalizations, teaching strategies, and students' in-class performance. As a result, selected rehearsal frames qualitatively describe teaching instructions that might promote students' body and hearing awareness, such as "close the eyes while playing" or "sing to internalize the pitch." Another analysis type, coding the short video events according to the observation grid's subcategories (child codes), made it possible to perceive the time teachers dedicate to specific verbal or non-verbal strategies. Furthermore, a coding overlay analysis indicated that teachers tend to stimulate. (i) Forethought – explain tasks, offer feedback and ensure that students identify a goal, (ii) Performance – teach study strategies and encourage students to sing and use vocal abilities to ensure inner audition, (iii) Self-reflection – frequent inquiring and encouraging the student to verbalize their perception of performance. Although developed in the context of individual string instrument lessons, this classroom observation grid brings together essential variables in a one-to-one lesson. It may find utility in a broader context of music education due to the possibility to organize, observe and evaluate teaching practices. Besides that, this study contributes to cognitive development by suggesting a practical approach to fostering self-regulated learning.

Keywords: music education, observation grid, self-regulated learning, string instruments, teaching practices

Procedia PDF Downloads 89
95 Needs-Gap Analysis on Culturally and Linguistically Diverse Grandparent Carers ‘Hidden Issues’: An Insight for Community Nurses

Authors: Mercedes Sepulveda, Saras Henderson, Dana Farrell, Gaby Heuft

Abstract:

In Australia, there is a significant number of Culturally and Linguistically Diverse (CALD) Grandparent Carers who are sole carers for their grandchildren. Services in the community such as accessible healthcare, financial support, legal aid, and transport to services can assist Grandparent Carers to continue to live in their own home whilst caring for their grandchildren. Community nurses can play a major role by being aware of the needs of these grandparents and link them to services via information and referrals. The CALD Grandparent Carer experiences have only been explored marginally and may be similar to the general Grandparent Carer population, although cultural aspects may add to their difficulties. This Needs-Gap Analysis aimed to uncover ‘hidden issues’ for CALD Grandparent Carers such as service gaps and actions needed to address these issues. The stakeholders selected for this Needs-Gap Analysis were drawn from relevant service providers such as community and aged care services, child and/or grandparents support services and CALD specific services. One hundred relevant service providers were surveyed using six structured questions via face to face, phone interviews, or email correspondence. CALD Grandparents who had a significant or sole role of being a carer for grandchildren were invited to participate through their CALD community leaders. Consultative Forums asking five questions that focused on the caring role, issues encountered, and what needed to be done, were conducted with the African, Asian, Spanish-Speaking, Middle Eastern, European, Pacific Islander and Maori Grandparent Carers living in South-east Queensland, Australia. Data from the service provider survey and the CALD Grandparent Carer forums were content analysed using thematic principles. Our findings highlighted social determinants of health grouped into six themes. These were; 1) service providers and Grandparent Carer perception that there was limited research data on CALD grandparents as carers; 2) inadequate legal and financial support; 3) barriers to accessing information and advice; 4) lack of childcare options in the light of aging and health issues; 5) difficulties around transport; and 6) inadequate technological skills often leading to social isolation for both carer and grandchildren. Our Needs-Gap Analysis provides insight to service providers especially health practitioners such as doctors and community nurses, particularly on the impact of caring for grandchildren on CALD Grandparent Carers. Furthermore, factors such as cultural differences, English language difficulties, and migration experiences also impacted on the way CALD Grandparent Carers are able to cope. The findings of this Need-Gap Analysis signposts some of the ‘ hidden issues’ that CALD Grandparents Carers face and draws together recommendations for the future as put forward by the stakeholders themselves.

Keywords: CALD grandparents, carer needs, community nurses, grandparent carers

Procedia PDF Downloads 305
94 Awareness of 'Psychosocial Restraint': A Proper Caring Attitude and Truly Listening to People with Dementia in the Hong Kong’S Residential Care Homes

Authors: Kenny Chi Man Chui

Abstract:

Background: In Chinese culture, the traditional equivalent term for English dementia is chi dai zheng, which, whether translated as ‘insanity’ or ‘idiocy’ carries a sharply negative connotation. In fact, even though the traditional name for dementia has evolved, from chi dai zheng to shi zhi zheng, nao tui hua zheng or ren zhi zhang ai zheng, educating the population about more respectful terms for the condition and promoting a positive understanding about people with dementia in society have proven to be time-intensive endeavors. By extension, the use of such terms promotes the perception that people with dementia undergo a ‘total loss of self’ or experience a ‘living death’ or ‘social death’. Both in Asia and elsewhere, the appropriate nomenclature for dementia remains controversial, and different medical and healthcare professionals in Hong Kong have taken various stances on how to refer to the condition there. Indeed, how this negative perception affects the interaction between people with dementia and the surrounding others? Methodology: Qualitative research with the concept of postmodernism, interpretivism, and Foucauldian theory was adopted as frameworks in applying participatory observations, in-depth interviews, and other qualitative methods. First, ten people with dementia—one man and nine women—living in two residential care homes in Hong Kong were interviewed, as were ten members of the care staff, all of whom were women. Next, to coach the staff in understanding the feelings and self-perceptions of people with dementia, two reflective training sessions were provided. Afterward, to assess the impact of the training sessions on the staff, two focus groups were held. Findings: The findings revealed that residents with dementia did not perceive themselves as being ‘demented’ and were confused by not getting responses from the others. From the understanding of care staff, they perceived the residents as being ‘demented’, desolate troublemakers. They described people with dementia as ‘naughty children’ who should be controlled and be punished while treated them as ‘psychiatric patients’ who could be ignored and be mute. “Psychosocial restraint” happened regarding the discrepancy of perception between people with dementia and the care staff. People with dementia did not think that their confusion of memory was related to dementia or, frankly speaking, they did not know what dementia was. When others treated them as ‘demented patients, the residents with mild to moderate dementia fiercely rejected that designation and reported a host of negative feelings, hence the fluctuations of mood and emotion noted by the care staff. Conclusion: As the findings revealed, the people with dementia were also discontent with the care arrangements in the care homes, felt abandoned by others and worried about bothering others. Their shifting emotional states and moods were treated as the Behavioral and Psychological symptoms of Dementia (BPSD), which nothing can do reported by the care staff in the residential care homes. People with dementia become social withdrawal or isolated in daily living, which should be alert and be changed by the social work professionals about the occurrence of “psychosocial restraint” in dementia care.

Keywords: psychosocial restraint, qualitative research, social work with dementitude, voice of people with dementia

Procedia PDF Downloads 162
93 Exploring the Physical Activity Behavior and Needs of Adolescent Girls: A Mixed-Methods Study

Authors: Vicki R. Voskuil, Jorgie M. Watson

Abstract:

Despite the well-established health benefits of physical activity (PA), most adolescents do not meet guidelines recommending 60 minutes of moderate to vigorous physical activity (MVPA) each day. Adolescent girls engage in less PA than boys, a difference that increases with age. By the 9th grade, only 20% of girls report meeting recommendations for PA with lower percentages for black and Hispanic girls compared to white girls. The purpose of the study was to explore the physical activity (PA) behavior and needs of adolescent girls. Study aims included assessment of adolescent girls’ PA behavior; facilitators of and barriers to PA, PA needs, and acceptability of the Fitbit-Flex 2 activity tracker. This exploratory study used a qualitative and quantitative approach. The qualitative approach involved a focus group using a semi-structured interview technique. PA was measured using the Fitbit-Flex 2 activity tracker. Steps, distance, and active minutes were recorded for one week. A Fitbit survey was also administered to assess acceptability. SPSS Version 22.0 and ATLAS.ti Version 8 were used to analyze data. Girls in the ninth grade were recruited from a high school in the Midwest (n=11). Girls were excluded if they were involved in sports or other organized PA ≥ 3 days per week, had a health condition that prevented or limited PA, or could not read and write English. Participants received a Fitbit-Flex 2 activity tracker to wear for one week. At the end of the week, girls returned the Fitbit and participated in a focus group. Girls responded to open-ended questions regarding their PA behavior and shared their ideas for future intervention efforts aimed at increasing PA among adolescents. Girls completed a survey assessing their perceptions of the Fitbit. Mean age of the girls was 15.3 years (SD=0.44). On average girls took 6,520 steps and walked 2.73 miles each day. Girls stated their favorite types of PA were walking, riding bike, and running. Most girls stated they did PA for 30 minutes or more at a time once a day or every other day. The top 3 facilitators of PA reported by girls were friends, family, and transportation. The top 3 barriers included health issues, lack of motivation, and weather. Top intervention ideas were community service projects, camps, and using a Fitbit activity tracker. Girls felt the best timing of a PA program would be in the summer. Fitbit survey results showed 100% of girls would use a Fitbit on most days if they had one. Ten (91%) girls wore the Fitbit on all days. Seven (64%) girls used the Fitbit app and all reported they liked it. Findings indicate that PA participation for this sample is consistent with previous studies. Adolescent girls are not meeting recommended daily guidelines for PA. Fitbit activity trackers were positively received by all participants and could be used in future interventions aimed at increasing PA for adolescent girls. PA interventions that take place in the summer with friends and include community service projects may increase PA and be well received by this population.

Keywords: adolescents, girls, interventions, physical activity

Procedia PDF Downloads 220
92 Caring for Children with Intellectual Disabilities in Malawi: Parental Psychological Experiences and Needs

Authors: Charles Masulani Mwale

Abstract:

Background: It is argued that 85% of children with the disability live in resource-poor countries where there are few available disability services. A majority of these children, including their parents, suffer a lot as a result of the disability and its associated stigmatization, leading to a marginalized life. These parents also experience more stress and mental health problems such as depression, compared with families of normal developing children. There is little research from Africa addressing these issues especially among parents of intellectually disabled children. WHO encourages research on the impact that child with a disability have on their family and appropriate training and support to the families so that they can promote the child’s development and well-being. This study investigated the parenting experiences, mechanisms of coping with these challenges and psychosocial needs while caring for children with intellectual disabilities in both rural and urban settings of Lilongwe and Mzuzu. Methods: This is part of a larger Mixed-methods study aimed at developing a contextualized psychosocial intervention for parents of intellectually disabled children. 16 focus group discussions and four in-depth interviews were conducted with parents in catchments areas for St John of God and Children of Blessings in Mzuzu and Lilongwe cities respectively. Ethical clearance was obtained from COMREC. Data were stored in NVivo software for easy retrieval and management. All interviews were tape-recorded, transcribed and translated into English. Note-taking was performed during all the observations. Data triangulation from the interviews, note taking and the observations were done for validation and reliability. Results: Caring for intellectually disabled children comes with a number of challenges. Parents experience stigma and discrimination; fear for the child’s future; have self-blame and guilt; get coerced by neighbors to kill the disabled child; and fear violence by and to the child. Their needs include respite relief, improved access to disability services, education on disability management and financial support. For their emotional stability, parents cope by sharing with others and turning to God while other use poor coping mechanisms like alcohol use. Discussion and Recommendation: Apart from neighbors’ coercion to eliminate the child life, the findings of this study are similar to those done in other countries like Kenya and Pakistan. It is recommended that parents get educated on disability, its causes, and management to array fears of unknown. Community education is also crucial to promote community inclusiveness and correct prevailing myths associated with disability. Disability institutions ought to intensify individual as well as group counseling services to these parents. Further studies need to be done to design culturally appropriate and specific psychosocial interventions for the parents to promote their psychological resilience.

Keywords: psychological distress, intellectual disability, psychosocial interventions, mental health, psychological resilience, children

Procedia PDF Downloads 428
91 Using Health Literacy and Medico-Legal Guidance to Improve Restorative Dentistry Patient Information Leaflets

Authors: Hasneet K. Kalsi, Julie K. Kilgariff

Abstract:

Introduction: Within dentistry, the process for gaining informed consent has become more complex. To consent for treatment, patients must understand all reasonable treatment options and associated risks and benefits. Consenting is therefore deeply embedded in health literacy. Patients attending for dental consultation are often presented with an array of information and choices, yet studies show patients recall less than half of the information provided immediately after. Appropriate and comprehensible patient information leaflets (PILs) may be useful aid memories. In 2016 the World Health Organisation set improving health literacy as a global priority. Soon after, Scotland’s 2017-2025 Making it Easier: A Health Literacy Action Plan followed. This project involved the review of Restorative PILs used within Dundee Dental Hospital to assess the Content and Readability. Method: The current PIL on Root Canal Treatment (RCT) was created in 2011. This predates the Montgomery vs. NHS Lanarkshire case, a ruling which significantly impacted dental consenting processes, as well as General Dental Council’s (GDC’s) Standards for the Dental Team and Faculty of General Dental Practice’s Good Practice Guidance on Clinical Examination and Record-Keeping. Current evidence-based guidance, including that stipulated by the GDC, was reviewed. A 20-point Essential Content Checklist was designed to conform to best practice guidance for valid consenting processes. The RCT leaflet was scored against this to ascertain if the content was satisfactory. Having ensured the content satisfied medicolegal requirements, health literacy considerations were reviewed regarding readability. This was assessed using McLaughlin’s Simple Measure of Gobbledygook (SMOG) formula, which identifies school stages that would have to be achieved to comprehend the PIL. The sensitivity of the results to alternative readability methods were assessed. Results: The PIL was not sufficient for modern consenting processes and reflected a suboptimal level of health literacy. Evaluation of the leaflet revealed key content was missing, including information pertaining to risks and benefits. Only five points out of the 20-point checklist were present. The readability score was 16, equivalent to a level 2 in National Adult Literacy Standards/Scottish Credit and Qualification Framework Level 5; 62% of Scottish adults are able to read to this standard. Discussion: Assessment of the leaflet showed it was no longer fit for purpose. Reasons include a lack of pertinent information, a text-heavy leaflet lacking flow, and content errors. The SMOG score indicates a high level of comprehension is required to understand this PIL, which many patients may not possess. A new PIL, compliant with medicolegal and health literacy guidance, was designed with patient-driven checklists, notes spaces for annotations/ questions and areas for clinicians to highlight important case-specific information. It has been tested using the SMOG formula. Conclusion: PILs can be extremely useful. Studies show that interactive use can enhance their effectiveness. PILs should reflect best practice guidance and be understood by patients. The 2020 leaflet designed and implemented aims to fulfill the needs of a modern healthcare system and its service users. It embraces and embeds Scotland’s Health Literacy Action Plan within the consenting process. A review of further leaflets using this model is ongoing.

Keywords: consent, health literacy, patient information leaflet, restorative dentistry

Procedia PDF Downloads 134